A site to transform Pubmed publications into these bibliographic reference formats: ADS, BibTeX, EndNote, ISI used by the Web of Knowledge, RIS, MEDLINE, Microsoft's Word 2007 XML.

Disorders of Environmental Origin - Top 30 Publications

Neurologic complications of acute environmental injuries.

Environmental injuries can result in serious neurologic morbidity. This chapter reviews neurologic complications of thermal burns, smoke inhalation, lightning strikes, electric injury, near drowning, decompression illness, as well as heat stroke and accidental hypothermia. Knowing the pathophysiology and clinical presentation of such injuries is essential to proper management of primary and secondary medical complications. This chapter highlights the most frequently encountered neurologic injuries secondary to common environmental hazards, divided into the topics: injuries related to fire, electricity, water, and the extremes of temperature.

Experience of living with nonspecific building-related symptoms.

Nonspecific building-related symptoms (NBRS) is a combination of general, skin and mucosal symptoms related to certain buildings. Despite high prevalence in the general population and severe symptomatology in certain cases there is no scientific documentation of quality of life in NBRS. The purpose of this study was to illuminate how individuals with NBRS experience daily life. Data were collected through descriptive, written texts and through telephone interviews with 11 individuals diagnosed with NBRS, and qualitative content analysis was conducted. Three main content areas were identified: (1) attitudes from the surrounding (categories: being questioned and lack of understanding from others; from zero to full support); (2) consequences (difficulties with daily activities; financial difficulties; affecting family and friends; emotional consequences); and (3) coping (learning to accept and finding solutions; avoiding; struggling; finding the positive; making one's home a sanctuary). As a conclusion, NBRS may affect several aspects of daily life, resulting in considerable alterations, limitations and emotional impact for the afflicted person and his/her family. Both environmental factors and attitudes from the surrounding can contribute to this impact on daily life. Strategies needed to cope with this impact may include both problem-focused and emotion-focused strategies, such as struggling, avoiding trigger factors and finding positive aspects.

Environmental risk factors for autism spectrum disorders.

Autism spectrum disorders (ASD) are syndromes that are predominantly defined by behavioral features such as impaired social interactions, restricted verbal and nonverbal communication, and repetitive or stereotyped behavior. In the past few decades, the reported prevalence of ASD has increased dramatically. This growth can be partially explained by an increased level of awareness of the problem among professionals and better diagnostic methods. Nevertheless, underpinning causes of ASD have not yet been detailed and explained. It is suggested that rather than having a single causative factor, ASD pathogenesis is influenced by environmental or genetic factors, or a combination of both. The aims of this review are to describe the environmental risk factors associated with ASD so as to provide a reference basis for current and future clinical and experimental work.

EUROPAEM EMF Guideline 2016 for the prevention, diagnosis and treatment of EMF-related health problems and illnesses.

