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7. Closing the Loops on Southern Ocean Dynamics: From the Circumpolar Current to Ice Shelves and From Bottom Mixing to Surface Waves

Author

Bennetts, LG, Shakespeare, CJ, Vreugdenhil, CA, Foppert, A, Gayen, B, Meyer, A, Morrison, AK, Padman, L, Phillips, HE, Stevens, CL, Toffoli, A, Constantinou, NC, Cusack, JM, Cyriac, A, Doddridge, EW, England, MH, Evans, DG, Heil, P, Hogg, AMC, Holmes, RM, Huneke, WGC, Jones, NL, Keating, SR, Kiss, AE, Kraitzman, N, Malyarenko, A, McConnochie, CD, Meucci, A, Montiel, F, Neme, J, Nikurashin, M, Patel, RS, Peng, J-P, Rayson, M, Rosevear, MG, Sohail, T, Spence, P, Stanley, GJ, Bennetts, LG, Shakespeare, CJ, Vreugdenhil, CA, Foppert, A, Gayen, B, Meyer, A, Morrison, AK, Padman, L, Phillips, HE, Stevens, CL, Toffoli, A, Constantinou, NC, Cusack, JM, Cyriac, A, Doddridge, EW, England, MH, Evans, DG, Heil, P, Hogg, AMC, Holmes, RM, Huneke, WGC, Jones, NL, Keating, SR, Kiss, AE, Kraitzman, N, Malyarenko, A, McConnochie, CD, Meucci, A, Montiel, F, Neme, J, Nikurashin, M, Patel, RS, Peng, J-P, Rayson, M, Rosevear, MG, Sohail, T, Spence, P, and Stanley, GJ

Abstract

A holistic review is given of the Southern Ocean dynamic system, in the context of the crucial role it plays in the global climate and the profound changes it is experiencing. The review focuses on connections between different components of the Southern Ocean dynamic system, drawing together contemporary perspectives from different research communities, with the objective of closing loops in our understanding of the complex network of feedbacks in the overall system. The review is targeted at researchers in Southern Ocean physical science with the ambition of broadening their knowledge beyond their specific field, and aims at facilitating better‐informed interdisciplinary collaborations. For the purposes of this review, the Southern Ocean dynamic system is divided into four main components: large‐scale circulation; cryosphere; turbulence; and gravity waves. Overviews are given of the key dynamical phenomena for each component, before describing the linkages between the components. The reviews are complemented by an overview of observed Southern Ocean trends and future climate projections. Priority research areas are identified to close remaining loops in our understanding of the Southern Ocean system.

Published
2024

11. Generalized eigenfunction expansion and singularity expansion methods for two-dimensional acoustic time-domain wave scattering problems.

Author

Wilks, B., Meylan, M. H., Montiel, F., and Wakes, S.

Subjects
EIGENFUNCTION expansions, DISCRETE Fourier transforms, SOUND wave scattering, MATRIX multiplications, SCATTERING (Physics)
Abstract

Time-domain wave scattering in an unbounded two-dimensional acoustic medium by sound-hard scatterers is considered. Two canonical geometries, namely a split-ring resonator (SRR) and an array of cylinders, are used to highlight the theory, which generalizes to arbitrary scatterer geometries. The problem is solved using the generalized eigenfunction expansion method (GEM), which expresses the time-domain solution in terms of the frequency-domain solutions. A discrete GEM is proposed to numerically approximate the time-domain solution. It relies on quadrature approximations of continuous integrals and can be thought of as a generalization of the discrete Fourier transform. The solution then takes a simple form in terms of direct matrix multiplications. In parallel to the GEM, the singularity expansion method (SEM) is also presented and applied to the two aforementioned geometries. It expands the time-domain solution over a discrete set of unforced, complex resonant modes of the scatterer. Although the coefficients of this expansion are divergent integrals, we introduce a method of regularizing them using analytic continuation. The results show that while the SEM is usually inaccurate at t=0 , it converges rapidly to the GEM solution at all spatial points in the computational domain, with the most rapid convergence occurring inside the resonant cavity. [ABSTRACT FROM AUTHOR]

Published
2024
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17. Additional file 1 of Chromogenic Escherichia coli reporter strain for screening DNA damaging agents

