The use of repeat doses of antenatal corticosteroids in women at risk for preterm delivery has been reported to reduce neonatal morbidity, as compared with a single course. In this follow-up study of infants of women at risk for preterm delivery who were enrolled in a randomized trial comparing a single course of antenatal corticosteroid with repeat doses, there were no significant differences in survival free of major neurosensory disability or body size between the groups at 2 years of corrected age. These data provide reassurance regarding the use of repeat doses of antenatal corticosteroids in women who remain at risk for preterm delivery.

In this follow-up study of infants of women at risk for preterm delivery who were enrolled in a randomized trial comparing a single course of antenatal corticosteroids with repeat courses, there were no significant differences in clinical outcomes. There were more cases of cerebral palsy in the repeat-corticosteroid group, although the difference between the groups was not significant.

A genomewide association study of North American and Swedish patients with rheumatoid arthritis who were seropositive for autoantibodies against cyclic citrullinated peptide yielded susceptibility variants in the usual suspects: HLA-DRB1 and PTPN22. A new locus was also implicated: a SNP that lies between the TRAF1 and C5 genes.

A polymorphism in the promoter region of CTGF is associated with susceptibility to systemic sclerosis. It increases expression of the gene in pulmonary fibroblasts by enhancing the binding of a specific transcription factor.

In the 117th Shattuck Lecture, Dr. Steven Schroeder asks why the American system fails to deliver a standard of health similar to that observed in many other countries. In his arguments, he focuses on the public health risks of smoking and obesity and how they have been managed.

During an evaluation for low back pain, a 67-year-old man is found to have gynecomastia on the right side that is nontender on palpation. Other than a body-mass index of 32, the findings on physical examination are normal. His medical history is notable only for hyperlipidemia; his only medication is a statin. How should his gynecomastia be evaluated and managed?

A 51-year-old man was admitted to this hospital because of a pulmonary nodule. Helicobacter pylori infection had been diagnosed 5 years earlier, and a subtotal gastrectomy had been performed for adenocarcinoma of the gastric antrum and pylorus 2 years earlier. In the year before admission, pleuritic chest pain developed, and multiple pulmonary nodules and cysts were seen on computed tomography (CT). Two weeks before admission, a new pulmonary nodule was seen on follow-up CT. A diagnostic procedure was performed.