FDA Approves New Epinephrine Injector That Talks

Sanofi US has introduced a new epinephrine injector (competitor to the more commonly known EpiPen made by Dey Pharma LP) that is equipped with audio and visual cues that helps a patient or care-giver administer epinephrine in cases of a severe allergic reaction (anaphylaxis).

Known as Auvi-Q, it was FDA approved Aug 13, 2012, and should soon become available for purchase by prescription.

Just like EpiPen, Auvi-Q comes in two different dosages of epinephrine... 0.3mg for patients who weigh more than 66 pounds and 0.15mg for those who weigh between 33 and 66 pounds. Each pack contains two devices with active drug plus a non-active training device.

During a life-threatening allergic reaction, Auvi-Q talks the patient or care-giver through each step of the injection process. If more time is needed, it can repeat the instructions step-by-step. The device also comes with written instructions printed on the side. In addition, there are visual cues with an alert light to signal when the injection is complete. Watch video.

Auvi-Q is about the size and shape of a credit card, the thickness of a cell phone and fits comfortably in a pocket or small purse. This size and shape is in contrast to the EpiPen which looks like a fat marker. Being compact and easy to carry should remove one obstacle that could be a reason why as many as two-thirds of patients do not carry their epinephrine injector device.

Like the EpiPen, the device also has an automatic retractable needle mechanism to prevent accidental needle sticks.

Source:
FDA Approves Auvi-Q Voice Activated Epinephrine Injector. EmaxHealth 8/13/12

Singer Nicki Minaj with Strained Vocal Cords

Media has reported that pop star Nicki Minaj had to cancel upcoming concerts in England due to injured vocal cords.

She apparently saw a doctor who diagnosed "strained vocal cords" after an x-ray and recommended voice rest for a few days.

The singer apparently ignored this advice and sang in New York City on Aug 18 causing her voice to substantially worsen resulting in her decision to cancel her concerts this weekend.

Details of her vocal cord condition are sparse. However, based on the limited information provided, there's a few things I can guess at.

First off, an x-ray can NOT diagnose any type of vocal cord condition. The singer must have undergone a trans-nasal endoscopic procedure which is the ONLY way to visualize the vocal cord and diagnose any vocal problems.

Given the singer was instructed to rest her voice for "a few days," she most likely suffered from a mild acute laryngitis causing inflamed vocal cords. By ignoring advice to rest her voice, she potentially turned a mild laryngitis into a more severe laryngitis. She probably did not suffer from any physical problems on her vocal cords like nodules or polyps which would take weeks if not months to recover (not days) as happened to singers Adele and John Mayer.

Really, at this point, strict voice rest, hydration, acid reflux control, and steroids (ie, prednisone) would enable her to recover her normal voice ASAP.

Here's a picture of a severe laryngitis (left) compared a normal appearing vocal cords (right). Note that the vocal cords are swollen and red compared to normal pearly white and thin appearance.

 

Source:
Nicki Minaj cancels U.K. concerts due to strained vocal cords. NBC News 8/18/12

Congressman Putney with Vocal Cord Cancer

Media has reported that Congressman Lacey Putney, chairman of the powerful Appropriations Committee in the House of Delegates, has early stage vocal cord cancer.

He is currently undergoing radiation therapy which has a high chance of cure with relatively minimal side effects along with voice preservation.

My suspicion is that he is suffering from squamous cell carcinoma which is the most common type of vocal cord cancer. Though radiation therapy is a common form of treatment for this type of early stage cancer, surgical excision without the need for radiation is also possible. No chemotherapy is necessary for early stage vocal cord cancer.

Below is a picture of an early stage right vocal cord squamous cell carcinoma.

Compare to normal:

Source:
Putney undergoing treatment for throat cancer. WSLS10 8/15/12