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1.
Ann Vasc Surg ; 2021 Feb 03.
Artigo em Inglês | MEDLINE | ID: mdl-33548404

RESUMO

BACKGROUND: High-ligation and stripping (HL/S) and external valvuloplasty (eVP) with the implantation of an external device to restore the valve's function, are surgical methods to eliminate reflux at the saphenofemoral junction. Furthermore, redo-surgery (RedoS) can be performed in terms of same side groin recurrences. It is unclear, if there is a difference in quality of life (QoL) between these 3 surgical treatment options. Therefore, it was the aim of our study to elucidate QoL in patients before and after surgical treatment at the saphenofemoral junction by comparing HL/S, eVP, and RedoS. METHODS: A total of 303 participants (156 HL/S, 81eVP, 64 RedoS) were recruited during the daily clinical routine. QoL was measured at admission and 6 weeks after the surgical procedure by means of SF-12 (12 item short form health survey) and Aberdeen Varicose Vein Questionnaire. RESULTS: The mean value of Aberdeen Varicose Vein Questionnaire was 14.5 (SD 2.1) preoperatively and 4.9 (SD 3.3) postoperatively in the HL/S group, 16.4 (SD 1.4) preoperatively and 6.8 (SD 2.5) postoperatively in the eVP group and 15.5 (2.2) preoperatively and 5.8 (SD 4.2) postoperatively in the RedoS group, which was statistically significant (P< 0.05) in all groups. Postoperatively, the mean values were statistically significant within the groups. Concerning physical aspects of the SF-12 we found a significant improvement in the RedoS group, while mental aspects were significantly better in the HL/S and eVP group postoperatively. Nevertheless, the clinical relevance of these SF-12 differences is questionable under consideration of the minimal important difference. CONCLUSIONS: Varicose vein surgery leads to a significant improvement of QoL in all groups. The implantation of an external patch could have a negative influence in QoL.

2.
Artigo em Alemão | MEDLINE | ID: mdl-33621990

RESUMO

In this review article, current information on the frequency and relevance of chemosensory disorders in Covid-19 was recorded, assigned pathophysiologically and statements on prognostic significance were derived. The results are based on a comprehensive literature search of all literature on this topic and our own experience in the treatment of patients with smell and taste disorders since the beginning of the pandemic.Current study results indicate that clinically less affected Covid-19 patients without inpatient treatment and who do not require ventilation often have disorders of the chemosensory system. In young patients and women in particular, they seem to be an indicator of a favorable prognosis for the course of the disease. Smell disorders can appear early, as the sole symptom or together with other symptoms of Covid-19 disease. It has not yet been clarified whether ageusia can occur independently or whether it is also felt in the context of anosmia. In the pandemic, the new occurrence of anosmia without congestion / obstruction/runny nose is probably an expression of an infection with SARS-CoV-2 and should always give rise to quarantine and testing for SARS-CoV-2. The smell disorder in Covid-19 mostly seems to be temporary; It is not yet possible to conclusively assess whether there is usually a full restitution. The therapeutic approaches already established for other postviral olfactory disorders (e. g. olfactory training) are also used here.

3.
Artigo em Inglês | MEDLINE | ID: mdl-33606083

RESUMO

PURPOSE: The present study aimed to establish a test battery for the clinical assessment of retronasal odor thresholds and retronasal odor identification. STUDY DESIGN: Prospective case-control series. METHODS: Sixty participants (36 women, 24 men, mean age 37.6 ± 19.4 years) were enrolled in this study; 36 were healthy controls and 24 were patients with olfactory dysfunction. Orthonasal olfactory function was assessed with the "Sniffin' Sticks" test battery. Retronasal olfaction was assessed with oral odorant delivery using special containers for threshold function, and with oral tasteless powders for odor identification. RESULTS: Retronasal and orthonasal olfaction were significantly correlated for threshold scores, identification score, and the sum of threshold and identification score (TI score). Validity analyses showed that the retronasal TI score was able to discriminate between healthy controls and patients with olfactory dysfunction. CONCLUSIONS: Normosmic participants can be distinctly differentiated from patients with olfactory dysfunction using a valid test battery comprised of retronasal threshold and identification tests. Based on the current findings, we advocate a TI score of 16 as a cut-off between patients and controls. Therefore, TI scores of 17 and above would indicate retronasal normosmia.

