10 research outputs found

    Compromising between European and US allergen immunotherapy schools: Discussions from GUIMIT, the Mexican immunotherapy guidelines

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    Background: Allergen immunotherapy (AIT) has a longstanding history and still remains the only disease-changing treatment for allergic rhinitis and asthma. Over the years 2 different schools have developed their strategies: the United States (US) and the European. Allergen extracts available in these regions are adapted to local practice. In other parts of the world, extracts from both regions and local ones are commercialized, as in Mexico. Here, local experts developed a national AIT guideline (GUIMIT 2019) searching for compromises between both schools. Methods: Using ADAPTE methodology for transculturizing guidelines and AGREE-II for evaluating guideline quality, GUIMIT selected 3 high-quality Main Reference Guidelines (MRGs): the European Academy of Allergy, Asthma and Immunology (EAACI) guideines, the S2k guideline of various German-speaking medical societies (2014), and the US Practice Parameters on Allergen Immunotherapy 2011. We formulated clinical questions and based responses on the fused evidence available in the MRGs, combined with local possibilities, patient's preference, and costs. We came across several issues on which the MRGs disagreed. These are presented here along with arguments of GUIMIT members to resolve them. GUIMIT (for a complete English version, see Supplementary data) concluded the following: Results: Related to the diagnosis of IgE-mediated respiratory allergy, apart from skin prick testing complementary tests (challenges, in vitro testing and molecular such as species-specific allergens) might be useful in selected cases to inform AIT composition. AIT is indicated in allergic rhinitis and suggested in allergic asthma (once controlled) and IgE-mediated atopic dermatitis. Concerning the correct subcutaneous AIT dose for compounding vials according to the US school: dosing tables and formula are given; up to 4 non-related allergens can be mixed, refraining from mixing high with low protease extracts. When using European extracts: the manufacturer's indications should be followed; in multi-allergic patients 2 simultaneous injections can be given (100% consensus); mixing is discouraged. In Mexico only allergoid tablets are available; based on doses used in all sublingual immunotherapy (SLIT) publications referenced in MRGs, GUIMIT suggests a probable effective dose related to subcutaneous immunotherapy (SCIT) might be: 50–200% of the monthly SCIT dose given daily, maximum mixing 4 allergens. Also, a table with practical suggestions on non-evidence-existing issues, developed with a simplified Delphi method, is added. Finally, dissemination and implementation of guidelines is briefly discussed, explaining how we used online tools for this in Mexico. Conclusions: Countries where European and American AIT extracts are available should adjust AIT according to which school is followed

    "Outside, it is snowing": Experience and finitude in the nonrepresentational landscapes of Alain Robbe-Grillet

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    Copyright © 2008 PionRomanillos J L, 2008. The definitive, peer-reviewed and edited version of this article is published in Environment and Planning D: Society and Space 26(5) 795 – 822 DOI: 10.1068/d6207This paper presents and explicates the anonymous and impersonal spatialities tentatively mapped in the novels of Alain Robbe-Grillet. Emerging from the kinds of landscapes and visualities articulated, these spatialities are at odds with the kind of anthropocentrism characteristic of phenomenological narratives of spatial experience that would start from an apparently stable human-subject position. It is argued that his body of literature dismantles the anthropocentric narratives and biographies that would produce in both the space of the world and the ‘phenomenological subject’ an unwarranted depth and naturalism. Importantly, and reflecting the theoretical turn towards the being of language, Robbe-Grillet questions the legitimacy of linguistic subjects to capture the spaces of the visible. As such, it is argued that his literature reflects an experience of the critiques of phenomenology. Importantly, this ‘critique’ goes hand in hand with the kinds of spatialities and landscapes that are rendered in the novels—the indefinite perspectives they open up, the paradoxical visualities they sustain or deny, and the disorientation they inject into the heart of spatial experience. These literary effects produce a nonanthropocentric and nonpersonal spatiality which, although contributing to an erasure of the ‘subject’, at the same time expose and open up a sociospatiality based on singularities, intensities, and finitude

    GUIMIT 2019, Guía mexicana de inmunoterapia. Guía de diagnóstico de alergia mediada por IgE e inmunoterapia aplicando el método ADAPTE

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    Geography, death and finitude

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    publication-status: PublishedRomanillos J L, 2011. The definitive, peer-reviewed and edited version of this article is published Environment and Planning A, 2011, Vol. 43, Issue 11, pp. 2533 – 2553 DOI: 10.1068/a4474Copyright © 2011 PionDespite growing interest in the geographies of death, loss, and remembrance, comparatively little geographical research has been devoted either to the historical and cultural practices of death, or to an adequate conceptualisation of finitude. Responding to these absences, in this paper I argue for the importance of the notion of finitude within the history and philosophy of geographical thought. Situating finitude initially in the context of the work of Torsten Hägerstrand and Richard Hartshorne, the notion is argued to be both productive of a geographical ethics, and as epistemologically constitutive of phenomenological apprehensions of ‘earth’ and ‘world’. In order to better grasp the sense and genealogy of finitude, I turn to the work of Martin Heidegger, Michel Foucault, and Georges Bataille. These authors are drawn upon precisely because their writings present powerful conceptual frameworks which demonstrate the intimate relations between spatiality, death, and finitude. At the same time, their writings are critically interrogated in the light of perhaps the most important aspect of the conceptual history of finitude: the way in which it has been articulated as a site of anthropocentric distinction. I argue for a critical deconstruction of this anthropocentric basis to finitude; a deconstruction which raises a series of profound questions over the ethics, normativities, and understandings of responsibility shaping contemporary ethical geographies of the human and nonhuman. In so doing, I demonstrate the geographical importance of the notion of finitude for a variety of arenas of debate which include: phenomenological understandings of spatiality; the biopolitical boundaries drawn between human and animal; and contemporary theorisations of corporeality, materiality, and hospitality

    Videogames, visuality and screens: reconstructing the Amazon in physical geographical knowledge

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    In this article we attend to an emergent practice of visualising GIS data in physical geography using the graphics engine of a videogame, Crysis. We suggest these modes of image-making aid the possibility of imagining and disseminating complex geographical data differently by re-contextualising seemingly abstract mathematical information within a human horizon of embodied meaning. Furthermore we argue these ways of imagining are closely linked to the technology and phenomenology of screens which make the presentation of these images possible. We close by reflecting on the possibility that these technologies are shifting the grounds of vision and the geographical imagination of users

    El sistema educativo español 2000

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    El objetivo del informe es proporcionar una visión de conjunto de la educación en España, que no pretende ser exhaustiva en ninguno de los aspectos abordados, pero sí describirlos con el detalle suficiente como para que la información proporcionada sea útil. El libro está organizado en tres grandes bloques de contenidos. En primer lugar se presentan cinco capítulos que abordan el contexto y los aspectos globales del sistema educativo. El segundo bloque recoge las distintas enseñanzas, etapas y niveles que comprende el sistema Educativo. El tercer y último bloque incluye los diferentes factores clave del sistema educativo.Ministerio Educación CIDEBiblioteca de Educación del Ministerio de Educación, Cultura y Deporte; Calle San Agustín 5 -3 Planta; 28014 Madrid; Tel. +34917748000; [email protected]

    Compromising between European and US allergen immunotherapy schools: Discussions from GUIMIT, the Mexican immunotherapy guidelines

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