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Biomedical subjects

E Negri

Publications and source records attributed to E Negri.

At least 505 records · Page 28Linked to original sources
PubMed1989

Risk factors for endometrioid, mucinous and serous benign ovarian cysts.

To evaluate the risk factors for serous, mucinous and endometrioid ovarian cysts, data were collected in a case-control study conducted in the greater Milan area based on 202 women with benign cysts (114 endometrioid and 88 serous or mucinous) of the ovary and 1127 controls. Questions were asked about menstrual and reproductive characteristics, marital status, education, history of various diseases, and lifetime use of oral contraceptives and other hormonal treatments. Higher social class, earlier menarche and longer interval between age at first marriage and first birth, a likely indicator of subfertility, were associated with an increased risk of serous, mucinous and endometrioid cysts. Women with endometrioid cyst were characterized by low parity, less frequent irregular or long menses, more frequent oral contraceptive use and low body mass index, while the most relevant risk factor associated with serous and mucinous cysts was greater age at first birth. The present data point out the epidemiological differences between endometrioid and serous or mucinous cysts. Further, they suggest that analyses of risk factors for epithelial ovarian cancer subdivided by various histotypes may be of interest in order to confirm possible heterogeneities in the aetiology of ovarian epithelial neoplasms.

Adult↗
PubMed1989

Socioeconomic indicators, tobacco and alcohol in the aetiology of digestive tract neoplasms.

The relationship between education, social class, smoking habits, alcohol consumption and the risk of digestive tract neoplasms was analysed in a case-control study of 50 cases of cancer of the mouth or pharynx, 209 of the oesophagus, 397 of the stomach, 455 of the colon, 295 of the rectum, 151 of the liver, 214 of the pancreas, and a total of 1944 control subjects admitted for acute, non-neoplastic or digestive tract disorders. Cancers of the mouth or pharynx, oesophagus and stomach were inversely and strongly related to education, with risk estimates ranging between 0.2 and 0.4 for the highest education categories. Significant, but weaker inverse relations were evident for rectal and liver cancer, too, whereas the risk of colon cancer was elevated among more educated individuals. There was no relationship between education and pancreatic cancer. The pattern of risk was largely comparable when the head of the household's occupation was used as indicator of social class. There were strong direct associations between cigarette (as well as pipe or cigar) smoking and cancers of the mouth or pharynx and oesophagus, and a moderate one with pancreatic cancer, but none of the other sites considered was related to smoking habits. Cancers of the mouth or pharynx and oesophagus were independently and strongly related to alcohol consumption, too, while the associations between alcohol and liver or pancreatic cancer were moderate and not significant. Cancers of the stomach, colon and rectum were unrelated to measures of alcohol consumption.

Adult↗
PubMed1989

Coffee consumption and myocardial infarction in women.

The relation between coffee consumption and the risk of acute myocardial infarction was evaluated in a hospital-based case-control study conducted in northern Italy between 1983 and 1987. The study consisted of 262 women with acute myocardial infarction and 519 controls admitted to the hospital for acute, nondigestive tract disorders. Information was obtained on the average number of cups of coffee or decaffeinated coffee consumed per day before the onset of the disease which led to hospital admission and on the total duration in years of the habit. There was a positive association between heavy coffee drinking and risk of myocardial infarction (relative risk (RR) = 2.7 for consumption of four cups or more per day). After allowance for smoking and other relevant covariates, the relative risk was not elevated for consumption of up to three cups per day, but still above unity for consumption of four or more cups per day (RR = 1.7), and the multivariate trend in risk was still significant (X1(2) = 5.14, p = 0.02). The risk estimates were grossly elevated among hyperlipidemic women (multivariate RR = 7.6 for moderate and 17.9 for heavy coffee drinkers). As a result of small absolute numbers, these estimates were largely unstable and the interaction between coffee and hyperlipidemia was not statistically significant. Such estimates, nonetheless, are of potential interest in terms of etiologic correlates and implications for prevention.