4.
Artigo em Inglês | MEDLINE | ID: mdl-33462664

RESUMO

OBJECTIVE: This cross-sectional study determined whether acute sensory irritative or (sub)chronic inflammatory effects of the eyes, nose or respiratory tract are observed in employees who are exposed to naphthalene at the workplace. METHODS: Thirtynine healthy and non-smoking male employees with either moderate (n = 22) or high (n = 17) exposure to naphthalene were compared to 22 male employees from the same plants with no or only rare exposure to naphthalene. (Sub)clinical endpoint measures included nasal endoscopy, smell sensitivity, self-reported work-related complaints and the intensity of naphthalene odor and irritation. In addition, cellular and soluble mediators in blood, nasal lavage fluid (NALF) and induced sputum (IS) were analysed. All measurements were carried out pre-shift on Monday and post-shift on Thursday. Personal air monitoring revealed naphthalene shift concentrations up to 11.6 mg/m3 with short-term peak concentrations up to 145.8 mg/m3 and 1- and 2-naphthol levels (sum) in post-shift urine up to 10.1 mg/L. RESULTS: Acute sensory irritating effects at the eyes and upper airways were reported to occur when directly handling naphthalene (e.g., sieving pure naphthalene). Generally, naphthalene odor was described as intense and unpleasant. Habituation effects or olfactory fatigue were not observed. Endoscopic examination revealed mild inflammatory effects at the nasal mucosa of exposed employees in terms of reddening and swelling and abnormal mucus production. No consistent pattern of cellular and soluble mediators in blood, NALF or IS was observed which would indicate a chronic or acute inflammatory effect of naphthalene in exposed workers. CONCLUSIONS: The results suggest that exposure to naphthalene induces acute sensory irritative effects in exposed workers. No (sub)chronic inflammatory effects on the nasal epithelium or the respiratory tract could be observed under the study conditions described here.

5.
Laryngoscope ; 2021 Jan 06.
Artigo em Inglês | MEDLINE | ID: mdl-33404079

RESUMO

OBJECTIVE/HYPOTHESIS: With the COVID-19 pandemic, chemosensory dysfunction are among the most prevalent symptoms. Most reports are subjective evaluations, which have been suggested to be unreliable. The objective is to test chemosensory dysfunction and recovery based on extensive psychophysical tests in COVID-19 during the course of the disease. STUDY DESIGN: Prospective cohort study. METHODS: A total of 111 patients from four centers participated in the study. All tested positive for SARS-COV-2 with RT-PCR. They were tested within 3 days of diagnosis and 28 to 169 days after infection. Testing included extensive olfactory testing with the Sniffin' Sticks test for threshold, discrimination and identification abilities, and with the Taste Sprays and Taste Strips for gustatory function for quasi-threshold and taste identification abilities. RESULTS: There was a significant difference in olfactory function during and after infection. During infection 21% were anosmic, 49% hyposmic, and 30% normosmic. After infection only 1% were anosmic, 26% hyposmic, and 73% normosmic. For gustatory function, there was a difference for all taste qualities, but significantly in sour, bitter, and total score. Twenty-six percent had gustatory dysfunction during infection and 6.5% had gustatory dysfunction after infection. Combining all tests 22% had combined olfactory and gustatory dysfunction during infection. After infection no patients had combined dysfunction. CONCLUSIONS: Chemosensory dysfunction is very common in COVID-19, either as isolated smell or taste dysfunction or a combined dysfunction. Most people regain their chemosensory function within the first 28 days, but a quarter of the patients show persisting dysfunction, which should be referred to specialist smell and taste clinics for rehabilitation of chemosensory function. LEVEL OF EVIDENCE: 3 Laryngoscope, 2021.

