717 research outputs found
Curso de verano a distancia sobre adhesión a estructuras dentarias
No full textFil: Iannetta, Carla. Universidad de Buenos Aires. Secretaría de Asuntos Académicos. Buenos Aires, ArgentinaEspecialista en Diseño de la Enseñanza con Tecnologías en el Nivel Superio
Funzione biventricolare in adolescenti e giovani adulti con infezione da HIV: valutazione con ecocardiografia tridimensionale e specole-tracking
No full textPremessa: lo scopo dello studio è quello di valutare i parametri di deformazione parietale biventricolare attraverso l’ecocardiografia tridimensionale speckle-tracking negli adolescenti e nei giovani adulti con infezione da HIV in terapia antiretrovirale. L’obiettivo finale è quello di rilevare un’eventuale disfunzione miocardica subclinica. Metodi: 21 pazienti con infezione da HIV tra i 12 e i 39 anni, 21 controlli normali della stessa età e 21 pazienti con cardiomiopatia dilatativa non ischemica sono stati studiati con metodiche di ecocardiografia standard e tridimensionale speckle-tracking. Tutti i pazienti con HIV avevano un’infezione ben controllata dalla terapia antiretrovirale con un buono status immunologico e anamnesi negativa per patologie cardiovascolari o altre patologie sistemiche croniche. Sono stati misurati i parametri di ecocardiografia standard relativi alla funzione ventricolare destra e sinistra. Con l’ecocardiografia tridimensionale sono stati misurati lo strain globale longitudinale (LV-GLS), radiale (LV-GRS) e circonferenziale (LV-GCS) del ventricolo sinistro; è inoltre stato calcolato il “twist” del ventricolo sinistro (LV-TW) e l’area strain globale (LV-GAS), intesa come la variazione percentuale dell’area derivata dai vettori dello strain longitudinale e circonferenziale. Sono infine stati misurati lo strain longitudinale globale e quello della parete libera del ventricolo destro. Risultati: i parametri LV-GLS e LV-GAS sono più bassi nei pazienti HIV rispetto ai controlli normali (rispettivamente p=0,002 e p=0,01). Non ci sono differenze significative tra i due gruppi per quanto riguarda i parametri di ecocardiografia standard. E’ stata riscontrata una debole correlazione positiva tra LV-GLS e l’età (r=0,215, p=0,034) e una debole correlazione negativa tra LV-GLS e il nadir dei linfociti T CD4+ (r=0,198, p=0,043). I pazienti con cardiomiopatia dilatativa hanno una riduzione più diffusa e marcata di LV-GLS e LV-GAS rispetto ai controlli (p<0,001), mentre nei pazienti con HIV la compromissione di questi parametri è localizzata soprattutto nelle porzioni basali e apicali del ventricolo sinistro. Anche lo strain longitudinale della parete libera del ventricolo destro è apparso significativamente ridotto nei pazienti con HIV (p=0,03). Nessun paziente aveva un pressione arteriosa sistolica polmonare > 35 mmHg. Conclusioni: l’ecocardiografia tridimensionale speckle-tracking può aiutarci ad identificare i pazienti con infezione da HIV a più alto rischio cardiovascolare, permettendo un’identificazione precoce della disfunzione biventricolare anche in presenza di normali parametri valutati con ecocardiografia standard. La compromissione dello strain nei pazienti HIV è meno marcata e più distrettuale rispetto a quella dei pazienti con cardiomiopatia dilatativa
Efficacy and tolerability of bilateral sustained-release dexamethasone intravitreal implants for the treatment of noninfectious posterior uveitis and macular edema secondary to retinal vein occlusion
No full textSteven J Ryder,1 Danilo Iannetta,1 Swetangi D Bhaleeya,2 Szilárd Kiss1 1Department of Ophthalmology, Weill Cornell Medical College, New York, NY, USA; 2Department of Ophthalmology, University of South Florida, Tampa, FL, USA Purpose: To report our experience with bilateral placement of dexamethasone 0.7 mg (DEX) sustained-release intravitreal implant in the management of noninfectious posterior uveitis or macular edema secondary to retinal vein occlusion.Methods: A retrospective chart review of patients with bilateral noninfectious posterior uveitis and macular edema secondary to retinal vein occlusion who were treated with DEX intravitreal implant was performed. Ocular side effects such as intraocular pressure (IOP), cataract, and tolerability