Chronic diseases and illnesses associated with non-specific symptoms are on the rise. In addition to chronic stress in social and work environments, physical and chemical exposures at home, at work, and during leisure activities are causal or contributing environmental stressors that deserve attention by the general practitioner as well as by all other members of the health care community. It seems necessary now to take "new exposures" like electromagnetic fields (EMF) into account. Physicians are increasingly confronted with health problems from unidentified causes. Studies, empirical observations, and patient reports clearly indicate interactions between EMF exposure and health problems. Individual susceptibility and environmental factors are frequently neglected. New wireless technologies and applications have been introduced without any certainty about their health effects, raising new challenges for medicine and society. For instance, the issue of so-called non-thermal effects and potential long-term effects of low-dose exposure were scarcely investigated prior to the introduction of these technologies. Common electromagnetic field or EMF sources: Radio-frequency radiation (RF) (3 MHz to 300 GHz) is emitted from radio and TV broadcast antennas, Wi-Fi access points, routers, and clients (e.g. smartphones, tablets), cordless and mobile phones including their base stations, and Bluetooth devices. Extremely low frequency electric (ELF EF) and magnetic fields (ELF MF) (3 Hz to 3 kHz) are emitted from electrical wiring, lamps, and appliances. Very low frequency electric (VLF EF) and magnetic fields (VLF MF) (3 kHz to 3 MHz) are emitted, due to harmonic voltage and current distortions, from electrical wiring, lamps (e.g. compact fluorescent lamps), and electronic devices. On the one hand, there is strong evidence that long-term exposure to certain EMFs is a risk factor for diseases such as certain cancers, Alzheimer's disease, and male infertility. On the other hand, the emerging electromagnetic hypersensitivity (EHS) is more and more recognized by health authorities, disability administrators and case workers, politicians, as well as courts of law. We recommend treating EHS clinically as part of the group of chronic multisystem illnesses (CMI), but still recognizing that the underlying cause remains the environment. In the beginning, EHS symptoms occur only occasionally, but over time they may increase in frequency and severity. Common EHS symptoms include headaches, concentration difficulties, sleep problems, depression, a lack of energy, fatigue, and flu-like symptoms. A comprehensive medical history, which should include all symptoms and their occurrences in spatial and temporal terms and in the context of EMF exposures, is the key to making the diagnosis. The EMF exposure is usually assessed by EMF measurements at home and at work. Certain types of EMF exposure can be assessed by asking about common EMF sources. It is very important to take the individual susceptibility into account. The primary method of treatment should mainly focus on the prevention or reduction of EMF exposure, that is, reducing or eliminating all sources of high EMF exposure at home and at the workplace. The reduction of EMF exposure should also be extended to public spaces such as schools, hospitals, public transport, and libraries to enable persons with EHS an unhindered use (accessibility measure). If a detrimental EMF exposure is reduced sufficiently, the body has a chance to recover and EHS symptoms will be reduced or even disappear. Many examples have shown that such measures can prove effective. To increase the effectiveness of the treatment, the broad range of other environmental factors that contribute to the total body burden should also be addressed. Anything that supports homeostasis will increase a person's resilience against disease and thus against the adverse effects of EMF exposure. There is increasing evidence that EMF exposure has a major impact on the oxidative and nitrosative regulation capacity in affected individuals. This concept also may explain why the level of susceptibility to EMF can change and why the range of symptoms reported in the context of EMF exposures is so large. Based on our current understanding, a treatment approach that minimizes the adverse effects of peroxynitrite - as has been increasingly used in the treatment of multisystem illnesses - works best. This EMF Guideline gives an overview of the current knowledge regarding EMF-related health risks and provides recommendations for the diagnosis, treatment and accessibility measures of EHS to improve and restore individual health outcomes as well as for the development of strategies for prevention.

Long-term effect of heavy-metal pollution on diversity of gastrointestinal microbial community of Bufo raddei.

Gastrointestinal (GI) microbiota plays a very important role in maintaining its host's health. However, the effects of environmental contamination on the GI microbiota homeostasis of amphibians have not yet been reported. The present study reveals the long-term effect of natural heavy-metal pollution on the GI microbial community diversity and structural changes of Bufo raddei (B. raddei). Basing on the 16S rRNA sequencing method, the GI microbiota of B. raddei from a heavily heavy-metal-polluted area (Baiyin, (BY)) and a relatively unpolluted area (Liujiaxia, (LJX)) were profiled. The results showed that heavy-metal pollution had caused significant shifts in the composition of the GI microbiota both at the phylum and genus levels. Specifically, Bacteroidetes dominated in the GI tract of B. raddei from BY, while Tenericutes was much more common in those from LJX. The ratio of Firmicutes/Bacteroidetes and the proportion of probiotics in the GI microbiota of B. raddei from BY were reduced compared to those from LJX, as well. Heavy-metal pollution also induced in a reduction of species diversity and decreased proportion of unique operational taxonomic units in the GI tract. In short, our results demonstrate that long-term heavy-metal exposure re-shaped the composition and decreased the species diversity of GI microbiota of B. raddei; our results also represent a novel approach to uncover the toxic effects of pollution on amphibians.

History of chemical sensitivity and diagnosis.

