Influence of the COVID-19 Pandemic on Admissions for Retinal Detachment in a Tertiary Eye Emergency Department

Purpose: To compare the incidence and clinical characteristics of retinal detachments (RDs) diagnosed in a tertiary eye emergency department (EED) during the COVID-19 pandemic and in the corresponding period of the previous 4 years. Methods: EED consultations performed from February 21, 2020 (first national case of COVID-19 infection) to May 3, 2020 (end of lockdown imposed by national Government) and for the same date range of 2016-2019 (pre-COVID-19 period), and with a confirmed diagnosis of RD were collected and reviewed. The following demographical and clinical features have been analyzed: age, gender, etiology of RD, macular involvement, best corrected visual acuity (BCVA), and duration of experienced symptoms. Results: Eighty-two subjects (20.5\ub11.0 eyes/year) were diagnosed with RD in the pre-COVID-19 period, compared to 12 patients in the COVID-19 period (-41.5%). During the pandemic, patients complained symptoms for a median of 8.5 days (IQR, 1.7-15 days) before the EED consultation, while in the pre-COVID-19 period, they declared they had been symptomatic for 2 days (IQR, 1-4 days) (p=0.037); macula-off RD raised from 56% to 75% and no one reported trauma as a triggering event. Conclusion: During the COVID-19 pandemic, the rate of RD diagnosed in our EED decreased significantly and patients waited longer before asking for an ophthalmologic examination. These findings are probably due to the fear of contracting the COVID-19 infection attending hospital environments. Even if emergency departments are often misused by people suffering non-urgent conditions, patients complaining of sudden visual loss, visual field defects, or phosphenes should always and promptly attend an EED visit to prevent a worse prognosis

Cytidine 5'-Diphosphocholine (Citicoline): Evidence for a Neuroprotective Role in Glaucoma

Glaucoma, a heterogeneous set of progressively degenerative optic neuropathies characterized by a loss of retinal ganglion cells (RGCs) and typical visual field deficits that can progress to blindness, is a neurodegenerative disease involving both ocular and visual brain structures. Although elevated intraocular pressure (IOP) remains the most important modifiable risk factor of primary open-angle glaucoma (POAG) and is the main therapeutic target in treating glaucoma, other factors that influence the disease course are involved and reaching the optimal IOP target does not stop the progression of glaucoma, as the visual field continues to narrow. In addition to a managed IOP, neuroprotection may be beneficial by slowing the progression of glaucoma and improving the visual defects. Citicoline (cytidine 5'-diphosphocholine) is a naturally occurring endogenous compound that has been investigated as a novel therapeutic agent for the management of glaucoma. Citicoline has demonstrated activity in a range of central neurodegenerative diseases, and experimental evidence suggests a it performs a neuromodulator and neuroprotective role on neuronal cells, including RGCs, associated with improvement in visual function, extension of the visual field and central benefits for the patient. This review aims to critically summarize the current evidence for the neuroprotective properties of citicoline in glaucoma

Challenges in diagnosis and management of acute hepatic porphyrias: from an uncommon pediatric onset to innovative treatments and perspectives

Acute hepatic porphyrias (AHPs) are a family of four rare genetic diseases resulting from a deficiency in one of the enzymes involved in heme biosynthesis. AHP patients can experience potentially life-threatening acute attacks, characterized by severe abdominal pain, along with other signs and symptoms including nausea, mental confusion, hyponatraemia, hypertension, tachycardia and muscle weakness. Some patients also experience chronic manifestations and long-term complications, such as chronic pain syndrome, neuropathy and porphyria-associated kidney disease. Most symptomatic patients have only a few attacks in their lifetime; nevertheless, some experience frequent attacks that result in ongoing symptoms and a significant negative impact on their quality of life (QoL). Initial diagnosis of AHP can be made with a test for urinary porphobilinogen, -aminolaevulinic acid and porphyrins using a single random (spot) sample. However, diagnosis is frequently missed or delayed, often for years, because the clinical symptoms of AHP are non-specific and mimic other more common disorders. Delayed diagnosis is of concern as some commonly used medications can trigger or exacerbate acute attacks, and untreated attacks can become severe, potentially leading to permanent neurological damage or fatality. Other attack triggers include hormonal fluctuations in women, stress, alcohol and low-calorie diets, which should be avoided in patients where possible. For the management of attacks, intravenous hemin is approved, whereas new therapeutic approaches are currently being investigated as a baseline therapy for prevention of attacks and improvement of QoL. Among these, a novel siRNA-based agent, givosiran, has shown very promising results in a recently concluded Phase III trial and has been approved for the management of AHPs. Here, we propose a challenging case study-with a very unusual pediatric onset of variegate porphyria-as a starting point to summarize the main clinical aspects (namely, clinical manifestations, diagnostic challenges, and therapeutic management) of AHPs, with a focus on the latest therapeutic innovations

