"Epidemiological, demographic, and clinical characteristics of 47 cases of Middle East respiratory syndrome coronavirus disease from Saudi Arabia: a descriptive study"
Lancet Jul 26
http://www.thelancet.com/journals/laninf/article/PIIS1473-3099(13)70204-4/fulltext
"Interpretation

Disease caused by MERS-CoV presents with a wide range of clinical manifestations and is associated with substantial mortality in admitted patients who have medical comorbidities. Major gaps in our knowledge of the epidemiology, community prevalence, and clinical spectrum of infection and disease need urgent definition."

"Fertility treatment and risk of childhood and adolescent mental disorders: register based cohort study"
BMJ Jul 5
http://www.bmj.com/content/347/bmj.f3978
"Conclusions There was a small increase in the incidence of mental disorders in children born after ovulation induction/intrauterine insemination. Children born after in vitro fertilisation/intracytoplasmic sperm injection were found to have overall risk comparable with children conceived spontaneously."

"Riociguat for the Treatment of Pulmonary Arterial Hypertension"
NEJM Jul 25
http://www.nejm.org/doi/full/10.1056/NEJMoa1209655 
"Riociguat significantly improved exercise capacity and secondary efficacy end points in patients with pulmonary arterial hypertension. (Funded by Bayer HealthCare; . . . "

"Characteristics Associated With Differences in Survival Among Black and White Women With Breast Cancer" 
JAMA Jul 2013
http://jama.jamanetwork.com/article.aspx?articleid=1719739 
"Conclusions and Relevance  In the SEER-Medicare database, differences in breast cancer survival between black and white women did not substantially change among women diagnosed between 1991 and 2005. These differences in survival appear primarily related to presentation characteristics at diagnosis rather than treatment differences."

"Alternate-Day, Low-Dose Aspirin and Cancer Risk: Long-Term Observational Follow-up of a Randomized Trial"
Annals Jul 2013
http://annals.org/article.aspx?articleid=1709803 
"Conclusion: Long-term use of alternate-day, low-dose aspirin may reduce risk for colorectal cancer in healthy women."

"Cause of Death Within 30 Days of Percutaneous Coronary Intervention in an Era of Mandatory Outcome Reporting"
Circ Jul 2013
http://content.onlinejacc.org/article.aspx?articleid=1687956
"Conclusions  Less than one-half of 30-day deaths are attributed to a PCI-related complication. Death certificates are inaccurate and do not report PCI-related deaths, which may represent a better marker of PCI quality."

"Emergency Department Bypass for ST-Segment–Elevation Myocardial Infarction Patients Identified With a Prehospital Electrocardiogram"
JACC Jun 20
http://circ.ahajournals.org/content/128/4/352.full 
"Conclusions—Among ST-segment–elevation myocardial infarction patients identified with a prehospital ECG, the rate of ED bypass varied significantly across US hospitals, but ED bypass occurred infrequently and was mostly isolated to working hours. Because ED bypass was associated with shorter reperfusion times and numerically lower mortality rates, further exploration of and advocacy for the implementation of this process appear warranted."

"Erlotinib versus docetaxel as second-line treatment of patients with advanced non-small-cell lung cancer and wild-type EGFRtumours (TAILOR): a randomised controlled trial"
Lancet Jul 22
http://www.thelancet.com/journals/lanonc/article/PIIS1470-2045(13)70310-3/fulltext 
"Interpretation

Our results show that chemotherapy is more effective than erlotinib for second-line treatment for previously treated patients with NSCLC who have wild-type EGFR tumours."

"Association of plasma uric acid with ischaemic heart disease and blood pressure: mendelian randomisation analysis of two large cohorts" 
BMJ Jul 2013
http://www.bmj.com/content/347/bmj.f4262 
"Conclusion By contrast with observational findings, there is no strong evidence for causal associations between uric acid and ischaemic heart disease or blood pressure. However, evidence supports a causal effect between body mass index and uric acid level and hyperuricaemia. This finding strongly suggests body mass index as a confounder in observational associations, and suggests a role for elevated body mass index or obesity in the development of uric acid related conditions."

"Targeting of Low-Dose CT Screening According to the Risk of Lung-Cancer Death"  
NEJM Jul 18  
http://www.nejm.org/doi/full/10.1056/NEJMoa1301851?query=featured_home 
"CONCLUSIONS

Screening with low-dose CT prevented the greatest number of deaths from lung cancer among participants who were at highest risk and prevented very few deaths among those at lowest risk. These findings provide empirical support for risk-based targeting of smokers for such screening. (Funded by the National Cancer Institute.)"

