This 2-year trial, which took place in an isolated workplace that facilitated retention in the study, randomly assigned 322 moderately obese subjects to one of three diets: a low-fat, restricted-calorie diet; a Mediterranean, restricted-calorie diet; or a low-carbohydrate, non–restricted-calorie diet. The results suggest that the Mediterranean and low-carbohydrate diets are effective alternatives to low-fat diets and that personal preferences and metabolic considerations might inform individualized tailoring of dietary interventions.

This open-label, phase 1–2, single-center study examined the use of intravenous immune globulin and rituximab to reduce anti-HLA antibodies and improve transplantation rates in 20 highly sensitized patients. Sixteen patients (80%) subsequently received a transplant, and the 1-year survival rates for patients and allografts were 100% and 94%, respectively. Larger and longer trials are needed to assess the safety of this approach.

Effective strategies to prevent falls among elderly persons have been identified but are underutilized. In this comparison of a region of Connecticut in which persons were exposed to interventions to prevent falls and a region without such exposure, the interventions were associated with a 9% reduction in serious injuries from falls. These findings suggest that the dissemination of information about fall prevention may reduce numbers of falls and serious injuries.

This study used national registries in Norway to identify children of different gestational-age categories who were born between 1967 and 1983 and to follow them through 2003. The risks of medical and social disabilities increased with decreasing gestational age at birth. Even among those who did not have medical disabilities, the gestational age at birth was associated with the education level attained, income, the receipt of social security benefits, and the likelihood of establishing a family.

The English pay-for-performance program allows "exception reporting," in which physicians exclude individual patients from calculations when the quality target should not apply. From April 2005 through March 2006, physicians excluded 5% of patients, and exception reporting accounted for only about 1.5% of the cost of the program.

A 25-year-old man presents to the emergency department with a toothache and is found to have been ingesting large quantities of acetaminophen. Although no acetaminophen is detectable in his blood, his serum alanine aminotransferase concentration is 75 IU per liter, and treatment with acetylcysteine is recommended. Acetylcysteine repletes glutathione stores in the liver. It helps to prevent hepatotoxicity in cases of acetaminophen overdose and also improves survival in patients with acetaminophen-induced hepatic failure.

A 52-year-old woman was admitted to this hospital because of fever and confusion. The patient was first taken to the emergency department of another hospital, where she was reported to be lethargic and disoriented. Several hours later, a tonic–clonic seizure occurred, and she was transferred to this hospital. The patient lived in a rural area of Massachusetts and had been bitten by mosquitoes. MRI scans showed multiple bilateral lesions in the brain that were hyperintense. On the fourth hospital day, the result of a diagnostic test was received.

A post-translationally modified portion of IgG seems to be the critical agent that mediates the antiinflammatory effect of this molecule.