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Biomedical subjects

C Lagazio

Publications and source records attributed to C Lagazio.

12 recordsLinked to original sources

Mitochondrial DNA restriction enzyme analysis and evaluation of the enological characteristics of Saccharomyces cerevisiae strains isolated from grapes of the wine-producing area of Collio (Italy).

A total of 70 strains of Saccharomyces cerevisiae were isolated from different grapes from the Collio Region. Chemical parameters and mitochondrial DNA (mtDNA) restriction patterns were determined. Higher alcohols were the main parameter useful for differentiating between strains, whereas the mtDNA analysis demonstrated a high genetic variability between strains. A weak correlation was observed when the dendrograms obtained from the chemical and genetic results were compared.

DNA, Mitochondrial↗

Anthropometric features in infants of mothers with gestational diabetes: relationship with treatment modalities.

We compared the effects of two treatment strategies (diet alone versus a combination of insulin and diet) on neonatal anthropometric measurements and the outcome of a full-term white infant sample born to mothers with gestational diabetes mellitus (GDM). Study subjects included 217 consecutive nonrandomized women with GDM with term singleton pregnancies. Insulin therapy was administered on the basis of anamnestic and maternal-fetal criteria. One hundred and twenty-one patients (group 1) received a combination of insulin and diet, and 96 (group 2) underwent diet alone. All 1,052 white patients with term singleton pregnancies without GDM, screened at the same time as the study group, formed the control group. The incidence of large-for-gestational-age (LGA) infants was significantly higher in group 2 (18.8%) compared with group 1 (9.9%) and the control group (8.3%). Male and female infants born to diabetic mothers of group 2 had significantly greater mean birth weights, ponderal indices, thoracic circumferences, weight/length ratios and significantly smaller mean cranial/thoracic circumference ratios than male and female infants in group 1 and the control group (p < 0.05, Scheffe test). Treatment of GDM mothers with insulin and diet has been shown to be able not only to normalize the incidence of LGA infants but also to influence the anthropometric characteristics of the infants born to these mothers to such an extent that they showed no significant differences compared to infants born to non-diabetic mothers.

Adult↗

Anthropometric characteristics of full-term infants: effects of varying degrees of "normal" glucose metabolism.

Aim of this study was to examine the maternal-neonatal outcome and the neonatal anthropometric characteristics of a full-term mother-infant pairs group with a positive oral glucose challenge test (GCT) without gestational diabetes mellitus (GDM). Our study involved 1615 white women with singleton pregnancies who underwent universal screening for GDM in two periods of pregnancy. This population was divided into three groups according to GCT results: 1) 172 patients with abnormal GCT in both periods; 2) 391 patient with normal GCT in the early period and abnormal GCT in the late period; 3) 1052 patients with normal GCT in both periods (control group). The incidence of LGA (large for gestational age) infants was higher in Group (40.7%) and Group 2 (22.0%) respect to control group (8.3%) (p < 0.00001 and p < 0.0001 respectively) and was significantly different in the two groups (p < 0.0008). Comparison among the three groups of LGA infants showed the following results: male and female newborns of Group I were heavier than those of Group 2 and of the control group, while males and females of the control group had significantly greater length and cranial circumference means. A significant decrease in ponderal index, choracic circumference, weight/length ratio means could be seen as well as a significative increase in cranial/thoracic circumference ratio means from Group I to the control group. These data confirm the involvement of fetal development in terms of weight and anthropometric characteristics in the presence of alterations in maternal glucose metabolism which are not currently classified as gestational diabetes.

Adult↗

Risk factors for fetal macrosomia: the importance of a positive oral glucose challenge test.

