93 research outputs found

    Tonic Pupil and Corneal Anesthesia after Vitrectomy and Encircling Band for Retinal Detachment in an Ex-Premature Child

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    An 11-year-old boy presented with a total retinal detachment in his right eye. He had a bilateral 360° argon laser treatment for an active retinopathy of prematurity performed after his birth. He underwent an uneventful pars plana vitrectomy, encircling band, 810-nm diode endolaser and heavy silicone oil (Densiron®) endotamponade. A tonic pupil and abolition of corneal sensitivity, with a large epithelial defect, were observed during the postoperative period. We discuss the possible etiopathogenic mechanisms of the long and short ciliary nerves damage, and the role that retinopathy of prematurity and retinal detachment laser treatment and the encircling band placement might have played in the development of the tonic pupil and the corneal anesthesia

    Fluidics of Single and Double Blade Guillotine Vitrectomy Probes in Balanced Salt Solution and Artificial Vitreous

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    urpose: To assess the fluidics of double-vitreous cutter blade (DB) compared with single-blade (SB) guillotine with 23-, 25-, and 27-gauge vitrectomy probes. To assess flow characteristics and flow rates in viscous and viscoelastic fluids. Methods: We used Particle Image Velocimetry to measure the flow field close to the tip of each cutter probe and we derived kinematic quantities of interest, such as kinetic energy and acceleration. We performed measurements both on a balanced salt solution (BSS) and on a viscoelastic artificial vitreous (AV). Results: The flow rate is significantly higher with DB than SB vitrectomy probes, for a given pumping pressure and cutting rate. The fluid flow observed is very different between BSS and AV tests. Conclusions: The DB has more efficient fluidics than SB vitrectomy probe in all tested conditions. Fluid acceleration depends on the cutting frequency, especially in the case of measurements in AV. The flow rate strongly depends on the pressure and it is little affected by the cutting frequency, in a range of clinical interest. The 27-G DB produces flow rates similar to the 23- and 25-G SB, with significantly smaller acceleration. The flow induced in the AV is different from that in BSS and oscillates at different frequencies. Translational Relevance: DB cutters prove to be more efficient in terms of lower acceleration for a given flow rate. The latter is mainly controlled by aspiration pressure and less by cut rates. The influence of vitreous rheology deserves further investigations

    On the active deformations of hybrid specimens

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    Purpose – The purpose of this study concerns numerical studies and experimental validation of the mechanical behavior of hybrid specimens. These kinds of composite specimens are made up of thin carbon and glass substrates on which some Macro Fiber Composite ® (MFC) piezoelectric patches are glued. A proper design and manufacturing of the hybrid specimens as well as testing activities have been performed. The research activity has been carried out under the FutureWings project, funded by the European Commission within the 7th Framework. Design/methodology/approach – The paper describes the basic assumptions made to define specimen geometries and to carry out experimental tests. Finite element (FE) results and experimental data (laser technique measurements) have been compared: it shows very good agreement for the displacements’ distribution along the specimens. Findings – Within the objectives of the project, the study of passive and active deformation characteristics of the hybrid composite material has provided reference technical data and has allowed for the correct adaptation of the FE models. More in particular, using the hybrid specimens, both the bending deformations and the torsion deformations have been studied. Practical implications – The deformation capability of the hybrid specimens will be used in the development of prototypical three-dimensional structures, that, through the electrical control of the MFC patches, will be able to change the curvature of their cross section or will be able to change the angle of torsion along their longitudinal axis. Originality/value – The design of nonstandard specimens and the tests executed represent a novelty in the field of structures using piezoelectric actuators. The numerical and experimental data of the present research constitute a small step forward in the field of smart materials technology

    MiRNAs in the vitreous humor of patients affected by idiopathic epiretinal membrane and macular hole

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    Purpose The aim of the present study was to assess the expression of miRNAs in the Vitreous Humor (VH) of patients with Macular Hole (MH) and Epiretinal Membrane (ERM) compared to a control group. Methods In this prospective, comparative study, 2-ml of VH was extracted from the core of the vitreous chamber in consecutive patients who underwent standard vitrectomy for ERM and MH. RNA was extracted and TaqMan® Low Density Arrays (TLDAs) were used to profile the transcriptome of 754 miRNAs. Results were validated by single TaqMan® assays. Finally, we created a biological network of differentially expressed miRNA targets and their nearest neighbors. Results Overall 10 eyes with MH, 16 eyes with idiopathic ERM and 6 controls were enrolled in the study. Profiling data identified 5 miRNAs differentially expressed in patients affected by MH and ERM with respect to controls. Four were downregulated (miR-19b, miR-24, miR-155, miR-451) and 1 was downregulated (miR-29a); TaqMan® assays of the VH of patients affected by MH and ERM, with respect to controls, showed that the most differentially expressed were miR-19b (FC -9.13, p: < 0.00004), mir-24 (FC -7.52, p: < 0.004) and miR-142-3p (FC -5.32, p: < 0.011). Our network data showed that deregulation of differentially expressed miRNAs induces an alteration of several pathways associated with genes involved in both MH and ERM. Conclusion The present study suggests that disregulation of miR-19b, miR-24 and miR-142-3p, might be related to the alterations that characterize patients affected by MH and ERM

