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Conditioned taste aversion with lipopolysaccharide and peptidoglycan does not activate cytokine gene expression in the spleen and hypothalamus of mice.

Several reports show that behavioural and physiological components of the acute phase reaction can be conditioned. However, the mechanisms responsible for these effects remain obscure. The underlying assumption that the changes observed in conditioned animals are dependent on a conditioned production of cytokines has never been demonstrated. In the present study, the possibility of conditioning the production of cytokines or molecules implicated in their signalling pathways was tested by submitting mice to conditioned taste aversion with a new saccharin taste paired with intraperitoneal (i.p.) injections of lipopolysaccharide (LPS, 0.83 microg/g) or peptidoglycan (PGN, 20 microg/g). After two conditioning sessions, conditioned mice developed a clear aversion to saccharine that was not associated with activation of genes of the cytokine network either at the periphery, or in the hypothalamus, as demonstrated by a macroarray approach and confirmed by real time RT-PCR. In contrast, there was an activation of the genes coding for nuclear factor kappa B (NFkappaB) and mitogen activated protein kinase (MAPK) signalling pathways in the spleen and to a lesser extent in the hypothalamus. This modulation of the NFkappaB and MAPK signalling pathways is interpreted in terms of a possible conditioned sensitisation of the immune system.

Analysis of Variance↗

Effect of protease inhibitors on the sense of taste.

The purpose of this study was to investigate the taste properties of protease inhibitors which are essential components of drug regimes used to treat human immunodeficiency virus (HIV) infection. In this study, the taste properties of four protease inhibitors (indinavir, ritonavir, saquinavir, and nelfinavir) were investigated in unmedicated HIV-infected patients and healthy controls. Three of the four protease inhibitors (indinavir, ritonavir, and saquinavir) were found to be predominantly bitter (with additional qualities of medicinal, metallic, astringent, sour, and burning). Nelfinavir was found to be relatively tasteless. HIV-infected and uninfected control subjects detected protease inhibitors at similar concentrations, but HIV-infected subjects perceived suprathreshold concentrations as more bitter than controls. Detection thresholds ranged from 0.0061 mM for saquinavir in HIV-infected patients to 0.0702 mM for ritonavir in uninfected control subjects. Suprathreshold studies indicated that protease inhibitors modified the taste perception of a variety of other taste compounds. These results are consistent with clinical findings that protease inhibitors produce taste complaints that can impact patient compliance.

Adult↗

Clinical findings in patients with orofacial discomfort complaints.

In 113 patients with orofacial and general complaints, which they assumed were caused by galvanic currents and/or metallic restorations, clinical dental and medical examinations were performed. Most of the patients had natural teeth with dental metallic restorations. A number of dental diagnoses, such as caries, pulpitis, periapical osteitis and periodontitis, were found. However, 16% were edentulous in one or both jaws and had complete dentures. 69% had possible metal contacts. Some oral mucosal changes were observed, but they were as frequent in patients without as in those with metal contact possibility. Signs of parafunctions and functional disturbances of the masticatory system were extremely frequent. A careful oral examination in these patients thus revealed many clinical dental and oral signs that could be more-or-less related to the complaints. Because of the extremely varying symptoms reported, however, only a small proportion could be fully explained by odontological and/or medical diagnoses, and in 38% of the patients, no clear odontological diagnosis was found that could explain the complaints.

Adult↗

The effect of head and neck irradiation on taste dysfunction: a prospective study.

Taste loss is a major cause of morbidity in patients undergoing head and neck irradiation. In a prospective study, 26 patients undergoing radical head and neck irradiation at the Royal Marsden Hospital, Sutton, and the Queen Elizabeth Hospital, Birmingham, were assessed for taste loss and xerostomia. Taste was tested using a subjective questionnaire and by objective taste testing with a series of solute solutions (sucrose, sodium chloride, urea and hydrochloric acid) at increasing concentrations, to determine the threshold level of taste sensation, both before and after radiotherapy. Xerostomia was assessed using a patient questionnaire. The volume of tongue and parotid contained within the high dose volume of the radiation treatment field was determined for each patient and correlated with the degree of objective and subjective taste loss as well as the degree of xerostomia. The results have shown that both objective (r = 0.59; P = 0.0016) and subjective taste loss (r = 0.78; P = 0.0001) was significantly associated with the proportion of tongue, but not parotid, contained within the radiation treatment field. The data gave no evidence to suggest any relationship between recovery of taste loss and volume of parotid or tongue irradiated. However, recovery of subjective taste loss, 1 month after completing radiotherapy was seen in two patients, both of whom had been treated using a wedge pair technique to avoid the contralateral area of the tongue. Changes in xerostomia were significantly correlated with the proportions of both tongue (r = 0.54; P = 0.004) and parotid (r = 0.82; P = 0.0001) within the radiation treatment fields.(ABSTRACT TRUNCATED AT 250 WORDS)

Head and Neck Neoplasms↗

Changes in taste associated with intravenous administration of pentamidine.

