22 results on '"Samantha Bobba"'
Search Results
2. Prognostic factors and epidemiology of adult open globe injuries from Western Sydney: a twelve-year review
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Haochi Ho, Jane Foo, Yi-Chiao Li, Samantha Bobba, Christopher Go, Jaya Chandra, and Adrian T. Fung
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Open globe injury ,Globe rupture ,Retinal detachment ,Ophthalmology ,RE1-994 - Abstract
Abstract Background To identify prognostic factors determining final visual outcome following open globe injuries. Methods Retrospective case series of patients presenting to Westmead Hospital, Sydney, Australia with open globe injuries from 1st January 2005 to 31st December 2017. Data collected included demographic information, ocular injury details, management and initial and final visual acuities. Results A total of 104 cases were identified. Predictors of poor final visual outcomes included poor presenting visual acuity (p
- Published
- 2021
- Full Text
- View/download PDF
3. An Unusual Presentation of Pediatric Conjunctival Mucosa-Associated Lymphoid Tissue Lymphoma
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Samantha Bobba, Christopher Go, Amanda Charlton, James Smith, Maciek Kuzniarz, and Subhashini Kadappu
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Ophthalmology ,RE1-994 - Abstract
Ocular adnexal mucosa-associated lymphoid tissue (MALT) lymphoma is uncommon in the pediatric population. Initial misdiagnosis is common and there is lacking consensus regarding the optimal approach to treatment. Herein, we report an atypical presentation of pediatric conjunctival MALT lymphoma and review the presentation and management of this rare condition.
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- 2019
- Full Text
- View/download PDF
4. An Unusual Presentation of Pediatric Conjunctival Mucosa-Associated Lymphoid Tissue Lymphoma
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Subhashini Kadappu, James Smith, Samantha Bobba, Maciek Kuzniarz, Amanda Charlton, and Christopher Ze Qian Go
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Pathology ,medicine.medical_specialty ,business.industry ,Mucosa-Associated Lymphoid Tissue Lymphoma ,Case Report ,MALT lymphoma ,General Medicine ,medicine.disease ,Lymphoma ,03 medical and health sciences ,0302 clinical medicine ,Lymphatic system ,lcsh:Ophthalmology ,lcsh:RE1-994 ,immune system diseases ,hemic and lymphatic diseases ,030220 oncology & carcinogenesis ,030221 ophthalmology & optometry ,Medicine ,Presentation (obstetrics) ,business ,Pediatric population - Abstract
Ocular adnexal mucosa-associated lymphoid tissue (MALT) lymphoma is uncommon in the pediatric population. Initial misdiagnosis is common and there is lacking consensus regarding the optimal approach to treatment. Herein, we report an atypical presentation of pediatric conjunctival MALT lymphoma and review the presentation and management of this rare condition.
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- 2019
5. The current state of stem cell therapy for ocular disease
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Damien G. Harkin, Audra M. A. Shadforth, Stephanie L Watson, Fred K. Chen, Nick Di Girolamo, Samantha Bobba, Alice Pébay, Samuel McLenachan, Michael D O'Connor, Megan Munsie, and Alex W. Hewitt
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0301 basic medicine ,medicine.medical_specialty ,Eye Diseases ,medicine.medical_treatment ,Best practice ,Psychological intervention ,Context (language use) ,Limbus Corneae ,Regenerative Medicine ,Regenerative medicine ,03 medical and health sciences ,Cellular and Molecular Neuroscience ,Patient safety ,0302 clinical medicine ,medicine ,Humans ,Intensive care medicine ,business.industry ,Stem-cell therapy ,Sensory Systems ,Clinical trial ,Ophthalmology ,030104 developmental biology ,030221 ophthalmology & optometry ,Patient Safety ,Stem cell ,business ,Stem Cell Transplantation - Abstract
Herein, we review the safety, efficacy, regulatory standards and ethical implications of the use of stem cells in ocular disease. A literature review was conducted, registered clinical trials reviewed, and expert opinions sought. Guidelines and codes of conduct from international societies and professional bodies were also reviewed. Collated data is presented on current progress in the field of ocular regenerative medicine, future challenges, the clinical trial process and ethical considerations in stem cell therapy. A greater understanding of the function and location of ocular stem cells has led to rapid advances in possible therapeutic applications. However, in the context of significant technical challenges and potential long-term complications, it is imperative that stem cell practices operate within formal clinical trial frameworks. While there remains broad scope for innovation, ongoing evidence-based review of potential interventions and the development of standardized protocols are necessary to ensure patient safety and best practice in ophthalmic care.
