Podcasts about Ige

Broadcast from KSQD, Santa Cruz on 12-04-2025: Dr. Dawn opens with an experimental vaccine that prevents severe allergic reactions by targeting IgE antibodies. The vaccine could eventually replace current monoclonal antibody treatments like omalizumab that require injections every two weeks. She explains how adjuvants work in vaccines as additives that irritate the immune system enough to notice the vaccine target. Aluminum hydroxide is s common adjuvant. Modern vaccines use small pathogen fragments rather than whole organisms, requiring adjuvants to trigger adequate immune response. Dr. Dawn expresses concern about the US Advisory Committee on Immunization Practices reviewing aluminum adjuvants this week. A Danish study of over one million children finding no connection between aluminum with autism and ADHA contradicts RFK,Jr's public claims.She worries that removing aluminum could devastate vaccine effectiveness and children's health, noting that whenever vaccination rates drop, diseases like measles return to native circulation. She recounts pertussis vaccine history—when Japan stopped vaccination due to rare adverse reactions (approximately one death per million doses), they lost about 5,000 children to whooping cough in the first year. The newer acellular vaccine using pathogen fragments plus adjuvants is safer but only lasts 4-5 years versus lifetime immunity from the older whole-cell version, necessitating "cocooning" strategies where everyone contacting newborns must be recently vaccinated. Dr. Dawn describes a vaccine to prevent fentanyl from reaching the brain now starting clinical trials in the Netherlands. It pairs a fentanyl-like molecule with a carrier protein large enough to trigger antibody production. Once primed, the immune system attacks any fentanyl entering the blood, preventing highs and overdoses—potentially helping people in addiction recovery and those accidentally exposed through contaminated drugs. She reports the first documented death from alpha-gal syndrome. Alpha-gal is a meat allergy triggered by Lone Star tick bites; the tick essentially vaccinates humans against the alpha-galactosidase protein found on beef and pork. Cases have increased since 2010 as climate change expands the tick's range northward, yet a 2023 survey found 42% of doctors had never heard of the condition. Dr. Dawn highlights research from Edith Cowan University showing that blood drawn after exercise suppresses cancer cell growth when added to tumor cultures. In breast cancer survivors, plasma from high-intensity interval training or weight lifting caused cancer cells to stop growing or die; blood drawn before exercise had no effect. The key mechanism involves myokines, particularly IL-6, released by contracting muscles. A Stanford study found colon cancer survivors who exercised were 37% less likely to experience recurrence. A caller asks about pig-to-human heart transplants and mask recommendations. Dr. Dawn clarifies that newer xenotransplant pigs have more genes edited to reduce rejection compared to the 2022 case. For masking, she recommends context-dependent use—especially in public restrooms where toilet flushing aerosolizes COVID-containing particles, transportation hubs, and hospitals, noting that COVID vaccination prevents death but not infection or long COVID. She advises the same caller about spacing vaccines because adjuvant loads stack. Most vaccines can be combined safely, but she recommends against pairing COVID and Shingrix vaccines due to their heavy adjuvant content—wait at least ten days between them. She suggests inducing a sweat the night of vaccination through hot baths, saunas, or exercise to reduce adjuvant-related discomfort without diminishing antibody response. Dr. Dawn discusses seasonal affective disorder. She recommends 5,000 units of vitamin D3 and morning light exposure. She suggests that sun avoidance advice may have gone too far. A UK study of 3.36 million people found 12-15% lower mortality with greater UV exposure even accounting for skin cancer risk. A Swedish study following 30,000 women for 20 years found sun-seekers had half the mortality risk. Benefits may involve nitric oxide production lowering blood pressure, with each 1,000 km from the equator correlating with 5 mmHg higher blood pressure. Lack of bright outdoor light also contributes to childhood myopia, with rates exceeding 80% in some Asian cities. Dr. Dawn concludes with Danish microbiologists at Copenhagen's Alchemist restaurant reviving an old Bulgarian practice of fermenting milk with live red wood ants. The resulting yogurt, cheese, and ice cream contain far more beneficial microbes than commercial products, with a complex lemony acidity. Only live ants work, and wild ants may carry parasites dangerous to humans.

In this conversation, we pull back the curtain on alpha-gal syndrome diagnostic testing at Thermo Fisher Scientific with Gary Falcetano, PA-C. Gary shares insights into how the alpha-gal syndrome test works and answers some of our most frequently asked questions. How do you talk to your provider about being tested? Is the test covered by insurance? What provider can order the test? He also dives into how Allergy Insider, Thermo Fisher's patient resource, is bringing alpha-gal into the conversation. Tune in now to learn more! Gary Falcetano, PA-C, serves as Senior Manager Global Medical and Scientific Affairs for allergy at Thermo Fisher Scientific. Gary has been a Board Certified Physician Assistant for over 28 years, and is the host of Allergy Insider's ImmunoCAST podcast.Visit Allergy Insider to learn more about their patient resources and be sure to follow on social media: @allergyinsider

My granddaughter suffers from menstrual cramps.  Do you have any suggestions?Do you recommend nicotinamide daily to prevent recurrence of basal cell cancers?What works best to lower fibrinogen?I've been on Ozempic for a year and have diarrhea every morning!Is bypass surgery still being done?Would you recommend Bergamot for fatty liver?

Thanksgiving and overindulgenceA food poisoning incidentObservations on health at ThanksgivingWhat do you think of online sites offering prescriptions for hair loss via a questionnaire?

On episode #94 of the Infectious Disease Puscast, Daniel and Sara review the infectious disease literature for the weeks of 11/11/25 – 11/19/25. Host: Daniel Griffin and Sara Dong Subscribe (free): Apple Podcasts, RSS, email Become a patron of Puscast! Links for this episode Viral Epstein-Barr virus reprograms autoreactive B cells as antigen-presenting cells in systemic lupus erythematosus (Science Translational Medicine) Hepatitis B reactivation following switch away from tenofovir-containing anti-retroviral therapy in people living with HIV: A case series and lessons for practice (CID) Antimicrobial drug-resistant Neisseria gonorrhoeae (GC) infections in men using doxycycline postexposure prophylaxis. A substudy of the ANRS 174 DOXYVAC trial (CID) HIV Pre-exposure Prophylaxis Does Not Increase Gonorrhea and Chlamydia Incidence in Young Black and Hispanic Men who Have Sex With Men: An Observational Cohort Study (OFID) Bacterial Global and regional knowledge of antibiotic use and resistance among the general public: a systematic review and meta-analysis (CMI: Clinical Microbiology and Infection) Infant Botulism Outbreak Linked to Infant Formula, November 2025 (CDC: Botulism) Outbreak Investigation of Infant Botulism: Infant Formula (November 2025) (FDA) Vitamin D deficiency at hospital admission with community-acquired pneumonia is associated with increased risk of mortality: A Prospective Cohort Study (OFID) Bat-Associated Hemotropic Mycoplasmas in Immunosuppressed Children, Spain, 2024 (Emerging Infectious Diseases) A Multicomponent Intervention to Improve Maternal Infection Outcomes (NEJM) Fungal The Last of US Season 2 (YouTube) Increasing Fluconazole Resistance in Candida parapsilosis: A 10-Year Analysis of Blood Culture Isolates at a US Reference Laboratory (2015–2024) (JID) British Society for Medical Mycology best practice recommendations for the diagnosis of serious fungal diseases: 2025 update (LANCET: Infectious Diseases) In Vivo Evolution of Candida auris Multidrug Resistance in a Patient Receiving Antifungal Treatment (JID) Parasitic Implications of a fatal anaphylactic reaction occurring 4 hours after eating beef in a young man with IgE antibodies to galactose-α-1,3-galactose (JACI: Journal of Allergy and Clinical Immunology In practice) WHO recommends R21/Matrix-M vaccine for malaria prevention in updated advice on immunization (WHO) Effectiveness of the RTS,S/AS01E malaria vaccine in a real-world setting over 1 year of follow-up after the three-dose primary schedule: an interim analysis of a phase 4 study in Ghana, Kenya, and Malawi (LANCET: Global Health) A systematic review and an individual patient data meta-analysis of ivermectin use in children weighing less than fifteen kilograms: Is it time to reconsider the current contraindication? (PLoS Neglected Tropical Diseases) Miscellaneous IL12RB1 deficiency appearing in North America: expanding the clinical phenotypes (CID) Music is by Ronald Jenkees Information on this podcast should not be considered as medical advice.

Persistent congestion, pressure, or a reduced sense of smell often gets mistaken for allergies or a stubborn cold when it may be something more, like chronic rhinosinusitis with nasal polyps (CRSwNP). Getting the right diagnosis is the first step toward real relief. Dr. Tonya Farmer, a board-certified ENT, joins Kortney and Dr. G to explain how chronic rhinosinusitis with nasal polyps (CRSwNP) is diagnosed. She walks us through the full evaluation: what symptoms matter, what a nasal endoscopy actually shows, when a CT scan is needed, and how type 2 inflammation fits into the picture. What we cover about diagnosing CRSwNP: Key symptoms: Persistent congestion, drainage, facial pressure, and especially loss of smell are major red flags for CRSwNP. Why duration matters: Chronic means 12 weeks or longer. If symptoms keep coming back or never truly improve, it's time to look deeper. The physical exam: ENTs use nasal endoscopy to see swelling, mucus, or polyps that aren't visible from the outside. When CT scans are needed: Imaging helps confirm sinus inflammation and shows the extent of polyp growth. Additional testing: Allergy testing, IgE levels, eosinophils, and other immune markers help identify type 2 inflammation and guide next steps. When to see a specialist: If antibiotics, steroids, or over-the-counter treatments aren't helping, ask for a referral to an allergist or ENT. Early diagnosis can prevent worsening symptoms and reduce the need for surgery. Set the foundations: Ep. 133: What is Chronic Rhinosinusitis with Nasal Polyps (CRSwNP)? ___   Made in partnership with The Allergy & Asthma Network. Thanks to Sanofi for sponsoring today's episode.  This podcast is for informational purposes only and does not substitute professional medical advice. Always consult with your healthcare provider for any medical concerns.

Guest: Dr. George Robinson is a Principal Research Fellow at University College London, where his lab focuses on juvenile-onset systemic lupus erythematosus. He discusses current approaches to diagnosis and treatment, as well as the role of sex differences in autoimmunity. (31:20) Featured Products and Resources: Stay up-to-date with the latest in immune regulation news. Download a free wallchart on regulatory T cells. The Immunology Round Up Long-Term Allergies: Allergy-associated IgE plasma cells exhibit limited accrual in the bone marrow, and instead reside in other tissues for extended periods. (3:40) Oral Immunotherapy for Peanut Allergy: Peanut oral immunotherapy reshapes T cell responses, suppressing allergy-associated type 2 helper T cells and boosting cytotoxic type 1 helper T cells, offering clues to long-term tolerance. (9:00) Neuroprotective Microglia in Alzheimer’s Disease: The protective function of microglia is governed by the transcription factor PU.1, which becomes downregulated following microglial contact with amyloid plaques. (18:09) Autoimmunity in ALS: Researchers showed that ALS is associated with recognition of the C9orf72 antigen and mapped the specific epitopes that are recognized. (23:20) Subscribe to our newsletter! Never miss updates about new episodes. Subscribe

Can specific foods trigger eczema and does avoiding them make eczema better? Many parents give it a try—but experts say it's not the right approach. So what's going on? We talk to Dr. Matthew Ridd, a leading eczema and food allergy researcher from the University of Bristol, to find out what the science actually says about diet and eczema. ReferencesTIGER (Trial of food allergy (IgE) tests for Eczema Relief)Food Allergy Test‐Guided Dietary Advice for Children With Atopic DermatitisGuidelines of care for the management of atopic dermatitisAtopic dermatitis (eczema) guidelines Guidelines for Early Food Introduction and Patterns of Food Allergy

Want to heal your child's eczema without steroids and save $200 this week? Click here to get started → EczemaKids.com Use code EPISODE200 to get $200 off the Eczema Elimination Method.... the COMPLETE eczema-reversal system that actually works. This offer is good for one week only and ends Tuesday, November 4th, 2025. If your child's ever had an allergy test hoping for answers, only to walk out more confused or flaring, this episode is for you. As we celebrate 200 episodes (and my birthday week!), I'm breaking down what allergy tests actually measure, why kids with eczema often react badly, and how to tell the difference between true, serious IgE allergies and immune overload. We'll talk about why scratch tests and immunotherapy often do more harm than good for eczema families, what to do if your child already flared after testing, and how to start healing their skin and gut from the inside out.

