Alterations In Smell Research Articles

Alteration of Smell and Taste Sensations in Covid-19 Positive Patients: A Prospective Cohort Study in Western India.

Loss/alteration of Smell and taste sensation is common in CoViD-19 infection. We conducted present study to find out the frequency, onset and severity of these lost sensations and their recovery in mild, moderate and severe COVID 19 positive patients in our setup. A questionnaire based study on 574 COVID-19 positive patients admitted in a dedicated COVID hospital between September–November, 2020 were followed up until their sensations recovered completely or maximum for two months. Fever was the most common symptom reported. Loss of smell and taste sensation is seen in 200 (34.84%) and 269 (46.86%) patients respectively; 163 (28.4%) developed both. Males were affected significantly more than females (p = 0.030 and 0.027). Approximately 1/4th patients [49 (24.5%) and 55 (20.45%)] reported loss of smell and taste sensation as their first symptom. Most common taste sensation lost was salty 191 (71.0%). Loss of smell sensation is seen maximally in mild cases and the difference among mild, moderate and severe cases is statistically significant (p = 0.00001); while the difference in loss of taste among all three grades of severity is statistically insignificant (p = 0.0770). Most of the patients [smell (142; 71%) and taste (198; 73.6%)] recovered after 2 weeks of onset of lost sensations while 96.5% (193/200) and 98.1% (264/269) patients reported complete recovery of smell and taste sensations after two months of onset. Present study shows that high percentage of COVID-19 positive patients develop loss of either one or both of smell and taste sensations but recovery is fast and complete in most of them.

Oral and Periodontal Manifestations of COVID-19 and its Plausible Association with Periodontal Disease

The coronavirus disease 2019 (COVID-19), has caused a significant and urgent threat to the global health. It has markedly affected the delivery of healthcare services all over the world. Early diagnosis of the disease is imperative to contain the spread of the viral infection. The virus can also lead to potential systemic complications such as lungs involvement, skin, and oral manifestations. The presence of oral lesions is emerging evidence that may indicates the presence of COVID-19 infection. Since, the virus has affinity for Angiotensin Converting Enzyme (ACE2) receptors present in the respiratory tract, oral mucosa, tongue and salivary glands; therefore, the oral cavity serves as a major habitat for invasion of the virus. This review aimed to discuss the oral and periodontal manifestations of COVID-19. Articles between December 2019 and April 2021 were searched for this narrative review in Pub Med, Scopus, Science Direct related to COVID-19 and its oral manifestations, using the following terms: “Corona virus,” “COVID-19,” and “SARS-CoV-2” in combination with “Stomatognathic diseases,” “Oral manifestation,” and “Mouth diseases” and "Periodontal diseases". The oral manifestations commonly associated with COVID-19 are salivary gland disorders, xerostomia, alteration of taste and smell and lesions in oral mucosa. The appearance of these oral manifestations during the asymptomatic phase of disease helps in early identification of the disease. The recent COVID-19 infection has been strongly associated with the appearance and establishment of cytokine storm. It is found that many components of the cytokine storm are common with the cytokine expression found in periodontitis. This narrative review aims at exploring the association between COVID-19 and periodontal disease through their cytokine profiles.

Future Challenges of Covid-19 and Oral Manifestations in Daily Dental Practice: A Literature Review.

ABSTRACTObjective:Some patients reportedly present with oral manifestations of coronavirus disease 2019 (Covid-19). It is unknown if this is due to the virus itself or a side effect of treatment; however, severe acute respiratory syndrome coronavirus 2 has been shown to have a predilection for angiotensin-converting enzyme receptors that are present in the respiratory tract, oral mucosa, tongue, and salivary glands, causing alterations in taste and smell. Therefore, the objective of this review was to present the future challenges of Covid-19 and oral manifestations in daily dental practice through a literature review.Materials and Methods:Scientific evidence in the databases Scopus and PubMed was searched using the Boolean operators. Articles published in Spanish and English between January and December 2020 were included.Results:Of the 89 articles found in Scopus, 69 were of the open access type and 20 were in the “others” category; only 22 scientific articles were found in PubMed.Conclusion:It is important to take into account these clinical manifestations such as loss of taste and smell in order to detect the disease. Good oral hygiene is also recommended as a preventive measure to reduce viral load, which considerably reduces the probability of infecting other people who are in contact with the infected patient.

