Anaphylaxis - top articles for July 2012

Here are my suggestions for some of the top articles about anaphylaxis for July 2012:

Epinephrine IM injection in the thigh (but not the upper arm) results in fastest rise of blood levels of epinephrine

Paucis Verbis: Anaphylaxis - from Academic Life in Emergency Medicine

Management of anaphylaxis in schools: Despite training, school personnel perform poorly when asked to demonstrate EpiPen

Anaphylaxis caused by skin contact with persulfates in hair-bleaching products - prick and patch tests can help

Lessons to Learn from Anaphylaxis Deaths - Atopic Girl's Guide to Living

FDA Sends Warning Letter to Pfizer Over EpiPen Ads - full text here:

Involvement of the dog allergen Can f 5 in a Case of Human Seminal Plasma Allergy

BMJ Learning @BMJLearning: Once again, our most popular module: Anaphylaxis: an update on management

Epinephrine in the treatment of anaphylaxis. Adult intramuscular dose is 0.3 to 0.5 ml of 1:1,000 concentration

Rapidly-disintegrating sublingual 40 mg epinephrine tablet had similar bioavailability to epi 0.3 mg autoinjector

Epinephrine Self-Administration in Anaphylaxis: EpiPen delivers 74%of dose vs. 26% for Anapen, Twinject, Adrenaclick - Syringe-based autoinjectors (eg, Anapen, Twinject, and Adrenaclick) are only capable of delivering 25.7% of the total 300 µg (77 µg or 0.08 mL of the 0.3 mL) of the dose contained in the device, whereas the EpiPen autoinjector (a cartridge-based device) delivers 74.3% (223 µg or 0.22 mL of the 0.3 mL) of the dose contained in its device.

The articles were selected from my Twitter stream @Allergy and Google Reader RSS subscriptions. Some of the top allergy accounts on Twitter contributed links. I appreciate the curation provided by @JuanCIvancevich @AllergyNet @IgECPD4 @DrAnneEllis @AACMaven @AllergieVoeding @allergistmommy @mrathkopf @wheezemd.

Please feel free to send suggestions for articles to and you will receive acknowledgement in the next edition of this publication.

Comments from Twitter:

Dr John Weiner @AllergyNet: That’s after 2.5secs. 10secs amount not reported. I have asked Anapen distributor in Australia to respond. Will follow-up

@Allergy: re: Epi & "That’s after 2.5secs. 10sec amount not reported" - 90% of EpiPen dose gets in 1 sec according to a recent Annals letter.

Dr John Weiner @AllergyNet: @Allergy Thanks Ves, useful info. Anapen distributor is seeing if their in-house registration data is available for release. Update: Aussie reg agency says Anapen delivers full dose.

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