Host: Todd Mahr, MD Guest: Warner Carr, MD What phases does the FDA use to approve a new medication, and why does this process take several years? Why must the active and excipient components of the medication, as well as the device, complete all of the testing phases? Dr. Warner Carr, allergist at Allergy and Asthma Associates in Mission Viejo, California, shares insight from his role as a new drug reviewer at the FDA. How do physicians play a vital role in the drug-approval process by providing clinical feedback to the FDA? Dr. Todd Mahr hosts.
Host: Ketan Sheth, MD, MBA Guest: Carlos Camargo, MD, DrPH, MPH What's the best strategy for managing patients with chronic asthma, and how can physicians create an action plan with their patients to treat an asthma exacerbation? Host Dr. Ketan Sheth reviews recent guideline recommendations for preventing asthma exacerbations with Dr. Carlos Camargo, associate professor of medicine and epidemiology at Harvard Medical School. How are acute and chronic management of asthma different?
Host: Ketan Sheth, MD, MBA Guest: William Lumry, MD Hereditary angioedema is relatively rare and is often misdiagnosed as an allergic reaction to medication or food. What symptoms are helpful differentiating points for making an accurate hereditary angioedema diagnosis? Dr. William Lumry, clinical professor of internal medicine at the University of Texas Southwestern Medical School, outlines the types of hereditary angioedema, factors which can contribute to an acute attack, and therapies to prevent or treat patients with this condition. Dr. Ketan Sheth hosts.
Host: Todd Mahr, MD Guest: Sidney Braman, MD, FACP, FCCP Chronic obstructive pulmonary disease, or COPD, is often diagnosed in late stages, as it is a slowly progressing condition. How can physicians diagnose patients with this deadly disease in its earlier stages, to increase the success of reversing some of its symptoms? Dr. Sidney Braman, professor of medicine at the Warren Alpert Medical School of Brown University, describes who is affected by COPD, and how physicians can best treat these patients. Dr. Todd Mahr hosts.
Host: Ketan Sheth, MD, MBA Guest: William Silvers, MD Are the symptoms of exercise-induced asthma always apparent, and if not, how can physicians diagnose the condition? Can exercise-induced asthma exist independently, or does it always signify an underlying asthmatic condition? Host Dr. Ketan Sheth discusses the pathogenesis of and treatments for exercise-induced asthma with Dr. William Silvers, clinical professor of medicine at the University of Colorado School of Medicine. Dr. Silvers will explain the phenomenon that the seemily innocuous food celery can specifically cause exercise-induced allergic reactions.
Host: Todd Mahr, MD Guest: Steven Weinstein, MD Clinical trials are essential to the safe development of medications. How are clinical trials structured, and what are the features of the various clinical trial stages? Dr. Steven Weinstein, clinical professor in the department of pediatrics at the University of California at Irvine, provides an overview of clinical trials with host Dr. Todd Mahr. What are the ethical considerations taken into account during clinical trials?
Host: Todd Mahr, MD Guest: Bradley E. Chipps, MD, FAAP, FACAAI, FAAAAI, FCCP What criteria are included in the modified asthma predictive index, and how does this index help physicians diagnose young patients with wheezing and coughing? When is bronchoscopy recommended as an important diagnostic tool for evaluating pediatric lower respiratory symptoms? Dr. Bradley Chipps, medical director of respiratory therapy at Sutter Medical Center, reviews how physicians might work up a young patient with these respiratory symptoms, and suggests the most effective treatments. Dr. Todd Mahr hosts.
Host: Todd Mahr, MD Guest: Jason Knuffman, MD A cough that continues for more than a couple of months is considered chronic. What are the most likely causes of chronic cough in non-smoking adults, other than asthma? Dr. Jason Knuffman, allergist in the department of allergy at Gunderson Lutheran Health System in LaCrosse, Wisconsin, discusses how to avoid some common pitfalls that are often encountered when evaluating and treating adults with chronic cough. Dr. Todd Mahr hosts.
Host: Ketan Sheth, MD, MBA Guest: Santiago Martinez, MD What is the relationship between immunity and autism? Do the immune systems of those with autism function differently than the rest of the population? Dr. Santiago Martinez, clinical assistant professor at Florida State University College of Medicine, joins host Dr. Ketan Sheth to discuss the immune systems of autism patients. Is there any evidence that might suggest that autoimmune disorders in mothers can somehow contribute to the development of autism in their children?
Host: Ketan Sheth, MD, MBA Guest: J. Allen Meadows, MD How are Medicare and health insurance companies affecting physicians and their patients' access to care? What can physicians do to influence policy at the local level? Dr. J. Allen Meadows, clinical instructor in the Montgomery Internal Medicine Residency Program at the University of Alabama at Birmingham, suggests ways allergists and other physicians can get involved with their communities and shape policies affecting how physicians care for their patients. Dr. Ketan Sheth hosts.
