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Stay Connected:   February 26, 2014
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Breaking News: No to Primatene HFA MDI
The FDA Nonprescription Drugs Advisory Committee and the Pulmonary Allergy Drugs Advisory Committee met jointly on Tuesday, Feb. 25, and voted that evening not to suggest approval of Primatene HFA MDI for over-the-counter use. Read more.

Articles in this newsletter written by ACAAI President Michael Foggs, MD, FACAAI, and Warner Carr, MD, FACAAI, prior to this development are still relevant. Read what they have to say and voice your opinion.

lung Allergic disease may reduce lung cancer risk
Asthma, eczema, and hay fever are inversely associated with lung cancer, according to a study in Annals of Allergy, Asthma and Immunology. Scientists at the University of Quebec and the University of Montreal examine the association using data from a population-based case–control study in metropolitan Montreal conducted from 1996 to 2002. Interviewers collected data from 1,169 incident lung cancer cases and 1,486 controls, using separate logistic regression models to estimate the relative risk of lung cancer, in subjects with and without asthma, eczema, or hay fever after adjusting for sociodemographic and lifestyle factors. History of allergic diseases seems to have a protective role in lung cancer incidence, said the authors.
 Businessman sitting on floor in corner of office and covering face with hands Prednisone-dependent severe asthma linked to depression
People with prednisone-dependent severe asthma are more likely to be depressed than people with severe asthma who aren’t prednisone-dependent and people with mild to moderate asthma, according to a study in Respiratory Medicine. Scientists in the Netherlands studied 187 subjects, 67 with prednisone-dependent severe asthma and 47 with non-prednisone severe dependent asthma. Another 73 subjects had mild to moderate asthma. Subjects with prednisone-dependent severe asthma were more than three times more likely to be depressed than non-prednisone dependent subjects with severe asthma, and 3.5 times more likely to be depressed than patients who had mild to moderate asthma.
 nausea Dexamethasone helps acute flare-ups, with less nausea 
Giving children with acute asthma flare-ups one or two doses of dexamethasone in the emergency department provides relief equal to five days of oral prednisone, while also reducing the nausea and vomiting, according to a meta-analysis in Pediatrics. Researchers at Medical College of Wisconsin, Milwaukee, included six emergency department trials in their meta-analysis, with each enrolling from 15 to 272 patients. Significantly fewer patients receiving dexamethasone vomited in the ED or at home after discharge, the authors said.

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A message from ACAAI President Michael B. Foggs, MD, FACAAI

Michael B. Foggs, MD, FACAAI
Dr. Michael B. Foggs

The College is fortunate to have Warner Carr, MD, FACAAI provide us with some important insights about how the U.S. Food and Drug Administration (FDA) deliberates regarding the disposition of over-the-counter versus prescribed medications, using Primatene HFA MDI as an example. Having served as a new drug reviewer for the Pulmonary and Allergy Drug Products division, he has firsthand knowledge about how the FDA reaches its decisions. One should ponder the following questions:

1. Should Primatene HFA MDI be OTC "and" behind-the-counter, requiring users to sign for this medication, with medical providers being notified when patients have requested this medication more than once within a period of 30 days?

2. Should academic medical societies insist that Primatene HFA MDI have a dose counter? Read More

Approval of new inhaled epinephrine HFA MDI: What is the FDA thinking?

Michael B. Foggs, MD, FACAAI
Warner Carr, MD, FACAAI
The approval of inhaled epinephrine in a pressurized HFA metered dose inhaler has spurred a lot of discussion about how this medication should be reintroduced to the United States market. The big question is: Should this product be an over-the-counter product, or should it be only available by prescription? There is an old saying that if you put 10 doctors in a room, you end up with 11 opinions. Read More

Save the date for the ACAAI Annual Meeting in Atlanta, Nov. 6-10

Mary Maier, MD, hosts a screening program during Fourth of July festivities.

Bring a free asthma and allergy screening
to your community

The ACAAI Nationwide Asthma Screening Program public service campaign, now in its 18th year, provides free tools to bring a screening to your community. You can offer a screening at any time during the year at any location, except your office.

The program gives allergists a chance to identify adults and children with breathing difficulties that might be asthma and nasal allergies, and explain how an allergist can help. Read More

   Save the date for the ACAAI Annual Meeting in Atlanta, Nov. 6-10
   Introducing the “Why See an Allergist” Videos
   How to work with local media during spring allergy season
   Foundation launches online donation and new video website features
   Call for entries for the third Alliance Photography Competition
   New HAE You Tube Channel
   Member spotlight on Bradley Chips for Golden Stethoscope Award

FELLOWS-IN-TRAINING (See AllQuestions? Contact your national FIT representative

Board Review Corner
Welcome to the Board Review Corner prepared by Drs. Monica Bhagat and Andrew Nickels, 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 on the top menu bar.

Review Questions: Janeway's Immunobiology 8th Edition by Kenneth Murphy

Chapter 2, Part I (pages 37-52): Innate Immunity: The First Lines of Defense – prepared by Niti Agarwal, MD, New York and Presbyterian Hospital, and Monica Bhagat, MD, University of Pennsylvania
Chapter 2, Part II (pages 53-71): Innate Immunity: The First Lines of Defense – prepared by Hannah Walford, MD, University of California, and Andrew Nickels, MD, Mayo School of Graduate Medical Education


Welcome to the AMA Corner managed and prepared by Alnoor A. Malick, MD, FACAAI, Delegate to the AMA House of Delegates, to keep you abreast of important AMA news and developments impacting allergy-immunology.

   Ensuring physician-led, team-based care a top priority of most medical societies
   Residents’ top concerns include time with patients, care coordination
   Federal panel on EHR meaningful use bombarded with complaints


Your journal club as a marketing effort

Dr. Bobby Lanier
Dr. Bobby Lanier
A very distinguished internist of Indian origin in a finely tailored suit, who has risen to the ranks of CEO of a major health consortium, commented to me during a lecture question and answer session. He said, “We never see you, not in the doctors’ lounge, not in the hospital cafeterias, not at our staff breakfasts. Finding an allergist is like finding the Abominable Snowman.” Read More


Dr. Richard Honsinger
A message from JCAAI President Richard Honsinger, MD, MACP, FACAAI

JCAAI ICD-10 webinar now available online

The Joint Council of Allergy, Asthma and Immunology’s two-part comprehensive webinar series on the 2014 mandatory switch to ICD-10 coding is now available online. Join your more than 500 colleagues who participated in the live presentations and learn how the switch will impact YOUR allergy practice! ICD-10 will be required for all billing beginning October 1. Read More


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