Archive for February, 2009

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Postural orthostatic tachycardia syndrome is an under-recognized condition in chronic fatigue syndrome

Friday, February 6th, 2009

Postural orthostatic tachycardia syndrome is an under-recognized condition in chronic fatigue syndrome

Hoad A, Spickett G, Elliott J, Newton J.

From the Northern CFS/ME Clinical Network, Equinox House, Silver Fox Way, Cobalt Business Park, Newcastle upon Tyne ME NorthEast, Bullion Hall, County Durham and Falls and Syncope Service, Institute of Cellular Medicine, Newcastle University, Newcastle, UK.

QJM. 2008 Sep 19.

BACKGROUND:
It has been suggested that postural orthostatic tachycardia syndrome (POTS) be considered in the differential diagnosis of those with chronic fatigue syndrome/myalgic encephalomyelitis (CFS/ME).
Currently, measurement of haemodynamic response to standing is not recommended in the UK NICE CFS/ME guidelines.

Objectives:
To determine prevalence of POTS in patients with CFS/ME.

Design: Observational cohort study.

METHODS:
Fifty-nine patients with CFS/ME (Fukuda criteria) and 52 age- and sex-matched controls underwent formal autonomic assessment in the cardiovascular laboratory with continuous heart rate and beat-to-beat blood pressure measurement (Task Force, CNSystems, Graz Austria). Haemodynamic responses to standing over 2 min were measured. POTS was defined as symptoms of orthostatic intolerance associated with an increase in heart rate from the supine to upright position of >30 beats per minute or to a heart rate of >120 beats per minute on standing.

RESULTS:
Maximum heart rate on standing was significantly higher in the CFS/ME group compared with controls (106 +/- 20 vs. 98 +/- 13; P = 0.02). Of the CFS/ME group, 27% (16/59) had POTS compared with 9% (5) in the control population (P = 0.006). This difference was predominantly related to the increased proportion of those in the CFS/ME group whose heart rate increased to >120 beats per minute on standing (P = 0.0002). Increasing fatigue was associated with increase in heart
rate (P = 0.04; r(2) = 0.1).

CONCLUSION:
POTS is a frequent finding in patients with CFS/ME. We suggest that clinical evaluation of patients with CFS/ME should include response to standing. Studies are needed to determine the optimum intervention strategy to manage POTS in those with CFS/ME.

http://www.ncbi.nlm.nih.gov/pubmed/18805903?dopt=AbstractPlus

PMID: 18805903 [PubMed - as supplied by publisher]

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Posted in Cardiovascular, Chronic Fatigue Syndrome | No Comments »

Indoor Air Quality report of the National Institute for Building Resear

Friday, February 6th, 2009

Several builders and remodelers have approached me about serving the needs of the chemically sensitive during this time of reduced building activity. They are ecstatic about the Indoor Air Quality report of the National Institute for Building Research. Several of us who work with chemically sensitive people got the U.S. Access Board to fund this report.

In this regard, we are especially indebted to Mary Lamielle, Susan Molloy, Dr. Ann McCampbell, and Toni Temple. The Access Board sets the standards for accommodation of people with disabilities. Builders are particularly interested in the sections starting on p. 86 dealing with building products.

http://ieq.nibs.org/ieq_project.pdf

I recommend that you tell builders interested in green building in your area about this report.

Lawrence Plumlee, M.D.

Posted in Air Pollutants, Indoor Air | No Comments »

Temporal trends of synthetic musk compounds in mother’s milk and associations with personal use of perfumed products

Friday, February 6th, 2009

Temporal trends of synthetic musk compounds in mother’s milk and associations with personal use of perfumed products

Lignell S, Darnerud PO, Aune M, Cnattingius S, Hajslova J, Setkova L, Glynn A.

National Food Administration, P.O. Box 622, SE-751 26 Uppsala, Sweden.

Environ Sci Technol. 2008 Sep 1;42(17):6743-8.

