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E Negri

Publications and source records attributed to E Negri.

558 records · Page 31Linked to original sources

Medical history and the risk of non-Hodgkin's lymphomas.

The relationship between selected aspects of medical history and the risk of non-Hodgkin's lymphomas (NHLs) was investigated using data from a hospital-based case-control study conducted in northern Italy on 177 cases of NHL and 561 controls in hospital for acute conditions, other than nonneoplastic or immunological. Among six viral diseases considered, only herpes zoster (shingles) had a relative risk (RR) significantly above unity [RR = 2.7; 95% confidence intervals (CI), 1.5 to 4.7]. The association, however, was restricted to subjects whose diagnosis of herpes zoster dated back to less than 10 years, suggesting that this slow-acting virus could be reactivated by the early development of NHL. Six of eight bacterial diseases considered showed RR above unity, and the estimate was significant for scarlet fever (RR = 1.9; 95% CI, 1.1 to 3.5) and pyelonephritis (RR = 5.3; 95% CI, 1.8 to 16.2). These associations were not restricted to the few years before lymphoma diagnosis. When various classes of infectious or inflammatory diseases were grouped together, no association was evident for viral infections (RR = 0.8; 95% CI, 0.6 to 1.2), acute bacterial diseases (RR = 1.0; 95% CI, 0.7 to 1.5), or allergic conditions (RR = 1.0; 95% CI, 0.6 to 2.1). The risk estimates were nonsignificantly above unity for chronic bacterial diseases (RR = 1.2; 95% CI, 0.7 to 1.2) and autoimmune conditions (RR = 1.4; 95% CI, 0.9 to 2.2), and significantly elevated for chronic inflammatory disease (RR = 1.9; 95% CI, 1.2 to 3.0).(ABSTRACT TRUNCATED AT 250 WORDS)

Adolescent↗

Histamine-2-receptor antagonists and gastric cancer: update and note on latency and covariates.

The relationship between treatment with histamine-2 (H2)-receptor antagonists (cimetidine and ranitidine) and subsequent risk of gastric cancer was analyzed with data of a case-control study conducted in northern Italy between 1983 and 1991 on 628 incident cases of gastric cancer and 1776 control subjects who had been hospitalized for acute, nonneoplastic, non-digestive-tract disorders, with a specific focus on time-risk relationships and analysis of covariates. Previous use of H2-receptor antagonists was reported by 45 (7.2%) cancer patients and 68 (3.8%) control subjects; the corresponding multivariate relative risk (RR) was 2.1 (95% confidence interval [CI] 1.4-3.8). A significantly elevated risk, however, was evident only among individuals (27 patients and 23 control subjects) who had started using the drug less than 5 yr before diagnosis (RR 3.8, 95% CI 2.1-6.1). The risk estimate declined to 2.1 (95% CI 1.0-4.2) for use starting 5-9 yr before diagnosis and to 0.4 (95% CI 0.2-1.2) for use starting greater than or equal to 10 yr before diagnosis. When the relationship between use of H2-receptor antagonists and gastric cancer risk was examined across strata of sex, age, and other selected covariates (educational level, tobacco use, and alcohol and coffee consumption), all RRs were greater than unity for use starting less than 5 yr before diagnosis, but there was no evidence of any consistent association for use starting in the more distant past. Furthermore, there was no evidence of heterogeneity in the RRs for H2-receptor antagonist use and gastric cancer across strata of the covariates examined.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗

[Risks and benefits of the contraceptive pill. A review of the results of an Italian study].