Host: Ketan Sheth, MD, MBA Guest: Renata Engler, MD How do insect allergies present challenges in emergency situations to first responders? What are the best ways to diagnose and treat anaphylaxis in patients away from a clinical setting? Host Dr. Ketan Sheth talks with Dr. Renata Engler, associate professor in the department of medicine at the Uniformed Services University of the Health Sciences, about treating insect allergy in the field. How is proper transport and storage of epinephrine particularly difficult for those in the military or others traveling to remote locations, and what can physicians do to ensure safety for patients in these situations?
Host: Ketan Sheth, MD, MBA Guest: I. Leonard Bernstein, MD The Joint Task Force on Practice Parameters for the Diagnosis and Treatment of Asthma has revised its allergy diagnostic testing parameters. What are the parameters trying to establish? What are the advantages of intracutaneous, skin prick, and in vitro testing for diagnosing allergies? Dr. I. Leonard Bernstein, co-director of the allergy research laboratory in the department of medicine at the University of Cincinnati Medical Center, and co-author of the parameters, explores allergy diagnostic testing options with host Dr. Ketan Sheth.
Host: Todd Mahr, MD Guest: Scott Sicherer, MD Because more children now live with food allergies than in decades past, at what point should a physician suspect that a patient might have a food allergy? What gastrointestinal symptoms are most common in children with food allergies? Dr. Scott Sicherer, associate professor of pediatrics at Mount Sinai School of Medicine in New York, reviews the most effective ways to diagnose and manage children with food allergies. Surprisingly, Dr. Sicherer says skin prick testing should not be the first diagnostic step. So what should physicians do when they suspect a child might have food allergies? Dr. Todd Mahr hosts.
Host: Todd Mahr, MD Guest: Stanley Fineman, MD, MBA Immunoglobulin replacement therapy has been used for treating various infections over the past 50 years. It has been traditionally administered intravenously, but now subcutaneous delivery of immunoglobulin is proving to be an attractive alternative. What disorders are immunoglobulin therapy used to treat, and what are the advantages to each type of preparation? Dr. Stanley Fineman, clinical associate professor in the department of pediatrics at Emory University School of Medicine, discusses novel approaches to immunoglobulin therapy with host Dr. Todd Mahr. Which patients are the best candidates for immunoglobulin therapy?
Host: Todd Mahr, MD Guest: Clifford Bassett, MD Gastroesophageal reflux disease (GERD) and laryngopharyngeal reflux (LPR) are both conditions stemming from acid reflux, but can manifest with different symptoms. What other health problems can be tied to LPR and GERD, and how can we determine the difference between the two? Dr. Clifford Bassett, assistant clinical professor of medicine and otolaryngology at the Long Island College Hospital and faculty member at the NYU School of Medicine, explains the characteristics of both conditions with host Dr. Todd Mahr.
Host: Todd Mahr, MD Guest: Alan Goldsobel, MD Cough is one of the most common symptoms but can develop as a symptom of various disorders, from asthma to bacterial infection to gastroesophogeal reflux disorder. How important is the character of a cough in determining the cause in children particularly? Host Dr. Todd Mahr explores cough guidelines and recommendations for children, alon with Dr. Alan Goldsobel, clinical professor in the department of medicine at the University of California San Francisco. At what point is a cough considered chronic, and when should a lingering cough be evaluated in children?
Host: Ketan Sheth, MD, MBA Guest: William Calhoun, MD, FACP, FCCP, FAAAAI, FACAAI There are numerous different asthma phenotypes, such as exercise-induced asthma and severe asthma. How does understanding the specific asthma phenotype help indicate which therapies might work best for a patient? What are the various biomarkers that can indicate asthma, and which ones can be used clincially? Dr. William Calhoun, chair of internal medicine and vice chair for research in the department of internal medicine at the University of Texas Medical Branch in Galveston, Texas, discusses the relationship between asthma phenotypes and biomarkers with host Dr. Ketan Sheth.
Host: Ketan Sheth, MD, MBA Guest: Amy Branum, MSPH The first federal study of food allergies in children by the Centers for Disease Control (CDC) found a steep increase in such allergies over the last decade. What accounts for the rise in diagnoses and hospitalizations? Is the severity of food allergies also increasing? Amy Branum, lead author of the CDC's study and a statistician at the National Center for Health Statistics, illustrates recent figures on pediatric food allergies with host Dr. Ketan Sheth.
Host: Ketan Sheth, MD, MBA Guest: Stanley Fineman, MD, MBA The role that biomarkers can play in asthma control by effectively measuring lung inflammation is a topic that has begun to get more attention lately in medical journals. Although use of most biomarkers is not clinically pragmatic for physicians yet, guest Dr. Stanley Fineman, clinical associate professor in the Department of Pediatrics at Emory University School of Medicine, predicts that biomarkers will likely play a more significant role in the future. Host Dr. Ketan Sheth asks, what other methods are most effective for monitoring control in asthma?
