Piezoelectric nanocomposite bioink and ultrasound stimulation modulate early skeletal myogenesis

Despite the significant progress in bioprinting for skeletal muscle tissue engineering, new stimuli-responsive bioinks to boost the myogenesis process are highly desirable. In this work, we developed a printable alginate/Pluronic-based bioink including piezoelectric barium titanate nanoparticles (nominal diameter: ∼60 nm) for the 3D bioprinting of muscle cell-laden hydrogels. The aim was to investigate the effects of the combination of piezoelectric nanoparticles with ultrasound stimulation on early myogenic differentiation of the printed structures. After the characterization of nanoparticles and bioinks, viability tests were carried out to investigate three nanoparticle concentrations (100, 250, and 500 μg mL^-1) within the printed structures. An excellent cytocompatibility was confirmed for nanoparticle concentrations up to 250 μg mL^-1. TEM imaging demonstrated the internalization of BTNPs in intracellular vesicles. The combination of piezoelectric nanoparticles and ultrasound stimulation upregulated the expression of MYOD1, MYOG, and MYH2 and enhanced cell aggregation, which is a crucial step for myoblast fusion, and the presence of MYOG in the nuclei. These results suggest that the direct piezoelectric effect induced by ultrasound on the internalized piezoelectric nanoparticles boosts myogenesis in its early phases.

Primers for the Adhesion of Gellan Gum-Based Hydrogels to the Cartilage: A Comparative Study

A stable adhesion to the cartilage is a crucial requisite for hydrogels used for cartilage regeneration. Indeed, a weak interface between the tissue and the implanted material may produce a premature detachment and thus the failure of the regeneration processes. Fibrin glue, cellulose nanofibers and catecholamines have been proposed in the state-of-the-art as primers to improve the adhesion. However, no studies focused on a systematic comparison of their performance. This work aims to evaluate the adhesion strength between ex vivo cartilage specimens and polysaccharide hydrogels (gellan gum and methacrylated gellan gum), by applying the mentioned primers as intermediate layer. Results show that the fibrin glue and the cellulose nanofibers improve the adhesion strength, while catecholamines do not guarantee reaching a clinically acceptable value. Stem cells embedded in gellan gum hydrogels reduce the adhesion strength when fibrin glue is used as a primer, being anyhow still sufficient for in vivo applications. This article is protected by copyright. All rights reserved.

A circular dichroism study of the protective role of polyphosphoesters polymer chains in polyphosphoester-myoglobin conjugates

Protein‐polymer conjugates are a blooming class of hybrid systems with high biomedical potential. Despite a plethora of papers on their biomedical properties, the physical–chemical characterization of many protein‐polymer conjugates is missing. Here, we evaluated the thermal stability of a set of fully‐degradable polyphosphoester‐protein conjugates by variable temperature circular dichroism, a common but powerful technique. We extensively describe their thermodynamic stability in different environments (in physiological buffer or in presence of chemical denaturants, e.g., acid or urea), highlighting the protective role of the polymer in preserving the protein from denaturation. For the first time, we propose a simple but effective protocol to achieve useful information on these systems in vitro, useful to screen new samples in their early stages.

Inhomogeneous Diastereomeric Composition of Mongersen Antisense Phosphorothioate Oligonucleotide Preparations and Related Pharmacological Activity Impairment

Mongersen is a 21-mer antisense oligonucleotide designed to downregulate Mothers against decapentaplegic homolog 7 (SMAD7) expression to treat Crohn's disease. Mongersen was manufactured in numerous batches at different scales during several years of clinical development, which all appeared identical, using common physicochemical analytical techniques, while only phosphorous-31 nuclear magnetic resonance (³¹P-NMR) in solution showed marked differences. Close-up analysis of 27 mongersen batches revealed marked differences in SMAD7 downregulation in a cell-based assay. Principal component analysis of ³¹P-NMR profiles showed strong correlation with SMAD7 downregulation and, therefore, with pharmacological efficacy in vitro. Mongersen contains 20 phosphorothioate (PS) linkages, whose chirality (Rp/Sp) was not controlled during manufacturing. A different diastereomeric composition throughout batches would lead to superimposable analytical data, but to distinct ³¹P-NMR profiles, as indeed we found. We tentatively suggest that this may be the origin of different biological activity. As similar manifolds are expected for other PS-based oligonucleotides, the protocol described here provides a general method to identify PS chirality issues and a chemometric tool to score each preparation for this elusive feature.

