Why Do My Allergies Change As I Age?


If we were to sum up allergies with an emoji, it’d be a shrug. We know so little about them, and yet tens of millions of Americans experience allergies of some kind or another throughout their lives. They come. They go. They evolve slowly or shift rapidly. Perhaps the only constant is that they’re becoming more common.

But there is some positive news for allergy sufferers everywhere.

“The only good thing about getting older is that​,​ in many cases, allergies are less prevalent,” says Clifford Bassett, medical director of Allergy & Asthma Care of NY and an allergy specialist at New York University. Changes inside and outside our bodies as we age affect the way we react to potential irritants from ragweed to crab to dogs. Why? Well, that’s a little more complicated, and there’s more than one possible reason that your allergy status just switched.

You outgrew it

Around 60 to 80 percent of kids with milk and egg allergies outgrow them by age 16. Only 20 percent of kids with peanut allergies do so, and only 14 percent of those allergic to tree nuts. Just 4 or 5 percent outgrow a shellfish allergy.

Why? Unfortunately, the answer is that we mostly have no idea. We know some general associations — the earlier a child has an adverse reaction to food, the more like they are to outgrow it — but scientists don’t yet understand why some kids age out of their reactions and others don’t. We do know that early exposure to small amounts of food allergens, especially peanuts, helps prevent allergies in the first place. But we have no idea how to actively reverse them once they happen. If you get allergies as a kid, you just have to wait and see if your tolerances change in the future.

One of the few things researchers have observed is that there does seem to be a time limit to ridding yourself of childhood allergies — if you haven’t outgrown an allergy by your teens, you’re likely to have it for life.

Ancient Cancer-Causing Virus Is On The Rise


HTLV-1 is a deadly ancient virus related to HIV. Unlike its long-lost cousin, most people have never even heard of it – even scientists don't truly understand it – and it’s currently spreading across parts of Australia like wildfire.

The majority of the worst affected areas are Indigenous Australian communities in Australia’s Northern Territory. It’s believed over 45 percent of adults in five communities around Alice Springs are infected with the deadly virus. In two communities, that rate was as high as 50 percent, The Guardian reports. Faced with this spike in cases, some of the world’s leading biomedical researchers are now calling for immediate action, before the situation goes from bad to worse.  

Human T-lymphotropic virus type, or HTLV-1, is a cancer-causing retrovirus transmitted through sexual contact, blood transfusion, and breastfeeding. It can lead to severe health problems by weakening the body’s immune system. However, it is an extremely different virus to HIV. Foremost, it can lead to an aggressive form of leukemia in 5 percent of people and a chronic paralytic disease in a further 1 to 4 percent. Most people have no symptom, however.

There are distinct populations of the virus found across the globe, cropping up in the Caribbean, Sub-Saharan Africa, Papua New Guinea, northern Australia, and among South American native peoples. They even found evidence of an HTLV-like virus in mummified remains of people who lived over 1,000 years ago in the Andes mountains. HIV, by comparison, has only existed in since approximately 1900.

Dr Robert Gallo, who first discovered HTLV-1 in 1979 and HIV as a cause of AIDS in 1984, has shown concern about the recent flare-up in Australia, urging for more energy and funds to find a viable treatment or even vaccinate against the virus.

"The prevalence is off the charts,” Dr Gallo said, speaking to CNN. "Nobody that I know of in the world has done anything about trying to treat this disease before."

"There's little to almost no vaccine efforts, outside of some Japanese research," he said. "So prevention by vaccine is wide open for research."

Part of this story is nothing new. A 1993 survey of Aboriginal communities of Australia’s Northern Territory found notable levels (between 4.7 and 13.9 percent) of infection. Sadly, researchers think they know why it hasn't been addressed yet.

“We need to do significantly more with HTLV-1,” Gallo told The Guardian. “I think it hasn’t received adequate funding or attention [yet], and there you get into the obvious reason: it’s not common among European-derived people at all, it’s rare.”

With the virus starting to appear more and more, and a few cases in the US and Europe cropping up, scientists studying HTLV-1 are hoping this brings some desperately needed attention to the deadly problem.

