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April 27, 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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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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Fifty-seven percent of readers responding said Public
Awareness & Food Allergy Awareness Week is the FAAN
education program most beneficial to their patients. |
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Are
you experiencing managed care mandates in your
state, such as those in New York, putting limits on
the duration, reimbursement and increasing co-pays
for immunotherapy?
Are you satisfied with the College’s response to the
HOD Resolution concerning Empire BS-BS? |
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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
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Calendar |
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JUNE
World Allergy Congress
June 26 – July 1
Munich, Germany
Link
JULY
Association of Asthma
Educators (AAE) Annual Conference
July 22-24, Las Vegas
Tel: 888-988-7747
E-mail
Link
AAE's National Asthma Educator Certification Review Course
July 24-25, Las Vegas
Tel: 888-988-7747
E-mail
Link
23rd Annual Aspen Allergy
Conference
July 27-30
Aspen, Colo.
Contact: Kathleen Goldy
Tel: 303-282-0491
E-mail
Link
8th Annual Scientific Session of
the Intermountain West
Allergy Association
July 28-30, Coeur d’Alene, Idaho
Link
AUGUST
Hong Kong
Allergy Convention
Jointly sponsored by ACAAI
Aug. 6-7, Hong Kong Convention & Exhibition Centre
Tel: 852-2559-5888
Fax: 852-2559-6910
E-mail
OCTOBER
New Trends & Recent Applications
in Allergy, Immunology and Infectious Diseases
Oct. 6-8, Taormina, Sicily
E-mail:jbella007@aol.com
or IRConsult@aol.com
Link
ONGOING
World Allergy Organization Society Meetings
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Sponsored
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Top
Stories |
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Study: As-needed steroid therapy OK
A recent report in the New England Journal of Medicine
suggests that patients with mild persistent asthma may be able
to keep their condition under control by using inhaled or oral
corticosteroids on an as-needed basis, rather than continuously.
Scientists at the University of California at San Francisco
studied 225 asthma patients, randomly assigning an as-needed
steroid regimen or daily steroid therapy for 1 year. In
addition, some intermittent-steroid users also were prescribed
daily zafirlukast. Rates of asthma flare-ups were similar among
all three treatment groups, despite little use of the inhaled
steroid by the as-needed group.
Chronic breathing problems tied to
anxiety, depression
Anxiety and depression is common among patients with chronic
breathing disorders, according to a study Chest.
Researchers at Baylor College of Medicine in Houston analyzed
1,334 patients who were treated for chronic breathing disorders
at the Michael E. DeBakey Veterans Affairs Medical Center, using
screening questions from Primary Care Evaluation of Mental
Disorders (PRIME-MD) to measure anxiety and depression
prevalence. Sixty-five percent screened positive for depression
and anxiety, 10 percent for anxiety only and 5 percent for
depression only.
Grandmother’s smoking linked to childhood
asthma
A child whose grandmother smoked while pregnant may have
nearly double the risk of developing childhood asthma, according
to a study in Chest. Researchers at the University of
Southern California in Los Angeles analyzed 908 children’s data
from phone interviews with parents or guardians. Of the 908, 338
had asthma within their first five years of life, and 570 were
controls. Results showed children with mothers who smoked while
pregnant were 1.5 times more likely to develop asthma early in
life. Those who had grandmothers who smoked while pregnant, were
2.1 times more likely to develop asthma. Further, if the child’s
mother did not smoke while pregnant, but the child's grandmother
did, the child still was 1.8 times more likely to develop
asthma.
Oral steroids, theophylline may up heart rhythm irregularity
Of drugs used to treat respiratory diseases, oral steroids
and theophylline are most likely to lead to irregular heart
rhythm, says a study in Epidemiology. U.S. and Spanish
researchers conducted a case-control study among asthma or COPD
patients, ages 10 to 79 — 710 with heart rhythm irregularity and
5,000 controls matched by sex and age —who were registered in
the U.K. General Practice Research Database. Researchers saw no
effect on the risk of rhythm disorders from inhaled steroid use,
but reported an elevated risk with oral steroid use and, to a
lesser degree, short-term theophylline use.
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 A word from President Myron
Zitt, M.D.
House of Delegates to the rescue!
Among the goals of the ACAAI are to maintain the highest
possible standards in the practice of allergy/immunology,
to perpetuate the tradition of medical ethics, and to
disseminate to the medical profession and to the public,
knowledge of allergic diseases in the interest of public
health and welfare. First and foremost though, our
greatest allegiance is to our patients. We must maintain
the highest quality of care for our patients and preserve
their access to our specialty. After all, “nobody does it
better than the allergist.” Nonetheless, we are confronted
with daily problems that threaten our ability to practice,
including such issues as reimbursement for services and
malpractice liability. But how can the College identify
and address the day-to-day problems that confront our
membership? How can we maintain a line of communication
with our grass roots?
