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Min, Hyun Jin. "Pharmacologic therapy of olfaction disroders induced by COVID-19 upper respiratory infection." Journal of the Korean Medical Association 63, no. 9 (September 10, 2020): 561–65. http://dx.doi.org/10.5124/jkma.2020.63.9.561.
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Postviral olfactory disorder refers to the sensorineural olfactory loss caused by upper respiratory tract infections. With the increasing awareness of olfactory or gustatory dysfunction as a potential early symptom of coronavirus disease 2019, postviral olfactory disorder has been attracting much attention. Postviral olfactory disorder is the most common type of olfactory disorder, especially among women aged over 50 years. Systemic or topical corticosteroids have commonly been used for treating this disorder, but the mechanism of corticosteroid action is unclear. Other medical treatment options such as alpha-lipoic acids and caroverine that stimulate nerve growth factor expression or prevent glutamatergic neurotoxicity have also been used. Although these drugs have been found to be useful in the treatment of postviral olfactory disorder in previous studies, the efficacy has not been statistically proven through a meta-analysis. Recently, olfactory training has been introduced in the treatment strategy for postviral olfactory disorder. It is a safe option without side effects that can be used for treating olfactory disorders caused by upper respiratory tract infections. Further rigorous studies are needed to determine the efficacy of the combination of drug treatment and olfactory training.
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Harju, Teemu, Markus Rautiainen, and Ilkka Kivekäs. "Significance of Imaging in the Diagnosis of Olfactory Disorder." Ear, Nose & Throat Journal 96, no. 2 (February 2017): E13—E17. http://dx.doi.org/10.1177/014556131709600213.
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The aim of this retrospective analysis was to examine olfactory disorders among the patients in the Ear, Nose, and Throat Clinic of Tampere University Hospital, Finland, from 2001 to 2011, and to evaluate the necessity of imaging in the examination of patients with olfactory disorders. Charts of 143 consecutive patients with a primary olfactory disorder were examined, and 69 patients who had undergone the necessary testing were included in the study. The most common causes of olfactory disorder were upper respiratory infection (23%), chronic rhinosinusitis (19%), head trauma (17%), and allergic or nonallergic rhinitis (6%). In 25% of the patients, no obvious cause for the symptoms was found. Computed tomography (CT) scans were normal in 37 of 52 (71%) patients and magnetic resonance imaging was normal in 21 of 25 (84%) patients. No intracranial or intranasal tumors were found in the overall cohort. Of the patients with additional symptoms (facial pain, headache, nasal discharge, or stuffiness), 58% had chronic rhinosinusitis. Of the patients with no additional symptoms or signs associated with chronic rhinosinusitis on clinical evaluation, only 2% had chronic rhinosinusitis on imaging. Only the detection of chronic rhinosinusitis and head trauma had clinical value in the determination of the etiology. A sinonasal CT scan should be considered in patients who have at least one symptom associated with sinusitis in addition to an olfactory disorder to confirm the etiology and to find those patients who may benefit from medical therapy or surgical treatment.
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Jung, Hwae-Joon, and Heung-Man Lee. "Contemporary Review of Olfactory Dysfunction in COVID-19." Journal of Rhinology 28, no. 2 (July 31, 2021): 73–80. http://dx.doi.org/10.18787/jr.2020.00346.
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The pandemic of coronavirus disease 2019 (COVID-19) is an extreme threat to international health care, resulting in more than two million deaths. Data reveal that olfactory disorder is a characteristic symptom of COVID-19 and has unique clinical manifestations. The olfactory dysfunction induced by COVID-19 has sudden onset, short duration, and rapid recovery, with anosmia often the only symptom. Severe acute respiratory syndrome-coronavirus-2 (SARS-CoV-2) affects the human body by binding to angiotensin converting enzyme 2 (ACE2) of the olfactory epithelium. However, the etiology of COVID-19-induced olfactory dysfunction is unclear. In many countries, vaccines for COVID-19 in human are beginning to be administered. Conventional conservative treatments are common for olfactory disorders caused by COVID-19. Rhinologists should be aware of olfactory dysfunction to avoid delayed diagnosis of COVID-19. The article reviews the latest scientific evidence of anosmia in COVID-19.
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Avrunin, Oleg, Yana Nosova, Sergii Zlepko, Ibrahim Younouss Abdelhamid, and Nataliia Shushliapina. "ASSESSMENT OF THE DIAGNOSTIC VALUE OF THE METHOD OF COMPUTER OLFACTOMETRY." Informatyka, Automatyka, Pomiary w Gospodarce i Ochronie Środowiska 9, no. 3 (September 26, 2019): 18–21. http://dx.doi.org/10.35784/iapgos.236.
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Olfactory studies can be a criterion for evaluating rhinosurgical intervention, and olfactory impairment may indicate respiratory impairment. Therefore, the urgent task is to develop an integrated approach to determining respiratory and olfactory disorders. A structural scheme was developed for the method of objective diagnosis of respiratory and olfactory disorders, taking into account the measu, rement of both the aerodynamic parameters of nasal breathing and the calculation of energy characteristics, which are used to determine olfactory sensitivity. The diagnostic significance of the proposed method of analyzing rhinofolipometry data with regard to additional parameters was assessed - it is necessary to take into account the time and power of breathing when the threshold of sensation of the odorivector is at the transition point of the airflow mode to the turbulent quadratic. It has been established that it is advisable to use the energy criteria of nasal breathing, pneumatic power and energy of nasal breathing under the action of the corresponding odor vector for the assessment of respiratory impaired olfactory. To assess the respiratory impairment of olfactory, it is necessary to use the method in which an odor vector is installed in the air path of the rhinomanometer, and the patient is asked to perform breathing maneuvers with a consistent increase in respiration rate while fixing the time at which olfactory sensitivity is achieved and then determining the respiratory energy characteristics. A statistical processing of diagnostic results was carried out, which confirms the adequacy of the model of independent statistical verification and makes it possible to use this method for the functional diagnosis of respiratory-olfactory disorders and testing of respiratory-olfactory sensitivity. The probability index of the error of the second kind is 0.17.
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Archer, Sanford M. "The Evaluation and Management of Olfactory Disorder Following Upper Respiratory Tract Infection." Archives of Otolaryngology–Head & Neck Surgery 126, no. 6 (June 1, 2000): 800. http://dx.doi.org/10.1001/archotol.126.6.800.
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Pan, Xiaodan, Yuan Zhang, Chengshuo Wang, and Luo Zhang. "Evaluation of nasal symptoms to distinguish eosinophilic from noneosinophilic nasal polyps based on peripheral blood." Allergy and Asthma Proceedings 42, no. 3 (May 1, 2021): 214–21. http://dx.doi.org/10.2500/aap.2021.42.210004.
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Background: Patients with eosinophilic chronic rhinosinusitis with nasal polyps (eCRSwNP) have poorer outcomes after endoscopic sinus surgery and a higher recurrence rate. Objective: This study aimed to investigate the profile of clinical symptoms of eCRSwNP and the related risk factors. Methods: We prospectively enrolled 298 inpatients with CRSwNP from February 2019 to December 2019. The patients were divided into eCRSwNP and non-eCRSwNP groups based on the percentage of blood eosinophils; the cutoff value was set at 3.05%. Clinical data on questionnaires, visual analog scale (VAS) scores, and laboratory tests were collected. The differences in clinical symptoms, including nasal congestion, rhinorrhea, olfactory disorders, and head and/or facial pain, between the two groups were analyzed to identify the influential factors. Logistic analysis and receiver operating characteristic curves were used to determine the diagnostic benefit for the specific symptom in the patients in the eCRSwNP group. Results: Nasal congestion and olfactory disorders were significantly different between the eCRSwNP and non-eCRSwNP groups. The patients in the eCRSwNP group more frequently had concerns about olfactory disorders (p = 0.002), whereas patients in the non-eCRSwNP group mostly had nasal congestion (p = 0.001). The logistic analysis showed that the primary risk factors for olfactory disorders of eCRSwNP were disease duration (p = 0.014) and alcohol intake (p = 0.012). Olfactory disorders were not associated with the disease course of the eCRSwNP group but were correlated with the disease duration of non-eCRSwNP (p = 0.008). A VAS score for the olfactory disorders of >5.75 could be used to predict the diagnosis of eCRSwNP (area under the curve, 0.674 [95% confidence intervals, 0.559‐0.689]; P < 0.001). Conclusion: Olfactory disorder might be the major nasal symptom that could be used to distinguish a peripheral eosinophilia‐based definition of eCRSwNP and non-eCRSwNP. The disease duration was a limiting factor for using olfactory to distinguish two subgroups of nasal polyp. The investigation with regard to the accurate time boundary should be further addressed.
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Fernandez, I. J., G. Molinari, G. Federici, M. Silvestri, E. De Corso, L. Presutti, M. Alicandri-Ciufelli, and D. Lucidi. "Delayed recovery from severe acute respiratory syndrome coronavirus-2 related anosmia predicts incomplete olfactory restoration." Journal of Laryngology & Otology 136, no. 3 (December 13, 2021): 237–42. http://dx.doi.org/10.1017/s0022215121004047.
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AbstractObjectiveThis study aimed to assess the olfactory recovery rates and patterns in a cohort of coronavirus disease 2019 positive patients, and to investigate the clinical predictors of poor long-term olfactory restoration.MethodsAn observational retrospective study was conducted on 146 patients between September 2020 and January 2021 at a tertiary referral hospital. Coronavirus disease 2019 positive patients with olfactory dysfunction were sent a modified version of the COVID-19 Anosmia Reporting Tool for Clinicians via e-mail.ResultsThe difference in median recovery time between complete recovery and incomplete or no recovery was statistically significant. On multivariate analysis, the only significant factor associated with incomplete or no recovery was anosmia duration.ConclusionAfter a mean time of 5.6 months from severe acute respiratory syndrome coronavirus-2 infection, persistent olfactory disorders were self-reported in 36.7 per cent of patients. Complete recovery was more likely to occur within 15 days. Given the high prevalence of coronavirus disease 2019, a large number of patients are expected to suffer from long-term olfactory morbidity.
