Attention! Answers to Questions from previous weeks/months are below.
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Answers to : Ragweed- AllergyIQ
1) True .
2) False. Ragweed season begins in the middle of August in the Midwest. It does come to a screeching halt after the first frost (either way the season is usually over by October).
3) False . Goldenrod is insect pollinated and does not typically cause allergic nasal symptoms (you would have to practically stick the plant up your nose to be bothered by it).
4) True . Ragweed, unlike goldenrod, does not require bees, butterflies or other insects to pollinate. The wind carries invisible pollen clouds hundreds of miles from their origin.
5) True!
6) True. An early start with certain medications such as antihistamines and prescription nasal steroids have been found (in clinical studies) to better prepare allergy sufferers for the oncoming season.
7) False! First of all never give up when it comes to your health. Allergy shots are often considered for people that fail to respond to medications. Moving to a different area of the country is not a good alternative in that almost all fifty states have indoor and outdoor allergens (although they differ from region to region).
Answers to: Asthma: Risk in Young Children
1) True: Transient Early Wheezer (TEW) is a subclass of early wheezing children that were more often born to mothers that smoked during pregnancy.
2) False: This passage describes the Non-Atopic Wheezer (NAW). Non-atopic means essentially, non-allergic. Allergic problems tend to be familial. NAWs often have no further chest symptoms by school age.
3) False: Recent studies actually show that diet restrictions during pregnancy to reduce childhood food allergy has no real basis.
4) False: Most children with any asthma symptoms after age 5 will continue to have asthma.
5) False: Inhaled corticosteroids (ICS) are the medication of choice for all ages of patients with asthma but ICS are considered controllers. No inhalant, pill or liquid form of asthma medication has been proven to prevent the development of asthma. There are ongoing studies addressing this issue.
6) False: Avoidance of peanuts may lead to loss of the hypersensitivity over time. This often takes years to occur. Retesting should be done periodically in order to verify the status of peanut allergy. If blood test or skin test becomes negative, some of the preparatory measures maintained for accidental ingestion may be reduced.
7) True: Allergy shots are potentially disease modifying. They do not work for everyone but they represent a highly successful way to reduce the need for medications and induce remission of asthma and allergy problems.
Allergy IQ- Fragrances
1) False- Fragrances are chemical irritants. They do not lead to IgE antibody formation in most circumstances (as allergens do). But they may trigger asthma and rhinitis
2) False- There are a few things you can do. Ask co-workers to limit or stop wearing fragrance; try to get your work site moved; work with housekeeping; get an air cleaning device if possible
3) True- Allergy shots are very good at reducing your response to allergens. The irritant response to fragrance and other irritant triggers tends to improve when the allergies are better controlled.
4) True- Contact dermatitis is not IgE mediated but occurs in some people exposed to fragrance after direct contact with the skin. It may cause a rash and symptoms similar to a poison ivy reaction.
5) False- Because of the increased demand, fragrance free products are easier to find in recent years.
6) True- I have seen many patients that are extremely sensitive to fragrance. Severe asthma and sinus problems may be triggered by a brief inhalation of an irritant.
7) True- Some people may have non-allergic rhinitis or intrinsic asthma both of which are disorders that are not triggered by allergens. Common triggers in this setting are: fragrance, fumes, odors, ash from cigarettes or cigars, dry air, cold air, pollution, and chemicals.
AllergyIQ: Hookah Bars
1) True: Hookah bars generally do not serve alcohol, allowing for younger teenagers to patronize their businesses.
2) True: Many Hookah smokers are under the false impression that Hookah tobacco "shisha" is either harmless or at least safer than cigarette tobacco. This is not true. The same or even more tar, nicotine, carbon monoxide and carcinogens are inhaled. In fact, by engaging in this smoking event one often has increased inhalation of toxic chemicals because of the length of time and often deeper inhalation.
3) False: There is tar and nicotine, but water does not filter out these bad elements. The water may cool down the inhaled smoke and as well humidify it, but this probably allows for the deeper inhalation and better tolerance of the irritant effect (probably not a good thing).
4) True: Smoking sessions are often 20-90 minutes in reserved, curtained off areas of the Hookah bar. Often 4-10 people are engaged in smoking together, sharing one or two hoses (disposable mouthpieces are often offered).
5) True: To my knowledge many parents and college faculty are clue less about this new fad impacting our youth.
6) False: The American Lung Association has reported multiple risks associated with Hookah smoking. Addiction is attributed to the high nicotine levels associated with this type of smoking. Hookah smoking more than doubles the risk of later smoking cigarettes.
7) False: I found a study in the Journal of American Medicine which reported carbon monoxide levels (CO) that were similar in active smokers compared to passive inhalation (just being in the same room but not smoking). The researchers studied about 30 college students and drew blood to monitor CO levels before and after a Hookah session.
8) True: Illinois smoking ban laws allow for businesses to offer tobacco smoking if 80% of their revenue is from smoking related service and 90% of the floor space dedicated to the smoking. Limited food and no alcohol can be served.
AllergyIQ: Cold Vs Allergy:
1) a. Allergy symptoms tend to have an abrupt onset and last for several weeks (season, seasons or year round)
2) b. Fever and muscle aches are usually due to viral syndromes (common cold or flu). Severe fatigue is more often in the infection setting although when allergy symptoms peak, one can get very tired.
3) d. All the above. (self explanatory)
4) c. Colds are not directly responsive to allergy shots although many patients on allergy shots have fewer colds. Both colds and allergies disrupt ventilation pathways of the sinuses, as well as compromise local immune defense leading to more frequent sinus infections.
5) d. Sorry, No well controlled trials that support the use of most herbals for managing colds (the same for allergies). The yeast free diet also lacks good scientific basis. Airborne has mostly testimonials of success but lacks scientific proof of effectiveness.
Zyrtec Quiz:
Answer: True- Zyrtec is labeled as low sedating. About 14% of adults experienced drowsiness or fatigue in clinical trials.
Allergy IQ
1) It is okay to bring a cat or dog into your home as long as your skin test to them are negative.
False: You may develop allergic sensitivity to the pet if you already have other allergies (pollens, molds etc.). Try not to do this.
2) Dust mite encasements are useless against cat and dog dander that infiltrates mattresses and pillows.
False: Certified dust mite encasements may also trap dander from cats and dogs and should be utilized for environmental controls.
3) There is evidence that weekly cat or dog bathing may be helpful for pet allergy.
True: Some studies have shown that frequent bathing of cats or dogs may reduce the allergy accumulation in homes.
4) Hepa filters (High Efficiency Air Filters) are highly effective at reducing indoor allergy triggers including pet dander.
True: HEPA filters are able to efficiently clear the air of extremely small particles including cat and dog dander as well as dust mite.
5) There are non-allergic cats and dogs available for allergy sufferers who desire these indoor pets.
False: There are no clearly established non-allergic dogs. There is a lineage of cats in which a major allergy gene has been bred out. They are very expensive though (more than $3000.00).