Search Results

Carpet Monsters

Nicholas P. Money

in Carpet Monsters and Killer Spores: A Natural History of Toxic Mold

This chapter explains how mold spores can cause allergies. Spores carry proteins on their surface, and those that act as antigens can cause a cascade of immune responses resulting in the miseries of ... More

This chapter explains how mold spores can cause allergies. Spores carry proteins on their surface, and those that act as antigens can cause a cascade of immune responses resulting in the miseries of allergic rhinitis or hay fever, allergic conjunctivitis, skin allergies, asthma, eczema or atopic dermatitis, and hypersensitivity pneumonitis. This chapter describes interactions between immune cells in allergies mediated by IgE and IgG, providing a primer on this complex field of medicine. The idea that allergy is a perversion of a response that evolved to combat parasitic infestations is discussed, along with the hygiene hypothesis that has been advanced as an explanation for the increasing prevalence of asthma.Less

Resuscitation and Transfer

Caroline Whymark, Ross Junkin, and Judith Ramsey

in SBAs for the Final FRCA

Uninvited Guests

Nicholas P. Money

in Carpet Monsters and Killer Spores: A Natural History of Toxic Mold

Black molds feed by secreting enzymes that dissolve complex molecules, like cellulose, as their filamentous hyphae insinuate themselves in their food sources. Many of the molds that grow in buildings ... More

Black molds feed by secreting enzymes that dissolve complex molecules, like cellulose, as their filamentous hyphae insinuate themselves in their food sources. Many of the molds that grow in buildings represent single phases in complex microbial life cycles. The diversity of mold species is astonishing, but relatively few species are prevalent in homes. Molds have a variety of effects upon human health. Many provoke allergies, some are implicated in fungal sinusitis, and a small subset can cause life-threatening infections. Evidence of the ubiquity of black molds is found in the fact that their growth on the exterior of office buildings in cities is usually mistaken for the effects of pollution.Less

Immunology and Allergy

Nigel Lane, Louise Powter, and Sam Patel (eds)

in Best of Five MCQs for the Acute Medicine SCE

The Possibility of Illness from Pigeon Allergens

Ralph Colp Jr. M.D.

in Darwin's Illness

In a footnote in Darwin on Man, it was suggested that Charles Darwin may have become ill because of “a severe allergy, possibly to pigeons, with which Darwin associated much”. However, there is no ... More

In a footnote in Darwin on Man, it was suggested that Charles Darwin may have become ill because of “a severe allergy, possibly to pigeons, with which Darwin associated much”. However, there is no evidence that he was allergic to pigeons. Every day, from 1856 through 1858, he would go to the aviary and closely examine the pigeons. Yet his illness was subacute and did not become especially severe. He does not seem to have been exposed to pigeons during the very severe exacerbations of his illness (1839–42, 1848–49, 1863–64, and 1865). In addition, the main symptoms of his illness were not similar to the symptoms of pigeon allergy.Less

The Problem with Peanuts

Matthew Smith

in Another Person's Poison: A History of Food Allergy

This chapter highlights the role of the peanut in making food allergy respectable. More than any other food allergen, peanuts became synonymous with food allergy and the subject of grassroots ... More

This chapter highlights the role of the peanut in making food allergy respectable. More than any other food allergen, peanuts became synonymous with food allergy and the subject of grassroots activism, voluntary industry action, legislation, and extensive media coverage. Unlike other developments in the history of food allergy—which were dominated by ideological debates among physicians, the clinical challenges of diagnosis and treatment, and the politics and economics of allergy—patients and parents were instrumental in putting the spotlight on peanut allergy by raising awareness, monitoring for peanut contamination, lobbying for better labels, and raising funds for research. Allergy associations and the food industry were also able to harness public concern about and interest in peanut allergy in order to shape understandings of food allergy in ways that were in their own interests.Less

Conclusion

Matthew Smith

in Another Person's Poison: A History of Food Allergy

This concluding chapter begins with a discussion of the lack of medical interest and the paucity of research on the rise of allergy and other immune dysfunctions. It argues that rather than thinking ... More

This concluding chapter begins with a discussion of the lack of medical interest and the paucity of research on the rise of allergy and other immune dysfunctions. It argues that rather than thinking imaginatively or creatively about such diseases, their causes, and what they might denote about our changing relationship with our foods, the environment, or our lifestyles, most clinicians and researchers have expended their energies on defending restrictive dogmas and debating about precise definitions. The chapter suggests that in order to explain the explosion of anaphylactic allergy and other allergic diseases, food allergists and orthodox allergists should look to reconcile their differences and examine food allergy afresh in a more pluralistic, open-minded, and holistic fashion.Less

Controversial Syndromes and Their Relationship to Fibromyalgia

Daniel J. Wallace and Janice Brock Wallace

in All About Fibromyalgia: A Guide for Patients and their Families

Over the years, a variety of health professionals have developed terms or phrases to denote seemingly unique clinical combinations of symptoms and signs. A ... More

