Telemedicine provides adequate medical assistance for physically distant patients by using the Information and Communication Technologies (ICT). Telemedicine includes techniques and tools for health monitoring and care implemented through systems providing rapid access to both specialists and patients. Telemedicine may link human and economic resources. Telemedicine may facilitate the access of patients to specialized healthcare in places lacking qualified personnel or in remote or difficult access areas thus reducing long waiting lists and high costs for the health systems. Telemedicine projects between different countries are developing, but ethical and legal issues are emerging. This article refers to telemedicine as a broad concept of distance medicine. The main purpose will be the medical-legal aspects. We will also describe the telemedicine in ophthalmology and the main issues raised by its implementation.

The Aurora kinases regulate chromosome segregation and cytokinesis, and alterations in their expression associate with cell malignant transformation. In this study, we demonstrated by qRT-PCR analysis of 14 seminomas that Aurora-A mRNA was, with respect to control tissues, augmented in five of 14 tumour tissues by 2.17 +/- 0.30 fold (P < 0.05) and reduced in 9 to 0.38 +/- 0.10 (P < 0.01). Aurora-B mRNA was increased in 11 tumour tissues by 4.33 +/- 0.82 fold (P < 0.01) and reduced in 3 to 0.41 +/- 0.11 fold. Aurora-C mRNA was reduced to 0.20 +/- 0.32 fold (P < 0.01) in 13 seminomas and up-regulated in one case. Western blot experiments, performed on protein extracts of nine seminomas and six normal testes, showed an up-regulation of Aurora-B protein by 10.14 +/- 3.51 fold (P < 0.05), while Aurora-A protein was found increased in four seminomas by 2.16 +/- 0.43 (P < 0.05), unchanged in three and reduced in two tumour tissues. Aurora-C protein was increased by 9.2 +/- 2.90 fold (P < 0.05), suggesting that post-transcriptional mechanisms modulate its expression. In conclusion, we demonstrated that expression of Aurora kinases is deregulated in seminomas, suggesting that they may play a role in the progression of testicular cancers.

In recent years, new technologies used in the field of ophthalmology have been emerging and developing rapidly. Two major aspects of these advancements are teleophthalmology and smartphones, which have enabled practitioners to achieve optimal outcomes in record time with minimal costs. Several rules and regulations have been applied to these technologies in order to frame them under the appropriate medico-legal ethics, and specialized committees have been dedicated to maintaining their efficacy and avoiding shortcomings. In addition multiple studies and case reports conducted worldwide have assessed them according to specific diseases or global concerns. This review article constitutes an up-to date account of almost all of the applications and medico-legal perspectives of technologies used in ophthalmology in order to summarize and better visualize their advantages and disadvantages.

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Purpose: Evaluate the efficacy and safety of intravitreal 0.19 mg fluocinolone acetonide (FAc) micro implant in patients with chronic diabetic macular edema (cDME). Methods: Prospective study recruiting subjects with cDME. Inclusion criteria: cDME for at least 2 years documented with OCT imaging; pseudophakia; previous treatments with laser photocoagulation and intravitreal injections of anti-VEGF and/or dexamethasone. Exclusion criteria: phakia; ocular hypertension; tractional component visible on OCT; glaucoma; previous vitrectomy. Outcome measures included best-corrected visual acuity (BVCA), intraocular pressure (IOP), and central macular thickness (CMT), measured 1, 3, 6, and 12 months post-injection. Data were compared with the Friedman test and significance was set at p < 0.05. Results: A total of 18 eyes with a median duration of cDME of 45 months (25–118 months). The 77% of subjects either maintained or improved their BVCA. About 17% and 33% of subjects showed an improvement of 15 ETDRS letters or more at 3 and 12 months respectively. The 17% and 28% of subjects showed a CMT <250 microns at 3 and 12 months, respectively. The median change in CMT thickness was of −370 and −373.5 microns at 3 and 12 months post-injection respectively ( p-value is 0.025). Changes in median IOP at 3 and 12 months post-injection were not statistically significant ( p-value is 0.210). Ocular hypertension (OHT) was detected in two eyes (11%). Conclusion: The FAc micro implant has proved efficacy in improving and/or maintaining BVCA in 77% of patients with cDME up to 12 months post-injection. Ocular hypertension is the most common side effect but responds well to topical therapy.