Introduction: Nowadays, there are many options to treat hearing-impaired patients: tympanoplastic surgery, hearing aids and a wide range of implantable devices. Objective: The aim of this study is to present the mid-term audiological and quality of life benefits after the implantation of the Osia®, a new active piezoelectric bone conduction hearing implant. Material and methods: The state of the tissues in implanted area, as well as audiological and quality of life results were analyzed six, nine and twelve months after implantation in a group of four adult patients with bilateral mixed hearing loss. Results: In all the cases, no postoperative complications were found. One year after surgery the mean audiological gain in FF PTA4 (pure tone average for 0.5, 1, 2, and 4 kHz) was 52.2±3.5 dB in comparison to the unaided situation, the mean speech understanding with Osia® in quiet was 90±8.2% for 50dB SPL, 98.8±2.5% for 65dB SPL and 100±0% for 80dB SPL, and mean speech understanding with Osia® in noise was 37.5%±23.6 for 50dB SPL, 93.8±4.8% for 65dB SPL and 98.8±2.5% for 80dB SPL. There was also an evident improvement in the quality of hearing as well as in the quality of life, measured by the APHAB (Abbreviated Profile of Hearing Aid Benefit) and the SSQ (Speech, Spatial and Qualities of Hearing Scale). Conclusions: The Osia® is an effective treatment option for patients with bilateral mixed hearing loss. The mid-term audiological and quality of life results are excellent, but further observations including bigger groups of patients and a longer follow-up are required.
Background : The aim of this study was to assess the impact of the Baha® Attract system implantation on the quality of life of hearing-impaired patients, who were qualified for surgery due to various audiological indications. Methods: A total of 96 patients implanted with the Baha® Attract system were asked to fill in the set of questionnaires: the Glasgow Benefit Inventory, the Abbreviated Profile of Hearing-Aid Benefit, and the BAHA Aesthetic, Hygiene, and Use. Totally 79 patients responded and were then analyzed. Patients were divided into 4 groups: A: with bilateral mixed or conductive hearing loss, B: with single-sided deafness, C: with unilateral mixed or conductive hearing loss, and D: others. Results: There was a significant improvement in quality of life measured by the Glasgow Benefit Inventory in all the analyzed groups, with a mean total score of 29.4 points ( P < .001). Similarly, the evaluation by the Abbreviated Profile of Hearing Aid Benefit questionnaire showed a significant improvement in terms of the global score in all the analyzed groups, with a mean gain of 38.6% ( P < .001). There were no differences between the groups. More than 90% of patients found the Baha® Attract system easy to place on their heads and maintain good hygiene. Of all the implant users, 81% were satisfied with the final aesthetic effect. Conclusion: The implantation of the Baha® Attract system significantly improves the quality of life of hearing-impaired patients in all subjective scales used. The system is effective for all audiological indications when strictly adhered to. The majority of patients are very satisfied with the aesthetic, hygienic, and utility aspects of the device.
Focal segmental glomerulosclerosis (FSGS) is a devastating form of nephrotic syndrome, often leading to end-stage renal failure after the failure of a succession of highly toxic therapies. It has long been thought to be caused by a circulating factor(s) that may be produced by cells of the immune system. Much research has focused on identifying such factor(s), including the development of a promising in vitro assay, which estimates glomerular permeability based on the swelling of isolated glomeruli in response to patients’ plasma. This assay has also been used as the basis of testing plasma fractions for permeability activity, with no specific factor yet identified. Other studies have attempted to replicate proteinuria in whole animals, by injecting plasma or plasma fractions from focal segmental glomerulosclerosis patients, with inconsistent results. More recently there has been evidence that there may be either inhibitory or missing factor(s) in plasma, with respect to permeability. An additional major biological advance is a growing appreciation of the podocyte as the target cell in this disease, and an understanding of the key molecules involved. Putting together this knowledge, with the latest technological advances in protein identification, provides promising avenues towards finally solving the basis of this enigmatic disease.
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