1
|
Torinsson Naluai Å, Östensson M, Fowler PC, Abrahamsson S, Andersson B, Lassesson S, Jacobsson F, Oscarsson M, Bohman A, Harandi AM, Bende M. Transcriptomics unravels molecular changes associated with cilia and COVID-19 in chronic rhinosinusitis with nasal polyps. Sci Rep 2023; 13:6592. [PMID: 37085563 PMCID: PMC10121071 DOI: 10.1038/s41598-023-32944-3] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/04/2022] [Accepted: 04/05/2023] [Indexed: 04/23/2023] Open
Abstract
Chronic rhinosinusitis with nasal polyps (CRSwNP) is a common upper respiratory tract complication where the pathogenesis is largely unknown. Herein, we investigated the transcriptome profile in nasal mucosa biopsies of CRSwNP patients and healthy individuals. We further integrated the transcriptomics data with genes located in chromosomal regions containing genome-wide significant gene variants for COVID-19. Among the most significantly upregulated genes in polyp mucosa were CCL18, CLEC4G, CCL13 and SLC9A3. Pathways involving "Ciliated epithelial cells" were the most differentially expressed molecular pathways when polyp mucosa and non-polyp mucosa from the same patient was compared. Natural killer T-cell (NKT) and viral pathways were the most statistically significant pathways in the mucosa of CRSwNP patients compared with those of healthy control individuals. Upregulated genes in polyp mucosa, located within the genome-wide associated regions of COVID-19, included LZTFL1, CCR9, SLC6A20, IFNAR1, IFNAR2 and IL10RB. Interestingly, the second most over-expressed gene in our study, CLEC4G, has been shown to bind directly to SARS-CoV-2 spike's N-terminal domain and mediate its entry and infection. Our results on altered expression of genes related to cilia and viruses point to the de-regulation of viral defenses in CRSwNP patients, and may give clues to future intervention strategies.
Collapse
Affiliation(s)
- Åsa Torinsson Naluai
- Department of Laboratory Medicine, Institute of Biomedicine, Sahlgrenska Academy at the University of Gothenburg, Gothenburg, Sweden.
- Core Facilities, Sahlgrenska Academy at the University of Gothenburg, Gothenburg, Sweden.
| | - Malin Östensson
- Department of Laboratory Medicine, Institute of Biomedicine, Sahlgrenska Academy at the University of Gothenburg, Gothenburg, Sweden
- Core Facilities, Sahlgrenska Academy at the University of Gothenburg, Gothenburg, Sweden
| | - Philippa C Fowler
- Department of Laboratory Medicine, Institute of Biomedicine, Sahlgrenska Academy at the University of Gothenburg, Gothenburg, Sweden
| | - Sanna Abrahamsson
- Core Facilities, Sahlgrenska Academy at the University of Gothenburg, Gothenburg, Sweden
| | - Björn Andersson
- Core Facilities, Sahlgrenska Academy at the University of Gothenburg, Gothenburg, Sweden
| | - Stina Lassesson
- Core Facilities, Sahlgrenska Academy at the University of Gothenburg, Gothenburg, Sweden
| | - Frida Jacobsson
- Core Facilities, Sahlgrenska Academy at the University of Gothenburg, Gothenburg, Sweden
| | - Martin Oscarsson
- Department of Otorhinolaryngology, Skaraborg Hospital, Skövde, Sweden
| | - Anton Bohman
- Department of Otorhinolaryngology, Uppsala University Hospital, Uppsala, Sweden
| | - Ali M Harandi
- Department of Microbiology and Immunology, Institute of Biomedicine, Sahlgrenska Academy at the University of Gothenburg, Gothenburg, Sweden
- Vaccine Evaluation Center, BC Children's Hospital Research Institute, University of British Columbia, Vancouver, Canada
| | - Mats Bende
- Department of Otorhinolaryngology, Skaraborg Hospital, Skövde, Sweden
| |
Collapse
|
2
|
Abstract
After symptom registration of 39 pregnant women and 23 nonpregnant women during several months, it was possible to conclude that nasal congestion during pregnancy occurs during the last 3 months before delivery. This symptom of pregnancy might be an underestimated problem not dependent on previous pregnancies. Nasal congestion during pregnancy does not seem to be correlated to other common inconveniences such as nausea and gastrointestinal reflux.
Collapse
Affiliation(s)
- Mats Bende
- Department of Otolaryngology, Central Hospital, S-541 85 Skövde, Sweden
| | - Ulf Hallgårde
- Department of Otolaryngology, Central Hospital, S-541 85 Skövde, Sweden
| | | |
Collapse
|
3
|
Abstract
Background This is an explorative study of growth-related nasal geometry in healthy children. Methods A total of 88 girls and boys between the ages of 4 and 16 years were followed over a period of 2 years by acoustic rhinometry. The registrations were correlated to height at each occasion. Results Although both the minimal cross-sectional area and the nasal volume increased in all age groups over 7 years, large individual variations in nasal geometry led to a weak relationship with growth. Conclusion In the undecongested nasal cavity in children, correlation of nasal geometry makes sense for height but not for age.
Collapse
Affiliation(s)
- Eva Millqvist
- Asthma and Allergy Research Group, Sahlgrenska University Hospital, Gothenburg, Sweden
| | - Mats Bende
- Allergy Center, Central Hospital, Skövde, Sweden
| |
Collapse
|
4
|
Abstract
Nasal geometry measured by acoustic rhinometry was compared with the subjective sensation of nasal stuffiness in healthy subjects before and after provocation with histamine. The correlation was poor at rest, but it was significant after histamine provocation in children and adults. It is easier to find a relationship between subjective and objective nasal obstruction after inducing congestion.
Collapse
Affiliation(s)
| | | | - Mats Bende
- Allergy Center, Central Hospital, Skövde, Sweden
| |
Collapse
|
5
|
Abstract
An animal model was developed to study the effect of nose drops on an acute sinusitis. Leukocyte-stimulating n-formylmethionyl-leucyl-phenylalanine (FMLP) was added to polyvinyl sponges and placed bilaterally into the maxillary sinuses of the rabbit. Oxymetazoline nose drops were applied in one nasal cavity, on the contralateral side, using the application of saline as control. After 2 hours, the animals were killed, and the sponges were removed for analysis of leukocyte content by light microscopy and determination of myeloperoxidase (MPO), an intracellular enzyme in polymorphonuclear leukocytes. The sinus mucosa was dissected bilaterally and prepared for whole-amount light microscopy. There was a reduced number of leukocytes in the sinus mucosa on the side treated with oxymetazoline nose drops compared with the contralateral side. No significant differences were found in the number of leukocytes or MPO in the sponges. The effect of oxymetazoline may be due to its blood-flow-reducing effect or an effect on the endothelium in the microvascular bed.
Collapse
Affiliation(s)
- Mats Bende
- Dept. of Applied Mechanics and Engineering Sciences-Bioengineering, University of California San Diego, La Jolla, California
| | - Anders ÅKerlund
- Dept. of Applied Mechanics and Engineering Sciences-Bioengineering, University of California San Diego, La Jolla, California
| | - Marcos Intaglietta
- Dept. of Applied Mechanics and Engineering Sciences-Bioengineering, University of California San Diego, La Jolla, California
| | | |
Collapse
|
6
|
Abstract
The effect of long-term treatment with nose drops on nasal obstruction was studied by measuring nasal airway resistance (NAR) in 12 patients with vasomotor rhinitis and in 10 healthy persons using anterior rhinomanometry. The dose-response effect on decongestion by xylometazoline was followed by decongestion induced by physical exercise. Measurements were performed before and after a 3-week treatment with nose drops containing xylometazoline. NAR at rest was significantly higher in the vasomotor rhinitis patient group than in the control group on the initial measurement, and the difference increased after the treatment period. No changes from before to after were found in the control group. Similar dose-response curves for xylometazoline were seen before and after the treatment period in both groups. Tolerance to xylometazoline apparently does not develop. Nose drops did not result in complete decongestion in patients with vasomotor rhinitis. These findings indicate that rebound congestion (rhinitis medicamentosa) develops in predisposed individuals, and interstitial edema of the nasal mucosa is a possible contributing pathophysiological mechanism.
Collapse
Affiliation(s)
- Anders Åkerlund
- Department of Otolaryngology, Central Hospital, Skövde, Sweden
| | - Mats Bende
- Department of Otolaryngology, Central Hospital, Skövde, Sweden
| |
Collapse
|
7
|
Bohman A, Oscarsson M, Holmberg K, Johansson L, Millqvist E, Nasic S, Bende M. Relative frequencies of symptoms and risk factors among patients with chronic rhinosinusitis with nasal polyps using a case-control study. Acta Otolaryngol 2018; 138:46-49. [PMID: 28826302 DOI: 10.1080/00016489.2017.1366052] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Abstract
OBJECTIVES The aim of this study was to investigate the relative frequency of important symptoms of chronic rhinosinusitis with nasal polyps (CRSwNP), the link between CRSwNP and the lower airways and the importance of smoking in CRSwNP. METHOD Three hundred and sixty-eight patients with CRSwNP and 1349 controls were recruited to the study and underwent a structured interview about symptoms from the upper and lower airways, and about smoking habits. Furthermore, all participants were clinically examined using nasal endoscopy. RESULTS Due to interactions between the outcome variables, a multiple logistic regression model was fitted to the data. Nasal secretions, nasal blockage and impaired sense of smell were symptoms associated with CRSwNP. Furthermore, male gender, increasing age and asthma were also associated with the disease. Current smoking was less frequent among patients with CRSwNP. CONCLUSION By comparing symptoms and risk factors of patients with CRSwNP with those of a large population-based control group and testing them in a multiple logistic regression model, we have been able to generate data that address key research interests in CRSwNP.
