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PubMed1996

A case of uncommon withdrawal symptoms after a short period of spinal morphine administration.

A 54-year-old female with chronic failed back surgery syndrome and pain in the back and the right leg was treated by chronic spinal morphine administration by an external pump. After a positive test instillation over a 3-week period the spinal catheter was removed. Within 24 h the patient developed fever, leucocytosis, impaired sense of smell and allodynia and hyperpathia in all 4 limbs. Infection was excluded as a possible cause and a withdrawal after a second test period some weeks later reinitiated the symptoms. The symptoms vanished after restarting the morphine administration. Finally, an internal Medtronic pump was implanted because the patient obtained good pain relief with the test instillation. Good pain relief could be obtained with the daily instillation of 5 mg morphine intrathecally. Fever, leucocytosis, impaired sense of smell, allodynia and hyperpathia in the limbs reappeared a few weeks later. Evaluation showed catheter migration out of the spinal canal.

Analgesics, Opioid↗
PubMed1995

Patterns of adrenocorticotropin secretagog release in response to social interactions and various degrees of novelty.

Colchicine blockade of axonal transport from the paraventricular nucleus to the median eminence was used to indirectly infer ACTH secretagog release in response to the psychological stressors of social interactions and various degrees of novelty. Placing a rat in a new cage with either the smell or presence of a novel conspecific decreased arginine vasopressin and oxytocin (OT) contents, but not corticotropin-releasing factor content. Secretagog contents were unchanged in rats in their home cages faced with a novel conspecific. Secretagog release during social stress is thus primarily a function of being in a novel setting. For different degrees of novelty, rats were placed in either a novel cage, a novel bucket, or a novel bucket smelling of another rat. Whereas secretagog contents were unchanged with a novel cage, OT content alone decreased in response to both the bucket and the unclean bucket. Despite a graded corticosterone response, there was no distinction in the OT response, suggesting that the colchicine technique cannot accurately reflect gradations of stressors.

Adaptation, Psychological↗
PubMed1989

Breakdown of dietary restraint following mere exposure to food stimuli: interrelationships between restraint, hunger, salivation, and food intake.

It was hypothesised that the hunger-enhancing effects of exposure to the sight and smell of palatable food would disinhibit eating in restrained eaters (self-reported dieters). In two experiments exposure to palatable food stimuli led to increases in motivational (hunger) ratings and salivation, and was followed by overeating in restrained subjects compared with the control condition (no food during exposure) and a condition in which nonpreferred food was presented during the exposure phase. The food intake of unrestrained subjects, on the other hand, was reduced following exposure to palatable food in the first experiment. This shows that breakdown of dietary restraint can be induced by food stimuli even when the food does not constitute a preload. Mere exposure to the sight and smell of palatable food is sufficient to precipitate loss of dieting motivation. The effects of exposure on hunger and salivation were, in general, unrelated to food intake or degree of dietary restraint. Therefore, changes in hunger do not appear to directly mediate increased food intake in dieters. Instead, it is tentatively suggested that anxiety resulting from exposure to liked food may play a role both in disinhibiting eating and suppressing salivation in restrained subjects.

Adolescent↗
PubMed1990

Reactivity to alcohol cues and induced moods in alcoholics.

It has been theorized that respondent conditioning processes in part underlie desire for alcohol and thus contribute to relapse after alcoholism treatment. One implication of this theory is that the relevant conditioned responses could be eliminated by respondent extinction, in which the alcoholic patient is exposed to alcohol-related stimuli while being prevented from consuming alcohol. However, exteroceptive cues such as the sight and smell of alcoholic beverages are not always sufficient to elicit desire for alcohol. In view of this, it has been suggested that interoceptive cues, such as mood states, may also play a role in eliciting desire for alcohol. To test this, eight alcoholic subjects were induced to experience negative or neutral moods on four separate days, and then exposed to the sight and smell of their favorite alcoholic drink, and to a neutral stimulus (seltzer water), in a within-subjects design. Results from this work indicate that: (a) negative moods can be reliably induced in the laboratory as confirmed by subjects' reports; (b) exposure to alcohol cues had no effect on desire for alcohol while subjects were in a relaxed, neutral mood state; (c) the presence of negative mood states alone appeared to be sufficient to elicit desire for alcohol in some subjects, regardless of whether alcohol or water was presented. These data argue that negative mood states may cue desire for alcohol independent of other cues. The data also suggest that reactivity to alcohol cues may be substantially reduced by relaxation.

