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[Zinc].

Zinc is indispensable for life from bacteria to man. As a trace element it is included in numerous enzymes or serves as their activator (more than 80 zinc metallo-enzymes). It is necessary for nucleic acid and protein synthesis, the formation of sulphated molecules (insulin, growth hormone, keratin, immunoglobulins), and the functioning of carbonic anhydrase, aldolases, many dehydrogenases (including alcohol-dehydrogenase, retinal reductase indispensable for retinal rod function), alkaline phosphatase, T cells and superoxide dismutase. Its lack provokes distinctive signs: anorexia, diarrhea, taste, smell and vision disorders, skin lesions, delayed healing, growth retardation, delayed appearance of sexual characteristics, diminished resistance to infection, and it may be the cause of congenital malformations. Assay is now simplified by atomic absorption spectrophotometry in blood or hair. There is a latent lack prior to any disease because of the vices of modern eating habits, and this increases during stress, infections or tissue healing processes. Its lack is accentuated during long-term parenteral feeding or chronic gastrointestinal affections. Correction is as simple as it is innocuous, and zinc supplements should be given more routinely during surgical procedures.

Acrodermatitis↗

[Drug side-effects in ORL practice (author's transl)].

Drug side-effects as opposed to toxic effects are defined and the specific side-effects of drugs used in otorhinolaryngology are then discussed. Drug induced changes in the ear, nose, throat, mouth, salivary glands and thyroid are listed. Only the most common and most important effects are discussed in detail. Some of the less commonly encountered side-effects have only been reported in a single patient and the mechanism involved is therefore uncertain. A good history is often valuable for reaching the correct diagnosis. It is also important for the physician to know the exact mechanism of a drug's action before prescribing it and to also inform the patient of the possible side-effects when these are relatively common.

Anti-Bacterial Agents↗

[Pathology of taste: knowledge and prospectives].

Taste anomalies have not been systematically investigated till recently in Italy. The influence of the taste on the choice of the foods, on the nutrition and on the same psycho-physic human mindedness has largely been demonstrated. In this study, taste anomalies associated with various pathologic conditions (nervous, endocrine, metabolic, infectious, immunological, carential or neoplastic disorders) are reported, as well as those produced by drugs, or surgical interventions. The type and the degree of taste anomalies associated to immunological diseases, allogeneic bone marrow transplantation and AL amyloidosis are particularly described.

Forecasting↗

Cacogeusia in amyloidosis associated with plasma cell dyscrasia.

Cacogeusia, being the patients' main complaint, is reported as a new symptom of amyloidosis, probably caused by a peripheral sensory neuropathy. A case is presented of a patient with weight loss, dysphagia, macroglossia and taste disturbances, due to amyloidosis associated with a plasma cell dyscrasia. The importance of oral manifestations in amyloidosis is discussed.

Aged↗

Zinc salts for the treatment of olfactory and gustatory symptoms in psychiatric patients: a case series.

BACKGROUND: Zinc salts have been used extensively in medical settings to treat disorders of gustatory and olfactory function. However, zinc supplements have not been tested in psychiatric patients with smell or taste symptoms. METHOD: The authors examined the effects of zinc supplements on five consecutive patients with symptoms of abnormal taste and smell perception in the context of acute psychiatric illness or treatment. RESULTS: All five patients had complete or partial amelioration of these olfactory and gustatory symptoms after treatment with zinc sulfate or zinc gluconate, apparently independent of the improvement in their underlying psychiatric disorder. CONCLUSION: We recommend treating unusual olfactory and gustatory symptoms with zinc salts, independent of the treatment for the underlying psychiatric disorder.

Antipsychotic Agents↗

Disturbances of taste and smell induced by drugs.

