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International Archives of Allergy and Immunology : Last 20 articles
Front & Back Matter
Wed, 01 Feb 2012 00:00:00 +0100
Int Arch Allergy Immunol 2012;157:X (DOI:10.1159/000336950)
The Loss of Smell in Persistent Allergic Rhinitis Is Improved by Levocetirizine due to Reduction of Nasal Inflammation but Not Nasal Congestion (the CIRANO Study)
Thu, 26 Jan 2012 00:00:00 +0100
Int Arch Allergy Immunol 2012;158:184–190 (DOI:10.1159/000331329)
Multiorgan Infiltration by CD8+ T Cells and 1p;16p Translocation in a Patient with Hypogammaglobulinemia and a Reduced Number of B Cells
Thu, 26 Jan 2012 00:00:00 +0100
Int Arch Allergy Immunol 2012;158:206–210 (DOI:10.1159/000331117)
Surgical Endoscopy (Online First™)
Training in laparoscopic colorectal surgery: a new educational model using specially embalmed human anatomical specimen
Sat, 28 Jan 2012 06:43:05 -0000
Abstract Background With an increasing percentage of colorectal resections performed laparoscopically nowadays, there is more emphasis on training “before the job” on operative skills, including the comprehension of specific laparoscopic surgical anatomy. As integration of technical skills with correct interpretation of the anatomical image must be incorporated in laparoscopic training, a human specimen training model with special emphasis on surgical anatomy was developed. Methods The new embalming method Anubifix™ combines long-term high-quality embalming of human bodies with almost normal flexibility and plasticity, and the body can be kept operational as long as conventionally embalmed human specimens. A colorectal training model was created in a specimen in which anatomical landmarks of colorectal anatomy were permanently colored to explore laparoscopic colorectal anatomy in a skills training setting. Airtight closure of the abdominal wall permits the creation of pneumoperitoneum. Residents were asked to test the model by mobilizing the small and large bowels and expose the central vessels and ureters. Afterward they were asked to fill out an eight-item questionnaire about the model. Results Eleven surgical residents in their first and second year of training participated. Responses to the questionnaire showed that a majority of residents considered the model to be representative of the real situation and superior to animal models or virtual reality simulators, and helped to improve the knowledge of three-dimensional anatomy and laparoscopic skills. Conclusion The new training model for laparoscopic colorectal surgery proved to be a high-quality tool, concentrating on laparoscopic colorectal anatomy in a skills training setting. We believe it may be a valuable adjunct to residency training programs based on the principle of “training before the job.” Content Type Journal ArticlePages 1-6DOI 10.1007/s00464-012-2158-yAuthors Juliette C. Slieker, Department of Surgery, Erasmus University Medical Center, Rotterdam, The NetherlandsHilco P. Theeuwes, Department of Anatomy and Neurosciences, Erasmus University Medical Center, Rotterdam, The NetherlandsGöran L. van Rooijen, Department of Anatomy and Neurosciences, Erasmus University Medical Center, Rotterdam, The NetherlandsJohan F. Lange, Department of Surgery, Erasmus University Medical Center, Rotterdam, The NetherlandsGert-Jan Kleinrensink, Department of Anatomy and Neurosciences, Erasmus University Medical Center, Rotterdam, The Netherlands Journal Surgical EndoscopyOnline ISSN 1432-2218Print ISSN 0930-2794
Educational and training aspects of new surgical techniques: experience with the endoscopic–laparoscopic interdisciplinary training entity (ELITE) model in training for a natural orifice translumenal endoscopic surgery (NOTES) approach to appendectomy
Sat, 28 Jan 2012 06:43:05 -0000
Abstract Background Natural orifice translumenal endoscopic surgery (NOTES) is a new surgical concept that requires training before it is introduced into clinical practice. The endoscopic–laparoscopic interdisciplinary training entity (ELITE) is a training model for NOTES interventions. The latest research has concentrated on new materials for organs with realistic optical and haptic characteristics and the possibility of high-frequency dissection. This study aimed to assess both the ELITE model in a surgical training course and the construct validity of a newly developed NOTES appendectomy scenario. Methods The 70 attendees of the 2010 Practical Course for Visceral Surgery (Warnemuende, Germany) took part in the study and performed a NOTES appendectomy via a transsigmoidal access. The primary end point was the total time required for the appendectomy, including retrieval of the appendix. Subjective evaluation of the model was performed using a questionnaire. Subgroups were analyzed according to laparoscopic and endoscopic experience. Results The participants with endoscopic or laparoscopic experience completed the task significantly faster than the inexperienced participants (p = 0.009 and 0.019, respectively). Endoscopic experience was the strongest influencing factor, whereas laparoscopic experience had limited impact on the participants with previous endoscopic experience. As shown by the findings, 87.3% of the participants stated that the ELITE model was suitable for the NOTES training scenario, and 88.7% found the newly developed model anatomically realistic. Conclusions This study was able to establish face and construct validity for the ELITE model with a large group of surgeons. The ELITE model seems to be well suited for the training of NOTES as a new surgical technique in an established gastrointestinal surgery skills course. Content Type Journal ArticleCategory Endoluminal SurgeryPages 1-7DOI 10.1007/s00464-012-2165-zAuthors Sonja Gillen, Department of Surgery, Klinikum rechts der Isar, Technische Universität München, Ismaninger Strässe 22, 81675 München, GermanyJörn Gröne, Department of Surgery, Charité–Campus Benjamin Franklin, Berlin, GermanyFritz Knödgen, Research Group MITI, Minimally Invasive Therapy and Intervention, Munich, GermanyPetra Wolf, Institute of Medical Statistics and Epidemiology, Technische Universität München, Ismaninger Strässe 22, 81675 München, GermanyMichael Meyer, Research Institute of Leather and Plastic Sheeting, FILK, Freiberg, GermanyHelmut Friess, Department of Surgery, Klinikum rechts der Isar, Technische Universität München, Ismaninger Strässe 22, 81675 München, GermanyHeinz-Johannes Buhr, Department of Surgery, Charité–Campus Benjamin Franklin, Berlin, GermanyJörg-Peter Ritz, Department of Surgery, Charité–Campus Benjamin Franklin, Berlin, GermanyHubertus Feussner, Department of Surgery, Klinikum rechts der Isar, Technische Universität München, Ismaninger Strässe 22, 81675 München, GermanyKai S. Lehmann, Department of Surgery, Charité–Campus Benjamin Franklin, Berlin, Germany Journal Surgical EndoscopyOnline ISSN 1432-2218Print ISSN 0930-2794