In this pilot study the authors set out to: (a) describe the incidence of taste changes associated with intravenous (i.v.) pentamidine treatment; and (b) determine the factors that are related to making the taste changes better and worse. A convenience sample (N = 18) of adult male outpatients with AIDS participated in this study. One hundred percent of the participants experienced an unpleasant taste after the administration of pentamidine. The largest percentage of patients had a metallic taste (89%, n = 16); while 67% (n = 12) experienced a bitter taste. These data suggest that healthcare providers need to assess for the unpleasant taste associated with i.v. pentamidine and develop appropriate management strategies.

AIDS-Related Opportunistic Infections↗

Oral manifestations and salivary flow rate, pH, and buffer capacity in patients with end-stage renal disease undergoing hemodialysis.

OBJECTIVE: The aim of this study was to investigate oral manifestations and salivary changes in patients with end-stage renal disease undergoing hemodialysis. STUDY DESIGN: Eighty-two patients undergoing hemodialysis for renal insufficiency were examined; 22 of these patients were randomly selected for salivary tests. Unstimulated whole saliva and stimulated parotid saliva were collected, and flow rate, pH, and buffer capacity were examined. Twenty-two healthy volunteers were included as controls. RESULTS: Uremic odor, dry mouth, and taste change were common symptoms. Petechia and/or ecchymosis and increase of tongue coating were major signs. The flow rates of unstimulated whole and stimulated parotid saliva were decreased in the patient group. The pH and buffer capacity of unstimulated whole saliva were increased in the patient group, but stimulated parotid saliva did not show any significant differences. CONCLUSIONS: Patients with end-stage renal disease undergoing hemodialysis showed apparent oral and salivary changes. The results help us understand the relationship between oral changes and renal insufficiency.

Adolescent↗

Gustatory function after third molar extraction.

OBJECTIVE: The purpose of this study was to determine the severity and time course of taste changes after extraction of all 4 third molars. STUDY DESIGN: Taste function in 17 patients was measured before third molar surgery and at 1 month and 6 months after surgery. Two tests were administered: a whole-mouth, above-threshold test in which subjects sipped, expectorated, and then rated the intensities and identified the taste qualities of various solutions, and a localized test in which subjects rated and identified solutions painted with cotton swabs on different oral sites. RESULTS: Intensity ratings for solutions in the whole-mouth test were reduced by approximately 14% for NaCl, citric acid, and quinine hydrochloride at 1 month after surgery and had not recovered by 6 months after surgery for citric acid (P<.02). The taste quality of NaCl was identified correctly less frequently after third molar extraction. Perceived taste intensity on discrete areas of the tongue was significantly reduced after surgery (P<.05). Patients with the most severely impacted molars gave the lowest taste intensity ratings to whole-mouth test solutions at 6 months after surgery (P<.02). In contrast, taste function in a group of subjects who received only local dental anesthesia was not affected. CONCLUSIONS: Gustatory deficits occur after third molar extraction, persist for as long as 6 months after surgery, and appear to be associated with depth of impaction.

Adolescent↗

Azelastine nasal spray as adjunctive therapy to azelastine tablets in the management of seasonal allergic rhinitis.

BACKGROUND: Azelastine rhinitis medications (nasal spray and tablets) have been shown to relieve the symptoms of allergic rhinitis. Nevertheless, many rhinitic subjects suffer from acute exacerbations of symptoms that sometimes require additional treatment. OBJECTIVE: To assess the efficacy and safety of azelastine nasal spray as adjunctive therapy to azelastine tablets in the management of symptomatic seasonal allergic rhinitis in subjects who remain symptomatic despite the oral medication. METHODS: A 2-day, randomized, multicenter, double-blind, placebo-controlled, parallel-group study. Two hundred thirty-three subjects with symptomatic allergic rhinitis received azelastine tablets (0.5 mg bid) for a minimum of seven days prior to receiving either azelastine nasal spray (2 sprays per nostril bid) or placebo nasal spray as adjunctive therapy. Efficacy was determined by improvement in rhinitis symptoms that were grouped according to total and major symptom complex severity scores. RESULTS: Mean percent improvements in the total symptom complex severity scores for azelastine were statistically significant (P < or = .05) or showed a trend toward statistical significance (.05 < or = P < .10) versus placebo from the second through the first ten hours after the initial dose and for each of the last five hours of the second day, demonstrating a rapid onset of action and sustained efficacy over the 2-day study period. Azelastine was well tolerated, and no subject discontinued therapy with azelastine due to an adverse experience. CONCLUSION: Azelastine nasal spray can be effectively administered as adjunctive therapy, in an outdoor environment in which subjects are exposed to pollen and other aeroallergens.

Administration, Inhalation↗

Uses and complications of uvulopalatopharyngoplasty.

