Biomedical subjects

Kai Osterberg

Publications and source records attributed to Kai Osterberg.

12 recordsLinked to original sources

PubMed2006

[Multiple chemical sensitivity, a well-defined illness?].

Some people react to smells or chemicals at levels far below toxicological thresholds with nonspecific symptoms, fear and social isolation. They may be diagnosed with multiple chemical sensitivity. There is no empirical evidence indicating that this condition is explained by toxicological mechanisms, even though a number of theories have been proposed. The authors of this review conclude that this is a functional condition. These patients need information and treatment in accordance with this fact. Instead of being advised how to avoid exposure to chemicals, they should be properly trained in appropriate confrontation with the chemicals encountered in everyday life.

Humans↗

PubMed2006

Adult survivors of childhood acute lymphoblastic leukaemia with GH deficiency have normal self-rated quality of life but impaired neuropsychological performance 20 years after cranial irradiation.

OBJECTIVE: Cranial radiotherapy (CRT) was, until recently, important for achieving long-term survival in acute lymphoblastic leukaemia (ALL). Because survival rates have improved markedly, the long-term complications, such as GH deficiency (GHD) and neuropsychological impairment, have become increasingly important. DESIGN AND PATIENTS: The level of self-reported quality of life and neuropsychological functioning was investigated in 44 adults (21 women) with a median age of 25 years who had been treated for childhood onset (CO) ALL with CRT (median 24 Gy). Comparison was made with matched population controls. A subset of patients with GHD was evaluated for neuropsychological functioning after 1 year of GH treatment. RESULTS: Compared to controls, the patients had significantly lower performance in neuropsychological tests. Early age at treatment had a significant negative impact on neuropsychological performance in adulthood. No relationship was found between dose of CRT, time since treatment of ALL or gender and neuropsychological performance. Compared to controls, the patients did not show a poor quality of life or a lowered availability of social interactions or social networks; however, significantly more patients were living alone or with their parents. After GH testing, the patients were all considered GH deficient or insufficient, but no relationship was observed between stimulated peak GH secretion and neuropsychological performance. Treatment with GH for 1 year in a subgroup of the patients did not improve their neuropsychological performance. CONCLUSIONS: This study showed that adults treated with CRT for CO ALL had GHD and significantly impaired neuropsychological performance, although self-reported quality of life was not affected. The effect of GH treatment in this patient group has to be further elucidated.

Adult↗

PubMed2006

Salivary cortisol and self-reported stress among persons with environmental annoyance.

OBJECTIVES: Increased vulnerability to stress has been suggested as a possible mechanism behind medically unexplained conditions such as sensitivity to electricity and common smells. This study examined whether subjective environmental annoyance among the general population is associated with increased physiological reactivity or subjective stress scores. METHODS: Four groups were studied (N=141): an electrically annoyed (N=17), a smell-annoyed (N=29), and a generally annoyed group (N=39) and a reference group matched for age, gender, and socioeconomic status (N=56). Over 5 days, the participants collected saliva for cortisol determination at awakening, 30 minutes after awakening, 8 hours after awakening, and at 9 o'clock in the evening. On the evening preceding the fifth day, the participants ingested a 0.5-mg dexamethasone tablet so that possible differential suppression of the hypothalamic-pituitary-adrenal (HPA) axis could be assessed. Each day, the participants also rated their subjective stress and health complaints. RESULTS: No significant differences were found between the groups regarding cortisol secretion over 5 days. The dexamethasone suppression test showed inhibited cortisol secretion in all four groups. No associations were found between the cortisol concentrations and the self-reported stress scores or subjective health complaints. CONCLUSIONS: Although the environmentally annoyed groups showed no signs of increased HPA-axis activation, being annoyed by both electrical devices and smells seems to be related to increased psychological activation in terms of self-reported stress. Because the participants were otherwise healthy and recruited from the general population, the results imply that subtle psychological stress processes may be important in the early development of environmental annoyance.

Adult↗

PubMed2005

The Meta-Contrast Technique: relationships with personality traits and cognitive abilities in healthy women.

