Stick Test Research Articles

Efficacy of the nasal airflow-inducing maneuver in the olfactory rehabilitation of laryngectomy patients: A systematic review and meta-analysis.

This is the first systematic review and meta-analysis to investigate the effectiveness of the nasal airflow-inducing maneuver (NAIM) in olfactory rehabilitation for total laryngectomy (TL) patients. We conducted a systematic literature search following Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. The inclusion criteria required that patients must have undergone a TL with subsequent NAIM training for at least 2weeks and olfactory evaluation. The impact of NAIM on olfactory outcomes compared to that at baseline was measured. Olfactory measures included the Sniffin' Sticks Test, Smell Disk Test, Scandinavian Odor Identification Test, and Quick Odor Detection Test. The primary outcome measures were the proportion of patients with normosmia at baseline and after intervention. Seven studies from 2000 to 2023 comprising a total of 290 TL patients met the inclusion criteria. The meta-analysis revealed that prior to intervention, the pooled proportion of patients with normosmia was 0.16 (95% confidence interval [CI]: 0.09‒0.27, p=0.01). After intervention, the same proportion increased to 0.55 (95% CI: 0.45‒0.68, p=0.001). Among the included patients, 88.3% were initially anosmic or hyposmic, which was reduced to 48.9% after NAIM practice, with 51.1% achieving normosmia. The percent improvement was not found to be significantly associated with the timing of intervention post-TL (p=0.18). NAIM increased the proportion of patients who achieved normosmia in TL patients. NAIM stands out as a safe, easily teachable maneuver with promising results. Further efforts are warranted to provide specific recommendations and guidelines for the use of NAIM in clinical practice.

#996 Validation of peritoneal NGAL as a biomarker for peritonitis: a comparison between laboratory-base method and rapid stick test

Abstract Background and Aims Neutrophil gelatinase-associated lipocalin (NGAL) is a protein involved in iron homeostasis, inflammation, and fibrosis. Initially discovered in human granulocytes, NGAL is found in various tissues. In renal contexts, NGAL's small size (23-25 kDa) and positive charge aid glomerular filtration and absorption in the proximal tubule. Notably, elevated NGAL levels were identified in peritoneal fluids during peritonitis in 2009, establishing it as a biomarker for early Peritoneal Dialysis (PD)-associated peritonitis diagnosis for values more than 100 μg/L. While our medical centre currently relies on the lab-based NGAL assay (NGALlab), advancements introduce the NGAL dipstick test (NGALds), offering a rapid and semi-quantitative colorimetric assessment. This study compares NGALds with NGALlab in clinical practice, assessing NGALds's potential for early peritonitis detection in PD patients' peritoneal fluid. Method This study involves a validation of diagnostic accuracy conducted through a retrospective analysis of parallel samples obtained from peritoneal effluents. Samples were collected from both healthy patients during routine analysis and from cases with suspected or confirmed peritonitis. Both NGALlab and NGALds analyses were conducted on each sample. The analysis aimed to evaluate the performance of the new NGALds by comparing it with the established NGALlab. Peritoneal NGALlab quantification employed the standard BioPorto test (BioPorto Diagnostics, Hellerup, Denmark), utilizing a particle-enhanced turbidimetric immunoassay. The novel NGALds is a rapid semi-quantitative assay that measures NGAL levels in biological fluids through colourimetric test strips, utilizing an antibody sandwich lateral flow dipstick test. NGAL values were categorized into colour-coded levels: 25 μg/L, 50 μg/L, 100 μg/L, 150 μg/L, 300 μg/L, and 600 μg/L. Statistical analyses were performed using SPSS Statistics 26.0 software. Spearman rank correlation coefficients (Rs) assessed categorical groups of NGAL values for peritoneal NGALds and NGALlab tests. A graphic comparison of these two tests was presented through a Bland-Altman plot Results Out of 301 peritoneal effluent samples, 156 were diagnosed with suspected peritonitis by ISPD Criteria. As Table 1 showed, NGALds showed a strong correlation with NGALlab categories (Rs = 0.876, P = 10−96), successfully diagnosing 96% (150 out of 156) peritonitis cases. Discrepancies between NGALlab and NGALds, visualized in the Bland-Altman plot (Fig. 1), were most notable when NGAL values exceeded the 600 μg/L threshold. However, this difference doesn't impact clinical significance, as high NGAL values remain diagnostically for peritonitis with both methods. Conclusion In conclusion, our study underscores a significant correlation between NGAL values measured by the laboratory method (NGALlab) and the NGAL dipstick test (NGALds). Importantly, NGALds exhibited a strong capability, correctly identifying 96% of peritonitis cases determined by NGALlab. Beyond statistical correlation, the NGAL dipstick emerges as a valid alternative for swift evaluation in patients presenting symptoms suggestive of peritonitis. Its ease of use, rapidity, and semi-quantitative colorimetric assessment make NGALds a patient-friendly tool. This user-friendly characteristic holds immense potential for streamlined clinical workflows, allowing for prompt and efficient peritonitis diagnosis.

