Olfaction Disorders

嗅觉障碍
  • 文章类型: Journal Article
    阿尔茨海默病是痴呆的最常见原因,它是全球死亡的主要原因之一。识别和验证预示着阿尔茨海默病发病和进展的生物标志物对于早期可靠诊断和有效的药物治疗至关重要。大量证据表明嗅觉功能障碍是包括阿尔茨海默病在内的神经退行性疾病的临床前症状。虽然嗅觉功能障碍与人类阿尔茨海默病的发病和进展之间存在相关性,这种关系的潜在机制仍然未知。本文的目的是回顾有关可能导致阿尔茨海默病相关嗅觉功能障碍发展的潜在因素的现有知识。这篇综述主要集中在与阿尔茨海默病相关的基因突变,包括淀粉样β蛋白前体,早老素1和2,载脂蛋白E突变,这可能(以不同的方式)驱动导致和维持嗅觉功能障碍的细胞事件。
     Alzheimer\'s disease is the most common cause of dementia, and it is one of the leading causes of death globally. Identification and validation of biomarkers that herald the onset and progression of Alzheimer\'s disease is of paramount importance for early reliable diagnosis and effective pharmacological therapy commencement. A substantial body of evidence has emerged demonstrating that olfactory dysfunction is a preclinical symptom of neurodegenerative diseases including Alzheimer\'s disease. While a correlation between olfactory dysfunction and Alzheimer\'s disease onset and progression in humans exists, the mechanism underlying this relationship remains unknown. The aim of this article is to review the current state of knowledge regarding the range of potential factors that may contribute to the development of Alzheimer\'s disease-related olfactory dysfunction. This review predominantly focuses on genetic mutations associated with Alzheimer\'s disease including amyloid-β protein precursor, presenilin 1 and 2, and apolipoprotein E mutations, that may (in varying ways) drive the cellular events that lead to and sustain olfactory dysfunction.
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  • 文章类型: Review
    <br><b>简介:</b>痴呆的早期发现和诊断在治疗中至关重要,减缓疾病进展,或抑制症状。关于早期检测阿尔茨海默病(AD)的潜在标志物,考虑了嗅觉变化的可能作用。</br><br><b>材料和方法:</b>使用电子数据库PubMed进行了文献检索,Scopus,和WebofScience在2022年5月30日至2022年8月2日之间。使用与嗅觉相关的关键字组合搜索术语“痴呆”。</br><br><b>结果:</b>通过数据库搜索共识别出1,288条记录。在这些文章中,49人最终被包括在分析中。结果显示嗅觉变化作为早期检测AD的潜在生物标志物的潜在作用。多项研究表明,AD患者可能会出现嗅觉障碍,PD,MCI或其他类型的痴呆症。即使嗅觉测试能够检测神经退行性疾病引起的嗅觉丧失,他们不能可靠地区分某些疾病。</br><br><b>结论:嗅觉评估一再被报道用于早期诊断,但不是为了鉴别诊断.</br>.
    <br><b>Introduction:</b> The early detection and diagnosis of dementia are of key importance in treatment, slowing disease progression, or suppressing symptoms. The possible role of changes in the sense of smell is considered with regard to potential markers for early detection of Alzheimer\'s disease (AD).</br> <br><b>Materials and methods:</b> A literature search was conducted using the electronic databases PubMed, Scopus, and Web of Science between May 30, 2022 and August 2, 2022. The term \"dementia\" was searched with keyword combinations related to olfaction.</br> <br><b>Results:</b> A total of 1,288 records were identified through the database search. Of these articles, 49 were ultimately included in the analysis. The results showed the potential role of changes in the sense of smell as potential biomarkers for early detection of AD. Multiple studies have shown that olfactory impairment may be observed in patients with AD, PD, MCI, or other types of dementia. Even though smell tests are able to detect olfactory loss caused by neurodegenerative diseases, they cannot reliably distinguish between certain diseases.</br> <br><b>Conclusions:</b> In individuals with cognitive impairment or neurodegenerative diseases, olfactory assessment has repeatedly been reported to be used for early diagnosis, but not for differential diagnosis.</br>.
