Researchers are unveiling new data on investigational findings in nearly 450 abstracts on the diagnosis and treatment of allergic diseases at the ACAAI Annual Meeting in Miami Beach, Fla., Nov. 5-10. Following are highlights of some key studies:
"Use of Epinephrine for the Treatment of Anaphylaxis by US Emergency Medical Service Personnel in the Pre-Hospital Setting." (Abstract #13: Oral Presentation, Nov. 8 at 2:00 p.m.) - Dana V. Wallace, M.D., Fort Lauderdale, Fla., et al - After determining that the current available and use of epinephrine (Epi) for anaphylaxis by emergency medical services personnel (EMS) in the pre-hospital setting is unknown, the ACAAI Drug and Anaphylaxis Committee surveyed 50 State EMS Medical Directors about the availability and use of Epi for anaphylaxis by EMS in their state. They determined that, although all 50 states have some level of EMS that is allowed to carry either Epi auto-injectors or vials, only 17 states require EMS-Basics to have Epi available, and 15 states do not require any level of EMS to carry Epi for anaphylaxis treatment. The major reasons that EMS do not carry Epi are: 1) lack of training 2) cost of auto-injectors, and 3) legal concerns about inappropriate or incorrect use of Epi. Dr. Wallace is developing programs through ACAAI to assist EMS in their crucial work for the public.
"Long-Term Use of Nasal Saline Irrigation: Harmful or Helpful?" (Abstract #32: Oral Presentation, Nov. 8 at 2:45 p.m.) - Talal M. Nsouli, M.D., Washington, D.C., et al - Despite the common use of nasal saline irrigation (NSI, or Neti Pot) in the treatment of sinus disease, investigators say there has been little statistical evidence to confirm its success. After monitoring 68 patients during a 12-month NSI phase, followed by a 12-month NSI discontinuation (NSID) phase, their statistical analyses revealed a 62.2 percent decrease in the frequency of acute rhinosinusitis during the discontinuation phase. Investigators conclude that, "although NSI has been shown to improve nasal mucociliary clearance, its daily long-term use may result in increased frequency of acute infection by potentially depleting the nose of its immune blanket of mucus. Therefore, the practicing clinician should be aware of this potential unwanted effect of long-term utilization of NSI."
"How to Eat Eggs - Proactive Egg Ingestion in High-risk Patients with Severe Egg Allergy." (Abstract #52: Oral Presentation, Nov. 9 at 1:45 p.m.) - Kazuyo Kuzume, M.D., et al, Ehime, Japan - Investigators performed open challenge testing in 29 high risk patients with severe egg allergy, beginning in a hospital carefully monitored by physicians. Initially, the tests consisted of boiled egg yolk ingested in small amounts that were doubled every 60 minutes, at most three times per day. Once the threshold amount was determined in the hospital, patients took the same dose every day at home for 5 days to 1 month depending on their condition, and then the dose was doubled and food ingestion continued. After they could eat one boiled egg yolk without any reactions for 2 weeks, the challenge test starting with small amounts of whole egg were performed in the same manner. Twenty five patients (86 percent) were able to eat one fourth of cooked whole egg within 10 months, and egg-white specific IgE levels decreased significantly after tolerance induction. Authors conclude this was an effective treatment for high-risk patients with egg allergy.