Friday June 23, 2017

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5

March 13

Pollen Video


March 13

Early Allergies

Jeffrey Bryant is used to the discomforts of hay fever in spring, when trees normally bloom in his hometown of Louisville, Ky. This year was different: Mr. Bryant felt his symptoms come on with a vengeance when it was still January.

"It's never been as bad as this and never started as early," Mr. Bryant says. The 48-year-old computer programmer usually relies on medications to ease his coughing, sneezing and other symptoms. Now, he is working with his doctor to get started on a series of shots that he hopes will control his allergies within a few weeks.

Spring allergies are arriving unseasonably early and allergists are predicting it will be an extended allergy season. As Laura Landro explains on Lunch Break, the cumulative effect on the body may be more severe.

Mild winter temperatures in many parts of the country—the fourth warmest winter since record-keeping began—have triggered an unusually early release of pollen from trees. That bodes badly for the millions of people who suffer from allergic rhinitis—commonly known as hay fever.

Allergists are predicting a longer, and more intense, allergy season than normal. Once people have been exposed to the early pollen, essentially priming the immune system to react to the allergens, there is little chance of relief even if temperatures cool down again. This priming effect can bring on even more severe symptoms for allergy patients, especially those with asthma, says Neil Kao, an allergist in Greenville, N.C.

Medications, including eye drops, antihistamines and nasal sprays, can relieve hay-fever symptoms for many people. For greatest effect, these products usually need to be used just before any exposure to pollen, says Stanley Fineman, an allergy specialist in Marietta, Ga. But this year "we didn't catch it in time because we didn't know the pollen was going to start so early," says Dr. Fineman, who also is president of the American College of Allergy, Asthma & Immunology, which represents allergists. Weather websites often signal when local pollen counts start to rise.

More aggressive treatments, including immune-boosting allergy shots, are also available, and specialists expect more patients may pursue these remedies this year if their symptoms are worse than normal.

Different pollens serve as triggers to different people. Allergy shots, which administer escalating doses of the offending allergens, work like a vaccine to create resistance in the patient. But these can take several months to become effective. Doctors increasingly are recommending faster treatment protocols that deliver the shots over a shorter period and can bring relief within a few weeks.

Allergists also may offer the same type of immunotherapy in the form of drops under the tongue, which patients can use at home after an initial visit. Pharmaceutical firms are developing immunotherapy tablets, to be taken orally, including one from Merck & Co . that has been shown in trials to reduce symptoms of ragweed allergy.

Other researchers are investigating new methods to give patients faster and more effective allergy relief, such as delivering the allergens through the skin or by way of the lymph nodes.

As many as 30% of children and up to 40% of adults suffer from seasonal allergies that cause reactions such as sneezing, itching, stuffy nose, and watery eyes. Trees are one of the earliest plants to release pollen, followed later by pollen from grass and flowering plants. For example, high concentrations of tree pollen in Kansas City, Mo., Tuesday came mainly from juniper, elm and maple trees, according to data compiled by the National Allergy Bureau, part of research group American Academy of Allergy, Asthma & Immunology. Ditto for Atlanta, where the top offenders were pine, oak and birch.

Some studies suggest climate change, by promoting longer blooming seasons, may increase the prevalence of certain allergens and the time during which people are exposed to them. Warmer temperatures also can boost concentrations of mold, another allergen that is usually killed by colder weather, says James Sublett, the Louisville allergy specialist treating Mr. Bryant.

Improved medications have been introduced to treat allergy symptoms in recent years, including antihistamines, nasal steroid sprays and drugs that block inflammatory chemicals produced by the body. The products are generally safe and effective. But in a large survey of adults presented at an annual allergy conference in 2006, about a third of respondents said they switched medication either because of a lack of effectiveness or side effects.

Unlike medication, allergy shots can potentially lead to lasting remission of symptoms after three to five years.

The treatment, which is formally known as subcutaneous immunotherapy and is generally covered by health insurance plans, may also help prevent development of asthma and new allergies. The shots are typically given once or twice a week for about five months, after which their frequency is reduced.