Endoscopic treatment of large colorectal tumors: comparison of endoscopic mucosal resection, endoscopic mucosal resection–precutting, and endoscopic submucosal dissection
Thu, 26 Jan 2012 06:55:34 -0000
Abstract Background Endoscopic mucosal resection (EMR) is a useful therapeutic technique for colorectal tumors. However, for tumors larger than 20 mm, the chance of piecemeal resection is high. Recently introduced endoscopic submucosal dissection (ESD) enables en bloc resection regardless of the tumor size. This study aimed to compare the effectiveness and outcomes of EMR, EMR-precutting (EMR-P), and ESD in the treatment of colorectal tumors 20 mm in size or larger. Methods This study reviewed 523 nonpedunculated colorectal tumors (499 patients) 20 mm or larger that received endoscopic treatment (EMR in 140 cases, EMR-P in 69 cases, and ESD in 314 cases) from January 2004 to November 2009. Results The mean sizes of the tumors were 21.7 ± 3.5 mm (EMR), 23.5 ± 5.6 mm (EMR-P), and 28.9 ± 12.7 mm (ESD). The ratios of adenocarcinomas were 15.7% (EMR), 29% (EMR-P), and 37.9% (ESD). The en bloc resection rates were 42.9% (EMR), 65.2% (EMR-P), and 92.7% (ESD), and the complete resection rates were 32.9% (EMR), 59.4% (EMR-P), and 87.6% (ESD). Perforation occurred in 2.9% of the EMR-P cases and 8% of the ESD cases. The recurrence rates were 25.9% (EMR; median follow-up period, 26 months), 3.2% (EMR-P; median follow-up period, 16 months), and 0.8% (ESD; median follow-up period, 17 months). Conclusion For the treatment of large, nonpedunculated colorectal tumors, ESD is more effective than either EMR or EMR-P. Although ESD is technically demanding, it has clinical significance by overcoming the limitations of both EMR and EMR-P. Content Type Journal ArticlePages 1-11DOI 10.1007/s00464-012-2164-0Authors Eun-Jung Lee, Department of Surgery, Daehang Hospital, 481-10 Bangbae Seocho, Seoul, 137-820 KoreaJae Bum Lee, Department of Surgery, Daehang Hospital, 481-10 Bangbae Seocho, Seoul, 137-820 KoreaSuk Hee Lee, Department of Pathology, Daehang Hospital, Seoul, KoreaEui Gon Youk, Department of Surgery, Daehang Hospital, 481-10 Bangbae Seocho, Seoul, 137-820 Korea Journal Surgical EndoscopyOnline ISSN 1432-2218Print ISSN 0930-2794
Laparoscopic splenectomy and azygoportal disconnection with intraoperative splenic blood salvage
Thu, 26 Jan 2012 06:55:34 -0000
Abstract Background Intraoperative blood salvage can reduce or avoid perioperative allogeneic blood transfusion. Salvaging the blood in the portal hypertension-induced enlarged spleen becomes an issue of concern during devascularization surgery because an enlarged spleen accommodates a large red cell pool. We report 20 cases of laparoscopic splenectomy and azygoportal disconnection and present the advantages of the use of intraoperative splenic blood salvage during the procedure. Methods A total of 20 cirrhotic patients with esophagogastric variceal bleeding refractory to treatment with β-blockers and endoscopic therapy were studied. Laparoscopic splenectomy with azygoportal disconnection was performed. During the procedure, an intraoperative autologous blood salvage device recovered the splenic blood. The perioperative data were recorded from various viewpoints. Results The operative time was 3.1 ± 0.3 h and the blood loss was 70.5 ± 32.5 ml. The weight of the excised and morcellated spleen was 826.0 ± 155.1 g. The volume of autotransfused blood was 541.0 ± 150.4 ml. No patient received a perioperative allogeneic blood transfusion. There were no significant complications either intraoperatively or postoperatively. The hemoglobin value increased from 9.3 ± 0.8 to 11.5 ± 1.1 g/dl at postoperative day 1 (p < 0.01). During a postoperative follow-up period of 18.0 ± 9.0 months for 18 patients, neither esophageal variceal bleeding nor encephalopathy recurred. Conclusion Laparoscopic splenectomy with azygoportal disconnection is a feasible, effective, and safe surgical method for the treatment of bleeding portal hypertension. Intraoperative splenic blood salvage can avoid the risk associated with allogeneic transfusion during the procedure, with an advantage of significantly increased postoperative hemoglobin levels. Content Type Journal ArticlePages 1-7DOI 10.1007/s00464-012-2159-xAuthors Yuedong Wang, Department of General Surgery, Zhejiang Provincial People’s Hospital, 158 Shangtang Rd, Hangzhou, 310014 ChinaYun Ji, Department of General Surgery, Zhejiang Provincial People’s Hospital, 158 Shangtang Rd, Hangzhou, 310014 ChinaYangwen Zhu, Department of General Surgery, Zhejiang Provincial People’s Hospital, 158 Shangtang Rd, Hangzhou, 310014 ChinaZhijie Xie, Department of General Surgery, Zhejiang Provincial People’s Hospital, 158 Shangtang Rd, Hangzhou, 310014 ChinaXiaoli Zhan, Department of General Surgery, Zhejiang Provincial People’s Hospital, 158 Shangtang Rd, Hangzhou, 310014 China Journal Surgical EndoscopyOnline ISSN 1432-2218Print ISSN 0930-2794
Nerve-sparing laparoscopic eradication of deep endometriosis with segmental rectal and parametrial resection: the Negrar method. A single-center, prospective, clinical trial
Thu, 26 Jan 2012 06:55:34 -0000
Abstract Background The weight of surgical radicality, together with a lack of anatomical theoretical basis for surgery and inappropriate practical skills, can lead to serious impairments to bladder, rectal, and sexual functions after laparoscopic excision of deep infiltrating endometriosis. Although the “classical” laparoscopic technique for endometriosis excision involving segmental bowel resection has proven to relieve symptoms successfully, it is hampered by several postoperative long-term and/or definitive pelvic dysfunctions. Methods In this prospective cohort study, we compare the laparoscopic nerve-sparing approach to the classical laparoscopic procedure in a series of 126 cases. Satisfactory data for bowel, bladder, and sexual function were considered as primary endpoints. Results A total of 126 patients were considered for analysis: 61 treated with nerve-sparing radical excision of pelvic endometriosis with segmental bowel resection (group B), and 65 treated with the classical technique (group A). Intraoperative, perioperative, and postoperative complications