Retinal fluorescence microscopy in artificial ophthalmic environment: the Humanized Phantom Eye

Phantom eye devices are designed to mimic the optical properties of the human eye; however, the retinal structures are typically emulated with synthetic tissues. Thus, it is currently impossible to exploit phantom eye devices for fluorescence microscopy experiments on cultures, or ex-vivo tissues, although these ophthalmic measurements would be of importance for many applications such as the testing of retinal biomarkers. Here we report and describe the development of a phantom eye designed to host biological samples, such as retinal cultures differentiated from human induced pluripotent stem cells. We characterized the imaging performance of the humanized phantom eye on standard biomarkers such as Alexa Fluor 532 and Alexa fluor 594

Anesthetic management of pregnant patients with cardiovascular disease: a commentary on the 2023 American Heart Association (AHA) scientific statement

The American Heart Association (AHA) has recently released a statement on cardiovascular management of pregnant women from an anesthesiological point of view. Although managing such situation is extremely frequent in clinical practice, poor attention is paid to the topic and many cardiologists and anesthesiologists in small centers have to cope with cardiovascular complications during pregnancy, being at the forefront as consultants. Consequently, we deem appropriate to dwell on this statement. The aim of the present commentary is to summarize the main practical indications provided by the AHA from a strictly cardiological point of view

Synergistic effect of chronic kidney disease, neuropathy, and retinopathy on all-cause mortality in type 1 and type 2 diabetes: a 21-year longitudinal study

BACKGROUND: The prognostic value of common and frequently associated diabetic microvascular complications (MVC), namely chronic kidney disease (CKD), cardiac autonomic neuropathy (CAN), peripheral neuropathy (DPN), and retinopathy (DR), is well established. However, the impact of their different combinations on long-term mortality has not been adequately assessed. METHODS: We retrospectively analyzed 21-year longitudinal data from 303 patients with long-standing type 1 (T1D) or type 2 diabetes (T2D), who were thoroughly characterized at baseline for the presence of MVC using (99m)Tc-DTPA dynamic renal scintigraphy, overnight urine collection, cardiovascular autonomic tests, monofilament testing, and dilated fundus oculi examination. RESULTS: After a 5,244 person-years follow-up, a total of 133 (43.9%) deaths occurred. The presence of CKD and CAN, regardless of other MVC, increased the adjusted all-cause mortality risk by 117% (HR 2.17 [1.45–3.26]) and 54% (HR 1.54 [1.01–2.36]), respectively. Concomitant CKD&CAN at baseline were associated with the highest mortality risk (HR 5.08 [2.52–10.26]), followed by CKD&DR (HR 2.95 [1.63–5.32]), and CAN&DR (HR 2.07 [1.11–3.85]). Compared with patients free from MVC, the mortality risk was only numerically higher in those with any isolated MVC (HR 1.52 [0.87–2.67]), while increased by 203% (HR 3.03 [1.62–5.68]) and 692% (HR 7.92 [2.93–21.37]) in patients with two and three concomitant MVC, respectively. CONCLUSIONS: Our study demonstrates the long-term, synergistic, negative effects of single and concomitant diabetic MVC on all-cause mortality, which should encourage comprehensive screenings for MCV in both T1D and T2D to improve risk stratification and treatment. SUPPLEMENTARY INFORMATION: The online version contains supplementary material available at 10.1186/s12933-022-01675-6

Prognostic value of 24-hour ambulatory blood pressure patterns in diabetes: A 21-year longitudinal study

Aims To establish the long-term prognostic value of abnormal circadian blood pressure (BP) patterns in diabetes. Materials and Methods We retrospectively examined a cohort of 349 outpatients with diabetes who were screened for microvascular complications and followed up for 21 years. Dipping, nondipping and reverse-dipping status were defined based on 24-hour ambulatory BP monitoring (ABPM) as >= 10% reduction, <10% reduction, and any increase in average nighttime versus daytime systolic BP (SBP), respectively. Results After 6251 person-years of follow-up (median [range] follow-up 21.0 [1.1-22.0] years, 52% women, age 57.1 +/- 11.9 years, 81.4% type 2 diabetes and 18.6% type 1 diabetes), a total of 136 deaths (39%) occurred. Compared with dippers, the nondippers and reverse dippers showed progressively higher prevalence of chronic kidney disease (CKD), cardiac autonomic neuropathy (CAN) and postural hypotension. Reverse dippers showed a 13.4% (2.5-year) reduction in mean overall survival and a twofold increased risk of all-cause mortality after adjustment for traditional risk factors (hazard ratio 2.2 [95% confidence interval 1.3-3.8]). Each 1% decrease in nighttime versus daytime SBP ratio was independently associated with a 4% reduction in 20-year mortality risk. Conclusions In patients with diabetes, reverse dipping is associated with a higher prevalence of CKD and CAN and more than doubled the adjusted risk of all-cause mortality over a 21-year observation

Female sex and angiotensin-converting enzyme (ace) insertion/deletion polymorphism amplify the effects of adiposity on blood pressure

