Asthma Capitals 2013

The Asthma Capitals is an annual research project of the AAFA to identify “the most challenging places to live with asthma.” This report provides a summary of factors used to compare and rank the 100 largest U.S. metro areas.

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Experts: High pollen count increases medical dangers

Borger resident Edwin Scott said his allergies have been so bad this season he’s been chasing his Zyrtec with Allegra. “Usually, I use Benadryl or something (to supplement Zyrtec), not one of the name-brand medicines,” Scott said.
Allergens may be something to sneeze at, but area residents should not underestimate them as higher moisture levels and higher temperatures have caused higher pollen levels, local allergy experts said.

“People should not take allergies as something mild,” Dr. Constantine K. Saadeh said. “(Allergies) can have serious ramifications.”

Serious allergy suffers face sinus infections that can lead to meningitis, he said.

People who suffer from asthma caused by allergies can suffer irreparable lung damage if their asthma goes untreated, Saadeh said.

West Texas A&M University Purchasing Director Bryan Glenn said he couldn’t make it to work Friday because of his seasonal allergy symptoms. He said he’s been taking allergy shots to no avail.

“My face is swollen and eyes are runny … ready for the first freeze,” Glenn said.

WT biology professor Arun Ghosh cited research by Rutgers University environmentalist Leonard Bielory to explain heightened pollen levels worldwide. Global climate change is prompting many plant species into a sort of species-
survival mode in which they release more pollen, Ghosh said.

“(Plants) cannot move themselves, so it’s kind of a gene-controlled phenomenon,” Ghosh said. “They are producing more reproductive units.”

Ghosh said West Texas residents face the worst allergy conditions in the state. He said he assumed allergens wouldn’t be prevalent in the area when he first moved to the Texas Panhandle due to the region’s limited plant life.

“Just the opposite thing is true,” Ghosh said. “Pollen grains, they can fly 300 to 400 miles. We receive pollen grains from Oklahoma, we receive pollen grains from Colorado, New Mexico — all of our neighboring states.”

This summer, a team of of WT researchers measured heightened levels of ragweed in Palo Duro Canyon State Park, Ghosh said. Nine years ago, researchers found scattered patches of ragweed in the canyon, but due to recent rains, a “continuous trail” of ragweed littered the landscape this summer, Ghosh said.

“Ragweed is the most important culprit that is causing allergies to 90 percent of people who are suffering from allergies in the world,” he said.

Another area culprit is the fungus alternaria, which forms on wheat plants and agitates residents with mold allergies, Ghosh said.

Saadeh said allergy sufferers can can take preventative measures to head off their symptoms, such as avoiding going outside between 4 and 8 p.m., as well as avoiding the outdoors when wind speeds range from 20 to 30 mph.

Over-the-counter antihistamine medicine can help mild allergy sufferers, but people experiencing more serious symptoms should talk to a doctor, he said. It’s also a good idea to wash clothes in hot water to deal with pollens that stick to clothing, Saadeh said.

Ghosh said allergy sufferers also should consider wearing a face mask when working outdoors. Parents can help their children tolerate allergies by letting them play outside at an early age, he said, and residents suffering from allergies should consider having their homes inspected for mold growing inside walls or air ducts.

To many, allergies are a minor annoyance, but they can be dangerous for others, Ghosh said. After all, pollens might be responsible for killing off the dinosaurs.

“You laugh at that, but it’s a very plausible theory, and many archaeologists and scientists … believe that the dinosaurs became extinct because of allergies,” Ghosh said.


By Russell Anglin
October 12, 2013

2013 Fall Allergy Capitals

This fall could be a perfect storm for allergy sufferers, as global weather conditions boost ragweed levels, and fall storms and tornadoes disperse allergens and outdoor mold, according to the Asthma and Allergy Foundation of America (AAFA).

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Ragweed Pollen and Mold will be the Key Allergens this Fall: AAFA

Ragweed pollen will be the key allergy causing source this season’s fall in the U.S. which would make more the season tougher for people with fall allergies.

The Allergy Foundation of America (AAFA), a not-for-profit organization, warns that this season's fall will be comparatively more difficult for people with allergies; ragweed pollen and mold will be the key allergy causing sources.

The global weather is likely to increase ragweed growth. Tornadoes and fall storms will disperse outdoor mold and allergens in the atmosphere, according to a report by AAFA.

The AAFA also created a list of challenging U.S. cities to live in for people with fall allergies. The list has been created on the basis of the usage of over-the-counter and prescription allergy medication, pollen levels and the number of Board Certified allergists present in each city.

The growing carbon dioxide levels and temperatures could boost the ragweed season by about a month or more, according to recent studies. The warmer weather now lasts for longer periods in the northern states of U.S. due to climatic changes.

Pollen from weeds is more problematic during fall compared to spring.

Though the season now commences later than its normal time, there is a fear of increased pollen distribution, which can trigger the allergy symptoms. These estimations are made on the basis of the forecast about the above-average tornadoes expected in the Midwest and the hurricane season predicted in the East.

Outdoor mold grow and spread more because of the wind patterns and the fall weather.

The allergic reactions to pollen and outdoor mold are often mistaken to be flu or cold, particularly during this season, which sometimes leads to delayed treatment.

Approximately 40 million Americans suffering from seasonal allergies are advised by the AAFA to learn more and seek advice from specialists for proper diagnosis and treatment of seasonal allergy symptoms.


By Nupur Jha
September 19, 2013

Caring for Chronic Conditions in Primary Care

With the Patient Protec­tion and Affordable Care Act now underway, more attention is being focused on patient-centered and coordinated care. As a result, primary care physicians (PCPs) are seeking new ways to organize care around patients. This includes providing in-office services that meet all of patients’ healthcare needs and/or taking responsibility for appropriate referrals.