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Daikhes, N. A., V. V. Vinogradov, S. S. Reshul’skii, M. L. Isaeva, E. B. Fedorova, A. M. Khabazova, E. V. Osipenko, et al. "Comprehensive rehabilitation of patients after total laryngectomy: major developmental milestones." Russian Otorhinolaryngology 21, no. 1 (2022): 93–104. http://dx.doi.org/10.18692/1810-4800-2022-1-93-104.
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Laryngectomy is a common treatment of locoregionally advanced (stage III and IV) laryngeal and hypopharyngeal cancer. Surgical treatment causes both vital (breathing, swallowing) and communicative (voice, smell) functions disorder. The degree of recovery of these functions affects the patient’s quality of life, the return to work, and the ability to be an active member of society. The most important role for psychosocial adaptation is played by the restoration of voice function. However, it is not the only direction in the rehabilitation of laryngectomized patients. Correction of the respiratory, swallowing, and olfactory disorders is also important and requires a multidisciplinary team of specialists. The article provides an overview of main methods of restoring lost functions after laryngectomy in historical retrospective.
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Rapiejko, Piotr. "Sense of smell disorders in family physician practice." Alergoprofil 17, no. 2 (May 26, 2021): 47–53. http://dx.doi.org/10.24292/01.ap.172260521.
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A properly functioning sense of smell recognizes both food and danger and provides sensory input. Sense of smell is lost and/or impaired in diseases accompanied by impaired nasal patency such as chronic rhinosinusitis with or without nasal polyps, allergic rhinitis, respiratory infections including acute rhinosinusitis. In the case of rhinosinusitis in adults, olfactory impairment is one of the four main symptoms of the disease. They can also be caused by damage to the olfactory neuron, e.g. in the course of a viral infection. Loss of smell and/or taste reported by patients with COVID-19 may be a diagnostic hint. Modern intranasal glucocorticosteroids are used to treat olfactory disturbances and loss of smell caused by nasal patency impairment (or accompanying diseases with nasal patency impairment).
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Yoo, Shin Hyuk, Hae-Won Kim, and Jun Hee Lee. "Restoration of olfactory dysfunctions by nanomaterials and stem cells-based therapies: Current status and future perspectives." Journal of Tissue Engineering 13 (January 2022): 204173142210834. http://dx.doi.org/10.1177/20417314221083414.
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Dysfunction in the olfactory system of a person can have adverse effects on their health and quality of life. It can even increase mortality among individuals. Olfactory dysfunction is related to many factors, including post-viral upper respiratory infection, head trauma, and neurodegenerative disorders. Although some clinical therapies such as steroids and olfactory training are already available, their effectiveness is limited and controversial. Recent research in the field of therapeutic nanoparticles and stem cells has shown the regeneration of dysfunctional olfactory systems. Thus, we are motivated to highlight these regenerative approaches. For this, we first introduce the anatomical characteristics of the olfactory pathway, then detail various pathological factors related to olfactory dysfunctions and current treatments, and then finally discuss the recent regenerative endeavors, with particular focus on nanoparticle-based drug delivery systems and stem cells. This review offers insights into the development of future therapeutic approaches to restore and regenerate dysfunctional olfactory systems.
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Qiu, Chenghao, Chong Cui, Charlotte Hautefort, Antje Haehner, Jun Zhao, Qi Yao, Hui Zeng, et al. "Olfactory and Gustatory Dysfunction as an Early Identifier of COVID-19 in Adults and Children: An International Multicenter Study." Otolaryngology–Head and Neck Surgery 163, no. 4 (June 16, 2020): 714–21. http://dx.doi.org/10.1177/0194599820934376.
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Objective To evaluate the prevalence and characteristics of olfactory or gustatory dysfunction in coronavirus disease 2019 (COVID-19) patients. Study Design Multicenter case series. Setting Five tertiary care hospitals (3 in China, 1 in France, 1 in Germany). Subjects and Methods In total, 394 polymerase chain reaction (PCR)–confirmed COVID-19-positive patients were screened, and those with olfactory or gustatory dysfunction were included. Data including demographics, COVID-19 severity, patient outcome, and the incidence and degree of olfactory and/or gustatory dysfunction were collected and analyzed. The Questionnaire of Olfactory Disorders (QOD) and visual analog scale (VAS) were used to quantify olfactory and gustatory dysfunction, respectively. All subjects at 1 hospital (Shanghai) without subjective olfactory complaints underwent objective testing. Results Of 394 screened subjects, 161 (41%) reported olfactory and/or gustatory dysfunction and were included. Incidence of olfactory and/or gustatory disorders in Chinese (n = 239), German (n = 39), and French (n = 116) cohorts was 32%, 69%, and 49%, respectively. The median age of included subjects was 39 years, 92 of 161 (57%) were male, and 10 of 161 (6%) were children. Of included subjects, 10% had only olfactory or gustatory symptoms, and 19% had olfactory and/or gustatory complaints prior to any other COVID-19 symptom. Of subjects with objective olfactory testing, 10 of 90 demonstrated abnormal chemosensory function despite reporting normal subjective olfaction. Forty-three percent (44/102) of subjects with follow-up showed symptomatic improvement in olfaction or gustation. Conclusions Olfactory and/or gustatory disorders may represent early or isolated symptoms of severe acute respiratory syndrome coronavirus 2 infection. They may serve as a useful additional screening criterion, particularly for the identification of patients in the early stages of infection.
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Popelyansky, A. Y. "About olfactory dysfunction in patients with neurotic disorders." Neurology Bulletin XXVIII, no. 1-2 (May 22, 1996): 35. http://dx.doi.org/10.17816/nb79407.
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In a specialized department of neuroses, the olfactory function was studied in 74 persons (68 women and 6 men from 21 to 63 years old) without a runny nose and other signs of acute respiratory infections. The control group consisted of 30 relatively healthy people. Attention was paid to anamnestic information about the originality of smell (dysesthesia, hyper- or hyposmia). A clinical experiment was conducted to recognize the smell of cologne, perfumes, deodorants and food products, taking into account the time and accuracy of the determination.
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Haehner, Antje, Belinda Marquardt, Romina Kardashi, Katja de With, Susann Rößler, Basile Nicolas Landis, Antje Welge-Luessen, and Thomas Hummel. "SARS-CoV-2 Leads to Significantly More Severe Olfactory Loss than Other Seasonal Cold Viruses." Life 12, no. 3 (March 21, 2022): 461. http://dx.doi.org/10.3390/life12030461.
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The aim of this study was to investigate whether COVID-associated olfactory impairment differs from olfactory disorders due to other upper respiratory tract infections. We investigated the frequency of a SARS-CoV-2 infection among subjects presenting with a subjective olfactory impairment to a corona outpatient clinic between October 2020 and March 2021. Olfactory and gustatory loss were tested psychophysically, and the type of infection, SARS-CoV-2 versus 14 other common cold viruses, was assessed with nasopharyngeal swabs. Differences between the smell impairment caused by the pathogens were compared. Out of the 2120 patients, 314 reported sudden smell and/or taste loss (14%). In 68.9% of them, olfactory and in 25.6%, gustatory dysfunction could be confirmed by psychophysical testing. Of those with a psychophysically determined loss of smell, 61% were tested positive for SARS-CoV-2. SARS-CoV-2 led to a significantly more severe loss of smell and more qualitative olfactory disorders than other pathogens. Apart from rhinorrhea, shortness of breath and sore throat accompanying cold symptoms do not differ significantly between the viruses indicating the particular importance of smell loss in the differential diagnosis of seasonal colds. Multiplex-PCR in non-COVID patients revealed that only 27% of them had rhinoviruses, whereas the remainder were no further identified pathogens. Olfactory screening significantly increases diagnostic accuracy in COVID-19 patients compared to subjective assessment of olfactory loss.
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Coolen, Tim, Valentina Lolli, Niloufar Sadeghi, Antonin Rovai, Nicola Trotta, Fabio Silvio Taccone, Jacques Creteur, et al. "Early postmortem brain MRI findings in COVID-19 non-survivors." Neurology 95, no. 14 (June 16, 2020): e2016-e2027. http://dx.doi.org/10.1212/wnl.0000000000010116.
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ObjectivesThe severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) is considered to have potential neuroinvasiveness that might lead to acute brain disorders or contribute to respiratory distress in patients with coronavirus disease 2019 (COVID-19). This study investigates the occurrence of structural brain abnormalities in non-survivors of COVID-19 in a virtopsy framework.MethodsIn this prospective, monocentric, case series study, consecutive patients who fulfilled the following inclusion criteria benefited from an early postmortem structural brain MRI: death <24 hours, SARS-CoV-2 detection on nasopharyngeal swab specimen, chest CT scan suggestive of COVID-19, absence of known focal brain lesion, and MRI compatibility.ResultsAmong the 62 patients who died of COVID-19 from March 31, 2020, to April 24, 2020, at our institution, 19 decedents fulfilled the inclusion criteria. Parenchymal brain abnormalities were observed in 4 decedents: subcortical microbleeds and macrobleeds (2 decedents), cortico-subcortical edematous changes evocative of posterior reversible encephalopathy syndrome (PRES; 1 decedent), and nonspecific deep white matter changes (1 decedent). Asymmetric olfactory bulbs were found in 4 other decedents without downstream olfactory tract abnormalities. No brainstem MRI signal abnormality was observed.ConclusionsPostmortem brain MRI demonstrates hemorrhagic and PRES-related brain lesions in non-survivors of COVID-19. SARS-CoV-2–related olfactory impairment seems to be limited to olfactory bulbs. Brainstem MRI findings do not support a brain-related contribution to respiratory distress in COVID-19.
