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PubMed2002

Management of smell and taste problems.

Lost or impaired smell or taste should be taken seriously, as it puts a person at higher risk for toxic exposures, such as gas leaks, smoke, and rotting food, and it also takes away the enjoyment of some of life's pleasures, such as the fragrance of flowers or the taste of good food or fine wine. In many patients, the loss follows a viral upper respiratory tract infection, and the only real treatment is to reassure patients that the problem may resolve if the damaged sensory cells regenerate. In other patients, the loss has more subtle causes and deserves a careful investigation and appropriate treatment. This article reviews the proper steps to take when investigating and treating chemosensory difficulties.

Directories as Topic↗
PubMedDate not supplied

Occupational and environmental disorders of the special senses.

Occupational hazards to vision, hearing, balance, olfaction, and taste typically constitute a small fraction of specialty medical practices in ophthalmology and otolaryngology. With the possible exception of noise-related hearing loss and VDT eye hazards, the scientific literature regarding these hazards tends to be scattered and variably accessible to occupational medicine practitioners. It is hoped that the current review will heighten the appreciation of these hazards among both generalists and specialists, and will encourage future documentation and reporting of this interesting group of disorders.

Environmental Exposure↗
PubMed2003

Patient satisfaction after trigeminal nerve repair.

OBJECTIVE: The purpose of this study was to measure patient satisfaction and to evaluate the factors influencing patients' perceptions of the outcome of inferior alveolar nerve or lingual nerve repair. STUDY DESIGN: We used a retrospective cohort study design and a sample of patients who underwent repair of inferior alveolar nerve or lingual nerve injuries. The major outcome variable was the patient's overall satisfaction with treatment. The patient's satisfaction was rated as either good to excellent (group A) or fair to poor (group B). RESULTS: The study sample was composed of 46 patients with a mean age of 28 +/- 12 years; 76% were female. Fifty-five percent of the sample reported their overall satisfaction to be good to excellent. No individual predictor factors were statistically associated with patient satisfaction. Among the outcome variables, the measures of taste, pronunciation, self-consciousness, and function were statistically significantly different (P <.05) between the 2 groups. CONCLUSIONS: After nerve repair, more than half of the patients rated their overall satisfaction with the operative results to be good to excellent.

Adult↗
PubMed1975

A syndrome of acute zinc loss. Cerebellar dysfunction, mental changes, anorexia, and taste and smell dysfunction.

Oral administration of the amino acid histidine to six patients with progressive systemic sclerosis produced anorexia, taste ans smell dysfunction, changes in mentation, and cerebellar dysfunction in each patient; these changes were associated with significant decreases in serum zinc concentration and significant increases in urinary zinc excretion. Administration of zinc ion, even with continued histidine administration, returned each of the signs and symptoms to or toward normal within 8 to 24 hours in each patient at the same time that correction of the serum zinc concentration occurred. The signs and symptoms noted constitute a syndrome related to acute zinc loss.

Adult↗
PubMed1980

Development of dependence on levorphanol in rats by oral intake of the drug -- the influence of taste on drinking behaviour in rats physically dependent on levorphanol.

Oral administration of levorphanol solution induces physical dependence in rats within a few days, as demonstrated by abstinence symptoms such as loss of body weight, sensitivity to touch and inversion of locomotor activity after withdrawal from the drug. In order to examine whether the physically dependent rats show an active drug-seeking behaviour they were given successively free choice between sweetened levorphanol solution (LSa) and two alternative drinking liquids -- sweetened tap water (WSa) and unadulterated water (W). In the case of LSa and W the rats chose LSa, but they preferred WSa to LSa. Another group of rats made dependent on unsweetened levorphanol solution (L) had the choice between L and W. They rejected L immediately.

Animals↗
PubMed1975

Taste-aversion learning in infant guinea pigs.

Infant guinea pigs were hand-fed a 10% sucrose solution and poisoned after delays of 0 min, 30 min, or 24+ hr. Subjects in the first 2 groups showed significant sucrose aversions when tested more than a month later. No significant difference existed between the 0- and 30-min groups; no deficiency in this type of learning was evident even in neonates. All 3 groups showed a lower sucrose preference if first exposed at ages 0-6 days than at 7-11 days. Evidently exposure to sucrose at the earlier ages was less effective in reducing later neophobia to sucrose; although the youngest animals had no evident deficiency in learning aversions, they may have been deficient in learning "safety".

Adaptation, Biological↗
PubMed2005

Evaluating the establishment and maintenance of visual-visual and gustatory-visual equivalence relations in adults with developmental disabilities.

