Health-Related Quality of Life in Adult Patients with Craniopharyngioma.

OBJECTIVE: Craniopharyngiomas (CPs) are benign, dysontogenetic tumors associated with complex endocrinologic and neurologic symptoms and high morbidity. The aim of this study is to elucidate modifiable effectors of health-related quality of life (HrQoL) of adult patients with CP following neurosurgical intervention using standardized instruments as well as descriptive analysis. METHODS: HrQoL (European Organization for the Research and Treatment of Cancer Quality of Life Questionnaire C30 and BN20) was evaluated in 20 adult patients with CP. We examined pre- as well as postoperative radiologic, hormonal, and symptom-oriented data in a retrospective analysis. Surgical approach, postoperative complications, and extent of resection were recorded. Additional descriptive analysis was performed on case records of all patients with HrQoL results. RESULTS: Long-term follow-up of HrQoL (mean of 75 months) was lower than the in healthy reference group (CP = 58, reference = 75). The most common postoperative complaints were endocrinologic disturbances (88%). Overall, univariate and multivariate logistic regression analysis revealed no significant predictors of reduced postoperative HrQoL. Descriptive analysis did, however, reveal a cluster of patients among those with the lowest global HrQoL which reported new postoperative anosmia and ageusia. CONCLUSIONS: The global HrQoL of our cohort showed a substantial reduction compared with a healthy reference population. Postoperative hyposmia and ageusia is found in patients with the lowest postoperative HrQoL who otherwise had no new significant endocrinologic or neurologic complications. As these symptoms are not regularly accounted for in the HrQoL instruments used in this study, further analysis is needed to determine the possible significance of this complication in CP surgery, and it may affect the choice of surgical approach as well as the information patients receive before consenting to surgery.

Sense of smell disorder and health-related quality of life.

OBJECTIVES: To compare health-related quality of life and depression between individuals with an inability to smell (anosmia) and a comparison group of individuals with a normal sense of smell. METHODS: Ninety individuals from an anosmia organization (anosmia based on self-report) were compared to 89 individuals with a normal sense of smell. The SF-36 and Beck Depression Inventory-II-NL (BDI-II-NL) were administered, along with the Questionnaire for Olfactory Dysfunction (QOD) to assess the degree of problems in daily life related to the smell impairment. RESULTS: Compared to the comparison group, scores in the anosmia group differed on: the QOD-subscale Life Quality (related to tasting and smelling: p < .001) and Parosmia (Smelling odors as different: p < .001); and the SF-36 subscales of Social Functioning, Vitality, Mental Health and General Health (p's < .05). Persons with anosmia scored higher on the BDI-II-NL than persons from the comparison group (p < .01). DISCUSSION: Once a smell dysfunction is recognized, interventions aiming at dealing with the loss of smell as a source of information and enjoyment, as well as at improvement of emotional wellbeing, social interaction, energy, and depression should be considered.

AAB and ABA Renewal as a Function of the Number of Extinction Trials in Conditioned Taste Aversion

Se realizaron tres experimentos en losque se exploró el efecto de renovación en aversión condicionada al sabor enfunción del número de ensayos de extinción. En el Experimento 1, tresgrupos de ratas recibieron un ensayo de condicionamiento, donde unasolución de sacarina se emparejó con LiCl, seguido por tres ensayos deextinción y dos ensayos de prueba. Los grupos difirieron en el contextodonde recibieron cada una de las fases (AAA, ABA y AAB). El cambio decontexto después de la extinción renovó la aversión condicionada al sabor,independientemente de si aquél implicó el regreso al contexto decondicionamiento (ABA) o el paso a un contexto diferente (AAB). En el Experimento 2, aumentar el número de ensayos de extinción a 5 eliminó larenovación en el grupo AAB. El Experimento 3 replicó estos resultadosdentro de un diseño factorial. Se discuten las implicaciones del efectodiferencial de la cantidad de extinción en la renovación AAB y ABA para lateoría de la recuperación de la información(AU)

Three experiments explored renewal in conditioned taste aversion afterdifferent amounts of extinction. In Experiment 1, three groups of ratsreceived a single conditioning trial where a saccharin solution was pairedwith LiCl, followed by 3 extinction trials, and a two-trial test. Groupsdiffered in the context where they received each of the phases (AAA, ABA,and AAB). The context change after extinction renewed taste aversion,regardless of whether it involved a return to the conditioning context(ABA), or going to a different context (AAB). In Experiment 2, increasingto 5 the number of extinction trials eliminated renewal in group AAB.Experiment 3 replicated these results within a factorial design. Theimplications of the differential effect of the amount of extinction on AABand ABA renewal for a retrieval theory of forgetting are discussed(AU)

Protection from extinction by concurrent presentation of an excitor or an extensively extinguished CS

