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De Biase P.,Azienda Ospedaliero Universitaria Careggi
International journal of immunopathology and pharmacology | Year: 2011

Reconstructions of large lesions or defects often require a bone graft or a bone substitute to promote healing. In common practice the reconstruction of a bone defect is dependent on the site and size of the lesion: in long bones intercalary defects may be managed with Ilizarov technique of bone transport and distraction osteogenesis or the use of a free or pedicled vascularized bone graft, or with Masquelet technique. For cavitary defects the available surgical options include autograft, allograft or xenograft or the use of synthetic scaffolds to promote bone regeneration. In order to promote a faster bone healing tissue engineering proposed the application of enriched graft to fill bone defects. The employment of enriched bone graft has been our choice in the last years to fill contained defects following curettage of a pseudotumoral lesion of bone. We report our clinical experience in terms of safety and success of these procedures at a long-term follow up.

Mazzini C.,Azienda Ospedaliero Universitaria Careggi
Case Reports in Ophthalmology | Year: 2013

Purpose: The aim of this study was to evaluate and report the visual, refractive and aberrometric outcomes of cataract surgery with implantation of the new aspheric Tecnis ZCT toric intraocular lens (IOL) in eyes with low to moderate corneal astigmatism. Methods: We conducted a prospective study of 19 consecutive eyes of 17 patients (mean age: 78 years) with a visually significant cataract and moderate corneal astigmatism [higher than 1 diopter (D)] undergoing cataract surgery with implantation of the aspheric Tecnis ZCT toric IOL (Abbott Medical Optics). Visual, refractive and aberrometric changes were evaluated during a 6-month follow-up. Ocular aberrations as well as IOL rotation were evaluated by means of the OPD-Station II (Nidek). Results: The six-month postoperative spherical equivalent and power vector components of the refractive cylinder were within ±0.50 D in all eyes (100%). Postoperative logMAR uncorrected and corrected distance visual acuities (UDVA/CDVA) were 0.1 (about 20/25) or better in almost all eyes (94.74%). The mean logMAR CDVA improved significantly from 0.41 ± 0.23 to 0.02 ± 0.05 (p < 0.01). No significant changes were found in corneal astigmatism (p = 0.73). The mean IOL rotation was 3.33 ± 1.94°. This parameter did not correlate with higher-order aberrations (r = -0.09, p = 0.73). A significant improvement in the Strehl ratio was also observed (p < 0.01), which was consistent with the significant reduction in higher-order aberrations (p = 0.02). Conclusion: Cataract surgery with implantation of the aspheric Tecnis ZCT IOL is a predictable and effective procedure for visual rehabilitation in eyes with cataract and low to moderate corneal astigmatism, providing an excellent postoperative ocular optical quality. © 2013 S. Karger AG, Basel.

Agency: Cordis | Branch: FP7 | Program: CP-FP | Phase: HEALTH.2012.2.4.5-2 | Award Amount: 8.55M | Year: 2012

Inflammatory bowel diseases affect 0.8% of the Europeans, and are associated with high morbidity, definite mortality and an increasing economic burden. Current diagnostic tools and therapeutics for IBD are unsatisfactory. Development of biomarkers allowing insights into pathogenesis, prognosis and targeted therapy is a major unmet need. This programme addresses that need. IBD-BIOM is a multidisciplinary consortium of leading academic and industrial SME researchers in inflammatory bowel disease, genomics, glycomics, glycoproteomics and activomics. Recent genome-wide association studies performed by IBD-BIOM partners have identified nearly 100 genes associated with IBD, but clinical application of these is so far limited. IBD-BIOM will capitalise on its existing high quality clinical, genetic, biochemical and immunological data and biological samples on over 6000 very well characterised IBD patients and controls by exploiting novel technological approaches made available through the expertise and global leading position of IBD-BIOM partners. These comprise cutting edge epigenetic, glycomic, glycoproteomic and activomic approaches which were all previously reported to be associated with inflammation and disturbances to the immune system. The inclusion of these complementary analyses in the diagnostics of IBD should also facilitate elucidation of pathways through which environmental exposures influence IBD risk and progression. A complex systems biology approach will be used to integrate, interrogate and understand this multidimensional dataset to identify novel early diagnostic and prognostic biomarkers and new targets for therapeutic intervention. The track record of achievement of IBD-BIOM partners coupled to the central and leading positions of the research-intensive SME partners in IBD-BIOM is a strong indication that the ambitions work programme will be achieved and a framework to facilitate swift conversion of research discoveries into commercial products.

