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 Of readers responding who currently hold a lifetime certificate, 83 percent do not plan to participate in MOC.

Supplemental selenium doesn’t improve asthma
Supplementing with selenium doesn’t appear to have clinical benefit in adults with asthma, according to a study in Thorax, even though selenium levels tend to be low among that population. Researchers at Imperial College London tested 197 adults from London with asthma, randomly assigning subjects to receive for 24 weeks either a yeast and selenium (100 micrograms daily) preparation or yeast-only placebo. Subjects receiving the selenium preparation had a 48-percent increase in blood levels of selenium during the trial. However, while some indicators of asthma severity improved more in the selenium group than in the placebo group, the difference was not statistically significant. 

AMA votes to lobby for laws allowing
anaphylaxis treatment drugs at school
Delegates at the American Medical Association recently voted at its annual policy meeting to lobby for laws allowing severely allergic children to bring lifesaving drugs to school. The new policy refers to drugs including prescription epinephrine and other injectable medicines that treat severe allergic reactions. The policy also urges schools to develop preparedness plans for handling severe allergic reactions and ensuring that all affected children have an individual emergency care plan. 

Five percent in U.S. report food allergies
More than 5 percent of U.S. adults may have food allergies, according to a study in the Journal of Allergy and Clinical Immunology. Researchers at the Food and Drug Administration used data from a 2001 national survey. About half of those with food allergies reported being allergic to at least one of the eight most common food allergens: milk and other dairy foods; fish; eggs; crustaceans, such as lobster and shrimp; tree nuts, such as walnuts; peanuts; soy; and wheat. Among those who read food labels, 40 percent reported “serious” or “very serious” difficulty trying to protect themselves. However, since the survey was administered, new legislation that went into effect in 2006 now requires food makers to list the eight most common food allergens in plain English.

A message from ACAAI President Dr. Daniel Ein

I recently attended an event with a number of twentysomethings, all of whom happened to be working on Wall Street, all trading different types of securities. (Apparently, being a trader is the new hot thing these days. The traders are the darlings of The Street, probably because they make the most money for their firms.) One of these young people, who happens to have gotten his position because his father is a billionaire hedge fund operator, was making fun of one of his buddies because his friend entertained the idea of going to medical school when his mother had been diagnosed with recurrent breast cancer. The young “Master of the Universe” teased his friend about what he called “the demented notion” of becoming a doctor.

Now, I have to admit, in the spirit of full disclosure, that my two sons have both spent time at major Wall Street firms. They have since graduated to what I consider more creative business pursuits. But I was horrified by the callousness and crass materialism I heard. The teasing was not meant as an observation of how difficult it is to be a doctor these days, but a statement that someone has to be intellectually defective to consider giving up a life of making big money for a life of helping others.

This got me thinking about my residents and students, the wonderful young people who are still full of idealism about and enthusiasm for what they are doing, who are eager to learn and anxious to be of service. Many of them remind me of myself and my classmates years ago. What I heard also caused me to reflect on my own 35 years of practice. The moments that have given me the greatest satisfaction mostly have to do with patients who return to tell us that they are so much better and so grateful for the change we have made in their lives.

Many of us feel so assaulted by the daily hassles: the endless regulations, the fighting with insurers and administrators, the loss of autonomy and respect, the relegation to “interchangeable units of production.” We forget what is really important about our professional lives, and that is that we are privileged to be able to practice medicine and have a positive impact on the lives of others.

Atul Gawande, a Harvard surgeon and a talented writer whose work mostly appears in The New Yorker, has written a new book, Better, about how physicians continually try to improve their performance for the sake of their patients, despite numerous internal and external obstacles. He concludes with five principles that he believes should guide us in our quest to be better physicians. One is “don’t complain,” even though we all have horror stories about the difficulty of practicing medicine these days. He points out that complaining doesn’t change anything, but does get us down. I would add that we should, in the words of the old song, “accentuate the positive and decentuate the negative.”

When we are really honest with ourselves, have we not had richer, more fulfilled lives by easing the suffering of others instead of having made money for someone else, by selling a bond at 21 instead of 20 7/8?

Symbicort now available in U.S.
AstraZeneca recently announced that Symbicort (combination budesonide/formoterol) pressurized metered dose inhaler is now available in the United States for the long-term maintenance treatment of asthma in patients 12 years of age and older. Symbicort is approved for patients whose disease is not adequately controlled on another asthma-controller medication or whose disease severity clearly warrants initiation of treatment with two maintenance therapies. It is available in two dose strengths, 80/4.5 and 160/4.5 µg of budesonide and formoterol, respectively.  

CMS begins voluntary Physician Quality Reporting Initiative (PQRI)
On July 1, the Centers for Medicare and Medicaid Services (CMS) began the voluntary Physician Quality Reporting Initiative (PQRI). To assist physicians and other eligible professionals who may elect to participate, the American Medical Association in collaboration with CMS, Mathematica Policy Research, Inc., and the National Committee for Quality Assurance, has developed participation tools.

The tools are designed to: aid in the selection of measures by physicians and other eligible professionals wishing to participate in the program; link to background information on the quality measures, including both the rationale and evidence base for each measure; and aid in the data collection required to report clinical performance data.