6.
Chem Senses ; 462021 Jan 01.
Artigo em Inglês | MEDLINE | ID: mdl-33421076

RESUMO

Viral rhinitis contributes significantly to olfactory dysfunction, but it is unclear how many patients have other chemosensory symptoms in addition to olfactory loss. This was addressed in the present reanalysis of data previously published in Pellegrino R, Walliczek-Dworschak U, Winter G, Hull D, Hummel T. 2017. Investigation of chemosensitivity during and after an acute cold. Int Forum Allergy Rhinol. 7(2):185-191, using unsupervised and supervised machine-learning methods. Fifty-eight patients with acute rhinitis and 59 healthy controls were assessed for orthonasal and retronasal olfactory function, taste, and intranasal trigeminal sensitivity. Unsupervised analysis showed that during rhinitis, clinical scores of olfactory function, expressed as threshold, discrimination, identification (TDI) values, were trimodally distributed. Two minor modes were separated from the main mode at TDI = 30.5, which corresponds to the established limit of hyposmia. This trimodal distribution was not observed after the rhinitis subsided. Olfactory function was not significantly impaired in 40% of all rhinitis patients, whereas it was transiently impaired in 59%. For this group, supervised machine-learning algorithms could be trained with information on retronasal olfactory function, gustatory function, and trigeminal sensitivity to assign patients to subgroups based on orthonasal olfactory function with a balanced classification accuracy of 64-65%. The ability to recognize patients with olfactory loss based on retronasal olfactory function as well as gustatory function and trigeminal sensitivity suggests in turn that these modalities are affected by rhinitis. However, the only modest accuracy at which this information allowed to reproduce the olfactory diagnosis indicated they are involved in the symptomatology of rhinitis to a lesser extent compared with the orthonasal olfactory function.

7.
Artigo em Inglês | MEDLINE | ID: mdl-33389011

RESUMO

OBJECTIVE: Functional magnetic resonance imaging (fMRI) allows the measurement of changes in blood flow in association with changes in brain activity. This technique has been used frequently to study brain activation in response to odorous stimuli. The aim of this study was to evaluate the effects of odor delivery conditions on brain responses obtained with fMRI. STUDY DESIGN: Prospective cohort study SETTING: Academic institution. METHODS: Twenty healthy volunteers (mean age = 29.5 years; 9 women, 11 men) participated. Three odor delivery methods were used: "tube" (odor presented intranasally with separate tubing for each nostril), "mask" (odor presented in a face mask covering the subject's nose) and "vacuum" (odor presented into the ambient air). Presentation of the pleasant "peach" odor was performed using a computer-controlled olfactometer. Subjects were asked to evaluate the intensity of the odors after each fMRI run. RESULTS: "Tube" showed higher self-rated odor intensity compared to "mask" and "vacuum" (F = 18.4, p < 0.001). Odor intensity had a positive correlation (r = 0.6, p < 0.05) with percent signal change extracted from the secondary olfactory cortex region in the mask condition. In the tube condition, several selected regions of interest (Amygdala, Insula, Thalamus) showed lower activations compared to the other two conditions (puncorrected < 0.001, mask > tube, vacuum > tube). CONCLUSION: Activations of region of interests (ROIs) in response to the odorous stimuli showed differences under the three conditions (mask, tube, vacuum). In this passive fMRI paradigm, this may partly reflect the differences in odor intensity, but also in attention and contextual variables related to odor perception.

