George A. Sprecace M.D.,
J.D., F.A.C.P. and Allergy Associates of New
London,
P.C.
www.asthma-drsprecace.com
Bronchial Asthma Topics
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Rapid Response for WEDNESDAY,
October 9,
2019
Interesting information, as is much that is written about Bronchial Asthma.
But there are three important issues that are being missed by most physicians and most commentators:
1)
the central importance of a carefully taken medical and allergy
history, by a certified Allergist or by a trained and motivated health
care provider. This would most often lead to complete diagnosis and a
treatment program that should include Allergy Immunotherapy for those
allergens that cannot be avoided.
2) the uselessness of the
"diagnosis" of COPD, actually a waste-basket for undiagnosed components
of Obstructive Airway Diseases: Bronchial Asthma, Chronic Bronchitis
and other consequences of personal and occupational life.
3) the
proper and experienced use of oral corticosteroids, both tablet and
inhaled, often used with a "all or nothing at all" approach.
4) the utility of biologics in selected cases - but not nearly as important as the above.
That approach will get our asthmatics better and keep them better.
GS
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Rapid Response for MONDAY,
December 24,
2018
THERE ARE FOUR KINDS OF MEDICAL RESEARCH, ALL DEPENDENT UPON VAST AMOUNTS OF FUNDING.
- Original Research, beginning de novo;
- New Research building upon research results already reported, sometimes many decades ago:
- Research essentially re-doing established work of the past, with or without attribution;
- Research that totally ignores established work of the past that still supports current mainstays of medical treatment.
It
is the fourth kind of research that I address here: work establishing
Allergy Immunotherapy, first in the clinical laboratory and practices
of pioneers like Dr's Robert Cooke and William Sherman beginning in the
1920's...and then entirely verified in the immunology laboratories of
scientists like Dr's. Larry Lichtenstein and Ichizaka in the 1960's.
That
Allergy Immunotherapy is a bed-rock of desensitization treatment for
serious inhalant allergies - particularly bronchial asthma and combined
asthma / chronic bronchitis.
And It Is Being Studiously
Ignored...by both practising clinicians who never bothered to become
familiar with it, and by researchers who would rather not lose research
grants while giving passing attention to the central role of inhalant
allergy in these fields. This leaves the patient to search out his or
her needs.
See the following extensive article entitled:
"Advances In Asthma In 2017:Mechanisms, Biologics, And Genetics.", in J. Allergy Clin Immunology, November 2018.
See if I missed anything.
GS- - - - - - - - - - - - - - - -
Rapid Response for FRIDAY and SATURDAY, December 7 and 8,
2018
NOW HEAR THIS!
If an established Asthmatic is not treated with
an accurate and complete diagnosis, with effective environmental
control - especially involving pets, with an effective (and not
excessive) program of anti-allergic and anti-inflammatory medications,
with prompt on-call and effective treatment of superimposed respiratory
tract infections, and WITH ALLERGY IMMUNOTHERAPY FOR UNAVOIDABLE
ALLERGENS, he or she, at whatever age, is BEING POORLY TREATED.
And
that is also true - and possibly especially so - for the many patients,
undiagnosed by their Pulmonologists, who continue to miss combined
Bronchial Asthma and Chronic Bronchitis, mis-labled as "COPD",
Everybody so affected, whether, parent or patient or primary care physician or pulmonologist:
EITHER LEARN, OR GET TO A CERTIFIED ALLERGIST, OR
GET OUT OF THE BUSINESS
George A. Sprecace., M.D., F.A.C.P, J.D.
asthma.drsprecace.com- - - - - - - - - - - - - - - -
Rapid Response for SUNDAY,
November 18,
2018
BRONCHIAL ASTHMA: THE MOST TREATABLE - AND OFTEN THE MOST POORLY
TREATED - SERIOUS MEDICAL CONDITION.
I have been writing about and treating Bronchial Asthma for many
decades. That information is available in several sections of this web
site, and is up-dated regularly.
Today, I present the latest caution, prompted by the very recent
re-approval by the FDA of Primatene Mist as an OTC medication
for the treatment of "mild asthma".
WRONG, AND POTENTIALLY
DANGEROUS.
In this position, I am joined by a Joint Statement just released by the
major medical organizations dealing with such subjects : "Several
Asthma, Allergy Groups Express "Deep Concern" Over Primatene Mist
Approval" (MPR, November 12, 2018).
- The
availability of this agent, racemic Epinephrine, will delay the quest
by asthmatics for proper, comprehensive and very effective medical
care, especially by that group with a high and dangerous tolerance for
asthma and for its hypoxic effects.
- The
medication is subject to overuse which can produce heart rhythm
problems.
Use
and overuse can easily result in a rebound worsening of the asthmatic
bronchospasm, resulting in crisis situations.
There may be usefulness for Primatene Mist, only by prescription and
under a doctor's emergency advice, in case of acute laryngospasm...and
then FOLLOWED IMMEDIATELY by transfer to an Emergency Room - in view of
the medication's propensity to produce worse rebound.
BEWARE: The life you save may be your own.
GS- - - - - - - - - - - - - - - -
AS
I HAVE NOTED MANY TIMES: FULLY 50% OF HEALTH CARE EXPENDITURES ARE
DIRECTLY RELATED TO UNHEALTHY LIFE-STYLE ACTIVITIES. STUPIDO!
GS
Study:
Smoking-Related Mortality Greatly Underestimated - Consultant360.Com
Rapid
Response for WEDNESDAY, December 3, 2014
Finally
the Pulmonologists come around to an observation that I made and
reported in 1970...and since then: that about 30% of patients
presenting ostensibly with Chronic Bronchitis have concomitant
Bronchial Asthma, which may be the only reversible part of their
condition. Thus, I have always considered "COPD" to be an
incomplete
diagnosis, detrimental to the patient.
GS
Rapid
Response for TUESDAY, August 19,
2014
Finally...
I presented a paper on this in 1970 at the Yale Allergy Clinic; and I
have been diagnosing and treating patients with it since then - with no
help from my Pulmonology colleagues.
GS
Offerings by George A. Sprecace M.D., J.D.:
Childhood Asthma - On My Mind,
GS
(Added 9/7/2013)
WAZZUP?! - New
and Notable, GS
Bronchial
Asthma, COPD, and Inflamation, GS
Problems and
Controversies
in Bronchial Asthma, GS
Emergency Room
Treatment of
Acute Bronchial Asthma, GS
Inflamation and
Remodeling
(Scarring) in Bronchial Asthma and COPD, GS
The Latest Research -
Reported
March, 2000, GS
Asthma and Other
Allergies:
What's It All About?, GS
Selected Notes
Taken from
the Text, "Inhaled Glucocorticoids In Asthma", GS
On the Current Rise
in Bronchial
Asthma Cases, GS
More Issues, GS
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