Charge Transport Properties in CZT Detectors Grown by the Vertical Bridgman Technique

Great efforts are being presently devoted to the development of CdTe and CdZnTe detectors for a large variety of applications, such as medical, industrial, and space research. We present the spectroscopic properties of some CZT crystals grown by the standard vertical Bridgman method and by the boron oxide encapsulated vertical Bridgman method, which has been recently implemented at IMEM-CNR. By this technique the crystal is grown in an open quartz crucible fully encapsulated by a thin layer of liquid boron oxide. This technique prevent the crystal-crucible contact allowing larger single grains with lower dislocation density to be obtained. Several mono-electrode detectors were realized with two planar gold contacts. The samples are characterized by an active area of ≈4x4 mm2 or ≈7x7 mm2 and with thickness ranging from 1 to 2 mm. The charge transport properties of the detectors have been studied by mobility-lifetime (μτ) product measurements, carried out at the European Synchrotron Radiation Facility (Grenoble) in PTF configuration, where the impinging beam direction is orthogonal to the collecting electric field. We have performed several fine scans between the electrodes with a beam spot of 10x10 μm2 at different energies from 60 keV to 400 keV. In this work we present the test results in terms of μτ product of both charge carriers and an evaluation of the spectroscopic response uniformity across the sensitive volume of tested samples

Endothelial Dysfunction in Acute Hepatic Porphyrias

Background Acute hepatic porphyrias (AHPs) are a group of rare diseases caused by dysfunctions in the pathway of heme biosynthesis. Although acute neurovisceral attacks are the most dramatic manifestations, patients are at risk of developing long-term complications, several of which are of a vascular nature. The accumulation of non-porphyrin heme precursors is deemed to cause most clinical symptoms. AimWe measured the serum levels of endothelin-1 (ET-1) and nitric oxide (NO) to assess the presence of endothelial dysfunction (ED) in patients with AHPs. Forty-six patients were classified, according to their clinical phenotype, as symptomatic (AP-SP), asymptomatic with biochemical alterations (AP-BA), and asymptomatic without biochemical alterations (AP-AC). Results Even excluding those under hemin treatment, AP-SP patients had the lowest NO and highest ET-1 levels, whereas no significant differences were found between AP-BA and AP-AC patients. AP-SP patients had significantly more often abnormal levels of ED markers. Patients with the highest heme precursor urinary levels had the greatest alterations in ED markers, although no significant correlation was detected. Conclusions ED is more closely related to the clinical phenotype of AHPs than to their classical biochemical alterations. Some still undefined disease modifiers may possibly determine the clinical picture of AHPs through an effect on endothelial functions

The enlargement of the Suez Canal and introduction of non-indigenous species to the Mediterranean Sea

The Suez Canal is one of the most important waterways in the world – during the last year 17,148 ships passed through the Canal – reducing emissions, saving time, and operating costs to shippers. The rapid increase in ship size from the “Post-Suezmax” (> 12,000 TEU) to the latest container vessels (> 19,000 TEU) now requires enlargements of port facilities and canals. A project of this magnitude, and with potentially negative environmental outcomes, requires a transparent and scientifically sound “Environmental Impact Assessment” (EIA). An explicit obligation on Parties to the Convention on Biological Diversity (https://www.cbd.int/doc/ legal/cbd-en.pdf) was made to consider transboundary impacts on biodiversity, particularly those associated with invasive non-indigenous species

Environmental awareness gained during a citizen science project in touristic resorts is maintained after 3 years since participation

