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Biomedical subjects

E Negri

Publications and source records attributed to E Negri.

At least 325 records · Page 18Linked to original sources
PubMed1994

Height and the risk of acute myocardial infarction in Italian women.

The relationship between body height and risk of acute myocardial infarction (AMI) was investigated in a case-control study conducted in Northern Italy on 429 women with AMI under age 75 and 863 controls in hospital for acute conditions, unrelated to known or potential risk factors for coronary heart disease. Compared to women in the highest tertile of height, the relative risks (RR) adjusted for age were 1.1 (95% confidence interval, CI, 0.9-1.5) for the intermediate tertile, and 1.3 (95% Cl 1.0-1.8) for the lowest tertile. The trend in risk was significant (chi 1(2) = 3.89, P = 0.05). Adjustment for several potential confounding variables, including age, body mass index, education, smoking habits, family history of AMI, history of diabetes, hypertension and hyperlipidaemia did not materially modify these estimates: the RR for the highest vs the lowest tertile was 1.4 (95% CI 1.0-1.0). The association was stronger in elderly women, i.e. in earlier generations, and in heavier ones. This positive association is discussed in terms of socio-economic conditions, since low stature may be related to poor living conditions and unfavourable environmental factors in childhood and adolescence among earlier generations of Italian women.

Adolescent↗
PubMed1994

Predictors of nonfatal reinfarction in survivors of myocardial infarction after thrombolysis. Results of the Gruppo Italiano per lo Studio della Sopravvivenza nell'Infarto Miocardico (GISSI-2) Data Base.

OBJECTIVES: This study was designed to reassess the prediction of recurrent nonfatal myocardial infarction in patients recovering from acute myocardial infarction after thrombolysis. BACKGROUND: Recurrent nonfatal myocardial infarction is a strong and independent predictor of subsequent mortality. Current knowledge of risk factors for nonfatal reinfarction is still largely based on data gathered before the advent of thrombolysis. Thus, this prospective study was planned to identify harbinger of nonfatal reinfarction in the postinfarction patients of the multicenter Grouppo Italiano per lo Studio della Sopravvivenza nell'Infarto Miocardico (GISSI-2) trial. METHODS: Predictors of nonfatal reinfarction at 6 months were analyzed by multivariate technique (Cox model) in 8,907 GISSI-2 survivors of myocardial infarction with clinical follow-up, relying on a set of prespecified variables reflecting residual ischemia, left ventricular failure or dysfunction, complex ventricular arrhythmias, comorbidity as well as demographic and historical factors. RESULTS: The postdischarge to 6-month incidence rate of nonfatal reinfarction was 2.5%. Independent predictors of nonfatal reinfarction were cardiac ineligibility for exercise test (relative risk 2.97, 95% confidence interval [CI] 1.98 to 4.45), previous myocardial infarction (relative risk 1.70, 95% CI 1.22 to 2.36) and angina at follow-up (relative risk 1.50, 95% CI 1.10 to 2.04). On further multivariate analysis, performed in 6,580 patients with both echocardiographic and electrocardiographic monitoring data available, a history of angina emerged as an additional risk predictor (relative risk 1.58, 95% CI 1.10 to 2.25). CONCLUSIONS: The 6-month incidence of nonfatal reinfarction is rather low in survivors of myocardial infarction after thrombolysis. Cardiac ineligibility for exercise testing and a history of coronary artery disease are risk predictors. Recurrent nonfatal infarction is not predictable by qualitative variables reflecting residual ischemia, except by postdischarge angina. Prediction of nonfatal reinfarction appears less accurate than prediction of mortality, as almost 50% of reinfarctions occur in patients without any of the identified risk factors.

Analysis of Variance↗
PubMed1994

Trends in cancer mortality in young adults in Europe, 1955-1989.

