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Month: February 2020

Good News/Bad News

Good News/Bad News

On September 13, 2019 an FDA advisory board recommended approval of an oral peanut vaccine (“OIT” for oral immunotherapy).  If this recommendation leads to approval, peanut allergic individuals will be faced with a tough decision.

Approval is based in part on large studies done in California on children and adults with severe peanut allergy.  In this study, 85% of the OIT treated patients were able to tolerate 4 grams of peanut without serious reaction.  That’s the good news.

The bad news is that stopping OIT lead to a fairly quick return of the severe allergy.  Additional bad news is that despite being protected from severe reactions a large number of patients had frequent mild allergic reactions and were prone to develop a condition called eosinophilic esophagitis – a form of allergic reflux.

High Dose Flu Vaccine

High Dose Flu Vaccine

High dose flu vaccine contains 4 times the amount of antigen (killed flu virus) than the standard vaccine.  People with the highest risk for death from influenza are infants, pregnant women and adults over 65.  The high dose flu vaccine is recommended as an option in the latter group.  People over age 65 have immune systems that are also aged and by giving them a higher dose there is a better chance of stimulating a good immune response.  In fact, research showed a 24% improvement in immune protection.

The tradeoff for some people is a greater likelihood of local reaction or systemic “achiness” after the higher dose.  For those individuals leery of these side effects the CDC proposes as another option receiving two of the regular dose vaccines a couple of months apart.   However, the second dose is not covered by Medicare or commercial insurance plans.

Vaping and Lung Disease

Vaping and Lung Disease

Vaping has become extremely popular in the last few years in part because it has been promoted as “a safe alternative to cigarettes”.  Currently 1/3 of all high school students report “some use” of vaping.

Unfortunately, hundreds of individuals have been hospitalized and died with an acute lung disease.  The most common cause of this lung disease is lipoid pneumonia which can affect multiple lobes of the lungs and lead to respiratory failure.  This form of disease seems to occur if the vaping material contains Vitamin E acetate, which is an unnecessary additive.

The two other forms of lung disease are acute eosinophilic pneumonia which is actually a severe allergic reaction to an excipient in the inhaled material.   A variety of excipients are available to promote usage such as fruit and candy flavors.  The second form of lung disease is cryptogenic organizing pneumonia.  This is a bit harder to diagnose and understand, but basically inhaling chemical and possibly infectious particles through the electronic system can allow direct and deep penetration of the pathogens into the lungs.

In all three forms of lung injury the patient becomes extremely short of breath and may need to be placed on a ventilator.  CT scans often show “diffuse white out” of the lung fields; that is, diffuse pneumonia.

Don’t Worry, Be Happy

Don’t Worry, Be Happy

By:  Sasha Klemawesch, MD

Scientists have known for a while that optimists tend to enjoy better health, and recently, a BU study came out reemphasizing just that.  Their research followed a large and varied group of people for more than a decade, and found that those with the sunniest dispositions lived 11 to 15% longer than their negative counterparts! And the results held even when they accounted for chronic diseases, socioeconomic status, smoking, et al; a Positive Mental Health Attitude was shown to be beneficial and protective.

Multiple previous studies have examined smaller and more select groups but came up with similar results.  Here are some key findings from a few of those past papers:

  • Middle age patients who underwent coronary artery bypass surgery were twice as likely to end up readmitted after discharge, and more than three times as likely to suffer repeat heart attacks if they identified as pessimists.
  • Another study showed that optimism can help stave off heart disease in the first place; a Harvard study followed about 1,000 men without coronary artery disease for 10 years, and the cynics were > 50% more likely to end up developing cardiovascular disease.
  • Optimists are more likely to have lower blood pressure and require fewer or no medications than their negative (hypertensive) neighbors.
  • In 2006, a group of approximately 200 health subjects were exposed to a common respiratory virus, and the happier people were less likely to develop significant symptoms compared to their surly (and now sniffly) peers.
  • In a study of more than 2,000 seniors, a cheery disposition significantly increased their odds of being able to remain living independently.
  • We know that laughter is contagious, but researchers also found that a good belly laugh revs your heart rate and your energy burning; 10 – 15 minutes of hearty laughter can burn 10 to 40 calories.
  • One of the earliest American studies regarding on how your outlook affects your health found that for every 10-point increase on a standardized pessimism rating scale, the corresponding mortality rate rose 19%.
  • Positive attitudes are associated with lower levels of CRP and IL-6, two key inflammatory markers often associated with higher risks of heart attacks and stroke.

Don’t worry if seeing the glass half-full does not come naturally to you though.  Optimism can be learned and taught.  (Ha, I just realized that only those of you who’d be worried or be telling yourself you’re a hopeless case would be those who are naturally more negative, so I guess that was sort of a silly thing to say.)  Nevertheless… if you would like to try and change your innate outlook, but aren’t sure where to start, a good quick overview I found on YouTube is: “Learned Optimism Positive Psychology” – Martin Seligman – Animated Book Review (practical psychology).  And the next video in the lineup is “Optimism – How to Become Optimist Right Now” (actualized.org).  It’s a bit longer, but both videos reference the book “Learned Optimism” by M. Seligman, which is one of the more respected works on the subject. So, if you would rather hold it in your hand than watch it on the computer, you could check that out too.

And finally, right now, before you put this paper down, SMILE!  You may feel silly, but the act of smiling triggers a release of feel-good neurotransmitters in the brain, and if you feel silly enough to laugh a bit, even better.  Laughing does the same.