A potential diagnostic pitfall in ST elevation: Acute pulmonary embolism or ST-segment elevation myocardial infarction.

The diagnosis of acute pulmonary embolism (APE) is a great challenge for physicians due to its nonspecific symptoms, and often missed or misdiagnosed as acute coronary syndrome. Electrocardiographic (ECG) abnormalities are seen in majority of patients with APE. Recently, APE with ST-segment elevation (STE) in leads V1 -V3 /V4 , mimicking ST-segment elevation myocardial infarction (STEMI), has been described. However, coronary angiography showed that the patient's coronary arteries were mostly normal. Herein, we describe a case of APE presenting with STE in V1 -V4 , along with severe stenosis of the left anterior descending (LAD) artery.

Atypical de Winter ECG pattern may be the mirror image of ST elevation.

BACKGROUND: The de Winter ECG pattern of ST-segment depression and tall symmetrical T waves, known as an ST elevation equivalent, accounts for approximately 2% of patients with occlusion of the proximal left anterior descending (LAD) coronary artery. The classic de Winter pattern is restricted to cases without ST elevation. However, mixed cases with different types of ST deviation have been described. Here, we describe an interesting case as an example of an ST elevation myocardial infarction (STEMI) equivalent, showing transient transmural ischemia of the inferolateral myocardium, with ECG changes that mimic the de Winter pattern.

An updated meta-analysis of 23 case-control studies on the association between miR-34b/c polymorphism and cancer risk.

The association between in microRNA-34b/c gene rs4938723 polymorphisms and cancer risk remains inconclusive. This meta-analysis was performed to analyze the association between microRNA-34b/c rs4938723 polymorphism and risk for cancer development. In total, 304 studies from PubMed, Embase, Web of Science, Wanfang, and Chinese National Knowledge Infrastructure databases were examined, and 23 studies were included in this meta-analysis. The 23 selected studies involved 10,812 cancer cases and 11,719 controls. Odds ratios (ORs) and 95% confidence intervals (CIs) were calculated to measure the strength of the association. Our results indicate a significant association between the rs4938723 polymorphism and cancer risk in the overdominant model (P heterogeneity = 0.018, OR = 1.093, and 95% CI = 1.015-1.177 for CT vs. CC/TT). Using a stratified subgroup analysis, rs4938723 polymorphisms were associated with an increased risk for hepatocellular carcinoma, but decreased risk for colorectal, gastric, and esophageal squamous cell cancer. These findings indicate that the rs4938723 gene is a susceptible locus for cancer.

Effect of statins on preventing infectious complications after surgery: Systematic review and meta-analysis.

OBJECTIVE: *These authors contributed equally to this work.A meta-analysis to investigate the association between preoperative statin use and the risk of postoperative infectious complications in patients undergoing surgery. METHODS: PubMed(®) and Embase(®) databases were searched for relevant studies. Data were extracted using a standardized data collection form. The primary effect measure was the odds ratio (OR) of postoperative infectious complications. Summary OR were calculated. RESULTS: The analysis included 10 cohort studies with a total of 147 263 participants. Statin use was associated with a lower incidence of postoperative infectious complications in all studies (summary OR 0.917, 95% confidence intervals [CI] 0.862, 0.975, fixed-effects model; summary OR 0.731, 95% CI 0.584, 0.870, random-effects model); cardiac surgery (summary OR 0.673; 95% CI 0.535, 0.847); treatment in the USA (summary OR 0.678; 95% CI 0.597, 0.770); retrospective cohort studies (summary OR 0.664; 95% CI 0.521, 0.846). CONCLUSION: Preoperative statin use is associated with a reduced risk of postoperative infectious complications.