scholarly journals Mexiletine Treatment for Neonatal LQT3 Syndrome: Case Report and Literature Review

2021 ◽  
Vol 9 ◽  
Author(s):  
Alena Bagkaki ◽  
Alexandros Tsoutsinos ◽  
Eleftheria Hatzidaki ◽  
Manolis Tzatzarakis ◽  
Fragiskos Parthenakis ◽  
...  
Keyword(s):  
High Risk ◽  
Literature Review ◽  
Neonatal Period ◽  
Positive Family History ◽  
Clinical Importance ◽  
Response To Treatment ◽  
Specific Response ◽  
Cardiac Events ◽  
Type 3 ◽  
Lqt Syndrome

Background: Early diagnosis of long QT type 3 (LQT3) syndrome during the neonatal period is of paramount clinical importance. LQT3 syndrome results in increased mortality and a mutation-specific response to treatment compared to other more common types of LQT syndrome. Mexiletine, a sodium channel blocker, demonstrates a mutation-specific QTc shortening effect in LQT3 syndrome patients.Case Presentation: A neonate manifested marked QTc prolongation after birth. An electrocardiogram (ECG) recording was performed due to positive family history of genetically confirmed LQT3 syndrome (SCN5A gene missense mutation Tyr1795Cys), and an association with sudden cardiac death was found in family members. The mexiletine QTc normalizing effect (QTc shortening from 537 to 443 ms), practical issues related to oral mexiletine treatment of our young patient, along with a literature review regarding identification and mexiletine treatment in infants with LQT3 syndrome are presented.Conclusions: Mexiletine could be considered in the treatment of high-risk LQT3 patients already in the neonatal period in addition to b-blocker therapy. Availability of standardized commercial mexiletine pediatric formulas, serum mexiletine level analyses, and future prospective studies are needed to evaluate the potential beneficial effect of early mexiletine treatment on the incidence of future acute cardiac events in these high-risk LQT syndrome patients.

Usefulness of Heart Rate to Predict Cardiac Events in Treated Patients With High-Risk Systemic Hypertension

2012 ◽  
Vol 109 (5) ◽  
pp. 685-692 ◽  
Author(s):  
Stevo Julius ◽  
Paolo Palatini ◽  
Sverre E. Kjeldsen ◽  
Alberto Zanchetti ◽  
Michael A. Weber ◽  
...  
Keyword(s):  
Heart Rate ◽  
High Risk ◽  
Systemic Hypertension ◽  
Cardiac Events

scholarly journals What makes the psychosis ‘clinical high risk’ state risky: psychosis itself or the co-presence of a non-psychotic disorder?

2021 ◽  
Vol 30 ◽  
Author(s):  
Laila Hasmi ◽  
Lotta-Katrin Pries ◽  
Margreet ten Have ◽  
Ron de Graaf ◽  
Saskia van Dorsselaer ◽  
...  
Keyword(s):  
High Risk ◽  
Drug Use ◽  
Psychotic Disorder ◽  
Positive Family History ◽  
Mental Health Service Use ◽  
Psychotic Symptoms ◽  
Polygenic Risk Score ◽  
Clinical High Risk ◽  
Drug Use Disorders ◽  
Per Se

Abstract Aims Although attenuated psychotic symptoms in the psychosis clinical high-risk state (CHR-P) almost always occur in the context of a non-psychotic disorder (NPD), NPD is considered an undesired ‘comorbidity’ epiphenomenon rather than an integral part of CHR-P itself. Prospective work, however, indicates that much more of the clinical psychosis incidence is attributable to prior mood and drug use disorders than to psychosis clinical high-risk states per se. In order to examine this conundrum, we analysed to what degree the ‘risk’ in CHR-P is indexed by co-present NPD rather than attenuated psychosis per se. Methods We examined the incidence of early psychotic experiences (PE) with and without NPD (mood disorders, anxiety disorders, alcohol/drug use disorders), in a prospective general population cohort (n = 6123 at risk of incident PE at baseline). Four interview waves were conducted between 2007 and 2018 (NEMESIS-2). The incidence of PE, alone (PE-only) or with NPD (PE + NPD) was calculated, as were differential associations with schizophrenia polygenic risk score (PRS-Sz), environmental, demographical, clinical and cognitive factors. Results The incidence of PE + NPD (0.37%) was lower than the incidence of PE-only (1.04%), representing around a third of the total yearly incidence of PE. Incident PE + NPD was, in comparison with PE-only, differentially characterised by poor functioning, environmental risks, PRS-Sz, positive family history, prescription of antipsychotic medication and (mental) health service use. Conclusions The risk in ‘clinical high risk’ states is mediated not by attenuated psychosis per se but specifically the combination of attenuated psychosis and NPD. CHR-P/APS research should be reconceptualised from a focus on attenuated psychotic symptoms with exclusion of non-psychotic DSM-disorders, as the ‘pure' representation of a supposedly homotypic psychosis risk state, towards a focus on poor-outcome NPDs, characterised by a degree of psychosis admixture, on the pathway to psychotic disorder outcomes.

Gestação de alto risco: epidemiologia e cuidados, uma revisão de literatura / High risk pregnancy: epidemiology and care, a literature review

2021 ◽  
Vol 4 (4) ◽  
pp. 14860-14872
Author(s):  
Thaynara Oliveira Alves ◽  
Raynara Laurinda Nascimento Nunes ◽  
Luis Henrique Alves De Sena ◽  
Fernanda Gonçalves Alves ◽  
Aline Gomes Silva De Souza ◽  
...  
Keyword(s):  
High Risk ◽  
Literature Review ◽  
High Risk Pregnancy ◽  
Risk Pregnancy

scholarly journals Difficulties in the diagnosis of fungal rhinosinusitis – Literature review

2016 ◽  
Vol 6 (21) ◽  
pp. 11-17 ◽  
Author(s):  
Elena Patrascu ◽  
Claudiu Manea ◽  
Codrut Sarafoleanu
Keyword(s):  
Literature Review ◽  
Clinical Examination ◽  
Correct Diagnosis ◽  
Response To Treatment ◽  
Research Directions ◽  
Fungal Rhinosinusitis ◽  
Patients At Risk ◽  
Controversial Topic ◽  
Invasiveness Potential

Abstract Fungal rhinosinusitis is an important pathological entity, a highly controversial topic in the medical world today, by the various research directions it offers. In order to be able to predict a patient’s prognosis and his response to treatment, first we must have a classification of fungal rhinosinusitis. The authors considered it is important to make a distinction between invasive and noninvasive forms of fungal rhinosinusitis. The most important step in the management of fungal rhinosinusitis is to have a correct diagnosis, based on strong criteria, which will lead to a better prognosis of this disease. Because of its invasiveness potential, especially in patients at risk, it is essential to have a correct and fast diagnosis in case of fungal rhinosinusitis, in order to begin the treatment as fast as possible, for a favourable prognosis. The only way to establish diagnosis in a reliable way is to make a detailed clinical examination and to take biopsy samples.

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