The association between oral contraceptives (o.c.) and disease risk was reviewed on the basis of data from a network of a case-control studies conducted in northern Italy since the early 1980's on about 150 cases below age 55 with acute myocardial infarction, 150 with gallstone disease, 350 with uterine fibromyoma, 170 with endometrial cancer, 700 with benign or malignant ovarian tumours, 2000 with breast cancer, 360 with intraepithelial and 370 with invasive cervical cancer, 20 with liver cancer plus over 2000 control women admitted to hospital for acute, non hormone-related non neoplastic diseases. The relative risk (RR) of myocardial infarction was 2.1 (95% confidence interval from 0.7 to 7.1) among current o.c. users, but only 4% of women were current users. There was no association between gallstone disease, uterine fibromyoma and o.c. use. Significant protections were observed with reference to endometrial cancer and benign, borderline and malignant ovarian tumours, while the RR was above unity (RR = 1.9) for invasive cervical cancer, but not for intraepithelial cervical neoplasia. A significantly increased risk was observed for primary liver cancer, which is however extremely rare in young women. With reference to breast cancer, there was no consistent duration-risk relationship, and the RR was 0.8 for use for 5 or more years. Thus, these data provide reassuring information on the relationship between o.c. use and the risk of several important diseases in a Southern European population.

Contraceptives, Oral↗

[24-hour esophago-gastric pH-metry: clinical indications].

Esophago-gastric 24 h pH-metry recording is a diagnostic technique that allows ambulatory monitoring of acid esophageal reflux during 24 h while the patient pursues his everyday activities. Prolonged pH recording allows evaluation of the correlation of esophageal or extraesophageal symptoms (i.e. arrhythmias, chest pain, asthma) with intraesophageal pH. It permits us to evaluate the effectiveness of antireflux therapy, to modify therapy, or change daily dosages.

Child↗

[Predictability of the anamnesis in pathology of the upper tract of the digestive system. Computerized analysis concerning 1000 subjects submitted to esophagogastroduodenoscopy].

The ability of history taking to predict endoscopically verified pathology of the upper gastrointestinal tract was evaluated in a group of 1000 patients submitted to esophagogastroduodenoscopy (EGDS). The presence of one or more of the following symptoms at the time of EGDS or 4 weeks previously, was considered: epigastric pain, dysphagia, dyspepsia, gastrointestinal bleeding, pyrosis, anorexia and/or weight loss, nausea and/or vomiting. The results of this elaboration showed that the presence of recent symptomatology does not allow differentiation of patients with endoscopically verified pathology from those without it. The presence of an "at risk history" consisting of one or more of the following factors was also evaluated: smoking 10 cigarettes per day, drinking 100 g alcohol per day, previous diagnosis of upper gastrointestinal tract pathology, gastrointestinal-irritating therapy. Data analysis showed notable importance of the presence of an "at risk history"; in fact, when compared with subjects without this type of history, "at risk" patients were twice as likely to have a pathological condition diagnosed. Thus, when protocols for endoscopic examination are established the history of the patient and his lifestyle must be taken into consideration.

Adult↗

History of thyroid diseases and subsequent thyroid cancer risk.

A history of benign thyroid diseases has been associated with the risk of thyroid cancer. We have analyzed this issue using data from a case-control study conducted in northern Italy between 1986 and 1992 on 399 incident, histologically confirmed thyroid cancer cases and 617 controls admitted to the hospital for acute, nonneoplastic, non-hormone-related diseases. The overall multivariate relative risk (RR) estimates were 2.8 [95% confidence interval (CI), 0.6-12.4] for previous episodes of thyroiditis, 27.1 (95% CI, 6.5-111.9) for adenoma, 8.2 (95% CI, 3.5-19.1) for goiter, 3.8 (95% CI, 1.4-10.9) for hyperthyroidism, and 1.5 (95% CI, 0.4-5.1) for hypothyroidism when all histotypes were analyzed. The RR for any thyroid disease was 7.7 (95% CI, 4.6-12.8). A family history of thyroid disease was significantly related to thyroid cancer with an RR of 1.6. The RR for having resided in endemic goiter areas was 1.3 for < 20 years of residence and 1.6 for 20 or more years. These associations were somewhat stronger when only papillary, follicular, and mixed papillary/follicular cancers were considered. Analyses of data in separate strata of sex and age suggested that several benign conditions play a more important role in females and in subjects younger than 50 years. Results were similar to the overall ones when papillary and follicular carcinomas were considered separately. The population-attributable risk for any previous thyroid disease was approximately 20% in this Italian population. These results confirm that history of thyroid disease is a relevant indicator of subsequent thyroid cancer risk also in areas at relatively low prevalence of goiter and other thyroid diseases.

