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Paediatrics
Published in Dave Maudgil, Anthony Watkinson, The Essential Guide to the New FRCR Part 2A and Radiology Boards, 2017
Dave Maudgil, Anthony Watkinson
Are the following statements regarding dextro-transposition true or false? It is characterised by ventriculoarterial discordance and atrioventricular concordance.The classic plain film appearance is ‘egg on side’.It is due to faulty cleavage of the bulbus cordis.It is more common in females.It results in acyanotic congenital heart disease.
Selective serotonin reuptake inhibitors and the risk of congenital anomalies: a systematic review of current meta-analyses
Published in Expert Opinion on Drug Safety, 2020
The relationship between maternal use of paroxetine and the risk of major anomalies was found to be statistically significant in 4 out of 5 meta-analyses [OR/RR = 1.18 (95% Cl = 1.05–1.1.32) −1.29) (95% Cl = 1.11–1.49)] [10,13,14,17,23] and cardiovascular defects in 6 out of 7 meta-analyses [OR/RR = 0.97 (95% Cl = 0.75–1.19) – 1.46 (95% Cl = 1.17–1.82)] [10,13–17,23]. Among specific cardiovascular anomalies, the risks of right ventricular outflow track defects [OR/RR = 2.15 (95% Cl = 1.04–4.44) – 2.29 (95% Cl = 1.06–4.93)] [17,23], bulbus cordis and cardiac septal closure anomalies [OR = 1.42 (95% Cl = 1.07–1.89)] [17] but not septal defects [OR = 0.78 (95% Cl = 0.32–1.82) – 1.58 (95% Cl = 0.90–2.78) [14,23] and VSD [OR/RR = 1.26 (95% Cl = 0.69–2.32) – 1.37 (95% Cl = 0.90–2.08) [17,23] were significantly higher in infants exposed to paroxetine compared to unexposed infants. Among other system anomalies, only eye-related defects were found to be statistically significant (RR = 2.26 (95% Cl = 1.04–4.44) [23]. The reported OR/RR were 2.06 (95% Cl = 0.92–4.60) and 2.38 (95% Cl = 1.14–4.97) for ASD [17,23]; however, the difference between infants exposed and unexposed to paroxetine was statistically significant solely in the meta-analysis by Bérard et al. [17]. These authors also reported that the ORs reported for major anomalies [OR = 1.28 (95% Cl = 0.74–2.22)] and cardiac defects [OR = 1.33 (95% Cl = 0.87–1.71] in comparisons between women with depressive and/or anxiety disorders and women who received paroxetine were similar to those reported ORs for comparisons (1.21and 1.27, respectively) between women exposed and unexposed to paroxetine in the total sample. In contrast, Gao et al. [23] found no significant association between the risk of major anomalies [RR = 1.17 (95% Cl = 0.97–1.41] and cardiovascular anomalies [RR = 1.27 (95% Cl = 0.89–1.80)] when the analyses were restricted to women with a psychiatric disorder.