Adult↗
PubMed1991

Cue reactivity in alcohol abusers: stimulus specificity and extinction of the responses.

Sixteen alcohol abusers who had completed detoxification were presented with seven different types of alcohol and non-alcohol related stimuli. The sight and smell of the alcoholic beverage most commonly consumed by each subject elicited the largest change in response for measures of heart rate, desire to drink, and self-reported withdrawal symptoms. Beverages progressively more different from the preferred one produced responses of consistently lower magnitude. In the second phase of the study, 10 subjects were exposed to 20 presentations of the sight and smell of their preferred drink. A gradual reduction in the magnitude of the response for all three measures was observed over the 20 presentations. These results were discussed in terms of a conditioning interpretation of cue reactivity. They indicate the need for cue exposure programs to be based on the particular drinking history of the individual.

Adult↗
PubMed1986

Quantitative microbiology of pressure sores in different stages of healing.

The quantitative microbiology of 25 pressure sores in different stages of healing was examined in 25 patients with spinal cord injury. When grossly necrotic tissue was present (stage 1), 5.8 isolates per patient with a density of 6.4 log10/g was recovered, with comparable findings for aerobes and anaerobes. In the absence of necrotic tissue but with the presence of undermining (stage 2), 1.5 aerobic and 0.2 anaerobic isolates were recovered per patient with a mean density of 2.7 and 0.1 log10/g of tissue for aerobic and anaerobic isolates, respectively. The lesions were almost sterile in patients with no necrotic tissue and no undermining (stage 3). Foul smell was always associated with the presence of anaerobes in deep tissue cultures, however, six patients with nonfoul-smelling lesions yielded anaerobes. A 75% quantitative concordance was seen between swab and biopsy culture results. The quantitative concordance between peripheral and central biopsy culture results was 63%, showing variability in results from different sampling areas. No relationship was observed between the density of microorganisms and the eventual outcome of the myocutaneous flap procedure.

Adult↗
PubMed2005

The perceived importance of sensory modalities in product usage: a study of self-reports.

Although popular belief holds that vision dominates human experience, this does not necessarily imply that people regard vision as the most important sensory modality during the interaction with every product. Instead, the relative importance of the different modalities is likely to depend on the type of product and on the task performed. In Study 1, respondents reported how important they found vision, audition, touch, taste, and smell during the use of 45 different products. In Study 2, the respondents answered a similar question for the evaluation of the safety, ease of use, and enjoyment experienced for 15 products. Importance ratings for the sensory modalities differed considerably between the products. Differences due to the types of evaluations were smaller. Averaged over products and evaluation types, vision was the most important sensory modality for product evaluations, followed by touch, smell, audition, and taste. However, for about half of the individual products, the importance ratings for vision were lower than for one of the other modalities. These findings are in line with the view that vision is regarded the dominant modality, because it plays an important part in many and an irrelevant part in virtually no product experiences.

Adolescent↗
PubMed2005

Olfactory dysfunction in sinusitis with infiltration of numerous activated eosinophils.

