Oral Allergy Syndrome

Are you allergic to certain foods?  My wife is. She is allergic to most fruits and vegetables. Sounds crazy doesn’t it. People who suffer from allergies to foods such as raw fruits and vegetables, and who have their allergic reactions largely in the mouth may be suffering from something called Oral Allergy Syndrome.  The term Oral Allergy Syndrome was first used in 1987 and, at that time, referred to people who had pollen sensitivity as well.  Now the term can be used to describe anyone with food allergies, who have symptoms in the mouth, regardless of pollen sensitivity.  Patients with this type of allergy will generally have a feeling of burning or itching in the oral cavity or throat as well as, possibly, the ear canal.  Diagnosis is often made though taking a thorough history, and then reintroducing the foods one at a time after they have been eliminated from the diet to see if, in fact, they cause a reaction.  Come to find out my wife isn't as wierd as I thought. The diagnosis is actually quite common among food-related allergies.

Prescriptions online?

We can buy so many things online these days.  A handbag, a pair of running shoes, a new watch and the list goes on.  So what about prescription drugs, can they be bought online as well?  The answer is yes, they can.  It can be done legally, and with the expectation that what will be delivered will be the correct product.  Now, having said all that, it is also true that prescription drugs can be sold or bought online illegally.  So how do you know what’s legal and what’s not?  The FDA provides some guidelines to help you as you try to decipher if the website your considering buying from is legitimate or not.  These include: buy in the U.S. only, don’t buy if they don’t require a prescription, and look for understandable privacy and security policies to name a few.  The bottom line is, before making a purchase you should carefully research who you are buying your prescriptions from.

Tecfidera—a new pill for MS

On Wednesday (3/27/13) Biogen announced the FDA approval of its new oral medication for multiple sclerosis (MS), which it will call Tecfidera^TM.  Its chemical name is dimethyl fumarate, and it was formerly called BG-12.  Tecfidera^TM is an oral medication, unlike Biogen’s current offerings of Avonex^TM and Tysabri^TM, which are both injections.  It is, however, not the first oral MS medication.  Novartis has Gilenya^TM and Sanofi produces Aubagio^TM.  One of the things that have set this medication apart is that its most common side effects were only flushing and certain GI events like diarrhea, nausea and abdominal pain.  It’s conceivable that this medication will become the new main pill on the market.  Allowing MS suffers an easier and safer way to manage their disease. 

Cellphones and Medicine

What’s one thing that nearly all patients have with them when they come to the office?  Aside from the need for expert medical advice, most patients also have a cellphone.  Why is this important?  Advances in medical technology have made it possible to use a cellphone to do things like take an EKG or check your glucose, without the pain of having a needle stick.  These are just a couple of things that Dr. Eric Topol, chief academic officer for Scripps Health, talked about with Dr. Nancy Sniderman on NBC’s Rock Center with Brian Williams.   It’s interesting that a 17-year-old girl actually developed the program for taking EKGs over a cellphone.

Search Engine Optimization

SEO means search engine optimization.  As doctors, we don't usually think about this much.  Search engines, however, are how many patients find us these days.  In other words, if we have web pages, we have to know how to optimize them.  That way patients can quickly find and search our pages to get the information they need.  Hopefully coming back to us again in the future.

That being said, many of us in the medical world don’t want to think about search engines.  That’s understandable, we would much rather spend our time healing patients than worrying about how they found us.  There are a few simple things we should consider, however, in putting together our web pages.  Things like key words and image descriptions can be very important in steering patients to and through our websites.  In Business Insider Magazine you can find a short list of things to consider as you seek to build or improve upon your website.

HIV Cure?

The National Institutes of health has published a statement saying that a two-year-old child, born to a mother with the AIDS causing HIV virus and testing positive for the virus itself, is now off medication.  How did this happen?  What implication does this have for future treatment of HIV infected newborns?  First off, lets be clear, being off medication is not the same thing as being cured.  The child, whose sex has not been released, has undetectable levels of virus using standard tests.  However, more sophisticated test still show that the virus remains.  The amount of virus is very low, and it is not replicating at this point. 

The theory is that this “functional” cure occurred because the child could be treated so quickly.  He or she received the first doses of antiretroviral medication (the HIV virus is a retrovirus) approximately 30 hours after it was born.  Thus preventing the virus from firmly establishing itself in its host’s cells.

The bottom line, in my opinion, is that this is a functional, not an absolute, cure.  It is certainly not impossible that in the future this child may need to be put back on antiretroviral therapy.  However, in the meantime at least, he or she does not have to be medicated and can go on living a normal life.

Sequestration

If you look anywhere in the news these days your bound to find something about sequestration.  In this case sequestration refers to budget cuts that were just put in place this month.  The cuts, however, were planned in the Budget Control Act of 2011.  The government spends tax dollars on many industries, but healthcare is one of the major players in this cut, taking up 3.6% of the GDP (Wikipedia: Medicare (US)). 

So how will sequestration affect healthcare?  In a study done by Tipp Ubach, a firm that specializes in economic impact studies, it was found that sequestration could cost us 766,000 healthcare related jobs by 2021.  Both directly and indirectly the healthcare industry and it’s supporters are going to be hit by the spending cuts.

I hope this study overestimates the effect sequestration will have.  I imagine we’ll see some job loss but we will also see some healthcare business adaptations. Doctors and patients will be on the frontlines as the healthcare spending cuts roll out, I hope they won’t be disappointed.