We analyzed two nitro musks (musk xylene and musk ketone) and five polycyclic musks (HHCB, AHTN, ADBI, ATII, and AHDI) in mother’s milk from primiparae women (N = 101) living in Uppsala County, Sweden, 1996-2003. Possible temporal trends in musk concentrations and associations with lifestyle/medical factors, such as use of perfumed products during pregnancy were studied. HHCB showed the highest median concentration (63.9 ng/g lipid) followed by AHTN (10.4 ng/g) and musk xylene (MX) (9.5 ng/g). Concentrations of the other substances were, in most cases, below the quantification limit (2.0-3.0 ng/g). Women with a high use of perfume during pregnancy had elevated milk concentrations of HHCB, and elevated concentrations of AHTN were observed among women reporting use of perfumed laundry detergent. This strongly suggests that perfumed products are important sources of musk exposure both among th e mothers and the nursed infants. Concentrations of AHTN and MX declined significantly between 1996 and 2003, suggesting a decline in the industrial use of the compounds in consumer products, or alterations in the consumer use pattern of perfumed products. No temporal trend in HHCB concentrations was seen. The lack of toxicity data makes it difficult to generalize about the safety of musk exposure of breast-fed infants.

http://www.ncbi.nlm.nih.gov/pubmed/18800558?dopt=AbstractPlus

PMID: 18800558 [PubMed - in process]

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Posted in Allergy, Fragrance | No Comments »

Assessment of the risk of fragrance allergy in the general population: challenges and methodological issues

Friday, February 6th, 2009

Assessment of the risk of fragrance allergy in the general population: challenges and methodological issues

Naldi L.

Centro Studi GISED, USC Dermatologia, Ospedali Riuniti, Bergamo, Italy. luigi.naldi@gised.it

Drug Saf. 2008;31(5):440-3.
There are still unanswered questions about the safety of fragrances. In this conference paper, fragrance allergy will be considered in the context of a wider discussion concerning the prevalence and causes of contact dermatitis. No criteria for a reliable diagnosis of ‘contact dermatitis’ are available. International recommendations and standardization for the patch test method exist; however, the question of whether agents that are positive are causally linked to contact dermatitis remains fraught with uncertainties concerning false-positive rates and clinical relevance. Most of the discussion concerning prevalence or incidence variations of allergic contact dermatitis to fragrances concentrate on the frequency of positive patch tests in clinical series, i.e. ‘floating numerators’. Risk assessment requires that data from different sources are integrated and compared. Therefore, both a ’sentinel surveillance’ syst em and more refined epidemiological studies in well defined populations are needed to reliably assess risks associated with fragrance exposure.

http://www.ncbi.nlm.nih.gov/pubmed/18422388?dopt=AbstractPlus

PMID: 18422388 [PubMed - indexed for MEDLINE]

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Posted in Allergy, Fragrance | No Comments »

Integrative medicine and the role of modified citrus pectin/alginates in heavy metal chelation and detoxification–five case reports.

Friday, February 6th, 2009

Forsch Komplementmed. 2007 Dec;14(6):358-64. Epub 2007 Dec 12. Links

Integrative medicine and the role of modified citrus pectin/alginates in heavy metal chelation and detoxification–five case reports.
Eliaz I, Weil E, Wilk B.

Amitabha Medical Clinic and Healing Center Sebastopol, CA 95472, USA. ieliaz@prodigy.net

Heavy metal body burden can contribute to chronic disease, as well as interfere with the body’s capacity to recover from illness. The five case studies presented here show that reduction in toxic heavy metals (74% average decrease) was achieved without side effects, with the use of PectaSol modified citrus pectin (MCP) (EcoNugenics; Santa Rosa, CA, USA) alone or with an MCP/alginates combination. The gradual decrease of total body heavy metal burden is believed to have played an important role in each patient’s recovery and health maintenance. This is the first known documentation of evidence of such results in a clinical report of case studies with possible correlation between clinical outcome and a reduction in toxic heavy metal load in patients using MCP and/or an MCP/alginate complex.

PMID: 18219211 [PubMed - indexed for MEDLINE]
http://www.ncbi.nlm.nih.gov/pubmed/18219211?dopt=AbstractPlus

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Posted in Heavy Metals | No Comments »

The role of modified citrus pectin as an effective chelator of lead in children hospitalized with toxic lead levels.