Medical device recalls reach historic levels in 2018 with software as leading cause


Medical device recalls reached record highs in the first three months of 2018 thanks to software complications that are likely to continue with the proliferation of high-tech devices.

Device recalls increased 126% in the first quarter of 2018. At 343 recalls, it was the highest number in a single quarter since 2005, according to a report by Stericycle’s Recall Index (PDF), which tracks recall data across several industries.

Software was the biggest driver of medical device recalls in the first quarter, accounting for 23% of all recalls. Software issues have been the leading factor in device recalls each quarter since the beginning of 2016.

Bethany Hills, an attorney at Mintz Levin in New York who chairs the firm's FDA practice, says the rapid increase is not totally unexpected. Medical device software is becoming increasingly complex, with analytics that provide a higher level of clinical decision support. 

"The more complex the software, the more likely it is that the developers did not account for all variables in the clinical environment, increasing the risk of bugs and errors," she told FierceHealthcare. "This risk increases further if the device manufacturer outsources software development because integration of outside software and the inability to quickly modify the code can lead to additional errors slipping through the cracks."

All told, more than 208 million devices were recalled in the beginning of the year, more than the total number of recalled devices in all of 2017. There doesn’t appear to be one singular reason for the startling uptick, making it difficult to pinpoint an underlying trend.

Dementia Risk Doubles Following Concussion


Researchers identified participants from two databases: one listing all-era veterans whose traumatic brain injuries — which includes concussion or mild traumatic brain injury – could have occurred during civilian or military life; and the second from vets serving in Iraq and Afghanistan, for whom most of these injuries had occurred in combat zones, such as from shockwaves in blasts.

“The findings in both groups were similar, indicating that concussions occurring in combat areas were as likely to be linked to dementia as those concussions affecting the general population,” said first author Deborah Barnes, PhD, MPH, professor in the UCSF departments of psychiatry, and epidemiology and biostatistics.

In total, 357,558 participants, whose average age was 49, were tracked. Half had been diagnosed with traumatic brain injury, of which 54 percent had had concussion. The study followed participants for an average of 4.2 years; 91 percent were male and 72 percent were white.

Among Iran and Afghanistan vets, concussion was defined as mild traumatic brain injury resulting in alteration of consciousness and amnesia for one day or less, based on a comprehensive medical evaluation. In the other vets, concussion was defined using a wide list of diagnostic codes in the electronic health record.

Trauma May Hasten Neurodegenerative Disorders

“There are several mechanisms that may explain the association between traumatic brain injury and dementia,” said senior author and principal investigator Kristine Yaffe, MD, professor in the UCSF departments of neurology, psychiatry, and epidemiology and biostatistics. “There’s something about trauma that may hasten the development of neurodegenerative conditions. One theory is that brain injury induces or accelerates the accumulation of abnormal proteins that lead to neuronal death associated with conditions like Alzheimer’s disease.

“It’s also possible that trauma leaves the brain more vulnerable to other injuries or aging processes,” said Yaffe, “but we need more work in this area.”

Why People Become More Prone to Distraction With Age

What? Who? When?Where? Why?.....


Older adults appear more easily distracted by irrelevant information than younger people when they experience stress or powerful emotions– and a specific network in the brain recently identified as the epicenter for Alzheimer’s and dementia may be to blame.

A USC-led study finds that seniors’ attention shortfall is associated with the locus coeruleus, a tiny region of the brainstem that connects to many other parts of the brain. The locus coeruleus helps focus brain activity during periods of stress or excitement.

Increased distractibility is a sign of cognitive aging, said senior author Mara Mather, an expert on memory and professor at the USC Leonard Davis School of Gerontology. The study found that older adults are even more susceptible to distraction under stress, or emotional arousal, indicating that the nucleus’s ability to intensify focus weakens over time.

“Trying hard to complete a task increases emotional arousal, so when younger adults try hard, this should increase their ability to ignore distracting information,” said Mather, who is also a professor with the USC Dornsife College of Letters, Arts and Sciences. “But for older adults, trying hard may make both what they are trying to focus on and other information stand out more.”

