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Serra R, Mathis T, Loria O, Denis P, Boscia G, Boscia F, Pinna A, Kodjikian L. The role of face-down positioning in full-thickness macular hole treated with inverted internal limiting membrane flap technique. Acta Ophthalmol 2024. [PMID: 38622819 DOI: 10.1111/aos.16689] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/11/2024] [Accepted: 03/26/2024] [Indexed: 04/17/2024]
Affiliation(s)
- Rita Serra
- Service d'Ophtalmologie, Hôpital de la Croix-Rousse, Hospices Civils de Lyon, Lyon, France
- Department of Medicine, Surgery and Pharmacy, Ophthalmology Unit, University of Sassari, Sassari, Italy
| | - Thibaud Mathis
- Service d'Ophtalmologie, Hôpital de la Croix-Rousse, Hospices Civils de Lyon, Lyon, France
- Laboratoire UMR-CNRS 5510 MATEIS, INSA, Université Lyon 1, Villeurbanne, France
| | - Olivier Loria
- Service d'Ophtalmologie, Hôpital de la Croix-Rousse, Hospices Civils de Lyon, Lyon, France
- Laboratoire UMR-CNRS 5510 MATEIS, INSA, Université Lyon 1, Villeurbanne, France
| | - Philippe Denis
- Service d'Ophtalmologie, Hôpital de la Croix-Rousse, Hospices Civils de Lyon, Lyon, France
| | - Giacomo Boscia
- Department of Translational Biomedicine Neuroscience, University of Bari "Aldo Moro", Bari, Italy
| | - Francesco Boscia
- Department of Translational Biomedicine Neuroscience, University of Bari "Aldo Moro", Bari, Italy
| | - Antonio Pinna
- Department of Medicine, Surgery and Pharmacy, Ophthalmology Unit, University of Sassari, Sassari, Italy
| | - Laurent Kodjikian
- Service d'Ophtalmologie, Hôpital de la Croix-Rousse, Hospices Civils de Lyon, Lyon, France
- Laboratoire UMR-CNRS 5510 MATEIS, INSA, Université Lyon 1, Villeurbanne, France
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Wehrle CJ, Raj R, Maspero M, Satish S, Eghtesad B, Pita A, Kim J, Khalil M, Calderon E, Orabi D, Zervos B, Modaresi Esfeh J, Whitsett Linganna M, Diago-Uso T, Fujiki M, Quintini C, Kwon CD, Miller C, Pinna A, Aucejo F, Hashimoto K, Schlegel A. Risk assessment in liver transplantation for hepatocellular carcinoma: long-term follow-up of a two-center experience. Int J Surg 2024:01279778-990000000-01005. [PMID: 38241354 DOI: 10.1097/js9.0000000000001104] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/02/2023] [Accepted: 01/08/2024] [Indexed: 01/21/2024]
Abstract
BACKGROUND Liver transplantation (LT) is a well-established treatment for hepatocellular carcinoma (HCC), but there are ongoing debates regarding outcomes and selection. This study examines the experience of LT for HCC at a high-volume center. METHODS A prospectively maintained database was used to identify HCC patients undergoing LT from 2000-2020 with>3 years follow-up. Data was obtained from the center database and electronic medical records. The Metroticket 2.0 HCC-specific five-year survival scale was calculated for each patient. Kaplan-Meier and Cox-regression analyses were employed assessing survival between groups based on Metroticket score and individual donor and recipient risk factors. RESULTS 569 patients met criteria. Median follow-up was 96.2 months (8.12 y; IQR 59.9-147.8). Three-year recurrence-free (RFS) and overall survival (OS) were 88.6% (n=504) and 86.6% (n=493). Five-year RFS and OS were 78.9% (n=449) and 79.1% (n=450). Median Metroticket 2.0 score was 0.9 (IQR 0.9-0.95). Tumor size>3 cm (P=0.012), increasing tumor number on imaging (P=0.001) and explant pathology (P<0.001) was associated with recurrence. Transplant within Milan (P<0.001) or UCSF-criteria (P<0.001) had lower recurrence rates. Increasing AFP-values were associated with more HCC-recurrence (P<0.001) and reduced OS (P=0.008). Chemoembolization was predictive of recurrence in the overall population (P=0.043) and in those outside Milan criteria (P=0.038). A receiver-operator curve using Metroticket 2.0 identified an optimal cut-off of projected survival>87.5% for predicting recurrence. This cut-off was able to predict RFS (P<0.001) in the total cohort and predict both, RFS (P=0.007) and OS (P=0.016) outside-Milan. Receipt of donation after brain death (DBD) grafts (55/478, 13%) or living-donor grafts (3/22, 13.6%) experienced better survival rates compared to donation after cardiac death (DCD) grafts (n=15/58, 25.6%, P=0.009). Donor age was associated with a higher HCC-recurrence (P=0.006). Both total ischemia time (TIT)>6hours (P=0.016) and increasing TIT correlated with higher HCC-recurrence (P=0.027). The use of DCD-grafts for outside-Milan candidates was associated with increased recurrence (P=0.039) and reduced survival (P=0.033). CONCLUSION This large two-center analysis confirms favorable outcomes after LT for HCC. Tumor size and number, pre-transplant AFP, and Milan criteria remain important recipient HCC-risk factors. A higher donor risk (i.e., donor age, DCD-grafts, ischemia time) was associated with poorer outcomes.
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Affiliation(s)
- Chase J Wehrle
- Transplantation Center, Department of Surgery, Digestive Disease Institute, Cleveland Clinic, OH
| | - Roma Raj
- Transplantation Center, Department of Surgery, Digestive Disease Institute, Cleveland Clinic, OH
| | - Marianna Maspero
- Transplantation Center, Department of Surgery, Digestive Disease Institute, Cleveland Clinic, OH
| | - Sangeeta Satish
- Transplantation Center, Department of Surgery, Digestive Disease Institute, Cleveland Clinic, OH
| | - Bijan Eghtesad
- Transplantation Center, Department of Surgery, Digestive Disease Institute, Cleveland Clinic, OH
| | - Alejandro Pita
- Transplantation Center, Department of Surgery, Digestive Disease Institute, Cleveland Clinic, OH
| | - Jaekeun Kim
- Transplantation Center, Department of Surgery, Digestive Disease Institute, Cleveland Clinic, OH
| | - Mazhar Khalil
- Transplantation Center, Department of Surgery, Digestive Disease Institute, Cleveland Clinic, OH
| | - Esteban Calderon
- Transplantation Center, Department of Surgery, Digestive Disease Institute, Cleveland Clinic, OH
| | - Danny Orabi
- Transplantation Center, Department of Surgery, Digestive Disease Institute, Cleveland Clinic, OH
| | - Bobby Zervos
- Cleveland Clinic Weston Hospital, Department of Liver Transplantation, Weston, FL
| | | | | | - Teresa Diago-Uso
- Transplantation Center, Department of Surgery, Digestive Disease Institute, Cleveland Clinic, OH
| | - Masato Fujiki
- Transplantation Center, Department of Surgery, Digestive Disease Institute, Cleveland Clinic, OH
| | - Cristiano Quintini
- Transplantation Center, Department of Surgery, Digestive Disease Institute, Cleveland Clinic, OH
| | - Choon David Kwon
- Transplantation Center, Department of Surgery, Digestive Disease Institute, Cleveland Clinic, OH
| | - Charles Miller
- Transplantation Center, Department of Surgery, Digestive Disease Institute, Cleveland Clinic, OH
| | - Antonio Pinna
- Cleveland Clinic Weston Hospital, Department of Liver Transplantation, Weston, FL
| | - Federico Aucejo
- Transplantation Center, Department of Surgery, Digestive Disease Institute, Cleveland Clinic, OH
| | - Koji Hashimoto
- Transplantation Center, Department of Surgery, Digestive Disease Institute, Cleveland Clinic, OH
| | - Andrea Schlegel
- Transplantation Center, Department of Surgery, Digestive Disease Institute, Cleveland Clinic, OH
- Department of Immunology, Lerner Research Institute, Cleveland Clinic, OH
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Serra R, Coscas F, Boulet JF, Cabral D, Tran THC, Pinna A, Lupidi M, Coscas G. Optical coherence tomography angiography macular biomarkers of peripheral retinal ischemia in diabetic macular edema: secondary endpoints from the clinical study "FOVEA". Graefes Arch Clin Exp Ophthalmol 2024:10.1007/s00417-024-06372-6. [PMID: 38244084 DOI: 10.1007/s00417-024-06372-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/27/2023] [Revised: 12/22/2023] [Accepted: 01/05/2024] [Indexed: 01/22/2024] Open
Abstract
PURPOSE To investigate the relationship between the macular values of fractal dimension (FD) and lacunarity (LAC) on optical coherence tomography angiography (OCTA) images and the presence of peripheral retina non-perfusion areas (NPAs) on fluorescein angiography (FA) in patients with treatment-naïve diabetic macular edema (DME). METHODS Fifty patients with treatment-naïve DME underwent a full ophthalmic examination, including best-corrected visual acuity measurement, FA, spectral-domain optical coherence tomography, and OCTA. Specifically, FA was performed to detect the presence of retinal NPAs, whereas fractal OCTA analysis was used to determine macular FD and LAC values at the level of the superficial and deep capillary plexus (SCP and DCP). FA montage frames of the posterior pole and peripheral retina, as well as macular OCTA slabs of the SCP and DCP, were obtained. RESULTS Thirty (60%) eyes with FA evidence of peripheral retinal NPAs in at least one quadrant showed significantly lower FD and higher LAC in both SCP and DCP, when compared with eyes presenting a well-perfused peripheral retina. Furthermore, macular FD and LAC values were found to be significantly associated with the extent of retinal NPAs. CONCLUSIONS Macular FD and LAC of both SCP and DCP seem to be strongly associated with the extent of peripheral retinal NPAs, thus suggesting that may be useful predictive biomarkers of peripheral ischemia in treatment-naïve DME eyes.
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Affiliation(s)
- Rita Serra
- Department of Medicine, Surgery and Pharmacy, Ophthalmology Unit, University of Sassari, Sassari, Italy.
- Istituto di Ricerca Genetica e Biomedica (IRGB), CNR, Cittadella Universitaria di Cagliari, (CA), 09042, Monserrato, Italy.
- Centre Ophtalmologique de l'Odéon, 113 bd Saint Germain, Paris, France.
| | - Florence Coscas
- Centre Ophtalmologique de l'Odéon, 113 bd Saint Germain, Paris, France.
| | | | - Diogo Cabral
- Instituto de Oftalmologia Dr. Gama Pinto, Lisbon, Portugal
| | - Thi Ha Chau Tran
- Ophthalmology Department, Lille Catholic Hospitals, Lille Catholic University, INSERM, U1172, Lille, France
| | - Antonio Pinna
- Department of Medicine, Surgery and Pharmacy, Ophthalmology Unit, University of Sassari, Sassari, Italy
| | - Marco Lupidi
- Eye Clinic, Department of Experimental and Clinical Medicine, Polytechnic University of Marche, Ancona, Italy
| | - Gabriel Coscas
- Centre Ophtalmologique de l'Odéon, 113 bd Saint Germain, Paris, France
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Fujiki M, Pita A, Kusakabe J, Sasaki K, You T, Tuul M, Aucejo FN, Quintini C, Eghtesad B, Pinna A, Miller C, Hashimoto K, Kwon CHD. Left Lobe First With Purely Laparoscopic Approach: A Novel Strategy to Maximize Donor Safety in Adult Living Donor Liver Transplantation. Ann Surg 2023; 278:479-488. [PMID: 37436876 DOI: 10.1097/sla.0000000000005988] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 07/14/2023]
Abstract
OBJECTIVE Evaluate outcome of left-lobe graft (LLG) first combined with purely laparoscopic donor hemihepatectomy (PLDH) as a strategy to minimize donor risk. BACKGROUND An LLG first approach and a PLDH are 2 methods used to reduce surgical stress for donors in adult living donor liver transplantation (LDLT). But the risk associated with application LLG first combined with PLDH is not known. METHODS From 2012 to 2023, 186 adult LDLTs were performed with hemiliver grafts, procured by open surgery in 95 and PLDH in 91 cases. LLGs were considered first when graft-to-recipient weight ratio ≥0.6%. Following a 4-month adoption process, all donor hepatectomies, since December 2019, were performed laparoscopically. RESULTS There was one intraoperative conversion to open (1%). Mean operative times were similar in laparoscopic and open cases (366 vs 371 minutes). PLDH provided shorter hospital stays, lower blood loss, and lower peak aspartate aminotransferase. Peak bilirubin was lower in LLG donors compared with right-lobe graft donors (1.4 vs 2.4 mg/dL, P < 0.01), and PLDH further improved the bilirubin levels in LLG donors (1.2 vs 1.6 mg/dL, P < 0.01). PLDH also afforded a low rate of early complications (Clavien-Dindo grade ≥ II, 8% vs 22%, P = 0.007) and late complications, including incisional hernia (0% vs 13.7%, P < 0.001), compared with open cases. LLG was more likely to have a single duct than a right-lobe graft (89% vs 60%, P < 0.01). Importantly, with the aggressive use of LLG in 47% of adult LDLT, favorable graft survival was achieved without any differences between the type of graft and surgical approach. CONCLUSIONS The LLG first with PLDH approach minimizes surgical stress for donors in adult LDLT without compromising recipient outcomes. This strategy can lighten the burden for living donors, which could help expand the donor pool.
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Affiliation(s)
- Masato Fujiki
- Department of General Surgery, Cleveland Clinic, Cleveland, OH
| | - Alejandro Pita
- Department of General Surgery, Cleveland Clinic, Cleveland, OH
| | - Jiro Kusakabe
- Department of General Surgery, Cleveland Clinic, Cleveland, OH
| | - Kazunari Sasaki
- Department of Surgery, Division of Abdominal Transplant, Stanford University, Palo Alto, CA
| | - Taesuk You
- Department of General Surgery, Cleveland Clinic, Cleveland, OH
| | - Munkhbold Tuul
- Department of General Surgery, Cleveland Clinic, Cleveland, OH
| | | | - Cristiano Quintini
- General Surgery, Digestive Disease Institute, Cleveland Clinic Abu Dhabi, Abu Dhabi, UAE
| | - Bijan Eghtesad
- Department of General Surgery, Cleveland Clinic, Cleveland, OH
| | - Antonio Pinna
- Transplant Center, Cleveland Clinic Florida, Weston, FL
| | - Charles Miller
- Department of General Surgery, Cleveland Clinic, Cleveland, OH
| | - Koji Hashimoto
- Department of General Surgery, Cleveland Clinic, Cleveland, OH
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Pinna A, Castiglia N, Montesu MA, Ronchi L, Serra R, Boscia G, Dore S. Intraocular Inflammation and Palpable Purpura in a Patient with Interstitial Pasteurella multocida Pneumonia. Ocul Immunol Inflamm 2023:1-5. [PMID: 37616557 DOI: 10.1080/09273948.2023.2249089] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/23/2023] [Revised: 08/05/2023] [Accepted: 08/13/2023] [Indexed: 08/26/2023]
Abstract
PURPOSE We describe a case of intraocular inflammation and palpable purpura in a patient with Pasteurella multocida pneumonia. METHODS A 75-year-old pseudophakic woman with type-2 diabetes and chronic obstructive pulmonary disease complained of lower limb palpable purpura and right vision loss of five-day duration. On admission, right visual acuity was hand motion. Slit-lamp examination disclosed severe conjunctival and ciliary injection, corneal oedema, 3-mm hypopyon with heavy fibrin accumulation and blood clots, and synechiae to the IOL. RESULTS Chest computed tomography revealed interstitial pneumonia. Sputum culture yielded P. multocida. Amoxicillin/clavulanic tablets (1 g × 3/daily) and topical and systemic steroids were given. Later on, fluorescein angiography showed multiple choroidal lesions bilaterally. With the above-mentioned therapy, there was full recovery of the skin, lung, and eye lesions. CONCLUSION This report emphasizes that P. multocida infection should be considered in patients with intraocular inflammation, palpable purpura, and interstitial pneumonia. A multidisciplinary approach is necessary for a correct diagnosis and management.