Alteration of Smell and Taste in Asymptomatic and Symptomatic COVID-19 Patients in Sicily, Italy.

Alteration of smell and taste has been reported in patients with coronavirus disease 2019 (COVID-19). The incidence and clinical-symptomatic manifestation of COVID-19 is different between northern and southern Italy. This study aims to evaluate the onset of alteration of smell and taste in asymptomatic and symptomatic patients in Sicily (extreme south of Italy). This prospective cross-sectional study was performed on asymptomatic and symptomatic COVID-19 patients tested for severe acute respiratory syndrome-coronavirus-2 (SARS-CoV-2) from May 1 to May 15, 2020. A questionnaire was used for evaluating the prevalence of smell and taste disorders in COVID-19 patients before performing nasopharyngeal swab. Of the total 292 patients, 242 (83.2%) were negative for SARS-CoV-2 and 50 were positive (16.8%). Twenty-six of the 50 (52%) SARS-CoV-2 positive patients reported smell/taste disorders. Twenty-eight of the 50 (57.1%) SARS-CoV-2 positive patients were hospitalized (group A), and 22 (42.9%) were nonhospitalized (group B). The mean age in group A and group B was 45.4 ± 13.7 years and 57.0 ± 15.0, respectively (P = .007). The symptoms reported by hospitalized patients were fever (71.4%), cough (64.2%), fatigue (82.1%), and dyspnea (100%), while in nonhospitalized patients, the most reported symptoms were sore throat (72.7%), rhinorrhea (77.2%), and altered smell (81.8%). Anosmia/hyposmia reported in group A and group B was 28.5% and 81.8%, respectively (P = .001). These preliminary results indicate that the majority of SARS-Cov-2 positive patients in southern Italy did not require hospitalization and presented with milder symptoms or no symptoms and the alterations in smell and taste occurred.

Factor structure and age invariance of the Cardiff Anomalous Perceptions Scale (CAPS) in healthy older and younger adults.

Although anomalous perceptual experiences are common in healthy older adults, they remain poorly characterized. In particular, it is unclear whether the phenomenology of these experiences differs between healthy older and younger adults. The current study examined similarities and differences in the factor structure of the Cardiff Anomalous Perceptions Scale (CAPS) in healthy, community-dwelling older (n = 194; Mage = 71.89, SD = 7.74, range = 52-91; 69.1% female) and younger adults (n = 421, Mage = 19.40, SD = 2.44, range = 17-34; 69.6% female; N = 615), using exploratory and confirmatory factor analysis, together with measurement invariance testing. The results found that a 2-factor correlated model comprising 23 of the original 32 CAPS items provided the best fit to the data. Further, scalar invariance was found between the two samples, indicating equivalence of the factor structure, factor loadings, and thresholds by age group. Compared with younger adults, the latent group means of older adults were also found to be equal on Factor 1, but significantly lower on Factor 2. Evidence of scalar age invariance on the CAPS suggests that this tool is valid for making comparisons between older and younger adults on two dimensions of anomalous perceptual experiences. Further, the results suggest that anomalous perceptions in the general community may be characterized by two components: anomalous body-centered self-experiences (e.g., alterations in body, touch, smell, and taste perception) and anomalous external experiences (e.g., auditory, visual, and sensed presence hallucinations); each of which may have different causes, correlates, and consequences for healthy ageing. (PsycInfo Database Record (c) 2020 APA, all rights reserved).

Radiation-induced neuropathies in head and neck cancer: prevention and treatment modalities.

Head and neck cancer (HNC) is the sixth most common human malignancy with a global incidence of 650,000 cases per year. Radiotherapy (RT) is commonly used as an effective therapy to treat tumours as a definitive or adjuvant treatment. Despite the substantial advances in RT contouring and dosage delivery, patients suffer from various radiation-induced complications, among which are toxicities to the nervous tissues in the head and neck area. Radiation-mediated neuropathies manifest as a result of increased oxidative stress-mediated apoptosis, neuroinflammation and altered cellular function in the nervous tissues. Eventually, molecular damage results in the formation of fibrotic tissues leading to susceptible loss of function of numerous neuronal substructures. Neuropathic sequelae following irradiation in the head and neck area include sensorineural hearing loss, alterations in taste and smell functions along with brachial plexopathy, and cranial nerves palsies. Numerous management options are available to relieve radiation-associated neurotoxicities notwithstanding treatment alternatives that remain restricted with limited benefits. In the scope of this review, we discuss the use of variable management and therapeutic modalities to palliate common radiation-induced neuropathies in head and neck cancers.