For instance, if an older adult is taking a memory test in a clinician’s office, he or she may be trying hard to focus but will be more easily distracted than a younger adult by other thoughts or noises in the background.

Lone Star Ticks Are a Carnivore’s Nightmare and They’re Just Waking Up


After keeping a food journal for nearly a year, Coughlin realized his symptoms occurred after eating meat, primarily pork. “I essentially spent a week proving my point,” Coughlin says. “I’d eat a bunch of red meat, and go through a series of pretty severe reactions.”

When he finally went to the hospital in 2016, the doctor tested him for all the usual allergies and was flummoxed by the lack of results. She gave him a strong antihistamine and an EpiPen and sent him home.

Frustrated, Coughlin started researching. He found similarities between his symptoms and documented cases of something called alpha-gal allergy. A major study on the allergic reaction had been done right across the Blue Ridge Mountains at the University of Virginia.

Suddenly, his hiking trips in that very mountain range came into focus: “I kept pulling ticks off of me,” he says. According to the research, those little brown bugs, marked by a telltale white spot, were to blame for his meat allergy. Coughlin was bit by lone star ticks.

Alpha-gal isn’t your typical hayfever-like allergy. It’s a severe, delayed-reaction immune response, which means it hits hours after someone who suffers from the allergy eats meat. People with alpha-gal describe their episodes as terrifying experiences that can land you in the emergency room and change the way you live your life.

“I was disheartened,” Coughlin says. “I’m a big eater.”

Even a decade ago, only small populations of lone star ticks were found in the northeastern U.S. As climate change shifts temperatures and humidity levels across the country, many types of ticks, which thrive in warm, humid weather, are able to expand their ranges. The EPA even uses Lyme disease, which is transmitted by blacklegged ticks, as an indicator to track where the country is warming. The spread of lone stars has been linked to climate change, and now, the ticks have made it all the way up through Maine, imparting severe red meat allergies on unsuspecting carnivores — and offering a window into our changing world and its effect on human health.

As lone stars expand into new communities this summer, the ticks are poised to catch people off guard. And just like Coughlin, these little fellows are big eaters.

Asyou read this, millions of tiny, black-and-brown-legged creatures are beginning to reawaken after laying dormant underneath layers of last year’s leaf cover.

Ticks are only second to mosquitoes as vectors for human disease. This week, the Centers for Disease Control and Prevention published a report showing illnesses from ticks, fleas, and mosquitoes are on the rise. Disease cases in the U.S. more than tripled between 2004 and 2016, and the report found that we’re ill-equipped to tackle the growing problem.

Large swaths of the eastern U.S. are already dealing with an epidemic of Lyme disease, an illness that can rob you of your short-term memory, your motor functions, and, very rarely, even your life.

And every so often, it seems, the ticks that rouse themselves from the leaf litter are armed with unexpected and mysterious pathogens, like the resurfaced Powassan virus or Pacific Coast tick fever. The CDC report says seven new tick-borne infections have been recorded since 2004. The organization hasn’t recognized alpha-gal allergies yet.

“It’s scary,” says Graham Hickling, the director of the University of Tennessee’s Center for Wildlife Health. “Pretty much every year, we’re finding something new.”

A combination of factors has allowed lone stars to conquer territories far outside their known range.

Climate change is among them. It’s likely affecting the viability rates for the thousands of eggs that a single lone star can lay at a time. “When we start getting these warm seasons, high rainfall kind of years, that probably means that those 2,000 baby ticks do a lot better,” Hickling says.

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Biomes, They are A-Changin’


Why your microbiome is considered an ‘essential organ’.

With an end result that amounts to a more or less flat line, homeostasis sounds passive — but it’s quite the opposite. For instance, a great deal goes into maintaining our circadian rhythm, or the body’s sleep-wake cycle. In most organisms, the internal clock is set to a 24-hour cycle, in keeping with light and dark. While cycling through each day, body temperature, stress hormones, wakefulness, and even digestion and metabolism are synced up to achieve balance within. But we don’t do it alone. More and more, we’re finding that our gut microbiome, the bustling community of microorganisms in our intestines, is intimately involved in this rhythmic ebb and flow.