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Affiliation(s)
- Antonio Pinna
- Department of Medicine, Surgery, and Pharmacy, University of Sassari, Sassari, Italy
- Ophthalmology Unit, Azienda Ospedaliero Universitaria di Sassari, Sassari, Italy
| | - Nicola Castiglia
- Microbiology and Virology Unit, Azienda Ospedaliero Universitaria di Sassari, Sassari, Italy
| | - Maria Antonia Montesu
- Department of Medicine, Surgery, and Pharmacy, University of Sassari, Sassari, Italy
| | - Lorenza Ronchi
- Ophthalmology Unit, Azienda Ospedaliero Universitaria di Sassari, Sassari, Italy
| | - Rita Serra
- Department of Biomedical Sciences, University of Sassari, Sassari, Italy
| | - Giacomo Boscia
- Eye Clinic Section, Department of Surgical Sciences, University of Turin, Turin, Italy
| | - Stefano Dore
- Department of Medicine, Surgery, and Pharmacy, University of Sassari, Sassari, Italy
- Ophthalmology Unit, Azienda Ospedaliero Universitaria di Sassari, Sassari, Italy
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Pinna A, Zinellu A, Serra R, Boscia G, Ronchi L, Dore S. Combined Branch Retinal Artery and Central Retinal Vein Occlusion: A Systematic Review. Vision (Basel) 2023; 7:51. [PMID: 37606497 PMCID: PMC10443287 DOI: 10.3390/vision7030051] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/22/2023] [Revised: 07/11/2023] [Accepted: 07/26/2023] [Indexed: 08/23/2023] Open
Abstract
We performed a systematic review and analyzed the current available data on branch retinal artery occlusion (BRAO) with simultaneous central retinal vein obstruction (CRVO), a rarely described occurrence. MEDLINE/PubMed and ISI Web of Sciences searches were performed according to MOOSE guidelines. Studies were considered eligible if they (1) described patients with simultaneous BRAO + CRVO and (2) had been published in peer-reviewed journals. We initially identified 239 records from databases. Ultimately, only 19 reports met the selection criteria. Twenty-nine patients (15 men, 14 women; mean age 43 ± 15 years) were analyzed. Seventeen (59%) patients presented vascular risk factors. Mean visual acuity at onset and final visual outcome were 20/83 and 20/45, respectively, an insignificant improvement. Vision improved in 48% of cases. A marked heterogeneity in treatment approach was found. Eight (28%) patients received no therapy, whereas for 21 (72%) a large variety of topical and/or systemic drugs was given. In the treated group, mean visual acuity at onset and final visual outcome were 20/90 and 20/44, respectively, a not statistically significant improvement. Results suggest that combined BRAO + CRVO occurs at a younger age than isolated BRAO or CRVO. At present, there is insufficient evidence to support any specific management to improve vision in simultaneous BRAO + CRVO.
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Affiliation(s)
- Antonio Pinna
- Department of Medicine, Surgery and Pharmacy, University of Sassari, 07100 Sassari, Italy;
- Ophthalmology Unit, Azienda Ospedaliero-Universitaria di Sassari, 07100 Sassari, Italy;
| | - Angelo Zinellu
- Department of Biomedical Sciences, University of Sassari, 07100 Sassari, Italy; (A.Z.); (R.S.)
| | - Rita Serra
- Department of Biomedical Sciences, University of Sassari, 07100 Sassari, Italy; (A.Z.); (R.S.)
| | - Giacomo Boscia
- Eye Clinic Section, Department of Surgical Sciences, University of Turin, 10126 Turin, Italy;
| | - Lorenza Ronchi
- Ophthalmology Unit, Azienda Ospedaliero-Universitaria di Sassari, 07100 Sassari, Italy;
| | - Stefano Dore
- Department of Medicine, Surgery and Pharmacy, University of Sassari, 07100 Sassari, Italy;
- Ophthalmology Unit, Azienda Ospedaliero-Universitaria di Sassari, 07100 Sassari, Italy;
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Boscia G, Viggiano P, Marzulli F, Grassi MO, Puzo P, Dore S, Pinna A, Alessio G, Boscia F. Continuous Eplerenone Treatment in Chronic Central Serous Chorioretinopathy: Long-Term Results from a Pilot Study. Clin Ophthalmol 2023; 17:2003-2012. [PMID: 37483844 PMCID: PMC10361091 DOI: 10.2147/opth.s411094] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/17/2023] [Accepted: 06/01/2023] [Indexed: 07/25/2023] Open
Abstract
Purpose To assess the long-term morpho-functional retinal and choroidal changes in chronic central serous chorioretinopathy (cCSC) pachychoroid eyes in response to continuous oral eplerenone (EPL) treatment. Methods This pilot study was conducted on patients with unilateral exudative cCSC. We enrolled a total of 17 exudative cCSC and 17 non-exudative fellow eyes of 17 patients. Baseline best-corrected visual acuity (BCVA) and anatomical (structural optical coherence tomography [OCT] and OCT angiography) parameters in both eyes were collected at baseline. Follow-up data were collected at 6, 12, and 48 months after initiation of EPL treatment. Results (i) Exudative cCSC eyes: Compared with baseline (0.34±0.13 LogMAR), BCVA significantly improved at follow-up examinations (6 months: 0.28±0.13 LogMAR, p=0.039; 12 months: 0.22±0.11 LogMAR, p=0.025; 48 months: 0.21±0.08 LogMAR, p=0.028). Furthermore, there was a significant reduction from baseline in all structural OCT parameters (subretinal fluid and subfoveal choroidal thickness [SFCT]; p<0.05). (ii) Non-exudative fellow eyes: There was no significant change in BCVA. There was a significant reduction from baseline in SFCT and choriocapillaris flow deficit percentage (p<0.05). Conclusion In this pilot study, continuous oral EPL therapy in cCSC pachychoroid eyes resulted in long-term morpho-functional improvement. The beneficial effect of EPL occurred within the first year and was maintained after four years. Based on these preliminary observations, EPL may be effective in the exudative forms of CSC.
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Affiliation(s)
- Giacomo Boscia
- Department of Translational Biomedicine Neuroscience, University of Bari “Aldo Moro”, Bari, Italy
| | - Pasquale Viggiano
- Department of Translational Biomedicine Neuroscience, University of Bari “Aldo Moro”, Bari, Italy
| | - Federica Marzulli
- Department of Translational Biomedicine Neuroscience, University of Bari “Aldo Moro”, Bari, Italy
| | - Maria Oliva Grassi
- Department of Translational Biomedicine Neuroscience, University of Bari “Aldo Moro”, Bari, Italy
| | - Pasquale Puzo
- Department of Translational Biomedicine Neuroscience, University of Bari “Aldo Moro”, Bari, Italy
| | - Stefano Dore
- Department of Medicine, Surgery and Pharmacy, University of Sassari, Sassari, Italy
| | - Antonio Pinna
- Department of Medicine, Surgery and Pharmacy, University of Sassari, Sassari, Italy
| | - Giovanni Alessio
- Department of Translational Biomedicine Neuroscience, University of Bari “Aldo Moro”, Bari, Italy
| | - Francesco Boscia
- Department of Translational Biomedicine Neuroscience, University of Bari “Aldo Moro”, Bari, Italy
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Serra R, Coscas F, Boulet JF, Cabral D, Tran THC, Solinas G, Pinna A, Lupidi M, Coscas G. Predictive Factors of Visual Outcome in Treatment-Naïve Diabetic Macular Edema: Preliminary Results from the Clinical Study "FOVEA". J Clin Med 2023; 12:3870. [PMID: 37373565 DOI: 10.3390/jcm12123870] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/20/2023] [Revised: 05/24/2023] [Accepted: 06/04/2023] [Indexed: 06/29/2023] Open
Abstract
Diabetic macular edema (DME) is a common cause of vision impairment in diabetic retinopathy. The aim of this study was to analyze the relationship between visual outcome and anatomic changes detected by traditional multimodal retinal imaging and optical coherence tomography angiography (OCTA) in DME eyes under treatment with Aflibercept. METHODS Sixty-six DME eyes of 62 patients under treatment with intravitreal Aflibercept and with one-year follow-up were enrolled. All participants underwent a full ophthalmic evaluation, including best correct visual acuity (BCVA) measurement, spectral-domain optical coherence tomography, fluorescein angiography and OCTA, both at baseline and final examination. Fractal OCTA analysis of the superficial and deep capillary plexus (SCP and DCP) was performed to estimate vascular perfusion density and lacunarity (LAC). RESULTS At the final examination, there was a significant improvement in terms of BCVA and central macular thickness (CMT). Furthermore, eyes with CMT <373 µm at baseline reached the higher BCVA at the last follow-up. Eyes with CMT ≥373 µm and DCP LAC <0.41 reached a higher final BCVA, if compared with eyes showing the same CMT but higher initial LAC. CONCLUSION A 12-month treatment with intravitreal Aflibercept for DME resulted in significant visual and anatomic improvement. Multimodal retinal imaging, together with fractal OCTA analysis, may provide useful biomarkers, predictive of visual outcome in DME.
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Affiliation(s)
- Rita Serra
- Department of Biomedical Sciences, University of Sassari, 07100 Sassari, Italy
- Istituto di Ricerca Genetica e Biomedica (IRGB), CNR, Cittadella Universitaria di Cagliari, 09042 Monserrato, Italy
- Centre Ophtalmologique de l'Odéon, 113 bd Saint Germain, 75006 Paris, France
| | - Florence Coscas
- Centre Ophtalmologique de l'Odéon, 113 bd Saint Germain, 75006 Paris, France
| | - Jean François Boulet
- Department of Ophthalmology, Paris VI University, 361 rue Clément Ader, Bâtiment C, 27000 Evreux, France
| | - Diogo Cabral
- Instituto de Oftalmologia Dr. Gama Pinto, 1150-255 Lisboa, Portugal
| | - Thi Ha Chau Tran
- Ophthalmology Department, Lille Catholic Hospitals, Lille Catholic University, INSERM U1172, 59000 Lille, France
| | - Giuliana Solinas
- Department of Biomedical Sciences, University of Sassari, 07100 Sassari, Italy
| | - Antonio Pinna
- Department of Medicine, Surgery, and Pharmacy, Ophthalmology Unit, University of Sassari, 07100 Sassari, Italy
| | - Marco Lupidi
- Eye Clinic, Department of Experimental and Clinical Medicine, Polytechnic University of Marche, 60121 Ancona, Italy
| | - Gabriel Coscas
- Centre Ophtalmologique de l'Odéon, 113 bd Saint Germain, 75006 Paris, France
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Dore S, Deiana A, Serra R, Turtas V, Boscia G, Pinna A. Intraocular osseous metaplasia with formation of hematopoietic bone marrow in a blind eye from birth. Eur J Ophthalmol 2023; 33:NP143-NP144. [PMID: 36320168 DOI: 10.1177/11206721221137150] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Affiliation(s)
- Stefano Dore
- Department of Medicine, Surgery and Pharmacy, University of Sassari, Sassari, Italy
- Unità Operativa di Oculistica, Azienda Ospedaliero-Universitaria di Sassari, Sassari, Italy
| | - Angelo Deiana
- Unità Operativa di Anatomia e Istologia Patologia, Azienda Ospedaliero-Universitaria di Sassari, Sassari, Italy
| | - Rita Serra
- Department of Biomedical Sciences, University of Sassari, Sassari, Italy
| | - Valeria Turtas
- Unità Operativa di Oculistica, Azienda Ospedaliero-Universitaria di Sassari, Sassari, Italy
| | - Giacomo Boscia
- Department of Medicine, Surgery and Pharmacy, University of Sassari, Sassari, Italy
| | - Antonio Pinna
- Department of Medicine, Surgery and Pharmacy, University of Sassari, Sassari, Italy
- Unità Operativa di Oculistica, Azienda Ospedaliero-Universitaria di Sassari, Sassari, Italy
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Fujiki M, Hashimoto K, Aucejo F, David Kwon CH, Eghtesad B, Miller C, Pinna A. Response to Comment on "Living Donor Liver Transplantation With Augmented Venous Outflow and Splenectomy: A Promised Land for Small Left Lobe Grafts". Ann Surg Open 2023; 4:e269. [PMID: 37600881 PMCID: PMC10431296 DOI: 10.1097/as9.0000000000000269] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/26/2023] [Accepted: 02/02/2023] [Indexed: 03/19/2023] Open
Affiliation(s)
- Masato Fujiki
- From the Department of General Surgery, Transplant Center, Cleveland Clinic, Cleveland, OH
| | - Koji Hashimoto
- From the Department of General Surgery, Transplant Center, Cleveland Clinic, Cleveland, OH
| | - Federico Aucejo
- From the Department of General Surgery, Transplant Center, Cleveland Clinic, Cleveland, OH
| | - Choon Hyuck David Kwon
- From the Department of General Surgery, Transplant Center, Cleveland Clinic, Cleveland, OH
| | - Bijan Eghtesad
- From the Department of General Surgery, Transplant Center, Cleveland Clinic, Cleveland, OH
| | - Charles Miller
- From the Department of General Surgery, Transplant Center, Cleveland Clinic, Cleveland, OH
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11
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Serra R, Rallo V, Pinna A, Steri M, Piras MG, Marongiu M, Coscas F, Gorospe M, Schlessinger D, Fiorillo E, Cucca F, Angius A. Polygenic risk score and biochemical/environmental variables predict a low-risk profile of age-related macular degeneration in Sardinia. Graefes Arch Clin Exp Ophthalmol 2023; 261:691-698. [PMID: 36264335 PMCID: PMC10601990 DOI: 10.1007/s00417-022-05858-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/13/2022] [Revised: 09/17/2022] [Accepted: 10/02/2022] [Indexed: 11/04/2022] Open
Abstract
PURPOSE To ascertain the prevalence and clinical and genetic features of age-related macular degeneration (AMD) in subjects living in the Lanusei valley, Central Sardinia, Italy, involved in a study on ageing (SardiNIA project). METHODS A total of 814 volunteers aged ≥ 50 years, randomly selected from the SardiNIA project dataset, were included. A color fundus (CF) photograph of the 30° central retina of each eye was obtained and graded according to the Age-Related Eye Disease Study system. Life-style choices were investigated using standardized questionnaires. The concentrations of several inflammatory biomarkers (i.e., complement component, fibrinogen, and C-reactive protein) were measured. Polygenic risk score (PRS) was calculated and compared with results obtained from a European cohort. RESULTS A total of 756 subjects had gradable CF photographs for AMD detection. In 91.3%, no signs of AMD were observed. The prevalence rates of early and late AMDs were 6.9% and 0.6%, respectively. A total of 85% of subjects were physically active; only 13.5% were current smokers. Low concentrations of complement component, fibrinogen, and C-reactive protein were found. We calculated the polygenic risk scores (PRS) using 40 AMD markers distributed on several candidate genes in Europeans and Sardinians. The mean PRS value was significantly lower in Sardinians than in the Europeans (0.21 vs. 0.248, respectively, p = 1.18 × 10-77). CONCLUSIONS In our cohort, most subjects showed no sign of any AMD type and late AMD was a condition rarely observed. Results of genetic, biochemical, and life-style investigation support the hypothesis that Sardinia population may present of a peculiar background with a protective effect against AMD development.
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Affiliation(s)
- Rita Serra
- Institute of Genetic and Biomedical Research, National Research Council, Cittadella Universitaria Di Cagliari, c/o S.S 554 bivio per Sestu Km 4,500, 09042, Monserrato, Cagliari, Italy.
- Department of Biomedical Sciences, University of Sassari, Sassari, Italy.
- Centre Ophtalmologique de L'Odeon, 113 bd Saint Germain, 75006, Paris, France.
| | - Vincenzo Rallo
- Institute of Genetic and Biomedical Research, National Research Council, Cittadella Universitaria Di Cagliari, c/o S.S 554 bivio per Sestu Km 4,500, 09042, Monserrato, Cagliari, Italy
| | - Antonio Pinna
- Department of Medicine, Surgery and Pharmacy, Ophthalmology Unit, University of Sassari, Sassari, Italy
| | - Maristella Steri
- Institute of Genetic and Biomedical Research, National Research Council, Cittadella Universitaria Di Cagliari, c/o S.S 554 bivio per Sestu Km 4,500, 09042, Monserrato, Cagliari, Italy
| | - Maria Grazia Piras
- Institute of Genetic and Biomedical Research, National Research Council, Cittadella Universitaria Di Cagliari, c/o S.S 554 bivio per Sestu Km 4,500, 09042, Monserrato, Cagliari, Italy
| | - Michele Marongiu
- Institute of Genetic and Biomedical Research, National Research Council, Cittadella Universitaria Di Cagliari, c/o S.S 554 bivio per Sestu Km 4,500, 09042, Monserrato, Cagliari, Italy
| | - Florence Coscas
- Centre Ophtalmologique de L'Odeon, 113 bd Saint Germain, 75006, Paris, France
| | - Myriam Gorospe
- Laboratory of Genetics and Genomics, National Institute On Aging, Baltimore, MD, USA
| | - David Schlessinger
- Laboratory of Genetics and Genomics, National Institute On Aging, Baltimore, MD, USA
| | - Edoardo Fiorillo
- Institute of Genetic and Biomedical Research, National Research Council, Cittadella Universitaria Di Cagliari, c/o S.S 554 bivio per Sestu Km 4,500, 09042, Monserrato, Cagliari, Italy
| | - Francesco Cucca
- Department of Biomedical Sciences, University of Sassari, Sassari, Italy
| | - Andrea Angius
- Institute of Genetic and Biomedical Research, National Research Council, Cittadella Universitaria Di Cagliari, c/o S.S 554 bivio per Sestu Km 4,500, 09042, Monserrato, Cagliari, Italy.