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- 2018
6. Prognostic Factors and Epidemiology of Open Globe Injuries from Western Sydney: A Twelve-Year Review
- Author
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Haochi Ho, Jane Foo, Yi-Chiao Li, Samantha Bobba, Christopher Go, Jaya Chandra, and Adrian Fung
- Subjects
genetic structures ,eye diseases - Abstract
BackgroundTo identify prognostic factors determining final visual outcome following open globe injuries.MethodsRetrospective case series of patients presenting to Westmead Hospital, Sydney, Australia with open globe injuries from 1st January 2005 to 31st December 2017. Data collected included demographic information, ocular injury details, management and initial and final visual acuities.ResultsA total of 104 cases were identified. Predictors of poor final visual outcomes included poor presenting visual acuity (p < 0.001), globe rupture (p < 0.001), retinal detachment (p < 0.001), Zone III wounds (p < 0.001), hyphema (p=0.003), lens expulsion (p = 0.003) and vitreous hemorrhage (p < 0.001). Multivariate analysis demonstrated presenting visual acuity (p < 0.001), globe rupture (p = 0.013) and retinal detachment (p = 0.011) as being statistically significant for predicting poor visual outcomes. The presence of lid laceration (p = 0.197) and uveal prolapse (p = 0.667) were not significantly associated with the final visual acuity. ConclusionsPoor presenting visual acuity, globe rupture and retinal detachment are the most important prognostic factors determining final visual acuity following open globe injury.
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- 2021
7. Isolated painful trigeminal neuropathy as an unusual presentation of chronic lymphocytic inflammation with pontine perivascular enhancement responsive to steroids: A case report
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Samantha Bobba, Manisha Narasimhan, and Alessandro S. Zagami
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Pathology ,medicine.medical_specialty ,Chronic lymphocytic inflammation ,business.industry ,Central nervous system ,Trigeminal neuropathy ,Inflammation ,General Medicine ,Middle Aged ,Trigeminal Neuralgia ,03 medical and health sciences ,0302 clinical medicine ,medicine.anatomical_structure ,Humans ,Medicine ,Female ,030212 general & internal medicine ,Neurology (clinical) ,Facial pain ,Presentation (obstetrics) ,medicine.symptom ,Encephalomyelitis ,business ,030217 neurology & neurosurgery - Abstract
Background Chronic lymphocytic inflammation with pontine perivascular enhancement responsive to steroids (CLIPPERS) is an inflammatory central nervous system disorder, typically presenting with subacute symptoms referable to brainstem and cerebellar pathology. This is the first report of CLIPPERS presenting with a painful trigeminal neuropathy. Case report We report an unusual case of CLIPPERS presenting with facial pain and sensory symptoms, in the absence of other brainstem or cerebellar signs. Perivascular enhancement of peri-pontine structures on neuroimaging, lymphocytic infiltrate on histopathology and rapid clinical and radiological responsiveness to glucocorticosteroids were key to diagnosis. Extensive investigations excluded various differential aetiologies. Conclusion The pathogenesis of CLIPPERS is poorly understood, and the diagnostic criteria are yet to be validated. In this case, facial pain was not associated with other brainstem or cerebellar signs, broadening current understanding of how CLIPPERS may present. This has clinical implications in guiding future investigations for patients presenting with painful trigeminal neuropathy.
