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Biomedical subjects

G Farchi

Publications and source records attributed to G Farchi.

At least 19 recordsLinked to original sources
PubMed1992

Alcohol and mortality in the Italian rural cohorts of the Seven Countries Study.

The relation of alcohol consumption to mortality is examined using the data of the Italian rural cohorts of the Seven Countries Study, a prospective investigation of factors related to cardiovascular disease (CVD). The present analysis includes 1536 men aged 45-64, whose dietary habits and food consumption, including alcoholic beverages, were measured in 1965. Of them, 463 men died in a follow-up period of 15 years. The analysis shows a J-shaped relationship between alcohol consumption, expressed as percentage of total daily energy intake, and both overall mortality and cardiovascular mortality; this J-shaped relationship is evident even after adjusting for age, cigarette smoking and occupation. The inverse relationship for consumption of small quantities of alcohol, which is represented by the left side of the J-curve, is no longer significant when all men with previous cardiovascular manifestations are excluded from the analysis, yet it is never completely eliminated.

Alcohol Drinking↗
PubMed1992

[The impact of AIDS on mortality in Italy].

Using the official mortality data, collected by ISTAT, and the data of the Italian Register of AIDS cases, in Istituto Superiore di Sanità, three arguments have been developed: 1) Study of causes according to which ISTAT could classify deaths from AIDS: the leading cause appears to be "Deficit of Cell Immunity" (I.C.D. 279.1). 2) Study of the under-estimation of official data with respect to those of the specific system. Under-estimation decreased over the years, reaching 20% in 1987 and 6% in 1988. 3) Analysis of the general mortality trend in all of Italy and in particular metropolitan areas, with a high concentration of cases, such as Rome and Milan; there is evidence of a possible influence of AIDS deaths on mortality of young age classes particularly notable among single males.

Acquired Immunodeficiency Syndrome↗
PubMed1992

[Estimation of the impact of cigarette smoking reduction on mortality from tumors of the lung and larynx].

In 1987, in Italy, 27,106 men and 4,159 women died from lung cancer or larynx cancer. Taking into consideration the smoking habits of the Italian population and the relative risks for pulmonary cancer, of smokers and ex-smokers versus nerve smokers, we estimate that 87% of deaths can be attributed to smoking. We know from previous studies that quitting smoking results in the reduction of the risk elapsed since quitting and that this reduction depends on the time and on the quantity of tobacco previously smoked before the cessation. We estimated the reduction in the number of deaths due to respiratory cancer if part of the population were to quit smoking. In males aged 35-74 years after 12 years, there would be 3,604 fewer deaths if 10% quit smoking and 11,915 fewer deaths if 100% quit smoking.

Adult↗
PubMed1991

[Lymph nodes of the neck. Diagnosis using magnetic resonance with gradient-echo technique].

As for the pathologic conditions of neck lymph nodes, the clinician needs to know if the involved node is reactive, phlogistic, or neoplastic in nature. If accurate tumor staging is required, imaging techniques play a fundamental role. Our study was aimed at assessing the actual role of MR imaging in the evaluation of neck lymph node involvement. The study was performed using an MR Max Plus by General Electrics operating with an 0.5 T superconductive magnet. We employed gradient-echo (GE) pulse sequences with TR 500, TE 15 ms and 90 degrees flip angle for T1-weighted images, and with TR 500, TE 30 ms and 25-30 degrees flip angles for T2-weighted images; for Pd-T2-weighted images, TR was 520, TE 30 ms, and flip angles were 40-45 degrees. The results were correlated with histopathologic findings obtained at biopsy. The advantages of GE sequences were: 1) whole neck imaging--thus saving time, and reducing radiation dose and contrast media; 2) optimal anatomical and topographic evaluation of the lesion; 3) imaging of the longitudinal diameter of the node; 4) higher sensitivity for lymph node tissue modifications; 5) imaging of necrosis, hemorrhage, and/or fibrosis. GE sequences were especially useful for accurate tumor staging, in the follow-up, and to verify response to therapy. However, even though MR imaging has proven to have high sensitivity, its specificity was similar to that of contrast-enhanced CT. Further studies with the use of paramagnetic contrast media are needed to solve these problems.

Diagnosis, Differential↗
PubMed1990

[Mortality from liver cirrhosis in Italy: a two-component model for estimation of the quota attributable to alcohol].

Liver cirrhosis is considered as a double etiology disease, being its incidence and mortality associated either to alcohol consumption or to a previous viral hepatitis infection of type "B" or "neither A nor B". A two components mathematical model is here used to estimate the proportion of liver cirrhosis mortality attributable to alcohol consumption and the proportion from hepatitis. The model has been fitted to mortality data of the 95 Italian provinces in 5 periods of three years each from 1969 to 1983. In 1981-83, the first-component (interpretable as due to alcohol) is estimated to account for 31% in males and 28% in females of total mortality from liver cirrhosis. Estimates are given also for large geographical areas, regions and provinces.

