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2.
Med. segur. trab ; 64(251): 217-240, abr.-jun. 2018. tab
Artigo em Espanhol | IBECS | ID: ibc-179779

RESUMO

Introducción: La contaminación y la exposición a productos químicos han condicionado un aumento de la prevalencia de enfermedades crónicas no sólo explicables por la genética o susceptibilidad individual. La Sensibilidad Química Múltiple (SQM) es un ejemplo de estas afecciones. Se trata de un trastorno adquirido, crónico y caracterizado por la aparición de síntomas recurrentes como respuesta a la exposición a compuestos químicos en concentraciones que no se consideran tóxicas para la población general. Su etiología es incierta y multifactorial, su diagnóstico clínico y su abordaje multidisciplinar. En ocasiones está vinculada a la exposición ocupacional, aunque la diversidad de sustancias que pueden desencadenarla la convierten en impredecible. Objetivo: La finalidad de este trabajo es aportar una visión general sobre esta patología con el objetivo de analizar la situación derivada de dicha afección tras la revisión de un caso de SQM. Metodología: Revisión bibliográfica del SQM mediante la búsqueda de literatura científica durante el mes de septiembre de 2017 utilizando los términos Mesh «Multiple Chemical Sensitivity.» Se presenta un caso clínico con diagnóstico de SQM vinculado a exposición ocupacional y se analiza la situación derivada de esta afección. Resultados: Se describe el caso clínico de una trabajadora de 45 años de edad, técnico de laboratorio en un hospital de referencia que tras el diagnóstico de hiperreactividad bronquial probablemente relacionado con la exposición a determinados reactivos comienza un periodo de incapacidad temporal con adaptaciones, cambios de puesto de trabajo y múltiples valoraciones por distintos especialistas hasta llegar al diagnóstico de SQM. Se analiza el informe médico de valoración y el expediente administrativo derivado de esta afección poniendo de manifiesto la dificultad que entraña la valoración de este tipo de patologías. Conclusión: Las peculiaridades del SQM en cuanto etiología, diagnóstico y tratamiento obligan a individualizar cada caso. La subjetividad que rodea el SQM lo convierte en una afección muy difícil de valorar. Uno de los grandes desafíos en la actualidad es continuar investigando para facilitar el abordaje multidisciplinar que requiere esta dolencia


Introduction: Pollution and exposure to chemical products has conditioned an increase in the prevalence of chronic diseases not only explained by genetics or individual susceptibility. The Multiple Chemical Sensitivity (MCS) is an example of these conditions. It is an acquired, chronic disorder identified by recurrent symptoms in response to exposure to chemical compounds at concentrations that are not considered toxic for the general population. Its etiology is uncertain and multifactorial; its diagnosis is clinical and must be multidisciplinary approached. It is sometimes linked to occupational exposure, being unpredictable most of the times due to the diversity of the categories that may trigger it. Objective: The purpose of this work is to provide a general overview of this pathology with the aim of analize the situation derived from this condition reviewing a case of MCS. Methodology: Literature review of the MCS through the search of scientific literature in the month of September 2017 using the terms Mesh «Multiple Chemical Sensitivity». A clinical case with a MCS diagnosis linked to an occupational exposure is presented and the consequences of the condition are analyzed. Results: The clinical case of a 45-year-old female laboratory technician in a reference hospital is described. After the diagnosis of bronchial hyperreactivity, probably related to certain reagents exposure, she begins a period of temporary disability with adaptations, changes in workplace and several valuations by specialized doctors ending with the diagnosis of MCS. The analysis of the medical assessment report and administrative record highlights the difficulty to assess this type of pathologies. Conclusion: The peculiarities of MCS in terms of etiology, diagnosis and treatment make it necessary to individualize each single case. The subjectivity surrounding the SQM makes it a very difficult condition to assess. One of the great challenges nowadays is to continue researching to facilitate the multidisciplinary approach that this ailment requires


