The use of a no-concentrated-sweets diet in the management of type 2 diabetes in nursing homes.
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Recent studies suggest a chemical perception of dietary fat in the oral cavity. To examine the role of gustation for the recognition of oleate and triolein, very short-term (5-min), two-bottle preference tests were conducted in anosmic rats. To minimize the effects of olfaction, texture and postingestive effects, rats were rendered anosmic with intranasal zinc sulfate, test substances were suspended in 0.3% xanthan gum solution and test fluids were offered for 5 min. Rats preferred oleate fluid but not triolein fluid to the control of 0.3% xanthan gum solution. The preference threshold for oleate in the rat oral cavity was between 0.2% and 0.5%. In the two-bottle preference tests between oleate and triolein, rats preferred oleate fluid to triolein fluid, showing discrimination of oleate and triolein. The results suggest that rat recognizes oleate by a gustatory cue and that fatty acid but not triglyceride is important for gustatory recognition of fat.
OBJECTIVE: Qualitative research methods explore the character and meaning of human phenomena. The methodology is unfamiliar to most clinicians, not only because of the different techniques and the type of studied issues, but also because of important differences regarding terminology and criteria for evaluating qualitative studies. This paper aims at discussing the potential contribution of qualitative methods to otorhinolaryngological research in general, and to describe a specific method with an otologic application in detail. METHOD: In order to explore different disturbing sound phenomena and coping strategies in patients with manifest tympanic membrane retractions, individual semi-structured interviews were performed. The transcripts were systematically analyzed by coding, categorizing, and interpreting the content of the text. The extracted themes, categories, and patterns were summarized. RESULTS: The method proved useful when exploring empirically known but non-measurable sound disturbances. Moreover, the findings provided further support for an alternative pathogenic theory suggesting the patient's playing an active role in the development of tympanic membrane retractions. CONCLUSIONS: Used as a complement to quantitative methods, qualitative methods offer a means for exploring the patient's experiences and role in the development, therapy, and prevention of disease. Otorhinolaryngology involves disorders of sensory functions such as hearing, equilibrium, smell and taste, as well as the vital functions of breathing and eating. The related symptoms might be experienced and coped with very differently depending on individual interpretations, fear of severe disease, etc. Furthermore, the clinician's and the patient's perspectives of symptoms and expectations regarding treatment may differ, which has implications for information, planning of therapy, and quality assessment in health care. There is no lack of study questions, but rather a lack of experience of alternative and pertinent methods.
Lithium is commonly used as a treatment for affective disorders in humans and as a toxin to produce conditioned taste aversions in rats. LiCl administration in rats has been correlated with activation of c-fos and cAMP-mediated gene transcription in many brain regions; however, little is known about the timing or duration of gene activation. We hypothesized that c-fos gene transcription is rapidly stimulated by LiCl, followed later by the expression of the inducible cAMP early repressor (ICER) transcription factor, a negative modulator of cAMP-mediated gene transcription. By in situ hybridization, we analyzed the timecourse of c-fos and ICER mRNA expression in the central nucleus of the amygdala (CeA), the paraventricular nucleus of the hypothalamus (PVN) and the supraoptic nucleus (SON) at seven time points (0, 0.3, 1, 3, 6, 9 and 12 h) after intraperitoneal LiCl injection (0.15 M, 12 ml/kg, 76 mg/kg). Expression of c-fos mRNA peaked between 20 min and 1 h and returned to baseline by 3 h in the CeA, PVN and SON. ICER mRNA was detected in these regions at 20 min, peaked at 1-3 h and returned to nearly baseline 9 h following LiCl injection. The time lag between c-fos mRNA expression and ICER mRNA expression within the same regions is consistent with ICER terminating c-fos gene transcription. However, no refractory period was detected for restimulation of c-fos transcription by a second injection of LiCl during the period of peak ICER mRNA expression, suggesting the involvement of other transcriptional modulators.
The very high sensitivity and specificity of odor identification tasks in discriminating between Alzheimer's patients and normals suggests that they reflect the presence of underlying neuropathology. Significant neuropathological changes are seen in areas critical to processing olfactory information, even in the early stages of Alzheimer's disease (AD). The current study was designed to investigate whether performance on olfactory tasks (odor threshold and odor identification) was related to volumetric MRI measures of mesial temporal areas central to olfactory information processing and important in the neuropathology of AD. Participants were 8 male and 5 female patients with probable AD, and 10 male and 12 female normal age-matched controls, diagnosed at the UCSD Alzheimer's Disease Research Center. The study investigated correlations between volumetric measures of hippocampus, the parahippocampal gyrus and the amygdala, and the psychophysical measures of olfactory function. Robust relationships were observed between mesial temporal lobe volumes and olfactory functional measures. The finding of a strong relationship between left hippocampal volume and performance on the odor identification task (r = .85) is compatible with a left-hemisphere superiority for verbally mediated olfactory tasks. The findings suggest a neural substrate for the breakdown in functional performance on verbally mediated odor identification tasks in Alzheimer's disease and suggest the utility of quantitative MRI measures and psychophysical performance in the assessment of AD. These results support the potential clinical utility of inclusion of odor identification tests in diagnostic batteries for detecting AD.
