We report a case series of 26 eyes of 26 patients undergoing planned cataract surgery from December 2021 to March 2022, who were diagnosed as having whitish round infiltrates in the surgical corneal ...incisions. The infiltrates were detected at the first check after 5–8 days from cataract surgery and were located either within the main corneal incision and/or in the smaller incisions. Corneal infiltrates (CIs) were single or multiple, without epithelial defects, and painless. All infiltrates were initially treated with full topical antibiotic coverage, in order to control eventual and serious postsurgical infection. However, at daily checks, the clinical course of CIs suggested a sterile etiology. For this reason, steroidal topical treatment was maintained for a long time with slow tapering until complete remission of the CIs. All infiltrates resolved completely in around 30–40 days. The surgical instruments and the sterilization process were scrutinized. A white amorphous material was found mainly on non-disposable anterior chamber cannulas and on irrigation/aspiration tips. Disposable cannulas were adopted, and machinery for cleaning and sterilization procedures were reviewed, with specific reference to water softener renewal. Thanks to these precautions, CIs never occurred again. Finally, our hypothesis was an immune corneal reaction to amorphous deposit on cannula tips. This case series describes a previously unknown complication of cataract surgery and our experience might be useful for other surgeons.
Hedonic hunger refers to consumption of food just for pleasure and not to maintain energy homeostasis. Recently, consumption of food for pleasure was reported to be associated with increased ...circulating levels of both the orexigenic peptide ghrelin and the endocannabinoid 2-arachidonoyl-glycerol (2-AG) in normal-weight subjects. To date, the effects of hedonic hunger, and in particular of chocolate craving, on these mediators in obese subjects are still unknown.
To explore the role of some gastrointestinal orexigenic and anorexigenic peptides and endocannabinoids (and some related congeners) in chocolate consumption, we measured changes in circulating levels of ghrelin, glucagon-like peptide 1 (GLP-1), peptide YY (PYY), anandamide (AEA), 2-AG, palmitoylethanolamide (PEA), and oleoylethanolamide (OEA) in 10 satiated severely obese subjects after consumption of chocolate and, on a separate day, of a non-palatable isocaloric food with the same bromatologic composition. Evaluation of hunger and satiety was also performed by visual analogic scale.
The anticipatory phase and the consumption of food for pleasure were associated with increased circulating levels of ghrelin, AEA, 2-AG, and OEA. In contrast, the levels of GLP-1, PYY, and PEA did not differ before and after the exposure/ingestion of either chocolate or non-palatable foods. Hunger and satiety were higher and lower, respectively, in the hedonic session than in the non-palatable one.
When motivation to eat is generated by exposure to, and consumption of, chocolate a peripheral activation of specific endogenous rewarding chemical signals, including ghrelin, AEA, and 2-AG, is observed in obese subjects. Although preliminary, these findings predict the effectiveness of ghrelin and endocannabinoid antagonists in the treatment of obesity.
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DOBA, FSPLJ, IZUM, KILJ, NUK, PILJ, PNG, SAZU, UILJ, UKNU, UL, UM, UPUK
To assess specific morphologic and functional characteristics in eyes with diabetic macular edema (DME) with subfoveal neuroretinal detachment (SND+) vs DME without SND (SND−).
Cross-sectional, ...prospective, comparative case series.
Seventy-two patients (72 eyes: 22 eyes SND+ and 50 eyes SND−) with treatment-naïve, center-involving DME were evaluated. Data gathering included fundus color photographs, fluorescein angiography, spectral-domain optical coherence tomography (SD-OCT), best-corrected visual acuity (BCVA), and microperimetry. The following parameters were evaluated with SD-OCT: central macular thickness (CMT including SND); central retinal thickness (CRT excluding SND); choroidal thickness (CT); nasal and temporal retinal thickness (RT) at 500 μm and 1500 μm from the fovea; the number of hyperreflective retinal spots (HRS) in the central 3000 μm; and the presence of SND and integrity of the external limiting membrane (ELM). Retinal sensitivity (RS) was evaluated within 4 degrees and 12 degrees of the fovea. Correlation among CT, RS, and HRS in patients with and without SND was determined.
CMT (P = .032), temporal RT at 1500 μm (P = .03), mean CT (P = .009), and mean number of HRS (P = .0001) were all higher in SND+ vs SND− eyes. CRT, BCVA, HbA1c, and prevalence of systemic arterial hypertension were not different between the 2 groups. RS within 4 degrees (P = .002) and 12 degrees (P = .015) was lower in SND+ vs SND− eyes. SND correlated significantly with disruption of the ELM (54.55% vs 24%, P = .01) and lower RS. A direct correlation was found between the number of HRS, presence of SND, CT, and RS within 12 degrees in SND− eyes, and an inverse correlation was found between CT and RS within 12degrees in SND+ eyes.
