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Pediatric AI, University of New Mexico, #1 Place for Business and Careers by Forbes, #5278 :: New Mexico :: Timeline Recruiting
Nestled against the Sandia Mountains, Albuquerque is a dream destination. Impossible to avoid our incredible scenery, we offer four beautiful seasons with that Southwestern backdrop we are famous
Allergy opportunity in North Carolina close to the Atlantic Ocean :: North Carolina :: CompHealth Inc
Job 9110905 Assume a waiting Allergy patient base in North Carolina Stable multi specialty group seeks a Board Certified / Eligible Allergy Doctor Assume a waiting patient base. Be busy from day one!
Excellent Allergy/Immunology Opportunity in Washington State :: Washington :: CompHealth Inc
Job 514776 Join a highly respected organization located in this beautiful part of Washington Receive excellent competitive base income Earning potential is huge and exciting Wonderful, desirable and
International Archives of Allergy and Immunology : Last 20 articles
Contents Vol. 150, 2009
Fri, 13 Nov 2009 00:00:00 +0100
Int Arch Allergy Immunol 2009;150:I-IV (DOI:10.1159/000259905)
Subject Index Vol. 150, 2009
Fri, 13 Nov 2009 00:00:00 +0100
Int Arch Allergy Immunol 2009;150:401-402 (DOI:10.1159/000259904)
Author Index Vol. 150, 2009
Fri, 13 Nov 2009 00:00:00 +0100
Int Arch Allergy Immunol 2009;150:398-400 (DOI:10.1159/000259903)
Latest Issue of Annals of Allergy, Asthma and Immunology
On the Cover
Weber, Richard W.
Smoking cessation toolbox for allergists
Johnson, Kimberly S.Tankersley, Michael S.
The atopic march: what's the evidence?
Ker, JenniferHartert, Tina V.
Surgical Endoscopy
Gastroesophageal reflux-associated aspiration alters the immune response in asthma
Sat, 14 Nov 2009 06:59:18 -0000
Abstract Background A large number of studies point toward chronic aspiration associated with gastroesophageal reflux disease (GERD) as an important factor involved in the development of asthma, the incidence of which has increased dramatically in industrially developed countries. Recent work suggests that medical intervention aimed at acid blockade is not sufficient to relieve the effects of chronic aspiration on asthma pathology, leaving surgical treatment of the disease as one of the few remaining options. This study examined the effect of chronic aspiration on the airway-associated immune response to allergens using a model of experimentally induced airway hypersensitivity in Balb/c mice. Methods The mice received aspiration of gastric fluid on days 1, 8, 15, 22, 29, 36, 43, and 50 and were sensitized to ovalbumin by intraperitoneal (IP) injection on days 33 and 47, challenged with aerosolized ovalbumin on day 54, and killed on day 56. Control mice received sham gastric fluid aspirations, sham induction of airway hypersensitivity, or both. Results Chronic aspiration of 50 μl murine gastric fluid once per week for 8 weeks had a profound effect on the immune system in the lung, with upregulation of the macrophage/monocyte-associated cytokines tumor necrosis factor-α (TNF-α) and interleukin-12 (IL-12) and profound downregulation of a broad array of T-cell-associated cytokines including interleukins 2, 4, 5, 6, 10, 13, and 23, as well as interferon-γ. The aspiration-induced depression of IL-5 production in particular was found only in mice with airway hypersensitivity and not in control mice without airway hypersensitivity. Conclusions The results indicate that chronic aspiration of gastric fluid has a profound effect on the nature of the allergic response to aerosolized allergens, suggesting that the aspiration may be an important factor affecting the pathogenesis of asthma. Content Type Journal ArticleDOI 10.1007/s00464-009-0727-5Authors Anitra D. Thomas, Duke University Medical Center Department of Surgery DUMC Box 2605 Durham NC 27710 USAKuei-Ying Su, Duke University Medical Center Department of Surgery DUMC Box 2605 Durham NC 27710 USAJui-Chih Chang, Duke University Medical Center Department of Surgery DUMC Box 2605 Durham NC 27710 USAJason H. Leung, Duke University Medical Center Department of Surgery DUMC Box 2605 Durham NC 27710 USASean M. Lee, Duke University Medical Center Department of Surgery DUMC Box 2605 Durham NC 27710 USAZoie E. Holzknecht, Duke University Medical Center Department of Surgery DUMC Box 2605 Durham NC 27710 USAMary Lou Everett, Duke University Medical Center Department of Surgery DUMC Box 2605 Durham NC 27710 USAWilliam Parker, Duke University Medical Center Department of Surgery DUMC Box 2605 Durham NC 27710 USAR. Duane Davis, Duke University Medical Center Department of Surgery DUMC Box 2605 Durham NC 27710 USAShu S. Lin, Duke University Medical Center Department of Surgery DUMC Box 2605 Durham NC 27710 USA Journal Surgical EndoscopyOnline ISSN 1432-2218Print ISSN 0930-2794
Optimizing lymphadenectomy in laparoscopic surgery for colon cancer
Sat, 14 Nov 2009 06:59:18 -0000
Optimizing lymphadenectomy in laparoscopic surgery for colon cancer Content Type Journal ArticleCategory LetterDOI 10.1007/s00464-009-0747-1Authors Christof Hottenrott, Chirurgische Klinik St. Elisabethenkrankenhaus Frankfurt Germany Journal Surgical EndoscopyOnline ISSN 1432-2218Print ISSN 0930-2794
Internal validity of randomized controlled trials reported in major gastrointestinal and surgical endoscopy journals in 2008
Sat, 14 Nov 2009 06:59:16 -0000