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  • 文章类型: Letter
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  • 文章类型: Journal Article
    目的:目的:回顾有关儿童患者COVID-19相关失语症发生率及其发病机制问题的出版物,诊断,治疗和恢复。小儿COVID-19失语症的特殊性是由于儿童占COVID-19患者的比例非常低(与成人相比),主要是病情较轻。对失语症及其正确诊断的认识在儿童和青少年中至关重要,考虑到它可能是COVID-19阳性儿科患者的唯一表现。
    方法:材料和方法:为了实现这一目标,对来自数据库的信息进行荟萃分析,然后对获得的数据进行统计处理和概括。
    结论:结论:关于儿童和青少年COVID-19失语症的出版物数量少于成人患者,所以重要的是要使用每一个值得信赖的。食欲不振可能是唯一的症状,儿科患者COVID-19感染的早期识别和最强预测因子。进一步科学研究的前景。关于COVID-19和其他感染的鉴别诊断的进一步研究,包括季节性流感,在自闭症谱系和不同类型的精神障碍的儿童和青少年中,可能同时表现为嗅觉和味觉功能障碍以及嗅觉缺失诊断。
    OBJECTIVE: Aim: To review the publications subject to the problem of COVID-19 associated anosmia incidence in pediatric patients as well as its pathogenesis, diagnostics, treatment and recovery. The peculiarity of pediatric COVID-19 anosmia is due to children accounting for very low percentage of COVID-19 patients (comparing to one in adults), mostly with milder course of the disease. Awareness of anosmia and its proper diagnostics is crucial in children and adolescents, considering it can be the only manifestation in COVID-19 positive pediatric patients.
    METHODS: Materials and Methods: In order to achieve this goal a meta-analysis of information from databases followed by statistical processing and generalisation of the obtained data was carried out.
    CONCLUSIONS: Conclusions: Publications on COVID-19 anosmia in children and adolescents are less numerous than those concerning adult patients, so it is important to use every single trustworthy one. Anosmia/ageusia may be the only symptom, early identifier and the strongest predictor of COVID-19 infection in pediatric patients. Prospects for further scientific researches. Further researches regarding differential diagnostics of COVID-19 and other infections, including seasonal influenza, manifesting with both olfactory and taste dysfunction as well as anosmia diagnostics in children and adolescents with autistic spectrum and different types of mental disorders are possible.
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  • 文章类型: Meta-Analysis
    本研究旨在系统评价鼻窦炎口服液治疗鼻窦炎(RS)的有效性和安全性。CNKI,万方,SinoMed,VIP,科克伦图书馆,PubMed,EMBase,WebofScience,和Ovid进行了Bidouyan口服液治疗RS患者的随机对照试验(RCT)。此外,参考列表和灰色文献是手动搜索的.两名研究者独立筛选文献并提取数据。在随机试验中,Cochrane协作评估偏倚风险的工具(RoB2.0)用于评估纳入研究对象的方法学质量。在RevMan5.3和Stata12.0中进行Meta分析,推荐等级,评估,采用开发和评估(GRADE)来评估证据质量。共纳入54个RCTs(35个药物组合和19个单一药物),包括7511例患者(观察组3973例,对照组3538例)。