Unintended Consequences: FDA Drug Safety Warning BackfiresUnintended Consequences: FDA Drug Safety Warning Backfires

FDA warnings to reduce the daily dosage of citalopram to 40 mg or less to avoid the possibility of cardiac arrhythmias not only failed to do so but also resulted in poor mental health outcomes. Medscape Medical News
Source: Medscape Psychiatry Headlines - Category: Psychiatry Tags: Psychiatry News Source Type: news

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Objective: To report the mortality data and life expectancy of geriatric hip fracture patients who underwent nonoperative management and compare that with a matched operative cohort. Design: Retrospective cohort study. Setting: Level 1 trauma center. Patients: Geriatric (65 years of age and older) femoral neck or intertrochanteric fracture (OTA/AO 31A and 31B) patients. Intervention: Operative treatment with either arthroplasty, cannulated screws, sliding hip screw device, or cephalomedullary nail compared with nonoperative cohort. Main Outcome Measurements: In-hospital, 30-day, and 1-year mortality. Resu...
Source: Journal of Orthopaedic Trauma - Category: Orthopaedics Tags: Original Article Source Type: research
Emery-Dreifuss muscular dystrophy (EDMD) is an early-onset, usually in the first decade, slowly progressive myopathy [1]. EDMD is mainly caused either by mutations in EMD gene encoding emerin in X-linked EDMD (X-EDMD) [2], or mutations in LMNA gene encoding lamins A and C in autosomal dominant and recessive forms [3]. EDMD clinical presentation includes the classical triad of symptoms with early joint contractures involving Achilles, elbows and the neck tendons, progressive muscle weakness and wasting beginning in the humero and peroneal regions, and cardiac disease combining cardiac arrhythmias, conduction defects and cardiomyopathy [4,5].
Source: Neuromuscular Disorders - Category: Neurology Authors: Tags: Case report Source Type: research
Publication date: Available online 17 June 2019Source: Journal of Theoretical BiologyAuthor(s): Joshua Veasy, Yi Ming Lai, Stephen Coombes, Rüdiger ThulAbstractCardiac alternans, in which the membrane potential and the intracellular calcium concentration exhibit alternating peak amplitudes at consecutive beats, constitute a precursor to fatal cardiac arrhythmia such as sudden cardiac death. A crucial question therefore concerns the onset of cardiac alternans. Typically, alternans are only reported when they are fully developed. Here, we present a modelling approach to explore recently discovered microscopic alternans,...
Source: Journal of Theoretical Biology - Category: Biology Source Type: research
​BY KATIE TAUSCH, MD; ELAINA CLARK; KIMBERLY KRESS GETZINGER, MD; SHANNA C. JONES, MDA 25-year-old man with a history of depression and narcotic abuse presented to the ED seven hours after ingesting 200 loperamide 2 mg tablets. He was found unresponsive at home. He was somewhat somnolent but oriented on arrival.His blood pressure was 76/43 mm Hg, pulse rate was 62 bpm, respiratory rate was 20 bpm, temperature was 35.7°C orally, and SpO2 was 98% on room air. His physical examination was otherwise normal. He said he took the loperamide "to get high and relax." He normally took 150–200 loperami...
Source: The Case Files - Category: Emergency Medicine Tags: Blog Posts Source Type: research
Abstract Magnesium is an essential mineral naturally present in the human body, where it acts as cofactor in several enzymatic reactions. Magnesium is a key cardiovascular regulator, which maintains electrical, metabolic, and vascular homeostasis. Moreover, magnesium participates in inflammation and oxidative processes. In fact, magnesium deficiency is involved in the pathophysiology of arterial hypertension, diabetes mellitus, dyslipidemia, metabolic syndrome, endothelial dysfunction, coronary artery disease, cardiac arrhythmias, and sudden cardiac death. In consideration of the great public-health impact of card...
Source: Cardiology Research and Practice - Category: Cardiology Authors: Tags: Cardiol Res Pract Source Type: research
Abstract Introduction: There is no study evaluating the Tp-e/QT and Tp-e/QTc ratios with T wave peak to end interval (Tp-e interval) used for evaluation of cardiac arrhythmia risk and ventricular repolarization changes in patients with primary aldosteronism (PA). We aimed to investigate whether there was a change in Tp-e interval, Tp-e/QT and Tp-e/QTc ratios in patients with PA. Method: Thirty patients with newly diagnosed hypertension (HT) and PA and 30 patients with primary HT were included. Twelve-lead electrocardiography (ECG) was performed in all patients. Tp-e interval, Tp-e/QT and Tp-e/QTc ratios were measu...
Source: Clinical and Experimental Hypertension - Category: Cardiology Authors: Tags: Clin Exp Hypertens Source Type: research
Conclusion: Synthetic receptors, particularly WP[6], exhibited high binding affinities towards Sch, and presented a significant potential as supramolecular therapeutics to treat the various side effects of Sch by specifically sequestering Sch in vivo.
Source: Theranostics - Category: Molecular Biology Authors: Tags: Research Paper Source Type: research
We report two cases of adults presenting with transient loss of consciousness (TLoC) followed by a rapid recovery. Careful history taking revealed a stereotyped prodrome of déjà vu, raising the possibility of these events being focal seizures rather than syncope. The patients were commenced on antiepileptic drugs (AEDs) at the same time as having cardiac monitoring organised. This confirmed asystole during the seizure symptoms, resulting in TLoC. It was assumed that the cardiac arrhythmia explained the entire picture, a permanent pacemaker (PPM) was inserted, and the AEDs were withdrawn in one patient and not...
Source: Journal of the Royal College of Physicians of Edinburgh - Category: General Medicine Tags: J R Coll Physicians Edinb Source Type: research
Nature Reviews Cardiology, Published online: 13 June 2019; doi:10.1038/s41569-019-0221-2Neuromodulation therapy might be clinically useful in the management and prevention of lethal arrhythmias. In this Review, the authors discuss the neuroanatomical and neurophysiological basis for neuromodulation therapy, critically appraise the latest data on the clinical efficacy of this approach and highlight areas in the field of cardiac autonomic control that show the most promise for clinical translation.
Source: Nature Reviews Cardiology - Category: Cardiology Authors: Source Type: research
After out-of-hospital cardiac arrest (OHCA) associated with obstructive coronary artery disease (CAD), the risk of recurrence during the early period is unclear and the indication for anti-arrhythmic treatment is debated. We assessed the incidence and predisposing factors for severe cardiac arrhythmias in this population.
Source: Resuscitation - Category: Emergency Medicine Authors: Tags: Clinical paper Source Type: research
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