Adult↗
PubMed1989

Smoking and myocardial infarction in women: a case-control study from northern Italy.

STUDY OBJECTIVE: To examine the relationship between smoking and myocardial infarction in women. DESIGN: Case-control study over 5 years. SETTING: Cases were women admitted to 30 coronary care units in northern Italy. Controls were admitted to the same hospitals with other acute disorders. PARTICIPANTS: These were 262 young and middle aged women with acute myocardial infarction (median age 49 years, range 24-69) and 519 controls with other acute disorders unrelated to ischaemic heart disease (median age 47 years, range 22-69). MEASUREMENTS AND MAIN RESULTS: Stratification and the Mantel-Haenszel procedure, and unconditional multiple logistic regression were used to obtain relative risks according to levels of cigarette smoking. The regression equations included terms for age, education, coffee and alcohol consumption, diabetes, hypertension, hyperlipidaemia, body mass index and oral contraceptive use. Compared to life long non-smokers, relative risk was not significantly above unity for ex-smokers but among current smokers showed a significant trend to increasing risk with larger numbers of cigarettes smoked, with risk estimates of 2.3, 5.9 and 11.0 for less than 15, 15-24 and greater than or equal to 25 cigarettes per day respectively. Smoking related risks were consistently raised across strata of hyperlipidaemia, hypertension and increased alcohol and coffee intake. CONCLUSIONS: In terms of population attributable risk, about 48% of all myocardial infarctions in young and middle aged Italian women were attributable to cigarette smoking, which is therefore by far the most important preventable determinant of the disease.

Adult↗
PubMed1989

Cancer mortality in a northern Italian cohort of rubber workers.

An analysis of the mortality of a cohort of 6629 workers employed from 1906 to 1981 in a rubber tyre factory in northern Italy (978 deaths and over 133,000 man-years at risk) showed that the all cause mortality ratio was slightly lower than expected (0.91). Overall cancer mortality was close to expected (275 v 259.4) but there were significant excess rates for two cancer sites: pleura (9 observed v 0.8 expected, which may be due to the use of fibre containing talc) and bladder (16 observed v 8.8 expected). Death rates were not raised for other sites previously associated with employment in the rubber industry, such as cancers of the lung and brain, leukaemias, or lymphomas. The substantially reduced relative risk of pleural cancer among workers first employed after 1940 (RR = 0.05 compared with before 1940) probably reflected improvements in working conditions over more recent periods. For cancer of the bladder, the relative risk was also lower for workers first engaged after 1940. Thus no appreciable risk for any disease was apparent for workers employed over the past four decades. Analysis for each of the 27 job categories showed a substantial excess for cancer of the pleura in the mechanical maintenance workers (4 observed v 0.17 expected); an excess of cancer of the lung (21 v 13.48) was also present in this job category.

Adult↗
PubMed1989

Determinants of stopping cigarette smoking in Italy.

The relation between socio-demographic factors, general lifestyle habits, smoking-related variables and rates for stopping cigarette smoking was evaluated using data from the 1983 Italian National Health Survey, on the basis of a sample of 19,472 males (15,473 current and 3,999 ex-smokers) and 7,371 females (6,707 current and 664 ex-smokers), representative of the whole Italian population of smokers. Overall rates for stopping (20.5% for males and 9.0% for females) were substantially lower than those observed over comparable calendar periods in other western countries. Besides age, and after allowance for it, stopping smoking was positively associated with higher education and socio-economic status, greater body mass index and the presence of smoking-related symptoms or diseases. Further, a strong inverse association was observed with coffee consumption, and a direct one with physical leisure activity. There was an U-shaped relation between average number of cigarettes per day and stopping smoking, since rates were lower for intermediate (15 to 24 cigarettes per day) smokers, and elevated both for light and heavy smokers, probably reflecting a lower degree of addiction and a greater prevalence of smoking-related disorders, respectively. The effect of most factors was independent, and these associations with quitting rate ratios were still evident after simultaneous allowance by means of multiple logistic regression. The existence of smoking related diseases or symptoms was the most frequent reason for quitting (50.7%); 30.3% reported to have stopped because of knowledge of the health consequences of smoking, 1.3% for economic reasons and 17.6% for other or undefined reasons.(ABSTRACT TRUNCATED AT 250 WORDS)

Adolescent↗
PubMed1989

[Cigarette smoking and the risk of myocardial infarction. A case-controlled study in northern Italy].

