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Biomedical subjects

M Anda

Publications and source records attributed to M Anda.

15 recordsLinked to original sources
PubMed2003

[Food allergy in the XXI century].

Food allergy is a clinical state of high frequency and possible risk to life. This article reviews the foodstuffs most often responsible for serious reactions, including data from the Autonomous Community of Navarre. Given that dietetic elimination is the primordial long term treatment for food allergy, its difficulties, limitations and risks are analyzed. Finally, we set out the new perspectives offered by technology in the field of food allergy, both in the production of hypoallergens and in the development of new forms of immunotherapy.

Diet↗
PubMed2003

[Allergy to Anisakis simplex].

Anisakis simplex is a parasite, belonging to the Anisakidae family. The life cycle of the parasite can include one or more intermediary hosts, their final hosts being marine mammals or large fish, in which the larvae develop until the adult stage is reached. Man is an accidental host who acquires the larvae by eating raw or undercooked fish. Since the mid-50s, when the first case studies were published in Holland and Japan, new cases have been emerging in different countries including Spain. Parasitization of man by the living larva is known as anisakiasis, principally giving rise to digestive symptomology, with other rare cases described of invasion of other organs such as the lung, the liver, the spleen, the pancreas, etc. Clinical pictures of allergy to IgE mediated anisakis simplex have also been described: reactions by thermostable antigens of the parasite that develop in spite of the fish being cooked or frozen, and an acute digestive parasitization with allergic symptoms called gastro-allergic anisakiasis. In the diagnosis of anisakiasis and/or allergy to Anisakis, the antecedent of the prior ingestion of fish as well as the clinical accompaniment can form basic data of considerable orientational value, and endoscopy can reveal the presence of the larvae and make possible their extraction. Besides, in cases of allergy the detection test for specific IgE facing Anisakis simplex, and cutaneous tests with fish should be carried out. The best treatment for avoiding this parasitization is prophylactic, avoiding the consumption of raw or undercooked fish, while a fish free diet is necessary in cases of true allergy to the thermostable proteins of the parasite.

Anisakiasis↗
PubMed2003

[Latex allergy. Clinical manifestations in the general population and reactivity crossed with foodstuffs].

Because of widespread latex manufacturing in the last decades, latex allergy has become an important clinical problem, not only in high-risk groups (health-workers) but also among the general population. Latex is used to produce a large variety of natural rubber products (medical equipment, household gloves, condoms, balls and balloons, footwear, baby pacifiers...) employed in the ordinary life, with high risk for patients allergic to latex. Among general population, children affected by myelomeningocele or spina bifida, have a higher risk to develop latex allergy. Clinical manifestations range from local reactions(contact dermatitis, urticaria), rhino-conjunctivitis, asthma, pharyngeal edema to severe systemic reactions such anaphylactic shock. Furthermore, latex can crossreact with some plant foods, and patients suffering from latex allergy often associate food allergy.

Cross Reactions↗
PubMed2003

[Perspectives in the treatment of allergy to latex: immunotherapy].

At present, allergy to latex is an important problem due to the severity of the symptomatology that it produces and the risk groups involved. Complete avoidance of latex is practically impossible, which is why in recent years there has been intense work on standardizing an extract in order not only to improve its clinical diagnosis but also to be able to offer a therapeutic alternative other than avoidance, such as immunotherapy. Since 1998, timely approaches to immunotherapy with latex have been published, with oral desensitization (three patients), subcutaneous (one patient) and sublingual (one patient). In every case there was an evident clinical improvement. At present, subcutaneous immunotherapy with latex, although efficient, is a high risk treatment. Sublingual immunotherapy with latex has recently been commercialized in Spain and we know of its efficacy through the results of an open test on 26 adult patients. The safety expectations are shown to be better than those for subcutaneous immunotherapy.

Humans↗
PubMed2003

[Local immunotherapy].

Specific immunotherapy, together with avoidance of the allergen and symptomatic treatment, forms part of the treatment of allergic pathology. The oldest, best known and most studied form is subcutaneous immunotherapy (SCIT), whose efficacy, both in the short and the long term, has been widely demonstrated in numerous studies. However, in spite of having been shown to be safe, it is not free of adverse effects and must be administered under the supervision of medical personnel. This has encouraged the search for new ways of administration of similar efficacy, with a good safety profile and good adherence on the patient's side. Sublingual immunotherapy (SLIT) is the most relevant of the different alternatives studied. In this alternative the antigen is administered in the form of drops under the tongue. There are different dosages of administration depending on the allergen involved. The optimum treatment dose has still to be determined, at present a wide range of dosages are found in comparison with subcutaneous immunotherapy. Its mechanism of action is little known although immunological changes have been observed in different studies. SLIT has shown a good safety profile with scarce secondary effects, normally of a local character. Similarly, different clinical tests have been carried out in which its efficacy has been shown in the treatment of respiratory allergy both in children and in adults. For this reason, although there are still unresolved data concerning this way of administering the immunotherapy, it has been proposed by the WHO as a valid alternative to SCIT.

