A Look at Anaphylaxis in America

A Look at Anaphylaxis in America

Anaphylaxis is an acute, life-threating condition that typically requires an ED visit, a prescription for medication, and physician follow-up. However, data regarding the prevalence of anaphylaxis in the United States are limited and vary widely. To help shed light on the state of anaphylaxis, Robert A. Wood, MD, and colleagues conducted random telephone surveys among the general U.S. adult population between July and November 2011. Results were published in the Journal of Allergy and Clinical Immunology. Using a stringent definition, the research team found that 1.6% of survey respondents “very likely” had anaphylaxis and that 5.1% had “probable” anaphylaxis. “Anaphylaxis is clearly a common condition, perhaps more than what has been estimated in prior surveys,” says Dr. Wood. “Furthermore, anaphylaxis is common among all age groups. It has been previously thought to be a pediatric problem, but our surveys focused entirely on adults. Healthcare providers will encounter anaphylaxis on a regular basis, and therefore should be inquiring about it while taking initial or integral medical histories.” Key Findings Beyond determining the prevalence of anaphylaxis, the researchers sought to gather information on the symptoms and triggers of anaphylactic reactions as well as how patients reacted to episodes in terms of accessing healthcare and using medications. After conducting a survey of the general population (public survey), a second survey was conducted targeting a higher-risk population of subjects with a history of allergic reactions (patient survey). “The symptoms typically thought to accompany anaphylaxis, such as skin reactions and respiratory issues, were indeed the most common among both groups,” says Dr. Wood (Figure). “Other common symptoms involved the gastrointestinal, cardiovascular, and neurologic systems....

Key Factors in Weight Gain After Pediatric Tonsillectomy

Studies have indicated that adenotonsillectomy may be associated with significant weight gain after surgery, a problem that can be concerning for both parents and patients. Previous research also suggests that the postoperative weight gain associated with adenotonsillectomy occurs mostly in children who undergo the procedure as treatment for diagnosed obstructive sleep apnea (OSA). “Potentially worrisome weight gains following adenotonsillectomy occurred primarily in children under the age of 6 years who were underweight or normal weight to begin with.” At the 2012 annual meeting of the American Academy of Otolaryngology–Head and Neck Surgeons, my colleagues and I presented data from a study involving a large population of children undergoing adenotonsillectomy and the demographic factors that may contribute to weight gain. We analyzed medical records of children aged 6 months to 18 years who had their tonsils removed between 2008 and 2011. These data were then refined to only include medical records for children who were routinely examined for at least 6 months after their surgery and had recorded height and weight measurements. All patients in the study had a history of OSA or recurrent tonsillitis. Who’s At Risk for Weight Gain? Results of our analysis showed that, on average, patients had a weight gain of 0.5 to 2.0 lbs— equivalent to a 0.4- to 0.6-point increase in BMI scores—after their surgery. Importantly, the gains that were observed were not dependent on whether the children had OSA or recurrent tonsillitis. In a multiple linear regression analysis that controlled for gender and height, only age was significantly and negatively associated with changes in BMI. Potentially worrisome weight gains following adenotonsillectomy occurred primarily...