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95% CI, 1.11 to 1.82), and recurrent urinary tract infections (OR, 1.63; 95% CI, 1.10 to
2.42) were all associated with serum creatinine testing. Conversely, use of either nonste-
roidal anti-inflammatory drugs (OR, 1.03; 95% CI, 0.89 to 1.21) or aminoglycosides or
contrast media (OR, 0.78; 95% CI, 0.54 to 1.14) was not associated with serum creatinine
testing. In the subgroup with serum creatinine data, the age-adjusted prevalence of CKD
was 9.33% (11.93% in women, 6.49% in men). However, in patients with eGFR less
than 60 mL/min/1.73 m(2), serum creatinine values were apparently normal (<1.2 mg/dL
in women, <1.4 mg/dL in men) in 54%, and GPs used ICD-9-CM codes for CKD in only
15.2%. Referral to nephrologists ranged from 4.9% for patients with eGFR of 59 to 30
mL/min/1.73 m(2) to 55.7% for those with eGFR less than 30 mL/min/1.73 m(2). LIMITA-
TIONS: The prevalence of decreased kidney function may be overestimated because of the
more frequent serum creatinine testing in sicker individuals and lack of creatinine calibra-
tion. CONCLUSIONS: In primary care, CKD stages 3 to 5 are frequent, but its awareness
is scarce because of limited rates of serum creatinine testing and difficulty recognizing
decreased eGFR in the absence of increased serum creatinine testing.
17. Mazzaglia G, Yurgin N, Boye KS, Trifirņ G, Cottrell S, Allen E, Filippi A, Medea G, Cricelli
C. Prevalence and antihyperglycemic prescribing trends for patients with type 2
diabetes in Italy: A 4-year retrospective study from national primary care data.

Pharmacol Res. 2008;57:358-363.
ABSTRACT. To estimate the prevalence of type 2 diabetes in Italy and to investiga-
te patient-related variables associated with the use of different antihyperglycemic
therapies. This study was conducted between the years 2000-2003 from a source
population comprising a cumulative sample of 394,719 patients from 320 General
Practitioners across Italy, who provide information to the Health Search/Thales Data-
base (HSD). A total sample of 23,729 of patients with type 2 diabetes age 15 years or
older was selected from the source population. During the study years, the prevalence
of type 2 diabetes increased from 4.7 to 6.0%. A significant increase in the use of
antihyperglycemic therapy was also observed between 2000 and 2003. In particular,
the use of biguanides increased. During the same period, the use of sulfonylurea
monotherapy, oral combination therapy and insulin with oral combination therapy
decreased. The results from the multivariate analysis revealed that healthier patients
were more likely to be prescribed biguanide and sulfonylurea monotherapy, whereas
patients with more diabetes complications and poorer glycemic control were more
likely to be prescribed oral combination therapy or insulin (monotherapy or combina-
tion therapy). In conclusion, the study results appear to suggest that the prescribing
patterns of Italian GPs and the predictors of different antihyperglycemic drug use are
consistent with recent scientific evidence.
18. Sacchetti E, Trifirņ G, Caputi A, Turrina C, Spina E, Cricelli C, Brignoli O, Sessa E, Mazzaglia
G. Risk of stroke with typical and atypical anti-psychotics: a retrospective cohort
study including unexposed subjects
. J Psychopharmacol. 2008;22:39-46.
ABSTRACT. The purpose of the study was to investigate the risk of stroke with typical
and atypical anti-psychotics in elderly subjects, weighting for a number of known risk
factors, including dementia. Data were retrospectively drawn from the primary care
setting from the Health Search Database, which stores information on about 1.5% of
the total Italian population served by general practitioners. All elderly patients (65+
years) prescribed an anti-psychotic in monotherapy from January 2000 to June 2003
were selected for the study. A cohort of patients not exposed to anti-psychotics was
taken from the same database. Subjects who had previously had a stroke were exclu-
ded. The main outcome measure was the incidence of first-ever stroke during exposure