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PubMed1987

Prevention and treatment of the orofacial complications of radiotherapy.

Radiotherapy of malignant head and neck tumors often causes extensive, permanent changes in salivary glands, peridental alveolar bone, and mucosal structures. Dental neglect and inappropriate dental management can cause complications. The potential orofacial side effects of radiotherapy are reviewed, as are preventive strategies for the dental treatment of patients scheduled to undergo radiotherapy.

Deglutition Disorders↗
PubMedDate not supplied

Hypogeusia, dysgeusia, hyposmia, and dysosmia following influenza-like infection.

Hypogeusia, with or without dysgenusia, and hyposmia, with or without dysosmia, followed an influenzal-like infection in 87 of 143 consecutive patients who presented at the Taste and Smell Clinic at the NIH with taste and smell abnormalities. Findings in this disease included pale nasal mucous membranes with marked patency of the nasal airway, a postive Rudolph sign, elevated detection and recognition thresholds for several tastants and odorants, disruption of the pore region of the tast dub observed on electron microscopy and infiltration of the upper lamina propria of the nasal mucous membrane wih chronic inflammatory cells observed on light microscopy. These findings, taken together, are relatively specific for the diagnosis of this surprisingly common disorder.

Adult↗
PubMed1985

[Otoneurologic symptomatology in mild craniocerebral injuries in the acute period].

Vestibular disorders are observed in all cases of a mild craniocerebral injury and are often the only objective sign of the sustained trauma because loss of consciousness and neurological symptoms may not infrequently be absent. Vestibular disorders are manifested by a small clonic horizontal bilateral multiple nystagmus. The caloric test revealed bilateral elevation of the caloric nystagmus in terms of duration and nature, with a regular alteration of the nystagmic phases. From the 5th to the 10th day after the injury there was an increase in asymmetric caloric nystagmus. Mild craniocerebral injury was characterized by an increase in sensory and vegetative responses after calorization. Spontaneous nystagmus and bilateral hyperreflexia of the caloric nystagmus were most expressed in the first 4 days and an increase in sensory and vegetative reactions within the first 9 days. Two weeks after a mild craniocerebral injury the vestibular disturbances were completely or partially compensated for by all parameters, which was expressed in the disappearance of the spontaneous nystagmus and the predominance of the symmetrically inhibited caloric nystagmus in the absence of sensory-vegetative reactions. In patients with diseases involving the cerebral vessels, compensation of vestibular disorders following a mild injury tends to be slower.

Acute Disease↗
PubMed1990

[Can one become dependent on sugar?].

Sugar consumption does not cause an addictive behaviour in the sense of psychiatry. In the public opinion sugar is thought to be a problematic food especially of the anticipated negative consequence for the body weight. The avoidance of sweet food evokes a craving for sugar, which is due to sensory deprivation as to physiological mechanisms as well. The preference of the sweet taste seems to be innate. Therefore the training of a moderate consumption of sweetened food is more effective than a rigorous avoidance of all sweet food.

Carbohydrates↗
PubMedDate not supplied

Taste memory induces brain activation as revealed by functional MRI.

PURPOSE: Our goal was to use functional MRI (fMRI) to measure brain activation in response to imagination of tastes in humans. METHOD: fMR brain scans were obtained in 31 subjects (12 men, 19 women) using multislice FLASH MRI and echo planar imaging (EPI) in response to imagination of tastes of salt and sweet in coronal sections selected from anterior to posterior temporal brain regions. Activation images were derived using correlation analysis, and ratios of areas of brain activated to total brain areas were calculated. Total activated pixel counts were used to quantitate regional brain activation. RESULTS: Activation was present in each section in all subjects after imagination of each tastant. Activation was similar in response to imagination of either salt or sweet and was quantitatively similar to that previously reported in response to imagination of odors of banana and peppermint. Activation was similar in both men and women as opposed to previous results of odor memory in which activation in men was greater than in women. However, subjective responses of intensity of imagined tastes were significantly greater than those previously obtained for odor memory and were consistently, albeit not significantly, greater in women than in men, similar to results previously reported for odor memory. Brain regions activated in response to taste imagination were consistent with regions previously described as involved with actual taste perception in both humans and animals. Regional brain localization for salt and sweet memories could not be differentiated. CONCLUSION: These studies indicate that (a) tastes can be imagined, (b) brain regions activated for taste imagination are consistent with regions previously described for actual taste perception, and (c) similar to odor memory for banana and menthone, regional brain localization for salt or sweet taste memories could not be differentiated.

