Services and Procedures
At Allergy and Asthma Medical P.C., we strive to provide greater Manhattan with high quality and up to the minute medical expertise. Dr. Nathanael Horne specializes in a variety of allergy and asthma testing procedures and treatments for both adults and children. Outlined below are some particular areas of Dr. Horne's clinical expertise. Dr. Horne is among the few New York allergy doctors who treat both adults and children. At Allergy and Asthma Medical P.C. we strive to treat these conditions using the most current available treatment modalities and medications.
Clinical Area of Expertise
Allergic reaction - An adverse immune response following repeated contact with otherwise harmless substances such as pollen, animal dander, dust, mold spores, foods or drugs.
Allergic rhinitis (seasonal and perennial) - Inflammation of the nasal mucous membranes due to an allergic response.
Allergic contact dermatitis - A type of rash caused by an allergic reaction to specific chemical substances that come in contact with the skin. Dr Horne has a special interest in the diagnosis and treatment of contact dermatitis and uses a greatly expanded panel of allergens from Dormer Laboratories in order to improve diagnosis. He also has access to several extensive contact allergen databases, such as CARD (Contact Allergen Replacement Database) through his membership in the American Contact Dermatitis Society.
Anaphylaxis - A medical emergency which involves an acute systemic (affecting the entire body) allergic reaction. It occurs after exposure to an allergen to which a person was previously sensitized. This reaction can be life-threatening.
Angioedema - A non-itching reaction in the skin's underlying tissue marked by swelling and red blotches, this often involves the face and hands, can be very dramatic and even restrict breathing, similar in pathology to hives (urticaria), but occurs in deeper tissue.
Asthma - A chronic, inflammatory lung disease characterized by recurrent breathing problems. Episodes of asthma can be triggered by allergens, infection, exercise, cold air and other factors. This condition is becoming more common in both adults and pediatric patients.
Asthma and allergies in athletes - Athletes with allergies and asthma have special needs for close monitoring to maximize athletic performance and comply with anti- doping regulations. Asthma with exercise in both adults and children is much more common than is usually believed.
Asthma in pregnancy - Pregnant patients with asthma need close monitoring to maximize their lung function and minimized possible adverse effects to the fetus from lack of oxygen or medication reactions.
Autoimmune disease - When the immune system mistakes self tissues for nonself and mounts an inappropriate attack, the result is an autoimmune disease. There are many different types of autoimmune diseases, some of the best known examples are rheumatoid arthritis and systemic lupus erythematosus.
Bronchitis - An inflammation of the bronchi (lung airways), resulting in persistent cough. Bronchitis is more common in smokers and in areas with high atmospheric pollution.
Drug allergy - An adverse immune reaction following contact with otherwise harmless drugs, usually manifested as a rash or other systemic complaints, up to and including anaphylaxis.
Eczema - An inflammation of the skin, usually causing itching and sometimes accompanied by crusting, scaling or blisters. A type of eczema often made worse by allergen exposure is termed "atopic dermatitis." This condition is particularly common in pediatric patients.
Food allergy - An adverse immune reaction following contact with otherwise harmless foods, the manifestations of this reaction may range from mild to life-threatening. These reactions may be found in both children and adults.
Immunodeficiency - A range of disorders, both inherited and acquired, that result in the dysfunction of part or all of the normal immune response.
Insect hypersensitivity - An adverse immune reaction following contact with insect stings (i.e. honeybees or yellow jackets), the manifestations of this reaction may range from mild to life-threatening.
Occupational asthma - A respiratory disorder directly related to inhaling fumes, gases, dust or other potentially harmful substances while "on the job." With occupational asthma, symptoms of asthma may develop for the first time in a previously healthy worker, or pre-existing asthma may be aggravated by exposures within the work place.
Otitis media - An inflammation of the middle ear (also called ear ache), commonly found in infants and children with allergic rhinitis.
Rhinitis - An inflammation of the mucous membrane that lines the nose, often due to an allergy to pollen, dust or other airborne substances. Seasonal allergic rhinitis, also known as "hay fever," is a disorder which causes sneezing, itching, a runny nose and nasal congestion. Non-allergic rhinitis is triggered by certain factors, such as strong smells, pollution, particulate matter in the air, smoke or other irritants.
Sinusitis - An acute or chronic inflammation of the membrane lining the facial sinuses, often caused by a bacterial or viral infection.
Urticaria (hives) - An allergic reaction of the skin or a skin condition commonly known as hives, characterized by the development of itchy, raised white bumps surrounded by an area of red inflammation.
