The impact of taste and smell alterations on quality of life in head and neck cancer patients.

PURPOSE: Taste and smell alterations (TSAs) are among the most frequent and troublesome symptoms reported by head and neck cancer (HNC) patients after treatment. Little is known about the relationship between TSAs and quality of life (QoL) among HNC patients. The aim of this study was to determine the effect of TSAs on overall QoL among tube-fed and orally fed HNC patients before treatment, at end of treatment and at 2.5-month follow-up. METHODS: Data were collected in a longitudinal study prior to treatment (n = 126), at end of treatment (n = 100) and at 2.5-month follow-up (n = 85). Chemosensory Complaint Score (CCS) and the University of Washington Quality of Life Questionnaire version 3 were used to assess TSAs and QoL, respectively. Generalized estimated equation modeling was used to estimate the effect of CCS on QoL. RESULTS: At end of treatment, QoL and CCS had declined for both tube-fed and orally fed patients and thereafter improved, but not to pre-treatment levels. Neither QoL nor CCS mean scores were different between the two groups at any time point. CCS was a significant predictor of overall QoL (ß = -1.82, p < 0.0001), social-emotional (ß = -1.76, p < 0.0001), physical (ß = -1.12, p < 0.0001) and overall functions (ß = -1.15, p < 0.0001) at a multivariate level. Taste was reported as an important symptom for both tube-fed and orally fed groups at end of treatment and follow-up. CONCLUSIONS: TSAs are an important symptom and an independent predictor of QoL for both tube-fed and orally fed HNC patients. HNC patients need support to manage TSAs, regardless of the method of nutritional intake.

Influence of multi-walled carbon nanotubes on the physico-chemical and biological responses of chitosan-based hybrid hydrogels.

Photoresponsive membranes were successfully obtained by combining chitosan (CS), poly(vinyl alcohol) (PVA) crosslinked with genipin (GEN) and filled with multi-walled carbon nanotubes (MWCNTs). It was demonstrated that adding a small quantity (0.01% w/v) of MWCNTs conferred to those nanocomposite hybrid hydrogels an outstanding photomechanical response under infrared irradiation. Moreover, it was observed that MWCNTs enhanced the crystallinity, increased the elastic modulus but did not contribute to the thermal stability of the nanocomposite hybrid hydrogels. The swelling capacity and contact angle values of these materials were modified through the addition of MWCNTs, and the offered free OH and NH2 functional groups in their current chemical structures. These functional groups - on hybrid hydrogels' surfaces - also enhanced the adhesion and proliferation of human dermal fibroblast cells, showing typical morphologies and sizes. Additionally, non-cytotoxic effects were observed for these nanocomposite hybrid hydrogels, suggesting their potential use in tissue engineering and biomedical applications. Chemical compounds studied in this article: Chitosan (PubChem CID: 71853); Polyvinyl alcohol (PubChem CID: 11199); Genipin (PubChem CID: 442424).

A systematic review of smell alterations after radiotherapy for head and neck cancer.

PURPOSE: To review the current knowledge on radiotherapy associated olfactory dysfunction among head and neck cancer (HNC) patients. METHODS: A systematic review of RT-related olfactory dysfunction in HNC was performed. Searches were conducted in several databases (Medline, EMBASE, CINAHL, CAB Abstracts, SCOPUS, Proquest Dissertations and Theses, PROSPERO, ALLEBM Reviews - Cochrane DSR, ACP Journal Club, DARE, CCTR, CMR, HTA, and NHSEED). Publications investigating olfactory dysfunction as an explicit side effect of Radiotherapy (RT, or RT-chemo or RT-monoclonal antibodies) were eligible, no limits were applied. RESULTS: Two hundred and twenty-nine papers were screened and 23 met inclusion criteria. CONCLUSIONS: Odor detection, identification and discrimination are olfactory functions impaired after RT for HNC. An RT dose-effect has been calculated for odor identification and odor discrimination. There were no studies of the effect of olfactory dysfunction on weight loss or energy intake among RT-treated HNC patients. To improve our understanding of RT associated olfactory dysfunction among HNC patients, future studies should include a multi-dimensional assessment of olfactory function in a longitudinal design, track other conditions affecting olfaction, assess retronasal olfactory perception, adopt validated self-report tools and explore the impact of olfactory dysfunction on the eating experience of HNC patients.

