The Allergist – Détails, épisodes et analyse

"History, history, skin test or serum IgE, and then consider doing the other test just to round out your testing until you're sure you've detected everything you need to detect.”  -- Dr. David Golden

As the leaves begin to fall, and the wasps begin to invade every patio lunch, Dr. Mariam Hanna sits down with Dr. David Golden, a leading expert on venom allergies and retired associate professor from Johns Hopkins. Together, they explore the swarm of complexities surrounding venom immunotherapy, from the nuances of diagnosis to emerging treatments on the horizon.

In this episode:

• Understanding venom allergies: The basics and beyond
• Large local reactions vs. systemic reactions: What’s the real risk?
• The role of skin testing vs. serum IgE in diagnosing venom allergies
• Venom immunotherapy: How effective is it, really?
• Emerging trends and treatments in venom allergy management
• Practical advice for managing venom allergies 

Prepare to get the buzz on everything venom-related in this insightful conversation. Tune in now!

Visit the Canadian Society of Allergy and Clinical Immunology

Find an allergist using our helpful tool

Find Dr. Hanna on X, previously Twitter, @PedsAllergyDoc or CSACI @CSACI_ca

The Allergist is produced for CSACI by PodCraft Productions

“FPIES is real, both acute and chronic FPIES. It's not a myth, and it can be an allergic emergency.” -- Dr. Nowak-Wegrzyn

Join Dr. Mariam Hanna for a comprehensive discussion on Food Protein-Induced Enterocolitis Syndrome (FPIES) with Dr. Anna Nowak-Wegrzyn, a leading expert in pediatric allergy and immunology at NYU Grossman School of Medicine. Dr. Nowak-Wegrzyn sheds light on this unique and often perplexing condition, offering critical insights for healthcare providers.

On this episode:

Understanding FPIES:

• Dr. Nowak-Wegrzyn explains FPIES, a non-IgE mediated food allergy that manifests differently from traditional food allergies. She details the typical presentation of FPIES, including severe vomiting, lethargy, and pallor, which can occur a few hours after food ingestion.

Difference in Presentation Between Children and Adults:

• Learn about how FPIES presents in different age groups. While it typically begins in infancy, Dr. Nowak-Wegrzyn discusses the mysterious cases where FPIES emerges in adults who have tolerated the triggering food for years.

How FPIES Differs from IgE-Mediated Food Allergies:

• Understand the key differences between FPIES and IgE-mediated food allergies. Dr. Nowak-Wegrzyn outlines why skin and blood tests may be negative in FPIES cases, despite the severity of symptoms.

Prognosis and Counseling Parents:

• Discover the prognosis for children with FPIES, with many outgrowing the condition by age three to five. Dr. Nowak-Wegrzyn emphasizes the importance of educating and empowering parents through careful counseling and shared decision-making.

Management and Treatment:

• Dr. Nowak-Wegrzyn discusses current strategies for managing FPIES, including dietary modifications, careful introduction of new foods, and the potential use of ondansetron for managing symptoms at home. She also addresses the use of epinephrine in atypical FPIES cases with IgE sensitization.

Tune in to this episode for an in-depth exploration of FPIES, offering practical advice and valuable insights for healthcare providers navigating this challenging condition.

Visit the Canadian Society of Allergy and Clinical Immunology

Find an allergist using our helpful tool

Find Dr. Hanna on X, previously Twitter, @PedsAllergyDoc or CSACI @CSACI_ca

The Allergist is produced for CSACI by PodCraft Productions

“I guarantee you, within the next five years or within my lifetime, there may be a permanent solution to a lot of medical conditions including (asthma)."  -- Dr. Jason Lee

Asthma remains a formidable foe, particularly when it escalates to its severe form. This episode of "The Allergist," Dr. Mariam Hanna, explores the complexities of severe asthma and the revolutionary impact of biologic therapies.

Dr. Jason Lee, a leading expert in allergy and immunology, sheds light on the evolution of asthma treatment. Gone are the days when inhalers and corticosteroids were our only options. Today, biologics offer a promising frontier, not just to manage but potentially to rewrite the course of the disease. Dr. Lee demystifies these powerful medications, tackling common concerns and highlighting the essential role of patient education in fostering adherence.