Trends in mortality in the age group 20-44 years for the 16 most common cancers or groups of cancer in young adults are presented for 24 European countries (i.e. those with > or = 1,000,000 inhabitants). The largest (up to 9-fold) and most frequent increases were recorded for cancer of the mouth and pharynx (> or = 2-fold increase from 1955-1959 to 1985-1989 in 10 countries), and oesophagus (in eight countries) in males, and for cancer of the skin, chiefly of melanomatous type, in males and females (in nine and eight countries, respectively). Consistent declines were observed for cancer of the stomach and uterus (chiefly, cervix), and for Hodgkin's disease, most notably in northern European countries. Little change emerged in the last 30 years or so in young adult mortality rates for cancer of the colon-rectum, pancreas, non-Hodgkin's lymphoma, leukaemias and cancers of the breast and ovaries in women. More than 2-fold elevations in lung cancer mortality rates in men aged 20-44 years were found only in a few previously non-market economy countries, and in Spain and Portugal. In some northern European countries, favourable downward trends in young males were accompanied by more than 2-fold increases in lung cancer mortality rates in young women. Overall, total cancer mortality rates in women at aged 20-44 years have declined over the last 35 years by more than 20% in 12 countries, and have not increased anywhere. Total cancer mortality rates in young males showed similar decreases in nine northern European countries, but increases of the same magnitude were also observed in most formerly non-market economy countries, and in Spain and Portugal.

Adult↗
PubMed1994

Age at starting smoking and number of cigarettes smoked.

A cross-sectional analysis of a sample of 3235 males and 2513 females included in a structured framework of case-control studies of various neoplasms conducted in northern Italy assessed the relationship between age at starting smoking and amount of cigarettes smoked per day. Age-standardized proportions of light, moderate, and heavy smokers and mean numbers of cigarettes smoked per day according to age at starting, together with age- and sex-adjusted odds ratios of being a heavy smoker were computed. Age at starting smoking was strongly associated with the number of cigarettes smoked per day. This relationship was evident in men and women and at younger and elderly ages, although in women the mean numbers of cigarettes smoked was lower than in men, and age at starting was a stronger predictor of subsequent heavy smoking in people younger than 55 years than in the elderly. Among males who had started smoking before age 17, 64% smoked less than 25 cigarettes/d and 37% smoked 25 or more cigarettes; corresponding proportions were 73% and 27% among those who had started at age 30 or later. Age-standardized mean number of cigarettes smoked per day by men who started before age 17 was 23.5, compared to 20.0 for those who started at age 30 or later. Corresponding values for women were 16.8 and 10.5. Compared to those who started smoking at age 30 or later, the odds ratios of smoking more than 25 cigarettes/d for those who started before age 17 were 2.2 (95% confidence interval (CI), 1.6 to 3.0) for men and 5.4 (95% CI, 3.0 to 9.6) for women.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗
PubMed1994

Worldwide patterns and trends in mortality from liver cirrhosis, 1955 to 1990.

Trends in mortality rates for liver cirrhosis between 1955 and 1990 have been analyzed for 38 countries (two from North America, six from Latin America, five from Asia, 23 from Europe, and Australia and New Zealand) on the basis of official death certification data derived from the World Health Organization database. Chile and Mexico had exceedingly high rates (around 60/100,000 males and 15/100,000 females in the late 1980s), while in Canada, the United States, and Latin American countries that provided data, cirrhosis death rates were between 5 and 17/100,000 males and 3 and 5/100,000 females over the same calendar period. The pattern of trends was, however, similar in all American countries, with some increase between the 1950s and the 1970s, and declines thereafter. A similar trend was observed in Japanese males, whose rate was 13.6 in 1990. Conversely, cirrhosis mortality declined steadily from 8.0 to 4.6 in Japanese females. Appreciable downward trends were observed in Hong Kong and Singapore, whereas mortality increased in Thailand. In Europe, in the late 1950s, the highest rates were registered in Portugal (33.6/100,000 males and 14.6/100,000 females), followed by France (31.8/100,000 males and 14.1/100,000 females), Austria, Italy, Spain, and Germany. Most of these countries, however, after some further rise up to the 1970s, showed reversal of the trends over most recent years. Thus, in the late 1980s or early 1990s, only Austria, Italy, and Portugal had cirrhosis mortality around 30/100,000 males and 10/100,000 females. Britain, Ireland, and Nordic countries started from much lower values (2 to 4/100,000 males), but showed some, although discontinuous, upward trend.(ABSTRACT TRUNCATED AT 250 WORDS)

Female↗
PubMed1994

A case-control study of diabetes mellitus and cancer risk.

