[Audiology in otolaryngology (author's transl)].
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Audiometry↗
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Ethacrynic acid alone and in combination with methyldopa in the management of mild hypertension. A report of 23 patients.
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Adult↗
Penicillamine for scleroderma.
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Animals↗
Clinical manifestations of zinc deficiency.
The essentiality of zinc for humans was recognized in the early 1960s. The causes of zinc deficiency include malnutrition, alcoholism, malabsorption, extensive burns, chronic debilitating disorders, chronic renal diseases, following uses of certain drugs such as penicillamine for Wilson's disease and diuretics in some cases, and genetic disorders such as acrodermatitis enteropathica and sickle cell disease. In pregnancy and during periods of growth the requirement of zinc is increased. The clinical manifestations in severe cases of zinc deficiency include bullous-pustular dermatitis, alopecia, diarrhea, emotional disorder, weight loss, intercurrent infections, hypogonadism in males; it is fatal if unrecognized and untreated. A moderate deficiency of zinc is characterized by growth retardation and delayed puberty in adolescents, hypogonadism in males, rough skin, poor appetite, mental lethargy, delayed wound healing, taste abnormalities, and abnormal dark adaptation. In mild cases of zinc deficiency in human subjects, we have observed oligospermia, slight weight loss, and hyperammonemia. Zinc is a growth factor. Its deficiency adversely affects growth in many animal species and humans. Inasmuch as zinc is needed for protein and DNA synthesis and for cell division, it is believed that the growth effect of zinc is related to its effect on protein synthesis. Whether or not zinc is required for the metabolism of somatomedin needs to be investigated in the future. Testicular functions are affected adversely as a result of zinc deficiency in both humans and experimental animals. This effect of zinc is at the end organ level; the hypothalamic-pituitary axis is intact in zinc-deficient subjects. Inasmuch as zinc is intimately involved in cell division, its deficiency may adversely affect testicular size and thus affect its functions. Zinc is required for the functions of several enzymes and whether or not it has an enzymatic role in steroidogenesis is not known at present. Thymopoeitin, a hormone needed for T-cell maturation, has also been shown to be zinc dependent. Zinc deficiency affects T-cell functions and chemotaxis adversely. Disorders of cell-mediated immune functions are commonly observed in patients with zinc deficiency. Zinc is beneficial for wound healing in zinc-deficient subjects. In certain zinc-deficient subjects, abnormal taste and abnormal dark adaptation have been noted to reverse with zinc supplementation.
Acrodermatitis↗
Hypothalamic serotonin in treatments for feeding disorders and depression as studied by brain microdialysis.
Microdialysis was used to measure changes in extracellular serotonin in the hypothalamus of rats while they engaged in feeding behavior or received drug treatments used to treat feeding disorders and affective disorders in humans. Hypothalamic serotonin increased significantly relative to controls in response to (1) intraperitoneal tryptophan after food deprivation, (2) the smell of food and eating a meal, (3) a conditioned taste aversion, (4) d-fenfluramine and fluoxetine, and (5) an amphetamine challenge test after chronic low doses of lithium. In some cases, increases correlated with nonspecific behavioral arousal were seen in the hippocampus. The results suggest that diet, drug, and behavioral therapies, alone or combined, can be used to preferentially modify hypothalamic serotonin in the control of behavioral, emotional, and endocrine problems.
Animals↗
Sjögren's syndrome: pathogenesis, diagnosis, and treatment.
Sjögren's syndrome (SS) is the most common autoimmune disorder among women. Symptoms occur when the infiltration of immune cells into the salivary and lacrimal glands causes a progressive decline in sight, smell, and taste. Although symptoms seriously disrupt quality of life, the disease's vague manifestations usually prevent individuals from seeking immediate help. By the time a diagnosis is rendered, significant systemic organ involvement may have occurred. Although there is no cure, clinician understanding of the epidemiology, etiology, and pathophysiology of SS enhances its symptomatic management in primary care settings.
Humans↗
Long-term adjustment of survivors of early-stage breast carcinoma, 20 years after adjuvant chemotherapy.