Circularly Polarized Luminescence of Encaged Eu(III) and Tb(III) Complexes Controlled by an Inherently Chiral Remote Unit

A molecular cage-based approach to obtain enantiopure lanthanide complexes with circular polarized luminescence (CPL) activities is presented. Hemicryptophane endohedral complexes were designed by functionalizing the molecular cage with pyridine-2,6-dipicolinamide coordinating...

Phaseocyclopentenones A and B, Phytotoxic Penta- and Tetrasubstituted Cyclopentenones Produced by Macrophomina phaseolina, the Causal Agent of Charcoal Rot of Soybean in Argentina

Two new penta- and tetrasubstituted cyclopentenones, named phaseocyclopentenones A and B (1 and 2), together with guignardone A (3), were isolated from Macrophomina phaseolina cultures. The phytopathogenic fungus was isolated from infected soybean tissues showing charcoal rot symptoms in Argentina. Charcoal rot is a devastating disease considering that soybean is one of the main legumes cultivated in the world. Phaseocyclopentenones A and B were characterized by 1D and 2D 1H and 13C NMR spectroscopic and HRESIMS spectrometric data and chemical methods as 4-benzoyl-3,4,5-trihydroxy-2-phenylcyclopent-2-enone and 3,5-dihydroxy-2,4-diphenylcyclopent-2-enone, respectively. The relative configuration of phaseocyclopentenones A and B was assigned by 1H and NOESY NMR methods, while their absolute configurations were assigned by electronic circular dichroism methods. When assayed on a nonhost plant (Solanum lycopersicum L.) by the leaf puncture assay, phaseocyclopentenones A and B and guignardone A showed phytotoxic activity, while only 1 and 2 were toxic when tested on cuttings of the same plant. No phytotoxicity or antifungal activity was detected for the three compounds on the host plant soybean (Glycine max L.) and against some of its fungal pathogens, namely, Cercospora nicotianae and Colletotrichum truncatum, also isolated from infected soybean plants in Argentina.

Time-resolved circularly polarized luminescence of Eu3+ -based systems

Chiral Eu³⁺ -based systems are frequently studied via circularly polarized luminescence spectroscopy. The emission lifetimes of each circular polarization, however, are virtually always ignored, because in a homogeneous sample of emitters, there should be no difference between the two. However, we show that in less robust Eu³⁺ complex structures, as in the chiral complex Eu (facam)₃ , a difference in the lifetimes of the two circularly polarized emission components arises due to heterogeneity of the complexes. In this case, each species within the sample could have different degrees of circularly polarized luminescence and decay rates at certain emission lines. The superposition of the emission components of the various chiral species leads to an overall difference in decay rate between the two circular polarizations. Such a difference is also shown for Eu³⁺ -doped chiral TbPO₄ ·D₂ O nanocrystals. We believe that this kind of measurement could be a unique tool for determining the homogeneity of a lanthanide-based chiral system, where other methods might fail in this task.

Effect of the Counterion on Circularly Polarized Luminescence of Europium(III) and Samarium(III) Complexes

Each enantiopure europium(III) and samarium(III) nitrate and triflate complex of the ligand L, with L = N,N′-bis(2-pyridylmethylidene)-1,2-(R,R + S,S)-cyclohexanediamine ([LnL(tta)₂]·NO₃ and [LnL(tta)₂(H₂O)]·CF₃SO₃, where tta = 2-thenoyltrifluoroacetylacetonate) has been synthesized and characterized from a spectroscopic point of view, using a chiroptical technique such as electronic circular dichroism (ECD) and circularly polarized luminescence (CPL). In all cases, both ligands are capable of sensitizing the luminescence of both metal ions upon absorption of light around 280 and 350 nm. Despite small differences in the total luminescence (TL) and ECD spectra, the CPL activity of the complexes is strongly influenced by a concurrent effect of the solvent and counterion. This particularly applies to europium(III) complexes where the CPL spectra in acetonitrile can be described as a weighed linear combination of the CPL spectra in dichloromethane and methanol, which show nearly opposite signatures when their ligand stereochemistries are the same. This phenomenon could be related to the presence of equilibria interconverting solvated, anion-coordinated complexes and isomers differing by the relative orientation of the tta ligands. The difference between some bond lengths (M–N bonds, in particular) in the different species could be at the basis of such an unusual CPL activity.