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Manhas, Monica, Disha Koul, Gopika Kalsotra, Amit Manhas, Parmod Kalsotra, Parmil Kumar, Abid Bhat, Anchal Gupta, and Aditya Saraf. "Incidence of Olfactory and Gustatory Dysfunctions in the Early Stages of COVID-19: An Objective Evaluation." International Archives of Otorhinolaryngology 26, no. 02 (April 2022): e265-e271. http://dx.doi.org/10.1055/s-0042-1743274.
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Abstract Introduction Coronavirus disease 2019 (COVID-19) is a dangerous infectious disease caused by a newly discovered severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) that has various clinical presentations. Numerable cases with non-specific olfactory and gustatory dysfunctions in COVID-19 have been reported from all over the globe. This is important as awareness will let people to self-isolate and help in limiting disease spread. Objective To objectively evaluate the frequency of olfactory and gustatory dysfunction, which may occur independently or with other symptoms, in laboratory confirmed COVID-19 patients at an early stage of the disease. Methods Objective evaluation of olfactory and gustatory function of 322 COVID-19 patients treated at our hospital, (SMGS, Government Medical College, Jammu), from August 2020 until November 2020. Results Our study population included 127 (39.4%) males and 195 (60.6%) females. Two hundred and twenty-six (70.2%) COVID-19 patients experienced olfactory and gustatory disorders. One hundred and sixty-five (51.2%) cases experienced both olfactory and gustatory disorders. Isolated olfactory dysfunction was reported in 34 (10.6%) patients, while 27 (8.4%) patients experienced only gustatory dysfunction. Conclusion The olfactory and gustatory dysfunctions, without any nasal obstruction or rhinorrhea, are significant symptoms in the clinical presentation of early COVID-19 patients. This presentation can be recognized at the earliest one, and it can reduce the high communicability of the COVID-19 disease.
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Bashar, Mohd Abu, and Nazia Begam. "Olfactory and taste disorders in COVID-19 patients: an update." International Journal of Scientific Reports 6, no. 9 (August 20, 2020): 379. http://dx.doi.org/10.18203/issn.2454-2156.intjscirep20203555.
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Since December 2019, a pandemic of coronavirus disease 2019 (COVID-19) caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) has spread globally. A spectrum of disease severity has been reported for the infection, with main symptoms of fever, fatigue, dry cough, myalgia, and dyspnoea.
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Park, Hyun-Joo, Dong Yeon Kim, Jung-Ho Bae, and Seung-Sin Lee. "The Effect of Stellate Ganglion Block on the Treatment of Sensorineural Olfactory Disorder Following Upper Respiratory Tract Infection." Korean Journal of Otorhinolaryngology-Head and Neck Surgery 56, no. 2 (2013): 84. http://dx.doi.org/10.3342/kjorl-hns.2013.56.2.84.
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Shuprovich, A. A. "Neurotropic effects of respiratory viral infections: mental and neuropsychological aspects." INTERNATIONAL JOURNAL OF ENDOCRINOLOGY (Ukraine) 17, no. 6 (January 4, 2022): 496–502. http://dx.doi.org/10.22141/2224-0721.17.6.2021.243215.
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The review is devoted to the problem of neurological complications that result from respiratory viral infections due to viral invasion to the central and peripheral nervous systems. Psychoneurological consequences after the disease of COVID-19 are considered separately. Viral pathogens can enter the central nervous system (CNS) in various ways, including through hematogenous infection of the endothelium (the “Trojan horse” mechanism) as well as through peripheral nerves or olfactory sensory neurons. The latter route is mostly used by respiratory viruses, such as coronaviruses (CoV), which enter the body intranasally because the olfactory nerve connects the nasal epithelium with the olfactory bulb — the way to the CNS. CoV in the human brain can cause long-term effects associated with the development or exacerbation of chronic neurological diseases, such as multiple sclerosis. Coronavirus COVID-19, which causes coronavirus disease, can provoke long-term outcomes after recovery, such as psychiatric symptoms and cognitive impairment, which are detected by cognitive screening. In the post-COVID period, patients demonstrated poor cognitive performance in the areas of attention, performance, and memory as well as increased levels of depression, anxiety, post-traumatic stress, fatigue, and sleep disturbances. These effects should be considered as possible post-viral disorders that require special diagnosis and appropriate treatment. Significant heterogeneity of applied approaches and methods hinders the comprehensive characterization of cognitive functions in specific areas since the studies often excluded people with previous cognitive impairment. Nevertheless, most studies indicate some degree of cognitive impairment in patients with COVID-19. Although the rates vary, a significant proportion of survivors show poor cognitive performance in the areas of attention, performance, and memory. These results have several important implications for further research, clinical management, and treatment of those who have experienced COVID-19.
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Spielman, A. I. "Chemosensory Function and Dysfunction." Critical Reviews in Oral Biology & Medicine 9, no. 3 (July 1998): 267–91. http://dx.doi.org/10.1177/10454411980090030201.
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Taste and smell are fundamental sensory systems essential in nutrition and food selection, for the hedonic and sensory experience of food, for efficient metabolism, and, in general, for the maintenance of a good quality of life. The gustatory and olfactory systems demonstrate a diversity of transduction mechanisms, and during the last decade, considerable progress has been made toward our understanding of the basic mechanisms of taste and smell. Understanding normal chemosensory function helps clarify the molecular events that underlie taste and smell disorders. At least 2,000,000 Americans suffer from chemosensory disorders-a number that is likely to grow as the aging segment of the population increases. Smell disorders are more frequent than taste disturbances, due to the vulnerability and anatomical distinctiveness of the olfactory system, and because a decline in olfactory function is part of the normal aging process. Common gustatory and olfactory complaints are due to a number of medications, to upper respiratory infections, to nasal and paranasal sinus diseases, and to damage to peripheral nerves supplying taste and smell. Most chemosensory complaints have an identifiable cause. Although diagnosis of taste and smell disorders has improved considerably over the last two decades, treatment of these disorders is still limited to conditions with discernible and reversible causes. Future research is needed for a better understanding of chemosensory mechanisms, establishing improved diagnostic procedures, and disseminating knowledge on chemosensory disorders among practitioners and the general public.
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Аrtemenkо, A. R., Al B. Danilov, and A. M. Plieva. "Smell dysfunction in patients with COVID-19." Russian neurological journal 25, no. 6 (January 7, 2021): 4–11. http://dx.doi.org/10.30629/2658-7947-2020-25-6-4-11.
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Coronavirus disease 2019 (COVID-19) is the cause of a global pandemic and the object of numerous studies worldwide. COVID-19 has many clinical manifestations, but smell dysfunction has become its unique “visiting card”. The purpose of this review is to analyze scientific data on anosmia in COVID-19 based on the results of primary research using PubMed, Google Scholar, and eLIBRARY databases. Olfactory dysfunction is a very common symptom in COVID-19: up to 85% of patients report these subjective sensations, but objective olfactory testing shows a higher prevalence — up to 98%. Up to 27% of patients may experience a sudden onset of anosmia as the first symptom. Therefore, anosmia can be crucial in timely identification of individuals infected with SARS-CoV 2. A feature of olfactory disorders in COVID-19 is the preservation of normal transnasal air flow conditions, when edema, hyperemia of the nasal mucosa and rhinorrhea characteristic of other respiratory viral infections are expressed slightly or aren`t expressed at all. Many studies show that the olfactory epithelium of the nasal cavity is an area of enhanced binding, replication, and accumulation of SARS-CoV2, which is due to the active expression of two host receptors (APF2 and TMPS2 proteases) by numerous non-neuronal olfactory epithelium cells. It is supposed that supporting cells of the olfactory epithelium are primarily affected, and olfactory receptor neurons and olfactory bulb neurons are affected secondarily. However, the final clinical and pathophysiological significance of olfactory symptoms remains to be determined
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Аrtemenkо, A. R., Al B. Danilov, and A. M. Plieva. "Smell dysfunction in patients with COVID-19." Russian neurological journal 25, no. 6 (January 7, 2021): 4–11. http://dx.doi.org/10.30629/2658-7947-2020-25-6-4-11.
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Coronavirus disease 2019 (COVID-19) is the cause of a global pandemic and the object of numerous studies worldwide. COVID-19 has many clinical manifestations, but smell dysfunction has become its unique “visiting card”. The purpose of this review is to analyze scientific data on anosmia in COVID-19 based on the results of primary research using PubMed, Google Scholar, and eLIBRARY databases. Olfactory dysfunction is a very common symptom in COVID-19: up to 85% of patients report these subjective sensations, but objective olfactory testing shows a higher prevalence — up to 98%. Up to 27% of patients may experience a sudden onset of anosmia as the first symptom. Therefore, anosmia can be crucial in timely identification of individuals infected with SARS-CoV 2. A feature of olfactory disorders in COVID-19 is the preservation of normal transnasal air flow conditions, when edema, hyperemia of the nasal mucosa and rhinorrhea characteristic of other respiratory viral infections are expressed slightly or aren`t expressed at all. Many studies show that the olfactory epithelium of the nasal cavity is an area of enhanced binding, replication, and accumulation of SARS-CoV2, which is due to the active expression of two host receptors (APF2 and TMPS2 proteases) by numerous non-neuronal olfactory epithelium cells. It is supposed that supporting cells of the olfactory epithelium are primarily affected, and olfactory receptor neurons and olfactory bulb neurons are affected secondarily. However, the final clinical and pathophysiological significance of olfactory symptoms remains to be determined
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Galmiche, Simon, Timothée Bruel, Yoann Madec, Laura Tondeur, Ludivine Grzelak, Isabelle Staropoli, Isabelle Cailleau, et al. "Characteristics Associated with Olfactory and Taste Disorders in COVID-19." Neuroepidemiology 55, no. 5 (2021): 381–86. http://dx.doi.org/10.1159/000517066.