Friday, February 6th, 2009

Altern Ther Health Med. 2008 Jul-Aug;14(4):34-8. Links

The role of modified citrus pectin as an effective chelator of lead in children hospitalized with toxic lead levels.
Zhao ZY, Liang L, Fan X, Yu Z, Hotchkiss AT, Wilk BJ, Eliaz I.

Department of Medicine, Children’s Hospital, Zhejiang University School of Medicine, Hangzhou, Republic of China.

CONTEXT: Lead toxicity is an ongoing concern worldwide, and children, the most vulnerable to the long-lasting effects of lead exposure, are in urgent need of a safe and effective heavy metal chelating agent to overcome the heavy metals and lead exposure challenges they face day to day. OBJECTIVE: This clinical study was performed to determine if the oral administration of modified citrus pectin (MCP) is effective at lowering lead toxicity in the blood of children between the ages of 5 and 12 years. METHOD: Hospitalized children with a blood serum level greater than 20 microg/dL, as measured by graphite furnace atomic absorption spectrometry (GFAAS), who had not received any form of chelating and/or detoxification medication for 3 months prior were given 15 g of MCP (PectaSol) in 3 divided dosages a day. Blood serum and 24-hour urine excretion collection GFAAS analysis were performed on day 0, day 14, day 21, and day 28. RESULT: This study showed a dramatic decrease in blood serum levels of lead (P = .0016; 161% average change) and a dramatic increase in 24-hour urine collection (P = .0007; 132% average change). CONCLUSION: The need for a gentle, safe heavy metal-chelating agent, especially for children with high environmental chronic exposure, is great. The dramatic results and no observed adverse effects in this pilot study along with previous reports of the safe and effective use of MCP in adults indicate that MCP could be such an agent. Further studies to confirm its benefits are justified.

PMID: 18616067 [PubMed - in process]
http://www.ncbi.nlm.nih.gov/pubmed/18616067?dopt=AbstractPlus

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Posted in Children, Heavy Metals | No Comments »

Reported symptoms of food hypersensitivity and sensitization to common foods in 4-year-old children

Friday, February 6th, 2009

http://www3.interscience.wiley.com/journal/119405359/abstract?CRETRY=1&SRETRY=0

Acta Pædiatrica
Volume 97 Issue 1, Pages 85 – 90

Published Online: 11 Dec 2007

Reported symptoms of food hypersensitivity and sensitization to common foods in 4-year-old children
Eva Östblom 1,2,3 , Magnus Wickman 1,3,4 , Marianne van Hage 3,5 , Gunnar Lilja 1,2,3
1.Department of Pediatrics’, Sachs’ Children’s Hospital, Stockholm, Sweden 2.Department of Clinical Science and Education, Karolinska Institutet, Stockholm, Sweden 3.Centre for Allergy Research, Karolinska Institutet, Stockholm, Sweden 4.National Institute of Environmental Medicine, Karolinska Institutet, Stockholm, Sweden 5.Clinical Immunology and Allergy Unit, Department of Medicine, Karolinska Institutet and University Hospital, Stockholm, Sweden
Correspondence
Eva Östblom, M.D., Department of Pediatrics, Sachs’ Children’s Hospital, S – 118 83 Stockholm, Sweden. Tel: +4686164000 | Fax: +468304571 | Email: eva.ostblom@ki.se

Supported by the Swedish Asthma and Allergy Associations Research Foundation, the Center For Allergy Research, Karolinska Institutet, the Swedish Heart and Lung Foundation, the Vardal Foundation for Health Care Sciences and Allergy Research and Stockholm County Council.
Copyright Journal Compilation © 2008 Foundation Acta Pædiatrica
KEYWORDS
BAMSE • children • food allergy • food hypersensitivity • sensitization

ABSTRACT
Aim: To characterize reported food hypersensitivity (FHS) among young children in a birth cohort.

Methods: At 4 years of age a parental questionnaire on FHS and allergic symptoms was evaluated. Blood was collected for analyses of IgE-antibodies to egg, milk, fish, wheat, peanut and soy. Complete questionnaire data was available for 3694 children (90%), and blood samples were obtained from 2563 children (63%).