The relationship between diabetes mellitus and cancer risk was investigated using data from an integrated series of case-control studies conducted in Northern Italy between 1983 and 1992. Cases were 9,991 patients with incident, histologically confirmed neoplasms below age 75, including 181 cancers of the oral cavity and pharynx, 316 of the oesophagus, 723 of the stomach, 828 of the colon, 498 of the rectum, 320 of the liver, 58 of the gall bladder, 362 of the pancreas, 242 of the larynx, 3,415 of the breast, 726 of the endometrium, 971 of the ovary, 125 of the prostate, 431 of the bladder, 187 of the kidney, 208 of the thyroid, 80 Hodgkin's lymphomas, 200 non-Hodgkin's lymphomas and 120 multiple myelomas. Controls were 7,834 subjects in hospital for acute, non-neoplastic, non-metabolic, non-hormone-related disorders. A history of diabetes was reported by 5.1% of male and 5.4% of female controls. Significantly elevated relative risks (RRs) among subjects with diabetes were observed for cancers of the liver [RR = 2.8, 95% confidence interval (CI) 2.0-3.9], pancreas (RR = 2.1, 95% CI 1.5-2.9) and endometrium (RR 3.4, 95% CI 2.7-4.3). After allowance for obesity and education as well as age and sex, the RRs were 3.0 for liver, 2.3 for pancreas, and 2.8 for endometrium. Diabetic subjects had no elevated risk for any of the other cancer sites considered. For liver and endometrial cancer the RRs remained elevated up to 10 years after diagnosis of diabetes (RR 2.6 and 2.0 respectively), while the RR for pancreatic cancer declined from 3.2 in the first 5 years after diagnosis of diabetes to 2.3 from 5 to 9 years and to 1.3 (95% CI 0.7-2.3) 10 or more years since diagnosis. This suggests that the relationship between diabetes mellitus and liver and endometrial cancer is probably real, while that with pancreatic cancer is compatible with diabetes being an early symptom of the disease, or at least of preneoplastic lesions.

Age Factors↗
PubMed1994

Selected micronutrient intake and the risk of colorectal cancer.

The relationship between estimated intake of selected micronutrients and the risk of colorectal cancer was analysed using data from a case-control study conducted in northern Italy. The study was based on 828 patients with colon cancer, 498 with rectal cancer and 2,024 controls in hospital for acute, non-neoplastic, non-digestive tract diseases. Relative risks (RRs) of intake quintiles were computed after allowance for age, sex and other major potential confounding factors, including an estimate of total energy intake. No apparent trend in risk across intake quintiles was evident for retinol, vitamin D, methionine and calcium. For beta-carotene, ascorbic acid, vitamin E and folate there was a trend of a protective effect with increasing consumption: the RR for the highest versus the lowest quintile was 0.32 for beta-carotene, 0.40 for ascorbic acid, 0.60 for vitamin E and 0.52 for folate. These inverse associations were similar for colon and rectal cancer, and consistent across strata of sex and age. When simultaneous allowance was made for all these micronutrients, besides other covariates, the only persistent protective effects were for beta-carotene (RR = 0.38 for the highest quintile) and ascorbic acid (RR = 0.52). Whether this reflects a specific, or stronger, effect of these micronutrients, rather than problems of collinearity between micronutrients or other limitations of the data, remains open to discussion. Still, this study suggests that specific micronutrients may exert an independent protective effect against colorectal carcinogenesis.

Adult↗
PubMed1994

Fertility drugs and risk of epithelial ovarian cancer in Italy.

The report of an increase of ovarian cancer risk among women who had used fertility drugs prompted us to analyse the relationship between fertility drugs and ovarian cancer in a case-control study which has been ongoing in four areas of Italy since 1992. The present analysis is based on 195 epithelial ovarian cancer cases and 1339 controls admitted to hospital for diseases other than gynaecological or malignant conditions. Fewer ovarian cancer cases than controls reported use of fertility drugs (odds ratio, after allowance for potential confounding factors: 0.7, 95% confidence interval: 0.2-3.3). Among nulligravid women, 5/177 control women compared with 0/36 cancer cases reported having ever used fertility drugs. Although only based on small numbers of women who were suffering from ovarian cancer and who had also used fertility drugs, the present study indicated that a role of ovarian stimulation in the aetiology of epithelial ovarian cancer is not established, although it is worth investigating.