Collapse
Affiliation(s)
- Anton Bohman
- Department of Otorhinolaryngology, Uppsala University Hospital, Uppsala, Sweden
| | - Martin Oscarsson
- Department of Otorhinolaryngology, Skaraborg Hospital, Skövde, Sweden
| | - Kenneth Holmberg
- Department of Otorhinolaryngology, The Sahlgrenska Academy at the University of Gothenburg, Gothenburg, Sweden
| | - Leif Johansson
- Department of Otorhinolaryngology, Skaraborg Hospital, Skövde, Sweden
| | - Eva Millqvist
- Department of Internal Medicine/Respiratory Medicine and Allergology, The Sahlgrenska Academy at the University of Gothenburg, Gothenburg, Sweden
| | - Salmir Nasic
- Research and Development Centre, Skaraborg Hospital, Skövde, Sweden
| | - Mats Bende
- Department of Otorhinolaryngology, Skaraborg Hospital, Skövde, Sweden
| |
Collapse
|
8
|
Bohman A, Juodakis J, Oscarsson M, Bacelis J, Bende M, Torinsson Naluai Å. A family-based genome-wide association study of chronic rhinosinusitis with nasal polyps implicates several genes in the disease pathogenesis. PLoS One 2017; 12:e0185244. [PMID: 29253858 PMCID: PMC5734761 DOI: 10.1371/journal.pone.0185244] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/17/2017] [Accepted: 09/09/2017] [Indexed: 11/19/2022] Open
Abstract
BACKGROUND The pathogenesis of chronic rhinosinusitis with nasal polyps is largely unknown. Previous studies have given valuable information about genetic variants associated with this disease but much is still unexplained. Our goal was to identify genetic markers and genes associated with susceptibility to chronic rhinosinusitis with nasal polyps using a family-based genome-wide association study. METHODS 427 patients (293 males and 134 females) with CRSwNP and 393 controls (175 males and 218 females) were recruited from several Swedish hospitals. SNP association values were generated using DFAM (implemented in PLINK) and Efficient Mixed Model Association eXpedited (EMMAX). Analyses of pathway enrichment, gene expression levels and expression quantitative trait loci were then performed in turn. RESULTS None of the analysed SNPs reached genome wide significant association of 5.0 x 10-8. Pathway analyses using our top 1000 markers with the most significant association p-values resulted in 138 target genes. A comparison between our target genes and gene expression data from the NCBI Gene Expression Omnibus database showed significant overlap for 36 of these genes. Comparisons with data from expression quantitative trait loci showed the most skewed allelic distributions in cases with chronic rhinosinusitis with nasal polyps compared with controls for the genes HLCS, HLA-DRA, BICD2, VSIR and SLC5A1. CONCLUSION Our study indicates that HLCS, HLA-DRA, BICD2, VSIR and SLC5A1 could be involved in the pathogenesis of chronic rhinosinusitis with nasal polyps. HLA-DRA has been associated with chronic rhinosinusitis with nasal polyps in previous studies and HLCS, BICD2, VSIR and SLC5A1 may be new targets for future research.
Collapse
Affiliation(s)
- Anton Bohman
- Department of Otorhinolaryngology, Uppsala University Hospital, Uppsala, Sweden
| | - Julius Juodakis
- Department of Obstetrics and Gynecology, Institute of Clinical Sciences, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
| | - Martin Oscarsson
- Department of Otorhinolaryngology, Skaraborg Hospital, Skövde, Sweden
| | - Jonas Bacelis
- Department of Obstetrics and Gynecology, Institute of Clinical Sciences, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
| | - Mats Bende
- Department of Otorhinolaryngology, Skaraborg Hospital, Skövde, Sweden
| | - Åsa Torinsson Naluai
- Department of Microbiology and Immunology, Institute of Biomedicine, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
| |
Collapse
|
9
|
Abstract
OBJECTIVES Nasal polyps are often seen in ENT practice, but little is known about the pathogenesis and the natural development. Our objective was to follow individuals with untreated nasal polyps prospectively, in terms of polyp size, symptoms, and respiratory function. METHODS Thirty-three individuals, aged 27 to 87 years, with untreated nasal polyps were identified in a population-based study. Peak nasal inspiratory flow, olfactory function, and size of the nasal polyps were examined. Respiratory symptoms were also registered. Follow-up examinations were performed after 6 and 13 years, with change between visits analyzed. RESULTS Over time, polyp size as well as occurrence of unilateral or bilateral polyps varied without an obvious pattern, with no consistent trends in respiratory function or symptoms. Twenty-one individuals (64%) were still untreated at the 6-year follow-up, and 12 (36%) remained untreated during the whole 13-year follow-up. Dropouts were due mainly to death. Seven individuals (21%) started treatment during the follow-up and had larger polyps and more subjective respiratory symptoms at baseline compared to the untreated group. CONCLUSION Nasal polyps found occasionally are often part of a chronic entity but do not necessarily evolve into a more serious condition over time. Treatment should therefore be based on the patients' subjective problems.
Collapse
Affiliation(s)
| | - Leif Johansson
- Department of Otorhinolaryngology, Skaraborgs Hospital, Sweden
| | - Mats Bende
- Department of Otorhinolaryngology, Skaraborgs Hospital, Sweden
| |
Collapse
|
10
|
Wehling E, Naess H, Wollschlaeger D, Hofstad H, Bramerson A, Bende M, Nordin S. Erratum to: Olfactory dysfunction in chronic stroke patients. BMC Neurol 2015; 15:237. [PMID: 26584820 PMCID: PMC4653868 DOI: 10.1186/s12883-015-0489-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/20/2015] [Accepted: 10/06/2015] [Indexed: 11/10/2022] Open
Affiliation(s)
- Eike Wehling
- Department of Physical Medicine and Rehabilitation, Haukeland University Hospital, Bergen, Norway. .,Department of Biological and Medical Psychology, University of Bergen, Bergen, Norway. .,Kavli Centre for Aging and Dementia Research, Haraldsplass Hospital, Bergen, Norway.
| | - Halvor Naess
- Department of Neurology, Haukeland University Hospital, Bergen, Norway.,Centre for Age-related Medicine, Stavanger University Hospital, Stavanger, Norway.,Institute of Clinical Medicine, University of Bergen, Bergen, Norway
| | - Daniel Wollschlaeger
- Institute for Medical Statistics, Epidemiology and Informatics, University Medical Center, JohannesGutenberg-University, Mainz, Germany
| | - Håkon Hofstad
- Department of Physical Medicine and Rehabilitation, Haukeland University Hospital, Bergen, Norway
| | - Annika Bramerson
- Department of Otorhinolaryngology, Central Hospital, Skövde, Sweden
| | - Mats Bende
- Department of Otorhinolaryngology, Central Hospital, Skövde, Sweden
| | - Steven Nordin
- Department of Psychology, University of Umeå, Umeå, Sweden
| |
Collapse
|
11
|
Wehling E, Naess H, Wollschlaeger D, Hofstad H, Hofstad H, Bramerson A, Bende M, Nordin S. Olfactory dysfunction in chronic stroke patients. BMC Neurol 2015; 15:199. [PMID: 26459234 PMCID: PMC4604071 DOI: 10.1186/s12883-015-0463-5] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/20/2015] [Accepted: 10/06/2015] [Indexed: 12/20/2022] Open
Abstract
Background The aim of the study was to investigate odor identification performance in patients one year after hospital admittance due to stroke. Predictors for olfactory dysfunction were investigated as well as self-reported olfactory function and pleasantness of olfactory items. Methods A 1-year prospective study was performed. Stroke location, classification and comorbidities were registered at hospital admission. One year after admission, olfactory function was assessed using standardized olfactory methods (screening for loss of detection sensitivity and an odor identification test). A group of matched controls was derived from a population-based study to compare odor identification performance between groups. Patients were asked for their personal judgment regarding their olfactory function and pleasantness of odorous items. In addition, global cognitive function and symptoms of depression were assessed. Results A total of 78 patients were enrolled (46 males, 32 females; mean age 68 years) of which 28.2 % exhibited reduced olfactory function (hyposmia) and 15.4 % exhibited loss of olfactory function (10.3 % functional anosmia, 5.1 % complete anosmia). Patients showed significantly lower olfactory performance compared to age- and sex-mated matched controls. Predictors of impaired olfactory function were age and NIHSS score. Self-reports indicated no significant differences between patients with normal olfactory function and those with reduced function. Yet, patients having an olfactory dysfunction rated odorous items as significantly less pleasant compared to patients without dysfunction. Conclusions Olfactory dysfunction seems to occur frequently after stoke even one year after initial admission. The deficits seem to relate to hyposmia and functional anosmia, and less to a complete loss of smell sensitivity.