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- 2018
8. Native and synthetic scaffolds for limbal epithelial stem cell transplantation
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Stephanie L Watson, Nick Di Girolamo, Alexander Richardson, Kim N. Nguyen, Mijeong Park, Samantha Bobba, and Denis Wakefield
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0301 basic medicine ,medicine.medical_specialty ,Biomedical Engineering ,Biocompatible Materials ,Limbus Corneae ,Biology ,Blindness ,Biochemistry ,Regenerative medicine ,Corneal Diseases ,Biomaterials ,Mice ,03 medical and health sciences ,0302 clinical medicine ,Tissue engineering ,Ophthalmology ,Cornea ,medicine ,Animals ,Humans ,Molecular Biology ,Corneal epithelium ,Tissue Engineering ,Tissue Scaffolds ,Corneal Transplant ,Epithelial Cells ,General Medicine ,eye diseases ,Surgery ,Transplantation ,030104 developmental biology ,medicine.anatomical_structure ,030221 ophthalmology & optometry ,sense organs ,Stem cell ,Stem Cell Transplantation ,Biotechnology - Abstract
Limbal stem cell deficiency (LSCD) is a complex blinding disease of the cornea, which cannot be treated with conventional corneal transplants. Instead, a stem cell (SC) graft is required to replenish the limbal epithelial stem cell (LESC) reservoir, which is ultimately responsible for regenerating the corneal epithelium. Current therapies utilize limbal tissue biopsies that harbor LESCs as well as tissue culture expanded cells. Typically, this tissue is placed on a scaffold that supports the formation of corneal epithelial cell sheets, which are then transferred to diseased eyes. A wide range of biological and synthetic materials have been identified as carrier substrates for LESC, some of which have been used in the clinic, including amniotic membrane, fibrin, and silicon hydrogel contact lenses, each with their own advantages and limitations. This review will provide a brief background of LSCD, focusing on bio-scaffolds that have been utilized in limbal stem cell transplantation (LSCT) and materials that are being developed as potentially novel therapeutics for patients with this disease. Statement of Significance The outcome of patients with corneal blindness that receive stem cell grafts to restore eye health and correct vision varies considerably and may be due to the different biological and synthetic scaffolds used to deliver these cells to the ocular surface. This review will highlight the positive attributes and limitations of the myriad of carriers developed for clinical use as well as those that are being trialled in pre-clinical models. The overall focus is on developing a standardized therapy for patients, however due to the multiple causes of corneal blindness, a personal regenerative medicine approach may be the best option.
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- 2018
9. Nature and incidence of severe limbal stem cell deficiency in Australia and New Zealand
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Stephanie L Watson, Charles N J McGhee, Nick Di Girolamo, Samantha Bobba, Richard A. Mills, Geoffrey J Crawford, Mark Daniell, Damien G. Harkin, Elsie Chan, and Brendan G. Cronin
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0301 basic medicine ,Response rate (survey) ,medicine.medical_specialty ,Pediatrics ,Visual acuity ,business.industry ,Incidence (epidemiology) ,eye diseases ,Transplantation ,Contact lens ,03 medical and health sciences ,Ophthalmology ,030104 developmental biology ,0302 clinical medicine ,Epidemiology ,Severity of illness ,030221 ophthalmology & optometry ,medicine ,Young adult ,medicine.symptom ,business - Abstract
Background This study aimed to determine the nature and incidence of severe limbal stem cell deficiency in Australia and New Zealand. Design A one-year pilot surveillance study with a one-year follow-up period was conducted in association with the Australian and New Zealand Ophthalmic Surveillance Unit. Participants The study included patients reported by practising ophthalmologists on the Surveillance Unit's database. Methods Ophthalmologists were provided with a definition of severe limbal stem cell deficiency, contacted on a monthly basis by the Unit and asked to report newly diagnosed cases. Main Outcome Measures Severe LSCD was defined as at least 6 clock hours of whorl-like epitheliopathy, an opaque epithelium arising from the limbus, late fluorescein staining of the involved epithelium, and superficial corneal neovascularisation or conjunctivalisation. Results On average, 286 report cards were sent by the Surveillance Unit to practising ophthalmologists each month (total 3429 over 12 months) and the Unit received an average of 176 responses per month (total 2111; 62% response rate). During the 1-year study period from April 2013-March 2014, 14 positive cases were reported to the Unit. A range of underlying aetiologies were implicated, with contact lens over-wear and cicatrising conjunctivitis being the most common (n = 3). Conclusions This surveillance study is the first worldwide to document the incidence of limbal stem cell deficiency, however due to study design limitations, it is likely to have been under-reported. It provides novel data on the demographics, clinical conditions and management of patients with limbal stem cell deficiency as reported by treating ophthalmologists.
