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

Radio in polifonia

La radio come media anticrisi alla luce della rivoluzione mediatica del web. Uno studio basato su interviste e analisi dei dati secondari.The radio as a media anti crisis in light of web revolution. A study based on interviews and analysis of secondary data

La cittadinanza verso la dimensione digitale

Con l’avvento della dimensione 2.0 nell’arena mediatica digitale, il web si diventa nuovo spazio libero di socializzazione e condivisione di idee. In contraddizione con un’epoca che privilegia atteggiamenti individualistici e relazioni sociali sempre più deboli e superficiali , la rete Internet sfrutta la sua caratteristica naturale di generare network, per creare punti d’incontro virtuali. Spazi, non fisici ma cloud, in cui è possibile avviare dialoghi e scambi culturali.With the advent of dimension 2.0 in the digital media arena, the web becomes a new space for socialization and sharing of ideas. In contradiction to an era that favors individual attitudes and social relations more and more weak and superficial, the Internet takes advantage of its natural characteristic of generate network, to create virtual meeting places. Spaces, non-physical but cloud, where you can start dialogues and cultural exchanges

Airway management by i-gel for open tracheal resection and reconstruction via combined cervicotomy and sternotomy surgical approach. A case report

Surgical resection and tracheal reconstruction are the most effective treatment options for airway stenosis. Tracheal surgery is challenging and requires a multidisciplinary approach and a highly specialized team of anesthesiologists and thoracic surgeons that are "sharing the airways". Several airway management tools, different devices, and various approaches can be required to ensure ventilation and gas exchange. We describe the case of a patient affected by tight tracheal stenosis, submitted to tracheal resection and reconstruction via combined cervicotomy and sternotomy surgical approach. Airway management was successfully performed by i-gel® (Intersurgical, UK) supraglottic device

Tropical storm impact in Central America

In this study of tropical storm impacts in Central America, the relationship between physical variables (available in 'real time') and damage is explored, and a simple tool for early approximate evaluation of the impact is developed. Land track and energy dissipation appear as the most interesting parameters that modulate the hurricane impact. Because of the difficulty of attaching a monetary estimate to the damage caused in a large number of cases (as is required in a statistical approach), an 'Impact Index' based on the logarithm of casualties is introduced. Thereafter, within a subset of events in which damage in monetary terms is known, a rough link between damage and the Impact Index is derived. Shortly after a new event, as soon as land track and energy dissipation are known, either by means of an empirical equation or using a contour graph, the Impact Index may be determined. Another empirical equation allows a rough estimate of damage in monetary units, but because this estimate is based on a limited number of cases, it must be treated with caution. The methodology is tested for a small set of independent cases. Vulnerability to tropical cyclones depends not only on natural factors but also on sociopolitical conditions. A coupled sociological and environmental approach is believed to be the best way to improve the early impact estimate methodology