Recognition of taste in patients during antineoplastic therapy with platinum drugs.

Taste changes caused by the use of platinum drugs have been described. However, few studies qualify the impaired tastes and whether these changes are derived exclusively from chemotherapy (QTx). AIMS: Evaluation of changes in sweet, sour, salty, bitter, and umami tastes in patients receiving QTx with platinum drugs was the aim of this study. METHODS: A total of 43 subjects, 21 from the study group and 22 from the control, were studied in two time periods, one before the start of QTx (T0) and another after two cycles of QTx (T1). The usual dietary intake, body mass index (BMI), handgrip strength and fatigue (through the fatigue pictogram) were evaluated to characterize the group studied. Taste Strips tests were performed for all 4 tastes and umami was studied by comparing Likert's scale using monosodium glutamate (GMS) food. Statistical analysis was performed using repeated measures (ANOVA), mixed model, with significance level p≤0.05. RESULTS: Salty and sour were the most affected tastes in the study group (p = 0.001 and 0.05); as well as the ionotropic receptors (p = 0.02) responsible for identifying these tastes. There was a difference between the times for BMI, dynamometry and impact in daily activities, by the fatigue pictogram (p = 0.008, 0.009 and 0.006 respectively). CONCLUSION: These findings suggest an important role in altering taste recognition, mainly in salty and sour tastes, identified by ionotropic receptors, which seems to be related to dietary changes. QTx has demonstrated a contribution to impairment of functionality and fatigue.

Taste changes as a metaphor for biographical disruption: A qualitative study in patients undergoing haematopoietic stem cell transplantation.

PURPOSE: and objective: The treatment side effects of patients undergoing haematopoietic stem cell transplantation can cause various eating difficulties. The objective of this study was to explore the significance of eating experiences and taste changes from the perspective of patients undergoing haematopoietic stem cell transplantation. METHOD: This was a qualitative, exploratory study based on semi-structured interviews applied during hospitalisation for haematopoietic stem cell transplantation. Thematic content analysis and the biographical disruption concept were used as theoretical references to explore the results. RESULTS: Twenty patients were studied. The overarching theme identified from the results was deconstruction of the taste reference resulting from sensory taste change, loss of eating references and changes to the hedonic relationship with food caused by the treatment. In addition to this deconstruction, participants described the reformulation of eating habits as a way of coping with the disease, which affected the eating experience and motivated the dietary strategies adopted. CONCLUSIONS: Taste changes during haematopoietic stem cell transplantation are related to both biological issues and metaphysical aspects. This study raises the meaning of loss of sensory references and their symbolic aspects. These results were important to expand our view to include other aspects that can contribute to improving the care given to these individuals.

Occlusal, chewing, and tasting characteristics associated with orofacial dysfunctions in children with unilateral cleft lip and palate: a case-control study.

OBJECTIVE: The objective of this study is to assess the associations between orofacial dysfunctions with malocclusion, masticatory performance, and taste in children with and without unilateral cleft lip and palate (UCLP). MATERIAL AND METHODS: A patient-based, matched, case-control study was conducted involving 108 8- to 10-year-old children divided in UCLP and control groups. Orofacial dysfunctions were evaluated using the Nordic Orofacial Test-Screening (NOT-S). Orthodontic treatment need was evaluated using the Goslon Yardstick Index (GYI) and the Index of Orthodontic Treatment Need (IOTN) of patients and controls, respectively. Masticatory performance was assessed using a chewable test material to determine median particle size (X 50) and distribution of particles in different sieves (b value). Taste perception was evaluated using four solutions (sweet, salty, bitter, or acid) in three different concentrations. RESULTS: More than half of the patients needed orthodontic surgery. UCLP group presented higher median particle size and needed more chewing cycles to comminute the artificial test into particles smaller than the median than those of controls. UCLP group had less perception of salty flavor than controls. There was a positive correlation between b value and NOT-S examination score for patients. In regression analysis, a significant interrelationship was observed between NOT-S examination score and b value. CONCLUSIONS: In the UCLP patients, masticatory performance was compromised probably as a result of facial asymmetry and speech disturbance; whereas, taste was less perceived only for salty flavor. CLINICAL RELEVANCE: These findings provide preliminary evidence that mastication and taste are altered in children with UCLP, so these factors must be followed up to ensure oral and general health in growing individuals.