Author

Mora-Gardu��o, Josu�� Daniel, Tamayo-Nu��ez, Jessica, Padilla-Vaca, Felipe, Ram��rez-Montiel, F��tima Berenice, Rangel-Serrano, ��ngeles, Santos-Escobar, Fernando, Guti��rrez-Corona, F��lix, P��ramo-P��rez, Itzel, Anaya-Vel��zquez, Fernando, Garc��a-Contreras, Rodolfo, Vargas-Maya, Naur�� Idalia, and Franco, Bernardo

Abstract

Additional file 1: Figure S1. Additional controls used in this study. Panel A shows the expression of AmilCP under the control of the uspA (Universal Stress Protein) promoter sequence. As an activating agent, H2O2 was used and mitomycin C as a negative control (MC). Panel B shows the effect of varying concentrations of SDS on the activation of the recA reporter strain. Panel C shows the activation of varying concentrations of ethanol. Panel D shows the viability and activation of the reporter strain during a 30 min. heat shock. The clear area on each experiment indicates cell death. The purple halos indicate reporter strain activation. Panel E, representative examples of 35 mm petri dish assays using MC at different concentrations and the plot of halo diameter against MC concentration, an average of three independent experiments, to show that below 1 ��g of MC the signal is barely detectable. Figure S2. Evaluation of lower concentrations of the chromium contaminated lixiviates from a chromite processing facility. Panel A shows the activation of the reporter strain at lower concentrations of the Cr(VI) containing lixiviates. In Panel B, control lixiviates are shown from the mountainside of the contaminated soil known to be clear of Cr(VI). The clear area on each experiment indicates cell death. The purple halos indicate reporter strain activation.

Published
2022
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19. Correction: One week of levofloxacin plus dexamethasone eye drops for cataract surgery: an innovative and rational therapeutic strategy (Eye, (2020), 10.1038/s41433-020-0869-1)

Author

Bandello, F., Coassin, M., Di Zazzo, A., Rizzo, S., Biagini, I., Pozdeyeva, N., Sinitsyn, M., Verzin, A., De Rosa, P., Calabro, F., Avitabile, T., Bonfiglio, V., Fasce, F., Barraquer, R., Mateu, J. L., Kohnen, T., Carnovali, M., Malyugin, B., Aragona, P., Arvedi, P., Cagini, C., Caretti, L., Cavallini, G. M., Cillino, S., Figini, I., Franco, L. M., La Mantia, A., Laborante, A., Lanzetta, P., Marcigaglia, M., Mariotti, C., Martini, E., Mastropasqua, L., Morselli, S., Passani, F., Pece, A., Pertile, G., Pioppo, A., Pirondini, C., Prantera, M., Rapisarda, A., Romano, M. R., Scarpa, G., Schiano-Lomoriello, D., Scorcia, V., Scuderi, G., Semeraro, F., Spedale, F., Staurenghi, G., Tognetto, D., Tosi, M., Trabucchi, G., Trivella, F., Villani, E., Vento, A., Vinciguerra, P., Alio, J. L., Alfonso Sanchez, J. F., Montiel, F. A., Lorenz, K., Panova, I., Eremina, A., Ciprandi, G., Bandello, F., Coassin, M., Di Zazzo, A., Rizzo, S., Biagini, I., Pozdeyeva, N., Sinitsyn, M., Verzin, A., De Rosa, P., Calabro, F., Avitabile, T., Bonfiglio, V., Fasce, F., Barraquer, R., Mateu, J. L., Kohnen, T., Carnovali, M., Malyugin, B., Aragona, P., Arvedi, P., Cagini, C., Caretti, L., Cavallini, G. M., Cillino, S., Figini, I., Franco, L. M., La Mantia, A., Laborante, A., Lanzetta, P., Marcigaglia, M., Mariotti, C., Martini, E., Mastropasqua, L., Morselli, S., Passani, F., Pece, A., Pertile, G., Pioppo, A., Pirondini, C., Prantera, M., Rapisarda, A., Romano, M. R., Scarpa, G., Schiano-Lomoriello, D., Scorcia, V., Scuderi, G., Semeraro, F., Spedale, F., Staurenghi, G., Tognetto, D., Tosi, M., Trabucchi, G., Trivella, F., Villani, E., Vento, A., Vinciguerra, P., Alio, J. L., Alfonso Sanchez, J. F., Montiel, F. A., Lorenz, K., Panova, I., Eremina, A., and Ciprandi, G.

Subjects
not available, Drug Therapy
Abstract

An amendment to this paper has been published and can be accessed via a link at the top of the paper.