8.
Behav Brain Res ; 402: 113127, 2021 Mar 26.
Artigo em Inglês | MEDLINE | ID: mdl-33422593

RESUMO

Most odors of foods and drinks are mixtures of molecules. By means of the coupled Gas Chromatography-Olfactometry (GC-O) technique, single components of flavor mixtures can be separated, identified and verbally evaluated by subjects. The number of single molecules smelled by subjects during GC-O analysis (i.e., the number of odor-active compounds) was previously found to be linearly correlated with odor Threshold (T) score. Using the "Sniffin' Sticks" test, the same subjects were classified as normosmic or hyposmic. Hydrophobic odorants are captured and transported through the mucus layer by the odorant binding proteins (OBPs), particularly expressed in the olfactory cleft and associated with the olfactory function. In this study, subjects were genotyped for the rs2590498 (A/G) polymorphism of the OBPIIa gene, whose major allele A is associated with a higher olfactory sensitivity as compared to the minor allele G. One-way ANOVA showed a significant effect of the genotype of the OBPIIa locus on the: a) T score; b) number of odor-active compounds smelled; c) intensity perceived when sniffing the complex odor of banana. In conclusion, the threshold olfactory performance, but also the individual ability to smell single molecules, can be attributed, partly at least, to the rs2590498 polymorphism of the OBPIIa gene.

9.
J Neurol Neurosurg Psychiatry ; 92(3): 271-281, 2021 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-33436502

RESUMO

Olfactory impairment and rapid eye movement sleep behaviour disorder (RBD) are prodromal symptoms of Parkinson's disease (PD) that may be associated with each other. This review aims to investigate the significance of olfaction in the diagnosis and prognosis of patients with RBD and to assess moderating factors affecting olfactory performance. We searched articles on olfaction in RBD and PD in five electronic databases. We identified 32 studies for the systematic review and used 28 of those, including 2858 participants for meta-analysis. Results revealed significant deficits in odour identification (g=-1.80; 95% CI: -2.17 to -1.43), threshold (g=-1.29; 95% CI: -1.67 to -0.91), discrimination (g=-1.08; 95% CI: -1.28 to -0.87) and overall olfactory function (g=-1.64; 95% CI: -1.94 to -1.35) in patients with RBD. Except for the Unified Parkinson's Disease Rating Scale Part III scores, none of the known moderating variables (including age, sex, disease duration and years of education) accounted for the olfactory function heterogeneity in patients with RBD. We identified similar olfactory impairments in patients with RBD and patients with PD (either with or without underlying RBD). These findings suggest that olfactory impairment may be a sensitive and stable diagnostic biomarker of RBD and appears to be useful for identifying patients with idiopathic RBD at high risk for early conversion to PD.

10.
Neuroimage ; 229: 117782, 2021 Jan 23.
Artigo em Inglês | MEDLINE | ID: mdl-33497777

RESUMO

INTRO: The human sense of smell is highly individual and characterized by a strong variability in the perception and evaluation of olfactory stimuli, depending on cultural imprint and current physiological conditions. Since this individual perspective has often been neglected in fMRI studies on olfactory hedonic coding, this study focuses on the neuronal activity and connectivity patterns resulting from subject-specific olfactory stimulation. METHODS: Thirty-one normosmic participants took part in a fMRI block designed paradigm consisting of three olfactory stimulation sessions. The most pleasant and unpleasant odors were individually specified during a pre-test for each participant and validated in the main experiment. Mean activation and functional connectivity analysis focusing on the right and left piriform cortex were performed for the predefined olfactory regions-of-interest (ROIs) and compared between the three olfactory conditions. RESULTS: Individual unpleasant olfactory stimulation as compared to pleasant or neutral did not alter mean BOLD activation in the predefined olfactory ROIs but led to a change in connectivity pattern in the right piriform cortex. CONCLUSION: Our data suggests that the individual pleasantness of odors is not detectable by average BOLD magnitude changes in primary or secondary olfactory brain areas, but reflected in temporal patterns of joint activation that create a network between the right piriform cortex, the left insular cortex, the orbitofrontal cortex, and the precentral gyrus. This network may serve the evolutionary defense mechanism of olfaction by preparing goal-directed action.