Assessing pathophysiology of cancer anorexia.

PURPOSE OF REVIEW: Cancer anorexia is a negative prognostic factor and is broadly defined as the loss of the interest in food. However, multiple clinical domains contribute to the phenotype of cancer anorexia. The characterization of the clinical and molecular pathophysiology of cancer anorexia may enhance the efficacy of preventive and therapeutic strategies. RECENT FINDINGS: Clinical trials showed that cancer anorexia should be considered as an umbrella encompassing different signs and symptoms contributing to appetite disruption in cancer patients. Loss of appetite, early satiety, changes in taste and smell are determinants of cancer anorexia, whose presence should be assessed in cancer patients. Interestingly, neuronal correlates of cancer anorexia-related symptoms have been revealed by brain imaging techniques. SUMMARY: The pathophysiology of cancer anorexia is complex and involves different domains influencing eating behavior. Limiting the assessment of cancer anorexia to questions investigating changes in appetite may impede correct identification of the targets to address.

Salivary tests associated with elderly people's oral health.

INTRODUCTION: The saliva constitutes essential condition for the individual's health. AIM: Identify the relation of the salivary flow and saliva pH with medicine use and oral discomfort in elderly. METHODS AND MATERIALS: Cross-sectional study with 68 elderly living in a long staying institution. Salivary tests were performed based on Bo Krasse's methodology. For pH, the Universalindikator - Merck tape was used. A questionnaire was applied, organising data through Software SPSS version 17. Pearson's qui-square distribution, Fisher's exact test and t-test for paired data were used, with significance level of 5% and confidence interval of 95%. RESULTS: Among the 68 elderly (average of 70.4 years, SD ± 7.27), 80% showed normal pH. The rate of salivary flow was as follows: very low, 32.3%; lowered, 41.2%; and normal, 25.5%; 30.9% reported dry mouth; 22.1% problems with taste; 17.6%, dysphagia; and 14.7%, burning mouth. 76.5% used medicines. There was statistical significance between medicine use and dry mouth (p = 0.015). They showed an association between salivary flow and medicine use (p = 0.048), feels dry mouth (0.018) and difficulty to swallow (p = 0.046), and saliva pH without stimulation and feels dry mouth (p = 0.003), difficulty to swallow (p=0.006) and burning mouth sensation (p = 0.014). CONCLUSION: Low salivary flow and saliva pH interfere on elderly people's health and medicine use influences on results.

Influence of taste disorders on dietary behaviors in cancer patients under chemotherapy.

OBJECTIVES: To determine the relationship between energy and nutrient consumption with chemosensory changes in cancer patients under chemotherapy. METHODS: We carried out a cross-sectional study, enrolling 60 subjects. Cases were defined as patients with cancer diagnosis after their second chemotherapy cycle (n = 30), and controls were subjects without cancer (n = 30). Subjective changes of taste during treatment were assessed. Food consumption habits were obtained with a food frequency questionnaire validated for Mexican population. Five different concentrations of three basic flavors --sweet (sucrose), bitter (urea), and a novel basic taste, umami (sodium glutamate)-- were used to measure detection thresholds and recognition thresholds (RT). We determine differences between energy and nutrient consumption in cases and controls and their association with taste DT and RT. RESULTS: No demographic differences were found between groups. Cases showed higher sweet DT (6.4 vs. 4.4 micromol/ml; p = 0.03) and a higher bitter RT (100 vs. 95 micromol/ml; p = 0.04) than controls. Cases with sweet DT above the median showed significant lower daily energy (2,043 vs.1,586 kcal; p = 0.02), proteins (81.4 vs. 54 g/day; p = 0.01), carbohydrates (246 vs.192 g/day; p = 0.05), and zinc consumption (19 vs.11 mg/day; p = 0.01) compared to cases without sweet DT alteration. Cases with sweet DT and RT above median were associated with lower completion of energy requirements and consequent weight loss. There was no association between flavors DT or RT and nutrient ingestion in the control group. CONCLUSION: Changes of sweet DT and bitter RT in cancer patients under chemotherapy treatment were associated with lower energy and nutrient ingestion. Taste detection and recognition thresholds disorders could be important factors in malnutrition development on patients with cancer under chemotherapy treatment.