These data may improve characterization of DME in eyes with SND. DME with SND correlates with greater CT, more HRS, disruption of the ELM, and significant macular functional impairment (RS decrease) vs SND−.
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GEOZS, IJS, IMTLJ, KILJ, KISLJ, NUK, OILJ, PNG, SAZU, SBCE, SBJE, UL, UM, UPCLJ, UPUK, ZRSKP
Subthreshold micropulse laser (SMPL) is a tissue-sparing technique whose efficacy is demonstrated for diabetic macular edema (DME) treatment. However, its mechanism of action is poorly known. A ...prospective observational study was performed on naïve DME patients treated with SMPL, to evaluate the changes of aqueous humor (AH) inflammatory and vaso-active biomarkers after treatments. AH samples of eighteen DME eyes were collected before and after SMPL. Ten non-diabetic AH samples served as controls. Full ophthalmic evaluation, spectral domain optical coherence tomography (SD-OCT) and fluorescein angiography were performed in DME group. Glass chip protein array was used to quantify 58 inflammatory molecules. Central retinal thickness (CRT) and visual acuity were also monitored. Several molecules showed different concentrations in DME eyes versus controls (p value < 0.05). Fas Ligand (FasL), Macrophage Inflammatory Proteins (MIP)-1α, Regulated on Activation Normal T Cell Expressed and Secreted (RANTES) and Vascular Endothelial Growth Factor (VEGF) were increased in DME at baseline versus controls and decreased after SMPL treatments (p < 0.05). CRT reduction and visual acuity improvement were also found. Inflammatory cytokines, mainly produced by the retinal microglia, were significantly reduced after treatments, suggesting that SMPL may act by de-activating microglial cells, and reducing local inflammatory diabetes-related response.
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IZUM, KILJ, NUK, PILJ, PNG, SAZU, UL, UM, UPUK
► We perform a LCA study of a ground-mounted 1778.48kWp photovoltaic plant. ► The main impact is related to the production, transport, installation of PV modules. ► The main LCA impact categories are ...Fossil fuels, Minerals, Respiratory inorganics. ► The LCA of the system shows that the assembly phase has the main impact. ► The PV plant is energy sustainable because the EPBT=4.17years and the EROEI=4.83.
Photovoltaic system is a technology for the production of electricity from renewable sources that is rapidly expanding thanks to its capability to reduce the energy consumption from traditional sources and to decrease the air pollution. During the operational phase, there are no emissions and the only input is represented by solar power. However, it should be noted that, considering the entire life cycle of a plant, photovoltaic systems, like any other means of electricity production, give rise to emissions, that focus especially in the manufacturing stage and installation of components.
The present work aims at evaluating the environmental impact, and therefore the actual sustainability of this technology, examining a ground-mounted 1778.48kWp photovoltaic plant, realized by TerniEnergia S.p.A. and located in Marsciano (Perugia, Italy). The analysis is conducted using the methodology of Life Cycle Assessment (LCA), which allows to consider all stages of the life cycle, from the extraction of raw materials to the plant’s disposal (“from a cradle to grave perspective”). In particular, the study takes into account the soil preparation, the installation of fence and electrical substations of low and medium voltage, the mounting of support structures, also with reference to hot dip galvanizing process, the production of modules, their installation, the wiring apparatus and the network connection. The transport of all components to the installation site is considered for each stage that is examined. The end of life scenario of the plant is also evaluated. The possibility to collect many detailed information in the construction site, during the building phase, adds value to the study. The analysis is carried out according to UNI EN ISO 14040 and UNI EN ISO 14044, which regulate the LCA procedure.
The LCA modelling was performed using SimaPro software application and using Eco Indicator 99 methodology. The results of the analysis allows to calculate some important parameters like EPBT (Energy Pay-Back Time), EROEI (Energy Return on Energy Invested), CO2 emissions and GWP100 (Global Warming Potential). Finally, the environmental impact of photovoltaic plant is compared to that of some traditional energy production systems.
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GEOZS, IJS, IMTLJ, KILJ, KISLJ, NUK, OILJ, PNG, SAZU, SBCE, SBJE, UL, UM, UPCLJ, UPUK
We performed a health needs assessment of the vulnerable population cared for by the Banco Farmaceutico, an Italian non-profit charitable organisation that supplies medicines for many centres ...belonging to different charities. Drug dispensed in the first half of 2014 by a representative sample of these centres were examined. An independently conducted telephone interview on our centres complemented this data. Adult males and migrants constituted the majority of the user population, and the most dispensed drugs were those for the respiratory system. Of all patients, 40% presented with a chronic problem and more than half needed polypharmacy. Users seek help spontaneously in 70% of the cases, with the centres being able to meet 80% of the existing demand. Patients that could not be managed were referred to local hospitals or collaborating doctors and reasons were explored. We believe our study to be a first attempt to characterise a growing population that is also increasingly represented in emergency departments and internal medicine wards. It is also an evaluation of the quality of data collected by charitable institutions, highlighting a significant need for improvement as they could be the only basis to monitor the health needs of this type of population.
