Reggio Emilia (Northern Italy) Interdisciplinary Uveitis Clinic: What We Have Learned in the Last 20 Years.

PURPOSE: To analyze the referral patterns and the clinical and therapeutic features of patients diagnosed with uveitis in an Italian tertiary referral center to provide a comparison with previously published series from the same center. METHODS: Retrospective retrieval of data on all new referrals to the Ocular Immunology Unit in Reggio Emilia (Italy) between November 2015 and April 2022 and comparison with previously published series from the same center. RESULTS: Among the 1557 patients, the male-to-female ratio was 1:1.27. Anterior uveitis was the most common diagnosis (53.7%), followed by posterior (21.6%), pan- (18.5%), and intermediate (6.2%) uveitis. The most identifiable specific diagnoses were anterior herpetic uveitis (18.4%), Fuchs uveitis (12.8%), and tuberculosis (6.1%). Infectious etiologies were the most frequent (34.1%) and were more diffuse among non-Caucasian patients (p < 0.001), followed by systemic disease-associated uveitis (26.5%), and ocular-specific conditions (20%). Idiopathic uveitis accounted for 19.4% of cases. Fuchs uveitis presented the longest median diagnostic delay (21 months). Immunosuppressants were administered to 25.2% of patients. Antimetabolites, calcineurin inhibitors, and biologicals were prescribed to 18.4%, 3%, and 11.4% of cases, respectively. Compared to our previous reports, we observed a significant increase in foreign-born patients and in infectious uveitis, a decrease in idiopathic conditions, and an increasing use of non-biological and biological steroid-sparing drugs. CONCLUSIONS: The patterns of uveitis in Italy have been changing over the last 20 years, very likely due to migration flows. Diagnostic improvements and a more widespread interdisciplinary approach could reduce the incidence of idiopathic uveitis as well as diagnostic delay.

Epidemiology of Pediatric Uveitis.

Uveitis is uncommon in children and its diagnosis and treatment are challenging. Little is known of the epidemiology of pediatric uveitis. Indeed, population-based studies in the literature are rare. However, there are many tertiary referral center reports that describe the patterns of uveitis in childhood, although few are from developed countries, and their comparison presents some issues. Anterior uveitis is the most frequent entity worldwide, especially in Western countries, where juvenile idiopathic arthritis is diffuse. Most cases of intermediate uveitis do not show any association with infectious or noninfectious systemic diseases. In low- and middle-income countries, posterior uveitis and panuveitis are prevalent due to the higher rates of infectious etiologies and systemic diseases such as Behçet disease and Vogt-Koyanagi-Harada disease. In recent decades, idiopathic uveitis rate has decreased thanks to diagnostic improvements.

MicroRNA-222 regulates muscle alternative splicing through Rbm24 during differentiation of skeletal muscle cells.

A number of microRNAs have been shown to regulate skeletal muscle development and differentiation. MicroRNA-222 is downregulated during myogenic differentiation and its overexpression leads to alteration of muscle differentiation process and specialized structures. By using RNA-induced silencing complex (RISC) pulldown followed by RNA sequencing, combined with in silico microRNA target prediction, we have identified two new targets of microRNA-222 involved in the regulation of myogenic differentiation, Ahnak and Rbm24. Specifically, the RNA-binding protein Rbm24 is a major regulator of muscle-specific alternative splicing and its downregulation by microRNA-222 results in defective exon inclusion impairing the production of muscle-specific isoforms of Coro6, Fxr1 and NACA transcripts. Reconstitution of normal levels of Rbm24 in cells overexpressing microRNA-222 rescues muscle-specific splicing. In conclusion, we have identified a new function of microRNA-222 leading to alteration of myogenic differentiation at the level of alternative splicing, and we provide evidence that this effect is mediated by Rbm24 protein.

Osteoinduction properties of different growth factors on cells from non-union patients: in vitro study for clinical application.