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12
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Bellanca RF, Pinna A, Catania G, Belcastro E, Angi M, D'Amico Ricci G. Multimodal Imaging Approach in a Patient with Vogt-Koyanagi-Harada-like Syndrome Due to Dabrafenib and Trametinib Use for Cutaneous Melanoma. Ocul Immunol Inflamm 2023; 31:402-406. [PMID: 35113757 DOI: 10.1080/09273948.2021.2025250] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/19/2021] [Accepted: 12/23/2021] [Indexed: 10/19/2022]
Abstract
PURPOSE To describe a case of ocular inflammation associated with dabrafenib and trametinib chemotherapy for cutaneous melanoma by using a multimodal image approach. MATERIALS AND METHODS We report on a 51-year-old woman with Vogt-Koyanagi-Harada-like syndrome, which occurred while she was undergoing treatment with dabrafenib and trametinib for cutaneous melanoma. The patient complained of sudden, bilateral vision loss of 2 days' duration. Anatomical and functional improvement was observed after administration of systemic steroids and cessation of chemotherapy. Later on, 6 weeks after restarting dabrafenib, she had an episode of granulomatous anterior uveitis, which was successfully managed with topical mydriatics and steroids. Strict follow-up with multimodal imaging was performed until recovery. CONCLUSIONS This report emphasizes the importance of strict ophthalmological follow-up with multimodal imaging in patients receiving dabrafenib and trametinib, and the need for a multidisciplinary approach in the management of ocular inflammation during chemotherapy.
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Affiliation(s)
| | - Antonio Pinna
- Department of Medical, Surgical, and Experimental Sciences, Ophthalmology Unit, University of Sassari, Sassari, Italy
| | | | - Elena Belcastro
- U.O. Oculistica 2, Turin Eye Hospital, ASL Città di Torino, Turin, Italy
| | - Martina Angi
- Ocular Oncology Service, Department of Surgery, Fondazione IRCCS Istituto Nazionale dei Tumori, Milan, Italy
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13
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Fujiki M, Hashimoto K, Quintini C, Aucejo F, Kwon CHD, Matsushima H, Sasaki K, Campos L, Eghtesad B, Diago T, Iuppa G, D'amico G, Kumar S, Liu P, Miller C, Pinna A. Living Donor Liver Transplantation With Augmented Venous Outflow and Splenectomy: A Promised Land for Small Left Lobe Grafts. Ann Surg 2022; 276:838-845. [PMID: 35894443 DOI: 10.1097/sla.0000000000005630] [Citation(s) in RCA: 13] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
OBJECTIVE Living donor liver transplantation (LDLT) using small grafts, especially left lobe grafts (H1234-MHV) (LLG), continues to be a challenge due to small-for-size syndrome (SFSS). We herein demonstrate that with surgical modifications, outcomes with small grafts can be improved. METHODS Between 2012 and 2020, we performed 130 adult LDLT using 61 (47%) LLG (H1234-MHV) in a single Enterprise. The median graft-to-recipient weight ratio was 0.84%, with graft-to-recipient weight ratio <0.7% accounting for 22%. Splenectomy was performed in 72 (56%) patients for inflow modulation before (n=50) or after (n=22) graft reperfusion. In LLG-LDLT, venous outflow was achieved using all three recipient hepatic veins. In right lobe graft (H5678) (RLG)-LDLT, the augmented graft right hepatic vein was anastomosed to the recipient's cava with a large cavotomy. Outcome measures include SFSS, early allograft dysfunction (EAD), and survival. RESULTS Graft survival rates at 1, 3, and 5 years were 94%, 90%, and 83%, respectively, with no differences between LLG (H1234-MHV) and RLG (H5678). Splenectomy significantly reduced portal flow without increasing the complication rate. Despite the aggressive use of small grafts, SFSS and EAD developed in only 1 (0.8%) and 18 (13.8%) patients, respectively. Multivariable logistic regression revealed model for end-stage liver disease score and LLG (H1234-MHV) as independent risk factors for EAD and splenectomy as a protective factor (odds ratio: 0.09; P =0.03). For LLG (H1234-MHV)-LDLT, patients who underwent prereperfusion splenectomy tended to have better 1-year graft survival than those receiving postreperfusion splenectomy. CONCLUSIONS LLG (H1234-MHV) are feasible in adult LDLT with excellent outcomes comparable to RLG (H5678). Venous outflow augmentation and splenectomy help lower the threshold of using small-for-size grafts without compromising graft survival.
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Affiliation(s)
| | | | | | | | | | | | | | - Luis Campos
- Transplant Center, Cleveland Clinic, Cleveland, OH
- Cleveland Clinic Abu Dhabi, Abu Dhabi, United Arab Emirates
| | | | - Teresa Diago
- Transplant Center, Cleveland Clinic, Cleveland, OH
| | - Giuseppe Iuppa
- Transplant Center, Cleveland Clinic, Cleveland, OH
- Cleveland Clinic Abu Dhabi, Abu Dhabi, United Arab Emirates
| | | | - Shiva Kumar
- Transplant Center, Cleveland Clinic, Cleveland, OH
- Cleveland Clinic Abu Dhabi, Abu Dhabi, United Arab Emirates
| | - Peter Liu
- Department of Radiology, Cleveland Clinic, Cleveland, OH
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14
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Aragona P, Giannaccare G, Mencucci R, Rubino P, Cantera E, Finocchiaro CY, Vaccaro S, Aiello F, Antoniazzi E, Barabino S, Bonini S, Carlini G, Chierego C, Gisoldi RAMC, Di Zazzo A, Fasciani R, Franch A, Gabbriellini G, Gagliano C, Leonardi A, Macrì A, Mosca L, Orfeo V, Pinna A, Pocobelli A, Protti R, Rama P, Rania L, Rechichi M, Russo A, Scorcia V, Spadea L, Trentadue M, Troisi S, Versura P, Villani E, Rolando M. The Management of Dry Eye Disease: Proceedings of Italian Dry Eye Consensus Group Using the Delphi Method. J Clin Med 2022; 11:6437. [PMID: 36362665 PMCID: PMC9656447 DOI: 10.3390/jcm11216437] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/19/2022] [Accepted: 10/26/2022] [Indexed: 01/13/2024] Open
Abstract
Dry eye disease (DED) is a highly prevalent, chronic and progressive condition that affects 5-33% of the world's adult population [...].
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Affiliation(s)
- Pasquale Aragona
- Department of Biomedical Sciences, Ophthalmology Clinic, University of Messina, 98121 Messina, Italy
| | - Giuseppe Giannaccare
- Department of Ophthalmology, University “Magna Græcia” of Catanzaro, Viale Europa, 88100 Catanzaro, Italy
| | - Rita Mencucci
- Eye Clinic, Department of Neuroscience, Psychology, Pharmacology and Child Health, University of Florence, 50134 Florence, Italy
| | - Pierangela Rubino
- Ophthalmology Unit, Department of General and Specialized Surgery, University Hospital of Parma, Via Gramsci 14, 43126 Parma, Italy
| | | | | | - Sabrina Vaccaro
- Department of Ophthalmology, University “Magna Græcia” of Catanzaro, Viale Europa, 88100 Catanzaro, Italy
| | - Francesco Aiello
- Ophthalmology Unit, Department of Experimental Medicine, University of Rome Tor Vergata, 00173 Rome, Italy
| | | | - Stefano Barabino
- Ocular Surface and Dry Eye Center, Ospedale L. Sacco, University of Milan, 20157 Milan, Italy
| | - Stefano Bonini
- Department of Ophthalmology, University of Rome Campus Biomedico, 00128 Rome, Italy
| | | | - Chiara Chierego
- Ophthalmic Unit, Department of Neurosciences, Biomedicine and Movement Sciences, University of Verona, 37129 Verona, Italy
| | | | - Antonio Di Zazzo
- Department of Ophthalmology, University of Rome Campus Biomedico, 00128 Rome, Italy
| | - Romina Fasciani
- Fondazione Policlinico Universitario A. Gemelli-IRCCS, 00168 Rome, Italy
| | - Antonella Franch
- Fondazione Banca Degli Occhi del Veneto Onlus, Department of Ophthalmology, SS Giovanni and Paolo Hospital, 30122 Venice, Italy
| | - Giovanna Gabbriellini
- Ophthalmology, Department of Surgical Medical, Molecular Pathology and of the Critical Area, University of Pisa, 56126 Pisa, Italy
| | - Caterina Gagliano
- Ophthalmology Clinic, San Marco Hospital, University of Catania, 95123 Catania, Italy
| | - Andrea Leonardi
- Ophthalmology Unit, Department of Neuroscience, University of Padua, 35121 Padua, Italy
| | - Angelo Macrì
- IRCCS San Martino Polyclinic Hospital, 16132 Genoa, Italy
| | - Luigi Mosca
- Fondazione Policlinico Universitario A. Gemelli-IRCCS, 00168 Rome, Italy
| | - Vincenzo Orfeo
- Ophthalmology Unit “Clinica Mediterranea”, 80122 Naples, Italy
| | - Antonio Pinna
- Department of Medicine, Surgery and Pharmacy, Ophthalmology Unit, University of Sassari, 07100 Sassari, Italy
| | - Augusto Pocobelli
- San Giovanni Addolorata Hospital, UOC Oftalmologia-Banca degli Occhi, 00184 Rome, Italy
| | - Romolo Protti
- Ophthalmic Unit, Hospital San Biagio, 28845 Domodossola, Italy
| | - Paolo Rama
- Cornea and Ocular Surface Unit, San Raffaele Scientific Institute, 20132 Milan, Italy
| | - Laura Rania
- Department of Ophthalmology, Istituto per la Sicurezza Sociale, San Marino State Hospital, 387261 Cailungo, San Marino
| | - Miguel Rechichi
- Centro Polispecialistico Mediterraneo, 88050 Selia Marina, Italy
| | - Andrea Russo
- Eye Clinic, Department of Neurological and Vision Sciences, University of Brescia, Piazzale Spedale Civili, 1, 25100 Brescia, Italy
| | - Vincenzo Scorcia
- Department of Ophthalmology, University “Magna Græcia” of Catanzaro, Viale Europa, 88100 Catanzaro, Italy
| | - Leopoldo Spadea
- Eye Clinic, Policlinico Umberto I, “Sapienza” University of Rome, 00161 Rome, Italy
| | - Marco Trentadue
- Azienda Ospedaliera “Ospedale Consorziale Policlinico”, 70124 Bari, Italy
| | - Salvatore Troisi
- Eye Department, AOU “San Giovanni di Dio e Ruggi d’Aragona”, 84131 Salerno, Italy
| | - Piera Versura
- Ophthalmology Unit, Department of Experimental, Diagnostic and Specialty Medicine (DIMES), Alma Mater Studiorum University of Bologna, S. Orsola-Malpighi Teaching Hospital Bologna, 40138 Bologna, Italy
| | - Edoardo Villani
- Eye Clinic, San Giuseppe Hospital, IRCCS Multimedica, University of Milan, 20123 Milan, Italy
| | - Maurizio Rolando
- Ocular Surface and Dry Eye Center, ISPRE Ophthalmics, 16129 Genoa, Italy
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15
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Orabona R, Sciatti E, Vizzardi E, Bonadei I, Metra M, Sartori E, Frusca T, Pinna A, Bellocco R, Prefumo F. Maternal Right Ventricular and Left Atrial Function in Uncomplicated Twin Pregnancies: A Longitudinal Study. J Clin Med 2022; 11:5432. [PMID: 36143080 PMCID: PMC9503833 DOI: 10.3390/jcm11185432] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/11/2022] [Revised: 09/11/2022] [Accepted: 09/13/2022] [Indexed: 11/25/2022] Open
Abstract
Objective: The knowledge regarding maternal cardiovascular hemodynamic adaptation in twin pregnancies is incomplete. We performed a longitudinal investigation of maternal right ventricular (RV) and left atrial (LA) function in a cohort of uncomplicated twin pregnancies compared to singleton pregnancies. Study design: Healthy women with uncomplicated twin pregnancies were prospectively enrolled and assessed by transthoracic echocardiography at 10−15 weeks’ (w) gestation (T1), 19-26 w gestation (T2), and 30−38 w gestation (T3). Subjects with uneventful singleton pregnancies were selected as controls at the same gestational ages. Cardiac findings were compared to those of women with uneventful singleton gestations. RV systolic and diastolic functions were assessed by conventional echocardiography (FAC, TAPSE, sPAP, E, A, DT) and tissue Doppler imaging (TDI) (E’, A’, S’, IVA, IVCT, IVRT, ET, MPI), and LA dimensions were calculated. Speckle-tracking imaging was also applied to evaluate RV global longitudinal strain and LA 2D strains (at LV end-systole (LAS) and at atrial contraction (LAA)). Results: Overall, 30 uncomplicated twin and 30 uncomplicated singleton pregnancies were included. Regarding maternal RV function in twins, all the parameters (FAC, TAPSE, sPAP, E, A, E/A, DT, E/E’, IVA, IVCT, MPI and 2D longitudinal strain) were almost stable throughout gestation, with the exception of the TDI findings (E’ decreased from T1 to T3 (p = 0.03), while E’/A’ increased from T1 to T2 and then decreased (p = 0.01); A’ and basal S’ increased (p = 0.04 and p = 0.03, respectively), while IVRT and ET significantly decreased (p = 0.009 and p = 0.007, respectively)). These findings were similar to those found for singleton pregnancies. LA dimensions significantly increased throughout gestation in both twins and singletons (p < 0.001), without intergroup difference. LA strains did not vary during either twin or singleton pregnancies, except for LAA in T1, which was higher among twins than among singletons. Conclusion: Maternal RV and LA function in uncomplicated twin pregnancies does not seem to undergo more significant changes than in singletons, being characterized by similar findings in RV systolic and diastolic functions, as well as LA dimensions and strains.
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Affiliation(s)
- Rossana Orabona
- Maternal Fetal Medicine Unit, Department of Obstetrics and Gynecology, University of Brescia, 25123 Brescia, Italy
| | - Edoardo Sciatti
- Section of Cardiovascular Diseases, Department of Medical and Surgical Specialties, Radiological Sciences and Public Health, University of Brescia, 25123 Brescia, Italy
| | - Enrico Vizzardi
- Section of Cardiovascular Diseases, Department of Medical and Surgical Specialties, Radiological Sciences and Public Health, University of Brescia, 25123 Brescia, Italy
| | - Ivano Bonadei
- Section of Cardiovascular Diseases, Department of Medical and Surgical Specialties, Radiological Sciences and Public Health, University of Brescia, 25123 Brescia, Italy
| | - Marco Metra
- Section of Cardiovascular Diseases, Department of Medical and Surgical Specialties, Radiological Sciences and Public Health, University of Brescia, 25123 Brescia, Italy
| | - Enrico Sartori
- Maternal Fetal Medicine Unit, Department of Obstetrics and Gynecology, University of Brescia, 25123 Brescia, Italy
| | - Tiziana Frusca
- Maternal Fetal Medicine Unit, Department of Obstetrics and Gynecology, University of Brescia, 25123 Brescia, Italy
- Department of Obstetrics and Gynecology, University of Parma, 43121 Parma, Italy
| | - Antonio Pinna
- Department of Statistics and Quantitative Methods, University of Milano-Bicocca, 20126 Milan, Italy
| | - Rino Bellocco
- Department of Statistics and Quantitative Methods, University of Milano-Bicocca, 20126 Milan, Italy
- Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, 171 65 Stockholm, Sweden
| | - Federico Prefumo
- Maternal Fetal Medicine Unit, Department of Obstetrics and Gynecology, University of Brescia, 25123 Brescia, Italy
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Orabona R, Sciatti E, Vizzardi E, Bonadei I, Metra M, Sartori E, Frusca T, Pinna A, Bellocco R, Prefumo F. Maternal Left Ventricular Function in Uncomplicated Twin Pregnancies: A Speckle-Tracking Imaging Longitudinal Study. J Clin Med 2022; 11:jcm11185283. [PMID: 36142928 PMCID: PMC9504023 DOI: 10.3390/jcm11185283] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/10/2022] [Revised: 08/28/2022] [Accepted: 09/06/2022] [Indexed: 12/04/2022] Open
Abstract
Objective: The knowledge of maternal cardiovascular hemodynamic adaptation in twin pregnancies is incomplete. We aimed to longitudinally investigate maternal left ventricular (LV) function in uncomplicated twin pregnancies. Methods: 30 healthy and uncomplicated twin pregnant women and 30 controls with normal singleton pregnancies were prospectively enrolled to undergo transthoracic echocardiography at 10–15 week’s gestation (w) (T1), 19–26 w (T2) and 30–38 w (T3). LV dimensions and volumes, as well as LV ejection fraction (LVEF), mass (LVM) and diastolic parameters (at transmitral pulsed wave Doppler and mitral annular plane tissue Doppler), were calculated. Speckle-tracking imaging was also applied to evaluate LV global longitudinal (GLS), radial and circumferential 2D strains. Results: During twin pregnancy, maternal LV dimensions, volumes and LVM had an increasing trend from T1 to T3, similar to singletons, while LVEF remained stable. There was LV remodeling/hypertrophy in 50% of women at T2 and T3 in both groups. Diastolic function had a worsening trend from T1 to T3 with no differences between twins and singletons, except for higher LV filling pressure (i.e., E/E′) at T2 in twins. Two-dimensional strains did not vary during gestation in either group, except for a linear trend to increase (i.e., worsen) GLS in singletons. Radial and circumferential 2D strains were impaired in about half of the women at each trimester, while GLS was altered in one-fourth/one-third of them in both groups. Conclusion: Maternal LV geometry, dimensions and function are significantly impaired during twin pregnancies, in particular in the second half of gestation, with no significant differences compared to singletons.