Physical symptom burden of post-treatment head and neck cancer patients influences their characterization of food: Findings of a repertory grid study.

BACKGROUND AND AIM: Dietary advice for post treatment head and neck cancer (HNC) patients emphasizes food characteristics of nutritional value and texture, and not patients' characterization of food. The aim of this study was to determine patients' characterization of food. METHODS: Repertory grid interviews were conducted with 19 orally-fed HNC patients between 4 and 10 months post-treatment to characterize foods commonly eaten, avoided and eaten sometimes. Patients compared and rated 12 foods using their own descriptors. Data were analyzed by General Procrustes Analysis (GPA). Socio-demographic status, taste and smell alterations, appetite and food intake data were also collected. Patient physical symptom burden was defined by University of Washington-Quality of Life Physical Function domain scores and used to stratify patients with "less physical symptom burden" (n = 11, score ≥ 61.7) or "greater physical symptom burden" (n = 8, score < 61.7). RESULTS: All patients used descriptors of taste, ease of eating, convenience, texture, potential to worsen symptoms and liking to characterize foods. Overall, avoided foods were characterized as having dry texture, while foods commonly eaten were characterized by their ease of eating and low potential to worsen symptoms. Descriptors of nutrition and smell were significant only for patients with greater physical symptom burden. CONCLUSIONS: Physical symptom burden influenced the characterization of foods among post-treatment HNC patients. Nutrition counseling must consider patients' physical symptom burden and the subsequent characterization of food that drive food selection or avoidance to facilitate dietary advice for adequate, appropriate and enjoyable food intake.

Protocolo para el análisis funcional de prótesis para pacientes con amputación parcial de pie / Protocol for the Functional Analysis of Prosthesis in Patients with Partial Foot Amputation

En la actualidad el desarrollo de prótesis presenta problemas que aún no se han solucionado por completo. A pesar de que se han desarrollado varios estudios enfocados a evaluar el funcionamiento de las prótesis, los trabajos que se presentan en la literatura se realizan con suposiciones de carga, de materiales, e incluso se practican bajo condiciones estáticas. La técnica de correlación de imágenes digitales ha sido útil en diversas aplicaciones, pero ha sido poco explorada en el ambiente de las prótesis. En este trabajo se presenta una técnica capaz de medir la deformación real en sistemas protésicos de pacientes amputados, bajo condiciones de carga y postura reales. Empleando el método de correlación de imágenes digitales es posible evaluar la prótesis del paciente sin necesidad de instrumentarla o modificarla. Además es posible conocer los principales puntos de deformación sin tener que fracturar la pieza. Con esta técnica es posible medir las principales zonas de deformación de un sistema protésico, con la ventaja de que la evaluación se pueden llevar a cabo aplicando cargas y posturas reales de un paciente en un análisis dinámico.

At present, the development of prostheses presents problems that have yet to be completely solved. Despite that various studies have been developed to evaluate the functioning of these prostheses, the works presented in the literature are conducted with suppositions of burden, of materials, and are even practiced under static conditions. The technique of Digital image correlation (DIC) has been useful in diverse applications, but has been scarcely explored in the ambience of prostheses. In this work, we present a technique capable of measuring the real deformation of prosthetic systems in patients with amputations, under real conditions of load and posture. Employing the DIC method, it is possible to evaluate a patient?s prosthesis without the need for instrumenting or modifying it. In addition, it is possible to know the main points of deformation without having to ultimate load the piece. With this technique, it is possible to measure the prosthetic system?s main deformation zones, with the advantage that evaluation can be performed applying the real loads and postures of a patient in a dynamic analysis.