Twitter Updates from the Severe Asthma Workshop at the 2008 Annual Meeting of American College of Allergy, Asthma & Immunology (ACAAI)

Twitter is a microblogging service where people answer the question “What are you doing?” via 140-character messages from their cellphone, laptop or desktop. The service can also be used to collect notes and ideas or to report from a medical conference. I have already explored the same communication channel while attending the NEJM Horizons Conference in October and the reports were generally met with approval by both the meeting participants and bloggers from around the world. This experience encouraged me to make the first attempt at using Twitter to post updates from the 2008 Annual Meeting of American College of Allergy, Asthma & Immunology (ACAAI). I attended the meeting to present our project AllergyCases.org to the program directors and fellows and to discuss 2 posters.

In order to make the Twitter postings (or “tweets”) easily searchable, I included the hash tag “#ACAAI” with each tweet from the meeting. You can search Twitter for “#ACAAI” to find tagged updates from any participants who used Twitter to report from the ACAAI meeting.

The short updates from the workshop about treating severe asthma were posted in real time on Twitter at an interval of every 3-5 minutes. After the workshop, I used my cell phone and the mobile Twitter interface to discuss the asthma updates with several fellows during and after the ACAAI meeting.

The oldest post is at the bottom, the newest at the top:

#ACAAI Severe Asthma: AAF pts have more ER visits and hospitalizations for multiple reasons: poverty, obesity, no PCP, cockroach exposure… 7:04 PM Nov 8th from web

#ACAAI Severe Asthma: Theophylline pendulum may be swinging back — useful again? 6:57 PM Nov 8th from web

#ACAAI Severe Asthma: No response to oral steroids? Consider GERD. 6:51 PM Nov 8th from web

#ACAAI Severe Asthma: Maximal dose of oral steroids beyond which there is no effect? 60 mg po qd. 6:51 PM Nov 8th from web

#ACAAI Severe Asthma: Older papers – methylprednisolone may “get into the lungs” better than prednisone – consider different steroid… 6:48 PM Nov 8th from web

#ACAAI Severe Asthma: Macrolides may be considered if nothing else helps. May have steroid-sparing effect. 6:47 PM Nov 8th from web

#ACAAI Severe Asthma: Clarithromycine tx for months is used in “infectious asthma” – studies ongoing. 6:45 PM Nov 8th from web

#ACAAI Severe Asthma: Monitor LFTs in Zileuton therapy. 6:44 PM Nov 8th from web

#ACAAI Severe Asthma: Zileuton is not the same as Singulair or Accolate. Works in a different way. 6:43 PM Nov 8th from web

#ACAAI Severe Asthma: Strategies for “SABA abuser” (Albuterol 18 x day), no response to ICS+LABA+LTRA? Consider zileuton and Xolair. 6:42 PM Nov 8th from web

#ACAAI Severe Asthma: FEV1 cutoff below which you don’t use Xolair for fear they won’t tolerate anaphylaxis? Some use 50-70% similar to SCIT 6:38 PM Nov 8th from web

#ACAAI Severe Asthma: Pts on Xolair tx – nasal polyps can get better. Nasal polyps are a heterogeneous disease like asthma. 6:32 PM Nov 8th from web

#ACAAI Severe Asthma: When do you give up on using Xolair? How long do you try? 4-6 months. 6:30 PM Nov 8th from web

#ACAAI Severe Asthma: There is no way to predict which patient will benefit from Xolair. 6:29 PM Nov 8th from web

#ACAAI Severe Asthma: Several attendees share experience with using Xolair in pts with IgE higher than 700. 6:28 PM Nov 8th from web

#ACAAI Severe Asthma: How do you monitor Xolair tx in pts with very high IgE? Monitor PFTs. Checking IgE levels is useless in these patients 6:26 PM Nov 8th from web

#ACAAI Severe Asthma: Xolair and IgE of 4k? Classic wisdom: Xolair will not bind enough IgE to be effective. Some pts still respond however 6:25 PM Nov 8th from web

#ACAAI Severe Asthma: Xolair use in pts with very high IgE (4-5 k)? Anecdotal evidence: it may help. Use the highest dose calculated for 700 6:23 PM Nov 8th from web

