Sense of smell disorder and health-related quality of life.

OBJECTIVES: To compare health-related quality of life and depression between individuals with an inability to smell (anosmia) and a comparison group of individuals with a normal sense of smell. METHODS: Ninety individuals from an anosmia organization (anosmia based on self-report) were compared to 89 individuals with a normal sense of smell. The SF-36 and Beck Depression Inventory-II-NL (BDI-II-NL) were administered, along with the Questionnaire for Olfactory Dysfunction (QOD) to assess the degree of problems in daily life related to the smell impairment. RESULTS: Compared to the comparison group, scores in the anosmia group differed on: the QOD-subscale Life Quality (related to tasting and smelling: p < .001) and Parosmia (Smelling odors as different: p < .001); and the SF-36 subscales of Social Functioning, Vitality, Mental Health and General Health (p's < .05). Persons with anosmia scored higher on the BDI-II-NL than persons from the comparison group (p < .01). DISCUSSION: Once a smell dysfunction is recognized, interventions aiming at dealing with the loss of smell as a source of information and enjoyment, as well as at improvement of emotional wellbeing, social interaction, energy, and depression should be considered.

Progressive respiratory distress due to neck mass.

The present report describes the case of an 80-year-old woman who presented at the emergency department with progressive respiratory distress caused by a massive anterior neck mass with tracheal deviation and compression. A CT scan showed diffuse enlargement of the thyroid gland. The patient underwent a left-sided hemithyroidectomy. Pathology unexpectedly revealed a primary thyroid lymphoma. Treatment with prednisone and vincristine was initiated to reduce tumour size and preserve the airway, resulting in rapid volume reduction and airway expansion. Primary thyroid lymphoma is a rare entity that requires adequate diagnosis and rapid initiation of treatment to reduce tumour volume and to prevent airway compromise.

Food perception with age and its relationship to pleasantness.

Differences between elderly subjects (n = 46, 61-86 years) and young subjects (n = 36, 18-25 years) in food perception and food liking were investigated. Intensity and liking ratings were assessed for custard dessert, in which flavor enrichment, textural change, and irritant addition were incorporated as strategies to compensate for sensory losses with increasing age. The sensory acuity (taste, olfaction, irritation, chewing efficiency) of both young and elderly subjects was measured with the help of different sensitivity tests. The elderly perceived the custards differently from the young, mainly as less intense in flavor (cherry/vanilla) and less intense in creaminess/swallowing effort. Several of the observed interaction effects were different for the elderly and the young. The majority of these differences manifested as lower intensity slopes for the elderly. Losses in sensitivity to taste and to olfactory and trigeminal stimuli as well as a reduced chewing efficiency were observed on average for the elderly compared with the young. Furthermore, subgroups of the elderly were observed in which the compensatory strategies flavor enrichment, textural change, and irritant addition led to an increase in food liking. However, these subgroups did not differ in their sensory acuity. The present study does not support the assumption that age-associated changes in food perception-caused by losses in sensory acuity-inevitably reduce the food liking of the elderly.

Compensation for age-associated chemosensory losses and its effect on the pleasantness of a custard dessert and a tomato drink.

Differences between elderly subjects (n=52, 60-85 years) and young subjects (n=55, 18-35) in their food liking and their olfactory capability were investigated. Two food systems were used: custard desserts and tomato drinks. Flavor enhancement/enrichment, textural change, and/or irritant addition were incorporated as compensatory strategies into these foods. The addition of low concentrations of both cherry flavor and cream flavor to the custard desserts influenced their pleasantness for the majority of the elderly. The addition of cream topping increased the pleasantness of the custard desserts for both the elderly and the young. The elderly equally liked the tomato drinks with no or with low irritant addition, whereas the young generally disliked an irritant addition. However, the food liking of the elderly was not generally increased by these different compensatory strategies. Instead, subgroups were observed for each compensatory strategy, in which applied compensatory strategies led to an increase in product pleasantness. Age-associated losses in olfactory capabilities did not sufficiently explain differences in food liking, as only elderly with similar olfactory capabilities to the young demonstrated a liking of enhanced flavor. The present study does not support the assumption that age-associated impairment in olfactory capability will inevitably lead to changes in food liking.

Dissociating pleasantness and intensity with quinine sulfate/sucrose mixtures in taste.