11.
Artigo em Inglês | MEDLINE | ID: mdl-33453291

RESUMO

BACKGROUND: Respiratory tract viruses are the second most common cause of olfactory dysfunction. As we learn more about the effects of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), with the recognition that olfactory dysfunction is a key symptom of this disease process, there is a greater need than ever for evidence-based management of postinfectious olfactory dysfunction (PIOD). OBJECTIVE: Our aim was to provide an evidence-based practical guide to the management of PIOD (including post-coronavirus 2019 cases) for both primary care practitioners and hospital specialists. METHODS: A systematic review of the treatment options available for the management of PIOD was performed. The written systematic review was then circulated among the members of the Clinical Olfactory Working Group for their perusal before roundtable expert discussion of the treatment options. The group also undertook a survey to determine their current clinical practice with regard to treatment of PIOD. RESULTS: The search resulted in 467 citations, of which 107 articles were fully reviewed and analyzed for eligibility; 40 citations fulfilled the inclusion criteria, 11 of which were randomized controlled trials. In total, 15 of the articles specifically looked at PIOD whereas the other 25 included other etiologies for olfactory dysfunction. CONCLUSIONS: The Clinical Olfactory Working Group members made an overwhelming recommendation for olfactory training; none recommended monocycline antibiotics. The diagnostic role of oral steroids was discussed; some group members were in favor of vitamin A drops. Further research is needed to confirm the place of other therapeutic options.

12.
J Alzheimers Dis ; 79(2): 585-595, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-33361601

RESUMO

BACKGROUND: Odor identification dysfunction occurs early in Alzheimer's disease (AD) and is considered a preclinical symptom along with subjective cognitive decline (SCD). Nevertheless, whether subjects with SCD are co-symptomatic with odor identification dysfunction remains unclear. OBJECTIVE: To compare the degree of odor identification dysfunction and assess the relation between odor identification and cognitive performance in the AD spectrum (including SCD, mild cognitive impairment (MCI), and AD). METHODS: Patients (84 SCD, 129 MCI, 52 AD) and 35 controls underwent the Sniffin' Sticks Screen 16 test and comprehensive neuropsychological examination. RESULTS: Odor identification scores were progressively lower moving from normal older adult to SCD, MCI, and AD. Additionally,the proportion of odor identification dysfunction were increasingly higher in the AD spectrum (p for trend <0.001), but no significant difference was found in the proportion of subjective olfactory dysfunction. No significant correlation was found between odor identification and cognition in the normal older adults and SCD subjects, but odor identification correlated with global cognition in the MCI (r = 0.199, p = 0.033) and in the AD (r = 0.300, p = 0.036) patients. Multiple linear regression showed that odor identification dysfunction was most strongly associated with memory among different cognitive subdomains and was most strongly associated with immediate verbal recall among different memory subdomains. CONCLUSION: Odor identification dysfunction is already present with SCD and deepens with disease severity in the AD spectrum, and it may contribute to predicting cognitive decline and identifying SCD subjects who are at risk of developing AD.

13.
Chem Senses ; 462021 Jan 01.
Artigo em Inglês | MEDLINE | ID: mdl-33347544

RESUMO

Olfactory habituation corresponds to a decreased behavioral or perceptual response to an odor after a prolonged exposure to this odor. Our aim was to investigate whether long-term olfactory habituation and its recovery are similar in young (<35 years old) and older adults (>50). Fifty-seven participants were recruited for a 5-week longitudinal study. They were exposed to one of the two odors (manzanate alpha [MA], irone alpha [IA]) for 2 weeks at home. Olfactory detection thresholds for both odors were measured before and after exposure. Results showed that the two age groups behaved similarly. The long-term exposure to an odor led to a temporary increase of its detection threshold (lower sensitivity to the odor). IA thresholds were more sensitive to the duration of exposure with the odor than MA thresholds. One week after termination of exposure, participants fully recovered and even became more sensitive to both odors. No cross-habituation was found between the two odors. Our findings highlight that long-term habituation is specific to the odor exposed, behaves the same in young and older adults, and is fully reversible in both age groups after 1 week.