Results: FHS was reported in 11% of the children (n = 397). Eczema was the most commonly reported symptom and the only symptom in half of these children. Food-related reactions from the airways, facial oedema or urticaria were reported in 198 children, and the majority of these children (75%) reported multiple symptoms. Furthermore, a combination of airway symptoms, facial oedema or urticaria together with sensitization to food suggested a more severe form of FHS. This was found in 1.6% of all children. Symptoms caused by peanut were closely associated with sensitization to peanut (p < 0.001).

Conclusions: FHS in 4-year-old children with any of asthma, rhino-conjunctivitis, facial oedema or urticaria in combination is in most cases associated to sensitization to food. This phenotype of FHS is likely to represent a more severe form of FHS.

Received
14 July 2007; revised 4 September 2007; accepted 12 September 2007.
DIGITAL OBJECT IDENTIFIER (DOI)
10.1111/j.1651-2227.2007.00556.x About DOI

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Posted in Food | No Comments »

Splenda alters gut microflora and increases intestinal p-glycoprotein and cytochrome p-450 in male rats

Friday, February 6th, 2009

Splenda alters gut microflora and increases intestinal p-glycoprotein and cytochrome p-450 in male rats

Abou-Donia MB, El-Masry EM, Abdel-Rahman AA, McLendon RE, Schiffman SS.

Department of Pharmacology, Duke University Medical Center, Durham, North Carolina 27708, USA. donia@duke.edu

J Toxicol Environ Health A. 2008;71(21):1415-29.

Splenda is comprised of the high-potency artificial sweetener sucralose (1.1%) and the fillers maltodextrin and glucose. Splenda was administered by oral gavage at 100, 300, 500, or 1000 mg/kg to male Sprague-Dawley rats for 12-wk, during which fecal samples were collected weekly for bacterial analysis and measurement of fecal pH. After 12-wk, half of the animals from each treatment group were sacrificed to determine the intestinal expression of the membrane efflux transporter P-glycoprotein (P-gp) and the cytochrome P-450 (CYP) metabolism system by Western blot. The remaining animals were allowed to recover for an additional 12-wk, and further assessments of fecal microflora, fecal pH, and expression of P-gp and CYP were determined. At the end of the 12-wk treatment period, the numbers of total anaerobes, bifidobacteria, lactobacilli, Bacteroides, clostridia, and total aerobic bacteria were significantly decreased; however, there was no significant treatment effect on enterobacteria. Splenda also increased fecal pH and enhanced the expression of P-gp
by 2.43-fold, CYP3A4 by 2.51-fold, and CYP2D1 by 3.49-fold. Following the 12-wk recovery period, only the total anaerobes and bifidobacteria remained significantly depressed, whereas pH values, P-
gp, and CYP3A4 and CYP2D1 remained elevated. These changes occurred at Splenda dosages that contained sucralose at 1.1-11 mg/kg (the US FDA Acceptable Daily Intake for sucralose is 5 mg/kg). Evidence indicates that a 12-wk administration of Splenda exerted numerous adverse effects, including (1) reduction in beneficial fecal microflora, (2) increased fecal pH, and (3) enhanced expression
levels of P-gp, CYP3A4, and CYP2D1, which are known to limit the bioavailability of orally administered drugs.

http://www.ncbi.nlm.nih.gov/pubmed/18800291?dopt=AbstractPlus

PMID: 18800291 [PubMed - in process]

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Posted in Food | No Comments »

Association of Urinary Bisphenol A Concentration With Medical Disorders and Laboratory Abnormalities in Adults

Friday, February 6th, 2009

Association of Urinary Bisphenol A Concentration With Medical Disorders and Laboratory Abnormalities in Adults

Iain A. Lang, PhD; Tamara S. Galloway, PhD; Alan Scarlett, PhD; William E. Henley, PhD; Michael Depledge, PhD, DSc; Robert B. Wallace, MD; David Melzer, MB, PhD

JAMA. 2008;300(11):1303-1310. Published online September 16, 2008 (doi:10.1001/jama.300.11.1303).