- Published
- 2016
10. Simulated patient and role play methodologies for communication skills training in an undergraduate medical program: Randomized, crossover trial
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Lauren Dunstan, Mominah Bhatti, Daniel Tran, Samantha Bobba, Dinuksha De Silva, Dominic Vickers, Silas Taylor, Sophie Roome, Jed Kitson, Boaz Shulruf, Ryan Falconer, Jamie Patel, Harleen Kaur, and Marrwah Ahmadzai
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Adult ,Male ,Students, Medical ,020205 medical informatics ,Adolescent ,education ,02 engineering and technology ,Simulated patient ,Peer Group ,Education ,03 medical and health sciences ,0302 clinical medicine ,Resource (project management) ,0202 electrical engineering, electronic engineering, information engineering ,business.product_line ,Humans ,030212 general & internal medicine ,Set (psychology) ,Role Playing ,Curriculum ,Aged ,Medical education ,Physician-Patient Relations ,Modality (human–computer interaction) ,Cross-Over Studies ,Communication ,Australia ,General Medicine ,Middle Aged ,Communication skills training ,Crossover study ,Patient Simulation ,Female ,Role playing ,Psychology ,business ,human activities ,Education, Medical, Undergraduate - Abstract
Background: Educators utilize real patients, simulated patients (SP), and student role play (RP) in communication skills training (CST) in medical curricula. The chosen modality may depend more on resource availability than educational stage and student needs. In this study, we set out to determine whether an inexpensive volunteer SP program offered an educational advantage compared to RP for CST in preclinical medical students. Methods: Students and volunteer SPs participated in interactions across two courses. Students allocated to SP interactions in one course participated in RP in the other course and vice versa. Audio recordings of interactions were made, and these were rated against criterion descriptors in a modified Calgary–Cambridge Referenced Observation Guide. Results: Independent t-test scores comparing ratings of RP and SP groups revealed no significant differences between methodologies. Discussion: This study demonstrates that volunteer SPs are not superior to RP, when used in CST targeted at preclinical students. This finding is consistent with existing literature, yet we suggest that it is imperative to consider the broader purpose of CST and the needs of stakeholders. Consequently, it may be beneficial to use mixed methods of CST in medical programs.
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- 2018
11. Intracranial Arterial Compression of the Anterior Visual Pathway
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Neeranjali S. Jain, Ashish Agar, Samantha Bobba, Calum W. K. Chong, M. Yashar S. Kalani, Ian C. Francis, Allison Newey, Andrew W. Kam, and Anna Michelle Waldie
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Anterior Visual Pathway ,genetic structures ,business.industry ,medicine.medical_treatment ,Microvascular decompression ,Anatomy ,Original Articles ,Compression (physics) ,eye diseases ,03 medical and health sciences ,Ophthalmology ,0302 clinical medicine ,Neuroimaging ,Neurovascular compression ,030221 ophthalmology & optometry ,medicine ,Neurology (clinical) ,business ,hormones, hormone substitutes, and hormone antagonists ,030217 neurology & neurosurgery - Abstract
Compression of anterior visual pathway (AVP) structures by intracranial arteries is observed not infrequently on neuroimaging. Whether or not such compression results in damage to these structures, however, remains unclear. This information is important to define as AVP compression by intracranial arteries may be a causative factor in patients with otherwise unexplained visual dysfunction. In a single centre, 37 patients with evidence of intracranial artery AVP compression demonstrated on magnetic resonance imaging were identified by retrospective review of case records over the period 2011–2017. Variables were collected, including patient demographics, visual acuity, visual fields, pupillary reactions and optic disc appearance for patients in the case series. Visual field deficits correlated with compression sites in the 37 patients examined. Internal carotid artery-optic nerve compression was the most frequent (unilateral compression n = 9, bilateral compression n = 14), followed by chiasmal compression by the anterior cerebral artery (n = 8) and a combination of optic nerve and chiasmal compression (n = 5). Visual acuity and visual fields were stable on follow-up (mean 4 years) in 24 of 26 cases (93%). We conclude that AVP compression by intracranial arteries may be a causative factor in unexplained visual dysfunction. The visual defects are largely non-progressive.