BACKGROUND: The long-term impact of breast carcinoma and its treatment was assessed in 153 breast carcinoma survivors previously treated on a Phase III randomized trial (Cancer and Leukemia Group B [CALGB 7581]) a median of 20 years after entry to CALGB 7581. METHODS: Survivors were interviewed by telephone using the following standardized measures: Brief Symptom Inventory (BSI), PostTraumatic Stress Disorder Checklist with the trauma defined as survivors' response to having had cancer (PCL-C), Conditioned Nausea, Vomiting and Distress, European Organization for Research and Treatment of Cancer QLQ-C30 (quality of life), Life Experience Survey (stressful events), MOS Social Support Survey, comorbid conditions (Older Americans Resources and Services Questionnaire), and items developed to assess long-term breast carcinoma treatment side effects and their interference with functioning. RESULTS: Only 5% of survivors had scores that were suggestive of clinical levels of distress (BSI), 15% reported 2 or more posttraumatic stress disorder (PTSD) symptoms (PCL-C) that were moderately to extremely bothersome, 1-6% reported conditioned nausea, emesis, and distress as a consequence of sights, smells, and tastes triggered by reminders of their treatment, 29% reported sexual problems attributed to having had cancer, 39% reported lymphedema, and 33%, reported numbness. Survivors who reported greater lymphedema and numbness that interfered with functioning had significantly worse PTSD (PCL-C; P = 0.008) com- pared with survivors who reported less lymphedema and numbness. Survivors with a lower level of education (P = 0.026), less adequate social support (P = 0.0033), more severe negative life events (P = 0.0098), and greater dissatisfaction with their medical care (P = 0.037) had worse PTSD compared with other survivors. CONCLUSIONS: Twenty years after the initial treatment, the impact of breast carcinoma on survivors' adjustment was minimal. However, the higher prevalence of PTSD symptoms in response to having had cancer is indicative of continuing psychologic sequelae long after treatment completion. Findings related to lymphedema and numbness and continued symptoms of PTSD suggest that the long-term psychologic and medical sequelae on adjustment may be underrecognized. To establish in more detail whether survivors' overall psychologic state is any different from that of individuals without cancer, a population of community residents without cancer would need to be studied.
Adaptation, Psychological↗
Future directions in chemosensory research.
The past two decades have witnessed phenomenal growth in chemosensory research in the basic sciences and clinical studies. Although chemosensory disorders today are recognized more widely for their marked impacts on QOL and public safety, the increased research focus has yet to translate into significant therapeutic advances for human olfactory or gustatory dysfunction. Nevertheless, it should be expected that active chemosensory research eventually will yield discoveries necessary to generate better treatment options for otolaryngologists and other physicians caring for smell and taste loss patients. As the understanding of chemosensory biology and disease pathophysiology grows, there is great promise that medical science will conquer the frustrating and debilitating health problems posed by olfactory and gustatory dysfunction. Moreover, it is likely that the lessons gained through chemosensory research will apply broadly to a range of human diseases affecting sensory modalities and the central nervous system.
Chemoreceptor Cells↗
[Sialorrhea. Value of isotopic examination (author's transl)].
Three types of sialorrhea can be distinguished: -- deglutition disorders, especially in patients with Parkinson's disease and those with anxiety, -- ptyalomania, -- primary hypersecretion at rest. Functional scintigraphic studies enable a physiological approach to be made, and this tends to group together, under the name of primary hypersecretion at rest, various clinical manifestations occurring in two main groups: -- elderly women complaining of a bitter taste in the mouth, -- plethoric men with large salivary glands. The scintigraphic recording apperances of secretion at rest, which occurs early and without obvious food stimuli, are also noted in other clinical types. It remains to be demonstrated whether they have a common physiopathological basis arising from disorders of the normal sensitivity of the buccal cavity.
Adolescent↗
Substance use in female adolescents with eating disorders.