Assuntos
Humanos , Feminino , Pessoa de Meia-Idade , Exposição a Produtos Químicos , Sensibilidade Química Múltipla/complicações , Sensibilidade Química Múltipla/diagnóstico , Hiper-Reatividade Brônquica/induzido quimicamente , Qualidade de Vida , Exposição Ocupacional , Sensibilidade Química Múltipla/etiologia , Hiper-Reatividade Brônquica/complicações
3.
Rev. esp. anestesiol. reanim ; 65(1): 49-52, ene. 2018. tab
Artigo em Espanhol | IBECS | ID: ibc-169357

RESUMO

El síndrome se sensibilidad química múltiple supone un conjunto de desórdenes complejos que incluyen, entre otros, una serie de trastornos psiquiátricos, síntomas de fatiga crónica y/o trastornos respiratorios. Los desencadenantes del cuadro serían alergenos inespecíficos o tóxicos que provocan una sensibilización neurofisiológica y la aparición de la sintomatología clínica. El tratamiento anestésico de estos pacientes supone siempre un reto para el anestesiólogo por la búsqueda y utilización de fármacos que no desencadenen o agraven los síntomas de dicha enfermedad. Así, el sevoflurano en estas circunstancias podría acercarse al «anestésico ideal». La realización de anestesia general con sevoflurano como agente anestésico único, junto con una serie de medidas ambientales, fueron la base para la realización exitosa de la cirugía en una paciente afecta de síndrome se sensibilidad química múltiple (AU)


Multiple chemical sensitivity syndrome is a group of complex disorders that include psychiatric disorders, chronic fatigue and/or respiratory problems. This syndrome could be triggered by specific allergens and toxins that cause neurophysiological sensitization and the appearance of the clinical symptomatology. Anaesthesia for these patients always poses a challenge for the anaesthetist, because they need to find and use drugs that do not trigger or aggravate the symptoms of the disease. Therefore, sevoflurane in these circumstances might be "the ideal anaesthetic". Performing general anaesthesia with sevoflurane as the sole anaesthetic agent, together with a series of environmental measures formed the basis for successful anaesthesia and surgery in our patient with a multiple chemical sensitivity syndrome (AU)


Assuntos
Humanos , Feminino , Adulto , Doenças dos Seios Paranasais/cirurgia , Procedimentos Cirúrgicos Nasais/métodos , Sensibilidade Química Múltipla/complicações , Fentanila/administração & dosagem , Anestésicos/administração & dosagem
4.
J Psychosom Res ; 99: 40-44, 2017 08.
Artigo em Inglês | MEDLINE | ID: mdl-28712429

RESUMO

OBJECTIVE: The goal of the present study was to investigate the association between multiple chemical sensitivity (MCS) and major depressive disorder (MDD), generalized anxiety disorder (GAD), MDD and GAD comorbidity (MDD+GAD), severe distress, and positive mental wellbeing. METHODS: This cross-sectional investigation was carried out using the 2012 Canadian Community Health Survey - Mental Health Component. The study population consisted of 21,977 individuals aged 20 and older, from Canada's ten provinces. Odds ratios were computed using multinomial logistic regression to calculate estimates of the association between MCS and mental illness. All analyses were weighted to take into account the complex survey design. RESULTS: Individuals with MCS had 2.37 (1.55, 3.64) times greater odds of MDD, 3.09 (1.80, 5.30) times greater odds of MDD+GAD, and 2.60 (1.67, 4.07) times greater odds of severe distress. No association between MCS and GAD was observed. A sex difference was observed with males with MCS having lower odds of positive mental wellbeing, whereas no association was observed in females. CONCLUSIONS: The present study findings supported an association between MCS and mental illness. The causal mechanism supporting this association remains unclear.


