Faricimab for the Treatment of Diabetic Macular Edema and Neovascular Age-Related Macular Degeneration.

Nowadays; intravitreal anti-vascular endothelial growth factor (VEGF) drugs are considered the first-line therapeutic strategy for treating macular exudative diseases; including wet age-related macular degeneration (w-AMD) and diabetic macular edema (DME). Despite the important clinical achievements obtained by anti-VEGF drugs in the management of w-AMD and DME; some limits still remain; including high treatment burden; the presence of unsatisfactory results in a certain percentage of patients and long-term visual acuity decline due to complications such as macular atrophy and fibrosis. Targeting the angiopoietin/Tie (Ang/Tie) pathway beyond the VEGF pathway may be a possible therapeutic strategy; which may has the potential to solve some of the previous mentioned challenges. Faricimab is a new; bispecific antibody targeting both VEGF-A and the Ang-Tie/pathway. It was approved by FDA and; more recently; by EMA for treating w-AMD and DME. Results from phase III trials TENAYA and LUCERNE (w-AMD) and RHINE and YOSEMITE (DME) have shown the potential of faricimab to maintain clinical efficacy with more prolonged treatment regimens compared to aflibercept (12 or 16 weeks) with a a good safety profile

An unusual complication after endovascular aneurysm repair for giant abdominal aortic aneurysm with aortocaval fistula: High bilirubin levels

Abdominal aortic aneurysm has among its rare complications the aortocaval fistula. It is observed in less than 1% of all abdominal aortic aneurysms and represents 3%–7% of clinical presentation in case of rupture. A male patient was presented to the emergency department with pulsating mass with continuous vascular systo-diastolic bruit, located in the lower part of abdomen with the back pain radiating anteriorly in lower abdomen. After diagnosis of abdominal aortic aneurysm with aortocaval fistula, a trimodular Endurant endograft was placed. Migration of the endoprosthesis was treated with Endoanchor and endovascular aneurysm sealing device. In the postoperative course, the patient had jaundice due to high bilirubin levels, cholestasis and increased hepatocyte cytolysis: aspartate aminotransferase and alanine aminotransferase. The treatment with appropriate continuous filtration rapidly reduced bilirubin values and the patient gradually improved

Sympathetic skin response in multiple sclerosis : a meta-analysis of case-control studies

The study was supported by a grant of the Italian Ministry of Health, Ricerca Corrente funding program 2014–2015 [RC2014].The usefulness of sympathetic skin responses (SSR) in multiple sclerosis (MS) has been advocated by several studies in the last 20 years; however, due to a great heterogeneity of findings, a comprehensive meta-analysis of case-control studies is in order to pinpoint consistencies and investigate the causes of discrepancies. We searched MEDLINE, EMBASE and Cochrane databases for case-control studies comparing SSR absence frequency and latency between patients with MS and healthy controls. Thirteen eligible studies including 415 MS patients and 331 healthy controls were identified. The pooled analysis showed that SSR can be always obtained in healthy controls while 34% of patients had absent SSRs in at least one limb (95% CI 22-47%; p < 0.0001) but with considerable heterogeneity across studies (I2 = 90.3%). Patients' age explained 22% of the overall variability and positive correlations were found with Expanded Disability Status Scale and disease duration. The pooled mean difference of SSR latency showed a significant increase in patients on both upper (193 ms; 95% CI 120-270 ms) and lower (350 ms; 95% CI 190-510 ms) extremities. We tested the discriminatory value of SSR latency thresholds defined as the 95% confidence interval (CI) upper bound of the healthy controls, and validated the results on a new dataset. The lower limb threshold of 1.964 s produces the best results in terms of sensitivity 0.86, specificity 0.67, positive predicted value 0.75 and negative predicted value 0.80. Despite a considerable heterogeneity of findings, there is evidence that SSR is a useful tool in MS.Publisher PDFPeer reviewe

A self-sterilizing fluorescent Nanocomposite as versatile material with broad-spectrum Antibiofilm features

