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Delaying solid food not linked to reduced asthma, allergic rhinitis risk
Delaying the introduction of solid foods for four months to six months may not decrease the risk of childhood asthma, allergic rhinitis or food/inhalant allergen sensitization, according to a study of 2,073 children in Pediatrics. Researchers at GSF-National Research Center for Environment and Health in Neuherberg, Germany, studied data from 6-year-old children participating in the LISA birth cohort study. According to the authors, “A delayed introduction of solids (past four months or six months) was not associated with decreased odds for asthma, allergic rhinitis, or sensitization against food or inhalant allergens at 6 years of age. On the contrary, food sensitization was more frequent in children who were introduced to solids later. The relationship between the timing of solid food introduction and eczema was not clear.”  

AAP updates policy about breast feeding, atopic disease risk
Eczema, asthma and food allergies may be delayed or prevented among high-risk infants who are either exclusively breast fed for at least four months or fed infant formula without cow milk protein, according to a report in Pediatrics. Updating a previous policy addressing the use of hypoallergenic infant formulas, the report says, "There is evidence that breast feeding for at least 4 months, compared with feeding formula made with intact cow milk protein, prevents or delays the occurrence of atopic dermatitis, cow milk allergy, and wheezing in early childhood” among infants at high risk of atophy. 

Obese suffer more severe asthma symptoms
Obese adults tend to suffer more severe asthma symptoms than adults who are not overweight, according to a study in Thorax. Researchers at Emory University and the Centers for Disease Control and Prevention in Atlanta studied 3,095 adults who were asked about their asthma symptoms during the previous five years. One third of the participants were obese. Subjects who were obese had more severe and more persistent symptoms, as well as missed more workdays than subjects who were not overweight. Obese subjects also were 66 percent more likely to suffer continuous symptoms during the past month. 

A message from ACAAI President Dr. Jay M. Portnoy

The Future of Allergy

Shortly before the ACAAI Annual Meeting in November, representatives from our three professional allergy organizations (ACAAI, AAAAI and JCAAI) began a process called the Allergy-Immunology Futures Study 2030. The purpose is to explore the future of the specialty of Allergy/Immunology over the next 20 years to 30 years. Since I have a hard enough time planning what to eat for lunch, I found the idea of planning that far in the future difficult, if not impossible. Most organizations have strategic plans that look three years, and, at most, five years into the future. So what gives? Why do this?

Collision course. Think of our specialty as an asteroid on a collision course with planet Earth in 30 years. The uncertainty of orbital predictions means that we don’t know with certainty that we actually will crash, so any course corrections we make now might worsen the situation rather than make it better. Obviously, we have to be very careful. We could simply wait 25 years and then do something, but such a delay would probably be too late. We are dealing with so much health care inertia that a large deflection over a short time simply would not work.

Our first step is to identify the forces that affect us now and over the next 30 years. These include the rising prevalence of allergic diseases; changes in treatment patterns as medications go over-the-counter and are prescribed by our primary care colleagues; under appreciation of the value of allergist-delivered care; scientific breakthroughs in treatment; insufficient numbers of allergy training programs; increased use of objective quality measures by health plans and patients; and a move toward use of technology along with effective evidence-based practice guidelines. If we can understand how these forces affect our specialty, we can begin to alter our trajectory in a predictable manner.

Potential scenarios. The future studies group has been advised to consider four potential scenarios: “Business as Usual” — do nothing; “A New World” — aggressively pursuing change; “Best Case” — full-speed ahead; and “Worst Case” — a dark age for allergy. In the “Business as Usual” scenario, we make a decision to let the forces described above take us where they will. We may crash into oblivion or we may do well. The “New World” scenario would involve making numerous changes in our specialty that sound good, but are not necessarily well thought out. The “Best Case” scenario sounds great; however, each of us may have a different idea of what “best case” would look like. As for the “Worst Case,” I suppose that I could always work in retail.

Collective heads. The bottom line is that cooperative planning for the future has never been more important than it is now. The College is beginning the process by preparing to launch a national public education campaign to address these issues and make our specialty better known and understood by those who need our help.

We need to put our collective heads together and decide what we want our specialty to look like in the future. Do we want to be the environment experts, do more with dermatology, or do we want to be genetic engineers in the brave new world of stem cell research and immune reconstitution? Whatever we decide, our Residency Review Committee needs to incorporate appropriate changes into the allergy program requirements, fellowship programs need to teach the new topics and skills, and the ABAI needs to write questions about the new topics to ensure competence. I therefore invite each of you to share your ideas and suggestions about the future of our specialty and these scenarios. Please send your comments to president@acaai.org and/or complete the brief poll questions below. I will share them with the Work Group to Explore the Future of the Specialty of Allergy, so we can collectively develop the best plan possible. After all, the dinosaurs didn’t do this, and look where they ended up.

College invites its Fellows to apply for leadership roles
The College invites applications for the positions of vice president for 2008-09, president-elect for 2008-09, treasurer for 2008-09, and for a position on its Board of Regents for 2008-2011.

All interested Fellows are encouraged to complete a questionnaire and submit it with a cover letter and curriculum vitae to the College office no later than Feb. 15, 2008.