Over the years, a variety of health professionals have developed terms or phrases to denote seemingly unique clinical combinations of symptoms and signs. A disorder or syndrome does not necessarily exist simply because it has been described in the medical literature. Some have stood the test of time, others overlap with syndromes described by different specialists, and additional terms may be favored by a single practitioner advocating a “cause.” This chapter reviews conditions that have overlapping features with fibromyalgia but are not yet regarded as full-blown, legitimate disorders by organized medicine. When Dr. Fine first met Wanda, she was a basket case. Wanda had canceled three prior appointments because smells from a new carpet had made her sick, Med fly agricultural spraying 30 miles away prevented her from getting out of bed, and she developed a severe headache when her neighbors’ house was being painted. She almost passed out in the elevator going to Dr. Fine’s office because somebody was smoking. Wanda had been to three allergists, who obtained normal skin tests and blood tests. Desperate, she traveled to Mexico, where “immune rejuvenating” injections were administered, and to Texas, where a clinical ecologist sequestered her in a pollution-free, environmentally safe quonset hut for a month. There she received daily colonies, antiyeast medication, and vitamin shots, to no avail. Dr. Fine elicited a history of aching, sleep disorder, a “leaky gut,” muscle pains, fatigue, and a spastic colon. His physical examination and mental status examination revealed evidence of anxiety, obsessive-compulsive tendencies, and fibromyalgia tender points. Wanda was treated with fluoxetine (Prozac) for pain and obsessive behavior, buspirone (Buspar), for anxiety during the day, and trazodone (Desyrel), a tricyclic, to help her sleep at night. She was referred to a psychologist who worked to improve Wanda’s socialization skills and encouraged her to go out rather than be a prisoner in her own home. Wanda is slowly improving but will need many months of therapy. Self-reported environmental sensitivities are observed in 15 percent of Americans. Less

Pancreatic Cancer

Anders Ekbom and Dimitrios Trichopoulos

in Textbook of Cancer Epidemiology

Cancer of the pancreas is slightly more common among men than women. Survival rarely exceeds six months. Trends in pancreatic cancer incidence in developed countries are slightly declining. The ... More

Cancer of the pancreas is slightly more common among men than women. Survival rarely exceeds six months. Trends in pancreatic cancer incidence in developed countries are slightly declining. The disease shows evidence of a familial occurrence. Tobacco smoking is the only established exogenous cause of the disease; smoking cessation is quickly followed by a reduction in risk. Consumption of fruits and vegetables is inversely associated. Alcohol, either consumed in moderate amounts or abused, does not substantially affect risk, although pancreatitis, frequently linked to excessive alcohol intake, has been found to slightly increase the risk of the disease. Among occupational factors the evidence is relatively strong only for chlorinated hydrocarbon solvents frequently used in dry cleaning. Adult-onset diabetes mellitus and perhaps pernicious anemia may increase the risk of pancreatic cancer, possibly through the action of gastrointestinal hormones or insulin. Several reports indicate that allergies may be inversely related to the risk of pancreatic cancer.Less

A life course approach to respiratory and allergic diseases

Diana Kuh and Yoav Ben-Shlomo

in A Life Course Approach to Chronic Disease Epidemiology

This chapter examines the independent and combined effects of perinatal or childhood exposures and adult lifestyle on the development of both allergic and non-allergic lung disease. Topics discussed ... More

This chapter examines the independent and combined effects of perinatal or childhood exposures and adult lifestyle on the development of both allergic and non-allergic lung disease. Topics discussed include the development of ventilary function, effects of childhood chest illness on lung function and respiratory disease, allergic sensitization, and later influences on adult respiratory disease. It also reviews trends in chronic obstructive pulmonary disease, asthma, and allergy.Less

Local anaesthesia for children

J.G. Meechan and G. Jackson

in Paediatric Dentistry

A child’s future perceptions and expectations are likely to be conditioned by early experiences of dental treatment. Just under half of all children report low to ... More

A child’s future perceptions and expectations are likely to be conditioned by early experiences of dental treatment. Just under half of all children report low to moderate general dental anxiety, and 10–20% report high levels of dental anxiety. Montiero et al. (2014) indicate that the prevalence of needle phobia may be as high as 19% in 4- to 6-year-olds. Davidovich et al. (2015) reflected that, for general practitioners and specialists alike, Local anaesthetic (LA) injection for an anxious child was the most stressful procedure regardless of the operator’s age, gender, or years of professional experience. Despite impressive reductions in caries in children in recent years, there still exists a social gradient with inequalities in experience of dental disease, and there remains a significant cohort of children for whom extractions and restoration of teeth are necessary. Aside from emerging restorative strategies that do not require LA (e.g. atraumatic restorative technique or placement of preformed metal crowns using the Hall technique), effective and acceptable delivery of LA remains an important tool to enable successful operative dental treatment to be carried out comfortably for child patients. Effective surface anaesthesia prior to injection is very important as a child’s initial experience of LA techniques may influence their future perceptions and help in establishing trust. Cooling tissues prior to injection has been described but is rarely used, and surface anaesthesia is generally achieved with intra-oral topical agents. Although the main use of topical agents is as a pre-injection treatment, they have been used as the sole means of anaesthesia for some procedures including the extraction of mobile primary teeth. It is possible to achieve a depth of 2–3mm of anaesthesia if topical agents are used correctly: • the area of application should be dried • topical anaesthetic agent should be applied over a limited area • the anaesthetic agent should be applied for sufficient time. In the UK 5% lidocaine (lignocaine) and 18–20% (17.9%) benzocaine gels are the most commonly used agents. Benzocaine topical anaesthetic gel is not recommended for use on children under 2 years old because of an increased risk of methaemoglobinaemia. Less

