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Fab Antivenom Found To Cause Fewer Allergic Reactions Than Previously Thought

Crofab AntivenomThe 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 Healthine.com by Paul Auerbach, M.D..

Advancement In Research For A Safer Yellow Fever Vaccine

Paperwork proving administration of a yellow fever vaccine.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 Healthine.com by Paul Auerbach, M.D..

Chronic Health Needs Must Be Addressed After A Natural Disaster

Sichuan earthquake rescue workers carrying an injured person. 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 Healthine.com by Paul Auerbach, M.D..

Wilderness Medical Society Publishes Prevention And Treatment Tips For Altitude Sickness

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 Healthine.com by Paul Auerbach, M.D..

Swimming May Not Be As Safe For Your Children As You Think

Lifeguard standing duty poolside.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 Healthine.com by Paul Auerbach, M.D..

Latest Interviews

IDEA Labs: Medical Students Take The Lead In Healthcare Innovation

It’s no secret that doctors are disappointed with the way that the U.S. healthcare system is evolving. Most feel helpless about improving their work conditions or solving technical problems in patient care. Fortunately one young medical student was undeterred by the mountain of disappointment carried by his senior clinician mentors…

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How To Be A Successful Patient: Young Doctors Offer Some Advice

I am proud to be a part of the American Resident Project an initiative that promotes the writing of medical students residents and new physicians as they explore ideas for transforming American health care delivery. I recently had the opportunity to interview three of the writing fellows about how to…

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Latest Book Reviews

Book Review: Is Empathy Learned By Faking It Till It’s Real?

I m often asked to do book reviews on my blog and I rarely agree to them. This is because it takes me a long time to read a book and then if I don t enjoy it I figure the author would rather me remain silent than publish my…

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The Spirit Of The Place: Samuel Shem’s New Book May Depress You

When I was in medical school I read Samuel Shem s House Of God as a right of passage. At the time I found it to be a cynical yet eerily accurate portrayal of the underbelly of academic medicine. I gained comfort from its gallows humor and it made me…

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Eat To Save Your Life: Another Half-True Diet Book

I am hesitant to review diet books because they are so often a tangled mess of fact and fiction. Teasing out their truth from falsehood is about as exhausting as delousing a long-haired elementary school student. However after being approached by the authors’ PR agency with the promise of a…

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