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

Antonio degli Albizzi and Lutheran Propaganda in Early Seventeenth-Century Italy

In the early 1610s, some Italian Lutheran propaganda came to the attention of the Holy Office. Such propaganda is an anomaly for the period, and questions the current scholarship on the topic. Via the bibliographic study of pamphlets previously neglected or unknown, this article investigates this activity, mostly attributing it to Antonio degli Albizzi (1547–1627), sometime secretary to the Cardinal of Austria. This curious case elucidates the longevity of interest in Lutheranism in the Italian peninsula, and, even if in the mind of just one man, the belief that seventeenth-century Italians could still turn to Protestantism.</jats:p

Flussometro primario per la misura di piccole portate di gas con riferimento alla pressione atmosferica

Alcuni prodotti devono garantire una certa ermeticità e quindi devono essere sottoposti ad un controllo che consiste nella misurazione del flusso di gas in ingresso o uscita attraverso possibili cricche, porosità, microfessure. Tra le diverse metodologie applicabili per la ricerca delle perdite, alcune sono molto semplici e permettono analisi qualitative, mentre altre, più sofisticate, consentono di quantificare la perdita. È comunque necessario disporre di rivelatori tarati in grado di misurare il flusso di gas. Le fughe di riferimento, componenti essenziali per la taratura dei rivelatori, sono in genere capillari in acciaio e generano un flusso di gas quando ai lori estremi vi è una differenza di pressione. Per garantire la corretta riferibilità delle fughe di riferimento l’INRIM ha progettato e realizzato un flussometro, campione primario per la misura di portate di gas < 1x10-4 Pa m3/s con riferimento alla pressione atmosferica. Recentemente è stato progettato e realizzato un sistema di controllo termico attivo al fine di migliorare l’accuratezza del flussometro ed estendere il limite inferiore di misura. Le modifiche apportate hanno portato tale limite a 1x10-6 P am3/s con incertezza estesa inferiore al 3%

Description of six cases of child cauda equina leptomeningitis: an emerging disease

Child cauda equina leptomeningitis (CCEL) is a typical clinical example of aseptic meningitis with patterns of an emerging disease, and it affects children aged 2-9. Here we will describe six cases of CCEL. After the prodromes, all children underwent an acute phase with hypoasthenia of the lower limbs, hyporeflexia, staggering and ataxia with steppage. Only in one case there were generalized fits and coma of grade 1-2 too. All children underwent a spinal magnetic resonance imaging (MRI), proving pathologic enhancement of cauda equina and conus medullaris leptomeningitis. At the same time, MRI made possible the differential diagnosis between cauda equina leptomeningitis and isolated minor forms of Guillain-Barre syndrome involving the lower limbs. Three hypotheses will be formulated for understanding the pathogen mechanism(s) of CCEL. The first one is based on the presence of an immediate viral damage on the meninges, the second one, the more likely, contemplates the occurrence of an immunomediated mechanism in a host genetically prone to react in an abnormal way from an immune viewpoint. The third hyphotesis consists in a two-time damage: an early immediate damage from the virus, and a later immunomediated reactio

A case of aneurysm on a persistent hypoglossal artery treated by endovascular coiling

We describe a 22-year-old woman admitted to hospital in emergency with nuchal headache and vomiting. CT scan disclosed subarachnoid hemorrhage. Digital subtraction angiography with three-dimensional rotational acquisitions showed a ruptured aneurysm of a right persistent primitive hypoglossal artery as the cause of symptoms and hemorrhage. The patient was successfully treated with endovascular coiling of the aneurysm. This is the second literature report describing endovascular treatment in this unusual condition