Olfactory Function and Surgery of the Lateral Nasal Wall - Systematic Review.

This study aimed to comprehend the influence of surgery on the lateral nasal wall, primarily focusing on the inferior turbinates, and its impact on olfactory function. A systematic review was carried out utilizing electronic databases like PubMed, Cochrane (including various registers and databases), and Web of Science. No restrictions were imposed on publication year or language. The PRISMA criteria guided study selection, and predefined inclusion and exclusion criteria were employed. Risk of bias assessment for randomized controlled trials (RCTs) utilized the "Revised Cochrane risk-of-bias tool for randomized trials (RoB 2)," while Hawker et al. scale evaluated the quality of non-RCT studies. The review encompassed nine studies after rigorous selection and bias assessment. All studies unanimously demonstrated improved olfactory function following surgery on the inferior turbinate. Different surgical techniques and olfactory assessment methods were employed across studies. Evaluation encompassed pre- and post-surgery olfactory measurements. Most studies employed the Visual Analogue Scale (VAS) and commercial smell test kits (like Sniffin' Stick Test). The Nasal Obstruction Symptom Evaluation (NOSE) scale was used in two studies, and the butanol threshold test in one. Olfactory improvement was measured through enhanced patient numbers or nasal cavities, often expressed via VAS scores. One study utilized both patient count and VAS scores. A few studies also employed NOSE scale and olfactory threshold measurements. All studies consistently concluded that olfactory function post-surgery was superior to preoperative measures. The collective evidence strongly suggests that surgery on inferior turbinates has a positive impact on olfactory function, as indicated by the studies reviewed. Nonetheless, for a comprehensive understanding of surgical efficacy, future research should incorporate randomized controlled trials featuring control groups. This would facilitate the establishment of optimal surgical techniques for specific indications and the formulation of practical guidelines.

Olfactory Dysfunction and Glaucoma.

Olfactory dysfunction is a well-known phenomenon in neurological diseases with anosmia and hyposmia serving as clinical or preclinical indicators of Alzheimer's disease, Parkinson's disease, and other neurodegenerative disorders. Since glaucoma is a neurodegenerative disease of the visual system, it may also entail alterations in olfactory function, warranting investigation into potential sensory interconnections. A review of the current literature of the last 15 years (from 1 April 2008 to 1 April 2023) was conducted by two different authors searching for topics related to olfaction and glaucoma. three papers met the selection criteria. According to these findings, patients with POAG appear to have worse olfaction than healthy subjects. Furthermore, certain predisposing conditions to glaucoma, such as pseudoexfoliation syndrome and primary vascular dysregulation, could possibly induce olfactory changes that can be measured with the Sniffin Stick test. the scientific literature on this topic is very limited, and the pathogenesis of olfactory changes in glaucoma is not clear. However, if the results of these studies are confirmed by further research, olfactory testing may be a non-invasive tool to assist clinicians in the early diagnosis of glaucoma.

Patients with parosmia respond faster to unpleasant odors than patients with hyposmia: Insights from olfactory event-related potentials.