Abstract Background Assessment of the reported methodology for randomized controlled trials (RCTs) in the major gastrointestinal and surgical endoscopy journals has never been reported. Methods Generation of the allocation sequence, allocation concealment, double blinding, sample size calculation, number of patients, and funding source included in methodologic quality were retrieved from each trial, and all the relevant trials were identified by a search of all clinical trials published in 2008 in four major gastrointestinal and surgical endoscopy journals. Results A total of 64 trials were included in the final analysis, which found that 50% (32/64) of all trials reported adequate generation of the allocation sequence, 58% (37/64) reported adequate allocation concealment, 47% (30/64) reported adequate blinding, 47% (30/64) reported adequate sample size calculation, and 67% (43/64) failed to disclose the funding source. Conclusions The study showed that the quality of the reported methodology in the major gastrointestinal and surgical endoscopy journals needs great improvement. Content Type Journal ArticleDOI 10.1007/s00464-009-0743-5Authors Yu Bai, Changhai Hospital, Second Military Medical University Evidence-Based Medicine Group, Department of Gastroenterology 168 Changhai Road Shanghai ChinaYong-Fa Wu, Changhai Hospital, Second Military Medical University Evidence-Based Medicine Group, Department of Gastroenterology 168 Changhai Road Shanghai ChinaDong Wang, Changhai Hospital, Second Military Medical University Evidence-Based Medicine Group, Department of Gastroenterology 168 Changhai Road Shanghai ChinaYang Xia, Changhai Hospital, Second Military Medical University Evidence-Based Medicine Group, Department of Gastroenterology 168 Changhai Road Shanghai ChinaJun Gao, Changhai Hospital, Second Military Medical University Evidence-Based Medicine Group, Department of Gastroenterology 168 Changhai Road Shanghai ChinaDuo-Wu Zou, Changhai Hospital, Second Military Medical University Evidence-Based Medicine Group, Department of Gastroenterology 168 Changhai Road Shanghai ChinaZhao-Shen Li, Changhai Hospital, Second Military Medical University Evidence-Based Medicine Group, Department of Gastroenterology 168 Changhai Road Shanghai China Journal Surgical EndoscopyOnline ISSN 1432-2218Print ISSN 0930-2794
Is endoscopic closure with clips effective for both diagnostic and therapeutic colonoscopy-associated bowel perforation?
Sat, 14 Nov 2009 06:59:15 -0000
Abstract Background Colonic perforation is an uncommon but serious colonoscopy-associated complication. This study assessed the effectiveness of conservative management with endoscopic clipping for colonoscopy-associated perforations. Methods Clinical manifestations and management outcomes were assessed for 38 patients with colonoscopy-associated colonic perforations that occurred between January 2001 and April 2008 at the Asan Medical Center, Seoul, Korea. These perforations were classified as endoscopically evident, endoscopically suspected, and radiologically proven. Results Of the 38 perforations, 19 were endoscopically evident, 9 were endoscopically suspected, and 10 were radiologically proven but without endoscopic evidence. Of the 19 patients with endoscopically evident perforations, 13 (68.4%) underwent endoscopic closure with clips, and all improved without surgery. All nine patients with endoscopically suspected perforations underwent endoscopic closure, and eight (88.9%) improved without surgery. Of the 10 radiologically proven perforations, 7 were detected within 1 day after colonoscopy. All the patients improved without surgery. However, two of the three patients with delayed perforations required emergency laparotomy. Consequently, of the 38 patients with perforations, 29 (76.3%) improved without surgery. Of the 28 patients with endoscopically evident or suspected perforations, conservative management was successful for 21 (95.5%) of the 22 patients with effective clipping, but for none (0%) of the 6 patients without clipping. Conclusions Conservative management by immediate endoscopic closure with clips can be effective for the treatment of colonic perforations detected during colonoscopy. Conservative management also may be tried cautiously for stable patients who have radiologically proven colonoscopy-associated perforations without endoscopic evidence. Content Type Journal ArticleDOI 10.1007/s00464-009-0746-2Authors Dong-Hoon Yang, University of Ulsan College of Medicine, Asan Medical Center Department of Internal Medicine 388-1, Pungnap-2dong, Songpa-gu Seoul 138-736 KoreaJeong-Sik Byeon, University of Ulsan College of Medicine, Asan Medical Center Department of Internal Medicine 388-1, Pungnap-2dong, Songpa-gu Seoul 138-736 KoreaKyung-Hoon Lee, University of Ulsan College of Medicine, Asan Medical Center Department of Internal Medicine 388-1, Pungnap-2dong, Songpa-gu Seoul 138-736 KoreaSoon Man Yoon, University of Ulsan College of Medicine, Asan Medical Center Department of Internal Medicine 388-1, Pungnap-2dong, Songpa-gu Seoul 138-736 KoreaKyung Jo Kim, University of Ulsan College of Medicine, Asan Medical Center Department of Internal Medicine 388-1, Pungnap-2dong, Songpa-gu Seoul 138-736 KoreaByong Duk Ye, University of Ulsan College of Medicine, Asan Medical Center Department of Internal Medicine 388-1, Pungnap-2dong, Songpa-gu Seoul 138-736 KoreaSeung-Jae Myung, University of Ulsan College of Medicine, Asan Medical Center Department of Internal Medicine 388-1, Pungnap-2dong, Songpa-gu Seoul 138-736 KoreaSuk-Kyun Yang, University of Ulsan College of Medicine, Asan Medical Center Department of Internal Medicine 388-1, Pungnap-2dong, Songpa-gu Seoul 138-736 KoreaJin-Ho Kim, University of Ulsan College of Medicine, Asan Medical Center Department of Internal Medicine 388-1, Pungnap-2dong, Songpa-gu Seoul 138-736 Korea Journal Surgical EndoscopyOnline ISSN 1432-2218Print ISSN 0930-2794
Objective classification of residents based on their psychomotor laparoscopic skills
Sat, 14 Nov 2009 06:59:14 -0000