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- 2018
12. Incidence, clinical features and diagnosis of cicatrising conjunctivitis in Australia and New Zealand
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Samantha Bobba, Connor Devlin, Mark Daniell, Stephanie L Watson, Elsie Chan, Nick Di Girolamo, Denis Wakefield, and Peter McCluskey
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Adult ,Male ,Pediatrics ,medicine.medical_specialty ,Surveillance study ,Demographics ,Article ,030207 dermatology & venereal diseases ,03 medical and health sciences ,Cicatrix ,0302 clinical medicine ,Incidence data ,medicine ,Humans ,Prospective Studies ,Prospective cohort study ,Aged ,Aged, 80 and over ,business.industry ,Incidence (epidemiology) ,Incidence ,Australia ,Mean age ,Middle Aged ,Conjunctivitis ,Ophthalmology ,030221 ophthalmology & optometry ,Population data ,Female ,business ,New Zealand - Abstract
AIMS: This study aimed to determine the incidence, clinical features and management of cicatrising conjunctivitis in Australia and New Zealand, also enabling comparison with data from the United Kingdom. METHODS: A prospective surveillance study was conducted over 17 months via the Australian and New Zealand Ophthalmic Surveillance Unit with a one-year follow-up period. Practicing ophthalmologists on the Surveillance Unit’s database were asked to report recently diagnosed cases of cicatrising conjunctivitis on a monthly basis. Initial and follow-up questionnaires were sent to ophthalmologists who had reported positive cases to obtain demographic and clinical data. The minimum incidence of cicatrising conjunctivitis was calculated based on cases reported during the study period and from population data. RESULTS: During the 17-month study period (December 2011–April 2013), 56 cases of cicatrising conjunctivitis were reported. Data was obtained for 35 cases (62%) with a mean age of 74 years (range, 28–94 years). The most common aetiologies were ocular mucus membrane pemphigoid (n = 18 cases, 51.4%), Stevens–Johnson Syndrome (n = 3, 8.6%) and graft versus host disease (n = 3, 8.6%). The minimum incidence of cicatrising conjunctivitis in Australia and New Zealand was 1.5 per million, comparable to incidence data from the United Kingdom. CONCLUSIONS: This study is the first to prospectively record the incidence of cicatrising conjunctivitis in Australia and New Zealand and the second worldwide. It provides novel data on demographics and management of cicatrising conjunctivitis, as reported by treating ophthalmologists.
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- 2018
13. Anterior Chamber Culture at the Conclusion of Cataract Surgery and Its Relation to Post-Cataract Surgery Endophthalmitis
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Sarah B Wang, Michael C Wehrhahn, Ian C. Francis, Olivia J. K. Fox, Calum W. K. Chong, Simon Irvine, and Samantha Bobba
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medicine.medical_specialty ,business.industry ,medicine.drug_class ,medicine.medical_treatment ,Incidence (epidemiology) ,Antibiotics ,Intraocular lens ,Phacoemulsification ,Cataract surgery ,medicine.disease ,Asepsis ,Single surgeon ,Surgery ,03 medical and health sciences ,0302 clinical medicine ,Endophthalmitis ,030221 ophthalmology & optometry ,medicine ,business ,030217 neurology & neurosurgery - Abstract
Purpose: The purpose of this study is to reassess the pathogenesis of postoperative endophthalmitis (POE), aiming to determine the presence of bacteria in the anterior chamber at the conclusion of phacoemulsification cataract surgery, and the subsequent development of POE. Methods: A single surgeon performed all cataract procedures across the two nominated day surgical centres. Phacoemulsification surgery with intraocular lens implantation (IOL) was performed on 209 eyes. Patient demographics and POE risk factors were obtained, as well as an anterior chamber (AC) aspirate from each patient at the conclusion of the surgical procedure. The aspirate was cultured for 1 – 5 days. Fourteen eyes also underwent bacterial 16S polymerase chain reaction (PCR) analysis of the AC aspirate. Any subsequent development of POE was recorded. No intracameral antibiotics were used. Results: Of the 209 cultures, three cases (1.4%) were positive for growth (95% confidence interval). The three positive cases yielded different microorganisms. One case was positive for bacteria (Corynebacterium species) while the other two cases were positive for fungi (Candida species and a Zygomycete). Cases with positive culture growth had no statistically significant difference in the incidence of preoperative, operative and postoperative risk factors for POE, compared with patients with negative culture. No patient in this study developed POE. Conclusion: The bacterial contamination rate of the AC after phacoemulsification surgery with IOL implantation is extremely low. Strict aseptic technique and definitively closed incisions can potentially be attributed to the zero percentage incidence of POE. It is probable that POE is more likely due to postoperative factors.