Adult↗
PubMed1990

[Staging of spinal metastasis using special techniques of magnetic resonance imaging].

The diagnosis of spine metastasis is a problem of great interest which leaves many questions unanswered. In this field MR imaging plays a fundamental role, as the only technique able to directly demonstrate the changes in bone marrow tissue, bound to tumoral activity. The introduction of gradient-echo (GE) sequences has helped reduce examination time. Moreover, with the accurate choice of pulse-sequence parameters (TR, TE, flip angle) additional information is acquired which is not yielded by conventional spin-echo (SE) sequences. Our study was aimed at evaluating MR sensitivity in the different stages of bone metastatic evolution. The comparative adequacy was evaluated of combined bone scintigraphy and conventional radiology versus MR imaging in 62 patients with vertebral metastases. Time interval between bone scan and/or radiological study and MR exam ranged from 10 days to 8 months. SE and GE T1-weighted images, and SE and GE T2-weighted images on the sagittal plane were employed, and axial images; coronal images were rarely acquired. Metastases were demonstrated by MR imaging at 122 vertebral levels, versus 88 true positives of combined scintigraphy and conventional radiology. Scintigraphic false-positives were observed at 15 vertebral levels, versus 9 with radiography. GE sequences were superior to SE ones in detecting vertebral morphologic lesions and bone marrow involvement thanks to their improved resolution and sensitivity. Moreover, GE sequences demonstrated tumoral bone marrow spread and persistent tumoral activity in the follow-up of spine metastases. Our results point to GE sequences as those of choice because of their higher resolution and sensitivity, which also allow response to treatment to be evaluated.

Humans↗
PubMed1990

[The relationship between the receptor status and the mammographic picture in operable breast cancer].

To verify the relationship of mammographic (Mx) patterns of breast cancer to hormone receptor content (ER, PgR) we studied 129 women (59% in postmenopause; average age 55) in the last 3 years. All women had operable breast cancer and were submitted to mammography before surgery. The tumors were classified, according to Mx characteristics, in 5 classes (Broberg, 1983). ER and PgR contents (cut-off for positivity: 10 fmol/mg prot cyt) were analyzed in all patients by means of DCC method. The percentage of ER+ cases was significantly higher in class I than in all other Mx classes (85% vs 57%; p = 0.02), whereas it was lowest in class IV (51% vs 70%; p = 0.03). The percentage of PgR+ cases was significantly different only in class I with respect to class IV (70% vs 41%; p = 0.002). As for ER and PgR mean tumor content, no statistically significant difference was observed between the 5 classes. When the 2 receptors were simultaneously considered the percentage of ER+ PgR+ cases was higher in class I than in all the extant classes (p = 0.01), and the percentage of ER- PgR- was higher in class IV than in the extant ones (p = 0.02). In selected subgroups of patients, Mx classification of breast cancer can help the physician predict the hormone receptor tumor status with sufficient reliability.

Adult↗
PubMed1989

Diet and 20-y mortality in two rural population groups of middle-aged men in Italy.

The relationships between individual diet, measured in 1965 on the two Italian rural cohorts of the Seven Countries Study on Cardiovascular Disease, and subsequent mortality from all and specific causes of death in 20 y are studied. The analysis covers 1536 men aged 45-64 y at entry to the study. By using a cluster analysis technique, individuals are aggregated into four groups so that the elements within a group have a higher degree of similarity in dietary nutrients than between groups. Impressive differences in death rates between groups are found especially at the 10- and 15-y anniversaries. The relative risk between the least and the most favored group in 15-y mortality from coronary heart disease is 4.7; in 10 y the relative risk for cancer mortality is 2.9 and for liver cirrhosis approximately 4.

Cardiovascular Diseases↗
PubMed1988

Mortality from liver cirrhosis in Italy: proportion associated with consumption of alcohol.

A descriptive analysis of the features of mortality from cirrhosis in Italy suggests that it is made up of two components which are characterized by different age trends. On the basis of this hypothesis, a model has been postulated and applied to the data for the 94 Italian provinces in order to identify the two components. When considering alcoholic drinking data, it appears that only one of these components is associated with the consumption of alcohol, both for men and for women. In this way an estimate can be made of the proportion of mortality in Italy which can be linked to alcohol consumption. For males, this is 40.4% (47.1% for the North, 29.7% for Central Italy, and 33% for the South/Islands). For females, the average is 24.6% (36.6% for the North, 16.2% for Central Italy, and 12.3% for the South/Islands). In absolute terms, these figures represent approx 5000 of the 13,000 deaths per year among males and around 1200 of the 5000 deaths from cirrhosis among females.

Adult↗
PubMed1987

Coronary risk factors and survival probability from coronary and other causes of death.