OBJECTIVES: To compare the number of activated eosinophils in the ethmoidal sinus mucosa with the computed tomographic findings and degree of olfactory dysfunction, and study the clinical characteristics of this disease. MATERIAL AND METHODS: Ethmoidal sinus mucosal specimens were obtained from 84 patients with bilateral sinusitis accompanied by endoscopic sinus surgery (ESS). The percentage of activated eosinophils identified by staining with EG2 antibody was compared with the nasal symptoms (nasal obstruction, nasal discharge, headache, problems of smell and overall), the CT images and the olfactory dysfunction assessed using the T&T olfactometry kit and the Alinamin test. In addition, comparison was made of the endoscopic findings obtained after the ESS and the results of the T&T olfactometry assessment. RESULTS: Specimens from 42 patients were classified in the group showing a high percentage of EG2-positive cells, while specimens from 40 patients were classified in the group showing a low percentage of EG2-positive cells. Comparison of the subjective symptoms in these two groups found a statistically significant difference only in relation to "problems of smell", while comparison of the two groups in terms of the CT scan findings found significant differences only in relation to the anterior and posterior ethmoidal sinuses. In addition, it was found that there was a possibility of manifestation of olfactory dysfunction in the group with a high percentage of EG2-positive cells even when the overall CT score was low. Comparison of the postoperative ethmoidal sinus endoscopic findings and the results using the T&T Olfactometry kit revealed that olfactory dysfunction occurs together with aggravation of the lesions. CONCLUSIONS: For the diagnosis of sinusitis accompanied by severe infiltration of activated eosinophils, attention should be paid not only to the eosinophil counts in the blood and the tissues, but also to the clinical findings, such as the status of lesions in the ethmoidal sinus as seen in CT scans and the manifestation of olfactory dysfunction.

Adult↗
PubMed2004

Tuber aestivum and Tuber uncinatum: two morphotypes or two species?

Tuber spp. are ectomycorrhizal fungi that establish symbioses with shrubs and trees. Because of their different smell and taste, Tuber uncinatum and Tuber aestivum are two truffle morphotypes with a different market value, but whether or not T. uncinatum and T. aestivum are different taxa is still an open debate among mycologists. In order to identify molecular keys characterizing both T. aestivum and T. uncinatum morphotypes, ITS/RFLPs analyses were carried out on a large collection of samples from all over Italy and from other European countries, followed by a study of the phylogenesis of ITS, beta-tubulin and EF 1-alpha genes, on representative samples. The present study provides compelling evidence that: (i) T. uncinatum and T. aestivum belong to the same species, (ii) neither morphotype presents a specific molecular fingerprint, but they may even share identical alleles at any of the loci analysed; (iii) T. aestivum is most likely under a selfing reproductive mode. Our findings suggest that ecological, rather than genetic causes may account for differences in sporal morphology, taste and smell between T. aestivum and T. uncinatum truffles.

Ascomycota↗
PubMed2005

Efficacy and safety of mometasone furoate nasal spray in nasal polyposis.

BACKGROUND: Studies have suggested that topical corticosteroids are effective in the treatment of nasal polyps; however, this has yet to be confirmed in a large, robust clinical trial. OBJECTIVE: To evaluate the efficacy and safety of mometasone furoate nasal spray (MFNS) for nasal polyposis. METHODS: A total of 354 subjects with bilateral nasal polyps and clinically significant congestion/obstruction participated in this multinational, randomized, double-blind, placebo-controlled study. Subjects received MFNS 200 microg once or twice daily or placebo for 4 months. Coprimary endpoints were (1) change from baseline to last assessment in physician-evaluated bilateral polyp grade score and (2) change from baseline averaged over month 1 in subject-assessed nasal congestion/obstruction. ANOVA was used for all efficacy endpoints, except for change in bilateral polyp grade score, for which baseline polyp grade was added as a covariate. RESULTS: Compared with placebo, MFNS 200 microg administered once or twice daily produced significantly greater reductions in bilateral polyp grade score (P < .001, P = .010, respectively) and congestion/obstruction (P = .001, P < .001), as well as improvement in loss of smell (P < .001, P = .036), anterior rhinorrhea (P < .001 for both), and postnasal drip (P < .001, P = .001) over month 1. MFNS 200 microg twice daily was superior to MFNS 200 microg once daily in reducing congestion/obstruction (P = .039), and there were more improvers in the MFNS 200 microg twice daily group (P = .035). MFNS was well tolerated in both groups. CONCLUSION: MFNS 200 mug, once or twice daily, was safe and significantly superior to placebo in reducing polyp grade (size and extent) and improving congestion/obstruction and return of sense of smell. MFNS is an effective medical treatment for nasal polyposis and may reduce or delay the need for surgery.