Collapse
Affiliation(s)
- Eike Wehling
- Department of Physical Medicine and Rehabilitation, Haukeland University Hospital, Bergen, Norway. .,Department of Biological and Medical Psychology, University of Bergen, Bergen, Norway. .,Kavli Centre for Aging and Dementia Research, Haraldsplass Hospital, Bergen, Norway.
| | - Halvor Naess
- Department of Neurology, Haukeland University Hospital, Bergen, Norway.,Centre for Age-related Medicine, Stavanger University Hospital, Stavanger, Norway.,Institute of Clinical Medicine, University of Bergen, Bergen, Norway
| | - Daniel Wollschlaeger
- Institute for Medical Statistics, Epidemiology and Informatics, University Medical Center, Johannes-Gutenberg-University, Mainz, Germany
| | | | - Hakon Hofstad
- Department of Physical Medicine and Rehabilitation, Haukeland University Hospital, Bergen, Norway
| | - Annika Bramerson
- Department of Otorhinolaryngology, Central Hospital, Skövde, Sweden
| | - Mats Bende
- Department of Otorhinolaryngology, Central Hospital, Skövde, Sweden
| | - Steven Nordin
- Department of Psychology, University of Umeå, Umeå, Sweden
| |
Collapse
|
12
|
Abstract
BACKGROUND Nasal polyps is a common disease but little is known about its` pathogenesis. Our hypothesis was that there are genetic factors involved in the development of this disease. The aim of this study was to examine close relatives of patients with nasal polyps and comparing them with a general population with regard to prevalence of polyps. METHODOLOGY Patients with nasal polyps who attended the clinic were recruited to the study and were asked whether they had any close adult relatives (siblings, parents or children). We intended to recruit two relatives per patient, one of each gender, for nasal endoscopy. The prevalence of nasal polyps in these relatives was compared with the prevalence of nasal polyps in a general population. RESULTS During a 4-year period, 368 patients and 410 relatives were recruited to the study. Although we were unable to recruit two close relatives for every patient, we were able to calculate nasal polyp prevalence within families as being 19.2%. Compared with the prevalence of nasal polyps among individuals in a general Swedish population from the same geographical area, the relative risk for polyps among relatives was almost five times higher. CONCLUSION This study strongly indicates that heredity is a factor of importance for development of nasal polyps.
Collapse
|
13
|
Bohman A, Oscarsson M, Bende M. Heredity, symptoms and risk factors of nasal polyps. Clin Transl Allergy 2015. [PMCID: PMC4493613 DOI: 10.1186/2045-7022-5-s4-p24] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
Affiliation(s)
- Anton Bohman
- Department of EarNose and Throat DiseasesUppsala University HospitalUppsalaSweden
| | - Martin Oscarsson
- Department of OtorhinolaryngologyHospital of SkaraborgSkövdeSkövdeSweden
| | - Mats Bende
- Department of OtorhinolaryngologyHospital of SkaraborgSkövdeSkövdeSweden
| |
Collapse
|
14
|
|
15
|
Abstract
BACKGROUND A reduced sense of smell may be one explanation for why patients with cancer in the ear, nose and throat (ENT) region who are treated with radiation therapy lose weight. The purpose of this study was to investigate whether radiation therapy has a negative effect on olfactory function and, if so, whether this effect is dose-related. METHODOLOGY Seventy-one patients were tested using odour-detection sensitivity and olfactory identification tests before radiation therapy and 20 months after it. RESULTS Patients who received radiation close to the olfactory organ showed a reduced sense of smell, in both tests. A multiple regression analysis showed that the radiation dose was related to decline in the olfactory function, while age, sex, chemotherapy and interactions between these variables were not. CONCLUSION Radiation therapy can damage olfactory cells.
Collapse
|
16
|
|
17
|
Millqvist E, Ternesten-Hasséus E, Bende M. Inhalation of menthol reduces capsaicin cough sensitivity and influences inspiratory flows in chronic cough. Respir Med 2012; 107:433-8. [PMID: 23266255 DOI: 10.1016/j.rmed.2012.11.017] [Citation(s) in RCA: 25] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/27/2012] [Revised: 11/13/2012] [Accepted: 11/16/2012] [Indexed: 12/19/2022]
Abstract
INTRODUCTION Chronic cough is a common clinical problem and there is a shortage of effective treatments for it. Within the group of transient receptor potential ion channels a receptor for the cooling substance menthol has been identified. This study aimed to assess whether pre-inhalation of dissolved, nebulised menthol could increase capsaicin cough thresholds and influence spirometric values. METHODS Fourteen patients with chronic cough and airway sensitivity to environmental irritants and 15 control subjects were tested on three occasions. Each one inhaled a 1 mL of nebulised menthol solution of 0.5% or 1% or placebo (saline with 0.05% menthol) at each visit in a randomized and double-blind order. They were then provoked by capsaicin inhalation. RESULTS Patients' cough thresholds differed significantly from the controls' on all three provocations (P < 0.0001). After inhalation of 1% menthol, the patients' cough thresholds were significantly higher (P < 0.02) compared to after placebo inhalation and to after 0.5% menthol inhalation (P < 0.05). The patients' peak inspiratory flows were significantly reduced after inhalation of the placebo (saline) (P < 0.05) but not after inhalation of 0.5% or 1% menthol. Forced inspiratory flows 50% were lowered after inhalation of placebo and of 0.5% menthol (P < 0.05) but not after 1% menthol. Among the controls, forced inspiratory flows 50% were lowered after only placebo inhalation (P < 0.05). CONCLUSIONS In patients with chronic cough, pre-inhalation of menthol reduces cough sensitivity to inhaled capsaicin and influences inspiratory flows. The findings may provide scientific support for the common practice of using menthol as a reliever for variant airway discomfort. The use of menthol in different cigarette brands could be questioned since it could conceal the natural irritation following smoking.
Collapse
Affiliation(s)
- Eva Millqvist
- Department of Internal Medicine/Respiratory Medicine and Allergology, The Sahlgrenska Academy at University of Gothenburg, Sweden.
| | | | | |
Collapse
|
18
|
Nordin S, Palmquist E, Bende M, Millqvist E. Normative data for the chemical sensitivity scale for sensory hyperreactivity: the Västerbotten environmental health study. Int Arch Occup Environ Health 2012; 86:749-53. [PMID: 22918527 DOI: 10.1007/s00420-012-0812-2] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/19/2011] [Accepted: 08/09/2012] [Indexed: 11/25/2022]
Abstract
OBJECTIVES The chemical sensitivity scale for sensory hyperreactivity (CSS-SHR) is used to quantify affective reactions to and behavioral disruptions by odorous/pungent substances in the environment and has documented good metric properties. However, normative data have not been available. The main objective of the present study was therefore to establish normative data for reference by means of a large-scale population-based study. MATERIALS AND METHODS From a random sample of 8,520 reachable inhabitants in the county of Västerbotten in Sweden, aged 18-79 years, stratified for age and gender, 3,406 individuals agreed to participate. RESULTS The results show fairly high internal consistency (Cronbach's α = 0.78-0.83) of the CSS-SHR and that it generates scores with approximately normal distributions (skewness: 0.045-0.454; kurtosis: -0.314 to 0.230), irrespective of age group and gender. Mean scores, standard deviations, confidence intervals, and proportions of individuals who met the diagnostic cutoff score for the CSS-SHR were obtained for reference of normality. CONCLUSIONS CSS-SHR can be recommended for quantification of affective reactions to and behavioral disruptions by odorous/pungent environmental substances, and with the advantage of comparing scores with normality.
Collapse
Affiliation(s)
- Steven Nordin
- Department of Psychology, Umeå University, 901 87, Umeå, Sweden,
| | | | | | | |
Collapse
|
19
|
Bende M, Millqvist E. Prevalence of chronic cough in relation to upper and lower airway symptoms; the Skövde population-based study. Front Physiol 2012; 3:251. [PMID: 22934008 PMCID: PMC3429028 DOI: 10.3389/fphys.2012.00251] [Citation(s) in RCA: 25] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/26/2012] [Accepted: 06/18/2012] [Indexed: 11/13/2022] Open
Abstract
The aim of this study was to determine the prevalence of chronic cough in relation to upper airway symptoms, in a cross-sectional, population-based epidemiological study. Another aim was to relate coughing to other explanatory variables and risk factors. A random sample of 1900 inhabitants from the age of 20, stratified for age and gender, was recruited. Subjects were invited for clinical examinations that included questions about general odor intolerance, respiratory symptoms, and smoking habits, and a smell identification test. In total, 1387 volunteers (73% of the sample) were investigated. The overall prevalence of self-reported chronic cough was 6.3% [95% confidence interval (CI): 5.0-7.6%]. Female gender, age, height, BMI, and smoking were significantly related to cough. Furthermore, nasal blockage, nasal secretion, sneezing, asthma, odor and cold air sensitivity, and aspirin intolerance also related to cough with statistical significance, indicating a close connection between chronic cough and upper airway symptoms. In keeping with other studies, this study demonstrates that chronic cough is a widespread problem in society, and is about twice as common in women than in men.
