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BMJ 2009; 339 doi: (Published 11 November 2009) Cite this as: BMJ 2009;339:b4558

Are serum troponin levels useful for distinguishing between those at low and high risk of death from acute pulmonary embolus? A meta-analysis of studies describing troponin levels and all-cause mortality in people with normal blood pressure and acute symptomatic pulmonary embolism concludes that although patients with raised troponin had a four fold increased risk of short term death compared with patients without raised levels, the prognostic value of troponin levels alone depends greatly on the cutoff points used. Other evidence is needed to assess risk of death accurately (Chest 2009;136:974-82 doi:10.1378/chest.09-0608).

A cardiologist and a psychiatrist have joined forces to explore the effect of “mirthful laughter” on the cardiovascular system (Medical Hypotheses 2009; 73:636-9, doi:10.1016/j.mehy.2009.02.044). Mirthful laughter releases beta endorphins, which have a high affinity for specific opiate receptors that are expressed in the vascular endothelium. Their idea—yet to be tested—is that one of the direct effects of this opiate receptor …

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