Managing the Dual Nature of Iron to Preserve Health

Because of its peculiar redox properties, iron is an essential element in living organisms, being involved in crucial biochemical processes such as oxygen transport, energy production, DNA metabolism, and many others. However, its propensity to accept or donate electrons makes it potentially highly toxic when present in excess and inadequately buffered, as it can generate reactive oxygen species. For this reason, several mechanisms evolved to prevent both iron overload and iron deficiency. At the cellular level, iron regulatory proteins, sensors of intracellular iron levels, and post-transcriptional modifications regulate the expression and translation of genes encoding proteins that modulate the uptake, storage, utilization, and export of iron. At the systemic level, the liver controls body iron levels by producing hepcidin, a peptide hormone that reduces the amount of iron entering the bloodstream by blocking the function of ferroportin, the sole iron exporter in mammals. The regulation of hepcidin occurs through the integration of multiple signals, primarily iron, inflammation and infection, and erythropoiesis. These signals modulate hepcidin levels by accessory proteins such as the hemochromatosis proteins hemojuvelin, HFE, and transferrin receptor 2, the serine protease TMPRSS6, the proinflammatory cytokine IL6, and the erythroid regulator Erythroferrone. The deregulation of the hepcidin/ferroportin axis is the central pathogenic mechanism of diseases characterized by iron overload, such as hemochromatosis and iron-loading anemias, or by iron deficiency, such as IRIDA and anemia of inflammation. Understanding the basic mechanisms involved in the regulation of hepcidin will help in identifying new therapeutic targets to treat these disorders

Effect of COVID-19-related lockdown on ophthalmic practice in Italy: A report from 39 institutional centers

BACKGROUND/OBJECTIVES: To compare the number of eye surgical procedures performed in Italy in the 2months following the beginning of lockdown (study period) because of COVID-19 epidemic with those performed in the two earlier months of the same year (intra-year control) and in the period of 2019 corresponding to the lockdown (inter-year control).METHODS: Retrospective analysis of surgical procedures carried out at 39 Academic hospitals. A distinction was made between elective and urgent procedures. Intravitreal injections were also considered. Percentages for all surgical procedures and incidence rate ratios (IRR) for rhegmatogenous retinal detachment (RRD) events were calculated. A p value <0.05 was considered significant.RESULTS: A total of 20,886 versus 55,259 and 56,640 patients underwent surgery during the lockdown versus intra-and inter-year control periods, respectively. During the lockdown, only 70% of patients for whom an operation/intravitreal injection was recommended, finally underwent surgery; the remaining patients did not attend because afraid of getting infected at the hospital (23%), taking public transportation (6.5%), or unavailable swabs (0.5%). Elective surgeries were reduced by 96.2% and 96.4%, urgent surgeries by 49.7% and 50.2%, and intravitreal injections by 48.5% and 48.6% in the lockdown period in comparison to intra-year and inter-year control periods, respectively. IRRs for RRDs during lockdown dropped significantly in comparison with intra- and inter-year control periods (CI: 0.65-0.80 and 0.61-0.75, respectively, p<0.001 for both).CONCLUSION: This study provides a quantitative analysis of the reduction of eye surgical procedures performed in Italy because of the COVID-19 epidemic

Effect of COVID-19-related lockdown on ophthalmic practice in Italy: A report from 39 institutional centers

