This study shows that variants of proteins that indirectly guide hydrolases to the lysosome are associated with stuttering. The authors analyzed genes at a locus previously implicated in stuttering and identified mutations affecting a subunit of GlcNAc-phosphotransferase and changes in genes encoding other proteins in the same enzyme complex or pathway. This unexpected finding implies a metabolic pathway in susceptibility to stuttering.

Women between 59 and 80 years of age with a bone mineral density T score of –2.5 or less at the femoral neck or spine received the selective estrogen-receptor modulator lasofoxifene (either 0.25 or 0.5 mg daily) or placebo for 5 years. Lasofoxifene was associated with lower risks of fractures, estrogen-receptor–positive breast cancer, coronary heart disease, and stroke, with no increase in endometrial cancer, but there was an increase in venous thromboembolic events.

The optimal timing for the initiation of antiretroviral therapy in patients with both human immunodeficiency virus infection and tuberculosis is unclear. This open-label study involves 642 such patients who received antiretroviral therapy initiated either during or after the completion of tuberculosis therapy. The initiation of antiretroviral therapy during tuberculosis therapy was associated with a relative reduction of 56% in the rate of death.

Efficient, economical screening for active tuberculosis in resource-poor environments is a challenge. Screening is particularly important when there is coinfection with human immunodeficiency virus (HIV) and therefore concomitant consideration of initiation of antiretroviral therapy and the risk of the immune reconstitution syndrome. In this study of 1748 patients in Cambodia, Thailand, and Vietnam who were infected with HIV, an assessment for the presence of one of three symptoms — cough, fever, or night sweats — for more than 21 days over the preceding 4 weeks was found to have 93% sensitivity and 36% specificity for the detection of active tuberculosis infection.