were similar between the two groups. Mean days of self-catheterization were significantly lower in the nerve-sparing group (39.8 days) compared with the non-nerve-sparing group (121.1 days; p < 0.001). The relapse rate within 12 months after surgery was comparable between the two groups. Patients of group A suffered from urinary retention more frequently between 1 and 6 months (p = 0.035) compared with group B and did not experience any improvement between 6 months and 1 year (p = 0.018). Overall detection of severe bladder/rectal/sexual dysfunctions was significantly different between the two groups, and 56 patients of group A (86.2%) reported a significantly higher rate of severe neurologic pelvic dysfunctions vs. 1 patient (1.6%) of group B (p < 0.001). Conclusions Our technique appears to be feasible and offers good results in terms of reduced bladder morbidity and apparently higher satisfaction than the classical technique. Considering that this kind of surgery requires uncommon surgical skills and anatomical knowledge, we believe that it should be performed only in selected reference centers. Content Type Journal ArticlePages 1-17DOI 10.1007/s00464-012-2153-3Authors Marcello Ceccaroni, Division of Gynecologic Oncology, International School of Surgical Anatomy, Sacred Heart Hospital, “Ospedale Sacro Cuore-Don Calabria”, Via Don A.Sempreboni no. 5, 37024 Negrar, VR, ItalyRoberto Clarizia, Division of Gynecologic Oncology, International School of Surgical Anatomy, Sacred Heart Hospital, “Ospedale Sacro Cuore-Don Calabria”, Via Don A.Sempreboni no. 5, 37024 Negrar, VR, ItalyFrancesco Bruni, Division of Gynecologic Oncology, International School of Surgical Anatomy, Sacred Heart Hospital, “Ospedale Sacro Cuore-Don Calabria”, Via Don A.Sempreboni no. 5, 37024 Negrar, VR, ItalyElisabetta D’Urso, Department of Obstetrics and Gynecology, European Gynecology Endoscopy School, Sacred Heart Hospital, Negrar, VR, ItalyMaria Lucia Gagliardi, Department of Obstetrics and Gynecology, A. Gemelli University Hospital, Catholic University of Sacred Heart, Rome, ItalyGiovanni Roviglione, Division of Gynecologic Oncology, International School of Surgical Anatomy, Sacred Heart Hospital, “Ospedale Sacro Cuore-Don Calabria”, Via Don A.Sempreboni no. 5, 37024 Negrar, VR, ItalyLuca Minelli, Department of Obstetrics and Gynecology, European Gynecology Endoscopy School, Sacred Heart Hospital, Negrar, VR, ItalyGiacomo Ruffo, Division of Gynecologic Oncology, International School of Surgical Anatomy, Sacred Heart Hospital, “Ospedale Sacro Cuore-Don Calabria”, Via Don A.Sempreboni no. 5, 37024 Negrar, VR, Italy Journal Surgical EndoscopyOnline ISSN 1432-2218Print ISSN 0930-2794
Use of fibrin sealant (Tisseel/Tissucol) in hernia repair: a systematic review
Thu, 26 Jan 2012 06:55:34 -0000
Abstract Background Abdominal wall and inguinal hernia repair are the most frequently performed surgical procedures in the United States and Europe. However, traditional methods of mesh fixation are associated with a number of problems including substantial risks of recurrence and of postoperative and chronic pain. The aim of this systematic review is to summarize the clinical safety and efficacy of Tisseel/Tissucol fibrin sealant for hernia mesh fixation. Methods A PubMed title/abstract search was conducted using the following terms: (fibrin glue OR fibrin sealant OR Tisseel OR Tissucol) AND hernia repair. The bibliographies of the publications identified in the search were reviewed for additional references. Results There were 36 Tisseel/Tissucol studies included in this review involving 5,993 patients undergoing surgery for hernia. In open repair of inguinal hernias, Tisseel compared favorably with traditional methods of mesh fixation, being associated with shorter operative times and hospital stays and a lower incidence of chronic pain. Similarly, after laparoscopic/endoscopic inguinal hernia repair, Tisseel/Tissucol was associated with less use of postoperative analgesics and less acute and chronic postoperative pain than tissue-penetrating mesh-fixation methods. Other end points of concern to surgeons and patients are the risks of inguinal hernia recurrence and of complications such as hematoma formation and intraoperative bleeding. Comparative studies show that Tisseel/Tissucol does not increase the risk of these outcomes and may, in fact, decrease the risk compared with tissue-penetrating fixation methods. When used in the repair of incisional hernias, Tisseel/Tissucol significantly decreased both postoperative morbidity and duration of hospital stay. Conclusions Clinical evidence published to date supports the use of Tisseel/Tissucol as an option for mesh fixation in open and laparoscopic/endoscopic repair of inguinal and incisional hernias. Guidelines of the International Endohernia Society recommend fibrin sealant mesh fixation, especially in inguinal hernia repair. Nonfixation is reserved for selected cases. Content Type Journal ArticleCategory ReviewPages 1-10DOI 10.1007/s00464-012-2156-0Authors René H. Fortelny, Department of General, Visceral and Oncological Surgery, Wilhelminenspital, Vienna, AustriaAlexander H. Petter-Puchner, Ludwig Boltzmann Institute for Experimental and Clinical Traumatology, Vienna, AustriaKarl S. Glaser, Department of General, Visceral and Oncological Surgery, Wilhelminenspital, Vienna, AustriaHeinz Redl, Ludwig Boltzmann Institute for Experimental and Clinical Traumatology, Vienna, Austria Journal Surgical EndoscopyOnline ISSN 1432-2218Print ISSN 0930-2794
pubmed: 1088-5412
Recurrent diarrhea in a 26-year-old man.
Baker TW, Stokes S, Clawson J, Garrett T, Sacha JJ, Gonzalez-Reyes E Recurrent diarrhea in a 26-year-old man. Allergy Asthma Proc. 2011 Nov;32(6):482-5 Authors: Baker TW, Stokes S, Clawson J, Garrett T, Sacha JJ, Gonzalez-Reyes E Abstract This is a case report of a 26-year-old healthy man with chronic diarrhea for 2 years. He was initially believed to have irritable bowel syndrome by his primary care physician after all stool studies yielded negative results. His symptoms persisted, which prompted a referral to a gastroenterology specialist. The patient's esophagogastroduodenoscopy revealed variable villous blunting and a paucity of CD 138 plasma cells, which helped reveal the final diagnosis. This cases illustrates a unique presentation of a common primary immunodeficiency that allergy/immunology specialists, along with primary care specialists, will likely encounter. PMID: 22221444 [PubMed - in process]
Characterization of patients with suspected seminal plasma hypersensitivity.
