Focus On Allergy

Host: Linda Bernstein, Pharm.D. Allergic reactions to peanut are unpredictable in occurrence and in how they present, with some individuals experiencing severe reactions from even trace amounts. Fortunately, there’s now an FDA-approved treatment option available that—when used in conjunction with peanut avoidance—can help reduce the risk of these allergic reactions in children with peanut allergy, as pharmacist Dr. Linda Bernstein explains.

Host: John J. Russell, MD Do pets help prevent allergies? Does the 5-second rule actually exist? And is dirt really good for a child’s immune system? Host Dr. John Russell talks with Jack Gilbert, Ph.D., Professor of Surgery at the University of Chicago and Director of the Microbiome Institute. Dr. Gilbert is author of the book Dirt is Good, answering questions about the potential benefits of exposure to germs and bacteria. He and Dr. Russell sift through common misconceptions about microbiomes to better understand their actual risks and benefits for the body's immune system, explaining its role in disease and health.

Host: Brian P. McDonough, MD, FAAFP Allergies occur when your immune system mistakes a normally harmless allergen for a dangerous invader and moves to destroy it, producing an allergic reaction. What exactly causes this response, and what are the best treatments to combat it? Host Brian McDonough chats with Dr. Avery August, Professor of Microbiology and Immunology at Cornell’s College of Veterinary Medicine, about his research regarding how allergens affect the immune system.

Host: Kathy King, RDN It's estimated that 4 - 8% of the U.S. population has at least one food allergy, and the incidence rate appears to be growing. How do we explain this harmful trend in public health, and what can clinicians and patients do to help mitigate the risk of developing food allergies? Host Kathy King is joined by Debra Indorato, nutrition advisor for Kids With Allergies, which is a division of the Asthma and Allergy Foundation of America. The two discuss the latest understandings and dietetic approaches to food allergies, sensitivities, and intolerances.

Host: Matt Birnholz, MD The simple act of going out to eat can be a tricky proposition for people dealing with gluten intolerance or sensitivity issues. A new portable device is aiming to help people with this problem by allowing them to test food’s gluten content and help find foods that they are able to eat. Host Dr. Matt Birnholz talks with guest Carla Borsoi, Vice President of Marketing at 6Sensor Labs, about how this device will assist people living with gluten intolerance or sensitivity issues.

Host: Brian P. McDonough, MD, FAAFP For most people, the home is a refuge and an oasis, a place to feel safe. But few ever wonder whether their homes and the everyday household items they use to clean and maintain them could be detrimental to their health. Joining Dr. Brian McDonough to discuss the unsettling health risks behind common household items, and what consumers should keep an eye on, is Andre LaCroix, Vice President of Easy Breathe, Inc.

Over the past decade, Food Protein Enterocolitis, or FPIES, has emerged as the most actively studied non–IgE-mediated gastrointestinal food allergy because of its acute onset, severity of symptoms, and distinctive clinical features. Yet as a rare allergic disorder of infancy and young childhood, it is often misinterpreted and misdiagnosed in clinical practice, leading to difficult treatment paths for patients and their families. Joining Dr. Renee Matthews to present a case history from the vantage point of a patient's mother, including challenges faced in reaching the correct diagnosis and starting effective treatment regimens, is Jennifer Kandt.

Host: Brian P. McDonough, MD, FAAFP As an unforgivingly cold, frigid winter in America has led to the explosive release of tree pollens over a short period this spring, seasonal allergies have returned with a vengeance. Says, Dr Mitchell Gaynor, clinical assistant professor of medicine at Weill Cornell Medical College in New York City, this could make for one of the worst allergy seasons of all time. How can primary care providers ready themselves on the frontlines of this mass allergy assault? Dr. Brian McDonough and Dr. Gaynor discuss strategies to keep clinicians on top of this emerging threat, including new understandings of eco-genetic mechanisms of allergic disease.

Guest: John Heffner, MD Host: Maurice Pickard, MD Do allergies to various types of fungi trigger worsening of asthma? Are patients with severe asthma sensitive to certain species of fungus more than others? Dr. John Heffner, professor of medicine at the Oregon Health and Science University, discusses how patients with asthma might benefit from antifungal agents. Does off-label use of itraconazole for patients with severe asthma require long-term adherence for optimal asthma control? Dr. Maurice Pickard hosts.

Guest: Gailen D. Marshall, MD, PhD Host: Todd Mahr, MD The media often report about the effect of stress on the immune system. What research supports the idea that certain individuals are more susceptible to stress than others, and how can physicians recognize patients who might be experiencing an immunological response to stress? What mechanisms might link rhinitis, asthma and chronic urticaria to stress? Dr. Gailen Marshall, professor of medicine and pediatrics at the University of Mississippi Medical Center, discusses the fascinating relationship between a patient's mental state and immunity. Dr. Todd Mahr hosts.

Guest: Norman Edelman, MD Host: Shira Johnson, MD More than 40 thousand people, including fire and rescue workers, were exposed to toxic dust in the wake of the attacks on the World Trade Center in New York City in September, 2001. Fast-forward more than a decade, and nearly a quarter of those first responders still have breathing issues. Dr. Norman Edelman, chief medical officer of the American Lung Association, joins host Dr. Shira Johnson to disuss what needs to be done for those who continue to suffer, as well as how children living in nearby neighborhoods have also been affected. The two also look at air quality and allergy and its affect on Americans.