Collapse
Affiliation(s)
- Mats Bende
- Department of Otorhinolaryngology, Central Hospital Skövde, Sweden
| | | |
Collapse
|
20
|
Thorold H, Thorvold H, Bende M. The effect of smoking on physiological decongestion of the nasal mucosa in human. Rhinology 2011; 48:438-40. [PMID: 21442081 DOI: 10.4193/rhino10.039] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
BACKGROUND Exercise is known to decongest the nasal mucosa which results in increased nasal patency. In a recent study it was suggested that smoking might influence the effect of exercise on the nasal mucosa. This implies that smoking may cause neurological damage to the normal nasal physiology, which has not previously been shown. The aim of this study was to investigate whether there was a difference in nasal mucosal reaction to exercise between smokers and non-smokers. METHODOLOGY Forty-two smokers and non-smokers underwent acoustic rhinometry to register nasal geometry before and after cycling on an ergometer cycle. A structured interview was used for questions about smoking habits and airway symptoms. RESULTS Both smokers and non-smokers had a significant increase in MCA (minimal cross-section area) and total nasal volume after exercise. There was no statistical significant difference between smokers and non-smokers. CONCLUSIONS Smoking does not seem to affect the normal physiological decongestion of the nasal mucosa after exercise.
Collapse
Affiliation(s)
- H Thorold
- Linköping University , Linköping, Sweden
| | | | | |
Collapse
|
21
|
Abstract
BACKGROUND Patients with airway symptoms induced by chemicals and odors are common in allergy clinics, but the problems cannot be explained by allergic or asthmatic reactions. Previous studies have shown that these patients often have increased sensitivity to inhaled capsaicin, which is known to reflect sensory reactivity; a diagnosis of airway sensory hyperreactivity (SHR) has been suggested for this condition. OBJECTIVES To examine the relationship between asthma and SHR and to investigate whether patients with SHR show signs of increased psychiatric morbidity. METHODS This study included 724 patients who were attending an allergy center because of suspected allergy or asthma. All the patients completed a quantitative questionnaire on self-reported affective reactions and behavioral disruptions caused by odorous/pungent substances. A standardized capsaicin inhalation test was performed and a questionnaire to assess psychiatric morbidity was administered in patients with pronounced chemical sensitivity to identify those with SHR. RESULTS The prevalence of SHR was approximately 6% in asthmatic patients in the allergy center population, which is in accordance with the prevalence in a general population. There was no significant indication that SHR was related to either depression or anxiety. CONCLUSION There is no strong relationship between SHR and either asthma or psychiatric morbidity.
Collapse
Affiliation(s)
- Ake Johansson
- Department of Respiratory Medicine, Central Hospital, Skövde, Sweden
| | | | | |
Collapse
|
22
|
Landis BN, Scheibe M, Weber C, Berger R, Brämerson A, Bende M, Nordin S, Hummel T. Chemosensory interaction: acquired olfactory impairment is associated with decreased taste function. J Neurol 2010; 257:1303-8. [PMID: 20221768 DOI: 10.1007/s00415-010-5513-8] [Citation(s) in RCA: 86] [Impact Index Per Article: 6.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/17/2009] [Revised: 02/02/2010] [Accepted: 02/17/2010] [Indexed: 11/28/2022]
Abstract
Olfaction, taste and trigeminal function are three distinct modalities. However, in daily life they are often activated concomitantly. In health and disease, it has been shown that in two of these senses, the trigeminal and olfactory senses, modification of one sense leads to changes in the other sense and vice versa. The objective of the study was to investigate whether and (if so) how, the third modality, taste, is influenced by olfactory impairment. We tested 210 subjects with normal (n = 107) or impaired (n = 103) olfactory function for their taste identification capacities. Validated tests were used for olfactory and gustatory testing (Sniffin' Sticks, Taste Strips). In an additional experiment, healthy volunteers underwent reversible olfactory cleft obstruction to investigate short-time changes of gustatory function after olfactory alteration. Mean gustatory identification (taste strip score) for the subjects with impaired olfaction was 19.4 +/- 0.6 points and 22.9 +/- 0.5 points for those with normal olfactory function (t = 4.6, p < 0.001). The frequencies of both, smell and taste impairments interacted significantly (Chi(2), F = 16.4, p < 0.001), and olfactory and gustatory function correlated (r (210) = 0.30, p < 0.001). Neither age nor olfactory impairment cause effects interfered with this olfactory-gustatory interaction. In contrast, after short-lasting induced olfactory decrease, gustatory function remained unchanged. The present study suggests that longstanding impaired olfactory function is associated with decreased gustatory function. These findings seem to extend previously described mutual chemosensory interactions also to smell and taste. It further raises the question whether chemical senses in general decrease mutually after acquired damage.
Collapse
Affiliation(s)
- Basile N Landis
- Smell and Taste Clinic, Department of Otorhinolaryngology, University of Dresden Medical School, Technische Universität Dresden, Fetscherstrasse 74, 01307 Dresden, Germany.
| | | | | | | | | | | | | | | |
Collapse
|
23
|
Landis BN, Welge-Luessen A, Brämerson A, Bende M, Mueller CA, Nordin S, Hummel T. “Taste Strips” – A rapid, lateralized, gustatory bedside identification test based on impregnated filter papers. J Neurol 2009; 256:242-8. [DOI: 10.1007/s00415-009-0088-y] [Citation(s) in RCA: 272] [Impact Index Per Article: 18.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/26/2008] [Revised: 07/19/2008] [Accepted: 08/14/2008] [Indexed: 11/29/2022]
|
24
|
Abstract
In the absence of other explanations, exercise-induced dyspnea is often labeled as a manifestation of asthma. The aim of this study was to use exercise provocation in cold air among patients with exercise-induced dyspnea, but without any bronchoconstriction, in order to study induced symptoms and different physiological parameters and to measure the possible influence of exercise in cold air on capsaicin cough sensitivity. Eleven patients with exercise-induced dyspnea but no asthma, along with 11 healthy controls, performed a capsaicin inhalation provocation on two occasions. One of these provocations was preceded by an exercise provocation in a cold chamber. Number of coughs, airway symptoms, spirometry, respiratory rate, pulse rate, end-tidal CO(2), and PSaO(2) were registered. During exercise, the patients coughed more than the controls and also had more airway symptoms. After exercise provocation, spirometry values remained unchanged, but capsaicin cough sensitivity was increased and end-tidal CO(2) decreased among the patients, both in comparison to the controls and in comparison to the patients themselves prior to exercise. Exercise-induced dyspnea may be associated with hypocapnia from hyperventilation and increased capsaicin cough sensitivity. The diagnosis of exercise-induced asthma should be questioned when the patient has no signs of bronchoconstriction.
Collapse
Affiliation(s)
- Ewa Ternesten-Hasséus
- Asthma and Allergy Research Group, Department of Respiratory Medicine and Allergology, The Sahlgrenska Academy at Göteborg University, Goteborg, Sweden.
| | | | | | | |
Collapse
|
25
|
Brämerson A, Millqvist E, Ydse B, Larsson C, Olofsson JK, Bende M. Event-related potentials in patients with olfactory loss. Acta Otolaryngol 2008; 128:1126-31. [PMID: 18607946 DOI: 10.1080/00016480801891702] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
Abstract
CONCLUSION The olfactory event-related potential (OERP) method provides a means of objectively assessing olfactory function. However, further validation is needed before OERPs can be routinely applied in clinical assessment of olfactory dysfunction. OBJECTIVE To assess OERPs in patients with olfactory impairment and in healthy controls to investigate possible dose-response effects of odor concentration on OERP parameters in these groups, thereby exploring possibilities and limitations regarding the clinical utility of the OERP method. SUBJECTS AND METHODS Twenty-three patients with a history of impaired olfactory function and 24 controls participated in the study. Olfactory function was assessed with psychophysical tests, i.e. assessment of the odor threshold, and odor identification. OERPs were obtained in response to the olfactory stimulant butanol at two different concentrations, presented via an olfactometer. RESULTS The OERP amplitudes increased and the latencies shortened with increasing stimulus concentration. Furthermore, a difference between the groups was found, with higher OERP amplitudes and shorter latencies in healthy subjects compared with patients.
Collapse
|
26
|
Ternesten-Hasséus E, Larsson C, Bende M, Millqvist E. Capsaicin provocation using two different inhalation devices. Respir Med 2008; 102:1784-90. [PMID: 18703328 DOI: 10.1016/j.rmed.2008.06.015] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/07/2008] [Revised: 06/03/2008] [Accepted: 06/27/2008] [Indexed: 11/25/2022]
Abstract
BACKGROUND Sensory hyperreactivity (SHR) has been suggested as one explanation for chemically induced airway symptoms; it can be diagnosed with a capsaicin inhalation test. Previous capsaicin inhalation studies of SHR have used a Pari Boy device. This model of inhalator device has become outdated, hence it is necessary to abandon it in favour of a new device. The aim of this study was to transfer the capsaicin inhalation test using the Pari Boy device to a corresponding model using the Maxin MA3 device. METHODS Twenty-one patients with SHR and 44 healthy controls visited the clinic twice and underwent a randomised protocol. The participants were provoked with saline and capsaicin using one of two devices, Pari Boy and Maxin MA3. Eight patients also underwent two additional capsaicin provocations with Maxin MA3. A new series of capsaicin concentrations was chosen for Maxin MA3. The results from each device were analysed, the agreement between the two devices and the repeatability of the Maxin MA3 were evaluated. RESULTS Among all participants, the mean number of coughs with the Pari Boy was 5.5 (95% CI: 2.7; 8.2) after inhalation of 0.4 micromol/L capsaicin and 20.0 (95% CI: 14.1; 25.9) after 2.0 micromol/L. With the Maxin MA3, the mean number of coughs was 3.6 (95% CI: 1.3; 4.0) after 0.06 micromol/L capsaicin, and 17.8 (95% CI: 12.0; 23.6) after 0.3 micromol/L. The Maxin MA3 showed good repeatability and the agreement between the devices with the capsaicin concentrations chosen for each device was considered to be good.
