Diagnosing, managing and preventing anaphylaxis:Systematic review

Background This systematic review used the GRADE approach to compile evidence to inform the European Academy of Allergy and Clinical Immunology's (EAACI) anaphylaxis guideline. Methods We searched five bibliographic databases from 1946 to 20 April 2020 for studies about the diagnosis, management and prevention of anaphylaxis. We included 50 studies with 18 449 participants: 29 randomized controlled trials, seven controlled clinical trials, seven consecutive case series and seven case-control studies. Findings were summarized narratively because studies were too heterogeneous to conduct meta-analysis. Results It is unclear whether the NIAID/FAAN criteria or Brighton case definition are valid for immediately diagnosing anaphylaxis due to the very low certainty of evidence. There was also insufficient evidence about the impact of most anaphylaxis management and prevention strategies. Adrenaline is regularly used for first-line emergency management of anaphylaxis but little robust research has assessed its effectiveness. Newer models of adrenaline autoinjectors may slightly increase the proportion of people correctly using the devices and reduce time to administration. Face-to-face training for laypeople may slightly improve anaphylaxis knowledge and competence in using autoinjectors. We searched for but found little or no comparative effectiveness evidence about strategies such as fluid replacement, oxygen, glucocorticosteroids, methylxanthines, bronchodilators, management plans, food labels, drug labels and similar. Conclusions Anaphylaxis is a potentially life-threatening condition but, due to practical and ethical challenges, there is a paucity of robust evidence about how to diagnose and manage it

Human immunoglobulin G levels of viruses and associated glioma risk

Few consistent etiological factors have been identified for primary brain tumors. Inverse associations to asthma and low levels of varicella-zoster virus, immunoglobulin (Ig) levels in prevalent cases have indicted a role for the immune system in the development of glioma. Because samples from prevalent cases of glioma could be influenced by treatments such as steroids and chemotherapy, we investigated pre-diagnostic samples from three large Scandinavian cohorts. To test the hypothesis that immune response levels to these viruses are associated etiologically with glioma risk, we investigated pre-diagnostic immunoglobulin levels for cytomegalovirus (CMV), varicella-zoster virus (VZV), adenovirus (Ad), and Epstein-Barr virus (EBV) including the nuclear antigen (EBNA1) using plasma samples from 197 cases of adult glioma and 394 controls collected from population-based cohorts in Sweden and Denmark. Low VZV IgG levels were marginally significantly more common in glioma cases than the controls (odds ratio (OR) = 0.68, 95% CI 0.41–1.13) for the fourth compared with the first quartile (p = 0.06 for trend). These results were more prominent when analyzing cases with blood sampling at least 2 years before diagnosis (OR = 0.63, 95% CI 0.37–1.08) (p = 0.03). No association with glioma risk was observed for CMV, EBV, and adenovirus

Travelling concepts, metaphors, and narratives : literary and cultural studies in an age of interdisciplinary research

The notion of 'travelling concepts' has had a remarkable impact on recent approaches in literary and cultural studies. With the increasing focus on interdisciplinary and international collaborations, the dynamic travelling of concepts between different discipilnes and across academic research cultures has become ever more important for the humanities in general and the study of literature and culture in particular. As this book serves to show, these journeys are highly complex and, while being very productive, they often bear considerable risks. Through constant adaptation, translation, and reassessment across research areas, concepts, as well as metaphors and narratives, gain new or broader heuristic potential while being confronted with new challenges. This volume covers a wide variety of approaches to the mobility of concepts nad the metaphor of travelling, ranging from synchronic and diachronic journeys of theories, metaphors, and research practices to the travelling of narratives and their translations across spatial, temporal, and medial boundaires. Sixteen contributions from various fields of literary and cultural studies explore the potential of transfers between disciplines, social subsystems, cultures, and historical periods. These contributions invite readers to trace conceptual journeys while reflecting upon the challenges, obstacles, and transformations of concepts, metaphors, and narratives meet as they undergo academic, literary, and cultural transformation

Introducing travelling concepts and the metaphor o f travelling : risks and promises o f conceptual transfers in literary and cultural studies

