Mastropasqua L.,University of Chieti Pescara |
Calienno R.,University of Chieti Pescara |
Lanzini M.,University of Chieti Pescara |
Nubile M.,University of Chieti Pescara |
And 3 more authors.
Molecular Vision | Year: 2016
Purpose: To correlate a biomicroscopic evaluation, an in vivo confocal microscopy examination, and impression cytologic findings of the corneal center and sclerocorneal limbus after cultured limbal stem cell transplantation and to test the effectiveness of in vivo confocal microscopy as a diagnostic procedure in ocular surface cell therapy reconstructive surgery. Methods: Six eyes of six patients affected by limbal stem cell deficiency after chemical burns underwent ex vivo expanded limbal stem cell transplantation (two eyes) and ex vivo expanded limbal stem cell transplantation with subsequent penetrating keratoplasty (four eyes) to restore corneal transparency. One year after surgery, all patients underwent a biomicroscopic evaluation, central cornea impression cytology to detect cytokeratin 12 (CK12) positivity, and in vivo confocal microscopy of the central cornea and the sclerocorneal limbus to investigate the epithelial cellular morphology, limbal architecture, and corneal inflammation level. Results: Impression cytology analysis showed CK12 positivity in five of six cases, in concordance with the biomicroscopic evaluation. Confocal microscopy pointed out irregular limbal architecture with the absence of the palisades of Vogt in all cases; the central epithelial morphology presented clear corneal characteristics in three cases and irregular morphology in the remaining three. Conclusions: After successful ex vivo expanded limbal stem cell transplantation, in the presence of a complete anatomic architecture subversion, documented by support of in vivo confocal microscopy, the sclerocorneal limbus seemed to maintain its primary function. In vivo confocal microscopy confirmed the procedure was a non-invasive, efficacious diagnostic ocular surface procedure in the case of cell therapy reconstructive surgery. © 2016 Molecular Vision.
Gruszka A.M.,Italian National Cancer Institute |
Lavorgna S.,University of Rome Tor Vergata |
Lavorgna S.,Laboratorio Of Neuro Oncoematologia |
Consalvo M.I.,University of Rome Tor Vergata |
And 21 more authors.
Blood | Year: 2010
Mutations in the nucleophosmin 1 (NPM1) gene are the most frequent genetic aberrations of acute myeloid leukemia (AML) and define a clinically distinct subset of AML. A monoclonal antibody (T26) was raised against a 19-amino acid polypeptide containing the unique C-terminus of the type A NPM1 mutant protein. T26 recognized 10 of the 21 known NPM1 mutants, including the A, B, and D types, which cover approximately 95% of all cases, and did not cross-react with wild-type NPM1 or unrelated cellular proteins. It performed efficiently with different detection technologies, including immunofluorescence, immunohistochemistry, and flow cytometry. Within a series of consecutive de novo AML patients, 44 of 110 (40%) and 15 of 39 (38%) cases scored positive using the T26 antibody in immunofluorescence and flow cytometry assays, respectively. T26-positive cases were found to be all carrying mutations of NPM1 exclusively, as determined by molecular analysis. T26 is the first antibody that specifically recognizes a leukemia-associated mutant protein. Immunofluorescence or flow cytometry using T26 may thus become a new tool for a rapid, simple, and cost-effective molecular diagnosis of AMLs. © 2010 by The American Society of Hematology.
PubMed | Azienda Ospedaliera San Giovanni Addolorata, University of Chieti Pescara and Biomedical University of Rome
Type: | Journal: Mediators of inflammation | Year: 2015
The aim of this study is to investigate in vivo and ex vivo ocular surface alterations induced by dry eye disease and modification after osmoprotective therapy. Forty-eight eyes of 24 patients suffering from dry eye have been recruited. All patients received Optive (compatible solutes) eye drops in one randomly selected eye and Hylogel (sodium hyaluronate 0,2%) in the other. Follow-up included a baseline visit and further examination 30-, 60-, and 90-day intervals (which comprises clinical evaluation, in vivo confocal microscopy-IVCM-of the ocular surface, and conjunctival impression cytology). No significant difference in Schirmer I Test, TBUT, and vital staining results was observed during the follow-up period in both groups. IVCM showed in all patients an improvement of ocular surface epithelial morphology and signs of inflammation (oedema and keratocyte activation). However, these modifications were more evident in patients treated with Optive therapy. A significant reduction of the expression of MMP9 and IL6 in Optive group was observed during the follow-up period in comparison to Hylogel treatment. Our results show that in dry eye disease therapy based on osmoprotective eye drops determines a reduction of inflammatory activation of ocular surface, with consequent improvement of the quality of corneal and conjunctival epithelium.
