Saturday July 4, 2020



January 25


Oralair(®) is a sublingual grass pollen immunotherapy tablet that was authorized for use in Europe on 26 November 2009 and is currently in Phase III clinical trials in the USA. It is indicated for the management of grass pollen allergic rhinitis with or without conjunctivitis in adults, adolescents and children (above the age of 5) with clinically relevant symptoms, confirmed by a positive cutaneous test and/or a positive titer of the specific IgE to the grass pollen. Treatment is composed of an initiation phase (3-day dose escalation: 100 IR [index of reactivity] on day 1, 200 IR on day 2 and 300 IR on day 3) and a continuation phase at a dosage of 300 IR/day. Treatment is scheduled to start approximately 4 months before the actual start of the pollen season and should be continued throughout the season. The treatment should be prescribed and initiated by an experienced allergy specialist. 

This paper is brought to you by the library at University of Nebraska-Lincoln 

January 24



November 16, 2010




At the very same time that we’re being inundated with advice on restricting salt intake, we’re also hearing about a new type of therapy based on the claim that spending time in a salt room, breathing in moist, salty air, can help ease chronic respiratory problems such as asthma while also clearing up skin issues such as acne or psoriasis. Based on a centuries-old Eastern European curative therapy, spalike salt rooms are beginning to appear around the country. Are the benefits for real?



The quasi-medical term for this treatment is "halotherapy." It involves sitting in a smallish room lined with blocks of salt mined from ancient salt caves. A generator (like a steam vaporizer) emits vapor containing about one-half cup of salt during a 45-minute session. People remain clothed for the treatment but often bring a clothing change for afterward since the salt tends to leave a residue.

It sounds like "a day at the beach" -- but does halotherapy help your health in any meaningful way? To find out, I called asthma and allergy specialist Leonard Bielory, MD, chair of the American College of Allergy, Asthma & Immunology (ACAAI) Integrative Medicine Committee and director, STARx Allergy and Asthma Center in Springfield, New Jersey.



Dr. Bielory calls salt rooms a "nice concept" but voices some concerns. He agrees that the salt particles may help skin conditions such as acne or eczema but he worries that salt therapy may prove detrimental to some people with asthma. He pointed out that asthma is the result of constriction in the respiratory tract, which can be caused by excess mucus or by spasms. Breathing salt-infused air might help break up mucus and therefore help some folks to breathe better, but others may find that the salt is an irritant that triggers spasms.


Dr. Bielory’s objections don’t stop there. There’s no way to guarantee the purity of the air in the rooms, he said -- pointing out that, theoretically at least, salt attracts certain bacteria and that each person coming for treatment brings a fresh supply of additional bacteria that might evolve in the environment. Other worries relate to the length of time and at what temperature it is safe to stay in the rooms, and whether salt rooms may be dangerous for people with other health conditions, such as cardiac problems.


Offering a different perspective, Daily Health News contributing medical editor Andrew L. Rubman, ND, was less dismissive. While agreeing with some of Dr. Bielory’s concerns, he pointed out that this therapy has hundreds of years of successful use in Europe behind it, and he knows naturopathic physicians who treat patients with inhaled salt therapy for such things as chronic bronchitis, asthma and chronic fatigue syndrome. "There is potential benefit for some patients under the supervision of a skilled doctor with experience," he said. Dr. Rubman agrees with Dr. Bielory that medical oversight is imperative because there is potential for harm.


Is it worth a try? Maybe, but don’t be casual about it. If you are interested in exploring the use of halotherapy for a particular medical concern, make sure you find a doctor "worth his salt" ... in other words, one who knows the way around this particular block.




Leonard Bielory, MD, chair of the American College of Allergy, Asthma & Immunology (ACAAI) Integrative Medicine Committee, professor and director, STARx Allergy & Asthma Center, Springfield, New Jersey, research associate, Rutgers University, Center of Environmental Prediction, New Brunswick, New Jersey.


January 23

Allergic Reaction

SPRINGFIELD, NJ (WCBS 880) - Battling allergies is a complicated fight, as one a local radio journalist knows about firsthand.

After years of reporting about allergies, WCBS 880′s Sean Adams figured it was about time he got checked out himself.

WCBS 880′s Sean Adams At The Doctor

“Woh!,” said Dr. Leonard Bielory.

