Mark G. Graham, MD, FACP

Chronic obstructive pulmonary disease is a leading cause of morbidity and mortality and a considerable drain on health care resources in the industrialized world. In some patients the disease is inherited, but the vast majority of cases are caused by cigarette smoking. Recognizing the signs and symptoms and understanding the disease progression will facilitate a timely diagnosis. Although the disease is incurable, encouraging patients to stop smoking and providing supplemental oxygen can enhance survival. Significant advances in management as outlined by the authors notwithstanding, efforts to reduce the prevalence of cigarette smoking hold the most promise for reducing the disease burden and associated costs.

Venous thromboembolism is a spectrum of diseases that includes deep vein thrombosis and pulmonary embolism. It is a common source of morbidity and an avoidable cause of mortality that typically occurs in high-risk persons or in specific clinical situations. The diagnosis of deep vein thrombosis or pulmonary embolism can be challenging because of their nonspecific signs and symptoms. As a result, they are underdiagnosed and undertreated. Over the past decade, new diagnostic tools have been developed that obviate the need for invasive pulmonary angiography. Concurrently, new treatment paradigms have become available since the introduction of low-molecular-weight heparin for initial therapy. Long-term warfarin anticoagulation guidelines tailored to specific clinical situations have been developed by expert consensus.