Tongue Cleaning Increases the Perceived Intensity of Salty Taste.

OBJECTIVE: Tongue coating, which refers to a greyish white deposit on the tongue surface, often covers the taste papillae on the dorsal tongue surface, decreasing taste sensitivity. This study investigated whether mechanical removal of the tongue coating affected the intensity of salt taste perception. PARTICIPANTS: This cross-sectional single blind study included 90 subjects (29 males, 61 females) with a mean age of 45 years (range 25-70 years). INTERVENTION: The presence and the amount of coating on the six sextants of the tongue were scored using the Winkel Tongue Coating Index (WTCI); the 90 included subjects had total WTCI scores ≥ 3. The intensity of the salt taste was tested using a drop of prepared tomato soup applied to the middle of the dorsal surface of the tongue before and then after tongue cleaning. MEASUREMENT: The salt taste intensity was measured using a general Labeled Magnitude Scale (gLMS). RESULTS: The mean salt taste intensity was significantly different (p value = 0.0002) after the intervention versus before it, with the taste intensity increasing after tongue cleaning. CONCLUSIONS: The results indicated that the salt taste intensity increased after removal of the tongue coating. This study indicates that tongue cleaning, a simple technique used for oral hygiene, may be an effective way to reduce excess salt intake. Tongue cleaning could help individuals adhere to the WHO recommendations on dietary salt intake.

[Morbid obesity in total knee arthroplasty: a critical case review]. / Morbide Adipositas in der Knieendoprothetik: Eine kritische Einzelfallbetrachtung.

HISTORY AND ADMISSION FINDINGS: In a 66-year-old obese woman (WHO stage III, BMI 51 kg/m2) pronounced osteoarthritis of the right knee was diagnosed. Because of progressive chronic pain of the right knee joint her walking distance was limited to a few meters. Conservative therapy was exhausted. INVESTIGATIONS: Clinical examination showed a restricted and painful range of motion of the right knee and distinctive obeseness on the trunk and the extremities including a lipedema/lymphedema. TREATMENT AND COURSE: After a complicated course of treatment lasting for 220 days the total knee replacement ended in an arthrodesis combined with a gastrocnemius muscle flap. CONCLUSION: With respect to this case the high complication-rates in obese patients should be taken into account: Total knee replacement can even lead to loss of the limb in the worst case. In addition to extended preoperative examination this indication should be critically scrutinized.

[Arthropathia ochronotica: a rare cause of early joint degeneration]. / Arthropathia ochronotica: eine seltene ursache frühzeitiger gelenkdegeneration.

HISTORY AND ADMISSION FINDINGS: A 70-year-old deaf-mute women suffered from progressive chronic pain of the right hip joint caused by destructive osteoarthritis of the hip. INVESTIGATIONS: In addition to painfully restricted range of motion of the right hip joint the clinical examination showed a bluish-black pigmentation of the ear-cartilage and the sclera. TREATMENT AND COURSE: A total endoprosthetic replacement of the right hip joint was performed. During surgery, blackening of the hip joint capsule and cartilage was found. Histological, the diagnosis of an ochronosis was confirmed. Discoloration after exposure of urine to air supported the diagnosis. Based on extensive internal medical examination relevant cardiac changes were excluded. CONCLUSION: Ochronosis (arthropathia ochronotica) is a rare entity which can be identified by a visual diagnosis. Early diagnosis can provide crucial information for the prognosis. Additionally, an interdisciplinary treatment concept should be established because of the early onset of degenerative changes at the skeletal system and pathological changes at internal organs. With suspicion on an ochronosis extended internal examinations are recommended in order to avoid complications.