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At least 1,009 records · Page 56Linked to original sources
PubMed2001

Precipitating and aggravating factors of migraine versus tension-type headache.

OBJECTIVE: We conducted the present study to determine whether there are headache precipitating and aggravating factors that differentiate migraine from tension-type headache and headache precipitating and aggravating factors that differentiate tension-type headache from migraine. METHODS: We interviewed 38 patients with migraine and 17 patients with tension-type headache (diagnosed using International Headache Society criteria) by telephone, using a questionnaire. The questionnaire inquired about the following precipitating and aggravating headache factors: (1) physical activity, (2) straining, (3) bending over, (4) stress/tension, (5) coughing/sneezing, (6) fatigue, (7) reading, (8) driving, (9) lack of sleep, (10) specific foods/drinks, (11) alcohol, (12) not eating on time, (13) smoke, (14) smell, (15) light, (16) noise, (17) menstruation, and (18) weather. RESULTS: The most common precipitating factors acknowledged by both groups of patients were stress/tension, not eating on time, fatigue, and lack of sleep. Weather, smell, smoke, and light were the precipitating factors that differentiated migraine from tension-type headache. Excluding those factors that are part of the International Headache Society migraine diagnosis, the aggravating factors were straining, bending over, and smell. We found no precipitating or aggravating factors differentiating tension-type headache from migraine. CONCLUSION: Apparently there are precipitating and aggravating factors differentiating migraine from tension-type headache but not vice versa. It is interesting that three of the migraine-specific precipitating factors (ie, weather, smell, and smoke) involve the nose/sinus system, suggesting a greater significance of this system in headache than is generally considered.

Eating↗
PubMed2000

Food-related sensory stimuli are able to promote pancreatic polypeptide elevation without evident cephalic phase insulin secretion in human obesity.

The data concerning the cephalic phase of insulin secretion (CPIS) in human obesity are controversial. We investigated the effect of a variety of sensory challenges on CPIS in 17 non-diabetic obese patients (four males, 13 females, mean age 41.1 years, mean BMI 38.7). Water, saccharin, and lemon juice were used as oral stimuli, and a complete meal was simply presented as visual and olfactory stimulations. Twelve healthy normal-weight subjects (four men, eight women, mean age 39.9, mean BMI 22.5) also underwent oral stimulation as controls, and the patients who underwent the sight and smell stimulations were also tested for pancreatic polypeptide (PP) changes in order to verify the occurrence of truly cephalic reflex during the test. Insulin levels were measured before and after each stimulation (every min for the first 5 min, and then after 10, 20, and 30 min). None of the stimuli (saccharin, lemon juice or water retained in the mouth for 2 min and were then spat out; the combined and separate sight and smell of a meal for 2 min) led to a significant increase in insulin in the obese patients (except in the case of one woman after oral stimulation). The oral stimuli led to a variable CPIS in one female and three male controls. Despite the absence of CPIS, the five obese patients undergoing all three sensory stimulations related to the meal (combined sight and smell, sight alone and smell alone) showed an early and significant increase in plasma PP concentrations within the first 3 min; this was more pronounced after the combined than after the separate exposure. Although only preliminary, these results underline the variability but substantial lack of CPIS in obese patients, thus suggesting that it can be considered a relatively rare and unrelevant event even in the presence of a true brain-mediated reflex revealed by the rapid and consistent increase in PP found in our experiments.

Adult↗
PubMed2004

Potential oscillation elicited by i.v. olfaction and its applicability as an objective clinical olfaction test.