Triflate ([EuL(tta)₂(H₂O)]·CF₃SO₃) and nitrate ([EuL(tta)₂]·NO₃) complexes, with L = N,N′-bis(2-pyridylmethylidene)-1,2-(R,R or S,S)-cyclohexanediamine, where tta = 2-thenoyltrifluoroacetylacetonate, show nearly opposite circularly polarized luminescence (CPL) signatures when dissolved in dichloromethane (DCM) or methanol (MeOH), even though their ligand stereochemistries remain unchanged. The presence (in DCM) and absence (in MeOH) of the counterion in the inner coordination sphere determine a strong change of the CPL activity of the relative europium(III) complex.

Modulation of circularly polarized luminescence through excited-state symmetry breaking and interbranched exciton coupling in helical push-pull organic systems

π-Helical push-pull dyes were prepared and their (chir)optical properties were investigated both experimentally and computationally. Specific fluorescent behaviour of bis-substituted system was observed with unprecedented solvent effect on the intensity of circularly polarized luminescence (CPL, dissymmetry factor decreasing from 10-2 to 10-3 with an increase in solvent polarity) that was linked to a change in symmetry of chiral excited state and suppression of interbranched exciton coupling. The results highlight the potential of CPL spectroscopy to study and provide a deeper understanding of electronic photophysical processes in chiral π-conjugated molecules.

Chiroptical detection of a model ruthenium dye in water by circularly polarized-electrochemiluminescence

We demonstrate the possibility to detect selectively the two single enantiomers of a model [Ru(bpy)₃]²⁺-based dye by circularly polarized-electrochemiluminescence (CP-ECL).

Anisometropia and isoametropia associated with microstrabismus: effectiveness of late anti-amblyopia treatment

PURPOSE

Outcomes Research Study on patients suffering from anisometropia or isoametropia associated with amblyopia and microstrabismus to show the impact of late occlusion treatment on therapeutic prognosis.

MATERIALS AND METHODS

Enrollment of all the eligible patients presenting to recruiting centers at the Department of Pediatric Ophthalmology and Strabismus - Ophthalmological Clinic - Policlinico Umberto I - Rome. At baseline, all patients will undergo an opthalmologic evaluation. Recruited patients will be followed for a 2-year period. Our test group was composed of 31 patients, 11 with bilateral and 20 with monolateral amblyopia, totalling 42 amblyopic eyes, and it was assessed - always by the same examiner - with the help of the following orthoptic examinations: Wirt test, Irvine-Jampolsky test (4 dioptre fixation task), Visuscope, Cover Test, Bagolini striated glasses, and Worth lights test. We assessed pre-post treatment variations observed in the overall group of amblyopic eyes, regardless of the differences between RE and LE.

OUTCOMES

Of the 31 children, 58.1% were males and 41.9% female, average age between 6 and 14 years. Of the 42 amblyopic eyes, after daily occlusion of 8 hours ± 2.30 SD, we recorded an improvement of 71.4%, and visual acuity increased from an average of 0.4 LogMAR to 0.1 LogMAR.

CONCLUSION

Late anti-amblyopic occlusion treatment proved effective in the long term for children 6 to 12 years, specifically regarding visual acuity, fixation, stereopsis, and binocular collaboration in patients suffering from anisometropia or isoametropia and microstrabismus.

Near-infrared circularly polarized luminescence from chiral Yb(iii)-diketonates

We report a rare example of near infrared circularly polarized luminescence (NIR-CPL) in the 920–1050 nm region associated with the f–f transitions of Yb diketonate complexes bearing chiral ancillary ligands.

Ocular motility alterations in orbital fractures: pre-post evaluation in maxillofacial surgical treatment

PURPOSE

The study aims to investigate the ability of maxillofacial surgery to reduce strabismus and improve ocular clinical symptomatology in patients with fracture of the medial or lateral floor of the orbit, or both, and to evaluate such abilities relative to the temporal distance between trauma and surgery.