“That was a priceless reaction,” said Adams.

“Your back is a priceless picture,” said Bielory, who is with the Rutgers University Center for Environmental Prediction, was referring to red blotches and hives on his back – the result of being pricked with sixty different allergens. “Your skin tests were quite explosive and showing a reaction even while you’re on an oral antihistamines… You have what I will call 4++, really severe reactions to multiple items.”

Some of that, Adams already knew.

“You were 4+ for a variety of trees, dust mite. We picked up a mild cat allergen,” Dr. Bielory said.

Now, Adams knows some more specifics.

“American Beech, red birch, red oak, sugar maple, box elder, hickory, red-top grasses – 4+,” said Dr. Bielory.

It was actually easier for Dr. Bielory to tell him what he wasn’t allergic to.

Information is power.

Adams can dust regularly, avoid certain grassy areas and cats, and take medication when certain trees are in bloom, but for some people antihistamines, eye drops, and nasal sprays are not enough.

Brad Taylor of Springfield might need something more potent.

“This year just really zapped me and I’m like, ‘You know what! I think I need to really see a specialist.’,” he said.

“It was at the point that I couldn’t get out [of the house],” says Ayal Betansky from Springfield. “Like everybody else, you take some kind of medicine – over the counter – hoping for good until you can’t stand it anymore and then you come to the doctor.”

He’s receiving immunotherapy – allergy shots that help his body build up a tolerance, and he’s hopeful that he can reduce the frequency of his visits to the doctor.

Audio File: 

January 22

Sternulation - Nothing to Sneeze At!!

Nothing to Sneeze  at!!

The all American Sneeze

Have you ever “sternulated”? We all have !!!  A sneeze (or sternutation) is a semi-autonomous, convulsive expulsion of air from the lungs through the nose and mouth, that occurs when the nerve endings of the mucous membrane of the nose are irritated, usually caused by foreign particles. Surprisingly enough, sneezing can be brought on (or out!) when the optic nerves in our eyes are exposed to bright light!

-- Or, particularly by a full stoach, or viral infection, and can lead to the spread of disease. But if you are one of the 18.2 million Americans who suffer from allergic rhinitis, or "hay fever," chances are you may be sneezing, reaching for a box of tissues or rubbing your itchy, red, watery eyes as you read this. It is April  and the start of yet another allergy season has begun, when pollen seems to cover the universe and very little relief is in sight. While many patients endure mild to moderate symptoms, the larger truth is that the world of allergies is a complex and costly landscape. More than 50 million Americans suffer from all forms of allergies, which some report that it the 5th or 6th leading cause of chronic diseases in the United States. For unknown reasons, the incidence of hay fever has risen substantially in the past 15 years. This may be due climate change that demonstrating increase in pollen seasons in the United States.

Thus Allergies – are truly nothing “nothing to sneeze at’! This saying, which has been around since the early 1800s, may come from the idea that someone might turn up his or her nose at something unimportant or unworthy. When you say something is "nothing to sneeze at," you're saying it's actually important  -- something that deserves serious attention. For example, coming in second place in the science fair is nothing to sneeze at. Even though you didn't come in first, second place is still an important accomplishment.  Sneezing was considered the right thing to do in good society of 17th century Europe when the craze for sneezing caught on. Indeed, it was considered that the more you sneezed, the more you proved yourself a member of the privileged class. To build up this new status symbol, all kinds of devices were used. It was soon realized that “snuff” caused sneezing. Therefore everyone who was someone carried with him a little box, containing a mixture of sneeze-producing herbs or tobacco. By drawing an ample pinch of it into the nostrils, an immediate hearty sneeze resulted. However, only the rich and idle had time to sneeze or could afford snuff. Hence the self-induced sneeze became synonymous with aristocratic living!! One indulged in it whenever they wanted to show your disapproval of anything said or, even more so, your lack of interest in the matter discussed. A sneeze was an unmistakable way of saying politely ‘you bore me.' Consequently and logically, anything ‘not to be sneezed at' was something really worthwhile!!!!

