Hearing loss and satisfaction with healthcare: An unexplored relationship

Patient healthcare satisfaction has become increasingly important since Medicare’s introduction of the Hospital Care Quality Information from the Consumer Perspective (HCAHPS) survey. Greater satisfaction is associated with important healthcare outcomes including lower risk of 30-day readmission

Обновленные рекомендации EULAR/ERA–EDTA 2019 г. по терапии волчаночного нефрита. Комментарии экспертов. Часть II

The paper presents the main provisions of the updated 2019 EULAR/ERA-EDTA guidelines for the lupus nephritis (LN) therapy, which have been prepared by an international group of rheumatologists, nephrologists, morphologists, and pediatricians. Part 2 of the article discusses additional therapy, monitoring, and prognosis for LN, and the management of patients with end-stage renal failure and antiphospholipid syndrome. Attention is paid to the problem of LN and pregnancy, as well as to the management of pediatric patients with kidney damage.Представлены основные положения обновленных рекомендаций EULAR/ERA–EDTA 2019 г. по терапии волчаночного нефрита (ВН), подготовленных международной группой ревматологов, нефрологов, морфологов и педиатров. Во второй части статьи обсуждаются дополнительная терапия, мониторинг и прогноз при ВН, вопросы ведения пациентов с терминальной почечной недостаточностью, антифосфолипидным синдромом. Уделено внимание проблеме ВН и беременности, а также тактике ведения пациентов детского возраста с поражением почек

Biomimetic collagen scaffolds for human bone cell growth and differentiation

Type I collagen provides a structural framework for connective tissues and plays a central role in the temporal cascade of events leading to the formation of new bone from progenitors. The aim of this study was to examine the ability of the cell-binding domain of type I collagen (P-15 peptide) to promote human bone marrow stromal cell adhesion, proliferation, and differentiation on three-dimensional scaffolds. Human bone marrow stromal cells were selected, expanded, and cultured on particulate microporous ABM ("pure" hydroxyapatite) phase adsorbed with or without P-15 under basal or osteogenic conditions. Immobilized P-15 increased alkaline phosphatase activity and bone morphogenetic protein 2 (BMP-2) gene expression after 1 and 5 days as determined by real-time polymerase chain reaction. P-15 promoted human bone marrow stromal cell attachment, spreading, and alignment on ABM as well as alkaline phosphatase-specific activity in basal and osteogenic cultures. The presence of mineralized bone matrix, extensive cell ingrowth, and cellular bridging between three-dimensional matrices adsorbed with P-15 was confirmed by confocal microscopy, scanning electron microscopy, and alizarin red staining. Negligible cell growth was observed on ABM alone. In vivo diffusion chamber studies using MF1-nu/nu mice showed bone matrix formation and organized collagen formation after 6 weeks. These studies indicate the potential of P-15 to generate appropriate biomimetic microenvironments for osteoblasts and demonstrate the potential for the exploitation of extracellular matrix cues for osteogenesis and, ultimately, bone regeneration

Muscle fiber type grouping does not change in response to prolonged resistance exercise training in healthy older men

Background: Ageing of skeletal muscle is characterized in some by muscle fiber type grouping due to denervation-reinnervation cycles, but the severity of fiber type grouping varies widely across individuals of the same chro-nological age. It remains unknown whether fiber type grouping is associated with lower muscle mass and/or reduced physical function in elderly. Therefore, we assessed the relationship between fiber type grouping and indices of muscle mass and physical function in older adults. In addition, we assessed whether fiber type grouping is affected by prolonged resistance training in older adults.Methods: Twenty young (21 +/- 2 y) and twenty older (70 +/- 4 y) healthy men participated in the present study. Body composition (DXA-scan), quadriceps cross-sectional area (CT-scan) and muscle strength (1RM) were assessed at baseline (young and old) and following 12 weeks of resistance training (old only). Percutaneous skeletal muscle biopsies from the vastus lateralis were collected at baseline (young and old) and following exercise training (old only). Immunohistochemical analyses were performed to evaluate type I and type II muscle fiber distribution, size, myonuclear content and grouping.Results: At baseline, type II fibers were significantly (P < 0.05) smaller in older compared with young adults (5366 +/- 1288 vs 6705 +/- 1168 mu m2). Whereas no differences were observed in type I, type II fiber grouping was significantly (P < 0.05) lower in older (18 +/- 18 %) compared with young (32 +/- 25 %) men. No significant correlations were observed between fiber type grouping and muscle mass or physical function. Prolonged resistance training in old men resulted in a significant increase (P < 0.05) in type II fiber size (from 5366 +/- 1288 to 6165 +/- 1484 mu m2) with no significant changes in the proportion of type I muscle fibers found grouped.Conclusion: Muscle fiber type grouping is not associated with lower body strength or muscle mass in healthy, older men. In addition, twelve weeks of resistance exercise training results in type II muscle fiber specific hy-pertrophy but does not affect fiber type grouping