The answer is the ACAAI House of Delegates (HOD). This
body serves as a forum for the discussion of issues and
the dissemination of information among allergists and
provides a mechanism for the official input of local,
state, and regional (LSR) allergy societies to the ACAAI
Board of Regents. The HOD meets once a year during the
ACAAI Annual Meeting. Each local state and regional
allergy society is represented by at least one Delegate
and one Alternate Delegate depending on its number of
members, and is entitled to at least one vote. The
Fellows-in-Training Section has similar representation on
the HOD. Although all ACAAI members may attend the annual
meeting and may address the HOD at the discretion of the
speaker of the House, only a Delegate can submit a
Resolution. If passed by the majority vote of the
Delegates in attendance a Resolution is brought before the
Board of Regents for further action.
In recent years, attendance at the HOD has diminished as
members have been discouraged that their voices are not
being heard. Last year in Boston, under the leadership of
our present Speaker of the House, Rosemarie Young, M.D., a
town hall format was adopted whereby although resolutions
and voting were restricted to Delegates, participation and
free interaction by all members was encouraged. As a
result, attendance went from a low of 40 in 2003 to a high
of 150 members at the 2004 Boston meeting. In addition,
under the direction of Dr. Young, the ACAAI created a Web
site on which members can exchange information. As the
Speaker of the House is a voting member of the Board of
Regents, she can readily introduce current information
gleaned from the HOD Web site throughout the year to the
Board of Regents for relatively speedy action. Therefore
the College now can respond quickly to the needs of its
LSR members.
At our November meeting, the Long Island Allergy & Asthma
Society and the New York State Allergy Society submitted a
resolution requesting that the College denounce and refute
the NY Empire BC/BS policy on Immunotherapy, which in
essence states that it is medically “inappropriate” for
physicians to administer immunotherapy for longer than
three years.
The
HOD Resolution states: “We consider this a
medical-legal statement giving the right of an HMO to
practice inappropriate medicine even when the scientific
studies, the FDA's statement on immunotherapy and the
practice parameters dictate otherwise.”
Furthermore, the Resolution states that, although this is
a local issue, “once this is accepted or ignored by the
medical profession, it will snowball across the nation
setting precedence for other or new practice guidelines
determined not by us but by the HMOs.”
• In response to the Resolution, the ACAAI Board of
Regents acted quickly to bring this matter to the
attention of the JCAAI and to authorize the development of
a letter to New York Empire Blue Cross/Blue Shield, to be
signed by the presidents of the ACAAI, AAAAI and JCAAI,
concerning the role of Practice Parameters in patient care
and specifically addressing the immunotherapy issue.
• The JCAAI also requested a legal opinion from the
College’s attorney, Rebecca L. Burke, with Powers, Pyles,
Sutter & Verville PC, on whether it is appropriate for
payers to base determinations of medical necessity on
adherence to specific practice parameters. The attorney’s
findings, which also were submitted to EmpireBC/BS,
concluded that “there is a clear consensus in the medical
community that practice parameters may not be applicable
to all patients and that it is up to the treating
physician, based on his or her clinical judgment, to
determine whether a practice parameter should be followed
in a specific situation.”
• The ACAAI, JCAAI and AAAAI issued a letter stating: “It
seems quite clear that there is no support for a decision
to require discontinuation of immunotherapy at the end of
three years in all cases. It also seems quite clear, that
based upon appropriate evidence-based standards,
immunotherapy can be continued beyond five years provided
there is a demonstration of medical necessity.”
• The Medical Society of the State of New York (MSSNY)
also was outraged that an insurance company was playing
doctor and wrote a third letter in support of the position
of the Allergy Groups.
The battle with Empire BC/BS is still ongoing. In the
meantime new issues that challenge physician reimbursement
and threaten patient access to specialist care continue to
arise.
Additional matters of concern have been expressed at the
November HOD meeting, including those regarding
increasingly rigid CME guidelines. This issue is being
aggressively addressed through an ad hoc Committee chaired
by Daniel Ein, M.D., which has formed a Coalition of
Medical Societies to oppose over-regulation. In the
meantime, the CME/CPD Committee, under the direction of
its Chair, Lyndon Mansfield, M.D., has established a new
College policy to comply with the 2004 Accreditation
Council for Continuing Medical Education (ACCME). In order
to assure the absence of “conflict of interest” (COI) in
any educational activities related either to our national
meeting or to joint sponsored events, such as our LSR
programs, it will be necessary to carefully review the
educational material to be presented. As this will be a
mammoth task, Dr. Mansfield is asking for ACAAI volunteers
to join a CME Peer Review panel to review educational
materials for COI and revise or remove any potential areas
of bias before conflicted material could threaten our CME
accreditation. Let me take this opportunity to thank those
who volunteer in advance for assisting the College in its
mission to provide the highest quality of CME for our
membership.
