Posterior corneal surface stability after femtosecond laser-assisted keratomileusis

The purpose of this study was to evaluate posterior corneal surface variation after femtosecond laser-assisted keratomileusis in patients with myopia and myopic astigmatism. Patients were evaluated by corneal tomography preoperatively and at 1, 6, and 12 months. We analyzed changes in the posterior corneal curvature, posterior corneal elevation, and anterior chamber depth. Moreover, we explored correlation between corneal ablation depth, residual corneal thickness, percentage of ablated corneal tissue, and preoperative corneal thickness. During follow-up, the posterior corneal surface did not have a significant forward corneal shift: no significant linear relationships emerged between the anterior displacement of the posterior corneal surface and corneal ablation depth, residual corneal thickness, or percentage of ablated corneal tissue

Factor analysis in the identification of dietary patterns and their predictive role in morbid and fatal events.

AbstractObjectiveThe purpose was to examine the role of dietary patterns derived from factor analysis and their association with health and disease.DesignLongitudinal population study, with measurement of diet (dietary history method), cardiovascular risk factors and a follow-up of 20 years for CHD incidence and 40 years for mortality.SettingTwo population samples in rural villages in northern and central Italy.SubjectsMen (n 1221) aged 45–64 years were examined and followed up.ResultsOne of the factors identified with factor analysis, run on seventeen food groups, was converted into a factor score (Factor 2 score) and used as a possible predictor of morbid and fatal events. High values of Factor 2 score were characterized by higher consumption of bread, cereals (pasta), potatoes, vegetables, fish and oil and by lower consumption of milk, sugar, fruit and alcoholic beverages. In multivariate analysis, Factor 2 score (mean 0·0061; sd 1·3750) was inversely and significantly associated (hazard ratio for a 1 sd increase; 95% CI) with 20-year CHD incidence (0·88; 0·73, 0·96) and 40-year mortality from CHD (0·79; 0·66, 0·95), CVD (0·87; 0·78, 0·96), cancer (0·84; 0·74, 0·96) and all causes (0·89; 0·83, 0·96), after adjustment for five other risk factors. Men in quintile 5 of Factor 2 score had a 4·1 years longer life expectancy compared with men in quintile 1.ConclusionsA dietary pattern derived from factor analysis, and resembling the characteristics of the Mediterranean diet, was protective for the occurrence of various morbid and fatal events during 40 years of follow-up

Artificial intelligence in diabetic retinopathy screening: clinical assessment using handheld fundus camera in a real-life setting

Aim: Diabetic retinopathy (DR) represents the main cause of vision loss among working age people. A prompt screening of this condition may prevent its worst complications. This study aims to validate the in-built artificial intelligence (AI) algorithm Selena+ of a handheld fundus camera (Optomed Aurora, Optomed, Oulu, Finland) in a first line screening of a real-world clinical setting. Methods: It was an observational cross-sectional study including 256 eyes of 256 consecutive patients. The sample included both diabetic and non-diabetic patients. Each patient received a 50°, macula centered, non-mydriatic fundus photography and, after pupil dilation, a complete fundus examination by an experienced retina specialist. All images were after analyzed by a skilled operator and by the AI algorithm. The results of the three procedures were then compared. Results: The agreement between the operator-based fundus analysis in bio-microscopy and the fundus photographs was of 100%. Among the DR patients the AI algorithm revealed signs of DR in 121 out of 125 subjects (96.8%) and no signs of DR 122 of the 126 non-diabetic patients (96.8%). The sensitivity of the AI algorithm was 96.8% and the specificity 96.8%. The overall concordance coefficient k (95% CI) between AI-based assessment and fundus biomicroscopy was 0.935 (0.891-0.979). Conclusions: The Aurora fundus camera is effective in a first line screening of DR. Its in-built AI software can be considered a reliable tool to automatically identify the presence of signs of DR and therefore employed as a promising resource in large screening campaigns

Dating Skin Lesions of Forensic Interest by Immunohistochemistry and Immunofluorescence Techniques: A Scoping Literature Review