Four adults with developmental disabilities were taught to make conditional discriminations between either pictures and their corresponding printed English and Spanish words, or tastes and their corresponding printed English and Spanish words. Participants required more training trials to master the visual-visual conditional discriminations than the gustatory-visual conditional discriminations, and 3 of the 4 participants performed with higher accuracy on visual equivalence class test trials than gustatory-visual equivalence class test trials. A follow-up equivalence test conducted 30 to 40 days later showed substantially greater stability over time for the gustatory-visual classes than for the visual classes, for all participants. That participants acquired gustatory-visual conditional discriminations, as well as equivalence classes based on those conditional discriminations, may have relevance for incorporating gustatory stimuli into mand training sessions, as well as for teaching individuals with sensory impairments in other modalities.

Adult↗
PubMed1998

Intermediate and long-term side effects of high-dose radioiodine therapy for thyroid carcinoma.

UNLABELLED: The present investigation is an evaluation of intermediate and long-term side effects in patients after high-dose radioiodine treatment due to differentiated thyroid carcinoma. METHODS: A total of 203 patients were interviewed using a standardized questionnaire. RESULTS: After radioiodine treatment, 76.8% of the patients reported intermediate (from discharge up to 3 mo) or long-term (more than 3 mo after treatment) complaints, and 61.1% reported long-term side effects. Nonstochastic side effects included sialoadenitis, which occurred in 33.0% of cases, and 27.1% of patients suffered from a transient loss of taste or smell. More than 1 yr after the last radioiodine application, 42.9% of patients suffered from reduced salivary gland function. Complete xerostomia occurred in 4.4% of patients. Hematological abnormalities were found in 9 patients. In 28.1% of patients a transient episode of alopecia was reported. In 22.7% of patients chronic or recurrent conjunctivitis was reported, and 4 patients underwent dacryocystorhinostomy; 13.8% of patients suffered from an increased frequency of influenza, but 3.4% reported a reduced occurrence of such infections. For sialoadenitis, the loss of taste/smell and dry mouth, the dependence on accumulated activity was significant. CONCLUSION: Severe long-term side effects are rare after high-dose radioiodine treatment. Moderate side effects are common. The side effects are commonly the result of radiation damage to the salivary glands. The frequency of such complaints advocates regular protection of the salivary glands.

Alopecia↗
PubMed1993

Case report of anorexia nervosa associated with Wilson's disease.

Wilson's disease is a recessively inherited disorder of copper metabolism with prominent hepatic, hematopoietic, central nervous system (CNS), and ocular involvement. Psychiatric manifestations are notoriously variable. The following case history of a patient with both anorexia nervosa and Wilson's disease is presented and discussed in the context of organic CNS lesions associated with anorexia nervosa-like syndromes.

Adult↗
PubMed2005

The extracellular zinc-sensing receptor mediates intercellular communication by inducing ATP release.

Taste and salivary secretion disorders have been linked to zinc deficiency, indeed zinc is found in secretory granules in the salivary gland. The signaling role for the zinc release in this tissue, however, is poorly understood. Here, we address the signaling pathways and physiological role of the zinc-sensing receptor, ZnR, in the ductal salivary gland cell line, HSY. Exposure of these cells to zinc triggered intracellular Ca2+ release from thapsigargin-sensitive stores. The G alpha q inhibitor, YM-254890 (1 microM), eliminated the Zn2+-dependent Ca2+ response, demonstrating that ZnR is a G alpha q-coupled receptor. Dose-response curves yielded an apparent K0.5 of 36 microM and a Hill coefficient of 7 in the absence of extracellular Ca2+, and K0.5 of 55 microM with a Hill coefficient of 3 in its presence. This indicates that although Zn2+ is essential for ZnR activation, Ca2+ may affect the receptor co-operativity. The homologous desensitization pattern of ZnR was characterized by pre-exposure of cells to Zn2+ at concentrations found to activate the receptor. Re-exposure of cells to Zn2+ elicited an attenuated Zn2+-dependent Ca2+ response for at least 3 h, indicating that the ZnR is strongly desensitized by Zn2+. Finally, we studied the paracrine affects of ZnR using a co-culture consisting of the HSY cells and vascular smooth muscle cells (VSMCs). While no Zn2+-dependent Ca2+ release was observed in VSMC alone, application of Zn2+ to the co-culture induced a Ca2+ rise in both HSY cells and VSMC. This Ca2+ rise was inhibited by the ATP scavenger, apyrase. Taken together, our results demonstrate that ZnR activity is monitored in salivary cells and is modulated by extracellular Ca2+. We further show that ZnR enhances secretion of ATP, thereby linking zinc to key signaling pathways involved in modification of salivary secretions by the ductal cells.

Adenosine Triphosphate↗
PubMed2000

A phase I/II trial of recombinant methionyl human brain derived neurotrophic factor administered by intrathecal infusion to patients with amyotrophic lateral sclerosis.