The relationship between test results from the Meta-Contrast Technique (MCT) and self-reports from Karolinska Scales of Personality (KSP), or the State Trait Anxiety Inventory (STAI-T), was investigated in 100 healthy women. Additionally, it was investigated whether age and cognitive abilities influenced the reports of picture recognition thresholds in the MCT. The results showed no agreement between the different ways to assess anxiety and defensiveness. However, age consistently predicted later reports of the perceptual recognition thresholds A1 (the car), A2 (the face) and C-phase. The WAIS-R Digit Symbol Score predicted earlier reporting of the recognition thresholds A1 and A2, but did not predict the final criteria for correct recognition (C-phase). The KSP aggression factor only predicted an earlier report of recognition threshold A2. The absence of a simple relationship between the different ways to assess anxiety and defensiveness, and the observed relationships regarding perceptual threshold levels, corroborates previous findings.

Adult↗

PubMed2004

Annoyance and performance of three environmentally intolerant groups during experimental challenge with chemical odors.

OBJECTIVES: This study investigated exposure- and subject-related determinants of annoyance and performance during the chemical odor provocation of healthy persons with self-reported environmental annoyance. METHODS: Persons with self-reported annoyance attributed to (i) chemicals or smells (smell-annoyed, SA, N=29), (ii) electrical equipment (electrically annoyed, EA, N= 16), and (iii) both smells and electricity (generally annoyed, GA, N=39) were, together with referents (N=54), challenged with n-butyl acetate in an exposure chamber at levels far below the threshold values for neurotoxic effects and trigeminal irritation. A sequence of three air concentrations, 0.37, 1.5, and 6 ppm (1.8, 7.1, and 28 mg/m3) was used, counterbalanced within groups, together with intermittent periods of room air between each exposure level. The response measures comprised ratings of annoyance and smell intensity and reaction-time tests. RESULTS: Only the GA group showed clearly elevated ratings of smell annoyance, mucous membrane irritation, and fatigue, as well as longer reaction times, compared with the referents, in response to the challenge. No group difference was found for the smell-intensity ratings. During intermittent periods without exposure, only the GA group maintained higher ratings for mucous membrane irritation and fatigue. Reaction time and all the rating dimensions showed a positive relationship with momentary n-butyl acetate concentration, while cumulative exposure had a more limited impact on the ratings and reaction time. A suggestion effect by the chamber environment before exposure could not be demonstrated. CONCLUSIONS: The results suggest that self-reported annoyance generalized to both electrical equipment and smells is a better predictor of chemical intolerance than self-reported annoyance to smells only.

Acetates↗

PubMed2003

Annoyance and performance during the experimental chemical challenge of subjects with multiple chemical sensitivity.

OBJECTIVES: This study explored the subjective reactions and psychological test performance of smell-intolerant subjects during consecutive challenges to chemicals with contrasting neurotoxic properties. METHODS: Women with symptoms compatible with multiple chemical sensitivity (N=10) and healthy referents (N=20) were individually challenged in an exposure chamber. All the subjects attended two separate 2-hour sessions of exposure to n-butyl acetate and toluene, in counterbalanced sequence. After an initial phase without exposure, air concentrations were increased in steps ranging from 3.6 to 57 mg/m3 for n-butyl acetate and from 11 to 180 mg/m3 for toluene. The response measures comprised ratings of annoyance and smell intensity and also neurobehavioral test performance. RESULTS: Both groups showed an increase in annoyance ratings and a decrease in test performance in the initial unexposed chamber phase and also in the first phase of the chemical exposure, these results indicating slight immediate expectancy or "suggestion" effects. During the six chamber phases, the ratings of mucous membrane irritation and fatigue showed a steeper increase in the group with multiple chemical sensitivity than among the referents, while the ratings of smell intensity and smell annoyance were similar in the two groups. A reduction in test performance was observed during the chamber phases, particularly in the group with multiple chemical sensitivity. No relation was found between the ratings or performance and chemical substance. CONCLUSIONS: Stronger immediate expectancy or "suggestion" reactions than normal did not characterize the group with multiple chemical sensitivity. This group showed a stronger than normal gradual build-up of fatigue, mucous membrane irritation, and reduced performance during chemical exposure. The results offer the most support to an irritative basis for multiple chemical sensitivity.

