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February 16, 2005 |
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Welcome to ACAAI eNews — a bi-weekly aggregated news service
from the American College of Allergy, Asthma & Immunology. To be
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Stories |
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Regulatory Updates |
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Distance Learning |
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Association
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Fellows-in-Training |
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Calendar |
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Archive |
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FIT Archive |
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Just over half — 56 percent — of readers responding say most
patients with chronic rhinosinusitis should be treated
empirically with an antibiotic effective against resistant
streptococcus pneumoniae. |
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Do
you support Sen. Clinton's proposed Family Asthma
Act bill?
What
percentage of your patients is from minority groups,
underserved, poor and disadvantaged populations? |
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Distance Learning |
2004 ACAAI ANNUAL MEETING
Nov. 12-17, Boston
Link
From the 2003 ACAAI ANNUAL MEETING
Nov. 7-12, 2003, New Orleans
• Two Symposia Online
Link
• Plenary Sessions CD-ROM and DVD
Link
• XI International Food Allergy Symposium,
General Sessions & Symposia
Audio CD & Audio Tape
Link
From the 2002 ACAAI ANNUAL MEETING
Nov. 15-20, San Antonio
• Five Symposia Online
Link
E-mail:
k.knauer@UHHS.com
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Calendar |
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MARCH
AAAAI Annual Meeting
March 18-22, San Antonio, Tex.
Tel: 414-272-6071
E-mail
Link
April
63rd Annual Course in Allergy & Clinical Immunology
University of Minnesota
April 8, Minneapolis
Tel: 612-626-7600
Link
JUNE
World Allergy Congress
June 26 – July 1, Munich, Germany
Link
JUNE
23rd Annual Aspen Allergy
Conference
July 27-30, Aspen, Colo.
Contact: Kathleen Goldy
Tel: 303-282-0491
E-mail
Link
ONGOING
World Allergy Organization Society Meetings
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Sponsored
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Top
Stories |
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Asthma, allergies during pregnancy may up child’s autism risk
Women who have asthma or allergies during pregnancy may have
a higher chance of having a child with autism, says a study in
the Archives of Pediatrics and Adolescent Medicine. Scientists
from Kaiser Permanente in Oakland, Calif., studied 407 children
with autism and 2,095 controls without asthma, looking for a
link between asthma, allergies and autoimmune disorders in
mothers during the four years surrounding pregnancy and the
later diagnosis of autism spectrum disorder in their children.
Asthma and allergies were significantly more common in the
mothers of autistic children. Asthma and allergies in the second
trimester of pregnancy increased the risk of having an autistic
child more than two-fold.
Black asthma patients may be less
responsive to steroids
Regardless of asthma status or severity, black patients seem
to require higher doses of steroids than Caucasians, according
to a study in Chest. Researchers at the National Jewish Medical
and Research Center in Denver looked at 395 asthmatic patients
and 202 healthy controls, giving them various tests to assess
their responsiveness to steroids. Researchers found that the
amount of steroid needed to block immune cell production was
significantly higher in blacks than in Caucasians, both in the
asthmatic and the non-asthmatic groups.
Taking vitamins during pregnancy may
affect child’s wheeze risk
A mother’s high intake of vitamin C during pregnancy may
increase her infant’s risk of developing wheezing as a toddler,
while low intake of vitamin E was associated with developing
wheezing in the second year of life and eczema among babies born
to allergic mothers. The study, in the American Journal of
Respiratory and Critical Care Medicine, stressed that the
findings may be "spurious," and researchers say not to change
the eating habits of expectant mothers. High vitamin C intake
can be a marker for higher socioeconomic status and a
health-conscious lifestyle, which are factors also associated
with increased asthma and allergy.
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 A word from President Myron
Zitt, M.D.
The impact of asthma on the well-being of our population
and of our health care system is significant. A
conservative estimate is that 17 million Americans
suffer from this illness at a cost of at least $14
billion a year. While time lost from school and work is
considerable, asthma accounts for 500,000
hospitalizations, 2 million emergency department visits
and, alarmingly, 5,000 deaths every year.
The burden of asthma, however, falls disproportionately
on minority groups, particularly blacks and Hispanics,
and on underserved, poor and disadvantaged populations.
Blacks are three times more likely to be hospitalized
and from three to five times more likely to die from
asthma than Caucasians. In New York’s Harlem, the
prevalence of asthma, which is rising most rapidly in
pre-school aged children, is more than twice that of the
general population, while the city’s annual rate of
hospitalization was recently reported as 62.9 percent
per 10,000 among Hispanics, 59.9 percent among blacks
and 12.2 percent among whites. A similar disparity is
noted with regard to Emergency Department visits and
activity limitations. Yet, inner-city children are least
likely to be treated with long-term controller
medications, which are recommended by national
guidelines for the optimal treatment of persistent
asthma.
Children living in inner-city areas are exposed to
increased concentrations of indoor pollutants, including
cockroach, mold and murine allergens, nitrogen dioxide
from natural gas stoves, and second-hand cigarette
smoke. High concentrations of ozone in their outdoor
play environment also may lead to increased asthma
prevalence and exacerbations.
Although research ranging from community intervention
trials to studies on the genetic and biomolecular basis
for asthma is ongoing, greater efforts must be made to
better understand disparities in disease prevalence,
clinical course and mortality and to improve outcomes.