OBJECTIVE: The aim of this study was to investigate whether minor abnormalities of glucose metabolism without gestational diabetes are a risk factor for fetal overgrowth. DESIGN: A sample of 1883 unselected white mother-infant pairs were screened for gestational diabetes using a 50 g 1-h oral glucose challenge test (GCT) in two periods of pregnancy: early (16-20 weeks) and late (26-30 weeks). METHODS: The effects of risk factors (glucose metabolism, previous history of mothers, obesity, multiparity and age of mothers) were estimated using a multinomial logit model. RESULTS: The level of risk was related to gestational age at the appearance of an abnormal GCT. Patients with an abnormal GCT in the early and late periods of pregnancy (Group 1) had a risk of delivering a large for gestational age (LGA) infant seven times higher than the control group (normal GCT in both periods), and patients with a normal GCT in the early period and an abnormal GCT in the late period (Group 2) showed a risk three times higher than the control group. Among the historical risk factors for LGA infants, such as maternal obesity, multiparity, previous gestational diabetes and previous delivery of an infant weighing 4000 g or more, only the latter was associated with fetal overgrowth with a risk level 4.7 higher than the control group. Group 1 patients had a significantly higher incidence of pregnancy-induced hypertension and preterm birth. There were no differences in the frequency of 5-min Apgar score < 7 and metabolic complications among the infants of all groups. We found a significantly higher rate of shoulder dystocia in Group 1 infants than in infants in the other groups. CONCLUSIONS: Our results suggest that a positive GCT at 26-30 weeks is the most important risk factor for fetal overgrowth. This result was strongly enforced in patients who had also shown a positive early GCT at 16-20 weeks.

Blood Glucose↗

Air pollution and lung cancer in Trieste, Italy: spatial analysis of risk as a function of distance from sources.

To investigate the relationship between four sources of environmental pollution (shipyard, iron foundry, incinerator, and city center) and lung cancer risk, we conducted a case-control study of decreased men in Trieste, Italy. We identified 755 cases of lung cancer and 755 controls through the local autopsy registry. Information on smoking habits, occupational history, and place of residence were obtained from the subject's next of kin. The case-control design was used to properly account for subject-specific confounders, which represent a major problem in geographical analysis. Spatial models were used to evaluate the effect of sources of pollution on lung cancer after adjustment for age, smoking habits, likelihood of exposure to occupational carcinogens, and levels of air particulate. The models are based on distance from the sources and enable estimation of the risk gradient and directional effects separately for each source. The risk of lung cancer was highly related to the city center (p = 0.0243), with an excess relative risk at zero distance of 2.2 and a smooth decrease moving away from the source (-0.015), and related to the incinerator (p = 0.0098), with an excess relative risk of 6.7 in the source and a very steep decrease (-0.176). These results are consistent with findings of previous analyses and provide further evidence that air pollution is a moderate risk factor of lung cancer.

Air Pollutants↗

[The assessment of disease risk in the proximity of a source of environmental pollution: a review].

An increasingly common public health problem is the perception that disease incidence has increased or a cluster of disease has occurred in a community. In most cases, a local factor (e.g. the location of a nuclear installation) is hypothesized to be associated with the disease. The paper presents a review of the main statistical methods used to assess disease risk near a putative source of environmental pollution. Both techniques based on counts in area units (e.g. administrative units) and case-control studies are considered.

Environmental Monitoring↗

[Case-control studies to assess relative risk in proximity of putative sources of environmental pollution].

This paper discusses the analysis of the disease risk as function of distance from prespecified exposure sources. Instead of the usual ecological framework, the proposed model is based on individual data and includes the major individual risks factors as covariates. The risk due to environmental exposure is modelled using excess relative risk as effect measure, while the effect of individual risk factors is modelled using relative risk. A case-control design is proposed to fit this model and to obtain effect estimates.

Case-Control Studies↗

[Comparison of epidemiologic methods in a case-control study of lung cancer and air pollution in Trieste, Italy].

To investigate the relationship between air pollution and histologic type of lung cancer we conducted a case-control study among deceased men in Trieste, Italy. 755 cases of lung cancer and 755 controls were identified through the local autopsy registry. Information on smoking habits, occupation and place of residence was obtained from the subject's next-of-kin. Air pollution at the residence of each subject was estimated from the average value of total particulate at the nearest monitoring station. Spatial models and logistic regression were used to evaluate the effect of residence and air pollution on LC after adjustment for age, smoking habits, likelihood of exposure to occupational carcinogens and social group. The risk of lung cancer increased with increasing level of air pollution for all types of lung cancer combined (P = 0.022), for small cell carcinoma (P = 0.016) and for large cell carcinoma (P = 0.049). Compared with inhabitants of the residential area, residents of the rural area had a relative risk (RR) of 0.6 (95% confidence interval (CI): 0.4-1.0). The RR was 1.5 (1.0-2.2) for residents of the center of the city and 1.4 (1.0-2.1) for residents of the industrial area. In the center of the city the excess risk was almost completely restricted to small cell carcinoma (RR = 2.0) and to large cell carcinoma (RR = 2.6). In the industrial area the risk was increased especially for adenocarcinoma (RR = 2.1). These results provide evidence that air pollution is a moderate risk factor for certain histologic types of lung cancer.

