Anaphylaxis is a severe, life-threatening, generalised hypersensitivity reaction. It affects 1 in 1,333 (~0.08%) of the English population during their lives, with 1% of cases being fatal. Management, underpinned by guidance from the Resuscitation Council (UK), focuses on a thorough clinical assessment and prompt administration of intramuscular adrenaline. Symptoms may recur, so patients must be observed for a period of no less than six hours. In a deployed environment evacuation must be swift and into a safe environment capable of providing critical care support. There are clear occupational implications following a case of anaphylaxis, and a confirmed case may affect service personnel’s fitness to deploy. This article will summarise the management of anaphylaxis in Royal Naval personnel.
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Obstet Gynecol
January 2025
Department of Obstetrics, Gynecology and Reproductive Science, University of California, San Diego, San Diego, California; and the Department of Obstetrics, Gynecology and Reproductive Science, Mount Sinai Health System & Icahn School of Medicine at Mount Sinai, New York, and the Department of Obstetrics, Gynecology and Reproductive Science, New York City Health and Hospitals - Elmhurst Hospital Center, Elmhurst, New York.
Although peak serum total bile acid (TBA) levels guide management of intrahepatic cholestasis of pregnancy (ICP), whether ICP progresses in severity and when or how to assess bile acid levels serially remains unclear. We conducted a secondary analysis of a single-institution retrospective cohort study to assess bile acid trends across pregnancy among individuals diagnosed with ICP and to evaluate whether there was progression to higher ICP severity. We defined ICP severity as mild (peak TBA less than 40 micromol/L), moderate (peak TBA between 40 and 100 micromol/L), or severe (peak TBA 100 micromol/L or greater).
View Article and Find Full Text PDFAnnu Rev Public Health
January 2025
1Center for Health Policy Research, University of California, Los Angeles, California, USA; email:
Achieving health equity necessitates high-quality data to address disparities that have remained stagnant or even worsened over time despite public health interventions. Data disaggregation, the breakdown of data into detailed subcategories, is crucial in health disparities research. It reveals and contextualizes hidden trends and patterns about marginalized populations and guides resource allocation and program development for specific needs in these populations.
View Article and Find Full Text PDFJMIR Hum Factors
January 2025
Women's Health Research Institute, Vancouver, BC, Canada.
Background: Digital health innovations provide an opportunity to improve access to care, information, and quality of care during the perinatal period, a critical period of health for mothers and infants. However, research to develop perinatal digital health solutions needs to be informed by actual patient and health system needs in order to optimize implementation, adoption, and sustainability.
Objective: Our aim was to co-design a research agenda with defined research priorities that reflected health system realities and patient needs.
JMIR Form Res
January 2025
Faculty of Medicine, The University of Queensland, Brisbane, Australia.
Background: Opioid medications are important for pain management, but many patients progress to unsafe medication use. With few personalized and accessible behavioral treatment options to reduce potential opioid-related harm, new and innovative patient-centered approaches are urgently needed to fill this gap.
Objective: This study involved the first phase of co-designing a digital brief intervention to reduce the risk of opioid-related harm by investigating the lived experience of chronic noncancer pain (CNCP) in treatment-seeking patients, with a particular focus on opioid therapy experiences.
Pediatr Emerg Care
February 2025
Professor, Departments of Emergency Medicine and Pediatrics, University of Michigan, Ann Arbor, MI.
The presence of hypothermia among young infants in the emergency department may be a sign of serious or invasive bacterial infections, or invasive herpes simplex viral infection. However, hypothermia may also occur due to a variety of other infectious and noninfectious conditions or environmental exposure. In some settings, hypothermia may represent a protective, energy-conserving response to illness.
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