Adenocarcinoma, Follicular↗

Patterns of mortality from major cancers in Europe.

All ages and truncated (35 to 64 years) mortality rates from all neoplasms and from cancers of the lung, stomach, intestines, and breast for the six calendar quinquennia from 1960-1964 to 1985-1989 were computed from official death certification data and population estimates obtained from the World Health Organization database for total Europe (excluding former Soviet Union) and for three broad European areas: (a) member countries of the European Economic Community for the last period of the study; (b) other Western European countries; and (c) Eastern European countries. In Europe, mortality rates for all neoplasms increased for men and decreased for women. The increase in men can be largely explained by the major tobacco-related lung cancer epidemic throughout Europe. Lung cancer mortality rates rose steeply in Eastern Europe, where the truncated rates reached the highest levels ever observed, and there is no evidence of a leveling off. Stomach cancer mortality decreased in all Europe for both sexes, although rates remained higher in Eastern Europe, while intestinal cancer rates tended to level off around the highest values in various areas of the continent. Breast cancer showed a moderate but steady increase. Overall, the most unfavorable trends were in Eastern Europe, due to major epidemics in tobacco-related neoplasms and in other common cancers related to diet and other lifestyle habits.

Adult↗

Risk factors for esophageal cancer in lifelong nonsmokers.

Information on the etiology of esophageal cancer in lifelong nonsmokers is of interest to understand and quantify risk factors for the disease in the absence of the residual confounding by tobacco. Of a total of 316 cases with histologically confirmed incident cancers of the esophagus, 46 (17 males and 29 females) who described themselves as lifelong nonsmokers were selected to assess esophageal cancer risk in the absence of potential confounding and interactive effects of smoking. These patients were compared to 230 lifelong nonsmoker controls (85 males and 145 females) admitted to hospital for acute, nonneoplastic, non-alcohol-related conditions. The major risk factor for cancer of the esophagus in lifelong nonsmokers was elevated alcohol consumption: compared to drinkers of fewer than 4 drinks per day the relative risk (RR) was 2.7 (95% confidence interval, 1.1-6.8) for 4 to fewer than 8 drinks, and 5.4 (95% confidence interval, 1.4-21.0) for 8 or more drinks, with a significant trend in risk. Among selected indicator foods considered, significant protective effects were observed for fish (RR = 0.5 for the highest consumption tertile), green vegetables (RR = 0.6), and fresh fruit intake (RR = 0.3). Consequently, there was a significant inverse relationship with an estimate of beta-carotene intake (RR = 0.5 and 0.4, respectively, for the middle and highest tertiles of intake versus the lowest), with a significant trend in risk. The estimated RR for the highest alcohol consumption and lowest beta-carotene intake category was 8.6, and these two factors together explained over 45% of cases. Gastrectomy and family history of cancer of the esophagus were also associated with increased risk (RR = 4.6 and 4.3, respectively).

Adult↗

Family history and the risk of liver, gallbladder, and pancreatic cancer.