Histories of mold, pollen, dust, food, chemicals, and electromagnetic field (EMF) sensitivities are the major categories of triggers for chemical sensitivity. They are tied together by the coherence phenomenon, where each has its own frequencies and identifiable EMF; therefore, they can be correlated. The diagnosis of chemical sensitivity can be done accurately in a less-polluted, controlled environment, as was done in these studies. The principles of diagnosis and treatment depend on total environmental and total body pollutant loads, masking or adaptation, bipolarity of response, and biochemical individuality, among others. These principles make less-polluted, controlled conditions necessary. The clinician has to use less-polluted water and organic food with individual challenges for testing, including dust, mold, pesticide, natural gas, formaldehyde, particulates, and EMF testing, which needs to be performed in less-polluted copper-screened rooms. The challenge tests for proof of chemical sensitivity include inhaled toxics within a clean booth that is chemical- and particulate-free at ambient doses in parts per million (ppm) or parts per billion (ppb). Individual foods, both organic and commercial (that are contaminated with herbicides and pesticides), are used orally. Water testing and intradermal testing are performed in a less-polluted, controlled environment. These include specific dose injections of molds, dust, and pollen that are preservative-free, individual organic foods, and individual chemicals, i.e. methane, ethane, propane, butane, hexane, formaldehyde, ethanol, car exhaust, jet fuel exhaust, and prosthetic implants (metal plates, pacemakers, mesh, etc.). Normal saline is used as a placebo. EMF testing is performed in a copper-screened room using a frequency generator. In our experience, 80% of the EMF-sensitive patients had chemical sensitivity when studied under less-polluted conditions for particulates, controlled natural gas, pesticides, and chemicals like formaldehyde.

Carbon Dioxide Detection and Indoor Air Quality Control.

When building ventilation is reduced, energy is saved because it is not necessary to heat or cool as much outside air. Reduced ventilation can result in higher levels of carbon dioxide, which may cause building occupants to experience symptoms. Heating or cooling for ventilation air can be enhanced by a DCV system, which can save energy while providing a comfortable environment. Carbon dioxide concentrations within a building are often used to indicate whether adequate fresh air is being supplied to the building. These DCV systems use carbon dioxide sensors in each space or in the return air and adjust the ventilation based on carbon dioxide concentration; the higher the concentration, the more people occupy the space relative to the ventilation rate. With a carbon dioxide sensor DCV system, the fresh air ventilation rate varies based on the number ofpeople in the space, saving energy while maintaining a safe and comfortable environment.

Pollutant Levels at Cooking Place and Their Association with Respiratory Symptoms in Women in a Rural Area of Delhi-NCR.

Household air pollution resulting from biomass and coal stoves is implicated in more than one-third cases of annual deaths from chronic lung diseases worldwide and nearly 3% of lung cancer deaths. This burden is borne largely by poor women in the developing countries. We carried out a study to evaluate its association with respiratory symptoms in women in a rural area.

Lack of contralateral suppression in transient-evoked otoacoustic emissions in multiple chemical sensitivity: a clinical correlation study.

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.

Possible association between acetazolamide administration during pregnancy and multiple congenital malformations.

Congenital malformations might occur because of environmental or genetic factors, and sometimes occur because of unknown causes. Acetazolamide is a carbonic anhydrase inhibitor that is used to treat idiopathic intracranial hypertension, glaucoma, and epilepsy. The use of acetazolamide has not been recommended for pregnant women because of reported teratogenic risks. Congenital malformations, such as ectrodactyly, syndactyly, cleft lip/palate, and retarded incisor teeth development, have been reported in experimental animals. However, tooth agenesis due to the use of acetazolamide has not been reported yet. Oligodontia is a severe type of tooth agenesis involving six or more congenitally missing teeth. The causes of oligodontia are attributed to environmental factors, such as irradiation, drugs, trauma, tumors, infection, genetic factors, or a combination. There is no credible evidence of undesirable effects of acetazolamide use in human pregnancy. However, we report a case of a 12-year-old Saudi boy who was exposed to maternal acetazolamide (1,000 mg/day) for treatment of idiopathic intracranial hypertension before pregnancy, during the first trimester, and throughout the pregnancy. This treatment might have resulted in some congenital malformations, such as ectrodactyly, syndactyly, and oligodontia.

Psychological symptoms and health-related quality of life in idiopathic environmental intolerance attributed to electromagnetic fields.

Need for better understanding of the etiology of idiopathic environmental intolerance attributed to electromagnetic fields (IEI-EMF) motivated the present study of psychological symptoms and health-related quality of life (HRQoL) in person who attribute health problems to electromagnetic fields.

Investigating paternal preconception risk factors for adverse pregnancy outcomes in a population of internet users.

