Allergy/Asthma

Children born to women with asthma whose condition was managed based on the fraction of exhaled nitric oxide, or FENO, in addition to their asthma symptoms as opposed to asthma symptoms only were more than 50% less likely to have diagnosed asthma in early childhood, according to results of a double-blind, randomized clinical trial.

Low-dose vital wheat gluten oral immunotherapy induced desensitization after 1 year of treatment in patients with wheat allergy, according to findings recently published in the Journal of Allergy and Clinical Immunology.

In recent years, much emphasis has been placed on the cautious and appropriate use of antibiotics as a means of mitigating the threat of antimicrobial resistance. Yet antibiotic overprescribing remains a concern, particularly in outpatient settings such the physician’s office, urgent care centers, clinics and EDs.

Approximately 20% of teenagers in New York City have asthma symptoms but have not received a diagnosis, according to research published in The Journal of Urban Health. Researchers wrote that neighborhood-level variables and demographic characteristics, including race or ethnicity, affected teenagers’ risk for having undiagnosed asthma.

My path to medicine began at age 8 years, after seeking career counsel from my pediatrician. During medical school, clever microorganisms and the diseases they caused fascinated me. How could these miniscule creatures bring entire populations to their knees? Inspired by stories of early pioneers like Dr. Rebecca Lancefield and Sir Alexander Fleming, the field of infectious diseases called to me. I flirted with other specialties throughout my training, but when speaking to family, friends and colleagues, it was obvious to everyone else that I was destined for infectious diseases long before I even knew what that specialty was. For my 5th grade science project, I had no interest in volcanoes or windmills. I launched a full-scale epidemiologic investigation of infectious diseases, including mosquito-borne illnesses on my island of Dominica. I assembled a panel of experts, did research and created an elaborate presentation, which won first place. The experience of learning about how these diseases affect human life and how we as humans can affect disease outcome lit a fire of excitement and passion for infectious diseases that still burns within me. Today, I find myself at the front lines of a battle to preserve our antibiotics for infections of the future. How humbling, to recognize that the work I do today honors what Sir Alexander Fleming recommended when he first discovered penicillin 90 years ago! I am also passionate about health disparities and increasing minority representation in medicine, and I am proud to be a part of a professional society that is committed to creating opportunities for diversity and inclusion among members as a means of providing care to a diverse patient population. I am proud to be a part of this group of esteemed clinicians that saves lives, cures ills and advocates fiercely for our patients.

Hernán Cortés and Pánfilo de Narváez brought smallpox to the Americas in 1520. Due to a lack of immunity, the native population was decimated, and Tenochtitlan fell to the Spanish in 1521. This was the subject of my fourth-grade history fair project and the beginning of my love for infectious diseases. I followed it up the next year by learning about the race for a polio vaccine. In high school, my physics teacher, Dr. Cunningham, suggested I read The Coming Plague by Laurie Garrett and the fascination continued — Ebola, Machupo, Marburg and others. I decided to go into medicine after my excellent college mentor and friend, Dr. Martín Gonzalez, suggested it as a career path toward infectious diseases fellowship. It was great advice and I love being an ID physician. I chose this career because of the allure of discovery and understanding how pathogens and people interact. I am fortunate to study just that for multidrug-resistant bacterial infections. I have excellent mentors helping me push the ID envelope: Jennie Kwon, Hilary Babcock, Margaret Olsen, Marin Kollef, Graham Colditz, Stephanie Fritz and others. Every day is a new challenge, and contrary to mid-20th century arrogance about the acquiescence of infections to modern medicine, infectious diseases are not subjugated by human egotism. ID physicians will always have important and exciting work to do.

Infectious Diseases leapt off the pages of Paul de Kruif’s Microbe Hunters in the eighth grade and has held me ever since. I was enticed by the curiosity of the early giants — Koch, Pasteur, Ehrlich. I gravitated to immunology in college, then clinical ID in medical school. There I found that ID specialists were considered the most thoughtful physicians in the hospital, performing the thorough history and examination to expose the disease, ordering the most appropriate testing and treatment, explaining the disease and remedy to patient and family. I discovered that ID specialists make brilliant discoveries at bench and bedside. They lead infection prevention, antibiotic and diagnostic stewardship, and public health, and these systems roles make ID an ideal platform for health care leadership. I could not wait for ID fellowship to join my mentors: Marty McHenry’s verbatim histories and jovial literature dives, David Longworth’s humanistic care and even-handed leadership, Tom Keys’ direct wisdom, Walt Tomford’s collegial passion, Susan Rehm’s clinical acumen and insightful mentorship, Steve Gordon’s vision and team building. I carry with me some of each of them. I would encourage anyone who finds this kind of diverse experience appealing to speak with ID specialists or IDSA and discover ID!

Infectious Disease News asked ID specialists when they chose to pursue a career in infectious diseases and why. Read more responses online at www.Healio.com/ID. You can share your story with us in 200 words or less by emailing the editors at infectiousdisease@healio.com, with the subject line “Hooked on ID.”

Low-dose vital wheat gluten oral immunotherapy induced desensitization after 1 year of treatment in patients with wheat allergy, according to findings recently published in the Journal of Allergy and Clinical Immunology.

Fasenra reduced daily rescue medication use by day 3 in patients with severe, uncontrolled asthma with eosinophilic inflammation, according to findings presented at the American College of Allergy, Asthma and Immunology Annual Scientific Meeting.