We reviewed the current literature (1980-1990, 1991-1996) concerning drugs associated with anosmia, hyposmia, dysgeusia, parageusia, and ageusia, and the impact of these adverse effects. Case reports of patients with sudden and delayed onset of one of these disorders with evidence for implication of a drug were included. Disturbances of taste and smell among the elderly and chronically ill, including those with thermal injury, decreases interest in eating and secondarily impairs healing of wounds. Mechanisms involved with these sensory disturbances include deposition of silver sulfate in nerves after use of topical agents containing silver, altered influx of calcium and other ions, chelation or depletion of tissue-bound zinc, disturbed bradykinin catabolism and second messenger synthesis, catabolism, and altered prostaglandin systems. Other mechanisms, particularly prolonged chemosensory disorders after early drug discontinuation, remain unknown.

Drug-Related Side Effects and Adverse Reactions↗

Low parotid saliva calmodulin in patients with taste and smell dysfunction.

Parotid saliva calmodulin was found both in 32 normal volunteers and in 60 patients with taste and smell dysfunction; salivary calmodulin concentration was significantly lower in the patients than in the volunteers. There were no differences in salivary calmodulin concentration with respect to age, sex, or salivary flow rate in either normal volunteers or patients. When patients were categorized by diagnosis, calmodulin concentration was found to be decreased in all patient groups. The concentration of calmodulin in saliva was about 10 times that found in serum, suggesting that the parotid gland is a major source of this protein.

Adult↗

[Evaluation of the senses of taste and smell in petroleum chemistry workers based on 3-year observations].

The authors have presented results of examinations of the smell and taste senses in 547 petrochemistry, workers, and 100 cotton industry workers composing a control group. In both groups, those aged 26 -- 35, with long duration of employment, predominated. In the primary group i.e. petroleum chemistry workers, dysgeusia has been found in 319 (58.3%) subjects with no reaction at all in 102 (18.6%) persons. Hyposmia has been found in 238 (43.5%) and anosmia in 50 (9.2%) subjects. In the control group, dysgeusia has been found in 69%, whereas anosmia in 24% of subjects.

Adult↗

Abnormalities of taste and smell after head trauma.

Abnormalities of taste and smell were studied in 29 patients after head trauma. These abnormalities included decreased taste acuity (hypogeusia), a distortion of taste acuity (dysgeusia), decreased smell acuity (hyposmia), and a distortion of smell acuity (dysosmia). This syndrome can occur even after minimal head trauma and can begin months after the moment of injury. The patients exhibited a significant decrease in total serum zinc concentration (patients, 77 ± 3 μg/100 ml, mean ± 1 SEM, vs controls, 99 ± 2 μg/100 ml, P>0·001) and a significant increase in total serum copper concentrations (113 ± 4 μg/100 ml vs 100 ± 2 μg/100 ml, P<0·001) compared with control subjects. Symptoms of hypogeusia, dysgeusia, and dysosmia are frequent sequelae of head injury and are important to the patients and to their care after trauma.

Adult↗

Damage to taste system and oral pain: burning mouth syndrome.

The burning mouth syndrome (BMS) is an oral pain disorder. Central or peripheral pain mechanisms may play a role in the oral burning of BMS. Various local, systemic and psychological factors have been found to be associated with BMS, but its etiology is not fully understood. This syndrome mostly affects middle-aged women and is frequently accompanied by taste complaints. This association of symptoms suggests an interaction between the mechanisms of nociception and gustation, 2 senses with strong hedonic components. There are connections between taste and oral pain in the central nervous system and it is possible that BMS and other oral pain phantoms result from damage to the taste system. This suggests that individuals who suffer from BMS are likely to be supertasters.

Burning Mouth Syndrome↗

How do children with adenoid hypertrophy smell and taste? Clinical assessment of olfactory function pre- and post-adenoidectomy.