Paternal preconception risk factors such as smoking, exposure to environmental substances, medication use, overweight and advanced age correlate with the occurrence of malformations and birth defects in the offspring. Nonetheless, the prevalence of risk factors for adverse pregnancy outcomes in the male population has been scarcely investigated and no report on preconception interventions targeting prospective fathers is available. We conducted a web-based survey to measure the prevalence of paternal preconception risk factors for adverse pregnancy outcomes in an Italian population of Internet users.

Air Pollution and the Risk of Birth Defects in Anqing City, China.

This study aimed to explore evidence for the influence of air pollution on the risk of birth defects in China and contribute to establish prevention strategies.

Long-Term Follow-Up in Patients With Airway Chemical Intolerance.

A 5-year follow-up study showed that a group of patients with airway symptoms from chemicals and scents had lasting symptoms, together with enduring increased capsaicin cough sensitivity. The aim was to follow up the same patients after another 5 years.

Dispositional aspects of body focus and idiopathic environmental intolerance attributed to electromagnetic fields (IEI-EMF).

Body focus is often considered an undesirable characteristic from medical point of view as it amplifies symptoms and leads to higher levels of health anxiety. However, it is connected to mindfulness, well-being and the sense of self in psychotherapy. The current study aimed to investigate the contribution of various body focus related constructs to acute and chronic generation and maintenance of medically unexplained symptoms (MUS). Thirty-six individuals with idiopathic environmental intolerance to electromagnetic fields (IEI-EMF) and 36 controls were asked to complete questionnaires assessing negative affect, worries about harmful effects of EMFs, health anxiety (HA), body awareness, and somatosensory amplification (SSA), and to report experienced symptoms evoked by a sham magnetic field. Body awareness, HA, SSA, and EMF-related worries showed good discriminative power between individuals with IEI-EMF and controls. Considering all variables together, SSA was the best predictor of IEI-EMF. In the believed presence of a MF, people with IEI-EMF showed higher levels of anxiety and reported more symptoms than controls. In the IEI-EMF group, actual symptom reports were predicted by HA and state anxiety, while a reverse relationship between symptom reports and HA was found in the control group. Our findings show that SSA is a particularly important contributor to IEI-EMF, probably because it is the most comprehensive factor in its aetiology. IEI-EMF is associated with both a fear-related monitoring of bodily symptoms and a non-evaluative body focus. The identification of dispositional body focus may be relevant for the management of MUS.

Coordination of governmental and public control in providing sanitary epidemiologic well-being of population and consumers' rights protection.

The article covers features of govenmental and public control in providing sanitary epidemiologic well-being of population and consumers' rights protection. Based on analysis of contemporary legislation, the authors evaluated terms "control" and "supervision", having different legal nature. The authors determined specific traits and define subjects and objects for public control in relationships aimed to provide sanitary epidemiologic well-being of population, evaluated legislative basis of citizens' claims to Rospotrebnadzor, pointed at difficulties in implementation of public control in connection with necessity to create new organizational and legal mechanisms widening control possibilities.


Work was performed within the framework of the State program of competitive recovery of Kazan (Volga) Federal University among the world's leading research and education centers and subsidies allocated to Kazan Federal University for the implementation of Public task in the field of scientific activities. In the paper there are presented results of the risk assessment for children's health, with allowances made for evolving cationic-anionic pattern of tap waters while moving along pipelines and distributing networks, discriminatingly on study area. The population health risk assessment was performed according to public health regulatory methods P in relation to the ionic composition of tap water consumed by children's population of the city of Kazan. The use of a risk assessment in consumption of tap water by the most susceptible population group with localized residence allows to identify zones in the boundaries of the urban area in which water is needed post-treatment of tap waters flowing to consumers.