Within MaxHeath Family Medicine, the focus is on increasing our ability to address all patient health concerns by adding a diverse array of services. In addition to a patient clinic, our practice houses centers for allergy, physical medicine and rehabilitation, cosmetic medicine, and weight loss. It also offers centers for sports medicine, brain health, and mental health. By offering more services, we have successfully improved patient outcomes, as well as financial benefits for the practice.

A Focus on Allergic Rhinitis & Asthma

Efficient treatment of chronic conditions is important to cultivating patient-centered primary care. Nearly half of all Americans have a chronic condition, and the prevalence of such conditions continues to increase. For example, approximately 60 million Americans suffer from allergic rhinitis (AR), which often precedes the onset of chronic allergic asthma. To enhance care of chronic conditions, we must shift from simple chronic disease-state management toward prevention-focused care.

In an effort to address AR, my colleagues and I implemented additional AR treatment protocols by establishing an allergy center. We work with United Allergy Services to supply allergy testing and immunotherapy to patients. For those who view their symptoms as a minor inconvenience, it is important that they avoid specific allergens. However, this avoidance approach can only work if the offending allergens have been identified. Allergy testing allows us to arm patients with information on what they’re allergic to and what to avoid. For those needing more substantial treatment, allergen immunotherapy addresses the underlying causes, helping reduce symptoms in about 85% of patients. Allergen immunotherapy has also been shown to prevent the development of new allergies and halt the progression of diseases, such as allergic asthma.

Allergy Care: Appropriate Resource Allocation

Increasing access to allergy care within primary care ultimately aligns with healthcare reform goals to deliver higher quality, affordable care to more patients. There are not many board-certified allergists and other allergy specialists, but demand for their services is projected to rise rapidly. By increasing the scope of care within our practice, we can help more patients fight chronic conditions like AR and allergic asthma. Given these benefits, the extent of care provided by PCPs will continue to expand as the healthcare industry evolves.

To learn more about Atrial Fibrillation Awareness Month, go to The Heart Rhythm Society also offers guides several helpful pocket guides for clinicians managing patients with atrial fibrillation. Two of these guides—“Managing the Patient With Atrial Fibrillation” and “Practical Rate and Rhythm Management of Atrial Fibrillation”—are available as free downloads.


By Jeffrey Bullar, MD
September 5, 2013

ADHD more likely in children with asthma or allergies

Children with a history of asthma and various allergies may be at higher risk of developing ADHD (attention deficit hyperactivity disorder), according to a study published in the journal Annals of Allergy, Asthma and Immunology.

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NPs offer a bright spot as primary care practices combat rising costs

ccording to a recent MGMA-ACMPE study (reported in the journal AAFP) over the last 11 years, the cost of running a medical practice in the United States has increased twice as quickly as the consumer price index. This surprising and dramatic gap underscores the significant financial challenges facing many primary care providers, including revenue streams that may fail to counter the rising costs of keeping a practice afloat.

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Allergy symptoms arrive in Charlotte early this year

"I have been sneezing a lot more lately when I am out running or exercising," said Regina Harrison.

As fall approaches, a lot of people suffer from allergies because of the change in weather, but people are noticing the symptoms: itchy and watery eyes, nasal congestion, coughing and sneezing much earlier this year.

Dr. Gray Norris said there has been a recent spike because of all of the rain we have had this summer.

"I think the weeds are a little bit early. I think they have gotten a little bit of a head start with all of the water we have had for them to grow," said Norris.

So far this year, Charlotte has seen more than 35 inches of rain. Normally by this time Charlotte has an average of 28 inches.

All of that wet weather has caused an early rise in ragweed and mold.

Norris said do not expect conditions to change any time soon.

"We are going to have fairly high levels until we get some really cold weather. Once we get a really good freeze that will knock the levels down," said Norris.

Charlotte has already seen a burst of cooler temperatures, but meteorologists don't expect the cold weather to arrive until late October.


By Vicki Graf
September 2, 2013

Fall allergy season arrives, approaching early September peak

Ragweed season is upon us, pollen counts show, and is expected to peak over the next couple of weeks.

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Heavy Traffic Pollution, Wood Fire Smoke May Worsen Asthma Symptoms

A word of caution to asthma-sufferers: Living by busy streets could make your symptoms worse, according to a new study.

Researchers from the University of Melbourne found that heavy traffic pollution seemed to increase asthma symptoms by 80 percent and smoke from wood fires seemed to increase symptoms by 11 percent among people with the condition.

"These findings may have particular importance in developing countries where wood smoke exposure is likely to be high in rural communities due to the use of wood for heating and cooking, and the intensity of air pollution from vehicular traffic in larger cities is significant," study researcher Dr. John Burgess, of the School of Population Health at the University of Melbourne, said in a statement.

Interestingly, researchers did not find an association between asthma onset and exposure to heavy traffic pollution or smoke from wood fires.

The study, published in the journal Respirology, included 1,383 adults, age 44, who were part of the Tasmanian Longitudinal Health Study. The study participants rated their exposure to wood fire smoke and traffic pollution. They were also asked to provide information on frequency of exposure to heavy traffic near their homes, as well as their exposure to wood smoke in the environment during the wintertime. Researchers tracked the participants' asthma symptoms and flare-ups over a year-long period.

Everyday Health previously reported that for traffic pollution in particular, particulate matter and atmospheric ozone are likely the biggest asthma culprits.

"Both pollutants can strain airways in asthma by increasing inflammation and susceptibilities to allergies and infections," Sumita B. Khatri, M.D., who is the co-director of the Cleveland Clinic Respiratory's Institute's Asthma Center, told Everyday Health.


August 21, 2012