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At least 811 records · Page 45Linked to original sources
PubMed1986

Auranofin versus penicillamine in rheumatoid arthritis. One-year results from a prospective clinical investigation.

Forty patients with definite or classical active rheumatoid arthritis were stratified by the minimization procedure to auranofin (6 mg/day) or penicillamine (go slow and low regime). This investigation is a prospective planned 3 year patient and 'doctor-open' as well as 'doctor-blind' clinical trial. This article describes the results after 12 months. Both drugs decreased disease activity and improved the functional capacity in a similar way. Two patients in the auranofin group and 5 in the penicillamine group stopped treatment due to major side effects. Four other patients in the auranofin group left treatment: 2 due to death from unrelated cause and 2 according to the Helsinki II Declaration. After one year a further patient in the auranofin group and 2 in the penicillamine group stopped treatment due to lack of clinical effect. Side effects due to auranofin were statistically more frequent distal in the gastrointestinal tract (loose stools/diarrhoea) than with penicillamine. In contrast, penicillamine produced significantly more side effects in the oral cavity (mainly taste disturbances) than auranofin. Other side effects were about equal in the two groups, but 2 cases of severe proteinuria and one with obstructive lung disease were observed in the penicillamine group. Only 3 patients did not complain of any untoward effect during the 12-month period. We conclude that on the basis of this one year investigation it is an open question whether one should select auranofin or penicillamine for the treatment of clinical active rheumatoid arthritis.

Acute Disease↗
PubMed2003

Analysis of taste disturbance before and after surgery in patients with vestibular schwannoma.

OBJECT: The frequency, nature, and history of subjective taste disturbance before and after vestibular schwannoma (VS) surgery was investigated. METHODS: Personal interviews were conducted in 108 patients with unilateral VS. Abnormalities in taste perception, either a significant reduction or a change in character, were experienced by 31 patients (28.7%) before surgery and by 37 (34.3%) after tumor removal. Preoperative taste disturbance worsened after surgery in five (16.1%) of the 31 patients, remained unchanged in eight (25.8%), improved in two (6.5%), and became normal in 16 (51.6%). Taste disturbance occurred postoperatively in 22 (28.6%) of 77 patients who had experienced no preoperative taste disturbance. The mean onset of the abnormality after resection was 1.1 +/- 1.7 months. Postoperative taste disturbance resolved in 24 of the 37 patients (64.9%) within 1 year after onset. CONCLUSIONS: Subjective taste disturbance was common before and after VS removal, and the natural history of this condition was very variable in the pre- and postoperative periods. All patients who undergo surgery for VS should receive appropriate counseling about the likelihood and course of postoperative complications, including dysfunction of the sensory component of the facial nerve.

Adult↗
PubMed2002

[Three-dimensional analysis of human Ebner's gland].

We analyzed changes in Ebner's gland with aging by 3-dimensional analysis to determine the relationship between the gland and the sense of taste. Samples were collected from Circumvallate papillae of the tongue in autopsied cases. After dehydration, samples were embedded in paraffin and cut into slices 5 microns thick for every 100 microns. Hematoxylin-Eosin staining was done. The section was photographed in black and white and printed. Three tissues, circumvallate papillae, epithelium, and Ebner's gland were identified and traced on an OHP sheet and imput to a computer. The cubic volume of Ebner's gland was measured by Cosmozone 2SA 3-dimensional analysis software by and acinar cell occupancy I-BAS one imaging analysis. A total of 60 cases from age groups in them 30s, 40s, 50s, 60s, 70s, and 80s were used. Each group contains 5 men and 5 women. The mean cubic volume of Ebner's gland in the 30s was 67.0 mm3, in the 40s was 64.6 mm3, in the 50s was 59.8 mm3, in the 60s was 39.2 mm3, in the 70s was 33.9 mm3, and in the 80s was 30.4 mm3. Statistical analysis showed a significant difference in Ebner's gland cubic volume between age groups at p < 0.01. In acinar cell occupancIEs the coefficient of correlation was -0.858 in men and -0.838 in women with the correlation diagram showing a negative correlation. The acinar cell occupancy decreases with age for the presumed acinar cell volume in the Ebner's gland, the coefficient of correlation was -0.929 in men and -0.854 in women, with the correlation diagram showing a negative correlation. The presumed acinar cell volume decreases with age. We concluded that Ebner's gland is concerned indirectly with diminished sensitivity of the sense of taste with aging.

