Recommended Readings

(1). David A Warrell et al. Clinical aspects of snakebite envenoming and its treatment in low-resource settings. Lancet 2023;401(10385):P1382-1398.

There is increasing recognition of the public health importance of snakebite envenoming. Worldwide annual incidence is likely to be 5 million bites, with mortality exceeding 150000 deaths, and the resulting physical and psychological morbidity leads to substantial social and economic repercussions. Prevention through community education by trained health workers is the most effective and economically viable strategy for reducing risk of bites and envenoming. Clinical challenges to effective treatment are most substantial in rural areas of low-resource settings, where snakebites are most common. Classic skills of history taking, physical examination, and use of affordable point-of-care tests should be followed by monitoring of evolving local and systemic envenoming. Despite the profusion of new ideas for interventions, hyperimmune equine or ovine plasma-derived antivenoms remain the only specific treatment for snakebite envenoming. The enormous interspecies and intraspecies complexity and diversity of snake venoms, revealed by modern venomics, demands a radical redesign of many current antivenoms.

(2). Lisa O’Mary. Cancer, Heart Disease Vaccines May Be Ready by 2030, Moderna Says. 2023

https://www.medscape.com/viewarticle/990670?ecd=WNL_trdalrt_pos1_ous_230417&uac=83814HV&impID=5343622

Vaccines for the world’s most deadly diseases, like cancer and heart disease, will likely be ready by 2030 and could save millions of lives, according to the top doctor at one the world’s leading drug companies.

(3). Janet E. Childerhose et al. Treating Chronic Pain in Sickle Cell Disease – The Need for a Biopsychosocial Model. N Engl J Med 2023; 388:1349-1351.

Chronic pain is the most common complication affecting adults with sickle cell disease (SCD).1 Pain profoundly affects people’s quality of life, functional ability, and health care utilization. Clinicians are often unsuccessful at addressing chronic pain in SCD, especially among the large number of patients for whom nonopioid analgesics aren’t sufficient and those who have developed opioid tolerance. Why aren’t we doing better?

We believe the medical community is looking at sickle cell pain through the wrong lens – treating it as a hematologic problem, while overlooking the neurologic, psychological, and social aspects of chronic pain. Given the current understanding of the neuropsychology of pain, the health care system has the ability to manage sickle cell pain more effectively. Doing so will require accepting a broader understanding of the experience of pain and devoting adequate resources to addressing its multiple dimensions.

(4). David M. Warmflash. 75 Years: A Look Back on the Fascinating History of Methotrexate and Folate Antagonists. 2023. https://www.medscape.com/viewarticle/987334

This article has been updated with information about Dr Yellapragada SubbaRow and his contribution to the development of methotrexate.