Abstract Background From the clinical point of view, it is important to recognize residents’ level of expertise with regard to basic psychomotor skills. For that reason, surgeons and surgical organizations (e.g., Acreditation Council for Graduate Medical Education, ACGME) are calling for assessment tools that credential residents as technically competent. Currently, no method is universally accepted or recommended for classifying residents as “experienced,” “intermediates,” or “novices” according to their technical abilities. This study introduces a classification method for recognizing residents’ level of experience in laparoscopic surgery based on psychomotor laparoscopic skills alone. Methods For this study, 10 experienced residents (>100 laparoscopic procedures performed), 10 intermediates (10–100 procedures performed), and 11 novices (no experience) performed four tasks in a box trainer. The movements of the laparoscopic instruments were recorded with the TrEndo tracking system and analyzed using six motion analysis parameters (MAPs). The MAPs of all participants were submitted to principal component analysis (PCA), a data reduction technique. The scores of the first principal components were used to perform linear discriminant analysis (LDA), a classification method. Performance of the LDA was examined using a leave-one-out cross-validation. Results Of 31 participants, 23 were classified correctly with the proposed method, with 7 categorized as experienced, 7 as intermediates, and 9 as novices. Conclusions The proposed method provides a means to classify residents objectively as experienced, intermediate, or novice surgeons according to their basic laparoscopic skills. Due to the simplicity and generalizability of the introduced classification method, it is easy to implement in existing trainers. Content Type Journal ArticleDOI 10.1007/s00464-009-0721-yAuthors Magdalena K. Chmarra, Delft University of Technology Department of BioMechanical Engineering, Faculty of Mechanical, Maritime and Materials Engineering (3mE) Mekelweg 2 2628 CD Delft The NetherlandsStefan Klein, University Medical Center Utrecht Image Sciences Institute Utrecht The NetherlandsJoost C. F. de Winter, Delft University of Technology Department of BioMechanical Engineering, Faculty of Mechanical, Maritime and Materials Engineering (3mE) Mekelweg 2 2628 CD Delft The NetherlandsFrank-Willem Jansen, Delft University of Technology Department of BioMechanical Engineering, Faculty of Mechanical, Maritime and Materials Engineering (3mE) Mekelweg 2 2628 CD Delft The NetherlandsJenny Dankelman, Delft University of Technology Department of BioMechanical Engineering, Faculty of Mechanical, Maritime and Materials Engineering (3mE) Mekelweg 2 2628 CD Delft The Netherlands Journal Surgical EndoscopyOnline ISSN 1432-2218Print ISSN 0930-2794
Appropriate management of common bile duct stones: A RAND Corporation/UCLA Appropriateness Method statistical analysis
Sat, 14 Nov 2009 06:59:13 -0000
Abstract Background Bile duct stones affect 10% of patients who undergo a cholecystectomy and therefore represent a major health problem. Laparoscopic common bile duct exploration, endoscopic sphincterotomy, and open surgical choledocholithotomy are the three available methods for dealing with choledocholithiasis. Though many trials and reviews have compared all three strategies, a list of indications for defined patient profiles is lacking. Methods We employed the RAND Corporation/UCLA Appropriateness Method (RAM) to evaluate the three procedures for bile duct stone clearance. An expert panel judged appropriateness after a comprehensive bibliography review, a first-round private rating of 108 different clinical situations, a consensus meeting, and a second round of definitive rating. A list of indications for each procedure was statistically calculated. Results A consensus was reached for 41 indications (38%). The endoscopic approach was always appropriate for preoperatively diagnosed bile duct stones and inappropriate for patients with single intraoperative detected stones causing cholangitis and bile duct dilatation. Laparoscopic bile duct exploration was appropriate for preoperatively diagnosed choledocholithiasis if patients had not undergone a previous cholecystectomy and no signs of cholangitis were detected. The laparoscopic approach was also appropriate for intraoperatively incidentally detected stones, except for septic patients with poor performance status and multiple calculi. Laparoscopic bile duct clearance was judged inappropriate for septic patients with poor performance status and absence of bile duct dilatation. Open surgery was appropriate in all patients with intraoperative diagnosis of choledocholithiasis and cholangitis and in septic patients with bile duct dilatation. There was no clinical situation in which open surgery was appropriate when bile duct stones were preoperatively diagnosed. Conclusions There is still uncertainty with respect to the management of choledocholithiasis, showing the need for further investigation. The RAM helps to elucidate appropriateness for the different treatment options in specific clinical settings. Content Type Journal ArticleDOI 10.1007/s00464-009-0748-0Authors Pablo Parra-Membrives, Valme University Hospital Hepato-bilio-pancreatic Surgery Unit of the General and Digestive Surgery Department Carretera de Cádiz s/n 41014 Sevilla SpainDaniel DĂaz-GĂłmez, Valme University Hospital Hepato-bilio-pancreatic Surgery Unit of the General and Digestive Surgery Department Carretera de Cádiz s/n 41014 Sevilla SpainRomán Vilegas-Portero, The Emerging Technologies Observatory Andalusian Agency for Health Technology Assessment Sevilla SpainMáximo Molina-Linde, The Emerging Technologies Observatory Andalusian Agency for Health Technology Assessment Sevilla SpainLourdes GĂłmez-Bujedo, High Resolution Hospital Center of Utrera Sevilla SpainJuan RamĂłn Lacalle-Remigio, University of Seville Department of Preventive Medicine Sevilla Spain Journal Surgical EndoscopyOnline ISSN 1432-2218Print ISSN 0930-2794
pubmed: 1088-5412
Solar urticaria.