Published
2020

22. Chronic obstructive pulmonary disease in severe mental illness: A timely diagnosis to advance the process of quitting smoking

Author

Jaen-Moreno, M. J., primary, Feu, N., additional, del Pozo, G. I., additional, Gómez, C., additional, Carrión, L., additional, Chauca, G. M., additional, Guler, I., additional, Montiel, F. J., additional, Sánchez, M.D., additional, Alcalá, J. A., additional, Gutierrez-Rojas, L., additional, Molina, V., additional, Bobes, J., additional, Balanzá-Martínez, V., additional, Ruiz-Rull, C., additional, and Sarramea, F., additional

Published
2021
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25. Recomendaciones para la atención oftalmológica durante el estado de alarma por la pandemia de enfermedad por coronavirus COVID-19

Author

Gegúndez-Fernández, J.A., primary, Zarranz-Ventura, J., additional, Garay-Aramburu, G., additional, Muñoz-Negrete, F.J., additional, Mendicute del Barrio, J., additional, Pablo-Júlvez, L., additional, García-Delpech, S., additional, López-Alemany, A., additional, Arnalich-Montiel, F., additional, Cordero-Coma, M., additional, and Cárceles, J.A., additional

Published
2020
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27. Correction: One week of levofloxacin plus dexamethasone eye drops for cataract surgery: an innovative and rational therapeutic strategy (Eye, (2020), 34, 11, (2112-2122), 10.1038/s41433-020-0869-1)

Author

Bandello, F., Coassin, M., Di Zazzo, A., Rizzo, S., Biagini, I., Pozdeyeva, N., Sinitsyn, M., Verzin, A., De Rosa, P., Calabro, F., Avitabile, T., Bonfiglio, V., Fasce, F., Barraquer, R., Mateu, J. L., Kohnen, T., Carnovali, M., Malyugin, B., Aragona, P., Arvedi, P., Cagini, C., Caretti, L., Cavallini, G. M., Cillino, S., Figini, I., Franco, L. M., La Mantia, A., Laborante, A., Lanzetta, P., Marcigaglia, M., Mariotti, C., Martini, E., Mastropasqua, L., Morselli, S., Passani, F., Pece, A., Pertile, G., Pioppo, A., Pirondini, C., Prantera, M., Rapisarda, A., Romano, M. R., Scarpa, G., Schiano-Lomoriello, D., Scorcia, V., Scuderi, G., Semeraro, F., Spedale, F., Staurenghi, G., Tognetto, D., Tosi, M., Trabucchi, G., Trivella, F., Villani, E., Vento, A., Vinciguerra, P., Alio, J. L., Alfonso Sanchez, J. F., Montiel, F. A., Lorenz, K., Panova, I., Eremina, A., and Ciprandi, G.

Published
2020

32. Overview of the Arctic Sea State and Boundary Layer Physics Program

Author

Thomson, J, Ackley, S, Girard-Ardhuin, F, Ardhuin, F, Babanin, A, Boutin, G, Brozena, J, Cheng, S, Collins, C, Doble, M, Fairall, C, Guest, P, Gebhardt, C, Gemmrich, J, Graber, HC, Holt, B, Lehner, S, Lund, B, Meylan, MH, Maksym, T, Montiel, F, Perrie, W, Persson, O, Rainville, L, Rogers, WE, Shen, H, Squire, V, Stammerjohn, S, Stopa, J, Smith, MM, Sutherland, P, Wadhams, P, Thomson, J, Ackley, S, Girard-Ardhuin, F, Ardhuin, F, Babanin, A, Boutin, G, Brozena, J, Cheng, S, Collins, C, Doble, M, Fairall, C, Guest, P, Gebhardt, C, Gemmrich, J, Graber, HC, Holt, B, Lehner, S, Lund, B, Meylan, MH, Maksym, T, Montiel, F, Perrie, W, Persson, O, Rainville, L, Rogers, WE, Shen, H, Squire, V, Stammerjohn, S, Stopa, J, Smith, MM, Sutherland, P, and Wadhams, P

Abstract

A large collaborative program has studied the coupled air‐ice‐ocean‐wave processes occurring in the Arctic during the autumn ice advance. The program included a field campaign in the western Arctic during the autumn of 2015, with in situ data collection and both aerial and satellite remote sensing. Many of the analyses have focused on using and improving forecast models. Summarizing and synthesizing the results from a series of separate papers, the overall view is of an Arctic shifting to a more seasonal system. The dramatic increase in open water extent and duration in the autumn means that large surface waves and significant surface heat fluxes are now common. When refreezing finally does occur, it is a highly variable process in space and time. Wind and wave events drive episodic advances and retreats of the ice edge, with associated variations in sea ice formation types (e.g., pancakes, nilas). This variability becomes imprinted on the winter ice cover, which in turn affects the melt season the following year.

