Publications by authors named "Patricia Rosen"

2 Publications

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Snake Eyes: Coral Snake Neurotoxicity Associated With Ocular Absorption of Venom and Successful Treatment With Exotic Antivenom.

J Emerg Med 2019 May 14;56(5):519-522. Epub 2019 Mar 14.

Department of Emergency Medicine, Baylor Scott and White Medical Center - Temple, Texas A&M Health Science Center College of Medicine, Temple, Texas.

Background: Coral snake bites from Micrurus fulvius and Micrurus tener account for < 1% of all snake bites in North America. Coral snake envenomation may cause significant neurotoxicity, including respiratory insufficiency, and its onset may be delayed up to 13 h.

Case Report: We present a unique patient encounter of M. tener venom exposure through the ocular mucous membranes and a small cutaneous bite, resulting in neurotoxicity. To our knowledge, this is the first reported case of systemic neurotoxicity associated with ocular contact with coral snake venom. Our patient developed rapid-onset skeletal muscle weakness, which is very uncommon for M. tener, along with cranial nerve deficits. Acquisition of antivenom was challenging, but our patient provides a rare report of resolution of suspected M. tener neurotoxicity after receiving Central American coral snake (Micrurus nigrocinctus) antivenom. Our patient subsequently developed serum sickness, a known delayed complication of antivenom. WHY SHOULD AN EMERGENCY PHYSICIAN BE AWARE OF THIS?: The emergency physician should be aware that coral snake venom may be absorbed through different routes. Neurotoxicity and respiratory insufficiency may be fatal and onset may be delayed up to 13 h. North American Coral Snake Antivenom is in very limited supply, so non-Food and Drug Administration-approved alternative coral snake antivenoms may be used for patients demonstrating neurotoxicity. Emergency physicians should be proactive in contacting a toxicologist to procure antivenom, as well as consideration of adjunctive treatments, such as neostigmine. Furthermore, whole immunoglobulin G products, such as antivenom, may result in immediate and delayed reactions.
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May 2019

Supporting women in labor: analysis of different types of caregivers.

Patricia Rosen

J Midwifery Womens Health 2004 Jan-Feb;49(1):24-31

Continuous labor support offers multiple benefits for mothers and infants. The type of caregiver that is the best support person in labor has not been identified. A critical review of the English language literature was conducted to describe the current state of knowledge on different types of labor support persons. Randomized trials and other published reports were identified from relevant databases and hand searches. Studies were reviewed and assessed by using a structured format. Eight randomized trials met the selection criteria for inclusion in this analysis. These trials investigated untrained and trained lay women, female relatives, nurses, lay midwives, and student lay midwives as labor support persons. Support by untrained lay women starting in early labor and continuing into the postpartum period demonstrates the most consistent beneficial effect on childbirth outcomes. However, more randomized controlled trials are warranted before firm conclusions may be drawn.
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March 2004