59 of the 74 measures in the PQRI were developed by the AMA-convened Physician Consortium for Performance Improvement®, in collaboration with the National Committee for Quality Assurance (NCQA) and/or a medical specialty society. ACAAI was one of the first participants in the Consortium and continues to play an active role.

For each of the measures in the program, the tools are now available online. CMS also posted technical corrections to some of the program's measure specifications. Additional information can be found on the CMS website:
• 2007 Physician Quality Reporting Initiative (PQRI) Measure Specifications [PDF, 812KB] - Updated 06/19/07
• June 18, 2007 Technical Corrections Release Notes, Version 1.1 [PDF, 19KB]
• General CMS PQRI Web site for additional information

Opa! Screening program goes to Greece,
reaches ethnic groups stateside
Joining Argentina, British Columbia, Ecuador, Panama, and Puerto Rico, Greece became the newest international site in the Nationwide Asthma Screening Program and extended the reach of the public service campaign.

ACAAI member Dr. John Moissidis was a first-time coordinator this year, and worked with the American Community Schools in Athens to conduct a three-day event.

“We partnered with the heads of schools, teachers, and nurses to coordinate the screening,” said Dr. Moissidis. “Thanks to our combined efforts, we were able to screen kids from elementary, middle, and high schools to increase awareness of the importance of diagnosing asthma early. It was a very successful project.”

The screening in Greece was one of more than 250 offered in 2007 by 208 ACAAI member allergists. The program is supported by AstraZeneca to help diagnosed asthmatics and people with breathing problems determine if they might have asthma and make sure the disease is under control.

Other efforts to expand on the success of the campaign were led by coordinators Drs. Ricardo Tan, Luz Fonacier and Sheldon Spector, who introduced the screening program to the International Association of Filipino Allergists and Immunologists. The 200-member group is coordinating efforts to screen the underserved Filipino-American communities.

Overall results of the 2007 program will be reported in upcoming issues of ACAAI News and the program’s Special Report newsletter.


ACAAI member Dr. John Moissidis screens a student in Athens,Greece

Annals is gaining impact
The Impact Factor of Annals of Allergy, Asthma & Immunology is on the rise, announced Editor-in-Chief Dr. Gailen D. Marshall.

“A journal’s impact factor is a measure of the frequency with which the average article in a journal has been cited in a given period of time,”
Dr. Marshall said.

Journal Impact Factor is from Journal Citation
Report (JCR), a product of Thomson ISI (Institute for Scientific Information). JCR provides quantitative tools for evaluating journals, and the impact factor is one of these.

“The impact factor is not the ‘be all to end all’ for the Annals, but is one measure of our value to the medical literature. Yet it still has to be considered when we attempt to attract the very best manuscripts possible for our readership. We have new and ongoing features that should allow us to continue to improve our impact factor in the future without compromising our responsibility to our readership,” he said.

Deadline for abstract online submission is July 15
The deadline to electronically submit an abstract for the 2007 ACAAI Annual Meeting in Dallas is 11:59 p.m., Sunday, July 15. Only electronic submissions will be accepted.

To submit an abstract, go to the ACAAI Web site and click on the headline "2007 Annual Meeting Abstract Submission." On-screen prompts will take you through the submission process.

If you have already begun to enter an abstract in the system -- but did not actually hit the "submit" button -- you must go back into the system and submit. After the abstract is submitted, you will receive an e-mail confirmation. Abstracts not officially submitted cannot be considered.

View the new Literature Review Course vodcasts
Presentations from the popular Literature Review Course, Everything You Should Have Read Last Year, But Didn’t, from the 2006 ACAAI Annual Meeting, are vodcast weekly.

The new vodcasts include:
• Occupational and Environmental Allergy – Dr. Mark S. Dykewicz (July 4-10)
• Asthma and Lower Respiratory Diseases – Dr. James T. Li (July 11-17)

Previous vodcasts from the Literature Review Course, the International Food Allergy Symposium and the “Asthma Control: How Are We Doing?” symposium are archived for continued viewing.

Each vodcast contains the original audio and presentation slides, and can be viewed from a computer or downloaded to a portable media player (such as an iPod). The ACAAI vodcast program is sponsored through an unrestricted educational grant from GlaxoSmithKline.

Dr. Ed O’Connell honored by Council of Science Editors
Dr. Edward J. O’Connell, past ACAAI president (1990-91) and former editor-in-chief of Annals of Allergy, Asthma & Immunology (1998-2005), in Rochester, Minn., received the CSE Distinguished Service Award from the Council of Science Editors.

The purpose of the award is to “honor those individuals who have worked diligently to further scientific communication and have made significant contributions to the Council of Science Editors.”

Dr. O’Connell has been on the CSE faculty for the past six years teaching the “Short Course for Journal Editors” and represented Annals at CSE meetings.

Board Review Corner
Welcome to the Board Review Corner prepared by Soo Kim-Delio, M.D., 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 “FIT Archive” link in the left column.

Review Questions: Chapter 4 of Pediatric Allergy: Principles & Practices, edited by Donald Y.M. Leung, et al. Review questions were written by Drs. Bret Haymore and Soo Kim-Delio, Walter Reed Army Medical Center.