14.
Neurol Res Pract ; 2: 51, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-33283160

RESUMO

Infection with the new severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) leads to a previously unknown clinical picture, which is known as COVID-19 (COrona VIrus Disease-2019) and was first described in the Hubei region of China. The SARS-CoV-2 pandemic has implications for all areas of medicine. It directly and indirectly affects the care of neurological diseases. SARS-CoV-2 infection may be associated with an increased incidence of neurological manifestations such as encephalopathy and encephalomyelitis, ischemic stroke and intracerebral hemorrhage, anosmia and neuromuscular diseases. In October 2020, the German Society of Neurology (DGN, Deutsche Gesellschaft für Neurologie) published the first guideline on the neurological manifestations of the new infection. This S1 guideline provides guidance for the care of patients with SARS-CoV-2 infection regarding neurological manifestations, patients with neurological disease with and without SARS-CoV-2 infection, and for the protection of healthcare workers. This is an abbreviated version of the guideline issued by the German Neurological society and published in the Guideline repository of the AWMF (Working Group of Scientific Medical Societies; Arbeitsgemeinschaft wissenschaftlicher Medizinischer Fachgesellschaften).

15.
Clin Otolaryngol ; 2020 Dec 28.
Artigo em Inglês | MEDLINE | ID: mdl-33370507

RESUMO

OBJECTIVE: The aim of the pilot study was to explore which of the salivary parameters best reflects improvement or deterioration of taste function. METHODS: A total of 14 patients were included. Taste ability was measured using taste strips and patients rated their symptom strength using visual analogue scales. Salivary parameters (flow rate, total proteins, proteolysis, catalase, total anti-oxidative capacity [TAC], carbonic anhydrase VI [caVI], and pH) were determined and the Beck Depression Inventory (BDI) was administered. All these parameters were measured twice with a one-year interval to acquire the changes of data. RESULTS: Patients with decreased taste function exhibited a decrease in salivary proteolysis and caVI, and an increase in salivary total protein. Patients with increased taste function also showed an increase in salivary total protein. Δ Salivary flow rate was negatively correlated with Δ taste strip scores. Δ Salivary pH was significantly lower in patients with increased taste function compared to patients with decreased taste function. Δ BDI was positively correlated with both Δ symptoms ratings. Across all patients, symptom ratings decreased while salivary total protein increased; salivary flow rate, proteolysis and caVI decreased significantly compared with baseline. CONCLUSIONS: The present longitudinal results suggest that changes of both taste function and taste complaints were accompanied by changes in salivary parameters, indicating that salivary parameters have the potential to be useful in the diagnosis of patients with qualitative taste disorders.

16.
PLoS One ; 15(12): e0243941, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-33326498

RESUMO

BACKGROUND: To introduce new ways to calculate OB volumes, checking their validity and comparing them to already established technique i.e. OB volumetric based on manual segmentation of OB boundaries. METHODS: Two approaches were used to calculate OB volumes (1) Manual Segmentation using planimetric manual contouring; (2) Box-frame method, calculating the parameters based on a box placed around the OB. RESULTS: We calculated OB volumes using both techniques and found comparable outcomes. High inter-observer reliability was found for volumes calculated by both observers. For manual segmentation, Cronbach's alpha (α) was 0.91 and 0.93 for right and left OB volume, respectively, whereas for the box-frame method α was 0.94 and 0.90 for right and left OB, respectively. CONCLUSIONS: The simple box-frame method of OB volume calculation appears reliable. Its results are comparable to an established technique.


Assuntos
Bulbo Olfatório/anatomia & histologia , Tamanho do Órgão/fisiologia , Olfato/fisiologia , Feminino , Humanos , Imagem por Ressonância Magnética , Masculino , Pessoa de Meia-Idade , Bulbo Olfatório/diagnóstico por imagem
17.
Dtsch Arztebl Int ; 117(41): 689, 2020 10 09.
Artigo em Inglês | MEDLINE | ID: mdl-33357339
18.
Compr Rev Food Sci Food Saf ; 19(6): 3439-3475, 2020 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-33337044