Administration, Intranasal↗
PubMed2005

Food choice of tactile defensive children.

OBJECTIVE: We explored whether tactile defensive children have picky eating habits because fussy or picky eaters are a general problem to parents and different health professionals. METHODS: Children (n = 62) of both sexes, ages 3 to 10 y, were assigned to an experimental tactile defensive (TD) group (n = 29) or a control non-TD group (n = 33). A questionnaire on eating habits was compiled and given to parents for completion during personal interviews (children were screened with a checklist and evaluated for tactile defensiveness with the Winnie Dunn Caregiver profile questionnaire). RESULTS: This research confirmed that the eating habits and food choices of TD and non-TD children differ significantly. TD children had a fair to poor appetite. They hesitated to eat unfamiliar foods, did not eat other people's houses, and refused certain foods because of the smell and temperature. They also had a problem eating vegetables. They often gagged and/or bit their inner lips and cheeks. The results showed a definite difference in the limited selection of foods that TD children chose and a pronounced aversion toward textures or consistencies, smells, and temperatures of food as compared with integrated children. CONCLUSIONS: Fussy or picky eaters should evaluated more widely than to treat only the feeding problem. Tactile or oral defensiveness can be treated. This report underlines the team approach of health professionals.

Case-Control Studies↗
PubMed2004

Chronic sinusitis and olfactory dysfunction.

Chronic rhinosinusitis encompasses a group of disorders characterized by inflammation of the mucosa of the nose and paranasal sinuses of at least 12 weeks' duration. In addition to nasal obstruction and discharge, chronic sinusitis is a common cause of olfactory dysfunction. Smell loss can result in problems including safety concerns, hygiene matters, appetite disorders, and changes in emotional and sexual behavior. Although smell loss related to sinonasal disease is probably the most treatable form of olfactory dysfunction and treatment can improve olfactory sensation in the setting of sinusitis, most studies show that the effects are usually transient and incomplete.

Anti-Bacterial Agents↗
PubMed2006

Acute effects of exposure to vapours of acetic acid in humans.

Acetic acid is used in plastics, chemical and pharmaceutical industries. Despite a widespread use, information of possible health effects is sparse. The aim of this study was to evaluate acute irritation during controlled exposure to vapours of acetic acid. Six female and six male healthy volunteers were exposed to 0 ppm (control exposure), 5 and 10 ppm acetic acid vapour for 2 h at rest in a balanced order. Subjective ratings of nasal irritation and smell increased significantly with exposure level. Except for smell, all average ratings at 10 ppm were at the lower end of the 0-100mm visual analogue scale, and did not exceed the verbal expression "somewhat" (26 mm). No effects on pulmonary function, nasal swelling, nasal airway resistance or plasma inflammatory markers (C-reactive protein, and interleukin-6), measured before and after exposure, were seen. There was a non-significant tendency to increased blinking frequency, as measured continuously during exposure, after exposure to 10 ppm acetic acid. In conclusion, our study suggests a mild irritative effect at 10 ppm acetic acid.

Acetic Acid↗
PubMed2002

[Olfaction disturbances in general ORL practice].

Analysis of smell disturbances in the ENT outpatients department of in a General Hospital. A retrospective and descriptive study. We include all patients with olfactory alterations as the main reason for consultation. The sample was 38 patients. Viral, postraumatic, toxic, drug-induced and inflammatory. We performed anamnesis, nasal endoscopic and scan images on all patients. Olfactory disturbances were more frequent in women older than 55 (2:1). The viral cause was the most frequent aethiology (55.3%). Nasal endoscopic exploration was normal in 68.4% patients. The CT scan was the main imaging study used (68.4%). The younger patients recovered better than the older ones. Smell disorders provoked by virus, toxic and medical drugs do have a better.