Collapse
Affiliation(s)
- Ewa Ternesten-Hasséus
- Asthma and Allergy Research Group, Department of Respiratory Medicine and Allergology, The Sahlgrenska Academy at Göteborg University, Sahlgrenska University Hospital, S-413 45 Göteborg, Sweden.
| | | | | | | |
Collapse
|
27
|
Millqvist E, Ternesten-Hasséus E, Bende M. Inhaled ethanol potentiates the cough response to capsaicin in patients with airway sensory hyperreactivity. Pulm Pharmacol Ther 2008; 21:794-7. [PMID: 18621137 DOI: 10.1016/j.pupt.2008.06.002] [Citation(s) in RCA: 15] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/08/2008] [Revised: 06/16/2008] [Accepted: 06/18/2008] [Indexed: 12/31/2022]
Abstract
A suggested explanation for airway symptoms induced by chemicals and scents is sensory hyperreactivity (SHR) of airway mucosal nerves. Patients with SHR have increased cough sensitivity to inhaled capsaicin, mediated by transient receptor potential (TRP) ion channels. In animal experiments, some TRP receptors are potentiated by ethanol, which is why in this study, the aim was to evaluate whether a pre-inhalation of ethanol could influence the capsaicin cough response in patients with SHR. Fifteen patients with SHR and 15 healthy controls were provoked on three occasions with two concentrations of inhaled capsaicin. Before each capsaicin provocation, a pre-inhalation of saline or one of two concentrations of ethanol was given in a double-blind, randomized fashion. The participants reacted in a dose-dependent way with cough on the capsaicin inhalations. Among the patients, but not in the control group, pre-inhalation of ethanol increased the cough response dose-dependently. The results suggest that the pathophysiology of SHR is related to airway mucosal TRP receptors in the sensory nerves. In scented products, the combination of ethanol as a solvent and perfume may augment an airway reaction in sensitive individuals.
Collapse
Affiliation(s)
- Eva Millqvist
- Department of Respiratory Medicine and Allergology, Asthma and Allergy Research Group, The Sahlgrenska Academy at University of Gothenburg, S-413 45 Gothenburg, Sweden.
| | | | | |
Collapse
|
28
|
Andersson L, Johansson A, Millqvist E, Nordin S, Bende M. Prevalence and risk factors for chemical sensitivity and sensory hyperreactivity in teenagers. Int J Hyg Environ Health 2008; 211:690-7. [PMID: 18403259 DOI: 10.1016/j.ijheh.2008.02.002] [Citation(s) in RCA: 37] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/03/2007] [Revised: 01/25/2008] [Accepted: 02/04/2008] [Indexed: 11/16/2022]
Abstract
The prevalence of chemical sensitivity (CS) and sensory hyperreactivity (SHR) was assessed in a teenage population. Among a random sample of 401 teenagers, 326 (81.3%) answered questionnaires assessing sensitivity to chemicals and noise, anxiety and depression. A subgroup of 85 teenagers conducted a capsaicin inhalation test. The estimated prevalence was 15.6% for general self-reported CS, 3.7% for CS with affective and behavioral consequences, about 1% for SHR. Sensitivity variables were positively intercorrelated. Risk factors for general CS were noise sensitivity (OR: 2.1), probable anxiety (OR: 2.5) and female sex (OR: 2.0). CS problems seem to be present also in teenagers, although less so than in adults. Furthermore, CS seems to be related to other environmental sensitivities.
Collapse
|
29
|
Millqvist E, Johansson A, Månsson T, Bende M. A prospective study of allergy development in 158 children and 128 adults with new extensive exposure to furred animals. Clin Exp Allergy 2007; 37:948-53. [PMID: 17517109 DOI: 10.1111/j.1365-2222.2007.02731.x] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
BACKGROUND There is still controversy over whether exposure to furred animals increases or decreases the risk of developing sensitization and allergic symptoms to such animals, and there is a need for further knowledge on this subject. OBJECTIVE The aim of this study was to follow allergy development in relation to new extensive exposure to furred animals in adults and children. METHODS A total of 286 individuals, 128 parents and 158 children, were recruited from 68 families who intended to buy a dog or a cat, or where one child of the family intended to start riding a horse. Subjects were examined before the new allergen exposure and once a year thereafter for 5 years, in all at six occasions, and they also completed questionnaires covering allergy symptoms. Serum IgE antibodies to cat, dog and horse were determined each year, and fur allergens from beds and living rooms were analysed. RESULTS Two-hundred and fifty-six study subjects remained for evaluation, 37 of whom showed signs of allergic sensitization at the start of the study. Four children (11%) in this pre-sensitized group developed IgE antibodies to their new animal and six (16%) to another animal. Among the 219 participants who were not sensitized when entering the study, one male adult (0.4%) developed a sensitization to his new animal, and nobody developed sensitization to other animals. Pre-sensitized individuals had significantly more allergic symptoms at the study start, but the symptom scores did not change over time. CONCLUSIONS When the first year of a human's life has passed, we have no strong evidence to recommend avoidance of a domestic animal in order to prevent new allergy development, even if there are known allergies in the family or if the individual is sensitized and has allergic symptoms to another allergen. Five years exposure to new fur allergens does not seem to influence sensitization to these animals in either sensitized or non-sensitized children and adults.
Collapse
Affiliation(s)
- E Millqvist
- The Allergy Centre of the Central Hospital, Skövde, Sweden
| | | | | | | |
Collapse
|
30
|
Johansson L, Bende M. Excessive obesity is related to daily symptoms of nasal blockage: the Skövde population-based study. Rhinology 2007; 45:205-207. [PMID: 17956019] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/25/2023]
Abstract
This study has as its focus on obesity as a factor of importance for nasal blockage. A random sample of 1.900 adults stratified according to age and gender were recruited from the general population. The study included a structured interview about symptoms of nasal blockage and asthma, and a clinical examination with nasal endoscopy. Smoking habits were evaluated by a questionnaire on current and previous smoking. A response rate of 73% was achieved. There was a statistically significant relationship between subjectively experienced daily nasal blockage and registered heavy overweight, but no relationship was found between nasal blockage and age, gender, diabetes or asthma. The odds ratio (OR) for individuals with excessive obesity to have daily symptoms of nasal blockage was 3.7 [95% CI 1.6-7.6]. In patients with nasal blockage, obesity as a cause should be taken into consideration.
Collapse
Affiliation(s)
- Leif Johansson
- Department of Otorhinolaryngology, Central Hospital, SE-541 85 Skövde, Sweden
| | | |
Collapse
|
31
|
Abstract
Voice problems are seldom reported in pollen allergy, although the allergic reaction involves the entire airways. The objective of this study was to investigate voice dysfunction during the pollen season in patients with allergic rhinitis. Thirty patients with verified birch pollen allergy and 30 controls were investigated twice, during the pollen season and outside the pollen season. Both times they scored respiratory and voice symptoms, the latter with the validated questionnaire Voice Handicap Index (VHI), and performed standardized voice recordings. These recordings were analyzed in a controlled manner by a professional voice therapist. During the allergy season, patients reported more respiratory and voice symptoms compared with controls. Those with blinded scored voice dysfunction scored their voice quality during springtime as 31 mm (95% confidence interval [CI] 20-42 mm), compared with 13 mm (95% CI 6-21 mm for participants without voice dysfunction (P<0.01). Furthermore, the group with experienced voice dysfunction scored significantly higher on the VHI in the functional and physical domains and in the total VHI score. Although voice problems during the pollen season are rarely discussed, in allergic rhinitis the larynx may also be involved. These findings support that some patients experience voice change, an experience which can be objectively confirmed.
Collapse
Affiliation(s)
- Eva Millqvist
- Department of Otorhinolaryngology and Allergy Centre, Central Hospital, Skövde, Sweden
| | | | | | | | | | | |
Collapse
|
32
|
Nordin S, Brämerson A, Millqvist E, Bende M. Prevalence of parosmia: the Skövde population-based studies. Rhinology 2007; 45:50-3. [PMID: 17432070] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/14/2023]
Abstract
AIM Parosmia can be defined as a qualitative odor distortion. Despite the consequences of this condition for quality of life, the scientific literature lacks information about the prevalence of parosmia in the general population, which was the objective of the present study. METHODS Random samples of 1,900 adult and 401 teenage inhabitants, stratified for age and gender, were drawn from the municipal population register of Skövde, Sweden. In total, 1,713 individuals (74% of the samples) agreed to participate, of which 1,387 (73%) were adults and 326 (81%) were teenagers. They responded to a question about parosmia by means of either a structured interview (adults) or a questionnaire (teenagers). RESULTS The overall prevalence of parosmia was 3.9% (4.0% in adults and 3.4% in teenagers), which was stable across gender, but differed somewhat between age groups, with highest prevalence in the age group 20-29 years. CONCLUSIONS The rather high overall prevalence, 3.9%, does indeed suggest that parosmia deserves attention when attempting to better understand olfactory dysfunction in clinical settings and in the general population of both adults and teenagers.