Meta分析显示,鼻窦炎口服液+常规治疗在提高总缓解率方面优于单纯常规治疗(RR=1.19,95CI[1.15,1.24],P&lt;0.00001)并降低Lund-Kennedy得分(MD=-1.94,95CI[-2.61,-1.26],P<0.00001),Lund-Mackay得分(MD=-2.14,95CI[-2.98,-1.31],P<0.00001),和视觉模拟量表(VAS)评分(MD_(总VAS评分)=-1.28,95CI[-1.56,-1.01],P&lt;0.00001;MD_(鼻塞VAS评分)=-0.58,95CI[-0.89,-0.27],P=0.0002;MD_(流鼻涕VAS评分)=-0.61,95CI[-0.93,-0.29],P=0.0002;MD_(嗅觉功能障碍VAS评分)=-0.43,95CI[-0.52,-0.34],P&lt;0.00001;MD_(头部和面部疼痛VAS评分)=-0.41,95CI[-0.57,-0.26],P<0.00001)。此外,联合治疗在提高粘膜纤毛转运率(MTR)方面优于常规治疗(MD=1.64,95CI[1.08,2.20],P&lt;0.00001)和降低炎性细胞因子{肿瘤坏死因子-α(TNF-α)(SMD=-1.95,95CI[-2.57,-1.33],P<0.00001),白细胞介素-6(IL-6)(SMD=-2.64,95CI[-4.08,-1.21],RS患者P=0.0003)}。此外,联合治疗并没有增加不良反应的发生率(RR=0.83,95CI[0.44,1.57],P=0.57)。Bidouyan口服液在增加总反应率方面优于常规治疗(RR=1.25,95CI[1.18,1.32],P<0.00001),降低Lund-Kennedy(P<0.01)和Lund-Mackay评分(P<0.05),缓解主要症状(P_(总VAS评分)<0.01;P_(鼻塞VAS评分)<0.01;P_(流鼻涕VAS评分)<0.01;P_(嗅觉功能障碍VAS评分)<0.05;P_(头面部疼痛VAS评分)<0.01),不良反应减少(P=0.03)。结果表明,鼻窦炎口服液或鼻窦炎口服液+常规治疗均可提高总有效率,降低Lund-Kennedy和Lund-Mackay的得分,减轻主要症状。此外,Bidouyan口服液+常规治疗可改善MTR,降低TNF-α和IL-6的表达,未引起严重不良事件。然而,由于纳入研究的方法学质量有限,需要大样本和高质量的随机对照试验来提供证据支持。
    This study aimed to systematically review the efficacy and safety of Bidouyan Oral Liquid in the treatment of rhinosinu-sitis(RS). CNKI, Wanfang, SinoMed, VIP, Cochrane Library, PubMed, EMbase, Web of Science, and Ovid were searched for the randomized controlled trial(RCT) of Bidouyan Oral Liquid for the treatment of RS patients. Moreover, the reference lists and the grey literature were searched manually. Two researchers independently screened the literature and extracted data. The Cochrane collaboration\'s tool for assessing risk of bias(RoB 2.0) in randomized trial was used to assess the methodological quality of the included stu-dies. Meta-analysis was performed in RevMan 5.3 and Stata 12.0, and the grades of recommendation, assessment, development and evaluation(GRADE) was employed to evaluate the quality of evidence. A total of 54 RCTs(35 with drug combinations and 19 with single drugs) comprising 7 511 patients(3 973 in the observation group and 3 538 in the control group) were included. Meta-analysis showed that Bidouyan Oral Liquid + conventional treatment was superior to conventional treatment alone in increasing the total response rate(RR=1.19, 95%CI[1.15, 1.24], P<0.000 01) and decreasing the Lund-Kennedy scores(MD=-1.94, 95%CI[-2.61,-1.26], P<0.000 01), Lund-Mackay scores(MD=-2.14, 95%CI[-2.98,-1.31], P<0.000 01), and visual analogue scale(VAS) scores(MD_(total VAS scores)=-1.28, 95%CI[-1.56,-1.01], P<0.000 01; MD_(nasal congestion VAS scores)=-0.58, 95%CI[-0.89,-0.27], P=0.000 2; MD_(runny nose VAS scores)=-0.61, 95%CI[-0.93,-0.29], P=0.000 2; MD_(olfactory dysfunction VAS scores)=-0.43, 95%CI[-0.52,-0.34], P<0.000 01; MD_(head and facial pain VAS scores)=-0.41, 95%CI[-0.57,-0.26], P<0.000 01). Furthermore, the