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PACK-CXL: Corneal cross-linking in infectious keratitis

Eye and Vision 2016年第1期3卷 84-88页

作者： David Tabibian cosimo mazzotta Farhad Hafezi Laboratory for Ocular Cell Biology University of GenevaGenevaSwitzerland Siena Crosslinking Center Siena University HospitalSienaItaly Department of Ophthalmology University of Southern CaliforniaLos AngelesCAUSA EyeCare Laboratory Research Zurich Associates(ELZA)Institute Webereistrasse 28953 DietikonSwitzerland Department of Ophthalmology Northampton General HospitalNorthamptonUnited Kingdom

Background:Corneal cross-linking(CXL)using ultraviolet light-A(UV-A)and riboflavin is a technique developed in the 1990’s to treat corneal ectatic disorders such as keratoconus.It soon became the new gold standard in multiple countries around the world to halt the progression of this disorder,with good long-term outcomes in keratometry reading and visual acuity.The original Dresden treatment protocol was also later on used to stabilize iatrogenic corneal ectasia appearing after laser-assisted in situ keratomileusis(LASIK)and photorefractive keratectomy(PRK).CXL efficiently strengthened the cornea but was also shown to kill most of the keratocytes within the corneal stroma,later on repopulated by those cells.Review:Ultraviolet-light has long been known for its microbicidal effect,and thus CXL postulated to be able to sterilize the cornea from infectious pathogens.This cytotoxic effect led to the first clinical trials using CXL to treat advanced infectious melting corneal keratitis.Patients treated with this technique showed,in the majority of cases,a stabilization of the melting process and were able to avoid emergentàchaud keratoplasty.Following those primary favorable results,CXL was used to treat beginning bacterial keratitis as a first-line treatment without any adjunctive antibiotics with positive results for most patients.In order to distinguish the use of CXL for infectious keratitis treatment from its use for corneal ectatic disorders,a new term was proposed at the 9th CXL congress in Dublin to rename its use in infections as photoactivated chromophore for infectious keratitis-corneal collagen cross-linking(PACK-CXL).Conclusion:PACK-CXL is now more frequently used to treat infections from various infectious origins.The original Dresden protocol is still used for this purpose.Careful modifications of this protocol could improve the efficiency of this technique in specific clinical situations regarding certain types of pathogens.

关键词： Infectious Keratitis Corneal cross-linking Keratoconus CXL PACK-CXL Corneal ulcer Ultraviolet light A Riboflavin

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Ultrathin Descemet stripping automated endothelial keratoplasty versus Descemet membrane endothelial keratoplasty:a fellow-eye comparison

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Eye and Vision 2020年第1期7卷 241-249页

作者： Rita Mencucci Eleonora Favuzza Elisa Marziali Michela Cennamo cosimo mazzotta Ersilia Lucenteforte Gianni Virgili Stanislao Rizzo Eye Clinic Department of NeurosciencePsychologyPharmacology and Child Health(NEUROFARBA)University of FlorenceEye ClinicLargo Brambilla 350134 FlorenceItaly Department of Medicine Surgery and NeurosciencesOphthalmology UnitSiena UniversitySienaItaly Siena Crosslinking Center SienaItaly Department of Clinical and Experimental medicine University of PisaPisaItaly

Background:To compare the visual outcome and patients’satisfaction after ultrathin Descemet stripping automated endothelial keratoplasty(UT-DSAEK)and Descemet membrane endothelial keratoplasty(DMEK)performed on fellow eyes of the same patients.Methods:In this retrospective study,the records of 18 pseudophakic patients affected by Fuchs endothelial dystrophy who underwent DMEK in one eye and UT-DSAEK in the fellow eye were reviewed.Best corrected visual acuity(BCVA),corneal pachymetry,keratometry,corneal aberrations,photopic and mesopic contrast sensitivity,and endothelial cell counts measured 12 months after surgery in either eye were analyzed and compared.The results of a satisfaction questionnaire were also reviewed.Results:Twelve months after surgery,BCVA was not significantly different in UT-DSAEK and DMEK eyes(0.10±0.04 and 0.07±0.07 logMAR,respectively);at both 4-and 6 mm optical zones total and posterior corneal higher order aberrations(HOAs),posterior astigmatism and total coma were significantly lower after DMEK;BCVA in both groups was significantly correlated mainly with anterior corneal aberrations;contrast sensitivity was higher after DMEK especially in mesopic conditions and at medium spatial frequencies;the endothelial cell density was similar,although slightly higher in the UT-DSAEK group(p=0.10).The satisfaction questionnaire showed that although patients were highly satisfied from both procedures,more than half of them preferred DMEK and reported a more comfortable and quicker postoperative recovery.Conclusions:DMEK and UT-DSAEK showed no evidence of difference in terms of postoperative BCVA,although DMEK had a better performance in terms of contrast sensitivity,posterior corneal aberrations and overall patient satisfaction.