BACKGROUND: Brain derived neurotrophic factor (BDNF) is a potent survival factor for motoneurons. This study investigated the safety and tolerability of recombinant methionyl human BDNF (r-metHuBDNF) infused intrathecally by means of an implanted pump in patients with ALS. METHODS: Twenty-five patients with probable or definite ALS were treated with either r-metHuBDNF (25, 60, 150, 400 or 1000 microg/day) or placebo in a 12-week, randomized, double-blinded, sequential, dose-escalation study. Test treatment was interrupted by a washout period from days 11 to 25 to allow the evaluation of laboratory safety measures. In each dose cohort four patients received r-metHuBDNF and one received placebo. On completion of the double-blind period of the study all patients continued to receive r-metHuBDNF in an open-label extension for up to 60 weeks. Lumbar cerebrospinal fluid (CSF) samples were taken periodically from all patients for the measurement of r-metHuBDNF levels and in a minority of patients these were supplemented by cistemal samples. RESULTS: Within days after the initiation of infusion the majority of patients receiving r-metHuBDNF reported mild sensory symptoms, including paraesthesias or a sense of warmth, which were usually confined to the lower limbs and were frequently exacerbated by neck flexion. In most instances these symptoms decreased or even disappeared over several weeks. Sleep disturbance, dry mouth, agitation and other behavioural effects were encountered at higher doses (>150 microg/day) and necessitated dose reductions. The spinal CSF levels of r-metHuBDNF were directly related to dose, with a lumbar to cervical ratio of approximately 4:1. CONCLUSIONS: The intrathecal delivery of r-metHuBDNF in doses of up to 150 microg/day was well tolerated and appears feasible. The reversible CNS effects with higher dose indicate that BDNF can be delivered cranially against CSF flow. The small number of patients and the design of the study did not permit conclusions to be drawn about the efficacy of the treatment.

Adult↗
PubMed1993

Encephalopathy associated with bismuth subgallate therapy.

A 74-year-old man developed paranoid ideation, memory impairment, and defective gustatory and olfactory function while on bismuth subgallate therapy for use as a colostomy deodorant. Twenty-four-hour urine bismuth was elevated at 889 micrograms/day, and whole blood bismuth concentration was 67 micrograms/L. The patient improved after discontinuation of bismuth subgallate; there was resolution of paranoid behavior and gustatory and olfactory functions improved. Follow-up whole blood bismuth concentration was 21 micrograms/L 4 weeks after cessation. Altered gustatory and olfactory function have not been previously reported with bismuth intoxication.

Aged↗
PubMed2003

Association between sweet preference and paternal history of alcoholism in psychiatric and substance abuse patients.

BACKGROUND: The relationship between preference for stronger sweet solutions and propensity to excessive alcohol drinking is supported by both animal and human studies. This study was designed to test the hypothesis that sweet preference is associated with the genetic risk of alcoholism as measured by a paternal history of alcoholism. METHODS: Participants were 180 patients admitted to a residential treatment program for the treatment of alcoholism, drug dependence, or psychiatric conditions. In addition to a routine medical examination, patients completed the standard sweet preference test twice (on the 9th and 24th days after admission), and the family history of alcoholism was evaluated. RESULTS: Sweet preference was shown to be stable over time. It was strongly associated with a paternal history of alcoholism, with family history-positive patients approximately 5 times more likely to prefer stronger sweet solutions than family history-negative subjects. Such factors as dependence on alcohol, cocaine, opiates, cannabis, other drugs (including prescription drugs), and tobacco smoking, as well as demographics (gender and age), did not significantly interfere with association between sweet preference and paternal history of alcoholism. CONCLUSIONS: These findings provide some support for the hypothesis that preference for stronger sweet solutions is associated with a genetic predisposition to alcoholism as measured by a paternal history of alcoholism.

Adult↗
PubMed2003

Combating iodine and iron deficiencies through the double fortification of fish sauce, mixed fish sauce, and salt brine.

Two iodine and seven iron compounds were tested for use in the fortification of pure fish sauce, mixed fish sauce, and salt brine for cooking as a means to combat iodine and iron deficiencies. Ferrous sulfate, sodium iron ethylenediaminetetraacetic acid, ferric ammonium citrate, and ferrous lactate were combined with potassium iodide with no effect on sensory quality. Product shelf-life testing revealed that no iron or iodine losses occurred during a three-month storage period. Although the color of most products darkened, the color was not significantly different from that of nonfortified products after two to three months. Sensory home-use tests revealed that the fortified products were acceptable to highly acceptable, with only 1.2% to 8.2% of the dishes cooked using the fortified products being reported as discolored. The cost of fortification was minimal, at 0.13 to 2.73 baht per bottle (750 ml) (42 baht = US$1). Consequently, these products show a potential for inclusion in national programs for the prevention of micronutrient deficiencies in Asian countries where fish sauce and its products are routinely consumed.

Anemia, Iron-Deficiency↗