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A30-year-old man complains of chest pain, dyspnea, fever, and nonproductivecough that began earlier in the day. The pain is constant and does notdiminish with rest; it worsens somewhat with deep inspiration and has localizedto the left chest. The patient has had no nausea, vomiting, or abdominal pain.He has been immobile for several years secondary to spinal cord disease buthas no history of cardiopulmonary disease.

The Year in Pediatrics

ROCHESTER, N.Y. -- Childhood obesity remained a focus of pediatrics during the year, along with concerns about safety, particularly the safety of psychiatric medications.

BERN, Switzerland -- Six months after implantation of coronary stents, patients who received drug-eluting versions had 30% to 40% less collateral function than patients treated with bare metal devices, researchers here reported.

PHILADELPHIA -- Proton pump inhibitors appear to be associated with an increase in hip fracture risk among older patients, particularly long-duration or high-dose use, according to a large study of British patients.

The Year in Diabetes

ROCKVILLE, Md. -- Against the background of the growing incidence of type 2 diabetes and obesity in the United States came news this year about the first new insulin delivery system in 80 years, as well as new categories of drugs for type 2 disease.

NEW YORK -- The ban on trans fats in this city was the highest profile event during the year in diet and nutrition, as Americans continued to struggle against ever-expanding waistlines and foods deemed unhealthy.

PERTH, Australia -- High-dose fish oil supplements given during pregnancy appear to be safe for the baby and even improve later hand-eye coordination, researchers here found in a small study.

AMSTERDAM, The Netherlands -- For writer's block, the kind that's in the hand rather than the head, consider a shot of botulinum toxin type A, wrote researchers here.

ST. LOUIS -- Bacteria in the gut may be arbiters of weight loss or gain, according to a revolutionary theory proposed by researchers here. They suggested that manipulation of intestinal microbes might be used one day to treat obesity.

COLLEGE STATION, Tex. -- A genetic analysis of spina bifida children has revealed the influence of variant choline-metabolism genes in the development of the disease in addition to perinatal consumption of choline-rich foods.

NEW HAVEN, Conn. -- Older Americans are flocking to gastroenterologists to take advantage of Medicare's all-beneficiary coverage of colonoscopy screening, and that's paying off in earlier colon-cancer detection, a study here suggested.

NEW YORK -- In front-page news articles on successive days, the New York Times accused Lilly of a campaign to promote off-label use of Zyprexa, its anti-psychotic medication, while systematically downplaying the drug's side effects. Lilly denied the allegations.