#ACAAI Severe Asthma: Treat GERD, if no response for a month, try doubling the dose. Don’t give up if no response at the lower dose. 6:19 PM Nov 8th from web

#ACAAI Severe Asthma: GERD – Beta agonists and theophylline relax GE sphincter which may exacerbate GERD and make asthma worse. 6:18 PM Nov 8th from web

#ACAAI Severe Asthma: Obesity – Losing weight (diet or surgery) changes metacholine sensitivity. Losing wt improves asthma in obese pts. 6:15 PM Nov 8th from web

#ACAAI Severe Asthma: What is behind the connection between obesity and asthma? Can diet play a role? 6:12 PM Nov 8th from web

#ACAAI Severe Asthma: Workshop shifts to Q&A brought by the participants. 6:11 PM Nov 8th from web

#ACAAI Severe Asthma: With genetics, we may be able to tailor-make the therapy to individual patients rather than blindly follow guidelines. 6:10 PM Nov 8th from web

#ACAAI Severe Asthma: Vit D deficiency could be a risk factor of asthma but there is not enough data to make a final conclusion. 6:07 PM Nov 8th from web

#ACAAI Severe Asthma: Ciclesonide is the new ICS. Activated by esterase in target tissues. Less suppression of HPA than other ICS – FP/BUD 6:05 PM Nov 8th from web

#ACAAI Severe Asthma: Xolair decreases hospitalizations in pts on moderate dose ICS. 6:04 PM Nov 8th from web

#ACAAI Severe Asthma: Omega-3 FA, fish oil may be beneficial in children. 6:02 PM Nov 8th from web

#ACAAI Severe Asthma: Lactose is added or removed from DPIs, check contents of each inhaler. 6:00 PM Nov 8th from web

#ACAAI Severe Asthma: Consider lactose sensitivity in pts who don’t respond to Advair or Symbicort. Check contents of each inhaler. 5:59 PM Nov 8th from web

#ACAAI Severe Asthma: Consider GERD if asthmatic pts don’t respond to medications. 5:58 PM Nov 8th from web

#ACAAI Severe Asthma: Asthma in 30% pts of pts with chronic asthma. 5:57 PM Nov 8th from web

#ACAAI Severe Asthma: Sinusitis in 75% of pts with moderate asthma. 5:57 PM Nov 8th from web

#ACAAI Severe Asthma: Link between sinusitis and asthma. 5:56 PM Nov 8th from web

#ACAAI Severe Asthma: Treat co-morbid conditions – rhinitis, sinusitis, GERD – “One airway disease” 5:55 PM Nov 8th from web

#ACAAI Severe Asthma: Some pts may have airway irritation from the delivery system, e.g. dry powder inhalants. Listen to pts… 5:53 PM Nov 8th from web

#ACAAI Severe Asthma: A subpopulation of patients may benefit from erythromycin or other ABx. 5:52 PM Nov 8th from web

#ACAAI Severe Asthma: Is asthma an infectious disease? 5:50 PM Nov 8th from web

#ACAAI “Some asthmatics don’t respond to ICS, so why try them at all?” but this is not what the guidelines say with their stepwise approach. 5:49 PM Nov 8th from web

#ACAAI Since 1976: Asthma is a heterogeneous disease, but this is not reflected in the guidelines. 5:47 PM Nov 8th from web

#ACAAI Attending the workshop Treating the severe asthmatic patient. 5:45 PM Nov 8th from web

#ACAAI As far as I know, this will be the first ACAAI meeting reflected on Twitter.

#ACAAI The #ACAAI tag means you will be able to find the tagged posts on Twitter Search http://search.twitter.com/

#ACAAI Going to the annual ACAAI meeting. I have 2 posters and 1 website presentation. Will be updating Twitter with the tag #ACAAI

Peanuts, Peanut Products Cause Most Severe Food Allergy Reactions In Children

Main Category: Allergy
Article Date: 09 Jul 2013 – 1:00 PDT Current ratings for:
Peanuts, Peanut Products Cause Most Severe Food Allergy Reactions In Children

Raise your hand if you like peanut butter. Most of us raise our hands, but some are forced to keep theirs down. They’re allergic.