Alterations in Smell During Pregnancy: Myth or Fact?

To compare the olfactory functions of pregnant and non pregnant females draining the tribal tertiary care centre. Odor identification (OI), odor discrimination (OD) and odor threshold (OT) in subjects and control group with no previous Sino-nasal symptoms or pathology were included in the study. Mean scores of all the parameters were calculated in both the groups. Group A being of 60 pregnant females in 1st trimester and Group B constituted 60 non pregnant females as control group. Both the groups were matched for Age and Normal Mucociliary clearance range. Modified Indian Smell Identification Kit was used to assess all parameters. Before doing objective olfactory assessment all the study participants were given questionnaire for subjective assessment of olfaction in which we found significant impairment in drinking beverage and fragrance perception of flowers in pregnant females compared to non pregnant females. We also found there was no significant difference in mean scores of various olfactory parameters in multigravida and non pregnant females. The mean OI score in both groups was 9.54 ± 1.87 and 8.70 ± 1.62 respectively. Mean OD score of the two groups was 8.80 ± 2.61 and 9.80 ± 2.61 respectively and the mean OT score of both the groups was 6.99 ± 4.63 and 4.13 ± 2.48 respectively.

COVID-19 is associated with clinically significant weight loss and risk of malnutrition, independent of hospitalisation: A post-hoc analysis of a prospective cohort study

Background & aimsCoronavirus disease 2019 (COVID-19) may associate with clinical manifestations, ranging from alterations in smell and taste to severe respiratory distress requiring intensive care, that might associate with weight loss and malnutrition. We aimed to assess the incidence of unintentional weight loss and malnutrition in COVID-19 survivors.MethodsIn this post-hoc analysis of a prospective observational cohort study, we enrolled all adult (age ≥18 years) patients with a confirmed diagnosis of COVID-19 who had been discharged home from either a medical ward or the Emergency Department of San Raffaele University Hospital, and were re-evaluated after remission at the Outpatient COVID-19 Follow-Up Clinic of the same Institution from April 7, 2020, to May 11, 2020. Demographic, anthropometric, clinical and biochemical parameters upon admission were prospectively collected. At follow-up, anthropometrics, the mini nutritional assessment screening and a visual analogue scale for appetite were assessed.ResultsA total of 213 patients were included in the analysis (33% females, median age 59.0 [49.5–67.9] years, 70% overweight/obese upon initial assessment, 73% hospitalised). Sixty-one patients (29% of the total, and 31% of hospitalised patients vs. 21% of patients managed at home, p = 0.14) had lost >5% of initial body weight (median weight loss 6.5 [5.0–9.0] kg, or 8.1 [6.1–10.9]%). Patients who lost weight had greater systemic inflammation (C-reactive protein 62.9 [29.0–129.5] vs.48.7 [16.1–96.3] mg/dL; p = 0.02), impaired renal function (23.7% vs. 8.7% of patients; p = 0.003) and longer disease duration (32 [27–41] vs. 24 [21–30] days; p = 0.047) as compared with those who did not lose weight. At multivariate logistic regression analysis, only disease duration independently predicted weight loss (OR 1.05 [1.01–1.10] p = 0.022).ConclusionsCOVID-19 might negatively impact body weight and nutritional status. In COVID-19 patients, nutritional evaluation, counselling and treatment should be implemented at initial assessment, throughout the course of disease, and after clinical remission.Clinicaltrials.gov registrationNCT04318366.