Adult↗
PubMed1994

Dietary assessment of patients with chemosensory disorders.

OBJECTIVE: To identify individuals who are at nutritional risk because of taste and/or smell disorders. DESIGN: Patients referred by a private physician for evaluation of a chemosensory complaint underwent an extensive battery of taste and smell tests, otorhinolaryngologic tests, and, in some cases, periodontal examinations and completed a dietary/health questionnaire, a 24-hour recall, and a 2-day diet record. SETTING: Patients were interviewed at the Monell-Jefferson Chemosensory Clinical Research Center, Philadelphia, Pa. SUBJECTS: We studied 310 patients (142 men and 168 women) with a primary complaint of chemosensory disorder. Mean age was 50.5 +/- 15.7 (range = 15 to 93 years). Normative data were provided by an additional 79 healthy control subjects (42 men and 37 women) with no taste or smell complaint. Their mean age was 48.8 +/- 18.8 years (range = 20 to 83 years). MAIN OUTCOME MEASURES: Chemosensory disorder-related changes in food habits (determined by questionnaire responses), nutrient intake (analysis of 3-day food records), and body weight (self-reported). STATISTICAL ANALYSES: Analysis of covariance, followed by post hoc analysis of adjusted means with the Tukey honestly significant difference test, was used to explore group differences in nutrient intake and body weight. chi 2 Analysis and the Pearson correlation coefficient were used to evaluate relationships between variables. RESULTS: When groups were classified according to chemosensory diagnosis, group differences were observed on global appetitive questions, but complaints were high in all groups. Approximately 65% (203 of 310) of patients had self-reported body weights within 5% of their predisorder weight, but clinically meaningful weight gains or losses were observed in each group. Patients with multiple chemosensory disorders were most likely to lose weight, whereas the incidence of weight gain was highest in patients with anosmia. Patient report of a change in eating patterns was the best predictor of weight change among the variables examined. CONCLUSIONS: Dietary responses to chemosensory disorders vary widely and may place patients at nutritional risk. Until better prognostic indexes are identified, dietitians should query patients about disorder-related alterations in eating patterns and provide appropriate individualized counseling.

Adult↗
PubMed1989

Oral evaluation of patients with chemosensory disorders.

The physical examination of the patient with dysgeusia must include a thorough intraoral examination. Although the initial screening examination may be performed by clinicians of various disciplines, specialized intraoral or dental examination may be required to diagnose and manage the dysfunction.

Dysgeusia↗
PubMed1989

[An unknown syndrome: acute zinc deficiency in the elderly in a surgical milieu].

Old people often present a chronic depletion in zinc. Any stress increases zinc consumption and zinc loss through the kidneys; acute depletion then appears. Anorexia is usual, psycho-neurological troubles induce to a wrong diagnostic of sudden senility or psychiatric disorder. Altered taste and a low blood level of zinc confirms the diagnostic. Zinc administration, usually per os, leads to a prompt recovery. 18 patients have been recorded; acute depletion occurred after infection or any ordinary surgical intervention.

Acute Disease↗
PubMed2006

The psychophysical relationship between bitter taste and burning sensation: evidence of qualitative similarity.

