Paolo Melillo

Researcher of Ophthalmology

Name Paolo
Surname Melillo
Institution Università degli Studi della Campania Luigi Vanvitelli
Address Eye Clinic, Multidisciplinary Department of Medical, Surgical and Dental Sciences, University of Campania Luigi Vanvitelli, Naples, Italy


  • Wearable technology and ECG processing for fall risk assessment, prevention and detection.

    Publication Date: 01/01/2015 on Conference proceedings : ... Annual International Conference of the IEEE Engineering in Medicine and Biology Society. IEEE Engineering in Medicine and Biology Society. Annual Conference
    by Melillo P, Castaldo R, Sannino G, Orrico A, de Pietro G, Pecchia L
    DOI: 10.1109/EMBC.2015.7320186

    Falls represent one of the most common causes of injury-related morbidity and mortality in later life. Subjects with cardiovascular disorders (e.g., related to autonomic dysfunctions and postural hypotension) are at higher risk of falling. Autonomic dysfunctions increasing the risk of falling in the short and mid-term could be assessed by Heart Rate Variability (HRV) extracted by electrocardiograph (ECG). We developed three trials for assessing the usefulness of ECG monitoring using wearable devices for: risk assessment of falling in the next few weeks; prevention of imminent falls due to standing hypotension; and fall detection. Statistical and data-mining methods are adopted to develop classification and regression models, validated with the cross-validation approach. The first classifier based on HRV features enabled to identify future fallers among hypertensive patients with an accuracy of 72% (sensitivity: 51.1%, specificity: 80.2%). The regression model to predict falls due to orthostatic dropdown from HRV recorded before standing achieved an overall accuracy of 80% (sensitivity: 92%, specificity: 90%). Finally, the classifier to detect simulated falls using ECG achieved an accuracy of 77.3% (sensitivity: 81.8%, specificity: 72.7%). The evidence from these three studies showed that ECG monitoring and processing could achieve satisfactory performances compared to other system for risk assessment, fall prevention and detection. This is interesting as differently from other technologies actually employed to prevent falls, ECG is recommended for many other pathologies of later life and is more accepted by senior citizens.

  • A pilot study for development of a novel tool for clinical decision making to identify fallers among ophthalmic patients.

    Publication Date: 01/01/2015 on BMC medical informatics and decision making
    by Melillo P, Orrico A, Attanasio M, Rossi S, Pecchia L, Chirico F, Testa F, Simonelli F
    DOI: 10.1186/1472-6947-15-S3-S6

    Falls in the elderly is a major problem. Although falls have a multifactorial etiology, a commonly cited cause of falls in older people is poor vision. This study proposes a method to discriminate fallers and non-fallers among ophthalmic patients, based on data-mining algorithms applied to health and socio-demographic information.

  • Macular function and morphologic features in juvenile stargardt disease: longitudinal study.

    Publication Date: 01/12/2014 on Ophthalmology
    by Testa F, Melillo P, Di Iorio V, Orrico A, Attanasio M, Rossi S, Simonelli F
    DOI: 10.1016/j.ophtha.2014.06.032

    To evaluate disease progression in a cohort of patients with a clinical and genetic diagnosis of Stargardt disease.

  • Macular abnormalities in Italian patients with retinitis pigmentosa.

    Publication Date: 01/07/2014 on The British journal of ophthalmology
    by Testa F, Rossi S, Colucci R, Gallo B, Di Iorio V, della Corte M, Azzolini C, Melillo P, Simonelli F
    DOI: 10.1136/bjophthalmol-2013-304082

    To investigate the prevalence of macular abnormalities in a large Caucasian cohort of patients affected by retinitis pigmentosa (RP).

  • Immediate versus delayed integrated point-of-care-ultrasonography to manage acute dyspnea in the emergency department.

    Publication Date: 27/04/2014 on Critical ultrasound journal
    by Pirozzi C, Numis FG, Pagano A, Melillo P, Copetti R, Schiraldi F
    DOI: 10.1186/2036-7902-6-5

    Dyspnea is one of the most frequent complaints in the Emergency Department. Thoracic ultrasound should help to differentiate cardiogenic from non-cardiogenic causes of dyspnea. We evaluated whether the diagnostic accuracy can be improved by adding a point-of-care-ultrasonography (POC-US) to routine exams and if an early use of this technique produces any advantage.