Webb LM, Mikita CP Solar urticaria. Allergy Asthma Proc. 2009 Sep-Oct;30(5):563-5 Authors: Webb LM, Mikita CP A case of solar urticaria is presented, followed by a discussion of the clinical characteristics, pathophysiology, diagnosis, and management of this disease. Special emphasis is given to clinical pearls and pitfalls for the practicing allergist. Solar urticaria is a physical urticaria that can be difficult to diagnose and distinguish from other photodermatoses. There are some characteristic features that are important to remember when evaluating a patient with suspected solar urticaria. Testing can be difficult without the assistance of an experienced dermatologist because there are several different wavelengths of light that can lead to a patient's symptoms. Solar urticaria tends to be a chronic disease with a low 5-year resolution rate but can usually be effectively managed with multiple antihistamines. PMID: 19843410 [PubMed - in process]
Twenty-one year old woman with severe eosinophilia and left bundle branch block.
Padi A, Silverman B, Schneider A Twenty-one year old woman with severe eosinophilia and left bundle branch block. Allergy Asthma Proc. 2009 Sep-Oct;30(5):558-62 Authors: Padi A, Silverman B, Schneider A Peripheral and tissue eosinophilia can occur in a wide variety of disease processes that include infectious, allergic, and primary hematologic disorders, and other more rare diseases such as hypereosinophilic syndromes (HES). We describe a case of a patient with severe eosinophilia and left bundle branch block. A 21-year-old woman with asthma and allergic rhinitis presented with neck pain and cough for >6 months with no other complaints. Physical exam was normal except for fever and minimal expiratory wheezes. Chest CT revealed diffuse airway inflammation with bronchiectasis. Admission electrocardiogram (EKG) was normal. Initial laboratory tests showed an absolute eosinophil count of 30,000 cells/mL. A thorough workup for eosinophilia was initiated, but the patient subsequently left against medical advice. The next day, in the outpatient pulmonary clinic, she was found to be tachycardic and an EKG showed sinus tachycardia with a new left bundle branch block. Laboratory tests revealed an eosinophil count of 33,200 cells/mL and elevated troponins. She was started on i.v. Solu-Medrol (Pfizer, Inc.). The next day, her EKG returned to normal. Three days later her absolute eosinophil count normalized. Identifying the cause of marked, persistent eosinophilia is a challenging problem. Excluding the more common causes of severe eosinophilia is required before making a diagnosis of HES and early therapeutic intervention can prevent morbidity from the disease. PMID: 19843409 [PubMed - in process]
Serum levels of protein oxidation products in patients with nickel allergy.
Gangemi S, Ricciardi L, Minciullo PL, Cristani M, Saitta S, Chirafisi J, Spatari G, Santoro G, Saija A Serum levels of protein oxidation products in patients with nickel allergy. Allergy Asthma Proc. 2009 Sep-Oct;30(5):552-7 Authors: Gangemi S, Ricciardi L, Minciullo PL, Cristani M, Saitta S, Chirafisi J, Spatari G, Santoro G, Saija A Nickel sensitization can not only induce allergic contact dermatitis (ACD), but also can induce an overlapping disease referred to as "systemic nickel allergy syndrome" (SNAS), characterized by urticaria/angioedema and gastrointestinal symptoms correlated to the ingestion of nickel-containing foods. This study was designed to determine if oxidative stress occurs in patients with nickel allergy. Thirty-one female patients (mean age 31.26 + 13.04 years, range 16-64 years) with confirmed nickel CD underwent oral nickel challenge because of clinically suspected SNAS; serum concentrations of protein carbonyl groups (PCGs) and nitrosylated proteins (NPs; biomarkers of oxidative stress) were measured before and after oral nickel challenge as well as in healthy female controls. Twenty-three of these 31 patients were diagnosed with SNAS because they had a positive reaction to the oral nickel challenge, and 8 patients had no reaction and therefore were classified as patients with contact nickel allergy only. Although both nickel-allergic patients and controls presented similar serum levels of PCGs, NP values in nickel-allergic patients appeared higher than in controls and tended to decrease after the challenge; furthermore, serum levels of NPs in patients affected by SNAS were higher (although not significantly) than in patients with nickel ACD only. The involvement of specific biomarkers of oxidative stress such as NPs and the lack of involvement of other biomarkers such as PCGs may help to better understand the alteration of the redox homeostasis occurring in nickel ACD and particularly in SNAS. PMID: 19843408 [PubMed - in process]
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Pediatric AI, University of New Mexico, #1 Place for Business and Careers by Forbes, #5278 :: New Mexico :: Timeline Recruiting
Nestled against the Sandia Mountains, Albuquerque is a dream destination. Impossible to avoid our incredible scenery, we offer four beautiful seasons with that Southwestern backdrop we are famous
Allergy opportunity in North Carolina close to the Atlantic Ocean :: North Carolina :: CompHealth Inc
Job 9110905 Assume a waiting Allergy patient base in North Carolina Stable multi specialty group seeks a Board Certified / Eligible Allergy Doctor Assume a waiting patient base. Be busy from day one!