OBJECTIVE: To assess the ability to smell and appreciate food in children with adenoid hypertrophy pre and post-adenoidectomy. METHODS: A total of 35 children with adenoid hypertrophy admitted for adenoidectomy (aged 5-9.3 years, mean age 5.9 years) were tested preoperatively. In a follow up appointment 3 months postoperatively, 28 of them returned and were tested again. The control group consisted of 30 healthy children (aged 5-10.2 years, mean age 6.1 years). Orthonasal olfactory function was assessed psychophysically using "Sniffin sticks" 12 item odor identification test. Retronasal olfaction was assessed using a collection of 12 grocery available powders applied to the oral cavity. RESULTS: Both orthonasal and retronasal olfactory function of the study group preoperatively were significantly lower in comparison with the results of the control group (p<0.0001). The difference in retronasal olfaction between groups was significantly higher in comparison with the difference in orthonasal odor identification (p=0.048). There is a strong correlation between adenoid hypertrophy grade and retronasal testing results (t=-5.461, p<0.0001), but not with the orthonasal results (t=-1.677, p=0.9). Significant improvement of orthonasal and retronasal olfaction was observed in the follow-up appointment (p<0.0001). Relative increase postoperatively was higher for the retronasal olfaction compared to orthonasal olfaction (p=0.0029). CONCLUSIONS: Children with adenoid hypertrophy have a reduced ability to smell, with retronasal olfactory function being more affected. Surgery had a greater impact on retronasal olfaction.

Adenoidectomy↗

The relationship between migraine pain and other associated symptoms.

This study explores the relationship of the pain of the migraine headache and the associated features of migraine. Migraineurs (n=1025) (ICHD-2, 1.1-1.2 and 1.5.1) were evaluated retrospectively using a detailed database (daily unremitting excluded). Variables studied included headache intensity and duration, associated symptoms and pain characteristics. Non-parametric correlations were used to evaluate relationships among variables. Headache intensity correlated with nausea, vomiting, photophobia, phonophobia, dizziness (all P=0.000), running of the nose/tearing of the eyes (P=0.007), and osmophobia (P=0.044), but not with diarrhoea or taste abnormality. Headache duration correlated only with osmophobia (P=0.002) and taste abnormality (P=0.005). Throbbing, pressure and stabbing pain correlated with most of the associated symptoms. Aching correlated only with taste abnormality. This correlational study demonstrates that migraine pain is clearly related to nausea, but is also correlated with other associated migraine symptoms. Taste abnormality and osmophobia are better correlated with headache duration rather than headache intensity.

Adult↗

Taste function in methadone-maintained opioid-dependent men.

It has been shown repeatedly that opioid dependence is associated with increased consumption of refined sugars. It is possible that this association results from altered taste reactivity in opioid-dependent subjects. Thus, in the present study, we compared taste responses to sweet, bitter, sour and salty solutions in methadone-maintained opioid-dependent men and healthy control subjects. The two groups did not differ in terms of rated intensity or pleasantness of sucrose (1-30%), quinine (0.001-0.005%), citric acid (0.02-0.1%) and sodium chloride (0.18-0.9%) solutions. Proportions of 'sweet-likers', i.e. subjects rating a 30% sucrose (0.88 M) solution as the most pleasant, were also similar in both groups. In line with the previous findings, the methadone-maintained subjects reported adding more table sugar to caffeinated beverages. The results of the present study suggest that changes in taste reactivity may not be responsible for altered dietary choices in opioid addicts.

Adult↗

Gustatory and olfactory dysfunction in dementia: not specific to Alzheimer's disease.

Significant losses in the ability to detect the taste of glutamic acid and to recognize odorants were found in demented patients when compared with age-matched controls. These losses were not specific to patients with Alzheimer's disease (AD) but were also found in demented patients without AD. Detection thresholds for bitter-tasting quinine HCl were not higher in demented patients than in age-matched controls but were higher than thresholds in young subjects. These data suggest that losses in taste in demented patients may vary with the chemical structure of the tastant. The degree of loss in the ability to recognize odorants was greater in patients with a family history of senile dementia.

Aged↗