Diagnosing parosmia is a challenge. The present study aimed to explore the distinctions between hyposmic patients with and without parosmia utilizing electroencephalography-derived olfactory event-related potentials (ERP). Forty-four patients with hyposmia were enrolled and divided into a group with parosmia (n=23, mean age±standard deviation=48±14 years, seven men) and a group without parosmia (n=21, age=52±12 years, seven men) based on the clinical interview. Additionally, 21 healthy controls (mean age=45±14 years, six men) were included. Various measurements were obtained, including the Sniffin' Stick test, threshold tests for the odorants furfural mercaptan and 2,6-nonadienal, a modified Sniffin' Stick parosmia test, and well-being ratings. Chemosensory ERPs were recorded separately for each nostril using high-precision, computer-controlled air-dilution olfactometry. Patients with parosmia had a decreased olfactory function similar to that observed in patients with hyposmia, although the odor sensitivity of patients with severe parosmia remained relatively unaffected. Patients with parosmia reported a decrease in well-being compared to controls. The severity of parosmia was positively correlated with odor sensitivity. Furthermore, patients with severe parosmia exhibited faster responses to unpleasant odors than patients without parosmia. Overall, the present findings support the idea that parosmia predominantly occurs during olfactory recovery, significantly disturbing patients and warranting the development of effective treatments. Notably, the relatively faster responses of hyposmic patients with severe parosmia suggest that the generation of distorted olfactory responses may involve early stages of the processing of olfactory information.

Optimalisasi Kesehatan dan Gizi Lansia Melalui Penyuluhan dan Pendampingan Gizi di Kelurahan Cipadu Jaya

The percentage of the elderly population in RW 01, Cipadu Village, has increased, indicating that in 2023, this area has entered the era of an aging population, where the percentage of the population aged 60 and above is almost reaching 10% or more. The purpose of this community service is to raise awareness among the community about a healthy lifestyle to prevent non-communicable diseases, to practice the preparation of healthy drinks, and early detection of health status through anthropometry and stick test methods. The methods used in this community service include counseling with the theme "Optimizing the Health and Nutrition of the Elderly," practical measurement of nutritional status, screening for Non-Communicable Diseases using the stick test method, followed by guidance and monitoring of older people. There has been a 21.1% increase in knowledge about balanced nutrition for older people and the preparation of healthy drinks. Screening for nutritional status shows that 37.3% are obese. Health checks indicate that out of 51 people, 78.4% have high blood pressure, 66,7% have high cholesterol levels, 43,1% have high uric acid levels, and 5.8% have diabetes. Assistance for one month on adopting a healthy lifestyle, including getting used to new healthy drinks, has reduced weight and blood pressure, but blood sugar and cholesterol have not consistently improved. Practicing a healthy lifestyle with assistance has not optimally achieved a healthy status. Therefore, periodic education on elderly nutrition and early detection is necessary to maintain and monitor healthy lifestyles.

Neurocognitive Changes in Patients with Post-COVID Depression.

Background: Depression and cognitive impairment are recognized complications of COVID-19. This study aimed to assess cognitive performance in clinically diagnosed post-COVID depression (PCD, n = 25) patients using neuropsychological testing. Methods: The study involved 71 post-COVID patients with matched control groups: recovered COVID-19 individuals without complications (n = 18) and individuals without prior COVID-19 history (n = 19). A post-COVID depression group (PCD, n = 25) was identified based on psychiatric diagnosis, and a comparison group (noPCD, n = 46) included participants with neurological COVID-19 complications, excluding clinical depression. Results: The PCD patients showed gender-dependent significant cognitive impairment in the MoCA, Word Memory Test (WMT), Stroop task (SCWT), and Trail Making Test (TMT) compared to the controls and noPCD patients. Men with PCD showed worse performances on the SCWT, in MoCA attention score, and on the WMT (immediate and delayed word recall), while women with PCD showed a decline in MoCA total score, an increased processing time with less errors on the TMT, and worse immediate recall. No differences between groups in Sniffin's stick test were found. Conclusions: COVID-related direct (post-COVID symptoms) and depression-mediated (depression itself, male sex, and severity of COVID-19) predictors of decline in memory and information processing speed were identified. Our findings may help to personalize the treatment of depression, taking a patient's gender and severity of previous COVID-19 disease into account.

The effectiveness of the STOP-X training program on the knee valgus angle and balance in female basketball players with dynamic knee valgus: a randomized controlled trial.