Excellent Allergy/Immunology Opportunity in Washington State :: Washington :: CompHealth Inc
Job 514776 Join a highly respected organization located in this beautiful part of Washington Receive excellent competitive base income Earning potential is huge and exciting Wonderful, desirable and
International Archives of Allergy and Immunology : Last 20 articles
Contents Vol. 150, 2009
Fri, 13 Nov 2009 00:00:00 +0100
Int Arch Allergy Immunol 2009;150:I-IV (DOI:10.1159/000259905)
Subject Index Vol. 150, 2009
Fri, 13 Nov 2009 00:00:00 +0100
Int Arch Allergy Immunol 2009;150:401-402 (DOI:10.1159/000259904)
Author Index Vol. 150, 2009
Fri, 13 Nov 2009 00:00:00 +0100
Int Arch Allergy Immunol 2009;150:398-400 (DOI:10.1159/000259903)
Latest Issue of Annals of Allergy, Asthma and Immunology
On the Cover
Weber, Richard W.
Smoking cessation toolbox for allergists
Johnson, Kimberly S.Tankersley, Michael S.
The atopic march: what's the evidence?
Ker, JenniferHartert, Tina V.
Surgical Endoscopy
Gastroesophageal reflux-associated aspiration alters the immune response in asthma
Sat, 14 Nov 2009 06:59:18 -0000
Abstract Background A large number of studies point toward chronic aspiration associated with gastroesophageal reflux disease (GERD) as an important factor involved in the development of asthma, the incidence of which has increased dramatically in industrially developed countries. Recent work suggests that medical intervention aimed at acid blockade is not sufficient to relieve the effects of chronic aspiration on asthma pathology, leaving surgical treatment of the disease as one of the few remaining options. This study examined the effect of chronic aspiration on the airway-associated immune response to allergens using a model of experimentally induced airway hypersensitivity in Balb/c mice. Methods The mice received aspiration of gastric fluid on days 1, 8, 15, 22, 29, 36, 43, and 50 and were sensitized to ovalbumin by intraperitoneal (IP) injection on days 33 and 47, challenged with aerosolized ovalbumin on day 54, and killed on day 56. Control mice received sham gastric fluid aspirations, sham induction of airway hypersensitivity, or both. Results Chronic aspiration of 50 μl murine gastric fluid once per week for 8 weeks had a profound effect on the immune system in the lung, with upregulation of the macrophage/monocyte-associated cytokines tumor necrosis factor-α (TNF-α) and interleukin-12 (IL-12) and profound downregulation of a broad array of T-cell-associated cytokines including interleukins 2, 4, 5, 6, 10, 13, and 23, as well as interferon-γ. The aspiration-induced depression of IL-5 production in particular was found only in mice with airway hypersensitivity and not in control mice without airway hypersensitivity. Conclusions The results indicate that chronic aspiration of gastric fluid has a profound effect on the nature of the allergic response to aerosolized allergens, suggesting that the aspiration may be an important factor affecting the pathogenesis of asthma. Content Type Journal ArticleDOI 10.1007/s00464-009-0727-5Authors Anitra D. Thomas, Duke University Medical Center Department of Surgery DUMC Box 2605 Durham NC 27710 USAKuei-Ying Su, Duke University Medical Center Department of Surgery DUMC Box 2605 Durham NC 27710 USAJui-Chih Chang, Duke University Medical Center Department of Surgery DUMC Box 2605 Durham NC 27710 USAJason H. Leung, Duke University Medical Center Department of Surgery DUMC Box 2605 Durham NC 27710 USASean M. Lee, Duke University Medical Center Department of Surgery DUMC Box 2605 Durham NC 27710 USAZoie E. Holzknecht, Duke University Medical Center Department of Surgery DUMC Box 2605 Durham NC 27710 USAMary Lou Everett, Duke University Medical Center Department of Surgery DUMC Box 2605 Durham NC 27710 USAWilliam Parker, Duke University Medical Center Department of Surgery DUMC Box 2605 Durham NC 27710 USAR. Duane Davis, Duke University Medical Center Department of Surgery DUMC Box 2605 Durham NC 27710 USAShu S. Lin, Duke University Medical Center Department of Surgery DUMC Box 2605 Durham NC 27710 USA Journal Surgical EndoscopyOnline ISSN 1432-2218Print ISSN 0930-2794
Optimizing lymphadenectomy in laparoscopic surgery for colon cancer
Sat, 14 Nov 2009 06:59:18 -0000
Optimizing lymphadenectomy in laparoscopic surgery for colon cancer Content Type Journal ArticleCategory LetterDOI 10.1007/s00464-009-0747-1Authors Christof Hottenrott, Chirurgische Klinik St. Elisabethenkrankenhaus Frankfurt Germany Journal Surgical EndoscopyOnline ISSN 1432-2218Print ISSN 0930-2794
Internal validity of randomized controlled trials reported in major gastrointestinal and surgical endoscopy journals in 2008
Sat, 14 Nov 2009 06:59:16 -0000
Abstract Background Assessment of the reported methodology for randomized controlled trials (RCTs) in the major gastrointestinal and surgical endoscopy journals has never been reported. Methods Generation of the allocation sequence, allocation concealment, double blinding, sample size calculation, number of patients, and funding source included in methodologic quality were retrieved from each trial, and all the relevant trials were identified by a search of all clinical trials published in 2008 in four major gastrointestinal and surgical endoscopy journals. Results A total of 64 trials were included in the final analysis, which found that 50% (32/64) of all trials reported adequate generation of the allocation sequence, 58% (37/64) reported adequate allocation concealment, 47% (30/64) reported adequate blinding, 47% (30/64) reported adequate sample size calculation, and 67% (43/64) failed to disclose the