[Family education, a model for allergy prevention]. / Educación familiar, un modelo de prevención alérgica.

It is frequent the lack of family adherence toward the therapeutic measures of the allergic diseases. The incidence in the therapeutic non compliance of the asthmatic patients vary from 20 to 80%. In the last decades, the symptomatic expression of the atopic diseases (AD) in the infancy, and in the adolescence of Venezuelans has been transformed into a health care problem, with an inaccessible therapeutic cost for the state and the family. The setup of the first allergic prevention program improved attitudes and perceptions toward bronchial asthma, allergic rhinitis, and atopic dermatitis, by the education of the risk family group, based on the results from previous investigations and adapted to the procedures and customs that govern our current society. A research project, through a multi-disciplinary group included an educational program model for the prevention of allergic diseases in a population from Caracas, Venezuelan allergic pregnant mothers, and their respective couples of a high and middle socioeconomic levels with no helminthic infections (n = 482), group A. Two subgroups were randomly selected for prospective evaluation: A1 (n = 20) without participation in the preventive program or control group, and A2 (n = 15) with participation in the program or intervened group, including strategies to be applied by the family, application of measures and reached goals; immunologic, pediatric, and nutritional sequential control; group B (n = 66), to validate the laboratory tests, and group C (n = 364) to validate immunoclinical diagnoses, in vivo immunodiagnostic tests to the parents and children (clinical history, skin prick tests for cow's milk, egg white, wheat, soybean, cladosporium and Dermatophagoides pteronnysinus), and in vitro tests (total serum IgE, Phadiatop, and Rast to the allergens previously selected). In conclusion, the program permits the identification of atopic risk children, sponsors the systematical application of intervention measures, economic, viable and projected toward the family affected, indicating a positive change through a self-family-management training and new conduct plans, facilitating the participation among the family, the community and the health team, that certifies, an optimistic therapy in the reduction of the clinical manifestations of the atopic diseases in young infants from this tropical population studied.

Common airborne allergens and their clinical relevance in the Caracas valley.

In order to determine the sequential prevalence of pollen grains and fungi spores in the city of Caracas by the volumetric method of collection and its effect on the population at risk, the first multidisciplinary team of aerobiological research was structured through a protocol designed for five experimental stages namely: a) Determination of the climatological parameters: temperature, relative humidity, speed and wind direction, precipitation and atmospheric stability, through simultaneous records of meteorological status located in the metropolitan area of Caracas; b) Collection, identification, classification and determination of the local distribution of the most important pollen grains existing in the zone under study; c) Collection, identification and classification of the most important fungi spores in the area; d) Preparation of the first pollinic calendar of Caracas and e) Evaluation of possible implication of the environment and the response through the IgE antibody in the selected patients in the area under study. Our results show: 1) The climatic conditions existing during the sampling period coincide with the analysis of the last 20 years in the Valley of Caracas. 2) The Venezuelan Central University (UCV) station was elected as the most representative point for permanent sampling. 3) An ideal statistical method is obtained in order to determine the spatial arrangement in the sampler rod of a dense type of fungi spores typical of the area under study. 4) The first pollinic calendar of Caracas was structured and 5) A seasonal tendency of the IgE response is shown. These results suggest an evident interrelation between the suggested concept of polyseasonality and antigenic polysensitization, and between individual seasonality with a specific reactivity and, finally, between tropical mixed seasonality with the expression of combined respiratory pathologies in our environment.