George A. Sprecace M.D., J.D., F.A.C.P. and Allergy Associates of New London, P.C.
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Bronchial Asthma Topics

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Rapid Response for WEDNESDAY, October 9, 2019

Interesting information, as is much that is written about Bronchial Asthma.
But there are three important issues that are being missed by most physicians and most commentators:
1) the central importance of a carefully taken medical and allergy history, by a certified Allergist or by a trained and motivated health care provider. This would most often lead to complete diagnosis and a treatment program that should include Allergy Immunotherapy for those allergens that cannot be avoided.
2) the uselessness of the "diagnosis" of COPD, actually a waste-basket for undiagnosed components of Obstructive Airway Diseases: Bronchial Asthma, Chronic Bronchitis and other consequences of personal and occupational life.
3) the proper and experienced use of oral corticosteroids, both tablet and inhaled, often used with a "all or nothing at all" approach.
4) the utility of biologics in selected cases - but not nearly as important as the  above.

That approach will get our asthmatics better and keep them better.

GS

Asthma Control in the Elderly: A Test of Personalized Coaching

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Rapid Response for MONDAY, December 24, 2018

THERE ARE FOUR KINDS OF MEDICAL RESEARCH, ALL DEPENDENT UPON VAST AMOUNTS OF FUNDING.
  1. Original Research, beginning de novo;
  2. New Research building upon research results already reported, sometimes many decades ago:
  3. Research essentially re-doing established work of the past, with or without attribution;
  4. Research that totally ignores established work of the past that still supports current mainstays of medical treatment.
It is the fourth kind of research that I address here: work establishing Allergy Immunotherapy, first in the clinical laboratory and practices of pioneers like Dr's Robert Cooke and William Sherman beginning in the 1920's...and then entirely verified in the immunology laboratories of scientists like Dr's. Larry Lichtenstein and Ichizaka in the 1960's.

That Allergy Immunotherapy is a bed-rock of desensitization treatment for serious inhalant allergies - particularly bronchial asthma and combined asthma / chronic bronchitis.

And It Is Being Studiously Ignored...by both practising clinicians who never bothered to become familiar with it, and by researchers who would rather not lose research grants while giving passing attention to the central role of inhalant allergy in these fields. This leaves the patient to search out his or her needs.

See the following extensive article entitled:
"Advances In Asthma In 2017:Mechanisms, Biologics, And Genetics.", in J. Allergy Clin Immunology, November 2018.
See if I missed anything.

GS

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Rapid Response for FRIDAY and SATURDAY, December 7 and 8, 2018

NOW HEAR THIS!
If an established Asthmatic is not treated with an accurate and complete diagnosis, with effective environmental control - especially involving pets, with an effective (and not excessive) program of anti-allergic and anti-inflammatory medications, with prompt on-call and effective treatment of superimposed respiratory tract infections, and WITH ALLERGY IMMUNOTHERAPY FOR UNAVOIDABLE ALLERGENS, he or she, at whatever age, is BEING POORLY TREATED.
And that is also true - and possibly especially so - for the many patients, undiagnosed by their Pulmonologists, who continue to miss combined Bronchial Asthma and Chronic Bronchitis, mis-labled as "COPD",
Everybody so affected, whether, parent or patient or primary care physician or pulmonologist:
EITHER LEARN, OR GET TO A CERTIFIED ALLERGIST, OR
GET OUT OF THE BUSINESS
George A. Sprecace., M.D., F.A.C.P, J.D.
asthma.drsprecace.com

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Rapid Response for SUNDAY, November 18, 2018

BRONCHIAL ASTHMA: THE MOST TREATABLE - AND OFTEN THE MOST POORLY TREATED -  SERIOUS MEDICAL CONDITION.
I have been writing about and treating Bronchial Asthma for many decades. That information is available in several sections of this web site, and is up-dated regularly.
Today, I present the latest caution, prompted by the very recent re-approval by the FDA of Primatene Mist as an OTC medication for the treatment of "mild asthma".
WRONG, AND POTENTIALLY DANGEROUS.
In this position, I am joined by a Joint Statement just released by the major medical organizations dealing with such subjects : "Several Asthma, Allergy Groups Express "Deep Concern" Over Primatene Mist Approval" (MPR, November 12, 2018).
Use and overuse can easily result in a rebound worsening of the asthmatic bronchospasm, resulting in crisis situations.

There may be usefulness for Primatene Mist, only by prescription and under a doctor's emergency advice, in case of acute laryngospasm...and then FOLLOWED IMMEDIATELY by transfer to an Emergency Room - in view of the medication's propensity to produce worse rebound.
BEWARE: The life you save may be your own.

GS

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AS I HAVE NOTED MANY TIMES: FULLY 50% OF HEALTH CARE EXPENDITURES ARE DIRECTLY RELATED TO UNHEALTHY LIFE-STYLE ACTIVITIES.  STUPIDO!

GS

Study: Smoking-Related Mortality Greatly Underestimated - Consultant360.Com


Rapid Response for WEDNESDAY, December 3, 2014

Finally the Pulmonologists come around to an observation that I made and reported in 1970...and since then: that about 30% of patients presenting ostensibly with Chronic Bronchitis have concomitant Bronchial Asthma, which may be the only reversible part of their condition.  Thus, I have always considered "COPD" to be an incomplete diagnosis, detrimental to the patient.

GS

What proportion of patients with COPD also have asthma and discuss the role of asthma? - MedPageToday.Com


Rapid Response
for TUESDAY, August 19
, 2014

Finally...

I presented a paper on this in 1970 at the Yale Allergy Clinic; and I have been diagnosing and treating patients with it since then - with no help from my Pulmonology colleagues.

GS


Diagnosing Asthma-COPD Overlap Syndrome - Consultant360.Com


Offerings by George A. Sprecace M.D., J.D.:

Childhood Asthma - On My Mind, GS  (Added 9/7/2013)

WAZZUP?! - New and Notable, GS

Bronchial Asthma, COPD, and Inflamation, GS

Problems and Controversies in Bronchial Asthma, GS

Emergency Room Treatment of Acute Bronchial Asthma, GS

Inflamation and Remodeling (Scarring) in Bronchial Asthma and COPD, GS

The Latest Research - Reported March, 2000, GS

Asthma and Other Allergies:  What's It All About?, GS

Selected Notes Taken from the Text, "Inhaled Glucocorticoids In Asthma", GS

On the Current Rise in Bronchial Asthma Cases, GS

More Issues, GS


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