Assuntos
Transtornos de Ansiedade/etiologia , Transtorno Depressivo Maior/etiologia , Sensibilidade Química Múltipla/complicações , Adulto , Idoso , Transtornos de Ansiedade/epidemiologia , Canadá , Comorbidade , Estudos Transversais , Transtorno Depressivo Maior/epidemiologia , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Sensibilidade Química Múltipla/epidemiologia , Inquéritos e Questionários , Adulto Jovem
6.
Med Clin (Barc) ; 149(4): 141-146, 2017 Aug 22.
Artigo em Inglês, Espanhol | MEDLINE | ID: mdl-28283271

RESUMO

BACKGROUND AND OBJECTIVES: Multiple chemical sensitivity (MCS) is a chronic, multisystem syndrome of unknown etiology. The aim of the present study was to describe the nutritional status and quality of life of patients suffering from MCS, as well as to identify potential polymorphisms associated with this illness. PATIENTS AND METHODS: A cross-sectional, descriptive study was performed on patients with a diagnosis of MCS. Data on anthropometric and body composition variables, hand muscle strength and quality of life were collected. The selection of single nucleotide polymorphisms (SNPs) was based on genes previously associated with MCS and genes involved in inflammatory and oxidative stress pathways. RESULTS: A total of 52 patients (93.2% female), with a mean age of 50.9 (10.3) years were included in the study. Among them, based on their BMI, 48% had an inadequate nutritional status (17% were underweight and 32% were overweight or obese). Thirty percent of patients had a low muscle mass for their age, 84% had muscle strength below the tenth percentile, and 51.8% had a high fat mass percentage. Regarding quality of life, all median scores were lower than those of other illnesses assessed for every subscale assessed. Statistically significant differences between patient cases and controls were found with respect to rs1801133 (MTHFR), rs174546 (FADS1) and rs1801282 (PPARγ) polymorphisms. CONCLUSION: A high percentage of patients had a poor nutritional status, low muscle strength and decreased muscle mass. These facts exacerbate the already-lower quality of life of these patients. Specific genetic polymorphisms associated with the syndrome or its pathogenesis were not identified.


Assuntos
Genótipo , Sensibilidade Química Múltipla , Estado Nutricional , Sobrepeso/etiologia , Polimorfismo de Nucleotídeo Único , Qualidade de Vida , Magreza/etiologia , Adulto , Composição Corporal , Estudos Transversais , Feminino , Marcadores Genéticos , Predisposição Genética para Doença , Força da Mão , Humanos , Masculino , Pessoa de Meia-Idade , Sensibilidade Química Múltipla/complicações , Sensibilidade Química Múltipla/diagnóstico , Sensibilidade Química Múltipla/genética , Sensibilidade Química Múltipla/fisiopatologia , Sobrepeso/diagnóstico , Sobrepeso/epidemiologia , Magreza/diagnóstico , Magreza/epidemiologia
7.
Psychiatry Res ; 249: 187-194, 2017 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-28113122

RESUMO

Idiopathic Environmental Intolerance (IEI) has been associated with psychogenic factors and an increased number of comorbid psychiatric disorders such as depression and anxiety disorder. The purpose of the current study was to examine a possible overlap of psychological and somatic symptoms between subjects with IEI and patients with major depression and schizophrenia as well as to specify characteristic differences. The different symptom clusters included symptoms of chemical intolerance, neurotoxicity and psychological distress as well as measurements of mental health such as anxiety, depression, somatoform symptoms, and schizophrenia-specific disturbances in cognitive domains. IEI patients reported higher overall levels in physical symptoms such as chemical intolerance, neurotoxicity and somatic symptoms not attributable to an organic cause. Schizophrenia patients showed higher overall levels in self-experienced disturbances in several schizophrenia-specific cognitive domains, whereas general psychological distress, anxiety and depression were rated highest by patients with major depression. Importantly, the groups markedly differed in the shapes of profiles of various symptom clusters. Our results provide evidence that IEI patients can be distinguished on the phenomenological level from patients with major depression or schizophrenia, and that distinct domains of psychological and somatic symptoms are particularly problematic in specific diagnostic groups.