PATIENTS AND METHODS

25 patients with traumatic diplopia were evaluated by CT, Goldman manual field of view, Hess-Lancaster test, eye examination and orthoptic examination, before and after surgery.

RESULTS

We observed: a statistically significant reduction of the deviation angle, both from close and long distance (P = 0.0054 and P = 0.0051 respectively) with a 38% reduction of the deviation from short distance and 54% from afar; a regression of diplopia in 20% of the surgically treated cases (CL from 0 to 39%), significant at the Mc Nemar test; a negative correlation with the time elapsed between the onset of the fracture and maxillofacial surgery (R = -0.26), even if the analysis did not show a statistical significance of the data (P = 0.2). However, it is evident that the maximum improvement is observed only in cases operated within 5 months of the trauma, while the failures (worsening or persistence of diplopia) were observed only in the cases operated later.

CONCLUSION

We can state that the intervention reduces strabismus and improves ocular symptomatology, as it statistically significantly reduces cases of diplopia; furthermore, it would seem preferable to intervene early, especially when damage to a muscular structure is suspected, even if the data do not allow definitive conclusions in this regard.

Broad-Range Spectral Analysis for Chiral Metal Coordination Compounds: (Chiro)optical Superspectrum of Cobalt(II) Complexes

Chiroptical broad-range spectral analysis extending from UV to mid-IR was employed to study a family of Co(II) N-(1-(aryl)ethyl)salicylaldiminato Schiff base complexes with pseudotetrahedral geometry associated with chirality-at-metal of the Δ/Λ type. While common chiral organic compounds have well-separated absorption and circular dichroism spectra (CD) in the UV/vis and IR regions, chiral Co(II) complexes feature an almost unique continuum of absorption and CD bands, which cover in sequence the UV, visible, near-IR (NIR), and IR regions of the electromagnetic spectrum. They can be collected in a single (chiro)optical superspectrum ranging from the UV (230 nm, 5.4 eV) to the mid-IR (1000 cm^-1, 0.12 eV), which offers a fingerprint of the structure and stereochemistry of the metal complexes. Each region of the superspectrum contributes to one piece of information: the NIR-CD region, in combination with TDDFT calculations, allows a reliable assignment of the metal-centered chirality; the UV-CD region facilitates the analysis of the Δ/Λ diastereomeric equilibrium in solution; and the IR-VCD region contains a combination of low-lying metal-centered electronic states (LLES) and ligand-centered vibrations and displays characteristically enhanced and monosignate VCD bands. Circular dichroism in the NIR and IR regions is crucial to reveal the presence of d-d transitions of the Co(II) core which, due to the electric-dipole forbidden character, would be otherwise overlooked in the corresponding absorption spectra.

Peribulbar anesthesia in sclero-retinal surgery: two quadrants vs single injection

PURPOSE

To evaluate the advantage of peribulbar anesthesia in two quadrants (infero-temporal and upper nasal) vs single injection technique (infero-temporal) for scleral rhegmatogenous retinal detachment surgery (RRD).

PATIENTS AND METHODS

57 patients, aged between 33 and 75 years (57.01 ± 8.68), waiting for retinal detachment surgery, were randomized in two groups: a group S (29 patients), with single quadrant injection technique and a group C (28 patients) with two quadrants injection. Patients in Group S were injected in two quadrants with a 10 ml mixture containing Mepivacaine 2% 5 ml and Ropivacaine 0.75% 5 ml, with hyaluronidase 10 IU/ ml. Patients in group C were injected with the same anesthetic mixture in one quadrant. Number of additional injection, during surgery, in two groups, were reported. Pain was tested with VAS (Verbal Analogue Scale 0-10) after regional block, when muscles were insulated, during scleral buckling positioning, when conjunctive was closed and 6, 12, 24 hours after surgery.

RESULTS

The need for a second peribulbar injection of anesthetic occurred in 9 patients of group C (32.14%); further injection was necessary in 1 patient (3.57%) of group S during scleral buckling (VAS = 7), statistically significant (p <0.05). Postoperative VAS 6 - 12 - 24 hours after surgery was not significant.

