tag:blogger.com,1999:blog-6248057085226614935.post33100803436622299..comments2024-03-20T03:09:24.173-05:00Comments on the short coat: One Way to Get a Fat Lip -Crickey!Lauren Westaferhttp://www.blogger.com/profile/10954779824260112126noreply@blogger.comBlogger6125tag:blogger.com,1999:blog-6248057085226614935.post-58446306408606553962012-12-17T21:49:53.473-06:002012-12-17T21:49:53.473-06:00Thank you so much, Lauren! I really appreciate you...Thank you so much, Lauren! I really appreciate your time and effort! Timhttps://www.blogger.com/profile/11261877096112108985noreply@blogger.comtag:blogger.com,1999:blog-6248057085226614935.post-70621264110544586262012-11-20T21:17:11.947-06:002012-11-20T21:17:11.947-06:00Hey, I'm certainly not an expert on this subje...Hey, I'm certainly not an expert on this subject. It sounds like that case was probably secondary to envenomation. However, in looking to answer your question, I did find case reports in pubmed of potentially exacerbated hypersensitivity to Hymenoptera, etc in individuals on ACE-inhibitors. These were collated in this report http://www.theannals.com/content/40/4/699.short but it certainly doesn't show causality, only potential association. Sorry I don't have a better answer for you!Lauren Westaferhttps://www.blogger.com/profile/10954779824260112126noreply@blogger.comtag:blogger.com,1999:blog-6248057085226614935.post-74255796638422496232012-11-13T16:50:03.537-06:002012-11-13T16:50:03.537-06:00Hi Lauren! Thanks so much for your blog. Been a fa...Hi Lauren! Thanks so much for your blog. Been a faithful reader for a while, and while only a paramedic (16 years in a very busy major urban EMS system) with hopes of moving into practice as a PA, this certainly is an excellent FOAMed resource for me! <br /><br />For this post in particular, I had a question that I haven't been able to find any good evidence for, although I suspect that there is some pathological similarities: While you can have ACE-I AE, have you heard of any patients presenting with an ACE-I anaphylaxis?I had an old student of mine who now works as a paramedic himself for a fire department call and described patient that he just treated for syncope following a sting from a yellow jacket to the top of the head while working in the yard. The yellow jacket was confirmed as two other insects were found in the man's t-shirt as his chest was exposed. The paramedic stated that the patient presented with clear breath sounds, a slight flush but without pronounced urticaria, no oral/tongue swelling but a chief complaint of syncope, a BP of 60/40ish, and had been started on lisinopril within the last couple of weeks. I had just read this post, had heard the PHARM podcast and was just thinking how similar these sounded. Thoughts?<br /><br />Thanks for your time,<br /><br />TimTimhttps://www.blogger.com/profile/11261877096112108985noreply@blogger.comtag:blogger.com,1999:blog-6248057085226614935.post-5699328246134320422012-10-23T17:57:27.558-05:002012-10-23T17:57:27.558-05:00I look forward to both the ecallantide in ACE-I AE...I look forward to both the ecallantide in ACE-I AE study and the guidelines for ACE-I AE. Thanks for keeping me abreast of these happenings!Lauren Westaferhttps://www.blogger.com/profile/10954779824260112126noreply@blogger.comtag:blogger.com,1999:blog-6248057085226614935.post-7604342548529022562012-10-22T19:06:46.022-05:002012-10-22T19:06:46.022-05:00We are just finishing a prospective, duble blinded...We are just finishing a prospective, duble blinded study with Ecallantide in ACE i angioedema - we have 46 patients to date with an n=50 - results to hopefully be published in the next 6 months.<br /><br />Although FFP has been touted as a possible therapy, many allergists state it can worsen the angioedema due to the bradykinin substrates in the FFP.<br /><br />This week, we (Department of Emergency Medicine at University of Cincinnati and the Division of Allergy and Immunology) will be hosting a meeting to develop ED consensus guidelines for the treatment of acute angioedema. Several prominent allergists as well as ED physicians (Camargo, Pines, Moellman, Collins, Nowak, Ward and Raja) will attempt to develop guidelines to address issues such as "when is fiberoptics necessary for evaluation " and "what is the best approach to the airway" in such individuals.<br /><br />I will keep you informed.<br /><br />Joseph Moellman, M.D.<br />Associate Professor of Emergency Medicine<br />University of CincinnatiAnonymousnoreply@blogger.comtag:blogger.com,1999:blog-6248057085226614935.post-63020779158856332152012-10-17T19:58:08.439-05:002012-10-17T19:58:08.439-05:00ACE-i AE is often oddly asymmetrical - ie one side...ACE-i AE is often oddly asymmetrical - ie one side of the tongue much more than the other which often makes me think of it. Anonymoushttps://www.blogger.com/profile/03106515699501055129noreply@blogger.com