OBJECTIVE: Alinamin has long been applied in Japan for testing i.v. olfaction and to diagnose olfactory disorders. The test is subjective, each subject being asked about the presence or absence of olfaction. The credibility of the answers is highly questionable in some cases; as a result, the reliability of the test is poor. Recent studies demonstrated an induced electric potential in the scalp during i.v. olfactory testing. Some patients complain of the pain of the injection during i.v. olfactory testing; therefore, the effect of this pain must be considered with respect to measurement of the i.v. olfaction-elicited potential (IVOP). MATERIAL AND METHODS: This investigation involved 179 subjects with various olfaction levels. Each subject received an Alinamin injection; the elicited potential amplitude was compared before and after the injection and the increasing ratio (IR) was computed. Gender, age, level of olfactory disorder, the presence or absence of olfaction and the presence or absence of the pain of injection were considered as factors affecting IR. RESULTS: IR showed significant increases in groups characterized by the presence of olfaction as well as in groups reporting pain of injection. The test subjects were further divided into four groups based on their olfaction and pain of injection patterns as follows: Group A, no smell and no pain; Group B, smell and no pain; Group C, no smell and pain; and Group D, smell and pain. Subjects exhibiting no recognizable olfaction or pain of injection (Group A) revealed no increase in IVOP following injection. Subjects with either recognizable olfaction or pain of injection (Groups B and C) exhibited a slight increase in IVOP following injection. Subjects with both noticeable olfaction and pain of injection (Group D) demonstrated a significant increase in IVOP following the injection with a very high value of IR (>2). Furthermore, there were significant differences between the four groups in terms of IR level, with the exception of Groups B and C. CONCLUSIONS: Olfaction is largely involved with the generation of IVOP. However, pain resulting from injection of Alinamin is considered to be a significant factor. IVOP showed significant effectiveness for diagnosing olfactory disorders in cases who did not experience pain of injection.

Adolescent↗
PubMed1999

Deterioration of olfaction and gustation as a consequence of total laryngectomy.

INTRODUCTION: After total laryngectomy the absence of a nasal airflow results in a decrease in olfaction and perception of flavors. MATERIALS AND METHODS: Odor perception was assessed in 63 laryngectomized patients with two different olfactory tests. The methods used by patients to smell were observed during olfactory testing. Patients' judgment about their olfaction and gustation was assessed by means of a structured questionnaire, semistructured interview, and self-rating. RESULTS: Based on the results of the olfactory tests, patients were categorized as "smellers" and "nonsmellers." Approximately one third of the patients were able to smell the odorous substances used in the olfactory tests. The smellers more often used a variety of methods to smell than the nonsmellers (P < .002); in most patients the method consisted of active use of facial muscles. Patients appeared well able to judge their own odor perception. Compared with the smellers, the nonsmellers judged their odor perception as worse (P < .003) and reported a more severe decrease in gustation after the operation (P < .033). The results of this study in laryngectomized patients confirm the interrelation between olfaction and gustation: the nonsmellers reported a poorer gustation and a more severe decrease in gustation and appetite than both the smellers and a reference group of elderly persons (P < .05). Patients who reported a deterioration of olfaction and gustation tended to experience negative consequences such as the inability to smell smoke, leaking gas, or agreeable odors. CONCLUSION: Olfaction and odor-related flavor sensation are seriously deteriorated after total laryngectomy.

Aged↗
PubMed2003

Anosmia: diagnosis and management.

Disorders of the sense of smell can be frustrating for both the patient and physician. Ongoing research in this field has provided insight into the possible mechanisms for smell loss; however, therapy is still limited. Commercially distributed smell testing kits and newer screening tests using material available in all clinical settings have made diagnosis and measurement of the degree of impairment available to all physicians. A detailed history and physical examination are the most powerful tools in the evaluation of smell disorders, whereas imaging studies are reserved for preoperative planning or detailed assessment of positive physical findings.

Humans↗
PubMed1998

Olfactory bulb and tract and temporal lobe volumes. Normative data across decades.

The sense of smell shows a diminution with age as measured by the University of Pennsylvania Smell Identification Test (UPSIT). To ascertain whether the volumes of the olfactory bulbs and tracts (OBTs) and the temporal lobes (TL) declined in parallel to smell function, we examined 36 individuals from ages 22 to 78 who did not complain of any loss of the sense of smell using magnetic resonance (MR) imaging. The OBT volumes showed an initial increase to the 4th decade of life and then a decrease with increasing age, while the trend in TL volume was not as dramatic. There was no correlation between OBT or TL volumes with unilateral or total UPSIT scores. The normative data by decades can be used to assess the OBTs of cohorts of patients with neurodegenerative disorders that affect olfaction.

