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

Tecniche di Analisi Spazio-temporali e matematico-statistiche per la valutazione di reti di monitoraggio delle acque sotterranee e relativa ottimizzazione: un caso di studio

This study has the aim of comparing critically the two groundwater monitoring networks located in Modena plain (Central Italy), in order to assess their consistency and to give suggestions to perform the monitoring. The data set used, related to water table elevation and nitrate concentration referred to spring and autumn sampling seasons throughout a 7 years period (1990-1996). The temporal behaviour shows a tight increase of values for parameters; the two networks appear consistent for water table elevation the contrary they seems to measure different situations for nitrates. A geostatistical approach of the problem has allowed observing that both the variables are stationary within a distance of about 20 km, so it has been possible to reconstruct and to map the spatial variability by ordinary kriging. Multivariate statistical analysis techniques have been applied to a suitable data set: only in the case of water table elevation the wells of the existing networks have been easily grouped in two homogeneous clusters; factor analysis has suggested the most representative sampling points for each cluster. Another criterion, based on nitrates pollution degree, was applied for choosing some wells on which make more frequent samplings

Un'indagine per la razionalizzazione delle reti di monitoraggio delle acque sotterranee nella pianura modenese

La comparazione critica di due reti di monitoraggio delle acque sotterranee, attive nella pianura modenese nel periodo 1990-96, ha permesso di ricostruire e mappare la variabilità spaziale della piezometria e del contenuto in nitrati mediante un approccio geostatisico ed applicando tecniche di analisi multivariata. I risultati dell'indagine hanno consentito di individuare alcuni pozzi sui quali intensificare le misure

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

Valutazione speditiva del rischio di contaminazione di falde acquifere mediante modelli matematici interattivi

Consiglio Nazionale delle Ricerche - Biblioteca Centrale -. P.le Aldo Moro, 7, Rome / CNR - Consiglio Nazionale delle RichercheSIGLEITItal

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