Smell and Taste Disorders in COVID-19 Patients: Objective Testing and Magnetic Resonance Imaging in Five Cases

Smell and taste disorders are acknowledged as characteristic symptoms for SARS-CoV-2 infection by now. These symptoms have been linked to a neuroinvasive course of disease. In this study, we investigated five consecutive COVID-19 patients with a prolonged course of dysosmia and dysgeusia. Those with objectifiable alteration in taste or smell were subjected to MRI with contrast agent to investigate possible involvement of the central nervous system. We found dysosmia and dysgeusia to be mostly objectifiable, but no evidence for neuroinvasiveness could be detected by MRI in the late stage of the disease. Alterations in taste and smell could be objectified in most patients. Nevertheless, no evidence for a neuroinvasive potential could be identified by MRI, at least in the late stage of disease. We encourage medical professionals to conduct specialized examinations and MRIs in the acute stage of disease, which guarantees an optimum patient care.

Giant Cell Arteritis and COVID-19: Similarities and Discriminators. A Systematic Literature Review.

To identify shared and distinct features of giant cell arteritis (GCA) and coronavirus disease 2019(COVID-19) to reduce diagnostic errors that could cause delays in correct treatment. Two systematic literature reviews determined the frequency of clinical features of GCA and COVID-19 in published reports. Frequencies in each disease were summarized using medians and ranges. Headache was common in GCA but was also observed in COVID-19 (GCA 66%, COVID-19 10%). Jaw claudication or visual loss (43% and 26% in GCA, respectively) generally were not reported in COVID-19. Both diseases featured fatigue (GCA 38%, COVID-19 43%) and elevated inflammatory markers (C-reactive protein [CRP] elevated in 100% of GCA, 66% of COVID-19), but platelet count was elevated in 47% of GCA but only 4% of COVID-19 cases. Cough and fever were commonly reported in COVID-19 and less frequently in GCA (cough, 63% for COVID-19 vs 12% for GCA; fever, 83% for COVID-19 vs 27% for GCA). Gastrointestinal upset was occasionally reported in COVID-19 (8%), rarely in GCA (4%). Lymphopenia was more common in COVID-19 than GCA (53% in COVID-19, 2% in GCA). Alteration of smell and taste have been described in GCA but their frequency is unclear. Overlapping features of GCA and COVID-19 include headache, fever, elevated CRP and cough. Jaw claudication, visual loss, platelet count and lymphocyte count may be more discriminatory. Physicians should be aware of the possibility of diagnostic confusion. We have designed a simple checklist to aid evidence-based evaluation of patients with suspected GCA.

Función sensorial y dependencia en adultos mayores con enfermedad crónica

Introducción: Con el envejecimiento se presentan cambios en los sentidos y en consecuencia, alteraciones en la función del gusto y olfato que influyen en la descompensación de enfermedades crónicas. Objetivo: conocer la función sensorial y su asociación con la dependencia para realizar Actividades básicas de la vida diaria e Instrumentales en adultos mayores con enfermedad crónica. Metodología: studio correlacional en una muestra de 96 participantes. Instrumentos utilizados: Carta Snellen, Audiómetro Manual, monofilamento de Semmes-Weinstein, prueba de aromas de Gustos Básicos e Índice de Barthel. El análisis estadístico implicó estadística descriptiva e inferencial, correlación de Spearman, U de Mann-Whitney. Resultados: El 71% de los participantes presentó alteración visual. 48% obtuvo audición normal en oído izquierdo y 43% oído derecho, 24% calificó con alteración táctil del pie izquierdo y 30% en pie derecho. Alteración de olfato y gusto en 77%. Presentaron dependencia en actividades Básicas (ABVD) 40%, 24 % en Instrumentadas (AIVD). Se identificó relación entre el tacto en ambos pies y agudeza auditiva con ABVD (p= <.05). La edad y AIVD (p=<.001) agudeza tacto pie izquierdo(p=<.031), auditiva(p=< .005), olfato (p=.018) y gusto (p= <.047). La dependencia en ABVD no presentó diferencia en la prueba con anteojos (U=146.000; p= <.754) y sin anteojos (U=127.500; p=.079); de igual manera en AIVD con anteojos (U=115.000; p= <.079) y sin anteojos (U=160.000; p=.202). Conclusión. A mayor función en los sentidos de tacto y oído, menor dependencia para realizar las ABVD y a mayor función del tacto, oído, olfato y gusto menor dependencia en las AIVD.

The Neurological Complexities and Prognosis of COVID-19.

