Stoke Prevention in Diabetes

Diabetes and ischemic stroke are common disorders that often arise together. Diabetics are at 1.5 to three times the risk of stroke compared with the general population and the associated mortality and morbidity is greater than in those without this underlying condition. Importantly, the relation between disturbed glucose metabolism and cerebrovascular disease is not restricted to acute ischemic stroke. Diabetes is also associated with more insidious ischaemic damage to the brain, mainly manifesting as small-vessel disease and increased risk of cognitive decline and dementia. This paper shows the epidemiologic relationships of stroke in type 2 diabetes and suggest that rigorous assessment and treatment of associated risk factors can substantially reduce the risk of stroke in patients with diabetes

Report on Non-fatal events cardio-cerebro-vascular to ten years in a Southern Italy cohort

Background: Data relating to non-fatal cardiovascular events are poor but these data are essential to organize targeted interventions on the territory and to understand their effectiveness. Methods: We calculated the rates of morbidity from cardiovascular events covering the period 1998/99 - 2008/09, in a cohort of 1200 persons (600 men and 600 women) aged 25 to 74 years. Data were standardized using the European standard population. Results: The incidence of events to ten years of nonfatal myocardial infarction was 2,2% in men and of 1,8% in women. PCI interventions to ten year have been 3,3% in men and 3,4% in women, the interventions of aorto-coronary bypass have been 2,4% and 0,5% for men and women respectively. While all major cardiovascular events have been more frequent in men, in women there was a higher incidence of stroke (1,6% vs 0,9%). Conclusion: Although by comparison with other European countries Italy is among the countries considered at low-risk of coronary heart disease, in Campania cardiovascular diseases reach higher rates than the rest of the country. Our results are in keeping with the literature data and confirm that cardiovascular diseases are a major public health problem. Local analysis are useful in providing additional information for planning prevention interventions targeted to its own territory

Methodology used in studies reporting chronic kidney disease prevalence: a systematic literature review

Background Many publications report the prevalence of chronic kidney disease (CKD) in the general population. Comparisons across studies are hampered as CKD prevalence estimations are influenced by study population characteristics and laboratory methods. Methods For this systematic review, two researchers independently searched PubMed, MEDLINE and EMBASE to identify all original research articles that were published between 1 January 2003 and 1 November 2014 reporting the prevalence of CKD in the European adult general population. Data on study methodology and reporting of CKD prevalence results were independently extracted by two researchers. Results We identified 82 eligible publications and included 48 publications of individual studies for the data extraction. There was considerable variation in population sample selection. The majority of studies did not report the sampling frame used, and the response ranged from 10 to 87%. With regard to the assessment of kidney function, 67% used a Jaffe assay, whereas 13% used the enzymatic assay for creatinine determination. Isotope dilution mass spectrometry calibration was used in 29%. The CKD-EPI (52%) and MDRD (75%) equations were most often used to estimate glomerular filtration rate (GFR). CKD was defined as estimated GFR (eGFR) <60 mL/min/1.73 m2 in 92% of studies. Urinary markers of CKD were assessed in 60% of the studies. CKD prevalence was reported by sex and age strata in 54 and 50% of the studies, respectively. In publications with a primary objective of reporting CKD prevalence, 39% reported a 95% confidence interval. Conclusions The findings from this systematic review showed considerable variation in methods for sampling the general population and assessment of kidney function across studies reporting CKD prevalence. These results are utilized to provide recommendations to help optimize both the design and the reporting of future CKD prevalence studies, which will enhance comparability of study result