[Disorders of smell and taste sensations].
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Ageusia↗
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The sights ... the sounds ... the smells ... Guatemala.
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Alberta↗
Golden parachutes. The sweet smell of failure.
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Chief Executive Officers, Hospital↗
[Sense of smell in allergic rhinitis].
BACKGROUND: Olfactory dysfunction is one of the major complaints in patients suffering from allergic rhinitis. Little is known about the onset of hyposmia in seasonal allergy. METHODS: We performed two prospective studies to examine olfactory function in allergic rhinitis using an established (modified CCCRC) test for olfactory threshold, identification and discrimination. RESULTS: In a pilot study the time-course of olfactory function in 14 patients with allergic rhinitis to grass pollen was examined at the beginning of the season. Olfactory function was evaluated birhinal on day 3, 7, 14, and 21 of the season. Preseasonally, all patients were normosmic. There was a significant decrease in threshold and identification between the third and fourteenth day of the season, resulting in a moderate hyposmia in the mean. Hyposmia was not correlated to subjective symptom of nasal blockage. Therefore, a follow-up study was performed on 17 patients and a control group with a similar study design including measurements of nasal volume flow (rhinomanometry) and an inflammatory cell activation marker (ECP) in nasal secretions. The time-course of the olfactory changes was much better correlated to the inflammatory measure than to nasal volume flow. CONCLUSIONS: Patients with allergic rhinitis develop a significant olfactory dysfunction under allergen exposition. Inflammatory dysfunction of the olfactory epithelium seems to be more important than respiratory dysfunction in the pathomechanism of allergic hyposmia.
Adult↗
One nurse is sick of care homes that smell of incontinence.
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Accreditation↗
[Smell in human sexuality (author's transl)].
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Animals↗
Cephalic phase of colonic pressure response to food.
A cephalic phase of colonic pressure response to food was sought in five normal subjects (mean age (22.6) years, 22-24), studied on six separate occasions by recording intraluminal pressures in the unprepared sigmoid colon. Gastric acid secretion was measured simultaneously by continuous aspiration through a nasogastric tube. After a 60 minute basal period, one of five 30 minute food related cephalic stimuli, or a control stimulus was given in random order; records were continued for a further 120 minutes. The cephalic stimuli were: food discussion, sight and smell of food without taste, smell of food without sight or taste, sight of food without smell or taste, and modified sham feeding; the control stimulus was a discussion of neutral topics. Colonic pressures were expressed as study segment activity index (area under curve, mm Hg.min) derived by fully automated computer analysis. Gastric acid output was expressed as mmol/30 min. Food discussion significantly (p < 0.02, Wilcoxon's rank sum test) increased colonic pressure activity compared with control or basal activity. Smell of food without sight or taste also significantly (p < 0.03) increased the colonic pressure activity compared with control and basal periods. Sham feeding and sight and smell of food without taste significantly (p < 0.02 and p < 0.03) increased colonic pressures compared with control but not basal activity. The increase in colonic activity after sight of food without smell or taste was not significantly different from control or basal activity (p = 0.44 and p = 0.34). Food discussion was the strongest colonic stimulus tested. Food discussion and sham feeding significantly (p<0.02) stimulated gastric acid output above control and basal values. Sight and smell of food without taste significantly (p<0.02) increased acid output above basal. Smell of food without sight or taste and sight of food without smell or taste did not significantly (p=0.06, p=0.34) increase acid output. In contrast with the effect on colonic pressures, sham feeding was the best stimulus of acid output. Increased colonic pressure activity after food discussion correlated significantly (r=0.45, p<0.02) with gastric acid output. There was no correlation (r=-0.1, p>0.5) between colonic pressure activity and gastric acid output in the control study. These data show that there is a cephalic phase of the colonic response to food.
Adult↗
Nasal airflow and olfactory function after the repair of cleft palate (with and without cleft lip).
OBJECTIVE: The objective of this study was to examine nasal airflow and olfactory functions in patients with repaired cleft palate compared with matching normal controls. STUDY DESIGN: The all-cleft group consisted of 25 patients with hard palate cleft comprising 15 patients with unilateral cleft palate and lip (UCLP); 2 with CP but no cleft lip (UCLP subgroup) and 8 patients with bilateral cleft lip and palate (BCLP subgroup). All had had surgical correction of the palate in infancy. The control group consisted of 20 nonaffected orthodontic patients. The median age of both groups was 14 years. The tests included the following: (1) nasal airflow measured by anterior rhinomanometry, (2) smell threshold for isoamyl-acetate determined using a 3-way forced choice method, (3) a self-administered questionnaire regarding the subjective perception of smell sense function, and (4) orthonasal and retronasal smell identification (correct/incorrect) and hedonics using visual analog scale (VAS). RESULTS: The respective test results follow. (1) When compared with the control group, the total airflow in the UCLP subgroup was significantly lower especially on the affected side; while in the BCLP subgroup it was lower than in the control group bilaterally. No significant difference was found between the cleft side of UCLP and BCLP subgroups. (2) The smell threshold of the UCLP subgroup was significantly higher than that of the control group and BCLP subgroup. No significant differences were found between right and left nostrils within the BCLP patients and between them and the control group. (3) No difference was found between the groups regarding the subjective perception of smell. (4) No significant differences were found between the UCLP and BCLP subgroups and between the all-cleft group and the control group, except for one item, regarding orthonasal and retronasal smell identification and hedonics. CONCLUSION: Although nasal airflow is significantly lower and the smell threshold higher on the cleft side, the day-to-day function of the sense of smell of cleft patients is similar to that of normal controls.