There are presented results of the socio-hygienic analysis of ecologically related skin pathology ofthe population of Primorsky Krai. The aim of the work is to establish the patterns of distribution of ecologically related skin diseases in various ecological bioclimatic zones of Primorsky Krai. There was performed an analysis of skin diseases ofform 12 according to ICD-10 main demographic groups (children, adolescents and adults) of the population of Primorsky Krai, residing in various bioclimatic zones of Krai with different levels of environmental stringency in rural and urban areas for the period of 2000-2013. There were established causal-effect relationships of the prevalence of skin diseases, as ecologically related pathology. The level of the prevalence of skin diseases among the population in the Primorye region depends on bioclimatic zones, the degree of the stringency of the environmental situation and combinations of environmental factors. The prevalence of skin diseases in adults, adolescents and children, as the organism's response to the impact ofthe parameters ofthe environment is affected by the complex offactors, the main of them are hygienic: the sanitary--hygienic level of ambient air pollution, the specification of chemical pollution and adverse physical factors in urban and rural settlements, the characteristics of the state of the soil. The medical-sociological research of the lifestyle of the population was performed on the basis of a specially designed questionnaire. The questionnaire included three arrays of issues: environmental, hygienic and social. On the basis of medical and sociological research with the use of multivariate analysis, method of correlation pleiades advanced by P. V. Terentiev, lifestyle and psycho-emotional factors, socio-hygienic, bioclimatic factors were found to play an important role in the prevalence of ecologically related pathology of skin in residents of Primorsky Krai. Differences in responses between urban and rural residents living in areas with various environmental stringency, confirm the preposition about the ambiguity of the approach to the solution of social, hygienic and environmental problems in areas with different socio-economic situation. The obtained results of the study allow us to determine the main directions of treatment and prevention and to develop targeted prevention programs.


In the paper there is evaluated the relationship of features of electronic state of the environment with a level of chronic, noninfectious diseases (CNID) in the regions of Russia, obtained on the basis of the monitoring measurements of the intensity of natural background electronic Bose condensate (BEBC) of natural ecosystems in a number of Russian regions and seas of the Arctic Ocean. The assessment of BEBC was implemented on results of measurements of redox state of distilled water being in the contact with natural water. The equilibrium redox state of distilled water, determined by the influx of electrons (quantum reduction) outside, is proportional to the intensity of BEBC. The obtained data attest to an increase in the intensity of the background of EBC in Siberia regions and, especially, within the limits ofwaters of Lake Baikal (the redox potential of the surface water in the lake ~ -70mV). Also there is observed a strong dependence of the background EBC in the latitudinal direction. Low levels of background EBC were noted in the Arkhangelsk region and the north-eastern Chukotka. Functioning of international systems of plasma sounding of ionosphere (such systems as HAARP) were established to have a detrimental effect on the background EBC in these regions. According to the results of measurements of the relative values of intensities of natural background of Bose condensate of electrons there was constructed the dependence reflecting the relationship of the prevalence of noninfectious diseases in the regions of Russia with the redox state of distilled water which can be characterized as a significant (regression coefficient R2 = 0.78). The relationship between noninfectious diseases (NID, %) with the intensity of the background of EBC (Ib rel. units) is estimated by the equation: NID [%] = 0.24Eh [mV]-25, where Eh ~ I/Ib. Numerical evaluations show that an increase in the biosphere redox potential of water by 90mV leads to an increase of the primary incidence by 20% (relatively to the average values for Russia). Analysis of results attests to the relationship of CNID with the electrophysical state of the environment that allows from different positions to arrive to true causes of their emergence, associated with changes in the electrophysical conditions of habitation and human activities that lead to the nascency of cellular metabolic disturbances.


In accordance with international approaches the ranking of permissible levels of chemicals in the soil for the Russian Federation was performed with the use of actual maximum permissible concentration (MPC), there were scientifically substantiated 33 standardsfor 26 substances and their combinations in the soil, differentiatedfor 6 groups offunctional areas for soil use. There is presented the algorithm determining the procedure for the establishment of MPC for unstudied chemicals for various functional areas of soil of populated areas, as well as draft of amendments to existing sanitary-hygienic regulations prior to processing the latter in accordance with modern requirements.

Application of Metabolomics to Multiple Chemical Sensitivity Research.

