Perceived disability from hearing and voice changes in the elderly

Aim: Dysphonia and hearing loss are underestimated conditions in the elderly, despite their significant prevalence (18% and 50%, respectively) and their sociopsychological implications. Previous studies have shown that the reason for this lack of consideration is related to the general misconception of a simple age-related issue, as well as to the reduced communication requirements of this population, which can result in infrequent requests/supply of care. The purpose of the present study was to evaluate, within an elderly population, the subjective perception of hearing and voice dysfunctions, the resulting changes in communication skills, and the perception of handicap and disability. Methods: Four anonymous questionnaires were administered to 400 participants (218 men, 182 women) aged older than 65 years, some of whom (276) were hospitalized and some of whom (124) were outpatients. The questionnaires consisted of questions regarding age-related changes in voice, multiple-choice questions on the qualitative characteristics of the voice, questions regarding verbo-acoustic communication (hearing), the Voice Handicap Index, and the Self Assessment of Communication regarding the perception of hearing loss-related handicap and disability. Statistical correlations were calculated for voice dysfunction between the perception of disability and the clinical assessment of voice quality obtained by the Grade, Roughness, Breathiness, Asthenia, Strain scale, and between the perception of disability and the demand for care. Results: More than half of the elderly patients reported not perceiving voice changes throughout their lives. Most of the participants were satisfied with their own voices, although 65% of them judged them to be qualitatively altered, and in 31.5% of the participants, pathology was found on phoniatric evaluation. Low scores for vocal handicap (Voice Handicap Index) were found, and the type of perceived disability was mainly physical, although the association between Voice Handicap Index scores and Grade, Roughness, Breathiness, Asthenia, Strain was statistically significant. A total of 62% of the patients perceived hearing changes over their lifetimes not related to previous ear infections, but significantly correlated with a family history of hearing problems and with the need for specialist consultations. However, the perception of hearing loss handicaps and disability showed lower mean values, showing that older patients recognized dysfunction, but did not consider it to be a disability. Conclusions: The present study showed that, despite the relevant incidence of hearing and voice disorders among the elderly population, the implications for communication abilities seems to be underestimated. Hence, it appears to be extremely important to undergo specialist screening consultations to detect eventual voice and hearing alterations, and to correct them with appropriate therapeutic strategies

Analisi proteomica della saliva in pazienti affetti da Sindrome di Sjogren primitiva