“The application process lets the Nominating Committee know of your desire for a leadership role in the College,” said ACAAI Past President and Nominating Committee Chair Dr. William K. Dolen. “The questionnaire allows the Nominating Committee to evaluate each candidate’s potential fairly, giving everyone an opportunity to express his or her interest in being on the Board of Regents or an officer.”

“Priority is given to Fellows with a track record of excellent service on College committees or who are substantially involved in other College activities. Applicants for the position of vice president must have previously served a three-year term on the ACAAI Board of Regents. We strongly encourage qualified individuals who previously applied to consider applying again,” Dr. Dolen said.

Applications are available on the College Web site.

ClinicalConnect offers you a direct line to abstract authors
As an added feature of the 2007 ACAAI Annual Scientific Meeting in Dallas, the College, with support by an educational grant from Merck & Co. Inc., introduced ClinicalConnect – an innovative approach to the scientific poster viewing experience.

Through ClinicalConnect you can engage in dynamic, two-way dialogues with authors of 20 key abstracts selected by the ACAAI Abstract Review Committee.

Visit the College Web site for selected poster identification tag numbers as well as PDFs of the abstracts. Then simply use your phone to dial into 888.57.ACAAI and punch in the identification tag number to retrieve key talking points presented by the lead author about the scientific research featured on his/her poster.

You may also send a recorded message or question to the author who will in turn, respond to you by e-mail.

Annual Meeting programs are now available as video podcasts
Using the latest information delivery technology, the College is continuing its program launched last year of electronically delivering Annual Meeting scientific presentations directly to its members as video podcasts.

Beginning this month, users can retrieve files manually from the College Web site, or subscribe (at no cost) to an RSS feed which will automatically download a new presentation as soon as it is posted. Members can view streaming weekly, 30-minute vodcasts of key sessions on their computer or download them as a file directly to a portable media player.

The first vodcasts will feature selected sessions from the 2007 Healthy Indoor Environment Conference in Dallas, beginning with the following scientific programs:
• Selecting an Indoor Environmental Quality Consultant and Interpreting Environmental
Reports — Kevin Kennedy, CIEC, and Dr. James M. Seltzer
• Effective Remediation Methods — Dr. James L. Sublett and Douglas A. Garrett

Future vodcasts will feature slides and audio from the Literature Review Course, named lectures and the symposium, “Allergic Rhinitis and the Allergist.”

This convenient service is sponsored by an education grant from GlaxoSmithKline.

ReachMD XM Radio Channel 157 now available free online to ACAAI members
For a limited time, as a special benefit of your ACAAI membership, you can get free access to ReachMD XM radio channel 157, the only 24/7 radio channel created by physicians with programming and medical education for physicians. This six-month free access to ReachMD XM 157 is a $23.99 value. This free e-subscription will give you the ability to listen to this outstanding medical content live online or download the interviews as podcasts.

The channel includes a special series called Hot Topics in Allergy which airs exclusively on the channel and online at ReachMD.com, and was created in partnership with the College. The short-form program highlights articles and key studies from the ACAAI medical journal, Annals of Allergy, Asthma & Immunology, as well as related literature reviews from its publication AllergyWatch. Interviews conducted at the 2007 ACAAI Annual Meeting in Dallas will be adapted for future broadcasts. Listen live or download Dr. Todd Mahr’s discussion with Dr. Ketan Sheth on the Pediatric Allergies in America survey.

It’s simple to redeem your free ACAAI member benefit — a $23.99 value. Go to www.reachmd.com and click on the “Redeem Promotion Code.” Enter the code: ACAAI. Press SUBMIT.

Meda Pharmaceuticals new sponsor of ACAAI eNews
The College thanks Meda Pharmaceuticals Inc. for its 2008 sponsorship of ACAAI eNews.

This past July, MedPointe and Meda AB, a global specialty pharmaceutical company, announced a merger agreement under which MedPointe became part of the Meda global family. You will see a gradual phase-in of the new name as well as their continued commitment to excellence you have grown to expect. If you have any concerns, please contact Meda Pharmaceuticals’ customer service hotline at 1-800-526-3840.

Board Review Corner
Welcome to the Board Review Corner prepared by Drs. Bret R. Haymore and Dr. Jennifer W. Mbuthia, Senior and Junior Representatives of ACAAI’s fellows-in-training (FITs) to the Board of Regents. The Board Review Corner is an opportunity to help hone your Board preparedness.

To refer to a previous Board Review Corner, click the “FIT Archive” link in the left column.

Review Questions: Chapter 18 of Pediatric Allergy: Principles & Practices, edited by Dr. Donald Y.M. Leung, et al. Review questions were written by Dr. Jennifer W. Mbuthia, Walter Reed Army Medical Center.

Copyright © 2008 American College of Allergy, Asthma & Immunology. All rights reserved.
ACAAI eNews is sent as a membership benefit of the American College of Allergy, Asthma & Immunology.
E-newsletter services provided by the medical editors at Ascend Media, LLC.

Do you have news, responses or opinions to share with us? Please e-mail the association office at enews@acaai.org