Several neurological manifestations and complications linked to SARS-CoV-2 have been reported along with well-known respiratory pathology. The global active transmission of SARS-CoV-2 and its unexplained characteristics has led to a pandemic. Since its rapid emergence from Wuhan, China, in December 2019, several studies have reported the impacts of COVID-19 on the CNS and PNS and its implications. This comprehensive review article comprises case reports, case series, metaanalysis, cohort studies, retrospective studies, and narrative reviews focusing on COVID-19-associated CNS and PNS complexities. The authors searched for over 200 articles and used 52 publications related to the neurological complexities of COVID-19 affecting the CNS and PNS as part of the literature review process. The predominant CNS symptoms noted in COVID-19 patients were headaches and dizziness, and the most common PNS symptoms were alterations in smell and taste. Case reports on headache/dizziness, intracerebral hemorrhage, acute hemorrhagic necrotizing encephalopathy, meningitis/encephalitis, encephalopathy, cerebrovascular events, chemosensory dysfunction, Guillain–Barre syndrome, and acute transverse myelitis/acute necrotizing myelitis in PCR-confirmed SARS-CoV-2 subjects are also reported. New-onset neurological symptoms were also observed in children with PCR-confirmed SARS-CoV-2 that developed pediatric multisystem inflammatory syndrome (PIMS). This comprehensive review article will assist the clinicians and researchers to gain information about the neurological manifestations and complications associated with COVID-19 and develop planning to treat these symptoms in concerned patients of all ages. However, it is unclear whether SARS-CoV2-associated neurological effects are due to primary infections or secondary response to the possible mechanisms discussed in this review.

Letter: Anosmia in COVID-19: Severe Acute Respiratory Syndrome Coronavirus 2 Through the Nasoliary Epithelium and a Possible Spreading Way to the Central Nervous System-A Purpose to Study.

To the Editor: Italy is currently one of the countries most affected by the global emergency of COVID-19, a lethal disease of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2).1 A lot of emergency centers from China,2 United Kingdom, and Italy,3 including our Department of Policlinic Umberto I of Rome, reported a significant number of COVID-19 patients presenting anosmia and ageusia as onset symptoms,4 and it is reported that anosmia appear at an early stage of the disease.2-4 There are 3 well-described syndromes in the current SARS-CoV-2 outbreak: asymptomatic, mild upper respiratory disease, and severe systemic disease. This minor and nonspecific symptomatology can represent the only manifestation of the disease in asymptomatic or in the mild form of the disease, but we have also noticed an asymptomatic anosmia during the early stages of COVID-19. These data poorly correlate with other studies reporting anosmia as the onset manifestation of the disease in only 5.1% of patients.2 It seems that this chemosensory dysfunction is present in 30% to 40% of all symptomatic patients.3,5 It is not possible to understand with certainty whether SARS-CoV-2 causes olfactory dysfunction through mechanisms other than nasal obstruction (a subsequent postviral olfactory dysfunction [PVOD] onset) or it may persist in resident cells, olfactory cells, and may become a factor or cofactor of a possible recurrence and a source of spread of the disease. Based on a recent work,5 it seems to be that the olfactory system (OS), despite being highly efficient at controlling neuroinvasion in normal conditions, is the main route of propagation within the central nervous system (CNS) used by human coronaviruses and respiratory viruses.6 PURPOSE OF STUDY Considering that the evidence of a specific virus in the nasal cavity is not equal to the persistence of the virus within the olfactory cells and that it has been shown that epithelium can be safely biopsied,7 we aim at withdrawing a sample of nasal mucosa of patients with proven serological diagnosis of COVID-19, in order to investigate the involvement of the upper nasal (ethmoidal) mucosa by SARS-CoV-2, through a minimally invasive endoscopic nasal procedure. Mucous fresh-frozen samples are taken to be sent for transmission nuclear magnetic resonance (NMR) microscopy study. With a reduction in olfactory function, we would have expected to also find a reduction in olfactory bulb volume, as it has been found to positively correlate with the performance of OS in healthy subjects.8 We also wanted to determine the clinical outcome of patients affected by SARS-CoV-2 experiencing alteration of taste and smell in order to better characterize these clinical manifestations and acquire information on the pathogenesis. In order to postulate a possible clinical screening tool to orientate testing of paucisymptomatic individuals, we aim at studying a correlation between progression of anosmia, clinical status, radiological pulmonary status, and presence and quantity of the virus in the nasal mucosa. DISCUSSION There is now a well-recognized association of a complete subjective loss of smell and taste over 24 to 72 h without other significant symptoms of a respiratory influence with SARS-CoV-2 in the current pandemic with multiple reports of smell loss with the infection,2-5 but we cannot recognize it as a typical isolated sudden onset anosmia (ISOA) or as a rhinological/neurological symptom of SARS-CoV-2. We do not know if this indeterminate symptom may or may not have a diagnostic or prognostic significance on the pathology. We prompt all healthcare practitioners with patients presenting with onset of anosmia to treat these patients as possible COVID-19 positive with appropriate precautions and to avoid the use of immunosuppressants and intranasal steroids, which although seem to be of relatively low risk can have an impact on the presumed neurological cause of the anosmia and increased risks of immunosuppression in the current pandemic. Disclosures The authors have no personal, financial, or institutional interest in any of the drugs, materials, or devices described in this article.