Acetates↗

PubMed2003

Effects of the implementation of an 84-hour workweek on neurobehavioral test performance and cortisol responsiveness during testing.

OBJECTIVES: This study examined whether long workhours in combination with an extended workweek (12 hours/7 days), as requested by the workers, impaired attention and cognitive performance and whether the degree of hypothalamic-pituitary-adrenal (HPA) activation was related to the response to the performance tasks. METHODS: A group of 41 male construction workers between 21 and 60 (mean 39) years of age who worked 84 hours a week, with alternate weeks off, was compared with a group of 23 male construction workers between 24 and 65 (mean 43) years of age who had a traditional 40-hour work schedule. Neurobehavioral test performance, self-ratings of fatigue and sleepiness, and salivary cortisol levels were evaluated in a counterbalanced repeated-measures design. RESULTS: The 84-hour group did not show any signs of reduced test performance or elevated fatigue and sleepiness. The 84-hour group had faster reaction times on day 7 than on days 1 and 5. Although the expected activation of the HPA axis was only found in the total study sample when workdays 1 and 5 were collapsed, the HPA activation can be considered normal. CONCLUSIONS: The results suggest that an 84-hour work regimen in response to requests from workers does not induce more performance deficits than an ordinary 40-hour workweek. An extended work schedule of 84 hours cannot in the short-term be considered to affect basic mental capabilities negatively.

Adult↗

PubMed2002

EUROQUEST--a questionnaire for solvent related symptoms: factor structure, item analysis and predictive validity.

The study evaluates the factor structure and predictive validity of the symptom questionnaire EUROQUEST (EQ) that had been developed with the goal of simplifying the evaluation of health effects associated with long-term solvent exposure. The EQ was added to the normal evaluation procedures for 118 male patients with suspected solvent-induced toxic encephalopathy (TE) referred to seven Swedish clinics of occupational medicine during an 18-month period. EQ was also completed by 239 males from a random sample of 400 Swedish males aged 25-64 years selected from the general population and a sample of 559 occupationally active male spray painters aged 25-64 years. Factor and item analyses of EQ responses were performed. Ordinary least square regression analysis was used to evaluate sensitivity and correlation to evaluate the specificity of EQ and the separate components. Questions concerning memory and concentration symptoms alone showed better sensitivity than the other five EQ dimensions singly or combined for the entire EQ and for a subset of questions approximating Q16, a widely used organic solvent symptom screening questionnaire. However, the diagnosis of TE required information in addition to exposure and responses to EQ and Q16-like questions. The results indicate that the subset of EQ questions concerning memory and concentration might replace the more cumbersome EQ and less sensitive Q16 in screening for TE, although none of the screening instruments alone replaces current clinical diagnostic procedures.

Adult↗

PubMed2002

High incidence of mental disorders, reduced mental well-being and cognitive function in hypopituitary women with GH deficiency treated for pituitary disease.

OBJECTIVE: Previous studies have shown possible neuroendocrine effects of GH. In the present study we investigated the incidence of mental disorders and the prevalence of mental distress and cognitive dysfunction in hypopituitary women with untreated GH deficiency compared to population-based controls. DESIGN AND PATIENTS: Thirty-three hypopituitary women with a median age of 64 years (range 39--77 years) were investigated cross-sectionally, without any change in hormone substitutions. Twenty-nine of the patients had been operated for a pituitary tumour, 25 had received radiotherapy and 15 had visual dysfunction. The patients were with a very high probability GH deficient, as 29 had subnormal IGF-I levels and the other four were GH deficient as assessed by an insulin tolerance test. The patients were compared with 33 controls matched for sex, age, smoking habits, educational level and residence. MEASUREMENTS: The incidence of mental disorders was calculated from the date of diagnosed hypopituitarism to the time of the present investigation. Mental well-being was assessed by three self-rating questionnaires: the Symptom Checklist-90 (SCL-90), the Interview Schedule for Social Interaction (ISSI) and the social network concept. The subjects were examined with neuropsychological tests of vocabulary (SRB:1 vocabulary test), perceptual speed (WAIS-R Digit Symbol), spatial ability (WAIS-R Block Design), verbal memory (Cronholm--Molander verbal memory test), spatial learning (Austin Maze Test) and reaction time (APT Two-way Reaction Time and APT Inhibition). RESULTS: The hypopituitary women had a higher incidence of mental disorders than the controls; Incidence Rate Ratio 4.5 (95% CI 1.0--21). The Global Severity Index, i.e. the average score of all 90 questions of the SCL-90, was higher in patients (P = 0.001), and the patients had significantly more symptoms of somatization, anxiety, depression, obsession--compulsion, hostility--irritability, phobic and psychotic symptoms (all P less-than-or-equal 0.04). Moreover, 14 patients compared to four controls were classified as possible cases of mental distress according to the SCL-90 (P = 0.006). The patients experienced lower availability of both social attachment (P = 0.02) and integration (P = 0.001), but there were no group differences in the adequacy of these dimensions or in emotional support. The patients had lower scores in four of seven neuropsychological tests (all P less-than-or-equal 0.04). CONCLUSIONS: The hypopituitary women had a higher incidence of mental disorders, more symptoms of mental distress and increased prevalence of cognitive dysfunction. The impaired results in the patients could possibly be explained by several factors, such as transfrontal surgery, radiotherapy, visual dysfunction and unphysiological hormone substitution. Moreover, it is probable that GH deficiency contributed, but placebo-controlled double-blind studies are warranted to investigate whether the psychological dysfunction is reversible on GH substitution.

