Association between age at disease onset of anti-neutrophil cytoplasmic antibody-associated vasculitis and clinical presentation and short-term outcomes

Objectives: ANCA-associated vasculitis (AAV) can affect all age groups. We aimed to show that differences in disease presentation and 6 month outcome between younger- A nd older-onset patients are still incompletely understood. Methods: We included patients enrolled in the Diagnostic and Classification Criteria for Primary Systemic Vasculitis (DCVAS) study between October 2010 and January 2017 with a diagnosis of AAV. We divided the population according to age at diagnosis: <65 years or ≥65 years. We adjusted associations for the type of AAV and the type of ANCA (anti-MPO, anti-PR3 or negative). Results: A total of 1338 patients with AAV were included: 66% had disease onset at <65 years of age [female 50%; mean age 48.4 years (s.d. 12.6)] and 34% had disease onset at ≥65 years [female 54%; mean age 73.6 years (s.d. 6)]. ANCA (MPO) positivity was more frequent in the older group (48% vs 27%; P = 0.001). Younger patients had higher rates of musculoskeletal, cutaneous and ENT manifestations compared with older patients. Systemic, neurologic,cardiovascular involvement and worsening renal function were more frequent in the older-onset group. Damage accrual, measured with the Vasculitis Damage Index (VDI), was significantly higher in older patients, 12% of whom had a 6 month VDI ≥5, compared with 7% of younger patients (P = 0.01). Older age was an independent risk factor for early death within 6 months from diagnosis [hazard ratio 2.06 (95% CI 1.07, 3.97); P = 0.03]. Conclusion: Within 6 months of diagnosis of AAV, patients >65 years of age display a different pattern of organ involvement and an increased risk of significant damage and mortality compared with younger patients

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

Effects of the degree of undercooling on flow induced crystallization in polymer melts

This study investigates the coupled effects of mild shear flow and temperature on the crystallization behavior of two thermoplastic polymers, namely, an isotactic polypropylene and an isotactic poly(1-butene). Rheological experiments are used to measure the crystallization induction time under isothermal, steady shear flow conditions. The experimental results clearly show the effects of the degree of undercooling on flow-induced crystallization (FIC). As temperature decreases, the corresponding increase in chain orientation at a given shear rate leads to an absolutely faster crystallization. At the same time, however, a temperature decrease makes the flow-induced driving force to crystallization relatively less influent with respect to the intrinsic kinetics. A FIC model based on the Doi–Edwards microrheological theory is shown to successfully describe the quantitative details of the observed experimental behavior

Effects of the degree of undercooling on flow induced crystallization in polymer melts

This study investigates the coupled effects of mild shear flow and temperature on the crystallization behavior of two thermoplasticpolymers, namely, an isotactic polypropylene and an isotactic poly(1-butene). Rheological experiments are used to measure thecrystallization induction time under isothermal, steady shear flow conditions. The experimental results clearly show the effects of the degreeof undercooling on flow-induced crystallization (FIC). As temperature decreases, the corresponding increase in chain orientation at a givenshear rate leads to an absolutely faster crystallization. At the same time, however, a temperature decrease makes the flow-induced drivingforce to crystallization relatively less influent with respect to the intrinsic kinetics. A FIC model based on the Doi–Edwards microrheologicaltheory is shown to successfully describe the quantitative details of the observed experimental behavior

Effects of the degree of undercooling on flow induced crystallization in polymer melts

This study investigates the coupled effects of mild shear flow and temperature on the crystallization behavior of two thermoplasticpolymers, namely, an isotactic polypropylene and an isotactic poly(1-butene). Rheological experiments are used to measure thecrystallization induction time under isothermal, steady shear flow conditions. The experimental results clearly show the effects of the degreeof undercooling on flow-induced crystallization (FIC). As temperature decreases, the corresponding increase in chain orientation at a givenshear rate leads to an absolutely faster crystallization. At the same time, however, a temperature decrease makes the flow-induced drivingforce to crystallization relatively less influent with respect to the intrinsic kinetics. A FIC model based on the Doi–Edwards microrheologicaltheory is shown to successfully describe the quantitative details of the observed experimental behavior

Correlazioni tra alterazioni del ciclo mestruale e pratica sportiva: nostra esperienza

L’obiettivo di questo studio è stato quello di valutare l’influenza di una intensa attività fisica sui disordini del ciclo mestruale. Abbiamo selezionato 108 atlete dedite a diversi sport e ne abbiamo raccolto l’anamnesi medica e ginecologica ed i dati riguardanti la loro attività sportiva. Successivamente abbiamo confrontato questi dati con quelli raccolti in una popolazione di 144 donne che non avevano mai praticato attività sportiva e che hanno costituito il gruppo di controllo. Si è osservato che se le atlete iniziano un’intensa attività fisica prima del menarca possono avere un ritardo dell’inizio delle mestruazioni. Inoltre fra le atlete è maggiore l’incidenza dell’amenorrea secondaria rispetto al gruppo controllo. Un importante beneficio dell’attività sportiva è stato invece riscontrato nei confronti della dismenorrea. Le conclusioni del nostro studio supportano l’ipotesi che un buon peso corporeo sia importante per l’inizio e la regolarità della funzione mestruale