Search

Aims: Diabetic retinopathy remains asymptomatic until its late stages but remains a leading cause of vision impairment and blindness. We studied quality of life and the ability to deal with the discomfort deriving from the presence of a chronic disease in patients with type 1 diabetes and different stages of retinopathy. Methods: Multicenter collaborative observational study involving nine centers screening for retinopathy in different areas of Italy. The National Eye Institute 25-item visual functioning questionnaire and the locus of control tool were administered to 449 people with type 1 diabetes between February 2016 and March 2018. Socio-demographic and clinical data were collected. Results: On multivariable analysis, severe retinopathy is associated with worse scores for general vision, ocular pain, near vision activities, distance vision activities, driving, color vision, peripheral vision and lower values of internal control, independently of visual acuity. Women had a perception of worse general health, distance vision activities and driving, and lower internal control and trust in others. Worse scores for visual-specific social functioning, visual-specific mental health, visual-specific role difficulties, visual-specific dependency and peripheral vision were associated with higher HbA1c levels. Fatalism increased with rising HbA1c levels. Conclusions: These results confirm that a gap exists between patients' knowledge and expectations on retinopathy and providers' expertise and assumptions. To bridge this gap, patient-centered education and engaging approaches may be more effective than simple information given during consultations. [ABSTRACT FROM AUTHOR]

Purpose: The evaluation of long-term heavy metal concentrations in the Gulf of Palermo (Italy) has been carried out in order to investigate how changes of pollution levels in the last 50 years can be reflected in marine sediments. Measurements of Cr, Cu, Hg, Pb, and Zn concentrations were performed on dated fractions of a sediment core. Time series analysis has allowed to obtain information on the chronology of the heavy metal pollution of the area and to identify seasonal components and trends. Materials and methods: Heavy metal concentrations in the <63 μm fraction of core sections were obtained by Atomic Absorption Spectrophotometry, after wet sieving, drying, and digestion procedures. Dating of sediment core had been previously achieved by excess Pb method. A methodological approach based on the time series analysis was used in order to investigate the presence of heavy metal cyclic variations and to outline the trend of each pollutant. A spectral analysis was performed on concentration data to investigate the presence of seasonal components. The additive component model, widely used to estimate seasonal and long-term behavior, was chosen for the time series analysis. R statistical software and advanced toolkits have been used. Results and discussion: Sediment core has been found to provide information for years from 1959 to 2004. Time series analysis results showed the presence of statistically significant cycles, of about 10.3, 7.2, and 4.8 years. Seasonal components of heavy metals concentrations and well known cycles have been compared. In particular, correlations with seasonal components of Sun Spot Number Cycle, Multivariate ENSO Index, and Winter North Atlantic Oscillation Index have been investigated. Moreover, the presence of trends in heavy metal concentration data has been highlighted. Conclusions: Time series analysis on the concentrations of heavy metals from a dated sediment core sampled in the Palermo Gulf (Italy) has been carried out. Cyclical pattern over a time of about 50 years have been identified thanks to spectral analysis. Statistically significant cycles have been detected, showing how metal concentrations in sediments also depend on natural cycles. Seasonal and trend components have been extracted, through time series decomposition by the LOESS procedures. Seasonal components of our data and of natural cycles show a good agreement in terms of series correlations. Sediment core, on a local scale and with good reliability, records the dynamics of heavy metal pollution of the area, also allowing comparisons on a much larger scale. [ABSTRACT FROM AUTHOR]

Two cases of impaired Dacron arterial graft incorporation are reported. They were characterized by the presence of an inflammatory reaction with periprosthetic collection rich in cells but with no detectable germs. The patients also showed total lack of systemic symptoms, including humoral signs of altered immune response, and the tendency of well-tolerated external discharge from the collection. Based on these data and on the body's behavior towards a small fragment of the same type of alloplastic material implanted subcutaneously in the forearm of one of these patients, this phenomenon has been interpreted as an intolerance to the graft material, similar to a generic foreign body reaction rather than an immunologic reaction. We think it is extremely important to differentiate this kind of aseptic graft intolerance from graft infections before deciding on adequate treatment. Moreover, our experience and that of other similar cases, collected from the literature, led us to suspect that many cases that are labeled as low-grade infections could not really be infections. The results reported here justify the need to distinguish between infections and intolerance to the graft material. [ABSTRACT FROM AUTHOR]