CONCLUSIONS

The peribulbar anesthesia may be proposed in scleral surgery of retinal detachment; the injection in two quadrants secured solid and satisfactory anesthesia, increasing the outcome of retinal surgery in loco-regional anesthesia.

Chiroptical methods in a wide wavelength range for obtaining Ln3+ complexes with circularly polarized luminescence of practical interest

We studied enantiopure chiral trivalent lanthanide (Ln3+ = La3+, Sm3+, Eu3+, Gd3+, Tm3+, and Yb3+) complexes with two fluorinated achiral tris(β-diketonate) ligands (HFA = hexafluoroacetylacetonate and TTA = 2-thenoyltrifluoroacetonate), incorporating a chiral bis(oxazolinyl)pyridine (PyBox) unit as a neutral ancillary ligand, by the combined use of optical and chiroptical methods, ranging from UV to IR both in absorption and circular dichroism (CD), and including circularly polarized luminescence (CPL). Ultimately, all the spectroscopic information is integrated into a total and a chiroptical super-spectrum, which allows one to characterize a multidimensional chemical space, spanned by the different Ln3+ ions, the acidity and steric demand of the diketone and the chirality of the PyBox ligand. In all cases, the Ln3+ ions endow the systems with peculiar chiroptical properties, either allied to f-f transitions or induced by the metal onto the ligand. In more detail, we found that Sm3+ complexes display interesting CPL features, which partly superimpose and partly integrate the more common Eu3+ properties. Especially, in the context of security tags, the pair Sm/Eu may be a winning choice for chiroptical barcoding.

A chiral lactate reporter based on total and circularly polarized Tb(iii) luminescence

Lactate anion signaling by a chiral Tb(iii) complex based on total and circularly polarized luminescence.

Taking advantage of Co(ii) induced enhanced VCD for the fast and sensitive determination of enantiomeric excess

Large Co(ii)-induced VCD signals provide a method for determining the enantiomeric excess of α-amino acids. This strategy can be followed for building new VCD protocols.

Reliability study of biometrics "do not contact" in myopia

PURPOSE

The aim of the study is a comparison between the actually achieved after surgery condition versus the expected refractive condition of the eye as calculated via a biometer.

MATERIALS AND METHODS

The study was conducted in a random group of 38 eyes of patients undergoing surgery by phacoemulsification.

RESULTS

The mean absolute error was calculated between the predicted values from the measurements with the optical biometer and those obtained in the post-operative error which was at around 0.47%

CONCLUSIONS

Our study shows results not far from those reported in the literature, and in relation, to the mean absolute error is among the lowest values at 0.47 ± 0.11 SEM.

Intracranial aneurysm and diplopia due to oculomotor nerve palsy: pre- and post-operative study

PURPOSE

The aim of this study was to analyze ocular signs and symptoms in patients with oculomotor nerve palsy due to compression exerted by an intracranial aneurysm. We compare the results of two surgical treatments (microsurgical clipping against endovascular embolisation) in relation with the size of the aneurysm and the time between diagnosis and therapeutical approach.

MATERIALS AND METHODS

The study involved 16 patients. Each patient underwent an ophthalmological evaluation at the baseline and immediately, 6 months and 1 year after surgery, including the study of eyelid ptosis, ocular motility, pupil function, non-concomitant strabismus, diplopia and visual acuity.

RESULTS

The best recovery was seen in the patients undergoing aneurysm clipping. Palpebral ptosis was the first sign to appear and the first to regress, followed by pupil and medial rectus function. Recovery of the other muscles was slower and often incomplete.

CONCLUSIONS

Ophthalmological examination is essential for the correct treatment and follow-up of patients with intracranial aneurysms.

Temporary diplopia upon hyoscine-N-butyl bromide administration: case report

Hyoscine-N-butyl bromide is a widely used antispasmodic belonging to the belladonna alkaloid class of semisynthetic quaternary ammonium compounds. These compounds exert a spasmolytic action on the smooth muscles of the bile-gastrointestinal tract, genitourinary tract, salivary glands (xerostomia), and also on the visual apparatus - in particular, the irido-ciliary complex. As a consequence, they provoke collateral effects such as mydriasis and accommodation disturbances. We report the case of a 23-year-old woman who complained of not only “dry mouth” but also “cloudy vision” and a “diplopia”, both of temporary type, 2 hours after oral administration of hyoscine-N-butyl bromide.