Summary In this truncated replay, Dr. Shyam Joshi explores the intersection between allergy and dermatology—focusing on how chronic spontaneous urticaria (CSU), atopic dermatitis, and food allergies often overlap. Learn how emerging biologics like omalizumab and dupilumab are reshaping treatment decisions, why comorbidities matter, and how collaboration between allergists and dermatologists creates better outcomes for patients with complex allergic and dermatologic conditions. This episode dives into real-world case studies, FDA updates on antihistamines, and the multidisciplinary approach to managing eczema and CSU in pediatric and adult populations. Takeaways - FDA Advisory on Antihistamines: Long-term use of cetirizine or levocetirizine can lead to rebound pruritus upon discontinuation—but gradual tapering minimizes symptoms. - Biologic Selection Depends on Comorbidities: - Omalizumab is effective for IgE-mediated food allergies and chronic urticaria. - Dupilumab is preferred for patients with eosinophilic esophagitis (EoE) or moderate-to-severe atopic dermatitis. - CSU Is Systemic: Symptoms may extend beyond hives—impacting joints, sleep, and energy levels. - Comorbid Conditions Are Common: Up to 20 % of CSU patients have asthma, allergic rhinitis, or food allergies; identifying these helps guide treatment and patient education. - Unified Messaging Builds Trust: Consistent communication from both dermatologists and allergists reduces unnecessary testing and supports adherence to treatment plans. Chapters 00:00 - Introduction: Bridging Allergy and Dermatology 00:45 - Case Study: An 18-Year-Old with Chronic Urticaria 02:00 - FDA Warning: Antihistamine Withdrawal Itch 03:45 - Selecting the Right Biologic: Food Allergy Considerations 04:45 - Eosinophilic Esophagitis and CSU         05:35 - The Systemic Nature of CSU 06:40 - Comorbidities in CSU and Atopic Patients 07:30 - Multidisciplinary Collaboration in Practice 08:00 - Closing Thoughts & Educational Disclaimer

For decades, allergists have focused on blocking what happens outside the mast cell: histamine, IgE, and interleukins. But now, there's a new way to stop allergic inflammation before it even starts: by targeting what happens inside the cell with BTK Inhibitors. Dr. Payel Gupta and Kortney are joined by Dr. Matthew Giannetti to unpack what BTK actually does and why inhibiting it represents an exciting breakthrough in allergy and immunology. Together, they explore how BTK inhibitors work, why this inside-the-cell approach is different from anything before, and what it could mean for people living with chronic spontaneous urticaria (CSU). What the episode covers about BTK inhibitors: BTK explained: Bruton's tyrosine kinase is a pivotal “last step” before mast-cell degranulation. How BTK inhibitors work: Blocking BTK can stop histamine release downstream of many outside triggers. The science: Why BTK binding is irreversible for each molecule and how the body “re-makes” BTK over time. Safety in brief: A look at petechiae (small pinpoint spots), what to monitor, and how shared decision-making guides treatment choices. The future of BTK inhibitors: Exploring their potential role in other allergic conditions.    ____ Made in partnership with The Allergy & Asthma Network. Thanks to Novartis for sponsoring today's episode.  This podcast is for informational purposes only and does not substitute professional medical advice. Always consult with your healthcare provider for any medical concerns.

Je retrouve le Pr Philippe Humbert, clinicien passionné et auteur du livre « Les Parasites : ces hôtes invisibles qui envahissent notre corps ». Nous poursuivons notre exploration des parasitoses, un sujet aussi fascinant qu'essentiel pour la pratique des médecins généralistes.Essayez Medistory ici: https://lc.cx/lNmj58

Je retrouve le Pr Philippe Humbert, clinicien passionné et auteur du livre « Les Parasites : ces hôtes invisibles qui envahissent notre corps ». Nous poursuivons notre exploration des parasitoses, un sujet aussi fascinant qu'essentiel pour la pratique des médecins généralistes.Essayez Medistory ici: https://lc.cx/lNmj58

Multiple food allergies are a daily stressor for millions of families. From avoiding social events to fearing accidental exposures, it can feel like living in a constant state of alert. Until recently, there were no FDA-approved treatments that targeted more than one allergen at a time. In this episode, we break down the study: “Omalizumab for the Treatment of Multiple Food Allergies,” published in 2024 in the New England Journal of Medicine. Known as the OUtMATCH trial, it's the first large-scale study to show that omalizumab (Xolair), a biologic already used for asthma and hives, may help people with multiple food allergies by raising the threshold for reactions. We explain how omalizumab works by blocking IgE, the antibody that triggers allergic reactions, and how the study measured changes in reaction thresholds (the amount of an allergen a person can ingest before reacting). We also explore the trial design, results, safety profile, and what all of this means for the day-to-day management of food allergies. What we cover in our episode about OUtMATCH trial How omalizumab works to prevent allergic reactions: Learn how blocking IgE increases the amount of allergen needed to trigger symptoms, offering protection from small, accidental exposures. Who qualified for the OUtMATCH trial and why: Find out which patients were included and how eligibility impacted outcomes. What success looked like in this study: Understand how researchers defined protection across multiple allergens. Why not everyone responded the same to omalizumab: Explore the variability in results and what it means for clinical care. What else the study found beyond food challenges: Hear about safety findings, quality of life data, and the open-label extension.

Is that penicillin or amoxicillin allergy real? Probably not. In this episode, we explore how to assess risk, talk to parents, and refer for delabeling. You'll also learn what happens in the allergy clinic, why the label matters, and how to be a better antimicrobial steward. Learning Objectives Describe the mechanisms and clinical manifestations of immediate and delayed hypersensitivity reactions to penicillin, including diagnostic criteria and risk stratification tools such as the PEN-FAST score. Differentiate between low-, moderate-, and high-risk penicillin allergy histories in pediatric patients and identify appropriate candidates for direct oral challenge or allergy referral based on current evidence and guidelines. Formulate an evidence-based approach for evaluating and counseling families in the Emergency Department about reported penicillin allergies, including when to recommend outpatient referral for formal delabeling. Connect with Brad Sobolewski PEMBlog: PEMBlog.com Blue Sky: @bradsobo X (Twitter): @PEMTweets Instagram: Brad Sobolewski References Khan DA, Banerji A, Blumenthal KG, et al. Drug Allergy: A 2022 Practice Parameter Update. J Allergy Clin Immunol. 2022;150(6):1333-1393. doi:10.1016/j.jaci.2022.08.028 Moral L, Toral T, Muñoz C, et al. Direct Oral Challenge for Immediate and Non-Immediate Beta-Lactam Allergy in Children. Pediatr Allergy Immunol. 2024;35(3):e14096. doi:10.1111/pai.14096 Castells M, Khan DA, Phillips EJ. Penicillin Allergy. N Engl J Med. 2019;381(24):2338-2351. doi:10.1056/NEJMra1807761 Shenoy ES, Macy E, Rowe T, Blumenthal KG. Evaluation and Management of Penicillin Allergy: A Review.JAMA. 2019;321(2):188–199. doi:10.1001/jama.2018.19283 Transcript Note: This transcript was partially completed with the use of the Descript AI and the Chat GPT 5 AI  Welcome to PEM Currents, the Pediatric Emergency Medicine podcast. As always, I'm your host, Brad Sobolewski, and today we are taking on a label that's misleading, persistent. Far too common penicillin allergy, it's often based on incomplete or inaccurate information, and it may end up limiting safe and effective treatment, especially for the kids that we see in the emergency department. I think you've all seen a patient where you're like. I don't think this kid's really allergic to amoxicillin, but what do you do about it? In this episode, we're gonna break down the evidence, walk through what actually happens during de labeling and dedicated allergy clinics. Highlight some validated tools like the pen FAST score, which I'd never heard of before. Preparing for this episode and discuss the current and future role of ED based penicillin allergy testing. Okay, so about 10% of patients carry a penicillin allergy label, but more than 90% are not truly allergic. And this label can be really problematic in kids. It limits first line treatment choices like amoxicillin, otitis media, or penicillin for strep throat, and instead. Kids get prescribed second line agents that are less effective, broader spectrum, maybe more toxic or poorly tolerated and associated with a higher risk of antimicrobial resistance. So it's not just an EMR checkbox, it's a label with some real clinical consequences. And it's one, we have a role in removing. And so let's understand what allergy really means. And most patients with a reported penicillin allergy, especially kids, aren't true allergies in the immunologic sense. Common misinterpretations include a delayed rash, a maculopapular, or viral exum, or benign, delayed hypersensitivity, side effects, nausea, vomiting, and diarrhea. And unverified childhood reactions that are undocumented and nonspecific. Most of these are not true allergies. Only a very small subset of patients actually have IgE mediated hypersensitivity, such as urticaria, angioedema, wheezing, and anaphylaxis. These are super rare, and even then they may resolve over time without treatment. If a parent or sibling has a history of a penicillin allergy, remember that patient might actually not be allergic, and that is certainly not a reason to label a child as allergic just because one of their first degree relatives has an allergy. So right now, in 2025, as I'm recording this episode, there are clinics like the Pats Clinic or the Penicillin Allergy Testing Services at Cincinnati Children's and in a lot of our peer institutions that are at the forefront of modern de labeling. Their approach reflects the standard of care as outlined by the. Quad ai or the American Academy of Allergy, asthma and Immunology and supported by large trials like Palace. And you know, you have a great trial if you have a great acronym. So here's what happens step by step. So first you stratify the risk. How likely is this to be a true allergy? And that's where a tool like the pen fast comes. And so pen fast scores, a decision rule developed to help assess the likelihood of a true penicillin allergy based on the patient's history. The pen in pen fast is whether or not the patient has a self-reported history of penicillin allergy. They get two points if the reaction occurred in the past five years. Two points if the reaction is anaphylaxis or angioedema. One point if the reaction required treatment, and one point if the reaction was not due to testing. And so you can get a total score of. Up to six points. If you have a score of less than three. This is a low risk patient and they can be eligible for direct oral challenge. A score greater than three means they're higher risk and they may require skin testing. First validation studies show that the PEN FFA score of less than three had a negative predictive value of 96.3%. Meaning a very, very low chance of a true allergy. And this tool has been studied more extensively in adults, but pediatric specific adaptations are emerging, and they do inform current allergy clinic protocols. But I would not use this score in the emergency department just to give a kid a dose of amoxicillin. So. For low risk patients, a pen fast score of less than three or equivalent clinical judgment clinics proceed with direct oral challenge with no skin testing required. The protocol is they administer one dose of oral amoxicillin and they observe for 62 120 minutes monitoring for signs of reaction Urticaria. Respiratory symptoms or GI upset. This approach is safe and effective. There was a trial called Palace back in 2022, which validated this in over 300 children. In adolescents. There were no serious events that occurred. De labeling was successful in greater than 95% of patients. And skin tested added no benefit in low risk patients. So if the child tolerates this dose, then you can remove that allergy immediately from the chart. Parents and primary care doctors will receive a summary letter noting that the challenge was successful and that there's new guidance. Children and families are told they can safely receive all penicillins going forward. And providers are encouraged to document this clearly in the allergy section of the EMR. So you're wondering, can we actually do this in the emergency department? Technically, yes, you can do what you want, but practically we're not quite there yet. So we'd need clearer risk stratification tools like the Pen fast, a safe place for monitoring, post challenge, clinical pathways and documentation support. You know, a clear way to update EMR allergy labels across the board and involvement or allergy or infectious disease oversight. But it's pretty enticing, right? See a kid you diagnose otitis media. You think that their penicillin allergy is wrong, you just give 'em a dose of amox and watch 'em for an hour. That seems like a pretty cool thing that we might be able to do. So some centers, especially in Canada and Australia, do have some protocols for ED or inpatient based de labeling, but they rely on that structured implementation. So until then, our role in the pediatric emergency department is to identify low risk patients, avoid over document. Unconfirmed reactions and refer to allergy ideally to a clinic like the pets. So who should be referred and good candidates Include a child with a rash only, especially one that's remote over a year ago. Isolated GI symptoms. Parents unsure of the details at all. No history of anaphylaxis wheezing her hives, and no recent serious cutaneous reactions. I would avoid referring and presume that this allergy is true. If they've had recent anaphylaxis, they've had something like Stevens Johnson syndrome dress, or toxic epidermolysis necrosis. Fortunately, those are very, very rare with penicillins and there's a need for penicillin during the ED visit without allergy backup. So even though we don't have an ED based protocol yet. De labeling amoxicillin or penicillin allergy can start with good questions in the emergency department. So here's one way to talk to patients and families. You can say, thanks for letting me know about the amoxicillin allergy. Can I ask you a few questions to better understand what happened? This is gonna help us decide the safest and most effective treatment for your child today, and then possibly go through a process to remove a label for this allergy that might not be accurate. You wanna ask good, open-ended questions. What exactly happened when your child took penicillin or amoxicillin? You know, look for rash, hives, swelling, trouble breathing, or anaphylaxis. Many families just say, allergic, when the reaction was just GI upset, diarrhea or vomiting, which is not an allergy. How old was your child when this happened? Reactions that occurred before age of three are more likely to be falsely attributed. How soon after taking the medicine did the reaction start? Less than one hour is an immediate reaction, but one hour to days later is delayed. Usually mild and probably not a true allergy. Did they have a fever, cold or virus at that time? Viral rashes are often misattributed to antibiotics, and we shouldn't be treating viruses with antibiotics anyway, so get good at looking at ears and know what you're seeing. And have they taken similar antibiotics since then? Like. Different penicillins, Augmentin, or cephalexin. So if they said that they were allergic to amoxicillin, but then somehow tolerated Augmentin. They're not allergic. If a patient had rash only, but no hive swelling or difficulty breathing, no reaction within the first hour. It occurred more than five years ago or before the kid was three. And especially if they tolerated beta-lactam antibiotics. Since then, they're a great candidate for de labeling and I would refer that kid to the allergy clinic. Generally, they can get them in pretty darn quick. Alright, we're gonna wrap up this episode. Most kids labeled penicillin allergic or amoxicillin allergic, or not actually allergic to the medication. There are some scores like pen fasts that are validated tools to assess risk and support de labeling. Direct oral challenge for most patients is safe, efficient, and increasingly the standard of care. There are allergy clinics like the Pats at Cincinnati Children's that can dela children in a single visit with oral challenges alone, needing no skin testing, and emergency departments can play a key role in identifying and referring these patients and possibly de labeling ourselves in the future. Well, that's all for this episode on Penicillin Allergy. I hope you learn something new, especially how to assess whether an allergy label is real, how to ask the right questions and when to refer to an allergy testing clinic. If you have feedback, send it my way. Email, comment on the blog, a message on social media. I always appreciate hearing from you all, and if you like this episode, please leave a review on your favorite podcast app. Really helps more people find the show and that's great 'cause I like to teach people stuff. Thanks for listening for PEM Currents, the Pediatric Emergency Medicine podcast. This has been Brad Sobolewski. See you next time.