Adolescent↗
PubMed1994

AIDS incidence rates in Europe and the United States.

OBJECTIVE: To facilitate the quantitative comparison of AIDS incidence statistics between countries and with other diseases using statistics based on age-standardized incidence rates instead of absolute number of cases. DESIGN: AIDS incidence rates for 19 countries belonging to the World Health Organization (WHO) European region, and for comparative purposes, the United States. METHODS: Incidence rates were standardized using the world standard population for all ages, from 1985 to 1992. The data were derived from the WHO European Non-Aggregate AIDS Dataset and the Centers for Disease Control and Prevention (CDC) AIDS Public Information Dataset, adjusted for reporting delays in each country. RESULTS: The AIDS incidence rate for men (81 in 1,000,000) in the United States was fourfold higher than the highest rate in a European country (Switzerland) in 1985; incidence rates in all other European countries, except France and Denmark, were below 10 in 1,000,000. Subsequently, AIDS incidence has increased more rapidly in southern Europe than in the rest of the continent. The estimated incidence rate for men in Spain (243 in 1,000,000) approached that in the United States (304 in 1,000,000) in 1992, and three additional countries (France, Switzerland and Italy) showed rates above 100 per million. The spread of the AIDS epidemic among women in some southern European countries was faster than in the United States. In Switzerland and Spain the standardized incidence rates in women were higher than in the United States by 1988 and 1992, respectively. CONCLUSIONS: Analysis trends in incidence rates avoids some weaknesses of AIDS statistics based on absolute numbers, and should become one of the standard tools for AIDS surveillance.

Acquired Immunodeficiency Syndrome↗
PubMed1994

Comparison of cancer mortality trends in major European areas, 1960-89.

In the prospect of a political and economic 'harmonization' of the European Economic Community (EEC) and, possibly, all Europe, the identification of differences in cancer frequencies and trends in major European areas (ie EEC, non-EEC western countries, and eastern European countries) can help to set health priorities. From 1960-64 to 1985-89 all-age mortality rates of some common cancers (mouth or pharynx, pancreas, lung, kidney, prostate and skin) increased substantially especially in East Europe. Conversely, mortality rates from cancer of the stomach, uterus, testis and from Hodgkin's disease declined, but, again, trends in East Europe were less favourable. Some elevations in rare malignancies (non-Hodgkin's lymphomas, multiple myeloma and connective and soft-tissue sarcomas) emerged rather uniformly in Europe, especially in elderly people. Most favourable trends in total cancer mortality were apparent among females in the EEC (minus 7%) and non-EEC western countries (minus 14%). The picture becomes gradually less favourable with respect to non-EEC western European males and eastern European females (virtually no change) and EEC males (plus 13%). With a 25% increase in total cancer mortality rates in the past 30 years, males in East Europe emerge as the 'problem' group. The even wider gap between West and East Europe in cancer rates in young males leaves no hope for future improvements in the absence of effective interventions. Raising public awareness (especially with respect to smoking and alcohol consumption), and increasing motivation and quality controls among health professionals are badly needed in disadvantaged European areas.

Adult↗
PubMed1994

Coffee consumption and risk of non-Hodgkin's lymphoma.

There is no adequate information on the carcinogenicity of coffee and, specifically, on a potential association of coffee drinking with non-Hodgkin's lymphoma. Consumption of coffee and other methylxanthine-containing beverages has been researched in a case-control study conducted in northern Italy. A total of 429 cases of incident histologically confirmed non-Hodgkin's lymphoma and 1,157 controls in hospital for acute, non-neoplastic, non-immunological, non-digestive tract diseases were interviewed during their hospital stay. Relative risk (RR) estimates and their 95% confidence intervals (CI), according to consumption of coffee and other methylxanthine-containing beverages, were derived from multiple logistic regression equations including terms for age, sex, study centre, body mass index, alcohol and smoking status. Compared with non-drinkers, the RR was 1.2 (95% CI, 0.8-1.7) for coffee drinkers. No trend in risk emerged with number of cups of coffee consumed/day (RR = 1.1 for one and three cups; RR = 1.2 for two; or RR = 0.9 for four cups/day), or duration of coffee intake (RR = 1.2 for less than 20 years; RR = 1.3 for 21-30 years; and RR = 1.1 for more than 30 years). Similarly, no significant association was observed with consumption of decaffeinated coffee (RR = 0.9) or tea (RR = 1.2). Consumption of cola was associated with a borderline risk (RR = 1.7; 95% CI 1.0-2.7). We found no association between non-Hodgkin's lymphoma and consumption of regular or decaffeinated coffee and tea.

