Ves Dimov, M.D.

Allergist/Immunologist at Cleveland Clinic. Associate Professor at FAU, Past President of Florida Allergy Society. Disclaimer at URL.

[Ves Dimov, M.D. @Allergy]

https://t.co/0iazR6CZao new chronic urticaria therapy: 25% of patients who started the study on barzolvolimab stopped treatment during the trial, changes in hair and skin color reported

[Ves Dimov, M.D. @Allergy]

https://t.co/cyBGcaTizU

[Ves Dimov, M.D. @Allergy]

Why people develop food allergy? Dishwater detergents may damage gut epithelial barrier, thus possibly playing a role in the increase in food allergy over the past few decades.

[Ves Dimov, M.D. @Allergy]

BAT and MAT : New cellular test for food allergy include basophil activation test (BAT) and mast cell activation test (MAT). BAT has been validated for peanut and sesame allergy

[Ves Dimov, M.D. @Allergy]

Non-specific lipid-transfer protein (nsLTP) allergy is considered the most common cause of food allergy and food induced anaphylaxis in southern Europe. It’s emerging in other parts in the world via sensitization to cannabis.

[Ves Dimov, M.D. @Allergy]

SNOT 5 may replace SNOT 22 for diagnosis of chronic sinusitis. As per the current guidelines, chronic sinusitis does not cause headaches. Acute sinusitis may cause headaches. That’s difficult to say, of course, as any chronic disease is prone to exacerbations.

[Ves Dimov, M.D. @Allergy]

The authors propose the use of currently available over-the-counter epinephrine inhaler for treatment of anaphylaxis. They also suggest that Symbicort should be available over-the-counter too. More research is needed of course, especially in the case of the epinephrine inhaler

[Ves Dimov, M.D. @Allergy]

Uncontrolled asthma is even deadlier in the setting of food allergy. One study described 21 cases of fatal reactions to foods. Asthma was present in all but one patient. If you have food allergy and asthma , make sure your asthma is under excellent control.

[Ves Dimov, M.D. @Allergy]

Food ladders in food allergy don’t have a clearly defined use yet. The idea is to introduce the foods at a faster pace, as opposed to oral immunotherapy.

[Ves Dimov, M.D. @Allergy]

The first trial of allergy shots, being injected in the tonsils, showed efficacy. This is another approach to intra lymphatic immunotherapy. In prior trials allergy shots were injected in inguinal lymph nodes. The proposed advantage of this therapy is shorter duration.

[Ves Dimov, M.D. @Allergy]

Atopic dermatitis in children is linked to a higher risk of asthma exacerbations. Atopic dermatitis is part of the classically described atopic march - several allergic diseases linked together

[Ves Dimov, M.D. @Allergy]

Repeat open application testing (ROAT) may be considered for fixed drug eruptions (FDE)

[Ves Dimov, M.D. @Allergy]

Food allergy to Ackee fruit is rare, but it was described in 1996. Ackee is poisonous, if eaten unripe. There are several mature trees in Fruit&spice park in the Redlands, Miami area, and the guides there always warn against eating the fruit if you don’t know how to prepare it.

[Ves Dimov, M.D. @Allergy]

The new Flonase tablet has nothing to do with Flonase nasal spray. It’s a totally different medication, different active ingredients. Flonase nasal spray may reduce nasal congestion vs Flonase tablet will not affect nasal congestion. OTC marketing can get confusing.

[Ves Dimov, M.D. @Allergy]

Food allergy to cashew tree nut is among the most dangerous food allergies because cashew is prone to causing major reactions at a very low dose. All food allergy researchers who work with patients allergic to cashew learn to respect it. https://t.co/1gW3fwkK7F

[Ves Dimov, M.D. @Allergy]

Omalizumab is a valuable alternative to oral immunotherapy (OIT) for treatment of food allergies. OIT studies show breaks in efficacy, complications such as EOE, and high dropout rates https://t.co/1gW3fwkK7F

[Ves Dimov, M.D. @Allergy]

Omalizumab as a treatment for food allergies increases the threshold at which the foods may cause an allergic reaction, it only works as long as you take it, and it may be needed as a lifelong treatment https://t.co/1gW3fwkK7F

[Ves Dimov, M.D. @Allergy]

@hjluks You’re in great shape Howard, keep up the good work!

[Ves Dimov, M.D. @Allergy]

Symbicort is one of the most effective and versatile asthma medication but it’s now generic and it’s being replaced by Breyna (nice green fountain logo, btw). If I may quote Andrew Murphy here, “asthma is not a monoclonal antibody deficiency”, consider ics/laba as per guidelines

[Ves Dimov, M.D. @Allergy]

A single day challenge with a penicillin antibiotic is just fine. No clear benefit to extending the challenge to a second day as of now. This review was done in the setting of beta lactam hypersensitivity.