Internal medicine
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Lacosamide is an antiepileptic drug that acts on voltage-gated sodium channels and was approved as an antiepileptic by the Food and Drug Administration in 2008. Although the efficacy and safety of lacosamide have been established in many previous trials, some case reports have shown that it may lead to cardiovascular side effects, especially in patients with electrical conduction system disorders. We herein report a case of life-threatening cardiac arrhythmia caused by lacosamide intoxication that was successfully treated with veno-arterial extracorporeal membrane oxygenation.
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Objective Considering the possibility that eosinophilic inflammation is involved in the pathogenesis of chronic epipharyngitis, this study determined whether or not the exhaled nitric oxide level of patients changed after epipharyngeal abrasive therapy (EAT). The diagnosis and follow-up of patients with chronic epipharyngitis were based on the endoscopic findings. If the exhaled nitric oxide level reflects the pathology of a patient with chronic epipharyngitis, the exhaled nitric oxide test can be performed for a follow-up examination as an objective test for chronic epipharyngitis. ⋯ When patients with chronic epipharyngitis were treated using EAT, exhaled nitric oxide levels were significantly lower after EAT than before EAT at the initial visit. Six months after EAT, the exhaled nitric oxide level was significantly lower than that at the initial visit. Conclusion During the follow-up examination of patients with chronic epipharyngitis, the exhaled nitric oxide test may be an effective objective test, along with changes in endoscopic findings.
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Objective We examined whether home blood pressure (BP)-based behavioural guidance had an additional anti-albuminuric effect on school workers with the simple diagnostic provision of microalbuminuria. Methods Of 169 school staff diagnosed with microalbuminuria (30-299.9 mg/gCr) in the annual 2019 health check-up, 91 agreed to receive home-BP-based guidance. Guidance comprised, for subjects with ≥135/85 mmHg, 5 days mean of home BP measurements, or encouraging medical consultation and lifestyle guidance; lifestyle guidance for subjects with BP 125-134/80-84 mmHg; and adequate lifestyle guidance for subjects BP <125/80 mmHg, if necessary. ⋯ Sensitivity analysis, excluding patients treated for hypertension or diabetes at baseline, demonstrated essentially similar results. In conclusion, the risk reduction of microalbuminuria was nearly 70% for both the home-BP-based guidance and non-guidance groups. Conclusion These data suggest that home BP-based guidance did not increase anti-albuminuric effects on simple diagnostic provision of microalbuminuria in school workers.