Assuntos
Transtorno Depressivo Maior/complicações , Sensibilidade Química Múltipla/complicações , Transtornos Somatoformes/complicações , Adulto , Ansiedade/complicações , Ansiedade/diagnóstico , Ansiedade/psicologia , Depressão/complicações , Depressão/diagnóstico , Depressão/psicologia , Transtorno Depressivo Maior/diagnóstico , Transtorno Depressivo Maior/psicologia , Feminino , Humanos , Masculino , Sintomas Inexplicáveis , Pessoa de Meia-Idade , Sensibilidade Química Múltipla/diagnóstico , Sensibilidade Química Múltipla/psicologia , Transtornos Somatoformes/diagnóstico , Transtornos Somatoformes/psicologia , Avaliação de Sintomas
8.
Acta Neuropsychiatr ; 29(5): 267-277, 2017 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-27919300

RESUMO

OBJECTIVE: To evaluate the efficacy of transcranially applied pulsed electromagnetic fields (PEMF) on functional impairments and symptom severity in multiple chemical sensitivity (MCS) patients. METHODS: The study was conducted as a nationwide trial in Denmark using a randomised, parallel-group, double-blind and placebo-controlled design. Sample size was estimated at 40 participants. Eligibility criteria were age 18-75 years and fulfilment of the MCS case criteria. Participants received either PEMF or placebo PEMF (no stimulation) applied transcranially for 6 weeks. The primary outcome was the Life Impact Scale (LIS) of the Quick Environmental Exposure and Sensitivity Inventory (QEESI). Secondary outcomes were the Symptom Severity Scale (SSS) and the Chemical Intolerance Scale of QEESI. RESULTS: A total of 39 participants were randomised to PEMF or placebo treatment. No significant difference was observed on QEESI LIS between groups with a mean change score of -5.9 in the PEMF group compared with -1.5 in the placebo group (p=0.35, effect size=-0.31). However, a significant decrease was detected on QEESI SSS within and between groups with a mean change score of -11.3 in the PEMF group compared with -3.2 in the placebo group (p=0.03, effect size=-0.60). CONCLUSION: PEMF treatment of 6 weeks showed no effect on functional impairments in MCS. However, a significant decrease in symptom severity was observed.


Assuntos
Terapia de Campo Magnético , Sensibilidade Química Múltipla/terapia , Adolescente , Adulto , Idoso , Método Duplo-Cego , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Sensibilidade Química Múltipla/complicações , Índice de Gravidade de Doença , Resultado do Tratamento , Adulto Jovem
9.
Noise Health ; 18(82): 143-9, 2016.
Artigo em Inglês | MEDLINE | ID: mdl-27157687

RESUMO

Multiple chemical sensitivity (MCS) is a chronic disorder characterized by a variety of symptoms associated with the exposure to chemicals at a concentration below the toxic level. Previous studies have demonstrated peculiar responses in brain activity in these patients with respect to sensory stimuli while the association between chemical sensitivity and other environmental intolerances such as noise sensitivity has been questioned by researchers. In this study, a cohort of 18 MCS patients underwent transient-evoked otoacoustic emission (TEOAE) testing with and without contralateral suppression to evaluate the functionality of the medial olivocochlear (MOC) reflex involved in speech-in-noise sensitivity. Results were compared with an age- and gender-matched control group (n = 20) and correlation analysis with disease onset and quick environmental exposure sensitivity inventory (qEESI) symptom severity scale was performed. Subjects affected by MCS showed statistically significant impairment of MOC reflex, and the onset of the disease and several symptom subscales showed to be correlated to such reduction in some of the frequencies tested. These data suggest that alterations of MOC reflex could be part of the complex features of this disease although more studies are needed to further explore auditory perception disorders in environmental intolerances.


Assuntos
Vias Auditivas/fisiologia , Percepção Auditiva/fisiologia , Potenciais Evocados Auditivos/fisiologia , Sensibilidade Química Múltipla/fisiopatologia , Adulto , Audiometria de Tons Puros , Estudos de Casos e Controles , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Sensibilidade Química Múltipla/complicações , Emissões Otoacústicas Espontâneas/fisiologia , Reflexo Acústico/fisiologia
10.
Med. clín (Ed. impr.) ; 146(3): 108-111, feb. 2016. tab
Artigo em Espanhol | IBECS | ID: ibc-147821