Published
2018

35. Active cloaking of rigid and elastic scatterers

Author

McMinn, T, Duncan, A, Eggler, D, Chung, H, Montiel, F, Pan, J, Kessissoglou, N ; https://orcid.org/0000-0002-3714-9437, McMinn, T, Duncan, A, Eggler, D, Chung, H, Montiel, F, Pan, J, and Kessissoglou, N ; https://orcid.org/0000-0002-3714-9437

Abstract

This work presents active cloaking of rigid and elastic cylindrical shells. The acoustic performance using single and multiple control sources and error sensors is investigated for different control configurations. Scattering by a rigid cylinder due to an incident plane wave is initially studied. The scattered acoustic field is actively attenuated using monopole control sources and error sensors located circumferentially around the cylinder. The structural and acoustic responses of an elastic shell due to an incident plane wave are then examined. Active cloaking at the shell circumferential modes is achieved using monopole control sources located in the surrounding fluid. Active structural acoustic cloaking is also achieved using control forces applied directly to the shell.

Published
2017

36. An analytical and numerical investigation of acoustic attenuation by a finite sonic crystal

Author

Montiel, F, Chung, H, Karimi, M, Kessissoglou, N, Montiel, F, Chung, H, Karimi, M, and Kessissoglou, N

Abstract

Sonic crystals are scatterers arranged periodically in a homogeneous fluid medium, for which sound does not transmit through the crystal in certain frequency bands known as stop bands. Acoustic wave transmission through a two-dimensional sonic crystal composed of a finite array of scatterers is investigated. Two types of scatterers are considered: sound-hard cylinders and C-shaped locally resonant scatterers. An analytical method is devised to solve the corresponding multiple scattering problems. The method combines an integral equation technique for the single scatterer with an enhanced multipole method using domain decomposition into slabs. A numerical approach using commercial software is also considered for validation and is based on the finite element method. Simulations of sound transmission through an array of 5 by 51 scatterers show remarkably good agreement with the corresponding infinite system. For an array comprising locally resonant scatterers, an approximate band gap around the resonator natural frequency is observed in addition to the band gap due to the overall periodicity of the finite sonic crystal.

Published
2017

38. Tobacco intensive motivational and estimate risk (timer). study protocol for a randomized controlled trial.

Author

Jaen-Moreno, M. J., Rull, C. Ruiz, Valdivia, F., Valverde, M., Osuna, M. I., Caro, I., Martin, D., Montiel, F. J., and Sarramea Crespo, F.

Subjects
RANDOMIZED controlled trials, PEOPLE with mental illness, CHRONIC obstructive pulmonary disease, MOTIVATION (Psychology), SMOKING cessation
Abstract

Introduction: Patients with serious mental illness (SMI) reduced life expectancy by up to 20 years. Smoking is the main preventable risk factor in relation to reducing mortality. Developing new tools to motivate patients towards cessation of smoking is a priority. Objectives: The objective is to evaluate the effectiveness to quit smoking of an intensive antitobacco intervention on lung damage and possibilities of prevention in patients with schizophrenia or bipolar disorder to quit smoking. Methods: It is a 12-month follow-up, multicenter study to evaluate an intensive motivational tool based on the individual risk of pulmonary damage and prevention opportunities. A minimum of 204 smokers will be included, aged over 40 years old, all of whom are patients diagnosed with either schizophrenia or bipolar disorder (BD). Chronic obstructive pulmonary disease (COPD) will be evaluated using spirometry, and the diagnosis will then be validated by a pneumologist and the lung age estimated. Based on this value, a motivational message about prevention will be issued for the intervention group, which will be reinforced by individualized text messages over a period of 3 months. Conclusions: In the context of community care, screening and early detection of lung damage could potentially be used, together with mobile technology, in order to produce a prevention message, which may provide patients with SMI with a better chance of quitting smoking. [ABSTRACT FROM AUTHOR]

Published
2020

39. Diágnóstico del lenticono en el síndrome de Alport: cálculo del ángulo apical de la cápsula anterior del cristalino mediante imágenes Scheimpflug

Author

Jarrín, E., Jarrín, I., and Arnalich-Montiel, F.