Wound age estimation is a significant issue in forensic pathology. Although various methods have been evaluated, no gold standard system or model has been proposed, and accurate injury time estimation is still challenging. The distinction between vital skin wounds—i.e., ante-mortem lesions—and skin alterations that occur after death is a crucial goal in forensic pathology. Once the vitality of the wound has been confirmed, the assessment of the post-trauma interval (PTI) is also fundamental in establishing the causal relationship between the traumatic event and death. The most frequently used techniques in research studies are biochemistry, molecular biology, and immunohistochemistry (IHC). Biochemical methods take advantage of the chemical and physical techniques. A systematic literature search of studies started on 18 February 2023. The search was conducted in the main databases for biomedical literature, i.e., PubMed and Scopus, for papers published between 1973 and 2022, focusing on different techniques of immunohistochemistry and immunofluorescence (IF) for estimating the PTI of skin wounds. The present study involves a comprehensive and structured analysis of the existing literature to provide a detailed and comprehensive overview of the different IHC techniques used to date skin lesions, synthesize the available evidence, critically evaluate the methodologies, and eventually draw meaningful conclusions about the reliability and effectiveness of the different markers that have been discovered and used in wound age estimation

Retinal Microvasculature in Nonproliferative Diabetic Retinopathy: Automated Quantitative Optical Coherence Tomography Angiography Assessment

Purpose: To perform a qualitative and quantitative assessment of the foveal microvasculature in eyes with diabetic maculopathy using optical coherence tomography angiography (OCT-A). Methods: Retrospective case series of 48 eyes with diabetic maculopathy and 47 healthy eyes evaluated by Spectralis OCT-A. Perifoveal arcade disruptions, linear vascular dilations, microaneurysms, intraretinal microvascular abnormalities and flow-void areas were qualitatively analyzed on OCT angiograms both for the superficial (SCP) and deep (DCP) capillary plexuses. A fully automated microstructural analysis of the foveal avascular zone (FAZ) metrics, vascular and avascular surfaces was performed. Quantitative values from diabetic patients were compared with those of healthy subjects. Results: A moderate agreement between SCP and DCP in terms of diabetes-induced vascular lesions in the qualitative assessment was shown. The comparative quantitative analysis between SCP and DCP in diabetic patients revealed a statistically significant difference (p < 0.05) in terms of FAZ perimeter and FAZ surface. No statistically significant difference was shown in total vascular and avascular surfaces. A statistically significant difference between the diabetic and control groups was noticed both for SCP and DCP considering FAZ metrics and vascular surfaces. Conclusions: A qualitative and quantitative OCT-A approach on retinal vascular perfusion may offer an objective and reliable method for monitoring disease progression in diabetic retinopathy

Full-thickness choroidal thinning as a feature of Fuchs Uveitis Syndrome: quantitative evaluation of the choroid by Enhanced Depth Imaging Optical Coherence Tomography in a cohort of consecutive patients

Purpose: To perform a quantitative analysis of choroidal thickness in patients with Fuchs Uveitis Syndrome (FUS) using enhanced depth imaging optical coherence tomography (EDI-OCT). Methods: All patients underwent comprehensive ophthalmic examination, including best-corrected visual acuity, slit-lamp biomicroscopy, applanation tonometry, axial length measurements with a swept-source biometer (IOLMaster 700, Carl Zeiss Medic AG, Jena, Germany) and macular 30° linear EDI- B-scan SD-OCT section (Spectralis HRAII+OCT, Heidelberg Engineering, Heidelberg, Germany) in both eyes. Analysis of choroidal thickness was performed at three different locations: subfoveally, 750 μm nasally, and 750 μm temporally to the fovea. Patients having received any surgery or intravitreal injections in the last 12 months and with axial length variance ≥ 1 mm between both eyes were excluded. Results: Sixteen eyes of eight consecutive patients with unilateral FUS were included. Segmented analysis of the choroid, separately considering Haller’s layer and Sattler’s–choriocapillaris layers, showed statistically significant lower values (p < 0.05) in affected eyes (FEs) compared to fellow eyes (NFEs). In NFEs, total choroidal thickness mean values ranged from 305.62 ± 92.96 μm to 347.50 ± 91.55 μm; in FEs those values were significantly lower (p < 0.05), ranging from 232.62 ± 89.33 μm to 255.62 ± 89.33 μm. Conclusion: Diffuse and full-thickness choroidal thinning in FEs was observed. Considering the absence of significant axial length differences between FEs and NFEs in our patient series, these data seem to suggest that the full-thickness choroidal thinning in FEs may be due to the inflammatory process. In that way, FUS might be regarded as an inflammatory condition involving the whole uveal tunic, even the posterior part of it, definitively supplanting the early definition of “heterochromic iridociclytis”