Collapse
|
33
|
Abstract
CONCLUSION A special consulting team for patients with olfactory disorders would be able to verify, describe, and explain the characteristics of the disorders, also in cases where a patient experiences a disorder, but has a normal sense of smell. OBJECTIVES The general purpose of this paper was to present our experience with patients seeking medical attention for olfactory disorders, and to describe how quantitative and qualitative olfactory disorders are diagnosed, what the etiologies are, and how quality of life is compromised in patients with olfactory disorders. SUBJECTS AND METHODS This investigation was performed prospectively over a 10-year period by one physician responsible for the consulting team for patients with olfactory disorders. Based on a standardized clinical examination, a structured interview, and assessment of olfactory function, its aim was to diagnose quantitative and qualitative disorders in 303 consecutive patients. Health-related quality of life was assessed with the Nottingham Health Profile (NHP) in about one-third of patients. RESULTS In the majority of patients, a reduced sense of smell was found after testing. Often, but not always, this was combined with qualitative disorders. Dominating etiologies were infections, nasal polyposis, head trauma, and aging. Patients complaining of olfactory disorders experience a significantly reduced quality of life regarding the impact of their health problem on paid employment, household work, and social and family life.
Collapse
Affiliation(s)
- Annika Brämerson
- Department of Otorhinolaryngology, Central Hospital, Skövde, Sweden
| | | | | |
Collapse
|
34
|
Nordin S, Brämerson A, Bringlöv E, Kobal G, Hummel T, Bende M. Substance and tongue-region specific loss in basic taste-quality identification in elderly adults. Eur Arch Otorhinolaryngol 2006; 264:285-9. [PMID: 17004086 DOI: 10.1007/s00405-006-0169-9] [Citation(s) in RCA: 27] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/13/2006] [Accepted: 07/15/2006] [Indexed: 10/24/2022]
Abstract
Physiological anorexia, decreased dietary variation, and weight loss associated with poor health are common conditions in the elderly population, with changes in chemosensory perception as important contributing causes. The present study of age-related taste loss aimed to investigate the question whether this loss is generalised and unspecific, or whether it exhibits differences in relation to certain tastants and/or differences in the topographical distribution of age-related loss. Impregnated "taste strips" with four concentrations of each of the tastants sucrose, NaCl, quinine-hydrochloride, and citric acid were applied on the tip, midlateral and posteromedial tongue regions to be identified as either sweet, salty, bitter, or sour by 30 young and 26 elderly adults. The results showed more pronounced age-related loss in identification for citric acid and quinine-hydrochloride than for sucrose and NaCl at both the tip and midlateral regions, but not at the posteromedial region where both age groups performed close to chance level. These findings may have implications for food preferences, and thus, the diets of elderly people.
Collapse
Affiliation(s)
- Steven Nordin
- Department of Psychology, Umeå University, Umeå, Sweden
| | | | | | | | | | | |
Collapse
|
35
|
Abstract
PURPOSE OF THE REVIEW Chronic cough can be caused by a number of factors, including infections, rhinosinusitis, asthma and environmental stimuli. This paper reviews recent findings and opinions regarding the role played by the upper airways in chronic cough. RECENT FINDINGS Chronic cough has a significant impact on quality of life, which is more pronounced in women. In Western countries, the reported occurrence of rhinosinusitis in patient groups with chronic cough ranges from 8% to 81%. Allergic rhinitis is a risk factor for later development of asthma. In children, bronchiectasis is combined with upper airway abnormalities in the majority of cases. Increased expression of the capsaicin receptor subtype named 'transient receptor potential vanilloid-1', which correlates with capsaicin cough response, has been identified in patients with chronic cough. Patients with airway chemical sensitivity and chronic cough as one symptom have augmented capsaicin cough sensitivity that is related to changed levels of nerve growth factor in nasal lavage. SUMMARY Involvement of the upper airways in chronic cough has been confirmed in several studies. However, there are considerable differences between different health centres in the occurrence of rhinosinusitis as a cause of chronic cough. In patients with chronic cough of various causes, a neurochemical alteration in both the upper and the lower airways appears to have taken place, followed by increased cough sensitivity.
Collapse
Affiliation(s)
- Eva Millqvist
- Asthma and Allergy Research Group, Department of Respiratory Medicine and Allergy, Sahlgrenska University Hospital, Göteborg, Sweden.
| | | |
Collapse
|
36
|
Abstract
STUDY OBJECTIVES The aim of this study was to investigate the relationship between the behavioral consequences of self-reported odor sensitivity with the chemical sensitivity scale for sensory hyperreactivity (CSS-SHR) and cough sensitivity to inhaled capsaicin. We also wanted to estimate the prevalence of airway sensory hyperreactivity (SHR), which was defined as a positive CSS-SHR score in combination with a positive capsaicin inhalation test result. DESIGN A general population-based study with randomly selected individuals after stratification for age and gender. SETTING Skövde Central Hospital, Departments of Lung Medicine and Otorhinolaryngology, Sweden. PARTICIPANTS A total of 693 randomly selected individuals from a population-based study in which 595 persons (86%) responded to the CSS-SHR questionnaire. INTERVENTIONS The individuals were divided into four groups with different odor sensitivity according to their CSS-SHR score. Of these, 137 individuals were randomly recruited for the capsaicin inhalation test. Capsaicin inhalation was performed with concentrations of 0.4 and 2.0 mumol/L in a randomized order. The number of coughs were registered and counted for 10 min from the start of each inhalation. MEASUREMENTS AND RESULTS Of the 137 individuals who were recruited for the capsaicin inhalation test, 103 (75%) participated. Sixteen individuals had increased cough sensitivity and fulfilled the criteria for a positive capsaicin inhalation test result. Of the individuals with a positive capsaicin inhalation test result, > 80% also had a positive CSS-SHR score. Only 5% of the individuals with a negative CSS-SHR score had a positive capsaicin inhalation test result. The order of inhaled capsaicin concentration was found to influence the results. The prevalence of SHR with the definition given above was estimated to be 6.3% in this general population. CONCLUSIONS A high CSS-SHR score was found to be directly related to the sensitivity for inhaled capsaicin, which made it possible to relate subjective data to objective findings.
Collapse
Affiliation(s)
- Ake Johansson
- Department of Otorhinolaryngology, Central Hospital, SE-541 85 Skövde, Sweden
| | | | | | | |
Collapse
|
37
|
Abstract
CONCLUSION This study was able to present representative data from Sweden as a whole and illuminates the epidemiological background of symptoms of the upper and lower airways. Current regular smokers, compared with non-smokers, had more problems with nasal blockage, cough and asthma. The relationship between the upper and lower airways was confirmed as regards airway symptoms. BACKGROUND Epidemiology of common respiratory symptoms is basic information in health care. This study has focused on the prevalence of upper and lower airway symptoms. PATIENTS AND METHODS A random sample of 1900 age- and gender-stratified adults was recruited from a general population for this study, which included a structured interview about symptoms of nasal secretions and blockage, cough and asthma, and a clinical examination with nasal endoscopy, and peak nasal-inspiratory flow (PNIF). Smoking habits were evaluated by a questionnaire for current and previous smoking. RESULTS A response rate of 73% was achieved. The prevalence of various symptoms varied between age strata and gender. There was a statistically significant relationship between subjectively experienced nasal blockage and objectively observed nasal congestion. PNIF was negatively related to age and height and was increased in male gender. Smoking was most common among females and related to nasal blockage, cough and asthma, but not to nasal secretions. Significant relationships between the upper and lower airways were found.
Collapse
|
38
|
Abstract
CONCLUSIONS The hypothesis that decongestants reduce the size of nasal polyps could not be verified. Decongestion is therefore recommended prior to nasal endoscopy, especially in polyp diagnosis, as it does not artificially change the size of the polyps. OBJECTIVE The role of nasal decongestants in nasal stuffiness is well established and their action is well known. Decongestants are also used prior to nasal endoscopy to achieve a better view of the nasal cavity in order to diagnose polyps. The question is whether this decongestion invalidates the estimation of polyp size in clinical and scientific practice. The aim of this study was to evaluate possible effects of topical decongestants on polyp extension in patients with nasal polyposis. MATERIAL AND METHODS The effect of the decongestants nafazoline and epinephrine on nasal polyp size was assessed by means of a double-blind, placebo-controlled randomized study. A sensitive endoscopic scoring system, lateral imaging, was used to assess the size and extension of the nasal polyps. RESULTS No significant effect of decongestion on polyp size could be found for either treatment.
