The Diagnosis and Treatment of

Chemical Sensitivities

 

February 28 – March 1, 2008

 

 

 

Overview

v      To briefly review the major principles of environmental medicine, so as to better appreciate the differences between toxicity and sensitivity to chemicals.

v      To provide important new insights into the mechanisms of chemical sensitivities that is behind many important health problems seen in your medical practice.

v      To present new diagnostic and treatment modalities to help you improve treatment outcomes in a safe and cost-effective manner for your complex patients suffering from chemical sensitivities.

v      To provide concepts and tools that will enhance the success of your practice now.

 

 

Objectives

           

At the end of this CME activity, the participant should be able to:

 

v      Review the basic principles of toxicology, homeostasis and environmental medicine.

v      Contrast the mechanisms behind chemical toxicity and chemical sensitivity.

v      Discuss the mechanisms of detoxication and detoxification.

v      Discuss the manifestations of chemical toxicity and sensitivity from multiple chemicals such as pesticides, solvents, and heavy metals in major biological systems, including neurotoxicity and immunotoxicity.

v      Take a home and work history and perform a physical examination to assess chemical injury and toxicity.

v      Recognize the scope of indoor and outdoor air pollution, and food and water pollution.

v      Discuss the available methods for detecting chemical contamination of the environment.

v      Assess the patient for biomarkers of the effects of toxic exposures on various biological systems.

v      Perform quantitative testing for chemicals, and how to test hymenoptera venoms, latex, and for antibiotic sensitivity

v      Utilize comprehensive treatment for chemical sensitivities: avoidance, nutritional, detoxification, sauna/heat, depuration, chelation of heavy metals, immunotherapy where applicable, etc.

v      Utilize psycho-neurological assessments and treatments for the effects of neurotoxicity.

v      Benefit from illustrative case study examples for chemical sensitivities that stress interactive discussions between faculty and attendees.

 

February 28, 2008

 

 

8:00 – 8:30 a.m.            The Goals and Objectives of the Course

                                    Kalpana D. Patel, M.D., FAAEM

1.                   Articulate why understanding of environmental chemical toxicity is necessary

 

8:30 – 9:00 a.m.            Overview of the Principles of Environmental Medicine for the Diagnosis and Treatment

                                    Kalpana D. Patel, M.D., FAAEM

1.                   Define environmental load – chemicals, etc

2.                   Articulate principles of homeostatis and hormesis

 

9:00 – 9:30 a.m.            The Comprehensive History of Chemical Sensitive Patient

                                    Kalpana D. Patel, M.D., FAAEM

1.                   Identify an adequate environmental history

2.                   Develop history of chemical injury

 

9:30 – 10:00 a.m.          The Comprehensive Physical Examination and Initial Lab Evaluation for the Work Up for the Chemically Sensitive Patient

                                    William J. Rea, M.D., FAAEM

1.                   Define how to physically evaluate chemical injury

2.                   Identify what lab tests to order based on history and diagnosis

 

10:00 – 10:30 a.m.        Break

 

10:30 – 11:00 a.m.        How Chemicals Affect the Immune System

                                    Aristo Vojdani, Ph.D., M.T.

1.                   Identify the biomarkers of immunotoxicity and interpret the meaning & significance of these findings.

2.                   Describe what encompasses the field of immunotoxicology.

3.                   Discuss the possible immunotoxicological mechanisms.

4.                   Describe how chemicals can induce Type I-IV allergy.

5.                   Explain how toxic chemicals can skew the development of Th2 cells and inhibit Th1 and the significance of such an effect.

6.                   Recognize the consequence of autoimmunity as a mechanism of immunotoxicity.

 

11:00 – 11:45 a.m.        The Common Sources of Toxic Chemicals That Can Cause Human Disease –  Pollutants, Organic Toxins, Plastics, Solvents, Pesticides and Pyrethroids (CPST)

                                    John L. Laseter, Ph.D.

1.       Discuss various pollutants, organic toxins, plastics, solvents, and pesticides which affect us adversely.

 

 

11:45 – 12:15 p.m.        Immunomarkers of Immunotoxicity from Lab Tests Interpretation of Solvents, Pesticides & Toxic Heavy Metals

                                    Aristo Vojdani, Ph.D., M.T.

1.                   Describe how to interpret lab findings with regard to their significance in the chemically injured patient

 

12:15 – 1:45 p.m.          Luncheon Sponsored by The Great Plains Laboratory, Inc. featuring keynote speaker William Shaw, Ph.D. speaking on                                            "Deficient Cholesterol: A Common New Factor in Autism"

 

 

1:45 – 2:15 p.m.            Lab Tests To Diagnosis the Presence of Chemicals and Their Systemic Effects

                                    John L. Laseter, Ph.D.