Host: Ketan Sheth, MD, MBA Guest: Sami Bahna, MD, DrPH Why are so many people allergic to peanuts? Can people have an allergy to a specific food the very first time they consume it? Both the types of food allergies and the numbers of individuals affected by food allergies increase every year. There are many potential reasons for the rise in food allergies, including the amount of food people consume and the variety of ingredients in what we eat. What other factors are involved in the development of food allergies? Dr. Sami Bahna, Professor of Pediatrics and Medicine as well as the Chief of the Allergy and Immunology Section at Louisiana State University Health Sciences Center, explores the realities of food allergies with host Dr. Ketan Sheth.
Host: Ketan Sheth, MD, MBA Guest: John Oppenheimer, MD Although asthma is chronic, it is treatable. The new asthma guidelines demonstrate a shift in attitudes. Whereas we used to assess the severity of the condition, now we ask how well it is controlled. Dr. John Oppenheimer, director of clinical research at Pulmonary and Allergy Associates as well as clinical associate professor of medicine at the New Jersey Medical School in Newark, New Jersey, explores the best ways to follow asthma control with host Dr. Ketan Sheth.
Host: Ketan Sheth, MD, MBA Guest: Jay Portnoy, MD Molds are unique organisms that surround us, yet there is growing concern about how molds can impact our health. What sorts of bodily reactions are linked to molds? Should we be worried about adverse health effects from all molds or are some generally safe? Dr. Jay Portnoy, chief of allergy, asthma and immunology at Children's Mercy Hospitals and Clinics and professor of pediatrics at the University of Missouri-Kansas City School of Medicine, discusses the realities of ever-present molds with host Dr. Ketan Sheth.
Host: Ketan Sheth, MD, MBA Guest: Stuart Stoloff, MD For the first time in 10 years, the guidelines for allergy management have been significantly updated. With the goal of optimizing asthma control for every patient, how were the new guidelines created, and how should they be applied? Dr. Stuart Stoloff, a family practitioner from Carson City, Nevada, and member of the National Asthma Education and Prevention Program’s Expert Panel 3, speaks with your host, Dr. Ketan Sheth on the creation of the new guidelines and their application in the exam room.
Host: Todd Mahr, MD Guest: William Berger, MD Guest: Bradley E. Chipps, MD, FAAP, FACAAI, FAAAAI, FCCP Recent research confirms adolescent asthma and obesity directly correlates with significant risk of adult asthma. Does obesity impact the therapy response rate? Which current devices confer precise delivery of medication? Host Dr. Todd Mahr guides a dialogue with Dr. Bradley Chipps, medical director of the Capital Allergy & Respiratory Disease Center in Sacramento, Calif., and Dr. William Berger, medical director of the Allergy and Asthma Associates of Southern California.
Host: Todd Mahr, MD Guest: Ketan Sheth, MD, MBA Dr Ketan Sheth was one of the advisors on the Pediatric Allergies in America survey. This was the largest and most comprehensive national survey of parents of allergy sufferers, allergy sufferers under age 18, and health provider perspectives concerning allergic rhinitis. The survey was designed using the same methods and many of the same measures as Allergies in America (2006). A number of important conclusions about the current state of nasal allergies among American children are: Nasal congestion was the most frequent and bothersome symptom for children with allergies; Children suffer considerable discomfort during allergy attacks, such that one third of parents reported their child’s discomfort was not tolerable without relief; Impact of nasal allergies to a child’s productivity is considerable with an average loss of 29% among children with allergies on days when their allergies are at their worst; Patient non-compliance with prescribed treatment for the condition is driven more by dissatisfaction with product effectiveness and duration, than side effects, cost or ease of administration; Doctors and parents agreed that better education of parents about their child’s condition and treatment of allergic rhinitis is important. The findings from the Pediatrics Allergies in America survey identify important challenges …
Host: Todd Mahr, MD Guest: Stephen Tilles, MD Aspirin is something widely used in everyday practice, and generally well-tolerated. Yet, potentially serious adverse effects - sometimes leading to hospitalization - exist. Who's at risk? What are the symptoms, and can Aspirin desensitization work for all patients? Join Dr. Todd A. Mahr as he speaks with Dr. Stephen Tilles, clinical assistant professor at the University of Washington School of Medicine, in a discussion of aspirin intolerance.
Host: Todd Mahr, MD Guest: Stephen Tilles, MD How common is Aspirin Intolerance? When was it first discovered, and what are the clinical manifestations? Dr. Stephen Tilles, clinical assistant professor at the University of Washington School of Medicine, joins Dr. Todd A. Mahr to discuss aspirin intolerance, highlighting symptoms and provocative testing.
Host: Todd Mahr, MD Guest: Phillip Lieberman, MD Join Dr. Todd Mahr as he interviews Dr. Phil Lieberman, lead author of "SAFE: A Multidisciplinary Approach to Anaphylaxis in the Emergency Room Department" that was published in the Annals of Allergy, Asthma, and Immunology.
Host: Todd Mahr, MD Guest: Michael Blaiss, MD Dr. Mahr and Dr. Blaiss discuss a recent article published in the Annals of Allergy, Asthma and Immunology focusing on allergic rhinitis and sleep disorders.
