Analysis of the effectiveness of training school personnel in the management of food allergy and anaphylaxis

Background: Food allergy is a very frequent and increasingly common disease in children and adolescents. It affects quality of life and can even be life-threatening. Given that 10-18% of allergic/anaphylactic food reactions take place in schools, it is essential to provide school personnel with training on the management of reactions. Methods: The Allergy Unit of Hospital Universitario de Fuenlabrada, Spain, organized a conference entitled "Management of Food Allergy in Children and Adolescents in School Centers" during which teachers, cooks, cafeteria monitors, and summer-camp leaders underwent a training course. Attendees filled out a questionnaire with eight questions before and after the course to assess their self-efficacy in management of food allergy and anaphylaxis. The results were compared. Results: A total of 191 people participated (51% dining-room monitors, 24% teachers, 13% cooks, and 12% other professions). The areas in which the attendees presented the lowest confidence before receiving the course were recognition of symptoms and treatment of the reactions/anaphylaxis. The mean score for each of the eight concepts evaluated improved after the training course. This improvement was significant in the management of anaphylaxis. Conclusions: Our study demonstrates the usefulness of a self-efficacy scale in school personnel as a tool to assess the ability to manage food allergy and anaphylaxis. It can help to identify problem areas in which more specific training programs can be implemented

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Analysis of the effectiveness of training school personnel in the management of food allergy and anaphylaxis.

BACKGROUND: Food allergy is a very frequent and increasingly common disease in children and adolescents. It affects quality of life and can even be life-threatening. Given that 10-18% of allergic/anaphylactic food reactions take place in schools, it is essential to provide school personnel with training on the management of reactions. METHODS: The Allergy Unit of Hospital Universitario de Fuenlabrada, Spain, organized a conference entitled "Management of Food Allergy in Children and Adolescents in School Centers" during which teachers, cooks, cafeteria monitors, and summer-camp leaders underwent a training course. Attendees filled out a questionnaire with eight questions before and after the course to assess their self-efficacy in management of food allergy and anaphylaxis. The results were compared. RESULTS: A total of 191 people participated (51% dining-room monitors, 24% teachers, 13% cooks, and 12% other professions). The areas in which the attendees presented the lowest confidence before receiving the course were recognition of symptoms and treatment of the reactions/anaphylaxis. The mean score for each of the eight concepts evaluated improved after the training course. This improvement was significant in the management of anaphylaxis. CONCLUSIONS: Our study demonstrates the usefulness of a self-efficacy scale in school personnel as a tool to assess the ability to manage food allergy and anaphylaxis. It can help to identify problem areas in which more specific training programs can be implemented.

Una causa de disfagia no habitual en la consulta del médico de familia / An unusual cause of dysphagia in the family doctor clinic

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Orina púrpura en bolsa / Purple urine in the bag

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Prevalence of sensitization to lipid transfer proteins and profilins in a population of 430 patients in the south of Madrid.

BACKGROUND: Lipid transfer proteins (LTPs) and profilins are the most important panallergens in the management of patients who are allergic to pollen and plant food in our area. LTPs are highly stable proteins that can induce systemic symptoms after ingestion. Profilins are labile proteins that are present in pollens and vegetables. Considered markers of several types of pollen sensitization, they are responsible for cross-reactivity between pollens and vegetables. The objective of this study was to assess the frequency of sensitization to LTP and profilin using skin prick tests (SPTs) in patients referred to our allergy unit for any complaint (not only pollen and plant food allergy). METHODS: The study sample comprised 430 consecutive patients who were evaluated using their medical history and SPTs with pollen, date palm profilin, and peach extract enriched in Pru p 3 (30 g/mL) as an LTP marker. RESULTS: We found that 52 (12.1%) patients were sensitized to profilin and 53 (12.3%) to LTP. Pollen allergy was diagnosed in 53% and plant food allergy in 11%. In the LTP-sensitized group and the profilin-sensitized group, 37.7% and 34.6% of the patients had plant food allergy, respectively. Thirty-three patients (62.3%) were sensitized to LTP but had no symptoms after eating vegetables. CONCLUSIONS: To the best of our knowledge, this is the first study to analyze the real rate of sensitization to profilin and LTP in a population sensitized to allergens other than pollens and plant foods. Twelve percent of patients were sensitized to both profilin and LTP. A large proportion of LTP-sensitized patients had no symptoms at the time of the study.

Paresia de miembros inferiores de presentación subaguda / Subacute paresis of the lower limbs

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Radiografía ósea

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Hiposudación por topiramato / Low sweat secretion due to topiramate

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[Assessment of ophthalmologic control of the diabetic patient in primary care]. / Evaluación del control oftalmológico del paciente diabético en atención primaria.