"Association Between Duration of Overall and Abdominal Obesity Beginning in Young Adulthood and Coronary Artery Calcification in Middle Age"  
JAMA Jul 17
http://jama.jamanetwork.com/article.aspx?articleid=1713590 
"Conclusions and Relevance  Longer duration of overall and abdominal obesity was associated with subclinical coronary heart disease and its progression through midlife independent of the degree of adiposity. Preventing or at least delaying the onset of obesity in young adulthood may lower the risk of developing atherosclerosis through middle age."

"Same-Day Discharge After Percutaneous Coronary Intervention"
JACC Jul 2013
http://content.onlinejacc.org/article.aspx?articleid=1685124
"Conclusions  In selected patients undergoing largely elective PCI, same-day discharge was associated with a low rate of major complications and appeared to be as safe as routine overnight observation."

"The Long-Term Multicenter Observational Study of Dabigatran Treatment in Patients With Atrial Fibrillation (RELY-ABLE) Study"
Circ Jun 14
http://circ.ahajournals.org/content/128/3/237.full
"Conclusions—During 2.3 years of continued treatment with dabigatran after RE-LY, there was a higher rate of major bleeding with dabigatran 150 mg twice daily in comparison with 110 mg, and similar rates of stroke and death."

"Glucocorticoid-induced osteoporosis: mechanisms, management, and future perspectives" 
Lancet Jun 28 
http://www.thelancet.com/journals/landia/article/PIIS2213-8587(13)70045-7/fulltext?_eventId=login

"A Guide to Utilization of the Microbiology Laboratory for Diagnosis of Infectious Diseases: 2013 Recommendations by the Infectious Diseases Society of America (IDSA) and the American Society for Microbiology (ASM)"
CID Jul 10
http://cid.oxfordjournals.org/content/early/2013/06/24/cid.cit278.full

"Intake of fish and marine n-3 polyunsaturated fatty acids and risk of breast cancer: meta-analysis of data from 21 independent prospective cohort studies"
BMJ Jun 27 http://www.bmj.com/content/346/bmj.f3706

"Cardiovascular Effects of Intensive Lifestyle Intervention in Type 2 Diabetes"  
NEJM Jul 11
http://www.nejm.org/doi/full/10.1056/NEJMoa1212914 
"CONCLUSIONS

An intensive lifestyle intervention focusing on weight loss did not reduce the rate of cardiovascular events in overweight or obese adults with type 2 diabetes."

"Prevalence and Extent of Obstructive Coronary Artery Disease Among Patients Undergoing Elective Coronary Catheterization in New York State and Ontario"  
JAMA Jul 10  
http://jama.jamanetwork.com/article.aspx?articleid=1710454 
"Results   . . . The observed rate of obstructive CAD was significantly lower in New York at 30.4%  . . .  than in Ontario at 44.8% . . .  of patients undergoing cardiac catheterization in New York had a greater than 50% predicted probability of having obstructive CAD than those in Ontario at 41% . . . At 30 days, crude mortality for patients undergoing cardiac catheterization was slightly higher in New York  . . . 

Conclusions and Relevance  In Ontario compared with New York State, patients undergoing elective cardiac catheterization were significantly more likely to have obstructive CAD. This appears to be related to a higher percentage of patients in New York with low predicted probability of CAD undergoing cardiac catheterization."

"Screening for HIV: U.S. Preventive Services Task Force Recommendation Statement"

"Screening for HIV: U.S. Preventive Services Task Force Recommendation Statement" 
Annals Jul 2
http://annals.org/article.aspx?articleid=1700660
"Recommendation: The USPSTF recommends that clinicians screen adolescents and adults aged 15 to 65 years for HIV infection. Younger adolescents and older adults who are at increased risk should also be screened. (Grade A recommendation)

The USPSTF recommends that clinicians screen all pregnant women for HIV, including those who present in labor who are untested and whose HIV status is unknown. (Grade A recommendation)"

"Biodegradable Polymer Biolimus-Eluting Stent Versus Durable Polymer Everolimus-Eluting Stent"

JACC Jul 2013 
http://content.onlinejacc.org/article.aspx?articleid=1709696
"Conclusions  One-year clinical and angiographic outcome after BES implantation was noninferior to and not different from that after EES implantation in a mostly stable coronary artery disease population. One-year clinical outcome after both BES and EES use was excellent, with a low rate of TLR and extremely low rate of stent thrombosis."

"Ambulatory Blood Pressure Changes After Renal Sympathetic Denervation in Patients With Resistant Hypertension"

"Ambulatory Blood Pressure Changes After Renal Sympathetic Denervation in Patients With Resistant Hypertension"
Circ Jun 18
http://circ.ahajournals.org/content/128/2/132.abstract
"Conclusions—RDN reduced office BP and improved relevant aspects of ambulatory BP monitoring, commonly linked to high cardiovascular risk, in patients with true-treatment resistant hypertension, whereas it only affected office BP in pseudoresistant hypertension."