关键词： DMEK UT-DSAEK DSAEK Descemet stripping automated endothelial keratoplasty Ultra-thin Descemet stripping automated endothelial keratoplasty Descemet membrane endothelial keratoplasty

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Cataract surgery on post radial keratotomy patients

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International Journal of Ophthalmology(English edition) 2017年第7期10卷 1168-1170页

作者： Alessandro Meduri Mario Urso Giuseppe A. Signorino Miguel Rechichi cosimo mazzotta Stephen Kaufman Department of Surgical Specialties Ophthalmology ClinicUniversity of Messina Department of Ophthalmology University Magna Graecia mazzotta Cross-Linking & Refractive Surgery Center Department of Ophthalmology State University of New York-DownstateBrooklyn and Manhattan

This study aims to evaluate and to compare three different approaches of cataract surgery to patients with previous radial keratotomy（RK）, and to analyze the mechanical properties of the cornea after cataract surgery. Three groups of patients, each one including 8 eyes of patients with 16 RK incisions. The first group includes eyes with the first cataract incision superiorly, the second group in the temporal area, the third group in temporal area and a precautionary stabilizing suture across the RK incision adjacent to the main tunnel. In the first group intraoperative dehiscence occurred in three eyes（37.5%）： it required immediate application of a suture. In the second group dehiscence occurred intraoperatively in two radial scars（20%）： it required immediate application of a suture. In the third group, no intraoperative dehiscences were observed. The stabilizing suture of the RK incision works safer, with a lower risk of dehiscences and less postoperative astigmatism.

关键词： radial keratotomy scar dehiscence cataract

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Long term results of accelerated 9mW corneal crosslinking for early progressive keratoconus:the Siena Eye-Cross Study 2

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Eye and Vision 2021年第1期8卷 154-165页

作者： cosimo mazzotta Frederik Raiskup Farhad Hafezi Emilio A Torres-Netto Ashraf Armia Balamoun Giuseppe Giannaccare Simone Alex Bagaglia Departmental Ophthalmology Unit USL Toscana Sud-EstCampostaggiaSienaItaly Siena Crosslinking Center 53035MonteriggioniSienaItaly Department of Ophthalmology C.G.Carus University HospitalDresdenGermany ELZA Institute DietikonSwitzerland Medical Faculty University of GenevaGenevaSwitzerland Roski Eye Institute University of Southern CaliforniaLos AngelesCAUSA Department of Ophthalmology University of WenzhouWenzhouChina Department of Ophthalmology Federal University of Sao PauloSao PauloBrazil Ashraf Armia Eye Clinic and Al Watany Eye Hospital Watany Research and Development CentreCairoEgypt Department of Ophthalmology University Magna Graecia of CatanzaroCatanzaroItaly

Purpose:To assess clinical results of the 9 mW/5.4 J/cm^(2) accelerated crosslinking(ACXL)in the treatment of progressive keratoconus(KC)over a span of 5 years.Methods:The prospective open non-randomized interventional study(Siena Eye-Cross Study 2)included 156 eyes of 112 patients with early progressive KC undergoing the Epi-Off 9 mW/5.4 J/cm^(2) ACXL at the Siena Crosslinking Centre,Italy.The mean age was 18.05±5.6 years.The 20-min treatments were performed using the New KXL I(Avedro,Waltham,USA),10 min of 0.1%HPMC Riboflavin soaking(VibeX Rapid,Avedro,Waltham,USA)and 10 min of continuous-light UV-A irradiation.Uncorrected distance visual acuity(UDVA),corrected distance visual acuity(CDVA),Kmax,coma,minimum corneal thickness(MCT),surface asymmetry index(SAI),endothelial cell count(ECC)were measured,and corneal OCT performed.Results:UDVA and CDVA improved significantly at the 3rd(P=0.028),Δ+0.17 Snellen lines and 6th postoperative month,respectively(P<0.001),Δ+0.23 Snellen lines.Kmax improved at the 6th postoperative month(P=0.03),Δ−1.49 diopters from the baseline value.Also,coma aberration value improved significantly(P=0.004).A mild temporary haze was recorded in 14.77%of patients without affecting visual acuity and without persistent complications.Corneal OCT revealed a mean demarcation line depth at 332.6±33.6μm.Conclusion:The 5-year results of Epi-Off 9 mW/5.4 J/cm^(2) ACXL demonstrated statistically significant improvements in UCVA and CDVA,corneal curvature and corneal higher-order aberrations which confers a long-term stability for progressive ectasia.Based on the results of the Siena Eye-Cross Study 2,the 9 mW/5.4 J/cm^(2) ACXL is a candidate to be the natural evolution of Epi-Off CXL treatment for the management of early progressive corneal ectasia,and thus optimize clinic workflow.

