Ask About Asthma with Dr. Adams

Posted on March 21st, 2012 by admin

Q. Who is considered an
asthma specialist?

 

A. Allergists and pulmonologists are
considered the best trained and most
experienced physicians to care for
asthmatics. These physicians are
internists or pediatricians who have
done 2-3 years additional training in
allergy or pulmonology.
Q. Should every
asthmatic be seen by an
asthma specialist?

A.. In an ideal situation the answer
is yes but with up to 34 million
asthmatics in this country the
practical answer is that this may not
always be possible. Internists and
family practitioners provide a large proportion of this care, particularly
for patients with mild asthma. For these mild patients I
recommend at least a one-time consultation with an asthma
specialist to review the diagnosis and management and to ensure
proper treatment. Patients with moderate to severe bronchial
asthma require the regular care of an asthma specialist. These
individuals suffer more frequent asthmatic attacks and often
require emergency care. Despite advances in treatment, 3-4
thousand asthmatics still die of asthmatic attacks each year. I
know that every asthma specialist feels that each one of these
deaths is preventable.
Q. Does every asthmatic need to be tested
for allergies?

A. It is estimated that a little more than 50% of asthma is allergic
(also called extrinsic). Non-allergic (intrinsic) asthma is more
common in adults while the allergic form usually starts in
childhood. I feel that every person with asthma should have an
allergy evaluation. This information may be invaluable since it may
identify an asthma trigger such as a specific food that can be
avoided. If the results of the allergy testing are negative the
physician may then focus on reducing other common asthma
triggers such as cigarette smoke or infection.
Q. Is wheezing always an indication of asthma?

A. The old adage that “all that wheezes isn’t asthma” is still true.
A wheeze is a high pitched sound that comes from the air passages
of the lungs when the flow of air through them isn’t smooth. Unfortunately
patients who wheeze are often immediately labeled
asthmatic and are given an asthma spray without a correct
diagnosis. There are a number of illnesses that can mimic asthma.
In children aspiration of a foreign body may produce wheezing
due to a partial blockage of an airway. Elderly adults with
congestive heart failure may wheeze due to excess fluid in the
lungs producing narrowing of the airways. This is often called
“cardiac asthma”. Dysfunction of the voice box or larynx in which
the vocal cords move in the opposite direction that they are
supposed to may produce severe wheezing and be mistaken for
asthma. This entity is known as “laryngeal asthma”.

Q. How should asthma be diagnosed?

A. Although a patient’s history and physical exam may suggest a
diagnosis of asthma, a definite diagnosis requires the demonstration
of narrowed bronchial tubes that are opened by the administration
of a bronchodilator medication. This simple test is called
spirometry which requires a patient to exhale forcibly into a device
which measures air movement. The results taken before and after
the use of a short-acting bronchodilator are compared. A 15%
improvement after the use of the bronchodilator is the criteria for
the diagnosis of asthma. 

 

Dr. Adams is a pulmonologist in private practice in New York City
and is the author of The Asthma Sourcebook, 3rd Edition
(McGraw-Hill). He hosts Doctor Radio on SiriusXM 81every
Tuesday from 6-8AM and 4-6PM .

Allergist Experts Discuss Current Standards and Future Directions in Immunotherapy

Posted on November 9th, 2011 by admin

ARLINGTON HEIGHTS, Ill., [Oct. 31, 2011] – How the advent of sublingual immunotherapy and other advances in allergen immunotherapy may alter allergy treatment in the U.S. were recently discussed by a panel of nationally recognized allergist experts.  The result is a new perspectives article published in the November issue of Annals of Allergy, Asthma & Immunology, the scientific journal of the American College of Allergy, Asthma and Immunology (ACAAI).

 

“2011 marked the 100th anniversary of immunotherapy and the release of the ACAAI’s third update of Practice Parameters for Immunotherapy,” said Dana V. Wallace, MD, ACAAI president, article co-author and associate clinical professor of medicine, Nova Southeastern University, Fort Lauderdale, Fla. “These milestones provided an excellent opportunity to review the parameter highlights and advances in treatment and create new credible resources for allergists, primary care physicians and other health care professionals.”

 

The perspectives article, podcasts and proceedings are based on the panel’s discussion at a recent Roundtable Forum on Immunotherapy.  Topics include:

  • The latest standards of care in immunotherapy, including an overview of recently updated practice parameters;
  • The status of sublingual immunotherapy (SLIT) in the U.S. and how it compares with traditional subcutaneous immunotherapy (SCIT);
  • Other delivery methods now available or on the horizon, including rush and cluster immunotherapy, intranasal, epicutaneous and intralymphatic immunotherapy, and needed research and unanswered questions; and
  • How advances in allergen immunotherapy may change and challenge the practices of allergists and other physicians.