Hematogenous spread of infections from colonized central intravenous catheters or central lines is a long-recognized problem with infection rates of 2 and 6.8 per 1000 days, respectively. Besides, removal of severe microbial colonization of implanted biomaterials is still a challenge and usually requires invasive operations. Hence, on demand self-sterilizing materials are required to avoid explant of colonized biomaterials and improve patient compliance. Moreover, photoluminescence is needed to make trackable biomaterials, which can be easily monitored upon implanting them in the body. Here, we propose the incorporation of near infrared (NIR) sensitive red-emitting carbon nanodot (CDs) into a polymeric matrix to give rise to innovative biomaterials with self-tracking and photothermal antimicrobial abilities. We obtain a material which can be processed to obtain medical devices using different techniques, among which, for instance, electrospinning. Herein, a proof-of-concept preparation of electrospun scaffolds is reported as it is highly desired in biomedical applications. Beside to confer imaging properties to the scaffold, that would allow an easy control over the in vivo positioning of implanted biomaterials as well as its degradation state and grade of integration with the surrounding native tissues, thanks to the capability to convert NIR light into local heat CDs can be exploited to exert broad-spectrum antimicrobial effect toward several pathogens. The rise in temperature can be easily modulated by controlling the irradiation time to achieve both an in vitro self-sterilization of the device and eventually in vivo destabilization of the microbial colonization. This innovative biomaterial could successfully inhibits biofilm formation and might be used as a powerful tool to treat antibiotic-resistant nature of biofilm-related infections in implanted medical devices

Baseline reef health surveys at Bangka Island (North Sulawesi, Indonesia) reveal new threats

Worldwide coral reef decline appears to be accompanied by an increase in the spread of hard coral diseases. However, whether this is the result of increased direct and indirect human disturbances and/or an increase in natural stresses remains poorly understood. The provision of baseline surveys for monitoring coral health status lays the foundations to assess the effects of any such anthropogenic and/or natural effects on reefs. Therefore, the objectives of this present study were to provide a coral health baseline in a poorly studied area, and to investigate possible correlations between coral health and the level of anthropogenic and natural disturbances. During the survey period, we recorded 20 different types of coral diseases and other compromised health statuses. The most abundant were cases of coral bleaching, followed by skeletal deformations caused by pyrgomatid barnacles, damage caused by fish bites, general pigmentation response and galls caused by cryptochirid crabs. Instances of colonies affected by skeletal eroding bands, and sedimentation damage increased in correlation to the level of bio-chemical disturbance and/or proximity to villages. Moreover, galls caused by cryptochirid crabs appeared more abundant at sites affected by blast fishing and close to a newly opened metal mine. Interestingly, in the investigated area the percentage of corals showing signs of ‘common’ diseases such as black band disease, brown band disease, white syndrome and skeletal eroding band disease were relatively low. Nevertheless, the relatively high occurrence of less common signs of compromised coral-related reef health, including the aggressive overgrowth by sponges, deserves further investigation. Although diseases appear relatively low at the current time, this area may be at the tipping point and an increase in activities such as mining may irredeemably compromise reef health.This research was partially funded by Coral Eye, which hosted FF and covered all field expenses. The non-profit organization Reef Check Italia Onlus sustained the cost for open source publication. The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript

Respiratory frequency is strongly associated with perceived exertion during time trials of different duration

In order to provide further insight into the link between respiratory frequency (fR) and the rating of perceived exertion (RPE), the present study investigated the effect of exercise duration on perceptual and physiological responses during self-paced exercise. Nine well-trained competitive male cyclists (23 ± 3 years) performed a preliminary incremental ramp test and three randomised self-paced time trials (TTs) differing in exercise duration (10, 20 and 30 min). Both RPE and fR increased almost linearly over time, with a less-pronounced rate of increase when absolute exercise duration increased. However, when values were expressed against relative exercise duration, no between-trial differences were found in either RPE or fR. Conversely, between-trial differences were observed for minute ventilation (.VE), .VO2 and heart rate (HR), when values were expressed against relative exercise duration. Unlike the relationship between RPE and both .VE and HR, the relationship between RPE and fR was not affected by exercise duration. In conclusion, fR, but not .VE, HR or [.VO2, shows a strong relationship to RPE and a similar time course, irrespective of exercise duration. These findings indicate that fR is the best correlate of RPE during self-paced exercise, at least among the parameters and for the range of durations herein investigated

Exploring the predictive value of the evoked potentials score in MS within an appropriate patient population : a hint for an early identification of benign MS?