Adult↗
PubMed2006

[Treatment outcome in patients with taste disturbance].

The importance of taste has been recently evaluated from the standpoint of quality of life, but few reports exist on the clinical status of taste disturbance. We classified taste disturbance by cause and studied the effect of treatment and recovery duration. Subjects were 321 patients with taste disturbance, i.e., 131 men and 190 women (mean age: 59.9 years). Electrogustometry (EGM) and filter paper disks (FPD) were used to assess taste function in all subjects. We also asked them all about the degree of symptoms using visual analog scale (VAS). Statistical analysis was done using the unpaired t-test, with p<0.05 considered significant. Patients were treated with zinc sulfate, ferrotherapy, herbal medicine, and minor tranquilizers. Causes of taste disturbance were classified into idiopathic, post-common-cold, drug-induced, psychogenic, constitutional, and iron deficiency. Idiopathic taste disturbance was the commonest cause (125 cases, 38.9%), followed by drug-induced (62 cases, 19.3%), and post common cold (38 cases, 11.8%). Drug induced and psychogenic taste disturbance have increased. Recovery from symptoms was 79/103 (76.7%) in idiopathic taste disturbance, 24/33 (72.7%) in post-common-cold, and 14/17 (82.4%) in iron deficiency. Recovery took 22.2 weeks. Recovery was 32/50 cases (62.4%) in drug induced, taking 48 weeks. For all causes, EGM and FPD results were not associated with the degree of symptoms. Both tests tended to show delayed improvement compared to symptoms. Cases taking more than 6 months from symptom onset to medical examination showed significantly lower improvement and longer recovery time than those taking 6 months on less (p = 0.04).

Adult↗
PubMed1995

[Healing process of taste receptor disturbance].

Patients with taste receptor disturbance were treated with zinc dosage, and their healing process was traced through the filter-paper-disc method and electrogustometry. The number of cases studied was 119,45 with idiopathic taste disturbance, 38 with drug-induced taste disturbance and 36 with zinc-deficient taste disturbance. 1) Three patterns of taste recovery were observed on the tongue surface. Out of a total of 119 cases, 54 cases (45.4%) were found to be improving on the anterior as well as posterior parts of the tongue simultaneously (simultaneous improvement type). Fifty-three cases (44.5%) showed recovery in the posterior part of the tongue (area of the glossopharyngeal nerve) earlier than in other parts of the tongue (posterior improvement type). Only 12 cases (10.1%) showed recovery in the anterior part of the tongue (area of the chorda tympani nerve) earlier than in other parts of the tongue (anterior improvement type), a significantly smaller number of cases compared with the other two types. In particular, very few cases of zinc deficient taste disturbance belonged to the anterior improvement type. Zinc dosage treatment proved to be more rapidly effective for the simultaneous improvement type. 2) With respect to differences in the recovery process of the four primary tastes, a tendency for the sweet and bitter taste qualities to recover earlier than the others was observed in the simultaneous improvement type. However, no phenomenon was observed that could support the existence of the so-called "tongue map", such as the bitter and sour taste recover first among the posterior improvement type or the sweet taste improving first among the anterior improvement type. 3) The results of this study revealed that the treatment of taste receptor disturbances starts with the posterior part of the tongue, which abounds in taste buds. 4) The study also demonstrated that electrogustometry is not suitable for tracing the process of taste receptor disturbance. 5) When tracing the effectiveness of treatment of taste receptor disturbance through the filter paper-disc method, it is sufficient to measure only the posterior part of the tongue (area of the glossopharyngeal nerve) until signs of healing appear.

