Effects of Insular Cortex Lesions on Conditioned Taste Aversion and Latent Inhibition in the Rat

The present study tested the hypothesis that lesions of the insular cortex of the rat retard the acquisition of conditioned taste aversions (CTAs) because of an impairment in the detection of the novelty of taste stimuli. Demonstrating the expected latent inhibition effect, nonlesioned control subjects acquired CTAs more rapidly when the conditioned stimulus (0.15% sodium saccharin) was novel rather than familiar (achieved by pre-exposure to the to-be-conditioned taste cue). However, rats with insular cortex lesions acquired taste aversions at the same slow rate regardless of whether the saccharin was novel or familiar. The pattern of behavioural deficits obtained cannot be interpreted as disruptions of taste detection or stimulus intensity, but is consistent with the view that insular cortex lesions disrupt taste neophobia, a dysfunction that consequently retards CTA acquisition because of a latent inhibition-like effect

Olfactory evaluation in obstructive sleep apnoea patients

The sense of smell has a high impact on the quality of life. The aim of the present study was to investigate olfactory dysfunction in patients with obstructive sleep apnoea syndrome (OSAS) and correlate the severity of disease with olfactory dysfunction. The relationships between nasal obstruction, nasal mucociliary cleareance and olfactory tests were also evaluated. Sixty patients with a diagnosis of OSAS were enrolled and underwent olfactory function evaluation. In all patients olfactory performance was tested with the Sniffin’ Sticks method. Mucociliary transport times and anterior rhinomanometry were performed to identify eventual nasal obstruction and deficits in nasal mucociliary clearance. Olfactory dysfunction was present in 22 (36.6%) patients of the study group: of these, hyposmia was present in 19 (86.4%) and anosmia in 3 (13.6%). The mean TDI score in the study group was 30. A strong correlation between the olfactory dysfunction and severity of sleep apnoea measured using the AHI was found. Patients with OSA would seem to have a high incidence of olfactory dysfunction. The degree of olfactory dysfunction appears to be related to the severity of disease. However, other co-factors such as nasal obstruction and reduced mucociliary clearance might also play a role in of the aetiology of this condition

Neurological manifestations and neuro-invasive mechanisms of the severe acute respiratory syndrome coronavirus type 2

Background and purpose Infections with coronaviruses are not always confined to the respiratory tract and various neurological manifestations have been reported. The aim of this study was to perform a review to describe neurological manifestations in patients with COVID-19 and possible neuro-invasive mechanisms of Sars-CoV-2. Methods PubMed, Web of Science and COVID-dedicated databases were searched for the combination of COVID-19 terminology and neurology terminology up to 10 May 2020. Social media channels were followed up between 15 March and 10 May 2020 for postings with the same scope. Neurological manifestations were extracted from the identified papers and combined to provide a useful summary for the neurologist in clinical practice. Results Neurological manifestations potentially related to COVID-19 have been reported in large studies, case series and case reports and include acute cerebrovascular diseases, impaired consciousness, cranial nerve manifestations and autoimmune disorders such as the Guillain-Barre syndrome often present in patients with more severe COVID-19. Cranial nerve symptoms such as olfactory and gustatory dysfunctions are highly prevalent in patients with mild to moderate COVID-19 even without associated nasal symptoms and often present in an early stage of the disease. Conclusion Physicians should be aware of the neurological manifestations in patients with COVID-19, especially when rapid clinical deterioration occurs. The neurological symptoms in COVID-19 patients may be due to direct viral neurological injury or indirect neuroinflammatory and autoimmune mechanisms. No antiviral treatments against the virus or vaccines for its prevention are available and the long-term consequences of the infection on human health remain uncertain especially with regard to the neurological system

Taste and olfaction in middle ear surgery

OBJECTIVE: The aim of this study was to assess pre- and postoperative taste ability in patients undergoing middle ear surgery for otosclerosis or chronic otitis media. Olfactory function was also evaluated to rule out taste deficits due to concomitant nasal pathology. METHODS: All patients underwent ear, nose, and throat examination, otomicroscopy, nasal endoscopy, anterior rhinomanometry, taste testing, and olfactory testing. Patients were evaluated at 1 to 5 days preoperatively (T0), and at 1 (T1), 6 (T6), and 12 (T12) months postoperatively. RESULTS: Both groups of patients experienced worsening of the mean taste threshold postoperatively. This phenomenon was more serious in poststapedotomy patients. Follow-up showed progressive improvement in both groups. All values of olfactory testing were within the normal range for otosclerosis patients. Patients with chronic otitis media showed variable postoperative findings. CONCLUSION: Chorda tympani function can be negatively affected by middle ear surgery. Deficits may be more marked in stapedotomy patients than in those undergoing tympanoplasty. Postoperative recovery of taste is satisfactory, although with different timelines for the 2 types of patholog

Management of erectile dysfunction with a novel orodispersible formulation of the PDE-5 inhibitor vardenafil

Erectile dysfunction (ED) is a medical condition which can affect men of all ages. As men live longer and the prevalence of cardiovascular disease and diabetes continue to increase, the problem of ED will become more prominent. The condition affects men both physically and emotionally. The profound psychological effect that this condition has on men should not be underestimated. A man with the problem of ED may feel robbed of his identity, may develop feelings of dissatisfaction with life in addition to anxiety, depression, low self-esteem and a decrease in quality of lifepeer-reviewe