Dynamic knee valgus (DKV) accompanied by poor balance is the cause of anterior cruciate ligament (ACL) injury in athletes, and the identification and correction of these factors are always of interest to researchers. Therefore, the purpose of this research was to investigate the effect of the STOP-X program on the knee valgus angle and static and dynamic balance in female basketball players with DKV defects. The present study was a quasi-experimental study. Thirty female basketball players with DKV defects were purposefully identified by the single-leg landing (SLL) test and were randomly assigned to two control (n = 15) and experimental (n = 15) groups. Static balance status was evaluated with the BASS STICK test, and dynamic balance status was evaluated with the Y-balance test (YBT). The experimental group performed the STOP-X program for 25-40min for eight weeks (three times per week), and the control group performed their traditional warm-up program. Data were analyzed by means of 2 × 2 repeated measures ANOVA followed by post hoc comparison (Bonferroni) at the significance level of (P < 0.05) with SPSS version 26. The results showed that with the use of the STOP-X program, there was a significant difference between the experimental and control groups in variables of the static balance (F = 56.45; P = 0.001; ES = 0.66, PC=↑59.64%), total dynamic balance score (F = 107.57; P = 0.001; ES=↑0.79, PC=↑19.84%), and knee valgus angle (F = 119.46; P = 0.001; ES = 0.81, PC=↓34.36%). In addition to reducing the knee valgus angle, applying the STOP-X injury prevention program can improve static and dynamic balance in female basketball players with DKV defects. Therefore, it can be recommended that sports trainers benefit from these advantages by adding STOP-X training to routine basketball exercises.

Clinical utility of and correlation between Sniffin' Sticks and TIB smell identification test (TIBSIT) among Hong Kong Chinese with or without chronic rhinosinusitis

IntroductionOlfactory dysfunction (OD) is common among patients with chronic rhinosinusitis (CRS). Validated and culturally specific tests, such as the “Sniffin’ Sticks” test (SST) and the TIB Smell Identification Test (TIBSIT), are crucial for the diagnosis and monitoring of OD. However, they have not been utilised in Hong Kong Chinese and their correlations are unknown.MethodsTwelve CRS patients and twenty healthy volunteers were prospectively recruited from a joint allergy-otorhinolaryngology clinic in Hong Kong and performed both SST and TIBSIT. Demographics, baseline characteristics and all test results were compared and analysed.ResultsPatients with CRS demonstrated significantly lower test scores than healthy controls (all p &amp;lt; 0.001). Significant and strong correlations were observed between all composite and subtest scores, particularly between the composite SST and TIBSIT scores (ρ = 0.789, p &amp;lt; 0.001). Multivariate analysis demonstrated that the presence of CRS and increasing age were significantly associated with OD.ConclusionBoth SST and TIBSIT are useful olfactory tests and are strongly correlated among Hong Kong Chinese. We advocate that either test can be used for measuring OD among CRS patients.

Diagnostic accuracy of the screenings Sniffin' Sticks Test (SST-12) in COVID-19 induced olfactory disorders.

Objective olfactory function can be assessed using validated olfactory tests like the Sniffin' Sticks Test (SST). However, their extensive nature makes them less suitable for clinical practice. To address this, shorter olfactory tests like the screenings Sniffin' Sticks Test (SST-12) can be used for screening purposes and reduce testing time. The SST-12 serves as a diagnostic tool for screening olfaction in cases unrelated to COVID-19. However, these screening tests are uncertain regarding their accuracy in detecting olfactory dysfunction in patients with COVID-19 as the plausible cause. We aim to determine the diagnostic accuracy of the SST-12 in adults with post-COVID-19 olfactory dysfunction. We performed a diagnostic accuracy study with data from 113 consecutive COVID-19 diagnosed patients who experienced objectified smell loss ever since. At approximately 6 months after their diagnosis, all participants underwent the SST (reference standard), part of the SST was the SST-12 (index test). Diagnostic accuracy of the SST-12 is measured as negative predictive value (NPV), positive predictive value (PPV), sensitivity, and specificity. The SST-12 detected smell loss in 85 patients among 91 patients with smell loss and ruled out smell loss in 15 patients among the 22 patients without smell loss based on the reference standard. Making sensitivity 93.4% (CI 0.87-0.97), and specificity 68.2% (CI 0.48-0.85). Out of the 92 patients with a positive test result on SST-12, 85 patients had indeed smell loss (PPV 92.4% CI 0.86-0.97), and out of the 21 patients with a negative test result, 15 patients had no smell loss regarding the reference standard (NPV 71.4% CI 0.50-0.88). The findings suggest that the SST-12 holds promise as a useful tool for identifying individuals with smell loss, also in individuals with COVID-19 as cause, but it is important to have a good understanding of the interpretation of the results of the SST-12 when considering its implementation in clinical practice.

