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Month: May 2014

Balancing act’s role in prevention

Balancing act’s role in prevention

A number of immune-modulator drugs are used today with good success in treating rheumatoid arthritis. The object of a study recently written up in Arthritis Research and Therapy was to see which ones reduced the benefit of flu vaccine.

As it turns out the drugs that work on tumor necrosis factor (TNF) had only a mild effect in reducing antibody production from flu vaccine. These drugs include Humira, Enbrel, Remicade and Cimzia.

Drugs that severely reduced antibody production were Rituxan and Orencia. Because the antibody response with these drugs was so poor, the researchers recommended several options: Vaccinate for flu before starting these medications; or, if the patient is already under therapy, give a second booster flu shot one month after the first shot.

Histamine therapy for eczema back in favor after research

Histamine therapy for eczema back in favor after research

Eczema affects up to 20 percent of the population and its incidence is steadily increasing. Eczema is often difficult to treat because it is a multi-factorial disease with numerous causes and triggers.

One therapy that has gone in and out of favor is the use of antihistamines. Proponents argue about their benefit based on positive responses in many patients. Detractors argue that they don’t help everyone, and that all they are capable of doing is controlling the itch, not really healing the cause.

New research from the Medical University of Vienna is putting antihistamines back in the spotlight. Scientists there have discovered that persistent histamine levels in the skin tissue speed the growth of skin cells, thus contributing to the scaling and itching that are hallmarks of eczema.

Keeping the histamine receptors focused on skin cells blocked with a maintenance dose of antihistamine can prevent the cell growth stimulation.

Mastering asthma rescue dose technique a ‘must’

Mastering asthma rescue dose technique a ‘must’

Dear Dr. K: How can I be sure my four-year old asthmatic daughter actually gets her rescue inhaler dose?

That is an excellent question and one that all parents of asthmatics should ask themselves.

There are actually several ways to answer your question. On a very practical level, if the symptom you were treating (cough, wheeze, shortness of breath) goes away within a few minutes of the treatment, then most likely, your daughter got the medicine and it helped. Also, most of the rescue medicines have mild side effects, especially increasing the heart rate and causing a slight hand tremor.

You could check her pulse before and after the inhalations to see any change.

Your best bet to ensure medicine delivery is to use proper technique. Most research studies looking into whether or not parents use proper technique reveal that only about 10 percent are doing everything right.

The crucial steps include:

  1. 1.  Shake the inhaler before use.
  2. 2.  If the inhaler is new “out of the box,” be sure the indicated priming has been done.
  3. Make sure a good seal is made with the spacer.

              a. For young children the spacer has a face mask that covers the nose and mouth.

              b. For somewhat older children the seal is made by ensuring the lips cover the mouthpiece.

  1. 4.  Do one puff at a time.
  2. 5.  Have the child exhale first, then deliver puff.
  3. 6.  Take six slow, deep breaths for the first puff.
  4. Wait 30 seconds between puffs.
  5. Then repeat steps 5 and 6. If you’re still not sure, bring your spacer and medicine to the next visit with your pediatrician, pulmonologist or allergist, for a critique of your technique.
New approach works on virulent TB type

New approach works on virulent TB type

Patients afflicted with multi-drug-resistant tuberculosis – 170,000 of whom died in 2013 of this untreatable (at least with antibiotics) form – may take hope from new research reported in Lancet this month.

New studies are investigating a novel therapy using infusions of autologous mesenchymal stromal cells (AMSC) to improve immune response against this virulent strain. The new therapy is actually working for many patients.

Herbal therapy in allergy ‘rooted’ in success, caution

Herbal therapy in allergy ‘rooted’ in success, caution

Rootology is an herbal therapy for allergy and respiratory problems that is becoming quite popular. It utilizes a number of plants and herbs from traditional Chinese medicine. Ingredients used include xanthium fruit, magnolia flower, platycodon root, angelica root, Forsythia, cinnamon, schizonepeta, ledebauriella root, schiganda, chrysanthemum, anemarrhena root, philodendron bark and licorice root.

Once considered homeopathic by academic scientists, new research shows that many of these ingredients are truly allopathic (conventional). This in turn leads to the dichotomy that this therapy is indeed “real” medicine, but it also has the potential for significant side-effects or toxicity. These negatives can occur because there is no FDA regulation on the dosages of the various components.

To discuss a few components let’s start with the xanthium fruit – one of the most important Chinese remedies. It definitely can help nasal congestion and sinus headaches, but in too large a dose can cause nausea, vomiting, diarrhea — and, in overdoses, drowsiness, seizures and coma.

Platycodon root’s expectorant properties thin mucus and clear phlegm. It is generally very safe.

Angelica root helps stop runny nose, but in high doses causes uterine contractions. In extremely high doses it has been used to induce medical abortion.

Cinnamon has been used by the Chinese for 4,000 years. Research in Western academic centers reveals that the active ingredients are terpenoids and diterpenes, which have anti-microbial properties and anti-allergy benefits.

The schizonepeta thistle contains chemical compounds including menthol, cineole, hesperidin and caffeic acid – all of which can help headache and reduce inflammation.

Schiganda is a berry from Asia whose active compound is lignan, a known immune stimulant.

Anemarrhena root is a member of the lily family. The active chemical it contains is saponin, which helps chest congestion and bronchitis.

In very large doses it can severely lower blood pressure and cause cardiac irritability.

Finally licorice root: Its two main ingredients, glycyrrhin and flavonoids. Glycyrrhin inhibits cortisol breakdown, hence its anti-inflammation properties. However, in high doses the extra adrenal hormones can lower blood potassium levels. The flavonoids are antimicrobials and antioxidants.

The bottom line is Rootology has true medicinal potential but also possible toxicity. It should be taken only with the guidance of a trained Chinese herbalist.

Q – Tips: Gustatory rhinitis

Q – Tips: Gustatory rhinitis

  • Gustatory rhinitis is a food allergy mimic with symptoms of profuse runny nose and/or post-nasal drip that occurs with eating. However, the symptoms are not brought on by an allergy to the food, but rather a neurologic reflex. As the brain sends signals to the GI tract to digest food, it mistakenly sends a signal to the nose to make mucus.
Q – Tips: Sucrose/Fructose Intolerance

Q – Tips: Sucrose/Fructose Intolerance

Sucrose/fructose intolerance is a mimic of food allergy. It is caused by gut fermentation of the inadequately absorbed sugar found in certain foods. The resultant symptoms are nausea, bloating, gas and diarrhea. The treatment is avoidance of the implicated food sources: cane sugar, beet sugar, all fruit and fruit products, corn syrup, most legumes, wine and beer.