PubMed | Azienda Ospedaliera San Giovanni Addolorata, University of Chieti Pescara and IRCCS Bietti Foundation
Type: | Journal: BioMed research international | Year: 2014
To evaluate the clinical outcomes and in vivo confocal microscopy (IVCM) features of keratoconus patients who underwent deep anterior lamellar keratoplasty (DALK).DALK was performed using the big bubble technique in all the patients. If the bubble was not successful to bare the descemet membrane, a manual dissection layer-by layer was performed to expose a deep stromal plane close to the DM. The patients were divided in two groups depending on the intraoperative baring of the descemet membrane: predescemetic DALK (PD-DALK) and descemetic DALK (D-DALK) group.One month after surgery the D-DALK patients show an increase of mean BCVA. In the PD-DALK group mean BCVA did not show significant improvement as compared to preoperative values. At 6 months after surgery mean BCVA was found to be similar in both groups. At 1 month IVCM the peak of reflectivity of the interface was lower in D-DALK group compared to PD-DALK. At 6 months the values of reflectivity were comparable.At 1 month D-DALK seems to lead to a minor interface reflectivity and to a better BCVA; these differences disappear after 6 months and the values of interface reflectivity and BCVA are comparable between D-DALK and PD-DALK.
La Mantia L.,Unit of Neurorehabilitation Multiple Sclerosis Center |
Tramacere I.,Fondazione Irccs Instituto Neurologico Carlo Besta |
Firwana B.,University of Arkansas for Medical Sciences |
Pacchetti I.,Fondazione Irccs Instituto Neurologico Carlo Besta |
And 2 more authors.
Cochrane Database of Systematic Reviews | Year: 2016
Background: Fingolimod was approved in 2010 for the treatment of patients with the relapsing-remitting (RR) form of multiple sclerosis (MS). It was designed to reduce the frequency of exacerbations and to delay disability worsening. Issues on its safety and efficacy, mainly as compared to other disease modifying drugs (DMDs), have been raised. Objectives: To assess the safety and benefit of fingolimod versus placebo, or other disease-modifying drugs (DMDs), in reducing disease activity in people with relapsing-remitting multiple sclerosis (RRMS). Search methods: We searched the Cochrane Multiple Sclerosis and Rare Diseases of the Central Nervous System (CNS) Group's Specialised Trials Register and US Food and Drug Administration reports (15 February 2016). Selection criteria: Randomised controlled trials (RCTs) assessing the beneficial and harmful effects of fingolimod versus placebo or other approved DMDs in people with RRMS. Data collection and analysis: We used standard methodological procedures as expected by Cochrane. Main results: Six RCTs met our selection criteria. The overall population included 5152 participants; 1621 controls and 3531 treated with fingolimod at different doses; 2061 with 0.5 mg, 1376 with 1.25 mg, and 94 with 5.0 mg daily. Among the controls, 923 participants were treated with placebo and 698 with others DMDs. The treatment duration was six months in three, 12 months in one, and 24 months in two trials. One study was at high risk of bias for blinding, three studies were at high risk of bias for incomplete outcome reporting, and four studies were at high risk of bias for other reasons (co-authors were affiliated with the pharmaceutical company). We retrieved 10 ongoing trials; four of them have been completed. Comparing fingolimod administered at the approved dose of 0.5 mg to placebo, we found that the drug at 24 months increased the probability of being relapse-free (risk ratio (RR) 1.44, 95% confidence interval (CI) (1.28 to 1.63); moderate quality of evidence), but it might lead to little or no difference in preventing disability progression (RR 1.07, 95% CI 1.02 to 1.11; primary clinical endpoints; low quality evidence). Benefit was observed for other measures of inflammatory disease activity including clinical (annualised relapse rate): rate ratio 0.50, 95% CI 0.40 to 0.62; moderate quality evidence; and magnetic resonance imaging (MRI) activity (gadolinium-enhancing lesions): RR of being free from (MRI) gadolinium-enhancing lesions: 