We evaluated the relation between smoking and myocardial infarction using data from a hospital-based case-control study conducted in Northern Italy on 262 young and middle-age women with acute myocardial infarction (median age: 49 years) and 519 controls (median age: 47 years), admitted for a series of acute conditions unrelated to any of the established or potential risk factors for ischaemic heart disease. With reference to lifelong non-smokers, the multivariate relative risk was not significantly higher for ex-smokers, but rose progressively with the number of cigarettes smoked. The risk estimates were 2.3, 5.9 and 11.0 for less than 15, 15-24, greater than or equal to 25 cigarettes per day. This trend in risk was statistically significant. Smoking-related risks were similar below and above 50 years of age; they were consistently and substantially higher in various strata of other major determinants of myocardial infarction (hyperlipidaemia, hypertension) or correlated lifestyle habits (alcohol and coffee). In terms of population attributable risk, 48% of all myocardial infarction in this data could be attributed to smoking. Although myocardial infarction is less frequent in Italian women compared to Northern European or American women, our data indicate that cigarette smoking is undoubtedly its most prominent cause. This confirms, once again, the urgent need to intervene and eliminate this risk factor.

Adult↗
PubMed1989

Smoking, prevalence of disease and health service utilization among the Swiss population.

The data of the 1981-83 Swiss National Health Survey "SOMIPOPS", based on a randomly selected sample of 4,235 individuals aged 20 or over representative of the whole Swiss population, were used to investigate the relation between smoking, prevalence of disease and frequency of health care utilization. The risks of several conditions, including hypertension, myocardial infarction and other heart diseases, asthma, tuberculosis and kidney disease were elevated among ex-smokers. The diseases showing elevated risks among current smokers and significantly positive dose-risk trends included acute bronchitis (relative risk, RR = 3.2 for heavy cigarette smokers vs never smokers), chronic bronchitis or lung emphysema (RR = 2.0), gastro-duodenal ulcer (RR = 1.8) and bone fractures (RR = 1.6). For respiratory conditions, the risk of pipe or cigar smokers was comparable to that of moderate cigarette smokers, whereas for ulcer (RR = 4.1) or fractures (RR = 2.0) the point estimates were even higher than for heavy cigarette smokers. Smokers tended to consult more frequently general practitioners, used more other outpatients services, and were more frequently admitted to hospital during the year preceding the interview. These effects were consistent across strata of age, socio-economic indicators, and persisted after allowance for major identified potential distorting factors. Thus, the results of this survey confirm that smoking is an important cause of morbidity and a major contributory factor to the use of health services.

Adult↗
PubMed1988

Risk factors for hepatocellular carcinoma in northern Italy.

The role of socio-demographic factors, lifestyle habits and selected dietary factors on the risk of hepatocellular carcinoma was evaluated in a hospital-based case-control study conducted in Northern Italy on 151 patients with hepatocellular carcinoma and 1,051 controls in hospital for acute, non-neoplastic or digestive conditions, unrelated to any of the known or potential risk factors for primary liver cancer. There were significant inverse relationships with levels of education and social class (relative risk, RR = 1.9 and 2.4 for lower vs. upper categories), and positive associations with clinical history of hepatitis (RR = 3.5, 95% confidence interval = 2.0-6.0) or liver cirrhosis (RR = 15.6, 95% CI = 8.3-29.4). The relative risk was not elevated in smokers and light or moderate alcohol drinkers, but the point estimate was above unity among heavy drinkers (RR = 1.5, 95% CI = 1.0-2.4). Among 14 food items considered, including important sources of vitamin A, protein and fats in the Italian diet, 5 were inversely and significantly related to liver cancer risk. This suggests that a diet deficient in several aspects may be related to hepatocellular carcinoma.

