Continuing Medical Education: an international reality.

We are all aware today of the growing interest in continuing medical education (CME) programmes in many European Countries and it is important to understand why and how CME could become an international reality. It is obvious that patients need a good doctor--the best possible--as far as medical knowledge, attention to the patient's quality of life and cost-control is concerned. All European health care systems have to take into consideration everything that causes patient dissatisfaction, risk management and unjustified expenses. An example is the increase of claims and complaints against doctors and the strong attention of patients to medical procedures. In other words, medicine worldwide is becoming a service industry and has to consider quality and quantity of performances as well as to pay attention to personal responsibility. The object of our work is to evaluate the CME systems present in Europe, to show the work done on CME by the CME Committee of the European Academy of Allergology and Clinical Immunology and to highlight the Consensus Report on CME approved by an international panel of CME experts.

Nutritional triggers in asthma.

Food and food additive triggers play an important role in approximately 5-8% of all asthma cases. Exact epidemiological data are lacking, partly because the etiological link is not always obvious, the diagnosis of food hypersensitivity is often complicated and ambiguous, food triggers usually act in concert with other trigger(s), and intraspecies and intrabotanic cross-reactivities between inhalant and nutritional allergens can make the time-course of the symptoms confusing. The participation of airway symptoms in food allergy goes up to 40%. Relevant diagnosis can only be established by the combination of procedures used for both food allergy and asthma. In the therapy avoidance measures are of great importance besides usual asthma therapy, and probably in combination with the reduction of gut permeability.