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A major clinical challenge encountered by thoracic surgeons lies in the decision to pursue surgery, which must be weighed between surgical risk and the reliability of CT findings.

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Only one third of patients admitted to the hospital with acute myocardial infarction have normal renal function, and 17% have severe renal impairment. Decreased renal function is associated with the presence of comorbid conditions, underuse of effective treatments, and higher mortality. Renal function parameters should not only be included in scoring systems to assess risk levels, but patients with abnormal renal function should benefit from careful application of guidelines-recommended treatments for acute and long-term care.

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This propensity-matched study, in which patients with and without diabetes were well balanced in all measured baseline characteristics, including traditional risk factors and comorbidities, found that diabetes was associated with increased mortality and hospitalization in ambulatory patients who had chronic, mild-to-moderate heart failure and were receiving angiotensin-converting enzyme inhibitors. These findings also highlight the sex- and age-related variations in the effect of diabetes in these patients.

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Neurocardiogenic syncope (vasovagal syncope) is the most common cause of loss of consciousness, ranging in various studies from 18% to 58% of all syncopal events.

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A substudy of the PLATO trial reveals that treatment with ticagrelor reduces cardiovascular death, myocardial infarction, and stroke in some patients with non-ST-elevation acute coronary syndrome.

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Upper gastrointestinal bleeding is a common medical emergency that continues to be a significant cause of morbidity and mortality. It requires rapid and appropriate intervention to control the associated hemodynamic instability and prevent continued or recurrent bleeding. Etiology is the key to prognosis. Lower gastrointestinal bleeding usually ceases spontaneously but may also result in hemodynamic instability or symptomatic anemia. Recognizing the signs and symptoms of upper versus lower gastrointestinal bleeding is crucial for prompt and appropriate treatment.

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People of good conscience, including many physicians, are sharply divided on the ethics of MAID/PAS. Unfortunately, much of the support for this practice is founded on several myths and misconceptions regarding existing MAID laws and practices, according to Ronald Pies, MD.

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We hypothesized that atherosclerotic renovascular disease (ARVD) might account for a growing proportion of end-stage renal disease in the United States because of shared risk factors and the aging of the population. We tested this hypothesis through an evaluation of 146 973 older patients starting dialysis therapy in the United States between 1996 and 2001.

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The recent approval of the NephroCheck biomarker assay is a big step forward in the management of acute kidney injury.

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A pediatrician in Flint, MI faced a torrent of criticism and official denials when she discovered her patients were being poisoned by dangerously high levels of lead in their water. Here's the inside story of how she fought back.

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We examined the relationship between the 6-minute walk test and self-perceived changes in symptoms in 1077 elderly patients with chronic heart failure. We found that changes in 6-minute walk test distance were sensitive to changes in self-perceived symptoms of heart failure.

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We investigated whether a program based on diffuse deployment of automated external defibrillators operated by trained volunteers and laypersons across the largest county in Italy would safely and effectively improve the current survival rate among patients with out-of-hospital cardiac arrest. Compared with historical control subjects, the new strategy resulted in a 3-fold increase in 1-year survival free of neurologic impairment.

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The ability to diagnose coronary artery disease (CAD) in women may be limited by the sensitivity and specificity of symptoms as well as of noninvasive testing. The choice of which test should be performed to evaluate the presence of CAD in women remains controversial. Currently American Heart Association/American College of Cardiology guidelines recommend initial evaluation with exercise electrocardiogram (ECG) testing. In a meta-analysis of 3721 women, however, exercise ECG had a sensitivity of 61% and a specificity of 70%1 as compared to 68% sensitivity and 77% specificity in men.

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The decreasing age of onset of hypertension in the general population paired with increasing life expectancy has resulted in an increased incidence of this disorder, which will likely culminate in higher rates of morbidity and mortality in the future.

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The ability to diagnose coronary artery disease (CAD) in women may be limited by the sensitivity and specificity of symptoms as well as of noninvasive testing. The choice of which test should be performed to evaluate the presence of CAD in women remains controversial. Currently American Heart Association/American College of Cardiology guidelines recommend initial evaluation with exercise electrocardiogram (ECG) testing. In a meta-analysis of 3721 women, however, exercise ECG had a sensitivity of 61% and a specificity of 70%1 as compared to 68% sensitivity and 77% specificity in men.

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This study evaluated the association between alcohol consumption and all-cause mortality, as well as the relevance of age-specific limits for alcohol consumption. Alcohol use, particularly consumption of excessive amounts, is negatively associated with many acute and chronic diseases. The direct and indirect economic burden due to alcohol use is substantial.

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Nuts should be given their own small space on the "MyPlate" in light of their solid evidence-based recommendation for daily consumption.

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Lack of correlation reinforces the need to individualize therapy based on clinical effectiveness for that patient in order to optimize treatment outcomes.