 

“These materials give practicing physicians a succinct overview of the latest research and developments in the field of immunotherapy, a convenient way to identify and access specific topics of interest and ‘listen in’ on the opinions and insights of top leaders in the field,” said Linda S. Cox, MD, article co-author, associate clinical professor of medicine, Nova  Southeastern University, Fort Lauderdale, Fla., and immediate past chair, ACAAI Immunotherapy and Diagnostics Committee.

 

The Roundtable and resource materials were supported by a grant from Merck.  Dr. Wallace and Dr. Cox co-chaired the Roundtable with the following participants: David I. Bernstein, MD, professor of internal medicine and co-director of the allergy training program, University of Cincinnati College of Medicine and member, ACAAI Board of Regents; Michael S. Blaiss, MD, clinical professor of pediatrics and medicine, University of Tennessee Health Science Center, Memphis, Tenn.; Ira Finegold, MD, chief of allergy and director of the Cook Institute of Allergy, St. Luke’s Roosevelt Hospital and clinical professor of medicine, Columbia University, New York City and chairman, ACAAI Immunotherapy and Diagnostics Committee; Bobby Q. Lanier, MD, clinical professor of immunology, University of North Texas Health Science Center, Fort Worth, Texas, and executive medical director, ACAAI; and Harold S. Nelson, MD, professor of medicine, National Jewish Health and the University of Colorado School of Medicine, Denver.

 Read more about changes in immunotherapy

About ACAAI

The ACAAI is a professional medical organization headquartered in Arlington Heights, Ill., that promotes excellence in the practice of the subspecialty of allergy and immunology. The College, comprising more than 5,000 allergists-immunologists and related health care professionals, fosters a culture of collaboration and congeniality in which its members work together and with others toward the common goals of patient care, education, advocacy and research.  Learn more at www.acaai.org and www.allergyandasthmarelief.org.

9 Allergy Myths Debunked

Posted on June 6th, 2011 by admin

Allergy season is at its worst in 10 years, meaning lots of itchy eyes, runny noses and wheezing lungs for the 93 million U.S. allergy sufferers out there.

“We are seeing a mini-crisis in New York City, among other U.S. cities, due to heavy winter and early spring precipitation that has caused more early, and sustained tree and grass pollens in many areas,” said Dr. Clifford Bassett, clinical assistant professor of medicine at the NYU School of Medicine and medical director of Allergy and Asthma Care of New York. “Secondary, we have seen a steady rise in pollen levels in many areas.”

Read More

Pollen and Storms Lead to Allergy Surge

Posted on April 7th, 2011 by admin

MELBOURNE hospitals have had an influx of patients with respiratory problems to their emergency departments in a phenomenon experts have described as ”thunderstorm asthma”.

The head of The Alfred hospital’s allergy and asthma service, Associate Professor Jo Douglass, said days Continue reading →

An Alternative to Allergy Shots

Posted on April 7th, 2011 by admin

Sublingual allergy therapy has been common practice in Europe for 30 years, but in the United States it’s still emerging as a way to treat allergies.  The treatment technique just recently hit Great Falls.  Dr. David Kluge, otolaryngologist at the Continue reading →

Cats on a plane? Allergy sufferers can’t escape

Posted on April 7th, 2011 by admin

Holiday travelers with cat allergies may find the best advice is beware in the air, according to a new study that says it’s nearly impossible to avoid feline fallout at 30,000 feet.

Whether it’s residue from cats actually on board, Continue reading →

Increasing CO2 Means Added Misery for 30 Million Allergy Sufferers

Posted on April 7th, 2011 by admin

The science of climate change arrived at the doctor’s office last week.

The setting was the Annual Scientific Meeting of the American College of  Allergy, Asthma & Immunology (ACAAI) in Phoenix. There, on Nov. 12 a packed symposium of allergist/immunologists Continue reading →

10 Ways to Naturally Combat Allergies

Posted on April 7th, 2011 by admin

Itchy eyes, runny nose, sneezing and coughing are all signs that allergy season has arrived, and it’s hitting harder than ever, with experts predicting this will be the worst allergy season in a decade. While many sufferers typically reach for Continue reading →

Allergy Free Christmas Trees Exist

Posted on April 7th, 2011 by admin

This weekend is the first big Christmas tree shopping weekend, but do you know your pine from a cypress? There are lots of options out there when it comes to live tree buying, including options that are allergy free.

Read More

New Food Allergy Guidelines to Debut December 6

Posted on April 7th, 2011 by admin

November 16, 2010 (Phoenix, Arizona) — Delegates to the American College of Allergy, Asthma & Immunology (ACAAI) 2010 Annual Scientific Meeting got a “taste” of new guidelines specifically created to help a wide variety of healthcare professionals, not just allergists, Continue reading →

 

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