Vieillissement et troubles du goût et de l’olfaction

Compared with other sensory modalities, age-related alterations in taste and smell are less known and less investigated in clinical practice. In fact, the elderly with a loss of smell or taste may not always report it or be aware of it. In addition, the clinical evaluation of taste and smell by specific tests is rarely performed.

La anosmia como síntoma temprano en pacientes con COVID-19

From the time of knowledge of the outbreak appearance in mid-December 2019 due to the new coronavirus (SARS-CoV-2) in the city of Wuhan, China, epidemiologic and clinical studies have been developing to best define the symptomatology of the disease from coronavirus 2019 (COVID-19). However, within some significant reports, we have been informed that one of the initial symptoms of this disease can also be alterations in smell and taste (30 and 60% in the Korean and German series, respectively).

Alterations in Smell or Taste in Mildly Symptomatic Outpatients With SARS-CoV-2 Infection

Michael Eliezer, MD; Charlotte Hautefort, MD; Anne-Laure Hamel, MD; Benjamin Verillaud, MD; Philippe Herman, MD, PhD; Emmanuel Houdart, MD, PhD; Corinne Eloit, MD

Assessment of symptom severity in chronic rhinosinusitis with and without polyps- a prospective study in tertiary care centre at Mandya

Chronic Rhinosinusitis has been classified into Chronic Rhinosinusitis with Polyps (CRSwNP) and Chronic Rhinosinusitis without Polyps (CRSsNP) in accordance with the manifestation of the chronic inflammatory process affecting the Sinonasal mucosa. Two subtypes of CRS have varied clinical and radiologic manifestations. Wide range of symptoms and their severity significanty affects the quality of living which can be systematically assessed using QOL questionnaire. Objectives: To assess the symptoms severity using SNOT 22 questionairre in CRSwNP and CRSsNP. Using the above data, the possibility of diagnosis of presence or absence of nasal polyps by symptom analysis will be correlated Materials and Methods: Duration of the study was two years from May 2016 to April 2018 and Convenient (purposive)sampling method was used for sampling. SNOT 22 sino nasal outcome test questionnaire, a validated tool was used to assess the patients. All these patients were evaluated according to the standard laboratory profiles of allergy. Analysis Data was entered into Microsoft Excel (Windows 7; Version 2007) and analyses were done using the Statistical Package for Social Sciences (SPSS) for Windows software (version 22.0; SPSS Inc, Chicago). Results: While Nasal obstruction was the most important symptom, Smoking tobacco(cigarettes) was also the most important characteristic that significantly affected both groups. Headache, Facial pain and Pressure were also universally present in both groups. Seromucinous Rhinorrhoea (4.03 vs 1.79; p value 0.001), Sneezing (4.24 vs 2.35; p value 0.001), Alteration of Taste and Smell (3.64 vs 1.25; p value 0.001) were also the factors that affected the quality of life. Conclusion: There is a considerable overlap in the presentation and no actual correlation can be made by using only symptomatology as a tool. Endoscopic and CT scan findings are the most important entities to finally differentiate these two conditions along with immunological studies.

Association of alterations in smell and taste with depression in older adults.

