Evaluation of acute chest pain syndromes by two-dimensional echocardiography: its potential application in the selection of patients for acute reperfusion therapy

Two-dimensional echocardiography is useful for the immediate diagnosis of acute myocardial infarction when diagnostic electrocardiographic changes are absent. The technique is also helpful in distinguishing myocardial infarction from other conditions that may clinically or electrocardiographically mimic infarction. The extent of myocardial infarction can be estimated by the two-dimensional echocardiographically derived wall motion score index. Therefore, two-dimensional echocardiography seems to be ideally suited for the initial noninvasive assessment of patients with acute chest pain syndromes, especially those who are considered for acute reperfusion therapy.     

Coffee Intake and Risk of Hypertension: A Meta-Analysis of Cohort Studies

BackgroundIt remains unclear whether coffee intake is associated with the risk of hypertension. This study aimed to investigate the association between coffee intake and the risk of hypertension by using a meta-analysis of cohort studies.MethodsPubMed and Embase were searched using keywords in September 2022 to identify studies on coffee intake and the risk of hypertension.ResultsWe included a total of 13 longitudinal cohort studies, which involved a total of 64,650 incident cases of hypertension among 314,827 participants. In a random effects model meta-analysis of all the studies, coffee intake was not significantly associated with the risk of hypertension (relative risk [RR], 0.97; 95% confidence interval [CI], 0.90–1.05; I² = 58.0%; n = 13). In the subgroup meta-analysis, coffee intake was associated with a decreased risk of hypertension in studies conducted in America (RR, 0.93; 95% CI, 0.87–0.98; I² = 4.6%; n = 5) and in low-quality studies (RR, 0.92; 95% CI, 0.88–0.96; I² = 0.0%; n = 7). In the remaining subgroup meta-analyses by amount of coffee intake, gender, type of coffee (decaffeinated vs. caffeinated), smoking, and years of follow-up, coffee intake was not significantly associated with the risk of hypertension.ConclusionThe current meta-analysis showed that coffee intake is not associated with the risk of hypertension.     

Mean platelet volume is the most valuable hematologic parameter in differentiating testicular torsion from epididymitis within the golden time

BackgroundWe aimed to assess the diagnostic value of hematologic parameters in the differential diagnosis of testicular torsion and epididymitis within and after the golden time.MethodsWe retrospectively reviewed the records of 250 patients aged <25 years who were diagnosed with epididymitis (n=119) or testicular torsion (n=131). The characteristics and hematologic parameters of patients in the two groups were analyzed. Receiver operating characteristic (ROC) curves were used to assess the validity of hematologic parameters as differential diagnostic tools with respect to the golden time (defined as 6 h of symptom duration). Further, we evaluated the predictive factors associated with orchiectomy in patients with testicular torsion.ResultsThe mean patient age was 14.4 years. Among patients with testicular torsion, 91.40% (53 of 58) underwent detorsion and orchiopexy within the golden time, whereas only 27.40% (20 of 73) of the affected testes were preserved after the golden time. Within the golden time, mean platelet volume (MPV) seemed to be the most valuable hematologic parameter [area under the curve (AUC) 0.855, 95% confidence interval (CI): 0.778–0.932]. In a multivariate analysis, symptom duration (symptoms beyond the golden time) was associated with orchiectomy in patients with testicular torsion.ConclusionsMPV showed the greatest hematologic value in the early stage of testicular torsion and epididymitis, suggesting its potential use for the differential diagnosis of these two conditions within the golden time.