Sublett JW, Bernstein JA Characterization of patients with suspected seminal plasma hypersensitivity. Allergy Asthma Proc. 2011 Nov;32(6):467-71 Authors: Sublett JW, Bernstein JA Abstract The epidemiology of seminal plasma hypersensitivity (SPH) is unknown. Case reports and a previous survey have identified two distinct phenotypes: localized and systemic reactors. The objective of this study was to use an Internet-based questionnaire to characterize and examine the differences among a population of women with suspected SPH. A questionnaire designed to distinguish women with probable SPH was made available via the Internet. Systemic symptoms included generalized pruritus, urticaria, angioedema, wheezing, chest tightness, shortness of breath, dizziness, and loss of consciousness whereas localized symptoms included vaginal burning, pain, swelling, erythema, or blister formation. Respondents with localized or systemic symptoms and whose symptoms were prevented with the use of a condom were included in the analysis. Frequency and means were calculated and further analyzed using chi-square and t-test analyses. A total of 165 women with probable SPH, 79 with systemic symptoms and 86 with only localized symptoms, were included in the analysis. Systemic compared with localized respondents were significantly older (mean age, 29.2 years versus 26.4 years; p = 0.01), had longer duration of symptoms (mean, 58 months versus 40.8 months; p = 0.03), and more frequently reported a family history of atopy (65.8% versus 50%; p < 0.05). Interestingly, significantly more systemic compared with localized respondents reported dog sensitization (11.4% versus 2.3%; p = 0.02). Localized and systemic SPH are more common than previously realized and should be considered in the differential diagnosis of anaphylaxis, vulvovaginitis, and dyspareunia. Additional research investigating the epidemiology, immunopathogenesis, and treatment of this disorder is warranted. PMID: 22221443 [PubMed - in process]
Ultrashort-specific immunotherapy successfully treats seasonal allergic rhinoconjunctivitis to grass pollen.
Dubuske LM, Frew AJ, Horak F, Keith PK, Corrigan CJ, Aberer W, Holdich T, von Weikersthal-Drachenberg KJ Ultrashort-specific immunotherapy successfully treats seasonal allergic rhinoconjunctivitis to grass pollen. Allergy Asthma Proc. 2011 Nov;32(6):466 Authors: Dubuske LM, Frew AJ, Horak F, Keith PK, Corrigan CJ, Aberer W, Holdich T, von Weikersthal-Drachenberg KJ PMID: 22221442 [PubMed - in process]
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Allergy-Immunology jobs in "Southwest Coastal Oregon Allergy/Immunization" - OR
Fri, 27 Jan 2012 13:27:44 -0500
Southwest coastal Oregon community in need of first Allergy/Immunology specialist due to patient demand in draw area covering over 13,000 population. This hospital employed position will require including
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Fri, 27 Jan 2012 13:27:44 -0500
Pittsburgh group adding another Allergist We are scheduling interviews with a busy Allergy Asthma & Immunology group adding another Allergist. This is primarily a clinical position with some teaching
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Front & Back Matter
Wed, 01 Feb 2012 00:00:00 +0100
Int Arch Allergy Immunol 2012;157:X (DOI:10.1159/000336950)
The Loss of Smell in Persistent Allergic Rhinitis Is Improved by Levocetirizine due to Reduction of Nasal Inflammation but Not Nasal Congestion (the CIRANO Study)
Thu, 26 Jan 2012 00:00:00 +0100
Int Arch Allergy Immunol 2012;158:184–190 (DOI:10.1159/000331329)
Multiorgan Infiltration by CD8+ T Cells and 1p;16p Translocation in a Patient with Hypogammaglobulinemia and a Reduced Number of B Cells
Thu, 26 Jan 2012 00:00:00 +0100
Int Arch Allergy Immunol 2012;158:206–210 (DOI:10.1159/000331117)
Surgical Endoscopy (Online First™)
Training in laparoscopic colorectal surgery: a new educational model using specially embalmed human anatomical specimen
Sat, 28 Jan 2012 06:43:05 -0000
Abstract Background With an increasing percentage of colorectal resections performed laparoscopically nowadays, there is more emphasis on training “before the job” on operative skills, including the comprehension of specific laparoscopic surgical anatomy. As integration of technical skills with correct interpretation of the anatomical image must be incorporated in laparoscopic training, a human specimen training model with special emphasis on surgical anatomy was developed. Methods The new embalming method Anubifix™ combines long-term high-quality embalming of human bodies with almost normal flexibility and plasticity, and the body can be kept operational as long as conventionally embalmed human specimens. A colorectal training model was created in a specimen in which anatomical landmarks of colorectal anatomy were permanently colored to explore laparoscopic colorectal anatomy in a skills training setting. Airtight closure of the abdominal wall permits the creation of pneumoperitoneum. Residents were asked to test the model by mobilizing the small and large bowels and expose the central vessels and ureters. Afterward they were asked to fill out an eight-item questionnaire about the model. Results Eleven surgical residents in their first and second year of training participated. Responses to the questionnaire showed that a majority of residents considered the model to be representative of the real situation and superior to animal models or virtual reality simulators, and helped to improve the knowledge of three-dimensional anatomy and laparoscopic skills. Conclusion The new training model for laparoscopic colorectal surgery proved to be a high-quality tool, concentrating on laparoscopic colorectal anatomy in a skills training setting. We believe it may be a valuable adjunct to residency training programs based on the principle of “training before the job.” Content Type Journal ArticlePages 1-6DOI 10.1007/s00464-012-2158-yAuthors Juliette C. Slieker, Department of Surgery, Erasmus University Medical Center, Rotterdam, The NetherlandsHilco P. Theeuwes, Department of Anatomy and Neurosciences, Erasmus University Medical Center, Rotterdam, The NetherlandsGöran L. van Rooijen, Department of Anatomy and Neurosciences, Erasmus University Medical Center, Rotterdam, The NetherlandsJohan F. Lange, Department of Surgery, Erasmus University Medical Center, Rotterdam, The NetherlandsGert-Jan Kleinrensink, Department of Anatomy and Neurosciences, Erasmus University Medical Center, Rotterdam, The Netherlands Journal Surgical EndoscopyOnline ISSN 1432-2218Print ISSN 0930-2794
Educational and training aspects of new surgical techniques: experience with the endoscopic–laparoscopic interdisciplinary training entity (ELITE) model in training for a natural orifice translumenal endoscopic surgery (NOTES) approach to appendectomy
Sat, 28 Jan 2012 06:43:05 -0000