When people get hives or swelling, they often think it's caused by an allergy. But in the case of chronic spontaneous urticaria (CSU), the culprit is often your own immune system. CSU isn't your typical allergic reaction, instead, it's frequently an autoimmune condition, where the immune system misfires and activates mast cells without any external trigger. In this episode, Dr. Payel Gupta and Kortney unpack what it means for CSU to be autoimmune and autoallergic. They explain how IgE and IgG antibodies can trigger histamine release, leading to hives and swelling. You'll also learn why allergy testing isn't useful for diagnosing CSU, and how tests like IgG food sensitivity panels can do more harm than good by leading to unnecessary food avoidance and confusion. What we cover in our episode about autoimmune CSU and chronic hives: Is CSU an allergy? Why CSU is often mistaken for an allergic reaction—and why standard allergy tests rarely provide helpful answers. How the immune system works in CSU: What mast cells are, how they release histamine, and their central role in chronic spontaneous urticaria. Understanding autoimmune CSU: Learn how the immune system can trigger hives from within, including the roles of IgE and IgG antibodies. Autoimmune hives explained: We explore how CSU can be autoimmune, why the immune system may attack itself, and what Type I and Type IIb autoimmune CSU really mean. ____ Made in partnership with The Allergy & Asthma Network. Thanks to Novartis for sponsoring today's episode.  This podcast is for informational purposes only and does not substitute professional medical advice. Always consult with your healthcare provider for any medical concerns.

Definitions and distinguishing features of urticaria and angioedema Common causes of acute urticaria in children and why infection is the leading driver When to suspect IgE-mediated allergy and how to recognise signs of anaphylaxis Practical dosing guidance for non-sedating antihistamines and the role of steroids Red flags that warrant referral and the place of biologics in chronic urticaria Host: Dr Rebecca Overton, GP and Medical Educator Expert: Dr Gabby Mahoney, Paediatric Allergist and Immunologist Total time: 35 mins Register for our fortnightly FREE WEBCASTS Every second Tuesday | 7:00pm-9:00pm AEST Click here to register for the next oneSee omnystudio.com/listener for privacy information.

Did you know that IgE, the antibody responsible for allergic reactions, is 30,000 times less abundant than other immunoglobulins in the body? This staggering fact underscores the importance of highly sensitive allergy diagnostics. In this episode, we pull back the curtain on what happens to allergy diagnostic blood samples after they leave your clinic. Clinical laboratory expert Jessica Murphy, MLS (ASCP), guides us through the intricate process of specific IgE testing, from sample processing to result interpretation. Learn about the advanced technology behind ImmunoCAP™ allergy diagnostics, the role of Phadia™ Laboratory Systems in ensuring accurate results, and the meticulous quality control measures employed by Thermo Fisher Scientific. Discover how regional respiratory profiles are curated, the significance of binding capacity in IgE detection, and the collaborative effort between clinicians and lab experts in reaching accurate diagnoses. Gain insights into interpreting allergy diagnostic results and their impact on patient management, illustrated through a real-world case study of a young patient with respiratory symptoms. Resources and references here: https://www.thermofisher.com/phadia/us/en/resources/immunocast/allergy-diagnostics-blood-draw-process.html

Did you know that 27 million Americans ride horses annually, surpassing both golf and tennis in popularity? This surprising statistic underscores the widespread exposure to potential horse allergens, even in urban areas. In this episode, we tackle the allergies commonly seen in rural environments. We explore the intriguing hygiene hypothesis, comparing asthma rates in Amish and Hutterite communities, and uncover the unexpected prevalence of horse allergies in urban settings. From barn dust to cross-reactive allergens, we dissect the complex interplay of rural allergens, their far-reaching effects, and the critical role of specific IgE testing in identifying these often-overlooked triggers. Gain insights into the unique challenges of diagnosing allergies in rural patients, the importance of thorough clinical histories, and strategies for distinguishing between allergic and non-allergic respiratory symptoms in agricultural settings. Resources and references available here: https://www.thermofisher.com/phadia/us/en/resources/immunocast/horse-allergies-and-rural-allergies-in-agricultural-environments.html?cid=0ct_3pc_05032024_9SGOV4

In today's episode, Fares returns from Mexico (0:32) as the duo reunites to break down everything that went down in the combat sports world this past weekend.They kick things off with UFC 318, where the BMF title was on the line. Max Holloway's dominance at lightweight continues (5:14), followed by a look back at favorite Dustin Poirier moments (18:07). Paulo Costa returned looking as dominant as ever against Roman Dolidze (23:25), while the real fight of the night was Kevin Holland vs. Daniel Rodriguez (28:58). Ige vs. Pitbull failed to deliver (39:34), but Michael Johnson opened the card with a shocking performance over Daniel Zellhuber (43:03).Then it's over to boxing, where Oleksandr Usyk remains the king of the heavyweights (57:26).https://www.instagram.com/thehbpod_/

SleepyJ and MeanGene break down UFC 318 full main card.

SleepyJ and MeanGene break down UFC 318 full main card.

Final picks and full card breakdown for #UFC318LIKE - COMMENT - PLEASE SUBSCRIBETimestamps:(00:00) - Intro / UFC 318 Intro(01:52) - UFC Nashville Recap(14:00) - F*ck Jon Jones (17:00) - Judice vs Caliari (20:15) - Ferreira vs McVey (23:27) - Spann vs Brzeski (25:40) - Crute vs Prachnio(29:05) - Fugitt vs Dulatov (32:13) - Gautier vs Valentin (35:14) - Prado vs Veretennikov(37:33) - Allen vs Vettori (42:00) - Phillips vs Oliveria Main Card:(46:00) - Johnson vs Zellhuber (51:27) - Ige vs Pitbull(56:44) - Holland vs Rodriguez (1:02:17) CO-MAIN: Costa vs Kopylov(1:08:30) MAIN: Holloway vs Poirier I post all my final picks on my social media accounts down below. FOLLOW AND SUB THE Social Media accountsTWITTER / X Account: @KIABmediaInstagram: @keepitabuck_media#ufcpicks #worththeweightmma

MMALOTN is back to give you breakdowns and predictions for UFC 311: Holloway vs Poirier 3.

Understanding IgE-mediated food allergies Common presentations and management of IgE-mediated food allergies Impact of anaphylaxis on quality of life Referral to specialists and the importance of timely intervention Resources and support for healthcare professionals and patients Host: Dr David Lim | Total Time: 35 mins Expert: Dr Wendy Freeman, General Practitioner and Health Educator Register for our fortnightly FREE WEBCASTSEvery second Tuesday | 7:00pm-9:00pm AEST Click here to register for the next oneSee omnystudio.com/listener for privacy information.

Click subscribe right now to make money from sports bettingGet my MMA picks & join our group chat: https://sublaunch.com/lucrativemmaMake CASH betting other sports: http://lucrativebettingtips.comJoin free Telegram community: https://t.me/+C2JP9D8JTekxODUx00:00 Intro02:47 Holloway vs Poirier17:41 Costa vs Kopylov24:38 Holland vs Rodriguez27:16 Ige vs Pitbull30:46 Wheel of Fortune Giveaway and Outro

In this episode of Bowel Sounds, hosts Dr. Temara Hajjat and Dr. Peter Lu speak with Dr. Gayle Diamond, a pediatric gastroenterologist at Children's Hospital of Philadelphia, about identifying and managing food protein-induced enterocolitis syndrome (FPIES). Learning objectivesIdentify the symptoms, etiology, and work up done for FPIESDiscuss the difference between FPIES vs. IgE-mediated food allergy vs. Milk protein-induced enterocolitis. Discuss the management of FPIES.Support the showThis episode may be eligible for CME credit! Once you have listened to the episode, click this link to claim your credit. Credit is available to NASPGHAN members (if you are not a member, you should probably sign up). And thank you to the NASPGHAN Professional Education Committee for their review!As always, the discussion, views, and recommendations in this podcast are the sole responsibility of the hosts and guests and are subject to change over time with advances in the field.Check out our merch website!Follow us on Bluesky, Twitter, Facebook and Instagram for all the latest news and upcoming episodes.Click here to support the show.