关键词： Crosslinking Keratoconus Accelerated crosslinking Epi-off Dresden accelerated protocol 9mW crosslinking CXL ACXL

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In vivo confocal microscopy: qualitative investigation of the conjunctival and corneal surface in open angle glaucomatous patients undergoing the XEN-Gel implant, trabeculectomy or medical therapy

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Eye and Vision 2020年第1期7卷 136-149页

作者： Stefano Baiocchi cosimo mazzotta Arianna Sgheri Alessandro Di Maggio Simone Alex Bagaglia Matteo Posarelli Leonardo Ciompi Alessandro Meduri Gian Marco Tosi Department of Medicine Surgery and NeurosciencesOphthalmology UnitPoliclinico Santa Maria alle ScotteUniversity of SienaViale Bracci 8ZIP code 53100 SienaItaly Ophthalmology Unit Department of Biomedical SciencesUniversity of MessinaMessinaItaly

Purpose:Assessing the quality of the ocular surface by in vivo scanning laser confocal microscopy(IVCM)in primary open angle glaucoma(POAG)patients treated by Xen 45 Gel Stent,medical therapy and trabeculectomy.Methods:Retrospective,single-center,single-masked,comparative study including 60 eyes of 30 patients(mean age 61.16±10 years)affected by POAG.Eyes were divided into 3 groups:Group 1 eyes underwent the Xen 45 Gel Stent procedure,Group 2 eyes were under medical therapy,Group 3 eyes were surgically treated by trabeculectomy.All patients underwent HRT II IVCM analysis of cornea,limbus,conjunctiva,sub-tenionian space and sclera.Results:The Xen 45 Gel stent,if properly positioned in the sub-conjunctival space preserves goblet cells and limits ocular surface inflammation.Regular corneal epithelial cells with micro-cysts,and normo-reflective sub-epithelial nerve plexus are documented by IVCM.In sub Tenon’s implants an alternative lamellar intra-scleral filtration is detectable.Combined surgical procedures show a noticeable number of inflammatory cells with rare micro-cysts.Post-trabeculectomy inflammatory reaction is more evident than Xen 45 Gel Stent associated surgical procedures,but less than medical therapy where a conspicuous presence of Langerhans cells,peri-neural infiltrates,marked loss of goblet cells and fibrosis is visible.Conclusion:Ocular surface inflammation was more notable in topical therapy than after trabeculectomy,which itself causes more inflammation than XEN Gel stents.

关键词： Glaucoma Primary open angle glaucoma POAG MIGS Xen 45 gel stent Ocular surface Inflammation Confocal microscopy IVCM

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Fully integrated and broadband Si-rich silicon nitride wavelength converter based on Bragg scattering intermodal four-wave mixing

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Photonics Research 2024年第3期12卷 I0001-I0010页