Abstract Background Natural orifice translumenal endoscopic surgery (NOTES) is a new surgical concept that requires training before it is introduced into clinical practice. The endoscopic–laparoscopic interdisciplinary training entity (ELITE) is a training model for NOTES interventions. The latest research has concentrated on new materials for organs with realistic optical and haptic characteristics and the possibility of high-frequency dissection. This study aimed to assess both the ELITE model in a surgical training course and the construct validity of a newly developed NOTES appendectomy scenario. Methods The 70 attendees of the 2010 Practical Course for Visceral Surgery (Warnemuende, Germany) took part in the study and performed a NOTES appendectomy via a transsigmoidal access. The primary end point was the total time required for the appendectomy, including retrieval of the appendix. Subjective evaluation of the model was performed using a questionnaire. Subgroups were analyzed according to laparoscopic and endoscopic experience. Results The participants with endoscopic or laparoscopic experience completed the task significantly faster than the inexperienced participants (p = 0.009 and 0.019, respectively). Endoscopic experience was the strongest influencing factor, whereas laparoscopic experience had limited impact on the participants with previous endoscopic experience. As shown by the findings, 87.3% of the participants stated that the ELITE model was suitable for the NOTES training scenario, and 88.7% found the newly developed model anatomically realistic. Conclusions This study was able to establish face and construct validity for the ELITE model with a large group of surgeons. The ELITE model seems to be well suited for the training of NOTES as a new surgical technique in an established gastrointestinal surgery skills course. Content Type Journal ArticleCategory Endoluminal SurgeryPages 1-7DOI 10.1007/s00464-012-2165-zAuthors Sonja Gillen, Department of Surgery, Klinikum rechts der Isar, Technische Universität München, Ismaninger Strässe 22, 81675 München, GermanyJörn Gröne, Department of Surgery, Charité–Campus Benjamin Franklin, Berlin, GermanyFritz Knödgen, Research Group MITI, Minimally Invasive Therapy and Intervention, Munich, GermanyPetra Wolf, Institute of Medical Statistics and Epidemiology, Technische Universität München, Ismaninger Strässe 22, 81675 München, GermanyMichael Meyer, Research Institute of Leather and Plastic Sheeting, FILK, Freiberg, GermanyHelmut Friess, Department of Surgery, Klinikum rechts der Isar, Technische Universität München, Ismaninger Strässe 22, 81675 München, GermanyHeinz-Johannes Buhr, Department of Surgery, Charité–Campus Benjamin Franklin, Berlin, GermanyJörg-Peter Ritz, Department of Surgery, Charité–Campus Benjamin Franklin, Berlin, GermanyHubertus Feussner, Department of Surgery, Klinikum rechts der Isar, Technische Universität München, Ismaninger Strässe 22, 81675 München, GermanyKai S. Lehmann, Department of Surgery, Charité–Campus Benjamin Franklin, Berlin, Germany Journal Surgical EndoscopyOnline ISSN 1432-2218Print ISSN 0930-2794
Endoscopic treatment of large colorectal tumors: comparison of endoscopic mucosal resection, endoscopic mucosal resection–precutting, and endoscopic submucosal dissection
Thu, 26 Jan 2012 06:55:34 -0000
Abstract Background Endoscopic mucosal resection (EMR) is a useful therapeutic technique for colorectal tumors. However, for tumors larger than 20 mm, the chance of piecemeal resection is high. Recently introduced endoscopic submucosal dissection (ESD) enables en bloc resection regardless of the tumor size. This study aimed to compare the effectiveness and outcomes of EMR, EMR-precutting (EMR-P), and ESD in the treatment of colorectal tumors 20 mm in size or larger. Methods This study reviewed 523 nonpedunculated colorectal tumors (499 patients) 20 mm or larger that received endoscopic treatment (EMR in 140 cases, EMR-P in 69 cases, and ESD in 314 cases) from January 2004 to November 2009. Results The mean sizes of the tumors were 21.7 ± 3.5 mm (EMR), 23.5 ± 5.6 mm (EMR-P), and 28.9 ± 12.7 mm (ESD). The ratios of adenocarcinomas were 15.7% (EMR), 29% (EMR-P), and 37.9% (ESD). The en bloc resection rates were 42.9% (EMR), 65.2% (EMR-P), and 92.7% (ESD), and the complete resection rates were 32.9% (EMR), 59.4% (EMR-P), and 87.6% (ESD). Perforation occurred in 2.9% of the EMR-P cases and 8% of the ESD cases. The recurrence rates were 25.9% (EMR; median follow-up period, 26 months), 3.2% (EMR-P; median follow-up period, 16 months), and 0.8% (ESD; median follow-up period, 17 months). Conclusion For the treatment of large, nonpedunculated colorectal tumors, ESD is more effective than either EMR or EMR-P. Although ESD is technically demanding, it has clinical significance by overcoming the limitations of both EMR and EMR-P. Content Type Journal ArticlePages 1-11DOI 10.1007/s00464-012-2164-0Authors Eun-Jung Lee, Department of Surgery, Daehang Hospital, 481-10 Bangbae Seocho, Seoul, 137-820 KoreaJae Bum Lee, Department of Surgery, Daehang Hospital, 481-10 Bangbae Seocho, Seoul, 137-820 KoreaSuk Hee Lee, Department of Pathology, Daehang Hospital, Seoul, KoreaEui Gon Youk, Department of Surgery, Daehang Hospital, 481-10 Bangbae Seocho, Seoul, 137-820 Korea Journal Surgical EndoscopyOnline ISSN 1432-2218Print ISSN 0930-2794
Laparoscopic splenectomy and azygoportal disconnection with intraoperative splenic blood salvage
Thu, 26 Jan 2012 06:55:34 -0000
Abstract Background Intraoperative blood salvage can reduce or avoid perioperative allogeneic blood transfusion. Salvaging the blood in the portal hypertension-induced enlarged spleen becomes an issue of concern during devascularization surgery because an enlarged spleen accommodates a large red cell pool. We report 20 cases of laparoscopic splenectomy and azygoportal disconnection and present the advantages of the use of intraoperative splenic blood salvage during the procedure. Methods A total of 20 cirrhotic patients with esophagogastric variceal bleeding refractory to treatment with β-blockers and endoscopic therapy were studied. Laparoscopic splenectomy with azygoportal disconnection was performed. During the procedure, an intraoperative autologous blood salvage device recovered the splenic blood. The perioperative data were recorded from various viewpoints. Results The operative time was 3.1 ± 0.3 h and the blood loss was 70.5 ± 32.5 ml. The weight of the excised and morcellated spleen was 826.0 ± 155.1 g. The volume of autotransfused blood was 541.0 ± 150.4 ml. No patient received a perioperative allogeneic blood transfusion. There were no significant complications either intraoperatively or postoperatively. The hemoglobin value increased from 9.3 ± 0.8 to 11.5 ± 1.1 g/dl at postoperative day 1 (p < 0.01). During a postoperative follow-up period of 18.0 ± 9.0 months for 18 patients, neither esophageal variceal bleeding nor encephalopathy recurred. Conclusion Laparoscopic splenectomy with azygoportal disconnection is a feasible, effective, and safe surgical method for the treatment of bleeding portal hypertension. Intraoperative splenic blood salvage can avoid the risk associated with allogeneic transfusion during the procedure, with an advantage of significantly increased postoperative hemoglobin levels. Content Type Journal ArticlePages 1-7DOI 10.1007/s00464-012-2159-xAuthors Yuedong Wang, Department of General Surgery, Zhejiang Provincial People’s Hospital, 158 Shangtang Rd, Hangzhou, 310014 ChinaYun Ji, Department of General Surgery, Zhejiang Provincial People’s Hospital, 158 Shangtang Rd, Hangzhou, 310014 ChinaYangwen Zhu, Department of General Surgery, Zhejiang Provincial People’s Hospital, 158 Shangtang Rd, Hangzhou, 310014 ChinaZhijie Xie, Department of General Surgery, Zhejiang Provincial People’s Hospital, 158 Shangtang Rd, Hangzhou, 310014 ChinaXiaoli Zhan, Department of General Surgery, Zhejiang Provincial People’s Hospital, 158 Shangtang Rd, Hangzhou, 310014 China Journal Surgical EndoscopyOnline ISSN 1432-2218Print ISSN 0930-2794