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- 2018
14. Management of the photic sneeze reflex utilising the philtral pressure technique
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Ian C. Francis, Ashish Agar, Samantha Bobba, Minas T. Coroneo, Sascha K.R. Spencer, and Olivia J. K. Fox
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Adult ,Aged, 80 and over ,Male ,medicine.medical_specialty ,business.industry ,Middle Aged ,medicine.disease ,Sneezing ,Photic sneeze reflex ,Ophthalmology ,Physical medicine and rehabilitation ,Reflex ,Correspondence ,Pressure ,Humans ,Medicine ,Female ,business ,Photic Stimulation ,Aged - Published
- 2019
15. Tracing the Fate of Limbal Epithelial Progenitor Cells in the Murine Cornea
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Iveta Slapetova, Denis Wakefield, Gary M. Halliday, N. Di Girolamo, Vanisri Raviraj, J.G. Lyons, Renee Whan, Naomi C. Delic, Philip R. Nicovich, and Samantha Bobba
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Cell Biology ,Anatomy ,Biology ,Somatic evolution in cancer ,Cell biology ,Transplantation ,medicine.anatomical_structure ,Cornea ,medicine ,Molecular Medicine ,Brainbow ,sense organs ,Stem cell ,Progenitor cell ,Developmental Biology ,Progenitor ,Corneal epithelium - Abstract
Stem cell (SC) division, deployment, and differentiation are processes that contribute to corneal epithelial renewal. Until now studying the destiny of these cells in a living mammal has not been possible. However, the advent of inducible multicolor genetic tagging and powerful imaging technologies has rendered this achievable in the translucent and readily accessible murine cornea. K14CreERT2-Confetti mice that harbor two copies of the Brainbow 2.1 cassette, yielding up to 10 colors from the stochastic recombination of fluorescent proteins, were used to monitor K-14+ progenitor cell dynamics within the corneal epithelium in live animals. Multicolored columns of cells emerged from the basal limbal epithelium as they expanded and migrated linearly at a rate of 10.8 µm/day toward the central cornea. Moreover, the permanent expression of fluorophores, passed on from progenitor to progeny, assisted in discriminating individual clones as spectrally distinct streaks containing more than 1,000 cells within the illuminated area. The centripetal clonal expansion is suggestive that a single progenitor cell is responsible for maintaining a narrow corridor of corneal epithelial cells. Our data are in agreement with the limbus as the repository for SC as opposed to SC being distributed throughout the central cornea. This is the first report describing stem/progenitor cell fate determination in the murine cornea using multicolor genetic tracing. This model represents a powerful new resource to monitor SC kinetics and fate choice under homeostatic conditions, and may assist in assessing clonal evolution during corneal development, aging, wound-healing, disease, and following transplantation. Stem Cells 2015;33:157–169
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- 2014
16. Comparison of Recent Studies of Postoperative Endophthalmitis From the Same National Database
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Samantha Bobba, Mitchell B. Lee, and Ian C. Francis
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medicine.medical_specialty ,business.industry ,General surgery ,010102 general mathematics ,01 natural sciences ,Postoperative endophthalmitis ,03 medical and health sciences ,Ophthalmology ,0302 clinical medicine ,030221 ophthalmology & optometry ,medicine ,National database ,0101 mathematics ,business - Published
- 2016
17. The central concept of empowerment in Indigenous health and wellbeing
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Samantha Bobba
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medicine.medical_specialty ,Native Hawaiian or Other Pacific Islander ,media_common.quotation_subject ,Health Promotion ,Population health ,Disease ,Nursing ,Health care ,medicine ,Health Services, Indigenous ,Humans ,Indigenous Peoples ,Empowerment ,media_common ,Government ,Health economics ,business.industry ,Health Policy ,Public health ,Australia ,Public Health, Environmental and Occupational Health ,Socioeconomic Factors ,Personal Autonomy ,Community health ,business - Published
- 2019
18. Ethics of medical research in Aboriginal and Torres Strait Islander populations
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Samantha Bobba
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medicine.medical_specialty ,Biomedical Research ,Native Hawaiian or Other Pacific Islander ,Research Subjects ,Context (language use) ,Population health ,Criminology ,Colonialism ,Indigenous ,03 medical and health sciences ,0302 clinical medicine ,Health care ,Humans ,Medicine ,030212 general & internal medicine ,Informed Consent ,Health economics ,business.industry ,030503 health policy & services ,Health Policy ,Public health ,Public Health, Environmental and Occupational Health ,Personal Autonomy ,Community health ,0305 other medical science ,business - Abstract
Conducting ethical health research in Aboriginal and Torres Strait Islander populations requires an understanding of their unique cultural values and the historical context. The assimilation of Indigenous people with the broader community through colonial policies such as the dispossession of land and forcible removal of children from their families in the Stolen Generation, deprived entire communities of their liberty. Poorly designed research protocols can perpetuate discriminatory values, reinforce negative stereotypes and stigmas and lead to further mistrust between the Indigenous community and healthcare professionals. The manuscript offers a fresh perspective and an up-to-date literature review on the ethical implications of conducting health research in Aboriginal and Torres Strait Islander communities.