funding source. Conclusions The study showed that the quality of the reported methodology in the major gastrointestinal and surgical endoscopy journals needs great improvement. Content Type Journal ArticleDOI 10.1007/s00464-009-0743-5Authors Yu Bai, Changhai Hospital, Second Military Medical University Evidence-Based Medicine Group, Department of Gastroenterology 168 Changhai Road Shanghai ChinaYong-Fa Wu, Changhai Hospital, Second Military Medical University Evidence-Based Medicine Group, Department of Gastroenterology 168 Changhai Road Shanghai ChinaDong Wang, Changhai Hospital, Second Military Medical University Evidence-Based Medicine Group, Department of Gastroenterology 168 Changhai Road Shanghai ChinaYang Xia, Changhai Hospital, Second Military Medical University Evidence-Based Medicine Group, Department of Gastroenterology 168 Changhai Road Shanghai ChinaJun Gao, Changhai Hospital, Second Military Medical University Evidence-Based Medicine Group, Department of Gastroenterology 168 Changhai Road Shanghai ChinaDuo-Wu Zou, Changhai Hospital, Second Military Medical University Evidence-Based Medicine Group, Department of Gastroenterology 168 Changhai Road Shanghai ChinaZhao-Shen Li, Changhai Hospital, Second Military Medical University Evidence-Based Medicine Group, Department of Gastroenterology 168 Changhai Road Shanghai China Journal Surgical EndoscopyOnline ISSN 1432-2218Print ISSN 0930-2794
Is endoscopic closure with clips effective for both diagnostic and therapeutic colonoscopy-associated bowel perforation?
Sat, 14 Nov 2009 06:59:15 -0000
Abstract Background Colonic perforation is an uncommon but serious colonoscopy-associated complication. This study assessed the effectiveness of conservative management with endoscopic clipping for colonoscopy-associated perforations. Methods Clinical manifestations and management outcomes were assessed for 38 patients with colonoscopy-associated colonic perforations that occurred between January 2001 and April 2008 at the Asan Medical Center, Seoul, Korea. These perforations were classified as endoscopically evident, endoscopically suspected, and radiologically proven. Results Of the 38 perforations, 19 were endoscopically evident, 9 were endoscopically suspected, and 10 were radiologically proven but without endoscopic evidence. Of the 19 patients with endoscopically evident perforations, 13 (68.4%) underwent endoscopic closure with clips, and all improved without surgery. All nine patients with endoscopically suspected perforations underwent endoscopic closure, and eight (88.9%) improved without surgery. Of the 10 radiologically proven perforations, 7 were detected within 1 day after colonoscopy. All the patients improved without surgery. However, two of the three patients with delayed perforations required emergency laparotomy. Consequently, of the 38 patients with perforations, 29 (76.3%) improved without surgery. Of the 28 patients with endoscopically evident or suspected perforations, conservative management was successful for 21 (95.5%) of the 22 patients with effective clipping, but for none (0%) of the 6 patients without clipping. Conclusions Conservative management by immediate endoscopic closure with clips can be effective for the treatment of colonic perforations detected during colonoscopy. Conservative management also may be tried cautiously for stable patients who have radiologically proven colonoscopy-associated perforations without endoscopic evidence. Content Type Journal ArticleDOI 10.1007/s00464-009-0746-2Authors Dong-Hoon Yang, University of Ulsan College of Medicine, Asan Medical Center Department of Internal Medicine 388-1, Pungnap-2dong, Songpa-gu Seoul 138-736 KoreaJeong-Sik Byeon, University of Ulsan College of Medicine, Asan Medical Center Department of Internal Medicine 388-1, Pungnap-2dong, Songpa-gu Seoul 138-736 KoreaKyung-Hoon Lee, University of Ulsan College of Medicine, Asan Medical Center Department of Internal Medicine 388-1, Pungnap-2dong, Songpa-gu Seoul 138-736 KoreaSoon Man Yoon, University of Ulsan College of Medicine, Asan Medical Center Department of Internal Medicine 388-1, Pungnap-2dong, Songpa-gu Seoul 138-736 KoreaKyung Jo Kim, University of Ulsan College of Medicine, Asan Medical Center Department of Internal Medicine 388-1, Pungnap-2dong, Songpa-gu Seoul 138-736 KoreaByong Duk Ye, University of Ulsan College of Medicine, Asan Medical Center Department of Internal Medicine 388-1, Pungnap-2dong, Songpa-gu Seoul 138-736 KoreaSeung-Jae Myung, University of Ulsan College of Medicine, Asan Medical Center Department of Internal Medicine 388-1, Pungnap-2dong, Songpa-gu Seoul 138-736 KoreaSuk-Kyun Yang, University of Ulsan College of Medicine, Asan Medical Center Department of Internal Medicine 388-1, Pungnap-2dong, Songpa-gu Seoul 138-736 KoreaJin-Ho Kim, University of Ulsan College of Medicine, Asan Medical Center Department of Internal Medicine 388-1, Pungnap-2dong, Songpa-gu Seoul 138-736 Korea Journal Surgical EndoscopyOnline ISSN 1432-2218Print ISSN 0930-2794
Objective classification of residents based on their psychomotor laparoscopic skills
Sat, 14 Nov 2009 06:59:14 -0000
