Author/Editor		Plevnik-Vodušek, V
Title		Delo v alergoloških ambulantah
Translated title		Analysis of work in an allergy outpatient clinic
Type		članek
Source		Slov Pediatr
Vol. and No.		Letnik 5, št. Suppl 2
Publication year		1998
Volume		str. 103-7
Language		slo
Abstract		The increasing incidence of allergy in children demands appropriate organisation of the health service. The set-up and workload of an outpatient clinical for allergic children is described. The role of the children's allergy outpatient clinic is in prevention, early diagnosis and treatment of allergic diseases. This taks is accompliches by close collaboration with primary care pediatricians, education of parents and children, and continuing monitoring of children's health, with the aim of referring only complex conditions to hospital and tertiary level specialists. Charts of 1559 children referred to our clinic in the period from 1. 10. 1996 to 31. 5. 1998 were analysed. The number of referals increased throughout this period. Allergy was present in 48% and smoking in 35% of families. The frequent diagnoses were atopic eczema (29%), bronchial asthma (16%), recurrent respiratory infections (12%) and other nonallergic skin symptoms (11%). In the first two years of life, children most most often had atopic eczema (41%), between 2 - 6 years of age and after 6 years of age, bronchial asthma (47% and 51%); allergic rhinitis was most frequent inschool-aged children (32%). Among the laboratory tests, skin prick tests and specific IgE were most often in agreement with the clinical picture, while the IgE screening test and total igE seemed less helpful. In conclusion, the increasing number of referrals resulting in a waiting list of children with allergic conditions support the notion that allergy outpatient clinics are needed. Their task can be accomplished by their intermediary role between primary care pediatricians and the hospital working together with other seconary level specialists (dermatologist, otorhinolaryngologist, pulmologist, dietician) whose consultations are needed because of the complexities of allergic diseases.
Summary		V prispevku sta prikazana pomen in vsebina dela v zunajbolnišnični alergološki ambulanti za otroke. Njene osnovne naloge so preprečevanje, zgodnje odkrivanje, zdravljenje in vodenje alergijskih bolezni v otroštvu. Pri delu tovrstne ambulante na sekundarni ravni je poudarek na preprečevanje alergijskih bolezni, ob tesnem sodelovanju s pediatri na primarni ravni, na poučevanju starŠev in njihovih otrok, ob kontunuiranem spremljanju in vodenju, nenazadnje pa je takšna ambulanta triažno mesto; od koder se diagnostično bolj zapleteni primeri usmerijo v bolnišnično alergološko ambulanto, oziroma na terciarno raven. V študijo je bilo vključenih 1559 otrok, ki so bili napoti v alergološko ambulanto v času od 1. 10. 1996 do 31. 5. 1998. Družinska anamneza glede alergijskih bolezni je bila pozitivna pri 48%. V domačem okolju je kadilo 35% družinskih članov. Naveč je bilo otrok z AD (atopični dermatitis) (29%), sledili so astmatiki (16%), nato pa tisti z nealergijsko kožno simptomatiko (11%) in tisti s pogostimi okužbami dihal (12%). V prvem letu otroci najpogosteje zbolevajo za AD (41%), za BA (bronhialno astmo) med 2 in 6 letom (47,5%) in po 6 letu (51%), medtem ko je AR (alergijski rinitis) bolezen šolarjev (92%). Glede preiskav so najbolj povedni rezultati kožnih vbodnih testov in specifičnih IgE. Manj občutljivi so presejalni testi IgE, najmanjšo diagnostično vrednost pa imajo celokupni IgE. Naraščanje Števila napotenih v otroško alergološko ambulanto in posledično daljša čakalna doba dokazujejo potrebnost takšne ustanove v slovenskem prostoru. Za doseganje osnovnih ciljev zunajbolnišnične alergološke ambulante je potebno dobro sodelovanje tako s pediatri na primarni ravni kot z alergologi v bolnišnici, glede na kompleksnost alergijskih bolezni pa tudi z različnimi strokovnjaki drugih strok: dermtologi, otorinolaringologi, pulmologi, dietetiki, psihologi.
Descriptors		HYPERSENSITIVITY CHILD OUTPATIENT CLINICS, HOSPITAL