S128 – Diagnosis and Treatment of 703 Patients with Taste Disorder

2008 ◽  
Vol 139 (2_suppl) ◽  
pp. P119-P120
Author(s):  
Shinya Miuchi ◽  
Masanori Umemoto ◽  
Atsushi Negoro ◽  
Hideki Oka ◽  
Tomomi Nin ◽  
...  
Keyword(s):  
Iron Deficiency ◽  
Common Cold ◽  
Recovery Period ◽  
Serum Zinc ◽  
Drug Induced ◽  
Zinc Supplement ◽  
Taste Disorder ◽  
Paper Disk ◽  
Filter Paper Disk ◽  
Number Of Patients

Objectives As life spans increase, the number of patients with taste disorder consulting in our taste clinic has increased. This study prospectively examined patients’ history, causes of taste disorder, and treatment outcomes. Methods Subjects consisted of 703 patients with taste disorder who consulted our taste clinic at the department of Otolaryngology, Hospital of Hyogo College of Medicine, between 1999 and 2007. There were 284 men and 419 women, and patient ages ranged from 12 years to 88 years with a mean age of 59.7 years. Electrogustometry (EGM) and filter paper disk method (FPD) were used to assess taste function. We also asked each patient to indicate the severity of symptoms using a visual analog scale (VAS). Patients were treated mainly with zinc sulfate (ZnSO4 300 mg/day, or polaprezinc 150 mg/day), and in some cases with iron supplement, herbal medicine, and minor tranquilizers. Results Idiopathic taste disorder was the most common cause (271 cases, 38.5%), followed by drug-induced (131 cases, 18.6%), post-common cold (83 cases, 11.8%), psychogenic (73 cases, 10.4%), iron-deficiency (37 cases, 5.3%) and others. Deficiency of serum zinc (less than 70 ?g/dl) was found in 50–70% of cases. The recovery rate was 130/183 (71.0%) in idiopathic, 41/61 (67.2%) in post-common cold, and 24/29 (82.8%) in iron deficiency. The recovery period in drug-induced (39.7 weeks) was longer than that in other cases (20.4 weeks). Results of EGM and FPD were not always associated with the severity of symptoms. Conclusions Treatment with zinc supplement may be useful for taste disorder.

Treatment of frostbite in an open way (without dressings)

1937 ◽  
Vol 33 (1) ◽  
pp. 84-86
Author(s):  
V. A. Petrovykh
Keyword(s):  
Recovery Period ◽  
Climatic Conditions ◽  
The Other ◽  
Critical Approach ◽  
Tatar Strait ◽  
Other Hand ◽  
Number Of Patients ◽  
The One ◽  
Apparent Similarity ◽  
Methods Of Treatment

The harsh climatic conditions of the coast of the Tatar Strait make explainable the large number of patients with frostbite who passed under our supervision during the winter of 1935-36 and amounted to 2.8% (26 people) of the total contingent of inpatients. The variety of recommended methods for treating frostbite, on the one hand, and the relatively long recovery period for all of them, on the other hand, made us take a critical approach to the proposed methods of treatment. All currently existing methods are reduced to the treatment of frostbite areas with bandages; and on the locus morbi apply indifferent or slightly disinfecting ointments, or a similar property of a powder, or wipes moistened with slightly disinfecting solutions, for example, Sol. kalii hyperm. 1: 1000. The apparent similarity of the external manifestations of frostbite and burns inspired us with the idea of ​​conducting frostbite therapy in an "open way", which has long occupied a well-deserved place in the treatment of burns.

Heparin-induced thrombocytopenia: when a low platelet count is a mandate for anticoagulation

Hematology ◽  
2009 ◽  
Vol 2009 (1) ◽  
pp. 225-232 ◽  
Author(s):  
Thomas L. Ortel
Keyword(s):  
Platelet Count ◽  
Heparin Therapy ◽  
Severe Thrombocytopenia ◽  
Drug Induced ◽  
Platelet Factor ◽  
Heparin Induced Thrombocytopenia ◽  
Immune Mediated ◽  
Number Of Patients ◽  
Increased Risk ◽  
Antibody Levels