"Cooking fuels and prevalence of asthma: a global analysis of phase three of the International Study of Asthma and Allergies in Childhood (ISAAC)"

"Cooking fuels and prevalence of asthma: a global analysis of phase three of the International Study of Asthma and Allergies in Childhood (ISAAC)"
Lancet May 31
http://www.lancet.com/journals/lanres/article/PIIS2213-2600(13)70073-0/fulltext
"Interpretation

The use of open fires for cooking is associated with an increased risk of symptoms of asthma and of asthma diagnosis in children. Because a large percentage of the world population uses open fires for cooking, this method of cooking might be an important modifiable risk factor if the association is proven to be causal."

"When a test is too good: how CT pulmonary angiograms find pulmonary emboli that do not need to be found"

BMJ Jul 2
http://www.bmj.com/content/347/bmj.f3368
"Conclusion— CT pulmonary angiography has reduced missed pulmonary embolism but seems to result in overdiagnosis. We need to learn which small emboli need treatment"

"Clopidogrel with Aspirin in Acute Minor Stroke or Transient Ischemic Attack"

NEJM Jul 4 
http://www.nejm.org/doi/full/10.1056/NEJMoa1215340?query=featured_home
"CONCLUSIONS

Among patients with TIA or minor stroke who can be treated within 24 hours after the onset of symptoms, the combination of clopidogrel and aspirin is superior to aspirin alone for reducing the risk of stroke in the first 90 days and does not increase the risk of hemorrhage."

"Home-Based Walking Exercise Intervention in Peripheral Artery Disease"

JAMA Jul 3
http://jama.jamanetwork.com/article.aspx?articleid=1707722
"Conclusion and Relevance  A home-based walking exercise program significantly improved walking endurance, physical activity, and patient-perceived walking endurance and speed in PAD participants with and without classic claudication symptoms. These findings have implications for the large number of patients with PAD who are unable or unwilling to participate in supervised exercise programs."

"Changes in Red Meat Consumption and Subsequent Risk of Type 2 Diabetes Mellitus"

JAMA IM Jun 17
http://archinte.jamanetwork.com/article.aspx?articleid=1697785
"Conclusions and Relevance  Increasing red meat consumption over time is associated with an elevated subsequent risk of T2DM, and the association is partly mediated by body weight. Our results add further evidence that limiting red meat consumption over time confers benefits for T2DM prevention."

"Elevated Cardiac Troponin T is Associated with Higher Mortality and Amputation Rates in Patients with Peripheral Arterial Disease"

"Elevated Cardiac Troponin T is Associated with Higher Mortality and Amputation Rates in Patients with Peripheral Arterial Disease"
JACC Jun 2013
http://content.onlinejacc.org/article.aspx?articleID=1700991 
"Conclusions  cTnT is frequently elevated in PAD patients and is associated with higher event rates in terms of total mortality and amputation. Even small cTnT elevations predict a markedly increased risk that is independent of an impaired renal function."

"Good Prognosis for Pericarditis With and Without Myocardial Involvement"

"Good Prognosis for Pericarditis With and Without Myocardial Involvement"
Circ  May / Jul 2013
http://circ.ahajournals.org/content/128/1/42.abstract
"Conclusions—The outcome of myopericardial inflammatory syndromes is good. Unlike acute coronary syndromes, troponin elevation is not a negative prognostic marker in this setting."

"Assessment of the sensitivity and specificity of Xpert MTB/RIF assay . . . "

"Assessment of the sensitivity and specificity of Xpert MTB/RIF assay as an early sputum biomarker of response to tuberculosis treatment"
Lancet Jul 1
http://www.lancet.com/journals/lanres/article/PIIS2213-2600(13)70119-X/fulltext
"Interpretation

The poor specificity precludes the use of the Xpert MTB/RIF assay as a biomarker for monitoring tuberculosis treatment, and should not replace standard smear microscopy and culture."

"Intake of fish and marine n-3 polyunsaturated fatty acids and risk of breast cancer"

BMJ Jun 27
http://www.bmj.com/content/346/bmj.f3706
"Conclusions Higher consumption of dietary marine n-3 PUFA is associated with a lower risk of breast cancer. The associations of fish and alpha linolenic acid intake with risk warrant further investigation of prospective cohort studies. These findings could have public health implications with regard to prevention of breast cancer through dietary and lifestyle interventions."

NEJM

"Oral Apixaban for the Treatment of Acute Venous Thromboembolism"
NEJM Jul 1
http://www.nejm.org/doi/full/10.1056/NEJMoa1302507?query=featured_home
"CONCLUSIONS

A fixed-dose regimen of apixaban alone was noninferior to conventional therapy for the treatment of acute venous thromboembolism and was associated with significantly less bleeding"