To determine the prevalence of substance use in adolescents with eating disorders, compare the results with a data set of Ontario high school students, and explore why adolescents with eating disorders do, or do not, use various substances. From January 1999 to March 2000, 101 female adolescents who met the DSM-IV criteria for an eating disorder were followed up in a tertiary care pediatric treatment center. They were asked to participate in a cross-sectional study using a self-administered questionnaire assessing substance use and investigating reasons for use and nonuse; 95 agreed to participate and 77 completed the questionnaire (mean age, 15.2 years). The patients were divided into two groups: 63 with restrictive symptoms only, 17 with purging symptoms. The rates of drug use between subjects and their comparison groups were compared by z-scores, with the level of significance set at.05. During the preceding year, restrictors used significantly less tobacco, alcohol, and cannabis than grade- and sex-matched comparison populations, and purgers used these substances at rates similar to those of comparison subjects. Other drugs seen frequently in the purgers included hallucinogens, tranquilizers, stimulants, LSD, PCP, cocaine, and "ecstasy." Both groups used caffeine and laxatives, but few used diet pills. Restrictors said they did not use substances because they were bad for their health, tasted unpleasant, were contrary to their beliefs, and were too expensive. Purgers generally used substances to relax, relieve anger, avoid eating, and "get away" from problems. Female adolescents with eating disorders who have restrictive symptoms use substances less frequently than the general adolescent population but do not abstain from their use. Those with purging symptoms use substances with a similar frequency to that found in the general adolescent population. Because the sample size for the purging group was small, firm conclusions cannot be drawn from our analysis. Health care providers who treat adolescents with eating disorders are in a good position to identify those who use substances and may be at risk for substance abuse.
Adolescent↗
Back to the future: Valentin Magnan, French psychiatry, and the classification of mental diseases, 1885-1925.
To this day one of the most curious gaps in the historiography of French psychiatry is the era between the fin-de-siècle and the 1920s, years that overlapped the life and career of Valentin Magnan (1835-1916), a pivotal figure in the historical classification of mental diseases. This paper seeks to address this shortcoming as well as contribute to the growing scholarly interest in the history of clinical psychiatry. It argues that Magnan was in many ways a tragic figure, someone who lived and worked at a time when circumstances conspired against him and his efforts to reform psychiatric classification. Essentially Magnan had the misfortune to practise psychiatry when Emil Kraepelin's influence began to spread beyond Germany's borders, sparking a nationalist reaction that penalized both French Kraepelinians and Magnan whose theories shared similarities with Kraepelin's. But Magnan's stature also suffered because of the intense internecine quarrels that arose in late nineteenth-century French psychiatry. Magnan was no helpless victim, though, and there is reason to believe that some of the criticism directed at him was based on documented personal failings. Ultimately, Magnan's theory of psychiatric classification was overtaken by these and other events in French psychiatry, culminating by the interwar period in the emergence of a new national, nosological pardigm that has dominated French psychiatry for most of the twentieth century. Thus Magnan was in many respects a pariah within French psychiatry by the early twentieth century. An examination of his career casts light on this crucial turning-point in the history of French psychiatry and indicates why and how the new model of classification was more to the tastes of his medical colleagues.
Classification↗
Sensory characteristics of beverages prepared with commercial thickeners used for dysphagia diets.
OBJECTIVE: To describe and compare sensory characteristics of six beverages prepared with four commercial thickeners used in dysphagia diets. DESIGN: The study used a completely randomized design within a test of each beverage. SUBJECTS/SETTING: Five highly trained descriptive sensory analysis panelists conducted the testing in a laboratory environment. INTERVENTION: Coffee, milk, apple juice, orange juice, Ensure (Abbott Laboratories, Abbott Park, IL), and water were thickened using two starch-based and two gum-based commercial thickeners according to manufacturers' instructions to achieve nectar-like and honey-like consistencies. MAIN OUTCOME MEASURES: Sensory attributes of the original beverages and the thickened samples were defined and scored. STATISTICAL ANALYSES PERFORMED: Sensory scores were analyzed by analysis of variance using general linear models and Fisher's least significant difference test to determine specific differences. RESULTS: All thickeners suppressed the main flavors of the base beverages and imparted slight off-flavors (bitter, sour, metallic, or astringent) in some beverages. Starch-based thickeners imparted a starchy flavor and grainy texture, whereas gum-based thickeners gave added slickness to the beverages. Although thickeners mixed well with some beverages, they were difficult to disperse in others, making some thickened beverages lumpy. CONCLUSIONS: All thickeners added either a starchy, grainy, or slick flavor or texture and tended to suppress the base flavor of beverages, especially at honey-like consistencies. Thus, individual decisions about which characteristics are more negative (eg, slick vs grainy texture) for specific patients must be made. Additional development of thickening agents seems necessary for improved sensory properties. Information from this article should help professionals and their patients with dysphagia better understand the sensory issues associated with the use of commercial thickening agents in various beverages.
Analysis of Variance↗
Hyperphagia: a necessary precondition to obesity?
