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Gut microbiome and good immune function

September 28, 2018 Stephen J. Klemawesch, MD

Previous issues of this newsletter have contained articles about the importance of the gut microbiome and human health in general and more specifically in good immune function. In this regard the use (and overuse) of antibiotics has come under intense scrutiny. This includes therapeutic antibiotics and those used in our food production. The premise here is that the antibiotics kill off some of our healthy microbiome and can lead to an overgrowth of “undesirables”. A recent article published…

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Dear Dr. K.; My ophthalmologist recently diagnosed me with dry eye syndrome. Is that being caused by my allergy?

September 28, 2018 Stephen J. Klemawesch, MD

The answer is no, yes, or maybe so. I’m not trying to be obtuse, but the answer is different for different people. Let’s start with the dry eye syndrome. It is very common and affects millions of Americans. Also, it can vary in severity from a mild nuisance to a vision altering severe condition. The common denominator for all people with dry eye syndrome, is compromised ocular lubrication. But, the condition has many causes which can overlap and interact….

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Shocking News

September 28, 2018 Stephen J. Klemawesch, MD

The immune system was once considered an independent, self-regulated system. But research over the past ten years has found that like most of the rest of the human body, it too is under the control of our nervous system. Some of the early research in this regard was designed to understand why we seem more prone to get sick if we are under stress or depressed. As it turns out the brain does have significant control over certain aspects…

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Monoclonal Antibodies for Migraine

September 28, 2018 Stephen J. Klemawesch, MD

The FDA has recently approved Aimovig (Erenumab) a once-a-month injection to prevent migraines. Aimovig is a monoclonal antibody that targets the calcitonin gene-related peptide receptor (CGRP). CGRP is a neurotransmitter that dilates blood vessels and stimulates pain. It was discovered that levels of CGRP go way up in people experiencing migraines. By blocking the receptor for CGRP the Aimovig is able to prevent headaches. Since Aimovig is a preventative agent, it is currently only recommended for patients with frequent…

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Q – Tips: asthma

September 28, 2018 Stephen J. Klemawesch, MD

A recent study in Europe was done on people with mild-persistent asthma. The study compared daily use of a combination inhaler with long lasting bronchodilator and steroid versus just using the inhaler when the asthma started to flare up. The rate of severe exacerbation of the asthma requiring either an ER visit or treatment with oral steroids was the same in both groups.

Q – Tips: Auvi Q

September 28, 2018 Stephen J. Klemawesch, MD

Auvi–Q, a form of adrenaline auto injector has recently come out with a lower dose injector for emergency treatment of anaphylaxis in children weighing less than 33 pounds. It contains .1 mg of epinephrine and has a shorter needle (to avoid hitting the bone when injected). Previous to this the only other available doses were .15 mg for people 30 to 60 pounds and .30 mg for people over 60 pounds.

Bronchodilators evolve better and safer

August 28, 2018 Stephen J. Klemawesch, MD

Dear Dr. K: I recently heard that the “black-box” warnings on LABAs (long-lasting bronchodilators) has been removed. Is that true, and are LABAs safe? These are two great questions. The answer to both is “yes”. It’s best, however, that we explain a few things. The two most common of these bronchodilators are Formoterol and Salmeterol. They are basically long-acting forms of Albuterol. When they first became available about 20 years ago they could be used as a single agent to…

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An allergy shot for Alzheimer’s? In the pipeline. . .

August 28, 2018 Stephen J. Klemawesch, MD

By: Sasha Klemawesch, RN, MD Well…sort of. Alzheimer’s has been and continues to be one of the most frustrating diseases for researchers, patients, and caregivers alike. But there may be hope on the horizon. A new immune therapy called Aducanumab – an antibody against B-Amyloid – is undergoing human testing right now. B-Amyloid leads to plaque creation and deposition in the brain, and those plaques, along with neurofibrillary tangles caused by the Tau protein, are the two key pathologic findings…

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Eczema med Dupixent may also offer major benefits to asthmatics

August 28, 2018 Stephen J. Klemawesch, MD

In a previous newsletter we discussed the new biologic drug Dupixent (Dupilumab) as a true “Godsend” for severe eczema. By way of reminder, it is a monoclonal antibody that blocks the interleukin-4 receptor, and thereby prevents the inflammation that causes eczema. This medicine has proven to be both safe and effective, and the injections can be done at home. Because interleukin-4 also plays a big role in asthmatic inflammation, researchers at Washington University have studied its benefits in severe steroid-dependent…

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Summer means lots of swimming fun, but remember to stay alert and aware

August 28, 2018 Stephen J. Klemawesch, MD

Bathing in warm sulfur spring water has been touted for its potential health benefits, but some susceptible individuals – especially allergic people who may tend to have dry skin or eczema – may turn up with a severe skin rash from exposure to this water. Typically, the rash appears suddenly about 24 hours after the water exposure. The rash is red with a look of “punched out” ulcers and pits. It is caused by the acidic nature of the hydrogen…

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