Long QT syndrome - causes and risk factors

Sudden cardiac death is a major public health challenge, which can be caused by genetic or acquired structural or electrophysiological abnormalities. These abnormalities include channelopathies such as long QT, short QT and Brugada syndromes. Long QT syndrome is a cardiac repolarization disorder and is associated with an increased risk of torsades de pointes (TdP). Main causes of acquired syndrome are specific medications and/or electrolytes imbalance. On the other hand common congenital causes are Jervell and Lange-Nielsen or Romano- Ward syndromes. Patients with risk factors, treated with specified QT prolongating drugs always require slow dose titration and electrocardiography monitoring. Aim of this study is to comprehensively and critically review the pathomechanisms of QT prolongation, risk factors and prevention methods

The new way of Dabigatran reversal – Idarucizumab

Since last few years a popularity of new oral anticoagulants significantly raised. There are following main direct oral anticoagulants (DOAC) used in therapy: Dabigatran, Rywaroxaban, Apixaban, Endoxaban. Dabigatran (Pradaxa) is the first oral direct thrombin inhibitor approved by FDA in stroke prevention in atrial fibrillation (AF). Anticoagulant effect occurs through direct thrombin binding. Unlike the vitamin K antagonists such as warfarin or acenokumarol, therapy with dabigatran has faster onset and offset action, doesn’t require routine monitoring has much less interactions. The main problem of treatment with dabigatran was difficulty in reversal of anticoagulant effect and overdose. Since three years the new antidote for dabigatran is available – Idarucizumab (Praxbind). Main indications for such use are dabigatran overdose, need of fast effect reversal before any interventions and life threatening bleeding. Despite other ways of anticoagulant effect reversal such as transfusion of plasma coagulation factors Idarucizumab is still highly recommended for direct use. Aim of this study is to review the new way of dabigatran reversal - Idarucizumab

Left atrial myxoma with concomitant coronary artery stenosis: comprehensive diagnosis and treatment

  A 69-year-old patient was admitted to the Department of Cardiology due to an accidental finding on a chest X-ray, enlarged heart outline, accompanied by worsening of heart failure to NYHA II with LVEF, about 30%. In the X-ray description, an enlargement of the left atrium silhouette with local calcifications. The patient underwent TTE, confirming the presence of a pedunculated tumor of the left atrium attached to the ceiling measuring 3.5x3.5x2.2 cm. Due to the ischemic heart disease manifestation patient uderwent coronarography confirming the presence of single-vessel coronary artery disease with changes in the middle segment of the LAD. Patient was treated with CABG LIMA-LAD surgery and removeal the left atrial tumor. Post operation tissue material prooved the preseance of left atrium myxoma. The postoperative course was uneventful, the patient was discharged home. &nbsp

Exposure to hydrogen peroxide – under the toxicologist eye

Introduction: Hydrogen peroxide is well soluble, odourless and colourless liquid with syrup consistency. It has different application depending on concentration. In 3% of concentration is present in almost every home as a disinfectant product, in higher concentration (35%) is used in pharmaceutical, chemical and cosmetic industry. The aim of the study: The purpose of this systemic review was to collect and analyse causes and possibilities of treatment a patient after ingestion a caustic substance. Material and method: Standard criteria were used to review the literature data. The search of articles in the PubMed and Google Scholar database was carried out using the following keywords: hydrogen peroxide, exposure, toxicology. Description of the state of knowledge: Exposure for hydrogen peroxide is not very common and most of the times is unintentional, except suicide attempts. Because it is a caustic substance and the main route of exposure is ingestion, most of symptoms are due to damage of gastrointestinal tract. However, the consequences of exposure range from short-time illness to brain damage or even death. Summary: Patient after exposure to >30% hydrogen peroxide should receive a complex treatment. Physicians need to be alert to the symptoms of not only gastrointestinal tract but also CNS. The patient may require specialized care by many specialists

Ligands of the CB2 cannabinoid receptors augment activity of the conventional antidepressant drugs in the behavioural tests in mice

Although a lot of information can be found on the specific dual role of the endocannabinoid system in the emotional-related responses, little is known whether stimulation or inhibition of the cannabinoid (CB) receptors may affect the activity of the frequently prescribed antidepressant drugs. Our interests have been particularly focused on the potential influence of the CB$_{2}$ receptors, as the ones whose central effects are relatively poorly documented when compared to the central effects of the CB$_{1}$ receptors. Therefore, we evaluated the potential interaction between the CB$_{2}$ receptor ligands (i.e., JWH133 - CB$_{2}$ receptor agonist and AM630 - CB$_{2}$ receptor inverse agonist) and several common antidepressant drugs that influence the monoaminergic system (i.e., imipramine, escitalopram, reboxetine). In order to assess the antidepressant-like effects we used two widely recognized behavioural tests, the mouse forced swim test (FST) and the tail suspension test (TST). Brain concentrations of the tested antidepressants were evaluated by the HPLC method. Intraperitoneal co-administration of per se ineffective doses of JWH133 (0.25 mg/kg) or AM630 (0.25 mg/kg) with imipramine (15 mg/kg), escitalopram (2 mg/kg), and reboxetine (2.5 mg/kg) significantly shortened the immobility time of mice in the FST and the TST, whereas it did not disturb their spontaneous locomotor activity. Furthermore, the brain levels of antidepressants were not changed. Summarizing, the results of the present study revealed that both activation and inhibition of the CB2 receptor function have a potential to strengthen the antidepressant activity of drugs targeting the monoaminergic system. Most probably, the described interaction has a pharmacodynamic background