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Affiliation(s)
- Rossana Orabona
- Maternal Fetal Medicine Unit, Department of Obstetrics and Gynecology, University of Brescia, 25123 Brescia, Italy
- Correspondence: ; Tel.: +39-030-399-5365; Fax: +39-030-399-6401
| | - Edoardo Sciatti
- Section of Cardiovascular Diseases, Department of Medical and Surgical Specialties, Radiological Sciences and Public Health, University of Brescia, 25123 Brescia, Italy
| | - Enrico Vizzardi
- Section of Cardiovascular Diseases, Department of Medical and Surgical Specialties, Radiological Sciences and Public Health, University of Brescia, 25123 Brescia, Italy
| | - Ivano Bonadei
- Section of Cardiovascular Diseases, Department of Medical and Surgical Specialties, Radiological Sciences and Public Health, University of Brescia, 25123 Brescia, Italy
| | - Marco Metra
- Section of Cardiovascular Diseases, Department of Medical and Surgical Specialties, Radiological Sciences and Public Health, University of Brescia, 25123 Brescia, Italy
| | - Enrico Sartori
- Maternal Fetal Medicine Unit, Department of Obstetrics and Gynecology, University of Brescia, 25123 Brescia, Italy
| | - Tiziana Frusca
- Maternal Fetal Medicine Unit, Department of Obstetrics and Gynecology, University of Brescia, 25123 Brescia, Italy
- Department of Obstetrics and Gynecology, University of Parma, 43121 Parma, Italy
| | - Antonio Pinna
- Department of Statistics and Quantitative Methods, University of Milano-Bicocca, 20126 Milan, Italy
| | - Rino Bellocco
- Department of Statistics and Quantitative Methods, University of Milano-Bicocca, 20126 Milan, Italy
- Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, 171 65 Stockholm, Sweden
| | - Federico Prefumo
- Maternal Fetal Medicine Unit, Department of Obstetrics and Gynecology, University of Brescia, 25123 Brescia, Italy
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17
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Esposti G, Luigi Esposti P, Costantino F, Zappalà D, Pinna A, Fruschelli M. Subthreshold Micropulse Laser for Long-Lasting Submacular Fluid after Rhegmatogeous Retinal Detachment Surgery. J Ophthalmic Vis Res 2022; 17:390-396. [PMID: 36160097 PMCID: PMC9493423 DOI: 10.18502/jovr.v17i3.11577] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/02/2021] [Accepted: 01/29/2022] [Indexed: 11/24/2022] Open
Abstract
Purpose To assess the safety and efficacy of subthreshold micropulse laser (SML) photo-stimulation in the management of persistent subfoveal fluid (PSF) after surgery for rhegmatogenous retinal detachment (RRD). Methods In this pilot study, 11 eyes of 11 patients (8 men, 3 women) with long-lasting (12–18 months) PSF after surgery for RRD were evaluated before and after photostimulation with subthreshold micropulse yellow laser. Ophthalmic examination included best-corrected visual acuity (BCVA), Amsler grid test, ophthalmoscopy, autofluorescence (AF), and optical coherence tomography (OCT) with measurement of central point foveal thickness (CPFT). Primary outcome was subfoveal fluid resolution and secondary outcome was BCVA improvement. Results The mean CPFT and BCVA were, respectively, 436.8 ± 28.8 μm and 0.25 ± 0.1 µm decimal equivalent (DE) before photostimulation and 278 ± 54.4 μm and 0.57 ± 0.2 µm DE after photostimulation, a statistically significant difference (P< 0.001). Nine (81.8%) eyes showed improved BCVA, disappearance of macular detachment on ophthalmoscopy, reduced retinal pigment epithelium distress on AF, and restored macular profile with no neuroretinal alterations on OCT scans. Conclusion Although PSF after RRD surgery is often a self-limiting disease, our results suggest that SML photostimulation may be effective and safe in patients with clinically significant long-lasting PSF. Larger case–control studies are necessary to confirm these results.
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Affiliation(s)
| | | | | | - Dario Zappalà
- Graduate School of Ophthalmology, University of Siena, Siena, Italy
| | - Antonio Pinna
- Department of Medical, Surgical, and Experimental Sciences, Ophthalmology Unit, University of Sassari, Sassari, Italy
| | - Mario Fruschelli
- Dipartimento di Scienze Mediche Chirurgiche e Neuroscienze, University of Siena, Siena, Italy
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Serra R, D’Amico Ricci G, Dore S, Coscas F, Pinna A. Evaluation of Radial Peripapillary Capillary Density in G6PD Deficiency: An OCT Angiography Pilot Study. J Clin Med 2022; 11:jcm11123282. [PMID: 35743352 PMCID: PMC9224991 DOI: 10.3390/jcm11123282] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/05/2022] [Revised: 05/29/2022] [Accepted: 06/06/2022] [Indexed: 12/04/2022] Open
Abstract
Glucose-6-phosphate-dehydrogenase (G6PD) deficiency is an inherited enzymatic disorder causing hemolytic anemia. The purpose of this pilot study was to compare vascular density (VD) values of the radial peripapillary capillary (RPC) plexus in G6PD-deficient and G6PD-normal men, using optical coherence tomography angiography (OCTA). METHODS 46 G6PD-deficient men and 23 age-matched male controls were included. A complete ophthalmological evaluation, consisting of slit-lamp biomicroscopy, best-corrected visual acuity, intra-ocular pressure measurement, structural optical coherence tomography, and OCTA scanning of the optic nerve head, was performed. The en-face angioflow images were carefully analyzed and the VD values of the RPC plexus were measured using the AngioAnalytics™ software embedded in the OCTA device. Medical conditions, including systemic hypertension, hypercholesterolemia, and diabetes mellitus, were also investigated. RESULTS G6PD-deficient eyes showed higher values of VD in all peripapillary sectors, but a statistical significance (p = 0.03) was reached only in the infero-temporal sector. There were no significant differences in terms of hypercholesterolemia, systemic arterial hypertension, and diabetes mellitus between the two study groups. CONCLUSION Results show that VD values of the RPC plexus are higher in G6PD-deficient men than in G6PD-normal subjects, but a statistically significant difference was found only in the inferior temporal sector. Overall, our preliminary findings support the hypothesis that the RPC layer of G6PD-deficient men consists of a denser vascular network, which may contribute to offering protection against ocular atherosclerotic vasculopathies.
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Affiliation(s)
- Rita Serra
- Department of Biomedical Sciences, University of Sassari, Viale San Pietro 43, 07100 Sassari, Italy
- Istituto di Ricerca Genetica e Biomedica (IRGB), CNR, Cittadella Universitaria di Cagliari, 09042 Monserrato, Italy
- Centre Ophtalmologique de l’Odeon, 113 bd Saint Germain, 75006 Paris, France;
- Correspondence:
| | - Giuseppe D’Amico Ricci
- Ophthalmology Unit, Department of Medical, Surgical, and Experimental Sciences, University of Sassari, 07100 Sassari, Italy; (G.D.R.); (S.D.); (A.P.)
| | - Stefano Dore
- Ophthalmology Unit, Department of Medical, Surgical, and Experimental Sciences, University of Sassari, 07100 Sassari, Italy; (G.D.R.); (S.D.); (A.P.)
| | - Florence Coscas
- Centre Ophtalmologique de l’Odeon, 113 bd Saint Germain, 75006 Paris, France;
| | - Antonio Pinna
- Ophthalmology Unit, Department of Medical, Surgical, and Experimental Sciences, University of Sassari, 07100 Sassari, Italy; (G.D.R.); (S.D.); (A.P.)
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Serra R, Coscas F, Angius A, Pinna A. Multiple bilateral retinal astrocytic hamartomas in Usher syndrome. J Fr Ophtalmol 2022; 45:363-364. [DOI: 10.1016/j.jfo.2021.09.017] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/13/2021] [Revised: 08/10/2021] [Accepted: 09/08/2021] [Indexed: 11/17/2022]
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Gonzalez AJ, Kapila N, Thomas E, Pinna A, Tzakis A, Zervos XB. Managing liver transplantation during the COVID-19 pandemic: A survey among transplant centers in the Southeast United States. World J Hepatol 2021; 13:2161-2167. [PMID: 35070016 PMCID: PMC8727207 DOI: 10.4254/wjh.v13.i12.2161] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/26/2021] [Revised: 06/29/2021] [Accepted: 11/18/2021] [Indexed: 02/06/2023] Open
Abstract
BACKGROUND The coronavirus disease-2019 (COVID-19) pandemic has had a profound worldwide impact. Indeed, it has led to a vast decrease in organ transplantation, including liver transplants (LT). There is little data regarding adjustments made by LT centers as a response to the COVID-19 pandemic.
AIM To assess the experience of LT centers in the United States during the pandemic.
METHODS We performed an observational survey study from May 11, 2020 to June 5, 2020. We sent out a 13 question survey to 15 LT centers across the southeastern United States.
RESULTS Eleven LT centers responded to the survey. We found that (11/11) 100% of transplant centers made adjustments because of the COVID-19 pandemic. At least 50% of transplant centers had at least one transplant recipient infected with COVID-19. To adjust, greater than 50% of centers performed fewer LT, 100% of patients were tested for COVID-19, and most centers implemented a virtual platform.
CONCLUSION The COVID-19 pandemic greatly affected liver transplantation in the southeastern United States. It was evident that a concerted effort was made by LT centers to protect their patients and employees from COVID-19 but also to continue the life-saving procedure of LT in this sick patient population. Further studies are needed to assess how LT centers around the world managed the pandemic in order to learn strategies to continue life-saving procedures in this patient population.
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Affiliation(s)
| | - Nikhil Kapila
- Department of Transplant, Cleveland Clinic Florida, Weston, FL 33331, United States
| | - Emmanuel Thomas
- Schiff Center for Liver Diseases, University of Miami Miller School of Medicine, Miami, FL 33136, United States
- Sylvester Cancer Center, University of Miami Miller School of Medicine, Miami, FL 33136, United States
| | - Antonio Pinna
- Department of Transplant, Cleveland Clinic Florida, Weston, FL 33331, United States
| | - Andreas Tzakis
- Department of Transplant, Cleveland Clinic Florida, Weston, FL 33331, United States
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Serra R, Pinna A, Carlino P, Giancipoli E, Tadayoni R, Couturier A, Boscia F. Long-term capillary changes in areas of dissociated optic nerve fibre layer after macular hole surgery. Acta Ophthalmol 2021; 99:e1252-e1253. [PMID: 33423366 DOI: 10.1111/aos.14750] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/24/2020] [Revised: 11/14/2020] [Accepted: 12/10/2020] [Indexed: 11/27/2022]
Affiliation(s)
- Rita Serra
- Ophthalmology Department AP‐HP Hôpital Lariboisière Université de Paris Paris France
- Department of Biomedical Sciences University of Sassari Sassari Italy
- Istituto di Ricerca Genetica e Biomedica (IRGB) CNR Cittadella Universitaria di Cagliari Monserrato Italy
| | - Antonio Pinna
- Department of Medical, Surgical, and Experimental Sciences Ophthalmology Unit University of Sassari Sassari Italy
| | - Paola Carlino
- Department of Medical, Surgical, and Experimental Sciences Ophthalmology Unit University of Sassari Sassari Italy
| | - Ermete Giancipoli
- Department of Biomedical Sciences University of Sassari Sassari Italy
| | - Ramin Tadayoni
- Ophthalmology Department AP‐HP Hôpital Lariboisière Université de Paris Paris France
| | - Aude Couturier
- Ophthalmology Department AP‐HP Hôpital Lariboisière Université de Paris Paris France
| | - Francesco Boscia
- Department of Medical, Surgical, and Experimental Sciences Ophthalmology Unit University of Sassari Sassari Italy
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22
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Ricci GD, Garippa G, Cortese S, Serra R, Boscia F, Dore S, Pinna A. In vitro larvicidal activity of ivermectin and povidone-iodine against Oestrus ovis. PLoS One 2021; 16:e0259044. [PMID: 34699563 PMCID: PMC8547687 DOI: 10.1371/journal.pone.0259044] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/09/2021] [Accepted: 10/12/2021] [Indexed: 11/23/2022] Open
Abstract
Purpose To assess the in vitro larvicidal activity of ivermectin and povidone-iodine (PVP-I) against Oestrus ovis, the most frequent cause of external ophthalmomyiasis. Methods L1 O. ovis larvae were collected from the nasal boots of sheep slaughtered in local abattoirs and transferred onto Petri dishes containing mucosal tissue (25 larvae/dish). The larvicidal activity of the following formulations was tested: 1% ivermectin suspension in balanced sterile saline solution (BSSS), 1% ivermectin solution in propylene glycol, propylene glycol, 0.6% PVP-I in hyaluronic acid vehicle (IODIM®), and combination of ivermectin 1% solution and 0.6% PVP-I. One mL of each formulation was added to different Petri dishes containing the larvae. The time needed to kill the larvae was recorded. Results 893 larvae were tested. The median time needed to kill the larvae was 46, 44, 11, 6, and 10 minutes for Iodim®, ivermectin 1% suspension, propylene glycol, ivermectin 1% solution, and a combination of ivermectin 1% solution with 0.6% PVP-I, respectively. Kaplan-Meyer analysis disclosed that the survival curves were significantly lower in samples treated with ivermectin 1% solution, ivermectin 1% solution + 0.6% PVP-I, and propylene glycol than in samples receiving other treatments or BSSS. Conclusion In this in vitro study, ivermectin 1% solution in propylene glycol, ivermectin 1% solution + 0.6% PVP-I, and propylene glycol alone showed a good, relatively rapid larvicidal activity against O. ovis larvae. Further experimental and clinical studies are necessary to establish whether, or not, these formulations may be considered as potential candidates for the topical treatment for external ophthalmomyiasis caused by O. ovis.
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Affiliation(s)
- Giuseppe D’Amico Ricci
- Department of Biomedical Sciences, University of Sassari, Sassari, Italy
- Ospedale Sperino-Oftalmico, SC Oculistica II, ASL Città Di Torino, Turin, Italy
| | - Giovanni Garippa
- Department of Veterinary Medicine, University of Sassari, Sassari, Italy
| | - Stefano Cortese
- SC di Farmacia, Azienda Ospedaliero-Universitaria di Sassari, Sassari, Italy
| | - Rita Serra
- Department of Biomedical Sciences, University of Sassari, Sassari, Italy
| | - Francesco Boscia
- Department of Basic Medical Science, Section of Ophthalmology, Neuroscience and Sense Organs, University of Bari, Bari, Italy
| | - Stefano Dore
- Department of Medical, Surgical, and Experimental Sciences, Ophthalmology Unit, University of Sassari, Sassari, Italy
- UOC di Oculistica, Azienda Ospedaliero-Universitaria di Sassari, Sassari, Italy
| | - Antonio Pinna
- Department of Medical, Surgical, and Experimental Sciences, Ophthalmology Unit, University of Sassari, Sassari, Italy
- UOC di Oculistica, Azienda Ospedaliero-Universitaria di Sassari, Sassari, Italy
- * E-mail:
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Pinna A, Porcu T, Paliogiannis P, Dore S, Serra R, Boscia F, Carru C, Zinellu A. Complete blood cell count measures in retinal artey occlusions. Acta Ophthalmol 2021; 99:637-643. [PMID: 33629472 DOI: 10.1111/aos.14699] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/30/2020] [Accepted: 11/03/2020] [Indexed: 11/26/2022]
Abstract
PURPOSE To investigate the role of complete blood cell count (CBC) measures in retinal artery occlusion (RAO). METHODS This was a case-control study, including 73 newly diagnosed RAO patients and 73 sex- and age-matched subjects without RAO. On the same day of RAO diagnosis, a blood sample was collected and CBC was determined using an automatic blood counter. Dimensional CBC indices, such as mean platelet volume (MPV) and red cell distribution width (RDW), and some CBC-combined indices, including neutrophil/lymphocyte ratio (NLR), derived NLR [dNLR = neutrophils/(white blood cells - neutrophils)] and platelet/lymphocyte ratio (PLR), were evaluated. Erythrocyte sedimentation rate (ESR) was also measured. RESULTS Median neutrophils, red cell distribution width (RDW), NLR and dNLR were 4.5x109 /L (IQR = 3.8-5.8), 13.4% (IQR = 12.7-14.75), 2.47 (IQR = 1.85-3.13) and 1.70 (IQR = 1.26-2.18) in RAO patients and 4x109 /L (IQR = 3.18-4.93), 12.9% (IQR = 12-14), 1.86 (IQR = 1.42-2.44) and 1.32 (IQR = 1.02-1.64) in controls. RAO patients had significantly higher values of neutrophils (p = 0.003), RDW (p = 0.0011), NLR (p = 0.0001) and dNLR (p = 0.0001). There were no significant differences between the values of white blood cells, lymphocytes, platelet count, MPV and PLR. Multivariate logistic regression models revealed a statistically significant correlation between RAO and increased RDW (OR = 1.36, 95% CI = 1.06-1.73, p = 0.015), NLR (OR = 2.02, 95% CI = 1.34-3.06, p = 0.0009) and dNLR (OR = 3.4, 95% CI = 1.71-6.75, p = 0.0005). CONCLUSION Results suggest that RDW, NLR and dNLR may be involved in the pathogenesis of RAO and predict its occurrence. However, high-quality epidemiologic studies, preferably of cohort design, are warranted to confirm whether, or not, an RDW, NLR and dNLR may be considered potential biomarkers of RAO.