The research leading to these results has received funding from Project AWARE Foundation, ASTOI Association, Milano, Ministry of Tourism of the Arab Republic of Egypt, Settemari S. p. A Tour Operator, Scuba Nitrox Safety International, Viaggio nel Blu Diving Center.Tourism is one of the largest economic sectors in the world. It has a positive effect on the economy of many countries, but it can also lead to negative impacts on local ecosystems. Informal environmental education through Citizen Science (CS) projects can be effective in increasing citizen environmental knowledge and awareness in the short-term. A change of awareness could bring to a behavioral change in the long-term, making tourism more sustainable. However, the long-term effects of participating in CS projects are still unknown. This is the first follow-up study concerning the effects of participating in a CS project on cognitive and psychological aspects at the basis of pro-environmental behavior. An environmental education program was developed, between 2012 and 2013, in a resort in Marsa Alam, Egypt. The study directly evaluated, through paper questionnaires, the short-term (after 1 week or 10 days) retention of knowledge and awareness of volunteers that had participated in the activities proposed by the program. After three years, participants were re-contacted via email to fill in the same questionnaire as in the short-term study, plus a new section with psychological variables. 40.5% of the re-contacted participants completed the follow-up questionnaires with a final sample size of fifty-five people for this study. Notwithstanding the limited sample size, positive trends in volunteer awareness, personal satisfaction regarding the CS project, and motivation to engage in pro-environmental behavior in the long-term were observed.Publisher PDFPeer reviewe

SIRT6 promotes metastasis and relapse in HER2-positive breast cancer

The histone deacetylase sirtuin 6 (SIRT6) has been endowed with anti-cancer capabilities in many tumor types. Here, we investigate the impact of SIRT6-overexpression (SIRT6-OE) in Delta16HER2 mice, which are a bona fide model of HER2-positive breast cancer. After an initial delay in the tumor onset, SIRT6-OE induces a more aggressive phenotype of Delta16HER2 tumors promoting the formation of higher number of tumor foci and metastases than controls. This phenotype of SIRT6-OE tumors is associated with cancer stem cell (CSC)-like features and tumor dormancy, and low senescence and oxidative DNA damage. Accordingly, a sub-set of HER2-positive breast cancer patients with concurrent SIRT6-OE has a significant poorer relapse-free survival (RFS) probability than patients with low expression of SIRT6. ChIP-seq, RNA-seq and RT-PCR experiments indicate that SIRT6-OE represses the expression of the T-box transcription factor 3 (Tbx3) by deacetylation of H3K9ac. Accordingly, loss-of-function mutations of TBX3 or low TBX3 expression levels are predictive of poor prognosis in HER2-positive breast cancer patients. Our work indicates that high levels of SIRT6 are indicative of poor prognosis and high risk of metastasis in HER2-positive breast cancer and suggests further investigation of TBX3 as a downstream target of SIRT6 and co-marker of poor-prognosis. Our results point to a breast cancer subtype-specific effect of SIRT6 and warrant future studies dissecting the mechanisms of SIRT6 regulation in different breast cancer subtypes

Sistema Integrato Multicentrico di Indicatori. Rapporto 2005. Provincia di La Spezia.

The SIMI (Integrated System of Indicators multicenter) Project contributes to the development of an integrated management of informative data streams related to drug addicted persons. This report analyzes the phenomenon of addiction on the territory of the La Spezia Province through a description of the network services that provide care and rehabilitation of those addicted. Besides the characteristics of users of local services for addictions, has been developed the analysis of the subjects reported to the prefectures for use of illegal drugs and any action taken. Standard methods of estimation were also applied to quantify the proportion of users of substances that do not relate to services and to identify certain characteristicsIl Progetto SIMI (Sistema Integrato Multicentrico di Indicatori) intende contribuire allo sviluppo di una gestione integrata e sinergica dei flussi informativi relativi ai consumatori di sostanze stupefacenti afferenti alle diverse amministrazioni dello Stato. In linea con quanto proposto dall\u27Osservatorio europeo di Lisbona, per la descrizione e analisi del fenomeno connesso all\u27uso/abuso di sostanze, risulta di fondamentale importanza la possibilit? di ottenere informazioni esaustive e comparabili sulle persone che usano e/o abusano di sostanze psicotrope. Il presente rapporto analizza il fenomeno delle dipendenze sul territorio della provincia di La Spezia attraverso la descrizione della rete dei servizi preposti alla cura e riabilitazione dei soggetti tossicodipendenti. Accanto alle caratteristiche degli utenti dei servizi territoriali per le dipendenze, ? stata sviluppata l\u27analisi dei soggetti segnalati alle Prefetture per uso di sostanze illegali e degli eventuali provvedimenti adottati. Sono state inoltre applicate metodologie standard di stima per quantificare la quota parte di utilizzatori di sostanze che non afferiscono ai servizi e per identificarne alcune caratteristiche