The relationship between family history of selected neoplasms in first-degree relatives and the risk of pancreatic, liver, and gallbladder cancer was investigated using data from a case-control study conducted in northern Italy on 320 histologically confirmed incident cases of liver cancer, 58 of gallbladder cancer, 362 of pancreatic cancer, and 1408 controls admitted to the hospital for acute, nonneoplastic, nondigestive tract disorders. Significant associations were observed between family history of hepatocellular carcinoma and primary liver cancer [relative risk (RR) = 2.4; 95% confidence interval (CI), 1.3 to 4.4], between family history of pancreatic cancer and pancreatic cancer (RR = 3.0; 95% CI, 1.4 to 6.6), and between family history of gallbladder cancer and gallbladder cancer (RR = 13.9; 95% CI, 1.2 to 163.9). The elevated risk of liver cancer associated with family history was not materially modified by adjustment for tobacco, alcohol, and personal history of cirrhosis and hepatitis (RR = 2.9; 95% CI, 1.5 to 5.3). Similarly, the risk for pancreatic cancer did not appreciably change after allowance for tobacco, alcohol, dietary factors, and medical history of diabetes and pancreatitis (RR = 2.8; 95% CI, 1.3 to 6.3). This pattern of risk would support the existence of a genetic component in the familial aggregation of liver and pancreatic cancer. In terms of population attributable risk, approximately 3% of the newly diagnosed liver and pancreatic cancers would be related to this familial component.

Aged↗

Attributable risk for oral cancer in northern Italy.

Using data from a case-control study conducted between 1984 and 1992 in the provinces of Milan and Pordenone, northern Italy, on 439 cases of oral and pharyngeal cancers and 2106 hospital controls, we computed the population attributable risk for oropharyngeal cancer in relation to tobacco, alcohol, and a measure of low beta-carotene intake. Two different models were used for estimating relative risks, one assuming that the three factors act multiplicatively on the relative risk and the second estimating separately each combination of alcohol and tobacco and assuming a multiplicative model only for beta-carotene. The estimated attributable risks were similar for the two models considered. For both models and both sexes, the single factor with the highest attributable risk was smoking, which accounted for 81-87% of oral cancers in males and for 42-47% in females. Alcohol explained about 60% of male cases, but only 15% of female ones, and low beta-carotene accounted for 24% of total cases (25% of males, 17% of females). Together the three factors were responsible for 91-94% of oropharyngeal cancers in males, 51-57% in females, and 85-88% in both sexes combined. The present knowledge of major identified risk factors could, in principle, reduce the burden of the disease in Italy from 2400 to about 200 deaths per year for males and from 500 to 230 for females, thus explaining the difference in incidence and mortality between the two sexes.

Adult↗

[Familial adenomatous polyposis. Problems encountered with rectum preservation in surgical treatment and life expectancy].

Familial adenomatous polyposis is a genetically inherited disease with very high risk of colorectal cancer and with a large expression of multiple extracolonic malignancies. In recent years two surgical options are available for the treatment of FAP: total colectomy with ileorectal anastomosis and restorative proctocolectomy with ileoanal reservoir. The preservation of the rectum offers good quality of life and good functional results, but needs an accurate surveillance of the rectal stump and screening for the development of cancer. Restorative proctocolectomy is reserved for patients with large or confluent polyps of the rectum, for older patients and for those who had already had an ileorectal anastomosis and who develops subsequently large adenomas at increased risk for rectal cancer. Prophylactic procedures of surveillance, screening and surgery have reduced in patients at risk the incidence of colorectal cancer. But recently an increased number of malignant extracolonic tumors (gastric cancer, duodenal and periampullary cancer, small intestinal cancer, adrenal and thyroid cancer) and abdominal desmoid tumors, that causes a significant mortality, has been documented. The knowledge of the extracolonic features of FAP suggests a careful follow-up of the patients and the prevention and treatment of upper gastrointestinal cancers and desmoid disease.

Adenomatous Polyposis Coli↗

[Diagnosis of celiac disease in an elderly subject: description of a clinical case].

A 70-year-old woman was admitted to the hospital because of a 5-year history of weight loss, weakness, anemia, osteomalacia, pathologic fractures and pain responding only to narcotic analgesics. A diagnosis of celiac disease was made on the basis of pathologic xylose absorption test results, studies confirming the presence of antigliadin and antiendomysial antibodies, and jejunal biopsy evidencing shortened or absent villi. The detection of unusual cases of celiac disease without diarrhea is on the increase. The only observable symptoms of this pathology may be osteomalacia or persistent iron deficiency anemia despite oral iron therapy.

Aged↗