Dr. Lee offers several actionable tips for physicians on managing severe asthma with biologics. He advises on the importance of patient education about the mechanisms and benefits of biologics to enhance adherence and reduce anxiety about these new treatments. He emphasizes the need for regular monitoring of lung function and inflammation markers to tailor therapy effectively. And Dr. Lee highlights the use of stepped-care approaches and discusses strategic timing for introducing or discontinuing biologic therapy based on patient response and overall asthma control. 

For allergists and healthcare professionals keen on cutting-edge treatments for severe asthma, this discussion is a treasure trove of practical insights and innovative strategies.

Visit the Canadian Society of Allergy and Clinical Immunology

Find an allergist using our helpful tool

Find Dr. Hanna on X, previously Twitter, @PedsAllergyDoc or CSACI @CSACI_ca

The Allergist is produced for CSACI by PodCraft Productions

“(Urticaria) is not an allergic condition, it's an autoimmune condition, one. Two, it's not dangerous, but it can last long. Three, we have very good strategies to control it.”                                                                                                                         
                                                                                                                                - Dr. Moshe Ben-shoshan

Hives are probably one of the most misunderstood rashes by the general public. Hives are not life-threatening, but they're debilitating. They're not an allergy, but they're often blamed for being one. They're a marker of autoimmunity with little to do with one particular disease and their course and triggers in one particular person is at best challenging to predict.

Dr. Moshe Ben-shoshan tackles the intriguing world of chronic urticaria; cutting through common misconceptions, and walking us through the latest in diagnostic strategies and management options for hives. From the targeted effectiveness of second-generation antihistamines to the advanced treatment possibilities offered by biologics like omalizumab, and even the role of immunosuppressants such as cyclosporine. Special attention is given to the nuances of chronic urticaria in children versus adults.

Emphasizing the critical role of disease scoring systems, Dr. Ben-shoshan explains how these tools are vital for assessing severity and guiding treatment decisions. The conversation also sheds light on the diagnostic value of blood tests, showcasing the multifaceted approach required to effectively manage hives.

Dr. Ben-shoshan tip-toes into the delicate territory of how to handle the increasing requests for testing and dietary modifications. We also take a quick glimpse into the future of urticaria management including targeted pediatric guidance and new biologics on the horizon. 

This episode offers an indispensable resource for allergists and healthcare professionals seeking to enhance their understanding of chronic urticaria. It’s packed with practical insights and a look towards promising advancements in the field.

Visit the Canadian Society of Allergy and Clinical Immunology

Find an allergist using our helpful tool

Find Dr. Hanna on X, previously Twitter, @PedsAllergyDoc or CSACI @CSACI_ca

The Allergist is produced for CSACI by PodCraft Productions

“Worst allergy season ever? Might not be an exaggeration for that patient.” 
                                                                                                                                   -- Dr. Adam Byrne

On this episode, Dr. Mariam Hanna is joined by Dr. Adam Byrne, an expert allergist and clinical immunologist, to unravel the complex relationship between climate change and allergic diseases. Dr. Byrne sheds light on how rising global temperatures, increased pollution, and changing ecosystems are not just environmental issues but are directly impacting the prevalence and severity of allergic conditions.

Together, they dissect the science behind why we're seeing an uptick in cases of asthma, allergic rhinitis, and atopic dermatitis. But the conversation doesn't stop at diagnosis and treatment; it also covers practical advice for allergists and patients alike on mitigating the health impacts of climate change. From advocating for cleaner air policies to adjusting daily routines, Dr. Byrne offers actionable strategies to address the evolving landscape of allergies.

This episode is essential listening for anyone in the allergy field, providing a comprehensive overview of the challenges and opportunities that lie ahead in managing allergies in a changing climate. Whether you're a healthcare professional or someone navigating the complexities of living with allergies, Dr. Byrne's insights offer valuable guidance for adapting to our planet's new normal.