The Neuromuscular Parameters Affecting Static and Dynamic Balance in Adolescent Male Soccer Players with Dynamic Knee Valgus

Background and Aims The anterior cruciate ligament injury in athletes is associated with disorders related to balance and postural control. Poor balance is a predictor of lower limb injury in athletes. This study aims to investigate the different neuromuscular parameters that affect the static and dynamic balance in adolescent male football players with Dynamic Knee Valgus (DKV). Methods This is a correlational study. Participants were 83 adolescent male football players with DKV (age: 12.63±0.72 years, height: 1.69±0.07 meters, weight: 23.23±7.74 58 kg, BMI: 20.32±2.38 kg /m2), who were selected using a purposive sampling method. The presence of DKV was assessed by the squat test. The strength of the trunk and hip muscles was assessed by manual muscle testing (MMT), trunk endurance by the McGill test, and range of motion (ROM) of hip and ankle joints by a goniometer. Moreover, the static and dynamic balances were evaluated by the Bass Stick test and Y balance test, respectively. The Pearson correlation test was used to examine the relationships at a significance level of 0.05. All statistical operations were performed by SPSS software, version 24. Results The results of the present study showed a significant relationship between static balance and the study parameters (P≤0.05) except for trunk flexion strength (P=0.16) and ROM (P&lt;0.05), hip flexion ROM (P=0.83), hip extension ROM (P=0.96), hip abduction ROM (P=0.77) and ankle dorsiflexion ROM (P=0.94). The dynamic balance at anterior-posterior direction had a significant relationship with trunk endurance and left-side plank (P=0.07) and strength (P=0.05), but not with plank test score (P=0.45). The dynamic Y balance at posteromedial direction had a significant relationship with all variables except for 60° flexion (P=0.40), plank (P=0.53), left-side plank (P=0.09), and trunk extension strength (P=0.23). The results of the study also showed the significant relationship of dynamic balance at posterolateral direction and the total score of Y balance test with total trunk endurance test score (P=0.03, P=0.003) and right-side plank (P=0.005, P=0.001). Moreover, trunk extension strength and hip strength variables had a significant relationship with posterolateral dynamic balance and total Y balance test score (P≤0.05). Furthermore, the ROM of ankle dorsiflexion had a significant relationship with balance at the posteromedial (P=0.03), posterolateral (P=0.02) directions and the total Y balance score (P=0.02). Conclusion Static balance of adolescent male soccer players with DKV has a significant relationship with trunk endurance, trunk strength and thigh strength. There is a significant relationship between dynamic balance and trunk endurance, trunk strength, hip strength, and ankle dorsiflexion ROM.

Psychometric validity of the sum score of the Sniffin' Sticks-Extended Test.

A common tool to measure olfactory function is the Sniffin' Sticks Test extended version (SSET). The SSET evaluates olfactory ability by summing the scores of three subtests: Threshold, Discrimination, and Identification. Recent meta-scientific literature revealed that many psychometric instruments currently in use have not been adequately validated, leading to a measurement crisis that raises concerns about the validity of the conclusions drawn with these instruments. Two examples of the measurement crisis are (i) the use of sum scores without testing their assumptions (e.g. unidimensionality and tau-equivalence), which indicate that all subtests have the same, stable relationship with their underlying construct, and (ii) the lack of assessment of measurement invariance across groups. Here, we aim to investigate the unidimensionality and tau-equivalence assumptions, internal consistency, and measurement invariance of sex and age groups of the SSET. We tested 988 (555 females, mean ± SD: 39.75 ± 18.60 years) participants with the Italian version of the SSET. The tau-equivalent model demonstrated excellent fit indices (CFI robust = 1, TLI robust = 1, RMSEA robust = 0, SRMR = 0.013), which best explain the data, indicating that all subtests are equally important in measuring olfactory function, but not necessarily equally precise. The results also revealed full measurement invariance across age groups and configural, partial metric, and scalar invariance across sexes, indicating that the use of latent means to compare sex groups should be chosen over raw scores. However, the SSET demonstrated moderate internal consistency. Future studies should clarify whether the reliability of the SSET can be increased.