The notion of 'travelling concepts' has had a remarkable impact on recent approaches in literary and cultural studies. With the increasing focus on interdisciplinary and international collaborations, the dynamic travelling of concepts between different discipilnes and across academic research cultures has become ever more important for the humanities in general and the study of literature and culture in particular. As this book serves to show, these journeys are highly complex and, while being very productive, they often bear considerable risks. Through constant adaptation, translation, and reassessment across research areas, concepts, as well as metaphors and narratives, gain new or broader heuristic potential while being confronted with new challenges. This volume covers a wide variety of approaches to the mobility of concepts nad the metaphor of travelling, ranging from synchronic and diachronic journeys of theories, metaphors, and research practices to the travelling of narratives and their translations across spatial, temporal, and medial boundaires. Sixteen contributions from various fields of literary and cultural studies explore the potential of transfers between disciplines, social subsystems, cultures, and historical periods. These contributions invite readers to trace conceptual journeys while reflecting upon the challenges, obstacles, and transformations of concepts, metaphors, and narratives meet as they undergo academic, literary, and cultural transformations

Hartgesotten hegemoniekritisch:Zu Ehren von Gabriele Dietze und Dorothea Dornhof

Feministinnen in Ost und West haben im Kontext marxistischer Diskurse schon früh darauf hingewiesen, dass Geschlecht keineswegs einen untergeordneten &#8216;Nebenwiderspruch‘ zum vermeintlichen Hauptwiderspruch des Klassengegensatzes darstellt. Vielmehr seien soziale Ungleichheitsachsen miteinander verwoben. Zuvor hatten PoC-Feministinnen auf den Zusammenhang von Sexismus und Rassismus aufmerksam gemacht. Im Zuge der ersten und zweiten &#8216;Welle‘ des Feminismus begannen feministische Künstler_innen und Aktivist_innen, transgressive Weiblichkeitsbilder auf der Folie binärer Geschlechterbilderzu entwerfen: Figuren wie die hartgesottene Detektivin, ermächtigende Monster oder kaltblütige Mörderinnen wurden zu notwendigen Gegenstrategien von Dämonisierung, Pathologisierung, Abwertung und Ausblendung des Weiblichen. Die Gender Studies haben Geschlecht als eine „wissensgenerierende und (wissens-)kritische Kategorie“ (Dietze/Hark 2006) in Bewegung definiert. Interventionen von Feministinnen of Color, postkolo- niale Perspektiven und queere Kritiken wiederum haben die Einheitlichkeit der Kategorie Geschlecht fundamental verunsichert. Sie machen für die Gender Studies die Notwendigkeit deutlich, Allianzen mit weiteren macht- und herrschaftskritischen Erkenntnisperspektiven zu suchen, und fordern ein, die eigenen Ausschlüsse und Hegemonietendenzen zu reflektieren. In diesem Zusammenhang spielen künstlerische Praktiken, kulturelle Artefakte und Ästhetiken sowie Popkultur eine entscheidende Rolle für die Sichtbarmachung marginalisierter Positionen. Dies erfordert eine (Selbst-)Kritik „okzidentaler (sexueller) Exzeptionalismen“ (Dietze), die über Geschlechterverhältnisse funktionieren, um den eigenen Kontext als emanzipiert darzustellen. Ebenso wichtig ist eine kritische Reflexion der Kategorie Gender selbst und ihr intersektionales Weiterdenken. Für die Dezentrierung von Macht und Wissen, auch über den akademischen Elfenbeinturm hinaus, sind Kollaborationen und Solidaritäten, strategische Essentialismen, Allianzen und Dialoge mit aktivistischen Kontexten und anderen Diskursen und Öffentlichkeiten unerlässlich.Donnerstag, 19. Januar 2017 13:30 Grußworte Christoph Holzhey, Beate Binder, Christina von Braun 14:00 Panel I: Kompliz_innen/Kollaborationen Claudia Brunner: Feminismus (un)kompliziert Sabine Hark: Was ist Kritik? Uber Dissidenz und Partizipation Jana Husmann: Gender hegemonial – Chancen von Streitkultur Moderation: Stefanie von Schnurbein 16:00 Pause 16:30 Panel II: Pop/Kultur Lisa Kuppler: Hard-Boiled Woman Revisited – Jessica Jones im Marvel Cinematic Universe Julie Miess: All Tomorrow’s Monsters Marietta Kesting: Goldene Zitronen – Race, Klasse und Gender in Beyonces „Lemonade“ Moderation: Eva Boesenberg 18:30 Pause 18:45 Abendvortrag Elahe Haschemi Yekani und Beatrice Michaelis: Partners in Crime. Von queerer Intersektionalität zu ethischem BegehrenHartgesotten hegemoniekritisch: Zu Ehren von Gabriele Dietze und Dorothea Dornhof, symposium, ICI Berlin, 19 January 2017 <https://doi.org/10.25620/e170119