Adolescent↗
PubMed1994

The application of different correlation coefficients to assess the reproducibility of a food frequency questionnaire.

We computed four different correlation coefficients to investigate the degree of reproducibility of the weekly consumption of 77 food items or groups of foods and of seven summary questions from a food frequency questionnaire developed in Italy for a case-control study on cancers of the breast and digestive tract. The questionnaire had been administered twice to 452 Italian men and women. These included Pearson correlation coefficients (a) using the weekly frequencies of consumption without any transformation (P1); (b) after applying the transformation log (x + 1) (P2); (c) after applying the transformation log (x + 0.01) (P3); and (d) the Spearman correlation coefficient (SP). The mean values were 0.55 for P1, 0.59 for P2, 0.56 for P3 and 0.59 for SP. All coefficients were positively correlated, although to variable extents: the Spearman correlation coefficient between P2 and SP was 0.92, and that between P1 and P3 was 0.53. Differences between the four coefficients were more marked for food items with a lower kappa statistic and lower intraclass correlation, ie for those items with more severe reproducibility problems. Thus, a single correlation coefficient may not be enough to detect zones of the distribution of a food item where misclassification problems are more severe. The correlation coefficients used to investigate reproducibility should therefore be chosen on the basis of subsequent data analyses.

Feeding Behavior↗
PubMed1994

Acute myocardial infarction: association with time since stopping smoking in Italy. GISSI-EFRIM Investigators. Gruppo Italiano per lo Studio della Sopravvivenza nell'Infarto. Epidemiologia dei Fattori di Rischio dell'Infarto Miocardico.

STUDY OBJECTIVE: The study aimed to investigate the relationship between years since stopping smoking and the risk of acute myocardial infarction. DESIGN: This was a hospital based, multicentre, case-control study conducted in Italy between September 1988 and June 1989 within the framework of the GISSI-2 clinical trial. SETTING: Over 80 coronary care units in various Italian regions participated. SUBJECTS: A total of 916 incident cases of acute myocardial infarction, below age 75 years, and with no history of ischaemic heart disease, and 1106 control subjects admitted to the same hospitals for acute, non-neoplastic, cardiovascular or cerebrovascular conditions that were not known or suspected to be related to cigarette smoking took part in the study. MAIN OUTCOME MEASURES AND RESULTS: Measures were relative risk (RR) estimates of acute myocardial infarction according to the time since stopping smoking and adjusted for identified potential confounding factors. Compared with never smokers, the multivariate RRs were 1.6 (95% confidence interval (CI) 0.8,3.2) for subjects who had given up smoking for one year; 1.4 (95% CI 0.9,2.1) for those who had stopped for two to five years; 1.2 (95% CI 0.7,2.1) for six to 10 years; and 1.1 (95% CI 0.8,1.8) for those who had not smoked for over 10 years. The estimated RR for current smokers was 2.9 (95% CI 2.2,3.9). The risks of quitters were higher for heavier smokers and those below age 50 years, while no difference emerged in relation to the duration of smoking, sex, and other risk factors for myocardial infarction. CONCLUSIONS: These results indicate that there is already a substantial drop in the risk of acute myocardial infarction one year after stopping. The risk in ex-smokers, however, seemed higher (although not significantly) than that of those who had never smoked, even more than 10 years after quitting. This could support the existence of at least two mechanisms linking cigarette smoking with acute myocardial infarction--one involving thrombogenesis or spasms that occurs over the short term, and another involving atherosclerosis that is a long term effect.

Adult↗
PubMed1994

Gastrectomy and subsequent risk of oesophageal cancer in Milan.