Olfactory Sensitivity in Covid 19 Infection Recovered Subjects.

Sense of smell is a vital perception in mammals. Temporary loss of smell is the main neurological symptom and one of the earliest and most commonly reported indicators of COVID-19. A observational hospital based analytical study carried out at a tertiary care centre for a period of 22months from January 2021 to October 2022. All the patients were subjected to sniffin stick test and all the data were noted, tabulated and compared to know the correlation of olfactory sensitivity to different parameters. Males were affected with hyposmia slightly more than females. There was not much difference in the olfactory sensitivity in various phases of uterine cycle. Olfactory sensitivity had a negative correlation with serum oestrogen and serum progesterone levels, which was significant. Mean olfactory sensitivity of males for different odours were slightly higher than females. BMI has a negative correlation with olfactory sensitivity in males as well as females, which was significant.

Validation of peritoneal neutrophil gelatinase-associated lipocalin as a biomarker for peritonitis: A comparison between laboratory-base method and rapid stick test

ABSTRACT Background: Neutrophil gelatinase-associated lipocalin (NGAL) is a multifunctional protein with roles beyond biomarker status, influencing critical processes. This study aimed to assess dipstick test for NGAL (NGALds), a novel dipstick test, against the established laboratory-based NGAL (NGALlab) method for early peritonitis detection, focusing on peritoneal fluid analysis to provide a rapid and cost-effective diagnostic tool for peritonitis management. Methods: Conducted at San Bortolo Hospital, Italy, this retrospective study collected samples from suspected or confirmed peritonitis cases between May 1, 2021, and December 31, 2021. Samples included peritoneal dialysate effluents (PDE) and underwent white blood cell counts, NGALds, NGALlab, and effluent culture. Results: The study analyzed 27 peritonitis cases, involving 133 PDE samples from 22 patients. NGALds exhibited a strong correlation (Rs = 0.732, P &lt; 0.05) with NGALlab, particularly for medium to high-risk peritonitis cases, with a 98% accuracy rate. Conclusion: NGALds effectively aligns with NGALlab for peritonitis diagnosis, offering a valuable diagnostic tool, particularly suitable for point-of-care and resource-limited healthcare settings. Further research should investigate its correlation with neutrophil levels in PDE, solidifying NGALds as an accessible and efficient resource for peritonitis management.

Dupilumab in chronic rhinosinusitis with nasal polyps: Real life data in a multicentric Sicilian experience

ObjectiveThis study aimed to evaluate the effectiveness and safety of dupilumab during the first year of treatment in a real-life setting, focusing on improvement in nasal polyp score (NPS) as well as specific symptoms, quality of life and olfactory function. Methodology/principalA multicentric observational cohort study was carried out. A total of 170 patients were enrolled in the Otorhinolaryngology Unit of the three University Hospitals and considered for dupilumab therapy. All recorder characteristics were age (at the first dupilumab application visit), sex, smoke habits, previous local and systemic corticosteroid therapy, history of endoscopic sinus surgery, number of previous endoscopic sinus surgery, concomitant asthma, history of an allergic condition, immunoglobulin E (IgE), allergy to nonsteroidal anti-inflammatory drugs (NSAIDs), Aspirin Exacerbated Respiratory Disease (AERD), other comorbidities associated, blood eosinophils, nasal polyp score, sinonasal outcome test 22 (SNOT 22), sniffin' stick test, the start date of dupilumab therapy and number of doses of dupilumab and eventually, Dupilumab's adverse events related to administration. The Wilcoxon test for dependent samples was performed to compare variables. Statistical significance was assumed for p values < 0.05. ResultsA statistically significant reduction in SNOT-22 and NPS was shown at the 6th and 12th month compared to baseline values (p < 0.001 for both comparisons). A statistically significant increase value at the Sniffin' sticks test was shown in the 6th and 12th month compared to baseline values (p < 0.001 for both comparisons).At the 12-month follow-up, according to EUFOREA indications, all patients were considered to remain in treatment with dupilumab and continued the treatment because of a reduced NPS, improved quality of life and a reduced need for system corticosteroids.Dupilumab seemed to be well tolerated by all patients. Any adverse effect of the drug led to the quit of biological treatment. ConclusionsThis multi-centric real-life study supported the effectiveness of dupilumab as an add-on therapy to intranasal corticosteroids in patients with severe uncontrolled CRSwNP in improvement of quality of life, severity of symptoms, polyp size reduction and smell function. Furthermore, our data support the safety profile of monoclonal therapy with dupilumab.