Adult↗
PubMed2002

Odor identification, eye tracking and deficit syndrome schizophrenia.

BACKGROUND: Deficit syndrome (DS) schizophrenia patients have smooth pursuit eye movement (SPEM) dysfunction. We examined if they also had smell identification deficits, since social affiliation is related to olfaction in other mammals. METHODS: Sixty-seven patients had DS assessments: 31 patients had SPEM and 50 had Smell Identification Test (SIT) assessments, and 14 patients had both measurements. RESULTS: DS patients had worse SPEM and SIT performance than the non-DS patients. Areas under the receiver-operator characteristic (ROC) curves for SIT and SPEM were both fairly accurate in identifying the DS. The odds ratio (OR) for the DS for impaired versus normal SPEM was 6.21 (95% confidence interval [CI]: 1.21, 32.25) and for microsmia versus normosmia was 10.4 (95% CI: 1.23, 88.18). Further analyses showed that the association of SIT with both SPEM and the DS could account for the SPEM-DS association. CONCLUSIONS: We found a strong association between the DS and SIT scores suggesting that the neural substrates of olfaction may be related to social affiliation in humans, as they are in other mammals. These data further support the notion that the DS defines a homogeneous subgroup of schizophrenia patients and further suggest that dysfunction in the neural circuitry of olfaction may contribute to its pathophysiology.

Adult↗
PubMed1993

Human olfactory neurons respond to odor stimuli with an increase in cytoplasmic Ca2+.

The sense of smell allows terrestrial animals to collect information about the chemical nature of their environment through the detection of airborne molecules. In humans smell is believed to play an important role in protecting the organism from environmental hazards such as fire, gas leaks and spoiled food, in determining the flavor of foods, and perhaps in infant-parent bonding. In addition, the study of human olfaction is relevant to a number of medical problems that result in olfactory dysfunction, which can affect nutritional state, and to the study of the etiology of neurodegenerative diseases which manifest themselves in the olfactory epithelium. Although much is known about behavioral aspects of human olfaction, little is understood about the underlying cellular mechanisms in humans. Here we report that viable human olfactory neurons (HON) can be isolated from olfactory tissue biopsies, and we find that HON respond to odorants with an increase in intracellular calcium concentration ([Cai]).

Biopsy↗
PubMed1997

Olfactory event-related potentials to amyl acetate in congenital anosmia.

Olfactory function was evaluated by olfactory event-related potentials and standardized psychophysical measures including the Smell Identification Test and odor detection threshold tests for 3 chemosensory stimulants in 9 subjects with isolated congenital anosmia and 9 age- and gender-matched normosmic controls. There was a significant difference in Smell Identification Test scores (P < 0.001) and odor detection thresholds for phenylethyl alcohol (P < 0.001) and isoamyl acetate (P < 0.001) between the anosmic and normosmic subjects. Detection thresholds for chloracetyl phenone, a trigeminal stimulant, did not differ between the 2 groups. Olfactory evoked potentials were recorded in response to amyl acetate and air control stimuli presented at volume flow rate of 5 l/min, stimulus duration of 40 ms, and randomized interstimulus intervals of 6-30 s. In the control subjects, evoked potentials to amyl acetate were characterized by 4 reproducible components (P1, N1, P2, and N2). In the subjects with congenital anosmia, no reproducible evoked potential components were identified in response to amyl acetate. No reproducible evoked potential components were seen in response to the air control stimulus in either the anosmic or normosmic groups. These data suggest that olfactory evoked potentials provide a specific measure of olfactory function.

Adult↗
PubMed2004

Anosmia and nasal sinus disease.

Smell loss associated with nasal sinus disease can be a frustrating condition for patients and their physicians. A better understanding of the causes and pathophysiology of olfactory dysfunction can provide a framework from which the physician can plan appropriate treatment and counsel patients as to probable outcomes. This article reviews the pathophysiology of smell loss and the diagnostic paradigms and treatment approaches for the more common causes of anosmia.

Chronic Disease↗