Nerve-sparing laparoscopic eradication of deep endometriosis with segmental rectal and parametrial resection: the Negrar method. A single-center, prospective, clinical trial
Thu, 26 Jan 2012 06:55:34 -0000
Abstract Background The weight of surgical radicality, together with a lack of anatomical theoretical basis for surgery and inappropriate practical skills, can lead to serious impairments to bladder, rectal, and sexual functions after laparoscopic excision of deep infiltrating endometriosis. Although the “classical” laparoscopic technique for endometriosis excision involving segmental bowel resection has proven to relieve symptoms successfully, it is hampered by several postoperative long-term and/or definitive pelvic dysfunctions. Methods In this prospective cohort study, we compare the laparoscopic nerve-sparing approach to the classical laparoscopic procedure in a series of 126 cases. Satisfactory data for bowel, bladder, and sexual function were considered as primary endpoints. Results A total of 126 patients were considered for analysis: 61 treated with nerve-sparing radical excision of pelvic endometriosis with segmental bowel resection (group B), and 65 treated with the classical technique (group A). Intraoperative, perioperative, and postoperative complications were similar between the two groups. Mean days of self-catheterization were significantly lower in the nerve-sparing group (39.8 days) compared with the non-nerve-sparing group (121.1 days; p < 0.001). The relapse rate within 12 months after surgery was comparable between the two groups. Patients of group A suffered from urinary retention more frequently between 1 and 6 months (p = 0.035) compared with group B and did not experience any improvement between 6 months and 1 year (p = 0.018). Overall detection of severe bladder/rectal/sexual dysfunctions was significantly different between the two groups, and 56 patients of group A (86.2%) reported a significantly higher rate of severe neurologic pelvic dysfunctions vs. 1 patient (1.6%) of group B (p < 0.001). Conclusions Our technique appears to be feasible and offers good results in terms of reduced bladder morbidity and apparently higher satisfaction than the classical technique. Considering that this kind of surgery requires uncommon surgical skills and anatomical knowledge, we believe that it should be performed only in selected reference centers. Content Type Journal ArticlePages 1-17DOI 10.1007/s00464-012-2153-3Authors Marcello Ceccaroni, Division of Gynecologic Oncology, International School of Surgical Anatomy, Sacred Heart Hospital, “Ospedale Sacro Cuore-Don Calabria”, Via Don A.Sempreboni no. 5, 37024 Negrar, VR, ItalyRoberto Clarizia, Division of Gynecologic Oncology, International School of Surgical Anatomy, Sacred Heart Hospital, “Ospedale Sacro Cuore-Don Calabria”, Via Don A.Sempreboni no. 5, 37024 Negrar, VR, ItalyFrancesco Bruni, Division of Gynecologic Oncology, International School of Surgical Anatomy, Sacred Heart Hospital, “Ospedale Sacro Cuore-Don Calabria”, Via Don A.Sempreboni no. 5, 37024 Negrar, VR, ItalyElisabetta D’Urso, Department of Obstetrics and Gynecology, European Gynecology Endoscopy School, Sacred Heart Hospital, Negrar, VR, ItalyMaria Lucia Gagliardi, Department of Obstetrics and Gynecology, A. Gemelli University Hospital, Catholic University of Sacred Heart, Rome, ItalyGiovanni Roviglione, Division of Gynecologic Oncology, International School of Surgical Anatomy, Sacred Heart Hospital, “Ospedale Sacro Cuore-Don Calabria”, Via Don A.Sempreboni no. 5, 37024 Negrar, VR, ItalyLuca Minelli, Department of Obstetrics and Gynecology, European Gynecology Endoscopy School, Sacred Heart Hospital, Negrar, VR, ItalyGiacomo Ruffo, Division of Gynecologic Oncology, International School of Surgical Anatomy, Sacred Heart Hospital, “Ospedale Sacro Cuore-Don Calabria”, Via Don A.Sempreboni no. 5, 37024 Negrar, VR, Italy Journal Surgical EndoscopyOnline ISSN 1432-2218Print ISSN 0930-2794
Use of fibrin sealant (Tisseel/Tissucol) in hernia repair: a systematic review
Thu, 26 Jan 2012 06:55:34 -0000
Abstract Background Abdominal wall and inguinal hernia repair are the most frequently performed surgical procedures in the United States and Europe. However, traditional methods of mesh fixation are associated with a number of problems including substantial risks of recurrence and of postoperative and chronic pain. The aim of this systematic review is to summarize the clinical safety and efficacy of Tisseel/Tissucol fibrin sealant for hernia mesh fixation. Methods A PubMed title/abstract search was conducted using the following terms: (fibrin glue OR fibrin sealant OR Tisseel OR Tissucol) AND hernia repair. The bibliographies of the publications identified in the search were reviewed for additional references. Results There were 36 Tisseel/Tissucol studies included in this review involving 5,993 patients undergoing surgery for hernia. In open repair of inguinal hernias, Tisseel compared favorably with traditional methods of mesh fixation, being associated with shorter operative times and hospital stays and a lower incidence of chronic pain. Similarly, after laparoscopic/endoscopic inguinal hernia repair, Tisseel/Tissucol was associated with less use of postoperative analgesics and less acute and chronic postoperative pain than tissue-penetrating mesh-fixation methods. Other end points of concern to surgeons and patients are the risks of inguinal hernia recurrence and of complications such as hematoma formation and intraoperative bleeding. Comparative studies show that Tisseel/Tissucol does not increase the risk of these outcomes and may, in fact, decrease the risk compared with tissue-penetrating fixation methods. When used in the repair of incisional hernias, Tisseel/Tissucol significantly decreased both postoperative morbidity and duration of hospital stay. Conclusions Clinical evidence published to date supports the use of Tisseel/Tissucol as an option for mesh fixation in open and laparoscopic/endoscopic repair of inguinal and incisional hernias. Guidelines of the International Endohernia Society recommend fibrin sealant mesh fixation, especially in inguinal hernia repair. Nonfixation is reserved for selected cases. Content Type Journal ArticleCategory ReviewPages 1-10DOI 10.1007/s00464-012-2156-0Authors René H. Fortelny, Department of General, Visceral and Oncological Surgery, Wilhelminenspital, Vienna, AustriaAlexander H. Petter-Puchner, Ludwig Boltzmann Institute for Experimental and Clinical Traumatology, Vienna, AustriaKarl S. Glaser, Department of General, Visceral and Oncological Surgery, Wilhelminenspital, Vienna, AustriaHeinz Redl, Ludwig Boltzmann Institute for Experimental and Clinical Traumatology, Vienna, Austria Journal Surgical EndoscopyOnline ISSN 1432-2218Print ISSN 0930-2794
pubmed: 1088-5412
Recurrent diarrhea in a 26-year-old man.