Humans↗
PubMed2001

Evapotranspiration for domestic wastewater reuse in remote indigenous communities of Australia.

In the past sewage ponding in indigenous settlements was commonplace as a result of overcrowding combined with inappropriate septic tank and leach drain design, installation and operation. The response over the past 10 years has been to develop reticulated sewerage systems to lagoons when the funds become available. These are often successful in terms of operation, improved public health and low maintenance but are expensive and wasteful of limited water supplies. Evapotranspiration (ET) is an effective method for on-site domestic effluent disposal in areas of Western Australia with soils of low permeability. Evapotranspiration systems have been established in a number of communities both for research/demonstration and as specified by architects. The systems usually follow two septic tanks for the disposal of all domestic effluent. A case study will be presented for a remote indigenous community where the ET systems installed for greywater only have been monitored over the last two years since installation. The use of evapotranspiration has enabled reuse of effluent for successful examples of revegetation and food production and points to the need for a holistic approach to design and service delivery in these communities that includes a total environmental management plan.

Conservation of Natural Resources↗
PubMed2001

Introduction of water conservation education packages: the opportunites and constraints affecting their success.

The Remote Area Developments Group in the Institute for Environmental Science at Murdoch University developed a video and booklet education package on water conservation. The package was developed after research, review of current efforts in water conservation, and consultation with communities showed that there was a need in this area. The package was distributed to all communities within Western Australia. Several different workshops were conducted with Indigenous Environmental Health Workers from around Western Australia in remote areas and in the Perth Metropolitan communities using the package. This paper will briefly describe the opportunities and constraints that exist for water conservation in remote Aboriginal communities in Western Australia as well as give an evaluation of the education package based on workshops, trials and survey instrument. This paper will explain the conclusions that have been drawn from the study: that a broad delivery style is the most advantageous style for remote communities, allowing the facilitator to assess the best style of delivery.

Australia↗
PubMed2001

Water harvesting techniques for small communities in arid areas.

Limited water resources exist in numerous remote indigenous settlements around Australia. Indigenous people in these communities are still living in rudimentary conditions while their urban counterparts have full amenities, large scale water supplies and behavioral practices which may not be appropriate for an arid continent but are supported by extensive infrastructure in higher rainfall coastal areas. As remote indigenous communities continue to develop, their water use will increase, and in some cases, costly solutions may have to be implemented to augment supplies. Water harvesting techniques have been applied in settlements on a small scale for domestic and municipal purposes, and in the large, broadacre farm setting for productive use of the water. The techniques discussed include swales, infiltration basins, infiltration trenches and "sand dam" basins. This paper reviews the applications of water harvesting relevant to small communities for land rehabilitation, landscaping and flood control. Landscaping is important in these communities as it provides shelter from the sun and wind, reduces soil erosion and hence reduced airborne dust, and in some cases provides food and nutrition. Case studies of water harvesting systems applied in the Pilbara Region, Western Australia for landscaping around single dwellings in Jigalong and Cheeditha, in a permaculture garden in Wittenoon and at a college and carpark in Karratha are described.

Agriculture↗
PubMed2001

On-site wastewater technologies in Australia.

Domestic wastewater reuse is currently not permitted anywhere in Australia but is widely supported by the community, promoted by researchers, and improvised by up to 20% of householders. Its widespread implementation will make an enormous contribution to the sustainability of water resources. Integrated with other strategies in the outdoor living environment of settlements in arid lands, great benefit will be derived. This paper describes six options for wastewater reuse under research by the Remote Area Developments Group (RADG) at Murdoch University and case studies are given where productive use is being made for revegetation and food production strategies at household and community scales. Pollution control techniques, public health precautions and maintenance requirements are described. The special case of remote Aboriginal communities is explained where prototype systems have been installed by RADG to generate windbreaks and orchards. New Australian design standards and draft guidelines for domestic greywater reuse produced by the Western Australian State government agencies for mainstream communities are evaluated. It is recommended that dry composting toilets be coupled with domestic greywater reuse and the various types available in Australia are described. For situations where only the flushing toilet will suffice the unique 'wet composting' system can be used and this also is described. A vision for household and community-scale on-site application is presented.