    A plasma miRNA-based classifier for small cell lung cancer diagnosis

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    IntroductionSmall cell lung cancer (SCLC) is characterized by poor prognosis and challenging diagnosis. Screening in high-risk smokers results in a reduction in lung cancer mortality, however, screening efforts are primarily focused on non-small cell lung cancer (NSCLC). SCLC diagnosis and surveillance remain significant challenges. The aberrant expression of circulating microRNAs (miRNAs/miRs) is reported in many tumors and can provide insights into the pathogenesis of tumor development and progression. Here, we conducted a comprehensive assessment of circulating miRNAs in SCLC with a goal of developing a miRNA-based classifier to assist in SCLC diagnoses.MethodsWe profiled deregulated circulating cell-free miRNAs in the plasma of SCLC patients. We tested selected miRNAs on a training cohort and created a classifier by integrating miRNA expression and patients’ clinical data. Finally, we applied the classifier on a validation dataset.ResultsWe determined that miR-375-3p can discriminate between SCLC and NSCLC patients, and between SCLC and Squamous Cell Carcinoma patients. Moreover, we found that a model comprising miR-375-3p, miR-320b, and miR-144-3p can be integrated with race and age to distinguish metastatic SCLC from a control group.DiscussionThis study proposes a miRNA-based biomarker classifier for SCLC that considers clinical demographics with specific cut offs to inform SCLC diagnosis

    Differentiation of COVID-19 signs and symptoms from allergic rhinitis and common cold : An ARIA-EAACI-GA(2)LEN consensus

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    Background Although there are many asymptomatic patients, one of the problems of COVID-19 is early recognition of the disease. COVID-19 symptoms are polymorphic and may include upper respiratory symptoms. However, COVID-19 symptoms may be mistaken with the common cold or allergic rhinitis. An ARIA-EAACI study group attempted to differentiate upper respiratory symptoms between the three diseases. Methods A modified Delphi process was used. The ARIA members who were seeing COVID-19 patients were asked to fill in a questionnaire on the upper airway symptoms of COVID-19, common cold and allergic rhinitis. Results Among the 192 ARIA members who were invited to respond to the questionnaire, 89 responded and 87 questionnaires were analysed. The consensus was then reported. A two-way ANOVA revealed significant differences in the symptom intensity between the three diseases (p < .001). Conclusions This modified Delphi approach enabled the differentiation of upper respiratory symptoms between COVID-19, the common cold and allergic rhinitis. An electronic algorithm will be devised using the questionnaire.Peer reviewe

    ARIA 2016 : Care pathways implementing emerging technologies for predictive medicine in rhinitis and asthma across the life cycle

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    The Allergic Rhinitis and its Impact on Asthma (ARIA) initiative commenced during a World Health Organization workshop in 1999. The initial goals were (1) to propose a new allergic rhinitis classification, (2) to promote the concept of multi-morbidity in asthma and rhinitis and (3) to develop guidelines with all stakeholders that could be used globally for all countries and populations. ARIA-disseminated and implemented in over 70 countries globally-is now focusing on the implementation of emerging technologies for individualized and predictive medicine. MASK [MACVIA (Contre les Maladies Chroniques pour un Vieillissement Actif)-ARIA Sentinel NetworK] uses mobile technology to develop care pathways for the management of rhinitis and asthma by a multi-disciplinary group and by patients themselves. An app (Android and iOS) is available in 20 countries and 15 languages. It uses a visual analogue scale to assess symptom control and work productivity as well as a clinical decision support system. It is associated with an inter-operable tablet for physicians and other health care professionals. The scaling up strategy uses the recommendations of the European Innovation Partnership on Active and Healthy Ageing. The aim of the novel ARIA approach is to provide an active and healthy life to rhinitis sufferers, whatever their age, sex or socio-economic status, in order to reduce health and social inequalities incurred by the disease.Peer reviewe

    Clinical Features, Cardiovascular Risk Profile, and Therapeutic Trajectories of Patients with Type 2 Diabetes Candidate for Oral Semaglutide Therapy in the Italian Specialist Care

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    Introduction: This study aimed to address therapeutic inertia in the management of type 2 diabetes (T2D) by investigating the potential of early treatment with oral semaglutide. Methods: A cross-sectional survey was conducted between October 2021 and April 2022 among specialists treating individuals with T2D. A scientific committee designed a data collection form covering demographics, cardiovascular risk, glucose control metrics, ongoing therapies, and physician judgments on treatment appropriateness. Participants completed anonymous patient questionnaires reflecting routine clinical encounters. The preferred therapeutic regimen for each patient was also identified. Results: The analysis was conducted on 4449 patients initiating oral semaglutide. The population had a relatively short disease duration (42%  60% of patients, and more often than sitagliptin or empagliflozin. Conclusion: The study supports the potential of early implementation of oral semaglutide as a strategy to overcome therapeutic inertia and enhance T2D management
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