Baker TW, Stokes S, Clawson J, Garrett T, Sacha JJ, Gonzalez-Reyes E Recurrent diarrhea in a 26-year-old man. Allergy Asthma Proc. 2011 Nov;32(6):482-5 Authors: Baker TW, Stokes S, Clawson J, Garrett T, Sacha JJ, Gonzalez-Reyes E Abstract This is a case report of a 26-year-old healthy man with chronic diarrhea for 2 years. He was initially believed to have irritable bowel syndrome by his primary care physician after all stool studies yielded negative results. His symptoms persisted, which prompted a referral to a gastroenterology specialist. The patient's esophagogastroduodenoscopy revealed variable villous blunting and a paucity of CD 138 plasma cells, which helped reveal the final diagnosis. This cases illustrates a unique presentation of a common primary immunodeficiency that allergy/immunology specialists, along with primary care specialists, will likely encounter. PMID: 22221444 [PubMed - in process]
Characterization of patients with suspected seminal plasma hypersensitivity.
Sublett JW, Bernstein JA Characterization of patients with suspected seminal plasma hypersensitivity. Allergy Asthma Proc. 2011 Nov;32(6):467-71 Authors: Sublett JW, Bernstein JA Abstract The epidemiology of seminal plasma hypersensitivity (SPH) is unknown. Case reports and a previous survey have identified two distinct phenotypes: localized and systemic reactors. The objective of this study was to use an Internet-based questionnaire to characterize and examine the differences among a population of women with suspected SPH. A questionnaire designed to distinguish women with probable SPH was made available via the Internet. Systemic symptoms included generalized pruritus, urticaria, angioedema, wheezing, chest tightness, shortness of breath, dizziness, and loss of consciousness whereas localized symptoms included vaginal burning, pain, swelling, erythema, or blister formation. Respondents with localized or systemic symptoms and whose symptoms were prevented with the use of a condom were included in the analysis. Frequency and means were calculated and further analyzed using chi-square and t-test analyses. A total of 165 women with probable SPH, 79 with systemic symptoms and 86 with only localized symptoms, were included in the analysis. Systemic compared with localized respondents were significantly older (mean age, 29.2 years versus 26.4 years; p = 0.01), had longer duration of symptoms (mean, 58 months versus 40.8 months; p = 0.03), and more frequently reported a family history of atopy (65.8% versus 50%; p < 0.05). Interestingly, significantly more systemic compared with localized respondents reported dog sensitization (11.4% versus 2.3%; p = 0.02). Localized and systemic SPH are more common than previously realized and should be considered in the differential diagnosis of anaphylaxis, vulvovaginitis, and dyspareunia. Additional research investigating the epidemiology, immunopathogenesis, and treatment of this disorder is warranted. PMID: 22221443 [PubMed - in process]
Ultrashort-specific immunotherapy successfully treats seasonal allergic rhinoconjunctivitis to grass pollen.
Dubuske LM, Frew AJ, Horak F, Keith PK, Corrigan CJ, Aberer W, Holdich T, von Weikersthal-Drachenberg KJ Ultrashort-specific immunotherapy successfully treats seasonal allergic rhinoconjunctivitis to grass pollen. Allergy Asthma Proc. 2011 Nov;32(6):466 Authors: Dubuske LM, Frew AJ, Horak F, Keith PK, Corrigan CJ, Aberer W, Holdich T, von Weikersthal-Drachenberg KJ PMID: 22221442 [PubMed - in process]
Permanent Allergy-Immunology Jobs
Allergy-Immunology jobs
Thu, 02 Feb 2012 06:40:56 -0500
All Allergy-Immunology jobs for Thu Feb 2 2012
Allergy-Immunology jobs in "Southwest Coastal Oregon Allergy/Immunization" - OR
Fri, 27 Jan 2012 13:27:44 -0500
Southwest coastal Oregon community in need of first Allergy/Immunology specialist due to patient demand in draw area covering over 13,000 population. This hospital employed position will require including
Allergy-Immunology jobs in "Pittsburgh, PA - Allergist" - PA
Fri, 27 Jan 2012 13:27:44 -0500
Pittsburgh group adding another Allergist We are scheduling interviews with a busy Allergy Asthma & Immunology group adding another Allergist. This is primarily a clinical position with some teaching
Sites:
Find an Allergist: A directory for locating a Board-Certified Allergist in one's area. Allows users to search by zip code.Allergy Centers (ASAC): Asthma, Sinus, & Allergy Centers (ASAC). Serving Central New Jersey, we are specialists in allergic, immunologic, and respiratory diseases of children and adults. Treating allergic diseases with personalized and compassionate service is our primary focus, and has been since 1974.
Throat Specialists: Cape Cod Ear, Nose, and Throat Specialists is staffed by physicians who are Board Certified in the field of Otolaryngology.
Allergy and Asthma Center: Allery and Asthma Center, Home Page
Allergy and Asthma Center: Information on treatment and prevention of allergies and asthma. Pamphlets about asthma ready for download.
Allergy and Asthma Center of Rochester: Allergy and Asthma Prevention: Dr. Ulrich Ringwald, Board Certified Allergist, has been serving the Rochester, Michigan, community for over 30 years. He is committed to helping children and adults with allergy, asthma, and other related problems.
Allergy and Clinical Immunology Medical Group: Practice located in Santa Monica, California.
Allergy Associates: Clinical drug trial oriented practice in Seattle, Washington.
Allergy Associates and Lab., Ltd.: Allergy Associates & Lab is the allergy practice of Dr. Suresh Anand in Tempe, AZ. The practice provides diagnosis of and care for allergy symptoms for patients in Chandler, Mesa, Phoenix and Scottsdale, AZ, as well as Tempe.
Allergy Associates of New London PC: This web site is designed to share 42 years of medical practice, education and teaching., This web site is designed to share over four decades of medical practice, education and teaching.
Allergy Asthma Sinusitis Clinic Inc.: Dr. Trivedi's clinic in Norwalk and Pomona, California.
Allergy Capital: allergy asthma info written by Australian specialist- asthma hay fever food anaphylaxis hives urticaria sinus sinusitis hayfever
Allergy jobs: Allergy immunology jobs site with automatic email updates and directory of recruitment firms.
Allergy Research Institute: Treatment clinic in Pune, India.
Allergy Test UK Ltd.: Allergy Testing UK - Book your Allergy Test now
Allergy, Asthma, Rheumatology, Associates, P.C.: Office information, services, resources for patients. Located in Syracuse, New York.