We analysed drug dispensation by charitable organisations in a year time. Drugs were grouped according to the Anatomic Therapeutic Chemical classification and the amount dispensed was calculated with ...the system of the Daily Defined Dose (DDD) and expressed as DDD/1000 subjects/day. A number of 87,550 subjects were studied (13,308 Italians; 74,242 Immigrants). Though we noticed a great sesonal variability, the drugs most frequently dispensed were those for the respiratory, cardiovascular and gastrointestinal system and antibiotics, which is different from the rest of the Italian population and the immigrant population assisted by our National Health Service (NHS). We also found that chronic diseases are increasing in these subjects. We conclude that the subjects not receiving NHS assitance have, at least in part, different health patterns and requirements. This should be considered when planning tailored interventions.
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DOBA, IZUM, KILJ, NUK, PILJ, PNG, SAZU, UILJ, UKNU, UL, UM, UPUK
Purpose
Retinal glia cells (RGC) activation and release of inflammatory cytokines have been associated with development of diabetic retinopathy (DR). In this study, we evaluated by protein array the ...presence of aqueous humour (AH) cytokines secreted by RGC in patients with diabetes without DR and with mild DR.
Methods
This is a cross‐sectional, case–control study. Thirty‐five subjects (diabetics and controls) underwent full ophthalmic examination and AH samples collection before cataract surgery at the Department of Ophthalmology University of Padova. AH samples were analysed for total protein concentration (Bradford method) and RGC‐related inflammatory cytokines using glass chip protein arrays.
Results
Twelve diabetic patients without DR, 11 diabetic patients with mild DR and 12 non‐diabetic controls were included. There was no significant difference in total protein concentration among the 3 groups. Interleukin IL‐1β, IL‐3, interferon gamma (IFN‐ɣ), (IFN‐ɣ)‐induced protein (IP)‐10 and monocyte chemotactic protein (MCP)‐2 were significantly increased in diabetics versus controls. IFN‐ɣ, IL‐1α, IL‐3 and MCP‐2 were significantly increased in diabetics without DR versus controls, whereas granulocyte–macrophage colony‐stimulating factor (GM‐CSF), IFN‐ɣ, IL‐10, IP‐10, regulated and normal T cell expressed and secreted (RANTES), and soluble tumour necrosis factor receptor (sTNF‐R)II were significantly increased in diabetics with mild DR versus controls. Macrophage inflammatory protein (MIP‐1β), GMCSF, RANTES and sTNF‐RII were significantly increased in diabetics with mild DR versus diabetics without DR (p < 0.05 at least for all).
Conclusions
Differences in expression profile of AH cytokines between diabetics, without and with mild DR, and controls have been documented. Retinal neuroinflammatory biomarkers of RGC activation evaluated in AH by protein array analysis could guide in detecting specific phenotypes with potential for personalized management.
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BFBNIB, DOBA, FZAB, GIS, IJS, IZUM, KILJ, NLZOH, NUK, OILJ, PILJ, PNG, SAZU, SBCE, SBMB, UILJ, UKNU, UL, UM, UPUK
Objective: Primary aldosteronism (PA), the most common cause of secondary hypertension, is associated with excess cardiovascular damage and, when unilateral, is amenable to surgical cure. Our ...objective was to determine whether the chorioretinal microvasculature is also affected. Design and method: Ocular CT-scan (OCT) and angio-OCT images of the superficial and deep retinal plexi were obtained in PA patients at diagnosis, in wash-out from RAAS-confounding drugs (WO), and again during mineralocorticoid receptor antagonist (MRA) therapy and 4-6 months after surgical cure (PS). The images were analysed for choroidal thickness and, upon automated ImageJ processing, for indexes of total vascular area density (VAD) and length fraction (VLF), a surrogate for the number of open vessels. Results: We enrolled 11 patients with PA (51±10 yrs; 27%F); of these, 10 who had unilateral PA underwent curative surgery (p<0.05 for BP, sK+ and ARR). We found that MRA therapy had no effect on any of the investigated parameters. At variance, curative surgery determined a reduction of VAD in both superficial and deep plexi (-6.4% retinal area, p=0.017 and -3.5%, p=0.023, respectively) and of VLF in the superficial plexus (-2.2%, p=0.033). Moreover, choroidal thickness (on average: -21μm, p=0.003 at 2-way ANOVA) decreased after adrenalectomy. Conclusions: OCT and angio-OCT images, which can accurately track changes in choroid- retinal vascularization, highlighted a decrease of retinal microvascular area and choroidal thickness in patients with unilateral PA, who were cured from PA.
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