ObjectiveExamine the relationship between depression and changes in smell or taste.Study DesignCross‐sectional analysis of 2011–2012 and 2013–2014 National Health and Nutrition Examination Survey (NHANES).MethodsWe examined 5,275 adults ≥40 years old who completed smell and taste questionnaires as well as a validated depression assessment instrument, the Patient Health Questionnaire (PHQ‐9). Analyses incorporated sampling weights to account for the complex sampling design and associations were analyzed using multivariate logistic regression adjusted for related demographics and socioeconomic data.ResultsThe prevalence of altered smell and taste was 23.0% (95% CI: 20.7–25.3%) and 11.9% (95% CI: 10.7–13.1%), respectively. Among those who met criteria for major depressive disorder, the prevalence of altered smell and taste was higher at 39.8% (95% CI: 33.4–46.1%) and 23.7% (95% CI: 18.7–28.7%), respectively. In a multivariate model adjusting for age, gender, education, major comorbidities, smoking history, heavy alcohol use, sinus disease, cold symptoms, and trauma history, adults ≥40 and <65 years old who reported alterations in smell (OR: 1.64, p = 0.004) and adults ≥40 years old who reported alterations in taste (OR: 1.77, p = 0.001) were more likely to meet criteria for major depressive disorder.ConclusionThere is a strong association between major depression and alterations in smell and taste among certain age groups in the general U.S. population. Primary care providers should screen for depression when patients report changes in smell or taste.Level of Evidence4.

Epilepsy Surgeries Requiring an Operculoinsular Cortectomy: Operative Technique and Results.

Epilepsy surgeries requiring an operculoinsulectomy pose significant difficulties because the perisylvian area is highly vascular, deep, and functional. To report the operative technique and results of epilepsy surgeries requiring an operculoinsular cortectomy at our institution. The data of all consecutive patients who had undergone an epilepsy surgery requiring an operculoinsular cortectomy with a minimum follow-up of 1 yr were reviewed. Tumor and vascular malformation cases were excluded. Surgical techniques are described based on findings during surgery. Twenty-five patients underwent an epilepsy surgery requiring an operculoinsular cortectomy: mean age at surgery was 35 y (9-51), mean duration of epilepsy was 19 y (5-36), 14 were female, and mean duration of follow-up was 4.7 y (1-16). Magnetic resonance imaging of the operculoinsular area was normal or revealed questionable nonspecific findings in 72% of cases. Investigation with intracranial EEG electrodes was done in 17 patients. Surgery was performed on the dominant side for language in 7 patients. An opercular resection was performed in all but 2 patients who only had an insulectomy. Engel class I seizure control was achieved in 80% of patients. Postoperative neurological deficits (paresis, dysphasia, alteration of taste, smell, hearing, pain, and thermal perceptions) were frequent (75%) but always transient except for 1 patient with persistent mild alteration of thermal and pain perception. Surgical treatment of operculoinsular epilepsy is effective in achieving seizure control and is associated with an acceptable long-term complication rate.

Persistent impairments 3\xa0years after (neo)adjuvant chemotherapy for breast cancer: results from the MaTox project

PurposeAlthough treatment for early breast cancer improved prognosis greatly, it can have significant long-term consequences, which must be considered during treatment decision.Methods453 patients with neoadjuvant or adjuvant treatment intention were recruited into the MaTox project within the prospective, multicentre, population-based German TMK cohort study (Tumour Registry Breast Cancer) between 2008 and 2009. Patient-reported outcomes (PROs) on 26 treatment-related symptoms were assessed via a specifically designed questionnaire at 4 weeks, 6 months, 18 months and 3 years after start of systemic treatment.ResultsThe results show that alterations in smell, taste and appetite were clearly improved 3 years after treatment. In contrast, post-surgical symptoms, restrictions in memory/attention, musculoskeletal system and polyneuropathy worsened substantially over time and were persistent after 3 years: 78% of the patients recorded impairment in memory, 73% muscle pain, 67% pain at the operated site and 57% paraesthesia in fingers or toes. A logistic regression model showed that risk factors for developing persistent paraesthesia symptoms were age, early paraesthesia symptoms and taxane-based therapy.ConclusionsOur data show that most patients with breast cancer have persistent impairments negatively influencing their daily life even 3 years after treatment. Furthermore, we highlight areas requiring special attention in follow-up care.