1.                   Discuss the biological monitoring of toxic exposure as methodology for performing source assessment.

2.                   Describe how to interpret lab findings with regard to their significance.

 

2:15 – 2:45 p.m.            An Overview of Skin and Sublingual Testing For Chemical Sensitivity

                                    Kalpana D. Patel, M.D., FAAEM

1.                   Define what tests clinically give information about chemical sensitivity

 

2:45 – 3:15 p.m.            Water and Soil Pollution (Include Radon)

                                    John L. Laseter, Ph.D.

1.                   Discuss the nature of water pollution and its assessment.

2.                   Discuss the nature of soil pollution and its assessment.

 

3:15 – 3:45 p.m.            Break

 

3:45 – 4:15 p.m.            Outdoor Air Pollution

                        William J. Meggs, M.D.

1.       Describe the major sources of outdoor air pollution and be able to define both general and individual responses to specific substances including hypersensitivity reactions.

2.       Discuss what medical interventions may be used to help the individual with adverse reactions to air pollutants.

 

4:15 – 4:45 p.m.            How to Evaluate and Optimally Document Findings of the Chemically Injured Patient

                                    William J. Meggs, M.D.

1.       Discuss different methods of evaluation of chemically injured patients.

2.       Describe how to document objective findings of evaluation to support the diagnosis of chemical injury.

 

4:45 – 5:15 p.m.            Working Up Chemically Injured Patients

                                    Practical Case Review for Causation - Injury

William J. Meggs, M.D.

1.       Articulate “how” and “what” to do for the case review to determine causation of injury in chemically injured patient.

 

5:15 – 6:15  p.m.           Case Presentation – Panel

                                    William J. Meggs, M.D.

                                    Aristo Vojdani, Ph.D., M.T.

                                    John L. Laseter, Ph.D.

                                    Moderator:  William J. Rea, M.D., FAAEM

 

6:15 – 6:45  p.m.           Questions and Answers

 

February 29, 2008

 

 

8:00 – 8:30 a.m.            An Overview of Toxicology

                                    William J. Meggs, M.D.

1.                   Discuss the principles of toxicology.

2.                   Articulate how the clinician may use.

 

8:30 – 9:00 a.m.            Respiratory Effects from Chemical Sensitivity

                                    Kalpana D. Patel, M.D., FAAEM

1.       List what chemicals cause respiratory illness

2.       Illustrate the reactive nature of the respiratory system to chemical exposure.

3.       Identify how to diagnose and treat

 

9:00 – 9:30 a.m.            Pesticide and Pyrethroids Poisoning and Chemical Sensitivity

                                    William J. Meggs, M.D.

1.       Recognize the full spectrum of organophosphate pesticide poisoning – neutrotoxicity, immunotoxicity, genotoxicity, etc.

2.       Discuss the limitations of laboratory testing for organophosphate pesticide poisoning.

3.       Discuss the effect of low level organophosphate pesticide exposure and its sequelae.

4.       Identify the pattern and injury of pyrethroids.

5.       Discuss some of the scientific literature regarding organophosphate pesticide poisoning.

 

9:30 – 10:00 a.m.          Cardiovascular Effects from Chemical Sensitivity

                        William J. Rea, M.D., FAAEM

1.       List what chemicals affect the CV system

2.       Describe the reactive nature of the CV system to chemical exposures.

3.       Identify how to diagnose and treat adverse CV effects from toxic chemical exposures.

 

10:00 – 10:30 a.m.        Break

 

 

10:30 – 11:00 a.m.        Indoor Air Pollution

                                    William J. Meggs, M.D.

1.       Discuss the sources of indoor air pollution and the potential clinical response of the individual including construction products, combustion products, cleaning products and commonly used office equipment.

2.       Explain sick buildings syndrome

3.       Describe basic modifications to interiors to reduce indoor air pollution including heating and air conditioning systems and construction materials.

 

11:00 – 11:30 a.m.        Food Pollution

                                    Kalpana D. Patel, M.D., FAAEM

1.       Describe the potential toxicity of specific foods and their additives.

 

11:30 – 12:00 p.m.        Neurotoxicity Effects from Chemical Sensitivity

                                    William J. Meggs, M.D.

