Publications by authors named "Jason H Kwah"
Diagnosis and clinical management of drug allergies in obstetrics and gynecology: an expert review.
Am J Obstet Gynecol
October 2024
Article Synopsis
- Drug allergies, especially to antibiotics like penicillin, are common in obstetrics and gynecology, affecting about 10% of the US population and complicating treatment options for infections.
- Using alternative antibiotics due to reported allergies can lead to significant complications such as increased surgery rates, longer hospital stays, and higher healthcare costs, plus a risk of severe reactions like anaphylaxis.
- More than 90% of those who claim a penicillin allergy can actually tolerate it, so allergy evaluations—including patient histories and tests—are recommended to ensure appropriate use of first-line antibiotics during pregnancy and beyond.
Article Synopsis
- Drug-induced hypersensitivity syndrome (DiHS), also known as DRESS, is a serious skin reaction that includes symptoms like fever and involvement of internal organs, commonly triggered by medications like anticonvulsants and antibiotics.
- The condition typically arises 2-6 weeks after drug exposure and is driven by a complex interaction between the drugs, viruses, and the immune system, particularly T-cells.
- This continuing medical education activity aims to inform healthcare professionals about the latest trends in DiHS/DRESS's epidemiology, underlying mechanisms, and clinical features for better prognosis and treatment.
Article Synopsis
- - Drug-induced hypersensitivity syndrome (DIHS) is a serious skin reaction that includes symptoms like rashes, fever, and problems with blood and organs, making it crucial to distinguish it from other similar conditions and diseases.
- - Although there are proposed diagnostic criteria for DIHS, there's no established consensus, so identifying the right cause can be complex and requires thorough evaluation.
- - The main treatment involves stopping the suspected drug immediately and using systemic corticosteroids, with ongoing research into alternatives; follow-up care is also essential to monitor for any long-term effects.
Article Synopsis
- The study aimed to compare antibiotic choices for treating Group B Streptococcus (GBS) in pregnant women with and without reported penicillin allergies and assess the impact on neonatal outcomes.
- The research analyzed 11,334 mother-infant pairs from a hospital over a 13-year period, finding that 10.3% of mothers had documented penicillin allergies, leading to a higher use of alternative antibiotics in these cases.
- Results showed that neonates of mothers receiving alternative antibiotics were more likely to undergo additional postnatal lab tests compared to those whose mothers received beta-lactam antibiotics, although no other significant neonatal outcome differences were observed.
Clinical Phenotypes of Immediate First-Dose Reactions to mRNA COVID-19: A Multicenter Latent Class Analysis.
J Allergy Clin Immunol Pract
February 2023
Article Synopsis
- This study aimed to categorize immediate allergic reactions after the first dose of mRNA COVID-19 vaccines and examine their relation to tolerance for the second dose.
- Researchers analyzed data from 265 patients who experienced allergic symptoms shortly after vaccination, identifying three distinct reaction phenotypes: Limited or Predominantly Cutaneous, Sensory, and Systemic.
- The majority of patients tolerated their second dose, but those in the Sensory phenotype (characterized by numbness or tingling) were more likely to experience intolerance, though this was not significant when considering objective signs.
Outpatient penicillin allergy evaluation during pregnancy and associated clinical outcomes.
Am J Obstet Gynecol MFM
September 2022
Article Synopsis
- A study evaluated a program at a large hospital that aimed to identify and test pregnant women with unverified penicillin allergies, as many do not have a true allergy and beta-lactam antibiotics are commonly needed during pregnancy.
- Of 689 women with documented penicillin allergies, 33.7% were referred for evaluation; 95.4% of those seen were eligible for testing, and 99.1% were found to be tolerant of penicillin.
- The findings suggested that referred women had a significantly lower chance of receiving alternative antibiotics compared to those who weren't referred, highlighting the importance of allergy verification in improving maternal and neonatal outcomes.
Article Synopsis
- This case series study investigates the safety of administering second doses of mRNA COVID-19 vaccines to individuals who experienced allergic reactions after their first dose.
- The research aims to understand the potential risks involved and determine if these individuals can safely receive their second vaccination.
- Findings from this study could provide crucial information for healthcare providers and patients regarding vaccination protocols for those with a history of allergies.
Background: Chronic rhinosinusitis (CRS) is complicated by frequent acute exacerbations leading to significant health care burden and impaired quality of life.
Objective: The objective of this study was to identify clinical factors associated with frequent acute exacerbation of CRS (AECRS).
Methods: This is a retrospective cohort study of patients with CRS from January 1, 2014, to May 31, 2016.
Article Synopsis
- Asthma affects about 5-8% of pregnant women and can be influenced by pregnancy-related changes, environmental factors, and medication adherence.
- Uncontrolled asthma can pose serious risks to both the mother and fetus, but managed asthma can lead to outcomes similar to those of non-pregnant women.
- Effective asthma management during pregnancy involves symptom evaluation, regular pulmonary function monitoring, patient education, and addressing any additional conditions like allergic rhinitis.
Article Synopsis
- The main goals of asthma treatment are to prevent serious health issues such as fatalities and exacerbations, maintain normal activity levels, reduce symptoms, and avoid harmful effects from medications.
- Treatment begins based on symptom severity, physical exams, and sometimes lung function tests, while also addressing comorbid conditions like allergies and sleep apnea.
- Specific therapies, such as allergen immunotherapy and biologics targeting type-2 inflammation, are available for allergic asthma; these treatments can reduce symptoms and medication usage but require careful consideration regarding patient adherence and therapy choice.
Article Synopsis
- - Rhinosinusitis is the inflammation of the paranasal sinuses, affecting about 12% of people, classified into acute (lasting less than 12 weeks) and chronic (lasting over 12 weeks), with three groups: CRS with nasal polyps, CRS without nasal polyps, and allergic fungal rhinosinusitis.
- - Nasal polyps, which occur in 20% of CRS patients, are fluid-filled growths caused by chronic inflammation, commonly presenting symptoms like congestion and loss of smell, and are associated with conditions such as asthma and cystic fibrosis.
- - Treatment for CRS includes intranasal corticosteroids, which effectively reduce polyp size and symptoms, while antibiotics are typically only suggested if
Article Synopsis
- * The study analyzed demographic data and noted that asthma, allergic rhinitis, gastroesophageal reflux disease, and antibody deficiency were significantly linked to CRS presence.
- * Findings suggest that CRS is prevalent in bronchiectasis patients and highlight the importance of considering these comorbid conditions in treatment and future research.