Independent experimental manipulation of subjective intensity and hedonic tone is required if one wants to study their separate effects on brain activity and behavior. This is problematic because hedonic tone and subjective intensity are related, leading to a pleasantness change each time the stimulus intensity is altered. In the present study, a solution to this problem was explored by combining a pleasant-tasting substance (sucrose) and a bad-tasting substance (quinine sulfate) into a number of different isointense mixtures. Here we show that subjective intensity as well as pleasantness can be accurately predicted, particularly in midrange, only if one corrects for mixture suppression.

Setting occupational exposure limits in humans: contributions from the field of experimental psychology.

Psychophysical methods from the field of experimental psychology are evaluated for their utility in the derivation of occupational exposure limits (OELs) for volatile chemicals based on acute sensory irritation in humans. The lateralization threshold method, which involves the localization of trigeminal vapor to the stimulated nostril, is evaluated for its underlying assumptions, reliability and validity. Whole body exposures, on the other hand, which involve the controlled, ambient exposure of human subjects to the irritant at one or a series of concentrations for an extended period are also discussed. It is concluded that the single-organ psychophysical method is largely resistant to response bias is practical and economical. However, its reliability and validity need further assessment. Whole body exposures, while having enhanced ecological validity, are more prone to demand characteristics, response bias, and subject beliefs than the traditional psychophysical procedures. An approach that involves the exposure of only the most sensitive organs such as the eyes and nose, via a mask or facebox, could facilitate the administration and alternation of odorant/irritant stimuli over a wide range of concentrations while enhancing ecological validity.

Comparison times are longer for hedonic than for intensity judgements of taste stimuli.

Response times of intensity and hedonic comparisons were determined in a within-subjects experimental design. Forced-choice paired comparisons of orange lemonades with various concentrations of added quinine sulfate were made by 48 subjects. Depending on experimental condition, the subjects had to focus either on intensity or on pleasantness and give their responses as fast as possible. The data showed shorter response times for intensity comparisons than for pleasantness comparisons. Although taste processing may be partially serial and partially parallel, the larger part of the response times and the differences between them may be due to cognitive processing.

Modeling panel detection frequencies by queuing system theory: an application in gas chromatography olfactometry.

In continuous vigilance tasks, the number of coincident panel responses to stimuli provides an index of stimulus detectability. To determine whether this number is due to chance, panel noise levels have been approximated by the maximum coincidence level obtained in stimulus-free conditions. This study proposes an alternative method by which to assess noise levels, derived from queuing system theory (QST). Instead of critical coincidence levels, QST modeling estimates the duration of coinciding responses in the absence of stimuli. The proposed method has the advantage over previous approaches that it yields more reliable noise estimates and allows for statistical testing. The method was applied in an olfactory detection experiment using 16 panelists in stimulus-present and stimulus-free conditions. We propose that QST may be used as an alternative to signal detection theory for analyzing data from continuous vigilance tasks.

Sensory evaluation of character impact components in an apple model mixture.

Food aromas generally are complex mixtures of volatiles. In the present study, we investigated the joint effects of hexyl acetate, trans-2-hexenal and 1-hexanol on the multi-attribute perception of an apple aroma. The first two substances were identified earlier as positive contributors to the apple aroma (high character impact), whereas the third component was identified as an irrelevant or negative contributor (low character impact). Aroma quality was quantified using a set of eight graphic rating scales. All three components had significant effects on the aroma profiles. These effects consist mainly of an effect of each component on the attribute that described its individual character and an effect of all three components on ratings on the main character attribute 'apple'. As expected, the high impact components increased 'apple' ratings, whereas the low character impact component decreased 'apple' ratings. Furthermore, intensity ratings on the attribute that corresponded with the odour of the low impact component were suppressed by the presence of high impact components. These results indicate that the contributions of odorants to the mixture's aroma are not linear combinations of separate odour intensities, because sensory interactions were observed. In addition, humans detect components in complex mixtures more accurately than studies on identification performance have suggested. We conclude that for an adequate assessment of the effects of multiple mixture components on changes in aroma perception, it is sufficient to employ multiple response scales measuring intensities of attributes that are distinctive with respect to the expected qualitative changes. Results of this approach should be subjected to multivariate methods of statistical analysis.