Adolescent↗
Parental reporting of smelly urine and urinary tract infection.
BACKGROUND: Parents often report that young children have "smelly urine" or a particular urinary odour. There is little evidence that these observations are relevant to the diagnosis of urinary tract infection (UTI). AIMS: To determine whether parental reporting of smelly urine is of any relevance to the diagnosis of UTI in children less than 6 years of age. METHODS: Parents whose children were having urine collected as part of their admission to a large district hospital were given a simple questionnaire to complete regarding the current smell of their child's urine. Parents were asked whether their child's urine smelled different from usual or had a particular smell. Microscopy and culture results of the child's urine were compared to their parent's questionnaire answers to see if there was a association between parental reporting of a different or particular urine smell and a diagnosis of UTI. RESULTS: One hundred and ten questionnaires and urine samples were obtained. Fifty two per cent of parents thought that their child's urine smelled different from usual or had a particular smell. Only 6.4% of children were diagnosed as having a UTI. There was no statistically significant association between parental reporting of abnormal urine smell and diagnosis of UTI. CONCLUSION: In determining whether a young child has a UTI, asking parents about urine smell is unlikely to be of benefit.
Child, Preschool↗
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↗
Olfactory loss in multiple sclerosis.
The objectives of the present study were to test odor identification ability in patients with multiple sclerosis (MS) and to examine possible correlations between smell identification test scores and various clinical variables. We performed a case-control study comparing the Cross Cultural Smell Identification Test scores of 40 patients with definite multiple sclerosis with those obtained in 40 age-, sex- and smoking-habit-matched healthy controls. The neurological impairment, the disability, the cognitive performances and the psychological functioning were also assessed. Patients with multiple sclerosis scored significantly poorer than controls on the Cross-Cultural Smell Identification Test (P<0.001). Olfactory function was borderline normal in four (10%) and abnormal in five (12.5%) MS patients, whereas it was normal in all controls (P<0.02). Significant correlations between the smell identification score and symptoms of anxiety (r=-0.43, P=0.006), depression (r=-0.42, P=0. 008) and severity of neurological impairment (r=-0.32, P=0.05) were found. Only two (5%) patients with multiple sclerosis reported having episodes of smell loss, suggesting a low level of awareness of this problem. Although smell changes are rarely reported, olfactory function is impaired in a considerable number of patients with MS. The observed association between decreased odor identification ability and symptoms of anxiety and depression in our patients suggests that mood and anxiety disorders have to be considered in assessing olfaction in MS patients. Clearly, smell disturbances deserve greater attention from health professionals and caregivers dealing with such patients.
Adult↗
Clinical study of flavor disturbance.
OBJECTIVE: We have observed that, in cases of smell loss, patients often complain of taste loss as well even though they actually have normal gustatory acuity according to gustatory tests; we have defined such symptoms as "flavor disturbance". The clinical features of flavor disturbance are reported in this paper. MATERIAL AND METHODS: A total of 297 patients (99 males, 198 females; mean age 55.5 years) were treated for olfactory disturbance at the hospital of Hyogo College of Medicine between July 1995 and August 2001. Sixty-six out of 297 patients (22.5%) also experienced taste disturbance, and 49 of these 66 cases were evaluated by means of smell and taste tests. These 49 patients who complained of taste and smell loss were classified into two groups according to the results of their smell and taste tests. Patients who only complained of olfactory disturbance were also reviewed. RESULTS: There was no relationship between the severity of olfactory disturbance and the degree of flavor disturbance. The incidence of flavor disturbance was high in patients with sudden olfactory disturbance after upper respiratory tract infection or head trauma and low in those with slowly progressive olfactory disturbance. The symptoms of flavor disturbance improved regardless of whether smell was improved or not. CONCLUSIONS: The patients with flavor disturbance tended to misrecognize that they had taste loss because of sudden smell loss, and there were more of these cases than we expected. When patients with smell and taste loss are treated, flavor disturbance should also be considered.
Case-Control Studies↗
Odor memory induces brain activation as measured by functional MRI.
