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Mediterranean diet during pregnancy lowers child’s allergy, asthma risk
Mothers who eat a Mediterranean diet of dairy products, fish, fresh fruits and vegetables, legumes, nuts, and olive oil during pregnancy may help protect their children against asthma and allergic disease, according to a study in Thorax. Researchers in Greece, Mexico, and Spain studied data from 468 women presenting for prenatal care on Menorca, a Spanish island, during a 12-month period. They followed the mother and child pairs for 6.5 years after birth, gathering information about dietary patterns and allergic disease symptoms. The children also underwent skin prick tests for six common aeroallergens. The children of mothers who ate a high-quality Mediterranean diet during pregnancy were significantly less likely to have persistent wheeze, atopic wheeze, and atopy than children whose mothers ate a low-quality Mediterranean diet.  

Study: People with allergies may be more likely to have IBS
People with allergies appear to be more likely to have irritable bowel syndrome (IBS) than do those without allergies, suggesting that the conditions may be linked in some instances, according to a study in Annals of Allergy, Asthma and Immunology. Scientists at Rush University Medical Center, Chicago, surveyed 125 patients attending either an allergy, gastroenterology or general medicine clinic. Among patients attending the allergy clinic, 44 percent had IBS, similar to the 39-percent rate among patients attending the gastroenterology clinic. Only 20 percent of patients attending the general clinic reported having IBS. Patients who reported having hay fever, eczema and asthma were three times more likely to have IBS. 

Asthma camps help kids manage their disease
Attending a special asthma camp can help children improve their asthma management skills, according to a study in the Annals of Allergy, Asthma and Immunology. Researchers at the University of California, San Diego, School of Medicine, evaluated 1,783 children from various socioeconomic backgrounds attending 24 different asthma camps. Every child had to have its physician confirm the diagnosis of asthma. However, researchers found that 37 percent of the children still had inadequately controlled asthma. Children who previously attended asthma camp had fewer hospitalizations and visits to the emergency department and the doctor's office than children who hadn't been to an asthma camp before. 

A message from the Joint Task Force on Practice Parameters

The Joint Task Force on Practice Parameters was created in 1989 by agreement between the AAAAI and the ACAAI for the purpose of developing boundaries within which the field of allergy and immunology could consistently provide the best quality of care for patients. During the past 18 years, this Task Force has published 22 parameters on asthma, rhinitis, sinusitis, immunodeficiency, food hypersensitivity, drug hypersensitivity, urticaria, stinging insect hypersensitivity, atopic dermatitis, anaphylaxis, contact dermatitis, allergen immunotherapy, and allergy diagnostictesting.

The original parameter on allergy diagnostic testing, published in 1995, was the second parameter developed by the Task Force. Under the leadership of Dr. I. Leonard Bernstein, who was instrumental in developing the original parameter, a comprehensive updated parameter on this topic will be published as a supplement to the Annals of Allergy Asthma and Immunology next month. This comprehensive document covers not just IgE-mediated reactions, but testing for a broad spectrum of immunologic reactions, and will serve as a valuable resource document for the practicing physician. It has been fine tuned by extensive discussion within the Joint Task Force on Practice Parameters, as well as by comments from reviewers, contributors, and the membership of the two sponsoring organizations on a number of controversial topics, e.g., the proper interpretation of in vitro tests for specific IgE antibodies. Acknowledging that the practice of medicine is constantly changing, the Joint Task Force will now strive to update all parameters every three years to five years.

With the possible exception of the parameter on allergen immunotherapy, no parameter developed by the Joint Task Force is likely to have as much impact on the practicing allergist/immunologist or can be expected to generate such strong feelings. It is essential, therefore, that the Task Force produce evidence-based recommendations, whenever possible, especially on controversial issues. Nevertheless, because of differences in practicing habits of allergists/immunologists, some of these recommendations cannot be expected to receive universal agreement, due to honest differences in opinion.

It is recognized that physicians could have legitimate reasons for selecting an approach different than that recommended in the updated parameter on allergy diagnostic testing. Therefore, where possible, options for patient management were discussed. It is the responsibility of each physician to read this document carefully. These are your parameters. They have undergone extensive review by many members of the ACAAI. They have not been dictated by other specialists, the federal government, managed care organizations or third-party payers.

Allergists should discuss the document, in particular those sections that may be in disagreement with the approach used in their practice. If they come to an evidence-based conclusion that they can provide better quality of care for their patients by using an approach different from that recommended in the parameter, they should be prepared to develop a statement for their practices explaining why they will continue to practice differently than what is recommended in the parameter.

For those who do not agree with recommendations made in the parameter, it is their responsibility to provide scientifically valid and evidence-based data that would support a different approach. Physicians who are in a position to provide data that would support an argument against any recommendation in this parameter should generate data by performing studies or analyzing existing data by meta-analysis or other generally accepted validation methods. The Joint Task Force on Practice Parameters welcomes generation of such data as a way of clarifying the best approach to providing quality of care for patients. In fact, the development of practice parameters provides the opportunity to identify areas where scientific evidence is inadequate and provide the impetus for future well-designed studies in these areas.

These parameters provide support for dissemination of an evidence-based approach to the practice of allergy. To do this will ensure that allergy/immunology is a mature specialty capable of establishing its own destiny. The ability of allergists/immunologists to develop parameters, and the ability of its members to adhere to the recommendations made in these parameters, when based on well-designed studies rather than habitual practice, adds credibility to our field at a time when such credibility is essential for the marketing of the allergist.

