A recent issue of the New England Journal of Medicine contained an excellent review article on the condition known as chronic pruritis – defined as an itch (either localized or generalized) that lasts longer than six weeks. The problem is more common in women than in men and more common in Asians than other races. The authors of the review article point out that chronic itch can be as debilitating as chronic pain, leading to changes in sleep patterns and…
Dear Dr. K: My aunt has Ramsay Hunt syndrome and her doctor said it was a second bout of chicken pox. Is that true? The answer to your question is yes and no. In the strictest sense the answer is no, because your aunt doesn’t have generalized chicken pox, but rather a very localized rash. The answer is yes because, in general terms, Ramsay Hunt is a special form of shingles which is a reactivation of the dormant chicken pox…
Recent research has discovered that narcolepsy is a genetically controlled autoimmune disease. Individuals with the gene HLA-DRz/DQI have a very high risk that their immune system will attack a part of the brain called the hypothalamus. It is in this brain region that an important neuropeptide called hypocretin is made. Hypocretin is a very important neuropeptide for maintaining alert wakefulness. If the cells in the hypothalamus that produce it are damaged or destroyed, narcolepsy occurs. This condition is characterized by…
Whoever said laughter is the best medicine didn’t know about a “mother’s kiss.” As it turns out, a recent case review study of nasal foreign bodies found that a mother’s kiss is the best and safest way to remove the object from the nose of a small child or infant. Using this technique an adult known and trusted by the child blocks the unaffected nostril and blows into the child’s mouth. The blowing should be gentle at first until the…
Get an infected cut or sprain an ankle and you will experience the healing benefit of inflammation. However, with the benefit also come the redness, swelling, heat and pain that are inflammation’s hallmarks. Although unpleasant, these symptoms dissipate rapidly and are reassuring that the immune system is doing its job to clear infection and guide repair of damaged tissue. The journal Science had a recent review of inflammation as it pertains to chronic diseases. The review looked at new research…
Dear Dr.: I heard there might be a new flu vaccine that is egg-free. You’re right. In fact you’re double right as there are two egg-free flu vaccines soon to be available. The first one is called Flucelvax, produced by Novartis. Canine kidney cells culture is used to grow the virus instead of chicken eggs. Tested in 11,000 patients, this new vaccine was 84 percent effective in preventing influenza. The second is Flublok, offered by Protein Sciences. This one is…
Dear Doc: ACE inhibitors do their job well, but cause big problems for some patients Angiotensin-converting enzyme (ACE) inhibitors comprise one of the safest and most effective treatments for hypertension (elevated blood pressure). They work by inhibiting conversion of angiotensin I to its active form, angiotensin II (which leads to hypertension). Unfortunately, they also inhibit the conversion of the peptide bradykinin to its inactive form. Hence, in some people this can lead to a build-up of the peptide which can…
Widely used pesticides and chlorinated water may be contributing to the increased frequency of food allergy. Researchers at Albert Einstein College of Medicine have found a strong correlation between urinary levels of dichlorophenols and the incidence of food allergy. Both children and adults who had measurable levels of the chemicals in their urine were much more likely to have food allergy. Dichlorophenols are commonly found in household pesticides, those used on fruits and vegetables and also in chlorinated tap water….
Food protein-induced enterocolitis syndrome (FPIES) has recently been reported to occur from orange juice, a previously unrecognized cause. FPIES mimics food allergy, but it is not mediated by IgE (Immunoglobulin E), the usual allergic mechanism. It is an acute inflammation of the GI tract, caused by a food protein that leads to nausea, vomiting and diarrhea. Frequently, affected children become dehydrated and require IV fluids. The condition is often mistaken for a GI flu until the causal association with a…
Food ingestion anaphylaxis caused by mites is a newly described syndrome, as detailed by the World Allergy Organization in this month’s Journal of Allergy and Clinical Immunology. Until recently mite allergy was best recognized as a major cause for allergic rhinitis and asthma via the inhalation of the microscopic mites. Millions of allergy sufferers actually receive allergy shots for this mite allergy. Over the years occasional case reports would appear in the medical literature about airway anaphylaxis; that is, sudden…