Abstract

Se describe un método simplificado para detectar lenticono anterior. Realizamos imágenes Scheimpflug del segmento anterior con Pentacam a 3 ojos de 2 pacientes con lenticono anterior y 16 ojos de controles sanos. Se identificó el ángulo del ápex de la cápsula anterior y se midió con AutoCAD.

Published
2015
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40. Percutaneous transaxillary access for endovascular aortic procedures in the multicenter international PAXA registry

Author

Oliver D. Bhadra, Massimo Lenti, Alvaro Moreno, Maria Lucia Locca, Inga U. Builyte, Luca Bertoglio, Jürgen Verbist, Roberto Chiesa, Alessandro Beneduce, Marco Ancona, Lenard Conradi, Jury Schewel, Jose M. Ligero, Wouter van den Eynde, Francisco Montiel, Hemindermeet Singh, Sonia Ronchey, Gianbattista Parlani, Nuno Dias, Javier Rio, Andrea Melloni, Matteo Montorfano, Amir Kaki, Tobias Schmidt, Gioele Simonte, Max Meertens, Dominic P.J. Howard, Björn Sonesson, Bertoglio, L., Conradi, L., Howard, D. P. J., Kaki, A., Van den Eynde, W., Rio, J., Montorfano, M., Dias, N. V., Ronchey, S., Parlani, G., Chiesa, R., Schewel, J., Ancona, M., Beneduce, A., Bhadra, O. D., Builyte, I. U., Lenti, M., Ligero, J. M., Locca, M. L., Melloni, A., Meertens, M., Montiel, F., Moreno, A., Schmidt, T., Simonte, G., Singh, H., Sonesson, B., and Verbist, J.

Subjects
Aortic valve, Vascular access closure device, Male, medicine.medical_specialty, Percutaneous, Time Factors, medicine.medical_treatment, Aortic Diseases, Heart Valve Diseases, Aorta, Thoracic, Punctures, TAVI, Thoracic aorta aneurysm, Ventricular assist device, Risk Assessment, Blood Vessel Prosthesis Implantation, Postoperative Complications, Axillary artery, Risk Factors, medicine.artery, Catheterization, Peripheral, medicine, Humans, Vascular closure device, Registries, Stroke, Aged, Retrospective Studies, Aged, 80 and over, business.industry, Endovascular Procedures, Odds ratio, medicine.disease, United States, Surgery, Europe, medicine.anatomical_structure, Treatment Outcome, Hemostasis, Aortic Valve, Axillary Artery, Female, Stents, Cardiology and Cardiovascular Medicine, business
Abstract

Background The aim of the study was to demonstrate the safety and effectiveness of a suture-mediated vascular closure device to perform hemostasis after an axillary artery access during endovascular procedures on the aortic valve, the aorta and its side branches. Methods A physician-initiated, international, multicenter, retrospective registry was designed to evaluate the success rate (VARC-2 reporting standards) of percutaneous transaxillary access closure with a suture-mediated closure device. Secondary end points were minor access vascular complications, transient peripheral nerve injury, stroke, and influence on periprocedural outcomes of puncture technique. Results Three hundred thirty-one patients (median age, 76 years; 69.2% males) in 11 centers received a percutaneous transaxillary access during endovascular cardiac (n = 166) or vascular (n = 165) procedures. The closure success rate was 84.6%, with 5 open conversions (1.5%), 45 adjunctive endovascular procedures (13.6%), and 1 nerve injury (0.3%). Secondary closure success was obtained in 325 patients (98%) after 7 bare stenting, 37 covered stenting, and 1 thrombin injection. Introducer sheaths 16F or larger (odds ratio, 3.70; 95% confidence interval, 1.22-11.42) and balloon-assisted hemostasis (odds ratio, 4.45; 95% confidence interval, 1.27-15.68) were associated with closure failure. A threshold of five percutaneous axillary accesses was associated with decreased rates of open conversion, but not with increased primary closure success. Primary closure success was 90.3% in the 175 patients with sheaths smaller than 16F, performed after the first 5 procedures in each center. Temporary nerve injury and stroke were observed in 2% and 4% of patients, respectively. Conclusions Percutaneous transaxillary aortic procedures, in selected patients, can be performed with low rates of open conversion. The need for additional endovascular bailout procedures is not negligible when introducers sheaths 16F or larger are required.

