[Multiple chemical sensitivity: study of 52 cases]. / Sensibilidad química múltiple: análisis de 52 casos.

BACKGROUND AND OBJECTIVE: Multiple chemical sensitivity (MCS) is characterized by a loss of tolerance to various environmental chemicals. The objective of this study was to describe patients with MCS seen in our hospital. PATIENTS AND METHOD: Patients consecutively seen by the Toxicology and Chronic Fatigue Units who presented symptoms of MCS were included. The diagnosis was clinical. All patients completed the Quick Environmental Exposure and Sensitivity Inventory (QEESI) questionnaire. RESULTS: Fifty-two patients were included. The average age (standard deviation) was 47.2 (7.6) years, and 46 (88%) were females. The origin of the syndrome was related to occupational exposure to various chemical agents in 31 cases (59.6%), including occupational accidents in 14 patients (fumigation of the workplace with insecticides). In 20 patients (38.5%), the syndrome could not be associated with any toxic exposure and was considered a manifestation of chronic fatigue syndrome. The QEESI showed mean scores of 72.9 (18.6) on the chemical inhalant intolerance scale, 45.5 (20.6) on the other intolerances scale, 69.8 (20.6) on the symptom severity scale, 4.4 (1.8) on the masking index and 66.6 (21.7) on the life impact scale. All patients were followed up for a minimum of 12 months, and during this period they remained stable with no deaths. CONCLUSIONS: MCS normally affects middle-aged women. It is frequently triggered by exposure to chemical agents, especially insecticides. An association with chronic fatigue syndrome is common. The prognosis is good but the patients' quality of life is seriously affected.

National multicentre study of acute intoxication in emergency departments of Spain.

OBJECTIVE: No studies have been published on global acute intoxication in Spanish emergency departments. We therefore designed a multicentre study to identify the epidemiology and management of intoxicated patients in Spain. METHODS: We prospectively recorded cases from 14 emergency departments during 14 randomized days between February and April 2000. We included all age groups and all kinds of acute intoxication patients (including alcohol), except food-related cases, inert foreign bodies and deaths before arrival at the emergency department. Phone calls to poison control centres and inpatients were not followed. RESULTS: A total of 419 cases were recorded, 0.66% of emergency department visits. The incidence of intoxication was higher at weekends and on Mondays (P<0.001). The mean age was 33 years (STD+/-18.10); males represented 56%, and 34.2% of patients arrived at the emergency department within the first 2 h. A total of 80% of patients were treated as outpatients, 3.7% were admitted to the intensive care unit, 6.7% were hospitalized, and 0.2% died. DISCUSSION: We recorded a slightly lower incidence than other European countries with the same epidemiological profile, except for a low incidence of acetaminophen cases. If we apply the European Association of Poisons Centres and Clinical Toxicologists gastric lavage criteria, there were an important number of unnecessary gut decontamination techniques in drug poisoning. Most patients were treated in emergency departments, without hospital admission.

[Analysis of patients attended in an emergency department due to ecstasy consumption]. / Análisis de las consultas generadas por el consumo de éxtasis en un servicio de urgencias.

BACKGROUND AND OBJECTIVE: There has been in recent years an increase in the number of medical emergencies due to the consumption of designer drugs. We decided to study the characteristics of medical emergencies generated by the consumption of amphetamine derivates. PATIENTS AND METHOD: For the period 2000-2002, the medical records of patients attending the Emergency Department (ED) who claimed to have consumed ecstasy or other amphetamine derivates or whose toxicological tests were positive for amphetamines were reviewed. RESULTS: A total of 230 cases were identified, of whom 135 attended the ED due directly to ecstasy consumption. The average age was 23 years and 68% were men. Most patients were attended on weekend nights. The main reasons for attendance at the ED were anxiety, agitation or cognitive disturbances, reduced consciousness and fits or motor disturbances. Eighty per cent of patients admitted having consumed ecstasy and 65% of patients had consumed additional drugs. Three severe cases were recorded: two died in the ED and another was admitted to the ICU. CONCLUSIONS: Ecstasy consumption generates common attendance at the Emergency Department and can be potentially fatal.