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Notes: Background : The epidemiology and clinical significance of occult hepatitis B virus infection (serum hepatitis B surface antigen-negative patients with detectable hepatitis B virus viraemia in serum) remains controversial with only limited information about its prevalence in patients on long-term dialysis.Aim : To address the epidemiology of occult HBV infection in a large cohort of dialysis patients.Methods : We screened a large cohort (n = 585) of Italian chronic dialysis patients; from this population, a group of hepatitis B virus surface antigen seronegative patients (n = 213) was tested by Amplicor hepatitis B virus Monitor Test to detect hepatitis B virus viraemia (hepatitis B virus-DNA) in serum.Results : Occult hepatitis B virus infection was absent (zero of 213 = 0%). Persistent hepatitis B virus surface antigen carriage was less frequent than anti-hepatitis B virus core antibody (anti-hepatitis B core antigen) seropositive status in this study group [1.88% (11 of 585) vs. 36% (216 of 585), P = 0.0001]. No dialysis patients seropositive for anti-hepatitis B core antibody in serum (zero of 123 = 0%) had detectable hepatitis B virus-DNA by polymerase chain reaction technology. No significant association between abnormal biochemical liver tests and serum anti-hepatitis B core antibody was noted in our population. Nominal logistic regression analysis demonstrated an independent and significant relationship between anti-HCV antibody and anti-hepatitis B virus core antibody in serum (Wald chi-square 16.06, P = 0.0001). The rate of seropositive patients for anti-hepatitis B virus core antibody was higher among study patients than controls with normal renal function [36.9% (216 of 585) vs. 21.4% (59 of 275), P = 0.0001]; this difference partially persisted after correction for demographic parameters, and viral markers.Conclusion : In conclusion, occult hepatitis B virus was absent in our study group. Anti-hepatitis B core antibody was significantly related to presence of anti-HCV antibody supporting shared modes of transmission. Clinical studies based on molecular biology techniques provided with higher sensitivity are planned.

Notes: A link between hepatitis C virus infection and development of diabetes mellitus has been suggested by many investigators; however, this remains controversial.The mechanisms underlying the association between hepatitis C virus and diabetes mellitus are unclear but a great majority of clinical surveys have found a significant and independent relationship between hepatitis C virus and diabetes mellitus after renal transplantation and orthotopic liver transplantation.We have systematically reviewed the scientific literature to explore the association between hepatitis C virus and diabetes mellitus in end-stage renal disease; in addition, data on patients undergoing orthotopic liver transplantation were also analysed. The unadjusted odds ratio for developing post-transplant diabetes mellitus in hepatitis C virus-infected renal transplant recipients ranged between 1.58 and 16.5 across the published studies. The rate of anti-hepatitis C virus antibody in serum was higher among dialysis patients having diabetes mellitus (odds ratio 9.9; 95% confidence interval 2.663–32.924). Patients with type-2 diabetes-related glomerulonephritis had the highest anti-hepatitis C virus prevalence [19.5% (24/123) vs. 3.2% (73/2247); P 〈 0.001] in a large cohort of Japanese patients who underwent renal biopsy. The link between hepatitis C virus and diabetes mellitus may explain, in part, the detrimental role of hepatitis C virus on patient and graft survival after orthotopic liver transplantation and/or renal transplantation.Preliminary evidence suggests that anti-viral therapies prior to renal transplantation and novel immunosuppressive regimens may lower the occurrence of diabetes mellitus in hepatitis C virus-infected patients after renal transplantation. Clinical trials are under way to assess if the hepatitis C virus-linked predisposition to new onset diabetes mellitus after renal transplantation may be reduced by newer immunosuppressive medications.

Notes: Abstract This paper is based on the findings of a survey on technological innovation in the Italian industry. All Italian manufacturing firms were screened in the analysis and, at the end of a screening process, 8,220 of them, which had introduced relevant technological innovations over the period 1981–1985, filled out either a mail questionnaire or were covered through a personal interview. Data and preliminary comments on the following problem-areas are set in the paper: type of innovation introduced in the firm (product, process), impact of innovations on the firm's products and sales, cost of innovation, technological relevance of innovations introduced, impact of innovations on the utilization of input factors, factors linked to the introduction of innovation, performance of R & D. Data show that technological innovation is a complex aspect of company life; it relates to both products and production processes: in more than half of the cases firms introduced both product and process innovations, whereas only products or processes were introduced in about 20 per cent of cases, respectively. It is also apparent that the majority of innovations are new only for the firm, and that only a limited share are new for the sector or for the country. Looking at the techno-scientific “quality” of the innovations introduced, quite often innovations were classified as technical improvements or enhancements, and in a very limited number of cases they were considered as applications of a scientific breakthrough. The breakdown of the innovation costs shows that, on average, more than half of the cost is attributed to investment (machinery, equipment, etc) one fourth to engineering and design activity, one fifth to R & D and the remaining 5 per cent to marketing activities. The most important factor linked to the introduction of innovation appears to be the acquisition of plant and machinery. This confirms the result of previous analyses which show that the introduction of new technologies hinges upon new machinery and equipment, often the sole means for the acquisition of technology produced by other economic agents — a diffusion and adaptation process is occurring. R & D was mentioned in a limited number of cases. In the paper a quantitative and qualitative analysis of the R & D performed by the firm is reported. In particular, it is shown that the number of R & D performing manufacturing firms is more than double that which emerges from the annual survey on research and development activities carried out by the Italian Central Statistical Office.