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Cost-effectiveness of watchful waiting versus immediate emergency department transfer after epinephrine autoinjector use in Canada.
Allergy Asthma Clin Immunol
January 2025
Collaboration for Outcomes Research and Evaluation, Faculty of Pharmaceutical Sciences, University of British Columbia, 2405 Wesbrook Mall, Vancouver, BC, V6T 1Z3, Canada.
Background: Until recently, immediate emergency department (ED) transfer after food-related anaphylactic reactions was recommended regardless of symptom resolution following use of an epinephrine autoinjector (EAI). We evaluated the cost-effectiveness of delayed ED transfer after EAI use in non-medical settings (watchful waiting) compared to immediate ED transfer among pediatric patients with food allergies in Canada.
Methods: We developed a probabilistic Markov model of individuals starting at age of one year who are at risk of severe food-related allergic reactions requiring epinephrine.
Combined T1-weighted MRI and diffusion MRI tractography of paraventricular, locus coeruleus, and dorsal vagal complex connectivity in brainstem-hypothalamic nuclei.
J Biol Methods
November 2024
Department of Psychiatry, Massachusetts General Hospital, Harvard Medical School, Boston, Massachusetts 02114, United States.
Background: Current multimodal neuroimaging plays a critical role in studying clinical conditions such as cardiovascular disease, major depression, and other disorders related to chronic stress. These conditions involve the brainstem-hypothalamic network, specifically the locus coeruleus (LC), dorsal vagal complex (DVC), and paraventricular nucleus (PVN) of the hypothalamus, collectively referred to as the "DVC-LC-PVN circuitry." This circuitry is strongly associated with the norepinephrine (NE) and epinephrine (E) neurotransmitter systems, which are implicated in the regulation of key autonomic functions, such as cardiovascular and respiratory control, stress response, and cognitive and emotional behaviors.
View Article and Find Full Text PDFEffect of epinephrine administration interval on cerebral perfusion in a porcine cardiac arrest model.
Am J Emerg Med
January 2025
Laboratory of Emergency Medical Services, Seoul National University Hospital Biomedical Research Institute, Seoul, South Korea.
Objectives: The recommended epinephrine administration interval during CPR is between 3 and 5 min. However, the optimal interval for improving cerebral perfusion remains controversial. This study aimed to evaluate the effects of epinephrine administration interval of 3 min or 5 min on cerebral perfusion pressure (CEPP) and cortical cerebral blood flow (CCBF) in a porcine cardiac arrest model.
View Article and Find Full Text PDFConcomitant pheochromocytoma and hyperaldosteronism in a 47-year-old man: a case report.
J Med Case Rep
January 2025
Cardiovascular Surgery Department, Shahid Rajaee Hospital, Alborz University of Medical Sciences, Karaj, Iran.
Background: The coexistence of pheochromocytoma and hyperaldosteronism is a rare and clinically significant finding with diagnostic challenges that need to be considered in the workup of patients with hypertension.
Case Presentation: This case report describes a 47-year-old Iranian man who initially presented with cold symptoms, chills, and headaches. Despite being diagnosed with panic disorder, his symptoms worsened, leading to a systolic blood pressure crisis.
Integrated Phase I Pharmacokinetics and Pharmacodynamics of Epinephrine Administered via Sublingual Film, Autoinjector, or Manual Injection.
Ann Allergy Asthma Immunol
January 2025
Department of Emergency Medicine, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA.
Background: Epinephrine is the first-line treatment for anaphylaxis and is administered via intramuscular (IM) or subcutaneous (SC) injection. AQST-109, a sublingual film containing a prodrug of epinephrine, is in development as an alternative delivery method for the treatment of severe allergic reactions including anaphylaxis.
Objective: To compare the pharmacokinetics (PK) and pharmacodynamics (PD) of epinephrine following administration of AQST-109 to epinephrine delivered by manual IM injection and epinephrine autoinjectors (EAIs).
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