Persistent vertical diplopia after cataract surgery: a case report

Diplopia is an event that can occur following cataract surgery, although its rate of occurrence is limited and ranges from 0.67% to 0.85%. The authors present a case of vertical diplopia arising after peribulbar anaesthesia for cataract surgery in a 78-year-old woman. Diplopia appeared at distance in primary position, while at near there was binocular single vision. Stereopsis was present at the Lang I - II Test, but the Wirth Test was incomplete. Although in the literature the frequency of these "accidents" is very limited, we think it is relevant to emphasize the need to perform pre-operative routine using a careful orthoptic examination along with a thorough medical, especially strabological, history.

Idiopathic juxtafoveal retinal telangiectasis and retinal macroaneurysm treated with indocyanine green dye-enhanced photocoagulation

This case report presents the use of indocyanine green dye-enhanced photocoagulation (ICG-DEP) for the treatment of idiopathic juxtafoveal retinal telangiectasis and a retinal macroaneurysm. A 35-year-old male with 20/20 vision had been followed for 5 years for a retinal macroaneurysm with retinal telangiectasis outside the macular area. He then presented with a recently decreased vision in his right. He had macular edema with a new area of idiopathic juxtafoveal retinal telangiectasis. After 4 focal argon laser treatments, angiographic closure of the lesions was not obtained and the retinal edema remained. After 3 sessions of ICG-DEP, the lesions were closed and the edema absorbed. The 810 nm infrared laser with ICG-DEP should be considered for the treatment of idiopathic juxtafoveal retinal telangiectasis and retinal macroaneurysms. In this case the procedure appears to be safe and well tolerated. It may allow for more direct energy absorption than that of the argon laser to these types of retinal lesions with better tissue closure.

Ocular traumatology in children. A retrospective study

OBIECTIVE: This study assesses the descriptive epidemiology of children with eye injuries presenting to the Emergency Department of a non exclusive Paediatric University Hospital - First Division of Ophthalmology of "Sapienza" University of Rome - over a period of 12 years.

STUDY DESIGN

A retrospective long term study of 12 years.

PARTICIPANTS

All paediatric patients (up to 14 years of age) presenting with ocular injuries and hospitalized.

METHODS

It was analyzed the incidence of the ocular trauma among males and females. The situation in which the trauma occurred, type of trauma (contusive or perforating), the presence of endo-bulbar foreign bodies, visual acuity outcome.

RESULTS

There were 203 patients who presented to the Emergency Department in the period examined. Contusive traumas were 130 (90 males, 40 females). The perforating trauma were 73 (63 males, 10 females). The presence of an endo-bulbar foreign body was registered in 10 patients. A detailed analysis of the causes of the trauma is therefore provided. We evidence that males were almost exclusively involved in sport traumas (60 males versus 2 females), and in second instance accidental trauma is almost equally divided between two genders.

CONCLUSIONS

Our retrospective study presents the paediatric cases of a non exclusive Paediatric University Hospital where 3% of ocular traumas requiring hospitalization were in children. Therefore our data could be useful in order to bring about the necessary preventive measures to minimize paediatric eye injuries.

OCT: Macular thickness in insulin-dependent patients without evident retinopathy: a preliminary study

OBJECTIVES

Aim of this study was to evaluate whether OCT would be able to show subclinical retinal modifications in diabetic patients not showing clinical alterations during routine comprehensive eye examinations. Furthermore, we analyzed whether there is a seat of topographical macular predilection for the alterations and the connection between their onset and the duration of the disease.

MATERIALS AND METHODS

39 Caucasian subjects, aged between 13 and 33 years, were enrolled. 20 of them were healthy subjects, and 19 were patients affected by insulin-dependent type I diabetes mellitus. OCT scans were performed on all subjects, and macular thickness maps were obtained. Macular thickness was compared between diabetic and healthy subjects. Diabetic patients were divided in two subgroups, on the basis of disease duration (<=/> 16 years), and compared with two age-matched subgroups of healthy subjects.

RESULTS

According to medical literature, macular thickness is significantly greater in men than in women. No further statistically significant differences could be detected in macular thickness if the disease has been lasting for 16 years or less. On the other hand, a statistically significant increase was detected in temporal macular thickness in patients affected by diabetes for more than 16 years.

