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Cat dander may bother patients with other allergies
Patients with allergies to mold, dust mites or timothy grass might also be affected by cat dander, even if they aren’t specifically allergic to cats, according to a study in the American Journal of Respiratory and Critical Care Medicine. Researchers from several organizations in Europe analyzed cross-sectional data from 1,884 participants at 20 centers in the European Community Respiratory Health Survey, which measured house dust mite and cat allergen in mattress dust samples, and IgE sensitization to four allergens. They found higher bronchial responsiveness when exposed to cat dander in research subjects who weren't allergic to cats, but were sensitive to three other common allergens: dust mites, mold or timothy grass. The authors concluded, "cat allergen exposure at moderate levels may be harmful to all atopic adults." 

Vitamin C, omega-3s may lower asthma risk
A teenager’s adequate intake of vitamin C and omega-3 fatty acids may promote respiratory health and lessen the effects of oxidative stress, according to a study in Chest. Researchers at the Harvard School of Public Health in Boston, the U.S. EPA and Health Canada studied 2,112 12th-grade students from 13 areas in the United States and Canada during the 1998-99 school year, assessing associations between diet, pulmonary function and respiratory symptoms. The researchers found that those who consumed less than one-quarter of a serving of fruit a day had lower average lung-function scores. Those who took in less than 5.2 milligrams a day of vitamin E had an increased risk of reported asthma. And taking in less than 22 milligrams per day of omega-3 fatty acids was associated with increased risk of chronic bronchitis, wheezing and asthma.

Dental assistants at higher risk for asthma, allergic disease
Dental assistants who are exposed at work to methacrylates, which are used in fillings and bonding agents, may be at increased risk for asthma, nasal and other respiratory symptoms, according to a study in Allergy. Researchers at the University of Birmingham in the U.K. and the University of Oulu in Finland conducted a cross-sectional study of 799 female dental assistants from the membership register of the Finnish Association of Dental Hygienists and Assistants. They found that assistants with daily methacrylates exposure for the past three months were nearly three times more likely to report adult-onset asthma than subjects with less exposure. Those assistants also had increased risk for nasal symptoms and work-related coughing. Respiratory symptom risk seemed to increase the longer the subjects had been on the job, and those with childhood allergies were particularly susceptible.

A message from Dr. Bryan L. Martin, ACAAI Alternate Delegate to the AMA House of Representatives

At the recent AMA House of Delegates (HOD) meeting in June, I was again pleased to see the high level of democracy in action within the organization. AMA policy can be introduced by any of the member organizations represented within the House of Delegates, to include the medical student section, specialty societies or the states. Once introduced as a resolution, the resolution is published and sent to all delegates and alternates for review.

Thus, all delegates review the resolutions prior to the meeting and begin to consider the merits or lack of merit of the resolution. At the meeting, each resolution is discussed at a variety of caucuses, to include the allergy caucus. At these discussions, the impact of the resolutions on the practice of allergy-immunology is discussed and a response is determined.

Resolutions are formally introduced in a reference committee. The reference committee receives input from the caucuses and from individuals in an attempt to hear all sides of the issue. When everyone is heard, there is no vote, but the next issue is introduced. After all testimony is complete, the reference committee meets as a group and deliberates in an attempt to determine the will of the group. The testimony is reviewed and the reference committee develops a recommendation. The recommendation may be to accept the resolution as is, to reject the resolution or to modify the resolution to meet the intent or the will of the audience. Sometimes similar resolutions have been submitted and are combined into one joint resolution.

The report of the reference committee is then presented to the HOD as a whole. The HOD then can discuss the issues and agree with the reference committee or go so far as to reopen debate on the original resolution, with or without amendments. The final decision is made by a vote of the HOD.

This process is critical. Even though it has the potential to be time consuming, it gives all delegates the chance to discuss the issues, make their voices heard and amend the resolutions in order to ensure the best possible ideas go forward in a logical manner. The many steps at which the resolution may be amended only makes the end product stronger.

Some would say the AMA is outmoded and lacks importance in a medical landscape dominated by the specialty societies. I cannot disagree more. If there were no AMA, we would have to invent a similar organization to represent all physicians. It is a horizontal organization that links the myriad medical organizations into a coherent force.

