Medical News

'Iodine allergy' label is misleading - Australian Prescriber

Constance H Katelaris, Professor, Clinical Immunology and Allergy, University of Western Sydney, and Campbelltown Hospital, Sydney; and William B Smith, Specialist, Clinical Immunology and Allergy, Royal Adelaide Hospital

Summary
'Iodine allergy' is not an accurate label for patients who have had allergic reactions to iodinated radiological contrast media or iodinated antiseptics. Allergy to seafood has nothing to do with iodine content as it is caused by specific immunoglobulin E to proteins. Seafood allergy is not a specific risk factor for reactivity to iodinated radiological contrast media, but a history of any moderate or severe allergic disorder confers a slight increase in risk. Patients with a previous history of allergy to radiological contrast media are at highest risk of a reaction. In some cases the risk of an allergic reaction to contrast media can be reduced by premedication, but, if previous reactions were severe, contrast media will usually remain contraindicated.

Key words: anaphylaxis, contrast media, seafood allergy.

(Aust Prescr 2009;32:125-8)

ICSS: Carotid endarterectomy superior to stenting, at least in the short term

From Medscape Medical News—a professional news service of WebMD

Stockholm, Sweden - Safety data from the International Carotid Stenting Study (ICSS), comparing carotid endarterectomy with stenting in patients with recently symptomatic carotid stenosis eligible for either procedure, shows superior results with surgery, at least at 30 days' postprocedure [1].

"We have provided in this randomized trial strong evidence that carotid endarterectomy is safer than carotid artery stenting in the primary intention-to-treat [ITT] analysis and also in the per-protocol analysis, where there were twice as many strokes associated with stenting as with carotid endarterectomy," principal investigator Dr Martin M Brown (University College London Institute of Neurology, UK) reported on behalf of ICSS investigators.

The difference in strokes was driven largely by nondisabling strokes associated with stenting, a finding that may have been balanced to some degree, Brown noted, by a much higher frequency of cranial nerve palsy seen with endarterectomy.

Still, he concluded, "Carotid endarterectomy is the treatment of choice for suitable patients with recently symptomatic carotid artery stenosis."

Their findings were presented at the European Stroke Conference 2009.

Michael DeBakey RIP

For those who do not know, Michael DeBakey passed away on June 11, 2008.
His obituary and a series of articles about him are available on the New York Times Website.

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