Food allergies affect nearly 10 percent of children younger than 4-years-old, and the peanut allergy causes the most severe reactions. Exposure to even trace quantities of peanuts can lead to a fatal reaction called anaphylaxis, causing breathing problems and heart arrhythmias that can lead to sudden death.

Only 20 percent of kids grow out of it, so if it’s not you, chances are someone around you deals with a peanut allergy. There are more people with peanut allergies than ever before[1]. Rather than make jokes about those missing the joy of PB&J, let’s see what we can do to help.

Paranoid over Peanuts. Thanks to George Washington Carver (who found 300 new uses for the legume) we now have peanuts everywhere, and some sufferers aren’t sure how close in contact they can get.

Thirty kids, ranging from 4 to 15, with documented peanut allergies were challenged by casual exposure to peanut butter. Their previous reactions stemmed from being kissed by someone who ate peanut butter, being near PB&J sandwiches, even being exposed to peanut breath.

In the study, dishes were prepared with a scoop of peanut butter and placed alongside tuna and mint extract to hide the peanut odor. Other dishes replaced the peanut butter with soy butter as a placebo test. The dishes were covered with gauze and held to the kids’ noses for 10 minutes. For an hour, they were watched for reactions.

No one exposed to the peanut butter had a reaction. One person reported an itch on the roof of the mouth, but it was provoked by the placebo test and resolved spontaneously. Based on this, researchers found it unlikely that the smell of peanuts triggers an allergic reaction.

Another large study of 4,685 peanut-allergic individuals found only 1 percent reported reactions to airborne peanut dust, 91 percent reported ingestion was the culprit. This should be somewhat reassuring that the smell of peanuts is likely not harmful.

Butter Clean Up. A pinch of nuts on the tongue is enough to cause a reaction. The common peanut, Arachis hypogaea, has eight different protein allergens named after its scientific name, from Ara h1 to Ara h8. Some people are allergic to one, and some to all eight, so wiping up the peanut butter becomes important. A study showed liquid and bar soap cleans Ara h1 just fine, but antibacterial hand-sanitizer left traces on 6 of 12 hands[2]. Most household cleaning agents were sufficient in cleaning tables.

Symptoms alert. Reactions typically occur within 20 minutes of exposure and can range from itchy skin (most common) to GI complaints (least common). Asthma reactions (coughing, wheezing) or anaphylaxis are the most serious. Ingesting nuts is the most common cause, and rarely does skin contact cause a problem.

A third of people will have a second reaction from the exposure 1-8 hours after the first reaction has resolved. Allergic people should wear MedicAlert bracelets and have injectable epinephrine (e.g., EpiPen) readily available.

If you’re peanut allergy free, do what you can to help those less fortunate avoid the risks and just enjoy the jelly.

Through world-class research and patient care, UNMC generates breakthroughs that make life better for people throughout Nebraska and beyond. Its education programs train more health professionals than any other institution in the state. Learn more at unmc.edu.

Written by Michael Huckabee, Ph.D., professor and director of the University of Nebraska Medical Center physician assistant program

Article adapted by Medical News Today from original press release. Click ‘references’ tab above for source.
Visit our allergy section for the latest news on this subject. Please use one of the following formats to cite this article in your essay, paper or report:

MLA

Huckabee, Michael. “Peanuts, Peanut Products Cause Most Severe Food Allergy Reactions In Children.” Medical News Today. MediLexicon, Intl., 9 Jul. 2013. Web.
24 Jul. 2013. APA

Please note: If no author information is provided, the source is cited instead.

posted by S Z Berg on 10 Jul 2013 at 7:56 am

Peanuts, Peanut Products Cause Most Severe Food Allergy Reactions In Children misinforms the public. Peanuts and peanut products do not cause the most severe food allergy reactions in children. Severity depends upon how allergic a child is. Anaphylactic reactions are not limited to peanuts.

S.Z. Berg
Award-winning Journalist
Blogger, The Huffington Post
Credits: New York Times, Washington Post, TheStreet.com,
Consumer Reports, Consumers Digest, The Scientist, Marie Claire, and others
Member, American Society of Journalists and Authors

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