Collapse
Affiliation(s)
- Leif Johansson
- Department of Otorhinolaryngology, Central Hospital, Skövde, Sweden.
| | | | | | | |
Collapse
|
39
|
Millqvist E, Bende M. Two-year follow-up with acoustic rhinometry in children. Am J Rhinol 2006; 20:203-4. [PMID: 16686389] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/09/2023]
Abstract
BACKGROUND This is an explorative study of growth-related nasal geometry in healthy children. METHODS A total of 88 girls and boys between the ages of 4 and 16 years were followed over a period of 2 years by acoustic rhinometry. The registrations were correlated to height at each occasion. RESULTS Although both the minimal cross-sectional area and the nasal volume increased in all age groups over 7 years, large individual variations in nasal geometry led to a weak relationship with growth. CONCLUSION In the undecongested nasal cavity in children, correlation of nasal geometry makes sense for height but not for age.
Collapse
Affiliation(s)
- Eva Millqvist
- Asthma and Allergy Research Group, Sahlgrenska University Hospital, Gothenburg, Sweden
| | | |
Collapse
|
40
|
Johansson A, Brämerson A, Millqvist E, Nordin S, Bende M. Prevalence and risk factors for self-reported odour intolerance: the Skövde population-based study. Int Arch Occup Environ Health 2005; 78:559-64. [PMID: 16001204 DOI: 10.1007/s00420-005-0616-8] [Citation(s) in RCA: 92] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/24/2004] [Accepted: 10/25/2004] [Indexed: 10/25/2022]
Abstract
OBJECTIVES The present study was performed to determine the prevalence of odour intolerance in adults with respect to both self-reported general intolerance and affective and behavioural consequences. Furthermore, we aimed to relate odour intolerance to explanatory variables and risk factors. METHOD This is a cross-sectional, population-based epidemiological study. A random sample of 1900 inhabitants from the age of 20, stratified for age and gender, were recruited. Subjects were invited for clinical examinations that included questions about general odour intolerance, respiratory symptoms and smoking habits, as well as a smell identification test. The chemical sensitivity scale for sensory hyperreactivity (CSS-SHR) was used to quantify affective and behavioural consequences. RESULTS In total 1387 volunteers (73% of the sample) were investigated. The overall prevalence of self-reported general odour intolerance was 33% (95% confidence interval (CI): 30-36%), with problems mainly from the upper respiratory tract. The prevalence of affective and behavioural consequences of odour intolerance (CSS-SHR score > or =43) was 19% (95% CI: 15-22%). The risk for the latter condition was increased in women compared with men (odds ratio = 2.3: 95% CI: 1.5-3.6), but no increased risk was found related to current smoking or impaired sense of smell. CONCLUSION This study demonstrates that intolerance to odours is a widespread problem in society, and that it is about twice as common in women than in men.
Collapse
Affiliation(s)
- A Johansson
- Department of Lung, Central Hospital, 54185 Skövde, Sweden
| | | | | | | | | |
Collapse
|
41
|
Millqvist E, Ternesten-Hasséus E, Ståhl A, Bende M. Changes in levels of nerve growth factor in nasal secretions after capsaicin inhalation in patients with airway symptoms from scents and chemicals. Environ Health Perspect 2005; 113:849-52. [PMID: 16002371 PMCID: PMC1257644 DOI: 10.1289/ehp.7657] [Citation(s) in RCA: 29] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Indexed: 05/03/2023]
Abstract
Patients complaining of upper and lower airway symptoms caused by scents and chemicals have previously been shown to have increased cough sensitivity to inhaled capsaicin, but the precise mechanisms behind this reaction are unknown. Hypothesizing that a neurochemical alteration related to sensory hyperreactivity (SHR) of the airway mucosa occurs, we measured levels of nerve growth factor (NGF) in nasal lavage fluid (NAL) before and after capsaicin inhalation provocations and related the capsaicin cough sensitivity to the NGF levels. Thirteen patients with SHR and 14 control subjects were provoked with capsaicin inhalation at three different doses. We measured NGF in NAL before and after provocation and recorded cough and capsaicin-induced symptoms. All subjects demonstrated a dose-dependent cough response to capsaicin inhalation, with a more pronounced effect in patients than in controls. Basal levels of NGF were significantly lower in the patient group than in the control subjects (p < 0.01). After capsaicin provocation, the patients showed a significant increase in NGF (p < 0.01), which was related to capsaicin cough sensitivity. The findings demonstrate that, in patients with airway symptoms induced by scents and chemicals, SHR is real and measurable, demonstrating a pathophysiology in the airways of these patients compared to healthy subjects.
Collapse
Affiliation(s)
- Eva Millqvist
- Asthma and Allergy Research Group, Department of Respiratory Medicine and Allergy, Sahlgrenska University Hospital, Göteborg, Sweden.
| | | | | | | |
Collapse
|
42
|
Nordin S, Martinkauppi M, Olofsson J, Hummel T, Millqvist E, Bende M. Chemosensory perception and event-related potentials in self-reported chemical hypersensitivity. Int J Psychophysiol 2005; 55:243-55. [PMID: 15649555 DOI: 10.1016/j.ijpsycho.2004.08.003] [Citation(s) in RCA: 28] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/01/2004] [Revised: 07/28/2004] [Accepted: 08/03/2004] [Indexed: 11/18/2022]
Abstract
Anormal chemosensory perception has been identified as a possible mechanism underlying odor intolerance, but research in this domain has yet been rather limited. The main objective of the present study was to investigate total perceived intensity, unpleasantness, sensory irritation, and cortical activity assessed with chemosensory event-related potentials (ERPs) for three concentrations of pyridine ranging from predominantly olfactory to trigeminal in activation. Results from 19 individuals with self-reported chemical hypersensitivity and 19 controls with self-reported normal chemical sensitivity show that the hypersensitive group, compared to controls, rated the pyridine stimuli to be more intense and unpleasant, and that these group differences increased with pyridine concentration. Sensory irritation was also the perceptual dimension found to correlate strongest with score on the chemical sensitivity scale. However, no group differences were found in ERP amplitudes or latencies. These findings suggest that self-reported chemical hypersensitivity (1) can be associated with anormal chemosensory perception, (2) may be more closely related to trigeminal function than to olfaction, and (3) has a neural basis at a higher cortical level than that captured by chemosensory ERPs.
Collapse
Affiliation(s)
- Steven Nordin
- Department of Psychology, Umeå University, Umeå, Sweden.
| | | | | | | | | | | |
Collapse
|
43
|
Abstract
OBJECTIVE To enable adequate planning of ENT healthcare it is important to know the prevalence of olfactory dysfunction in the general population. Whether an individual will actually seek medical attention for olfactory dysfunction is likely to depend predominantly on his/her self-evaluation of the sense of smell. This motivated an investigation of the prevalences of self-reported poorer- and better-than-normal odor detection sensitivity in the general population. MATERIAL AND METHODS A random sample of 1900 adult inhabitants, stratified for age and gender, was drawn from the municipal population register of Skövde, Sweden. Subjects were asked to attend a structured interview concerning their self-evaluation of their odor detection sensitivity. RESULTS In total, 1387 volunteers (73% of the sample) were investigated. The overall prevalences of self-reported poorer- and better-than normal odor detection sensitivity were 15.3% and 17.4%, respectively. The prevalence of poorer sensitivity was found to increase with age, and the prevalence of better sensitivity was lower in men than women. CONCLUSIONS Considering the fairly high participation rate in this study and the fact that the population of Skövde is representative of the general Swedish population, the obtained prevalences can be considered representative of the general Swedish adult population.
Collapse
Affiliation(s)
- Steven Nordin
- Department of Psychology, Umeå University, Umeå, Sweden.
| | | | | |
Collapse
|
44
|
Abstract
BACKGROUND It is well known that some patients with allergy complain of airway symptoms from chemicals (ASCs) and strong odours. However, the importance of such information for the treatment of allergic disease is not known. Such symptoms in non-allergic patients have previously been shown to be related to increased sensory nerve reactivity, which is expressed as increased cough sensitivity to inhaled capsaicin. OBJECTIVE The aim of this study was to examine ASC in atopic patients and relate it to cough reaction to capsaicin inhalation. MATERIALS AND METHODS Fifty-seven consecutively chosen, skin prick-positive patients with symptoms of the upper and/or lower airways completed a questionnaire concerning ASC. The patients were then divided into two groups, those with and those without such symptoms. Both groups were provoked with inhaled capsaicin in three increments and compared with 73 healthy control subjects. RESULTS Out of 57 atopic patients, 34 reported ASC agents and 23 did not. The patients with ASC were older (P<0.01) and coughed significantly more on capsaicin provocation (P<0.001), but did not differ from them with respect to the allergic disease or its treatment or to smoking habits. Patients with atopy but without ASC did not differ from healthy controls with regard to sensitivity to capsaicin inhalation. The scored degree of ASC was directly related to the number of coughs during the capsaicin provocation. CONCLUSION ASC in atopic patients are related to increased airway sensory nerve reactivity. There is still no explanation for this in certain patients with atopy, but age may be a confounding factor.
