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Purpose: The aim of the study was to evaluate the tangential retinal displacement occurring following macular hole surgery, and to assess the impact of the internal limiting membrane (ILM) peeling size on the extent of the retinal movement., Methods: This retrospective study included patients with full-thickness macular hole undergoing 25-gauge pars plana vitrectomy with ILM peeling. Patients received either a small ILM peeling with a size of 2-disc diameters or a large peeling extended up to the vascular arcades. Near-infrared retinal imaging was performed with the Spectralis (Heidelberg Engineering, Carlsbad, Germany) before and 6 months after surgery. The tangential retinal displacement was evaluated comparing the optical flow of near-infrared images with a custom digital image analysis algorithm., Results: 44 eyes of 44 patients undergoing vitrectomy with small (n = 24) or large (n = 20) ILM peeling were included. An average overall displacement of 31.3 ± 22.8 µm towards the optic disc was observed after surgery. Large ILM peeling was associated with a significantly higher overall displacement (P = 0.009), displacement in the central 4-mm circle (P < 0.001) and outer 8-mm ring (P = 0.001). Macular holes closure was achieved in 100% and 83.3% of patients in the large and small peeling group, respectively (P = 0.055)., Conclusions: Pars plana vitrectomy with ILM peeling for macular hole results in a tangential retinal displacement towards the optic disc. A larger extent of the ILM peeling leads to a greater tangential movement, possibly improving the macular hole closure rate.

Extracellular vesicles (EVs) are membrane-enclosed bio-nanoparticles secreted by cells and naturally evolved to transport various bioactive molecules between cells and even organisms. These cellular objects are considered one of the most promising bio-nanovehicles for the delivery of native and exogenous molecular cargo. However, many challenges with state-of-the-art EV-based candidates as drug carriers still exist, including issues with scalability, batch-to-batch reproducibility, and cost-sustainability of the final therapeutic formulation. Microalgal extracellular vesicles, which we named nanoalgosomes, are naturally released by various microalgal species. Here, we evaluate the innate biological properties of nanoalgosomes derived from cultures of the marine microalgae Tetraselmis chuii, using an optimized manufacturing protocol. Our investigation of nanoalgosome biocompatibility in preclinical models includes toxicological analyses, using the invertebrate model organism Caenorhabditis elegans, hematological and immunological evaluations ex vivo and in mice. We evaluate nanoalgosome cellular uptake mechanisms in C. elegans at cellular and subcellular levels, and study their biodistribution in mice with accurate space-time resolution. Further examination highlights the antioxidant and anti-inflammatory bioactivities of nanoalgosomes. This holistic approach to nanoalgosome functional characterization demonstrates that they are biocompatible and innate bioactive effectors with unique bone tropism. These findings suggest that nanoalgosomes have significant potential for future therapeutic applications., (© 2024. The Author(s).)

Background: Studies have indicated an association between cesarean section (CS), especially elective CS, and an increased risk of celiac disease (CD), but the conclusions of other studies are contradictory. The primary aim of this study (CD-deliver-IT) was to evaluate the rate of CS in a large population of CD patients throughout Italy.  METHODS: This national multicenter retrospective study was conducted between December 2020 and November 2021. The coordinating center was the Pediatric Gastroenterology and Liver Unit of Policlinico Umberto I, Sapienza, University of Rome, Lazio, Italy. Eleven other referral centers for CD have participated to the study. Each center has collected data on mode of delivery and perinatal period of all CD patients referring to the center in the last 40 years., Results: Out of 3,259 CD patients recruited in different Italian regions, data on the mode of delivery were obtained from 3,234. One thousand nine hundred forty-one (1,941) patients (60%) were born vaginally and 1,293 (40%) by CS (8.3% emergency CS, 30.1% planned CS, 1.5% undefined CS). A statistically significant difference was found comparing median age at time of CD diagnosis of patients who were born by emergency CS (4 years, CI 95% 3.40-4.59), planned CS (7 years, CI 95% 6.02-7.97) and vaginal delivery (6 years, CI 95% 5.62-6.37) (log rank p < 0.0001)., Conclusions: This is the first Italian multicenter study aiming at evaluating the rate of CS in a large population of CD patients through Italy. The CS rate found in our CD patients is higher than rates reported in the general population over the last 40 years and emergency CS seems to be associated with an earlier onset of CD compared to vaginal delivery or elective CS in our large nationwide retrospective cohort. This suggests a potential role of the mode of delivery on the risk of developing CD and on its age of onset, but it is more likely that it works in concert with other perinatal factors. Further prospective studies on other perinatal factors potentially influencing gut microbiota are awaited in order to address heavy conflicting evidence reaming in this research field., (© 2024. The Author(s).)