of bilateral injections was reviewed.Results: Twenty-two eyes of eleven patients treated with a total of 32 DEX implants were included. Ten of eleven patients received bilateral implants due to active noninfectious uveitis while the other demonstrated macular edema in both eyes following separate central retinal vein occlusions. Among the patients with bilateral uveitis, the mean interval between DEX implant in the initial eye and the subsequent DEX in the fellow eye was 15.6 days (range 2–71 days). Seven of the ten patients received the second implant in the fellow eye within 8 days of the initial implantation. None of the patients had bilateral implantations on the same day. Seven eyes required reimplantation for recurrence of inflammation (mean interval between first and repeat implantation was 6.00±2.39 months). Following single or, in the case of the aforementioned seven eyes, repeat DEX implantation, all 20 uveitic eyes demonstrated clinical and/or angiographic evidence of decreased inflammation in the form of reduction in vitreous cells on slit lamp ophthalmoscopy, macular edema on ophthalmoscopy, or optical coherence tomography and/or disc and vascular leakage on fluorescein angiography. The mean follow-up for all eyes after initial implantation was 23.57 months (range 1–48 months). IOP was significantly higher (P=0.028) at 6 months (16.62 mmHg ±5.97) but not (P=0.82) at most recent follow-up (14.9±3.37 mmHg) when compared with baseline (14.68±3.02 mmHg). Four eyes (18.2%) required initiation of IOP-lowering medications. During the follow-up period, no eyes underwent filtration or cataract extraction. No serious ocular adverse effects were noted during the follow-up period.Conclusion: In patients with bilateral noninfectious posterior uveitis and macular edema secondary to vein occlusion, bilateral injection of DEX intravitreal implant was well tolerated and had an acceptable safety profile. Keywords: bilateral uveitis, dexamethasone implant, Ozurdex 
Ab interno intraluminal suture to reverse ocular hypotony after glaucoma drainage device implantation
No full textThis letter describes our experience in treating glaucoma valve induced ocular hypotony using a minimally invasive ab interno approac
Re: "Deep Anterior Lamellar Keratoplasty in Eyes With Intrastromal Corneal Ring Segments"
No full textxletter to edito
Climate change and crop-pest dynamics in the Mediterranean Basin
No full textA causa dei cambiamenti climatici valutare e gestire sistemi coltura-parassita nel Bacino del Mediterraneo sarà più difficile che altrove a livello globale. Il Bacino del Mediterraneo è infatti per molti versi un hot spot in termini di cambiamento globale, poiché in quest’area del pianeta i cambiamenti climatici attesi sono più intensi della media e minacciano una diversità biologica e culturale estremamente ricca ed intrecciata, oltre ad incrementare la vulnerabilità nei confronti delle invasioni biologiche. Di conseguenza per affrontare efficacemente i problemi causati da parassiti in questo hot spot sarà sempre più necessario un approccio olistico, tale da consentire un’analisi dettagliata di quelle complesse e spesso sfuggenti interazioni che sono alla base di ogni decisione sensata a livello di campo. Partendo da oltre trent’anni di progresso scientifico multidisciplinare ispirato a studi pionieristici effettuati presso l’Università della California, il progetto ENEA GlobalChangeBiology in collaborazione con CASAS Global sta sviluppando uno strumento interdisciplinare per descrivere in maniera meccanicistica (ossia descrivere processi mediante un modello), analizzare e gestire problemi agro-ecologici basandosi sul paradigma unificante che tutti gli organismi, esseri umani compresi, acquisiscono e allocano risorse mediante processi analoghi. Si tratta del paradigma delle analogie ecologiche che è intrinsecamente olistico. Recenti analisi sviluppate utilizzando questo paradigma mostrano come lo strumento messo a punto abbia fornito e continuerà a fornire alle agenzie governative la base scientifica necessaria per integrare la resilienza eco-sociale ai cambiamenti climatici in sistemi agricoli presenti nel Bacino del Mediterraneo e altrove.Climate change will