New Insights On Ocular Sarcoidosis: An Optical Coherence Tomography Angiography Study

Purpose: To report optical coherence tomography angiography (OCT-A) findings in eyes with ocular sarcoidosis (OS) and to compare these findings with those of fluorescein angiography (FA). Methods: Observational, cross-sectional, case-control study. Patients presenting with OS involving the posterior segment were evaluated using FA, structural-OCT and OCT-A. OCT-angiograms of the superficial (SCP) and deep (DCP) capillary plexuses and choriocapillaris (CC) were qualitatively and quantitatively analyzed. Results: OCT-A seemed more sensitive than FA in detecting perifoveal capillary arcade disruptions, areas of hypoperfusion/non-perfusion and capillary abnormalities (p<0.05). Capillary hypoperfusion was more frequently detected in the DCP than in SCP, conversely capillary abnormalities were more often observed at the level of the SCP. Capillary vessel density values were significantly lower in eyes with OS than in healthy controls both at the level of DCP and CC (p<0.05). Conclusion: The depth-resolved nature of OCT-A allowed new insights on OS-induced microvascular and perfusion impairments

Quantitative and Qualitative Assessments of Retinal Structure with Variable A-Scan Rate Spectralis OCT: Insights into IPL Multilaminarity

The aim of this study was to evaluate the qualitative and quantitative differences between 20 and 85 kHz A-scan rate optical coherence tomography (OCT) images acquired by spectral domain OCT. The study included 60 healthy subjects analyzed with horizontal linear scans with a variable A-scan rate (SHIFT technology, Heidelberg Engineering, Heidelberg, Germany). The retinal thickness measurement of each retinal layer was performed in three different positions (subfoveal, nasal, and temporal). The qualitative assessment was performed by two independent observers who rated every image with a score ranging from 1 (“sufficient”) to 3 (“excellent”) on the basis of three parameters: visualization of the vitreo-retinal interface, characterization of the retinal layers, and visualization of the sclero-choroidal interface. No statistically significant differences in terms of retinal layer thickness between the two A-scan rate scans were observed (p > 0.05). The coefficient of variation of the retinal thickness values was lower in the 20 kHz group (25.8% versus 30.1% with the 85 kHz). The 20 kHz images showed a higher quality index for both observers. An inner plexiform layer (IPL) multilaminarity was detected in 78.3% of patients from the 20 kHz group and in 40% of patients from the 85 kHz group (p < 0.05)

NILDE - uno strumento per la valutazione della efficienza delle biblioteche del sistema BIBLIOSAN del Ministero della Salute