Adolescent↗
PubMed1995

[Morphometric study of chorda tympani-derived fibers along their course in the lingual nerve].

The topographical organization of chorda tympani-derived fibers (Ch-fibers) was investigated macroscopically and histologically along their entire course through the lingual nerve in 81 adult Japanese cadavers (113 sides), in order to obtain basic data to explain the taste disturbance occurring after oral anesthesia. Ch-fibers frequently (approx. 80%) merged and intermingled with nerve bundles composed of fibers of the lingual nerve proper (L-fibers) above the level of the mandibular foramen (intermingled type). However, on 23 sides (20.4%) the Ch-fibers could be separated under a stereomicroscope from the L-fiber bundles during their course behind the oral cavity (separated type). Moreover, on 12 of the 23 sides, the Ch-fibers were clearly separated from the L-fibers, since the Ch-fibers formed an independent nerve bundle attached to the surface of the L-fiber bundles throughout almost their entire course to the tongue. Irrespective of whether they were intermingled or separated, however, the Ch-fibers traveled downward, maintaining their superficial and posterolateral topographical organization in the lingual nerve. In 8 of the 12 clearly separated cases, the perimeter of the myelinated fibers was analyzed at three levels: the hard palate, the mandibular foramen and immediately above the angle of the mandible. At each level, the perimeter spectrum of Ch-fibers was significantly smaller (mean: 16.6 +/- 5.4 microns, e.q. at the level of the mandibular foramen) than that of the L-fibers (mean: 20.2 +/- 6.2 microns, at the same level) (p < 0.01). Moreover, the lingual nerve consistently had 2-3 buccal branches supplying the lining of the oral cavity posterior to the internal oblique line of the mandibular ramus. These buccal branches did not contain Ch-fibers, but were composed of only L-fibers, possibly including pain fibers. These observations suggest that physicians performing nerve block to and around the mandibular foramen tend to regard the inferior alveolar nerve and the lingual nerve as targets of the block, irrespective of whether or not this is intended, since the buccal branch of the lingual nerve should also be anesthetized in such cases. Moreover, local anesthetics seem to have a rapid effect on Ch-fibers, because of their superficial position in the lingual nerve and their smaller diameter than L-fibers. Consequently, Ch-fibers along the lingual nerve seem to be easily damaged by local anesthesia of the oral region. Greater care should therefore be exercised to avoid producing a taste disturbance when performing oral anesthesia in clinical practice.

Adult↗
PubMed1983

Zinc and the special senses.

There is evidence that zinc is important for maintenance of the special senses: vision, taste, and smell. Rod function is impaired in zinc deficiency due partly to its role in vitamin A metabolism. However, optic nerve function may also be affected by zinc status. Microophthalmia, anophthalmia, and optic nerve abnormalities have all been found in the offspring of female rats fed zinc-deficient diets. Zinc deficiency clearly decreases taste acuity in both animals and humans. However, other nutritional and non-nutritional conditions also produce hypogeusia. There is limited evidence that zinc deficiency impairs olfactory acuity in humans. New approaches to the assessment of taste and smell abnormalities may provide reliable and reproducible associations between zinc deficiency and taste and smell defects.

Animals↗
PubMedDate not supplied

Terbinafine-associated taste disturbance with normal taste threshold scores.

The medical literature reveals numerous reports of transient taste disturbance associated with the use of oral terbinafine. A review of these reports, however, fails to confirm taste disturbances by formal taste testing. In this article, a case of long-standing taste dysfunction in a patient who exhibited normal formal taste thresholds is described.

Administration, Oral↗
PubMed2003

[Gemcitabine-cisplatin combination in the first line treatment of non-small cell lung cancer. Our experience and analysis of safety].