This report compares the effect of rhBMPs and PRG on cells derived from human non-union sites. Treatment of non-union continues to be a challenging task for the trauma surgeon often resulting in unsatisfactory results and long-term morbidity. Over the past two decades, the possibility to use growth factors in bone regeneration has been investigated. In this study we compared the in vitro capability of two recombinant human bone morphogenetic proteins (rhBMP-2 and rhBMP-7) and activated platelet-rich plasma (PRG) to stimulate proliferation and/or differentiation of cells derived from non-union patients. Cells derived from the lesion sites, osteoblasts and mesenchymal stem cells (MSCs) derived from other bone sites of the same patients were used. Treatment with rhBMP-7 or rhBMP-2 showed an improvement in the expression of osteoblastic markers (osteonectin and osteocalcin) in cells derived from human non-union sites. This enhancement was more marked in MSCs, while no significant changes were observed in osteoblast cultures. The PRG treatment produced in all analysed samples a considerable increase in cell proliferation without affecting cell differentiation. On the basis of our results, for an effective biological treatment of non-unions, small amounts of autologous bone marrow (MSCs) are necessary in the lesion site in order to provide both growth factors and a sufficient number of responsive cells. Finally, our results prove that sequential timing administration of PRG and rhBMPs may be used in new therapeutic strategy.

Late post-operative paraparesis after rib penetration of the spinal canal in a patient with neurofibromatous scoliosis.

Rib displacement into the spinal canal is a rare cause of paraplegia or paraparesis in patients affected by neurofibromatous scoliosis. We describe a case of paraparesis in a 14-year-old child affected by neurofibromatous dystrophic kyphoscoliosis, treated with combined posterior and anterior spinal arthrodesis. Seventeen days after the surgical treatment the patient developed clinical signs and symptoms of paraparesis. A CT scan showed the head of the fifth rib protruding into the spinal canal with cord compression. Rib resection and posterior cord decompression were carried out following complete neurological recovery.

[A case of ameloblastoma in a girl 2 years and 6 months old]. / Un caso di ameloblastoma in una bambina di due anni e sei mesi.

The paper reports a case of ameloblastoma in a patient aged two and half. The natural history of the disease is described together with therapy used.

[Presence and type of fillings found in a group of 531 school aged children]. / Presenza e tipo di otturazioni riscontrate in una popolazione di 531 bambini in età scolare.

An epidemiological investigation carried out in a population of children aged between six and twelve is reported. The relationship between caries and type of filling encountered was analysed.

[Evaluation of toothbrushing in a group of 531 school aged children]. / Valutazione dello spazzolamento dentario di una popolazione di 531 bambini in età scolare.

Data concerning the evaluation of tooth brushing collected during odontostomatological screening in Val Pellice are reported. The screening was carried out by a dental team from Turin's Mauriziano Hospital and covered a population of 531 children aged between six and twelve.

[Study of oral hygiene in a group of 531 children using OHI-S]. / Studio dell'igiene dentale in una popolazione di 531 bambini secondo l'OHI-S.

An analysis of the results of an epidemiological study on 531 children aged between 7 and 10 and resident in the mountain district of Val Pellice is presented. Special reference is made to the bacterial plaque and tartar.

[Epidemiological study of caries incidence in a group of 531 school aged children]. / Ricerca epidemiologica sull'incidenza della carie in una popolazione di 531 bambini in eta scolare.

The results of an epidemiological study on the incidence of caries in the school population of Val Pellice are reported. The purpose of the study was to acquire new knowledge on the dental health of infants and prepare a suitable prophylaxis and treatment plan.

[Current status of research on anticaries vaccines]. / Lo stato attuale della ricerca sui vaccini anticarie.

The experiment which was performed in different animal special confirmed that Streptococcus mutans is the main etiological agent implicated in dental caries. Nonetheless, since the use of anti-Streptococcal vaccines might lead to severe side effects, research is now focused on obtaining purified vaccines that do not create cruciate cardiac cross-reactivity.