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<b><i>Introduction:</i></b> Olfactory and taste disorders (OTDs) have been reported in COVID-19 caused by severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2), the mechanisms of which remain unclear. We conducted a detailed analysis of OTDs as part of 2 seroepidemiological investigations of COVID-19 outbreaks. <b><i>Methods:</i></b> Two retrospective cohort studies were conducted in a high school and primary schools of Northern France following a COVID-19 epidemic in February-March 2020. Students, their relatives, and school staff were included. Anti-SARS-CoV-2 antibodies were identified using a flow-cytometry-based assay detecting anti-S IgG. <b><i>Results:</i></b> Among 2,004 participants (median [IQR] age: 31 [11–43] years), 303 (15.2%) tested positive for SARS-CoV-2 antibodies. OTDs were present in 91 (30.0%) and 92 (30.3%) of them, respectively, and had 85.1 and 78.0% positive predictive values for SARS-CoV-2 infection, respectively. In seropositive participants, OTDs were independently associated with an age above 18 years, female gender, fatigue, and headache. <b><i>Conclusion:</i></b> This study confirms the higher frequency of OTDs in females than males and adults than children. Their high predictive value for the diagnosis of COVID-19 suggests that they should be systematically searched for in patients with respiratory symptoms, fever, or headache. The association of OTDs with headache, not previously reported, suggests that they share a common mechanism, which deserves further investigation.
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Antonevich, N. G., A. Y. Hancharou, V. L. Chekan, E. A. Shulepova, and A. H. Rynda. "Therapy of chronic stenosis of laryngotracheal stenosis with the use of mesenchymal stem cells: two-year observation results." Proceedings of the National Academy of Sciences of Belarus, Medical series 17, no. 4 (December 5, 2020): 417–26. http://dx.doi.org/10.29235/1814-6023-2020-17-4-417-426.
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Laryngotracheal stenosis is a serious pathological process that leads to the narrowing of the airways because of damage of the mucous membrane and the formation of pathophysiological mechanisms of regeneration. Mesenchymal stem cells (MSCs) are known to be able to suppress the inflammatory response and to stimulate tissue regeneration; that is why, they are a promising biomedical cell product for treatment of laryngotracheal stenosis. The aim of this study was to evaluate the safety, tolerability, and long-term clinical efficacy of cell therapy of laryngotracheal stenosis using autologous MSCs of the olfactory lining (OL). The clinicalstudy included patients with a diagnosis of laryngotracheal stenosis (J38.6 and J95.5 according to ICD-10) without compromising the integrity of the cartilage frame with or without a tracheostomy/laryngostomy, including patients after surgical interventions to restore the lumen of the larynx and trachea. Clinical trials of laryngotracheal stenosis using autologous olfactory mucosa-derived mesenchymal stem cells were carried out. Cell therapy was safe and well tolerated, and prevented the restenosis and formation of scar granulation tissue during 2 years of observation in all patients included in the clinical study. The restoration of the larynx and trachea lumen, the improved respiratory function and the increased exercise tolerance were observed in 6 patients who had no cartilage disorder. The data obtained indicate the high clinical efficacy of the method of cell therapy of laryngotracheal stenosis using autologous olfactory mucosa-derived mesenchymal stem cells.
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Shushliapina, N. O. "Analysis of the aerodynamic parameters influence of nosebreasing for diagnostics of respiratory-olfactory disorders." Klinical Informatics and Telemedicine 13, no. 14 (December 26, 2018): 74–80. http://dx.doi.org/10.31071/kit2018.14.09.
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Fung, Timothy K. H., Benson W. M. Lau, Shirley P. C. Ngai, and Hector W. H. Tsang. "Therapeutic Effect and Mechanisms of Essential Oils in Mood Disorders: Interaction between the Nervous and Respiratory Systems." International Journal of Molecular Sciences 22, no. 9 (May 3, 2021): 4844. http://dx.doi.org/10.3390/ijms22094844.
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Essential oils (EOs) are extracted from plants and contain active components with therapeutic effects. Evidence shows that various types of EOs have a wide range of health benefits. In our previous studies, the potential of lavender EO for prevention and even treatment of depression and anxiety symptoms was demonstrated. The favourable outcomes may be due to multiple mechanisms, including the regulation of monoamine level, the induction of neurotrophic factor expression, the regulation of the endocrine system and the promotion of neurogenesis. The molecules of EOs may reach the brain and exert an effect through two distinctive pathways, namely, the olfactory system and the respiratory system. After inhalation, the molecules of the EOs would either act directly on the olfactory mucosa or pass into the respiratory tract. These two delivery pathways suggest different underlying mechanisms of action. Different sets of responses would be triggered, such as increased neurogenesis, regulation of hormonal levels, activation of different brain regions, and alteration in blood biochemistry, which would ultimately affect both mood and emotion. In this review, we will discuss the clinical effects of EOs on mood regulation and emotional disturbances as well as the cellular and molecular mechanisms of action. Emphasis will be put on the interaction between the respiratory and central nervous system and the involved potential mechanisms. Further evidence is needed to support the use of EOs in the clinical treatment of mood disturbances. Exploration of the underlying mechanisms may provide insight into the future therapeutic use of EO components treatment of psychiatric and physical symptoms.
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Morozova, S. V., and L. A. Keda. "Rational approach to the treatment of acute rhinosinusitis in comorbides with dysosmia." Meditsinskiy sovet = Medical Council, no. 6 (May 27, 2020): 7–13. http://dx.doi.org/10.21518/2079-701x-2020-6-7-13.
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Dysosmia is a frequent symptom in acute rhinosinusitis. Post-infectious dysosmia has a large share in the structure of olfactory disorders. The most common is postviral dysosmia. The sense of smell in acute rhinosinusitis can change both in the conductive and sensorineural types, but most often it is of a mixed nature, has an acute beginning and a favorable prognosis. There is also a transformation of the olfactory epithelium into a multilayer flat or respiratory epithelium. The pathogenesis of acute rhinosinusitis is based on an increase in edema of the mucous membrane of the upper respiratory tract and, as a result, the block of the natural sinuses of the paranasal sinuses, which leads to a violation of their ventilation and stagnation of secretions in the sinus cavity. For the treatment of acute rhinosinusitis, antibacterial, vasoconstrictive drugs, elimination and irrigation therapy are used.it is important to restore mucociliary transport, and therefore it is necessary to prescribe mucoactive and secretolytic drugs. A special role among these medicines is played by herbal preparations, among which one of the most effective and well-studied is a combined herbal preparation that includes Gentiana lutea, Primula veris, Rumex acetosa, Sambucus nigra, Verbena officinalis. Due to the anti-inflammatory and secretolytic effects, treatment regimens that include this drug provide high efficiency and optimal treatment times for patients with acute rhinosinusitis. Studies have shown that this drug has shown inhibitory activity in vitro against respiratory viruses, including respiratory syncytial virus, adenovirus and parainfluenza. In addition, it has been proven that when using this drug, a pronounced anti-inflammatory effect develops in the form of a decrease in prostaglandin E2 levels, cyclooxygenase-2 expression, tumor necrosis factor, and especially interleukin. In addition, the inclusion of this drug in the complex therapy of acute rhinosinusitis contributes to the restoration of olfactory function in the form of reducing the threshold of smell, increasing the ability to distinguish and identify odors. Data from the studies presented in the article demonstrate high efficacy and good tolerance of this drug.
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Egorov, V. I., D. M. Mustafaev, A. O. Kochneva, and Zh E. Komarova. "New coronavirus infection in the practice of an otolaryngologist." Russian Otorhinolaryngology 19, no. 4 (2020): 8–12. http://dx.doi.org/10.18692/1810-4800-2020-4-8-12.
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Coronavirus disease 2019 (COVID-19) is a global pandemic that affects millions of people and kills hundreds of thousands of people. Chinese researchers found that the most common clinical manifestations of the disease were: fever, dry cough, shortness of breath, muscle weakness, muscle pain and various degrees of respiratory disorders. But despite this, a more in-depth understanding of COVID-19 revealed many other clinical manifestations. Cough, shortness of breath, sore throat, rhinorrhea, nasal congestion, acute tonsillitis, enlarged cervical lymph nodes, or dizziness are symptoms that an otolaryngologist may encounter when examining patients with COVID-19. And olfactory dysfunction has recently been recognized as an important symptom of COVID-19 and is increasingly being used as a tool to identify patients with COVID-19, particularly in cases of asymptomatic carriers who may unknowingly be the main cause of the spread of the disease. The analysis of detected cases of coronavirus infection and the diagnosis of upper respiratory pathologies in these patients, including olfactory dysfunction, allowed us to understand the frequency of their occurrence in the Moscow region, to compare with world data, and to evaluate their role, in the aspect of early diagnosis of COVID-19.
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Akinsanya, A. O., and A. Inman. "A rare autopsy case of pentalogy of Cantrell with tetralogy of Fallot and olfactory bulb agenesis." American Journal of Clinical Pathology 156, Supplement_1 (October 1, 2021): S22. http://dx.doi.org/10.1093/ajcp/aqab191.041.