Although it has long been studied as a pure sensory irritant, the ability of capsaicin to evoke, mask, and desensitize bitter taste suggests that burning sensations and bitter taste might be closely related perceptually. The current study investigated the psychophysical relationship between bitterness and burning using 2 different approaches. In Experiment 1, spatial discrimination of 4 taste stimuli was measured in the presence or absence of capsaicin. The subjects' task was to report which of 3 swabs, spaced 1 cm apart and presented to the tongue tip, contained a taste stimulus when 1) water was presented on the other 2 swabs or 2) when 10 muM capsaicin was presented on all 3 swabs. The presence of capsaicin did not change performance on the 3 alternative forced-choice (3-AFC) task for sweet, sour, and salty stimuli, while the localization error for 1.8 mM quinine sulfate (QSO(4)) increased significantly. In Experiment 2, the perceptual similarity/dissimilarity of taste stimuli and capsaicin was measured directly using pairs of stimuli applied to opposite sides of the tongue tip on swabs separated by 2 cm. Multidimensional scaling analyses showed that capsaicin fell nearer to QSO(4) than to any other taste stimulus. Cluster analysis corroborated this finding: capsaicin was closely linked with QSO(4) and the capsaicin-QSO(4) group was separated from the other taste stimuli. The latter result indicated that bitterness was more similar to burning than to the other tastes. These findings imply that despite being mediated by different sensory modalities, bitterness and burn are qualitatively similar. We speculate that this similarity reflects a common function of these 2 sensations as sensory signals of potentially harmful stimuli.

Adolescent↗
PubMed1997

A comparison of zopiclone and propiomazine as hypnotics in outpatients: a multicentre, double-blind, randomized, parallel-group comparison of zopiclone and propiomazine in insomniacs.

In a double-blind, parallel-group study of 135 patients with a mean age of 60 years, zopiclone 5 mg was compared with propiomazine 25 mg. The patients rated their sleep in a diary. There were statistically significant differences in favour of zopiclone for nine out of 13 variables measuring subjective sleep quality and quantity. Concerning side-effects, bad taste was reported more frequently in the zopiclone group and restless legs in the propiomazine group.

Adult↗
PubMedDate not supplied

Current status of zinc deficiency in the pathogenesis of neurological, dermatological and musculoskeletal disorders.

Recent clinical and experimental studies suggest that zinc deficiency may play an important role in the pathogenesis of (1) acrodermatitis enteropathica, and in certain cases of (2) hypogonadal dwarfism, (3) congenital malformations, (4) hypogeusia and hyposmia, (5) nyctalopia and (6) impaired wound healing. Distrubances of zinc metabolism also occur in a broad spectrum of other clinical disorders. The pathophysiological factors which are responsible for hypozincemia include: (1) nutritional deficiency and/or intestinal malabsorption of zinc; (2) hyperzincuria secondary to aminoaciduria; (3) hormonal effects (cortisol, growth hormone, estrogens); (4) hypoalbuminemia; and (5) effects of leukocytic endogenous mediator. The clinical diagnosis of zinc deficiency in patients with specific neurological, dermatological and musculoskeletal disorders is complicated by the complex interactions of these pathophysiological factors and by the need for more dependable laboratory indices of zinc deprivation.

Acrodermatitis↗
PubMed2003

Increasing children's acceptance of vegetables; a randomized trial of parent-led exposure.

Despite considerable epidemiological evidence of the health benefits of a diet high in fruit and vegetables, consumption in pre-school children remains well below recommended levels. This study evaluated the effectiveness of an exposure-based intervention, carried out by parents in the home, in increasing children's liking for a previously disliked vegetable. 156 parents of 2-6 year old children were randomly assigned to Exposure, Information or Control groups after a pre-intervention taste test at which a 'target' vegetable was selected. Parents in the Exposure group gave their child a taste of this vegetable daily for 14 days, parents in the Information group were given nutritional advice and a leaflet, and parents in the Control group received no further intervention. All participants took part in a post-intervention taste test. Greater increases in liking, ranking and consumption of the 'target' vegetable from pre- to post-intervention occurred in the Exposure group than in either of the other two groups. Only the Exposure group showed significant increases across all three outcomes. It can be concluded that a parent-led, exposure-based intervention involving daily tasting of a vegetable holds promise for improving children's acceptance of vegetables. These findings suggest a parental advice strategy which could be disseminated directly to parents or by health professionals.

Adult↗