Adult↗
PubMed1997

Episode of toxic gas exposure in sewer workers.

OBJECTIVES: Sewer workers are used to unpleasant smells, but may be required to investigate unusual ones. Twenty six men were involved in investigation of episodes of such a smell after neighbourhood complaints over several weeks. METHODS: Workers exposed to the smell were investigated by clinical follow up, lung function tests, and measurement of pituitary function. RESULTS: 14 of the 26 developed subacute symptoms including sore throat, cough, chest tightness, breathlessness, thirst, sweating, irritability, and loss of libido. Severity of symptoms seemed to be dose related. Minor symptoms resolved over several weeks but those more seriously affected have shown deteriorating respiratory symptoms and lung function and remain unable to work a year after the incident. In one, evidence of mild cranial diabetes insipidus was found. Analysis of gas from the sewer showed the presence of a mixture of thiols and sulphides, known to be highly odorous and not normally found in sewers. The source remains unknown. CONCLUSIONS: Several of these men seem to have developed delayed airways disease and disturbances of hypothalamic function. Such an outcome has not to our knowledge been described before. Despite the presence of the smell, standard safety gas detection equipment used to ensure the sewer was safe to enter failed to indicate the presence of a hazard. Protection against such incidents can only be provided by the use of positive pressure breathing apparatus.

Adult↗
PubMed2006

Olfaction in neurodegenerative disorder.

There has been gradual increase of interest in olfactory dysfunction since it was realised that anosmia was a common feature of idiopathic Parkinson's disease (IPD) and Alzheimer-type dementia. It is an intriguing observation that a premonitory sign of a disorder hitherto regarded as one of movement or cognition may be that of disturbed sense of smell. In this review of aging, IPD, parkinsonian syndromes, tremor, Alzheimer's disease (AD), motor neuron disease (MND), Huntington's chorea (HC) and inherited ataxia, the following observations are made: (1) olfactory senescence starts at about the age of 36 years in both sexes and accelerates with advancing years, involving pleasant odours preferentially; (2) olfactory dysfunction is near-universal, early and often severe in IPD and AD developing before any movement or cognitive disorder; (3) normal smell identification in IPD is rare and should prompt review of diagnosis unless the patient is female with tremor-dominant disease; (4) anosmia in suspected progressive supranuclear palsy and corticobasal degeneration is atypical and should likewise provoke diagnostic review; (5) subjects with hyposmia and one ApoE4 allele have an approximate 5-fold increased risk of later AD; (6) impaired sense of smell may be seen in some patients at 50% risk of parkinsonism, and possibly in patients with unexplained hyposmia; (7) smell testing in HC and MND where abnormality may be found is not likely to be of clinical value, and (8) biopsy of olfactory nasal neurons reveals non-specific changes in IPD and AD and at present will not aid diagnosis.

Aging↗
PubMed2005

Comparison of pharmaceutical properties of topical non-steroidal anti-inflammatory drug preparations on quality of life.

To compare the effects of different pharmaceutical properties of commercially available topical nonsteroidal antiinflammatory drugs (NSAIDs) on the quality of life, we administered a questionnaire to 65 healthy volunteers. We investigated five creams, five gels, and four solutions of topical NSAID preparations in this study. The survey was conducted to clarify the relationship of their answers and pharmaceutical properties of the topical NSAID preparations. Questions addressed spreadability, smell, viscosity, and comfort level of the topical NSAID preparations. Among the five creams, Napageln had lower spreadability, less smell, and greater viscosity than the other preparations. Because of its easy spreadability, weak smell, and low viscosity, the volunteers favored Sector cream among the cream preparations. Among the five gel preparations, Inteban had less spreadability, stronger smell, and higher viscosity than the other preparations. The volunteers favored Epatec over the other gel preparations. All four solutions had the odor of menthol and other artificial ingredients, except for Napageln. These findings indicate that information on the pharmaceutical properties of commercially available topical NSAID preparations will be helpful to physicians and pharmacists in conducting medical treatment and prescribing.

