Anaesthesia, Surgery and Life-Threatening Allergic Reaction

NAP6 Report

Anaesthesia, Surgery and Life-Threatening Allergic Reactions

Report and findings of the Royal College of Anaesthetists' 6th National Audit Project

NAP6: Perioperative Anaphylaxis is the largest ever prospective study of anaphylaxis related to anaesthesia and surgery.

The full NAP6 Report is available in full as a single PDF, or as individual chapters below.

Some key findings of NAP6 are summarised on the NAP6 Infographic.
 NAP6 Infographic.pdf (718 KB)

Full Report

 NAP6-REPORT-2018 FINAL.pdf (11.75 MB)

Recent Advances in Drug-Induced Hypersensitivity Syndrome/Drug Reaction with Eosinophilia and Systemic Symptoms

Journal of Immunology Research
Volume 2018, Article ID 5163129, 10 pages
https://doi.org/10.1155/2018/5163129

Review Article

Hideaki Watanabe

Department of Dermatology, Showa University School of Medicine, Tokyo, Japan

Correspondence should be addressed to Hideaki Watanabe; hwatanabe@med.showa-u.ac.jp

Copyright © 2018 Hideaki Watanabe. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

Drug-induced hypersensitivity syndrome (DIHS), also termed as drug reaction with eosinophilia and systemic symptoms (DRESS), is a multiorgan systemic reaction characterized by a close relationship with the reactivation of herpes virus. Published data has demonstrated that among patients with DIHS/DRESS, 75–95% have leukocytosis, 18.2–90% show atypical lymphocytes, 52–95% have eosinophilia, and 75–100% have hepatic abnormalities. Histologically, eosinophils were observed less frequently than we expected (20%). The mainstay of DIHS/DRESS treatment is a moderate dose of systemic corticosteroids, followed by gradual dose reduction.

The Microbiome and Risk for Atherosclerosis

Viewpoint

Anthony L. Komaroff, MD¹

Author Affiliations Article Information

JAMA. Published online May 14, 2018. doi:10.1001/jama.2018.5240

Hot new areas of biomedicine sometimes generate cool skepticism. Little more than a decade ago, investigators proposed that the gut microbiome might be contributing to obesity. Since then, the microbiome has been linked to numerous major diseases, including atherosclerosis, although some have been skeptical about this association.

Atopic dermatitis: a review of topical nonsteroid therapy

• Drugs Context
• v.7; 2018
• PMC5886549

Drugs Context. 2018; 7: 212521.

Published online 2018 Apr 3. doi:  10.7573/dic.212521

PMCID: PMC5886549

PMID: 29632548

Ariana Papier, BA1 and Lindsay C Strowd, MD2

Author information ► Article notes ► Copyright and License information ► Disclaimer

Abstract
Background
Atopic dermatitis is a chronic inflammatory skin condition that affects up to 20% of children and 3% of adults globally. Although topical corticosteroids are considered to be the first-line agents, they can be associated with cutaneous and systemic adverse effects. Since the early 2000s, two new classes of nonsteroid topical therapies, topical calcineurin inhibitors and phosphodiesterase 4 (PDE4) inhibitors, have been introduced and provide a safe treatment alternative.

An update on molecular cat allergens: Fel d 1 and what else? Chapter 1: Fel d 1, the major cat allergen

B. Bonnet, K. Messaoudi, F. Jacomet, E. Michaud, J. L. Fauquert, D. Caillaud and B. Evrard

Allergy, Asthma & Clinical Immunology 2018, 14:14 | Published on: 10 April 2018 Abstract Background Cats are the major source of indoor inhalant allergens after house dust mites. The global incidence of cat allergies is rising sharply, posing a major public health problem. Ten cat allergens have been identified. The major allergen responsible for symptoms is Fel d 1, a secretoglobin and not a lipocalin, making the cat a special case among mammals.

Association Between Use of Acid-Suppressive Medications and Antibiotics During Infancy and Allergic Diseases in Early Childhood

Edward Mitre, MD¹; Apryl Susi, MS²; Laura E. Kropp, MPH¹; et al

David J. Schwartz, MD³; Gregory H. Gorman, MD²; Cade M. Nylund, MD²

Author Affiliations Article Information

JAMA Pediatr. Published online April 2, 2018. doi:10.1001/jamapediatrics.2018.0315

Audio(7:04)

Association Between Use of Acid-Suppressive Medications and Antibiotics During Infancy And Allergic Diseases in Early Childhood

Key Points

Question  Does use of medications that disturb the microbiome in infancy increase subsequent risk of developing allergic diseases?

Findings  In this cohort study of 792 130 children, the hazard of developing an allergic disease was significantly increased in those who had received acid-suppressive medications or antibiotics during the first 6 months of life.

Meaning  Exposure to acid-suppressive medications or antibiotics in the first 6 months of life may increase risk of allergic disease development.

Critical view of anaphylaxis epidemiology: open questions and new perspectives

Allergy, Asthma & Clinical Immunology201814:12

https://doi.org/10.1186/s13223-018-0234-0

Luciana Kase TannoEmail author,

Ana Luiza Bierrenbach,

F. Estelle R. Simons,

Victoria Cardona,

Bernard Yu-Hor Thong,

Nicolas Molinari,

Moises A. Calderon,

Margitta Worm,

Yoon-Seok Chang,

Nikolaos G. Papadopoulos,

Thomas Casale,

Pascal Demoly and

on behalf the Joint Allergy Academies

AbstractIn contrast to the majority of allergic or hypersensitivity conditions, worldwide anaphylaxis epidemiological data remain sparse with low accuracy, which hampers comparable morbidity statistics. Data can differ widely depending on a number of variables.

Social Media as a Catalyst for Policy Action and Social Change for Health and Well-Being: Viewpoint

Journal of Medical Internet Research

• Douglas Yeung, PhD 

ABSTRACT

This viewpoint paper argues that policy interventions can benefit from the continued use of social media analytics, which can serve as an important complement to traditional social science data collection and analysis. Efforts to improve well-being should provide an opportunity to explore these areas more deeply, and encourage the efforts of those conducting national and local data collection on health to incorporate more of these emerging data sources.

Social media remains a relatively untapped source of information to catalyze policy action and social change. However, the diversity of social media platforms and available analysis techniques provides multiple ways to offer insight for policy making and decision making. For instance, social media content can provide timely information about the impact of policy interventions. Social media location information can inform where to deploy resources or disseminate public messaging. Network analysis of social media connections can reveal underserved populations who may be disconnected from public services. Machine learning can help recognize important patterns for disease surveillance or to model population sentiment. To fully realize these potential policy uses, limitations to social media data will need to be overcome, including data reliability and validity, and potential privacy risks.

Traditional data collection may not fully capture the upstream factors and systemic relationships that influence health and well-being. Policy actions and social change efforts, such as the Robert Wood Johnson Foundation’s effort to advance a culture of health, which are intended to drive change in a network of upstream health drivers, will need to incorporate a broad range of behavioral information, such as health attitudes or physical activity levels. Applying innovative techniques to emerging data has the potential to extract insight from unstructured data or fuse disparate sources of data, such as linking health attitudes that are expressed to health behaviors or broader health and well-being outcomes.

J Med Internet Res 2018;20(3):e94

doi:10.2196/jmir.8508