Introduction: “Witchcraft, A Fad, or A Racket?”

Matthew Smith

in Another Person's Poison: A History of Food Allergy

This introductory chapter begins with a review of some contemporary statistics about food allergy. Food allergies, for instance, occur when the immune system overreacts to proteins found in food. ... More

This introductory chapter begins with a review of some contemporary statistics about food allergy. Food allergies, for instance, occur when the immune system overreacts to proteins found in food. Today it is estimated that 4 percent of adults and 8 percent of children in North America are allergic to some food, including peanuts, eggs, and milk. The chapter then sets out the book's purpose, namely to describe the history of food allergy in order to address the following questions: Why has food allergy transformed from a questionable medical entity to a condition deemed serious enough to change the ways in which we produce, prepare, and consume food? Why has food allergy always been so controversial? Why have explanations for food allergy been so elusive? And why are more and more children allergic to food. An overview of the subsequent chapters is also presented.Less

Food Allergy Before Allergy

Matthew Smith

in Another Person's Poison: A History of Food Allergy

This chapter examines how physicians in previous centuries came to understand and explain the bizarre symptoms that some people experienced after eating particular foods. Rather than attempting to ... More

This chapter examines how physicians in previous centuries came to understand and explain the bizarre symptoms that some people experienced after eating particular foods. Rather than attempting to prove that reports of bizarre food reactions were what we would now call food allergy, it shows how such responses were understood prior to the emergence of allergy as a medical and cultural phenomenon. How did physicians interpret strange responses to food before 1906? Were they common explanations for otherwise unexplained symptoms? If they were not a regular feature of medical practice, does this mean that reactions to food were unheard of—a conclusion that might support some current theories about the epidemiology of food allergy—or does it mean instead that compared with the vast amount of endemic infectious disease and nasty pathogens commonly found in poorly preserved food, they were believed to be clinically unimportant? Either way, what bearing does the history of such reactions, the prehistory of food allergy, have on the understandings of food allergy that emerged after von Pirquet coined his term?Less

Anaphylaxis, Allergy, and the Food Factor in Disease

Matthew Smith

in Another Person's Poison: A History of Food Allergy

This chapter charts the emergence of allergy as a specific field of medical inquiry in the early years of the twentieth century. It considers debates about food allergy, which could be distilled to ... More

This chapter charts the emergence of allergy as a specific field of medical inquiry in the early years of the twentieth century. It considers debates about food allergy, which could be distilled to how one defined allergy and how one applied such definitions in clinical practice. Anaphylaxis denoted a restricted definition of food allergy, which was limited to certain reactions and, by extension, certain kinds of food. For orthodox allergists, who believed that the rates of food allergy were exaggerated, it was Charles Richet's definition of anaphylaxis that mattered most. Allergy, as defined by Clemens von Pirquet, widened the spectrum, allowing for a greater array of symptoms, especially chronic complaints, to be included under its umbrella. Physicians who regarded food allergy as a widespread clinical phenomenon adhered to this definition. But for some, including the clinical ecologists who defected from allergy in the 1960s, even von Pirquet's term did not go far enough. They, instead, turned away from the immune system and toward Francis Hare, whose inductive process had convinced them that food played a key role in countless chronic health problems, including mental illness.Less

Strangest of All Maladies

Matthew Smith

in Another Person's Poison: A History of Food Allergy

This chapter describes the excitement and controversy generated by clinical and popular interest in food allergy during the first several decades of the twentieth century. It became apparent that ... More

This chapter describes the excitement and controversy generated by clinical and popular interest in food allergy during the first several decades of the twentieth century. It became apparent that although food allergy was included in the same family of allergic disease as hay fever and pet dander allergy, it did not always follow the same rules as those conditions. Early food allergists had to diagnose, treat, and classify food allergy differently than orthodox allergists who focused on other allergies. They also relied more on the testimony and cooperation of their patients. The two factions that would emerge within allergy—food allergists, who employed a broad definition of food allergy and thought it was widespread, and orthodox allergists, who employed a narrower definition of food allergy and thought it was rare—would contest how to understand, explain, and treat food allergy throughout the twentieth century.Less