Acid reflux is commonly thought to be a preventable cause of wheezing. In this randomized, placebo-controlled trial, the investigators found that proton-pump inhibitors do not reduce asthma exacerbations.

The authors of this study measured putative brown-adipose-tissue activity in relation to body composition and energy metabolism, using a standard protocol and integrated positron-emission tomography and computed tomography. Twenty-three of 24 healthy men had detectable levels of activity after cold exposure but not under thermoneutral conditions. Brown-adipose-tissue activity was positively related to resting metabolic rate and was significantly lower in overweight or obese subjects than in lean subjects.

This study used ¹⁸F-fluorodeoxyglucose positron-emission tomographic and computed tomographic scans to identify substantial depots of brown adipose tissue in a region extending from the anterior neck to the thorax. Such depots were found in 7.5% of the women (76 of 1013) and 3.1% of the men (30 of 959). The amount of brown adipose tissue was inversely correlated with body-mass index, especially in older people, suggesting a potential role of brown adipose tissue in adult human metabolism.

Brown adipose tissue helps maintain normal body temperature in newborn humans but was thought to be absent in healthy adults. This report shows the presence of substantial amounts of metabolically active brown adipose tissue, as documented by biochemical, molecular, and morphologic criteria, and by a cold-induced glucose uptake in paracervical and supraclavicular adipose tissue that was increased by a factor of 15.

The prognosis and treatment of myocarditis vary according to the cause, and clinical and hemodynamic data usually offer guidance on when to refer a patient to a specialist for endomyocardial biopsy. The aim of this review is to provide a practical and current approach to the evaluation and treatment of suspected myocarditis.

A 47-year-old man was admitted to the hospital because of fever, headache, rash, and vomiting. The patient had been well until 8 days earlier, when pleuritic chest pain developed, along with a maculopapular rash that spared the palms and soles. Examination of the cerebrospinal fluid disclosed an elevated white-cell count (70% lymphocytes), elevated protein levels, and a normal glucose level. Vancomycin, ceftriaxone, and acyclovir were administered. Additional diagnostic tests were performed.

In January, the Food and Drug Administration (FDA) issued guidance permitting pharmaceutical and device manufacturers to distribute reprints of articles from medical journals that discuss the off-label use of products. The authors review the history of FDA regulation of off-label promotion and discuss the pertinent legal and policy issues.

A protein implicated in the preservation of cardiomyocytes during infarction may also promote fibrosis.