OBJECTIVE: To evaluate ophthalmic control in patients with diabetes mellitus (DM) in primary care (PC). DESIGN: Crossover observation study. SETTING: Hellín Health Centre (Albacete). PATIENTS: 137 diabetics selected at random, excluding pregnant women and children under 14. MEASUREMENTS AND MAIN RESULTS: The variables of age, sex, type of diabetes (DM1/DM2), years of evolution, ophthalmic control and appearance of diabetic retinopathy (DR) were studied. Mean age was 68.5 +/- 10.9 years. 52% were women (n = 72). 88% had DM2 (n = 121). Time of evolution from diagnosis was < 5 years in 46% (n = 63), 6-10 years in 23% (n = 32), 11-15 years in 14% (n = 19), > 15 years in 5% (n = 7) and nothing was recorded for 12% (n = 16). 41% (n = 56) of the patients had not had an ophthalmic evaluation. Of the 59% (n = 81) referred to the ophthalmology out-clinic (OOC), 65 patients followed recommendations of the Spanish Society of Retina and Vitreous Humour, and 16 were referred for other reasons, of which cataracts was the most common eye pathology. Of these 81 patients referred to the OOC, 29% did not have DR (n = 23), and 44% did (n = 36). Of this 44%, 14 were light, 15 moderate, 3 severe and 4 proliferating cases. The reports were not sent back to PC in 27% of cases (n = 22). CONCLUSIONS: Ophthalmic referral in PC is still deficient for a large number of DM patients. DR of varying degrees was detected in a high number of cases who did have an ophthalmic check-up. Communication between PC and ophthalmic care concerning diabetic patients must improve.

Evaluación del control oftalmológico del paciente diabético en atención primaria / Evaluation of the ophthalmic control of diabetic patients in primary care

Objetivo. Evaluar el control oftalmológico en pacientes con diabetes mellitus (DM) en atención primaria (AP). Diseño. Estudio observacional, transversal. Emplazamiento. Centro de Salud Hellín (Albacete). Pacientes. Un total de 137 diabéticos, seleccionados aleatoriamente, excluyéndose embarazadas y menores de 14 años. Mediciones. Se estudiaron las variables: edad, sexo, tipo diabetes (DM1/DM2), años evolución, control oftalmológico y aparición de retinopatía diabética (RD). Resultados principales. La edad media fue 68,5 ñ 10,9 años. 52 por ciento mujeres (n = 72); 88 por ciento DM2 (n = 121). El tiempo de evolución desde el diagnóstico fue 15 años del 5 por ciento (n = 7) y en 12 por ciento (n = 16) no aparecía registrado. Al 41 por ciento (n = 56) de los pacientes no se les había realizado evaluación oftalmológica. Del 59 por ciento (n = 81) remitido a consultas externas de oftalmología (CEO), 65 pacientes siguieron recomendaciones de la Sociedad Española de Retina y Vitreo, y 16 fueron derivados por otras causas, de las cuales la patología ocular más frecuente eran cataratas. De los 81 pacientes derivados a CEO, un 29 por ciento no presentó RD (n = 23). En un 44 por ciento había RD (n = 36): 14 leve, 15 moderada, 3 severa y 4 proliferativa. En un 27 por ciento de casos no se remitieron los informes a AP (n = 22). Conclusiones. La derivación oftalmológica de la DM en AP es aún deficiente en un porcentaje importante de pacientes. En un elevado número de casos en los que se realizó una revisión oftalmológica se detectó RD en sus distintos grados. Debe mejorar la comunicación entre AP y atención oftalmológica respecto a los pacientes diabéticos (AU)

[Psychologic morbidity in perimenopause. Concordance of its diagnosis between a primary care team and its referral mental health center]. / Estudio de morbilidad psíquica en la perimenopausia. Concordancia de diagnóstico entre un equipo de atención primaria y su centro de salud mental de referencia.

OBJECTIVES: To determine the most common psychiatric diagnoses and the characteristics of women of menopausal age referred from a Health Centre to their Health Area's Mental Health Centre. DESIGN: A crossover observational study. SETTING: The Mental Health Centre (MHC) and Primary Care Team (PCT) at Barajas (Health Area 4, Madrid). PATIENTS: 88 women between 44 and 55, referred from the PCT to the MHC up to 1st June 1997. VARIABLES STUDIED: definitive diagnoses from the MHC (CIE-9), suspected diagnoses by the PCT, age, marital status, education, psychiatric antecedents (family and/or personal) and family problems. CONCLUSIONS: The commonest psychiatric pathologies were depression and anxiety. The patients' profile is: married woman, primary or lower educational level, without paid work and with family problems. The concordance found reflects the need to improve the psychiatric training of PC doctors.