Albert's spreadsheet

[michael edward badolato jr]

Dear Albert,

The following is the fill out of your spread sheet.

There seems to be a gap in our mutual understanding. If you are making fun of the 6 hour test then I'd have to ask you why its asking too much that you have at least 6 hours of knowledge on this disease (smile). You may be misunderstanding my view if you don't have that knowledge. Again I point out that 100% of clinically healthy nonsmoking children living in the combustion aerosol of Mexico City have airway and brain damage and the ACA has numerous components that activate MCS disease process.

However, let me emphasize I have little or no quarrel with the diagnostic success of the 1999 Criteria - it is simply that it does not acknowledge the ACA which constitutes a significant or high level of exposure. It cannot be stated or assumed to be a low level of exposure. Such assumption contradicts 15 years of conclusive evidence that has developed since the 1999 Criteria was written. That is the problem - I agree that the 1999 Criteria has been good diagnostically but it is incorrect in not acknowledging that the ACA is an ongoing significant exposure producing ongoing inflammation and blurring the distinctions of so called "inciting" exposures and producing subclinical predispositional changes increasing vulnerability to subsequent exposure.

By the way I reorganized MCS 3a with a Conclusion and reduced the use of the CAR acronym so that the article conforms to a review study outline and conclusion style.

Thanks, I hope you'll keep in touch.

Mike

Spread sheet fill in:

Why developed:

same as with the 1999 Criteria -in agreement with the 1999 Criteria goal of adequate inclusivity - except to specify that while leaving five of the six 1999 Consensus Criteria essentially intact - the 2015 Consensus corrects impression MCS is a syndrome in response to unrelated chemicals in a low level, commonly tolerated, non inciting background atmosphere. Amendment includes language more consistent with intent (2,3,4) and information - especially concerning the ACA (3,4). Pt 1 of the 1999 Consensus is not included because reproducibility of symptoms upon repeated exposure is effected by masking and overlap of continuous exposure to the ACA and other chemicals - saturating trigeminal and olfactory receptor sites and eliciting both immediate and delayed precipitation of symptomatology. 

Causes recognized by authors of definition:

there is no requirement for recognition of a specific cause

Biomarker tests required:

there are no biomarker tests required

Inclusions by definition:

same as with the 1999 Criteria

Allowed co-morbidities:

all co-morbidities are allowed (which means by definition of the term co-morbidity - not a replacement condition responsible for the disease

Clinical experience:

human biopsy and autopsy studies of clinically healthy nonsmoking subjects confirm that the continuous exposure to the ambient combustion aerosol (ACA) produces degrees of airway tissue and brain damage - including severe - depending on intensity of exposure - causing or setting up a predisposition for MCS and increased vulnerability to personal  exposures - and numerous studies demonstrate conclusively that the ACA will support existing MCS disease process by activating sensory nerves releasing inflammatory mediators and in at least some cases by increased penetration of ACA components. There is a price to be paid for continuous every breath exposure to a thousand chemicals and heavy metals complexed to a fine particle core with prolonged residence time in tissue. Most people having MCS are women with an introverted intuitive cast of mind (to borrow the term) with an accompanied genetically sensitive airway tissue - expected to be genetically determined quantitative differences in sensory receptors, acid sensitive pathways, and neuropeptide release.

recognized cures:

while long term tissue damage usually precludes a cure, the 2015 Consensus is not concerned with the controversial issue of a cure