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FILTRATION FRACTION IN PATIENTS WITH UNILATERAL KIDNEY-DISEASE AND ARTERIAL-HYPERTENSION
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Reply to Ribera Montés et al
No full textReply to Ribera Montés et al.
Sir—We have read with interest the letter of Ribera Montés et al. [1]. In response to the authors' comments on our article [2], we note that, in contrast with recent observations [3] (but not with older studies [4]), the frequency of asymptomatic bacteriuria (ASB) was similar in women with and without diabetes, as was found in our study. In addition, a significantly higher mean level of glycosyilated hemoglobin (HbA1c) was demonstrated in women with type 2 diabetes who had ASB, compared with women with diabetes who did not have ASB [2]. With regard to the HbA1c confidence interval, the differences between the groups mean values and upper, and lower confidence intervals (P < .05) were 0.7, 1.4, and 0.005, respectively.
The authors of the letter [1] reported a prevalence of ASB of 25.6% in their cohort of women with type 2 diabetes using the criterion of 2 consecutive positive urine culture results. This rate of ASB is much higher than that reported in other studies that used the same criterion in defining ASB [5] and is higher than the rate observed in our study [2], in which a single positive result of a urine culture of a clean-voided midstrem urine sample was used. This difference could be explained by hypothesizing additional risk factors for ASB in the population in the study by Ribera Montés' et al. [1]—for example, how many women with indwelling bladder catheter or recent vesical catheterization were included in their study?
Regarding the metabolic control of disease in the women with diabetes in our study, we state that ∼50% of our patients had HbA1c values of ⩽8.5%. In 1997, when we started the study, an HbA1c value of 7%–8.5% had been suggested as the ideal realistic therapeutic window [6]. The method we used for HbA1c assay was high-performance liquid chromatography (HPLC); the authors of the letter [1] have not indicated whether they used the same method or an immunological method. Some discrepancies have been reported in the HbA1c assay using immunological and HPLC methods [7].
In addition, we note that recently, according to the American Diabetic Association [8], a preprandial plasma glucose level of 90–130 mg/dL has been recommended. These values are slightly lower than those found in our diabetic women. Furthermore, in our study [2], microalbuminuria and an increased plasma fibrinogen level (a well-known marker of inflammation) were not demonstrated as risk factors for ASB. Pyuria did occur at a similar rate in bacteriuric women with and without diabetes.
We confirm that, in our cohort of 176 women with type 2 diabetes, there was a significant association between an increase in the HbA1c level and the risk of developing ASB. We agree with Ribera Montés et al. [1] that it is difficult to compare the results of different reported studies, because patients included in the studies may be very heterogeneous. For this reason, studies are in progress in our laboratory to identify further risk factors for ASB, in addition to the role played by the degree of metabolic control of diabetes
Epidemiological and clinical features of 139 patients with tuberculosis at a teaching hospital in Italy (Pisa, 1996-2000)
No full textIn order to describe epidemiologic and clinical features of patients with tuberculosis (TB) identified recently in the hospital of Pisa (Tuscany, Italy), a retrospective study of all cases of TB notified to the Local Public Health Service during January 1996-December 2000 was performed. The diagnosis of TB was made following the criteria of the WHO. A total of 139 patients affected by TB were identified. Diagnosis was microbiologically proved in 81 patients. Mean age was 53.8+/-20.5 S.D. yrs. Thirty-five (25.2%) patients were extra European community citizens (mostly from Africa). The incidence of TB (N/100.000) was 8.4 in 1996 and 6.8 in 2000. Sixty-eight point three per cent of patients had pulmonary TB, 24.5% extrapulmonary and 7.2% mixed TB. The rate of extrapulmonary TB was 15.9% and 39.2% in the 1996-98 and in the 1999-2000 periods, respectively (p = 0.002). Extrapulmonary TB was more frequent in extra European community citizens (42.8%) than in Italian ones (18.3%), p = 0.003. Seven patients were presenting also advanced HIV infection. Microscopic examination for acid fast bacilli in sputum or bronchial secretion resulted negative in 17.4% of proved pulmonary TB (positive culture for Mycobacterium tuberculosis). The chest x-rays showed pleural effusion in 19 patients. Pulmonary cavitation was documented in 15 patients with negative chest x-rays. Fever was not present in 42.4% of the patients at the moment of diagnosis. Three point eight percent of the isolated strains of M. tuberculosis were in vitro multidrug-resistant. The data presented showed an important rate of TB in Pisa. We have yet to understand if the decreased rate observed in 2000 represents a new trend as reported in other North American and European countries. The rate of extrapulmonary TB shows a trend to increase accordingly to recent literature. The isolation rate of multidrug-resistant strains of M. tuberculosis in Pisa seems to be similar to the rates reported in other areas of Europ
Going Beyond Counting First Authors in Author Co-citation Analysis
Full text linkThe present study examines one of the fundamental aspects of author co-citation analysis (ACA) - the way co-citation
counts are defined. Co-citation counting provides the data on which all subsequent statistical analyses and mappings
are based, and we compare ACA results based on two different types of co-citation counting - the traditional type that
only counts the first one among a cited work's authors on the one hand and a non-traditional type that takes into
account the first 5 authors of a cited work on the other hand. Results indicate that the picture produced through this non-traditional author co-citation counting contains more coherent author groups and is therefore considerably clearer. However, this picture represents fewer specialties in the research field being studied than that produced through the traditional first-author co-citation counting when the same number of top-ranked authors is selected and analyzed. Reasons for these effects are discussed
Variations on the Author
Full text link“Variations on the Author” discusses two of Eduardo Coutinho’s recent films (Um Dia na Vida, from 2010, and Últimas Conversas, posthumously released in 2015) and their contribution to the general question of documentary authorship. The director’s filmography is characterized by a consistent yet self-effacing form of authorial self-inscription: Coutinho often features as an interviewer that rather than express opinions propels discourses; an interviewer that is good at listening. This mode of self-inscription characterizes him as an author who is not expressive but who is nonetheless markedly present on the screen. In Um Dia na Vida, however, Coutinho is completely absent form the image, while Últimas Conversas, on the contrary, includes a confessional prologue that moves the director from the margins to the center of his films. This article examines the ways in which these works stand out in the filmography of a director who offers new insights into the notion of cinematic authorship
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