make assessing and managing crop-pest systems in the Mediterranean Basin more difficult than elsewhere on the globe. The Basin is in many ways a hot spot of global change, as higher than average projected climate change threatens an extremely rich and intertwined biological and cultural diversity, and increases its vulnerability to biological invasions. As a consequence, pest problems in this hot spot will require a holistic approach to deconstruct the elusive complex interactions that are the underpinning basis for sound decision making at the field level. Building on 30+ years of multidisciplinary progress inspired by pioneering work at University of California, the ENEA GlobalChangeBiology project in collaboration with CASAS Global is developing an interdisciplinary tool to mechanistically describe (i.e., model), analyze and manage agro-ecological problems based on the unifying paradigm that all organisms including humans acquire and allocate resources by analogous processes – the paradigm of ecological analogies that is holistic by design. Recent analyses using this approach show how the tool provided and will continue to provide governmental agencies with the scientific basis for building eco-social resilience to climate warming into agricultural systems across the Mediterranean Basin and elsewhere
Subretinal Injection of Recombinant Tissue Plasminogen Activator and Gas Tamponade to Displace Acute Submacular Haemorrhages Secondary to Age-Related Macular Degeneration
No full textDanilo Iannetta,1 Michele De Maria,1 Elena Bolletta,2 Valentina Mastrofilippo,1 Antonio Moramarco,1 Luigi Fontana1 1Ophthalmology Unit, Azienda USL-IRCCS di Reggio Emilia, Reggio Emilia, Italy; 2Ocular Immunology Unit, Azienda USL-IRCCS di Reggio Emilia, Reggio Emilia, ItalyCorrespondence: Danilo IannettaOphthalmology Unit, AUSL-IRCCS Reggio Emilia, Viale Risorgimento 80, Reggio Emilia, ItalyTel +39 0522296520Fax +39 0522295839Email [email protected]: To analyse the efficacy of subretinal injection of recombinant tissue plasminogen activator (rtPA) and gas tamponade for the displacement of submacular haemorrhage (SMH).Methods: This single-centre, retrospective, case series included 25 consecutive patients (25 eyes) who underwent pars plana vitrectomy (PPV) with subretinal rtPA injection and 20% sulphur hexafluoride (SF6) tamponade. The primary outcome was SMH displacement rate, defined as the absence of subretinal blood within (complete) or outside (partial) 1500 μm centred on the fovea one month after PPV. Secondary outcomes were final best-corrected visual acuity (BCVA), central macular thickness (CMT), recurrence probability, number of anti-vascular endothelial growth factor (VEGF) injections after PPV, and intra- and post-operative complications.Results: Successful displacement was obtained in all 25 eyes (100%), with complete and partial displacement obtained in 15 (60%) and 10 (40%), respectively. BCVA significantly improved from 1.81± 0.33 to 1.37± 0.52 LogMar at 12 months from surgery (p = 0.001). The bivariate correlation analysis revealed that earlier the surgery had better visual prognosis at the end of the follow-up (p = 0.007). CMT significantly decreased from 922 ± 273.69 μm at baseline to 403.53 ± 314.64 μm at 12 months follow-up (p < 0.001). SMH recurrence was observed in two (8%) patients with a mean survival time of 11.6 ± 0.339 months and a cumulative survival probability of 88% at the end of follow-up. After PPV, the mean number of anti-VEGF injections was 3.00 ± 0.957 with no correlation with final visual acuity (p = 0.365). No intraoperative complications were recorded. Only one patient developed open funnel retinal detachment 40 days after primary PPV.Conclusion: PPV with rtPA subretinal injection and SF6 tamponade is a safe and effective technique in displacing acute SMHs secondary to neovascular AMD. It is recommended to perform within 14 days from the onset of the symptoms to achieve BCVA improvement at 12 months and proper imaging to plan future anti-VEG treatment.Keywords: macular degeneration, submacular haemorrhage, recombinant tissue plasminogen activator, pars plana vitrectomy, subretinal injectio
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