Allergic conjunctivitis: a cross-sectional study.

BACKGROUND: Ocular allergy is a common disease in daily practice. OBJECTIVES: A cross-sectional study was conducted to evaluate clinical aspects of and therapeutic approaches to ocular allergy in Italy. METHODS: Of the 3685 patients affected by ocular allergy and enrolled by 304 ophthalmologists nationally, 3545 were eligible to be included in the statistical analysis. A questionnaire was administered in office to record demographic data, comorbidities, trigger factors, number of conjunctivitis episodes, and past treatments. Signs and symptoms were graded according to their severity, frequency, and duration. RESULTS: Mean age of enrolled patients was 38 ± 19 years. Seasonal allergic conjunctivitis (55% of patients) was equally distributed among the different age groups, while perennial allergic conjunctivitis (18%) increased with age and vernal keratoconjunctivitis (9%) was more frequent under the age of 18. Itching and redness were reported in 90% and 85%, respectively; lid skin involvement was observed in 22% of cases and keratitis in 11%. Pollen sensitivities were indicated as the most frequent triggers; however, exposure to non-specific environmental conditions, pollutants, and cigarette smoke was frequently reported. Only 35% of patients underwent a diagnostic evaluation of specific allergic sensitization, with positive allergy tests found in 82% of this subset. With regard to treatment, topical decongestants were used in 43% of patients, corticosteroids in 41%, antihistamines in 29%, systemic antihistamines in 27%, and mast cell stabilizers in 15%. CONCLUSION: This survey provided useful epidemiological information regarding the clinical characteristics and treatment options of a large cohort of patients affected by different forms of ocular allergy. CLINICAL RELEVANCE: An understanding of ocular allergic disease, its incidence, demographics, and treatment paradigms provides important information towards understanding its pharmacoeconomics and burden on the national health system.

Hemodynamic classification of varicoceles in men: our experience.

AIM: The aim of this work is to propose a new hemodynamic classification of male varicoceles that can improve the accuracy of staging and the quality of the examination report. We retrospectively analyzed data on outpatients referred to our vascular ultrasonography service by general practitioners or urologists for work-up of "varicoceles." Quantification and characterization of venous reflux is essential for selecting patients who require treatment and for evaluating the latter's effectiveness, as demonstrated by our experience in a subgroup of 58 patients referred for imaging after surgery on endovascular procedures. MATERIALS AND METHODS: We performed scrotal Doppler sonography on 278 males seen during the period 2009-2011 for doubts raised during clinical assessment of varicoceles or for postoperative evaluation of residual reflux. RESULTS: The diagnosis of varicocele was confirmed on 193 subjects; in 32 patients who had undergone percutaneous or surgical treatment the examination demonstrated the presence of residual reflux, while in 85 cases the presence of pain or a scrotal mass was not associated with venous reflux. CONCLUSIONS: Standardized instrumental criteria have been developed for the diagnosis of varicoceles but not for their staging. The classification system we propose provides a simple, hemodynamically accurate method for qualitatively evaluating venous reflux, and it can be a useful tool for verifying the success of surgical and endovascular procedures for correcting varicoceles.

In vivo confocal microscopy of ocular surface squamous neoplasia.

PURPOSE: To analyse in vivo structural and cellular features of ocular surface squamous neoplasia using clinical confocal microscopy. METHODS: Ten consecutive cases of untreated ocular surface squamous neoplasia were in vivo investigated using clinical confocal microscopy (ConfoScan4, Nidek Co. Ltd, Gamagori, Japan) with a × 40 surface non-contact objective lens. Confocal microscopy images were compared with cytologic samples obtained by scraping technique. RESULTS: Confocal microscopy examination revealed large areas of superficial cells debris and/or keratin debris accompanied by syncytial-like groupings, loss of the normal structure of the conjunctival epithelium and or of the corneal basal epithelium layer, papillomatous organization, large fibrovascular structures, and fine vessels perpendicular to the tumour surface. Sub-epithelial (pre-Bowman) space involvement was documented in four cases (50%). Irregular healthy tissue infiltration at the lateral edge of the lesion was documented in two cases (20%) whereas abrupt demarcation between neoplastic cells and normal epithelium was documented in eight cases (80%). In vivo cyto-morphologic study using clinical confocal microscopy showed cellular anisocytosis, pleocytosis, and anisonucleosis, enlarged nuclei with high nuclear to cytoplasmic ratio, high reflective cytoplasm and indistinct cytoplasmic borders in all cases (100%) . CONCLUSION: CCM appears to be a promising and non-invasive method for in vivo structural and cellular analysis of OSSN.

Bioelectrical impedance analysis and diabetes mellitus: which correlation among fructosamine, glycosylated haemoglobin and exchangeable potassium.

AIM: Bioelectrical impedance analysis (BIA) can monitor diabetics suffering from the frequently occurring state of hyperglycemia, as this can cause alterations in the water distribution in the body. The aim of the present study was to evaluate the relationship between the composition of the body and the diabetic disease during decompensation through the impedanciometric analysis in diabetic patients of type 1 and type 2 and to understand the possible alterations of water distribution. METHODS: The study was carried out with 52 subjects (8 males, 44 females), average years 46.5; 15 of them were diabetic, 7 characterised by diabetes of type 1 and 8 by diabetes of type 2. All the patients recruited were in poor metabolic control (glycosylated hemoglobin [HbAlc] >6%). In order to avoid any errors during the evaluation ofa water distribution in the body, patients suffering from hypertension were excluded from the recruitment process. All patients underwent impedanciometry total body using the HUMAN IM SCAN apparatus multifrequency. RESULTS: Through the application of BIA, our work has shown how diabetic patients have a lower quantity of extracellular water (ECW) and exchangeable potassium (Ke) in the body, as compared to non-diabetic patients. The causes of this could be the alteration of the plasmic osmolarity and the possible reduction of the mass of metabolically active cells. Further-more a relationship between fructosamine in the blood and Ke has been found and, alongside another, more significant, between HbA1c and Ke. According to the opinions of the authors, such results are worthy for further studies in order to obtain a greater accuracy in the evaluation of the amount of Ke and an alternative in estimation of metabolic control.