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Affiliation(s)
- Antonio Pinna
- Department of Medical, Surgical, and Experimental Sciences University of Sassari Sassari Italy
- Azienda Ospedaliero‐Universitaria di Sassari Sassari Italy
| | - Tiziana Porcu
- Department of Medical, Surgical, and Experimental Sciences University of Sassari Sassari Italy
| | | | - Stefano Dore
- Department of Medical, Surgical, and Experimental Sciences University of Sassari Sassari Italy
| | - Rita Serra
- Department of Biomedical Sciences University of Sassari Sassari Italy
| | - Francesco Boscia
- Section of Ophthalmology Department of Basic Medical Science, Neuroscience and Sense Organs University of Bari Bari Italy
| | - Ciriaco Carru
- Azienda Ospedaliero‐Universitaria di Sassari Sassari Italy
- Department of Biomedical Sciences University of Sassari Sassari Italy
| | - Angelo Zinellu
- Department of Biomedical Sciences University of Sassari Sassari Italy
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24
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Gonzalez A, Zervos X, Pinna A, Singh KT, Castaneda D, Reino D, Ebaid S, McWilliams C, Donato C, Al Khalloufi K. Orthotopic Liver Transplantation in a Cirrhotic Patient With Recent COVID-19 Infection. ACG Case Rep J 2021; 8:e00634. [PMID: 34258306 PMCID: PMC8270595 DOI: 10.14309/crj.0000000000000634] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/23/2020] [Accepted: 03/30/2021] [Indexed: 12/22/2022] Open
Abstract
The coronavirus disease 2019 (COVID-19) pandemic has led to a decrease in liver transplantation because of concerns regarding safety and healthcare resource utilization. There are scant data regarding the safety, optimal timing, and preferred postsurgical immunosuppression regimens for liver transplantation in patients recovered from COVID-19 infection. We describe our experience with one of the first reported cases of orthotopic liver transplantation in a patient who had recently recovered from COVID-19 infection. Using our experience as an example, orthotopic liver transplantation in patients that have recovered from COVID-19 may be safe.
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Affiliation(s)
- Adalberto Gonzalez
- Department of Gastroenterology and Hepatology, Cleveland Clinic Florida, Weston, FL
| | - Xaralambos Zervos
- Department of Gastroenterology and Hepatology, Cleveland Clinic Florida, Weston, FL
| | - Antonio Pinna
- Department of Transplant, Cleveland Clinic Florida, Weston, FL
| | | | - Daniel Castaneda
- Department of Gastroenterology and Hepatology, Cleveland Clinic Florida, Weston, FL
| | - Diego Reino
- Department of Transplant, Cleveland Clinic Florida, Weston, FL
| | - Samer Ebaid
- Department of Transplant, Cleveland Clinic Florida, Weston, FL
| | - Carla McWilliams
- Department of Infectious Disease, Cleveland Clinic Florida, Weston, Florida, Weston, FL
| | - Christian Donato
- Department of Infectious Disease, Cleveland Clinic Florida, Weston, Florida, Weston, FL
| | - Kawtar Al Khalloufi
- Department of Gastroenterology and Hepatology, Cleveland Clinic Florida, Weston, FL
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25
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Nagino M, DeMatteo R, Lang H, Cherqui D, Malago M, Kawakatsu S, DeOliveira ML, Adam R, Aldrighetti L, Boudjema K, Chapman W, Clary B, de Santibañes E, Dong J, Ebata T, Endo I, Geller D, Guglielmi A, Kato T, Lee SG, Lodge P, Nadalin S, Pinna A, Polak W, Soubrane O, Clavien PA. Proposal of a New Comprehensive Notation for Hepatectomy: The "New World" Terminology. Ann Surg 2021; 274:1-3. [PMID: 33630445 DOI: 10.1097/sla.0000000000004808] [Citation(s) in RCA: 65] [Impact Index Per Article: 21.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/22/2022]
Affiliation(s)
- Masato Nagino
- Department of Gastroenterological Surgery, Aichi Cancer Center Hospital, Nagoya, Japan
| | - Ronald DeMatteo
- Department of Surgery, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania
| | - Hauke Lang
- Department of General, Visceral and Transplant Surgery, University Hospital Mainz, Mainz, Germany
| | - Daniel Cherqui
- Hôpital Paul Brousse, APHP - Université Paris - Saclay, Villejuif, France
| | - Massimo Malago
- Department of HPB- and Liver Transplantation Surgery, University College London, Royal Free Hospitals, London, UK
| | - Shoji Kawakatsu
- Department of Gastroenterological Surgery, Aichi Cancer Center Hospital, Nagoya, Japan
| | - Michelle L DeOliveira
- Department of Surgery & Transplantation, University Hospital Zurich, Zurich, Switzerland
| | - René Adam
- Hôpital Paul Brousse, APHP - Université Paris - Saclay, Villejuif, France
| | - Luca Aldrighetti
- Hepatobiliary Surgery Division, Department of Surgery, IRCCS San Raffaele Hospital, School of Medicine, Milan, Italy
| | - Karim Boudjema
- Department of Hepatobiliary and Digestive Surgery, Rennes University Hospital, Rennes, France
| | - William Chapman
- Section of Transplantation Surgery, Siteman Cancer Center, Barnes-Jewish Hospital, Washington University School of Medicine, St. Louis, Missouri
| | - Bryan Clary
- Department of Surgery, University of California at San Diego, San Diego, California
| | - Eduardo de Santibañes
- Department of Surgery, Division of HPB Surgery, Liver Transplant Unit, Italian Hospital of Buenos Aires, Buenos Aires, Argentina
| | - Jiahong Dong
- Hepato-pancreato-biliary Center, Beijing Tsinghua Changgung Hospital, School of Clinical Medicine, Tsinghua University, Beijing, China
| | - Tomoki Ebata
- Department of Surgery, Nagoya University Graduate School of Medicine, Nagoya, Japan
| | - Itaru Endo
- Department of Gastroenterological Surgery, Graduate School of Medicine, Yokohama City University, Yokohama, Japan
| | - David Geller
- Division of Hepatobiliary and Pancreatic Surgery, Department of Surgery, University of Pittsburgh Medical Center, Pittsburgh, Pennsylvania
| | - Alfredo Guglielmi
- Department of Surgery, General and Hepatobiliary Surgery, University of Verona, Verona, Italy
| | - Tomoaki Kato
- Center for Liver Disease and Transplantation, Columbia University Medical Center, New York, New York
| | - Sung-Gyu Lee
- Hepato-Biliary Surgery & Liver Transplantation, Asan Medical Center, Ulsan University, Seoul, Republic of Korea
| | - Peter Lodge
- HPB and Transplant Unit, St. James's University Hospital, Leeds, UK
| | - Silvio Nadalin
- Department of General and Transplant Surgery, University Hospital Tübingen, Tübingen, Germany
| | - Antonio Pinna
- Center for Abdominal Transplantation Weston, Cleveland Clinic Florida, Weston, Florida
| | - Wojciech Polak
- Department of Surgery, Division of Hepatopancreatobiliary and Transplant Surgery, Erasmus MC, University Medical Center Rotterdam, Rotterdam, The Netherlands
| | - Olivier Soubrane
- Department of HPB Surgery and Liver Transplant, Beaujon Hospital, Clichy, France
| | - Pierre-Alain Clavien
- Department of Surgery & Transplantation, University Hospital Zurich, Zurich, Switzerland
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26
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Ravaioli M, Prosperi E, Pinna A, Siniscalchi A, Fallani G, Frascaroli G, Maroni L, Odaldi F, Serenari M, Cescon M. Restoration of portal flow with varix in liver transplantation for patients with total portal vein thrombosis: An effective strategy in the largest center experience. Clin Transplant 2021; 35:e14303. [PMID: 33797802 DOI: 10.1111/ctr.14303] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/15/2020] [Revised: 03/19/2021] [Accepted: 03/26/2021] [Indexed: 12/12/2022]
Abstract
INTRODUCTION Postoperative complications and worse prognosis still burden liver transplantations (LT) with complex portal vein thrombosis (CPVT). When an engorged left gastric vein (LGV) is present, the portal inflow is restorable with an anastomosis between the graft portal vein and the LGV of the recipient. We analyzed short- and long-term results of this procedure in 12 LT with CPVT. METHODS Between 2005 and 2019, 55 patients with CPVT underwent LT. We applied this technique in 12 patients. In six cases, we placed a vascular graft to obtain a tension-free structure. We evaluated patency, short- and long-term results. RESULTS No intraoperative complication was observed. The median duration of LT, blood transfusion, deceased donor age, and MELD score of the recipients were 7 h, 1250 mL, 72 years, and 19. Seven patients were affected by hepatocellular carcinoma. No major complications or PVT recurrence were observed. One patient required a liver re-transplantation for primary non-functioning syndrome. The mean hospital stay was 20 days. The actuarial patient survival was 85% with a mean FU of 4 years. The two late deaths were due to hepatocellular carcinoma recurrence and sepsis for cholangitis. CONCLUSIONS This technique in presence of both CPVT and engorged LGV is feasible and safe for patients, with good short- and long-term results.
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Affiliation(s)
- Matteo Ravaioli
- Department of General Surgery and Transplantation, IRCCS, Azienda Ospedaliero-Universitaria di Bologna, Bologna, Italy.,Department of General Surgery and Transplantation, University of Bologna, Bologna, Italy
| | - Enrico Prosperi
- Department of General Surgery and Transplantation, IRCCS, Azienda Ospedaliero-Universitaria di Bologna, Bologna, Italy
| | - Antonio Pinna
- Department of General Surgery and Transplantation, IRCCS, Azienda Ospedaliero-Universitaria di Bologna, Bologna, Italy
| | - Antonio Siniscalchi
- Department of General Surgery and Transplantation, IRCCS, Azienda Ospedaliero-Universitaria di Bologna, Bologna, Italy
| | - Guido Fallani
- Department of General Surgery and Transplantation, IRCCS, Azienda Ospedaliero-Universitaria di Bologna, Bologna, Italy
| | - Giacomo Frascaroli
- Department of General Surgery and Transplantation, IRCCS, Azienda Ospedaliero-Universitaria di Bologna, Bologna, Italy
| | - Lorenzo Maroni
- Department of General Surgery and Transplantation, IRCCS, Azienda Ospedaliero-Universitaria di Bologna, Bologna, Italy
| | - Federica Odaldi
- Department of General Surgery and Transplantation, IRCCS, Azienda Ospedaliero-Universitaria di Bologna, Bologna, Italy
| | - Matteo Serenari
- Department of General Surgery and Transplantation, IRCCS, Azienda Ospedaliero-Universitaria di Bologna, Bologna, Italy
| | - Matteo Cescon
- Department of General Surgery and Transplantation, IRCCS, Azienda Ospedaliero-Universitaria di Bologna, Bologna, Italy.,Department of General Surgery and Transplantation, University of Bologna, Bologna, Italy
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D'Amico Ricci G, Del Turco C, Belcastro E, Palisi M, Romano MR, Pinna A, Panico C, La Spina C. Covid-19 and acute conjunctivitis: Controversial data from a tertiary refferral Italian center. Eur J Ophthalmol 2021; 31:2910-2913. [PMID: 33499675 DOI: 10.1177/1120672121991049] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
PURPOSE Although acute conjunctivitis has been listed from the beginning as a possible sign of COVID-19, the likelihood of this association remains unclear. The aim of this study was to investigate the relationship between COVID-19 and conjunctivitis. METHODS In this retrospective, observational study, we recruited all patients with signs and symptoms of acute conjunctivitis seen at the Eye Emergency Department (ED), Turin Eye Hospital, between 01/01/2020 and 12/05/2020 and cross-checked our data with the Piedmont Region online COVID-19 registry in the same period. RESULTS Among 10,065 patients seen at our ED during the timespan considered, 88 underwent a nasopharyngeal swab (NS) for SARS-CoV-2 detection within 4 weeks before/after our examination. On average, NS was performed -0.72 ± 1.8 weeks before/after eye examination. Of the 77 patients with a negative NS, 26 (33.8%) had a diagnosis of acute conjunctivitis, whereas the remaining 51 (66.2%) had other eye disorders. Among the 11 patients with COVID-19, 7 (63,6%) had a diagnosis of acute conjunctivitis. We found a non-statistically significant increase in NS positivity rate (21.2%) among cases examined at our ED for acute conjunctivitis, compared to the NS positivity rate (7.3%) in patients examined for all other eye conditions (p = 0.092). The Odds Ratio of having a positive NS in patients with acute conjunctivitis was 3.43 (95% I.C. = 0.9-12.8, p = 0.06). Considering online-registry data of Turin population during the same time-span, among 2441 positive NS cases only 27 (1.1%) presented with acute conjunctivitis. CONCLUSION Our results do not reveal a statistically significant correlation between COVID-19 and acute conjunctivitis. SYNOPSIS The present study analyzes retrospectively data from a tertiary eye referral center to investigate the relationship between COVID-19 infection and conjunctivitis.
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Affiliation(s)
| | - Claudia Del Turco
- U.O. Oculistica 2, Turin Eye Hospital, ASL Città di Torino, Turin, Italy.,Ophthalmology Unit, Humanitas Gradenigo Hospital, Turin, Italy
| | - Elena Belcastro
- U.O. Oculistica 2, Turin Eye Hospital, ASL Città di Torino, Turin, Italy.,Ophthalmology Unit, Humanitas Gradenigo Hospital, Turin, Italy
| | - Marco Palisi
- General Surgey Unit, Ospedale Mauriziano, Turin, Italy
| | - Mario R Romano
- Department of Biomedical Sciences, Humanitas University, Milan, Italy
| | - Antonio Pinna
- Department of Medical, Surgical, and Experimental Sciences, Ophthalmology Unit, University of Sassari, Sassari, Italy
| | - Claudio Panico
- U.O. Oculistica 2, Turin Eye Hospital, ASL Città di Torino, Turin, Italy.,Ophthalmology Unit, Humanitas Gradenigo Hospital, Turin, Italy
| | - Carlo La Spina
- U.O. Oculistica 2, Turin Eye Hospital, ASL Città di Torino, Turin, Italy.,Ophthalmology Unit, Humanitas Gradenigo Hospital, Turin, Italy
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Serra R, Coscas F, Pinna A, Cabral D, Coscas G, Souied EH. QUANTITATIVE OPTICAL COHERENCE TOMOGRAPHY ANGIOGRAPHY FEATURES OF INACTIVE MACULAR NEOVASCULARIZATION IN AGE-RELATED MACULAR DEGENERATION. Retina 2021; 41:93-102. [PMID: 32281767 DOI: 10.1097/iae.0000000000002807] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
PURPOSE To compare quantitative optical coherence tomography angiography parameters between treatment-naïve quiescent macular neovascularizations (MNVs) and previously treated nonexudative Type 1 MNVs, in patients with age-related macular degeneration. METHODS The eyes included in the study were analyzed by fluorescein angiography, indocyanine green angiography, spectral-domain optical coherence tomography, and optical coherence tomography angiography. According to their medical history and multimodal imaging evaluation, Type 1 MNVs were divided into 2 groups: 1) treatment-naïve quiescent MNVs; 2) previously treated nonexudative Type 1 MNVs. Quantitative optical coherence tomography angiography parameters, including perfusion density (PD), fractal dimension (FD), and lacunarity (LAC) were calculated. Receiver operating characteristic curves, showing the ability of PD, FD, and LAC to discriminate between the two MNV groups, were built. RESULTS Twenty-two eyes with treatment-naïve quiescent MNVs and 20 eyes with MNVs previously treated nonexudative Type 1 MNVs were analyzed. Mean FD and LAC were statistically different between the two study groups (P < 0.05). Lacunarity showed the best discrimination ability, followed by FD and PD (area under curve = 0.83, 0.78, 0.62, respectively). CONCLUSION Results suggest that FD and LAC may be useful optical coherence tomography angiography biomarkers to objectively discriminate inactive MNVs with different prognosis, such as treatment-naïve quiescent MNVs and previously treated nonexudative Type 1 MNVs, in age-related macular degeneration patients.