ABSTRACT

Context Bisphenol A (BPA) is widely used in epoxy resins lining food and beverage containers. Evidence of effects in animals has generated concern over low-level chronic exposures in humans.

Objective To examine associations between urinary BPA concentrations and adult health status.

Design, Setting, and Participants Cross-sectional analysis of BPA concentrations and health status in the general adult population of the United States, using data from the National Health and Nutrition Examination Survey 2003-2004. Participants were 1455 adults aged 18 through 74 years with measured urinary BPA and urine creatinine concentrations. Regression models were adjusted for age, sex, race/ethnicity, education, income, smoking, body mass index, waist circumference, and urinary creatinine concentration. The sample provided 80% power to detect unadjusted odds ratios (ORs) of 1.4 for diagnoses of 5% prevalence per 1-SD change in BPA concentration, or standardized regression coefficients of 0.075 for liver enzyme concentrations, at a significance level of P < .05.

Main Outcome Measures Chronic disease diagnoses plus blood markers of liver function, glucose homeostasis, inflammation, and lipid changes.

Results Higher urinary BPA concentrations were associated with cardiovascular diagnoses in age-, sex-, and fully adjusted models (OR per 1-SD increase in BPA concentration, 1.39; 95% confidence interval [CI], 1.18-1.63; P = .001 with full adjustment). Higher BPA concentrations were also associated with diabetes (OR per 1-SD increase in BPA concentration, 1.39; 95% confidence interval [CI], 1.21-1.60; P < .001) but not with other studied common diseases. In addition, higher BPA concentrations were associated with clinically abnormal concentrations of the liver enzymes -glutamyltransferase (OR per 1-SD increase in BPA concentration, 1.29; 95% CI, 1.14-1.46; P < .001) and alkaline phosphatase (OR per 1-SD increase in BPA concentration, 1.48; 95% CI, 1.18-1.85; P = .002).

Conclusion Higher BPA exposure, reflected in higher urinary concentrations of BPA, may be associated with avoidable morbidity in the community-dwelling adult population.

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Posted in Bisphenol A, Plastics | No Comments »

Super-infection by Bacillus thuringiensis H34 or 3a3b can lead to death in mice infected with the influenza A virus.

Friday, February 6th, 2009

FEMS Immunol Med Microbiol. 2000 Nov;29(3):177-81. Links

Super-infection by Bacillus thuringiensis H34 or 3a3b can lead to death in mice infected with the influenza A virus.
Hernandez E, Ramisse F, Gros P, Cavallo J.

Service de Biologie Médicale, Hôpital d’Instruction des Armées Begin, 69 Avenue de Paris, 94160 Saint-Mandé, France. hnz.eric@freesurf.fr

Bacterial super-infections are the main cause of complication and mortality after influenza virus (IAV) infection. Since Bacillus thuringiensis (Bt) is considered non-pathogenic for humans and is widely sprayed in urban areas, the aim of this work was to evaluate the potential pathogenicity of a combined infection Bt-IAV in a mouse model of pneumonia. Bacteria used for super-infections were Bt serotype H34 isolated from human infection and the insecticidal strain 3a3b obtained from a commercial source. Virus strain was A/Scotland/20/74 (H3N2) adapted to BALB/c mice by serial lung passage. Combined infection with 4% of the viral lethal dose 50% (LD(50)) and 10(2) spores of Bt H34 killed 40% of the mice. Mortality rates increased up to 55% and 100% when combined infections were done with respectively 10(4) and 10(7) spores. The insecticidal strain Bt 3a3b was less pathogenic than Bt H34. A dose of 10(4) spores associated with 4% of IAV LD(50) killed 50% of the mice. This inoculum must be compared with the doses usually sprayed in agriculture: 10(11) spores m(-2). Total protection against super-infection was obtained when mice were treated with amantadine. Even if only a few cases of Bt human infection have been reported, these results suggest a possible risk for workers spraying Bt-based biopesticides during flu outbreaks.

PMID: 11064263 [PubMed - indexed for MEDLINE]

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Posted in Influenza | No Comments »

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