Anaphylaxis in Elderly Patients-Data From the European Anaphylaxis Registry

Background: Elicitors and symptoms of anaphylaxis are age dependent. However, little is known about typical features of anaphylaxis in patients aged 65 years or more. Methods: The data from the Network for Online Registration of Anaphylaxis (NORA) considering patients aged ≥65 (elderly) in comparison to data from adults (18–64 years) regarding elicitors, symptoms, comorbidities, and treatment measures were analyzed. Results: We identified 1,123 elderly anaphylactic patients. Insect venoms were the most frequent elicitor in this group (p < 0.001), followed by drugs like analgesics and antibiotics. Food allergens elicited less frequently anaphylaxis (p < 0.001). Skin symptoms occurred less frequently in elderly patients (77%, p < 0.001). The clinical symptoms were more severe in the elderly (51% experiencing grade III/IV reactions), in particular when skin symptoms (p < 0.001) were absent. Most strikingly, a loss of consciousness (33%, p < 0.001) and preexisting cardiovascular comorbidity (59%, p < 0.001) were more prevalent in the elderly. Finally, adrenaline was used in 30% of the elderly (vs. 26% in the comparator group, p < 0.001) and hospitalization was more often required (60 vs. 50%, p < 0.001). Discussion and Conclusion: Anaphylaxis in the elderly is often caused by insect venoms and drugs. These patients suffer more often from cardiovascular symptoms, receive more frequently adrenaline and require more often hospitalization. The data indicate that anaphylaxis in the elderly tends to be more frequently life threatening and patients require intensified medical intervention. The data support the need to recognize anaphylaxis in this patient group, which is prone to be at a higher risk for a fatal outcome

Installation and commissioning of the LINC-NIRVANA near-infrared MCAO imager on LBT

This paper reports on the installation and initial commissioning of LINC-NIRVANA (LN), an innovative high resolution, near-infrared imager for the Large Binocular Telescope (LBT). We present the delicate and difficult installation procedure, the culmination of a re-integration campaign that was in full swing at the last SPIE meeting. We also provide an update on the ongoing commissioning campaigns, including our recent achievement of First Light. Finally, we discuss lessons learned from the shipment and installation of a large complex instrument

Commissioning multi-conjugate adaptive optics with LINC-NIRVANA on LBT

This paper reports on early commissioning of LINC-NIRVANA (LN), an innovative Multi-Conjugate Adaptive Optics (MCAO) system for the Large Binocular Telescope (LBT). LN uses two, parallel MCAO systems, each of which corrects turbulence at two atmospheric layers, to deliver near diffraction-limited imagery over a two-arcminute field of view. We summarize LN's approach to MCAO and give an update on commissioning, including the achievement of First Light in April 2018. This is followed by a discussion of challenges that arise from our particular type of MCAO and the solutions implemented. We conclude with a brief look forward to the remainder of commissioning and future upgrades

Prosecutors’ perceptions on improving child witness interviews about abuse

This edited volume reviews the latest research on investigative interviewing in order to provide insights on the psychological processes of the person being interviewed as well as to offer guidelines for conducting credible and useful ..