Carcinoma, Hepatocellular↗
PubMed1988

Short term increase in risk of breast cancer after full term pregnancy.

To determine whether there is a short term increase in the risk of breast cancer after a full term birth data from two hospital based, case-control studies in Italy were pooled. Analysis was restricted to women aged under 50 with two or more children (573 women with cancer and 570 controls). A relative risk for breast cancer of 2.66 was seen in women who had given birth during the three years preceding the interview compared with women whose last birth had occurred 10 or more years before, after adjustment for age, age at first birth, and parity. The relative risk slowly decreased for women who had last given birth three to 10 years before. Multivariate analyses confirmed the protective effect of an early age at first birth and the age dependent effect of parity on the risk of breast cancer--that is, a direct relation below age 40 and an inverse one in older women. These data provide epidemiological evidence that a full term birth is followed by a transient increase in the risk of breast cancer, which for some time contrasts with and overcomes the long term protection of pregnancy at an early age. They therefore confirm predictions from animal studies and theoretical models that pregnancy prevents the early stages of breast carcinogenesis but promotes the late stages of the process.

Adult↗
PubMed1988

A case-control study of diet and colo-rectal cancer in northern Italy.

The relation between dietary factors and the risk of colorectal cancer was investigated in a case-control study conducted in Northern Italy on 339 cases of colon cancer, 236 cases of rectal cancer and 778 controls admitted to hospital for acute, non-neoplastic or digestive disorders. Consistent positive associations were observed with more frequent consumption of starchy foods (pasta or rice) (relative risk, RR = 3.0 for colon and 1.8 for rectum for highest vs. lowest tertile) and beef/veal meats (RR = 2.1 for colon, 2.3 for rectum), whereas reduced relative risks were observed in subjects reporting more frequent green vegetable consumption (RR = 0.5 for highest vs. lowest tertile), a few specific vegetable or fruit items, and coffee (RR = 0.6 for highest vs. lowest tertile). Various fats in seasonings were positively, but inconsistently, related to intestinal cancer risk, whereas no association was evident with measures of whole grain foods or alcohol intake. For both intestinal sites, a 4- to 5-fold difference in risk was evident between the extreme quintiles of a simple score obtained by algebraic sum of the 4 major groups of foods. These findings could not be explained in terms of confounding by socio-economic status or other major potential distorting factors, are in agreement with the results from previous studies of colo-rectal cancer in Southern Europe, and are consistent with various aspects of the descriptive epidemiology of intestinal cancer in Italy.

Adult↗
PubMed1988

Descriptive epidemiology of perinatal and infant mortality in various Italian geographic areas.

On the basis of the number of livebirths, stillbirths and deaths within the first year of life published annually by the Central Institute of Statistics and data on demographic, environmental variables, general indicators of health organization, and reproductive habits, the descriptive epidemiology of perinatal and infant mortality in Italy between 1955 and 1984 has been reviewed. Although a marked reduction in Italian stillbirth (from 28.4 in 1955 to 7.1/1,000 births in 1984), perinatal (from 46.2 to 14.5/1,000 births) and infant mortality rate (from 51.0 to 11.3/1,000 live births) was observed, still broad differences between geographical areas within the country remained largely unchanged in proportional terms, since perinatal and infant mortality remained substantially lower in Northern, richer areas. Strong correlation coefficients emerged between perinatal and infant mortality rates and general indicators of health care organization such as number of hospital beds/1,000 inhabitants (and less strongly with number of obstetric beds) or per capita health expenditure. If rates from Northern Italy for the year 1984 were applied to the whole of the country, over 1,000 deaths in the first year of life could be avoided.

Data Interpretation, Statistical↗
PubMed1988

The application of trend surface models to the analysis of time factors in Swiss cancer mortality.