AllergyImmunoLinx: Allergist& Immunologists keep current with free medical news and daily newsletters. AllergyImmunoLinx and MDLinx combine the most current medical journal news and research from premier medical and healthcare journals and news sources. Comprehensive, specialized content updated every day on the w...
American Board of Allergy and Immunology: American Board of Allergy and Immunology, information on certification, recertification, verification
American College of Allergy, Asthma and Immunology: Clinical association promoting research, advocacy, and professional and public education.
Asthma, Allergy and Pulmonary Associates, P.C.: Philadelphia, Pennsylvania sub-specialty medical practice. Includes patient information, about the staff, the Research Center and directions including hours of operation.
Auckland Allergy Clinic: Auckland Allergy Clinic offers information about diagnosis, management and treatment of asthma, allergies, anaphylaxis, bronchitis, dermatitis, eczema, food allergies, hay fever, immunologic problems and sinusitis.
Breakspear Medical Group: Breakspear Hospital is a privately owned and run day hospital specialising in the treatment of allergy and environmental illness in Hertfordshire House, Wood Lane, Hemel Hempstead, Herts HP2 4FD, England, UK
Canadian Society of Allergy and Clinical Immunology: The Canadian Society of Allergy and Clinical Immunology is one of the oldest specialty societies in Canada. It was founded in 1945 as the Canadian Society for the Study of Allergy and changed its name in 1954 to the Canadian Academy of Allergy. In 1967, it adopted the present name, The Canadian S...
CityAllergy: Michael Chandler, MD and Gary Stadtmauer, MD: New York practice which provides care for asthma, allergy, sinus and other allergic conditions.
Colorado Allergy and Asthma Centers, P.C.: Denver metro area Allergy and Asthma clinics.
Corpus Christi Allergy and Asthma Center: Based in South Texas, with the aim of treating patients with allergies with the fewest medicines while also aiming to keep asthmatics well and out of hospitals.
Cote Allergy Clinic: allergy and asthma treatment at the NAET Holistic Centre UK, specializing in permanent elimination of allergies,symptoms,latest treatments fibromyalgia,candida,aspergers disorder,with revolutionary new procedures.
Daniel Suez, M.D., Allergy, Asthma and Immunology Clinic, P.A.: Located in Irving, Texas.
Division of Allergic Diseases and Clinical Immunology of the Mayo Clinic: Allergic Diseases Department, Mayo Clinic in Rochester, Minn.
Dr. Braly's Allergy Relief: The Natural Way: Dr. Braly's Allergy Relief provides safe and natural treatments for more than 150 chronic health conditions caused by food allergy.
Dr. Grossan The Ear, Nose and Throat On-line Consultant: sinusitis, ear, nose, throat, andSCUBA-related problem advice by Dr. Grossan, a specialist andauthor. Treatment without drugs. Special advice is offered for AIDSand CF patients.
Dr. Sally Rockwell, Seattle, Washington: Books and counseling: food allergies, allergy free, gluten-free, dairy-free recipes, candida yeast, elimination and rotation diets, hypoglycemia, hyperactivity, eating disorders, non-dairy calcium, and diabetes. Seattle, Washington.
Exemplar Allergy Clinic: Our physicians practice medicine, not business. Our patients realize the value of the small practice...a lot of attention, responsiveness, knowing your name...that's important to us. Our focus here is allergies for both adults and children. As the region's only Board Certified Allergy &...
Fort Wayne Allergy Consultants, Inc.: Fort Wayne Allergy and Asthma Consultants, Inc.. Member of the Medem Network: Connecting Physicians and Patients Online.
Hudson Valley Asthma and Allergy Associates: Offices in Croton-on-Hudson and Yorktown Heights, New York. Providing information on services, office hours and driving directions. Links to resources for allergy sufferers.
ImmunologyLinx: Allergist& Immunologists keep current with free medical news and daily newsletters. AllergyImmunoLinx and MDLinx combine the most current medical journal news and research from premier medical and healthcare journals and news sources. Comprehensive, specialized content updated every day on the w...
Johnson Medical Associates: Specializing in environmental-sensitivity, allergies, chronic illness, and internal medicine - Johnson Medical Associates uses traditional and alternative medicine based on each patients needs, in a state-of-the-art facility.
Joint Council of Allergy, Asthma and Immunology: Provides a mechanism for keeping allergists and immunologists aware of socio-economic issues which affect them. Represents the specialty of allergy or immunology in federal agencies and the Congress. Information on how to join, practice parameters and issues.
Louisville Allergy and Asthma: Louisville Allergy & Asthma, PSC. Member of the Medem Network: Connecting Physicians and Patients Online.
Marycliff Allergy Specialist: Medical clinic in Spokane, Washington.
Metrowest Allergy Associates, PC: Allergy specialists in the Waltham and Metrowest Boston.
Northwest Allergy and Asthma Clinics: Clinics located in Alaska and Washington states.
NY Allergy and Immunology: NY Allergist for Allergy, Sinus & Asthma Center with Testing & Treatment in New York City Allergist, Manhattan Allergist, and Ridgewood. Allergy Triggers.
NYC Allergist Dr. Nejat: NY Allergist for Allergy, Sinus & Asthma Center with Testing & Treatment in New York City Allergist, Manhattan Allergist, and Ridgewood. Allergy Triggers.
Philip L. Case, M.D.: Philip L. Case, MD Freehold NJ Allergist. Member of the Medem Network: Connecting Physicians and Patients Online.
Regional Allergy and Asthma Consultants: Five clinics located in western North Carolina. Site provides a patient education area with brochures and health quizzes on allergy, sinus and asthma.
Savannah Allergy Associates, P.C.: Savannah Allergy Associates, P.C.. Member of the Medem Network: Connecting Physicians and Patients Online.
Sinuses.com: Sinusitis: A Treatment Plan that works for asthma and allergy too. Sinusitis: A Treatment Plan that works for asthma and allergy too.
Southwest Asthma and Allergy Associates: Board certified allergists in Houston at Southwest Asthma and Allergy Associates. Providing treatment for allergies and asthma. Multiple locations spanning the greater Houston area. Need a Houston allergist.
Spokane Allergy and Asthma Clinic: The Spokane Allergy and Asthma Clinic exists for the benefit of all patients who suffer with allergies and asthma. We seek to discover and to apply new knowledge and understanding of allergies and asthma to benefit the lives of our patients.
Surrey Allergy Clinic: Understanding Allergy explaining Food Allergies Allergy Testing and Allergic Reactions, Member of British Allergy Society
The Salinas Allergy Clinic: The Salinas Allergy Clinic: Helping children and adults with asthma and allergies since 1976.
Valley, Ear, Nose, and Allergy Group: Valley Ear, Nose, and Allergy Group
Weballergy.com: Allergy, Asthma and Immunology Information
