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Tricyclic antidepressants (TCAs) are a drug class that were first released to the market in 1959 as a pharmacotherapy for major depressive disorder (MDD). Today, TCAs are Food and Drug Administration (FDA) approved to treat a variety of illnesses, depending on the formulation. TCAs that have FDA approval to treat MDD include amitriptyline, amoxapine, doxepin, desipramine, nortriptyline, protriptyline, imipramine, and trimipramine. Clomipramine is FDA approved for obsessive-compulsive disorder (OCD) in ages ten and older.Histamine is one of the earliest identified mediators of allergy. Researchers identified its role in the modulation of allergic reactions as early as 1932. Since then, research has determined histamine to be a mediator of autoimmune conditions, gastric acid secretion, and hematopoiesis. Histamine is present within all bodily tissues; however, its sites of highest concentration include the lungs, basophils, and mast cells. It is also a potent vasoactive agent through its effects on bronchial smooth muscles and nociceptive itch nerves. Histamine regulates a variety of physiological functions by playing a key role in the inflammatory response of the body. It also has a vital role in various pathomechanisms of inflammatory diseases, which have led to the identification of novel histamine receptors over the years and greater recognition of its functions in the immune system.A single ventricle or univentricular heart is a broad term covering various cardiac structural abnormalities in which one ventricle is severely underdeveloped, or a ventricular septal wall did not form. Through various mechanisms, the anomalous structure typically results in the mixing of oxygenated and deoxygenated blood. Occurrences are generally caused by genetic factors, though environmental factors are known to promote malformation.Procainamide is a medication used in the management and treatment of ventricular arrhythmias, supraventricular arrhythmias, atrial flutter, atrial fibrillation, AV nodal re-entrant tachycardia, and Wolf-Parkinson-White syndrome. It is a Class 1A antiarrhythmic agent. This activity reviews the literature, indications, action, and contraindications for procainamide as a valuable agent in the treatment of arrhythmias.Erythromelalgia is a rare clinical syndrome characterized by a triad of redness, warmth, and burning pain, most notably affecting the extremities. It usually affects the lower extremities (most commonly feet) or may involve upper extremities (hands) in few cases. The episodes are typically precipitated by exercise and relieved by cooling the affected parts. Although erythromelalgia is typically bilateral, it can present unilaterally, especially in secondary cases. Atypical cases presenting with lesions and symptoms solely involving the face have been observed; however, they are extremely rare and are often misdiagnosed. Other terms used to describe the erythromelalgia are burning feet syndrome, erythermalgia, Gerhardt disease, and Mitchell disease. The term erythromelalgia is derived from the Greek words erythros, meaning "red," melos meaning "limb," and algos meaning "pain." It was first described in 1878 by Silas Weir Mitchell and was initially termed "Mitchell Disease." Smith and Allen proposed another term erythermalgia in 1938 to emphasize the characteristic warmth of this syndrome. Two gentlemen from the Netherland by the names of Drenth and Michiels proposed the name erythromelalgia in 1990. Classification The term erythromelalgia and erythermalgia were differentiated on the basis of responsiveness to aspirin by Drenth and Michiels and following three categories were established (a) Erythromelalgia in thrombocythemia It is platelet mediated and aspirin responsive. This occurs in association with essential thrombocytosis and polycythemia vera. (b) Primary erythermalgia Refers to an idiopathic or inherited disorder. Also called aspirin resistant erythermalgia of unknown origin. (c) Secondary erythermalgia Aspirin resistant and associated with different medical conditions.Airway patency and adequate respiratory effort are both essential for normal oxygenation and ventilation within the body so that normal physiological processes can proceed without metabolic derangement. This is even more important in patients with acute illness or injury that gives rise to increased metabolic demand. Accordingly, safe and effective airway management is a core skill for clinicians involved in prehospital emergency medical services (EMS). The variable and hazardous nature of the prehospital environment introduces a number of unique complexities that are not seen in hospital-based emergency care, such as poor patient positioning, limited backup, a restricted choice of equipment, and low ambient light. Tat-beclin 1 activator These may result in a patient’s airway being “situationally difficult” to manage, obliging the EMS clinician to use modified techniques and decision-making processes. This article focuses on some specific examples of technical and non-technical challenges that may be encountered and present general principles for prehospital management of the airway under adverse conditions.Potassium is the predominant cation of intracellular fluid. As a component of extracellular fluid, potassium has a normal range of approximately 3.5 to 5.0 mEq/L. Potassium levels below this range, or hypokalemia, broadly result from increased excretion, decreased intake, and increased movement into cells. Regardless of the cause, hypokalemia is a significant clinical derangement to address due to the increased risk of life-threatening cardiac arrhythmias. Potassium chloride (KCl) is the preferred agent for correcting most presentations of hypokalemia.A chromosome is a DNA molecule that contains the genetic information for an organism. The structure of the chromosome is composed of the DNA of the organism and special proteins to form the dense, coiled architecture. The tertiary structure of the chromosome is a crucial component in transcription regulation and cellular replication and division.During normal pregnancy, the female body undergoes physiologic changes in almost every organ system to harbor the growing fetoplacental unit. The hematologic system is no exception to this convention as the maternal blood undergoes changes both in quantity as well as its constitution. The constituents of maternal blood are testable to screen and diagnose a wide variety of conditions relating to both healthy pregnancies as well as diseases associated with pregnancy. A little before reaching full term, the volume of maternal blood is about 30% above baseline. The excess is likely due to increased levels of estrogen and aldosterone, which cause the kidneys to retain higher amounts of fluid. A higher number of erythrocytes accompanies this excess fluid with a slightly increased mean corpuscular volume in a healthy pregnancy. Therefore, at delivery, there are between 1 to 2 liters of excess blood in the maternal circulatory system. The prominent hematologic changes are physiologic anemia, expanded plasma volume, mild thrombocytopenia, a mild prothrombotic state, and in some individuals, mild neutrophilia.