Spring 2009
Triple Threat

synapse: University of Nevada, Reno School of Medicine

Budhecha, Hogan, Wilson

The school's pediatric triple threat consists of, left to right, Dr. Sonia Budhecha, Dr. Mary Beth Hogan, and Dr. Nevin Wilson. They are all board-certified. Photos by John Byrne.

The University of Nevada School of Medicine’s pediatric allergy specialty group, based in Reno, has hit the ground running since being established less than two years ago and views itself as the classic triple threat of academicians doing research heavily based in clinical experience.

Story by Anne McMillin, APR

The team of Nevin Wilson, M.D., an ’82 school alumnus who is a board-certified pediatrician, allergist and immunologist and chairs the pediatrics department; Mary Beth Hogan, M.D., a board-certified pediatric allergist and immunologist; and Sonia Budhecha, M.D., a board-certified pediatric pulmonologist, work together to address the allergy needs of pediatric and adult patients in northern Nevada.

Currently, several allergy studies are underway within the pediatrics department that were inspired by patients.

“Our research is focused on what we are seeing in the practice,” Hogan said. “We then use our research results in the clinic to help patients.”

Being from the East Coast, Hogan was familiar with seeing mold and mildew allergies, but the prevalence of northern Nevada pollens was a new phenomenon to her.

“Reno sits in a geographical bowl with little rain, so the pollens cannot be washed out—they are perennial,” she said. As a result, she didn’t expect to see patients presenting with mold and dust mite allergies.

After taking environmental histories, Wilson and Hogan discovered pervasive swamp cooler use in these patients’ households. Swamp cooler use encouraged dust mite and mold growth in an otherwise arid Nevada environment due to the cooler’s primary purpose of humidifying the air.

They took their ideas to the school’s institutional review board to develop a study, “Effect of evaporative (swamp) coolers on skin test sensitivity to dust mites and molds in a desert environment.”

They developed patient surveys and subsequent statistical analysis revealed that patients with swamp coolers had a higher incidence of dust mite and mold allergy than patients with air conditioners. Based on these results, the doctors made specific recommendations to patients and their families on how to avoid the allergens.

Those recommendations include installing a gauge to ensure the home’s humidity remains below 40 percent, adding mold inhibitors to the swamp cooler’s water pan, changing filters regularly and beginning a regime of routine maintenance since swamp coolers add more humidity when they are functioning improperly.

Wilson recently presented the results of this study to the national meeting of the American College of Allergy Asthma and Immunology.

In addition, the medical school’s pediatric allergy group is one of several sites working as a clinical trials unit to investigate an orphan drug’s effectiveness in treating a disease known as hereditary angioedema. This clinical trial, known as the EDEMA4 study, asks: How can we best treat patients with this disease to decrease sudden swelling of tissues under the skin and in the airway and gastrointestinal tract?

Patients are also the inspiration for a study determining how pet ownership attitudes influence parents to follow through on recommended medical treatments for their children’s allergies.

“We want to know if parents are actually hearing our recommendations regarding pets in the house, and if so, are their attitudes about their pet affecting their ability to follow through with our avoidance advice,” Hogan said.

Hogan said once a child or adult is diagnosed with pet allergies, there are two medically recommended options. The first is to remove the pet to an outside environment.

In northern Nevada, pet owners are often reluctant to do that for fear of the animal being killed by coyotes.

The second piece of advice involves thorough and regular cleanings of the pet and the house. These labor- and time-intensive solutions meet resistance from busy working families and usually wane over time.

Hogan said data analysis on the patient survey response portion for this pet attitude study is currently in progress.

Even though the pediatric allergy specialty is relatively new to the School of Medicine and University Health System, the school’s clinical practice, Hogan said the ultimate goal is to build the allergy program to include a training fellowship program.