作者： VALERIO VITALI THALÍA DOMÍNGUEZ BUCIO HAO LIU JOSÉMANUEL LUQUE GONZÁLEZ FRANCISCO JURADO-ROMERO ALEJANDRO ORTEGA-MOÑUX GLENN CHURCHILL JAMES C.GATES JAMES HILLIER NIKOLAOS KALFAGIANNIS DANIELE MELATI JENS H.SCHMID ILARIA CRISTIANI PAVEL CHEBEN J.GONZALO WANGÜEMERT-PÉREZ ÑIGO MOLINA-FERNÁNDEZ FREDERIC GARDES cosimo LACAVA PERIKLIS PETROPOULOS Optoelectronics Research Centre University of SouthamptonSouthampton SO171BJUK 2ElectricalComputer and Biomedical Engineering DepartmentUniversity of PaviaPavia 27100Italy 3Telecommunication Research Institute(TELMA)Universidad de MálagaCEI Andalucı´a TECHE.T.S.I.Telecomunicación29010 MálagaSpain 4School of Science and TechnologyNottingham Trent UniversityNottingham NG118NSUK 5Department of Electrical EngineeringEindhoven University of TechnologyEindhoven 5600 MBThe Netherlands 6Department of Materials Science and EngineeringUniversity of IoanninaIoannina 45110Greece 7Centre de Nanosciences et de NanotechnologiesUniversitéParis-SaclayCNRS91120 PalaiseauFrance 8Advanced Electronics and Photonics Research CenterNational Research Council CanadaOttawaOntario K1A 0R6Canada

Intermodal four-wave mixing(FWM)processes have recently attracted significant interest for all-optical signal processing applications thanks to the possibility to control the propagation properties of waves exciting distinct spatial modes of the same waveguide.This allows,in principle,to place signals in different spectral regions and satisfy the phase matching condition over considerably larger bandwidths compared to intramodal processes.However,the demonstrations reported so far have shown a limited bandwidth and suffered from the lack of on-chip components designed for broadband manipulation of different modes.We demonstrate here a silicon-rich silicon nitride wavelength converter based on Bragg scattering intermodal FWM,which integrates mode conversion,multiplexing and de-multiplexing functionalities on-chip.The system enables wavelength conversion between pump waves and a signal located in different telecommunication bands(separated by 60 nm)with a 3 dB bandwidth exceeding 70 nm,which represents,to our knowledge,the widest bandwidth ever achieved in an intermodal FWM-based system.

关键词： scattering pump modal

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Concomitant medications and circulating tumor cells:friends or foes?

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Cancer Drug Resistance 2023年第1期6卷 30-34页

作者： Serena Di cosimo Vera Cappelletti Department of Advanced Diagnostics Fondazione IRCCS Istituto Nazionale dei TumoriMilano 20133Italy

The use of concomitant medications by patients with cancer is observed almost globally;however,little attention has been paid to this topic in the medical literature.Most clinical studies do not describe the type and duration of drugs used at the time of inclusion and during treatment or how these drugs may affect the experimental and/or standard therapy.Even less information has been published on the potential interaction between concomitant medications and tumor biomarkers.However,we do know that concomitant drugs can complicate cancer clinical trials and biomarker development,thus contributing to their interaction,leading to side effects,and resulting in suboptimal adherence to anticancer treatment.On the basis of these premises and moving from the study by Jurisova et al.,which reported the effect of commonly used drugs on the prognosis of women with breast cancer and the detection of circulating tumor cells(CTCs),we comment on the role of CTCs as an emerging diagnostic and prognostic tool for breast cancer.We also report the known and hypothesized mechanisms of CTC interplay with other tumor and blood components,possibly modulated by widespread drugs,including over-the-counter compounds,and discuss the possible implications of commonly used concomitant medications on CTC detection and clearance.After considering all these points,it is conceivable that concomitant drugs are not necessarily a problem,but on the contrary,their virtuous mechanisms can be exploited to reduce tumor spread and enhance the effect of anticancer therapies.

关键词： Breast cancer concomitant medications circulating tumor cells

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Practical Implementation and Operational Experience of Dynamic Mode Decomposition in Wide-area Monitoring Systems of Italian Power System

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Journal of Modern Power Systems and Clean Energy 2023年第3期11卷 793-802页

作者： Andrea Vicario Alberto Berizzi Giorgio Maria Giannuzzi cosimo Pisani Department of Energy at Politecnico di Milano MilanItaly Terna S.p.A. RomeItaly

This study presents the assumptions and strategies for the practical implementation of the dynamic mode decomposition approach in the wide-area monitoring system of the Italian transmission system operator,Terna.The procedure setup aims to detect poorly damped interarea oscillations of power systems.Dynamic mode decomposition is a data-driven technique that has gained increasing attention in different fields;the proposed implementation can both characterize the oscillatory modes and identify the most influenced areas.This study presents the results of its practical implementation and operational experience in power system monitoring.It focuses on the main characteristics and solutions identified to reliably monitor the interarea electromechanical modes of the interconnected European power system.Moreover,conditions to issue an appropriate alarm in case of critical operating conditions are described.The effectiveness of the proposed approach is validated by its application in three case studies:a critical oscillatory event and a short-circuit event that occurred in the Italian power system in the previous years,and a 15-min time interval of normal grid operation recorded in March 2021.