In this episode of the Radical Health Rebel Podcast, Dr. Tetyana Obukhanych — immunologist and gut health expert — shares both her scientific expertise and personal journey with chronic gut health issues.She explores how vaccines, glyphosate, and gluten impact the gut and immune system, and explains the difference between IgE and non-IgE allergies. Tetyana also opens up about her struggles with chronic fatigue and gut dysfunction, and how dietary changes and alternate day fasting played a key role in her healing. The conversation covers time-restricted eating, metabolic individuality, fasting for women, exercise, hormone balance, and how fasting can rejuvenate gut stem cells. She offers practical, science-based advice for incorporating fasting in a way that supports gut and overall health.We discussed:00:00 Introduction to Tetyana Obukhanych01:34 Personal Journey with Gut Health Issues05:24 The Impact of Vaccines on Gut Health10:10 Understanding Non-IgE Mediated Allergies12:02 Glyphosate and Its Effects on Gut Health14:40 The Role of Gluten in Gut Health15:03 Chronic Fatigue and Its Connection to Gut Health17:55 Dietary Changes and Their Impact20:42 Exploring Ancestral Diets22:04 Metabolic Typing and Individualized Nutrition26:23 The Benefits of Alternate Day Fasting35:51 Personalizing Fasting Approaches36:36 Understanding Time-Restricted Eating (TRE)39:41 The Impact of Fasting on Energy Levels42:43 Balancing Fasting with Exercise45:55 Exploring Anabolic and Catabolic Phases49:48 The Transition from Athleticism to Sedentary Life51:07 First Steps to Alternate Day Fasting53:47 Fasting and Gut Health58:40 Circadian Rhythms and Fasting01:00:48 Fasting and the Menstrual Cycle01:03:15 Adrenal Health and FastingYou can find Tetyana @:Personal Health Education Community:https://bbch.community/Youtube Channel:https://www.youtube.com/@PersonalHealthEducationSend us a textSupport the showDon't forget to leave a Rating for the podcast!You can find Leigh @: Leigh's website - https://www.bodychek.co.uk/Leigh's books - https://www.bodychek.co.uk/books/ Chronic Pain Breakthrough Blueprint - https://bit.ly/ChronicPainValuableTips Substack - https://substack.com/@radicalhealthrebelYouTube Channel - https://www.youtube.com/@radicalhealthrebelpodcast Rumble Channel - https://rumble.com/user/RadicalHealthRebel Leigh's courses: StickAbility - https://stickabilitycourse.com/ Mastering Client Transformation (professional course) - https://www.functionaldiagnosticnutrition.com/mastering-client-transformation/ Eliminate Adult Acne Programme - https://eliminateadultacne.com/

Have you ever wondered whether your child really needs an allergy test? Or have you been tempted by those flashy direct-to-consumer kits, this conversation is a must-listen. Let's tackle the rise of at-home “food sensitivity” tests, the difference between IgE and IgG, and why a detailed history matters more than any panel of results.  In this episode, I'm joined once again by pediatric allergist Dr. Dave Stukus to break down what parents really need to know about allergy testing. From food allergies to seasonal sniffles, we dive into when testing is actually helpful—and when it leads to confusion, false positives, and unnecessary food restrictions.  We discuss:  Why most at-home food sensitivity tests are misleading—and what to do instead When allergy testing is truly helpful (and when it backfires) How to tell the difference between food allergies, intolerances, and sensitivities To connect with Dr. Dave Stukus follow him on Instagram @allergykidsdoc, check out all his resources at https://www.nationwidechildrens.org/find-a-doctor/profiles/david-r-stukus We'd like to know who is listening! Please fill out our Listener Survey to help us improve the show and learn about you! 00:00 – Intro 01:16 – Why History Matters More Than Tests 03:00 – When Should You Test? 05:26 – False Positives and the Limits of Testing 07:03 – Blood vs. Skin Testing: What's the Difference? 09:07 – Eczema in Infants: To Test or Not to Test? 11:01 – Seasonal Allergies and the Right Time to Test 12:08 – Myth: “Allergy Tests Aren't Reliable in Infants” 14:20 – The Problem with Food Sensitivity Tests 17:13 – The Red Flags of Unvalidated Testing 20:07 – The Real Harm of Over-Testing 22:35 – Final Takeaway: Ask Questions, Follow the Science 23:27 – The Truth About Panel Testing 25:10 – Can You Test for Seasonal Allergies Year-Round? 26:05 – Where to Follow Dr. Stukus 26:53 – Dr. Mona's Reflection and Wrap-Up Our podcasts are also now on YouTube. If you prefer a video podcast with closed captioning, check us out there and subscribe to PedsDocTalk. We love the sponsors that make this show possible! You can always find all the special deals and codes for all our current sponsors on the PedsDocTalk Podcast Sponsorships page of the website.  Learn more about your ad choices. Visit podcastchoices.com/adchoices

Have you ever wondered whether your child really needs an allergy test? Or have you been tempted by those flashy direct-to-consumer kits, this conversation is a must-listen. Let's tackle the rise of at-home “food sensitivity” tests, the difference between IgE and IgG, and why a detailed history matters more than any panel of results.  In this episode, I'm joined once again by pediatric allergist Dr. Dave Stukus to break down what parents really need to know about allergy testing. From food allergies to seasonal sniffles, we dive into when testing is actually helpful—and when it leads to confusion, false positives, and unnecessary food restrictions.  We discuss:  Why most at-home food sensitivity tests are misleading—and what to do instead When allergy testing is truly helpful (and when it backfires) How to tell the difference between food allergies, intolerances, and sensitivities To connect with Dr. Dave Stukus follow him on Instagram @allergykidsdoc, check out all his resources at https://www.nationwidechildrens.org/find-a-doctor/profiles/david-r-stukus We'd like to know who is listening! Please fill out our Listener Survey to help us improve the show and learn about you! 00:00 – Intro 01:16 – Why History Matters More Than Tests 03:00 – When Should You Test? 05:26 – False Positives and the Limits of Testing 07:03 – Blood vs. Skin Testing: What's the Difference? 09:07 – Eczema in Infants: To Test or Not to Test? 11:01 – Seasonal Allergies and the Right Time to Test 12:08 – Myth: “Allergy Tests Aren't Reliable in Infants” 14:20 – The Problem with Food Sensitivity Tests 17:13 – The Red Flags of Unvalidated Testing 20:07 – The Real Harm of Over-Testing 22:35 – Final Takeaway: Ask Questions, Follow the Science 23:27 – The Truth About Panel Testing 25:10 – Can You Test for Seasonal Allergies Year-Round? 26:05 – Where to Follow Dr. Stukus 26:53 – Dr. Mona's Reflection and Wrap-Up Our podcasts are also now on YouTube. If you prefer a video podcast with closed captioning, check us out there and subscribe to PedsDocTalk. We love the sponsors that make this show possible! You can always find all the special deals and codes for all our current sponsors on the PedsDocTalk Podcast Sponsorships page of the website.  Learn more about your ad choices. Visit podcastchoices.com/adchoices

Meet Eleanor, a mom on a mission. When her son was diagnosed with severe food allergies in 2004, Eleanor was launched into a whirlwind of support and advocacy for the food allergy community, eventually leading her to found and lead the Food Allergy and Anaphylaxis Connection Team (FAACT). Alongside the FAACT leadership team, she provides the education, advocacy, awareness, and grassroots outreach needed for the food allergy community through programming available to all. Tune in to hear the story behind Eleanor's incredible efforts and successes and her commitment to inclusivity that drives everything she does.To learn more about FAACT, their amazing resources, and Camp TAG visit: https://www.foodallergyawareness.org/Follow on social media @faactnewsEleanor Garrow-Holding has worked, educated, and advocated in the food allergy community since 2004. She was inspired to start this work after her son, Thomas, was diagnosed with life-threatening food allergies to tree nuts, peanuts, wheat, and sesame; eosinophilic esophagitis (EoE) triggered by milk and wheat; asthma; and environmental allergies. In December 2015, Thomas had a food challenge with wheat and was no longer IgE-allergic to wheat. After a 3-month trial with wheat and another 3-month trial with milk (post wheat) in his diet and upper endoscopies, he has also outgrown the wheat and milk triggers for EoE and is in remission from EoE as of July 2016. Thomas outgrew his peanut allergy in 2016 at age thirteen. In October 2019, at age sixteen, Thomas outgrew almond, sesame, and brazil nut and continues to avoid walnut, cashew, pecan, hazelnut, and pistachio.As CEO of the Food Allergy & Anaphylaxis Connection Team (FAACT), Eleanor provides leadership, development, and implementation for all of FAACT's initiatives and programs, including Camp TAG (The Allergy Gang) – a summer camp for children with food allergies and their siblings that Eleanor founded in 2009. Eleanor has a Bachelor of Healthcare Administration degree from Lewis University in Romeoville, IL, and worked in hospital management for 15 years in Chicago and suburban Chicago prior to working in the nonprofit sector.After Thomas was diagnosed in 2004, Eleanor established a food allergy support group in a southwest Chicago suburb, Parents of Children Having Allergies (POCHA) of Will County, focusing on education and advocacy; chaired the FAAN Walk for Food Allergy in Chicago in 2007 and 2008; was awarded the FAAN Muriel C. Furlong Award for Community Service in 2008; and advocated in the Illinois state legislature on food allergy and Eosinophilic Disorders (EGID, EoE) issues. Thanks to the efforts of Eleanor and other patient advocates, legislation to ensure insurance coverage for elemental formulas was signed into law in 2007 and legislation establishing food allergy management guidelines for Illinois schools was signed into law in 2009.Eleanor joined the Food Allergy & Anaphylaxis Network™ (FAAN) in 2009 as Vice President of Education and Outreach, where she oversaw educational initiatives, all food allergy conferences, the Teen Summit, Camp TAG (The Allergy Gang) now under FAACT's umbrella, a Teen Advisory Group, support group development, and more. She advocated for the Food Allergy & Anaphylaxis Management Act (FAAMA) in Washington, DC, with her son Thomas as part of FAAN's Kids Congress on Capitol Hill and also advocated on Capitol Hill for the School Access to Emergency Epinephrine Act. Eleanor served on the expert panel for the CDC's Voluntary Guidelines for Managing Food Allergies in Schools and Early Care and Education Programs and was a reviewer for the National Association of Education (NEA) Food Allergy Book: What School Employees Need to Know. Eleanor conducted numerous radio, television, and print interviews on food allergy issues and wrote articles for Allergic Living and Living Without magazines. She presented at national and regional conferences about food allergy management in school and restaurant settings and educated personnel in schools and school districts across the country on food allergy management in schools and continues to do so with FAACT.In 2013, Eleanor joined the Cincinnati Center for Eosinophilic Disorders (CCED) as Senior Specialist of Program Management at Cincinnati Children's Hospital and Medical Center. There she led day-to-day clinical operations, clinical research projects, program development, marketing, and development.Eleanor has and continues to educate employees from numerous food industry companies and entertainment venues about food allergies, such as McDonald's Corporation, The Hain Celestial Group, Mars Wrigley, all SeaWorld Parks, and more.Leading the charge at FAACT, Eleanor and the FAACT Leadership Team provides the education, advocacy, awareness, and grassroots outreach needed for the food allergy community. Eleanor serves on the National Peanut Board's Allergy Education Advisory Council, Global Allergy & Airways Patient Platform Board (GAAPP), St. Louis Children's Food Allergy Management & Education (FAME) National Advisory Board, and Association of Food and Drug Officials (AFDO) Food Allergen Control Committee. In August 2015, Eleanor was inducted into The National Association of Professional Women's (NAPW) VIP Professional of the Year Circle for her commitment to healthcare and nonprofit industries. FAACT is The Voice of Food Allergy Awareness. In 2022, Eleanor was a Contributor for The Change Guidebook (3-8-2022, HCI/Simon & Schuster).