combined treatment outperformed conventional treatment alone in improving the mucociliary transport rate(MTR)(MD=1.64, 95%CI[1.08, 2.20], P<0.000 01) and lowering the levels of inflammatory cytokines{tumor necrosis factor-α(TNF-α)(SMD=-1.95, 95%CI[-2.57,-1.33], P<0.000 01), interleukin-6(IL-6)(SMD=-2.64, 95%CI[-4.08,-1.21], P=0.000 3)} in RS patients. In addition, the combined treatment did not increase the incidence of adverse reactions(RR=0.83, 95%CI[0.44, 1.57], P=0.57). Bidouyan Oral Liquid was superior to conventional treatment in increasing total response rate(RR=1.25, 95%CI[1.18, 1.32], P<0.000 01), decreasing the Lund-Kennedy(P<0.01) and Lund-Mackay scores(P<0.05), alleviating major symptoms(P_(total VAS scores)<0.01; P_(nasal congestion VAS scores)<0.01; P_(runny nose VAS scores)<0.01; P_(olfactory dysfunction VAS scores)<0.05; P_(head and facial pain VAS scores)<0.01), and decreasing adverse reactions(P=0.03). The results showed that either Bidouyan Oral Liquid or Bidouyan Oral Liquid + conventional treatment can increase the total response rate, decrease the Lund-Kennedy and Lund-Mackay scores, and mitigate major symptoms. In addition, Bidouyan Oral Liquid + conventional treatment improved MTR and reduced the expression of TNF-α and IL-6 without causing serious adverse events. However, due to the limited methodological quality of the included studies, large-sample and high-quality RCTs are needed to provide evidence support.
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  • 文章类型: Journal Article
    背景:强有力的证据表明,嗅觉功能障碍(OD)可以预测神经退行性疾病如阿尔茨海默病和帕金森病的额外神经认知能力下降。然而,在年轻人群中探索嗅觉和认知的研究是有限的。本综述的目的是评估非COVID-19相关OD的非老年人的认知变化。
    方法:我们对PubMed,OvidEmbase,WebofScience,和科克伦图书馆在制定这一范围审查。感兴趣的主要结果是小于60岁的成年人的OD和认知功能之间的关联。
    结果:我们确定了2878项研究的标题和摘要综述,167正在进行全文审查,和54选择用于数据提取。其中,34项研究报道了限制在18-60岁之间的人群,而其余20项研究包括了更多的异质性人群,除了一些60岁以上的人群外,大多数人都在这个目标年龄范围内。在纳入的研究中,嗅觉丧失的病因是神经精神疾病(37%),特发性原因(25%),2型糖尿病(7%),创伤(5%),感染(4%),智力残疾(4%),其他(18%)。一些研究报告了许多关联,有时是混合的,导致关联总数大于纳入的54项研究。总的来说,21/54研究表明嗅觉和认知之间存在正相关,7/54证明没有关联,25/54报告了好坏参半的结果,只有1/54显示出负关联。
    结论:大多数研究表明OD和认知之间存在正相关,但是与老年人相比,这些数据与年轻人的关联不那么强烈。尽管研究人群和结果存在异质性,这项范围审查是进一步调查这一主题的起点。值得注意的是,由于本综述中的许多研究涉及可能对嗅觉和认知产生混杂影响的疾病,未来的研究应该控制这些混杂因素,并纳入非精神病原因导致嗅觉丧失的非老年人.
    BACKGROUND: Strong evidence suggests that olfactory dysfunction (OD) can predict additional neurocognitive decline in neurodegenerative conditions such as Alzheimer\'s and Parkinson\'s diseases. However, research exploring olfaction and cognition in younger populations is limited. The aim of this review is to evaluate cognitive changes among non-elderly adults with non-COVID-19-related OD.
