Association of kidney disease measures with risk of renal function worsening in patients with type 1 diabetes

Background: Albuminuria has been classically considered a marker of kidney damage progression in diabetic patients and it is routinely assessed to monitor kidney function. However, the role of a mild GFR reduction on the development of stage 653 CKD has been less explored in type 1 diabetes mellitus (T1DM) patients. Aim of the present study was to evaluate the prognostic role of kidney disease measures, namely albuminuria and reduced GFR, on the development of stage 653 CKD in a large cohort of patients affected by T1DM. Methods: A total of 4284 patients affected by T1DM followed-up at 76 diabetes centers participating to the Italian Association of Clinical Diabetologists (Associazione Medici Diabetologi, AMD) initiative constitutes the study population. Urinary albumin excretion (ACR) and estimated GFR (eGFR) were retrieved and analyzed. The incidence of stage 653 CKD (eGFR < 60 mL/min/1.73 m2) or eGFR reduction > 30% from baseline was evaluated. Results: The mean estimated GFR was 98 \ub1 17 mL/min/1.73m2 and the proportion of patients with albuminuria was 15.3% (n = 654) at baseline. About 8% (n = 337) of patients developed one of the two renal endpoints during the 4-year follow-up period. Age, albuminuria (micro or macro) and baseline eGFR < 90 ml/min/m2 were independent risk factors for stage 653 CKD and renal function worsening. When compared to patients with eGFR > 90 ml/min/1.73m2 and normoalbuminuria, those with albuminuria at baseline had a 1.69 greater risk of reaching stage 3 CKD, while patients with mild eGFR reduction (i.e. eGFR between 90 and 60 mL/min/1.73 m2) show a 3.81 greater risk that rose to 8.24 for those patients with albuminuria and mild eGFR reduction at baseline. Conclusions: Albuminuria and eGFR reduction represent independent risk factors for incident stage 653 CKD in T1DM patients. The simultaneous occurrence of reduced eGFR and albuminuria have a synergistic effect on renal function worsening

Cerebral Magnetic Resonance Imaging as Predictor of Learning Disabilities in Extremely Low Birth Weight

It is difficult to predict the risk of the development of learning disabilities among extremely low birth weight neonates (birth weight > 501 and > 1000 g). In this study we assessed the relationship between the dilatation of the lateral ventricles on cerebral magnetic resonance (MRI) taken at the post-gestational age of 40 weeks and learning disabilities at school age. The means area of lateral ventricles of the learning disabilities-suspected group was significantly larger than that of the control group (396.4 and 281.7 mm 2 , respectively; P < 0.01). There were no differences between the groups of children in gestation, birth weight and developmental quotient at school age. We could say that the dilatation of lateral ventricles assessed by MRI performed at the correct term may be a predictor of learning disabilities recognisable at school age

Mortality from cancer and chronic respiratory diseases among workers who manufacture carbon electrodes

OBJECTIVES—To investigate the risk of cancer and non-neoplastic respiratory diseases among workers who manufacture carbon electrodes, as this industry entails exposure to mixtures of polycyclic aromatic hydrocarbons.
METHODS—A historical cohort study was carried out of 1006 male workers employed for at least 1 year between 1945 and 1971 in a carbon (graphite) electrode production plant in central Italy, who were followed up for mortality between 1955 and 1996. The ratio of observed to expected deaths (standardised mortality ratios, SMRs) was computed from both national and (for the period 1964-96) regional age and period specific mortalities. A multivariate Poisson regression analysis was performed to investigate the relative risk (RR) of death according to duration of employment and time since first employment in the factory.
RESULTS—A total of 424 workers had died, 538 were still alive, and 44 were lost to follow up. Mortalities from all causes, all cancers, and respiratory tract cancer were in line with the regional figure. An excess was found over the expected deaths from skin cancer including melanoma (SMR 3.16, 95% confidence interval (95% CI) 0.65 to 9.23) and from non-neoplastic respiratory diseases (SMR 1.58, 95% CI 1.16 to 2.11). Poisson regression analysis including age as a covariate showed an increased risk of dying from gastric cancer with increasing duration of employment, and an increase in the RR of dying from lung cancer and from non-neoplastic respiratory diseases with increasing time since first employment, although the linear trend was not significant.
CONCLUSION—This study supports previous findings that working in the carbon electrode manufacturing industry may not increase the risk of dying from respiratory cancer. However, a possible association with non-malignant respiratory diseases cannot be excluded.