RESUMO

Introducción y objetivo: La sensibilidad química múltiple (.SQM) es un trastorno multisistémico de etiología controvertida que afecta a algunos sujetos al exponerse a productos químicos a concentraciones no perjudiciales. El objetivo de este trabajo es describir las características epidemiológicas, clínicas y psicológicas de una muestra de pacientes con SQM, para un posterior tratamiento grupal específico. Pacientes y método: Estudio descriptivo de los pacientes diagnosticados de SQM en una unidad de toxicología, mediante la administración del cuestionario Quick Environmental Exposure and Sensitivity Inventory, junto con la entrevista estructurada SCID-II, la escala de ansiedad HAS y el test de personalidad tipo A, PCTA. Resultados: Se incluyeron 73 pacientes, con una edad media de 52,6 años (rango 33-77; DE 9,29), siendo 66 mujeres (90,4%). El 53% estaban clasificados como grado i-ii y ii. Sesenta y un pacientes (83%) presentaron algún tipo de comorbilidad, fundamentalmente dolor crónico, fibromialgia y fatiga crónica, con niveles de ansiedad mayores (puntuación media 19,2), predominio de rasgos de personalidad fóbico-evitativo y patrón de conducta tipo A (31,1%). Conclusiones: La SQM afecta principalmente a mujeres de mediana edad, con comorbilidades (dolor crónico, fibromialgia y fatiga crónica), elevada ansiedad y conductas de evitación. Este análisis previo debería ayudar a ofrecer un abordaje psicoterapéutico específico a estos pacientes (AU)


Introduction and objective: Multiple chemical sensitivity (MCS) is a multisystem disorder of controversial etiology, affecting some subjects when exposed to chemicals at no harmful concentrations. The objective of this paper is to describe the epidemiological, clinical and psychological features of a sample of patients with MCS for further specific group treatment. Patiens and method: Descriptive study of patients diagnosed with MCS in a toxicology unit. We administered the Quick Environmental Exposure and Sensitivity Inventory, the structured interview SCID-II, the anxiety scale HAS and the type A personality test, PCTA. Results: Seventy-three patients were included. The mean age was 52,6 years (range 33-77; SD 9.29). Sixty-six were females (90.4%). Fifty-three percent were classified as i-ii and ii grade. Sixty-one patients (83%) presented some type of comorbidity, mainly chronic pain, fibromyalgia and chronic fatigue. They exhibited higher levels of anxiety (average score of 19.2), prevalence of phobic-avoidant traits of personality and type A behavior in 31.1%. Conclusions: MCS affects middle-aged women with comorbidities (chronic pain, fibromyalgia and chronic fatigue) and high anxiety and avoidance behaviors. This preliminary analysis should help provide a specific therapeutic approach to these patients (AU)


Assuntos
Humanos , Masculino , Feminino , Pessoa de Meia-Idade , Sensibilidade Química Múltipla/complicações , Sensibilidade Química Múltipla/epidemiologia , Sensibilidade Química Múltipla/psicologia , Exposição a Produtos Químicos , Testes de Personalidade/estatística & dados numéricos , Inquéritos e Questionários , Ansiedade/epidemiologia , Transtornos de Ansiedade/epidemiologia , Transtornos de Ansiedade/psicologia , Escala de Ansiedade Manifesta/estatística & dados numéricos , Escala de Ansiedade Manifesta/normas , Comorbidade
11.
J Vestib Res ; 26(5-6): 459-468, 2016.
Artigo em Inglês | MEDLINE | ID: mdl-28262643

RESUMO

Multiple chemical sensitivity (MCS) is a common clinical diagnosis in western populations and its symptoms are thought to be mainly related to chemical compounds exposure. Although MCS subjects refer to complain from many central nervous system symptoms, including dizziness, no study to now deepened vestibular detriment nor to what extent such an impairment could worsen MCS. Thus, the purpose of present study was to objectively highlight those clinical/subclinical aspects of vestibular impairment that could be related to MCS symptoms cohorts. A principal component analysis within a wide battery of otoneurological test scores was employed in 18 right-handed MCS patients and 20 sex- and age-matched healthy individuals. A deranged dimensionality in near-optimal re-weighting within otoneurological variables was found in MCS as compared with healthy subjects. These data seem to support the idea that MCS physiopathological underpinnings could lead to a peripheral and higher vestibular decay that could be addressed as a further aspect to better follow MCS patients up along natural history of disease in clinical practice.