Influence of the endocannabinoid system on the antidepressant activity of bupropion and moclobemide in the behavioural tests in mice

Background Though there are several classes of antidepressant drugs available on the pharmaceutical market, depression that affects globally over 320 million people is still undertreated. Scientists have made attempts to develop novel therapeutical strategies to maximize effectiveness of therapy and minimize undesired reactions. One of the ideas is use of either dual-action agents or combined administration of two substances that affect diverse neurotransmissions. Thus, we investigated whether the selected CB receptor ligands (oleamide, AM251, JWH133, and AM630) can have an impact on the activity of bupropion and moclobemide. Bupropion belongs to the dual acting drugs, whereas moclobemide is an inhibitor of monoamine oxidase. Methods The mice forced swim test and the tail suspension test were applied in order to determine the potential antidepressant-like activity, whereas the HPLC method was used in order to assess the brain concentrations of the tested antidepressants. Results An intraperitoneal injection of sub-effective doses of oleamide (5 mg/kg), AM251 (0.25 mg/kg), and AM630 (0.25 mg/kg) increased activity of bupropion (10 mg/kg) in both behavioural tests. Effects of moclobemide (1.5 mg/kg) were potentiated only by AM251. These results were not influenced by the hypo- or hyperlocomotion of animals. Conclusion The outcomes of the present study revealed that particularly activation or inhibition of the CB1 receptor function may augment the antidepressant activity of bupropion, whereas only inhibition of the CB1 receptor function manages to increase activity of moclobemide. Most probably, an interplay between CB receptor ligands and bupropion or moclobemide takes place at the cellular level

Treatement methodes for Long QT syndrome

Long QT syndrome (LQTS) is a potentially fatal cardiac disorder caused by channelopathies. Such arrhythmia is often life threatening and might cause sudden cardiac death. There are many reasons of LQTS especially: specific medications and/or electrolytes imbalance or congenital causes like Jervell and Lange-Nielsen or Romano- Ward syndromes. In recent years many ways of treatment have been developed. Except conservative treatment with B-blockers also two surgical methods improved, implantable cardioverter defibrillator (ICD) and left cardiac sympathetic denervation (LCSD). Techniques of LCSD evolved causing side effects more tolerable and lowering the risk of Horner's syndrome. Aim of this study is to review the role of sympathectomy in LQTS

Selected Natural Products in Neuroprotective Strategies for Alzheimer’s Disease—A Non-Systematic Review

Neurodegenerative disorders such as Alzheimer’s disease (AD) are distinguished by the irreversible degeneration of central nervous system function and structure. AD is characterized by several different neuropathologies—among others, it interferes with neuropsychiatrical controls and cognitive functions. This disease is the number one neurodegenerative disorder; however, its treatment options are few and, unfortunately, ineffective. In the new strategies devised for AD prevention and treatment, the application of plant-based natural products is especially popular due to lesser side effects associated with their taking. Moreover, their neuroprotective activities target different pathological mechanisms. The current review presents the anti-AD properties of several natural plant substances. The paper throws light on products under in vitro and in vivo trials and compiles information on their mechanism of actions. Knowledge of the properties of such plant compounds and their combinations will surely lead to discovering new potent medicines for the treatment of AD with lesser side effects than the currently available pharmacological proceedings

Selected Physical and Spectroscopic Properties of TPS Moldings Enriched with Durum Wheat Bran

The impact of the amount of durum wheat bran additive used on the selected structural, mechanical, and spectroscopic properties of thermoplastic starch moldings was examined in this study. Bran was added to corn starch from 10 to 60% by weight in the blends. Four temperature settings were used for the high-pressure injection: 120, 140, 160, and 180 °C. The highest value of elongation at break (8.53%) was observed for moldings containing 60% bran. Moreover, for these moldings, the tensile strength and flexural strength were lower (appropriately 3.43 MPa and 27.14 MPa). The highest deformation at break (1.56%) were obtained for samples with 60% bran and injection molded at 180 °C. We saw that higher bran content (50 and 60%) and a higher injection molding temperature (160 °C and 180 °C) significantly changed the color of the samples. The most significant changes in the FTIR spectra were observed at 3292 and 1644 cm−1 and in the region of 1460–1240 cm−1. Moreover, notable changes were observed in the intensity ratio of bands at 1015 and 955 cm−1. The changes observed correspond well with the amount of additive used and with the injection temperature applied; thus it may be considered as a marker of interactions affecting plasticization of the material obtained