Just diagnosed with a food allergy and feeling lost? You're not alone and don't have to figure out food allergy life by yourself. We're here to help you understand food allergy basics: what causes allergic reactions, how to recognize symptoms, and how to manage your allergy safely, every day. This is the second episode in our Food Allergies: Ages & Stages, and it's all about building a strong foundation after a new diagnosis. Whether it's your child, your partner, or you who was recently diagnosed, Kortney and Dr. Payel Gupta walk through everything you need to know in those early days. From understanding how allergic reactions work to learning about life-saving tools like epinephrine, and new management options like OIT and omalizumab. Dr. G explains what causes your immune system to misfire, how fast symptoms can appear, and why no two reactions are the same. We also dive into real-life strategies like carrying your epinephrine device, knowing when and how to use it, and navigating social situations. Plus, Kortney shares personal tips that have helped her live safely with food allergies for over 30 years. What we cover in our episode about managing a new food allergy diagnosis What just happened?! We explain what causes allergic reactions, including the roles of IgE, histamine, and mast cells. Are all allergic reactions the same? Learn how quickly reactions can occur and why symptoms aren't always predictable. Why is epinephrine so important? When to use epinephrine, how to use it, and why antihistamines aren't enough. New options to help manage food allergies. A look at treatments like OIT and omalizumab (Xolair) and why you still need to carry your epi. Peace of mind with an action plan. What to include in a Food Allergy Action Plan and how to help others take your allergy seriously. Episode 2 in our “Food Allergies: Ages & Stages” series  Across six episodes, we explore how food allergies show up and shift through different phases of life, from introducing solids in infancy to navigating school and adapting in adulthood. We're here with evidence-based info, expert insights, and lived experience to guide you through it all. Episodes mentioned to help build your foundation: Episode 59: What is Anaphylaxis and When to Use Epinephrine Episode 95: The Science Behind Allergic Reactions Episode 98: Food Allergy Treatment and Management Ep. 110: Early Introduction of Allergenic Foods – Preventing Food Allergies Before They Start Made in partnership with The Allergy & Asthma Network. Thanks to Genentech and Acuqestive for sponsoring today's episode.  This podcast is for informational purposes only and does not substitute professional medical advice. Always consult with your healthcare provider for any medical concerns.

Thank you for joining us for our 2nd Cabral HouseCall of the weekend! I'm looking forward to sharing with you some of our community's questions that have come in over the past few weeks…   Bryan: Hi Dr C. A couple weeks ago I noticed a skin rash running up the side of my back and on both sides of my lower abdomen. I chalked it up as a fluke and it went away for a while. Until this morning. I figured out the culprit seems to be my portable steam sauna which I have in my room. I've been using a steam sauna for years and never had this happen before. Wish I could upload a photo but is there anything you could recommend for this kind of problem? It doesn't hurt, the skin just feels warm and looks red. Could it be Rosacea? Appreciate any insight. Best,                                                          Andy: Hey any idea how to cure eye floaters I haven't seen any protocols on how to cure them?                                            Deanna: Thank you for your informative podcast and for sharing your expertise. My two-year-old son has been diagnosed with Food Protein-Induced Enterocolitis Syndrome (FPIES) to oars, and I'm seeking guidance on potential triggers or the best approach to testing and managing this condition. For some context, he also has IgE-mediated food allergies to peanuts, certain tree nuts, and eggs and eczema so I thought the gut could be a place to start. I would greatly appreciate any advice or recommendations you may have. Thank you in advance for your help!                                                                     Lana: Hi Dr Cabral, thank you for taking the time to answer the community questions, very much appreciate this gift. My daughter is 8 years old and I have found a couple of grey hairs in her head, root to tip. Why could this be?                                   Anonymous: In the last two years, I've been through all the protocols. Labs are looking good. Continually working on stress reduction. I sleep well, move a lot, eat a healthy diet with lots of grass fed/finished beef from our ranch, dark greens, try to eat the rainbow. I'm taking Cardio, Vision, Cell Boost, multi, omegas, balanced zinc, magnesium. I keep constantly get light headed every time i move too fast, winded easily, yawn a lot. After your episode on low iron, I just ran blood labs and my iron (29), ferritin (3), iron sat (7%) hematocrit (33.7%), hemoglobin (9.8), MCH (23.6), MCHC (29.1), RDW (19.6%), and Alk Phos (14) are all really low. I am not sure what else could be causing these low levels; I have struggled for many years. any advice is appreciated. (37 female, normal cycle)   Thank you for tuning into this weekend's Cabral HouseCalls and be sure to check back tomorrow for our Mindset & Motivation Monday show to get your week started off right! - - - Show Notes and Resources: StephenCabral.com/3383 - - - Get a FREE Copy of Dr. Cabral's Book: The Rain Barrel Effect - - - Join the Community & Get Your Questions Answered: CabralSupportGroup.com - - - Dr. Cabral's Most Popular At-Home Lab Tests: > Complete Minerals & Metals Test (Test for mineral imbalances & heavy metal toxicity) - - - > Complete Candida, Metabolic & Vitamins Test (Test for 75 biomarkers including yeast & bacterial gut overgrowth, as well as vitamin levels) - - - > Complete Stress, Mood & Metabolism Test (Discover your complete thyroid, adrenal, hormone, vitamin D & insulin levels) - - - > Complete Food Sensitivity Test (Find out your hidden food sensitivities) - - - > Complete Omega-3 & Inflammation Test (Discover your levels of inflammation related to your omega-6 to omega-3 levels) - - - Get Your Question Answered On An Upcoming HouseCall: StephenCabral.com/askcabral - - - Would You Take 30 Seconds To Rate & Review The Cabral Concept? The best way to help me spread our mission of true natural health is to pass on the good word, and I read and appreciate every review!  

Description: Co-hosts Ryan Piansky, a graduate student and patient advocate living with eosinophilic esophagitis (EoE) and eosinophilic asthma, and Holly Knotowicz, a speech-language pathologist living with EoE who serves on APFED's Health Sciences Advisory Council, interview Dr. Melanie Ruffner, an Attending Physician with the Division of Allergy and Immunology and the Center for Pediatric Eosinophilic Disorders at Children's Hospital of Philadelphia. Dr. Ruffner describes her work in clinic and the paper she co-authored about pediatric and adult eosinophilic esophagitis (EoE). She covers the questions they considered in the paper and the conclusions they reached. Disclaimer: The information provided in this podcast is designed to support, not replace the relationship that exists between listeners and their healthcare providers. Opinions, information, and recommendations shared in this podcast are not a substitute for medical advice. Decisions related to medical care should be made with your healthcare provider. Opinions and views of guests and co-hosts are their own.   Key Takeaways: [:49] Co-host Ryan Piansky introduces the episode, brought to you thanks to the support of Education Partners Bristol Myers Squibb, GSK, Sanofi, Regeneron, and Takeda. Ryan introduces co-host Holly Knotowicz.   [1:17] Holly introduces today's topic, pediatric and adult eosinophilic esophagitis (EoE), and introduces today's guest, Dr. Melanie Ruffner.   [1:23] Dr. Melanie Ruffner is an attending physician with the Division of Allergy and Immunology in the Center for Pediatric Eosinophilic Disorders at Children's Hospital of Philadelphia. Holly welcomes Dr. Ruffner to Real Talk.   [1:50] As an attending physician in the Center for Pediatric Eosinophilic Disorders at Children's Hospital of Philadelphia, Dr. Ruffner sees patients who have eosinophilic esophagitis and other eosinophilic disorders, including eosinophilic GI tract disorders.   [2:09] Dr. Ruffner also leads a research group that studies how the immune system causes inflammation in response to certain foods, leading to EoE.   [2:20] Inflammation in the esophagus is tied to other diseases like epithelial barrier dysfunction and fibrosis.   [2:28] Our bodies use many different proteins that allow cells to communicate with one another. One type of signaling protein that causes inflammation is called cytokines.   [2:41] Dr. Ruffner's group is interested in how these signaling proteins called cytokines interact with epithelial cells and how that impacts the oral function of the esophagus in patients with EoE.   [3:02] In training, Dr. Ruffner became interested in eosinophilic esophagitis and other non-IgE-mediated food allergies because we don't have a lot of clear treatments or clear mechanisms that cause them.   [3:21] Dr. Ruffner felt there was a lot of work to be done in that area. It was rewarding to be in clinical encounters with those patients. Often, patients had spent a long time trying to find out what was happening and to find a treatment plan that worked for them.   [4:31] Dr. Ruffner's group sees some patients who have eosinophilic gastroenteritis and patients who are referred for hypereosinophilia with impacts of inflammation in other organ systems.   [5:06] Dr. Ruffner co-authored a paper about pediatric and adult EoE published in the Journal of Allergy and Clinical Immunology. It explored if EoE in pediatric patients and adult patients is a spectrum or distinct diseases.   [5:29] EoE is a chronic allergic condition that affects the esophagus. The esophagus carries food from the mouth to the stomach. In people with EoE, the immune system overreacts to foods and causes inflammation in the esophagus.   [5:47] Eosinophils are a type of white blood cell. Eosinophils infiltrate the tissue in the esophagus of people with EoE. Doctors look for eosinophils in the tissue of the esophagus as a sign that inflammation in the esophagus is EoE.   [6:04] The symptoms of EoE can vary in children and adults. That was one of the things the doctors were interested in when they were thinking about this paper. There are no blood or allergy tests that make it easy to diagnose EoE, which requires an endoscopy.   [6:31] An endoscopy is performed by a gastroenterologist. The gastroenterologists look at the appearance of the esophagus and take biopsies.   [6:49] A pathologist counts the eosinophils in the tissue to determine if there are eosinophils present. If there are more than 15 eosinophils in the high-powered field of the microscope and symptoms and clinical conditions are present, EoE is diagnosed.   [7:25] One of the variables Dr. Ruffner considers is that symptoms can be different in children versus adults. In older adolescents and adults, the classic symptom is difficulty swallowing or dysphagia. That is often caused by fibrosis in the esophagus.   [7:54] In younger children this is often not how EoE presents. They may vomit or refuse food. They may experience more weight loss. Symptoms vary over the lifespan. Pediatric EoE symptoms of nausea and abdominal pain can also show up in adults.   [9:54] Atopy refers to allergic conditions. In the paper, a history of atopy means a history of allergic conditions, like atopic dermatitis, IgE-mediated food allergy, allergic rhinitis, or asthma.   [10:37] These disorders tend to cluster together, over time, because they share many common genetic risks. They cluster in families because some of the genetic risks are the same. Not every family member will have the same atopic or allergic conditions.   [11:07] In families, perhaps one person will have atopic dermatitis and allergic rhinitis while another will have atopic dermatitis, allergic rhinitis, asthma, and EoE. They may have inherited different genetics or had different environmental exposures.   [11:50] Ryan says that describes his family. They each have different atopic conditions. Ryan got them all! Dr. Ruffner says it describes her family, as well.   [12:26] Dr. Ruffner says it's understandable for families to stress about atopic conditions. Unfortunately, right now, there's no way to predict who will develop which atopic conditions. It's on the minds of the medical and research communities.   [13:10] IgE is an antibody that binds to food allergens and mediates anaphylaxis, usually within 30 minutes, with hives, vomiting, and difficulty breathing. Not everyone with a diagnosed food allergy will be given an epinephrine auto-injector.   [13:44] IgE-mediated food allergies are influenced by type 2 cytokines. Cytokines are immune system signaling proteins that have been labeled as groups. The group that is involved in allergy most heavily is under the label type 2.   [14:15] These type 2 cytokines are responsible for influencing B cells to make IgE. In the tissue in EoE, we find that there is a large amount of these type 2 cytokines present.   [14:37] This is quite relevant because dupilumab, the monoclonal antibody that has been approved to treat EoE, targets type 2 inflammation by blocking type 2 cytokines.   [16:04] Dr. Ruffner says one of the biggest challenges in the field of EoE is we don't have a way to stratify who should get which treatment for EoE. Patients have to choose between diet and pharmacologic therapy.   [16:48] We don't know enough about the inflammatory profiles to give any patient the specific guided information that one therapy would be better than another.   [17:11] Pediatric and adult patients are given the same treatment options. Some dosing, such as proton pump inhibitors and dupilumab, is weight-based so different doses are needed.   [17:36] Over time, people's needs change. From early school age to when people leave home, they may have very different needs. They may do well on diet therapy when their diet is controlled by parents, but, on their own, that may not be the best option for them.   [18:20] Therapy may change over time to support each patient's individual goals. It can be challenging because therapies are imperfect. Each therapy has a percentage probability of success. Not every therapy is guaranteed to work for every individual.   [19:01] There is some flexibility and possibility of switching between therapies to support people. Ryan shares one of his experiences in changing treatments.   [20:03] Some patients are stable on a therapy for a time but then see symptoms creep back up. Dr. Ruffner strongly suggests they talk to their care team for an endoscopy and biopsy to see if they need to switch therapy and if their diet has changed.   [21:31] In young children, Dr. Ruffner sees a much higher incidence of feeding refusal. The child may have a preferred food or a preferred texture like puree, long past when that would be appropriate for the age.   [22:41] It can be very difficult to move past this learned behavior even if remission is achieved through therapy. The child may need feeding therapy to help with that. [22:59] Feeding behaviors in older individuals may be much more subtle. Talk about them with your care team. Needing water to eat, cutting food very small, and fearing to eat around people are common eating behaviors to discuss in older patients.   [23:53] These eating behaviors affect people's well-being deeply because they affect how social they feel when they are around people. Ideally, you want to be around people and share in social times.   [24:16] Holly has used these eating behaviors herself and notices them in other people. When adults come to her for therapy, she asks how many times they refill their water when they eat, and if food ever gets stuck. They are surprised that those are symptoms.   [26:01] Dr. Ruffner says it's important to recognize the difference in symptoms in diagnosing EoE. The main risk factor of EoE is fibrosis, over time. The thought is that early in EoE there is an inflammatory phenotype, but later, there is a fibrotic phenotype.   [26:51] The phenotype refers to the presentation or characteristic of disease. What is the appearance at endoscopy? What do we see in the biopsied tissue? Is there fibrosis or not?   [27:15] This is the crux of the paper: Is this on a spectrum, that the inflammation is driving the fibrosis, or are these two different things altogether? There is some evidence to suggest that the inflammation contributes to this fibrosis over time.   [27:40] One thing that is missing is following a group of patients from the start and having that evidence. There is mechanistic evidence from studies to show that inflammation can contribute to fibrosis. That was one of the discussions in the paper.   [28:29] In endoscopies, something that can be seen with fibrosis or fibrostenotic features is more of an appearance of rings and narrowing of the esophagus. A proportion of patients with strictures or narrowing need to have them dilated.   [29:11] For patients who have dilation, it can help with symptoms significantly. When pathologists look at the tissue with fibrosis, they can see changes in the protein structure. There is more collagen and other changes in the tissue, causing fibrosis.   [30:03] Some patients use adaptive eating behaviors to adapt to significant changes in their esophagus and go for many years without being diagnosed until they present with an impaction when food becomes stuck in their esophagus.   [30:46] This makes EoE a challenging disorder for many because it can be very difficult to diagnose. The journey to a diagnosis is very individual. As a group, adults are much more likely to have fibrosis, leading to dysphagia, strictures, or impaction.   [31:25] Statistically, across all patients, you see fibrosis more in adults than in children.   [32:42] In the paper, Th1 cells are mentioned. Th1 is an immune system term referring to a cell that produces interferon-gamma. Studies show there may be differences in interferon signaling in different age groups but it needs to be studied further.   [33:57] Dr. Ruffner's team had looked at a small group and saw that interferon signaling seemed to be relatively similar between children and adults. Both CD4 and CD8 T cells (types of immune system cells) are potentially producing interferon in the esophagus.   [34:32] More study needs to be done around those immune system cells and their potential significance in EoE, if any.   [35:33] The paper suggests that EoE in children and adults is essentially a spectrum of the same disorder rather than distinct diseases.   [35:42] Aspects of immunology, responses to different treatments across children and adults, the similar responses to diet and different medications, and over time in the same individuals, indicate these are changes and complications over time.   [36:41] Dr. Ruffner suggests that medical researchers need to understand which patients are at the highest risk of complications and work to identify the best treatments to prevent those.   [37:14] Dr. Ruffner is thinking about the response to proton pump inhibitor therapy. One of the things she is looking at is whether or not proton pump inhibitors affect how eosinophils migrate into the tissue.   [37:33] They are finding that it seems that PPIs can decrease the degree of migration of eosinophils into the tissue. They are very interested in looking at that. Ryan says when Dr. Ruffner gets that paper published, she'll have to come back on the show!   [38:06] Ryan thanks Dr. Ruffner. For our listeners who would like to learn more about eosinophilic disorders, including EoE, please visit APFED.org and check out the links in the show notes.   [38:15] If you're looking to find a specialist who treats eosinophilic disorders, we encourage you to use APFED's Specialist Finder at APFED.org/specialist.   [38:24] If you'd like to connect with others impacted by eosinophilic diseases, please join APFED's online community on the Inspire Network at APFED.org/connections.   [38:33] Ryan thanks Dr. Ruffner for participating in the podcast episode. Holly also thanks APFED's Education Partners Bristol Myers Squibb, GSK, Sanofi, Regeneron, and Takeda for supporting this episode.   Mentioned in This Episode: Dr. Melanie Ruffner, MD, PhD, Attending Physician with the Division of Allergy and Immunology and the Center for Pediatric Eosinophilic Disorders at Children's Hospital of Philadelphia “Pediatric and adult EoE: A spectrum or distinct diseases?” by Stanislaw J. Gabryszewski, Melanie A. Ruffner, and Jonathan M. Spergel   APFED on YouTube, Twitter, Facebook, Pinterest, Instagram Real Talk: Eosinophilic Diseases Podcast apfed.org/specialist apfed.org/connections   Education Partners: This episode of APFED's podcast is brought to you thanks to the support of Bristol Myers Squibb, GSK, Sanofi, Regeneron, and Takeda.   Tweetables:   “EoE is a chronic allergic condition that affects the esophagus. The esophagus carries food from the mouth to the stomach. In people with EoE, the immune system overreacts to food allergens and causes inflammation in the esophagus.” — Dr. Melanie Ruffner   “In EoE, there are no blood or allergy tests that make it easy to diagnose EoE without an endoscopy.” — Dr. Melanie Ruffner   “Is EoE on a spectrum, that the inflammation is driving the fibrosis, or are these two different things altogether? There is some evidence to suggest that the inflammation contributes to fibrosis over time.” — Dr. Melanie Ruffner   “When pathologists look at the tissue with fibrosis, they can see the changes in the protein structure.” — Dr. Melanie Ruffner   “There are some folks who have adapted their eating behavior quite significantly and may have quite a number of chronic changes in their esophagus that they have adapted around, and they go for many years without being diagnosed.” — Dr. Melanie Ruffner

