Since its approval by the Food and Drug Administration, computer-aided detection has come into use for screening mammography at many facilities. The authors of this observational study of almost 430,000 mammograms found that the use of computer-aided detection reduced the accuracy of mammography and that its systemwide use would increase the annual cost of mammography by an estimated $550 million in the United States.

Although airway inflammation is an established component of disease pathology in asthma and chronic obstructive pulmonary disease (COPD), the nature of this inflammation is not clear. In this study, in which airway specimens from subjects with asthma or COPD were examined for the presence of invariant natural killer cells, very few of these immunoregulatory T lymphocytes, restricted by the antigen-presenting molecule CD1d, were identified.

In this large, randomized trial in Tanzania, daily multivitamin supplementation in HIV-negative pregnant women reduced the incidence of low birth weight (<2500 g) and small-for-gestational-age infants, although it did not significantly reduce the risk of prematurity or fetal death. Given their potential benefits and low cost, multivitamins should be considered for all pregnant women in developing countries.

Despite the frequency of neural-tube defects, little is known about their cause. In this study, the authors implicate the gene VANGL1 in three children with the disease, two of them with familial types of disease — a finding that points to the need for further study of this gene and others that lie in the same pathway.

A 62-year-old man is admitted with fever, cough, and dyspnea. He is weak, appears to be dehydrated, and has purulent sputum. His temperature is 39.2°C, respirations 22, and blood pressure 128/69 mm Hg. There are crackles over the left lower lung field, and chest radiography shows a density in the left lower lobe that is consistent with pneumonia. Should thromboprophylaxis be provided? If so, in what form?

Liver disease due to chronic HBV or HCV infection is becoming a leading cause of death among persons with HIV infection. Both the risk of hepatocellular carcinoma and the risk of hepatotoxicity due to antiretroviral drugs increase in patients with coinfection. This review presents an approach to the use of newer treatments for both HCV and HBV infections in patients with HIV infection, and it provides an update on optimal management to prevent complications of advanced liver disease.

A 49-year-old man came to the clinic with a 1-week history of suprapubic pain and fever. On examination, he had a temperature of 38.1°C but appeared well.