La Sindrome di Sjogren primitiva (SS) ¨¨ una malattia autoimmune sistemica a patogenesi multifattoriale che colpisce in maniera peculiare le ghiandole esocrine salivari e lacrimali. La flogosi cellulo-mediata determina una progressiva compromissione della funzione ghiandolare che si traduce, dal punto di vista clinico, in una tipica sindrome sicca caratterizzata da secchezza orale e oculare persistenti. Scopo del lavoro. Considerando la peculiarit¨¤ della SS nel coivolgimento diretto delle ghiandole salivari, scopo del lavoro ¨¨ stato quello di caratterizzare mediante analisi proteomica il profilo proteico salivare di pazienti affetti da SS e comparare il pattern ottenuto con quello di controlli sani e di un gruppo di controlli ¡°patologici¡± al fine di identificare eventuali biomarkers di malattia. Pazienti e metodi: Sono stati arruolati nello studio: 15 pazienti con diagnosi di SjS, formulata in accordo con i Criteri Internazionali validati per la diagnosi di malattia, 15 controlli sani e 30 ¡°controlli patologici¡± comparabili per sesso ed et¨¤. Nell¡¯ambito dei 30 controlli patologici: 15 soggetti risultavano affetti da Sclerodermia sistemica progressiva(malattia autoimmune sistemica in grado di determinare un impegno fibrotico non flogistico delle ghiandole salivari), 6 presentavano una Sindrome Sicca Idiopatica non immunomediata e, 9 soggetti risultavano asintomatici per quanto relativo alla secchezza delle mucose ma erano portatori di autoanticorpi patologici (anti Ro/SSA e anti La/SSB),altamente specifici per la SS. La caratterizzazione del profilo proteico salivare ¨¨ stata effettuata combinando l¡¯elettroforesi bidimensionale con la spettrometria di massa (MALDI-TOF mass spectrometry). Risultati:Lo studio ha permesso mettere in evidenza numerose differenze tra il pattern proteico salivare dei pazienti con SS ed i profili proteici salivari dei soggetti sani e dei controlli patologici. In particolare nei pazienti con SjS ¨¨ stato possibile osservare una riduzione nei livelli di espressione di alcune tipiche proteine salivari acinari (albumina, ¦Á-amilasi salivare, PIP, cheratina 6L, anidrasi carbonica VI), un¡¯alterata espressione di proteine coinvolte nell¡¯equilibrio proteasi / antiproteasi con una riduzione delle cistatine e dei loro precursori ed un incremento dell¡¯inibitore dell¡¯elastasi leucocitaria, un incremento di proteine coinvolte nel danno tissutale (actina, lipocalina-1 precursore) e, infine,un¡¯aumentata espressione di proteine infiammatorie e legate all¡¯autoimmunit¨¤(calgranulina B, ciclofillina A, catena leggera ¦Ê delle immunoglobuline, beta2-microglobulina). Conclusioni:Lo studio, seppure preliminare, ha permesso di documentare come il pattern proteico salivare dei pazienti con SjS risulti profondamente alterato e presenti aspetti peculiari che, in parte riflettono l¡¯impegno flogistico selettivo da parte della malattia delle ghiandole salivari, in parte riflettono le alterazioni del microambiente orale che essa induce e, in parte, infine, la natura autoimmune sistemica della SS. Complessivamente, quindi,seppure a livello preliminare, lo studio ha mostrato come l¡¯analisi proteomica di fluidi biologici, scarsamente complessi e facilmente reperibili come la saliva, possa rappresentare un ulteriore ausilio nella diagnosi delle malattie reumatiche, in generale, e della SjS in particolare

Fibre tip sensor with embedded FBG-LPG for temperature and refractive index determination by means of the simple measurement of the FBG characteristics

A novel optical fibre sensing system based on a hybrid long period grating (LPG) and Bragg grating (FBG) configuration is proposed and demonstrated experimentally. The hybrid configuration, which uses the difference in temperature and refractive index (RI) different response of a Bragg grating and a long period grating, makes it possible to discriminate simultaneously the temperature and the refractive index of different aqueous solutions. RI (1.33 RIU-1.40 RIU) and temperature (21°C-28°C) working ranges have been experimentally determined. Experimental results show that the maximum accuracy in the refractive index measurement (0.004 RIU) with temperature compensation has been achieved within the working ranges

Strontium Functionalization of Biomaterials for Bone Tissue Engineering Purposes: A Biological Point of View

Strontium (Sr) is a trace element taken with nutrition and found in bone in close connection to native hydroxyapatite. Sr is involved in a dual mechanism of coupling the stimulation of bone formation with the inhibition of bone resorption, as reported in the literature. Interest in studying Sr has increased in the last decades due to the development of strontium ranelate (SrRan), an orally active agent acting as an anti-osteoporosis drug. However, the use of SrRan was subjected to some limitations starting from 2014 due to its negative side effects on the cardiac safety of patients. In this scenario, an interesting perspective for the administration of Sr is the introduction of Sr ions in biomaterials for bone tissue engineering (BTE) applications. This strategy has attracted attention thanks to its positive effects on bone formation, alongside the reduction of osteoclast activity, proven by in vitro and in vivo studies. The purpose of this review is to go through the classes of biomaterials most commonly used in BTE and functionalized with Sr, i.e., calcium phosphate ceramics, bioactive glasses, metal-based materials, and polymers. The works discussed in this review were selected as representative for each type of the above-mentioned categories, and the biological evaluation in vitro and/or in vivo was the main criterion for selection. The encouraging results collected from the in vitro and in vivo biological evaluations are outlined to highlight the potential applications of materials' functionalization with Sr as an osteopromoting dopant in BTE

Halogen bonds direct the solid state architectures of a multivalent iodopropargylcalix[4]arene

