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Biomedical subjects

F Parazzini

Publications and source records attributed to F Parazzini.

At least 325 records · Page 18Linked 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

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

Enhanced preovulatory progesterone levels in clomiphene citrate-induced cycles.

We measured basal body temperature, cervical mucus, follicular diameter, and serum LH, FSH, 17 beta-estradiol, and progesterone daily in 40 spontaneous ovulatory cycles in 27 infertile women and in 40 clomiphene citrate-induced ovulatory cycles in 31 women. The cervical score was significantly lower and the serum FSH, LH, and 17 beta-estradiol levels were significantly higher during the follicular phase in induced compared with spontaneous cycles. Serum progesterone was significantly higher on the 3 days preceding ovulation and the day of ovulation in the induced cycles. These increased preovulatory serum progesterone levels could contribute to the lower cervical mucus score in the induced compared with spontaneous cycle, whereas their effect on the endometrium is still unclear.

Adult↗
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

Ectopic pregnancy and recurrent spontaneous abortion: two associated reproductive failures.

The association between spontaneous abortion and ectopic pregnancy was evaluated in a case-control study conducted on 161 women (cases) with recurrent spontaneous abortions (two or more consecutive spontaneous abortions) and 170 control subjects who delivered normal infants. The risk of ectopic pregnancy in women with a history of recurrent spontaneous abortion was about fourfold that of controls (relative risk adjusted for age and number of pregnancies = 4.3; 95% confidence interval 1.4-14.7). This association was confirmed by comparing the observed number of extrauterine pregnancies in women with recurrent spontaneous abortions with the expected number computed from regional data on the frequency of ectopic pregnancies; the estimated relative risk was 3.7, with a 95% confidence interval of 2.2-7.0. The present report found an association between spontaneous abortions and ectopic pregnancies, suggesting some common risk/etiologic factors for these two reproductive failures.

Abortion, Habitual↗
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

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

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

Trends in ectopic pregnancies and use of intrauterine devices in Lombardy, Italy 1979-1983.

The frequency of ectopic pregnancies in Lombardy (a region in Northern Italy with a population of about 9 million inhabitants) over the period 1979-1983 was estimated using the Regional Hospital Discharge Registration System, where information is collected on all discharges from public and private hospitals. The ratio of ectopic pregnancies rose from 4.43/1000 pregnancies in 1979 to 4.93/1000 pregnancies in 1982 and flattened off in 1983 (4.78/1000 pregnancies). The frequency of ectopic pregnancies increased with maternal age from 2.30/1000 pregnancies in teenagers to 6.01/1000 pregnancies in women 30-39 years old, but remained constant thereafter (5.84/1000 pregnancies in women aged 40 or older). These trends were consistent with available information on intrauterine device (IUD) sales over the same calendar period. On the basis of a random subsample of the same dataset, we evaluated by means of a case-control approach, the relative risk of ectopic pregnancy in relation to IUD use. Current IUD users had an estimated age-adjusted relative risk of ectopic pregnancy of 3.6 (95% confidence interval = 1.4-8.0) in comparison with an hospital-based control group of non-pregnant women. In etio-pathological terms, the interpretation of this finding is not obvious since it is possible that IUD users are simply less protected than pill, barrier or other traditional method users against ectopic pregnancy. Nonetheless, on a public health scale, the impact of IUD on the incidence of ectopic pregnancy should be evaluated in relative terms of comparison with other methods and their utilisation in different populations.

Adult↗
PubMed1988

Prediction and self-prediction of ovulation in clomiphene citrate-treated patients.

We studied 15 infertile patients for a total of 25 cycles in order to compare the predictive value of the following parameters in timing ovulation: basal body temperature (BBT), cervical mucus, serum E2 and LH, follicular growth as shown by ultrasonography, and urinary LH. The patients themselves tested urinary LH at home using Clearplan kits. BBT had low value as a predictive test for the time of ovulation, whereas ultrasonography had a predictive value of 9%, serum E2 50%, cervical mucus 59%, serum LH 63.6% and Clearplan kits 63.6%. The best predictive reliability in timing ovulation was obtained by considering both serum LH and E2 measurements. The Clearplan kits were as reliable as serum LH measurements and have greater practical advantages.

Adult↗
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↗
PubMed1988

The problem of identification of prognostic factors for persistent trophoblastic disease.

The role of anamnestic and clinical factors in defining the high group at risk of developing persistent trophoblastic disease (PTD) has been analyzed in 301 cases of hydatidiform mole. Patients age 40 or more years with AB blood, and a previous history of molar pregnancy had an elevated risk of developing PTD. The presence of various risk factors increased the frequency of PTD. However, with discriminant analysis, correct classification of outcome was obtained for only 69% of cases. Despite the magnitude of risk of PTD for women with three or more risk factors, the clinical relevance of prognostic variables in the prediction of outcome was limited by the low proportion of women classified in the low- and high-risk groups, making the identification at diagnosis of the women who could benefit of prophylactic chemotherapy extremely difficult and hence of little clinical importance.

ABO Blood-Group System↗
PubMed1988

Maternal mortality in Italy, 1955 to 1984.

Between 1955 and 1984 Italian maternal mortality steadily declined by about 90% (from 133.3 per 100,000 live-births in 1955 to 11.4 in 1984). Maternal mortality rose with age and was about tenfold higher in the highest risk group (greater than or equal to 40 years old) compared with the lowest risk group (less than 20 years old). Deaths in pregnancy with abortive outcomes represented about 8% to 10% of maternal mortality as a whole; these percentages were constant throughout the calendar period considered. Geographically, there was no noticeable reduction in the northern/southern mortality ratio, which was constantly about 0.75.

Adult↗
PubMed1988

Increased frequency of complete hydatidiform mole in women with repeated abortion.

The association between spontaneous abortion and gestational trophoblastic disease (GTD) has been investigated in a study based on 93 women with 2 consecutive (repeated) spontaneous abortions and 82 control subjects who delivered normal babies. Nine molar pregnancies were observed among 7 of the 93 cases of repeated abortion while no control reported previous GTD. This difference was statistically significant and was not explained by allowance for age and number of pregnancies between cases and controls (chi 2(1) = 4.20; P = 0.04). When the observed number (9) of hydatidiform mole in the 385 pregnancies of the women with repeated abortion was compared with the expected one (0.28) based on the regional frequency data, the estimated relative risk was 32.1 with a 95% confidence interval from 13.9 to 63.3. The present findings confirm the association between GTD and spontaneous abortion and indicate that the risk is larger in women with repeated abortions.

Abortion, Habitual↗