    METHODS: We performed a structured comprehensive literature search of PubMed, Ovid Embase, Web of Science, and Cochrane Library in developing this scoping review. The primary outcome of interest was the association between OD and cognitive functioning in adults less than 60 years of age.
    RESULTS: We identified 2878 studies for title and abstract review, with 167 undergoing full text review, and 54 selected for data extraction. Of these, 34 studies reported on populations of individuals restricted to the ages of 18-60, whereas the remaining 20 studies included a more heterogeneous population with the majority of individuals in this target age range in addition to some above the age of 60. The etiologies for smell loss among the included studies were neuropsychiatric disorders (37%), idiopathic cause (25%), type 2 diabetes (7%), trauma (5%), infection (4%), intellectual disability (4%), and other (18%). Some studies reported numerous associations and at times mixed, resulting in a total number of associations greater than the included number of 54 studies. Overall, 21/54 studies demonstrated a positive association between olfaction and cognition, 7/54 demonstrated no association, 25/54 reported mixed results, and only 1/54 demonstrated a negative association.
    CONCLUSIONS: Most studies demonstrate a positive correlation between OD and cognition, but the data are mixed with associations less robust in this young adult population compared to elderly adults. Despite the heterogeneity in study populations and outcomes, this scoping review serves as a starting point for further investigation on this topic. Notably, as many studies in this review involved disorders that may have confounding effects on both olfaction and cognition, future research should control for these confounders and incorporate non-elderly individuals with non-psychiatric causes of smell loss.
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  • 文章类型: Systematic Review
    背景:嗅觉障碍是慢性鼻窦炎伴鼻息肉(CRSwNP)的主要症状之一,然而,目前可用的治疗方案对嗅觉恢复的影响尚不明确。这项系统评价的目的是收集医学影响的证据,外科,和生物疗法对CRSwNP患者嗅觉结局的影响。
    方法:本综述由两名评审员进行,根据系统审查和荟萃分析(PRISMA)指南的首选报告项目。使用关键评估技能计划(CASP)评估定性综合中包含的所有研究的证据质量。
    结果:定性综合纳入了44项研究(评估鼻窦手术[n=23],生物制剂[n=15],和常规医学治疗[n=6]);大多数具有中等至高的方法学质量。总的来说,通过客观或主观工具(或两者)测量的所有分析干预措施均检测到嗅觉的显著改善.然而,大多数研究使用不同的结果测量,阻碍干预措施之间的比较,临床相关变化的数据缺失.
    结论:口服皮质类固醇,生物制剂和鼻窦手术改善与CRSwNP相关的嗅觉障碍,但是现有研究中的高度变异性无法进行准确的比较.
    BACKGROUND: Olfactory impairment is one of the cardinal symptoms of chronic rhinosinusitis with nasal polyps (CRSwNP). However, the effect of currently available therapeutic options on the recovery of the sense of smell is not well defined. The aim of this systematic review was to compile evidence on the impact of medical, surgical, and biological treatment on olfactory outcomes in patients with CRSwNP.
    METHODS: This review was conducted by 2 reviewers according to the Preferred Reporting Items for Systematic reviews and Meta-Analyses (PRISMA) guidelines. The quality of evidence of all the studies included in the qualitative synthesis was evaluated using the Critical Appraisal Skills Programme (CASP).
    RESULTS: Forty-four studies were included in the qualitative synthesis. These assessed sinonasal surgery (n=23), biologics (n=15), and conventional medical treatment (n=6). The methodological quality was moderate-to-high in most. Overall, significant improvements in the sense of smell were detected with all the interventions analyzed and measured using an objective tool, a subjective tool, or both. However, most studies used different outcome measures, thus hindering comparisons between interventions, and data on clinically relevant changes were missing.