116noBackground/objectives: To compare the number of eye surgical procedures performed in Italy in the 2 months following the beginning of lockdown (study period) because of COVID-19 epidemic with those performed in the two earlier months of the same year (intra-year control) and in the period of 2019 corresponding to the lockdown (inter-year control). Methods: Retrospective analysis of surgical procedures carried out at 39 Academic hospitals. A distinction was made between elective and urgent procedures. Intravitreal injections were also considered. Percentages for all surgical procedures and incidence rate ratios (IRR) for rhegmatogenous retinal detachment (RRD) events were calculated. A p value <0.05 was considered significant. Results: A total of 20,886 versus 55,259 and 56,640 patients underwent surgery during the lockdown versus intra-and inter-year control periods, respectively. During the lockdown, only 70% of patients for whom an operation/intravitreal injection was recommended, finally underwent surgery; the remaining patients did not attend because afraid of getting infected at the hospital (23%), taking public transportation (6.5%), or unavailable swabs (0.5%). Elective surgeries were reduced by 96.2% and 96.4%, urgent surgeries by 49.7% and 50.2%, and intravitreal injections by 48.5% and 48.6% in the lockdown period in comparison to intra-year and inter-year control periods, respectively. IRRs for RRDs during lockdown dropped significantly in comparison with intra- and inter-year control periods (CI: 0.65–0.80 and 0.61–0.75, respectively, p < 0.001 for both). Conclusion: This study provides a quantitative analysis of the reduction of eye surgical procedures performed in Italy because of the COVID-19 epidemic.nonenonedell'Omo R.; Filippelli M.; Virgili G.; Bandello F.; Querques G.; Lanzetta P.; Avitabile T.; Viola F.; Reibaldi M.; Semeraro F.; Quaranta L.; Rizzo S.; Midena E.; Campagna G.; Costagliola C.; Marolo P.; Traverso C.E.; Iester M.; Cutolo C.A.; Azzolini C.; Donati S.; Premi E.; Nucci P.; Vujosevic S.; Staurenghi G.; Bottoni F.; Romano F.; Grosso D.; Borrelli E.; Sacconi R.; Milella P.; Ganci S.; Romano M.R.; Ricciardelli G.; Allegrini D.; Casaluci M.; Romano D.; Marchini G.; Chemello F.; Amantea C.; Frisina R.; Pilotto E.; Parrozzani R.; Veritti D.; Sarao V.; Daniele T.; Busin M.; Parmeggiani F.; De Nadai K.; Furiosi L.; Mastropasqua R.; Battaglia B.; Gironi M.; Gandolfi S.; Luciani E.; Mora P.; Schiavi C.; Bertaccini P.; Finzi A.; Roda M.; Cagini C.; Lupidi M.; Giansanti F.; Bacherini D.; Tosi G.; De Benedetto E.; Nardi M.; Figus M.; Posarelli C.; Mariotti C.; Pirani V.; Nicolai M.; Bonini S.; Coassin M.; Di Zazzo A.; Savastano M.; Savastano A.; Gambini G.; Vico U.D.; Spadea L.; Iannaccone A.; Nucci C.; Ricci F.; Aiello F.; Afflitto G.G.; Mastropasqua L.; D'Onofio G.; Evangelista F.; Brescia L.; Napolitano P.; Polisena P.; Gianfrancesco N.; Trivisonno D.; Petti F.; Simonelli F.; Rossi S.; Tartaglione A.; Rosa N.; Bernardo M.D.; Iaculli C.; Valeria Bux A.; Maggiore G.; Boscia F.; Sborgia G.; Grassi M.O.; Scorcia V.; Giannaccare G.; Parisi G.; Cillino S.; Alaimo F.; Aragona P.; Meduri A.; Pinna A.; Sollazzo A.; Peiretti E.; Siotto E.Dell'Omo, R.; Filippelli, M.; Virgili, G.; Bandello, F.; Querques, G.; Lanzetta, P.; Avitabile, T.; Viola, F.; Reibaldi, M.; Semeraro, F.; Quaranta, L.; Rizzo, S.; Midena, E.; Campagna, G.; Costagliola, C.; Marolo, P.; Traverso, C. E.; Iester, M.; Cutolo, C. A.; Azzolini, C.; Donati, S.; Premi, E.; Nucci, P.; Vujosevic, S.; Staurenghi, G.; Bottoni, F.; Romano, F.; Grosso, D.; Borrelli, E.; Sacconi, R.; Milella, P.; Ganci, S.; Romano, M. R.; Ricciardelli, G.; Allegrini, D.; Casaluci, M.; Romano, D.; Marchini, G.; Chemello, F.; Amantea, C.; Frisina, R.; Pilotto, E.; Parrozzani, R.; Veritti, D.; Sarao, V.; Daniele, T.; Busin, M.; Parmeggiani, F.; De Nadai, K.; Furiosi, L.; Mastropasqua, R.; Battaglia, B.; Gironi, M.; Gandolfi, S.; Luciani, E.; Mora, P.; Schiavi, C.; Bertaccini, P.; Finzi, A.; Roda, M.; Cagini, C.; Lupidi, M.; Giansanti, F.; Bacherini, D.; Tosi, G.; De Benedetto, E.; Nardi, M.; Figus, M.; Posarelli, C.; Mariotti, C.; Pirani, V.; Nicolai, M.; Bonini, S.; Coassin, M.; Di Zazzo, A.; Savastano, M.; Savastano, A.; Gambini, G.; Vico, U. D.; Spadea, L.; Iannaccone, A.; Nucci, C.; Ricci, F.; Aiello, F.; Afflitto, G. G.; Mastropasqua, L.; D'Onofio, G.; Evangelista, F.; Brescia, L.; Napolitano, P.; Polisena, P.; Gianfrancesco, N.; Trivisonno, D.; Petti, F.; Simonelli, F.; Rossi, S.; Tartaglione, A.; Rosa, N.; Bernardo, M. D.; Iaculli, C.; Valeria Bux, A.; Maggiore, G.; Boscia, F.; Sborgia, G.; Grassi, M. O.; Scorcia, V.; Giannaccare, G.; Parisi, G.; Cillino, S.; Alaimo, F.; Aragona, P.; Meduri, A.; Pinna, A.; Sollazzo, A.; Peiretti, E.; Siotto, E

Effect of COVID-19-related lockdown on ophthalmic practice in Italy: A report from 39 institutional centers

BACKGROUND/OBJECTIVES: To compare the number of eye surgical procedures performed in Italy in the 2months following the beginning of lockdown (study period) because of COVID-19 epidemic with those performed in the two earlier months of the same year (intra-year control) and in the period of 2019 corresponding to the lockdown (inter-year control).METHODS: Retrospective analysis of surgical procedures carried out at 39 Academic hospitals. A distinction was made between elective and urgent procedures. Intravitreal injections were also considered. Percentages for all surgical procedures and incidence rate ratios (IRR) for rhegmatogenous retinal detachment (RRD) events were calculated. A p value &lt;0.05 was considered significant.RESULTS: A total of 20,886 versus 55,259 and 56,640 patients underwent surgery during the lockdown versus intra-and inter-year control periods, respectively. During the lockdown, only 70% of patients for whom an operation/intravitreal injection was recommended, finally underwent surgery; the remaining patients did not attend because afraid of getting infected at the hospital (23%), taking public transportation (6.5%), or unavailable swabs (0.5%). Elective surgeries were reduced by 96.2% and 96.4%, urgent surgeries by 49.7% and 50.2%, and intravitreal injections by 48.5% and 48.6% in the lockdown period in comparison to intra-year and inter-year control periods, respectively. IRRs for RRDs during lockdown dropped significantly in comparison with intra- and inter-year control periods (CI: 0.65-0.80 and 0.61-0.75, respectively, p&lt;0.001 for both).CONCLUSION: This study provides a quantitative analysis of the reduction of eye surgical procedures performed in Italy because of the COVID-19 epidemic