International audienceThe pathophysiological link between adiposity and blood pressure is not completely understood, and evidence suggests an influence of sex and genetic determinants. We aimed to identify the relationship between adiposity and blood pressure, independent of a robust set of lifestyle and metabolic factors, and to examine the modulating role of sex and Angiotensin-Converting Enzyme (ACE) insertion/deletion (I/D) polymorphisms. In the Relationship Between Insulin Sensitivity and Cardiovascular Disease (RISC) study cohort, 1211 normotensive individuals, aged 30 to 60 years and followed-up after 3.3 years, were characterized for lifestyle and metabolic factors, body composition, and ACE genotype. Body mass index (BMI) and waist circumference (WC) were independently associated with mean arterial pressure, with a stronger relationship in women than men (BMI: R=0.40 versus 0.30; WC: R=0.40 versus 0.30, both P<0.01) and in individuals with the ID and II ACE genotypes in both sexes (P<0.01). The associations of BMI and WC with mean arterial pressure were independent of age, sex, lifestyle, and metabolic variables (standardized regression coefficient=0.17 and 0.18 for BMI and WC, respectively) and showed a significant interaction with the ACE genotype only in women (P=0.03). A 5 cm larger WC at baseline increased the risk of developing hypertension at follow-up only in women (odds ratio, 1.56 [95% CI, 1.15-2.10], P=0.004) and in II genotype carriers (odds ratio, 1.87 [95% CI, 1.09-3.20], P=0.023). The hypertensive effect of adiposity is more pronounced in women and in people carrying the II variant of the ACE genotype, a marker of salt sensitivity

Additional file 1 of Synergistic effect of chronic kidney disease, neuropathy, and retinopathy on all-cause mortality in type 1 and type 2 diabetes: a 21-year longitudinal study

Additional file 1: Table S1. Baseline characteristics of the subgroup of study participants fully characterized for the presence of CKD, CAN, and DR. Table S2. Baseline characteristics of the study participants fully characterized for the presence of CKD, CAN, and DR stratified by the number of MVC

CLINICAL PREDICTORS OF 30-DAY MORTALITY IN HOSPITALIZED PATIENTS WITH LUNG CANCER: A RETROSPECTIVE SINGLE-CENTER OBSERVATIONAL STUDY

Background: Lung cancer patients experience high rates of hospitalization, mainly due to the high risk of complica- tions that emerge during the natural history of disease. We designed a retrospective single-center observational study aimed at defining clinical predictors of 30-day mortality in hospitalized lung cancer patients. Methods: Clinical records from the first admission of lung cancer patients to the Oncology ward of University Hospital of Parma from January 1 st, 2017 to January 1 st, 2022 were collected. Results: 251 consecutive patients were enrolled at the time of data cut-off. Median age was 66 years (Range, 29-85). 161 (64%) patients were men and 210 (84%) cur- rent/former smokers. ECOG-PS was 0/1 in 175 (69%) cases. The most frequent histology was adenocarcinoma (n=120, 48%), followed by small-cell lung cancer (n=73, 29%). The majority of patients had stage IV disease (n=209, 83%) and half of them presented bone metastasis. Main reasons for hospital admission were anticancer treat- ment start (n=146, 58%) and cancer-related complications (n=75, 30%). The most frequently reported symptoms at admission were pain (n=131, 52%) and dyspnea (n=92, 37%). Median Blaylock Risk Assessment Screening Score (BRASS) was 7 (Range, 1-28), with 153 (61%) patients having at least one previous hospital admission within the last 3 months. Clinical deterioration (n=102, 41%) and infections (n=71, 28%) were the main complications dur- ing the hospital stay. Baseline clinical predictors of 30-day mortality were high BRASS score (&gt;20 vs ⩽ 20: 34.3% vs 11.9%, p&lt;0.001), previous hospital admission (Yes vs No: 22.2% vs 11.2%, p=0.038), number of metastatic sites (⩾ 3 vs &lt; 3: 26.5% vs 13.4%, p=0.017), bone metastasis (Yes vs No: 29.0% vs 10.8%, p=0.001) and presence of pain (Yes vs No: 24.4% vs 11.7%, p=0.009). Among com- plications, clinical deterioration (Yes vs No: 37.3% vs 5.4%, p&lt;0.001) and blood transfusion (Yes vs No: 32.6% vs 15.1%, p=0.010) relevantly increased 30-day mortality. At multivariate analysis, high BRASS score (OR 2.89, 95% CI 1.17-7.12, p=0.021), bone metastasis (OR 2.99, 95% CI 1.07-8.37, p=0.037) and clinical deterioration (OR 9.58, 95% CI 4.18-21.96, p&lt;0.001) were significantly associated with increased risk of 30-day mortality. Conclusions: Our results suggest that basal high BRASS score, bone metastasis and clinical deterioration during hospital stay could be used as clinical predictors of 30-day mortality in hospitalized lung cancer patients

Tecnologie dell’informazione e della comunicazione e insegnamento dell’italiano

Le tecnologie dell’informazione e della comunicazione possono rappresentare un’opportunità per la didattica della lingua italiana sotto molteplici punti di vista, a condizione che si sia consapevoli delle loro potenzialità e dei loro limiti. Gli stimoli offerti possono impattare sulla motivazione o sullo sviluppo di specifiche abilità, offrendo nuovi impulsi ad attività tradizionali oppure aprendo inattesi orizzonti di lavoro sulla lingua. I contributi presentati in questo volume danno conto di varie sperimentazioni didattiche legate all’applicazione di un’ampia gamma di strumenti tecnologici in grado di impattare sulle pratiche didattiche di insegnamento dell’italiano. Oggetto di interesse è l’utilizzo degli smartphone per migliorare l’insegnamento della grammatica, la scrittura collaborativa sincrona e asincrona in modalità wiki, il digital storytelling, la scrittura di sintesi a partire da testi letterari con Twitter, la creazione di podcast per lo sviluppo delle abilità orali, il ricorso ad applicazioni per la creazione di fumetti sulla riflessione linguistica o a piattaforme di gamification per la didattica del lessico. Le ricerche illustrate sono collegate alle attività dell’unità di ricerca dell’Università di Bologna del progetto europeo Erasmus+ E-LENGUA (E-Learning Novelties towards the Goal of a Universal Acquisition of Foreign and Second Languages)