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Asthma symptoms worse among pregnant women carrying girls
Pregnant women with asthma who are carrying a girl tend to suffer more severe asthma symptoms than those carrying a boy, according to a study in the American Journal of Epidemiology. Researchers at Yale University School of Medicine observed 702 pregnant women in southern New England, collecting information on lung function and other factors that could affect the women’s asthma severity. Until about 30 weeks’ gestation, asthma symptoms worsened in all women, regardless of the sex of their babies. And after 30 weeks, all the women’s lung function improved. However, during the entire pregnancy, women carrying boys had nearly 10 percent better lung function than mothers carrying girls. 

Ill-fitting masks affect medication delivery to young asthmatics
Face masks that some young children with asthma use to inhale their medicines often don’t work properly because of poor fit and inflexible material, according to a study in Respiratory Care. Such masks have typically been developed for other purposes, such as anesthesia, resuscitation and aerosol therapy. Scientists at Wake Forest-Virginia Tech Biomedical Engineering & Sciences in Winston-Salem, N.C., assessed seven of the most common masks, in combination with pressurized, metered-dose inhalers, on the head portion of 2-year-old-sized mannequins typically used for teaching CPR. The researchers measured the total volume of each mask and then tested how much force was needed. None of the masks tested worked ideally, according to Dr. Bruce Rubin, the study’s senior author.

Gas stoves may increase symptoms in asthmatic children
Nitrogen dioxide emitted by gas stoves and unvented heaters may lead to increased wheezing, persistent cough, shortness of breath, and chest tightness in children with asthma, says a study in the American Journal of Respiratory and Critical Care Medicine — especially children who live in larger, multi-family dwellings. Researchers at the Yale Center for Perinatal, Pediatric and Environmental Epidemiology studied 728 asthmatic children, under 12 years old, in 242 multi-family housing units and 486 single-family housing units. They found that 45.9 percent of multi-family housing units had nitrogen dioxide concentrations greater than 20 parts per billion, compared with 9.3 percent of single-family housing units. While there are no indoor standards, the current U.S. EPA outdoor standard for nitrogen dioxide is 53 parts per billion.  

EPA rolls out age groups for tracking childhood toxic exposure
The Risk Assessment Forum of the Environmental Protection Agency recently announced a final report, “Guidance on Selecting Age Groups for Monitoring and Assessing Childhood Exposures to Environmental Contaminants," in the Federal Register. The report suggests age groupings that can be used in monitoring studies and while conducting risk assessments that are child-focused. The final report is based on a September 2003 draft, with changes from peer reviews and public comments. The groupings are expected to improve exposure and risk assessments for the EPA by categorizing children based on a more current understanding of physiological and psychological developmental stages.    

Joint Task Force reviews calcineurin inhibitor statement
The Joint Task Force reviewed its April 2005 Report of the Topical Calcineurin Inhibitor Task Force of the ACAAI and AAAAI on Feb. 1, and the committee decided that no update was needed at that time. The guidelines, based on a thorough analysis of available data, conclude that current data does not support the use of “black box” warnings for calcineurin inhibitors.

The joint report was issued to members of both organizations following a February 2005 recommendation of the FDA Pediatric Advisory Committee and a FDA Public Health Advisory of March 2005. The report was again reviewed by the ACAAI/AAAAI joint committee in January following the FDA’s release of updated product labels for the calcineurin inhibitors, pimecrolimus and tacrolimus.

Members of the Joint Task Force are Drs. Vincent Beltrani, Jan Bernhisel-Broadbent, Mark Boguniewicz, Ernest N. Charlesworth, Luz Fonacier (ACAAI Co-Chair), Donald Y. M. Leung (AAAAI Co-Chair), Jonathan Spergel and David Weldon.

Dr. Carr joins troops in Iraq at 21st Combat Support Hospital
Dr. Warner Carr, Walter Reed Army Medical Center, Washington, D.C., will be leaving for Iraq to serve at the 21st Combat Support Hospital in March after attending a 10-day trauma refresher course at the Army Trauma Training Center.

“All military doctors are trained in combat casualty care and are expected to pitch in during times of war,” said Dr. Carr. “I don’t know exactly what to expect, but I will be going as an internal medicine physician to treat trauma patients, as well as non-combat diseases. I’ll be working in the emergency department, intensive care and giving general ward care. I may also be treating locals and non-U.S. military that require long-term care.”

Dr. Carr said he appreciates the supportive calls and e-mails he has received, and he asks ACAAI members to continue to support their military colleagues who are in a unique profession.

“Within days we may go from the setting of large hospitals and academic institutions, and sitting on advisory boards and national committees, to supporting our young soldiers who are fighting and dying in Iraq,” he said.

Formerly a Fellow-in-Training representative on the ACAAI Board of Regents (2003-2004), Dr. Carr chairs the Basic and Clinical Immunology Committee and is vice chair of the Young Physicians Committee. He is a member of the Scientific Council, the Annual Program Committee and the Bylaws Committee.

Dr. Carr may be reached periodically in Iraq at warner.carr@us.army.mil until his return to the U.S., expected by early October.

Attend the ACAAI-HSACI meeting in Athens, visit the Greek Isles
Join your colleagues in Athens for the ACAAI and Hellenic Society of Allergy & Clinical Immunology (HSACI) symposium, Allergy Update in Greece, Sept. 6-9, 2006. Extend your stay to tour the enchanting island of Santorini and other Greek Isles.

This international meeting brings together many of the finest researchers and clinicians to present cutting-edge lectures on the most important topics for the clinical practice of allergy and immunology.

The deadline for online abstract submission is May 15,. Oral presentations will include topics of “Adverse Reactions to Foods” and “Allergy and Autoimmunity.” Poster presentations will include these and other topics. The presenting author should be registered for the Congress.

Tours feature sightseeing in Athens, including the Acropolis, Panatheinaiko Stadium, the Parthenon and much more; Cape Sounion to see the Temple of Poseidon; Delphi, the “Center of the Ancient World,” visiting the Temple of Apollo and the Museum; Argolis, crowned by the mighty ramparts of the Palamidi Fortress and Nafplion; and a one-day cruise of the Saronic Gulf to visit the Greek islands Aigina, Poros and Hydra.

The modern Athens Ledra Marriott Hotel is the perfect venue for this meeting, with its spacious conference center and view of the Acropolis. For program and registration information, visit the ACAAI Web site.

Immunology Review Corner
Welcome to the Board Review Corner, prepared by Dr. Karla R. Davis, senior 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 63 of the 6th edition of Middleton’s Allergy Principles and Practice, edited by N. Franklin Adkinson, et al. Review questions were written by Drs. Eric Chenworth, Mayo Clinic; Karla R. Davis, Walter Reed Medical Center; Anne K. Ellis, McMaster University; and Soo Kim-Delio, Walter Reed Army Medical Center.