Assuntos
Sensibilidade Química Múltipla/complicações , Doenças Vestibulares/etiologia , Adulto , Estudos de Coortes , Tontura/etiologia , Feminino , Análise de Fourier , Teste do Impulso da Cabeça , Humanos , Masculino , Pessoa de Meia-Idade , Sensibilidade Química Múltipla/diagnóstico , Sensibilidade Química Múltipla/fisiopatologia , Exame Neurológico , Análise de Componente Principal , Vertigem/etiologia , Doenças Vestibulares/diagnóstico , Doenças Vestibulares/fisiopatologia , Testes de Função Vestibular
12.
G Chir ; 36(4): 168-71, 2015.
Artigo em Inglês | MEDLINE | ID: mdl-26712072

RESUMO

Clinical practice sometimes brings to face with situations quite peculiar, potentially dangerous for the patient's life. In the great majority of cases, pathologies associated with each other (cardiovascular, respiratory, neurological), while in other cases we can treat rare diseases or syndromes. It's considered exceptional the simultaneous presence of "rare" pathologies in a single patient. This exceptionality has been a push to treat a patient as a "unique" asking for help to deeper studies of pharmacogenetics. Our case reports the management of a patient with Ehlers-Danlos syndrome (EDS) and Multiple Chemical Sensitivity (MCS), undergoing a total thyroidectomy. We found several problems, and we tried to find effective solutions for the management of the patient during the whole peri-operative process, from a clinical, pharmacological and also from a surgical point of view.


Assuntos
Síndrome de Ehlers-Danlos/complicações , Bócio Nodular/complicações , Bócio Nodular/cirurgia , Sensibilidade Química Múltipla/complicações , Tireoidectomia , Índice de Massa Corporal , Bócio Nodular/diagnóstico , Humanos , Masculino , Pessoa de Meia-Idade , Monitorização Fisiológica/métodos , Obesidade/complicações , Fatores de Risco , Resultado do Tratamento
13.
Iran J Allergy Asthma Immunol ; 14(1): 19-27, 2015 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-25530135

RESUMO

The aetiology behind odor-related chronic somatic symptoms (O-RCSS) is unknown, although both immunological and psychiatric causes have been suggested. The aim of this study was to investigate the occurrence of self-reported asthma and hay fever and psychiatric symptoms in individuals having O-RCSS compared to individuals with similar chronic somatic symptoms (CSS) which were not odors-related, and also compared to healthy controls. Data from the Hordaland Health Study were used. 13,799 individuals, 40-45 years, answered a questionnaire including 16 questions related to somatic symptoms. They also indicated if the symptoms were odor-related, and answered questions about asthma and hay fever. Anxiety and depression were measured with the Hospital Anxiety and Depression Scale. 38 (0.6%) men and 106 (1.4%) women had O-RCSS, whereas 88 (1.5%) men and 192 (2.5%) women had CSS. Adjusted logistic regression analyses showed increased odds of self-reported asthma in those with O-RCSS compared to those with CSS (males: 3.81, 1.06-13.8, females: 2.60, 1.05-6.93) and compared to male and female controls (3.56, 1.89-6.68 and 4.81, 1.92-12.1 respectively). Increased odds of self-reported hay fever were in addition seen in females with O-RCSS. There were no differences in psychiatric symptoms between individuals with O-RCSS and CSS, although individuals in both groups showed increased odds compared to male and female controls. Increased occurrence of self-reported asthma was exclusively found among male and females with O-RCSS, compared to CSS and controls. Increased occurrence of psychiatric symptoms was seen both in individuals with O-RCSS and CSS.


