Background Olfactory impairment is increasingly recognized as a biomarker of frailty, but the relationship between olfactory subdomains that describe peripheral or central dysfunction and frailty remains unexplored. Methods We examined 1,160 older adults from the National Social Life, Health, and Aging Project (NSHAP) Wave 3. Olfactory identification (OI): the ability to identify an odorant; and olfactory sensitivity (OS): the ability to detect the presence of an odorant, were assessed using 5 and 6-point measures respectively. Frailty was operationalized as both a 37-item Frailty Index (FI) and the 5-item Physical Frailty Phenotype (PFP). Mixed models were fit to examine the association between OI, OS, FI and PFP, while adjusting for demographic and clinical covariates. Results Subjects in the most-frail PFP category had lower OI and OS scores (OI: 3.88 vs 4.19, p= 0.016; OS: 3.15 vs 3.47, p= 0.031), whereas, subjects in the most-frail FI category exhibited lower OI scores but not OS scores when compared to non-frail subjects (OI: 3.72 vs 4.27, p= 0.014; OS: 3.19 vs 3.43, p= 0.476). Adjusted mixed models showed that a point increase in OI was associated with a lower PFP score (β= -0.107, p= 0.006) and FI score (β= -0.009, p= 0.010). A point increase in OS was associated with a lower PFP score (β= -0.058, p= 0.016), but not FI score (β= -0.004, p= 0.064). Conclusions Both OS and OI, predominantly peripheral and central measures of olfaction respectively, are associated with frailty implicating olfaction as a potential biomarker and risk factor for frailty.
IntroductionParathyroid glands may be compromised during thyroid surgery which can lead to hypoparathyroidism and hypocalcemia. Identifying the parathyroid glands relies on the surgeon’s experience and the only way to confirm their presence was through tissue biopsy. Near infrared autofluorescence technology offers an opportunity for real-time, non-invasive identification of the parathyroid glands.MethodsWe used a new research prototype (hANDY-I) developed by Optosurgical, LLC. It offers coaxial excitation light and a dual-Red Green Blue/Near Infrared sensor that guides anatomical landmarks and can aid in identification of parathyroid glands by showing a combined autofluorescence and colored image simultaneously.ResultsWe tested the imager during 23 thyroid surgery cases, where initial clinical feasibility data showed that out of 75 parathyroid glands inspected, 71 showed strong autofluorescence signal and were correctly identified (95% accuracy) by the imager.ConclusionsThe hANDY-I prototype demonstrated promising results in this feasibility study by aiding in real-time visualization of the parathyroid glands. However, further testing by conducting randomized clinical trials with a bigger sample size is required to study the effect on levels of hypoparathyroidism and hypocalcemia.
BACKGROUND AND PURPOSE: MR imaging of the inner ear on heavily T2-weighted sequences frequently has areas of signal loss in the vestibule. The aim of the present study was to correlate the anatomic structures of the vestibule with areas of low signal intensity. MATERIALS AND METHODS:We reviewed T2-weighted spin-echo MR imaging studies of the internal auditory canal from 27 cases and cataloged signal intensity variations in the vestibulum of inner ears. Using a histologic preparation of a fully mounted human ear, we prepared 3D reconstructions showing the regions of sensory epithelia (semicircular canal cristae, utricular, and saccular maculae). Regions of low signal intensity were reconstructed in 3D, categorized by appearance, and compared with the 3D histologic preparation. RESULTS:The region corresponding to the lateral semicircular canal crista showed signal loss in most studies (94%). In the utricle, a focus of signal loss occurred in the anterior-cranial portion of the utricle and corresponded to the location of the utricular macula and associated nerve on histopathologic specimens (63% of studies). Additional areas of low signal were observed in the vestibule, corresponding to the fluid-filled endolymphatic space and not to a solid anatomic structure.CONCLUSIONS: Small foci of signal loss within the inner ear vestibule on T2-weighted spin-echo images correlate with anatomic structures, including the lateral semicircular canal crista and the utricular macula. More posterior intensity variations in the endolymphatic space are likely artifacts, potentially representing fluid flow within the endolymph caused by magneto-hydrodynamic Lorentz forces.
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