A locus on chromosome 17 has previously been shown to be associated with susceptibility to asthma. This study shows that the association is specific to early-onset asthma (occurring at the age of 4 years or younger) in those exposed to environmental tobacco smoke in early life. The study implicates markers regulating at least two genes — ORMDL3 and GSDML — in determining susceptibility.

The authors have established a method for the analysis of gene expression in tissue specimens preserved in formaldehyde. The expression profile of tissue adjacent to primary hepatocellular carcinoma, rather than the cancer itself, is associated with late recurrence. This finding, together with other data, suggests that the late recurrences are actually second primary tumors.

In this double-blind, placebo-controlled, 52-week trial among postmenopausal women not receiving estrogen therapy, treatment with a patch delivering 300 µg of testosterone per day resulted in a significant although modest increase in the 4-week frequency of satisfying sexual episodes (1.4 more episodes per month), but the women were also subject to more adverse events, including androgenic side effects.

A 57-year-old man presents to his primary care provider because he would like to quit smoking. A trial of varenicline, a partial agonist of the nicotinic acetylcholine receptor that has been shown to increase rates of smoking abstinence as compared with placebo, is recommended. In light of reports of neuropsychiatric side effects, including suicidal behavior, patients treated with varenicline should be closely monitored for behavioral symptoms.

The incidence of venous thromboembolic disease increases by a factor of four with pregnancy, and in developed countries pulmonary embolus is the leading cause of maternal death. This review provides guidance on the diagnosis and management of thromboembolic disease in pregnant women, including guidelines for the prophylactic use of anticoagulant agents in women at high risk during pregnancy and the puerperium.

A 20-year-old man presented to the emergency department after a syncopal episode. During the previous 2 weeks, he had had persistent low-grade fever, anorexia, rhinorrhea, and headache. On the morning of admission, he felt weak and then collapsed while walking into a room; he had no other antecedent symptoms.

Voters view health care as an important issue in the 2008 U.S. presidential election. Most voters favor major changes in our health care system. Registered voters who planned to vote for Senator Obama placed higher priority on increasing coverage for the uninsured, and Senator McCain's supporters gave higher priority to health care reforms that would not raise taxes.

A mouse model of chronic obstructive airway disease suggests that viral infection leads to changes in the airways seen in human asthma and chronic obstructive pulmonary disease by activating invariant natural killer cells.