Chicken or egg? 5-year-old not confused

Chicken or egg? 5-year-old not confused

Poets and philosophers long have argued chicken/egg algorithms. And scientists have argued food allergy/eczema scenarios. For years it was felt food allergy was the seminal event preceding eczema. The natural history and logic of this position are hard to dismiss. Even a 5-year-old who recently completed his allergy testing to better understand his skin rash, (which showed strong positives to both egg white and egg yolk), asked me why he needed to have these tests for his “eggs-ema.” Wasn’t it…

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Allergenic children born that way

Allergenic children born that way

Infants who have food allergy display a pro-inflammatory profile at the time of birth in their umbilical cord blood. So say research scientists at the University of Melbourne. They found that the length of a woman’s labor seemed to lead to greater numbers of white blood cells that produce inflammatory proteins (called cytokines). In other words: short labor also leads to less chance of food allergy; long labor leads to a greater chance of food allergy.

Dear Doc: How long can I count on my Epipen?

Dear Doc: How long can I count on my Epipen?

Dear Dr. K: I keep an Epipen for “just in case,” but so far I have never had to use it. I keep replacing it when it expires, but it is expensive. Is it possible to use it past its expiration date?  The answer is “yes, probably.” The “probably” is based on the clarity of the liquid. If, when you look through the syringe and the medicine is clear, then it’s both safe and effective. If the liquid is yellow…

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Not allergy, but relief offered

Not allergy, but relief offered

Pityriasis rosea is not an allergic condition but is frequently seen by allergists as its main manifestation is a skin rash that looks “temptingly allergic” in nature. This rash is preceded by a single spot called the “herald patch.” This clue is sometimes missed because it appears in a hidden spot on the body such as the back or armpit. Within one to two weeks of the herald, a generalized rash appears. The spots are circular to oval in shape…

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Long study of steroids in childhood asthma released

Long study of steroids in childhood asthma released

The results of a Harvard study done over the past 25 years on childhood asthma are somewhat distressing. The research was published in a recent edition of The New England Journal of Medicine. Known as CAMP – Childhood Asthma Management Program – the study allowed long-term outcomes to be determined. It compared the use of a daily inhaled steroid versus placebo for the first 4.5 years. Then the children were returned to the care of their pediatricians and followed for…

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Q – Tips: phenylephrine

Q – Tips: phenylephrine

A recent double-blind study comparing phenylephrine to placebo showed no measurable difference in reducing nasal congestion. For people who need/use pseudoephedrine for their congestion, it is available “behind the counter” and must be signed for.

Dear Doc: Wheat, gluten, inflammation — baffling!

Dear Doc: Wheat, gluten, inflammation — baffling!

Dear Dr. K: I’ve had a blood test for gluten sensitivity, allergy tests for wheat and even an intestinal biopsy for celiac. All the tests are negative, but I still feel better when I avoid wheat. What gives? What gives is that wheat is not good for you. No medical test is perfect. Even “gold standard” tests such as chest X-ray for pneumonia or cardiac catheterization for coronary blockage sometimes fail to demonstrate an existing abnormality. The bottom line is…

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Drug hypersensitivity genetic?

Drug hypersensitivity genetic?

The most common cause for drug allergy is from IgE-mediated (allergic) reactions, such as having hives from penicillin. New research is discovering a second mechanism for drug reaction being called “drug hypersensitivity,” as it is mediated by T-lymphocytes. The reactions are different from the arch-typical “allergy” in that they tend to be somewhat delayed and different types of rashes. Examples are measles-type bumps, the life-threatening skin condition Steven-Johnson Syndrome or liver irritation. Of great interest is that there seems to…

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‘Magic Bullet’ antibodies beef up to meet today’s need

‘Magic Bullet’ antibodies beef up to meet today’s need

In the early 1900s, German scientist and Nobel Laureate Paul Ehrlich pioneered an antiserum to help combat diphtheria. His anti-serum saved many lives in the pre-antibiotic era. He also popularized the concept in medicine of a “Magische Kugel” (Magic Bullet). His idea was to find treatments that were so specific that they only worked on their specific targets without any collateral effect or damage to the body. In 1975 Cesar Milstein and Georges Kohler (also Nobel Laureates) invented hybridoma technology…

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