BACKGROUND: Testing of retronasal olfactory sensitivity is routinely performed in many ENT-departments in German speaking countries. One of the most popular tests relates to an anecdotal report by Güttich [1]. In this test, liquids are placed on the patient's tongue; the patient is then asked to describe the aroma. Assuming that anosmic patients should not use other descriptors than "sweet," "sour," "salty," and "bitter", this test design is frequently applied in disability compensation settings. Surprisingly though, so far there are no studies regarding the sensitivity or specificity of this test in terms of the differentiation between hyposmic and anosmic patients. METHODS: The present investigation was performed in 50 anosmics, 42 hyposmics, and 13 normosmics. The diagnosis "hyposmia" or "anosmia" was based on 1. the patients' history, 2. psychophysical tests using an established test of olfactory function, the "Sniffin' Sticks," and 3. the recording of olfactory evoked potentials. RESULTS: We obtained the following major results: 1. In comparison to hyposmis and normosmics, anosmic patients had greater difficulty identifying the aromas. However, correct identification was not always possible for normosmics. 2. Regarding the differentiation between anosmic and hyposmic patients, the test's sensitivity was 86% with a specificity of 62%. This clearly limits routine clinical application of this test. CONCLUSIONS: Retronasal testing appears to be an elegant and simple means in order to screen olfactory function. However, the presently investigated approach is limited with regard to the discrimination between anosmic and hyposmic patients.
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Many neuroimaging studies have implicated the orbital frontal cortex (OFC) in the pathophysiology of obsessive-compulsive disorder. In recent years there have been significant advances in elucidating the anatomical characteristics of the OFC in nonhuman primates. The authors review literature on the cytoarchitecture and afferent and efferent connections of the OFC, giving particular attention to the OFC's relationship to limbic and paralimbic regions, the mediodorsal thalamus, the basal ganglia, and sensory association cortices. These cytoarchitectural divisions and connections are discussed in terms of how they may influence thinking about the OFC's contribution to obsessive-compulsive disorder.
Propafenone, an anti-arrhythmic medication recently introduced in class lc, was tested in a multicentric open study including 3,687 patients (mean age: 60 years), presenting a supra ventricular (n = 2,146, 59 p. cent), nodal (n = 351, 10 p. cent) or ventricular (n = 1,613, 44 p. cent) arrhythmia, in order to study its efficacy and tolerance. After exclusion of the patients on whom there was a contra-indications to the use of anti-arrhythmic drugs, Propafenone was administered orally, on a long-term basis, at the usual dose of 600-900 mg per 24 hours. The efficacy and tolerance were evaluated according to the usual clinical and paraclinical criteria (EKG, Holter) on the 15th day, then every month during the treatment period. The efficacy of the treatment was evaluated as very good in 54 p. cent of the cases, good in 25 p. cent of the cases, average in 8 p. cent of the patients and non-existent or non significant for 13 p. cent of the patients. Electrocardiographic alterations under Propafenone are already described: CF, PR, QRS. A cardiac undesirable side effect occurred 102 times, most often a sinus bradycardia type (n = 26), atrio-ventricular conduction disorders (n = 22) or intraventricular conduction disorders (n = 26), disorders of cardiac decompensation (n = 10) or arrhythmogenic effect (n = 18). Other side effects are gastro-intestinal in nature (taste alterations, nausea, vomiting, gastralgia) for 23 p. cent of the patients treated, neuro-sensorial in origin (dizziness, visual disorders, tremors) for 13 p. cent of the patients or of another nature for 5 p. cent of patients.(ABSTRACT TRUNCATED AT 250 WORDS)
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Malnutrition as the cause of developing atherosclerosis is undoubtedly of major importance. For that reason, proper nutrition and eating habits among the population is of specific significance in preventive medicine. In order to establish a more pronounced food consciousness among the population of Styria, a questionnaire was issued to 1.354 persons attending the Graz Autumn Fair in 1991. The results showed above all that approximately 40% of the subjects investigated presented a disease due to malnutrition and metabolic disorder, mainly hyperlipidemia. The choice of various foods varied according to male and female tastes; roasted pork was more often a men's favourite dish (p < 0.001) while women had a prediction for vegetarian food (p < 0.001). There was, however, no difference in the choice of eating habits in persons with or without metabolic disorders. Thus, women in general do pursue a healthier consciousness was not so pronounced in man. Yet, it could not be established by means of the questionnaire that subjects with metabolic disorders showed different eating habits with respect to their disease.
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