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- 2019
19. Nature and incidence of severe limbal stem cell deficiency in Australia and New Zealand
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Samantha, Bobba, Nick, Di Girolamo, Richard, Mills, Mark, Daniell, Elsie, Chan, Damien G, Harkin, Brendan G, Cronin, Geoffrey, Crawford, Charles, McGhee, and Stephanie, Watson
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Adult ,Aged, 80 and over ,Male ,Time Factors ,Incidence ,Stem Cells ,Australia ,Epithelium, Corneal ,Visual Acuity ,Pilot Projects ,Limbus Corneae ,Middle Aged ,Severity of Illness Index ,Corneal Diseases ,Young Adult ,Population Surveillance ,Humans ,Female ,Aged ,Follow-Up Studies ,New Zealand ,Stem Cell Transplantation - Abstract
This study aimed to determine the nature and incidence of severe limbal stem cell deficiency (LSCD) in Australia and New Zealand.A 1-year pilot surveillance study with a 1-year follow-up period was conducted in association with the Australian and New Zealand Ophthalmic Surveillance Unit.The study included patients reported by practising ophthalmologists on the Surveillance Unit's database.Ophthalmologists were provided with a definition of severe limbal stem cell deficiency, contacted on a monthly basis by the Unit and asked to report newly diagnosed cases.Severe LSCD was defined as at least 6 clock hours of whorl-like epitheliopathy, an opaque epithelium arising from the limbus, late fluorescein staining of the involved epithelium and superficial corneal neovascularization or conjunctivalization.On average, 286 report cards were sent by the Surveillance Unit to practising ophthalmologists each month (total 3429 over 12 months) and the Unit received an average of 176 responses per month (total 2111; 62% response rate). During the 1-year study period from April 2013 to March 2014, 14 positive cases were reported to the Unit. A range of underlying aetiologies were implicated, with contact lens over-wear and cicatrizing conjunctivitis being the most common (n = 3).This surveillance study is the first worldwide to document the incidence of limbal stem cell deficiency; however, because of study design limitations, it is likely to have been under-reported. It provides novel data on the demographics, clinical conditions and management of patients with limbal stem cell deficiency as reported by treating ophthalmologists.
- Published
- 2016
20. Contact lens delivery of stem cells for restoring the ocular surface
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N. Di Girolamo, Stephanie L Watson, and Samantha Bobba
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medicine.medical_specialty ,Conjunctiva ,Biology ,eye diseases ,Surgery ,Contact lens ,Transplantation ,medicine.anatomical_structure ,Cornea ,Cancer research ,medicine ,Limbal stem cell ,sense organs ,Stem cell ,Progenitor cell ,Ocular surface - Abstract
Since the 1980s when pioneering techniques were developed on the use of limbal tissue transplantation, significant progress has been made on developing limbal stem cell therapies. Ex vivo expansion of autologous progenitor cells has reduced the risk of inducing limbal stem cell deficiency in the donor eye, and the use of novel carriers has improved the logistical ease of the procedure. More recently contact lenses (CLs) have been trialled as a vehicle for ocular stem cell delivery, reducing the risk of cryptogenic and xenogeneic infections. This chapter discusses current approaches to limbal stem cell transplantation, its therapeutic use for limbal stem cell deficiency, and the advantages of CLs as a vehicle for stem cell delivery compared to current methodologies.