1.                   List what chemicals cause neurotoxicity

2.                   Discuss the neurological aspects of chemical exposure.

3.                   Articulate how the clinician diagnoses and treats

 

12:00 – 1:30 p.m.          Lunch

 

1:30 – 2:00 p.m.            Gastrointestinal and Genito Urinary System Dysfunction from Chemical Sensitivity

                                    William J. Rea, M.D., FAAEM

1.                   List what chemicals affect the GU system

2.                   Explain the reactive nature of the GU system to chemical exposure.

3.                   Identify how to diagnose and treat

 

2:00 – 2:30 p.m.            Ear, Nose, And Throat and Chemical Sensitivity

                                    Kalpana D. Patel, M.D., FAAEM

1.       List what chemicals affect the ENT system

2.       Explain the reactive nature of the ENT system to chemical exposure.

3.       Identify how to diagnose and treat.

 

                       

2:30 – 3:00 p.m.            Musculoskeletal Syndromes and Chemical Sensitivity

                                    Kalpana D. Patel, M.D., FAAEM

1.       List what chemicals affect the musculoskeletal  system

2.       Explain the reactive nature of the musculoskeletal  system to chemical exposure.

3.       Identify how to diagnose and treat.

 

3:00 – 3:30  p.m.           An Overview of  Treatment Modalities – Avoidance, Sauna, and More

                                    William J. Rea, M.D., FAAEM

1.                   Articulate an overview of modalities of treatment used to reduce effects of environmental exposure and re-create homeostatis and hormesis.

2.                   Discuss the pertinent facts about how heat therapy can be used to treat chemical exposure.

 

3:30 – 4:15 p.m.            Beverage Break in Exhibit Hall

 

4:15 – 4:45 p.m.            The Role of Optimal Macronutrient and Micronutrient Status in the Treatment of Chemical Sensitivity

                                    William J. Rea, M.D., FAAEM

1.       Integrate the knowledge of nutrients in the practice of environmental medicine.

 

4:45 – 5:15 p.m.            The Important Role of Oxygen Therapy in the Treatment of Chemical Sensitivity

                                    William J. Rea, M.D., FAAEM

1.       Describe the use of oxygen therapy to cause tissue health with recovery from toxic stimulus

2.       Discuss the immune modulators and how to use them with oxygen treatment.

3.       Describe how to diagnose surgically removable chemicals that cause disease.

4.       List the details of safe surgery for the chemically sensitive and chronic disease patient.

 

5:15 – 5:45 p.m.            Questions and Answers

 

 

March 1,2008

 

8:00 – 8:30 a.m.            The Role of Injection Therapies in the Treatment of Chemical Sensitivity: Chemicals, Viruses, Bacteria, and Neuropeptides

                                    Kalpana D. Patel, M.D., FAAEM

1.       Describe how to treat with injections for chemicals, virus, bacteria and neuropeptides.

 

8:30 – 9:30 a.m.            Practicum Case History and Intradermal Chemical Testing and Treatment

                                    Kalpana D. Patel, M.D., FAAEM

William J. Rea, M.D., FAAEM

1.       Discuss what tests are available for assessing sensitivity to various chemicals, drugs, hymenoptera venoms, and latex, and how they are performed.

2.       Discuss how and when to use these tests.

 

 

9:30  - 10:30 a.m.          The Role of Toxic Heavy Metals  in Chemical Sensitivity and

Do’s & Don’ts of Chelation Treatment

                                    David W. Quig, Ph.D.

1.                   Identify primary sources of commonly encountered toxic metals

2.                   Explain overlap between exposures and chemicals with respect to mechanisms for combined adverse health effects.

 

 

10:30 – 11:15  a.m.       Break

 

 

11:15  – 12:00 p.m.       Questions and Answers

 

 

 

Faculty:

John Laseter, Ph.D., MT

AccuChem Labs

990 N. Bowser Road  Ste 800

Richardson  TX   75081

 

William J. Meggs, M.D.

Room 4W54, Bordy Bldg.

Greenville  NC   27858

 

Kalpana Patel, M.D.

65 Wehrle Dr.

Buffalo  NY   14225

 

David W. Quig, Ph.D.

Doctors Data, Inc.

3755 Illinois Ave.

St. Charles  IL   60174

 

William J. Rea, M.D.

Environmental Health Center - Dallas

8345 Walnut Hill Lane  Ste 220

Dallas  TX   75231

 

Aristo Vojdani, Ph.D., MT

Immunosciences Lab., Inc.

8693 Wilshire  Ste 200

Beverly Hills  CA   90211

 

Principal Audience:

Practicing MD’s and DO’s, and other health professionals interested in enhancing the outcomes of common complex illnesses contributed by chemical sensitivities, using new cause-oriented, patient-centered concepts and modalities.  This CME activity will be especially helpful for allergists, occupational medicine physicians, toxicologists, and primary care physicians who must triage or treat these patients.

 

Primary Methods of Teaching:

v      Plenary Sessions

v      Roundtables

v      Case Presentations

v      Question and Answer Sessions

v      Comprehensive Syllabus