Published
2021

41. One week of levofloxacin plus dexamethasone eye drops for cataract surgery: an innovative and rational therapeutic strategy

Author

Bandello, Francesco, Coassin, Marco, Di Zazzo, Antonio, Rizzo, Stanislao, Biagini, Ilaria, Pozdeyeva, Nadezhda, Sinitsyn, Maksim, Verzin, Alexander, De Rosa, Pasquale, Calabrò, Francesco, Avitabile, Teresio, Bonfiglio, Vincenza, Fasce, Francesco, Barraquer, Rafael, Mateu, Josè Lamarca, Kohnen, Thomas, Carnovali, Marino, Malyugin, Boris, Pasquale, Aragona, Paolo, Arvedi, Carlo, Cagini, Luigi, Caretti, Gian Maria Cavallini, Salvatore, Cillino, Innocente, Figini, Livio Marco Franco, Alberto La Mantia, Antonio, Laborante, Paolo, Lanzetta, Mattia, Marcigaglia, Cesare, Mariotti, Enrico, Martini, Leonardo, Mastropasqua, Simonetta, Morselli, Franco, Passani, Alfredo, Pece, Grazia, Pertile, Antonino, Pioppo, Cesare, Pirondini, Marcello, Prantera, Antonio, Rapisarda, Romano, Mario R., Giuseppe, Scarpa, Domenico, Schiano-Lomoriello, Vincenzo, Scorcia, Gianluca, Scuderi, Francesco, Semeraro, Franco, Spedale, Giovanni, Staurenghi, Tognetto, Daniele, Marco, Tosi, Giuseppe, Trabucchi, Fausto, Trivella, Edoardo, Villani, Andrea, Vento, Paolo, Vinciguerra, Alió, Jorge L., Alfonso Sanchez, Josè F., Francisco Arnalich Montiel, Katrin, Lorenz, Irina, Panova, Alena, Eremina, Giorgio, Ciprandi, Bandello F., Coassin M., Di Zazzo A., Rizzo S., Biagini I., Pozdeyeva N., Sinitsyn M., Verzin A., De Rosa P., Calabro F., Avitabile T., Bonfiglio V., Fasce F., Barraquer R., Mateu J.L., Kohnen T., Carnovali M., Malyugin B., Aragona P., Arvedi P., Cagini C., Caretti L., Cavallini G.M., Cillino S., Figini I., Franco L.M., La Mantia A., Laborante A., Lanzetta P., Marcigaglia M., Mariotti C., Martini E., Mastropasqua L., Morselli S., Passani F., Pece A., Pertile G., Pioppo A., Pirondini C., Prantera M., Rapisarda A., Romano M.R., Scarpa G., Schiano-Lomoriello D., Scorcia V., Scuderi G., Semeraro F., Spedale F., Staurenghi G., Tognetto D., Tosi M., Trabucchi G., Trivella F., Villani E., Vento A., Vinciguerra P., Alio J.L., Alfonso Sanchez J.F., Montiel F.A., Lorenz K., Panova I., Eremina A., Ciprandi G., Francesco, Bandello, Marco, Coassin, Antonio, Di Zazzo, Stanislao, Rizzo, Ilaria, Biagini, Nadezhda, Pozdeyeva, Maksim, Sinitsyn, Alexander, Verzin, Pasquale, De Rosa, Francesco, Calabrò, Teresio, Avitabile, Vincenza, Bonfiglio, Francesco, Fasce, Rafael, Barraquer, Josè Lamarca, Mateu, Thomas, Kohnen, Marino, Carnovali, Boris, Malyugin, Aragona, Pasquale, Arvedi, Paolo, Cagini, Carlo, Caretti, Luigi, Maria Cavallini, Gian, Cillino, Salvatore, Figini, Innocente, Marco Franco, Livio, La Mantia, Alberto, Laborante, Antonio, Lanzetta, Paolo, Marcigaglia, Mattia, Mariotti, Cesare, Martini, Enrico, Mastropasqua, Leonardo, Morselli, Simonetta, Passani, Franco, Pece, Alfredo, Pertile, Grazia, Pioppo, Antonino, Pirondini, Cesare, Prantera, Marcello, Rapisarda, Antonio, Romano, Mario R., Scarpa, Giuseppe, Schiano-Lomoriello, Domenico, Scorcia, Vincenzo, Scuderi, Gianluca, Semeraro, Francesco, Spedale, Franco, Staurenghi, Giovanni, Tognetto, Daniele, Tosi, Marco, Trabucchi, Giuseppe, Trivella, Fausto, Villani, Edoardo, Vento, Andrea, Vinciguerra, Paolo, Alió, Jorge L., Alfonso Sanchez, Josè F., Arnalich Montiel, Francisco, Lorenz, Katrin, Panova, Irina, Eremina, Alena, Ciprandi, Giorgio, Bandello, F., Coassin, M., Di Zazzo, A., Rizzo, S., Biagini, I., Pozdeyeva, N., Sinitsyn, M., Verzin, A., De Rosa, P., Calabro, F., Avitabile, T., Bonfiglio, V., Fasce, F., Barraquer, R., Mateu, J. L., Kohnen, T., Carnovali, M., Malyugin, B., Aragona, P., Arvedi, P., Cagini, C., Caretti, L., Cavallini, G. M., Cillino, S., Figini, I., Franco, L. M., La Mantia, A., Laborante, A., Lanzetta, P., Marcigaglia, M., Mariotti, C., Martini, E., Mastropasqua, L., Morselli, S., Passani, F., Pece, A., Pertile, G., Pioppo, A., Pirondini, C., Prantera, M., Rapisarda, A., Romano, M. R., Scarpa, G., Schiano-Lomoriello, D., Scorcia, V., Scuderi, G., Semeraro, F., Spedale, F., Staurenghi, G., Tognetto, D., Tosi, M., Trabucchi, G., Trivella, F., Villani, E., Vento, A., Vinciguerra, P., Alio, J. L., Alfonso Sanchez, J. F., Montiel, F. A., Lorenz, K., Panova, I., Eremina, A., and Ciprandi, G.