Visit the Canadian Society of Allergy and Clinical Immunology

Find an allergist using our helpful tool

Find Dr. Hanna on X, previously Twitter, @PedsAllergyDoc or CSACI @CSACI_ca

The Allergist is produced for CSACI by PodCraft Productions

“Food allergy tests are not screening tests…I will pause for dramatic effect…Food allergy tests are not screening tests.” Dr. David Stukus

Dr. Mariam Hanna is joined by Dr. David Stukus, a leading pediatric allergist and clinical immunologist from Nationwide Children's Hospital in Columbus, Ohio. Together, they dive into the critical issues surrounding food allergy diagnostics and the latest advancements in treatment options, including developments in the field of oral immunotherapy (OIT) and the recent FDA approval of Omalizumab for food allergies.

Dr. Stukus debunks common misconceptions about testing and emphasizes the importance of a nuanced approach to interpreting results when diagnosing food allergies He advocates for evidence-based practices and the necessity of individualized treatment plans, highlighting the role of clinicians in guiding patients through the complexities of managing food allergies.

The conversation also explores the future of food allergy treatments, with Dr. Stukus expressing optimism about the potential for more personalized therapies that cater to the unique needs of each patient. He stresses the importance of shared decision-making between clinicians and patients, ensuring that treatment choices are informed, thoughtful, and tailored to achieve the best possible outcomes.

This episode is a must-listen for allergists aiming to keep ahead of the evolving landscape of food allergy management, offering deep insights into the challenges, innovations, and hopes for the future. 

Visit the Canadian Society of Allergy and Clinical Immunology

Find an allergist using our helpful tool

Find Dr. Hanna on X, previously Twitter, @PedsAllergyDoc or CSACI @CSACI_ca

The Allergist is produced for CSACI by PodCraft Productions

“People think leadership has to be a loud person standing in front of everybody, declaring themselves the leader. Leadership isn't a dictatorship. Leadership is not always that loud person.”  -- Dr. Zainab Abdurrahman

On this episode of "The Allergist," we explore what leadership in medicine actually means with Dr. Zainab Abdurrahman, an accomplished allergist and clinical immunologist. Dr. Abdurrahman, who wears many hats including that of an assistant clinical professor of pediatrics at McMaster University and the incoming president-elect of the Ontario Medical Association, shares her insights on what it means to be a leader in the medical field.

Leadership, as Dr. Abdurrahman explains, is not just about being at the forefront; it's about inspiring and motivating others, guiding teams towards a common goal, and sometimes, leading from behind to allow others to shine. This episode is not just about the theoretical aspects of leadership but also about its practical applications in the challenging landscape of healthcare.

Dr. Abdurrahman's journey is a testament to the diverse forms leadership can take, from being the team lead in mock codes to shaping the future direction of healthcare in Ontario. She discusses the challenges and opportunities that come with being a female leader in medicine, breaking stereotypes, and paving the way for future generations.

So, whether you're an aspiring leader, a medical professional, or someone curious about the intersection of leadership and medicine, this episode offers valuable insights and inspiration. Join Dr. Mariam Hanna and Dr. Zainab Abdurrahman on "The Allergist" as they explore the essence of leadership in medicine and how it shapes the healthcare landscape.

Visit the Canadian Society of Allergy and Clinical Immunology

Find an allergist using our helpful tool

Find Dr. Hanna on X, previously Twitter, @PedsAllergyDoc or CSACI @CSACI_ca

The Allergist is produced for CSACI by PodCraft Productions

“We don't do any fresh food skin testing because they have not been validated.  And we know, if we put food on skin, we may well get a positive test, but we have no idea how to interpret that. And I think that's really important.” -- Dr. Douglas Mack

On this episode of "The Allergist," we're climbing the food ladder with Dr. Douglas Mack, a pediatric allergy, asthma, and immunology specialist. Dr. Mack brings his expertise to the table, discussing the nuances of milk and egg allergies in children. Are all allergies created equal? Spoiler alert: they're not. We dive into the world of phenotypes, genetic markers, and the big question – can we predict who's going to outgrow their allergies and who's in it for the long haul?

We're not just talking science; we're talking practical, real-world applications. Dr. Mack sheds light on the shift from 'ladders' for non-IgE mediated food allergy to IgE mediated ones. It's a journey through the evolution of allergy treatments.