I often hear questions, such as:
“Why belong to the AMA?”
“Is the AMA still relevant?”
“Is the AMA worth the money after I already pay my subspecialty and specialty society fees?”

As the alternate delegate who represents you, the members of the College, at the AMA, I must respond, “It is not only worth it, it is vital that we are here.” We should all belong to the AMA, and all ensure that we officially list the College as our subspecialty organization to ensure that we remain relevant to the AMA and that our voice is heard when issues that affect us are discussed.

An example of how important this can be is shown in the report on anaphylaxis approved at this meeting. College members provided input and critical review to ensure that this report reflected the best available science and therapeutics.

Not relevant? How can issues affecting graduate medical education, continuing medical education, anaphylaxis, payment, relationships with insurance companies and tort reform not be relevant to us all? It is critical that we are part of this activity and at the AMA table. While I don't always agree with the positions and policies of the AMA, I know my voice as a representative of the College and as an individual is valued and heard.

For more information about the 2007 Annual Meeting of the AMA House of Delegates, visit the AMA Web site.

FDA finalizes black box warning for Xolair
The U.S. Food and Drug Administration recently finalized the wording for a new warning label about anaphylaxis for Genentech Inc.'s asthma drug Xolair. The FDA reports that anaphylaxis occurs in about 2 in 1,000 patients taking Xolair.  

Save the date for the 2007 College meeting in Texas
The ACAAI Annual Meeting, Nov. 8-14, 2007, is at the Gaylord Texan Resort and Convention Center, situated on 150 acres on Lake Grapevine in the heart of Texas wine country.

The resort’s restaurants are the finest in regional cuisine, offering live music, entertainment, dining and dancing at the Glass Cactus overlooking the lake. Shoppers can visit the unique stores and markets on site, or take the free shuttle to downtown Grapevine or Grapevine Mills, the largest shopping mall in Texas.

For recreation and relaxation, there is something for everyone, including:
• Biking, jogging trails and horseback riding
• World class spa and fitness center, a contemporary outdoor pool and a 20-meter indoor lap pool
• 18-hole golf course at nearby Cowboy Golf Club
• Boating, waterskiing, jet skiing and fishing on Lake Grapevine.

Join your colleagues in this wonderful setting brimming with authentic Texas style and hospitality. Look for your Preliminary Program in the mail soon. Online registration will open on July 25.

Healthy Indoor Environment Conference kicks off Dallas meeting
The full-day “Healthy Indoor Environment Conference” will be held Thursday, Nov. 8, in conjunction with the ACAAI Annual Scientific Meeting in Dallas. The conference will cover practical information you and your patients can implement immediately.

Morning sessions will cover healthy building characteristics, functional vs. non-functional buildings, building-related health effects and health-related environmental history. Attendees will look at the ins and outs of animal, dust mite and other bug allergens and learn about particulates and other irritants – where they come from and where they go.

The luncheon keynote speaker is Jeff May, author of books My House is Killing Me! The Home Guide for Families with Allergies and Asthma; The Mold Survival Guide: For Your Home and for Your Health; and My Office is Killing Me! The Sick Building Survival Guide.

Afternoon breakout sessions will cover environmental measurement, sampling and interpreting reports; effective methods of remediation; and recommendations for patients. Thomas Kelly, director, Office of Regulatory Management and Information of the Environmental Protection Agency will discuss “The Future of Indoor Environment Health.”

Drs. James M. Seltzer and James L. Sublett are joined by Kevin Kennedy, CIE, as co-chairs of the planning committee. The conference is supported by an educational grant from Clorox.

Board Review Course materials are still available
If you were unable to attend the ACAAI/AAAAI Certification/Maintenance of Certification Board Review Course held in April, you can take the course from the convenience of your home or office.

The Review Course DVDs, audio CDs and mp3s are available for purchase at the ACAAI Online Store. Plus, the syllabus is still available for $110 by e-mailing Dianne Kubis at diannekubis@acaai.org. We also have the 2005 and 2006 Question & Answer booklets available for $20.

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