Assuntos
Asma/complicações , Sensibilidade Química Múltipla/complicações , Odorantes , Rinite Alérgica Sazonal/complicações , Adulto , Asma/epidemiologia , Asma/psicologia , Depressão/complicações , Depressão/epidemiologia , Feminino , Humanos , Incidência , Masculino , Pessoa de Meia-Idade , Sensibilidade Química Múltipla/epidemiologia , Sensibilidade Química Múltipla/psicologia , Noruega/epidemiologia , Rinite Alérgica Sazonal/epidemiologia , Rinite Alérgica Sazonal/psicologia , Autorrelato
14.
Respir Med ; 108(9): 1371-6, 2014 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-25129869

RESUMO

BACKGROUND: Among patients with chronic unexplained cough, there is a recognized subgroup with respiratory symptoms induced by environmental irritants like chemicals and odours. The diagnosis of sensory hyperreactivity (SHR) has been suggested for this group of patients and can be made using a tidal breathing capsaicin inhalation test. The aim of the present study was to evaluate the ability of a single-breath, dose-response capsaicin threshold test to discriminate such patients from control subjects. METHODS: A total of 46 patients with chronic cough and SHR who had previously shown a positive reaction in accordance with limits set for a tidal breathing capsaicin test were tested once with a single-breath, dose-response capsaicin cough threshold test, assessing capsaicin concentrations to evoke 2 (C2), 5 (C5) or 10 (C10) coughs. Twenty-nine subjectively healthy control subjects were also included and tested with the threshold method. RESULTS: Patients had significantly lower C2, C5 and C10 in comparison to controls. From the results among patients and controls, sensitivity and specificity were calculated, and a receiver operating characteristic curve was constructed, showing excellent ability for C5 and C10 to discriminate patients from control subjects. CONCLUSIONS: For patients with SHR and chronic cough, capsaicin cough sensitivity was once again confirmed to be increased, in this case, using the single-breath dose-response method. Limits set for cough reactions regarded as more sensitive than normal can be useful in diagnostics and further research. C5 seems to be the best measure to use in research and differential diagnostics.


Assuntos
Capsaicina , Tosse/induzido quimicamente , Sensibilidade Química Múltipla/diagnóstico , Fármacos do Sistema Sensorial , Administração por Inalação , Adulto , Idoso , Testes Respiratórios/métodos , Testes de Provocação Brônquica/métodos , Capsaicina/administração & dosagem , Estudos de Casos e Controles , Doença Crônica , Relação Dose-Resposta a Droga , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Sensibilidade Química Múltipla/complicações , Curva ROC , Fármacos do Sistema Sensorial/administração & dosagem , Limiar Sensorial , Adulto Jovem
16.
Psychoneuroendocrinology ; 40: 140-50, 2014 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-24485486

RESUMO

BACKGROUND: Multiple chemical sensitivity (MCS) is a medically unexplained condition characterized by reports of recurrent unspecific symptoms attributed to exposure to low levels of common volatile chemicals. The etiology of MCS is poorly understood, but dysregulation of the immune system has been proposed as part of the pathophysiology. OBJECTIVE: To compare plasma levels of cytokines in Danish MCS individuals with a healthy, sex- and age-matched control group. METHOD: Blood samples were obtained from 150 un-exposed MCS individuals and from 148 age- and sex-matched healthy controls. Plasma concentrations of 14 cytokines, chemokines and growth and allergen-specific IgE were measured. All participants completed a questionnaire including questions on MCS, psychological distress, morbidities and medication use at the time of the study. RESULTS: Plasma levels of interleukin-1ß, -2, -4, and -6 were significantly (P<0.001) increased in the MCS group compared with controls, tumor necrosis factor-α was borderline significantly (P=0.05) increased and interleukin-13 was significantly decreased (P<0.001). CONCLUSION: MCS individuals displayed a distinct systemic immune mediator profile with increased levels of pro-inflammatory cytokines and interleukin-2 and inverse regulation of Th2 associated cytokines interleukin-4 and interleukin-13 suggestive of low-grade systemic inflammation, along with a deviating Th2-associated cytokine response not involving IgE-mediated mechanisms.