Expanding the spectrum of impulse control disorders in Parkinson's disease: the phenomenology of sweet craving

Thesis (M.A.)--Boston UniversityBackground: The recognized spectrum of impulse control disorders in Parkinson’s disease (PD) includes pathologic gambling, hypersexuality, compulsive buying, and binge eating, and is commonly related to exposure to dopamine agonist medications. Sweet craving in the general population is a phenomenon that is closely linked to several factors, including poor impulse control. Craving for sweets, though recognized to occur in PD, has not previously been studied. Methods: First, patients with idiopathic PD and normal controls who reported craving sweets completed craving questionnaires (CQ), taste threshold testing, assessment of mood symptoms and olfactory testing. CQ scores were correlated with these results and other demographic information. A pathologic craving score was identified as the 75th percentile of the mean CQ score for all PD patients. Second, patients with PD and controls completed a series of questionnaires addressing the presence of a variety of impulse control disorders and sweet craving to determine the prevalence of sweet craving in PD and disease and medication-related factors that are associated with each. Results: Craving for sweets is present in about 5.5% of patients with idiopathic PD. Similar to the determinants of other ICDs, determinants of sweet craving include female gender (p=0.0001), decreased olfactory function (t-test: p=0.0001; fisher’s exact method: comparing QSIT scores of 0 and 2 (p=0.0179), 0 and 3 (p=0.0182)), self-reported current or past history of depression (p=0.048) and obsessive-compulsive traits (p=0.044), higher Hoehn & Yahr staging (p=0.0001; fisher’s exact method: no significance), younger onset of disease (p=0.015), and longer duration of disease (p=0.003). Conclusions: Craving for sweets in PD is similar in its phenomenology to other recognized ICDs in this population of patients. Though the potential implications of this behavior may be less hazardous than those of other pathologic behaviors, it broadens the spectrum of ICDs that should be recognized in PD and discussed with patients

Smell and taste disorders in the UK: first experiences with a specialised smell and taste outpatient clinic

Olfactory dysfunction is common, affecting 1‐5% of those under the age of 60 1 and at least 20% of those aged more than 60 years. 2 In many UK centres, the approach to it is variable and routine olfactory testing is not performed, as noted by a recent survey of British ENT surgeons. 3 This is in contrast to Europe and the USA, where many specialist smell and taste centres already exist

Dietary-Free Glutamate: Implications for Research on Fear-Overconsolidation and PTSD

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Anosmia and Ageusia as the Only Indicators of Coronavirus Disease 2019 (COVID-19)

The patient is a 60-year-old woman with a history of vertigo and seasonal allergies who presented to the hospital with the chief complaint of headache. Radiological findings were negative for intracranial abnormalities. The headache was due to trigeminal neuralgia. She had concurrent complaints of anosmia and ageusia without fever, respiratory symptoms, or obvious risk factors. However, it was determined to test the patient for coronavirus disease 2019 (COVID-19) infection despite extremely low clinical suspicion. Unfortunately, she was found to be COVID-19 positive after she was discharged from the hospital while she remained asymptomatic. There is currently a lack of published case reports describing COVID-19 patients with the sole symptoms of anosmia and ageusia in the United States of America

Improving differential diagnosis of vocal cord dysfunction

textPurpose: The purpose of this study was to assess whether the factors historically presented in the literature to differentiate vocal cord dysfunction (VCD) from breathing difficulties of other etiologies accurately predict and identify patients who have VCD. The researchers were also interested in whether patients with VCD have a higher risk of misdiagnosis than patients with breathing difficulties of other etiologies. Finally, the present study investigated whether patients with VCD were more likely to have their symptoms attributed to psychological factors than patients with breathing difficulties of other etiologies. Method: A survey comprised of 23 questions regarding the participants’ previous and current diagnoses, triggers that precede breathing difficulty, and whether or not the participants have ever been misdiagnosed was posted to internet support groups, websites, blogs, and forums. The final participant pool included 20 participants with VCD and 25 participants with asthma. Results: None of the factors investigated accurately differentiated participants with asthma from participants with VCD one hundred percent of the time. However, participants with VCD were more likely to report throat tightness during an attack, association of an attack with symptoms of acid reflux, and rapid resolution of symptoms without treatment. Conversely, participants with asthma were more likely to report expiratory stridor and chest tightness, full resolution of symptoms with use of asthma medications, nocturnal symptoms or symptoms just after waking, and symptoms that seemed to be triggered by environmental agents or allergens. Preliminary findings from the present study suggest that patients with VCD are both more likely to receive a misdiagnosis and have their symptoms attributed to psychological factors than participants with asthma. Conclusion: A diagnosis of VCD must be made very carefully, ideally with instrumental evaluation of the vocal mechanism during an acute “attack” of breathing difficulty. The factors identified in the literature to differentially diagnose patients with asthma from patients with VCD do not accurately differentiate these populations. These findings suggest that continued education about the nature of VCD and differential diagnosis should be paramount to medical professionals.Communication Sciences and Disorder