Keywords: carbon electrode manufacturing; polycyclic aromatic hydrocarbons; historical cohort stud

Écritures de la déportation

Au-delà du succès tardif de Primo Levi, le témoignage littéraire en Italie de l’expérience de la Shoah ou de la déportation a été apporté par un nombre significatif d’hommes et de femmes. Ces témoignages apparurent dès 1945 et, parmi ceux-ci, certains sont dus à des femmes étrangères qui choisirent la langue italienne pour narrer l’expérience des Lager et qui insistèrent sur les aspects de la déformation du corps, de la nourriture, du rapport à la mère et du refus de la maternité. Ne manquent pas non plus les récits d’enfants cachés afin d’échapper à la capture et à la mort ; ou des expériences uniques comme celle de Luce d’Eramo, qui voulut expérimenter volontairement la vie des Lager ou, comme Helga Schneider, qui découvrit être la fille d’une criminelle nazie. Mais outre les déportés juifs, les déportés politiques firent eux aussi entendre leurs voix, au moyen de différents genres littéraires, allant de l’autobiographie à la fiction ; les reportages sur le ghetto de Varsovie ou les romans sur la rafle du ghetto de Rome ont eux aussi contribué à insérer la Shoah dans la mémoire culturelle italienne. Il nous semble important de revenir sur ces thèmes aujourd’hui, au moment où la vérité historique est mise en doute par le racisme et par les artifices rhétoriques de la « post-vérité ». Al di là del successo tardivo di Primo Levi, la testimonianza letteraria in Italia sull’esperienza della Shoah o della deportazione è stata condotta da un numero significativo di uomini e donne. Le testimonianze iniziarono fin dal 1945 e alcune di queste sono dovute a donne straniere che assunsero l’italiano come lingua per narrare l’esperienza dei Lager e che hanno insistito sugli aspetti della deformazione del corpo, del cibo, del rapporto con la madre e del rifiuto della maternità. Non mancano le narrazioni di bambini nascosti per farli scampare alla cattura e alla morte; o esperienze uniche di chi, come Luce d’Eramo, volle provare volontariamente la vita dei Lager, o, come Helga Schneider, ha scoperto di essere figlia di una criminale nazista. Ma oltre allo sterminio degli ebrei anche i deportati politici fecero sentire la loro voce, con generi letterari diversi, dall’autobiografia alla fiction; e anche i reportages dal ghetto di Varsavia o i romanzi sulla retata nel ghetto di Roma hanno contribuito a inserire la Shoah nella memoria culturale italiana. Ci sembra importante tornare su questi temi nei nostri tempi, quando la verità storica viene messa in dubbio dal razzismo e dagli artifici retorici della post-verità. Beyond Primo Levi’s well-known contributions on the topic, a significant number of other men and women have provided a literary testimony from Italy on the experience of the Holocaust and the Deportation. Beginning in 1945, a number of these testimonies were narrated by women from other countries who chose Italian as the language to recount the experience of the Lager. These women insisted on treating topics like the deformation of the body, food, their relationships with their mothers and the refusal of motherhood. We also have narratives from individuals who, as children, were secretly hidden in order to save their lives. Unique stories, like that of Luce d’Eramo, who purposely chose to experience the horrors of life in an extermination camp, or Helga Schneider, who discovered she was the daughter of a Nazi war criminal, can also be found amongst these narratives. Beyond autobiography, different literary genres, including fiction, were used by political deportees to shed light on their experiences, while the reportages from the Warsaw ghetto and the novels on the round-up in the Rome ghetto also contributed to introduce the Holocaust into the Italian cultural memory. It seems important to come back to these topics in this day and age when historical truth is being questioned by racism and post-truth rhetoric