Aim: To study the effect of the treatment of dry eye in Sjögren's syndrome patients with hypotonic or isotonic hyaluronate eye drops. Methods: 40 Sjögren's syndrome patients were divided in two groups and treated as follows: group 1 with hypotonic (150 mOsm/l) 0.4% hyaluronate eye drops; group 2 with isotonic 0.4% hyaluronate eye drops. The eye drops were instilled six times a day for 90 days. Grading of subjective symptoms, break up time (BUT), corneal fluorescein staining, conjunctival rose bengal staining, Schirmer's I test, and conjunctival impression cytology were carried out at 0 and 15, 30, 90 days from the beginning of the study. Patients were examined in a blind fashion. For the statistical analysis the Student's t test, Mann-Whitney U test, and χ 2 test were performed. Results: Symptoms were statistically significantly improved at day 15 in both groups but group 1 patients had a global score statistically significantly better group 2 (p=0.02). At day 15 group 1 patients had an improvement from baseline values of BUT (p=0.003), fluorescein, and rose bengal score (p=0.000001 and p=0.0004 respectively). Group 2 patients had, at day 15, an improvement of BUT and fluorescein score compared to baseline values (p=0.05 and p=0.0001 respectively). A comparison between the two groups showed better results for group 1 patients at day 15 for rose bengal stain (p=0.01) and for BUT (p=0.05) and fluorescein score (p=0.0003) at day 90. The conjunctival impression cytology showed that group 1 had a statistically significant better total score than group 2 starting from day 15 and lasting throughout the study (p<0.02). Also group 2 patients showed an improvement from baseline values starting from day 30 (p=0.000005). Conclusion: Hyaluronate eye drops are useful for treating severe dry eye in Sjögren's syndrome patients. The use of a formulation with pronounced hypotonicity showed better effects on corneoconjunctival epithelium than the isotonic solution.S odium hyaluronate eye drops have been used in several trials for the treatment of dry eye.

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The Aurelian Mammal Age for peninsular Italy was introduced on the basis of faunal assemblages mainly recovered at sites along the Via Aurelia west of Rome. These sites exposed a set of sedimentary deposits currently attributed to the Aurelia and to the Vitinia Formations correlated with MIS 9 and MIS 7, respectively. In the present paper we reconstruct the geologic-stratigraphic setting in the western sector of Rome within the wider context of glacio-eustatically controlled, geochronologically constrained aggradational successions defined for this region. We present a chronostratigraphic study based on dedicated field surveys, that, combined with five new40Ar/39Ar ages and eighteen trace-element and EMP glass analyses of volcanic products, allow us to revise age and correlation with the Marine Isotopic Stages for 10 sites out of 12 previously attributed to the Aurelia Formation and the Torre in Pietra Faunal Unit. In particular, we demonstrate a MIS 13/MIS 11 age for several sections along the Via Aurelia between Malagrotta and Castel di Guido. Based on this new geochronological framework, the first occurrences of Canis lupus and Vulpes vulpes in Italy are antedated to MIS 11, within the Fontana Ranuccio Faunal Unit of the Galerian Mammal Age, consistent with the wider European context. This contribution is intended as the groundwork for a revision of the Middle Pleistocene Mammal Ages of the Italian peninsula, according to the improved chronostratigraphy of the geologic sections hosting the faunal assemblages

Natural history of ERD secondary to ischemic BRVO is poor, and MGLP is able to prevent visual acuity deterioration through a 24-month follow-up.