Collapse
Affiliation(s)
- E Millqvist
- Asthma and Allergy Research Group, Sahlgrenska University Hospital, Gothenburg, Sweden.
| | | | | |
Collapse
|
45
|
Abstract
OBJECTIVES/HYPOTHESIS Patients with olfactory dysfunction appear repeatedly in ear, nose, and throat practices, but the prevalence of such problems in the general adult population is not known. Therefore, the objectives were to investigate the prevalence of olfactory dysfunction in an adult Swedish population and to relate dysfunction to age, gender, diabetes mellitus, nasal polyps, and smoking habits. STUDY DESIGN Cross-sectional, population-based epidemiological study. METHODS A random sample of 1900 adult inhabitants, who were stratified for age and gender, was drawn from the municipal population register of Skövde, Sweden. Subjects were called to clinical visits that included questions about olfaction, diabetes, and smoking habits. Examination was performed with a smell identification test and nasal endoscopy. RESULTS In all, 1387 volunteers (73% of the sample) were investigated. The overall prevalence of olfactory dysfunction was 19.1%, composed of 13.3% with hyposmia and 5.8% with anosmia. A logistic regression analysis showed a significant relationship between impaired olfaction and aging, male gender, and nasal polyps, but not diabetes or smoking. In an analysis of a group composed entirely of individuals with anosmia, diabetes mellitus and nasal polyps were found to be risk factors, and gender and smoking were not. CONCLUSION The sample size of the population-based study was adequate, with a good fit to the entire population, which suggests that it was representative for the Swedish population. Prevalence data for various types of olfactory dysfunction could be given with reasonable precision, and suggested risk factors analyzed. The lack of a statistically significant relationship between olfactory dysfunction and smoking may be controversial.
Collapse
Affiliation(s)
- Annika Brämerson
- Department of Otorhinolaryngology, Central Hospital, Skövde, Sweden
| | | | | | | | | |
Collapse
|
46
|
Nordin S, Millqvist E, Löwhagen O, Bende M. A short Chemical Sensitivity Scale for assessment of airway sensory hyperreactivity. Int Arch Occup Environ Health 2004; 77:249-54. [PMID: 15024570 DOI: 10.1007/s00420-004-0504-7] [Citation(s) in RCA: 56] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/05/2003] [Accepted: 01/16/2004] [Indexed: 10/26/2022]
Abstract
OBJECTIVES A short version of the 21-item Chemical Sensitivity Scale (CSS), called the Chemical Sensitivity Scale for Sensory Hyperreactivity (CSS-SHR), was developed and evaluated for the quantifying of self-reported affective reactions to and behavioral disruptions in daily activities by odorous/pungent substances among patients with sensory hyperreactivity (SHR) for clinical and epidemiological studies. METHODS Twenty-two patients with clinically diagnosed SHR and 124 control participants responded to the CSS and to additional questions about chemical sensitivity for the evaluation of the CSS-SHR. RESULTS Eleven of the 21 items of the CSS were selected, on statistical grounds, to constitute the CSS-SHR, which was found to generate approximately normal distributions, have good test-retest reliability (r(xy)=0.87), satisfying internal consistency (r(alpha)=0.76-0.84) and predictive and concurrent validity, and to be uni-dimensional. The metric properties of the CSS-SHR were, despite its few items, comparable with those of the CSS. A proposed diagnostic cut-off score for SHR demonstrated a high correct classification rate (92%) for the CSS-SHR. CONCLUSIONS The favorable metric properties of the CSS-SHR and its sensitivity/specificity suggests that it is useful for clinical diagnosis and epidemiological study of sensory hyperreactivity in combination with other diagnostic tools.
Collapse
Affiliation(s)
- Steven Nordin
- Department of Psychology, Umeå University, 901 87, Umeå, Sweden.
| | | | | | | |
Collapse
|
47
|
Johansson L, Brämerson A, Holmberg K, Melén I, Akerlund A, Bende M. Clinical relevance of nasal polyps in individuals recruited from a general population-based study. Acta Otolaryngol 2004; 124:77-81. [PMID: 14977082 DOI: 10.1080/00016480310016037] [Citation(s) in RCA: 23] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
Abstract
OBJECTIVE To compare the clinical presentations of individuals with nasal polyps detected by endoscopy in a general population sample with those of patients with nasal polyp disease seeking medical attention. MATERIAL AND METHODS A total of 38 individuals with nasal polyps from a population-based sample were compared with 38 matched controls and a third group consisting of 44 patients who presented to an outpatient clinic with symptoms and diagnosed nasal polyps Upper and lower airway symptoms were registered. Polyp size, peak nasal inspiratory flow (PNIF), olfactory function and health-related quality of life were measured. RESULTS Compared with the individuals with nasal polyps in the population sample, patients actively seeking medical care for nasal polyposis experienced more symptoms of nasal blockage and an impaired sense of smell, and had more extensive polyps and reduced PNIF. There were equal frequencies of asthma symptoms in these two groups. Compared with the controls, the individuals with nasal polyps in the population sample had a greater frequency of asthma symptoms and aspirin intolerance and also experienced an impaired sense of smell. CONCLUSION Nasal polyps alone, as seen occasionally, are indicative of airway disease involving the upper and lower respiratory tracts.
Collapse
Affiliation(s)
- L Johansson
- Department of Otorhinolaryngology, Central Hospital, Skövde, Sweden
| | | | | | | | | | | |
Collapse
|
48
|
Abstract
Patients with nasal polyps present repeatedly in otorhinolaryngology practices, but the prevalence of nasal polyps in the general population is not known. Our objective was to investigate the prevalence of nasal polyps in an adult Swedish population in relation to age, gender, asthma, and aspirin intolerance. A random sample of 1,900 inhabitants over the age of 20 years, stratified for age and gender, was drawn from the municipal population register in Skövde, Sweden, in December 2000. The subjects were called to clinical visits that included questions about rhinitis, asthma, and aspirin intolerance and examination by nasal endoscopy. In total, 1,387 volunteers (73% of the sample) were investigated. The sample size was adequate, with a good fit to the whole population. The prevalence of nasal polyps was 2.7% (95% confidence interval, 1.9-3.5), and polyps were more frequent in men (2.2 to 1), the elderly (5% at > or = 60 years of age), and asthmatics. Subjective symptoms of aspirin intolerance were not found to correlate with polyps. Nasal polyps were more common in adults than was stated by the a priori estimate. The Skövde population-based study is considered representative for the Swedish population.
Collapse
Affiliation(s)
- Leif Johansson
- Department of Otorhinolaryngology, Central Hospital, Skövde, Sweden
| | | | | | | | | |
Collapse
|
49
|
Oberg D, Akerlund A, Johansson L, Bende M. Prevalence of nasal septal perforation: the Skövde population-based study. Rhinology 2003; 41:72-5. [PMID: 12868370] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/03/2023]
Abstract
BACKGROUND Patients with nasal septal perforation appear from time to time in Ear, Nose, and Throat (ENT) practices, but the prevalence in a general population is not known. OBJECTIVE The objective was to investigate the prevalence of nasal septal perforation in an adult Swedish population, and to relate septal perforation to possible risk factors, such as age, gender, diabetes mellitus, nasal polyps, and smoking. METHODS A random sample of 1,900 inhabitants over the age of 20, stratified for age and gender, was drawn from the municipal population register in Skövde, Sweden, in December 2000. Subjects were called to clinical visits that included questions about diabetes and smoking habits. Nasal endoscopy was performed and, when a perforation was observed, the size was measured. RESULTS In total, 1,387 volunteers (73% of the sample) were investigated. The sample size was adequate, with a good fit to the whole population. The prevalence of nasal septal perforation was 0.9% [95% CI 0.5-1.6%]. Nasal polyps was a possible risk factor, odds ratio of 11.5 [95% CI 3.0-43.5], but not age, gender, diabetes, or smoking. CONCLUSION The prevalence of nasal septal perforation was found to be less than 1% in an adult population.
Collapse
Affiliation(s)
- Dan Oberg
- Department of Otorhinolaryngology, Central Hospital, Skövde, Sweden
| | | | | | | |
Collapse
|
50
|
Nordin S, Brämerson A, Murphy C, Bende M. A Scandinavian adaptation of the Multi-Clinic Smell and Taste Questionnaire: evaluation of questions about olfaction. Acta Otolaryngol 2003; 123:536-42. [PMID: 12809108 DOI: 10.1080/00016480310001411] [Citation(s) in RCA: 45] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
Abstract
OBJECTIVE A Scandinavian adaptation of the Multi-Clinic Smell and Taste Questionnaire (MCSTQ-Sc) was evaluated with respect to comprehension and test-retest reliability for responses to questions about olfactory dysfunction (abnormal sensitivity, parosmia and phantosmia) and related questions about medical history and consequences of olfactory dysfunction. MATERIAL AND METHODS Comprehension was evaluated in a first study in 20 patients with chief complaints of olfactory dysfunction by comparing questionnaire- and interview-based responses. Test-retest reliability was evaluated in a second study in 30 other patients with olfactory complaints. RESULTS Data from the two studies suggest that the vast majority of the questions evaluated from the MCSTQ-Sc are comprehensible and generate responses with very good reliability. Distinct exceptions were poor agreement between the questionnaire- and interview-based responses for questions about the number of cigarettes smoked and the pleasantness and typical episode length of phantosmia; the test-retest reliability regarding the nostril side of phantosmia also showed poor agreement. The results suggest the importance of probing these areas further in the clinical interview. CONCLUSION The findings imply that, with a few caveats, the MCSTQ-Sc is a useful tool for the clinical assessment of olfactory dysfunction and its consequences.
Collapse
Affiliation(s)
- S Nordin
- Department of Psychology Umeå University, Umeå, Sweden.
| | | | | | | |
Collapse
|