August 24th, 2011 by Paul Auerbach, M.D. in News, Research
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The current standard of care with regard to using antivenom for pit viper snakes (e.g., rattlesnakes, copperheads, cottonmouths) in North America is to use Crotalidae polyvalent immune Fab antivenom (CroFab;FabAV). This antivenom is created using a process that obtains antibodies “raised” by immunizing sheep and then harvesting and purifying the product. One of the major benefits of using this product is to take advantage of a lesser incidence of allergic reactions (than have traditionally been observed with previous products). It appears that the situation regarding the incidence of allergic reactions may be better than previously thought.
In the article, “Short Term Outcomes After Fab Antivenom Therapy for Severe Crotaline Snakebite,” Eric Lavonas, MD and colleagues (Ann Emerg Med 2011;57:128-137) examined Read more »
This post, Fab Antivenom Found To Cause Fewer Allergic Reactions Than Previously Thought, was originally published on
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August 20th, 2011 by Paul Auerbach, M.D. in Research
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Yellow fever is an affliction caused by a potentially lethal viral (flavivirus) hemorrhagic (causes bleeding) virus common in parts of Africa and South America. A highly effective vaccine made from live virus (known as the “17D vaccine”) is currently used to inject persons to prevent yellow fever; this vaccine is known to rarely cause serious adverse effects, namely, onset of allergic reactions, or a life-threatening or fatal infection that resembles yellow fever.
So, there is need for a safer (“nonreplicating”—in other words, not based on live virus) vaccine. In a recent article, “An Inactivated Cell-Culture Vaccine against Yellow Fever,” Thomas Monath, MD and his coauthors described their experience with a potentially safer vaccine (NEJM, 2011;364:1326-33). In their study, Read more »
This post, Advancement In Research For A Safer Yellow Fever Vaccine, was originally published on
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August 18th, 2011 by Paul Auerbach, M.D. in Health Policy
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Sichuan earthquake rescue workers carrying an injured person. In light of the widespread media coverage of natural disasters, such as the earthquake in Haiti and the tsunami in Japan, the public and medical professionals are aware of the anticipated immediate medical needs in these kinds of emergencies. However, it is less well known that after the initial management of life- and limb-threatening injuries, there may be an enormous need to provide care to persons with chronic illnesses. This is because they are displaced from their homes, become exposed to adverse environmental and socioeconomic hardships, lose access to healthcare, are deprived of their sources of medications, and so forth.
Some of my colleagues were allowed to enter Japan after the tsunami, and their observations agree with this assessment, which was also confirmed in a recent paper, “Chronic health needs immediately after natural disasters in middle-income countries: the case of the 2008 Sichuan, China earthquake,” authored by Emily Chan and Jackie Kim (Eur J Emerg Med 2011;18:111-114). The authors considered physical, social and public health preparedness. Read more »
This post, Chronic Health Needs Must Be Addressed After A Natural Disaster, was originally published on
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August 5th, 2011 by Paul Auerbach, M.D. in Health Tips
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Led by Andrew Luks MD and his colleagues, the Wilderness Medical Society has published Consensus Guidelines for the Prevention and Treatment of Acute Altitude Illness (Wild Environ Med 2010:21;146-155). These guidelines are intended to provide clinicians about best evidence-based practices, and were derived from the deliberations of an expert panel, of which I was a member. The disorders considered were acute mountain sickness (AMS), high altitude cerebral edema (HACE), and high altitude pulmonary edema (HAPE). The guidelines present the main prophylactic and therapeutic modalities for each disorder and provide recommendations for their roles in disorder management. The guidelines also provide suggested approaches to prevention and management of each disorder that incorporate the recommendations.
In outline format, here is what can be found in these Guidelines: Read more »
This post, Wilderness Medical Society Publishes Prevention And Treatment Tips For Altitude Sickness, was originally published on
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July 28th, 2011 by Paul Auerbach, M.D. in Health Tips
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As summer continues in North America, and for anyone who goes near the water during any time of year, prevention of drowning is very important. The American Academy of Pediatrics (AAP) takes its responsibilities on this issue seriously, and in 2010 issued a policy statement on prevention of drowning. This is a remarkable and well-thought out document that addresses all of the important issues associated with risk for and prevention of drowning. The online version of the policy statement, along with updated information and services, is available on the web.
The document points out that, historically, drowning has been the second leading cause of unintentional death in individuals aged one to 19 years, causing more than 1,100 deaths per year in the United States alone.
The AAP defines drowning as “the process of experiencing respiratory impairment from submersion/immersion in liquid.” It does not imply any particular outcome. Persons may “drown” and survive. The categories of outcomes include:
- death
- no morbidity
- morbidity (moderately disabled, severely disabled, vegetative state/coma, and brain death)
There is a discussion of entanglement in drains, particularly in females who are underwater with long hair near a suction outlet. Inflatable pools pose a particular hazard if they are not fenced.
The AAP has previously taken the stance that children are not developmentally ready for swimming lessons until after their fourth birthday. They based this opinion on factors including: Read more »
This post, Swimming May Not Be As Safe For Your Children As You Think, was originally published on
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