Search

Recognizing Mendelian disorders should improve health care for persons with strong familial risks for common chronic diseases. The Online Mendelian Inheritance in Man (OMIM) database was reviewed to identify Mendelian disorders featuring 17 common chronic diseases, including 9 cardiovascular conditions, diabetes, and 7 common cancers. Mendelian disorders were selected if any one of the 17 diseases was reported in more than two families manifesting in adulthood. Patterns of chronic diseases and modes of inheritance associated with these Mendelian disorders are described. The GeneTests/Reviews database and other websites were reviewed to determine availability of genetic testing and management and prevention recommendations for the selected disorders. Of 2,592 (OMIM) entries reviewed, 188 Mendelian disorders were selected. Most (67.7%) are autosomal dominant disorders. Almost half (45.8%) feature combinations of the chronic diseases under study. At least one gene is known for 68.8% of the selected disorders, and clinical genetic testing is available for 55% of disorders. Guidelines for management and prevention are available for 33.9% of these, ranging from recommendations for supportive care to guidelines for managing affected persons and screening relatives. Significant clinical heterogeneity exists for Mendelian disorders that might present as strong family histories of common chronic diseases. Recognition of the different combinations of diseases within a pedigree, including mode of inheritance and heritable disease risk factors, facilitates diagnosis of these Mendelian disorders. Genetic testing is available for most disorders, which can further clarify the genetic risk, and for some, recommendations for management and prevention are available. However, evidence-based guidelines are needed. Published 2004 Wiley-Liss, Inc.dagger.

Case studies of the efforts of Motorola and Cray Supercomputer to sell their products in Japan and reveal the varied structural impediments limiting foreign access to the Japanese marketplace. In both of these cases, U.S. trade policy was used to improve market access with limited but largely beneficial results. The case studies demonstrate that in the presence of the unique structural features of Japanese business and government organization, something akin to 'managing trade' is sometimes required to achieve something amin to competitive outcome. (Reprinted by permission of the publisher.)

Vice-President Al Gore has played a key role in developing the economic policies of the Clinton presidency. As he seeks the Democratic party's nomination as presidential candidate, Gore is calling for a balanced budget or better each year, targeted tax cuts to encourage research and lifelong learning and a rise in investment in research, education and technology. He has gained widespread support for his policy of using the majority of the large fiscal surpluses anticipated for the period to 2014 for saving Social Security and modernizing Medicare.

THREE BILLION NEW CAPITALISTS: THE GREAT SHIFT OF WEALTH AND POWER TO THE EAST BY CLYDE PRESTOWITZ Basic Books, 278 pages, $26.95 GLOBALIZATION: WHY IT WORKS BY MARTIN WOLF Yale [...]

IT HAS BEEN A BLESSING FOR THE ELDERLY, BUT MEDICARE'S COVERAGE IS ERODING AND IT FACES A MOUNTING DEFICIT. HERE'S HOW TO FIX IT. Before enactment of Medicare in 1965, [...]