1.36, 95% CI 1.27 to 1.45; low quality evidence. The mean change of MRI T2-weighted lesion load favoured fingolimod at 12 and 24 months. No significant increased risk of discontinuation due to adverse events was observed for fingolimod 0.5 mg compared to placebo at six and 24 months. The risk of fingolimod discontinuation was significantly higher compared to placebo for the dose 1.25 mg at 24 months (RR 1.93, 95% CI 1.48 to 2.52). No significant increased risk of discontinuation due to serious adverse events was observed for fingolimod 0.5 mg compared to placebo at six and 24 months. A significant increased risk of discontinuation due to serious adverse events was found for fingolimod 5.0 mg (RR 2.77, 95% CI 1.04 to 7.38) compared to placebo at six months. Comparing fingolimod 0.5 mg to intramuscular interferon beta-1a, we found moderate quality evidence that the drug at one year slightly increased the number of participants free from relapse (RR 1.18, 95% CI 1.09 to 1.27) or from gadolinium-enhancing lesions (RR 1.12, 95% CI 1.05 to 1.19), and decreased the relapse rate (rate ratio 0.48, 95% CI 0.34 to 0.70). We did not detect any advantage for preventing disability progression (RR 1.02, 95% CI 0.99 to 1.06; low quality evidence). We did not detect any significant difference for MRI T2-weighted lesion load change. We found a greater likelihood of participants discontinuing fingolimod, as compared to other DMDs, due to adverse events in the short-term (six months) (RR 3.21, 95% CI 1.16 to 8.86), but there was no significant difference versus interferon beta-1a at 12 months (RR 1.51, 95% CI 0.81 to 2.80; moderate quality evidence). A higher incidence of adverse events was suggestive of the lower tolerability rate of fingolimod compared to interferon-beta 1a. Quality of life was improved in participants after switching from a different DMD to fingolimod at six months, but this effect was not found compared to placebo at 24 months. All studies were sponsored by Novartis Pharma. Authors' conclusions: Treatment with fingolimod compared to placebo in RRMS patients is effective in reducing inflammatory disease activity, but it may lead to little or no difference in preventing disability worsening. The risk of withdrawals due to adverse events requires careful monitoring of patients over time. The evidence on the risk/benefit profile of fingolimod compared with intramuscular interferon beta-1a was uncertain, based on a low number of head-to-head RCTs with short follow-up duration. The ongoing trial results will possibly satisfy these issues. © 2016 The Cochrane Collaboration.
Serrao S.,Fondazione G.B. Bietti IRCCS |
Lombardo G.,CNR Institute for Chemical and Physical Processes |
Lombardo G.,Vision Engineering Italy Srl |
Desiderio G.,CNR Institute for Chemical and Physical Processes |
And 4 more authors.
Journal of Ophthalmology | Year: 2014
Purpose. To investigate the structure and irregularity of the capsulotomy cutting edges created by two femtosecond (FS) laser platforms in comparison with manual continuous circular capsulorhexis (CCC) using environmental scanning electron microscopy (eSEM). Methods. Ten anterior capsulotomies were obtained using two different FS laser cataract platforms (LenSx, n=5, and Victus, n=5). In addition, five manual CCC (n=5) were obtained using a rhexis forceps. The specimens were imaged by eSEM (FEI Quanta 400, OR, USA). Objective metrics, which included the arithmetic mean deviation of the surface (Sa) and the root-mean-square deviation of the surface (Sq), were used to evaluate the irregularity of both the FS laser capsulotomies and the manual CCC cutting edges. Results. Several microirregularities were shown across the FS laser capsulotomy cutting edges. The edges of manually torn capsules were shown, by comparison of Sa and Sq values, to be smoother (P<0.05) than the FS laser capsulotomy edges. Conclusions. Work is needed to understand whether the FS laser capsulotomy edge microirregularities, not seen in manual CCC, may act as focal points for the concentration of stress that would increase the risk of capsular tear during phacoemulsification as recently reported in the literature. © 2014 Sebastiano Serrao et al.
