Dicer and Drosha are RNase enzymes involved in RNA interference from precursor molecules. RNA interference can either silence or enhance the expression of specific target genes. This study of ovarian-cancer cells showed that the combination of low Dicer expression and low Drosha expression was associated with a poor prognosis and that low Dicer expression was an independent factor associated with a poor clinical outcome.

In a randomized trial, adult patients with witnessed out-of-hospital cardiac arrest were assigned to receive either the thrombolytic agent tenecteplase or placebo during cardiopulmonary resuscitation. There were no significant differences between the groups in the return of spontaneous circulation, survival to hospital admission or discharge, neurologic outcome, or 30-day survival. There were more intracranial hemorrhages in the tenecteplase group.

In this multicenter, randomized, double-blind, placebo-controlled trial, treatment with the alpha-adrenergic receptor blocker alfuzosin (as compared with placebo) did not reduce symptoms in men who had received a diagnosis of chronic prostatitis–chronic pelvic pain syndrome in the preceding 2 years and who had not previously been treated with an alpha-adrenergic receptor blocker. The findings do not support the use of alfuzosin for men in whom chronic prostatitis–chronic pelvic pain syndrome has recently been diagnosed.

This epidemiologic report from the Centers for Disease Control and Prevention describes an outbreak of adverse reactions, occurring principally in dialysis units, that were caused by unfractionated heparin contaminated with oversulfated chondroitin sulfate. The identification of the contaminant and removal of the contaminated lots will end the outbreak, but it represents a serious breach in the safety of the U.S. drug supply.

A man with erythrocytosis of undetermined cause was found to have a mutation in the prolyl hydroxylase domain 2 gene (PHD2), the product of which regulates hypoxia-inducible factor (HIF), a transcription factor that activates hypoxia-inducible genes. A recurrent paraganglioma was subsequently found. The evidence implicates PHD2 as a tumor-suppressor gene and a key regulator of HIF.

This review discusses the most common forms of temporomandibular disorders: myofascial pain disorder, intra-articular disk derangement disorders, osteoarthritis, and rheumatoid arthritis. Current views on its pathogenesis and presentation and recommended diagnostic studies and treatment approaches are discussed.

A 51-year-old woman was admitted to this hospital because of anemia and splenomegaly. Fatigue, night sweats, leg swelling, dyspnea on exertion, and early satiety had begun 2 months earlier. Examination and imaging studies disclosed a massively enlarged spleen, extending below the pelvic brim, with slightly enlarged intraabdominal lymph nodes; an IgM paraprotein was present in the serum, and the partial-thromboplastin time was prolonged. A diagnostic procedure was performed.

The introduction of three transcription factors into the pancreatic acinar cell of the mouse induces transdifferentiation to an insulin-secreting beta cell.