New Alcohol Sensitivity in Patients With Post-acute Sequelae of SARS-CoV-2 (PASC): A Case Series.
2023; 15 (12): e51286
Post-acute sequelae of SARS-CoV-2 (PASC), or long COVID, is characterized by persistent symptoms after acute SARS-CoV-2 infection that can vary from patient to patient. Here, we present a case series of four patients with a history of SARS-CoV-2 infection referred to the Post-Acute COVID-19 Syndrome (PACS) Clinic at Stanford University for evaluation of persistent symptoms, who also experienced new-onset alcohol sensitivity. Alcohol reactions and sensitivity are not well characterized in the literature as it relates to post-viral illness. While there have been some anecdotal reports of new alcohol sensitivity in PASC patients in the media, there is a paucity of published data in the medical literature about this topic. During their medical consultation, the patients self-reported new changes in their symptoms or behaviors following the use of alcohol. A new onset of alcohol sensitivities should be assessed along with other post-COVID-19 symptoms and may provide novel avenues to explore the pathobiology of illness and potential interventions.
View details for DOI 10.7759/cureus.51286
View details for PubMedID 38288178
View details for PubMedCentralID PMC10823305
Postpartum long-acting reversible contraceptive use among active-duty, female U.S. Army soldiers.
American journal of obstetrics and gynecology
BACKGROUND: Postpartum utilization of long-acting reversible contraception (LARC) has been found to be effective at increasing inter-pregnancy intervals, reducing unintended pregnancies, and optimizing health outcomes for mothers and babies. Among female active-duty military members, reproductive planning may be particularly important, yet little is known about postpartum long-acting reversible contraceptive use among active-duty soldiers.OBJECTIVES: (1) To quantify postpartum uptake of long-acting reversible contraception among U.S. Army active-duty female soldiers, and (2) to identify demographic and military-specific characteristics associated with utilization.STUDY DESIGN: This retrospective cohort study used longitudinal data on all digitally recorded health encounters for active-duty U.S. Army soldiers from 2014-2017. The servicewomen included in our analysis were aged 18-44 years with at least one delivery and a minimum of four months of total observed time post-delivery within the study period. We defined postpartum long-acting reversible contraception utilization as initiation in the delivery month or in the three calendar months following delivery, and identified likely immediate postpartum initiation via the proxy of placement recorded during the same month as delivery. We then evaluated predictors of postpartum long-acting reversible contraception utilization using multivariable logistic regression.RESULTS: Inclusion criteria were met by 15,843 soldiers. Of those, 3,162 (19.96%) received a method of long-acting reversible contraception in the month of, or within the three months following, delivery. Fewer than 5% of these women utilized immediate postpartum long-acting reversible contraception. Among women receiving a postpartum long-acting reversible contraceptive method, 1,803 (57.0%) received an IUD, 1,328 (42.0%) received an etonogestrel implant and 31 received both (0.98%). Soldiers of younger age, self-reported White race, and those married or previously married were more likely to initiate long-acting reversible contraception in the postpartum period. Race-stratified analyses showed that self-reported White women had the highest utilization rates overall. Compared to these women, the adjusted odds of postpartum utilization among self-reported Black and Asian/Pacific Islander women were 18% and 30% lower, respectively (both p<0.001). There was also a trend of decreasing postpartum utilization with increasing age within each race group. Differences observed between age groups and race identities could partially be attributed to differential utilization of permanent contraception (sterilization), which was found to be significantly more prevalent among both women aged 30 years or older, as well as among Black-identifying women.CONCLUSION: Among active-duty U.S. Army servicewomen, one in five utilized postpartum long-acting reversible contraception, with fewer than 5 percent of these women utilizing an immediate postpartum method. Within this population with universal healthcare coverage, we observed relatively low rates of utilization and significant differences in uptake of effective postpartum long-acting contraceptive methods across self-reported race categories.
View details for DOI 10.1016/j.ajog.2023.07.023
View details for PubMedID 37460035