Gary Falcetano, Scientific Affairs Manager for Allergy at Thermo Fisher Scientific, is a leader in allergy and autoimmune diagnostics, providing specific IgE tests and the instruments to run them. Accurately diagnosing allergies can be challenging, but specific IgE testing can help confirm the underlying causes by looking at individual allergen components for precise diagnosis. This is the first step in determining the appropriate management approach to potentially interrupt the atopic march, where allergies can progress or even be life-threatening. Gary explains, "It runs the gamut of just about anything that could potentially be an allergy disease. So I think the majority of our testing is done in both environmental allergies and food allergies. What people think about when we, especially this time of year in the US, with spring about to become a big onslaught, are environmental allergies, including pollens, grass, trees, and weeds. Also, looking at some of the indoor triggers to environmental allergies like dust mites, pets, molds, and mice is pretty key when assessing for respiratory-type symptoms. On the food side, any of a number of foods can potentially cause a patient to produce specific IgE, which is the sensitization that allows us to become allergic." "We all think of respiratory allergies as straightforward, but there's an overlap of symptoms, especially from non-allergic causes, that can cause similar symptoms. So when thinking about respiratory allergies, we think about nasal congestion, post-nasal drip, and cough. Those symptoms can all be certainly caused by allergies, but they also can be caused by non-allergic triggers. That's one of the places where diagnostic allergy testing or specific IgE testing comes in to confirm whether we're dealing with an allergy. Then, if it's an allergy, what specifically is driving the symptoms? Once we rule out allergy, we can go down a whole other diagnostic pathway for all the various causes, like non-allergic rhinitis." #ThermoFisherScientific #Allergies #AllergyTesting #ClinicalDiagnostics #PatientCare #IgETesting thermofisher.com Download the transcript here

Gary Falcetano, Scientific Affairs Manager for Allergy at Thermo Fisher Scientific, is a leader in allergy and autoimmune diagnostics, providing specific IgE tests and the instruments to run them. Accurately diagnosing allergies can be challenging, but specific IgE testing can help confirm the underlying causes by looking at individual allergen components for precise diagnosis. This is the first step in determining the appropriate management approach to potentially interrupt the atopic march, where allergies can progress or even be life-threatening. Gary explains, "It runs the gamut of just about anything that could potentially be an allergy disease. So I think the majority of our testing is done in both environmental allergies and food allergies. What people think about when we, especially this time of year in the US, with spring about to become a big onslaught, are environmental allergies, including pollens, grass, trees, and weeds. Also, looking at some of the indoor triggers to environmental allergies like dust mites, pets, molds, and mice is pretty key when assessing for respiratory-type symptoms. On the food side, any of a number of foods can potentially cause a patient to produce specific IgE, which is the sensitization that allows us to become allergic." "We all think of respiratory allergies as straightforward, but there's an overlap of symptoms, especially from non-allergic causes, that can cause similar symptoms. So when thinking about respiratory allergies, we think about nasal congestion, post-nasal drip, and cough. Those symptoms can all be certainly caused by allergies, but they also can be caused by non-allergic triggers. That's one of the places where diagnostic allergy testing or specific IgE testing comes in to confirm whether we're dealing with an allergy. Then, if it's an allergy, what specifically is driving the symptoms? Once we rule out allergy, we can go down a whole other diagnostic pathway for all the various causes, like non-allergic rhinitis." #ThermoFisherScientific #Allergies #AllergyTesting #ClinicalDiagnostics #PatientCare #IgETesting thermofisher.com Listen to the podcast here

MMALOTN is back to give you breakdowns and predictions for UFC 314: Volkanovski vs Lopes. THIS PATREON IS FOR THE FIGHT LINK DATABASE, NOT MY PICKS/BETS/WRITE UPS.

If you've optimized your health but still struggle, this episode is for you. My friend Chris joins me to break down lab work, individualized interventions, and why test interpretation matters as much as the results.Chris has a powerful story—growing up with severe eczema, nearly becoming a doctor, and ultimately choosing to help people outside the medical system. Now, he works with complex cases, helping my community troubleshoot persistent health challenges. We cover mitochondrial support, circadian alignment, diet pitfalls, and the importance of finding the right practitioner.Book with Chris | https://www.sarahkleinerwellness.com/private-coaching-with-team-skw​​Topics Discussed: How can lab testing help identify hidden health issues?What are the pros and cons of HTMA hair testing?How does mitochondrial support impact overall health?What are common pitfalls of the repeat and carnivore diets?Why is it important to find the right practitioner for lab work interpretation?Timestamps: 00:00:00 - Introduction00:04:01 - How I met Chris00:05:58 - Chris's health journey00:11:36 - Challenges in personalized care00:16:17 - Importance of circadian alignment00:21:36 - Coaching protocol insights00:24:03 - Mitochondria and genetics00:26:28 - Eczema and skin health00:31:02 - Chronic allergies00:33:53 - LDA treatment & biofilms00:37:08 - IgE scores in allergy testing00:38:10 - Issues with HTMA hair testing00:45:34 - Mineral levels & digestion00:47:07 - Chronic illness & holistic care00:51:18 - Nutrition myths & influencers00:57:55 - “Safety weight” & hormones00:59:55 - The carnivore diet01:06:37 - Genetics & diet01:11:02 - Where to find ChrisSponsored By: Viva Rays | Go to vivarays.com & use code: YOGI to save 15%Check Out Chris: Book with Chris | https://www.sarahkleinerwellness.com/private-coaching-with-team-skwWebsite Instagram Twitter This video is not medical advice & as a supporter to you and your health journey - I encourage you to monitor your labs and work with a professional!________________________________________Get all my free guides and product recommendations to get started on your journey!https://www.sarahkleinerwellness.com/all-free-resourcesCheck out all my courses to understand how to improve your mitochondrial health & experience long lasting health! (Use code PODCAST to save 10%) -  https://www.sarahkleinerwellness.com/coursesSign up for my newsletter to get special offers in the future! -https://www.sarahkleinerwellness.com/contactFree Guide to Building your perfect quantum day (start here) -https://www.sarahkleinerwellness.com/opt-in-9d5f6918-77a8-40d7-bedf-93ca2ec8387fMy free product guide with all product recommendations and discount codes:https://www.sarahkleinerwellness.com/resource_redirect/downloads/file-uploads/sites/2147573344/themes/2150788813/downloads/84c82fa-f201-42eb-5466-0524b41f6b18_2024_SKW_Affiliate_Guide_1_.pdfMy Circadian App - AppleMy Circadian App - AndroidMy Circadian App - Youtube