    CONCLUSIONS: Oral corticosteroids, biologics, and sinonasal surgery improve the olfactory impairment associated with CRSwNP. However, the heterogeneous nature of existing studies does not allow accurate comparisons.
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  • 文章类型: Systematic Review
    The presented systematic review contains basic information about the frequency, characteristic features of the course and pathogenesis of olfactory, gustatory and auditory disorders that occur with COVID-19, with which an otorhinolaryngologist meets in his practice. These disorders are often the first, and sometimes the only, manifestations of the underlying disease, which determines their role in early diagnosis and timely detection of the underlying disease. The article includes original articles, clinical case reports and literary reviews.
    Представленный систематический обзор содержит основную информацию о частоте, характерных особенностях течения и патогенезе обонятельных, вкусовых и слуховых нарушений, возникающих при COVID-19, с которыми врач-оториноларинголог встречается в своей практике. Эти нарушения часто являются первыми, а иногда и единственными проявлениями основного заболевания, что определяет их роль в ранней диагностике и своевременном выявлении COVID-19. Для анализа отобраны оригинальные статьи, отчеты о клинических случаях и обзоры литературы.
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  • 文章类型: Meta-Analysis
    背景:嗅觉功能障碍是COVID-19患者的常见表现,可显著影响其生活质量。皮质类固醇已被提议作为一种潜在的治疗方法,但它们的功效仍存在争议。本系统评价和荟萃分析旨在全面分析糖皮质激素治疗COVID-19相关嗅觉功能障碍的疗效。
    方法:在PubMed,科克伦图书馆,和Embase数据库截至2023年3月1日。纳入了研究糖皮质激素对COVID-19患者嗅觉功能障碍影响的随机对照试验。主要结果是随访结束时的嗅觉评分,次要结局是嗅觉功能障碍的持续时间和恢复率.
    结果:有999名参与者的7项随机对照试验被纳入荟萃分析。与对照组相比,皮质类固醇治疗可显著改善嗅觉评分,标准化平均差异为0.55(95%CI:0.15~0.95).外用皮质类固醇被发现是有效的,但全身性皮质类固醇没有。此外,更长的持续时间和更高的皮质类固醇治疗剂量也可能与嗅觉评分的显著改善相关.对嗅觉功能障碍的持续时间或恢复率无明显影响。
    结论:我们的研究结果表明,局部皮质类固醇治疗是改善COVID-19相关嗅觉功能障碍的可行选择,但需要进一步的研究来研究最佳治疗方案和安全性.
    BACKGROUND: Olfactory dysfunction is a common manifestation in COVID-19 patients and can significantly impact their quality of life. Corticosteroids have been proposed as a potential treatment, but their efficacy remains controversial. This systematic review and meta-analysis aims to comprehensively analyze the efficacy of corticosteroid therapy for treating COVID-19-related olfactory dysfunction.
    METHODS: A literature search was conducted in PubMed, Cochrane Library, and Embase databases up to March 1, 2023. Randomized controlled trials investigating the effects of corticosteroids on olfactory dysfunction in patients with COVID-19 were included. The primary outcome was the olfactory score at the end of follow-up, and the secondary outcomes were the duration and the rate of recovery from olfactory dysfunction.
    RESULTS: Seven randomized controlled trials with 999 participants were included in the meta-analysis. Compared with the control group, corticosteroid treatment resulted in a statistically significant improvement in olfactory score with a standardized mean difference of 0.55 (95% CI: 0.15 to 0.95). Topical corticosteroids were found to be effective, but systemic corticosteroids were not. In addition, longer durations and higher dosages of corticosteroids treatment may also be associated with significant improvements in olfactory scores. No significant effect was observed on the duration or recovery rate of olfactory dysfunction.
    CONCLUSIONS: Our findings suggest that topical corticosteroid treatment is a viable option for improving COVID-19-related olfactory dysfunction, but further research is needed to investigate optimal treatment protocols and safety profiles.
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