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Affiliation(s)
- Rita Serra
- Department of Biomedical and Surgical Sciences, University of Sassari, Sassari, Italy
- Istituto di Ricerca Genetica e Biomedica (IRGB), CNR, Cittadella Universitaria di Cagliari, Monserrato (CA), Italy
- Centre Ophtalmologique de l'Odeon, Paris, France
| | - Florence Coscas
- Centre Ophtalmologique de l'Odeon, Paris, France
- Department of Ophthalmology, Centre Hospitalier Intercommunal de Creteil University Paris Est Creteil, Creteil, France
| | - Antonio Pinna
- Ophthalmology Unit, Department of Medical, Surgical, and Experimental Sciences, University of Sassari, Sassari, Italy ; and
| | - Diogo Cabral
- Instituto de Oftalmologia Dr. Gama Pinto, Lisboa, Portugal
| | - Gabriel Coscas
- Centre Ophtalmologique de l'Odeon, Paris, France
- Department of Ophthalmology, Centre Hospitalier Intercommunal de Creteil University Paris Est Creteil, Creteil, France
| | - Eric H Souied
- Department of Ophthalmology, Centre Hospitalier Intercommunal de Creteil University Paris Est Creteil, Creteil, France
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Orabona R, Sciatti E, Vizzardi E, Bonadei I, Metra M, Sartori E, Frusca T, Pinna A, Bellocco R, Prefumo F. Maternal hemodynamics, arterial stiffness and elastic aortic properties in twin pregnancy. Physiol Meas 2021; 41:125001. [PMID: 33385315 DOI: 10.1088/1361-6579/abb760] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
Abstract
OBJECTIVE There is scant information about maternal cardiovascular hemodynamic change during twin pregnancies. Aim of the study is to investigate longitudinal changes in maternal arterial stiffness, elastic aortic properties and ventricular-arterial coupling (VAC) in uncomplicated twin pregnancies compared to singleton ones. APPROACH In this prospective longitudinal study, we performed applanation tonometry and transthoracic echocardiography in the first (T1; 10-15 weeks' gestation (w)), second (T2; 19-26 w) and third trimesters (T3; 30-38 w) in women with uncomplicated twin pregnancies, both monochorionic and dichorionic. Heart-rate-corrected augmentation index (AIx@75) was studied as indicator of arterial stiffness. Aortic diameters and elastic properties were calculated. VAC was defined as the ratio between aortic elastance (Ea) and left ventricular end-systolic elastance (Ees). Finally, stroke volume (SV), cardiac output (CO) and total vascular resistance (TVR) were evaluated. The findings were compared to those of women with uncomplicated singleton pregnancies. MAIN RESULTS Thirty women with twin gestations (11 monochorionic) and 30 singleton controls were obtained for analysis. Blood pressure and TVR significantly decreased from T1 to T2 and then rose in T3, with higher values in twins than in singletons. AIx@75 showed the same trend in both groups with lower values at T2 in twins. SV and CO linearly increased throughout gestation with no significant intergroup difference. Aortic diameters and elastic properties remained stable throughout gestation, with no significant intergroup differences. Both Ea and Ees were greater (i.e. worse) in twins than in singletons at T1 and T3, showing a significant linear trend towards reduction in the two groups, meaning lower vascular and ventricular loads. Using longitudinal analysis blood pressure, TVR, Ea and Ees depended from both multiple gestation and gestational age. SIGNIFICANCE In twins, maternal hemodynamics does not seem to undergo more significant changes than in singletons being characterized by higher blood pressures and TVR with no differences in CO, SV, aortic dimensions and elastic properties. Despite VAC is maintained within its normal range, total vascular load (i.e., Ea) resulted higher in twin than singleton pregnancies throughout gestation. It is conceivable that these findings may represent one of the underlying cause for the increased risk of adverse obstetric outcomes described in multiple gestations.
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Affiliation(s)
- Rossana Orabona
- Department of Obstetrics and Gynecology, University of Brescia, Brescia, Italy. Equally contributors
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Pinna A, Carlino P, Serra R, Boscia F, Dore S, Carru C, Zinellu A. Red Cell Distribution Width (RDW) and Complete Blood Cell Count-Derived Measures in Non-Arteritic Anterior Ischemic Optic Neuropathy. Int J Med Sci 2021; 18:2239-2244. [PMID: 33859533 PMCID: PMC8040420 DOI: 10.7150/ijms.53668] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/24/2020] [Accepted: 12/18/2020] [Indexed: 12/03/2022] Open
Abstract
Purpose: To assess the role of complete blood cell count (CBC) dimensional indices and CBC-derived measures in non-arteritic anterior ischemic optic neuropathy (NA-AION). Methods: In this retrospective case-control survey, 37 newly diagnosed NA-AION patients and 37 sex- and age-matched cataract controls were enrolled in 2017-2018. On the same day of NA-AION diagnosis, a blood sample was collected and CBC was determined using an automatic blood counter. CBC dimensional indices, such as mean platelet volume (MPV) and red cell distribution width (RDW), and CBC-combined indices, including neutrophil/lymphocyte ratio (NLR), derived NLR [dNLR = neutrophils/(white blood cells - neutrophils)], and platelet/lymphocyte ratio (PLR), were evaluated. Erythrocyte sedimentation rate (ESR) was also measured. Results: Mean platelet count, median MPV, RDW, NLR, and dNLR were 221±48 x 109/L, 8.2 fL (IQR=7.6-8.9), 13% (IQR=12-14.5), 2.50 (IQR=1.77-3.06), and 1.73 (IQR=1.31-2.07) in NA-AION patients and 248±56 x 109/L, 7.60 fL (IQR=7.05-8.25), 12% (IQR=11.6-13), 1.95 (IQR=1.43-2.49) and 1.36 (IQR=1.07-1.69) in controls. NA-AION patients showed significantly lower platelet count (p=0.03) and significantly higher median values of MPV (p=0.01), RDW (p=0.015), NLR (p=0.03), and dNLR (p=0.01). Multivariate logistic regression models disclosed a significant correlation only between higher levels of RDW and NA-AION (p≤0.05). The attributable risk of the association between NA-AION and RDW was 33%. Conclusions: Results suggest that RDW may be somehow involved in the pathogenesis of NA-AION. However, high-quality cohort studies are warranted to confirm whether, or not, an altered RDW may be considered a potential biomarker of this vascular disorder affecting the optic nerve.
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Affiliation(s)
- Antonio Pinna
- Department of Medical, Surgical, and Experimental Sciences, University of Sassari, Sassari, Italy.,Azienda Ospedaliero-Universitaria di Sassari, Sassari, Italy
| | - Paola Carlino
- Department of Medical, Surgical, and Experimental Sciences, University of Sassari, Sassari, Italy
| | - Rita Serra
- Department of Biomedical Sciences, University of Sassari, Sassari, Italy
| | - Francesco Boscia
- Section of Ophthalmology, Department of Basic Medical Science, Neuroscience and Sense Organs, University of Bari, Bari, Italy
| | - Stefano Dore
- Department of Medical, Surgical, and Experimental Sciences, University of Sassari, Sassari, Italy
| | - Ciriaco Carru
- Azienda Ospedaliero-Universitaria di Sassari, Sassari, Italy.,Department of Biomedical Sciences, University of Sassari, Sassari, Italy
| | - Angelo Zinellu
- Department of Biomedical Sciences, University of Sassari, Sassari, Italy
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Serra R, Coscas F, Pinna A, Cabral D, Coscas G, Souied EH. Fractal analysis of polypoidal choroidal neovascularisation in age-related macular degeneration. Br J Ophthalmol 2020; 105:1421-1426. [PMID: 32892164 PMCID: PMC8479737 DOI: 10.1136/bjophthalmol-2020-317011] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/27/2020] [Revised: 07/17/2020] [Accepted: 08/16/2020] [Indexed: 11/04/2022]
Abstract
Aim To describe optical coherence tomography angiography (OCTA) features of polypoidal choroidal neovascularisation (PCNV) secondary to age-related macular degeneration. Methods A retrospective consecutive series of 51 patients with a diagnosis of PCNV, based on clinical and multimodal imaging, was analysed. All patients with PCNV underwent a comprehensive ophthalmological examination, including fluorescein and indocyanine green angiography, structural optical coherence tomography (OCT) and OCTA. Two blinded retinal specialists carefully reviewed OCTA slabs in order to assess the morphological patterns of PCNV lesions. Furthermore, fractal analysis of PCNV en face images on OCTA, including vascular perfusion density (VPD), fractal dimension (FD) and lacunarity (LAC), was performed. Results Fifty-one PCNV eyes were included in the study. In all, the branching vascular network appeared hyper-reflective. Polyps showed two different patterns: in 34/51 (67%) eyes, they corresponded to hypo-reflective structures, whereas in the remaining 17 (33%) eyes, they appeared as hyper-reflective lesions. In all PCNV eyes, mean VPD, FD and LAC were 0.76±0.17%, 1.46±0.12 and 2.4±0.87, respectively. No significant difference was found between PCNVs showing a different OCTA pattern, in terms of quantitative OCTA parameters. Conclusion Fractal analysis provides quantitative parameters demonstrating that PCNVs with different OCTA patterns share the same neovascular architecture and branching complexity. These new findings improve our ability to interpret OCTA slabs, opening new areas of discussion about this type of neovascular lesion.
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Affiliation(s)
- Rita Serra
- Department of Surgical and Biomedical Sciences, University of Sassari, Sassari, Italy
- Istituto di Ricerca Genetica e Biomedica (IRGB), CNR, Cittadella Universitaria di Cagliari, 09042, Monserrato (CA), Cagliari, Italy
- Centre Ophtalmologique de l'Odéon, 113 bd Saint Germain, Paris, France
- Department of Ophthalmology, Centre Hospitalier Intercommunal de Creteil University Paris Est Créteil, Créteil, France
| | - Florence Coscas
- Centre Ophtalmologique de l'Odéon, 113 bd Saint Germain, Paris, France
- Department of Ophthalmology, Centre Hospitalier Intercommunal de Creteil University Paris Est Créteil, Créteil, France
| | - Antonio Pinna
- Department of Medical, Surgical, and Experimental Sciences,, University of Sassari, Sassari, Italy
| | - Diogo Cabral
- Instituto de Oftalmologia Dr. Gama Pinto, Lisboa, Portugal
| | - Gabriel Coscas
- Centre Ophtalmologique de l'Odéon, 113 bd Saint Germain, Paris, France
- Department of Ophthalmology, Centre Hospitalier Intercommunal de Creteil University Paris Est Créteil, Créteil, France
| | - Eric H Souied
- Department of Ophthalmology, Centre Hospitalier Intercommunal de Creteil University Paris Est Créteil, Créteil, France
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Serra R, Coscas F, Pinna A, Peri M, Zucca I, Sellam A, Giancipoli E, Boscia F. Detection of serum uric acid in primary open angle glaucoma: A pilot study. Eur J Ophthalmol 2020; 31:1857-1861. [PMID: 32698611 DOI: 10.1177/1120672120944012] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
PURPOSE To assess the association between the serum levels of uric acid (UA) and primary open-angle glaucoma (POAG). METHODS In this pilot study, 46 eyes of 23 patients with a clinical history of POAG and 30 eyes of 15 healthy subjects were included. All patients underwent a complete ophthalmological examination, including best corrected visual acuity (BCVA), intraocular pressure (IOP), and gonioscopy. Visual field parameters, such as mean deviation (MD) and pattern standard deviation (PSD), and optical coherence tomography (OCT) values of the optic nerve head, including retinal nerve fiber layer (RNFL) thickness and vertical cup/disc ratio (VCDR), were noted. A blood sample was collected from each subject for serum UA measurement. RESULTS IOP, MD, PSD, RNFL thickness, and VCDR resulted significantly different in POAG patients, when compared with controls (p < 0.05). POAG patients showed significantly lower levels of mean serum UA than healthy controls (4.00 ± 0.66 mg/dL vs 4.95 ± 0.86 mg/dL, respectively, p < 0.0001). Furthermore, severe POAG patients showed mean serum levels of UA lower than mild POAG patients (3.36 ± 0.70 mg/dL vs 4.22 ± 0.51 mg/dL, respectively, p = 0.01). Visual field and OCT parameters were statistically correlated with the mean serum levels of UA in POAG eyes (p < 0.05). CONCLUSION Results suggest that in POAG patients, serum UA levels may be decreased and correlated with visual field and OCT parameters worsening. Further larger multi-center prospective studies are necessary to confirm our findings and establish the role of UA in glaucoma.
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Affiliation(s)
- Rita Serra
- Department of Biomedical Sciences, University of Sassari, Sassari, Italy.,Istituto di Ricerca Genetica e Biomedica, CNR, Cittadella Universitaria di Cagliari, Monserrato (CA), Italy
| | - Florence Coscas
- Department of Ophthalmology, Centre Hospitalier Intercommunal de Creteil, University Paris Est Creteil, Creteil, France
| | - Antonio Pinna
- Department of Medical, Surgical, and Experimental Sciences, Ophthalmology Unit, University of Sassari, Sassari, Italy
| | - Marcella Peri
- Department of Surgical Sciences, Eye Clinic, University of Cagliari, Cagliari, Italy
| | - Ignazio Zucca
- Department of Surgical Sciences, Eye Clinic, University of Cagliari, Cagliari, Italy
| | | | - Ermete Giancipoli
- Department of Biomedical Sciences, University of Sassari, Sassari, Italy
| | - Francesco Boscia
- Department of Medical, Surgical, and Experimental Sciences, Ophthalmology Unit, University of Sassari, Sassari, Italy
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Pinna A, Porcu T, Marzano J, Boscia F, Paliogiannis P, Dore S, Alessio G, Carru C, Zinellu A. Mean Platelet Volume, Red Cell Distribution Width, and Complete Blood Cell Count Indices in Retinal Vein Occlusions. Ophthalmic Epidemiol 2020; 28:39-47. [PMID: 32648802 DOI: 10.1080/09286586.2020.1791349] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/30/2023]
Abstract
PURPOSE To evaluate the role of some complete blood cell count (CBC)-derived measures in retinal vein occlusion (RVO). METHODS This was a retrospective case-control study, including 127 newly diagnosed RVO patients and 127 sex- and age-matched subjects without RVO. A blood sample was obtained and a complete blood cell count was performed. Neutrophil/lymphocyte ratio (NLR), derived NLR [dNLR = neutrophils/(white blood cells‒neutrophils)], and platelet/lymphocyte ratio (PLR) were calculated. We also performed a meta-analysis of the available data, ours included, on the correlation between mean platelet volume (MPV) and RVO. Standardized mean differences (SMD) were used to build forest plots and assess differences in MPV values between RVO patients and controls. RESULTS Median MPV and red cell distribution width (RDW) were 8.7 fL (IQR = 7.8-9.5) and 13.2% (IQR = 12.4-14.2) in RVO patients and 7.8 fL (IQR = 7.1-8.5) and 13% (IQR = 12-14) in controls. RVO patients had significantly higher values of MPV (P < .0001) and RDW (P = .005). There were no significant differences between the values of white blood cells, lymphocytes, neutrophils, platelets, NLR, dNLR, and PLR. Multivariable logistic regression analysis revealed a statistically significant correlation between increased MPV and RVO (OR = 1.74, 95% CI = 1.38-2.2, P < .0001). 519 RVO patients and 414 controls from 6 case-control studies were included in the meta-analysis. Pooled results disclosed that MPV values were significantly higher in RVO patients (SMD = 0.41 fL, 95% CI = 0.04-0.79, P = .032), but extreme heterogeneity was observed (I2 = 86.1%, P < .001). CONCLUSION Results suggest lack of association between CBC-derived inflammatory indices and RVO. Conversely, MPV and, to a lesser extent, RDW may be disease biomarkers in RVO.