In the past several decades, research on the gut microbiome has connected the bugs that live in our colon with just about every aspect of health and wellbeing imaginable, from digestion to immune function to social behavior. In many cases, the microbes that inhabit the body have so much impact on their host’s function that the microbiome is considered an essential organ in and of itself. Now, some of the newest research is revealing that these powerful microbes are affected by — and may even be in control of — some of the body’s important rhythms as well.

Biosimilar Switch Succeeds in Single Center

Biologics are medicines created in cells that are used primarily to treat autoimmune illnesses. You see a lot of ads for them these days for illnesses like rheumatoid arthritis, psoriasis, irritable bowel syndrome. They are very expensive, and there is a kind of generic version of a biologic called a biosimilar. There have been concerns about how effective biosimilars will be compared with the original biologic. This study says that at least for this biosimilar, moving everybody from the biologic to the biosimilar resulted in better symptom reduction that what patients got with the original biologic. Good news!


Switching from etanercept (Enbrel) to its biosimilar Benepali was successfully implemented in a single-center study of patients with rheumatoid arthritis, investigators reported here.

The switch program took place during 2017, and resulted in a cost saving of approximately £500,000 ($680,000) annually at current prices. Patients were sent a letter before the program began from the clinic's pharmacist, explaining the switch, and also received a telephone call to answer any questions they might have. Participants then attended an education session and were seen in a dedicated clinic staffed by a rheumatology consultant and specialist pharmacist.

Participants also completed an 11-part questionnaire that asked about tolerability and adverse events associated with the biosimilar. As to the ease of using the injector pen, there was an 11% increase after the switch to Benepali, from 7.8 to 8.6 on a scale, with 1 representing "very difficult" and 10 being "very easy."

"The Benepali pen was preferred to Enbrel, and patients commented on the easier technique and less manual dexterity required," the investigators noted.

Oral Steroid

When asked how patients felt their rheumatoid arthritis was responding, 75% said it was no different, 11% said it had improved, and 17% felt it was worse. And when asked "how pleased" they felt about the switch, 43% of patients said they were pleased and 23% were not pleased, while the remainder were indifferent or not sure.

A total of eight patients ultimately switched back to the originator etanercept. In five patients, this was because of adverse events including rash and diarrhea, and in three, it was because of difficulty with the autoinjector pen. In addition, there were two disease flares after the switch.

"The reassuring results of this switching program should positively encourage clinicians and patients to switch to the biosimilar in order to optimize the cost saving to the National Health Service," Shah and colleagues concluded.

New Long-Term Care Medicare Benefit Proposed


A newly proposed Medicare benefit would extend services to eligible beneficiaries for long-term care. The proposal was within a discussion draft of a bill by Representative Frank Pallone (D-NJ), released at a Wednesday roundtable discussion with aging and disability advocates.

The proposal, The Medicare Long-Term Care Services and Supports Act of 2018, would establish a cash benefit within Medicare for beneficiaries that could be used toward all long-term services and supports, including nursing facility care, adult day care programs, home health aide services, personal care services, transportation and assistance provided by a family caregiver.

“The growing need for long-term care is one of the greatest threats to retirement security for American seniors, and the adult children who care for them,” Pallone said in a statement. “It’s time to expand Medicare to include a long-term care benefit so that millions of seniors and individuals with disabilities no longer have to face financial ruin before they get assistance. I’m hoping that this proposal will begin an important discussion, and look forward to getting feedback from interested stakeholders.”

The proposal, if introduced and enacted, would be the first new Medicare benefit since Part D, which was approved in 2003 and implemented in 2006.

The discussion draft of the bill aims to help families pay for long-term care, which can cost a senior an average of $140,000 out of pocket. More than 15% of seniors will incur costs in excess of $250,000, according to Pallone. Furthermore, more than 70% of seniors older than 65 will need some long-term care services and supports in their lifetime.

The reach would extend beyond the narrow limits of many Medicare services, including those of home health care, and it would incentivize people to seek care at home, “the setting where most people want to be,” according to Pallone.