Adenocarcinoma↗

Non-parametric maximum likelihood estimators for disease mapping.

A Non-Parametric Maximum Likelihood approach to the estimation of relative risks in the context of disease mapping is discussed and a NPML approximation to conditional autoregressive models is proposed. NPML estimates have been compared to other proposed solutions (Maximum Likelihood via Monte Carlo Scoring, Hierarchical Bayesian models) using real examples. Overall, the NPML autoregressive estimates (with weighted term) were closer to the Bayesian estimates. The exchangeable NPML model ranked immediately after, even if it implied a greater shrinkage, while the truncated auto-Poisson showed inadequate for disease mapping. The coefficients of the autoregressive term for the different mixtures have clear interpretations: in the breast cancer example, the larger cities in the region showed high rates and very low correlation with the neighbouring areas, while the less populated rural areas with low rates were strongly positively correlated each other. This pattern is expected since breast cancer is strongly correlated with parity and age at first birth, and the female population of the rural areas experienced a decline in fertility much later than those living in the larger cities. The leukemia example highlighted the failure of the Poisson-Gamma model and other general overdispersion tests to detect high risk areas under specific conditions. The NPML approach in Aitkin is very general, simple and flexible. However the user should be warned against the possibility of local maxima and the difficulty in detecting the optimal number of components. Special software (such as CAMAN or DismapWin) had been developed and should be recommended mainly to not experienced users.

Algorithms↗

Exploratory tools for disease mapping in geographical epidemiology.

In the present paper a new shrinkage estimator of relative risk, useful in disease mapping, is compared with the empirical and full Bayes estimators, using death certificate data for lung cancer (males and females) and breast cancer (females) 1982-1988 in the Emilia-Romagna region (Italy). The estimates are obtained averaging the relative risks obtained from recursive partitioning of the set of observed values. The number of partitions is fixed in advance and behaves as a smoothing parameter, the lower the number the higher the degree of shrinkage toward the overall mean of the observed values.

Algorithms↗

[Trends in mortality from primary pleural tumor and incidence of pleural mesothelioma in Italy: a particularly serious situation].

We present: a) an analysis of the past mortality from Primary Pleural Tumors (PPT) occurred in Italy between 1968 and 1992 by an age-cohort-period model, using a Poisson regression model, estimating the risk of dying by birth cohort, the Lifetime Cumulative risk (25-84 years) by birth cohort, the risk by calendar period and testing the full model (age-cohort-period effects); b) a summary of the incidence of mesothelioma as recorded in Italy by Cancer Registries and Mesothelioma Registries. The highest Lifetime Cumulative Risk of dying from TTP is recorded for the birth cohort 1946-'50 (6.2 per thousand among males, 1.64 among females). Whereas the risk by birth cohort becomes flat among females born after 1936, among males the risk is increasing up to the youngest birth cohorts. By calendar period, the highest risk of dying is observed in the last period (1991-'92). The inclusion in the full model of the calendar period term increases significantly the goodness-of-fit of the model among females, but not among males. The highest incidence of mesothelioma in both genders registered by 150 Cancer Registries all over the world is currently recorded among the population of Genoa and Trieste, where large ship-building plants are located. Even higher incidence mesothelioma rates have been recently recorded in other areas of Italy. The trend in PPT mortality in Italy could have been influenced, but not explained, by the increased awareness over time of the disease, but it fits well with the pattern occurring in most industrialized countries of western Europe, with the unprotected industrial use of asbestos which occurred in Italy, and also with the gender characteristics of the work-force employed in asbestos-exposing activities. A ban of asbestos use has been introduced in Italy in 1992. However, considering that asbestos seems to act as an initiator for mesothelioma, the trend in male mortality for PPT will not peak until two or three decades.

Adult↗