Abstract Heparin-induced thrombocytopenia (HIT) is an immune-mediated disorder caused by the development of antibodies to platelet factor 4 (PF4) and heparin. The thrombocytopenia is typically moderate, with a median platelet count nadir of ~50 to 60 × 109 platelets/L. Severe thrombocytopenia has been described in patients with HIT, and in these patients antibody levels are high and severe clinical outcomes have been reported (eg, disseminated intravascular coagulation with microvascular thrombosis). The timing of the thrombocytopenia in relation to the initiation of heparin therapy is critically important, with the platelet count beginning to drop within 5 to 10 days of starting heparin. A more rapid drop in the platelet count can occur in patients who have been recently exposed to heparin (within the preceding 3 months), due to preformed anti-heparin/PF4 antibodies. A delayed form of HIT has also been described that develops within days or weeks after the heparin has been discontinued. In contrast to other drug-induced thrombocytopenias, HIT is characterized by an increased risk for thromboembolic complications, primarily venous thromboembolism. Heparin and all heparin-containing products should be discontinued and an alternative, non-heparin anticoagulant initiated. Alternative agents that have been used effectively in patients with HIT include lepirudin, argatroban, bivalirudin, and danaparoid, although the last agent is not available in North America. Fondaparinux has been used in a small number of patients with HIT and generally appears to be safe. Warfarin therapy should not be initiated until the platelet count has recovered and the patient is systemically anticoagulated, and vitamin K should be administered to patients receiving warfarin at the time of diagnosis of HIT.

Drug-Induced Taste Disorder: Due to Zinc Chelation?

1990 ◽  
pp. 255-260 ◽  
Author(s):  
Minoru Ikeda ◽  
Hiroshi Tomita ◽  
Kunihiko Sekimoto
Keyword(s):  
Drug Induced ◽  
Taste Disorder ◽  
Zinc Chelation

scholarly journals On the mechanisms of sensitization and attachment of antibodies to RBC in drug-induced immune hemolytic anemia

Blood ◽  
1987 ◽  
Vol 69 (4) ◽  
pp. 1006-1010 ◽  
Author(s):  
A Salama ◽  
C Mueller-Eckhardt
Keyword(s):  
Specific Binding ◽  
Drug Induced ◽  
Cell Complexes ◽  
Large Panels ◽  
Plot Analysis ◽  
Number Of Patients ◽  
Immune Hemolytic Anemia ◽  
Drug Dependent ◽  
Reaction Patterns

Abstract The mechanisms of sensitization and attachment of drug-dependent antibodies to RBC in drug-induced immune hemolytic anemias are largely speculative. Nomifensine has been incriminated in causing immune hemolysis in a large number of patients. The hemolysis was usually of the so-called immune complex type, less commonly of the autoimmune type, and more surprisingly, few patients had developed both types of hemolysis. To determine whether nomifensine (metabolite)-dependent antibodies (ndab) exhibit specificity for antigenic structures of RBC membranes, 30 ndab were tested against large panels of RBC with common and rare antigens. We found that only 14 out of 30 ndab were invariably reactive with all cells tested. Nine antibodies were, similar to the majority of idiopathic or drug-induced autoantibodies, not or only weakly reactive with Rhnull RBC. Three antibodies did not react with cord RBC and could be inhibited by soluble I antigen. The remaining four antibodies gave inhomogeneous reaction patterns or were even negative with selected RBC; their specificity could not be identified. On a Scatchard plot analysis of one ndab, a maximum of 173,000 drug- dependent antibodies of the IgG class can specifically bind per RBC in the presence of the drug. Although nomifensine and its metabolites do not attach tightly onto RBC, our results clearly indicate that RBC do not act as “innocent bystanders,” but rather serve as a surface for a loose attachment of drugs that possibly cause a subtle structural change in the cell antigens and, by this means, allow in vivo sensitization; and a specific binding of the resultant antibodies. This concept would explain why these antibodies can be directed against drug- cell complexes, against cell antigens alone (autoantibodies), or against both in the same patient.

scholarly journals OSA Upper Airways Surgery: A Targeted Approach

Medicina ◽  
2021 ◽  
Vol 57 (7) ◽  
pp. 690
Author(s):  
Andrea De Vito ◽  
B. Tucker Woodson ◽  
Venkata Koka ◽  
Giovanni Cammaroto ◽  
Giannicola Iannella ◽  
...  
Keyword(s):  
Treatment Options ◽  
Sleep Apnea Syndrome ◽  
Upper Airway ◽  
Apnea Hypopnea Index ◽  
Upper Airways ◽  
Drug Induced ◽  
Pharyngeal Wall ◽  
Obstructive Sleep ◽  
Number Of Patients ◽  
Methodological Bias

