RESUMEN
To develop models to estimate nitrogen (N) losses of children on chronic peritoneal dialysis (CPD) from easily measurable indexes and laboratory tests, we measured the N content and all nitrogenous compounds in dialysate (D), urine (U), and feces over 3 days in 19 pediatric patients on CPD. Total measured N losses (TNm) were 5.56+/-2.26 g/day (69.9+/-11.1% in dialysate, 16.3+/-10.6% in urine, and 13.6+/-4.6% in feces). Correlation coefficients between measured dialysate and urinary N losses and the single nitrogenous compounds indicated values of over 0.9 only for urea in dialysate and urine; fecal N losses correlated well with body surface area (BSA). Taking into account these correlations, we developed a univariate additive model and three multivariate models to predict total estimated N losses (TNe). The best prediction of TNm was obtained with model 3, which considered not only urea output in dialysate and urine but also dialysate protein loss and BSA: TNe (g/day)=0.03+/-1.138 UN urea+0.99 DN urea+1.18 BSA+0.965 DN protein. A confirmatory analysis performed on a second group of 23 pediatric patients on CPD, using all four models, showed a higher percentage of studies with a relative difference between TNm and TNe less than 10% for model 3 than for the other models. Thus, N losses of pediatric patients on CPD can be estimated from measured urea and protein losses in dialysate and urea loss in urine, together with BSA.
Asunto(s)
Modelos Biológicos , Nitrógeno/metabolismo , Diálisis Peritoneal/efectos adversos , Adolescente , Análisis de Varianza , Superficie Corporal , Niño , Preescolar , Creatinina/metabolismo , Heces/química , Humanos , Nitrógeno/orina , Diálisis Peritoneal Ambulatoria Continua , Reproducibilidad de los ResultadosRESUMEN
BACKGROUND: The goals of the present report are to assess the differences in distribution of traditional coronary risk factors in a work setting, aimed at identifying specific groups at risk and to compare mean values of such risk factors and of an overall risk score of the entire working sample with the results observed in the third WHO-MONICA population survey carried out in northern Italy (Area Brianza). METHODS: In the SEMM study 7872 employees (2601 men and 5271 women) were enrolled between 1992 and 1996. The third MONICA survey in Brianza was carried out on an age- and gender-stratified random sample of 831 men and 884 women in 1993-1994, selected from the 25-64-year-old residents of five municipalities, representative of the study population. In both studies coronary risk factors were measured according to the MONICA protocol, adopting standardized methods. RESULTS: In comparison with the MONICA population sample, the entire working group showed lower mean levels of blood pressure and total cholesterol, higher prevalence of current cigarette smokers and lower mean levels of HDL cholesterol, in both gender groups. Prevalence of overweight subjects was higher among men in the working group, but the opposite pattern was detected in women. The overall risk score, calculated using the coefficients of a proportional hazard survival equation estimated in a large collaborative Italian follow-up study, resulted lower in the working sample, in both gender groups. This result may be attributed to a selection bias known in occupational epidemiology as "healthy worker effect". In contrast to this finding, the prevalence of smokers, in particular among women, was higher in the employed sample, indicating that working stress conditions may play some role. CONCLUSIONS: In order to extend the assessment of cardiovascular risk factors as well as prevention activities in work settings, some advantages are highlighted: the high participation rates, the feasibility to adopt standardized protocols, and easier and cheap procedures for censoring in follow-up studies. Moreover, due to the recently adopted legislation in Italy which increases the number of working categories to be included in periodic clinical examinations, prevention activities in work settings to contrast the epidemic of widespread chronic diseases, like cardiovascular diseases, are encouraged. This will also allow for the investigation of individual variations over time of coronary risk factors.
Asunto(s)
Enfermedad Coronaria/diagnóstico , Enfermedades Profesionales/diagnóstico , Vigilancia de la Población , Adulto , Distribución por Edad , Distribución de Chi-Cuadrado , Enfermedad Coronaria/epidemiología , Enfermedad Coronaria/prevención & control , Femenino , Humanos , Italia/epidemiología , Estilo de Vida , Masculino , Persona de Mediana Edad , Enfermedades Profesionales/epidemiología , Enfermedades Profesionales/prevención & control , Prevalencia , Modelos de Riesgos Proporcionales , Factores de Riesgo , Distribución por SexoRESUMEN
OBJECTIVES: To review the epidemiological evidence on risk factors for urinary incontinence (UI) in women. METHODS: Using Medline and a manual search we identified the main papers published in English up to 1998. RESULTS: There is consistent evidence that the frequency of UI increases with age, but there is little information on the frequency of different types of UI in different age groups. With regard to other risk factors, there is a clinical consensus that vaginal delivery and, more in general, obstetric traumas are associated with UI, although epidemiological studies are not always consistent. Less defined is the role of race, menopausal status, history of gynecological surgery, body mass index, smoking, and coffee and alcohol consumption on the risk of UI. CONCLUSION: In the coming years, epidemiological research should focus particularly on the potential differences in the epidemiological characteristics of different types of UI in order to gain insight into the pathogenic mechanisms.
Asunto(s)
Incontinencia Urinaria/epidemiología , Adolescente , Adulto , Distribución por Edad , Anciano , Anciano de 80 o más Años , Índice de Masa Corporal , Terapia de Reemplazo de Estrógeno , Femenino , Humanos , Menopausia , Persona de Mediana Edad , Complicaciones Posoperatorias/epidemiología , Factores de Riesgo , Factores Sexuales , Incontinencia Urinaria/etiología , Infecciones Urinarias/complicacionesRESUMEN
Two questionnaires were administered to evaluate stress risk factors in 1652 employees of the Milan Town Council (772 Social Service personnel and 880 administrative staff). The study was focused on cardiovascular diseases. The Mopsy questionnaire is a selection of scales selected by the World Health Organization for international multicenter studies on cardiovascular morbidity, while the Mood Scale of Kjellberg & Iwanowski (1989) is a brief scale translated from Swedish used to measure "actual" stress and arousal state in neurotoxicology. The aim of the present study was to validate the Italian version of the Mood Scale for its possible use in health surveillance and research on stress and arousal changes at work. Appropriate statistical data analyses were applied to study the construct validity (factor analysis), concurrent validity (correlations with the Mopsy scale) and internal consistency (Cronbach alpha). The data confirm the Swedish results on the Mood Scale factor analysis. A good face and construct validity and a good internal consistency were observed. Nevertheless, the Mood Scale does not allow collection of demographic, anamnestic and personal data as does the Mopsy questionnaire.