A Shift in Asthma Strategy

A Shift in Asthma Strategy

They say “nothing stays the same” and as I keep aging, I couldn’t agree more! Change is always occurring in medical guidelines as well.  What I’d like to address here is how this applies to asthma therapy.  For quite some time now, the standard of care for asthmatics has been to have both a rescue inhaler and a maintenance inhaler.  The majority of rescue inhalers use albuterol, a bronchodilator, which relaxes airway smooth muscles that are constricted.  The benefit is…

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Tardigrade Research

Tardigrade Research

Tardigrades are microscopic organisms about the size of a dust mite but are really cute as they look like a baby manatee.  For being so tiny they have some really special properties that scientists hope to adapt to human health.  Tardigrades are incredibly tough.  They can survive being frozen down to minus 272° Celsius, being exposed to a vacuum in outer space, being completely dried out and being exposed to 500 times the dose of x-rays that would kill a…

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Bronchiectasis

Bronchiectasis

Bronchiectasis is a lung condition characterized by cough and sputum production in the presence of abnormal thickening and pocket formation of bronchial walls which is visible on special lung imaging.  The little pockets are similar in their mischief to the pockets that can occur in the wall of the colon:  diverticula.  In both scenarios the pockets can sometimes accrete enough bacteria that it leads to acute bronchitis in the lung and diverticulitis in the colon.    In the bronchial tubes the…

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Hydrogels

Hydrogels

Hydrogels are cross linked networks of biocompatible polymers that can swell or shrink in a controlled and reversible manner that can be tuned to specific physiologic conditions.  Wow!  That was a mouthful.  But if you re-read that sentence carefully you will find the description of an almost perfect delivery system (think UPS/Fedex) for intact proteins via the GI tract.  Since the development of recombinant human insulin in the 1970’s a new class of medications called protein therapeutics has changed the…

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Dear Dr. K;

Dear Dr. K;

I recently read something about micro needles and vaccines.  Is that anything similar to my getting my flu shot intradermally? Actually yes, it is.  As you know, the traditional and standard way to administer most vaccines (including Covid) is intramuscular; that is, injecting the vaccine fluid into a muscle.  The vaccine is then processed by migratory immune cells in the blood vessels and lymph system.  Obviously, this method works well.  But the dermis of our skin actually contains 1,000 times…

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Constrictive Bronchiolitis

Constrictive Bronchiolitis

Many smokers consider electronic cigarettes (vaping) to be a safer alternative to traditional cigarettes.  In some respect they are correct.  However, a newly described condition: constrictive bronchiolitis is appearing in some people who vape.  Bronchioles are the smaller arborations in the “bronchial tree”.  The trachea branches into bronchi which in turn branch into bronchioles.  The people who develop this condition have significant narrowing of these smaller airways that is caused by tissue thickening called fibrosis.  The pathophysiology of this condition…

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Long Haulers

Long Haulers

The plodding nature of scientific research is a source of frustration to many of us, especially with reference to this Covid pandemic and the long haulers.  But recent research at Stanford University seems to provide new insight.  In their studies of long haulers, they discovered that the majority of them continue to shed live virus in their stool.  Moreover, some of the long haulers who were “stool negative” did show live virus in biopsies of the intestinal lining.  And yet…

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Dear Dr. K –

Dear Dr. K –

My husband has intrinsic asthma and I have extrinsic asthma.  Despite having our COVID vaccines he caught COVID and I didn’t.  What’s up? Well, first of all I’m impressed that you know the difference between intrinsic and extrinsic asthma phenotypes.  To try and simplify what is a complex science most asthma can be categorized as high TH2 (extrinsic) or low TH2 (intrinsic).  TH2 is a type of lymphocyte that can cause inflammation.  In high TH2 asthma the main mediators of…

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RSV Vaccine

RSV Vaccine

Many Americans “have reached their limit” with vaccines due to the ongoing Covid pandemic.  But sadly, Covid isn’t the only game in town.  RSV (Respiratory Syncytial Virus) hasn’t gone away and continues to cause illness, hospitalization and death.  It is a single stranded RNA virus that can infect people at all ages.  It is the leading cause of respiratory hospitalizations in infants.  It is also problematic for people over 65, also causing hospitalization and death.  RSV vaccine research has been…

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Ticks Bite!

Ticks Bite!

By:  Sasha Klemawesch, MD It used to be that you only had to worry about ticks in certain parts of the country and during certain times of the year. However (at the risk of mentioning any potentially “politically charged” content), climate change has not only prolonged tick season, but has also changed the geographic distribution of various bites. Depending where you live in the country, a variety of ticks abound, leading to various infections endemic to each area. For the…

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