Growing in popularity is a faster treatment, known as "cluster" therapy, that involves two to four injections one day a week for three weeks. Patients' own immune systems are mobilized and able to counteract naturally occurring allergens often within a few weeks, says Richard Weber, an allergy specialist at National Jewish Health in Denver. Risks include an increased chance of irritation at the injection site and a possibly serious reaction to the allergen.

Rachel Lowe, a 40-year-old plastic-surgery nurse in Marietta, Ga., recently started cluster shots recommended by Dr. Fineman after her allergies kicked in in early February. "I always dread when everything is in bloom because my allergies are so bad that I need to lock myself indoors sometimes and can't enjoy the spring," she says.

Some physicians are administering drops under the tongue, known as sublingual immunotherapy, that contain the same substances used in shots. The technique has been used since the 1980s in Europe, where it has been shown to produce lasting remissions in long-term use. It doesn't have U.S. regulatory approval, but some doctors give it to patients anyway as an "off-label" use of the substance.

Other doctors steer clear of the technique because insurers typically don't cover it and there are no standards in the U.S. for dosage and duration of treatment, says Linda Cox, an allergist in Fort Lauderdale, Fla. Another concern, she says: potential liability if something goes wrong.

Steven Prager, an allergist in California, says he began offering sublingual immunotherapy two years ago because many patients don't like shots or find multiple office visits inconvenient. He says he develops a formula for the drops for each patient based on the severity of their allergies. The treatments cost about $75 a month.

Source: The Wall Street Journal 


March 12

FDA Loophole - When is milk not milk?

Because of a loophole in food labeling laws, foods that contain casein or caseinates (milk derivatives) can legally be advertised as non-dairy products. Read ingredient labels carefully!


March 10

To herbal remedy or not to herbal remedy? That is the question

Herbals Not the Answer for Asthma, Study Show

FRIDAY, Feb. 5 (HealthDay News) -- Many asthma patients who use herbal remedies experience increased symptoms and poorer quality of life, a new study shows.

Researchers followed 326 asthma patients for 33 months. Of those patients, 25 percent said they used herbal remedies and used prescribed inhaled corticosteroids (ICS) less often than other patients.

The patients who used herbal remedies were younger, more likely to have been hospitalized or intubated for asthma, have concerns about possible adverse effects of ICS, and have difficulty following a medication schedule.

"Results indicate patients using herbal remedies are less likely to take their prescribed medications. These patients report worse asthma control and poorer quality of life than patients who follow medication plans. Underuse of prescribed medication is one of the main factors contributing to poor outcomes in asthma patients," study author Dr. Angkana Roy, of the pediatrics department at Mount Sinai School of Medicine in New York City, said in a news release.

The study appears in the February issue of the Annals of Allergy, Asthma & Immunology.

"Patients interested in herbal remedies need to use them to complement treatment and not as an alternative, or they will not maximize their health and may actually hinder it as this study shows," Dr. Leonard Bielory, chairman of the integrative medicine committee at the American College of Allergy, Asthma & Immunology, said in the news release.

"Remember, asthma is a serious disease and needs to be treated that way. Always ask your allergist about medication concerns and discuss use of herbal remedies," Bielory added.

Source: healthlibrary.epnet.com 


March 09

How Probiotics Work

The bacteria found in some fermented dairy products, such as yogurt, may alter gene expression in human gut microbes, and resultant tweaks to metabolic processes could be behind gastrointestinal benefits often observed in people consuming such probiotic products, according to a study published (26 October) in Science Translational Medicine. The work was funded by several grants from the National Institutes of Health and by Danone Research, the scientific research arm of Groupe Danone, a Paris-based multinational food products corporation that specializes in dairy products.

Since the 1990s, clinical trials have shown that probiotic bacteria can aid digestion in humans, but the molecular mechanisms involved in conferring those health benefits have proved difficult to pin down. The study has shown is that maybe one of the mechanisms is by shifting the course of expression and how the microbes speak. This may be a clue to how these types of foods are healthy.


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Location: Springfield, NJ
Today's Date: June 23, 2017
Station Director: Leonard Bielory, M.D
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