Administration, Topical↗
PubMed2006

Olfactory disorder in children with 22q11 deletion syndrome.

OBJECTIVE: 22q11 deletion syndrome, a common human interstitial deletion syndrome (1:5000), is associated with a heterogeneous physical phenotype, including several factors that markedly increase the risk for olfactory disorder. Despite its potential consequences, pediatric studies of impaired olfaction are rare, and odor detection in children with 22q11 deletion syndrome has not yet been examined. METHODS: The University of Pennsylvania Smell Identification Test was administered to 62 children, including 39 with 22q11 deletion syndrome and 23 neurotypical control siblings who ranged in age from 5.3 to 14.8 years. Lowered smell detection accuracy among affected children was predicted. RESULTS: Substantially more children with 22q11 deletion syndrome (68%) as compared with neurotypical control subjects (13%) had University of Pennsylvania Smell Identification Test scores > or = 2 SDs below the standardization sample mean. Frequency of impairment in younger versus older children did not differ. The score distributions of children with and without velopharyngeal insufficiency did not differ; however, markedly lower score variance among children with velopharyngeal insufficiency suggested its negative impact on olfaction. Posthoc error analyses revealed that affected children had special difficulty detecting smells that are associated with fumes and smoke. CONCLUSIONS: Odor detection failures are ubiquitous among children with 22q11 deletion syndrome and are not associated with developmental delay or performance characteristics of younger affected children. Additional studies are needed to examine further the impact on olfaction of velopharyngeal insufficiency and compromised nasal airway patency. Children with 22q11 deletion syndrome should be evaluated routinely for olfactory disorder. When deficits are identified, caregivers should be warned of potential dangers that are associated with this type of sensory impairment.

Adolescent↗
PubMed2002

Effects of appropriate and inappropriate odors on product evaluations.

In accounting for an odorant's effect on the evaluation of a product, both the odor's intrinsic pleasantness and its appropriateness for that particular product are relevant. When comparing the effects of pleasant smells, consumers are likely to prefer products with appropriate smells to those with an inappropriate smell. We investigated the effect of adding congruent and incongruent odorants on product evaluations for each of three product categories: food (tea, instant whip, cake mix), personal care (shampoo, deodorant, lip balm), and household products (cream cleaner, air freshener, furniture wax). In a between-subjects design, 96 respondents judged scented and unscented products presented in commercial packages of major national brands. The respondents assessed the overall evaluation, 14 to 19 beliefs about the product, buying intention, and the frequency of use for each product. Respondents were instructed to evaluate each product as they would in a store. Although congruency ratings between odor and product show that the manipulation of congruency was successful, no main effect was found for the congruency on overall evaluations of the products. To account for this unexpected finding, we speculate that congruency between odor and product may be more important during product consumption or product use than during its selection. In addition, the odor's effects may have been attenuated in our experiment because we asked our respondents to rate each product on the attribute 'has a nice smell'.

Adolescent↗
PubMed2000

A case of primary amenorrhea, diabetes and anosmia.

This case details a patient with primary amenorrhea with an unusual cause. She presented at age 16 with short stature, minimal sexual development and no prior menses. Her history was significant for poorly controlled type 1 diabetes. She had been evaluated previously for growth hormone deficiency, and had received a short course of growth hormone therapy. Of greatest significance was the fact that she had also had a decreased sense of smell since her youth. Although a previous computerized tomography scan had been reported as normal, follow-up magnetic resonance imaging demonstrated the absence of olfactory bulbs. Smell testing confirmed the absence of smell and testing of gonadotropin releasing hormone demonstrated an inadequate response. All of these features suggested Kallmann syndrome. This syndrome commonly presents with delayed onset of puberty and decreased or absent sense of smell. There are also many associated features, and the disease is remarkable for its great genotypic and phenotypic variability. Current understanding of its pathogenesis, the commonly associated features of Kallmann syndrome and the impact of diabetes on growth and sexual development are reviewed.

Adolescent↗
PubMed2002

[Hearing disorders, dysosmia and dysgensia in patients undergoing irradiation for head and neck cancer].