To conclude, our HOD is becoming a growing force in
shaping ACAAI policy. The town hall format for a free
exchange of information at our annual meeting and the new
HOD Web site make it infinitely easier to communicate with
your peers and to make the Board of Regents aware of
recent challenging developments. I urge you to participate
actively to keep our specialty viable and to assure that
“nobody does it better than the allergist.”
Myron Zitt, M.D.
President, ACAAI |
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Regulatory Updates |
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Judge’s ruling reignites ephedra controversy
An April 13 ruling by Judge Tena Campbell of the U.S.
District Court in Utah threatens the U.S. Food and Drug
Administration’s year-old national ban on ephedra and raises
questions about the strength of its regulatory authority over
dietary supplements. Such products, which are considered food
products, are not subject to the same restrictions as
prescription drugs. Some physicians are worried the judge's
decision ultimately could cause the return of what they view as
a life-threatening substance. |
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Association
News |
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Record
attendance at Board and Recertification Review Course
A record-breaking 658 attendees participated in the ACAAI/AAAAI
Conjoint Committee Board and Recertification Review Course
held April 14-17 at the Renaissance Hotel in Chicago.
The program was coordinated by the American College of
Allergy, Asthma & Immunology, and was co-sponsored by the
College and the American Academy of Allergy, Asthma &
Immunology.
The purpose of the intensive course, made possible by a
generous educational grant from sanofi-aventis Group, was to
help allergists prepare for the ABAI Certification Exam on
Oct.10-16, and the Recertification Exam on Oct. 17-21.
Program co-chairs were Richard W. Weber, M.D., representing
the College, and Richard F. Lockey, M.D., representing the
Academy. Opening remarks were made by ACAAI representative
Suellyn S. Rossman, M.D.
The ABAI Board Review Course was initiated by the College in
1985 to assist fellows-in-training and other physicians to
prepare for the certification and recertification exams, and
has been held continually every second year in conjunction
with the ABAI Exam.
If you are interested in purchasing the course syllabus, it is
available at a cost of $95. For more information, please
e-mail
diannekubis@acaai.org.
Call for abstracts: online submission now available
The ACAAI abstract submission site for the 2005 Annual Meeting
is now
online. Submissions will be accepted until July 17, 2005.
Authors should follow all directions carefully as they proceed
through the system’s step-by-step process. The assigned
abstract ID number will allow authors to resume or edit a
previous submission.
Abstracts selected for oral or poster presentations will be
published in the Annual Meeting Abstract Book and
published in Annals of Allergy, Asthma & Immunology
next January. FIT Abstracts will be considered for the ACAAI
Clemens von Pirquet Award, provided they submit a detailed
description (not to exceed four pages) of the work.
Jointly sponsored CME meeting in Sicily this fall
The ACAAI is partnering with four organizations to present an
International Symposium: New Trends & Recent Applications
in Allergy, Immunology & Infectious Diseases, Oct. 6-8,
2005. The CME conference will be held at the Russott Hotel,
Giardini Naxos, Italy, near beautiful Taormina, Sicily.
Co-supporters are the Italian Society of Microbiology (SIM),
the International Center for Interdisciplinary Studies of
Immunology in Washington, D.C., the Italian Society of Ear,
Nose and Throat Infectious Disease (SIIO) and the University
of Catania.
The scientific program entails state-of-the-art lectures on
current developments in allergic and non-allergic disease
management and infectious disease states. The Italian hosts,
Mario LaRosa, M.D., Giuseppe Nicoletti, M.D., and Agostino
Serra, M.D., extend a warm invitation to share in this
educational experience.
This activity is being planned and implemented in accordance
with the Essential Areas and Policies of the Accreditation
Council for Continuing Medical Education (ACCME) through the
joint sponsorship of the American College of Allergy, Asthma &
Immunology (ACAAI) and International Research Consultants
(IRC). The ACAAI is accredited by the ACCME to provide
continuing medical education for physicians.
The final program is available on the member section of the
College Web
site. For further information, please contact
Jacqueline Roberts at
jbella007@aol.com or
IRConsult@aol.com.
Allergy Practice Tip: Walkie
Talkie
Advice from The Patient-Centered Allergy Practice
Instead of chasing your nurse around the office, use
walkie-talkies. That way, you can talk when you are ready.
There is no reason to hold up patient care waiting for your
nurse. For more advice on technology in the allergy practice,
visit
www.PatientCenteredAllergyPractice.com.
These tips are drawn The Patient-Centered Allergy Practice,
a CME Series in Practice Management, endorsed by the
American College of Allergy, Asthma & Immunology. |
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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 46 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 and Todd Levin.
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