PubMed | CAMO SpA, CNR Institute for Chemical and Physical Processes, Azienda Ospedaliera San Giovanni Addolorata and Fondazione G.B. Bietti IRCCS
Type: | Journal: Journal of ophthalmology | Year: 2014
Purpose. To investigate the structure and irregularity of the capsulotomy cutting edges created by two femtosecond (FS) laser platforms in comparison with manual continuous circular capsulorhexis (CCC) using environmental scanning electron microscopy (eSEM). Methods. Ten anterior capsulotomies were obtained using two different FS laser cataract platforms (LenSx, n = 5, and Victus, n = 5). In addition, five manual CCC (n = 5) were obtained using a rhexis forceps. The specimens were imaged by eSEM (FEI Quanta 400, OR, USA). Objective metrics, which included the arithmetic mean deviation of the surface (Sa) and the root-mean-square deviation of the surface (Sq), were used to evaluate the irregularity of both the FS laser capsulotomies and the manual CCC cutting edges. Results. Several microirregularities were shown across the FS laser capsulotomy cutting edges. The edges of manually torn capsules were shown, by comparison of Sa and Sq values, to be smoother (P < 0.05) than the FS laser capsulotomy edges. Conclusions. Work is needed to understand whether the FS laser capsulotomy edge microirregularities, not seen in manual CCC, may act as focal points for the concentration of stress that would increase the risk of capsular tear during phacoemulsification as recently reported in the literature.
Lombardo M.,Fondazione G.B. Bietti IRCCS |
Lombardo M.,Vision Engineering Italy Srl |
Rosati M.,Fondazione G.B. Bietti IRCCS |
Pileri M.,Azienda Ospedaliera San Giovanni Addolorata |
And 2 more authors.
Clinical Ophthalmology | Year: 2014
Background: The purpose of this study was to evaluate the effect of daily administration of mannitol-enriched sodium hyaluronate ophthalmic solution on the corneal optical properties of subjects wearing low Dk hydrogel (etafilcon A) contact lenses (CLs).Methods: Forty-five subjects wearing etafilcon A CLs daily for more than 6 months were recruited into this pilot study. Fifteen of the subjects administered a 10% mannitol-enriched 0.05% sodium hyaluronate solution (study group) once daily and 30 subjects did not administer any ophthalmic solution (control group). The subjects were examined at baseline and one month after recruitment. Changes in central corneal thickness (CCT) and corneal light backscatter were evaluated by Scheimpflug imaging (Pentacam HR). Changes in corneal total high-order aberration, corneal spherical aberration, coma, and trefoil were evaluated using the OPD scan II.Results: At one month, corneal light backscatter decreased significantly in the study group (#18.30 arbitrary units; P,0.05) and this was highly correlated with a decrease in CCT (R=0.81; P=0.04). The decrease in corneal total high-order aberration, spherical aberration, and coma was significantly higher in the study group than in the control group (P,0.05). No changes in corneal light backscatter or CCT were found in the control group during follow-up.Conclusion: Once-daily administration of a mannitol-enriched lubricant ophthalmic solution was effective for improving the corneal optical quality and reducing corneal swelling in subjects wearing low Dk hydrogel (etafilcon A) CLs during one month follow-up. © 2014 Lombardo et al.
Galeoto G.,University of Rome La Sapienza |
Mollica R.,University of Rome La Sapienza |
Astorino O.,Azienda Ospedaliera San Giovanni Addolorata |
Cecchi R.,University of Rome La Sapienza
Giornale Italiano di Medicina del Lavoro ed Ergonomia | Year: 2015
The aim of the work is to highlight the need, the duty and the obligation also for the physiotherapist to obtain a valid informed consent of the patient. Materials and methods: The authors, starting with the informed consent forms that already exist for physicians, offer four modules tailored to the needs of the physiotherapist, specific to each field of rehabilitation. Results and conclusions: Such informed consent may be very useful to physiotherapists to fulfill the obligations of giving information and obtaining consent from patients. At the same time it allows physiotherapists to obtain all information they need about patient's condition and permit patient to understand the proposed treatment and adhere to it. © PI-ME, Pavia 2015.
Boccanelli A.,Azienda Ospedaliera San Giovanni Addolorata
Recenti Progressi in Medicina | Year: 2010
The clinical efficacy of aldosterone inhibition in heart failure was proved in two important clinical trials, RALES and EPHESUS, which demonstrated a reduction in mortality with aldosterone receptor blocker therapy in patients with severe and post-MI heart failure. The echocardiographic study AREA IN-CHF evaluated, for the first time, the effectiveness of aldosterone receptor blocker therapy in patients with mild to moderate heart failure (NYHA class II). The AREA IN-CHF rationale and results can be considered the pathophysiological background of the survival study EMPHASIS-HF conducted in a similar population of patients. On May 27, 2010 it was announced the earlier discontinuation of the recruitment to the EMPHASIS-HF that had an estimated end date around October 2011. Discontinuation is related to the excess of benefit in reducing risk of cardiovascular death or hospitalization for heart failure, obtained by antialdosteronic therapy.