Guest: Robert Pass, MD Host: Jennifer Shu, MD Congenital cytomegalovirus (CMV) infection causes auditory, cognitive and neurologic impairment in thousands of infants each year in the United States. Recognition of infection in pregnant women is difficult because CMV often produces few symptoms, and antiviral treatment during pregnancy may have toxic effects. Could a new experimental vaccine hold the key to preventing maternal CMV infection during pregnancy and decrease the incidence of congenital CMV infection and its sequelae? Host Dr. Jennifer Shu evaluates the progress toward a CMV vaccine with Dr. Robert Pass, professor of pediatrics and microbiology at the University of Alabama at Birmingham School of Medicine. Dr. Pass also explains the proposed mechanism of action for the vaccine.

Guest: Rob Neville Host: Bruce Japsen Despite medical advancements in drugs and delivery devices for asthma and allergy sufferers, some patients are not getting appropriate dosages. But new advances are being worked on that could improve care for many through nanotechnology. Rob Neville, executive chairman of Savara Pharmaceuticals, tells host Bruce Japsen about the use of nanotechnology as an emerging way to administer drugs more effectively for improved respiratory care.

Guest: Robert Wise Host: Lee Freedman, MD What evidence links gastroesophogeal reflux to worsened asthma, and does prescribing a proton pump inhibitor to patients with asthma help alleviate their asthma symptoms? Dr. Robert Wise, professor of medicine at Johns Hopkins University School of Medicine, discusses the role of proton pump inhibitors for patients with asthma. In patients with poorly controlled asthma and asymptomatic reflux, is a proton pump inhibitor beneficial?

Guest: Christina Robohm, PA-C Host: Lisa Dandrea Lenell, PA-C, MPAS, MBA How does a PA handle the situation when a parent does not want to vaccinate their child? Christina Robohm, physician assistant and associate professor of pediatrics at the University of Colorado at Denver, tackles this growing issue with host Lisa Dandrea Lenell. The two discuss how PAs make sure parents receive accurate information in order to make an informed decision whether or not they want their children to receive vaccinations, the pros and cons of not vaccinating, and what it means for other children around them and the community at large. They also look at the controversy over vaccinations and autism.

Guest: Paul Offit, MD Host: Jennifer Shu, MD Vaccines have been described as one of the greatest medical advances in history. Yet some segments of the population view them as a potential vehicle for causing more harm than good to young patients. What led to this change in perception about vaccines, and how can physicians best counsel patients who harbor concerns? For answers to these critical questions and much more, Dr. Jennifer Shu welcomes one of the foremost figures in the debate over vaccine safety, Dr. Paul Offit, chief of the division of infectious diseases and director of the Vaccine Education Center at the Children's Hospital of Philadelphia, and the Maurice R. Hilleman Professor of Vaccinology and a professor of pediatrics at the University of Pennsylvania School of Medicine.

Guest: Paul Offit, MD Host: Jennifer Shu, MD Most parents support the immunization of their kids according to the recommended vaccine schedule. But increasing numbers are choosing to forgo this routine entirely or follow an alternative vaccine schedule. How are these vaccine practices impacting the health of our young patients and more broadly, the health of the general public? Host Dr. Jennifer Shu examines the key questions surrounding the alternative vaccine schedules and how to guide young patients and their families through this process, with Dr. Paul Offit, chief of the division of infectious diseases and director of the Vaccine Education Center at the Children's Hospital of Philadelphia, and the Maurice R. Hilleman Professor of Vaccinology at the University of Pennsylvania School of Medicine.

Guest: Harold S. Nelson, MD Host: Jennifer Shu, MD The incidence of asthma has doubled in the past two decades, though the cause of this rise is difficult to pinpoint. While the hygiene hypothesis has, for years, served as one possible explanation, newer studies show a possible link between asthma and vitamin levels or exposure to certain chemicals or medications. How might this knowledge help us prevent the development of asthma, and what research still needs to be performed to determine the key factors here, and put an end to the increasing incidence of asthma? Dr. Harold Nelson, professor of medicine at the University of Colorado School of Medicine and National Jewish Health hospital in Denver, lays out the evidence for these potential risk factors, from the child's date of birth, to acetaminophen use, to vitamin D levels, to exposure to cleaning sprays and other household chemicals. Dr. Jennifer Shu hosts.

Guest: Jesse Joad, MD, MS Host: Jennifer Shu, MD Long-acting, single-agent beta agonists should be used in tandem with a corticosteroid for the treatment of asthma. Despite a black box warning from the Food and Drug Administration (FDA) to this effect, evidence suggests nearly half of our patients do not take these medications together, which appears to result in more severe asthma attacks and an increased mortality risk. In theory, longer-acting beta agonists (LABAs) should help with compliance, but if these single-agent drugs aren't taken as recommended, is there a role for them in the treatment of asthma? Dr. Jesse Joad, professor of pediatrics at the University of California, Davis School of Medicine and a former member of the FDA's Pulmonary and Allergy Drug Advisory Committee, talks with host Dr. Jennifer Shu about the pharmacologic and logistical differences between LABAs taken as monotherapy and LABAs taken in combination with a steroid. Dr. Joad ...

Guest: David Fleischer, MD Host: Jennifer Shu, MD Wheat, eggs, milk, peanuts and other nuts, soybeans and seafood: all of these can be an integral part of a balanced, healthy diet for growing children. Instead, many are off-limits for an increasing number of children diagnosed with food allergies. Though the rise in food allergies is certainly worrisome, we're learning that some food allergies may actually be misdiagnosed. Host Dr. Jennifer Shu welcomes Dr. David Fleischer, assistant professor of pediatrics at the University of Colorado School of Medicine and National Jewish Health in Denver, for a conversation about how we can improve our capacity to accurately assess food allergies, and help many of our young patients tolerate, or even enjoy, a wider range of food. Starting with a clinical history, what kind of workup should be done before patients are referred to an allergist? How should allergen-specific antibody blood tests be incorporated into this process?