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Affiliation(s)
- Antonio Pinna
- Department of Medical, Surgical, and Experimental Sciences, University of Sassari , Sassari, Italy.,Azienda Ospedaliero-Universitaria Di Sassari , Sassari, Italy
| | - Tiziana Porcu
- Department of Medical, Surgical, and Experimental Sciences, University of Sassari , Sassari, Italy
| | - Jacopo Marzano
- Department of Medical, Surgical, and Experimental Sciences, University of Sassari , Sassari, Italy
| | - Francesco Boscia
- Department of Medical, Surgical, and Experimental Sciences, University of Sassari , Sassari, Italy.,Azienda Ospedaliero-Universitaria Di Sassari , Sassari, Italy
| | | | - Stefano Dore
- Department of Medical, Surgical, and Experimental Sciences, University of Sassari , Sassari, Italy
| | - Giovanni Alessio
- Section of Ophthalmology, Department of Basic Medical Science, Neuroscience and Sense Organs, University of Bari , Bari, Italy
| | - Ciriaco Carru
- Azienda Ospedaliero-Universitaria Di Sassari , Sassari, Italy.,Department of Biomedical Sciences, University of Sassari , Sassari, Italy
| | - Angelo Zinellu
- Department of Biomedical Sciences, University of Sassari , Sassari, Italy
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Serra R, Gherardini M, Coscas F, Pinna A, Boscia F. Retinal Granuloma Associated with Primary HHV6 Infection in an Immunocompetent Patient: A Case Report and Review of the Literature. Ocul Immunol Inflamm 2020; 28:754-757. [DOI: 10.1080/09273948.2019.1642496] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
Affiliation(s)
- Rita Serra
- Department of Biomedical Sciences, University of Sassari, Sassari, Italy
- Istituto di Ricerca Genetica e Biomedica (IRGB), CNR, Cittadella Universitaria di Cagliari, Cagliari, Italy
| | - Manuela Gherardini
- Eye Clinic, Department of Surgical Science, University of Cagliari, Cagliari, Italy
| | - Florence Coscas
- Department of Ophthalmology, Centre Hospitalier Intercommunal de Creteil University Paris Est Creteil, Creteil, France
| | - Antonio Pinna
- Department of Medical, Surgical, and Experimental Sciences, Ophthalmology Unit, University of Sassari, Sassari, Italy
| | - Francesco Boscia
- Department of Medical, Surgical, and Experimental Sciences, Ophthalmology Unit, University of Sassari, Sassari, Italy
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Bocca B, Forte G, Pisano A, Farace C, Giancipoli E, Pinna A, Dore S, Madeddu R. A pilot study to evaluate the levels of aqueous humor trace elements in open-angle glaucoma. J Trace Elem Med Biol 2020; 61:126560. [PMID: 32485500 DOI: 10.1016/j.jtemb.2020.126560] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/07/2019] [Revised: 03/03/2020] [Accepted: 05/20/2020] [Indexed: 11/29/2022]
Abstract
BACKGROUND Primary open angle glaucoma (POAG) is the most common form of chronic, progressive optic neuropathies characterized by slow degeneration of the retinal ganglion cells and their axons, resulting in visual field loss. Risk factors for this disease are elevated intraocular pressure (IOP), increased age, European and African ethnicity, family history, myopia and decreased corneal thickness. In addition, studies indicated that levels of trace elements are also significantly related to the POAG. METHOD The association between toxic and essential elements and POAG was explored in a population-based case-control study in the Sardinia Island (Italy). The aqueous humor levels of Al, Cd, Cu, Fe, Hg, Mn, Ni, Pb and Zn were measured in 25 POAG patients compared to 20 age- and gender-matched healthy controls by sector field inductively coupled mass spectrometry. Risk factors as gender, age and increased IOP were also explored. RESULTS The concentrations of Fe, Hg and Zn were significantly higher in POAG patients than in control subjects, showing these elements as possible determinants in POAG development or degeneration. Other findings were the increased Cu and Fe levels in glaucomatous patients with age less than 70 years. Levels of Ni were found elevated in POAG females. Mercury accumulated more in POAG females, in patients over 70 years and in those with higher levels of IOP in the left eye. Moreover, the positive associations CuFe and Mn-Zn may indicate synergistic effects of elements. CONCLUSIONS Altogether, these findings suggested a multifactorial role in the risk for POAG disease. The present study documented the levels of trace elements in aqueous humor of Sardinian POAG patients for the first time.
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Affiliation(s)
- Beatrice Bocca
- Department of Environment and Health, Italian National Institute for Health, Viale Regina Elena 299, 00161 Rome, Italy
| | - Giovanni Forte
- Department of Environment and Health, Italian National Institute for Health, Viale Regina Elena 299, 00161 Rome, Italy.
| | - Andrea Pisano
- Department of Biomedical Sciences-Histology, University of Sassari, Viale San Pietro 43/B, 07100 Sassari, Italy
| | - Cristiano Farace
- Department of Biomedical Sciences-Histology, University of Sassari, Viale San Pietro 43/B, 07100 Sassari, Italy
| | - Ermete Giancipoli
- Department of Medical Surgical and Experimental Sciences, Ophthalmology Unit, University of Sassari, Viale San Pietro 43/C, 07100 Sassari, Italy
| | - Antonio Pinna
- Department of Medical Surgical and Experimental Sciences, Ophthalmology Unit, University of Sassari, Viale San Pietro 43/C, 07100 Sassari, Italy
| | - Stefano Dore
- Department of Medical Surgical and Experimental Sciences, Ophthalmology Unit, University of Sassari, Viale San Pietro 43/C, 07100 Sassari, Italy
| | - Roberto Madeddu
- Department of Biomedical Sciences-Histology, University of Sassari, Viale San Pietro 43/B, 07100 Sassari, Italy; I.S.R.C.T.--International Society for Research on Cadmium Toxicity, Viale San Pietro 43/B, 07100 Sassari, Italy
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Pinna A, Saccani G, Schivazappa C, Simoncini N, Virgili R. Revision of the cold processing phases to obtain a targeted salt reduction in typical Italian dry-cured ham. Meat Sci 2020; 161:107994. [DOI: 10.1016/j.meatsci.2019.107994] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/26/2019] [Revised: 10/21/2019] [Accepted: 10/29/2019] [Indexed: 12/20/2022]
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Pinna A, Donadu MG, Usai D, Dore S, D'Amico‐Ricci G, Boscia F, Zanetti S. In vitro antimicrobial activity of a new ophthalmic solution containing povidone-iodine 0.6% (IODIM ® ). Acta Ophthalmol 2020; 98:e178-e180. [PMID: 31486592 DOI: 10.1111/aos.14243] [Citation(s) in RCA: 37] [Impact Index Per Article: 9.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/06/2019] [Accepted: 08/17/2019] [Indexed: 12/13/2022]
Abstract
PURPOSE To assess the in vitro antimicrobial activity of a new commercial ophthalmic solution containing povidone-iodine 0.6% (IODIM® ). METHODS Staphylococcus aureus ATCC 43300, Pseudomonas aeruginosa ATCC 27853, three ocular bacterial isolates (1 S. epidermidis, 1 S. aureus, 1 P. aeruginosa) and five Candida species were used. The bacterial and fungal isolates were cultured on Columbia blood agar base plates and Sabouraud-dextrose agar plates, respectively and incubated overnight at 37°C. Bacterial and fungal suspensions in sterile saline solution were prepared to an optical density equal to 0.5 McFarland standard (approximately 108 CFU/ml). Suspensions of the isolates were made in IODIM® solution to obtain a final concentration of 106 CFU/ml. The suspensions were then distributed in conical tubes in a final volume of 1 ml and incubated at 37°C. At different time-points (1, 5, 10, 15, 20, 25, 30 min and 24 hr), 10 μl of each suspension was removed, seeded on Columbia blood agar base and Sabouraud-dextrose agar plates and then incubated for 24 hr at 37°C. Positive and negative controls were included in all experiments. RESULTS After 5-min incubation, there was no bacterial growth on any plate. Conversely, IODIM® failed to kill the Candida isolates after 30 min' exposure and needed 24 hr to eradicate the organisms. CONCLUSION IODIM® ophthalmic solution showed in vitro antimicrobial activity against S. epidermidis, S. aureus, P. aeruginosa and Candida species. Results suggest that it may be a potential candidate for the treatment of ocular surface infections and antimicrobial prophylaxis before intravitreal injections.
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Affiliation(s)
- Antonio Pinna
- Department of Medical, Surgical, and Experimental Sciences University of Sassari Sassari Italy
- Azienda Ospedaliero‐Universitaria di Sassari Sassari Italy
| | | | - Donatella Usai
- Department of Biomedical Sciences University of Sassari Sassari Italy
| | - Stefano Dore
- Department of Medical, Surgical, and Experimental Sciences University of Sassari Sassari Italy
- Azienda Ospedaliero‐Universitaria di Sassari Sassari Italy
| | | | - Francesco Boscia
- Department of Medical, Surgical, and Experimental Sciences University of Sassari Sassari Italy
- Azienda Ospedaliero‐Universitaria di Sassari Sassari Italy
| | - Stefania Zanetti
- Department of Biomedical Sciences University of Sassari Sassari Italy
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Pinna A, Porcu T, Marzano J, Boscia F, Paliogiannis P, Carru C, Zinellu A. Complete blood cell count indexes in non‐arteritic anterior ischemic optic neuropathy. Acta Ophthalmol 2019. [DOI: 10.1111/j.1755-3768.2019.5244] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Affiliation(s)
- Antonio Pinna
- Department of Medical Surgical and Experimental Sciences University of Sassari Sassari Italy
| | - Tiziana Porcu
- Department of Medical Surgical and Experimental Sciences University of Sassari Sassari Italy
| | - Jacopo Marzano
- Department of Medical Surgical and Experimental Sciences University of Sassari Sassari Italy
| | - Francesco Boscia
- Department of Medical Surgical and Experimental Sciences University of Sassari Sassari Italy
| | - Panagiotis Paliogiannis
- Department of Medical Surgical and Experimental Sciences University of Sassari Sassari Italy
| | - Ciriaco Carru
- Department of Biomedical Sciences University of Sassari Sassari Italy
| | - Angelo Zinellu
- Department of Biomedical Sciences University of Sassari Sassari Italy
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Feo CF, Ginesu GC, Pinna A, Galotti F, Paliogiannis P, Fancellu A, Porcu A. In situ reconstruction with autologous graft in the treatment of secondary aortoenteric fistulas: A retrospective case series. Ann Med Surg (Lond) 2019; 49:53-56. [PMID: 31890198 PMCID: PMC6926104 DOI: 10.1016/j.amsu.2019.11.020] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/08/2019] [Revised: 11/20/2019] [Accepted: 11/24/2019] [Indexed: 02/08/2023] Open
Abstract
Infections caused by secondary aortoenteric fistulas (SAEF) may be extremely complex and threaten patient's life. We report our surgical approach to SAEF consisting in removal of the infected graft and in situ reconstruction using an autologous venous graft. Seven consecutive patients with SAEF treated with graft removal and in situ reconstruction using an autologous venous graft from 2008 to 2017 were reviewed. Six of seven patients (86%) survived 30-day. In one case a graft thrombosis and acute lower limb ischemia occurred requiring re-operations. All patients received injective antibiotic therapy for 20 days, followed by oral therapy for 3 months. There were no major complications at long-term follow-up. Our results suggest that superficial femoral vein reconstruction of the abdominal aorta for SAEF is effective with an acceptable in-hospital mortality and low rate of major complications. We stress the importance of the deep femoral veins to create the graft because the large saphenous vein is often affected by significant intimal hyperplasia that can cause steno-occlusive complications. In situ reconstruction for secondary aortoenteric fistulas is effective. We stress the importance of the deep femoral veins to create the graft. One of the largest series of secondary aortoenteric fistulas treated with venous graft. Morbidity and mortality are acceptable at long-term follow-up.
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Affiliation(s)
- Claudio F Feo
- Department of Medical, Surgical and Experimental Sciences, University of Sassari, 07100, Sassari, Italy
| | - Giorgio C Ginesu
- Department of Medical, Surgical and Experimental Sciences, University of Sassari, 07100, Sassari, Italy
| | - Antonio Pinna
- Department of Medical, Surgical and Experimental Sciences, University of Sassari, 07100, Sassari, Italy
| | - Francesca Galotti
- Department of Medical, Surgical and Experimental Sciences, University of Sassari, 07100, Sassari, Italy
| | - Panagiotis Paliogiannis
- Department of Medical, Surgical and Experimental Sciences, University of Sassari, 07100, Sassari, Italy
| | - Alessando Fancellu
- Department of Medical, Surgical and Experimental Sciences, University of Sassari, 07100, Sassari, Italy
| | - Alberto Porcu
- Department of Medical, Surgical and Experimental Sciences, University of Sassari, 07100, Sassari, Italy
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Serra R, Floris M, Pinna A, Boscia F, Cucca F, Angius A. Novel mutations in c2orf71 causing an early onset form of cone-rod dystrophy: A molecular diagnosis after 20 years of clinical follow-up. Mol Vis 2019; 25:814-820. [PMID: 31819343 PMCID: PMC6887784] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/02/2019] [Accepted: 11/29/2019] [Indexed: 11/04/2022] Open
Abstract
Purpose Cone rod-dystrophies (CRDs) are pigmentary retinopathies mainly involving cones. CRDs typically present with decreased visual acuity and loss of sensitivity in the central visual field, reflecting the primary dysfunction of cones associated with night blindness and concentric visual field loss due to rod dysfunction. We describe the phenotype, natural history, and molecular analysis results of an early onset form of CRD. Methods An otherwise healthy 25-year-old man from Sardinia, Italy, initially presented with subacute visual loss and central scotoma in both eyes. He underwent a complete ophthalmic examination, electrophysiologic testing, and genetic counseling. We first applied a candidate gene approach on ABCA4 to detect mutations; then, we performed exome sequencing (WES) on all family members to identify causative mutations. Results The ophthalmic examination was unremarkable except the fundus examination, which revealed a well-circumscribed ring-shaped area of choroidal and RPE atrophy surrounding the fovea in the left eye and small white patches of atrophy around the fovea in the right eye. The ocular features and medical history were consistent with a diagnosis of CRD. Twenty years later, he showed a marked impairment in visual function, secondary to severe atrophic maculopathy associated with sparse pigmentary deposits. Molecular analysis identified two novel frameshift mutations in C2orf71: c.3039dupC: p.Ser1014Leufs*93 and c.1804_1805delAG:p. His603Argfs*77. Conclusions The mutations in C2orf71 reported in this study comprise protein truncation mutations, which are likely to be involved in the pathogenesis of this severe form of early onset CRD.
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Affiliation(s)
- Rita Serra
- Department of Biomedical Science, University of Sassari, Sassari, Italy
| | - Matteo Floris
- Department of Biomedical Science, University of Sassari, Sassari, Italy
| | - Antonio Pinna
- Department of Medical, Surgical, and Experimental Sciences, Ophthalmology Unit, University of Sassari, Sassari, Italy
| | - Francesco Boscia
- Department of Medical, Surgical, and Experimental Sciences, Ophthalmology Unit, University of Sassari, Sassari, Italy
| | - Francesco Cucca
- Department of Biomedical Science, University of Sassari, Sassari, Italy
| | - Andrea Angius
- Department of Biomedical Science, University of Sassari, Sassari, Italy,Institute of Genetic and Biomedical Research, National Research Council (CNR), Monserrato (Cagliari), Italy
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Ravanbakhsh M, Labbaf S, Karimzadeh F, Pinna A, Houreh AB, Nasr-Esfahani MH. Mesoporous bioactive glasses for the combined application of osteosarcoma treatment and bone regeneration. Mater Sci Eng C Mater Biol Appl 2019; 104:109994. [PMID: 31500021 DOI: 10.1016/j.msec.2019.109994] [Citation(s) in RCA: 29] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/20/2018] [Revised: 06/28/2019] [Accepted: 07/18/2019] [Indexed: 01/07/2023]
Abstract
In this study, mesoporous bioactive glass (MBG) sub-micro particles were prepared through sol-gel synthesis and possessed a uniform and spherical structure with particle size of 302 ± 43 nm, a pore size of 4 nm and a high surface area of 354 m2 g-1. Alendronate (AL) is often used for the treatment of bone associated diseases, in particular osteosarcoma. However, due to the low bioavailability and high toxicity at increased doses, local and sustained release would be an ideal approach to AL delivery. Here, MBGs and aminated MBGs (AMBG) were applied as carriers for AL loading. High encapsulation efficiency of 75% and 85% and loading efficiency of 60% and 63%, for MBG and AMBG, respectively, was achieved. The release profile of AL from AMBG showed a better sustained and controlled release mechanism compared to MBG. In vitro results demonstrated the non-cytotoxic nature of both MBG and AMBG following exposure to MG63 osteoblast like cell line. AL release from MBG and AMBG, even at lower concentration, provoked decreased MG63 proliferation. The osteogenic potential of MBG and AMBG following exposure to dental pulp stem cells was evaluated using alizarin red assay.