Un experimento enaversión condicionada al sabor evaluó el impacto de la extinción de unestímulo condicionado (EC) crítico, S, en compuesto con un segundo EC,A, sobre la respuesta condicionada elicitada por el EC S durante supresentación en solitario en la prueba. Tras un tratamiento inicial decondicionamiento con los ECs A y S, el experimento manipuló el número deensayos de extinción con el EC A en solitario (esto es, 0, 5, o 10 ensayos)previamente al tratamiento con el compuesto AS. Además, dos grupos decontrol recibieron ensayos de extinción con S en solitario o ningúntratamiento de extinción con S. Los resultados de las condiciones querecibieron 0 o 10 ensayos de extinción con el EC A previamente a lasexposiciones no reforzadas de AS indicaron protección de la extinción de laaversión elicitada por el EC S, mientras que la condición que recibió 5ensayos de extinción con el EC A antes de los ensayos con AS mostró unaextinción desprotegida de la aversión elicitada por el EC S. Los modelosasociativos actuales tienen dificultades para explicar este patrón deresultados(AU)

One conditioned taste aversion experiment with rats assessed the impact ofextinguishing a target conditioned stimulus (CS), S, in compound with asecond CS, A, upon conditioned responding elicited by CS S whenpresented alone at test. Following initial conditioning treatment with CSs Aand S, the experiment manipulated number of extinction trials with CS Aalone (i.e., 0, 5, or 10 trials) prior to AS compound treatment. In addition,two control groups received either extinction trials with S alone or noextinction treatment with S. Conditions receiving either 0 or 10 extinctiontrials with CS A prior to nonreinforced exposures to AS showed resultsindicating that aversion elicited by CS S was protected from extinction,whereas a condition receiving 5 extinction trials with CS A prior to AS trialsshowed unprotected extinction of aversion elicited by CS S. Currentassociative models are challenged in accounting for this pattern of results(AU)

Overshadowing and potentiation of illness-based context conditioning

En cinco experimentos, se investigó el condicionamientocompuesto sabor-contexto empleando ratas como sujetos. Los animalesfueron expuestos a un contexto novedoso en el que tenían acceso a unasolución de ácido cítrico ó de sacarina antes de ser inyectados con LiCl. Acontinuación medimos la aversión condicionada al contexto empleando unprocedimiento de bloqueo. Cuando el sabor que acompañaba al contextodurante el condicionamiento era relativamente aversivo (ácido cítrico)observamos un nivel relativamente bajo de condicionamiento contextual; deacuerdo con nuestra interpretación, el sabor ácido ensombreció al contexto.Por el contrario, cuando el sabor era agradable (solución de sacarina) seobservó una potenciación del condicionamiento contextual. Nuestradiscusión de los resultados toma en consideración las propiedadesmotivacionales del sabor que acompaña a contexto en el momento delcondicionamiento(AU)

In five experiments using rats, we investigated compound context-flavorconditioning. The subjects were allowed to spend time in the target context,where they had access to a flavored solution (either citric acid or saccharine)before receiving an injection of LiCl. Context aversion was then assessed byusing a blocking procedure. When the flavor accompanying the context wasa non-palatable one, citric acid, impaired learning about the context wasobserved, an instance of overshadowing. However, when we presentedsaccharine in the novel environment enhanced learning about the contextwas found, an instance of context potentiation. The role of the motivationalproperties of the flavor that accompanies the target context duringconditioning is discussed(AU)

[Quality of life and voice intelligibility in laryngeal cancer patients--relevance of the "satisfaction paradox"]. / Lebensqualität und Sprachverständlichkeit bei Patienten mit Kehlkopfkarzinom--Relevanz des "Zufriedenheitsparadoxes".

BACKGROUND: Aim of this study was to compare postoperative quality of life and voice intelligibility of laryngeal cancer patients. PATIENTS AND METHODS: Two studies assessed the quality of life (by EORTC QLQ-C30 and EORTC QLQ-H&N35) and the voice intelligibility (by PLTT and FPAL) of 218 laryngectomized and 151 partially resected patients. The data of 86 patients was analysed on the basis of matched pairs (matching criteria: sex and tumour stage). RESULTS: The smelling and tasting of the laryngectomized patients were more affected. Other domains of quality of life did not differ significantly between the groups. The subjective assessment of voice intelligibility led to worse results among the patients with partial laryngectomy, although the objective test proved the contrary. CONCLUSIONS: Subjective and objective assessment of quality of life can differ, which led to paradox results in this study, especially for voice intelligibility. This might be due to the fact that partially resected patients have higher expectations of their operation.

Case of ageusia from a variety of causes.

We report a case of a 31-year-old woman with ageusia. Her ageusia was related to a variety of causes including an unbalanced diet, administration of the anti-epileptic drug, carbamazepine and psychological factors. Her taste function recovered after stopping the carbamazepine and treatment with liver extracts and zinc sulphate.

The effects of loss of taste and smell in a case of anorexia nervosa and bulimia nervosa.

A woman with a mixed eating disorder is reported. Her disorder did not remit after a head injury which caused her to lose her sense of taste and smell.