关键词： Power system control power system dynamics wide-area monitoring system(WAMS) dynamic mode decomposition

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Paraneoplastic myopathy-related rhabdomyolysis and pancreatic cancer:A case report and review of the literature

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世界临床病例杂志 2023年第28期11卷 6823-6830页

作者： Andrea Costantini Lucia Moletta Elisa Sefora Pierobon Simone Serafini Michele Valmasoni cosimo Sperti Department of Surgical Oncological and Gastroenterological SciencesUOC Chirurgia Generale 1University of PaduaPadua 35128Italy Department of Surgical Oncological and Gastroenterological SciencesUOC Chirurgia Generale 2University of PaduaPadua 35128Italy

BACKGROUND Rhabdomyolysis is a life-threatening condition,often leading to progressive renal failure and death.It is caused by destruction of skeletal muscle and the release of myoglobin and other intracellular contents into the circulation.The most frequent cause of this condition is“crush syndrome”,although several others have been described and paraneoplastic inflammatory myopathies associated with various types of cancer are repeatedly reported.CASE SUMMARY We describe a rare case of a patient with pancreatic cancer who developed rhabdomyolysis early on,possibly due to paraneoplastic myositis leading to acute renal failure and eventually to rapid death.A 78-year-old Caucasian woman was referred to our hospital for obstructive jaundice and weight loss due to a lesion in the pancreatic head.She presented increasingly severe renal insufficiency with anuria,a dramatic increase in creatine phosphokinase(36000 U/L,n.v.20-180 U/L)and myoglobin(>120000μg/L,n.v.12-70μg/L).On clinical examination,the patient showed increasing pain in the lower limbs associated with muscle weakness which was severe enough to immobilize her.Paraneoplastic myopathy linked to the malignant lesion of the pancreatic head was suspected.The patient was treated with hemodialysis and intravenous methylprednisolone.Despite all the efforts to prepare the patient for surgery,her general condition rapidly deteriorated and she eventually died 30 d after hospital admission.CONCLUSION The possible causes of rhabdomyolysis in this patient with pancreatic cancer are discussed,the development of paraneoplastic myopathy being the most likely.Clinicians should bear in mind that these syndromes may become clinically manifest at any stage of the cancer course and their early diagnosis and treatment could improve the patient’s prognosis.

关键词： Paraneoplastic myopathy Rhabdomyolysis Pancreatic cancer Acute renal failure Paraneoplastic myositis Prognosis Case report

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5-ASA in ulcerative colitis:Improving treatment compliance

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World Journal of Gastroenterology 2009年第35期15卷 4353-4355页

作者： cosimo Prantera Marina Rizzi Department of Gastroenterology Azienda Ospedaliera San Camillo-ForlaniniCirconvallazione Gianicolense 8700152 RomeItaly Department of Gastroenterology University Campus Bio Medicovia Alvaro del Portillo 20000128 Rome Italy

5-aminosalicylic acid(5-ASA)compounds are a highly effective treatment for ulcerative colitis(UC).While UC patient compliance in clinical studies is over 90%, only 40%of patients in every day life take their prescribed therapy.Adherence to medication has been emphasized recently by a Cochrane meta-analysis that has suggested that future trials of 5-ASA in UC should look at patient compliance rather than drug efficacy. Better compliance can be obtained by reducing the number of tablets and times of administration.Given that the 5-ASA formulations have different delivery systems that split the active moiety in various regions of the intestine,it is particularly important that an adequate dose of the drug arrives at the inflamed part of the colon.5-ASA Multi matrix(MMx)is a novel,high strength(1.2 g),oral formulation designed for oncedaily dosing.It releases the active moiety throughout the colon.Different studies with this compound have shown that it is as effective as 5-ASA enema in the treatment of mild-to-moderate,left-sided UC,and is comparable to a pH-dependent,delayed release 5-ASA (Asacol ),even if given once daily.Recently,the effectiveness in the acute phase of UC has been confirmed also in maintenance.In conclusion,at present,5-ASA MMx seems theoretically the best agent for maintaining patient compliance,and consequently,treatment effectiveness.

关键词：溃疡性结肠炎氨基水杨酸灌肠治疗依从性加州大学活性成分抗坏血酸计量设计

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