NILDE as evaluation tool among BIBLIOSAN libraries.Il Sistema Bibliosan, che riunisce tutte le biblioteche degli Enti di Ricerca Biomedici del Ministero della Salute, ha la finalit? di creare le condizioni ideali per la condivisione e la distribuzione efficace dell\u27informazione scientifica tra i suoi ricercatori, grazie ad un sistema di document delivery regolamentato e ad una politica di acquisti consortili di risorse on line. Nel Regolamento di Bibliosan, adottato da tutte le strutture coinvolte, sono fissati i criteri ed i requisiti di cooperazione per la condivisione e la diffusione delle informazioni bibliografiche. Tra questi elementi ? essenziale la presenza di ogni biblioteca nel catalogo collettivo ACNP e l?utilizzo del sistema NILDE per il document delivery. Ad ogni biblioteca del sistema ? stata anche richiesta una esplicita adesione ad uno standard qualitativo basato su di livelli minimi di performance, la verifica dei quali, "de facto", rappresenta l?avvio di un sistema di monitoraggio sulle attivit? delle strutture stesse. Lo scambio di documenti attraverso Nilde e i dati da esso derivabili, sono stati preziosi indicatori di attivit? e di produttivit? nelle biblioteche Bibliosan. La rilevazione dei dati catalografici, la loro congruit?, la quantit? degli scambi delle strutture, le modalit? di document delivery, i tempi di risposta e le difformit? al rispetto al regolamento Nilde e Bibliosan costituiscono, per il Ministero della Salute, oggetto di analisi e strumento di valutazione di tutte le Istituzioni finanziate con i fondi per la ricerca in Sanit?. Il monitoraggio dell\u27attivit? di document delivery, nel quadriennio 2004-2007, ha consentito di analizzare e confrontare i dati relativi al servizio di scambio, non solo tra le strutture Bibliosan ,ma anche con le strutture esterne al Sistema. Dal totale degli scambi ? stata evidenziata una situazione iniziale di rapida evoluzione ed una successiva fase di stabilizzazione. L?attivit? formativa ed informativa rivolta ai bibliotecari ha certamente contribuito alla iniziale rapida diffusione dell?uso del sistema. ? stato inoltre interessante rilevare come i tempi di riposta del document delivery siano andati via via riducendosi mostrando un incremento di efficienza nelle bibliteche e la progressiva riduzione del numero di casi in cui era possibile rilevare una difformit? dal regolamento. L\u27analisi degli scambi si rivela quindi uno strumento di controllo fondamentale il cui monitoraggio risulta ormai indispensabile a controllare il funzionamento del Sistema Bibliosan. Le innovazioni introdotte sulla pagina personalizzata per accedere a PubMed rappresentano la novit? Bibliosan 2008. Attraverso questa interfaccia l?utente pu? direttamente arrivare da PubMed al fulltext degli articoli di proprio interesse e scaricarli (se ne ha il diritto) da internet o inviare la richiesta di recupero articoli alla propria biblioteca tramite Nilde-utente. Il monitoraggio del numero di utenti registrati in Nilde per ogni Biblioteca ed il traffico in DD da essi creato costituir? un nuovo indicatore di efficienza della biblioteca stessa. Questi dati permetteranno anche di capire quanto la biblioteca si ? fatta conoscere all?interno della propria struttura e quanto ? stata capace di soddisfare qualitativamente e quantitativamente le esigenze informative dei propri utenti

Factor analysis in the identification of dietary patterns and their predictive role in morbid and fatal events

AbstractObjectiveThe purpose was to examine the role of dietary patterns derived from factor analysis and their association with health and disease.DesignLongitudinal population study, with measurement of diet (dietary history method), cardiovascular risk factors and a follow-up of 20 years for CHD incidence and 40 years for mortality.SettingTwo population samples in rural villages in northern and central Italy.SubjectsMen (n 1221) aged 45–64 years were examined and followed up.ResultsOne of the factors identified with factor analysis, run on seventeen food groups, was converted into a factor score (Factor 2 score) and used as a possible predictor of morbid and fatal events. High values of Factor 2 score were characterized by higher consumption of bread, cereals (pasta), potatoes, vegetables, fish and oil and by lower consumption of milk, sugar, fruit and alcoholic beverages. In multivariate analysis, Factor 2 score (mean 0·0061; sd 1·3750) was inversely and significantly associated (hazard ratio for a 1 sd increase; 95% CI) with 20-year CHD incidence (0·88; 0·73, 0·96) and 40-year mortality from CHD (0·79; 0·66, 0·95), CVD (0·87; 0·78, 0·96), cancer (0·84; 0·74, 0·96) and all causes (0·89; 0·83, 0·96), after adjustment for five other risk factors. Men in quintile 5 of Factor 2 score had a 4·1 years longer life expectancy compared with men in quintile 1.ConclusionsA dietary pattern derived from factor analysis, and resembling the characteristics of the Mediterranean diet, was protective for the occurrence of various morbid and fatal events during 40 years of follow-up