Procedures performed by Dr. Nathanael Horne at Allergy and Asthma Medical P.C.
Treatment and diagnosis of allergic and pulmonary conditions can vary depending on the severity and duration of the discomfort, reaction, and/or condition. At Allergy and Asthma Medical P.C., we use our expertise in the most current testing methodologies and procedures to diagnose our patients. A brief description of some of the treatment and diagnostic procedures we offer are listed below Dr. Horne's expertise in these procedure is among the most current of all New York allergy doctors, in addition, Dr. Horne is one of the few New York allergy doctors to offer accelerated immunotherapy (allergy shots) schedules (see below) to his patients.
Allergy skin testing - The scratch, or more accurately, the prick-puncture test (one of the most common methods) involves placement of a small amount of suspected allergy-causing substances (allergens) on the skin (usually the forearm, upper arm, or the back), and then pricking the skin so that the allergen is introduced under the skin surface. The skin is observed closely for signs of a reaction, usually swelling and redness of the site - a controlled hive with a so-called wheal and flare. Results are usually obtained within about 20 minutes, and several suspected allergens can be tested at the same time.
A similar method involves injection of a small amount of allergen under the surface of the skin (intradermal), this test is done by allergy doctors in adults as a stronger version of the prick-puncture test, but is rarely done in pediatric patients.
CAP-RAST testing – A sensitive and specific blood test for allergies- used in conjunction with allergy skin testing for diagnosis of allergies. RAST stands for radioallergosorbent test, and the CAP-RAST is a specific version of the RAST test with good performance characteristics. It is not necessary to stop taking antihistamines prior to the test.
Immunotherapy ("allergy shots or vaccinations or allergy desensitization") - A form of preventive and anti-inflammatory treatment of allergy to substances such as pollen, dust mites, fungi and stinging insect venom. It involves administering gradually increasing doses of the substance (allergen) to which the person is allergic. The incremental increases of the allergen cause the immune system to become less sensitive to the substance, which reduces the symptoms of allergy when the substances are encountered in the future, and the benefits can last for years after a course of treatment. This is frequently done in lieu of the intradermal test in pediatric patients. Dr. Horne is one of the few New York allergy doctors to offer accelerated immunotherapy (allergy shots) schedules, sometimes referred to as “rush” or “cluster” protocols for allergy shots. “Rush” or “cluster” immunotherapy protocols are frequently more convenient for the patients, and may lead to quicker relief of allergy symptoms.
Drug desensitization- Similar to above, It involves administering gradually increasing doses of the drug to which the person is allergic. The incremental increases of the allergen cause the immune system to become less sensitive to the substance, However, the effects of this do not last long after the procedure, and the drug must be administered immediately after desensitization in order to take advantage of this time window. The drug can then be given continuously, as in aspirin desensitization, or for a defined period of time, as in an antibiotic. If the course of treatment is interrupted, the desensitization procedure must be performed again.
Administration of immunomodulatory agents - Medications that can increase or suppress immune responses of the body, given for autoimmune diseases or immunodeficiency.
Patch tests - A form of skin testing in which suspected allergens are applied to the skin, covered and observed for several days to see if a reaction occurs. This is often used in identifying the possible causes of allergic contact dermatitis (see above).
Peak Flow - A peak flow meter is a small, hand-held device used to manage asthma by monitoring lung capacity. The peak flow meter measures the patient’s ability to expel air from the lungs, or peak expiratory flow rate (PEFR). From these changes in measurement, patients and doctors may determine lung functionality, severity of asthma symptoms, and treatment options.
Rhinoscopy - A procedure in which a thin, lighted tube is inserted into the nose to look for abnormal areas. Also called nasoscopy, this is frequently done in the evaluation of congestion or sinusitis.
Spirometry - This test measures how well the lungs exhale. The information gathered during this test is useful for allergy doctors in diagnosing certain types of lung disorders, but is most useful when assessing for obstructive lung diseases (especially asthma and chronic obstructive pulmonary disease, COPD). In a spirometry test, a person breathes into mouthpiece that is connected to an instrument called a spirometer. The spirometer records the amount and the rate of air that is breathed in and out over a specified time. Some of the test measurements are obtained by normal, quiet breathing, and other tests require forced inhalation or exhalation after a deep breath.
Sublingual Immunotherapy (SLIT) - This is a variation on traditional immunotherapy in which the allergens are self-administered by the patient at home by placing drops under the tongue. This method is ideal for patients that might not be able to adhere to the traditional allergy shot schedule. See www.allergychoices.com for more information.