RESUMO

The intention to send a crewed mission to Mars involves a huge amount of planning to ensure a safe and successful mission. Providing adequate amounts of food for the crew is a major task, but 20 years of feeding astronauts on the International Space Station (ISS) have resulted in a good knowledge base. A crucial observation from the ISS is that astronauts typically consume only 80% of their daily calorie requirements when in space. This is despite daily exercise regimes that keep energy usage at very similar levels to those found on Earth. This calorie deficit seems to have little effect on astronauts who spend up to 12 months on the ISS, but given that a mission to Mars would take 30 to 36 months to complete, there is concern that a calorie deficit over this period may lead to adverse effects in crew members. The key question is why astronauts undereat when they have a supply of food designed to fully deliver their nutritional needs. This review focuses on evidence from astronauts that foods taste different in space, compared to on Earth. The underlying hypothesis is that conditions in space may change the perceived flavor of the food, and this flavor change may, in turn, lead to underconsumption by astronauts. The key areas investigated in this review for their potential impact on food intake are the effects of food shelf life, physiological changes, noise, air and water quality on the perception of food flavor, as well as the link between food flavor and food intake.

19.
PLoS One ; 15(12): e0244330, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-33373378

RESUMO

INTRODUCTION: Reduced antiplatelet activity of aspirin (ALR) or clopidogrel (CLR) is associated with an increased risk of thromboembolic events. The reported prevalence data for low-responders vary widely and there have been few investigations in vascular surgery patients even though they are at high risk for thromb-embolic complications. The aim of this prospective observational monocentric study was to elucidate possible changes in ALR or CLR after common vascular procedures. METHODS: Activity of aspirin and clopidogrel was measured by impedance aggregometry using a multiple electrode aggregometer (Multiplate®). Possible risk factors for ALR or CLR were identified by demographical, clinical data and laboratory parameters. In addition, a follow-up aggregometry was performed after completion of the vascular procedure to identify changes in antiplatelet response. RESULTS: A total of 176 patients taking antiplatelet medications aspirin and/or clopidogrel with peripheral artery disease (PAD) and/or carotid stenosis (CS) were included in the study. The prevalence of ALR was 13.1% and the prevalence of CLR was 32% in the aggregometry before vascular treatment. Potential risk factors identified in the aspirin group were concomitant insulin medication (p = 0.0006) and elevated C-reactive protein (CRP) (p = 0.0021). The overall ALR increased significantly postoperatively to 27.5% (p = 0.0006); however, there was no significant change in CLR that was detected. In a subgroup analysis elevation of the platelet count was associated with a post-procedure increase of ALR incidence. CONCLUSION: The incidence of ALR in vascular surgery patients increases after vascular procedures. An elevated platelet count was detected as a risk factor. Further studies are necessary to analyse this potential influence on patency rates of vascular reconstructions.

20.
Neuroscience ; 452: 126-137, 2020 Nov 14.
Artigo em Inglês | MEDLINE | ID: mdl-33197506

RESUMO

Flavor perception results from the integration of at least odor and taste. Evidence for such integration is that odors can have taste properties (odor-induced taste). Most brain areas involved in flavor perception are high-level areas; however, primary gustatory and olfactory areas also show activations in response to a combination of odor and taste. While the regions involved in flavor perception are now quite well identified, the network's organization is not yet understood. Using a close to real salty soup model with electroencephalography brain recording, we evaluated whether odor-induced saltiness enhancement would result in differences of amplitude and/or latency in late cognitive P3 peak mostly and/or in P1 early sensory peak. Three target solutions were created from the same base of green-pea soup: i) with a "usual" salt concentration (PPS2), ii) with "reduced" salt (PPS1: -50%), and iii) with reduced salt and a "beef stock" odor (PPS1B). Sensory data showed that the beef odor produced saltiness enhancement in PPS1B in comparison to PPS1. As the main EEG result, the late cognitive P3 peak was delayed by 25 ms in the odor-added solution PPS1B compared to PPS1. The odor alone did not explain this peak amplitude and higher latency in the P3 peak. These results support the classical view that high-level integratory areas process odor-taste interactions with potential top-down effects on primary sensory regions.

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