The iodoalkynyl group is a ditopic synthon, able to act as a halogen bond (XB) donor through the iodine atom and as an XB acceptor on the C≡C triple bond. With the aim of exploring the self-assembly properties via XB of calix[4]arene macrocycles containing this synthon, we synthesized and characterized a tetra(iodopropargyl)calix[4]arene (3). In the solid state, all the iodoalkynyl units of 3 are involved in intermolecular XB interactions as both donors and acceptors, resulting in a two-dimensional network of calixarene double layers. On the contrary, in the cocrystal of 3 with 4,4′-bipyridine, a bidentate XB acceptor, the iodine atoms are halogen bonded to the pyridine nitrogen atoms forming a one-dimensional ribbon of calixarenes alternated by two 4,4′-bipyridine units. These supramolecular architectures are the first example of solid-state networks of calixarene derivatives where the self-assembly is mostly driven by XBs

Protocol of Co-Culture of Human Osteoblasts and Osteoclasts to Test Biomaterials for Bone Tissue Engineering

open5no: New biomaterials and scaffolds for bone tissue engineering (BTE) applications require to be tested in a bone microenvironment reliable model. On this assumption, the in vitro laboratory protocols with bone cells represent worthy experimental systems improving our knowledge about bone homeostasis, reducing the costs of experimentation. To this day, several models of the bone microenvironment are reported in the literature, but few delineate a protocol for testing new biomaterials using bone cells. Herein we propose a clear protocol to set up an indirect co-culture system of human-derived osteoblasts and osteoclast precursors, providing well-defined criteria such as the cell seeding density, cell:cell ratio, the culture medium, and the proofs of differentiation. The material to be tested may be easily introduced in the system and the cell response analyzed. The physical separation of osteoblasts and osteoclasts allows distinguishing the effects of the material onto the two cell types and to evaluate the correlation between material and cell behavior, cell morphology, and adhesion. The whole protocol requires about 4 to 6 weeks with an intermediate level of expertise. The system is an in vitro model of the bone remodeling system useful in testing innovative materials for bone regeneration, and potentially exploitable in different application fields. The use of human primary cells represents a close replica of the bone cell cooperation in vivo and may be employed as a feasible system to test materials and scaffolds for bone substitution and regeneration.This project has received funding from the European Research Council (ERC) under the European Unions Horizon 2020 research and innovation program (grant agreement No 681798-BOOST). Available online: http://www.ercprojectboost.eopenBorciani, Giorgia; Montalbano, Giorgia; Baldini, Nicola; Vitale-Brovarone, Chiara; Ciapetti, GabrielaBorciani, Giorgia; Montalbano, Giorgia; Baldini, Nicola; Vitale-Brovarone, Chiara; Ciapetti, Gabriel

Occurrence of hashimoto thyroiditis among the first- and second-degree relatives of systemic lupus erythematosus patients with Hashimoto thyroiditis

Occurrence of Hashimoto thyroiditis among the first- and second-degree relatives of systemic lupus erythematosus patients with Hashimoto thyroiditis

Co–culture systems of osteoblasts and osteoclasts: Simulating in vitro bone remodeling in regenerative approaches

Bone is an extremely dynamic tissue, undergoing continuous remodeling for its whole lifetime, but its regeneration or augmentation due to bone loss or defects are not always easy to obtain. Bone tissue engineering (BTE) is a promising approach, and its success often relies on a “smart”scaffold, as a sup- port to host and guide bone formation through bone cell precursors. Bone homeostasis is maintained by osteoblasts (OBs) and osteoclasts (OCs) within the basic multicellular unit, in a consecutive cycle of resorption and formation. Therefore, a functional scaffold should allow the best possible OB/OC cooper- ation for bone remodeling, as happens within the bone extracellular matrix in the body. In the present work OB/OC co-culture models, with and without scaffolds, are reviewed. These experimental systems are intended for different targets, including bone remodeling simulation, drug testing and the assessment of biomaterials and 3D scaffolds for BTE. As a consequence, several parameters, such as cell type, cell ratio, culture medium and inducers, culture times and setpoints, assay methods, etc. vary greatly. This review identifies and systematically reports the in vitro methods explored up to now, which, as they al- low cellular communication, more closely resemble bone remodeling and/or the regeneration process in the framework of BTE