UNLABELLED: The study included 30 patients who underwent irradiation for head and neck cancer in the Regional Oncology Center. Cobalt 60 was used to irradiate facial--cervical area bilaterally and parotid glands partially. Before and after the irradiation, audiometric test, examination for osmaesthesia and sense of taste were performed. MATERIAL AND METHOD: All patients underwent laryngologic examination. The sense of smell was estimated by using quantitative method (smell threshold test) and qualitative method (identificational test). Butyl alcohol with serial watery dilution from 0, 002 to 4 were used in the threshold tests. The identificational test relies on recognition of seven commonly known smells. The examination of taste was performed using the quantitative and qualitative methods. The assessment of taste threshold was made with electrogustometer. The organ of hearing was examined with tone audiometry. RESULTS: Audiometric examination of the patients before irradiation revealed sensorineural hearing loss in 14 patients while 6 patients proved mixed hearing loss. After the irradiation, 50% of the patients showed further hearing loss in the range of 5-30 dB. After the irradiation, the percentage of patients with anosmia was elevated to 20%. Normosmic patients were not observed. The quantitative method of the sense of taste before and after irradiation did not show a significant difference. Only 10% of patients who underwent irradiation recognized 4 basic tastes, 30% of them did not show the sense of taste in the qualitative method. CONCLUSION: 1. After the irradiation, 50% of the patients developed further hearing loss. 2. Olfactometric examination of the patients after laryngectomy showed different degree of hyposmia. 3. The quantitative method of smell performed in patients before and after irradiation showed no significant differences. 4. Distinct deterioration of taste recognition was observed in the qualitative method compared to the examination before irradiation.

Adult↗
PubMed1995

[Effect of fog on diurnal changes in peak expiratory flow rates in an asthmatic].

To evaluate the effects of fog on asthmatics, we analyzed the symptoms of a 45-year-old female during the foggy season and the relation between diurnal peak expiratory flow rate (PEFR) and fog and other meteorological factors. Her asthma attacks had been induced by specific smells: perfume, smoke from burning grass or industrial smoke. Two years previously, she had moved to the suburbs of Sapporo, where fog frequently occurs. From that time her asthmatic symptoms had been exacerbated, so it was suspected that the fog might have had some influence. We analyzed 251 measures of PEFR from June to August 1994. The average and standard deviation of PEFR in the absence of fog and specific smells was 403 +/- 40 L/min (n = 195). PEFR was significantly lower (p < 0.01) when it was foggy (347 +/- 60 L/min; n = 40), when specific smells were present (333 +/- 60 L/min; n = 5) and when there were both fog and specific smells (340 +/- 53 L/min: n = 11). On the other hand, there were no changes associated with other meteorological factors: barometric pressures, relative humidity, mean temperature, minimal temperature and most frequent wind direction. These results suggested that the inhalation of fog decreases PEFR and is an exacerbating factor in bronchial asthma.

Asthma↗
PubMed1993

Oral malodor--a review.

Oral malodor has many etiologies. The use of accurate descriptor terms to describe this condition facilitates its clinical diagnosis and treatment by health care professionals. Oral malodor, a generic descriptor term for foul smells emanating from the mouth, encompasses ozostomia, stromatodysodia, halitosis (both pathological halitosis and physiological halitosis) and fetor oris or fetor ex ore. These latter terms, in turn, denote different sources of oral malodor. The terms ozaena, fetor narium, dysosmia, hyperosmia, cacogeusia, and dysgeusia are also related to oral malodor, and assist in accurately describing a clinical presentation. Systemic pathological states, such as diabetes mellitus, uremia and hepatic diseases, induce metabolic products that are detectable as oral smells. Local oral conditions produce volatile sulphur compounds and other breakdown products that intensify oral malodors. The clinical labelling and interpretation of different oral malodors both contribute to the diagnosis and treatment of underlying disease. This article stresses the relationship between smell and taste, emphasizes specific meanings for related oral malodor terms, reviews smell comprehension and indicates some of those commonly-encountered associated clinical conditions.