Agency: Cordis | Branch: FP7 | Program: CP-FP | Phase: HEALTH-2007-2.4.2-6 | Award Amount: 3.43M | Year: 2009

The main purpose of the EVINCI-study is to test the impact of combined anatomo-functional non invasive cardiac imaging for detection and characterization of Ischemic Heart Disease (IHD). The EVINCI-study is a prospective clinical European multicenter trial performed in a cohort of 700 patients with suspected IHD. Patients with intermediate pre-test probability will undergo clinical and biohumoral characterization, including novel circulating markers of cardiovascular risk. They will be admitted to a non-invasive cardiac evaluation, consisting of anatomic imaging, by multislice computerized tomography, combined with functional tests among radionuclide, magnetic resonance and ultrasound imaging. Heart catheterization will be performed to validate non-invasive diagnosis and follow-up to assess outcome. The diagnostic accuracy of combined non-invasive anatomo-functional imaging will be tested against reference methods for diagnosing epicardial coronary lesions (coronary angiography), vessel wall atherosclerosis (intracoronary ultrasound) and impaired coronary flow reserve (intracoronary doppler/pressure wire). The individual profiles from anatomo-functional cardiac imaging and clinical-biohumoral data will be combined and tested against outcome. A cost-benefit analysis (including an estimate of procedural/radiological risks) of the new diagnostic work-up will also be performed. A relevant part of the EVINCI-study will be dedicated to the development, in cooperation with the industry, of an advanced informatics platform able to synthetically present to the end-user (patients, physicians, etc.) the integrated cardiological diagnostic profile of the individual patient as resulting from clinical-biohumoral and multi-imaging assessment. Overall results will be disseminated in cooperation with the European Society of Cardiology (ESC) and will guide the work of a dedicated ESC Commission which will release specific European Recommendations.

Luzzatto L.,Istituto Toscano Tumori | Gianfaldoni G.,Azienda Ospedaliero Universitaria Careggi | Notaro R.,Core Research Laboratory
British Journal of Haematology | Year: 2011

Paroxysmal nocturnal haemoglobinuria (PNH) is a serious form of acquired haemolytic anaemia with several features that make it unique, including the fact that it is caused by clonal expansion, in the context of bone marrow failure, of a haematopoietic stem cell that has a somatic mutation in a gene crucial for the synthesis of glycosylphosphatidylinositol anchors; and that this also produces a life-threatening acquired thrombophilic state. Until recently, the two only main options for patients with PNH were either allogeneic bone marrow transplantation or supportive management, including blood transfusion: both options require some skill and good patient-doctor collaboration. Since the start of this millennium a major advance has been the introduction of eculizumab, a monoclonal antibody that targets the C5 protein of the complement system: blockade of C5 prevents activation of the complement distal pathway, and thus abrogates the complement-mediated intravascular haemolysis that severely plagues patients with PNH. This review outlines an approach to the management of all three major components of the clinical picture of PNH - namely haemolysis, thrombosis and bone marrow failure - based on the literature and on personal experience. We consider specifically how the use of eculizumab has modified other aspects of the management of PNH, and even the pathophysiology itself of this disease. Finally, we develop a treatment algorithm which others might find helpful. © 2011 Blackwell Publishing Ltd.

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