To this end, the ACAAI is cosponsoring a two-day
National Workshop on Asthma Health Disparities organized
by Kevin B. Weiss, M.D., director of the Midwest Center
for Health Services and Policy Research at the
Northwestern University Feinberg School of Medicine with
the joint support of the Otho S.A. Sprague Memorial
Institute in Chicago. At this February conference,
College Representatives Jay Portnoy, M.D., Michael Foggs,
M.D., and Santiago Martinez, M.D., are joining members
of other co-sponsoring organizations, including AAAAI,
ACCP, ALA, AAE, AAFA and AANMA to “identify critical and
practical next steps to take in reducing asthma health
disparities.”
To further address the issue of asthma health
disparities, Sen. Hillary Rodham Clinton is considering
the proposal of a bill titled the “Family Asthma
Clinical and Environmental Health Research Act” (Family
Asthma Act), which can be divided in several sections.
A) Authorizes that $80 million be allotted annually, for
fiscal years 2006-2010 for the Secretary of Health and
Human Services, acting through the Director of the NIH
to award grants to qualified entities, including
hospitals, health clinics, medical schools and
non-profit institutions for the purpose of establishing
pilot projects in:
a) asthma surveillance, including genetic studies,
pulmonary function and tests for exposure to allergens
b) asthma management
B) Authorizes $6 million over the next five years, to
expand the activities of the National Asthma Education
and Prevention Program of the NIH. Included would be
recommendations as to areas of improvement in federal
programs related to asthma, particularly those that:
a) reduce morbidity, mortality and financial costs
b) reduce the burden associated with the management of
chronic asthma
c) decrease the burden of asthma on disproportionately
affected populations
C) Authorizes $8 million annually to expand the
activities of the national Centers for Disease Control
and Prevention in both asthma surveillance and
prevention activities and in the publication of data
regarding childhood asthma prevalence and mortality
rates.
D) Authorizes $10 million annually for the next 5 years
for funding of fellowships “to train providers to act as
asthma specialists in order to increase the number of
individuals who can provide comprehensive asthma
management to patients.”
Our Board of Regents will be convening in Washington,
D.C., in May and hopes to arrange a meeting with Sen.
Clinton’s representatives, in an effort to refine the
Family Asthma Act. Our motivation is to decrease
disparities in asthma care, and improve asthma outcomes.
To that end, ensuring that significant funding, as
requested in Section D, is provided to train fellows in
Allergy and Immunology is essential. We certainly can
document that when it comes to asthma care, “nobody does
it better than the allergist.”
Myron Zitt, M.D.
President, ACAAI |
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Regulatory Updates |
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GAO: Access to physicians up for Medicare beneficiaries
L recently released study by the Government Accountability
Office showed an increase from April 2000 to April 2002 in
Medicare beneficiaries’ access to physician care in virtually
all parts of the country – both urban and rural areas. The study
was requested by Sens. Chuck Grassley and Max Baucus in response
to concerns that access to physician services would be
compromised as a result of the negative 5.4 percent update for
Medicare physician payments in 2002. The study also found that
Medicare-participating physicians did not attempt to compensate
for the 2002 negative payment update by refusing to accept
assignment for Medicare services.
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Drugs and Devices |
FDA issues warning about Zyprexa, Zyrtec errors
The Food and Drug Administration recently issued a warning
to physicians and pharmacists about errors in the prescription
and dispensation of two medications with similar names: Zyprexa,
an antipsychotic manufactured by Eli Lilly, and
Zyrtec, an antihistamine manufactured by Pfizer. “From a risk
management standpoint, this is an important issue, and points
out the importance of writing prescriptions legibly,” ACAAI
President Myron J. Zitt, M.D. said.
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Association
News |
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Annual meeting symposia online for complimentary viewing
Symposia held at the 2004 ACAAI Annual Meeting in Boston is
now
online and available for complimentary viewing. The
online session features streaming audio/video and includes
the speakers’ slide presentation.
Supported by an educational grant from Genentech/Novartis,
the Webcast "From Allergen to Asthma: Intervention Points
for More than Symptomatic Relief" includes the following
presentations:
• Natural History of Asthma and the Possibility of Altering
the Course of the Disease – William W. Busse, M.D.
• The Role and Limitations of Systemic and Inhaled
Corticosteroids in Asthma Therapy – H. William Kelly, PharmD
• New and Emerging Therapies in the Treatment of Asthma –
Alkis Togias, M.D.
Allergy Practice Tip: The
Right Encounters
Advice from The Patient-Centered Allergy Practice
Allergists need to see enough patients to provide adequate
access but not so many patients that care quality declines.
So, what is the right number of patient encounters per day?
According to The Patient-Centered Allergy Practice, the
median in allergy practices is 26.5 encounters per day per
full-time equivalent (FTE) physician, and 18.65 per FTE
provider (all physicians, plus all mid-level providers).
This does not include shot patients.
These tips are drawn from The Patient-Centered Allergy
Practice, a CME Series in Practice Management, provided by
Physicians Practice, endorsed by the American College of
Allergy, Asthma & Immunology, and supported through an
education grant from sanofi-aventis.
For more advice, visit
www.PatientCenteredAllergyPractice.com |
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Fellows-in-Training |
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Welcome to the Board Review Corner prepared by Thao Ngoc Tran,
M.D., a representative of ACAAI’s fellows-in-training (FITs) to
the Board of Regents. The Board Review Corner is your chance to
test your Board preparedness.
To refer to a previous Board Review Corner, click the “Archive”
link in the left column.
Immunology Review Corner: Chapter 37 of the 6th edition
of Middleton’s Allergy Principles and Practice, edited by
N. Franklin Adkinson, et al. Review questions were written by
fellows-in-training Drs. Thao Tran, Karla Lowe, Todd Levin and
Nathaniel Horne.
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