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Affiliation(s)
- M Ravanbakhsh
- Department of Materials Engineering, Isfahan University of Technology, Isfahan 84156-83111, Iran
| | - S Labbaf
- Department of Materials Engineering, Isfahan University of Technology, Isfahan 84156-83111, Iran.
| | - F Karimzadeh
- Department of Materials Engineering, Isfahan University of Technology, Isfahan 84156-83111, Iran
| | - A Pinna
- Department of Materials, Imperial College London, South Kensington Campus, London SW7 2AZ, UK
| | - A Baharlou Houreh
- Department of Cellular Biotechnology, Cell Science Research Center, Royan Institute for Biotechnology, ACECR, Isfahan, Iran
| | - M H Nasr-Esfahani
- Department of Cellular Biotechnology, Cell Science Research Center, Royan Institute for Biotechnology, ACECR, Isfahan, Iran
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Lamanna R, Pinna A, Bettini T, Rimini E, Pradella M, Simula L, Fanello M, Moffa M, Rossi L. Biological risks related to unintentional movements or behavior laboratory attendant. Clin Chim Acta 2019. [DOI: 10.1016/j.cca.2019.03.644] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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Lamanna R, Bettini T, Simula L, Rimini E, Tomei A, Pinna A, Moffa M, Pradella M, Fanello M, Rossi L. How to get into a laboratory and emerge healthy and intact Vademecum of Health and Safety Study Group (HSSG) SIPMEL (Italian Society of Clinical Pathology and Laboratory Medicine). Clin Chim Acta 2019. [DOI: 10.1016/j.cca.2019.03.642] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
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Pinna A, Solinas G, Giancipoli E, Porcu T, Zinellu A, D'Amico-Ricci G, Boscia F, Lanzetta P, Avitabile T, Schwartz AG, Carru C. Glucose-6-Phosphate Dehydrogenase (G6PD) Deficiency and Late-stage Age-Related Macular Degeneration. Int J Med Sci 2019; 16:623-629. [PMID: 31217728 PMCID: PMC6566738 DOI: 10.7150/ijms.30155] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/24/2018] [Accepted: 12/07/2018] [Indexed: 11/30/2022] Open
Abstract
Purpose: Age-related macular degeneration (AMD) is the leading cause of blindness in the elderly in Western Countries. Evidence indicates that Glucose-6-Phosphate Dehydrogenase (G6PD) deficiency, a common genetic abnormality, may protect against ischemic heart and cerebrovascular disease, ocular vascular disorders, and colorectal cancer. This study was undertaken to ascertain whether G6PD deficiency may protect against AMD. Materials and Methods: 79 men with late-stage AMD and 79 male, age-matched cataract controls without AMD were recruited in March-December 2016. Smoking status, clinical history, and drug use were recorded. A blood sample was taken from each participant. Complete blood count, hemoglobin, glucose, creatinine, cholesterol, triglycerides, transaminases, bilirubin, and erythrocyte G6PD activity were measured. Stepwise logistic regression was used to investigate the association between G6PD deficiency and AMD. Results: G6PD deficiency was found in 7 (8.9%) AMD patients and 8 (10.1%) controls, a not statistically significant difference. Stepwise logistic regression disclosed that AMD was significantly associated with increased diastolic blood pressure (OR=1.09, 95% CI=1.03-1.15, P=0.02) and LDL-cholesterol (OR=1.02, 95% CI=1.0001-1.03, P=0.049) and lower values of white blood cell (WBC) count (OR=0.71, 95% CI=0.56-0.88, P=0.02) and aspartate aminotransferase (AST) (OR=0.92, 95% CI=0.85-0.99, P=0.044). Conclusion: Results suggest that G6PD deficiency has no protective effect on nor is a risk factor for AMD. Larger studies are necessary to confirm whether increased diastolic blood pressure and LDL-cholesterol and lower values of WBC count and AST are risk factors for AMD.
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Affiliation(s)
- Antonio Pinna
- Department of Medical, Surgical, and Experimental Sciences, University of Sassari, Sassari, Italy.,Azienda Ospedaliero-Universitaria di Sassari, Sassari, Italy
| | - Giuliana Solinas
- Department of Biomedical Sciences, University of Sassari, Sassari, Italy
| | - Ermete Giancipoli
- Department of Biomedical Sciences, University of Sassari, Sassari, Italy
| | - Tiziana Porcu
- Department of Medical, Surgical, and Experimental Sciences, University of Sassari, Sassari, Italy
| | - Angelo Zinellu
- Department of Biomedical Sciences, University of Sassari, Sassari, Italy
| | | | - Francesco Boscia
- Department of Medical, Surgical, and Experimental Sciences, University of Sassari, Sassari, Italy.,Azienda Ospedaliero-Universitaria di Sassari, Sassari, Italy
| | - Paolo Lanzetta
- Department of Medicine - Ophthalmology, University of Udine, Udine, Italy
| | | | - Arthur G Schwartz
- Fels Institute for Cancer Research and Molecular Biology, Temple University School of Medicine, Philadelphia, Pennsylvania, USA
| | - Ciriaco Carru
- Department of Biomedical Sciences, University of Sassari, Sassari, Italy.,Azienda Ospedaliero-Universitaria di Sassari, Sassari, Italy
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Chaves-López C, Usai D, Donadu MG, Serio A, González-Mina RT, Simeoni MC, Molicotti P, Zanetti S, Pinna A, Paparella A. Potential of Borojoa patinoi Cuatrecasas water extract to inhibit nosocomial antibiotic resistant bacteria and cancer cell proliferation in vitro. Food Funct 2018; 9:2725-2734. [PMID: 29658045 DOI: 10.1039/c7fo01542a] [Citation(s) in RCA: 31] [Impact Index Per Article: 5.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
Abstract
Borojó (Borojoa patinoi Cuatrec.) is a fruit used in Colombian traditional medicine with supposed antihypertensive, antitumoral, diuretic, healing, immunological, anti-inflammatory and aphrodisiac effects. To explore the relative merits in terms of biological activities of borojó aqueous extract (BAE), we investigated in vitro its antimicrobial activity on nosocomial pathogenic and multidrug resistant (MDR) strains of Pseudomonas aeruginosa (6), Staphylococcus aureus (1) and Candida species (6), as well as its cytotoxicity on human conjunctive Wong-Kilbourne derivative (WKD) cells and Caco-2 cells from heterogeneous human epithelial colorectal adenocarcinoma. The bacteriostatic activity was observed overall on P. aeruginosa strains, as evidenced by the increase of the lag phase (43 hours) and reduction of the maximum growth rate detected using 187.5 mg BAE per mL. The bactericidal activity, instead, was observed at 375 mg BAE per mL. On the other hand, BAE showed an anti-proliferative effect against the Caco-2 cell line and was shown to be toxic on the WKD cell line at concentrations ranging from 0.05 to 187.5 μg mL-1. The analysis of the phenolic fraction of the fruit aqueous extract (BAE) using UHPLC-MS/MS showed the presence of 26 compounds, with vanillic, syringic and o-coumaric acids as the most abundant. Among these molecules, 7.81 ng mL-1 luteolin and myricetin, singly tested, were able to reduce bacterial growth. To the best of our knowledge, we are unaware of any previous studies demonstrating the anti-bacterial activity of borojó aqueous extract against antibiotic resistant strains of P. aeruginosa, and its anti-proliferative effect against WKD and Caco-2 cell lines. The latter result offers a potential base for new interest and investigations in relation to colon carcinoma models and borojó fruit consumption, since in Colombia this fruit is consumed also for its supposed antitumoral effects.
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Affiliation(s)
- Clemencia Chaves-López
- Faculty of Bioscience and Technology for Food, Agriculture and Environment, University of Teramo, Teramo, Italy.
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Cossu ML, Ginesu GC, Feo CF, Fancellu A, Pinna A, Vargiu I, Addis F, Barmina M, Sotgiu G. Surgical outcomes in patients with hepatic synchronous and metachronous colorectal metastases. Ann Ital Chir 2018; 88:497-504. [PMID: 29339595 DOI: pmid/29339595] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/08/2023]
Abstract
AIM To evaluate the impact of several clinical and pathological factors on the outcomes of surgery for hepatic colorectal cancer metastasis. METHODS Eighty-four liver metastasectomies in 77 consecutive patients with 90 colorectal cancer hepatic metastases were performed in our institution from 2009 to 2014. Surgery was carried out in 75 cases, as two patients were not eligible for surgery. Among them 43 (Group A) were affected by synchronous, and 32 (Group B) by metachronous lesions. Furthermore, 9 reoperations were performed in patients with initially synchronous lesions. The follow-up after surgery included total body CT scan every 3 months for the first year, and every 6 months for 4 years thereafter. Blood level of CEA was determined every 3 months. RESULTS The univariate analysis evidenced significantly more recurrences in patients with synchronous lesions (p=0.011), and higher grade, pN stage and CEA blood levels. In multivariate logistic regression analysis the statistically significant parameters found were: the pT stage (OR: 3.92, p = 0.039), the use of adjuvant chemotherapy for the colonic tumor (OR: 0.19, p = 0.025), and the adjuvant chemotherapy (OR: 4.11, p = 0.048). The global survival was 32 patients (41.5%), 17 with synchronous and 15 with metachronous lesions, and a significant difference in long-term survival between these two groups was found (p = 0.008). CONCLUSIONS The most relevant prognostic factor in patients with hepatic colorectal cancer dissemination is the timing of metastasis; the metachronous lesions present better survival when surgically treated. KEY WORDS Colorectal cancer, Liver, Metastasis, Surgery.
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Pinna A, Porcu T, D'Amico-Ricci G, Dore S, Boscia F, Paliogiannis P, Carru C, Zinellu A. Complete Blood Cell Count-Derived Inflammation Biomarkers in Men with Age-Related Macular Degeneration. Ocul Immunol Inflamm 2018; 27:932-936. [PMID: 29953308 DOI: 10.1080/09273948.2018.1485960] [Citation(s) in RCA: 20] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
Abstract
Purpose: To investigate the role of some blood count-derived inflammation biomarkers in age-related macular degeneration (AMD). Methods: Seventy-nine men with late-stage AMD and 79 male age-matched cataract controls without AMD were recruited in March-December, 2016. A blood sample was taken. The following blood cell count-derived indexes were evaluated: neutrophil/lymphocyte ratio (NLR), derived NLR [dNLR = neutrophils/(white blood cells ‒ neutrophils)], platelet/lymphocyte ratio (PLR), monocyte/lymphocyte ratio (MLR), (neutrophils × monocytes)/lymphocyte ratio (SIRI), and (neutrophils × monocytes × platelets)/lymphocyte ratio (AISI). Results: AMD patients had significantly lower median values of white blood cells, monocytes, neutrophils, platelets, and mean platelet volume (MPV). Regarding the combined indexes, only AISI was significantly lower in AMD patients than in controls. Receiver operating characteristics curve analysis revealed that the ability of AISI and MPV to predict AMD is poor. Conclusion: Results suggests that NLR, dNLR, PLR, MLR, SIRI, and AISI are unreliable disease biomarkers in men with AMD. Larger scale studies are necessary to confirm these findings.
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Affiliation(s)
- Antonio Pinna
- Department of Medical, Surgical, and Experimental Sciences, University of Sassari , Sassari , Italy.,Azienda Ospedaliero, Universitaria di Sassari , Sassari , Italy
| | - Tiziana Porcu
- Department of Medical, Surgical, and Experimental Sciences, University of Sassari , Sassari , Italy
| | | | - Stefano Dore
- Department of Medical, Surgical, and Experimental Sciences, University of Sassari , Sassari , Italy.,Azienda Ospedaliero, Universitaria di Sassari , Sassari , Italy
| | - Francesco Boscia
- Department of Medical, Surgical, and Experimental Sciences, University of Sassari , Sassari , Italy.,Azienda Ospedaliero, Universitaria di Sassari , Sassari , Italy
| | | | - Ciriaco Carru
- Azienda Ospedaliero, Universitaria di Sassari , Sassari , Italy.,Department of Biomedical Sciences, University of Sassari , Sassari , Italy
| | - Angelo Zinellu
- Department of Biomedical Sciences, University of Sassari , Sassari , Italy
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Pinna A, Zaccheddu F, Boscia F, Carru C, Solinas G. Homocysteine and risk of age-related macular degeneration: a systematic review and meta-analysis. Acta Ophthalmol 2018; 96:e269-e276. [PMID: 27966830 DOI: 10.1111/aos.13343] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/05/2016] [Accepted: 10/17/2016] [Indexed: 02/03/2023]
Abstract
There is still no agreement on total plasma homocysteine (tHcy) role in age-related macular degeneration (AMD), the leading cause of new blindness in industrialized countries. We performed a systematic review and meta-analysis of the published data on the correlation between tHcy and AMD. MEDLINE/PubMed and ISI Web of Sciences searches were performed according to MOOSE guidelines. Case-control studies were eligible for inclusion. Participants and controls were AMD patients and subjects without AMD. The main outcome measure was wet AMD. Homocysteine level was the main exposure variable. Data were pooled using a random-effects model. Twelve case-control studies were identified: 10 assessed wet AMD, four dry AMD, one early AMD, one late AMD, and one any AMD. As for wet AMD, there was a total of 453 cases and 514 controls. Mean tHcy was on average 1.1 μmol/l (95% confidence interval [CI] = 0.96-1.25) greater in wet AMD cases, but there was evidence of extreme between-study heterogeneity (p < 0.001, I2 = 91.8%). In a model homogenous for age, including six wet AMD studies (214 cases, 274 controls), mean tHcy was on average 0.58 μmol/l (95% CI = 0.35-0.73) greater in the case group, a not statistically significant result (p = 0.144) associated with moderate heterogeneity (I2 = 39.2%). Our meta-analysis indicates that there is some weak evidence that increased tHcy might be associated with wet AMD; however, this result should be interpreted cautiously, because of a marked between-study heterogeneity and the possible effect of publication bias. Future studies, preferably of cohort design, are necessary before any firm conclusions on the putative role of increased tHcy on AMD can be drawn.
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Affiliation(s)
- Antonio Pinna
- Department of Surgical, Microsurgical, and Medical Sciences; Ophthalmology Unit; University of Sassari; Sassari Italy
- Azienda Ospedaliero-Universitaria di Sassari; Sassari Italy
| | - Francesco Zaccheddu
- Department of Surgical, Microsurgical, and Medical Sciences; Ophthalmology Unit; University of Sassari; Sassari Italy
| | - Francesco Boscia
- Department of Surgical, Microsurgical, and Medical Sciences; Ophthalmology Unit; University of Sassari; Sassari Italy
- Azienda Ospedaliero-Universitaria di Sassari; Sassari Italy
| | - Ciriaco Carru
- Azienda Ospedaliero-Universitaria di Sassari; Sassari Italy
- Department of Biomedical Sciences; Section of Clinical Biochemistry; University of Sassari; Sassari Italy
| | - Giuliana Solinas
- Department of Biomedical Sciences; Laboratory of Epidemiology and Biostatistics; University of Sassari; Sassari Italy
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Donadu M, Usai D, Pinna A, Porcu T, Mazzarello V, Fiamma M, Marchetti M, Cannas S, Delogu G, Zanetti S, Molicotti P. In vitro activity of hybrid lavender essential oils against multidrug resistant strains of Pseudomonas aeruginosa. J Infect Dev Ctries 2018; 12:9-14. [PMID: 31628828 DOI: 10.3855/jidc.9920] [Citation(s) in RCA: 28] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/08/2017] [Accepted: 01/18/2018] [Indexed: 10/31/2022] Open
Abstract
INTRODUCTION Lavender is an evergreen shrub native to Northern Africa and other mountainous Mediterranean regions. It grows throughout Southern Europe, the United States, and Australia. Lavender essential oil has been used since ancient times and is known for its anti-inflammatory, antidepressant, antiseptic, antifungal and antimicrobial properties. METHODOLOGY in this study, the antimicrobial activity of two Lavender essential oils (Lavanda sumian and Lavanda grosso) against 16 multidrug-resistant P. aeruginosa strains from clinical ocular samples taken from migrant patients has been investigated. The in vitro cytotoxic activity on human Wong-Kilbourne derivative (WKD) conjunctiva cells from healthy patients and nitric oxide synthase (NOS) activity on murine macrophage (J774.1A) were also evaluated. RESULTS L. sumian showed lower antimicrobial activity when compared to L. grosso. Both lavender oils tested had no cytotoxic effect at very low concentrations, mostly L. grosso. The essential oils extracted from L. sumian and L. grosso significantly reduced NOS in a cell model. CONCLUSION Increase in drug resistance and lack of new antibiotics may encourage the development of natural antimicrobial treatments.
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Affiliation(s)
| | | | | | | | | | | | - Mauro Marchetti
- CNR, Institute of Biomolecular Chemistry, Li Punti, Sassari, Italy.
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Abstract
Purpose To report a patient with Turner's syndrome who developed graft rejection after penetrating keratoplasty (PK) for keratoconus and to review the ophthalmic literature on the association between keratoconus and Turner's syndrome. Methods A woman with bilateral keratoconus and Turner's syndrome (45,XO) was referred for progressive visual loss in the right eye. Best-corrected visual acuity was 20/400 in the right eye. Slit-lamp examination revealed corneal thinning with ectatic protrusion of the central cornea and Vogt's striae in the right eye. The patient underwent PK in the right eye in January 2001. She developed graft rejection in April 2003 and visual acuity dropped to hand motion. After treatment with topical and systemic steroids and systemic cyclosporine A, visual acuity recovered to 20/80 in July 2003. Results The authors know of only three other reported patients (six eyes) with keratoconus in Turner's syndrome. Five eyes underwent PK with good visual rehabilitation, but one developed immunologic graft rejection 7 years after surgery. On the whole, considering the current report and the other cases described in the literature, graft rejection occurred in 2 out of 6 eyes (33.3%). The graft survival rate was 80% after 2 years and 40% after 7 years. Conclusions The results suggest that grafts for keratoconus in patients with Turner's syndrome might have an increased risk of immunologic rejection. Corneal grafts in Turner's syndrome need to be monitored closely. Early detection of graft rejection and aggressive treatment with topical and systemic steroids and systemic cyclosporine A can save the graft and restore useful vision.
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Affiliation(s)
- A Pinna
- Institute of Ophthalmology, University of Sassari, Sassari--Italy.
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