And for those thinking, "What about the risks?" – we've got you covered. Dr. Mack doesn't shy away from discussing the potential dangers and the importance of understanding patient-specific risks. It's a candid conversation about the realities of treating food allergies, the challenges allergists face, and the hope for future advancements.

So, grab your headphones and join us. Whether you're a seasoned allergist or just starting to climb the allergy ladder, "The Allergist" is here to guide you every step of the way. 

Visit the Canadian Society of Allergy and Clinical Immunology

Find an allergist using our helpful tool

Find Dr. Hanna on X, previously Twitter, @PedsAllergyDoc or CSACI @CSACI_ca

The Allergist is produced for CSACI by PodCraft Productions

"Collaboration and communication is how we make change." - Dr. Victoria Cook

Join Dr. Mariam Hanna in a fast paced conversation with Dr. Victoria Cook, a trailblazer in Quality Improvement, as they discuss how QI is not just reshaping patient care but also revitalizing the healthcare workforce by mitigating burnout.

On this episode:

• Unveiling the science and strategy behind Quality Improvement and its profound impact on healthcare systems and patient outcomes.

• Demystifying the Model of Improvement and the Plan-Do-Study-Act (PDSA) cycle, and their instrumental role in driving systematic changes in healthcare.

• Addressing the common challenges in implementing QI and unveiling practical solutions to overcome these hurdles.

• Highlighting the significant role of QI initiatives in reducing physician burnout, fostering a healthier work environment, and ensuring the well-being of healthcare professionals.

• Gaining insightful perspectives on the future of QI in medicine, its growing prominence, and its potential to redefine patient care and healthcare delivery.

Don't miss out on this deep dive into QI because, you are already doing Quality Improvement, you just need to do it well. Listen now!

Visit the Canadian Society of Allergy and Clinical Immunology

Find an allergist using our helpful tool

Find Dr. Hanna on X, previously Twitter, @PedsAllergyDoc or CSACI @CSACI_ca

The Allergist is produced for CSACI by PodCraft Productions

“We cannot be dogmatic about what we say about epinephrine…we need as a field to stop being so dogmatic and do more studies to understand."   -- Dr. Matthew Greenhawt

Join us on this eye-opening episode, where we explore the latest breakthroughs in allergy and immunology with Dr. Matthew Greenhawt as he walks us through the pivotal articles of 2023 that are redefining the field.

On this episode:

• Review penicillin allergy delabeling and why this is ready to incorporate into your medical practice.
• Understand the evidence for various atopic dermatitis treatment strategies using evidence-based graded recommendations.
• Discover the potential of dupilumab in its two newest indications - eosinophilic esophagitis and COPD. 
• Delve into our latest understanding of epinephrine doses and future directions in research on this fundamental medication.
• Exclusive insights into the EPITOPE trial from the lead author.

This episode is a must-listen for allergists and immunologists looking for a quick literature review and key highlights from 2023. Tune in now for a journey into the heart of the articles that will change the field of allergy!

Links to articles mentioned in the episode:

The Safety of the Direct Drug Provocation Test in Beta-Lactam Hypersensitivity in Children: A Systematic Review and Meta-Analysis - PubMed (nih.gov) 

Atopic dermatitis (eczema) guidelines: 2023 American Academy of Allergy, Asthma and Immunology/American College of Allergy, Asthma and Immunology Joint Task Force on Practice Parameters GRADE- and Institute of Medicine-based recommendations - PubMed (nih.gov)

Dupilumab in Adults and Adolescents with Eosinophilic Esophagitis - PubMed (nih.gov)

Dupilumab for COPD with Type 2 Inflammation Indicated by Eosinophil Counts - PubMed (nih.gov)

Optimal dose of adrenaline auto-injector for children and young people at risk of anaphylaxis: A phase IV randomized controlled crossover study - PubMed (nih.gov)

Phase 3 Trial of Epicutaneous Immunotherapy in Toddlers with Peanut Allergy - PubMed (nih.gov)

Visit the Canadian Society of Allergy and Clinical Immunology

Find an allergist using our helpful tool

Find Dr. Hanna on X, previously Twitter, @PedsAllergyDoc or CSACI @CSACI_ca

The Allergist is produced for CSACI by PodCraft Productions