Blog, para el estudio, la publicación, la investigación, la asesoría y la consulta médica,prevención, diagnóstico, tratamiento de las enfermedades alergicas, el asma, la inmunología y la pediatría global en niños y adultos. En Venezuela e internacionalmente. Blog for the study, publication, research, assesment and the consultancy of medical prevention, diagnosis, treatment of the allergic diseases: asthma,immunology and pediatrics in children and adults in Venezuela and world-wide.
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Sunday, August 18, 2013
Saturday, August 17, 2013
Sunday, August 11, 2013
MOULD ALLERGY / ALERGIA POR HONGOS
The moulds causing allergy are simple plants (fungi) of microscopic size.
They occur in nature in large quantities living on organic matter such as other plants, foods and dry leaves. The reproductive bodies, the spores, readily become airborne with aid of air turbulence. Also mycelia (the vegetative part of a fungus) of moulds may become airborne and act as allergens.
Under proper weather and microclimate conditions the spores germinate an develope into new mould colonies.
The amount of mould spores in the air is variable; from a few spores/m3 outdoors in cold winter moulds up to 1 million/m3 in situations where mouldy material is occupationally handled. Usually thousans of moulds spores per m3 are required to initiate allergic symptoms, large spores e.g. Alternaria, being the exception.
Cladosporium (Hermodendrum) and Alternaria occur world-wide and are the most frequently observed causes of mould allergy.
They are basically out-doors moulds and their appearance is related
to the life cycle of local crops and foliage. The increase of dead plant particles over the vegetation season together with seasonal increase in warmth and humidity leads to increased mould growth.
Allergy to Aspergillus, Mucor and Penicillium are usually the offenders in patients with perennial symptoms to moulds. Furniture and mattress dust and stuffed animal toys may be particularly rich in mould spores in the home. Damp cellars are fertile grounds for growth of moulds. But moulds also attack paper products, wallpaper paste, wood and, of course, food (e.g. Mucor on bread). In the manufacture of some foods moulds are intentionallt added e.g. to cheese (Aspergillus and Penicillium) and soy sauce (Aspergillus).
In the University of Kansas, USA, mould allergy, diagnosis, testing and treatment, have been used since the 1 950´s; being Dr. Frederick Speer at his Shawnee-mission Allergy Clinic at Outlook Drive, an Scholar on that subject.
Dr. Speer taught me how to collect mould spores and fungi to study them throught the microscope and learn the incidence of burden moulds in the environment. For Dr. Speer a Microscope Department was a small outlet where you could handle the whole gadgets require to investigate and study the mould population in any season.
By the way, I brought all that setting to my Allergy Clinic at Centro Medico de Caracas where I practice Allergy since 1975.
As a matter of fact, moulds in Caracas are about the same as in Kansas and Oklahoma, without the season variations that we do not have down here.
The diagnosis of mould allergy is done by History, Prick and
Rast in vitro testing, with good results if you are aware of the stuff.
Treatment of mould allergy is the same as for other offenders: diagnosis, avoidance, medication and Immunotherapy.
Moulds as allergens or antigens can cause allergies according to the classified nomenclature of Asthma and the Allergic Diseases.
See my article on Classified Nomenclature in this same Blog.
Mould Allergy as treated by Carlos E Mijares, MD
We follow the University of Kansas Allergy Protocol and are in closed contact with that Medical Center, since then.
Dr Jay Portnoy is the Head of Allergy and Immunology and pediatrics at the Mercy´s Children Hospital in Kansas City, Missouri. Professor, Dr Robert C. Dockhorn was my teacher at that hospital, and is now living in Prairie Village, Kansas, Kansas City, USA.
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