This spring, patients may be reporting that some foods cause their mouth to itch. Is this a food allergy? Or is this pollen food allergy syndrome (PFAS)? In this episode of ImmunoCAST tackles the clinical challenge of distinguishing this condition from more severe food allergies. We explore the mechanisms behind PFAS, its relationship to seasonal allergies, and the importance of comprehensive allergy evaluation. Key topics include the role of specific IgE testing, differentiating between true food allergies and cross-reactivity with pollen, and management strategies such as avoiding trigger foods and processing methods to denature allergens. Gain valuable insights into improving patient outcomes through accurate diagnosis and tailored management plans. Episode resources and references available at https://www.thermofisher.com/phadia/us/en/resources/immunocast/%20pollen-food-allergy-syndrome-ige-testing-cross-reactivity.html?cid=0ct_3pc_05032024_9SGOV4

Welcome to HCPLive's 5 Stories in Under 5—your quick, must-know recap of the top 5 healthcare stories from the past week, all in under 5 minutes. Stay informed, stay ahead, and let's dive into the latest updates impacting clinicians and healthcare providers like you! Interested in a more traditional, text rundown? Check out the HCPFive! Top 5 healthcare headlines for March 9-16, 2025: 1. CagriSema Yields Nearly 16% Weight Loss in Phase 3 REDEFINE 2 Trial In the Phase 3 REDEFINE 2 trial, CagriSema showed weight reduction in adults with obesity or overweight and type 2 diabetes, outperforming placebo. 2. Lorundrostat Significantly Lowers Blood Pressure in Key Hypertension Trials The Phase 3 Launch-HTN and Phase 2 Advance-HTN trials showed lorundrostat effectively reduced blood pressure in uncontrolled or resistant hypertension with a favorable safety profile. 3. PharmaTher Receives New Early June FDA Goal Date for Ketamine PharmaTher announced the FDA set a new Priority Review goal date of June 4, 2025, for ketamine to treat anesthesia, pain, mental health, and neurological conditions. 4. FDA Awards Fast Track Designation to ATSN-201 Gene Therapy for XLRS The FDA granted Fast Track designation to ATSN-201 for X-linked retinoschisis, allowing Atsena Therapeutics to seek Priority Review for their gene therapy. 5. FDA Approves First Interchangeable Biosimilar for Omalizumab The FDA approved omalizumab-igec (OMLYCLO) as the first interchangeable biosimilar to Xolair for asthma, CRSwNP, IgE-mediated food allergy, and CSU.

Why do conditions like asthma, nasal polyps, or eczema become more severe when they coexist? Kortney and Dr. Payel Gupta are joined by Dr. Michael Blaiss to explore the common thread linking multiple allergic and inflammatory diseases: Type 2 Inflammation. If you've ever wondered why certain conditions often appear together, this deep dive will help you connect the dots. Type 2 Inflammation is a hot topic in immunology because it's the engine that drives many allergic and inflammatory diseases. It's also the key to modern treatment strategies, including targeted biologic therapies. Dr. Blaiss explains how clinicians recognize multiple Type 2-driven conditions in the same patient, why it is important to know the connection between multiple conditions and Type 2 inflammation, and the big-picture benefits of treating inflammation aggressively to prevent complications. What We Cover in our Episode about The Diseases Related to Type 2 Inflammation Conditions Related to Type 2 Inflammation: Explore how chronic rhinosinusitis with nasal polyps (CRSwNP), rhinitis, asthma, atopic dermatitis (eczema), prurigo nodularis, eosinophilic esophagitis (EoE), and food allergies can all share a common inflammatory pathway. The Likelihood of Having Multiple Type 2 Conditions: How often do patients have more than one condition related to Type 2 Inflammation, and why is recognizing overlap a potential game-changer for diagnosis and treatment? Treating the Root Inflammation vs. Individual Symptoms: Discover how clinicians decide whether to address each condition separately or tackle the underlying Type 2 inflammatory process affecting them all. Markers & Personalized Medicine: Dr. Blaiss discusses whether potential tests, such as eosinophil counts or IgE levels, can confirm Type 2 inflammation. He also explains how knowing you have Type 2 Inflammation can help guide targeted therapy. Prevention & Aggressive Intervention: Understand why it's crucial to treat inflammation early to reduce the risk of developing multiple Type 2 conditions and how this proactive approach benefits long-term health. Want to know more? Type 2 Inflammation Overview – Explains the role of Type 2 inflammation in conditions like asthma and nasal polyps. This podcast is for informational purposes only and does not substitute for professional medical advice. If you have any medical concerns, always consult with your healthcare provider. Produced in partnership with The Allergy & Asthma Network. Thanks to Sanofi and Regeneron for sponsoring today's episode. While they support the show, all opinions are our own, and sponsorship doesn't influence our content or editorial decisions. Any mention of brands is for informational purposes and not an endorsement.

Episode 184: Multiple Myeloma BasicsSub-Interns and future Drs. Di Tran and Jessica Avila explain the symptoms, work up and treatment of multiple myeloma. Written by Di Tran, MSIV, Ross University School of Medicine; Xiyuan Yang, MSIV, American University of the Caribbean. Comments by Jessica Avila, MSIV, American University of the Caribbean. Edits by Hector Arreaza, MD.You are listening to Rio Bravo qWeek Podcast, your weekly dose of knowledge brought to you by the Rio Bravo Family Medicine Residency Program from Bakersfield, California, a UCLA-affiliated program sponsored by Clinica Sierra Vista, Let Us Be Your Healthcare Home. This podcast was created for educational purposes only. Visit your primary care provider for additional medical advice.Di: Hi everyone, this is Di Tran, 4th year medical student from Ross university.  It's a pleasure to be back.  To be honest, this project is a part of teamwork of two medical students, myself and another 4th year, her name is XiYuan.  She came from the AUC. Unfortunately, due to personal matters she was unable to make it to the recording today which makes me feel really sad. Jessica: My name is Jessica Avila, MSIV, American University of the Caribbean.Di: The topic we will present today is Multiple Myeloma. Multiple myeloma is typically a rare disease and it's actually a type of blood cancer that affects plasma cells in the bone marrow.Jessica: Let's start with a case: A 66-year-old male comes to his family doctor for an annual health checkup. He is not in any acute distress but he reports that he has been feeling tired and weaker than usual for the last 3 months. He also noticed that he tends to bruise easily. He has a history of arthritis and chronic joint pain, but he thinks his back pain has gotten worse in the last couple of months. Upon checking his lab values, his family doctor found that he has a calcium level of 10.8 and a creatinine level of 1.2, which has increased from his baseline. Given all that information, what do you think his family doctor is suspecting? And what kind of tests she can order for further evaluation?Di: Those symptoms sound awfully familiar – are we talking about the CRAB? You know, the diagnostic criteria for Multiple Myeloma.Jessica: Exactly! Those are called “myeloma-defining events.” Do you remember what those are?Di: CRAB criteria comes in 4 flavors.  It's HYPERCALCEMIA with >1mg/dL, RENAL INSUFFICIENCY with serum creatinine >2mg/dL, ANEMIA with hemoglobin value 10% plasma cells, PLUS any one or more of the CRAB features, we can make the official diagnosis of multiple myeloma. Di:  Before we go deeper, let's back up a little bit and do a little background.  So, what do we know about the immunoglobulins, also known as antibodies? Back from years of studying from medical school, we know that the plasma cells are the ones that producing the antibodies that help fight infections.  There  are various kinds that come with various functions.  Each antibody is made up of 2 heavy chains and 2 light chains.  For heavy chains, we have A, D, E, G, M and for light chains we have Kappa and Lambda.Jessica: Usually, the 5 possible types of immunoglobulins for heavy chains would be written as IgG, IgA, IgD, IgE, and IgM.  And the most common type in the bloodstream is nonetheless the IgG. Di: What is multiple myeloma? In myeloma, all the abnormal plasma cells make the same type of antibody, the monoclonal antibody.  The cause of myeloma is unknown, but there are lots of studies and evidence that show a number of potential etiologies, including viral, genetic, and exposure to toxic chemicals, especially the Agent Orange, which is a chemical used as herbicide and defoliant. It was used as a chemical warfare by the U.S. military during the Vietnam War from 1961 to 1971.Jessica: We need to order some specific blood tests to see if there is elevated monoclonal proteins in the blood or urine. So, to begin with we'll need to take a very thorough history and physical exam. Next, we'll do labs, such as CBC, basic metabolic panel, calcium, serum beta-2 microglobulin, LDH, total protein, and some not so common tests: serum protein electrophoresis (SPEP), immunofixation of blood or urine (IFE), quantitative immunoglobulins (QIg), serum free light chain assay, and serum heavy/light chain ratio assay.If any of the results is abnormal, we should consider referring our patient to an oncologist.Di: Interesting! I read that Multiple Myeloma symptoms vary in different patients.  In fact, about 10-20% of patients with newly diagnosed myeloma do not have any symptoms at all.   Otherwise, classic symptomatic presentations are weakness, fatigue, increased bruising under the skin, reduced urine output, weakened bones that is likely prone to fractures, etc. And if multiple myeloma is highly suspected, a Bone Marrow biopsy should be done with testing for flow cytometry and fluorescent in situ hybridization (FISH). Actually, if any of the “Biomarkers of malignancy (SLIM)” is met we can also diagnose multiple myeloma even without the CRAB criteria. Jessica: The diagnosis is made if one or more of the following is found: >= 60% of clonal plasma cells on bone marrow biopsy, > 1 lytic bone lesion on MRI that is at least 5mm in size, or a biopsy confirmed plasmacytoma. Di: Imaging comes in at the final step especially if we able to find one or more sites of osteolytic bone destruction > 5mm on an MRI scan.Jessica: What if the bone marrow biopsy returns > 10% of monoclonal plasma cells, but our patient doesn't have either the CRAB or the Biomarker criteria? Di: That's actually a very good question, since Multiple Myeloma is part of a spectrum of plasma cell disorders. That's when smoldering myeloma comes into play. It is a precursor of active multiple myeloma. Smoldering myeloma is further categorized as high-risk or low-risk based on specific criteria.A less severe form is called Monoclonal Gammopathy of Undetermined Significance, or simply MGUS, with < 10% bone marrow involvement. Those are diagnoses we give once we rule out actual multiple myeloma, which are defined by the amount of M-protein in the serum.Jessica:  When to get started on treatment? Multiple Myeloma is on a spectrum of plasma cells proliferative disorders, starting from MGUS to Smoldering Myeloma, to Multiple Myeloma and to  Plasma Cell Leukemia.  Close supervision/active watching is enough for MGUS and low risk Smoldering Myeloma. But once it has progressed to high-risk smoldering myeloma or to active Multiple Myeloma, chemotherapy is usually required. Some situations may require emergent treatment to improve renal function, reduce hypercalcemia, and to prevent potential infections.Di: As of 2024, treatment of Multiple Myeloma comprises the Standard-of-Care approved by the FDA. In fact, the quadruple therapy is a combination of 4 different class of drugs that include a monoclonal antibody, a proteasome inhibitor, an immunomodulatory drug, and a steroid. Jessica: They are Darzalex (daratumumab), Velcade (bortezomib), Revlimid (lenalidomide) and dexamethasone.  Other treatment plans for Multiple Myeloma include chemotherapy, immunotherapy, radiation therapy (for plasmacytomas) and stem cell transplants. The patient will also be on prophylaxis acyclovir and Bactrim while on chemotherapy. Sometimes anticoagulants are also considered because the chemo increases the risk of venous thromboembolic events.Di: Although the disease is incurable, but with the advancing of novel therapies and clinical trials patients with multiple myeloma are able to live longer.  Problem is the majority of patients diagnosed with Multiple Myeloma are older adults (>65), the risk of falling is adding to multiple complications of the disease itself, such as bone density loss, pain, neurological compromises, distress and weakness.  Palliative care may come in help at any point in time throughout the course of treatment but is most often needed at the very end of the course. Jessica, can you give us a conclusion for this episode?Jessica: Multiple Myeloma may not be the most common cancer, but we have to be aware of the symptoms and keep it in our differential diagnosis for patients with bone pain, easy bruising, persistent severe headaches, unexplained renal dysfunction, and remember the CRAB: HyperCalcemia, Renal impairment, Anemia and Bone lesions.Even without trying, every night you go to bed a little wiser. Thanks for listening to Rio Bravo qWeek Podcast. We want to hear from you, send us an email at RioBravoqWeek@clinicasierravista.org, or visit our website riobravofmrp.org/qweek. See you next week! _____________________References:International Myeloma Foundation. (n.d.). International Myeloma Working Group (IMWG) criteria for the diagnosis of multiple myeloma. https://www.myeloma.org/international-myeloma-working-group-imwg-criteria-diagnosis-multiple-myeloma Laubach, J. P. (2024, August 28). Patient education: Multiple myeloma symptoms, diagnosis, and staging (Beyond the Basics). UpToDate. https://www.uptodate.com/contents/multiple-myeloma-symptoms-diagnosis-and-staging-beyond-the-basics.University of California San Francisco. (n.d.). About multiple myeloma. UCSF Helen Diller Family Comprehensive Cancer Center. https://cancer.ucsf.edu/research/multiple-myeloma/about Theme song, Works All The Time by Dominik Schwarzer, YouTube ID: CUBDNERZU8HXUHBS, purchased from https://www.premiumbeat.com/.