Joint Task Force on Practice Parameters: Drs. Richard A. Nicklas (Co-Chair) Jay M. Portnoy (Co-Chair), David I. Bernstein, Joann Blessing-Moore, Linda S. Cox, David A. Khan, David M. Lang, John J. Oppenheimer, Christopher C. Randolph, Diane E. Schuller, Sheldon L. Spector, Stephen A. Tilles and Dana V. Wallace.

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View the new Literature Review Course vodcasts
Presentations from the popular Literature Review Course at the 2007 ACAAI Annual Meeting, are vodcast weekly.

The new Literature Review vodcasts include:
• Basic Immunology and Genetics — by Dr. David A. Khan
• Update in Clinical Immunology — by Dr. Jack M. Routes

Each vodcast contains the original audio and presentation slides and can be viewed from a computer or downloaded to a portable media player (like an iPod). Future vodcasts will feature named lectures and the symposium, “Allergic Rhinitis and the Allergist.” Previous vodcasts, including two from the Healthy Indoor Environment Conference, are archived for continued viewing.

The ACAAI vodcast program is sponsored by an unrestricted educational grant from GlaxoSmithKline.

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 dialogue with authors of 20 key abstracts selected by the ACAAI Abstract Review Committee.

Visit the College Web site for the identification tag numbers of the posters that have been selected for participation in this program, as well as the abstracts in PDF files. 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.

Members in the spotlight
The College recognizes Drs. P.K. Vedanthan, Fort Collins, Colo., and Karen Jackson, Lombard, Ill., for their achievements:

Dr. P. K. Vedanthan’s A/I Training in India: With a population of more than 1 billion and growing, India has an estimated 100 million people with allergies, asthma, and related conditions. Because India does not have the manpower or the infrastructure to handle this huge patient population, Dr. P. K. Vedanthan, established a formal training program in India.

Diploma in Allergy & Asthma (DAA) — a year-long distance learning course with a week practicum every quarter inaugurated at Christian Medical College (CMC), Vellore, Tamil Nadu — is the first formal training program in the field of allergy and asthma to be offered to qualified physicians in India. The curriculum is based on the Allergy, Asthma & Immunology Fellowship program in the United States, but more clinically oriented and modified to Indian conditions.



Patient praises Dr. Karen Jackson: The College received a letter from a patient praising Dr. Karen A. Jackson, who treated her severe allergic diseases, including uncontrolled asthma and continual respiratory infections, over the past two years. Excerpts from the letter follow.

“During this time Dr. Jackson provided me with exceptional care and her commitment to me as a patient was extraordinary. I became so ill that I was in her office on a weekly, sometimes biweekly, basis and needed to have her paged on several occasions. I went from a person that could go hiking in the mountains of western Montana to someone who could not walk down the block or up a set of stairs without having an asthma attack.

“Dr. Jackson is truly committed to her profession and her patients. I believe with all my heart that if it weren’t for Dr. Jackson, one of my emergency room visits would have been my last. I now can return to teaching. and I am beginning to resume my normal activities. I now have hope that my life will continue to get back to normal.”

Submit notable achievements and read about those of your peers in ACAAI eNews. Please e-mail member news notices to joannfaber@acaai.org.

Plans announced for second advocacy training conference
The Allergy & Asthma Network Mothers of Asthmatics has announced that its second annual Advocacy Conference will be held May 5-7 in Washington, DC.

The conference brings together allergists and other health care providers, patients, families, industry representatives, and legislators to address critical allergy and respiratory issues. Workshops will help attendees become effective advocates at the national and state levels, as well as in their own communities.

The preliminary agenda includes:
• Media and message training
• Meeting with your elected officials
• Internet advocacy
• Countdown to the metered-dose inhaler transition
• Disaster preparedness: Lessons learned for future planning
• Student rights — and readiness — to carry asthma and anaphylaxis medications
• Improving health care for Hispanic families
• The Language of Asthma™

Continuing Medical Education credit is available through joint ACAAI sponsorship. Young advocates (ages 10-16) will have their own three-day program.

Contact AANMA’s Jennifer Sprinkel at (800) 878-4403, ext. 108, for details or download a registration form: www.breatherville.org/cityhall/ch_breathingmatters.htm.

Resources are available for planning your asthma camp
It’s getting to be that time of year for many of you in terms of preparation for your 2008 asthma camp season. Valuable resources are available from the Consortium on Children’s Asthma Camps Web site.

The Controlling Asthma Pre-Camp Guide will help you maximize your current pre-camp materials. Content…graphics…it’s all there for your consideration.

Also if you have not done so — or if you know of a new asthma camp in your area —please register your asthma camp in the Consortium on Children’s Asthma Camps online Asthma Camp Directory. To add a camp (or if you forgot your existing password), please e-mail asthmacamp@alamn.org for a password. You also can call Jill Heins Nesvold, MS, executive director, at (651) 223-9578.

The Consortium on Children’s Asthma Camps was founded in 1988 by six sponsoring organizations, including the College, which is recognized on the Consortium’s Web site for its ongoing support. ACAAI’s representatives on the Consortium’s Board of Directors are Drs. Sherwin A. Gillman, Mario Cruz-Rivera, and Margaret F. Guill, who also serve on the College’s Ad Hoc Committee to Advise the Consortium on Asthma Camps.

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 19 of Pediatric Allergy: Principles & Practices, edited by Donald Y.M. Leung, et al. Review questions were written by Dr. Bret R. Haymore, 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.
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Do you have news, responses or opinions to share with us? Please e-mail the association office at enews@acaai.org