Adult↗

PubMed2002

Personality, mental distress, and risk perception in subjects with multiple chemical sensitivity and toxic encephalopathy.

Personality, mental distress, and risk perception were assessed in (a) cases of multiple chemical sensitivity (MCS; n = 17), (b) chemically intolerant toxic encephalopathy cases (TE), type 2A (n = 31) and 2B (n = 26), and (c) healthy referents (n = 200). MCS cases showed elevated mental distress scores on the Depression, Interpersonal Sensitivity, Global Severity Index, and Somatization scales in the Symptom Checklist 90 (SCL-90). In the Karolinska Scales of Personality (KSP) the MCS group showed an elevation only on the Psychasthenia scale. Both TE groups showed elevations across the KSP anxiety scales Muscular Tension, Psychasthenia, and Somatic Anxiety. TE type 2B subjects also showed elevations on the Irritability and Indirect Aggression scales. However, neither MCS nor TE groups showed deviating personality characteristics in the Meta Contrast Technique test. Similarly, none of the groups deviated from referents in a risk perception inventory.

Adult↗

PubMed2002

The meta-contrast technique: relationships with personality traits and cognitive abilities in a healthy male study sample.

The relationship between defensive strategies as measured by the Meta-Contrast Technique (MCT) and self-reported trait anxiety, trait aggression and defensiveness, as measured by the Karolinska Scales of Personality (KSP), was investigated in 83 healthy men. Further aims of the study were to describe and document how a healthy and demographically well defined group of subjects responded to the MCT, and to investigate whether age, personality traits and cognitive abilities influenced the reports of picture recognition thresholds in the MCT. The results indicated no agreement between the conceptualization of anxiety as measured by the MCT and anxiety as measured by the KSP inventory. Nor was there any agreement between defensive strategies in the MCT and trait defensiveness as defined with the KSP. However, age, personality traits, and cognitive abilities all contributed to explain the variations in the threshold values of recognition of stimuli pictures, all of which are of central importance in the scoring of MCT protocols.

Adult↗

PubMed2002

Neuropsychological test performance of Swedish multiple chemical sensitivity patients--an exploratory study.

To address the hypothesis of brain dysfunction as a component of the multiple chemical sensitivity (MCS) syndrome, a neuropsychological battery comprising 8 tests was given to 17 Swedish MCS patients and 34 demographically matched controls. Across the 6 tests used as indicators of brain impairment, comprising a total of 17 test variables, the MCS group performed poorer only in a complex reaction time test (mean reaction time; p = 0.002; t test). Correction for self-ratings of mental distress and trait psychasthenia did not eliminate the deviation in the reaction time test. Because the results on most tests were within normal limits, brain impairment was not evidenced. However, the similar minor deviations in neurobehavioral tests observed in several studies of MCS patients indicate the need for a study on a larger sample of MCS cases.

Adult↗