Mushroom Misery

Mushroom Misery

Shiitake dermatitis is a big price to pay for the joy of shiitake mushrooms.  The dermatitis consists of intense itching that occurs shortly after ingesting raw or undercooked shiitake mushrooms.  Characteristic of the rash are raised, red streaks which is also called “flagellate erythema” because it literally looks like the sequela of being whipped.  Other than this characteristic appearance, the dietary history is the cue to diagnosis.     It responds quickly to oral antihistamines and/or steroids.  It is prevented by adequate…

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Supplements or Not 

Supplements or Not 

The Journal of the American Medical Association recently published a study done by scientists in Cambridge, Mass.  This group did refined chemical analysis on 60 different health supplements.  Their findings were very disconcerting.  Just 11 percent of the products contained an accurate amount of the key ingredients listed on the label.  Forty percent had none of the indicated ingredients.  Forty Five percent had inaccurate amounts varying from .02 percent of the amount listed to 334 percent of the amount listed….

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Thymus

Thymus

Scientists at Mass General Hospital in Boston recently published findings on 1,150 adult patients in their hospital who underwent thymectomy (removal of the thymus gland).  The thymus gland is a bit of a mysterious organ found in our chest that is most active in early childhood.  It is located in the chest between the lungs and just above the heart.  In infants the gland is large and completely covers the front of the heart.  Until this recent study scientists have…

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Chronic PPI Use and Asthma

Chronic PPI Use and Asthma

New research shows that prolonged use of proton pump inhibitors (PPI’s) can increase the risk for developing asthma.  PPI’s are the “drugs of choice” for esophageal reflux, gastritis and gastric ulcers.  But their long-term use impacts the gut microbiome which in turn can cause immune dysregulation.  It is this “tilting” of immune function that increases the risk for asthma.  Prolonged use of PPI’s by women during pregnancy also increases the risk for their child to develop asthma.  One strategy to…

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Cross Reactive Epitopes & Food Allergy

Cross Reactive Epitopes & Food Allergy

A recent article in the Journal of Allergy and Clinical Immunology provided an update on our understanding of cross reactivity.  First by way of definition an epitope is a discreet (usually small) portion of a molecule that is the binding target of an antibody.  In the case of allergic problems, the antibody is IgE.  By way of example think of distinguishing features that help you identify a car:  the Mercedes Star and the Dodge Ram.  Allergy is directed at this…

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Dear Dr. K;

Dear Dr. K;

I’ve seen you and multiple other doctors for what has been called unexplained chronic cough.  Now I’ve read about the new drug Gefapixant.  Do you think I’m a candidate? My answer is a qualified yes. But before I continue my answer let me first give a summary of your own situation that might be of help to other kindred spirits.  Your cough is called “unexplained” because despite our best efforts the medical specialists you’ve seen have failed to find a…

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Dear Dr. K;  I read something that indicated chronic sinusitis can predispose to stroke.  It scared me.  Is it true? 

Dear Dr. K;  I read something that indicated chronic sinusitis can predispose to stroke.  It scared me.  Is it true? 

The short answer to your question is yes. But, the best answer to your question is maybe.  First of all, it is important to know that vascular problems in general whether due to blockage from plaque or due to a clot have inflammation as a common denominator.  Whether you’re talking about a coronary artery or a carotid artery or an intracranial artery its arterial inflammation that sets the stage for the problem.  By way of example, its arterial inflammation that…

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Bones and Alzheimer’s

Bones and Alzheimer’s

Whoever would have thought that bone health could impact the development of dementia?  Until I learned about new research in this regard, I wouldn’t have connected the two.  The operant word here is “health” and that is a function of exercise.  Now, if you’ve read these newsletters in the past you’re probably thinking; Oh boy, here comes another sermon on the value of exercise.  And guess what?  You’re right! The research connecting the two is from the fields of neuroscience…

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The T(r)OOTH of the Matter

The T(r)OOTH of the Matter

By:  Sasha Klemawesch, MD During residency, we had a DDS come do a grand rounds lecture. During it, he advised not rinsing after brushing. I paid no heed to his recommendation at the time since the idea of not rinsing your mouth out after you brush your teeth seemed so bizarre and gross (also probably I was too busy passing notes w my coresident to listen all that closely to a dental lecture – snore!). The American zeitgeist writ large…

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TEWL

TEWL

TEWL stands for trans epidermal water loss.  It is the “unperceived” loss of water through our skin, in distinction to the “perceived” loss of water when we sweat.  It is also sometimes called insensible water loss.  It has been known for quite some time that children and adults with eczema have a greater TEWL than normal, but the difference has never been carefully measured.  The Allergy and Asthma Proceedings recently published new research doing just that.  The measurements were adjusted…

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