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Abstract Introduction/Objective Pentalogy of Cantrell is an uncommon congenital disorder characterized by sternal, diaphragmatic, pericardial, intracardiac and supraumbilical abdominal or chest wall defects. It is usually associated with other abnormalities and thus poses a therapeutic challenge, with a high mortality rate despite early diagnosis. Methods/Case Report This is an autopsy case of a 1 day old, former 37-week-old male infant with a prenatal diagnosis of incomplete pentalogy of Cantrell including omphalocele, ectopia cordis, pleural effusions, cardiac anomalies and polyhydramnios who was delivered via elective cesarean section. Maternal history included tobacco use during pregnancy, multiple psychiatric disorders, and a family history of an unbalanced translocation. The infant required intubation, ventilation, and chest tube insertion at birth due to respiratory distress. He also developed pneumoperitoneum which had to be decompressed. Within 24 hours the infant passed, despite advanced care. On autopsy, external examination showed central and peripheral cyanosis and a large omphalocele containing the heart, parts of the liver and intestines. Initial internal examination revealed a hypoplastic left lung, anterior diaphragmatic defect and absence of the pericardium. Organ dissection post-fixation showed an overriding aorta, pulmonic stenosis, subaortic valve ventricular septal defect and right ventricular hypertrophy, all components of tetralogy of Fallot. On brain examination, the olfactory groove and bulb were both absent. Examination of the placenta and 3 vessel cord revealed no abnormalities. Chromosomal microarray analysis on cord blood was normal. Conclusion The spectrum of defects seen in this disease complex has been postulated to be due to failure of differentiation or migration of mesenchymal structures during embryonic development but ultimately, this entity is not well understood. Identifying various disease associations through autopsies can help to establish possible etiologies, and options for therapeutic interventions or screening.
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Rábano-Suárez, Pablo, Laura Bermejo-Guerrero, Antonio Méndez-Guerrero, Javier Parra-Serrano, Daniel Toledo-Alfocea, Daniel Sánchez-Tejerina, Teresa Santos-Fernández, et al. "Generalized myoclonus in COVID-19." Neurology 95, no. 6 (May 21, 2020): e767-e772. http://dx.doi.org/10.1212/wnl.0000000000009829.
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ObjectiveTo report 3 patients infected with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) who developed generalized myoclonus.MethodsPatient data were obtained from medical records from the University Hospital “12 de Octubre,” Madrid, Spain.ResultsThree patients (2 men and 1 woman, aged 63–88 years) presented with mild hypersomnia and generalized myoclonus following the onset of the so-called inflammatory phase of coronavirus disease 2019 (COVID-19). All of them had presented previously with anosmia. Myoclonus was generalized with both positive and negative jerks, predominantly involving the facial, trapezius, sternocleidomastoid, and upper extremities muscles. These myoclonic jerks occurred spontaneously and were extremely sensitive to multisensory stimuli (auditive and tactile) or voluntary movements, with an exaggerated startle response. Other causes of myoclonus were ruled out, and none of the patients had undergone respiratory arrest or significant prolonged hypoxia. All of them improved, at least partially, with immunotherapy.ConclusionsOur 3 cases highlight the occurrence of myoclonus during the COVID-19 pandemic as a post- or para-infectious immune-mediated disorder. However, we cannot rule out that SARS-CoV-2 may spread transneuronally to first- and second-order structures connected with the olfactory bulb. Further investigation is required to clarify the full clinical spectrum of neurologic symptoms and optimal treatment.
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Shponka, I. S., V. I. Popovych, О. М. Usova, O. O. Bondarenko, Yu V. Haman, and H. Z. Shchuruk. "Morphological features of changes in peripheral olfactory structures in SARS-COV-2 coronavirus infection." Pathologia 18, no. 3 (December 1, 2021): 278–85. http://dx.doi.org/10.14739/2310-1237.2021.3.234369.
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Coronavirus infection caused by the SARS-CoV-2 virus is an extremely important and urgent problem of modern medicine. It spreads quickly, has a high probability of a severe course and a large number of critical complications in patients from the risk group. The presence of pathognomonic symptoms, one of which is the development of hypo– or anosmia, makes it possible to quickly differentiate coronavirus infection from other acute respiratory viral infections, that is, to isolate the patient on time and begin correct treatment, taking all possible risks into account. The aim is to identify the morphological features of olfactory structural elements in patients with coronavirus disease (COVID-19) for a better understanding of the mechanisms of olfactory disorders development in coronavirus infection. Materials and methods. The basis of the work is a retrospective analysis of autopsy material, namely the mucous membrane of the upper parts of the nasal cavity (olfactory epithelium) and olfactory bulbs of nine deceased (4 women and 5 men) aged from 53 to 79 years with a laboratory-confirmed diagnosis of COVID-19 and anosmia in anamnesis. We used standard hematoxylin and eosin staining and immunohistochemical reactions in accordance with the TermoScientific protocols (USA) with antibodies to neurospecific beta-III tubulin (clone TuJ-1) and RnDsystems protocols with antibodies to olfactory marker protein (OMP) and angiotensin converting enzyme (ACE-2). To compare the results, a control group of 9 deaths (3 women and 6 men) aged from 59 to 68 years with a laboratory-refuted diagnosis of COVID-19 was formed. The causes of death of these patients were complications of diabetes, coronary heart disease and cerebrovascular disorders of the ischemictype. Results. The average age of the deceased with a laboratory-confirmed diagnosis of COVID-19 and a history of anosmia and the control group was 64.67 ± 7.73 and 62.33 ± 6.48 years, respectively. The expression of olfactory marker protein (OMP) and neurospecific beta-III tubulin (clone TuJ-1) was partially positive (40.89 (25.00–52.00) and 42.44 (29.00–55.00) cells in the field of view at a magnification of 200×, respectively) in seven out of nine sections of the olfactory mucous membrane of deaths with a laboratory-confirmed diagnosis of COVID-19 and anosmia in anamnesis. The reaction with antibodies to angiotensin converting enzyme (ACE-2) was focally or subtotally absent (34.33 (14.00–49.00) cells in the field of view at 200× magnification). There was expression of these three markers in control sections of the olfactory mucosa of a deceased with a laboratory excluded diagnosis of COVID-19 and no symptoms of anosmia (Mann–Whitney test, P < 0.05). In sections of olfactory bulbs of patients with COVID-19 weak (Mann–Whitney test, P < 0.05) expression of receptors for angiotensin-converting enzyme (ACE-2) (26.78 (15.00–39.00) cells in field of view at a magnification of 200×) was revealed in contrast to control sections (100.56 (94.00–107.00) cells in the field of view at a magnification of 200×). Conclusions. The development of anosmia in SARS-CoV-2 coronavirus infection has specific features. This may be due to the primary destruction of cells expressing receptors for the angiotensin-converting enzyme (ACE-2-positive: sustentacular cells of the olfactory mucosa, neurons of the olfactory bulbs). Subsequent dysfunction of olfactory cells (OMP- and TuJ-1-positive) is also possible.
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Aliyeva, M. B., S. S. Saparbayev, D. N. Ayaganov, M. S. Kurmangazin, and N. M. Tuychibaeva. "Neurological aspects of COVID-19." Kazan medical journal 102, no. 6 (December 13, 2021): 877–86. http://dx.doi.org/10.17816/kmj2021-877.
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The coronavirus disease COVID-19 began to spread worldwide in December 2019 from the city of Wuhan (China). COVID-19 is often accompanied by fever, hypoxemic respiratory failure and systemic complications (for example, gastrointestinal, renal, cardiac, neurological, and hepatic lesions), thrombotic phenomena. Central nervous system damage is caused by the primary effect on it, direct neuroinvasion of the virus, and more often by secondary effect due to systemic hyperinflammation. Neurological manifestations include fatigue, headache, insomnia, and olfactory/taste disorders. Neurological manifestations and complications of COVID-19 are diverse: (1) cerebral circulatory disorders, including ischemic stroke and macro/microhemorrhages; (2) encephalopathy; (3) para/postinfectious autoimmune complications, such as GuillainBarre syndrome; (4) meningoencephalitis; (5) neuropsychiatric complications (psychosis and mood disorders). In terms of pathogenesis, neurological disorders in COVID-19 can be caused by neurotropicity and neurovirulence of SARS-CoV-2, cytokine storm, hypoxemia, homeostasis disorders, as well as their combined effects. COVID-19 adversely affects the course and prognosis of chronic neurological disorders in comorbid patients. The review highlights the need for vigilance to early neurological complications in patients infected with SARS-CoV-2 and other coronaviruses, especially since some neurological complications may precede respiratory manifestations.
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Esvelt, Marian A., Zachary T. Freeman, Alexander T. Pearson, Jack R. Harkema, Gregory T. Clines, Katrina L. Clines, Melissa C. Dyson, and Mark J. Hoenerhoff. "The Endothelin-A Receptor Antagonist Zibotentan Induces Damage to the Nasal Olfactory Epithelium Possibly Mediated in Part through Type 2 Innate Lymphoid Cells." Toxicologic Pathology 47, no. 2 (December 30, 2018): 150–64. http://dx.doi.org/10.1177/0192623318816295.
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Zibotentan, an endothelin-A receptor antagonist, has been used in the treatment of various cardiovascular disorders and neoplasia. Castrated athymic nude mice receiving zibotentan for a preclinical xenograft efficacy study experienced weight loss, gastrointestinal bloat, and the presence of an audible respiratory click. Human side effects have been reported in the nasal cavity, so we hypothesized that the nasal cavity is a target for toxicity in mice receiving zibotentan. Lesions in the nasal cavity predominantly targeted olfactory epithelium in treated mice and were more pronounced in castrated animals. Minimal lesions were present in vehicle control animals, which suggested possible gavage-related reflux injury. The incidence, distribution, and morphology of lesions suggested direct exposure to the nasal mucosa and a possible systemic effect targeting the olfactory epithelium, driven by a type 2 immune response, with group 2 innate lymphoid cell involvement. Severe nasal lesions may have resulted in recurrent upper airway obstruction, leading to aerophagia and associated clinical morbidity. These data show the nasal cavity is a target of zibotentan when given by gavage in athymic nude mice, and such unanticipated and off-target effects could impact interpretation of research results and animal health in preclinical studies.
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Eka Trie Sanggita, Vira. "Pemeriksaan Fungsi Penghidu Pada Rinitis Alergi." Jurnal Syntax Fusion 2, no. 01 (January 20, 2022): 165–70. http://dx.doi.org/10.54543/fusion.v2i01.140.