Abstract Background From the clinical point of view, it is important to recognize residents’ level of expertise with regard to basic psychomotor skills. For that reason, surgeons and surgical organizations (e.g., Acreditation Council for Graduate Medical Education, ACGME) are calling for assessment tools that credential residents as technically competent. Currently, no method is universally accepted or recommended for classifying residents as “experienced,” “intermediates,” or “novices” according to their technical abilities. This study introduces a classification method for recognizing residents’ level of experience in laparoscopic surgery based on psychomotor laparoscopic skills alone. Methods For this study, 10 experienced residents (>100 laparoscopic procedures performed), 10 intermediates (10–100 procedures performed), and 11 novices (no experience) performed four tasks in a box trainer. The movements of the laparoscopic instruments were recorded with the TrEndo tracking system and analyzed using six motion analysis parameters (MAPs). The MAPs of all participants were submitted to principal component analysis (PCA), a data reduction technique. The scores of the first principal components were used to perform linear discriminant analysis (LDA), a classification method. Performance of the LDA was examined using a leave-one-out cross-validation. Results Of 31 participants, 23 were classified correctly with the proposed method, with 7 categorized as experienced, 7 as intermediates, and 9 as novices. Conclusions The proposed method provides a means to classify residents objectively as experienced, intermediate, or novice surgeons according to their basic laparoscopic skills. Due to the simplicity and generalizability of the introduced classification method, it is easy to implement in existing trainers. Content Type Journal ArticleDOI 10.1007/s00464-009-0721-yAuthors Magdalena K. Chmarra, Delft University of Technology Department of BioMechanical Engineering, Faculty of Mechanical, Maritime and Materials Engineering (3mE) Mekelweg 2 2628 CD Delft The NetherlandsStefan Klein, University Medical Center Utrecht Image Sciences Institute Utrecht The NetherlandsJoost C. F. de Winter, Delft University of Technology Department of BioMechanical Engineering, Faculty of Mechanical, Maritime and Materials Engineering (3mE) Mekelweg 2 2628 CD Delft The NetherlandsFrank-Willem Jansen, Delft University of Technology Department of BioMechanical Engineering, Faculty of Mechanical, Maritime and Materials Engineering (3mE) Mekelweg 2 2628 CD Delft The NetherlandsJenny Dankelman, Delft University of Technology Department of BioMechanical Engineering, Faculty of Mechanical, Maritime and Materials Engineering (3mE) Mekelweg 2 2628 CD Delft The Netherlands Journal Surgical EndoscopyOnline ISSN 1432-2218Print ISSN 0930-2794
Appropriate management of common bile duct stones: A RAND Corporation/UCLA Appropriateness Method statistical analysis
Sat, 14 Nov 2009 06:59:13 -0000
Abstract Background Bile duct stones affect 10% of patients who undergo a cholecystectomy and therefore represent a major health problem. Laparoscopic common bile duct exploration, endoscopic sphincterotomy, and open surgical choledocholithotomy are the three available methods for dealing with choledocholithiasis. Though many trials and reviews have compared all three strategies, a list of indications for defined patient profiles is lacking. Methods We employed the RAND Corporation/UCLA Appropriateness Method (RAM) to evaluate the three procedures for bile duct stone clearance. An expert panel judged appropriateness after a comprehensive bibliography review, a first-round private rating of 108 different clinical situations, a consensus meeting, and a second round of definitive rating. A list of indications for each procedure was statistically calculated. Results A consensus was reached for 41 indications (38%). The endoscopic approach was always appropriate for preoperatively diagnosed bile duct stones and inappropriate for patients with single intraoperative detected stones causing cholangitis and bile duct dilatation. Laparoscopic bile duct exploration was appropriate for preoperatively diagnosed choledocholithiasis if patients had not undergone a previous cholecystectomy and no signs of cholangitis were detected. The laparoscopic approach was also appropriate for intraoperatively incidentally detected stones, except for septic patients with poor performance status and multiple calculi. Laparoscopic bile duct clearance was judged inappropriate for septic patients with poor performance status and absence of bile duct dilatation. Open surgery was appropriate in all patients with intraoperative diagnosis of choledocholithiasis and cholangitis and in septic patients with bile duct dilatation. There was no clinical situation in which open surgery was appropriate when bile duct stones were preoperatively diagnosed. Conclusions There is still uncertainty with respect to the management of choledocholithiasis, showing the need for further investigation. The RAM helps to elucidate appropriateness for the different treatment options in specific clinical settings. Content Type Journal ArticleDOI 10.1007/s00464-009-0748-0Authors Pablo Parra-Membrives, Valme University Hospital Hepato-bilio-pancreatic Surgery Unit of the General and Digestive Surgery Department Carretera de Cádiz s/n 41014 Sevilla SpainDaniel DĂaz-GĂłmez, Valme University Hospital Hepato-bilio-pancreatic Surgery Unit of the General and Digestive Surgery Department Carretera de Cádiz s/n 41014 Sevilla SpainRomán Vilegas-Portero, The Emerging Technologies Observatory Andalusian Agency for Health Technology Assessment Sevilla SpainMáximo Molina-Linde, The Emerging Technologies Observatory Andalusian Agency for Health Technology Assessment Sevilla SpainLourdes GĂłmez-Bujedo, High Resolution Hospital Center of Utrera Sevilla SpainJuan RamĂłn Lacalle-Remigio, University of Seville Department of Preventive Medicine Sevilla Spain Journal Surgical EndoscopyOnline ISSN 1432-2218Print ISSN 0930-2794
pubmed: 1088-5412
Solar urticaria.