Assuntos
Citocinas/sangue , Mediadores da Inflamação/sangue , Inflamação/sangue , Sensibilidade Química Múltipla/sangue , Adolescente , Adulto , Idoso , Estudos de Casos e Controles , Comorbidade , Feminino , Humanos , Inflamação/complicações , Inflamação/epidemiologia , Masculino , Pessoa de Meia-Idade , Sensibilidade Química Múltipla/complicações , Sensibilidade Química Múltipla/epidemiologia , Adulto Jovem
19.
Vertex ; 24(111): 373-91, 2013.
Artigo em Espanhol | MEDLINE | ID: mdl-24312923

RESUMO

We present a description of the Central Sensitivity Syndrome (CSS) and some of its main components such as Multiple Chemical Sensitivity Syndrome, Chronic Fatigue Syndrome and Fibromyalgia. We review the changes in pain perception, describing the physiology and pathophysiology of the painful experience from the medulla horn to the CNS. We explain the theory of central sensitization as the basis to the syndrome. We refer to the differences between fibromyalgia and depressive disorders, is spite of their frequent presentation in comorbidity. We state the main clinical and neurobiological differences. We point out the main psychoneuroimmunoendocrinologic differences such as adrenal activity (hypoactivity vs. hyperactivity, DST hypersuppressive response vs. DST non suppression, hypersensitivity of central glucocorticoid receptors vs. desensitization of these, among others), thyroid (probable reverse T3 vs. flat stimuli TSH response curve) and growth hormone secretion (probable increase vs. disruption of normal circadian rhythm) that makes CSS resemble PTSD. We describe differential changes in sleep patterns (alpha-delta intrusion vs. altered sleep time, REM latency, and stage 3/4) and immunological disturbances almost opposite in each pathological entity. We finally argue which medical specialty should treat these complex syndromes.


Assuntos
Transtorno Depressivo/complicações , Síndrome de Fadiga Crônica/complicações , Fibromialgia/complicações , Sensibilidade Química Múltipla/complicações , Humanos , Síndrome
20.
Oxid Med Cell Longev ; 2013: 356235, 2013.
Artigo em Inglês | MEDLINE | ID: mdl-24367721

RESUMO

BACKGROUND: Multiple chemical sensitivity (MCS) is a chronic condition characterized by an exaggerated response to toxicants. We ascertained the prevalence of allergy to metals and toxicological aspects in MCS patients. METHODS: We conducted a retrospective review of medical records of 41 patients with MCS. We performed patch testing (n = 21) for dental series and did lymphocyte transformation test (n = 18) for metals. We measured mercury in samples of blood (n = 19), urine (n = 19), saliva (n = 20), and scalp hair (n = 17) to investigate the association between mercury levels and cases of MCS. RESULTS: The prevalence of metal immune hypersensitivity in a subset of 26 patients was 92.3 percent. Elevations of mercury occurred in 81.2 percent (26 of 32). The mean (±SD) in blood concentrations of mercury was 7.6 ± 13.6 µg/L; mean in urine was 1.9 ± 2.5 µg/L; mean in scalp hair was 2.2 ± 2.5 µg/g; mean in saliva was 38.1 ± 52.1 µg/L. Subgroup analyses showed that elevation of mercury levels in biological matrices were associated with mercury amalgams in patients with MCS (22 patients), compared with controls (8 patients) (odds ratio 11 : 95 percent confidence interval 1.5 to 81.6; P = 0.023). CONCLUSIONS: Our data show an increased prevalence of metal allergy and elevation of mercury levels in bioindicators among patients with MCS.


Assuntos
Hipersensibilidade/complicações , Metais/efeitos adversos , Sensibilidade Química Múltipla/complicações , Adulto , Índice de Massa Corporal , Estudos de Coortes , Amálgama Dentário/efeitos adversos , Dieta , Suplementos Nutricionais , Feminino , Cabelo/metabolismo , Hormônios/metabolismo , Humanos , Hipersensibilidade/sangue , Hipersensibilidade/epidemiologia , Hipersensibilidade/urina , Itália/epidemiologia , Masculino , Estado Civil , Mercúrio/sangue , Mercúrio/urina , Sensibilidade Química Múltipla/sangue , Sensibilidade Química Múltipla/epidemiologia , Sensibilidade Química Múltipla/urina , Prevalência , Fatores de Risco , População Rural , Saliva/metabolismo , Fumar/efeitos adversos , População Urbana
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