Halitosis↗
PubMed2007

Retronasal and orthonasal olfactory ability after laryngectomy.

OBJECTIVE: To characterize orthonasal and retronasal olfactory ability in patients who have had a total laryngectomy (TL). DESIGN: Prospective psychophysical evaluation of orthonasal and retronasal olfactory function. SETTING: Academic center outpatient clinic. PATIENTS: Volunteer sample of 36 subjects who underwent laryngectomy 0.5 to 25.0 years after TL (median, 3.5 years) and 36 age-, sex-, and smoking history-matched controls. MAIN OUTCOME MEASURES: Scores on established psychophysical tests of orthonasal and retronasal olfaction and self-rating scores of smell assessed with a visual analog scale. RESULTS: Assessment of orthonasal olfactory ability yielded a mean composite score of 4.3 (maximum score, 7) for the TL group and 5.3 for the control group (P = .002). Evaluation of retronasal olfactory ability resulted in a mean score of 11.0 (maximum score, 20) for the TL group vs 14.3 for the control group (P<.001). The mean self-rating scores of smell were 2.9 and 6.6 (maximum score, 10) for the TL and control groups, respectively (P<.001). Self-ratings of smell positively correlated with orthonasal (r(S) = 0.42; P<.001) and retronasal (r(S) = 0.50; P<.001) olfactory ability. CONCLUSIONS: Laryngectomy is associated with measurable decreases in olfactory function that are also subjectively perceived. Quantification of decrements in orthonasal and retronasal olfactory function can be used to characterize the severity of hyposmia and to assess the potential for, and efficacy of, olfactory rehabilitation. Although self-assessment with a simple visual analog scale successfully identifies many laryngectomy patients who have objective evidence of olfactory dysfunction, further investigation is necessary to evaluate and compare its validity and reliability with other available survey instruments that purport to measure olfaction.

Aged↗
PubMed1987

Characterization of olfactory dysfunction.

Management of dysosmic patients frequently is hampered by an incomplete description of their chief complaint and sometimes inadequate qualitative analysis of their symptoms. Qualitative analysis of olfactory dysfunction by an Odorant Confusion Matrix helps to characterize more fully sense of smell in the dysosmic patient. It is well grounded in psychophysical theory, thereby permitting physiological inferences about specific neural dysfunctions. The quantitative measure derived from the matrix correlates well with another quantitative measure of olfactory ability, the Smell identification Test, and provides the opportunity for valid comparisons among and within patients. Examination of illustrative case reports demonstrates that the qualitative features of the Odorant Confusion Matrix offer additional insights to support etiologic diagnoses of disturbances in sense of smell.

Adult↗
PubMed1995

Long-term follow-up of olfactory loss secondary to head trauma and upper respiratory tract infection.

OBJECTIVE: To determine the extent to which olfactory function can improve after loss induced by head trauma or a previous upper respiratory tract infection (URI) and the time for this improvement for more effective patient counseling. DESIGN: Patients initially evaluated at the University of Cincinnati (Ohio) Taste and Smell Center were reevaluated for olfactory loss with the University of Pennsylvania (Philadelphia) Smell Identification Test 1 to 5 years after initial testing. Changes in score on this test were used to indicate improvement in sensory function. Subjective information on olfactory ability and olfactory symptoms was also collected. SETTING: University-based tertiary care center. PATIENTS AND OTHER PARTICIPANTS: Forty-one patients with olfactory loss induced by head trauma (20) or previous URI (21). RESULTS: Seven (35%) of 20 patients with head trauma improved on the smell test by 4 points or more. Fourteen of 21 (67%) patients with a previous URI had improved scores of this magnitude or more. A statistically significant correlation was noted between the amounts of improvement and length of follow-up for URI patients. Thirteen of these patients also reported improved olfactory function. CONCLUSION: These findings for patients with head trauma are consistent with other reports of recovery of (or improvement in) olfactory function after trauma-induced loss. For patients with previous URI, these data indicate that improvement in olfactory function occurs, but the improvement may take several years.

Adult↗