Long-term Recovery Patterns of Olfactory Function after Trans-sphenoidal Approach with Nasoseptal Flap Elevation.

Introduction Nasoseptal flap is widely used in reconstruction of the skull base to prevent cerebrospinal fluid leakage after surgery for skull base lesions. There has been a debate on whether more severe olfactory dysfunction occurs after nasoseptal flap elevation than the conventional trans-sphenoidal approach. Objective To compare the long-term recovery patterns associated with nasoseptal flap and the conventional trans-sphenoidal approach. Methods The subjects were divided into the conventional trans-sphenoidal approach group and the nasoseptal flap elevation group. We followed up self-reported olfactory score using the visual analogue scale and threshold discrimination identification (TDI) score of the Korean Version of the Sniffin Stick test II for 12 months, with olfactory training. Results The study included 31 patients who underwent the trans-sphenoidal approach. Compared with preoperative status, the mean visual analogue scale and TDI scores in the conventional trans-sphenoidal approach group recovered 2 months postoperatively, while in the nasoseptal flap elevation group the visual analogue scale and TDI scores recovered 6 months and 3 months after surgery, respectively. Twelve months after surgery, the visual analogue scale and TDI scores in the conventional trans-sphenoidal approach group were 9.3 ± 0.5 and 28.5 ± 4.3, while those from the nasoseptal flap elevation group were 8.9 ± 1.5 and 27.2 ± 4.7 ( p = 0.326; 0.473). Only one of the patients in the nasoseptal flap elevation group had permanent olfactory dysfunction. Conclusion The olfactory function recovered more gradually in the nasoseptal flap elevation group than in the conventional trans-sphenoidal approach group, but there was no difference between the two groups after 6 months.

Prefrontal dysfunction in post-COVID-19 hyposmia: an EEG/fNIRS study.

Subtle cognitive dysfunction and mental fatigue are frequent after severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection, characterizing the so-called long COVID-19 syndrome. This study aimed to correlate cognitive, neurophysiological, and olfactory function in a group of subjects who experienced acute SARS-CoV-2 infection with persistent hyposmia at least 12 weeks before the observation. For each participant (32 post-COVID-19 patients and 16 controls), electroencephalography (EEG) and functional near-infrared spectroscopy (fNIRS) data were acquired using an integrated EEG-fNIRS system during the execution of a P300 odd-ball task and a Stroop test. The Sniffin' Sticks test was conducted to assess subjects' olfactory performance. The Montreal Cognitive Assessment (MoCA) and the Frontal Assessment Battery (FAB) were also administered. The post-COVID-19 group consisted of 32 individuals (20 women and 12 men) with an average education level of 12.9 ± 3.12 years, while the control group consisted of 16 individuals (10 women and 6 men) with an average education level of 14.9 ± 3.2 years. There were no significant differences in gender (X2 = 0, p = 1) or age between the two groups (age 44.81 ± 13.9 vs. 36.62 ± 11.4, p = 0.058). We identified a lower concentration of oxyhemoglobin (p < 0.05) at the prefrontal cortical level in post-COVID-19 subjects during the execution of the Stroop task, as well as a reduction in the amplitude of the P3a response. Moreover, we found that post-COVID-19 subjects performed worst at the MoCA screening test (p = 0.001), Sniffin's Sticks test (p < 0.001), and Stroop task response latency test (p < 0.001). This study showed that post-COVID-19 patients with persistent hyposmia present mild deficits in prefrontal function, even 4 months after the end of the infection. These deficits, although subtle, could have long-term implications for quality of life and cognitive wellbeing. It is essential to continue monitoring and evaluating these patients to better understand the extent and duration of cognitive impairments associated with long COVID-19.