CONCLUSIONS

In patients affected by insulin-dependent diabetes for more than 16 years OCT detects early subclinical alterations in peripheral temporal macular region.

Clinical manifestations due to pharmacological interactions in pediatric ophthalmic surgery: topical drugs and general anaesthesia

INTRODUCTION

The authors consider the type and the incidence of the adverse effects due to the interaction between ophthalmic drugs and general anaesthesia in pediatric ophthalmic surgery.

PATIENTS AND METHODS

The experience included 176 general anaesthesia in 100 children aged between 9,2 months and 11,4 years (mean age 4,9 years).

RESULTS

In the 100 patients we reported: 4 cases (2.7% general anaesthesias) of sinus tachycardia with heart rhythm varying between 170 and 180 beats per minute (3.6%); 5 cases of sinus bradycardia, varying between 60 and 70 beats per minute (3.3%); 3 cases of bronchospasm (2%); 2 cases of psychomotor agitation/disturbances in pre-convulsive state after anaesthesia (1.3%); 3 cases of arterial hypotension (60-70 mmHg) (2%); 7 cases of skin rush around neck and chest (4.6%); 1 case of prolonged apnoea (0.6%).

CONCLUSIONS

The clinical manifestations, principally on the cardio-circulatory and nervous system are subjected to critical revision, to foresee the pharmacological interferences and therefore to prepare the necessary measure of medical treatment.

[Waardenburg Syndrome: a review of literature and case reports]

Waadernburg syndrome (WS) is an autosomal dominant disease clinically and genetically heterogeneous. It is characterized by non-progressive sensorineuronal hearing loss of variable degree and anomalous pigmentation (of the eyes, skin and stria vascularis of cochlear duct) caused by melanocytes absence. The syndrome is caused by mutations in genes that regulate the melanocytes differentiation from the neural crest during embriogenetic development. This study will review the literature on WS and explain more in detail the ocular findings in WS, while reporting new findings on two newly diagnosed cases.

Effect of brimonidine on patients undergoing uncontrolled IOP with beta-blockers

The authors evaluated the effect of the replacement of beta-blockers with brimonidine drops in patients taking beta-blockers only or with dorzolamide, having IOP > 20 mmHg. The study was divided into two sections: one group treated with brimonidine b.i.d. (23 patients) and the other group treated with brimonidine + dorzolamide b.i.d. (17 patients). The effect of the substitution showed after 90 days of treatment with a reduction of 8.59 +/- 1.2 mmHg (P < 0.001) in the first group and 6.1 +/- 1.7 mmHg (P < 0.001) in the second group. Three patients in the first group and four patients in the second group presented minor adverse effects which did not justify discontinuation of treatment. Brimonidine was effective treatment as a substitute for beta-blockers only when associated with dorzolamide.

Topical ibopamine and corticosteroids in the treatment of post-surgery ocular hypotony

PURPOSE

The aim of the present preliminary study, performed on post-surgical hypotony, was the evaluation of the effects on ocular hypotony of the concomitant administration of ibopamine and corticosteroids.

METHODS

14 patients (11 males-3 females; mean age 47 years) with ocular hypotony following several vitroretinal surgical intervention in different districts, were enrolled. The inclusion criteria were: mean IOP during tonometric curve equal or lower than 6 mmHg, stable IOP for at least 60 days, ongoing treatment with 0.1% dexamethasone (4 times/day), successful surgical intervention, 2% ibopamine (4 times/day) was added to the corticosteroid therapy for 30-60 days.

RESULTS

Before ibopamine administration, mean IOP was 4.07 mmHg SD 1.71. At the end of the treatment period, mean IOP increased by 89% in comparison to baseline values (+ 3.64 mmHg SD 5.57). This difference was statistically significant (paired t = 2.39; P = 0.03). One month after ibopamine-treatment discontinuation, mean IOP decreased to pre-treatment values (4.86 mmHg SD 3.50).

CONCLUSIONS

The results of the present study, although preliminary, suggest the possibility of a future pharmacological treatment of ocular hypotony with ibopamine, whose rationale is based on the increase of aqueous humor production by stimulating the D1 dopaminergic receptor.