Fatal ampicillin-sulbactam anaphylaxis in a 34-year-old male.

A 34-year-old man receiving his first dose of ampicillin-sulbactam for osteomyelitis in a hospital setting experienced fatal drug-induced anaphylaxis.

Needs assessment for an infant and toddler food allergy curriculum for pediatric residents.

Background: The prevalence of pediatric food allergies is increasing. Although pediatric residents are frontline providers for children with food allergies, little is known about pediatric residents' educational experiences and comfort with infant and toddler food allergy. Methods: An anonymous online needs assessment survey was created and distributed to 64 residents in one residency program. The survey explored residents' knowledge sources, experience, and comfort in diagnosing, treating, and counseling patients with regard to food allergy and anaphylaxis. Results: Fifty-one pediatric residents (79.7%) completed the survey. Pediatric residents who had formal engagement with allergy-trained clinicians had 8.27 times the odds (odds ratio 8.27 [95% confidence interval, 1.16-59.01]; p = 0.035) of feeling comfortable in treating infant and toddler anaphylaxis compared with those who did not feel comfortable. Conclusion: These findings suggest that a standardized pediatric residency curriculum, in partnership with pediatric allergists, may present enhanced educational opportunities for pediatric residents.

Neighborhood social cohesion and sleep outcomes in the Native Hawaiian and Pacific Islander National Health Interview Survey.

Study Objective: Native Hawaiians and Pacific Islanders (NHPIs) have the lowest attainment of healthy sleep duration among all racial and ethnic groups in the United States. We examined associations of neighborhood social cohesion with sleep duration and quality. Methods: Cross-sectional analysis of 2464 adults in the NHPI National Health Interview Survey (2014). Neighborhood social cohesion was categorized as a continuous and categorical variable into low (<12), medium (12-14), and high (>15) according to tertiles of the distribution of responses. We used multinomial logistic regression to examine the adjusted odds ratio of short and long sleep duration relative to intermediate sleep duration. We used binary logistic regression for dichotomous sleep quality outcomes. Sleep outcomes were modeled as categorical variables. Results: Forty percent of the cohort reported short (<7 hours) sleep duration and only 4% reported long (>9 hours) duration. Mean (SE, range) social cohesion score was 12.4 units (0.11, 4-16) and 23% reported low social cohesion. In multivariable models, each 1 SD decrease in neighborhood social cohesion score was associated with higher odds of short sleep duration (odds ratio [OR]: 1.14, 95% confidence interval [CI]: 1.02, 1.29). Additionally, low social cohesion was associated with increased odds of short sleep duration (OR: 1.53, 95% CI: 1.10, 2.13). No associations between neighborhood social cohesion and having trouble falling or staying asleep and feeling well rested were found. Conclusion: Low neighborhood social cohesion is associated with short sleep duration in NHPIs.

Diet and Sleep Physiology: Public Health and Clinical Implications.

This mini-review examines the complex relationship between diet and sleep and explores the clinical and public health implications of the current evidence. Dietary quality and intake of specific nutrients can impact regulatory hormonal pathways to alter sleep quantity and quality. Sleep, in turn, affects the intake of total energy, as well as of specific foods and nutrients, through biological and behavioral mechanisms. Initial research in this field focused primarily on the effects of short sleep duration on nutritional quality. However, more recent studies have explored the dynamic relationship between long sleep duration and diet. Current evidence suggests that extremes of sleep duration alter sleep patterns, hormonal levels, and circadian rhythms, which contribute to weight-related outcomes and obesity, and other risk factors for the development of chronic disease such as type 2 diabetes and cardiovascular disease. These patterns may begin as early as childhood and have impacts throughout the life course. Given that non-communicable diseases are among the leading causes of death globally, deeper understanding of the interactions between sleep and nutrition has implications for both public health and clinical practice.