FCAAIA Notes: Precautionary food labeling (PAL) does not apply to foods that are intended to contain a known common food allergen. The vast majority of packaged foods with PAL do not contain food allergens. But, a small percent do and some of those may accidentally contain enough to trigger a reaction in the most sensitive patients. And, the specific wording of the PAL does not identify foods most or least likely to be contaminated.
So, what should you do? Continue reading
FCAAIA Notes: Until now, I have only posted articles about a specific brand of a medication if it is the only one available in its class. However, the absence of Auvi-Q has been a real problem from many patients, especially because the manufacturers of its competitor (EpiPen by Mylan) raised its price prohibitively high. Continue reading
FCAAIA Notes: Epicutaneous immunotherapy (EPIT) has been under study for peanut desensitization for quite some time. It is still a long way from market. EPIT appears effective in protecting peanut allergic patients from small accidental ingestions. Some patients even tolerated very high doses in challenge. But, in comparison to oral peanut immunotherapy (OIT) Continue reading
FCAAIA Notes: The vast majority of children with asthma have allergies and should have allergy testing. Therefore, a thorough history of environmental exposures, correlated with the patient’s history and his testing results allow for focused recommendations for allergen avoidance.
The role of allergy in asthma is so well established that national and international guidelines for the care of asthma indicate that patients with persistent asthma (and allergy) should be considered candidates for allergy shots. Continue reading
FCAAIA Notes: Are you allergic to a food? Are you sure?
This is one of many studies over the years that food allergy is not as common as the public perception. Why the discrepancy? I could think of many possible reasons, but two come to mind quickly. First, the term Continue reading
FCAAIA Notes: Air pollution is not just an outdoor problem. In fact, many patients neglect the effect that air pollution can have inside their homes. Air purifiers are useful for some people with asthma or allergies, but not others. This study looked at the effect of air purifiers on asthma control as it relates to small particulates that are irritants, not allergens.
Fireplaces, kerosene heaters, smoking, and wood stoves are some common and easily avoidable sources of particulate indoor air pollution. Continue reading
FCAAIA Notes: It often takes a while before common variable immunodeficiency (CVID) is diagnosed after the onset of symptoms. Early on, its presentation can mimic asthma and allergic rhinitis with complications of recurrent infections. It can evolve insidiously, so seeing the same physician regularly might result in earlier diagnosis. But as also noted in this article, patients with allergic airway disease can develop CVID later.
Physicians need to be aware of CVID, know when to suspect it, and know how to make the diagnosis. Continue reading
FCAAIA Notes: The EAT (Enquiring About Tolerance) study was published early this year by the same researchers in London who published the LEAP and LEAP-On studies. This meta-analysis confirms the findings of EAT giving us assurance that its findings are reproducible.
Now comes a difficult question…can the findings of LEAP and EAT be extended to other foods or different risk groups? We don’t know for sure, but consensus among allergists is that diversification of the diet and early introduction (by 6 months old) of highly allergenic foods to infants who tolerate them is likely to decrease (not eliminate) the risk of food allergy. Continue reading
FCAAIA Notes: In elderly patients with asthma and COPD which is the lesser of two evils, high exposure to air pollution or not exercising? According to this study, exercise is the winner. It is important to make sure your disease is in optimal control and you might require albuterol pre-treatment before exercise. But, then you should exercise regualrly.
Of course, exercise has many benefits beyond respiratory health. By the way, if you don’t consider yourself elderly, don’t think we are letting you off the hook….You should still be exercising regularly! Continue reading
FCAAIA Notes: This is yet another study showing that the use of antibiotics without proof or high suspicion of a bacterial infection is unwarranted. I could go even farther and say it is inappropriate, as overuse of antibiotics increases resistance to antibiotics among bacteria and greatly increases medical costs.
That is not to say that we are not all guilty at times of over-prescribing. Sometimes we suspect a bacterial infection when there is none. Continue reading