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Rhinitis is an inflammation of the lining membrane or nasal mucosa characterized by one or more symptoms such as sneezing, nasal congestion, itchy nose, and rhinorrhea or runny nose. Allergic rhinitis (hay fever) is clinically a disorder of nasal function resulting from an allergic reaction to allergen exposure through an inflammatory process mediated by specific IgE in the nasal mucosa. Allergic rhinitis can also be regarded as a chronic inflammatory disease of the upper respiratory tract with a reported prevalence of around 40% of the general population. The writing of this article was obtained from various sources in the form of scientific journals and guidelines for related institutions. Source searches were carried out on various online portals such as Medscape, NCBI Google Scholar and other health websites with the keyword “Allergic Rhinitis”. Allergic rhinitis is an inflammatory disease of the nasal mucosa caused by exposure to allergens. The prevalence of rhinitis in Indonesia is around 3-4% at the age of 6-7 years and 4-5% at the age of 13-14 years. Allergic rhinitis can occur when a person's immune system reacts to allergens such as dust mites, pollen, pet dander, mold spores, and insects such as cockroaches. Symptoms and signs that can occur in allergic rhinitis include runny nose, nasal congestion, itching in the nose, ears, throat, and palate, sneezing, coughing, headache, snoring due to nasal obstruction, and decreased sense of smell and taste. Allergic rhinitis that occurs in childhood worsens with age. The diagnosis of olfactory function in allergic rhinitis begins with anamnesis, physical examination and supporting examinations such as imaging and olfactory chemosensory examinations such as the UPSIT (University of Pennsylvania Small Identification) test, The Connectitut Chemosensory Clinical Research Center (CCCRC) test, and the "Sniffin Sticks test".
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Giacomelli, Andrea, Laura Pezzati, Federico Conti, Dario Bernacchia, Matteo Siano, Letizia Oreni, Stefano Rusconi, et al. "Self-reported Olfactory and Taste Disorders in Patients With Severe Acute Respiratory Coronavirus 2 Infection: A Cross-sectional Study." Clinical Infectious Diseases 71, no. 15 (March 26, 2020): 889–90. http://dx.doi.org/10.1093/cid/ciaa330.
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Lovato, Andrea, and Cosimo de Filippis. "Clinical Presentation of COVID-19: A Systematic Review Focusing on Upper Airway Symptoms." Ear, Nose & Throat Journal 99, no. 9 (April 13, 2020): 569–76. http://dx.doi.org/10.1177/0145561320920762.
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Aim: Pharyngodynia, nasal congestion, rhinorrhea, smell, and taste dysfunctions could be the presenting symptoms of coronavirus disease 2019 (COVID-19) caused by severe acute respiratory syndrome coronavirus 2. The aim was to perform a systematic review of current evidences on clinical presentation of COVID-19, focusing on upper airway symptoms in order to help otolaryngologists identifying suspected cases. Methods: We searched PubMed and Web of Science electronic databases. Results: We included 5 retrospective clinical studies for a total of 1556 hospitalized patients with COVID-19, 57.5% were male and mean age was 49.1 years. Pooled data revealed that pharyngodynia was present in 12.4% of patients, nasal congestion in 3.7%, and rhinorrhea was rare. No reports on COVID-19 and olfactory/gustative disorders matched inclusion criteria but preliminary evidences suggested they could be present. Common symptoms were fever (85.6%), cough (68.7%), and fatigue (39.4%). Frequent comorbidities were hypertension (17.4%), diabetes (3.8%), and coronary heart disease (3.8%); 83% of patients had alterations on chest computed tomography that were bilateral in 89.5% of cases. Ground-glass opacity was the most common finding (50%). Lymphopenia (77.2%) and leucopenia (30.1%) were common. Critical cases with complications were 9%, intensive care unit admission was required in 7.3%, invasive ventilation in 3.4%, and mortality was 2.4%. Conclusion: Otolaryngologists should know that pharyngodynia, nasal congestion, olfactory, and gustative disorders could be the presenting symptoms of COVID-19. Clinical presentation together with radiological and laboratory findings could help to identify suspected cases.
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Orrù, Graziella, Ciro Conversano, Eleonora Malloggi, Francesca Francesconi, Rebecca Ciacchini, and Angelo Gemignani. "Neurological Complications of COVID-19 and Possible Neuroinvasion Pathways: A Systematic Review." International Journal of Environmental Research and Public Health 17, no. 18 (September 14, 2020): 6688. http://dx.doi.org/10.3390/ijerph17186688.
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The Coronavirus Disease 2019 (COVID-19) outbreak has shocked the whole world with its unexpected rapid spread. The virus responsible for the disease, the Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2), enters host cells by means of the envelope spike protein, which binds to angiotensin-converting enzyme 2 receptors. These receptors are highly expressed in heart, lungs, respiratory tract epithelium, endothelial cells and brain. Since an increasing body of significant evidence is highlighting a possible neuroinvasion related to SARS-CoV-2, a state of the art on the neurological complications is needed. To identify suitable publications, our systematic review was carried out by searching relevant studies on PubMed and Scopus databases. We included studies investigating neurologic manifestations of SARS-CoV-2 in patients over 18. According to the analyzed studies, the most frequent disorders affecting central nervous system (CNS) seem to be the following: olfactory and taste disorders, ischemic/hemorrhagic stroke, meningoencephalitis and encephalopathy, including acute necrotizing encephalopathy, a rare type of encephalopathy. As regards the peripheral nervous system (PNS), Guillain-Barré and Miller Fisher syndromes are the most frequent manifestations reported in the literature. Important clinical information on the neurological manifestations of SARS-CoV-2 would help clinicians raise awareness and simultaneously improve the prognosis of critically ill patients.
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Zięba, Natalia, Grażyna Lisowska, Adam Dadok, Joanna Kaczmarek, Grażyna Stryjewska-Makuch, and Maciej Misiołek. "Frequency and Severity of Ear–Nose–Throat (ENT) Symptoms during COVID-19 Infection." Medicina 58, no. 5 (April 29, 2022): 623. http://dx.doi.org/10.3390/medicina58050623.
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Background and Objectives: Coronavirus disease 2019 (COVID-19) is a new disease entity caused by the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). The main symptoms of infection at the onset of the pandemic include dyspnea, cough and high fever. Ear–nose–throat (ENT) symptoms are among the ones presented by patients in the course of infection. The aim of the study was to analyze the frequency of ENT symptoms and to assess their severity and duration in COVID-19 patients. Materials and Methods: The study included 337 patients who had been infected with SARS-CoV-2, as confirmed by a PCR test. The study participants were >18 years old; the mean age was 43.98 years ± 13.47 SD. The convalescents completed a questionnaire that contained 26 questions, including 9 detailed questions related to ENT symptoms, such as sore throat, vertigo, dizziness, hearing disorders, olfactory disorders, taste disturbance, headache, cough and dyspnea. The severity of symptoms was assessed using a Visual Analogue Scale (VAS). Results: The most reported ENT symptoms were olfactory disorders, which occurred in 72% of patients. The second most frequent symptom was taste disturbance (68%), VAS = 6.79 ± 3.01. Vertigo and dizziness were reported by 34% of respondents (VAS = 4.01 ± 2.01). Tinnitus was observed in 15% of patients, VAS = 3.87 ± 1.98; 14% of the subjects reported hearing impairment (VAS = 3.81 ± 2.37). Conclusions: Symptoms related to the sense of smell, taste and hearing are some of the most common symptoms in the course of COVID-19, which is important in the therapeutic and epidemiological management of patients. Delayed diagnosis and treatment of symptoms, especially those related to the hearing organ, may result in greater permanent damage.
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Adedokun, Kamoru Ademola. "Emerging Neuropathophysiological and Acid-base Disorder in Coronavirus Disease-19: A Close Look at Diagnostic Prospect in Containment Operations." Open Access Macedonian Journal of Medical Sciences 8, T1 (September 24, 2020): 387–90. http://dx.doi.org/10.3889/oamjms.2020.5303.
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The two major barriers militating against rapid containment of the spread of coronavirus (CoV) disease (COVID)-19 include lack of effective contact tracing and the failure to detect and diagnose the infection early. Lack of diagnostic tools for early diagnosis has contributed to the bane of the current wild spread of COVID-19 and its containment. The current chest computed tomography (CT) for COVID-19 screening, an evolving technique, is arguably reported to have 97% diagnostic sensitivity over the viral polymerase chain reaction (PCR) that has detection of 70%. However, CT has largely been criticized as speculative and thus generates disagreement among various international radiology societies and organizations. Until now, nucleic acid detection by real-time PCR (advanced with next-generation sequencing) remains the gold standard test and clinical diagnosis technique for COVID-19. The use of this method in diagnoses, while it is more precise, is also time-consuming and may not meet the goal of rapid detection of early infection with severe acute respiratory syndrome CoV-2. Although many available tests, such as other PCR-based, serology, isothermal nucleic amplification, and among others, are coming up, the testing accuracy and/or timeliness have hampered their expected performance level. As a result, there is still a need to develop more methods to detect the current spread of COVID-19 rapidly. COVID-19 is now associated with olfactory dysfunctions in several reports. Recently, the Centers for Disease Control (CDC) established that anosmia is a notable symptom of COVID-19. Furthermore, acute systemic acidosis has been associated with COVID-19. This report critically discusses the potential pathophysiologies of COVID-19 in association with neuropathological and acid-base disorders and their prospect for diagnostics.
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Bagnasco, Diego, Giovanni Passalacqua, Fulvio Braido, Elena Tagliabue, Filippo Cosini, Marta Filauro, Alessandro Ioppi, et al. "Quick Olfactory Sniffin’ Sticks Test (Q-Sticks) for the detection of smell disorders in COVID-19 patients." World Allergy Organization Journal 14, no. 1 (January 2021): 100497. http://dx.doi.org/10.1016/j.waojou.2020.100497.
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Bordovsky, S. P., K. D. Tolmachev, K. K. Kriukova, O. I. Gurina, and I. S. Preobrazhenskaya. "Cognitive impairment in hospitalized patients with COVID-19." Meditsinskiy sovet = Medical Council, no. 2 (March 10, 2022): 24–32. http://dx.doi.org/10.21518/2079-701x-2022-16-2-24-32.
