The #FirstDayofSummer means increasing outdoor activities and tis the season for stings.
Many people are misdiagnosed as having venom allergy...and others with true allergy do not receive proper treatment.
I'll address some misconceptions in this thread ⬇️ #FridayThoughts
Venom is naturally irritating - a NORMAL response after being stung is redness, swelling, pain, itching.
Treatment is supportive with ice, pain meds, antihistamines.
This is not infection (no need for antibiotics). This does not increase risk for future allergy.
Large local reactions are common: Exaggerated swelling at the same body part that was stung. I get these with stings - makes my hand swell twice normal size.
Also not an allergy. Treatment is supportive with ice, pain meds, antihistamines.
Generalized hives after being stung is worrisome in adults > 16 yrs old but not in children.
Adults with this story should be evaluated with allergy testing & consider immunotherapy.
Kids not at increased risk for future anaphylaxis.
ANYONE who has had anaphylaxis after being stung should be evaluated by an allergist with venom allergy testing and consideration for immunotherapy.
Prior anaphylaxis from venom = high risk for future anaphylaxis. Immunotherapy can dramatically decrease that risk to < 10%.
Venom allergy testing has a lot of false positive results, which can lead to unnecessary use of allergy shots. Skin test preferable to blood testing.
Venom allergy is NOT inherited - no need to test siblings/children.
Also no reason to test "just to make sure".
It is well known that suspected identification of the stinging insect is often incorrect.
Venom allergy testing must include honey bees, wasps, hornets and yellow jackets.
Honey bees are the only stinging insect that typically leaves stinger in place - it is barbed and attached to the abdominal cavity. Bees often die after stinging, partly why they are docile and don't sting unless provoked.
Don't squeeze the stinger! There's still venom in sac
Avoidance measures should be a part of any allergy management plan, but not always easy with venom. Some easy steps to take to avoid future stings.
I, for one, never drink out of a can left outdoors - I don't want to swallow a curious yellow jacket!
As always, this thread should never replace medical advice from your personal doctor or clinician. Hopefully this info clarified some common misconceptions.
I hope everyone has a fun filled summer without any stings!
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As businesses & restaurants reopen, it’s important to remember that #COVID19 is still here, waiting for opportunities to infect as many people as possible.
We can take some basic measures to limit spread, but it requires an understanding of why that’s still important. Thread⬇️
We still don’t know how many people have been or are currently infected with #COVID19.
More testing is necessary to help us understand basic principles about prevalence and incidence, which informs just about all other public health measures.
Rate of infection is also important. This will change over time & is subject to a LOT of factors (proximity, activities, time in close contact).
Current #COVID19 estimates: 1 infected person can infect 2 others.
Montelukast blocks part of the leukotriene pathway, which can be activated as part of the late phase allergic response for people with environmental allergies (pets, pollen, etc) or asthma.
It is NOT an antihistamine.
It has NEVER been a 1st line treatment for asthma/allergies.
Montelukast can help some people as an add on treatment when their allergic rhinitis or asthma is not well controlled with other medications.
It is commonly misused by itself to treat allergic rhinitis, which is not effective. New FDA warning encourages not using as such.
You see, I farted a lot last week. I was also bloated. I was curious why, so I turned to the internet.
The 1st link informed me that I may have a food intolerance, so I looked that up ⬇️
I quickly found some handy dandy quizzes designed to see if I may have a food intolerance.
Question 1 - excessive flatulence. Check.
Question 2 - wait, what? Why is a food intolerance quiz asking if I have metallic taste in my mouth or blurry vision?
There's more ⬇️
OMG!!! According to this quiz, a food intolerance could be causing my AGGRESSIVE OUTBURSTS😱
And now I may have finally found a reason for my clumsiness!!!
Lastly, this quiz associates food intolerance with arthritis, psoriasis and all sorts of chronic conditions.
10% of people reading this believe they are allergic to penicillin, but >95% of you are not actually allergic.
Inappropriate labeling of penicillin allergy is rampant and leads to unnecessary avoidance, use of less effective alternatives, & antibiotic resistance. Thread⬇️
Too many unqualified people have the ability to label someone as having penicillin allergy, which stays on the medical record forever.
The fact is, true allergy is much more rare than suspected. Side effects are common, as are other symptoms, which get mislabeled as ‘allergy’
Simple questions can stratify risk for penicillin allergy.
No increased risk or reason to avoid based on:
-Family history (drug allergy not inherited)
-Received again without problems
-Diarrhea, upset stomach, yeast infections (side effects) #nationalpenicillinallergyday
Primary outcome - 67% of participants could tolerate a single dose of 600 mg (total 1043 mg) peanut vs 4% in placebo after ~12 months of peanut oral immunotherapy (300 mg daily maintenance)
One peanut kernel contains about 250-300 mg of protein.
AR101 peanut immunotherapy has a goal daily dose of 300 mg.
There is a gradual build up starting with very small doses and then the maintenance dose must be taken daily. nejm.org/doi/suppl/10.1…