  • Three-year follow-up after unilateral subretinal delivery of adeno-associated virus in patients with Leber congenital Amaurosis type 2.

    Publication Date: 01/06/2013 on Ophthalmology
    by Testa F, Maguire AM, Rossi S, Pierce EA, Melillo P, Marshall K, Banfi S, Surace EM, Sun J, Acerra C, Wright JF, Wellman J, High KA, Auricchio A, Bennett J, Simonelli F
    DOI: 10.1016/j.ophtha.2012.11.048

    The aim of this study was to show the clinical data of long-term (3-year) follow-up of 5 patients affected by Leber congenital amaurosis type 2 (LCA2) treated with a single unilateral injection of adeno-associated virus AAV2-hRPE65v2.

  • Heart rate variability and target organ damage in hypertensive patients.

    Publication Date: 15/11/2012 on BMC cardiovascular disorders
    by Melillo P, Izzo R, De Luca N, Pecchia L
    DOI: 10.1186/1471-2261-12-105

    We evaluated the association between linear standard Heart Rate Variability (HRV) measures and vascular, renal and cardiac target organ damage (TOD).

  • Pupillometric analysis for assessment of gene therapy in Leber Congenital Amaurosis patients.

    Publication Date: 19/07/2012 on Biomedical engineering online
    by Melillo P, Pecchia L, Testa F, Rossi S, Bennett J, Simonelli F
    DOI: 10.1186/1475-925X-11-40

    Objective techniques to assess the amelioration of vision in patients with impaired visual function are needed to standardize efficacy assessment in gene therapy trials for ocular diseases. Pupillometry has been investigated in several diseases in order to provide objective information about the visual reflex pathway and has been adopted to quantify visual impairment in patients with Leber Congenital Amaurosis (LCA). In this paper, we describe detailed methods of pupillometric analysis and a case study on three Italian patients affected by Leber Congenital Amaurosis (LCA) involved in a gene therapy clinical trial at two follow-up time-points: 1 year and 3 years after therapy administration.

  • Nonlinear Heart Rate Variability features for real-life stress detection. Case study: students under stress due to university examination.

    Publication Date: 07/11/2011 on Biomedical engineering online
    by Melillo P, Bracale M, Pecchia L
    DOI: 10.1186/1475-925X-10-96

    This study investigates the variations of Heart Rate Variability (HRV) due to a real-life stressor and proposes a classifier based on nonlinear features of HRV for automatic stress detection.

  • Discrimination power of long-term heart rate variability measures for chronic heart failure detection.

    Publication Date: 01/01/2011 on Medical & biological engineering & computing
    by Melillo P, Fusco R, Sansone M, Bracale M, Pecchia L
    DOI: 10.1007/s11517-010-0728-5

    The aim of this study was to investigate the discrimination power of standard long-term heart rate variability (HRV) measures for the diagnosis of chronic heart failure (CHF). The authors performed a retrospective analysis on four public Holter databases, analyzing the data of 72 normal subjects and 44 patients suffering from CHF. To assess the discrimination power of HRV measures, an exhaustive search of all possible combinations of HRV measures was adopted and classifiers based on Classification and Regression Tree (CART) method was developed, which is a non-parametric statistical technique. It was found that the best combination of features is: Total spectral power of all NN intervals up to 0.4 Hz (TOTPWR), square root of the mean of the sum of the squares of differences between adjacent NN intervals (RMSSD) and standard deviation of the averages of NN intervals in all 5-min segments of a 24-h recording (SDANN). The classifiers based on this combination achieved a specificity rate and a sensitivity rate of 100.00 and 89.74%, respectively. The results are comparable with other similar studies, but the method used is particularly valuable because it provides an easy to understand description of classification procedures, in terms of intelligible "if … then …" rules. Finally, the rules obtained by CART are consistent with previous clinical studies.