To study different temporal components on cancer mortality (age, period and cohort) methods of graphic representation were applied to Swiss mortality data from 1950 to 1984. Maps using continuous slopes ("contour maps") and based on eight tones of grey according to the absolute distribution of rates were used to represent the surfaces defined by the matrix of various age-specific rates. Further, progressively more complex regression surface equations were defined, on the basis of two independent variables (age/cohort) and a dependent one (each age-specific mortality rate). General patterns of trends in cancer mortality were thus identified, permitting definition of important cohort (e.g., upwards for lung and other tobacco-related neoplasms, or downwards for stomach) or period (e.g., downwards for intestines or thyroid cancers) effects, besides the major underlying age component. For most cancer sites, even the lower order (1st to 3rd) models utilised provided excellent fitting, allowing immediate identification of the residuals (e.g., high or low mortality points) as well as estimates of first-order interactions between the three factors, although the parameters of the main effects remained still undetermined. Thus, the method should be essentially used as summary guide to illustrate and understand the general patterns of age, period and cohort effects in (cancer) mortality, although they cannot conceptually solve the inherent problem of identifiability of the three components.

Age Factors↗
PubMed1988

Dietary factors and risk of trophoblastic disease.

The risk of gestational trophoblastic disease in relation to frequency of consumption of selected dietary items was evaluated with data from a case-control study conducted in Northern Italy on 148 women with histologically confirmed gestational trophoblastic disease and two control groups, one consisting of 372 obstetric control subjects and one consisting of 406 patients in the hospital for acute, nonobstetric, nongynecologic conditions. Patients with gestational trophoblastic disease tended to consume several foods less frequently, including the major sources of vitamin A and animal protein in the Italian diet. Relative risk estimates were significantly below unity in both control groups for green vegetable, carrot, liver, and cheese consumption and in the obstetric control group only for milk, meat, eggs, fresh fruit, and fish. Inverse relationships emerged between the risk of gestational trophoblastic disease and beta-carotene or retinol intake index. The trend of decreasing risk with increasing intake was significant for beta-carotene consumption. The present findings confirm that various aspects of diet may influence the risk of gestational trophoblastic disease. However, the limitation of available evidence still introduces serious uncertainties in the interpretation of these findings and suggests the potential importance of further epidemiologic and biochemical research to obtain more precise definition of specific dietary correlates of gestational trophoblastic disease.

Adolescent↗
PubMed1988

Dietary vitamin A and the risk of intraepithelial and invasive cervical neoplasia.

The risk of invasive and intraepithelial cervical neoplasia in relation to the frequency of intake of the major sources of preformed vitamin A (retinol) and beta-carotene in the Italian diet was analyzed in a study of 392 cases of invasive cancer compared with 392 age-matched controls hospitalized for acute conditions unrelated to any of the established or suspected risk factors for cervical cancer, and of 247 cases of cervical intraepithelial neoplasia compared with 247 controls found to have normal smears at the same screening clinics where cases had been identified. Women with invasive cancer consumed milk, green vegetables, and carrots less frequently, but no significant relation was noted for meat or liver. Consequently, estimated beta-carotene, but not retinol, intake was inversely and strongly related to the risk of invasive cervical cancer. Compared with women whose intake was over 150,000 international units (IU) per month, the relative risks were 3.0 for 100 to 149,999 and 4.7 for less than 100,000 IU. It was not possible to show that these relationships were incidental, since allowance for several identified potential distorting factors, including indicators of social status and the major risk factors for cervical cancer, did not materially modify the risk estimates. In contrast, no association emerged between any of the food items and vitamin A estimates considered and intraepithelial neoplasia. Thus, the results of this study can be interpreted in one of two ways: either some residual uncontrolled bias was responsible for the strong dietary correlates of invasive cervical cancer risk or beta-carotene (or any other correlate of a vegetable-rich diet) has effect on one of the later stages of the process of carcinogenesis, thus influencing the risk of invasive carcinoma but not of its precursors.

Adolescent↗