It is with profound sadness that we announce the passing of Dr. Robert M. Biondi on October 7. Dr. Biondi founded FCAAIA years ago. He was our friend, colleague, mentor, and modest leader at FCAAIA. Dr. Biondi loved the practice of allergy and loved his patients. He never stopped studying and learning about allergy and immunology. He was recognized by the American Academy of Allergy, Asthma, and Immunology as a distinguished clinician before his retirement several years ago. It was, perhaps, his proudest professional moment.
Dr. Biondi was an avid reader with a wealth of knowledge on a multitude of topics. We never tired of hearing his tales of his days in the armed forces as a young pediatrician and as a neophyte allergist when he moved to Norwalk so many years ago.
Bob loved spending time with his wonderful and loving wife Sue and they enjoyed his too brief retirement together in New Jersey. His three children, Nick, Paul, and Mike often visited Bob and Sue on Martha’s Vineyard with the daughters-in-law and grandchildren of whom he was so proud. He loved every minute with them and boasted of needing a vacation when he came back to work after the whole family visited.
We will miss Bob Biondi, a truly wonderful man.
FCAAIA Notes: For all intents and purposes, one can usually consider allergic rhinitis and asthma as the same disease affecting different ends of the same airway. I frequently refer to the combination as “allergic airway disease”. The conditions have the same underlying pathophysiology, immunology, triggers, and tenets of treatment. We know that the vast majority of young people with asthma have allergies. We have also long recognized the “atopic march” or “allergic march”, in which patients progress from atopic dermatitis, to allergic rhinitis, to asthma. Continue reading
FCAAIA Notes: So much to learn about the human microbiome, the Hygiene Hypothesis, and endotoxin! I have published many articles about these “hot topics” in allergy and immunology, including another one today (Classroom Airborne Endotoxin Levels Lead To Increased Asthma Symptoms). I am not sure what the final answer will be, but I doubt it will be simple. I publish this article solely because it is intriguing adds another piece to an already complex puzzle. Continue reading
FCAAIA Notes: Patients with eosinophilic esophagitis (EoE) tend to be highly atopic/allergic (or at least tend to have a lot of positive skin tests to aeroallergens), although it is probably only a small proportion whose EoE is triggered by aeroallergens. I don’t think there is any question that some patients have seasonal worsening of their EoE in association with worsening seasonal allergy symptoms. In, fact I have had quite a few such patients myself.
Although it makes intuitive sense that those patients would improve on allergy shots for their pollinosis, there are no data confirming or refuting that theory. Continue reading
FCAAIA Notes: I have written about food oral immunotherapy (OIT) many times in this column. This is another study indicating that OIT to food, in this case egg, is not 100% effective, is not a permanent cure if not continued in those who tolerate it, and is not 100% safe. Fortunately a great majority of children allergic to egg can eventually tolerate it in baked products, making avoidance a little less of a burden. Continue reading
FCAAIA Notes: There are only 2 proven and natural cures for airway allergy: Avoidance of the allergens and allergy shots. As effective as injections are, we recognize they are an inconvenience. Studies from many years ago show that in the long run, injections coast LESS than staying ion medications, particularly if you add in the indirect costs of illness such as lost time from work. But, when we talk about costs, we are talking about TOTAL costs (what you insurance company pays plus your out-of-pocket costs).
Unfortunately, the current state of medical insurance is that your co-pays and deductibles are higher and your insurance company pays less every year Continue reading
FCAAIA Notes: This article is just a reminder about the very important findings of the Learning Early About Peanut (LEAP) study published in March 2015 and referred to a few times in this blog. Infants at risk for peanut allergy (atopic dermatitis or egg allergy) should be tested and if appropriate have peanut introduced in to their diets early in life. Such introduction decreases but does not eliminate the risk of the child developing peanut allergy. Continue reading
FCAAIA Notes: This is an up-to-date review of allergic rhinitis, its causes, triggers, treatments, co-morbidities, and natural history. Continue reading
FCAAIA Notes: The Food Allergen Labeling and Consumer Protection Act (FALCPA) of 2004 was important legislation requiring clear labelling of products containing the 8 major food allergens (milk, egg, wheat, soy, peanut, tree nuts, fish, and shellfish). Since then it seems that everything including foods that do not contain one of those allergens has some sort of warning label as a legal disclaimer (“May contain…”, “Packaged in a facility….”, “Processed in a facility……”, “Processed on equipment….”, etc.). Anyone shopping for a family member with food allergy knows how confusing and frustrating this is, even though most of those products do not contain the offending allergen.
I agree with Dr. DunnGalvin that some sort of standard is necessary Continue reading
FCAAIA Notes: The incidence of food allergy steadily rose over several decades. Because food allergy was more prevalent, it is not surprising that more people had episodes requiring hospitalization. What is surprising and unclear is why the rate rose so dramatically in fewer than 10 years. Maybe people became complacent and weren’t as careful in avoiding their known food allergens. Maybe episodes were more severe (but why?). On the other hand, maybe there was just better recognition of anaphylaxis Continue reading