- Published
- 2016
21. Contact Lenses: A Delivery Device for Stem Cells to Treat Corneal Blindness
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Nick Di Girolamo and Samantha Bobba
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0301 basic medicine ,medicine.medical_specialty ,medicine.medical_treatment ,Cell- and Tissue-Based Therapy ,Disease ,Limbus Corneae ,Stem cell marker ,Corneal Diseases ,03 medical and health sciences ,0302 clinical medicine ,Drug Delivery Systems ,medicine ,Humans ,Intensive care medicine ,Disease burden ,business.industry ,Guided Tissue Regeneration ,Stem Cells ,Epithelium, Corneal ,Epithelial Cells ,Stem-cell therapy ,Contact Lenses, Hydrophilic ,Review article ,Surgery ,Contact lens ,Ophthalmology ,030104 developmental biology ,030221 ophthalmology & optometry ,Stem cell ,business ,Conjunctiva ,Optometry - Abstract
Worldwide, 45 million people are blind. Corneal blindness is a major cause of visual loss, estimated to affect 10 million. For the most difficult to treat patients, including those with a disease called limbal stem cell deficiency, a donor corneal graft is not a viable option; thus, patients are treated with specialized stem cell grafts, which fail in a significant proportion (30 to 50%) of subjects. This unacceptable failure rate means there is a pressing need to develop minimally invasive, long-lasting, cost-effective therapies to improve patient quality of life and lessen the economic burden. Restoring vision in patients with severe corneal disease is the main focus of our research program; however, to achieve our goals and deliver the best quality stem cell therapy, we must first understand the basic biology of these cells, including their residence, the factors that support their long-term existence, markers to identify and isolate them, and carriers that facilitate expansion, delivery, and protection during engraftment. We recently achieved some of these goals through the discovery of stem cell markers and the development of a novel and innovative contact lens-based cell transfer technique that has been successfully trialed on patients with corneal blindness. Although several popular methodologies are currently available to nurture and transfer stem cells to the patients' ocular surface, contact lenses provide many advantages that will be discussed in this review article. The job for clinician-researchers will be to map precisely how these cells contribute to restoring ocular health and whether improvements in the quality of cells and the cell delivery system can be developed to reduce disease burden.
- Published
- 2015
22. Clinical outcomes of xeno-free expansion and transplantation of autologous ocular surface epithelial stem cells via contact lens delivery: a prospective case series
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Sharron Chow, Stephanie L Watson, Nick Di Girolamo, and Samantha Bobba
- Subjects
Adult ,Male ,medicine.medical_specialty ,genetic structures ,Contact Lenses ,Medicine (miscellaneous) ,Biology ,Biochemistry, Genetics and Molecular Biology (miscellaneous) ,Transplantation, Autologous ,Limbal stem cell deficiency ,Corneal Diseases ,03 medical and health sciences ,0302 clinical medicine ,Ophthalmology ,medicine ,Humans ,Prospective Studies ,Progenitor cell ,Cells, Cultured ,030304 developmental biology ,Aged ,Aged, 80 and over ,0303 health sciences ,Wound Healing ,Stem Cells ,Research ,Australia ,Epithelium, Corneal ,Epithelial Cells ,Cell Biology ,Middle Aged ,eye diseases ,3. Good health ,Transplantation ,Contact lens ,Treatment Outcome ,Immunology ,030221 ophthalmology & optometry ,Molecular Medicine ,Female ,sense organs ,Stem cell ,Wound healing ,Ocular surface ,Stem Cell Transplantation - Abstract
Introduction Depletion of limbal stem cells leads to a debilitating condition known as limbal stem cell deficiency, characterised by impaired corneal wound healing and poor vision. The aim of this study was to determine whether delivering progenitor cells on a contact lens is a viable and effective alternative to current transplantation techniques, which are complicated by biological and xenogeneic materials. Methods Sixteen eyes of 16 patients who had total (n = 14) and partial (n = 2) limbal stem cell deficiency (chemical burns, five eyes; iatrogenic causes, four eyes; aniridia, three eyes; trachoma-induced, two eyes; contact lens over-wear, one eye; and cicatrising conjunctivitis, one eye) and who had failed prior therapy were recruited prospectively into the study. Autologous limbal (n = 7) or conjunctival epithelial (n = 9) biopsies were harvested from patients and placed on the concave surface of silicone hydrogel contact lenses. Cells were expanded in culture with autologous serum and transplanted onto the ocular surface. Results Restoration of a transparent avascular and clinically stable corneal epithelium was attained in 10 of 16 eyes (63%) at a median follow-up time of 2.5 years (range of 0.8 to 5.8 years). Although minor complications occurred in two eyes of two patients because of contact lens insertion or removal, these were not associated with long-term sequelae. Conclusions This is the first and largest study to evaluate the mid-term outcomes of autologous limbal/conjunctival stem cell transplantation via a US Food and Drug Administration-approved contact lens, demonstrating that delivery of ocular progenitor cells via this procedure offers a viable, effective, and xeno-free alternative to current transplantation methodologies. Trial registration Australian New Zealand Clinical Trials Registry ACTRN012607000211460. Registered 17 April 2007.
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