In our Department we have studied the first line treatment of 90 stage IIIA-IV non-small cell lung cancer patients using gemcitabine/cisplatin combination. Thirteen cases have been unevaluable for various reasons. At the time of evaluation the planned 4 cycles have been delivered to 38% of patients (34/90). The PR was 39% (30/77), the CR was 2.6% (2/77) while the ORR was found to be 41% (32/77). 226 treatment cycles have been evaluated for side effects. There was no treatment-induced death in this series. CTC grade 3-4 neutropenia occurred in 5.7% of the cycles and only in 2 cases combined with fever. CTC grade 3-4 thrombocytopenia occurred in 4.4% of the cycles but only one patient required platelet suspension administration. Grade 3-4 anaemia developed in 3.5% of the cycles where 5 cases have been treated with RBC concentrate while 3 cases with erythropoietin. Complete alopecia occurred in 6 patients but 3 of them received brain irradiation as well. CTC grade 3-4 nausea and vomiting occurred in 4.4 and 3% of the cycles, respectively, but rehydration was only necessary in 3% of the cycles. Delay of the therapy due to hematological toxicity or vomiting occurred in 8% of the cycles but did not last longer than 2 weeks. Severe CTC grade 3-4 nephrotoxicity did not occur in this study while grade 1-2 elevation of serum creatinine level was found in 1.7% of the cycles. We have concluded that the gemcitabine/cisplatin combination is a safe outpatient modality for the first line treatment of advanced non-small cell lung cancer patients.

Adult↗
PubMed1999

Taste changes experienced by patients receiving chemotherapy.

PURPOSE/OBJECTIVES: To increase knowledge about the nature, frequency, and quality-of-life (QOL) effects associated with taste changes after chemotherapy. DESIGN: Cross-sectional, descriptive. SETTING: 11 outpatient urban and suburban oncology centers. SAMPLE: 284 adults who had received at least two chemotherapy cycles. METHODS: Patients completed a taste change questionnaire and the Functional Assessment of Cancer Therapy-General, and nurses collected demographic and disease-related information. Descriptive statistics, Spearman correlations, chi-square, Mann-Whitney, and Kruskal-Wallis one-way analysis of variance were calculated. FINDINGS: Taste changes were frequent and at least moderately severe for many patients, who often reported dry mouth, decreased appetite, nausea, and vomiting. Cisplatin and doxorubicin were the agents most likely to be related to severe taste changes and to have caused greater distress from taste changes, which also were associated with decreased QOL. Oncology nurses and physicians rarely discussed taste changes with patients, who often tried changing the ways they seasoned their food. CONCLUSIONS: Taste changes are a frequent and significant problem for patients receiving chemotherapy and have negative effects on patients' QOL. Oncology nurses and physicians typically do not offer self-management suggestions to patients. IMPLICATIONS FOR NURSING RESEARCH AND PRACTICE: Repeated-measures research may provide a clearer understanding of chemotherapy-associated taste changes over time. Studies to examine strategies suggested from this and other research as well as clinical literature may determine which self-care interventions are most useful. Nurses should inform patients that taste changes may occur following chemotherapy, provide self-management information, and assess for related problems that could increase chemotherapy morbidity.

Adult↗
PubMed1976

Role of nutrition in the oral health of the aging patient.

The food, diet and nutrition needs of the elderly patient should be considered a part of his total supportive management. It is incumbent upon the dentist to provide the patient with this nutritional information for optimal oral health, because what is good for preventing oral disease will be equally good for preventing general illness. Essentially, if the clinician keeps in mind that the calorie needs for an older patient are less but all other nutrient requirements are as high in old age as they were in youth, the geriatric patient will be well treated. Certainly there are distinctive environmental, physiological and psychological problems that must be considered, but these should not be imponderable. The best possible general advice is that daily diets should include meat, milk, vegetables and fruit, and bread. We suggest an emphasis on good quality protein foods and a generous selection of vegetables and fruits and somewhat less stress on fats, starches, and sugars to avoid an excess of calories. For the individual geriatric new denture wearer we might add that each diet prescription should be based on an analysis and evaluation of his individual food habits (the "why" of the diet) and actual food intake (the "what" of the diet). Furthermore, the physical nature of the diet should be consistent with the patient's experience and ability to swallow, chew, and bite with his dental prosthesis.

Aged↗