STUDY OBJECTIVE: To analyse quantitatively the relationship between gastrectomy and oesophageal cancer risk. DESIGN: This was a case-control study, based on a structured questionnaire that included a problem-oriented medical history. SETTING: A network of hospitals in the Greater Milan area between 1984 and 1992. SUBJECTS: Subjects were 316 incident, histologically confirmed cases of oesophageal cancer (258 males and 58 females), and 1408 controls (1031 males, 377 females), admitted to hospital for acute, non-neoplastic, non-digestive tract conditions. MEASUREMENTS AND MAIN RESULTS: Relative risks (RR) and the corresponding 95% confidence intervals (CI) adjusted for age and sex, plus area of residence, education, tobacco, and alcohol consumption. There was an association of borderline significance of oesophageal cancer with gastric ulcer (RR = 1.6), but not with duodenal ulcer (RR = 0.9). Among cases, 25 (7.9%) reported a history of gastrectomy, versus 29 (2.1%) of the controls. The corresponding multivariate RR was 3.8 (95% CI 2.0, 7.0). The RR of oesophageal cancer was significantly raised (RR = 3.6) within 20 years after gastrectomy, and the association seemed stronger with increasing time since gastrectomy (RR = 4.2). CONCLUSIONS: Since gastrectomy may cause gastric hypoacidity and favour oesophageal reflux, and hence oesophagitis, the results of this study, if confirmed, are of interest to a better understanding of the mechanisms of oesophageal carcinogenesis.

Adult↗
PubMed1994

Efficacy of placebo in the treatment of patients with amenorrhea.

Thirty-two amenorrheic patients were treated with a tablet oral placebo preparation for a period varying from 30 to 180 days. Another 24 amenorrheic patients were also treated with a placebo administered i.m. for a period varying from 30 to 120 days. As a consequence of the treatment, 27 patients (48%) had menstrual bleedings. The progestogen withdrawal test responsive patients were more responsive to placebo (73 vs. 14% in the progestogen withdrawal test nonresponsive, p < 0.001). The time lag between starting the medication and the first bleeding varied between 4 and 120 days with a mean value of 33.9 (SD 26.3). Oral placebo was more effective than the intramuscular form (56 vs. 38%, p < 0.05).

Administration, Oral↗
PubMed1994

Determinants of body mass index: a study from northern Italy.

Overweight and obesity are associated with increased mortality and morbidity, and human weight is influenced by multiple factors, both genetically and environmentally determined. We investigated the influence of some socioeconomic, behavioral, dietary and reproductive factors on body mass index (BMI). Data were obtained from a comparison group of a case-control study of gastrointestinal cancers from the four largest teaching and general hospitals in Milan, northern Italy. The subjects were 1,188 men and 832 women admitted between January 1985 and June 1992 to the hospitals under study for diseases other than malignant or digestive and not known or suspected to be related to alcohol or tobacco. The following were measured: BMI (Quetelet's index, weight, kg/height, m2) and the corresponding standard errors (s.e.) in strata of selected variables, linear regression coefficients (beta) and correlation coefficients between BMI and each variable. Mean BMI increased with age until 35-44 years in men and 45-54 years in women. In both sexes BMI was inversely associated with education and social class. Smokers tended to be leaner than non-smokers, but no consistent trend was observed with increasing numbers of cigarettes. Alcohol drinkers had mean BMI similar to non-drinkers, except heavy drinking women who were lighter. BMI was not significantly associated with coffee, decaffeinated coffee, tea, bread, vegetable and fruit consumption. No relation was observed between total estimated caloric intake and BMI. In women BMI was directly associated with marriage and number of children, and inversely with oral contraceptive use.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗
PubMed1994

Alcohol drinking and prevalence of self-reported gallstone disease in the 1983 Italian National Health Survey.

We studied the relation between alcohol drinking and gallstone disease, using data from the 1983 Italian National Health Survey. This survey included information on 58,462 adults age 25 years and over (27,912 males and 30,550 females), randomly selected within strata of geographical area, size of the municipality of residence, and size of the household. The prevalence of gallstone disease or cholecystectomy was 2.4% among males and 4.8% among females. Compared with alcohol abstainers, the relative risk of gallstone disease, controlling for age, sex, education, smoking, and body mass index, was 0.83 [95% confidence interval (CI) = 0.73-0.92] for occasional and regular moderate drinkers (< 25 ml of ethanol per day), 0.67 (95% CI = 0.59-0.77) for intermediate drinkers (25-50 ml per day), and 0.58 (95% CI = 0.47-0.70) for heavy drinkers. This inverse association was consistent across strata of age, sex, and body mass index.

Adult↗