This study was supported by the Italian Ministry of Health, Ricerca Corrente funding plan to the institutional research activity of the Scientific Institute S. Maria Nascente of the Don C. Gnocchi Foundation.Background: The prognostic value of evoked potentials (EPs) in multiple sclerosis (MS) has not been fully established. The correlations between the Expanded Disability Status Scale (EDSS) at First Neurological Evaluation (FNE) and the duration of the disease, as well as between EDSS and EPs, have influenced the outcome of most previous studies. To overcome this confounding relations, we propose to test the prognostic value of EPs within an appropriate patient population which should be based on patients with low EDSS at FNE and short disease duration. Methods: We retrospectively selected a sample of 143 early relapsing remitting MS (RRMS) patients with an EDSS < 3.5 from a larger database spanning 20 years. By means of bivariate logistic regressions, the best predictors of worsening were selected among several demographic and clinical variables. The best multivariate logistic model was statistically validated and prospectively applied to 50 patients examined during 2009-2011. Results: The Evoked Potentials score (EP score) and the Time to EDSS 2.0 (TT2) were the best predictors of worsening in our sample (Odds Ratio 1.10 and 0.82 respectively, p=0.001). Low EP score (below 15-20 points), short TT2 (lower than 3-5 years) and their interaction resulted to be the most useful for the identification of worsening patterns. Moreover, in patients with an EP score at FNE below 6 points and a TT2 greater than 3 years the probability of worsening was 10% after 4-5 years and rapidly decreased thereafter. Conclusions: In an appropriate population of early RRMS patients, the EP score at FNE is a good predictor of disability at low values as well as in combination with a rapid buildup of disability. Interestingly, an EP score at FNE under the median together with a clinical stability lasting more than 3 years turned out to be a protective pattern. This finding may contribute to an early identification of benign patients, well before the term required to diagnose Benign MS (BMS).Publisher PDFPeer reviewe

The use of red lentil flour in bakery products: How do particle size and substitution level affect rheological properties of wheat bread dough?

Inclusion of pulses flour in bread formulation has important nutritional effects but its successful implementation is challenging and requires a good understanding of the effect of flour functionality, granulometry and substitution level on bread quality. Accordingly, this work studied red lentil flour and its dimensional fractions (coarse, medium, fine, extra-fine), considering compositional, morphological, functional, and thermal properties. Additionally, the effect of substituting wheat flour with lentil flour and its fractions at different levels (0, 10, 15, 20, 25 and 30% [w/w] flour basis) on dough rheology was studied using a Mixolab device, to predict bread quality. Although flour's properties were significantly affected by particle size, multivariate statistics suggested that the substitution level was the major factor affecting rheological properties of doughs made with blends of wheat and lentil flours. A 10% substitution level of wheat flour by lentil flour provides optimum rheological properties regardless of lentil flour particle size, while at higher substitution level (15–30%), a coarse fraction can provide higher performance compared to unfractionated flour and finer fractions. The results of this study pose an important base to intelligently develop wheat-lentil bread applications in the future.info:eu-repo/semantics/acceptedVersio

Influence of Surgical Technique on Post-Operative Complications in the Extraction of the Lower Third Molar: A Retrospective Study

The surgical extraction of the impacted third molar is frequently associated with several complications. The purpose of this study is to assess how two different surgical protocols affect post-operative complications during the extraction of the lower impacted third molars. In order to compare and evaluate two different techniques (triangular flap vs. envelope flap), and the relative post-extraction complications, two groups of 150 patients each underwent to surgical impacted third molar extraction and 60 days of follow-up. The complication rate in the two groups was 14.00% in group A and 17.33% in group B. There was a strong association between smoking (OR: 2.8) and the use of oral contraceptives (OR: 1.75) with complications. The age- and sex-related incidence of complications in hard tissue healing has great variability in the literature; the analysis performed on our data did not show a statistically significant association between them. Even though related to a higher incidence of transient changes in sensitivity, it was found that the envelope flap saw a lower percentage of complications. There is still no clarity on which is the best protocol for the extraction of the lower impacted third molar, and the choice often depends on the surgeon’s experience