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Introduction. The COVD-19 pandemic caused by the SARS-CoV-2 continues from March 2020. The virus primarily affects the respiratory system. Moreover, there is new data about the various organ damage caused by COVID-19 such as heart, skin, kidney and central nervous system. That’s why it is necessary to investigate the neurological features of the COVID-19.The aim of the study. To investigate the effect of COVID-19 on the cognitive functions of hospitalized patients.Materials and methods. the PCR-positive patients hospitalized at the University Clinical Hospital No. 3 had been included in the study since March 2020 for May 2021. Thorax CT scan, physical and neurological examination, the biochemical blood test was provided for all patients. The neuropsychological examination was made by: MoCA, TMTA, TMTB, and emotional condition was tested by HADS.Results. 33 patients (21 (64.6%) women) were included; the median age was 73.0 [67.0; 76.0]. The average MoCA value was 22.64 points, median: 24.00 points [20.00; 25.00], median TMTA execution speed: 68 seconds [49.00; 84.00], TMTB: 194 seconds [153; 245.75]. HADS (depression) median: 7.0 [5.00; 9.00], for HADS (anxiety) median: 8.0 [4.00; 10.00]. A link between the olfactory disorders and low MoCA results (p = 0.015) was found according to the regression analysis. Moreover, the patient’s age, lung damage degree had a negative impact on the duration of TMTB (p = 0.001 and p = 0.049). The propensity score matching was made to confirm that the olfactory disturbances, regardless of other factors, are associated with a lower MoCA result (p = 0.012).Conclusion. The potential mechanisms, modality, defect duration and pharmacological response of cognitive disorders have a great interest. That’s why it is necessary to conduct clinical and experimental studies on patients, pathomorphological material and animal models.
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Dlouhy, Brian J., Olatilewa Awe, Rajesh C. Rao, Patricia A. Kirby, and Patrick W. Hitchon. "Autograft-derived spinal cord mass following olfactory mucosal cell transplantation in a spinal cord injury patient." Journal of Neurosurgery: Spine 21, no. 4 (October 2014): 618–22. http://dx.doi.org/10.3171/2014.5.spine13992.
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Over the last decade, human cell transplantation and neural stem cell trials have examined the feasibility and safety of these potential therapies for treatment of a variety of neurological disorders. However, significant safety concerns have surrounded these trials due to the possibility of ectopic, uncontrolled cellular growth and tumor formation. The authors present the case of an 18-year-old woman who sustained a complete spinal cord injury at T10–11. Three years after injury, she remained paraplegic and underwent olfactory mucosal cell implantation at the site of injury. She developed back pain 8 years later, and imaging revealed an intramedullary spinal cord mass at the site of cell implantation, which required resection. Intraoperative findings revealed an expanded spinal cord with a multicystic mass containing large amounts of thick mucus-like material. Histological examination and immunohistochemical staining revealed that the mass was composed mostly of cysts lined by respiratory epithelium, submucosal glands with goblet cells, and intervening nerve twigs. This is the first report of a human spinal cord mass complicating spinal cord cell transplantation and neural stem cell therapy. Given the prolonged time to presentation, safety monitoring of all patients with cell transplantation and neural stem cell implantation should be maintained for many years.
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Omidi, Ameneh. "Extrapulmonary Manifestations of Coronavirus Disease 2019: A Narrative Review." Journal of Arak University Medical Sciences 23, no. 5 (December 1, 2020): 604–13. http://dx.doi.org/10.32598/jams.23.cov.6186.1.
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Background and Aim: Coronaviruses are a large family of viruses that are known to cause respiratory tract infections in humans. SARS-CoV-2 is a new type of this family initiated in late 2019 and its related disease is known as Coronavirus Disease 2019 (COVID-19). Common symptoms of COVID-19 include fever, dry cough, fatigue, myalgia, arthralgia and shortness of breath. Methods & Materials: In This narrative review a literature search was conducted in scientific databases including Google Scholar and PubMed to find studies published from December 2019 to May 10 2020 on the role the extrapulmonary manifestations of COVID-19. Ethical Considerations: Ethical issues (including plagiarism, misconduct, data fabrication, falsification, double publication or submission, redundancy) have been completely observed by the authors. Results: In addition to respiratory symptoms, involvement of various organs such as gastrointestinal tract, nervous system, skin, olfactory system, cardiovascular system, liver, kidney, and eyes was also reported. Extrapulmonary manifestations of COVID-19 included anosmia, ageusia, skin rash, chickenpox-like blisters, acute cardiac failure with increased troponin levels, kidney inflammation and edema, common gastrointestinal symptoms (e.g. diarrhea, nausea and vomiting), elevated liver enzyme levels, neurological disorders (e.g. stroke), nonspecific symptoms (e.g. headache and dizziness), and decreased consciousness level. Conclusion: The hypothetical mechanisms of various organ involvements during COVID-19 include immune-mediated inflammation such as cytokine storm, respiratory dysfunction, hypoxemia, cellular damage, or combination of these mechanisms. Further studies should be conducted on the causes of various COVID-19-induced damages to determine the exact relationship between the pathogenesis, prognosis and severity of the disease.
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Allan, G. M., F. McNeilly, I. Walker, T. Linne, J. Moreno-Lopez, P. Hernandez, S. Kennedy, et al. "A Sequential Study of Experimental Porcine Paramyxovirus (LPMV) Infection of Pigs: Immunostaining of Cryostat Sections and Virus Isolation." Journal of Veterinary Diagnostic Investigation 8, no. 4 (October 1996): 405–13. http://dx.doi.org/10.1177/104063879600800401.
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La Piedad Michoacan Paramyxovirus (LPMV) is a recently recognized paramyxovirus infecting pigs throughout Mexico. Disease syndromes observed in field cases associated with LPMV infection include neurologic, respiratory, and reproductive disorders. Clinical signs and the distribution of LPMV virus and antigen in tissue samples from pigs experimentally infected with LPMV by natural routes were studied. Severe neurologic disease and death occurred following experimental inoculation of 3- and 17-day-old pigs. All of the pigs inoculated at 3 days of age were either dead or moribund by 8 days after inoculation, whereas 30% of the pigs inoculated at 17 days of age were affected. Virus was consistently recovered from or demonstrated in tissues from the respiratory tract of both groups of pigs. LPMV and antigen were also demonstrated in central nervous system (CNS) tissues from these pigs; however, differences in virus distribution within the CNS were demonstrated in the 2 groups. In the pigs inoculated at 17 days of age, isolation of LPMV was restricted to the olfactory bulb and midbrain. In contrast, in the pigs inoculated at 3 days of age, isolation of LPMV was more widespread throughout the CNS tissue examined. Virus excretion studies indicated that nasal spread of LPMV was more important than fecal spread. Comparatively large quantities of infectious LPMV were consistently recovered from urine samples of experimentally infected pigs.
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Globa, E. V., N. B. Zelinska, V. A. Yengovatova, O. A. Horosha, N. L. Pogadayeva, and І. О. Peretyatko. "Congenital hypothalamic hypogonadism — a Kallmann syndrome in boys. Clinical cases." Clinical Endocrinology and Endocrine Surgery, no. 4 (December 16, 2021): 53–65. http://dx.doi.org/10.30978/cees-2021-4-53.
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Central hypogonadism (CH) is a rare disease that occurs with a frequency of 1 : 8000 in women and 1 : 4000 in men. In 60 % of cases of CH, it is caused by Kallmann syndrome (KS) — a disease in which hypogonadotropic hypogonadism is combined with olfactory disorders (hyposmia or anosmia).Aim — to study clinical features, principles of diagnosis of CH/KS and evaluation of the effectiveness of various treatment. Materials and methods. 4 cases with CH/KS from three families had been described. Laboratory and instrumental investigations were used to confirm the KS; genetic diagnosis was performed using targeted next-generation sequencing (tNGS hypogonadotropic panel).Results. Patients with CH/KS had a wide spectrum of genital disorders (micropenia, cryptorchidism, microorchidism), which appeared at different age. Extragenital pathology was found in three of four patients: namely disorders of kidney, eye, respiratory system, hypoparathyroidism, hypothyroidism and epilepsy. It should be noted that all patients had olfactory disorders, which appeared in two of them only during a detailed survey after receiving genetic testing. In all patients, the diagnosis of CH was confirmed by the test with triptorelin 0.1. Also, all patients who underwent densitometry were found to have significant osteoporosis. In three patients, genetic testing confirmed hemizygous pathogenic variants in ANOS1 gene, while in one patient a heterozygous variant in FGFR1 gene was confirmed. After treatment with chorionic gonadotropin (HCG), two patients responded positively, with a descent of the testicles into the scrotum and an increase of testosterone level and testicular volume. However, in the other two patients there was no positive trend in treatment with HCG, therefore, the use of recombinant human FSH (r-FSH) in the form of priming and then further — in combination with HCG may be considered. Although the presence of severe microorchidism, cryptorchidism, low levels of AMH, inhibin B, and an unsatisfactory response to the previous treatment with HCG indicates extremely unfavorable prognosis. Therefore, in order to achieve the fertility in some patients with CH/KS, the most likely attempt is the use of assisted reproductive technologies.Conclusions. The leading problem in the treatment of patients with KS is their different response to hormone therapy, including different manifestations of the disease.
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Fileva, Lyubov V., and Andrey Y. Ovchinnikov. "Morphological and functional state of the nasal cavity after surgical interventions in the vertical section of the lacrimal ducts." Science and Innovations in Medicine 5, no. 1 (March 15, 2020): 28–31. http://dx.doi.org/10.35693/2500-1388-2020-5-1-28-31.