Reliability and construct validity of three temperament tests in farmed Finnraccoons (Nyctereutes procyonoides)

The associations between the Stick test, Feeding test and Subjective evaluation of the temperament were tested in 214 juvenile Finnraccoons, raised in five different housing conditions, which varied in relation to group size and composition, available area, animal density and level of enrichment. The stick test and Feeding test were carried out once, but Subjective evaluation was carried out by six assessors, in pairs. In the Stick test, 57 % of the animals explored the novel stick in a curious way, 13 % bite the stick in an aggressive way and 3 % actively avoided the stick in a fearful way. In the feeding test, 79 % of the animals ate within 30 s in the presence of human, being interpreted as confident. The animals classified as Aggressive or Curious in the Stick test ate more probably in the Feeding test than those classified as Fearful. In the Subjective evaluation of the temperament, majority of the animals were classified as confident; the percentage of Confident animals varied from 60 % to 85 % between the six assessors. The inter-assessor reliabilities between the assessor pairs doing testing at the same time varied from poor to excellent (Cohen’s kappa from 0.39 to 0.85). The higher percentage of assessors that classified the animal as Confident, the more probably the animal ate in the Feeding test. The agreement between the Subjective evaluation of the temperament and the outcome of the Stick test was poor (Cohen’s kappa below 0.40). We could not detect any effect of the housing condition on the results. The results show that all tests measure the same aspects of temperament, especially fearfulness. In the Feeding test and Subjective evaluation of the temperament, the Finnraccoons’ response is affected mainly by their confidence towards human.

IDENTIFIKASI AMFETAMIN PADA URINE SOPIR ANGKOT DI PAJAK HORAS PEMATANGSIANTAR

The prevalence of drug abuse is quite high in Indonesia in the land transportation sector, including public transportation. Amphetamines are among the most widely used drugs in the community which are included in the Psychotropic class II. Amphetamines are also a group of drugs that stimulate the central nervous system, which can affect the brain's cortex to increase mental activity. Amphetamines can trigger the release of several neurotransmitters in the body, such as dopamine, norepinephrine, and serQotonin. The increase caused by these neurotransmitters can increase energy stimulation, increase physical endurance, motor activity, and cause a feeling of pleasure. All organs in the body work harder, so users feel more focused, empowered, confident and able to think quickly. The effect of using amphetamine is that it can eliminate fatigue and drowsiness. The aim of the study was to determine whether the content of amphetamine compounds was present in the urine samples of public transportation drivers at the Horas Pematangsiantar Tax. The sampling location was carried out at the Pematangsiantar Horas Tax while the research location was carried out at the Simpang Bah Jambi Health Center. The type of research used is qualitative data research which is described descriptively using a stick test tool with the Immunoassay method which was carried out in May 2023. The examination results of 50 samples were negative. The conclusion based on the results of the examination was that there was no amphetamine content or negative results in the urine of public transportation drivers at the Horas Pematangsiantar Tax.

Reliability and validity of the Polish version of the Questionnaire of Olfactory Disorders.

The comprehensive counseling of patients with olfactory dysfunctions requires accurate diagnosis. The recommendations include subjective assessment. The Questionnaire of Olfactory Disorders (QOD) is a disease-specific questionnaire for the subjective evaluation of olfactory dysfunctions. The study included 54 patients with olfactory dysfunctions, who were recruited to the study group (SG). The other 47 patients without the history of olfactory dysfunction and nasal cavity pathology were voluntarily allocated to the control group (CG). The protocol of the study was introduced to each patient and included: olfactory testing with Sniffin' Stick test, fulfillment of the Polish version of World Health Organization Quality of Life brief questionnaire and completing of the Polish version of the QOD. All participants (101) were invited for refilling the QOD questionnaire after 2 weeks for the test-retest statistics. The Polish QOD statements were significantly correlated and met the requirement by having test-retest correlation larger than 0.7. We found that internal consistency of the test measured by Cronbach's alpha coefficient was very high. The mean scores of the QOD test in normosmic SG patients were compared with corresponding scores in normosmic CG patients using U Mann-Whitney test. The analysis revealed statistically significant differences on mean QOD scores for each domains except QOD-S between both groups. The Polish version of the QOD demonstrated high rate of the validity and the reliability. This instrument may be widely used in research projects and clinical practice concerning olfactory disorders in Polish patients. NA.