PURPOSE: Our goal was to use functional MRI (fMRI) to measure brain activation in response to imagination of odors in humans. METHOD: fMR brain scans were obtained in 21 normal subjects (9 men, 12 women) using multislice FLASH MRI in response to imagination of odors of banana and peppermint and to the actual smells of the corresponding odors of amyl acetate and menthone, respectively, in three coronal sections selected from anterior to posterior temporal brain regions. Similar studies were obtained in two patients with hyposmia using FLASH MRI and in one patient with hyposmia using echo planar imaging, both before and after theophylline treatment, which returned smell function to or toward normal in each patient. Activation images were derived using correlation analysis, and ratios of areas of brain activated to total brain areas were calculated. RESULTS: Activation was present in each section in all normal subjects and in each patient after imagination of each vapor. In normal subjects, brain activation in response to imagination of odors was significantly less than that in response to the actual smell of these odors, and activation following imagination of banana odor was significantly greater in men than in women, as was previously reported for the actual smell of the odor of amyl acetate. However, in relative terms, albeit at an absolute lower brain activation level, the ratio of brain activation by imagination of banana to activation by actual amyl acetate odor was about twice as high in women as in men. Before treatment, in patients with hyposmia, brain activation in response to odor imagination was greater than after presentation of the actual odor itself. After treatment, in patients with hyposmia in whom smell acuity returned to or toward normal, brain activation in response to odor imagination was not significantly different quantitatively from that before treatment; however, brain activation in response to the actual odor was significantly greater than that in response to imagination of the corresponding odor. Brain regions activated by both odor imagination and actual corresponding odor were similar and consistent with regions previously described as responding to odors. CONCLUSION: These studies indicate that (a) odors can be imagined and similar brain regions are activated by both imagined and corresponding actual odors; (b) imagination of odors elicits quantitatively less brain activation than do actual smells of corresponding odors in normal subjects; (c) absolute brain activation in men by odor imagination is greater than in women for some odors, but on a relative basis, the ratio for odor imagination to actual smell in women is twice that in men; (d) odor imagination, once the odor has been experienced, is present, recallable, and capable of inducing a relatively constant degree of brain activation even in the absence of the ability to recognize an actual corresponding odor.
Adult↗
Scratch and sniff. The dynamic duo.
Are odors diagnostic? In this age of polymerase chain reactions, in situ hybridization, and immunohistochemical staining, is there any room left for the nose in diagnosing disease? Long ago, and perhaps far away, smell was crucial to describing an illness. Infectious diseases were known by their characteristics odors--scrofula as smelling like stale beer; typhoid, like freshly baked brown bread; rubella, like plucked feathers; and diphtheria, as "sweetish." Anosmics might be banned from medical school. Perhaps we have left the descriptions behind along with these illnesses we rarely encounter today. After all, how many young physicians, residents, or medical students have ever seen a case of diphtheria or even rubella, and how many fewer have ever plucked a chicken? We have learned that pellagra (that "must appear" diagnosis in our differential by rote, but not by example, for photosensitive dermatoses) should smell like sour bread and that the exotic favus should smell "mousy" (Table 1). What does Candida smell like--a "heavy sweetness"? Darier's disease in poor control--"organic"? Pseudomonal infections--"foul and biting"? And are not our patients with noninfected eczematous dermatitis distinct for lacking any peculiar odor, do they not actually smell "dry"? We cannot blame the abandonment of our olfactory skills on the younger generation, for how many of us could describe those odors we smell every day? Would we be able to detect a subtle change in the odor of our patient with psoriasis, a change perhaps signifying superinfection?
Animals↗
Facial EMG responses to odors in solitude and with an audience.
Two experiments were undertaken to examine whether facial responses to odors correlate with the hedonic odor evaluation. Experiment 1 examined whether subjects (n = 20) spontaneously generated facial movements associated with odor evaluation when they are tested in private. To measure facial responses, EMG was recorded over six muscle regions (M. corrugator supercilii, M. procerus, M. nasalis, M. levator, M. orbicularis oculi and M. zygomaticus major) using surface electrodes. In experiment 2 the experimental group (n = 10) smelled the odors while they were visually inspected by the experimenter sitting in front of the test subjects. The control group (n = 10) performed the same experimental condition as those subjects participating in experiment 1. Facial EMG over four mimetic muscle regions (M. nasalis, M. levator, M. zygomaticus major, M. orbicularis oculi) was measured while subjects smelled different odors. The main findings of this study may be summarized as follows: (i) there was no correlation between valence rating and facial EMG responses; (ii) pleasant odors did not evoke smiles when subjects smelled the odors in private; (iii) in solitude, highly concentrated malodors evoked facial EMG reactions of those mimetic muscles which are mainly involved in generating a facial display of disgust; (iv) those subjects confronted with an audience showed stronger facial reactions over the periocular and cheek region (indicative of a smile) during the smelling of pleasant odors than those who smelled these odors in private; (v) those subjects confronted with an audience showed stronger facial reactions over the M. nasalis region (indicative of a display of disgust) during the smelling of malodors than those who smelled the malodors in private. These results were taken as evidence for a more social communicative function of facial displays and strongly mitigates the reflexive-hedonic interpretation of facial displays to odors as supposed by Steiner.
Adult↗