Background: The etiology of age-related olfactory loss is still unclear, but it has been claimed that polypharmacotherapy may contribute to olfactory dysfunction, particularly in the elderly, who are more likely to need multiple drugs. The present pilot study investigated the relationship between smell and the number and type of drugs taken in a group of elderly. Methodology: 50 elderly volunteers (≥65 years old) who were healthy from the sinonasal standpoint (SNOT 22<1) and had no cognitive impairments [Mini Mental State Examination (MMSE) > 18] were administered the Screening 12 test® and tested on their n-butanol olfactory threshold. Their olfactory performance was then connected with the number and type of drugs participants used. Results: The mean age of the included volunteers was 74±7 years. No association emerged between odor identification and number of drugs taken. The number of drugs taken correlated directly with a worse olfactory threshold and with a worse MMSE score, meaning a worse cognitive status. Odor identification significantly worsened with age. Comparing those volunteers taking only one drug known to not influence olfaction with another subgroup of volunteers taking five or more drugs, it was evident that subjects taking only one drug scored significantly better in olfactory threshold test and MMSE, and marginally better in olfactory identification test. For what concerns the difference between male and female volunteers, no difference in olfactory test result was shown, both for threshold and identification. Univariate analysis showed a direct correlation between the consumption of calcium channel blockers, ß-blockers, acetylsalicylic acid and olfactory threshold, meaning a worse sense of smell. Acetylsalicylic acid also correlated inversely with odor identification, meaning again a worse sense of smell, and so did potassium-sparing diuretics. Multivariate analysis showed that MMSE scores correlated with a better sense of smell, that is a lower olfactory threshold, and that α-blockers and acetylsalicylic acid negatively affected olfactory threshold, meaning a worse sense of smell. Acetylsalicylic acid also correlated inversely with odor identification, meaning again a worse sense of smell. Conclusions: The number of drugs taken demonstrated to be significantly correlated with a worse olfactory threshold and worse MMSE. Larger studies on elderly volunteers are needed to confirm these preliminary findings.
Background: Rhinomanometry, acoustic rhinometry (AR) and peak nasal inspiratory flow (PNIF) are popular methods for nasal patency evaluation. The aim of the present study was to compare these three methods with the reported nasal symptoms to determine the best diagnostic tool to assess nasal obstruction. Methods: 101 subjects were evaluated using PNIF, 4-phase rhinomanometry (4PR), AR, Visual Analogue Scale for nasal obstruction (VAS-NO) and Sino-Nasal Outcome Test (SNOT-22). Correlations among PNIF, 4PR, AR, VAS-NO and SNOT-22 were obtained. Results: VAS-NO and SNOT-22 were moderately correlated with each other (r = 0.54, p < 0.001). 4PR was moderately correlated with PNIF (r = –0.31, p = 0.0016) and AR (r = –0.5, p < 0.001). VAS-NO was mildly correlated with PNIF (r = –0.29, p = 0.0034). SNOT-22 was moderately correlated with PNIF (r = –0.31, p = 0.0017). After dividing the population into symptomatic and asymptomatic subjects, based on their VAS-NO score, the former showed significantly lower PNIF values (p = 0.009) and higher 4PR values (p = 0.013) compared to the latter ones. Conclusion: PNIF and 4PR showed a significant moderate correlation with each other, but PNIF showed a significant correlation (weak-moderate) with the reported nasal symptom scores.
Background An ever-increasing number of people are involved in sport activities at high altitude. Objective This study aimed to evaluate the pulmonary and nasal functions, including nasal cytology, in healthy volunteers moving for 1 week from an altitude of 2000 m to another of 3400 m. Methods Peak nasal inspiratory flow (PNIF), pulmonary function, including peak expiratory flow (PEF), mucociliary transport time (MCTt), nasal cytology, and oxygen saturation (O2 sat) were studied in 5 different occasions—T1: at base camp (2000 m); T2: at the mountain refuge (3400 m); T3: after 7 days at 3400 m; T4: after the return at the base camp (2000 m); and T5: at the base camp (2000 m) after 15 days. Results With respect to T1, PEF values decreased at T2 ( P = .004), T3 ( P = .004), T4 ( P = .000), and T5 ( P = .001). Forced expiratory volume in the first second and forced vital capacity did not differ among the 5 different times of measurements. In regard to T1, PNIF values increased at T2 ( P = .003) and T3 ( P = .001). MCTt and O2 sat showed similar but opposite changes with MCTt increased at T2 and T3 in respect to T1 ( P = .000 for both), while O2 sat decreased at T2 and T3 in respect to T1 ( P = .000 for both). At nasal cytology, the number of neutrophils increased at T2 in respect to T1 ( P = .008). At multivariate analysis, PNIF changed with altitude from T1 to T4 even accounting for the effect of all the other variables (T1 vs T2 PNIF, P = .009; T1 vs T3 PNIF, P = .007; T1 vs T4 PNIF, P = .021). Conclusions Although the study has some limitations, being conducted on a small cohort and at no controlled environmental conditions, data seem to support the utility of MCTt for studying nasal mucosa damage induced by high altitude. Nasal cytology seems to be able to identify the inflammation of the nasal mucosa exposed to hypoxia. Further investigations on larger series and possibly conducted in hypobaric chamber at controlled standardized conditions are necessary in order to confirm these results and, most importantly, the improvement of PNIF at high altitude.
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