Uvulopalatopharygoplasty has become widely performed for chronic snoring and for cases of obstructive sleep apnoea. Unfortunately this operation is not without morbidity and complications. We report our results of a prospective series of 50 patients undergoing uvulopalatopharyngoplasty with a minimum follow-up of one year. Snoring was abolished in 18 (36 per cent) and substantially reduced in the remainder. Obstructive sleep apnoea syndrome, identified in 11 patients pre-operatively, was reduced in severity in all but three. Troublesome complications were seen in 18 (36 per cent) patients, namely intermittent velopharyngeal incompetence in five (10 per cent), pharyngeal dryness in 11 (22 per cent) and loss of taste in five (10 per cent). One patient had nasopharyngeal stenosis requiring correction. A cautious approach to this operation is required with rigorous case selection. The importance of full assessment and careful follow-up should not be underestimated.

Adult↗

Hemiageusia, hemianaesthesia and hemiatrophy of the tongue.

A patient with a submandibular gland carcinoma was found clinically to have a unilateral chorda tympani, lingual and hypoglossal nerve deficit. This unique neurological entity of loss of taste sensation of one-half of the tongue (hemiageusia), hemianaesthesia and hemiatrophy of the tongue, has not previously been reported.

Aged↗

Oral gossypol in the treatment of patients with refractory metastatic breast cancer: a phase I/II clinical trial.

Gossypol has demonstrated in vitro effects on cell cycle regulation and anti-tumor activity against mammary carcinoma cell lines. This Phase I/II study assesses both the effect of gossypol on cell cycle regulatory proteins in vivo and the clinical effect. Twenty women with refractory metastatic breast cancer received oral gossypol at daily doses between 30 and 50 mg per day. Gossypol plasma levels were measured (n = 8) and the modulation of the retinoblastoma (Rb) gene protein and Cyclin D1 was assessed by serial biopsies (n = 4). Grade I-II toxicities with gossypol treatment included nausea in 30% of patients, fatigue 15%, emesis 15%, altered taste sensation 15% and diarrhea in 10% of patients. Two of the three patients receiving 50 mg/day experienced dose limiting dermatologic toxicity (grade III). One patient had a minor response and two patients had stable disease with > 50% decline in serial assessments of the serum tumor markers. Immunohistochemical analysis of cyclin D1 and Rb expression in serial biopsies of four patients revealed both a concurrent decrease in cyclin D1 expression and an increase in nuclear Rb expression in three patients. The maximal tolerated dose (MTD) of gossypol was 40 mg/day. Gossypol appears to affect the expression of Rb protein and cyclin D1 in breast cancer metastases at doses achievable, yet had negligible antitumor activity against anthracycline and taxane refractory metastatic breast cancer. The cell cycle regulatory effects of gossypol suggest a potential role for gossypol as a modulating agent in conjunction with other cell cycle specific compounds.

Administration, Oral↗

Bulimia and taste: possible interactions.

Potential abnormalities of taste were examined in bulimic subjects who purged by vomiting and in controls. When spatial testing of the tongue and palate was performed by direct local application of sweet, salty, sour, and bitter solutions, bulimics showed a selective spatial loss on the palate. The palate may be affected by purging because vomit is directed toward the roof of the mouth where the palate receptors are located. The data suggest that the acid in vomit damages these receptors. Bulimics and controls did not differ in their basal ratings of intensity or pleasantness of sweet, salty, sour, and bitter stimuli when these were sipped rather than directly applied to the tongue. However, after ingesting a glucose load, controls found sweet taste significantly less pleasant, whereas bulimics did not. The results suggest that bulimics may also have an abnormal experience of satiety.

Adolescent↗

Caffeine self-administration in humans: 2. A within-subjects comparison of coffee and cola vehicles.

The reinforcing effects of caffeine ingested in coffee versus cola were studied. Eleven participants who drank both coffee and cola (3-10 cups of coffee and 1-6 cans of cola daily; M = 632 mg caffeine/day) were tested in 4 conditions: cola at 33 mg/serving (the usual dose), coffee at 33 mg/serving, cola at 100 mg/serving, and coffee at 100 mg/serving (the usual dose). Each condition consisted of 6 double-blind weekly trials. In each trial, participants sampled caffeinated and noncaffeinated beverages and then had concurrent access to the 2 beverages. Relative use of these beverages was used to assess caffeine reinforcement. Across the 4 conditions (24 weeks), reliable caffeine reinforcement occurred in 5 participants (45%). Caffeine reinforcement did not differ as a function of vehicle or serving dose, and no vehicle-dose interactions were found. With both cola and coffee at the commonly used doses, self-reported motivation to work was greater and drowsiness and laziness smaller with caffeinated than noncaffeinated beverages. Results indicate that, among users of both coffee and cola, caffeine self-administration and subjective effects occur with both vehicles.

Adult↗