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Month: April 2011

Quick Tips – Ears

Quick Tips – Ears

The ears are self-cleaning structures. The use of Q-Tips can pack the wax into the canal causing a blockage or can over dry the canals and lead to itchy ears. The wax (cerumen) is a natural moisturizer for the ear canals. It also has anti-bacterial properties. Let it do its jobs.

Quick Tips – Pets

Quick Tips – Pets

Another reminder: to reduce pollen and mold being brought into your house by pet dogs, rinse their paws on the way back inside. A shallow pan with water at the back door or the garage works well for this task. Also, the human inhabitants can leave their shoes outside to the same end.

IV aspirin treatment for migraines in the pipeline

IV aspirin treatment for migraines in the pipeline

Researchers in Britain recently published an article in the journal Neurology about the use of IV aspirin for chronic migraines.

They did a five-year study on 168 patients with severe, frequent migraines.

The patients were given IV aspirin for 15 days a month for three months. Over the ensuing five years, 25 percent of the patients experienced a dramatic improvement in headache severity and frequency, and 40 percent had a moderate improvement.

Two patients dropped out of the study. One had “needle phobia,” while the other had worsening of her asthma from the aspirin.

The researchers speculated that the aspirin helped reset the pain receptors for headache to a less fragile state.

Currently, the therapy is not available in the U.S., but researchers are moving to make application to the FDA for approval of its use.

Effective therapy; no increased risk with asthma

Effective therapy; no increased risk with asthma

Inhaled corticosteroids are an important therapy for a variety of lung conditions, especially Chronic Obstructive Pulmonary Disease (COPD) and asthma.

It has been known for several years that inhaled steroids increase the risk of pneumonia in patients with COPD. Whether this is also true in asthmatics has not been studied.

A recent research paper in the Journal of Respiratory and Critical Care Medicine indicates that inhaled steroids do not raise the risk for pneumonia in asthmatics. In the cited clinical trial involving 15,000 children and adults with asthma there was no increased risk for pneumonia.

A second study looked at low-dose versus higher-dose inhaled steroids in asthmatics and there was no increase in risk in the high-dose group.

Molluscum rash: common, upsetting, not allergy

Molluscum rash: common, upsetting, not allergy

One of the most common rashes that allergists are asked to see that is non-allergic in origin is Molluscum Contagiosum.

The rash tends to be a source of great consternation for parents, while the child who is afflicted generally is unaware or at least unperturbed by the rash.

The parental angst comes primarily from the fact that the rash lasts for weeks, even months, and can slowly spread. The child’s indifference comes because the rash neither hurts nor itches.

The rash is caused by a poxvirus, which is a very distant relative of smallpox. It is spread primarily by skin-to-skin contact between children. It consists of individual dome-like papules (about the size of small pimples) that are flesh-colored and have a tiny dimple (umbilication) in the top.

The degree of involvement can vary from as few as one to three papules to dozens of them. Children with eczema are prone to have a greater number of papules and to have them last longer.

Most pediatricians, allergists, dermatologists and infectious disease doctors recommend benign neglect as treatment. In the vast majority of cases the rash resolves on its own without scarring.

Of the treatments that are available, the most commonly implemented is destructive therapy. Usually, this is accomplished by curetting the lesions, but they can also be burned by cold or heat. This treatment leads to minor scar formation. Other treatments available are immune-modulation and antiviral therapies.

A little dirt might be good for us

A little dirt might be good for us

Research continues to seek an explanation for the escalating frequency of allergy problems and asthma.

The leading hypothesis for this phenomenon of burgeoning allergies is the Hygiene Hypothesis. Simply stated, it posits that we are too clean, which leaves immune systems idle. This idleness leads to deviant behavior in the form of allergy, asthma and autoimmune conditions.

Researchers at the University of Munich just published their findings in this regard in the New England Journal of Medicine.

Their study included 16,511 children living on farms in Bavaria and Austria, and matched controls living in urban settings.

The results were very interesting.

First of all, the farm children all had a much-reduced risk for developing asthma than the city children. Secondly, the risk reduction was directly related to the diversity of microbial exposure the children had.

In other words, the greater variety of bacteria and fungi they were exposed to, the greater the risk reduction.

The research scientists visited the homes and farms of all the study children and took samples that were subjected to standard culture techniques and a special DNA analysis.

Based on their sampling studies they found that farm children were exposed to greater a variety of microbes both outdoors and inside their homes. They mused that the farmers must track the microbes into the house on shoes and clothing. In general, these microbes do not cause infections, but they do keep the children’s immune systems busy identifying and cataloging the bacteria and fungi.

Shingles: changes, incidence and new vaccine

Shingles: changes, incidence and new vaccine

Dear Dr. K: I had shingles three years ago and now I have it again. I thought you were only supposed to get shingles once.

Your impression and what I was taught in medical school are identical, but, unfortunately, are now incorrect. There are probably two reasons for this change. One reason is that until a disease state is subjected to critical analysis, misjudgments of incidence and frequency can be made. The other is that due to modern antiviral drugs the disease itself has changed. In other words, before we had antiviral drugs to treat the shingles, the illness could be quite severe causing nerve damage, scarring of the skin and, in some cases, blindness.

But because of its severity it elicited a strong immune response and therefore a strong resistance to further outbreaks.

The use of the new antiviral drugs is very helpful in treating the shingles and preventing complications, but their result can be a less permanent immune resistance.

The Mayo Clinic has researched these trends and in its patient population they find 6.2 percent of people have a second attack of shingles within eight years. The rate was highest in people who had severe pain with their first episode. It was also higher in women and persons past the age of 50.

One new weapon in the war on shingles is the new vaccine Zostavax. It currently is recommended for adults 60 years and older as a one-time shot to help prevent shingles.