Obstructive sleep apnea syndrome (OSA) is a multi-factorial disorder, with quite complex endotypes, consisting of anatomical and non-anatomical pathophysiological factors. Continuous positive airway pressure (CPAP) is recognized as the first-line standard treatment for OSA, whereas upper airway (UA) surgery is often recommended for treating OSA patients who have refused or cannot tolerate CPAP. The main results achievable by the surgery are UA expansion, and/or stabilization, and/or removal of the obstructive tissue to different UA levels. The site and pattern of UA collapse identification is of upmost importance in selecting the customized surgical procedure to perform, as well as the identification of the relation between anatomical and non-anatomical factors in each patient. Medical history, sleep studies, clinical examination, UA endoscopy in awake and drug-induced sedation, and imaging help the otorhinolaryngologist in selecting the surgical candidate, identifying OSA patients with mild UA collapsibility or tissue UA obstruction, which allow achievement of the best surgical outcomes. Literature data reported that the latest palatal surgical procedures, such as expansion sphincter palatoplasty or barbed reposition palatoplasty, which achieve soft palatal and lateral pharyngeal wall remodeling and stiffening, improved the Apnea Hypopnea Index, but the outcome analyses are still limited by methodological bias and the limited number of patients’ in each study. Otherwise, the latest literature data have also demonstrated the role of UA surgery in the improvement of non-anatomical factors, confirming that a multidisciplinary and multimodality diagnostic and therapeutical approach to OSA patients could allow the best selection of customized treatment options and outcomes.

A phase II trial to assess the activity of MVA5T4 plus interleukin-2 in patients (Pts) with metastatic renal cell carcinoma (MRCC)

2006 ◽  
Vol 24 (18_suppl) ◽  
pp. 14642-14642 ◽  
Author(s):  
A. Gary ◽  
L. Marsh ◽  
M. McDonald ◽  
S. Naylor ◽  
R. Harrop ◽  
...  
Keyword(s):  
Immune Response ◽  
Clinical Outcome ◽  
Renal Cell ◽  
Karnofsky Performance Status ◽  
Performance Status ◽  
Recovery Period ◽  
Interleukin 2 ◽  
Human Tumor ◽  
Prior Therapy ◽  
Number Of Patients

14642 Background: MVA 5T4 consists of a highly attenuated vaccinia virus (modified Vaccinia Ankara, MVA) containing the human tumor associated antigen (TAA) 5T4. Greater than 90% of renal cell cancers are overexpressed by the 5T4 antigen. The primary purpose of this trial is to validate the hypothesis that, in this group of pts, it is possible to induce immune responses either humoral and/or cellular to 5T4 and to break tolerance to the antigen. The immune response will be correlated to clinical outcome. Methods: Eligibility included: pathologic diagnosis of confirmed clear cell or papillary cancer, progressive measurable MRCC, adequate organ/marrow function, Karnofsky Performance Status (KPS) ≥ 80%, any prior therapy, and no active CNS involvement. The dosage schedule of subcutaneous low dose IL-2 will be an initial dose 250,000 U/kg/dose for 5 days in week 1 followed by 125,000 U/kg/dose for 5 days each of weeks 2–6 inclusive. There will then be a 2 week recovery period before the next cycle commences. The dosage regimen of MVA 5T4 will be intramuscular injections given 14 days prior to the first cycle, day 0 and 1 injection given at the beginning of week 4 of the first cycle. In subsequent cycles, booster injections of MVA 5T4 will be given at week 1 only, prior to the commencement of subcutaneous IL-2 therapy. Results: 10 pts have been treated with MVA 5T4 and the LD IL2 regimen. The combination has been extremely well tolerated with no MVA 5T4 related events thus far. Although the study is still continuing to accrue, there are early signs of clinical responses in a number of patients receiving the combination. The immunological analysis is in progress. Conclusion: MVA 5T4 is well tolerated in this group of patients. The immune response will be presented along with clinical outcome. [Table: see text]

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