EAACI guideline: Anaphylaxis (2021 update)

International audienceAnaphylaxis is a clinical emergency which all healthcare professionals need to be able to recognize and manage. The European Academy of Allergy and Clinical Immunology Anaphylaxis multidisciplinary Task Force has updated the 2014 guideline. The guideline was developed using the AGREE II framework and the GRADE approach. The evidence was systematically reviewed and recommendations were created by weighing up benefits and harms. The guideline was peer-reviewed by external experts and reviewed in a public consultation. The use of clinical criteria to identify anaphylaxis is suggested with blood sampling for the later measurement of tryptase. The prompt use of intramuscular adrenaline as first-line management is recommended with the availability of adrenaline autoinjectors to patients in the community. Pharmacokinetic data should be provided for adrenaline autoinjector devices. Structured, comprehensive training for people at risk of anaphylaxis is recommended. Simulation training and visual prompts for healthcare professionals are suggested to improve the management of anaphylaxis. It is suggested that school policies reflect anaphylaxis guidelines. The evidence for the management of anaphylaxis remains mostly at a very low level. There is an urgent need to prioritize clinical trials with the potential to improve the management of patients at risk of anaphylaxis

EAACI guidelines: Anaphylaxis (2021 update)

Anaphylaxis is a clinical emergency which all healthcare professionals need to be able to recognize and manage. The European Academy of Allergy and Clinical Immunology Anaphylaxis multidisciplinary Task Force has updated the 2014 guideline. The guideline was developed using the AGREE II framework and the GRADE approach. The evidence was systematically reviewed and recommendations were created by weighing up benefits and harms. The guideline was peer-reviewed by external experts and reviewed in a public consultation. The use of clinical criteria to identify anaphylaxis is suggested with blood sampling for the later measurement of tryptase. The prompt use of intramuscular adrenaline as first-line management is recommended with the availability of adrenaline autoinjectors to patients in the community. Pharmacokinetic data should be provided for adrenaline autoinjector devices. Structured, comprehensive training for people at risk of anaphylaxis is recommended. Simulation training and visual prompts for healthcare professionals are suggested to improve the management of anaphylaxis. It is suggested that school policies reflect anaphylaxis guidelines. The evidence for the management of anaphylaxis remains mostly at a very low level. There is an urgent need to prioritize clinical trials with the potential to improve the management of patients at risk of anaphylaxis

Diagnosing, managing and preventing anaphylaxis: systematic review

Background: This systematic review used the GRADE approach to compile evidence to inform the European Academy of Allergy and Clinical Immunology's (EAACI) anaphylaxis guideline. Methods: We searched five bibliographic databases from 1946 to 20 April 2020 for studies about the diagnosis, management and prevention of anaphylaxis. We included 50 studies with 18 449 participants: 29 randomized controlled trials, seven controlled clinical trials, seven consecutive case series and seven case-control studies. Findings were summarized narratively because studies were too heterogeneous to conduct meta-analysis. Results: It is unclear whether the NIAID/FAAN criteria or Brighton case definition are valid for immediately diagnosing anaphylaxis due to the very low certainty of evidence. There was also insufficient evidence about the impact of most anaphylaxis management and prevention strategies. Adrenaline is regularly used for first-line emergency management of anaphylaxis but little robust research has assessed its effectiveness. Newer models of adrenaline autoinjectors may slightly increase the proportion of people correctly using the devices and reduce time to administration. Face-to-face training for laypeople may slightly improve anaphylaxis knowledge and competence in using autoinjectors. We searched for but found little or no comparative effectiveness evidence about strategies such as fluid replacement, oxygen, glucocorticosteroids, methylxanthines, bronchodilators, management plans, food labels, drug labels and similar. Conclusions: Anaphylaxis is a potentially life-threatening condition but, due to practical and ethical challenges, there is a paucity of robust evidence about how to diagnose and manage it.</p