Multiple chemical sensitivity (MCS) is an acquired chronic disorder characterized by nonspecific symptoms in multiple organ systems associated with exposure to low-level chemicals. Diagnosis of MCS can be difficult because of the inability to assess the causal relationship between exposure and symptoms. No standardized objective measures for the identification of MCS and no precise definition of this disorder have been established. Recent technological advances in mass spectrometry have significantly improved our capacity to obtain more data from each biological sample. Metabolomics comprises the methods and techniques that are used to determine the small-level molecules in biofluids and tissues. The metabolomic profile-the metabolome-has multiple applications in many biological sciences, including the development of new diagnostic tools for medicine. We performed metabolomics to detect the difference between 9 patients with MCS and 9 controls. We identified 183 substances whose levels were beyond the normal detection limit. The most prominent differences included significant increases in the levels of both hexanoic acid and pelargonic acid, and also a significant decrease in the level of acetylcarnitine in patients with MCS. In conclusion, using metabolomics analysis, we uncovered a hitherto unrecognized alteration in the levels of metabolites in MCS. These changes may have important biological implications and may have a significant potential for use as biomarkers.

Community exposure to asbestos in Casale Monferrato: from research on psychological impact to a community needs-centered healthcare organization.

Asbestos exposure has a negative impact on both the physical health of the population, and on its psychological and community components. Usually such issues are addressed via top-down strategies, but this approach is unable to address the interpersonal processes connected to living in a specific context.

Endotoxin, ergosterol, muramic acid and fungal DNA in dust from schools in Johor Bahru, Malaysia--Associations with rhinitis and sick building syndrome (SBS) in junior high school students.

This paper studied associations between ocular symptoms, rhinitis, throat and dermal symptoms, headache and fatigue in students by ethnicity and in relation to exposure to chemical microbial markers and fungal DNA in vacuumed dust in schools in Malaysia. A total of 462 students from 8 randomly selected secondary schools in Johor Bahru, Malaysia, participated (96% response rate). Dust was vacuumed from 32 classrooms and analysed for levels of five types of endotoxin as 3-hydroxy fatty acids (C10, C12, C14, C16 and C18 3-OH), muramic acid, ergosterol and five sequences of fungal DNA. Multiple logistic regression was applied. Totally 11.9% reported weekly ocular symptoms, 18.8% rhinitis, 15.6% throat and 11.1% dermal symptoms, 20.6% headache and 22.1% tiredness. Totally 21.1% reported pollen or furry pet allergy (atopy) and 22.0% parental asthma or allergy. Chinese students had less headache than Malay and Indian had less rhinitis and less tiredness than Malay. Parental asthma/allergy was a risk factor for ocular (odds ratio=3.79) and rhinitis symptoms (OR=3.48). Atopy was a risk factor for throat symptoms (OR=2.66), headache (OR=2.13) and tiredness (OR=2.02). There were positive associations between amount of fine dust in the dust samples and ocular symptoms (p<0.001) and rhinitis (p=0.006). There were positive associations between C14 3-OH and rhinitis (p<0.001) and between C18 3-OH and dermal symptoms (p=0.007). There were negative (protective) associations between levels of total endotoxin (LPS) (p=0.004) and levels of ergosterol (p=0.03) and rhinitis and between C12 3-OH and throat symptoms (p=0.004). In conclusion, the amount of fine dust in the classroom was associated with rhinitis and other SBS symptoms and improved cleaning of the schools is important. Endotoxin in the school dust seems to be mainly protective for rhinitis and throat symptoms but different types of endotoxin could have different effects. The ethnic differences in symptoms among the students deserve further attention.

Clinical problems in patient with Ehlers-Danlos syndrome and Multiple Chemical Sensitivity undergoing total thyroidectomy.

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.

Assessment of glutathione peroxidase-1 polymorphisms, oxidative stress and DNA damage in sensitivity-related illnesses.

Oxidative stress increase is a key event for development of sensitivity-related illnesses (SRIs). The aim of this work was to evaluate the influence of a genetic variant in the antioxidant enzyme glutathione peroxidase (GPx1) on oxidative stress development in SRIs.

Reply to Letter to the Editor: Cognitive therapy in Sick Building Syndrome: Myths, beliefs or evidence.

Cognitive therapy in sick building syndrome: Myths, believes or evidence.

Multiple chemical sensitivity: Clinical evaluation of the severity and psychopathological profile.

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.

Idiopathic environmental intolerance.

Inflammatory Mediator Profiling of n-butanol Exposed Upper Airways in Individuals with Multiple Chemical Sensitivity.

Multiple Chemical Sensitivity (MCS) is a chronic condition characterized by reports of recurrent symptoms in response to low level exposure to various chemical substances. Recent findings suggests that dysregulation of the immune system may play a role in MCS pathophysiology.