Webb LM, Mikita CP Solar urticaria. Allergy Asthma Proc. 2009 Sep-Oct;30(5):563-5 Authors: Webb LM, Mikita CP A case of solar urticaria is presented, followed by a discussion of the clinical characteristics, pathophysiology, diagnosis, and management of this disease. Special emphasis is given to clinical pearls and pitfalls for the practicing allergist. Solar urticaria is a physical urticaria that can be difficult to diagnose and distinguish from other photodermatoses. There are some characteristic features that are important to remember when evaluating a patient with suspected solar urticaria. Testing can be difficult without the assistance of an experienced dermatologist because there are several different wavelengths of light that can lead to a patient's symptoms. Solar urticaria tends to be a chronic disease with a low 5-year resolution rate but can usually be effectively managed with multiple antihistamines. PMID: 19843410 [PubMed - in process]
Twenty-one year old woman with severe eosinophilia and left bundle branch block.
Padi A, Silverman B, Schneider A Twenty-one year old woman with severe eosinophilia and left bundle branch block. Allergy Asthma Proc. 2009 Sep-Oct;30(5):558-62 Authors: Padi A, Silverman B, Schneider A Peripheral and tissue eosinophilia can occur in a wide variety of disease processes that include infectious, allergic, and primary hematologic disorders, and other more rare diseases such as hypereosinophilic syndromes (HES). We describe a case of a patient with severe eosinophilia and left bundle branch block. A 21-year-old woman with asthma and allergic rhinitis presented with neck pain and cough for >6 months with no other complaints. Physical exam was normal except for fever and minimal expiratory wheezes. Chest CT revealed diffuse airway inflammation with bronchiectasis. Admission electrocardiogram (EKG) was normal. Initial laboratory tests showed an absolute eosinophil count of 30,000 cells/mL. A thorough workup for eosinophilia was initiated, but the patient subsequently left against medical advice. The next day, in the outpatient pulmonary clinic, she was found to be tachycardic and an EKG showed sinus tachycardia with a new left bundle branch block. Laboratory tests revealed an eosinophil count of 33,200 cells/mL and elevated troponins. She was started on i.v. Solu-Medrol (Pfizer, Inc.). The next day, her EKG returned to normal. Three days later her absolute eosinophil count normalized. Identifying the cause of marked, persistent eosinophilia is a challenging problem. Excluding the more common causes of severe eosinophilia is required before making a diagnosis of HES and early therapeutic intervention can prevent morbidity from the disease. PMID: 19843409 [PubMed - in process]
Serum levels of protein oxidation products in patients with nickel allergy.
Gangemi S, Ricciardi L, Minciullo PL, Cristani M, Saitta S, Chirafisi J, Spatari G, Santoro G, Saija A Serum levels of protein oxidation products in patients with nickel allergy. Allergy Asthma Proc. 2009 Sep-Oct;30(5):552-7 Authors: Gangemi S, Ricciardi L, Minciullo PL, Cristani M, Saitta S, Chirafisi J, Spatari G, Santoro G, Saija A Nickel sensitization can not only induce allergic contact dermatitis (ACD), but also can induce an overlapping disease referred to as "systemic nickel allergy syndrome" (SNAS), characterized by urticaria/angioedema and gastrointestinal symptoms correlated to the ingestion of nickel-containing foods. This study was designed to determine if oxidative stress occurs in patients with nickel allergy. Thirty-one female patients (mean age 31.26 + 13.04 years, range 16-64 years) with confirmed nickel CD underwent oral nickel challenge because of clinically suspected SNAS; serum concentrations of protein carbonyl groups (PCGs) and nitrosylated proteins (NPs; biomarkers of oxidative stress) were measured before and after oral nickel challenge as well as in healthy female controls. Twenty-three of these 31 patients were diagnosed with SNAS because they had a positive reaction to the oral nickel challenge, and 8 patients had no reaction and therefore were classified as patients with contact nickel allergy only. Although both nickel-allergic patients and controls presented similar serum levels of PCGs, NP values in nickel-allergic patients appeared higher than in controls and tended to decrease after the challenge; furthermore, serum levels of NPs in patients affected by SNAS were higher (although not significantly) than in patients with nickel ACD only. The involvement of specific biomarkers of oxidative stress such as NPs and the lack of involvement of other biomarkers such as PCGs may help to better understand the alteration of the redox homeostasis occurring in nickel ACD and particularly in SNAS. PMID: 19843408 [PubMed - in process]
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 patient’s 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
This directory is based on the Open Directory and may have been modified