What do asthma, eczema, EoE, and nasal polyps have in common? They all stem from Type 2 inflammation! Type 2 inflammation is a major cause of many allergic and inflammatory conditions, yet it remains widely misunderstood. In this first episode of our four-part series on Type 2 Inflammation, we discuss the basics, unpack its impact on the immune system, explain how it contributes to chronic inflammation in the body, and explain why it matters for treatment and management. What we cover in our episode about Type 2 Inflammation Understanding Inflammation: Inflammation is your body's natural defence mechanism, but it can become problematic when it turns chronic. Normal vs. Chronic Inflammation: Not all inflammation is bad! Learn the difference between the body's normal immune response and long-term chronic inflammation. What Sets Type 2 Inflammation Apart? Unlike other immune responses, Type 2 inflammation involves a specific pathway. Key Players in Type 2 Inflammation: Th2 cells, cytokines (IL-4, IL-5, IL-13), IgE antibodies, and eosinophils. Measuring Type 2 Inflammation: How blood tests can help determine if Type 2 inflammation is contributing to your symptoms. Want to know more? Type 2 Inflammation Overview – Explains the role of Type 2 inflammation in conditions like asthma and nasal polyps. This podcast is for informational purposes only and does not substitute for professional medical advice. If you have any medical concerns, always consult with your healthcare provider. Produced in partnership with The Allergy & Asthma Network. Thanks to Sanofi for sponsoring today's episode. While they support the show, all opinions are our own, and sponsorship doesn't influence our content or editorial decisions. Any mention of brands is for informational purposes and not an endorsement.  

Think diagnosing food allergies is as simple as running a test? Think again. Food allergy testing is a maze of gray areas, false positives, and, hopefully, a clear food allergy diagnosis. Navigating food allergy testing can feel overwhelming, with skin pricks, blood tests, and conflicting advice. How do you determine which tests are truly useful? How can you avoid unnecessary dietary restrictions from false results? In this episode, Dr. David Stukus, a board-certified allergist and immunologist, joins Dr. Gupta and Kortney to demystify the science of food allergy testing. From the importance of patient history to the latest diagnostic tools, Dr. Stukus provides clear guidance to help you make informed decisions while navigating food allergy testing. What we cover in our episode about food allergy testing The Crucial Role of History in Food Allergy Diagnosis: Dr. Stukus highlights why understanding a patient's reaction history (symptoms, timing, and context) is critical for guiding effective testing decisions. Choosing the Right Tests: We break down skin prick testing, blood tests like IgE and component testing, and innovations like epitope mapping. Dr. Stukus explains why IgG testing is untrustworthy and emphasizes oral food challenges as the gold standard for diagnosis. False Positives and Negatives: Learn why expert interpretation of test results is crucial and how overtesting can lead to unnecessary restrictions and confusion. When to See an Allergist: Practical advice on when to consult a specialist and what to expect during your visit for evidence-based care. This podcast is made in partnership with The Allergy & Asthma Network. Thanks to Genentech for sponsoring today's episode. About Our Guest Dr. David R. Stukus is a renowned allergist and immunologist at Nationwide Children's Hospital and a professor at Ohio State University College of Medicine. He is known for his dedication to patient education and myth-busting in allergy care and is a trusted expert in food, asthma, and environmental allergies. Follow Dr. Stukus on Instagram: @allergykidsdoc

On the top 200 drugs podcast, we cover 5 more medications. The medications covered on today's episode include; omalizumab, nitroglycerin, apixaban, gabapentin, and etanercept. Omalizumab is a monoclonal antibody used in moderate to severe asthma. It targets IgE-mediated asthma attacks and reactions. Anaphylaxis is a significant concern with the use of this medication. Sublingual nitroglycerin is frequently used on an as needed basis for angina symptoms. I discuss major drug interactions and much more. Apixaban is an anticoagulant used to prevent stroke in atrial fibrillation. It can also be used in DVT/PE treatment and prevention. Gabapentin is classified as an antiepileptic agent but is most commonly used for neuropathic type pain. Etanercept targets TNF alpha which plays an important role in autoimmune diseases such as rheumatoid arthritis.

Relive the magic of UFC 308's live watch party with Mike Heck and Jed Meshew! Check out the original UFC 308 Watch Party here: https://www.youtube.com/live/-F8ZPFzscbg Timestamps: Intro (0:00) Shara Bullet vs. Arman Petrosyan (23:58) Shara Bullet double spinning back fist KO (42:20) Lerone Murphy vs. Dan Ige (59:40) Ige drops Murphy in Round 1 (1:04:25) Murphy wins decision (1:20:42) Magomed Ankalaev vs. Aleksandar Rakic (1:36:27) Ankalaev wins decision (1:55:55) Robert Whittaker vs. Khamzat Chimaev (2:13:17) Chimaev dislocates Whittaker's jaw with crank submission (2:17:15) Ilia Topuria vs. Max Holloway (2:41:50) Topuria knocks out Holloway in Round 3 to retain title (2:55:40) Follow Mike Heck: @MikeHeck_JR Follow Jed Meshew: @JedKMeshew Subscribe to MMA Fighting Check out our full video catalog Like MMA Fighting on Facebook Follow on Twitter Read More: http://www.mmafighting.com Learn more about your ad choices. Visit podcastchoices.com/adchoices

Relive the magic of UFC 308's live watch party with Mike Heck and Jed Meshew! Check out the original UFC 308 Watch Party here: https://www.youtube.com/live/-F8ZPFzscbg Timestamps: Intro (0:00) Shara Bullet vs. Arman Petrosyan (23:58) Shara Bullet double spinning back fist KO (42:20) Lerone Murphy vs. Dan Ige (59:40) Ige drops Murphy in Round 1 (1:04:25) Murphy wins decision (1:20:42) Magomed Ankalaev vs. Aleksandar Rakic (1:36:27) Ankalaev wins decision (1:55:55) Robert Whittaker vs. Khamzat Chimaev (2:13:17) Chimaev dislocates Whittaker's jaw with crank submission (2:17:15) Ilia Topuria vs. Max Holloway (2:41:50) Topuria knocks out Holloway in Round 3 to retain title (2:55:40) Follow Mike Heck: @MikeHeck_JR Follow Jed Meshew: @JedKMeshew Subscribe to MMA Fighting Check out our full video catalog Like MMA Fighting on Facebook Follow on Twitter Read More: http://www.mmafighting.com Learn more about your ad choices. Visit podcastchoices.com/adchoices

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Thank you for joining us for our 2nd Cabral HouseCall of the weekend! I'm looking forward to sharing with you some of our community's questions that have come in over the past few weeks…   Raquel: Hi, I wanted to know if it's possible to get rid of food and environmental allergies. I cannot tolerate fruits, vegetables, nuts, and nickel-containing products due to these. Even if I cook everything (OAS), I still get an itchy mouth, wheezing, and/or vomiting/diarrhea (especially with eggplant, coconut, and nuts). I did IgE blood and skin testing and was allergic to everything tested. I also tried allergy shots for 5 years. I also have IBS-D and fiber/grains are a major trigger. The one thing that has worked to reduce my symptoms (hives, itchy mouth, asthma, diarrhea) is to eat an elimination diet (no plants), but I am worried about this long term. I am allergic to your HistPro and Sinus Support supplements I assume due to the plants in them. Any help greatly appreciated, thanks so much!     Matthew: My mother saw her doctor and he told her that her heart is not pumping enough blood throughout her body and she needs to see specialist. Now on the allopathic side I know they're gonna have her take heart medication. I know my experience that heart medication causes so many problems overtime just like other medication cause problems. I wanted to know what can she do for a naturopathic/ functional medicine perspective, or should I say try before she goes into the medication aspect? Because from the sounds of it to me, her EF or ejection fracture is lower than it should be. I may be wrong but that's what it sounds like to me. I'm hoping you can help thanks     Amy: Should one take a break from berberine need to be stopped after taking it 6 months? It is the only thing that stopped my hot flashes so i don't want to stop.     Maria: Why does the heat of the sun make me feel sick?     Jillian: My 3.5 year old daughter develops a cough that can last a month+ after being sick. This cough wakes her at night, sometimes causing her to vomit from coughing so hard. During these times she will cough after running around also. This happens every few months, with some time in between of no symptoms. It seems like asthma but I am unsure of what to do. How safe are breathing treatments and inhalers for children? Does this mean she requires antibiotics to clear any infection from a lingering sickness? Most importantly, why would this be happening to her? Would removing tonsils help? I'm trying to weigh the pros and cons of treating her with western medicine letting it be and seeing if it stops as she gets older. She's only had antibiotics once in her life and eats fairly well for a toddler.   Thank you for tuning into this weekend's Cabral HouseCalls and be sure to check back tomorrow for our Mindset & Motivation Monday show to get your week started off right! - - - Show Notes and Resources: StephenCabral.com/3166 - - - Get a FREE Copy of Dr. Cabral's Book: The Rain Barrel Effect - - - Join the Community & Get Your Questions Answered: CabralSupportGroup.com - - - Dr. Cabral's Most Popular At-Home Lab Tests: > Complete Minerals & Metals Test (Test for mineral imbalances & heavy metal toxicity) - - - > Complete Candida, Metabolic & Vitamins Test (Test for 75 biomarkers including yeast & bacterial gut overgrowth, as well as vitamin levels) - - - > Complete Stress, Mood & Metabolism Test (Discover your complete thyroid, adrenal, hormone, vitamin D & insulin levels) - - - > Complete Food Sensitivity Test (Find out your hidden food sensitivities) - - - > Complete Omega-3 & Inflammation Test (Discover your levels of inflammation related to your omega-6 to omega-3 levels) - - - Get Your Question Answered On An Upcoming HouseCall: StephenCabral.com/askcabral - - - Would You Take 30 Seconds To Rate & Review The Cabral Concept? The best way to help me spread our mission of true natural health is to pass on the good word, and I read and appreciate every review!