Allergology in the public health service of the Community of Madrid: Current situation and opportunities in the XXI century public health system [La alergología en el sistema sanitario público de la comunidad de madrid: Situación actual y oportunidades en el sistema sanitario público del siglo xxi]
Ortega J.D.,Hospital Universitario La Paz |
Chivato T.,University of San Pablo - CEU |
De La Hoz B.,Hospital Universitario Ramon y Cajal |
Elices A.,Seccion de Alergologia |
And 4 more authors.
Anales del Sistema Sanitario de Navarra | Year: 2014
The high prevalence of allergic diseases and the use of more complex diagnostic techniques and therapeutic options require allergists to be highly trained professionals and healthcare organizations to be knowledgeable about available structural and human resources. Updated information is lacking in Spain, and current activity indicators do not reflect complexity The present article analyzes the situation of allergology in Madrid and proposes improvements where necessaryThe heads of the allergy departments of public hospitals in Madrid voluntarily completed a purpose-designed survey Data on care activity (2010) and on teaching and research activity (2009-2010) were provided. A SWOT analysis was performed, and strategic lines and proposals for improvement were designed.One hundred and seventeen allergists (41% with a PhD) worked in 24 hospitals with an allergology department (4.6 physicians/center; s3 in 10 hospitals). All the institutions had an outpatient clinic (4,000 first consultations/hospital/year, 36% high-resolution rate; 6200 successive visits/hospital/year) performing complex diagnostic and therapeutic procedures, most of which were not taken into account by activity indicators. Two hospitals had their own hospitalization facilities and 10 were accredited teaching hospitals (2.78 medical residents/ year). The survey revealed that, twice yearly, a typical allergology service participated in 4 research projects, 2 clinical trials, 16 publications and 17 communications at scientific meetings, with notable differences between hospitals.Allergists in Madrid are well prepared. The allergology care structure is adequate, although possibly insufficient. Quality and efficiency can be improved with new tools for recording activity and by increasing coordination and taking advantage of new technologies and geographical proximity. © 2014, Gobierno de Navarra. All rights reserved.
Rodriguez S.F.,University of Extremadura |
Molina R.T.,University of Extremadura |
Palacios I.S.,University of Extremadura |
Garijo A.G.,Seccion de Alergologia
Grana | Year: 2011
Burkard personal samplers for Petri dishes use two air throughput devices, either with a sieve or with a funnel, for monitoring of airborne fungi concentration. These two different methods have been compared in a comparative study. The two personal traps used for comparison were run simultaneously, one equipped with a sieve and one with a funnel only. Possible correlations with rainfall, temperature, wind speed, and relative humidity were studied. The average concentrations were 74 and 339 colony forming units/m 3 (a factor of 4.6 difference) for the funnel and sieve devices, respectively. More than 70 taxa of airborne fungi were identified. The four most important genera in decreasing order of concentration were Cladosporium, Alternaria, Penicillium, and Aspergillus, the last two present in similar concentration. A significant negative correlation with wind speed was detected. Statistical analysis (ANOVA) revealed significant differences between the two sampler types except for Alternaria. In conclusion, the sampler with a sieve provides more colonies than the same sampler with a funnel. Both kinds of samplers are affected by wind speed, with the capture of airborne fungi propagules being reduced as the speed increases. © 2011 Collegium Palynologicum Scandinavicum.
Antolin-Amerigo D.,University of Alcala |
Moreno Aguilar C.,Hospital Universitario Reina Sofia |
Vega A.,Seccion de Alergologia |
Alvarez-Mon M.,University of Alcala
Current Allergy and Asthma Reports | Year: 2014
Venom immunotherapy (VIT) is the most effective form of specific immunotherapy to date. Hitherto, several relevant queries remain unanswered, namely optimal doses, duration, and means of assessment. Important progress has been lately made in terms of diagnosis by means of component-resolved diagnosis. Moreover, basophil activation test results in patients with negative serum immunoglobulin E (IgE) and skin prick test confer this technique a promising future, although these outcomes shall be considered with caution. This review aims to unravel the important advances made on diagnosis, management, and prognosis and also focuses on several undetermined aspects of VIT. © 2014 Springer Science+Business Media.
Perez De Llano L.A.,Servicio de Neumologia |
Carballada Gonzalez F.,Seccion de Alergologia |
Castro Anon O.,Servicio de Neumologia |
Pizarro Perea M.,Servicio de Hematologia |
And 2 more authors.
Archivos de Bronconeumologia | Year: 2010
Introduction: The coexistence of potentially aggravating processes is common in asthmatics, particularly in patients with difficult control.The primary aim of this study is to ascertain whether comorbidity id more common in uncontrolled patients. As a secondary aim, we propose to evaluate the correlation between the asthma control test (ACT) and the fraction of exhaled nitric oxide (FENO). Patient and methods: A prospective, observational study comparing the function and clinical picture of two groups of asthmatics: controlled (ACT≥20) and uncontrolled (ACT<20). They were all assessed for, smoking, rhinosinusitis, obesity, anxiety, depression, vocal cord dysfunction, gastro-oesophageal reflux (GORD), allergic bronchopulmonary aspergillosis (ABPA), COPD and nasal polyps. Results: A total of 50 patients with controlled asthma and 102 with suboptimal control were included. The patients with an ACT≥20 had better lung function, less variation in PEF, less bronchial hyper-reactivity and lower FENO values.Comorbidities were found in 95% of the controlled asthmatics and in 97% of the uncontrolled. Only the presence of nasal polyps, GORD and ABPA was more frequent in the uncontrolled group. However, the simultaneous presence of 3 or more comorbidity factors was significantly more frequent in patients with sub-optimal control (P=0.01).There was no significant correlation between the FENO and the ACT values (rho=-0.08; P=0.32). Conclusions: Aggravating comorbidities are more common in patients with sub-optimal control. There was no correlation between the FENO and the ACT values. © 2009 SEPAR.
Prieto L.,University of Valencia |
Orosa B.,Servicio de Neumologia |
Barato D.,Seccion de Alergologia |
Marin J.,University of Valencia
Journal of Asthma | Year: 2011
Background. Exhaled breath condensate (EBC) pH has been considered as a biomarker of airway inflammation in asthma. However, little information is available on the duration of argon deaeration required to achieve a stable pH in EBC samples. Objective. To identify differences in EBC pH after argon deaeration for 2, 4, and 8 min. Methods. EBC pH was determined in EBC samples from 48 subjects with allergic rhinitis (11 asthmatics) and 14 healthy volunteers without deaeration and after argon deaeration for 2, 4, and 8 min. Results. The mean (95% CI) pH values obtained from samples analyzed after 4 min [7.66 (7.52-7.80)] and 8 min [7.70 (7.55-7.85)] of argon deaeration were significantly less acidic (p < .001) than those identified after 2 min of deaeration [7.53 (7.40-7.66)]; differences between pH values at 4 and 8 min were not significant. Furthermore, changes in EBC pH of nondeaerated samples after 4 and 8 min of deaeration were significantly greater than those after 2 min, the mean difference being 0.11 (95% CI, 0.02-0.20, p °< .05) and 0.13 (95% CI, 0.04-0.22, p °< .01), respectively; differences between changes at 4 and 8 min were not significant. Conclusions. Stabilization of EBC pH is achieved after argon deaeration for 4 min. Therefore, this deaeration period may be recommended instead of the 7-8 min used in several studies. © 2011 Informa Healthcare USA, Inc.