Weight-gain is generally attributed to a caloric imbalance resulting from hyperphagia. However, this attribution is often made without observing caloric intakes during the initial accumulation of fat stores. Instead, this conclusion is drawn because many obese organisms overeat, and overconsumption is sufficient to cause weight-gain. The literature is reviewed, specifically those studies on the onset of caloric overconsumption relative to weight-gain and the accumulation of fat during food restriction, which suggests that hyperphagia is not necessary for animals prone to obesity to become fatter and heavier. It is observed that animals with genetically- and surgically-induced obesity often become fat prior to hyperphagia and continue to gain even if food restricted to subnormal levels. Overconsumption does speed this gain.
Animals↗
Pediatric drug formulations of sodium benzoate: I. Coated granules with a hydrophilic binder.
High doses of sodium benzoate are applied in the treatment of some rare metabolic disorders. In most cases children are affected who often refuse the oral uptake of sodium benzoate as a powder or in solution due to its bad taste. Therefore, small-sized, saliva-resistant microcapsules have been developed containing high doses of the drug substance. Granules were produced by roller compacting of sodium benzoate powder without any additives, by solvent-free cold extrusion and hot-melt extrusion adding poly(ethylene glycol)s of different grades. The granules with a diameter of less than 1 mm were film-coated by an ethanolic solution of Eudragit E 100. The microcapsules from hot-melt extrusion containing 25% Macrogol 4000 were most stable during the coating process and showed the highest yields. Sodium benzoate is completely released from the microcapsules within 9 min into 0.1 N HCl and 0.01 N HCl whereas dissolution into buffer pH 6.8 is different in the initial phase and completed after 14 min. The bad taste of sodium benzoate is not recognized in the buccal space for at least 5 min. The microcapsules are stable during storage for at least 6 months.
Capsules↗
Using simultaneous presentation to increase vegetable consumption in a mildly selective child with autism.
A multiple baseline design was used to evaluate the effects of adding condiments on the consumption of previously rejected foods (vegetables). Adding condiments produced increased food acceptance across three food items. Data are discussed in relation to conditioned food preferences and establishing operations.
Adolescent↗
Signs of risk of obesity in newborn babies.
A study if discussed from which it is postulated that newborn babies who are thin (according to skinfold measurement) and who have normal-weight parents are 'buffered against obesity', while newborn babies who have moderate or thick skinfolds and who have overweight parents are at high risk of becoming obese.
Adult↗
Acceptability and viscosity of low cost home processed supplementary foods developed for pre-school children.
Four supplement mixtures using whole wheat, pearl millet, bengal gram, green gram, groundnuts and amaranth leaves were developed employing roasting and malting techniques. Malting used in the formation of the supplements reduced significantly hot paste viscosity of all the four supplements and increased their nutrient density per unit volume. The results of organoleptic trials conducted on rural mothers revealed that taste, texture, colour, aroma, appearance and overall acceptability of all the four supplements were excellent with mean scores of overall acceptability (9.77, 9.33, 9.11 and 8.75) for supplements I, II, III and IV, respectively. Children did not develop any GIT disorders after consuming the products. Trained panelists found all the four supplements acceptable as indicated by Nine point hedonic scale.
Amaranthus↗
[Experimental study on the effect of the topical application of steroids on olfactory disturbance in mice].
Although the topical treatment with steroids is the widespread method for olfactory disorders in human, the reports are limitted to clinical observations. The aim of this report is to evaluate the effect of topically applied of steroids in mice on the repairing course by the experimental olfactory disorders caused by zinc sulfate. The olfaction of mice was estimated by the record of behavioral task, using Cycloheximide, commonly used as repellent in rodents. When mice taste Cycloheximide for the first time, immediately the mice experience a very disagreeable taste leading to the simultaneous memory of the odor of Cycloheximide. Those who once experienced the taste and odor of Cycloheximide, will avoid simply by the odor next time. Two bottles were offered to mice, one containing distilled water and the other 0.01% Cycloheximide. When the mouse drank the distilled water, the response was interpreted as a correct response. When the Cycloheximide solution was chosen, an error. Twenty four mice were tested at ten times during a 10-minute trial, and the rates of correct response were counted. From the next day after the treatment of zinc sulfate, nasal application of 0.1% beta-methasone (group A), or nasal application of distilled water (group B) were applied to each group of twelve mice for five days. The results were as follows. 1. In the first experiment, the correct response was 85% (group A), and 80.8% (group B), however at the second trial, all responses were correct.(ABSTRACT TRUNCATED AT 250 WORDS)
Administration, Intranasal↗