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Objectives - to compare the condition of the nasal cavity after a dacryocystorhinostomy of external and endonasal access. Material and methods. Comparative assessment of the results of the study of 96 patients with chronic dacryocystitis was done. The patients were divided into 2 groups: group 1 included persons who underwent the videoendoscopic endonasal dacryocystorhinostomy; group 2 - patients with external dacryocystorhinostomy. For all the participants, there were registered the complaints and anamnesis, the data of video-endoscopy of the nasal cavity, anterior active rhinomanometry, transport and olfactory functions. The information on the state of the nasal cavity after surgery in the vertical section of the lacrimal ducts was also obtained. Results. In both groups we revealed the changes in the mucous membrane, in the anatomical structures of the nasal cavity, in the mobility of the ciliated epithelium, respiratory functions and olfaction. When comparing the results in both groups, the statistically significant differences were found in the questionnaire data - a complaint of lacrimation, and the data on the mucociliary clearance disorders (p
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Wirawan, Chandra, and Shierly . "Neurological manifestations in COVID-19 infection." International Journal of Research in Medical Sciences 8, no. 11 (October 28, 2020): 4168. http://dx.doi.org/10.18203/2320-6012.ijrms20204928.
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The emerge of coronavirus disease 2019 (COVID-19), previously known as novel coronavirus (2019-nCoV), in Wuhan, China, in December 2019, has spread throughout the world. COVID-19 is known to cause respiratory disease. However, several scientific studies have shown nervous system involvement in COVID-19 infection. The potential mechanisms of this infectious disease transmission to the brain are through infected olfactory epithelium, hematogenous spread and immune-related pathway. Nervous system involvement in COVID-19 infection can be classified as central nervous system (CNS) involvement, peripheral nervous system involvement (PNS) and muscle. CNS involvement, including headache, cerebrovascular disease, impaired consciousness, meningitis, encephalitis, dizziness and seizure. PNS manifestations, such as anosmia, ageusia or dysgeusia, oculomotor nerve palsy and Guillain-Barre syndrome (GBS). Myalgia or arthralgia is the most common presentation of muscle involvement in COVID-19 infection. This review concludes that neurological disorders as COVID-19 clinical features must be recognized by medical professionals in order to have appropriate diagnosis and treatment so that COVID-19 patients can have better prognosis.
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Dantas, Kassyo Lenno Sousa, Wilian Reis Rosário, Alice Gabrielly Landim Lima, Antonio Ycaro Rodrigues Lucena, Thallyson Jose Dourado de Sousa, Jeferson Noslen Casarin, Fabíola Santos Lima de Oliveira, Milena Sousa Freitas, Cristiane Santos Silva e. Silva Figueiredo, and Domingos Magno Santos Pereira. "SARS-CoV-2: a view on its origin, transmission, genetic characteristics and pathogenicity." Revista Eletrônica Acervo Saúde 13, no. 6 (June 28, 2021): e7567. http://dx.doi.org/10.25248/reas.e7567.2021.
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Objective: To describe the origin, transmission, morphological and genetic characteristics of SARS-CoV-2 and its pathogenicity mechanisms. Bibliographic review: At the end of December 2019, health centers in Wuhan, Hubei-China province, observed several cases of pneumonia of unknown origin, associated with a new etiologic agent, a virus, with a similar, but distinct, genomic sequence of SARS-CoV and MERS-CoV, named as severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). The most common symptoms at the beginning of the infection are fever, cough, fatigue, olfactory and taste disorders; on the other hand, severe cases include pulmonary impairment and hypoxia. Currently, there are no antiviral agents with proven clinical efficacy and vaccination occurs in slow steps in most countries, with symptomatic treatment and life support still being the main therapeutic interventions available. Final considerations: SARS-CoV-2 presents itself as one of the biggest public health problems in the world nowadays. The search for new drugs to treat COVID-19 is constant, however, so far no new drug is available for use with 100% proven clinical efficacy.
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Yanti, Budi, T. Andi Syahputra, Fitri Amalia Rahma, Rauzatil Aula Katuri, and Rosi Mega Safitri. "Keanekaragaman Manifestasi Klinis pada Coronavirus Disease 2019 (COVID-19)." Journal Of Health Science (Jurnal Ilmu Kesehatan) 5, no. 2 (November 28, 2020): 47–54. http://dx.doi.org/10.24929/jik.v5i2.997.
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Abstract
Coronavirus disease 2019 (COVID-19) was caused by SARS-CoV-2 and is currently a global public health problem. This disease transmits through aerosols and saliva when coughing and sneezing from a person with symptoms or carrier people. The diversity of clinical manifestations would be detected and depended on the number of ACE2 receptor expressions that are scattered throughout the human body. The more expression in the organ, the more frequent symptoms that appear in the patient. The respiratory dysfunction is the most common symptoms that will be detected and followed by the olfactory dysfunction such as anosmia, the visual dysfunction such as conjunctivitis, the digestive dysfunction such as nausea, vomiting, and diarrhea, the vascular dysfunction such as thrombosis and embolism, and the cardiovascular dysfunction such as Acute Cardiac Injury and Acute Coronary Syndrome. This review literature used an internet-based search engine method that aims to discuss functional disorders in the human body system that caused diversity of clinical manifestations in COVID-19.
Key words:
Diversity, Symptoms, COVID-19, SARS CoV-2
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Shushliapina, N. O., and O. Ye Cherniakova. "FEATURES OF CAPILLARY BLOOD FLOW IN PATIENTS WITH PATHOLOGY OF INTRANASAL STRUCTURES AND NASAL BREATHING DISORDERS." International Medical Journal, no. 3 (September 16, 2020): 53–59. http://dx.doi.org/10.37436/2308-5274-2020-3-11.
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The investigation of the vascular microcirculation system is important for diagnosis, assessment of the severity and nature of pathological processes in human body, monitoring the effectiveness of treatment. Monitoring the state of microcirculation in impaired respiratory function of the nose helps to study the subtle mechanisms of regulation of vascular−tissue relations. To do this, there were used the biomicroscopic methods to study capillary blood flow, one of the most relevant and promising is optical capillaroscopy of the nail bed. This method makes it possible to identify at the evidence level the peculiarities of the functioning of the peripheral circulatory system by the state of the capillary system and to evaluate the effectiveness of treatment by the rheological properties of blood in hematological practice. There were examined 145 patients by means of computer capillaroscopy to study the rate of capillary circulation in the patients with pathology of intranasal structures and nasal breathing disorders. All patients underwent a complete clinical examination, routine instrumental examinations, and computer capillaroscopy using a video capillaroscope with a visual magnification of up to 550 times. The obtained images were stored and processed according to a special software. During the characterization of the capillaroscopic picture there were evaluated: pathological tortuosity, change in the caliber of arterioles and venules, disorganization of the capillary network, the number of functioning capillaries. Changes in the speed and nature of capillary blood flow (accelerated, slow, stasis) were observed. The optical capillaroscopy method allows not only to visually assess the condition of microvessels, but also to determine such an important parameter as blood circulation, actually, it can replace the study of laser Doppler. Such data will be important in the diagnosis of respiratory and olfactory disorders and the formation of adequate tactics for their treatment. Key words: microcirculation, microcirculatory tract, capillary circulation, nasal obstruction, nasal breathing disorders, pathology of intranasal structures, computer capillaroscopy.
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Gerdts, Volker, Jörg Beyer, Béla Lomniczi, and Thomas C. Mettenleiter. "Pseudorabies Virus Expressing Bovine Herpesvirus 1 Glycoprotein B Exhibits Altered Neurotropism and Increased Neurovirulence." Journal of Virology 74, no. 2 (January 15, 2000): 817–27. http://dx.doi.org/10.1128/jvi.74.2.817-827.2000.
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ABSTRACT Herpesvirus glycoproteins play dominant roles in the initiation of infection of target cells in culture and thus may also influence viral tropism in vivo. Whereas the relative contribution of several nonessential glycoproteins to neurovirulence and neurotropism ofPseudorabies virus (PrV), an alphaherpesvirus which causes Aujeszky's disease in pigs, has recently been uncovered in studies using viral deletion mutants, the importance of essential glycoproteins is more difficult to assess. We isolated an infectious PrV mutant, PrV-9112C2, which lacks the gene encoding the essential PrV glycoprotein B (gB) but stably carries in its genome and expresses the homologous gene of bovine herpesvirus 1 (BHV-1) (A. Kopp and T. C. Mettenleiter, J. Virol. 66:2754–2762, 1992). Apart from exhibiting a slight delay in penetration kinetics, PrV-9112C2 was similar in its growth characteristics in cell culture to wild-type PrV. To analyze the effect of the exchange of these homologous glycoproteins in PrV's natural host, swine, 4-week-old piglets were intranasally infected with 106 PFU of either wild-type PrV strain Kaplan (PrV-Ka), PrV-9112C2, or PrV-9112C2R, in which the PrV gB gene was reinserted instead of the BHV-1 gB gene. Animals infected with PrV-Ka and PrV-9112C2R showed a similar course of disease, i.e., high fever, marked respiratory symptoms but minimal neurological disorders, and excretion of high amounts of virus. All animals survived the infection. In contrast, animals infected with PrV-9112C2 showed no respiratory symptoms and developed only mild fever. However, on day 5 after infection, all piglets developed severe central nervous system (CNS) symptoms leading to death within 48 to 72 h. Detailed histological analyses showed that PrV-9112C2R infected all regions of the nasal mucosa and subsequently spread to the CNS preferentially by the trigeminal route. In contrast, PrV-9112C2 primarily infected the olfactory epithelium and spread via the olfactory route. In the CNS, more viral antigen and significantly more pronounced histological changes resulting in more severe encephalitis were found after PrV-9112C2 infection. Thus, our results demonstrate that replacement of PrV gB by the homologous BHV-1 glycoprotein resulted in a dramatic increase in neurovirulence combined with an alteration in the route of neuroinvasion, indicating that the essential gB is involved in determining neurotropism and neurovirulence of PrV.