Subjects
medicine.medical_specialty, medicine.medical_treatment, Levofloxacin, Article, Dexamethasone, Cataract, 03 medical and health sciences, 0302 clinical medicine, Endophthalmitis, Pharmacotherapy, Postoperative Complications, Internal medicine, medicine, Tobramycin, Clinical endpoint, Humans, Endophthalmitis, Cataract, Intracameral cefuroxime, Adverse effect, business.industry, Cataract surgery, Intracameral cefuroxime, medicine.disease, not applicable, Anti-Bacterial Agents, Ophthalmology, Italy, Spain, 030221 ophthalmology & optometry, Ophthalmic Solutions, business, 030217 neurology & neurosurgery, medicine.drug
Abstract

Background: Cataract surgery is the most common operation performed worldwide. A fixed topical corticosteroid-antibiotic combination is usually prescribed in clinical practice for 2 or more weeks to treat post surgical inflammation and prevent infection. However, this protracted schedule may increase the incidence of corticosteroid-related adverse events and notably promote antibiotic resistance. Methods: This International, multicentre, randomized, blinded-assessor, parallel-group clinical study evaluated the non-inferiority of 1-week levofloxacin/dexamethasone eye drops, followed by 1-week dexamethasone alone, vs. 2-week gold-standard tobramycin/dexamethasone (one drop QID for all schedules) to prevent and treat ocular inflammation and prevent infection after uncomplicated cataract surgery. Non-inferiority was defined as the lower limit of the 95% confidence interval (CI) around a treatment difference >–10%. The study randomized 808 patients enrolled in 53 centres (Italy, Germany, Spain and Russia). The primary endpoint was the proportion of patients without anterior chamber inflammation on day 15 defined as the end of treatment. Endophthalmitis was the key secondary endpoint. This study is registered with EudraCT code: 2018-000286-36. Results: After the end of treatment, 95.2% of the patients in the test arm vs. 94.9% of the control arm had no signs of inflammation in the anterior chamber (difference between proportions of patients = 0.028; 95% CI: −0.0275/0.0331). No case of endophthalmitis was reported. No statistically significant difference was evident in any of the other secondary endpoints. Both treatments were well tolerated. Conclusions: Non-inferiority of the new short pharmacological strategy was proven. One week of levofloxacin/dexamethasone prevents infection, ensures complete control of inflammation in almost all patients and may contain antibiotic resistance.

Published
2020

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