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Allergist/clinical immunologist maintenance of certification and training program reaccreditation are mandatory in some countries. The World Allergy Organization conducted surveys in 2009 and 2011 to assess where such programs were available and to promote the establishment of such programs on a global level. This was done with the presumption that after such an ''inventory,'' World Allergy Organization could offer guidance to its Member Societies on the promotion of such programs to assure the highest standards of practice in the field of allergy and clinical immunology. This review draws on the experience of countries where successful programs are in place and makes recommendations for those wishing to implement such programs for the specialty. Keywords: allergy and clinical immunology, allergist, physician skills, physician competencies, physician performance measurement

Pollen and mold allergies are highly problematic in Islamabad. This study was conducted to investigate the type and concentration of airborne pollens/molds causing allergic diseases in susceptible individuals. A volumetric spore trap (Burkard) was placed at the height of 11 m and ran continuously for 3 years. Once a week, the collecting drum was prepared by affixing Melinex tape with a double sided adhesive that was coated with a thin layer of silicone grease. Every Sunday at 9:00 AM the drum was replaced by another drum and the pollen/mold spores were removed and permanently mounted on slides. Using a microscope, the trapped particles were identified and recorded as counts per cubic meter of air per hour. From these data, the pollen and mold calendars were constructed and expressed as counts per cubic meter of air per day. Skin prick tests were performed on more than 1000 patients attending the Pakistan Allergy, Asthma & Clinical Immunology Centre of Islamabad. The results indicated that there were 2 main pollen plants that contributed to seasonal allergies. These were Broussonetia papyrifera and Cannabis sativa during the March/April season and the July/September season, respectively. Although mold spores were continuously detected throughout the year, the most prominent mold was undetected mold and unconfirmed mold species similar to Stachybotrys species, which was high from July to September/October. Two additional molds contributing to allergic reactions were Pithomyces species and Cladosporium species, which were active during January and April, with the latter also being detected between October and November. These results may prove beneficial to both patients and physicians in planning a therapeutic protocol for avoidance and amelioration. Keywords: pollen and mold calendar, aerobiology, Islamabad, Burkard spore trap, Broussonetia papyrifera, Cannabis sativa, skin prick test, SPT, asthma, allergic rhinitis

We read with great interest the recent study by Chen K and colleagues [1] which showed an increase risk of asthma hospital admissions in all age groups with total pollen. However, there are numerous issues that have been overlooked in the analysis of the pollen variable. If these issues were considered, the authors may have observed stronger species-specific effects thereby contributing to the evidence base on which pollen species is the major trigger of asthma exacerbations requiring hospitalization. This article is protected by copyright. All rights reserved.

Urticaria and angioedema can be caused by allergic and non-allergic mechanisms. While acute

There has been an increase in the prevalence of food allergy seen in children in the last few decades. As these children reach adulthood, physicians will have an increased role in ongoing management of these allergic disorders. Food allergy in adults may result from a persistence of reactions that commenced in infancy and early childhood or it may occur for the first time in adulthood through new sensitisations. Such sensitisation may occur directly to a food allergen or indirectly via cross reactivity with an aeroallergen. Adults may present with a spectrum of clinical manifestations from oral allergy syndrome to fatal anaphylaxis. Persistence of childhood allergy is particularly relevant for peanut allergy which has significantly increased in the last two decades. Only approximately 20% of peanut-allergic children will develop tolerance to peanuts so there will be an increasing number of individuals reaching adulthood where this problem will need to be addressed. In addition to peanut, tree nuts, fruits, vegetables and seafood are implicated as common causes of food allergy in adulthood. The management of food allergy consists of appropriate education regarding avoidance of implicated foods, modifying potential risk factors for anaphylaxis such as asthma, and prompt recognition and treatment of acute reactions.

Background The Allergies surveys have been conducted in several regions of the world, and provide the first worldwide comparative data on the prevalence and impact of nasal allergies. Here we report specifically on the impact of nasal allergies on daily life and work productivity in America (AIA), Asia Pacific (AIAP), Latin America (AILA) and Middle East (AIME) surveys. Methods Patients who were previously diagnosed by a health care professional with nasal allergies (hay fever, allergic rhinitis or nasal allergies, plus sinus disease in AIAP), exhibited symptoms, and/or had received treatment, were included. Standardized questionnaires provided by Abt SRBI were used; individual questions and methodology varied slightly between regions. In total, around 90,000 households were screened, including responses from 6,081 patients. Results Patients reported that allergies have a big impact on their daily lives, including limiting indoor and outdoor activities, work and having pets. A high percentage of those surveyed missed work or had their work performance affected by allergies in the past year, with work productivity decreasing by 23% in AIA, 24% in AIAP, 33% in AILA and 30% in AIME when allergy symptoms were at their worst. Nasal allergies also interfered with many patients' sleep, and were associated with feelings of depression, anxiety, irritability and tiredness. In terms of the impact of symptoms, 38% of those surveyed in AIA, 53% in AIAP and 46% in AILA reported that they could not tolerate the discomfort of an allergy attack without relief. Conclusions Nasal allergies have a big impact on patients' lives all around the world, and there is still an unmet need for effective treatments that reduce symptoms. As a result, work productivity levels and daily activities are hugely affected in a large proportion of individuals with nasal allergies, throughout the world.

Unfortunately, the original version of this article [1] contained an error. The spelling of author name Vera van Kempen was incorrect. The correct spelling can be found below.