BACKGROUND Venlafaxine,a serotonin-norepinephrine reuptake inhibitor,is widely prescribed for the treatment of major depressive disorder.At therapeutic dose,it is generally safe,with a low incidence of adverse effects...BACKGROUND Venlafaxine,a serotonin-norepinephrine reuptake inhibitor,is widely prescribed for the treatment of major depressive disorder.At therapeutic dose,it is generally safe,with a low incidence of adverse effects.However,massive venlafaxine inge-stion can cause serious cardiotoxicity,leading to life-threatening arrhythmias.CASE SUMMARY A 31-year-old woman with a history of depression ingested 14.8 g of venlafaxine along with 6 mg of estazolam and 6 mg of flunitrazepam.On admission,2 hours post-ingestion,she presented only with mild QTc prolongation.At 4 hours post-ingestion,she developed a generalized tonic-clonic seizure.Following endo-tracheal intubation,intravenous midazolam infusion was initiated and 50 g of activated charcoal was administered via a nasogastric tube.At 15 hours post-ingestion,she developed ventricular tachycardia that rapidly progressed to refr-actory ventricular fibrillation,which was successfully treated with veno-arterial extracorporeal membrane oxygenation.Toxicological analysis revealed serum ve-nlafaxine and O-desmethylvenlafaxine concentrations 17µg/mL and 10µg/mL,respectively,at 15 hours post-ingestion.CONCLUSION In cases of massive venlafaxine ingestion,continuous intensive monitoring,particularly of QTc,is essential for at least 24 hours,even when initial clinical signs are mild.If refractory ventricular arrhythmias occur,prompt ini-tiation of veno-arterial extracorporeal membrane oxygenation should be considered.展开更多
Introduction: With the arrival of the 21st century, drastic worldwide changes to natural, economic and social events have occurred. These include the Great East Japan Earthquake, and the global financial crisis. Furth...Introduction: With the arrival of the 21st century, drastic worldwide changes to natural, economic and social events have occurred. These include the Great East Japan Earthquake, and the global financial crisis. Furthermore, Japan experienced the introduction of a specific education system. In this study, we traced and compared the psychological characters of university freshmen for 16 years (years 2000-2016) using Big-Five personalities inventory (Japanese version). Methods: A total of 1189 physically and mentally healthy university freshmen participated in this study. They were divided into four groups according to the year they entered university. They completed a self-filled questionnaire, Big-Five personalities inventory, which consists of Extraversion, Agreeableness, Neuroticism, Conscientiousness and Openness. Result and Discussion: Compared with the year 2008, Extraversion nominally increased in 2012, however, it statistically significantly decreased in 2016. Agreeableness notably decreased from 2000 to 2008, then showed an increase in 2012. Compared to 2000, Neuroticism was statistically significantly lower in 2008 and 2016. Such statistically significant differences were not observed in the other two personalities. The personalities of university freshmen have changed in the last 16 years, which may be been caused by drastic changes. However, further research (e.g., larger-scale studies or studies including other university students) is required to support the current findings.展开更多
文摘BACKGROUND Venlafaxine,a serotonin-norepinephrine reuptake inhibitor,is widely prescribed for the treatment of major depressive disorder.At therapeutic dose,it is generally safe,with a low incidence of adverse effects.However,massive venlafaxine inge-stion can cause serious cardiotoxicity,leading to life-threatening arrhythmias.CASE SUMMARY A 31-year-old woman with a history of depression ingested 14.8 g of venlafaxine along with 6 mg of estazolam and 6 mg of flunitrazepam.On admission,2 hours post-ingestion,she presented only with mild QTc prolongation.At 4 hours post-ingestion,she developed a generalized tonic-clonic seizure.Following endo-tracheal intubation,intravenous midazolam infusion was initiated and 50 g of activated charcoal was administered via a nasogastric tube.At 15 hours post-ingestion,she developed ventricular tachycardia that rapidly progressed to refr-actory ventricular fibrillation,which was successfully treated with veno-arterial extracorporeal membrane oxygenation.Toxicological analysis revealed serum ve-nlafaxine and O-desmethylvenlafaxine concentrations 17µg/mL and 10µg/mL,respectively,at 15 hours post-ingestion.CONCLUSION In cases of massive venlafaxine ingestion,continuous intensive monitoring,particularly of QTc,is essential for at least 24 hours,even when initial clinical signs are mild.If refractory ventricular arrhythmias occur,prompt ini-tiation of veno-arterial extracorporeal membrane oxygenation should be considered.
文摘Introduction: With the arrival of the 21st century, drastic worldwide changes to natural, economic and social events have occurred. These include the Great East Japan Earthquake, and the global financial crisis. Furthermore, Japan experienced the introduction of a specific education system. In this study, we traced and compared the psychological characters of university freshmen for 16 years (years 2000-2016) using Big-Five personalities inventory (Japanese version). Methods: A total of 1189 physically and mentally healthy university freshmen participated in this study. They were divided into four groups according to the year they entered university. They completed a self-filled questionnaire, Big-Five personalities inventory, which consists of Extraversion, Agreeableness, Neuroticism, Conscientiousness and Openness. Result and Discussion: Compared with the year 2008, Extraversion nominally increased in 2012, however, it statistically significantly decreased in 2016. Agreeableness notably decreased from 2000 to 2008, then showed an increase in 2012. Compared to 2000, Neuroticism was statistically significantly lower in 2008 and 2016. Such statistically significant differences were not observed in the other two personalities. The personalities of university freshmen have changed in the last 16 years, which may be been caused by drastic changes. However, further research (e.g., larger-scale studies or studies including other university students) is required to support the current findings.