 Medical science dispelled ancient beliefs concerning the out-of-control sneeze, and snuffed out superstitions in the process. Primitive people held the belief that a sneeze signified approaching death, and immediately assisted the distressed person by crying out "God help you!" Egyptians, Romans, and Greeks, saw the sneeze as an omen of approaching danger, or, on a more positive note, as a way of foretelling the future. Lucky ones sneezed to the right, while unlucky ones sneezed to the left. Biblically speaking, sneezing meant a certain death, until Jacob and made a deal with God, whereby a prayer per sneeze cheated the grim reaper. Pope Gregory the Great, in response to the sixth century plague in Italy, carved out his place in history as being the one responsible for insisting that prayers, such as "God bless you!," be said in response to the deadly sneeze. He did not, however, order that tissues be kept close at hand to snare the airborne germs spewed forth by the sneeze.

 However, one that suffers from such misery can now find relief in the hands of those specially trained to address the “sternulation”! May God bless you  with the help of an Allergist!

January 21

Antibiotics in Animals

Antibiotics in the Animals We Eat

Low-dose antibiotics in animal feed fuel drug-resistance in human infectious diseases.

By Bonnie M. Marshall and Stuart B. Levy | April 1, 2012

For as many decades as antibiotic resistance has thwarted the cure of bacterial infections, scientists have pondered the origins of resistance genes and how they became such a problem. Fingers were pointed squarely at the overprescription of antibiotics in human medicine—and rightly so, as early on, these drugs were liberally utilized for every imaginable malady without concern for the possible consequences. Not long after their discovery, however, these miracle drugs were applied not only to sick humans and animals, but to healthy ones as well.

Nowhere is this practice more prevalent and controversial than in animal husbandry, where animal feeds laced with small amounts of antibiotic are provided over extended periods of rearing. Labeled as “growth promotion” and employed primarily in large, concentrated feedlots for poultry, swine, and cattle, this nontherapeutic application appeared to fatten the animals faster, prevent rampant herd disease, and help bring healthy animals to market more quickly.

While US farmers and other stakeholders have argued tenaciously for the continuation of subtherapeutic dosing, Europeans adopted the “precautionary principle,” instituting sequential bans on the practice beginning in the mid-1990s. Arguments on both sides of this issue continue to the present day, but evidence of the negative consequences of low-dose antibiotic feeding has been mounting. Since 1976, several persuasive scientific studies have illustrated how animals fed low-dose antibiotics not only propagate resistant bacteria, but spread these resistant strains to farmers, their families, community residents, and ultimately, hospitalized patients. Particularly worrisome is the continued use in animals of antibiotics that are close structural relatives of those that are used in human medicine.  It is feared that, in time, these drugs will lose potency as bacteria express “cross-resistance” to the related drugs.

Some researchers have countered that the resistant bacterial strains found in serious hospital infections bear little or no resemblance to the strains found in farm animals. They argue that eliminating antibiotics on the farm would harm animal health, result in economic loss, and have little or no impact on reducing human morbidity and mortality. However, these rebuttals overlook the inherently promiscuous nature of bacteria—in particular, the transferable genetic elements they often carry (e.g., bacterial plasmids, transposons, phages) that can readily share DNA segments bearing resistance genes. They pass among strains, species, and even diverse bacterial genera, rearranging and accumulating even more resistance genes. Tracking the evolution of such complex bacterial exchanges from food animals to people poses a daunting challenge, making definitive proof elusive. But we argue that the preponderance of evidence, coupled with a diminishing pipeline of new antibiotics and the appearance of multidrug-resistant “superbugs,” warrants closer scrutiny of how and where we are using these antimicrobials—and the adoption of stricter measures of control.

While still declining to issue an all-out ban on subtherapeutic feeding, the US Food and Drug Administration has taken measured steps in the right direction. First, in 2005, the agency prohibited the use of fluoroquinolones in poultry, and just this January, it prohibited certain off-label uses of cephalosporins in livestock generally. It is a matter of concern, however, that the FDA does not address the ongoing use of penicillins and tetracyclines as growth promoters. Thus, we are still a long way from the steps needed to safeguard precious classes of drugs for effective treatment of human disease.

Judicious surveillance in Europe in the decades following the bans on antibiotic use in animals has shown that the emergence and spread of resistant bacteria can be controlled and even reversed. Alternatives to antibiotics in animal husbandry in these countries, including improving hygiene practices and reducing overcrowding, need to be more fully explored for implementation in the United States.


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Location: Springfield, NJ
Today's Date: July 04, 2020
Station Director: Leonard Bielory, M.D
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