Agriculture↗
PubMed2000

Reuse of wastewater in aboriginal communities in Western Australia.

Western Australia is a very arid area and freshwater is a precious resource. The wise and efficient use of this resource is essential for the establishment of communities in this region. Wastewater reuse in Aboriginal communities is a very recent development. Initially leach drains disposed of wastewater. Due to their failure most of the major communities now have the effluent from the septic tanks collected by a small diameter reticulated sewerage system and directed to oxidation ponds for treatment. The overflow from the oxidation ponds is allowed to flow over land or to a creek without any specific use. This paper discusses available reuse options as well as the options specific to Aboriginal communities in Western Australia. It is intended to demonstrate that in arid regions reuse wastewater can act as a water conservation and pollution control measure.

Conservation of Natural Resources↗
PubMedDate not supplied

[Treatment perspectives: immunotherapy with latex].

Latex allergy currently constitutes a serious problem because of the severity of its symptoms and the at-risk groups it affects. Since complete avoidance of this substance is practically impossible, in the last few years intense efforts have been made to standardize a latex extract with the aim not only of improving clinical diagnosis but also of being able to offer other therapeutic alternatives, such as specific immunotherapy.Since 1998, reports of immunotherapy with oral (three patients) subcutaneous (one patient) and sublingual latex desensitization (one patient) have been published. In all cases, clinical improvement was evident. In 2000, Laynadier published the first pilot study, a phase IIB multicenter, randomized, double-blind, placebo-controlled trial that evaluated the efficacy and safety of specific immunotherapy with latex in patients with occupational allergy. Twenty health care workers without obvious latex exposure and with latex allergy-induced symptoms of rhinitis and/or asthma were included. Treatment started with a 2-day course of rush immunotherapy in hospital and maintenance therapy was continued for 1 year. Efficacy was assessed by symptom and medication scores and by variation in the conjunctival reactivity threshold. The safety of the extract was also evaluated. In the overall analysis of symptom score, the treated group showed a marked improvement and the medication score was significantly lower in patients in the active treatment group than in the placebo group. Concerning safety, almost half the patients receiving active treatment showed local reactions starting with the first injection and four of the nine patients in this group suffered moderate-to-severe systemic reactions. In view of this first clinical trial, it can be concluded that this treatment is effective but that its tolerance is low.A second clinical trial with the same characteristics and extract is currently underway. Its aim is to validate the previous protocol, confirm the efficacy of specific immunotherapy with latex, improve its safety and, if possible, determine the optimal dose.J. Sastre et al. have recently (Formigal 2002) presented the results of the first double-blind study with latex immunotherapy using an extract standardized by the ALK-Abelló-España group. The authors included 24 patients with latex sensitization and symptoms of occupational allergy. To diagnose respiratory allergy, an inhalation challenge was performed in a closed 7-m2 chamber and, in case of contact urticaria, glove-wearing and rubbing tests were performed, using a vinyl glove as negative control. Treatment consisted of a first phase of incremental doses for 14 weeks, with 18 injections, followed by maintenance doses for 6 months. Sixteen patients received active treatment and 8 received placebo. Of the 578 doses administered, adverse effects were observed in 41 (7.1 %). There were 21 immediate systemic reactions (5.7 % of the doses) and 10 delayed systemic reactions (2.6 % of the doses). Adverse effects were more frequent in patients with underlying respiratory disease (p < 0.05). After 6 months' treatment, a clear improvement in the cutaneous response index was found in the active treatment group and in the rubbing and glove-wearing tests. The authors conclude that the immunotherapy tested was a high-risk treatment and that the greatest clinical improvement was found in cutaneous symptoms.In conclusion, although effective, latex immunotherapy is currently a high-risk treatment.

Desensitization, Immunologic↗
PubMedDate not supplied

Rheumatic manifestations in the course of anaphylaxis caused by Anisakis simplex.

Human anisakidosis is a parasitic infection caused by the larvae of Anisakis simplex. Classical clinical manifestations include epigastric pain, occlusion, diffuse abdominal pain, appendicitis, and anaphylactoid reactions. Arthralgias or arthritis have been infrequently reported. We present three patients with proven hypersensitivity to A. simplex together with rheumatologic complaints after ingestion of parasitized fishes. A. simplex must be considered in the differential diagnosis of arthralgias/ arthritis especially if associated with urticaria.

Adult↗