The analysis concerns the two rural Italian cohorts of the Seven Countries Study and includes 1,712 men who, at the entry examination in 1960, were aged 40-59 years and whose 20-year follow-up examinations were complete for life status, dates, and causes of death. Excluded were 175 men because they lacked one or more of the risk factors selected for the study. A total of 517 deaths occurred in the remaining 1,537 men. The Cox proportional hazards regression model was applied with a forward procedure to include the entry risk factors in the model. First, total mortality was used as the endpoint. Then the risk factors identified as being related to total mortality were used to predict specific causes of death, i.e., coronary heart disease, stroke, cancer, violent death, and other causes. Blood pressure appeared as a nonspecific risk factor for all causes, including cancer and violence, forced expiratory volume and arm circumference appeared as nonspecific risk factors, smoking habits could not be easily classified, and cholesterol was definitely specific only for coronary deaths. Models for estimating survival probabilities from total mortality and from any of several causes of death are provided.

Adult↗
PubMed1986

The prediction of future health in healthy middle-aged men.

Two cohorts of men aged 49-59 at entry, representing cluster samples of two rural areas in Northern and Central Italy, for a total of 1712 subjects have been followed-up for 20 years within an epidemiological study originally designed for cardiovascular disease. After 20 years, only 41 men have been judged to have remained substancially healthy throughout the observation period, i.e. free from a number of major diseases. Univariate and multivariate analyses trying to predict the maintenance of health status showed that among 21 selected characteristics only the following one had a significant power: age, cigarette smoking (adverse effect) and vital capacity (favourable effect). A minor role was also played by the body mass index (adverse effect) and forced expiratory volume (favourable effect). Those who did not remain healthy exibited a greater increase in blood pressure and body mass index.

Adult↗
PubMed1986

Age, period, cohort and geographical area effects on the relationship between risk factors and coronary heart disease mortality. 15-year follow-up of the European cohorts of the Seven Countries study.

The effects of three major risk factors (i.e. serum cholesterol, systolic blood pressure and smoking habits) on prediction of coronary heart disease (CHD) mortality in relation to three nuisance variables--i.e. geographical location, age of subject at examination and period of examination--are analyzed using data from three different 5-year apart examinations of the Seven Countries Study and observations on CHD mortality in the corresponding 15-year follow-up period. First, a cross-classification exploratory analysis including both CHD-free subjects at entry and prevalence subjects, by different geographical areas, age classes and examination times is presented. Secondly, a logistic regression including the three major risk factors and the three nuisance variables, regarded both as confounders and effect modifiers is discussed. The prevalence status of the subjects is also considered as a nuisance variable in this second analysis. Results showed that: (a) there is a highly significant (p less than 0.001) marked decrease in the association between cholesterol level and CHD mortality with increasing age of subject; (b) a decreasing association with coronary heart disease mortality as age increases also holds for smoking habits (p less than 0.05). This association, however, tends to be reinforced with time (p less than 0.05), i.e. the relative risk of heavy smokers vs non-smokers is four times bigger in the period 1970-75, than in the period 1960-65, age and all other factors being equal; (c) a possible dependence of the association between systolic blood pressure and CHD on geographical area is suggested, although this finding could be the result of chance with a 10% probability.

Adult↗
PubMed1985

[Risk factors between blood cholesterol and coronary disease].

Some risk functions are presented linking serum cholesterol to the development of coronary heart disease. They are produced from epidemiological studies on Italian population samples made of men aged 40-59 at entry and followed up to 20 years. The purpose is to provide a simple tool for the estimation of the expected risk and of that depending on changes of the risk factor.

Adult↗
PubMed1984

HDL serum cholesterol and 24-year mortality of men in Finland.

Examinations of 'healthy' men in Helsinki and in rural west and east Finland in 1956 included estimation of total cholesterol and that in the HDL and beta fractions separated by electrophoresis. Vital status to the end of 1980 has been ascertained for all but eight of the 526 men aged 35-61 and for all but two of 261 men aged 30-34 at entry. Among the men aged 35-61, in 24 years 155 died, 63 from coronary heart disease; among the men aged 30-34, 36 died, 16 from coronary heart disease. All causes and coronary death rates were highest in east Finland where HDL cholesterol was also highest. Coronary death rates were not related to HDL cholesterol in east or west Finland but 16 men dead from coronary heart disease in Helsinki tended to have low HDL values. Consideration of five other entry characteristics did not change the picture with regard to HDL-mortality relationships. Solution of the multiple logistic equation using all those variables found the probability of 24-year coronary death was not significantly related to HDL but was significantly related, positively, to the non-HDL cholesterol concentration. HDL and total cholesterol mean values for men of the same age in the same area of Finland, with lipoprotein separation by the new recommended methods, agree closely with the means recorded in 1956. These 24-year findings are not necessarily in conflict with reports in the literature on an inverse relationship between coronary heart disease incidence and HDL cholesterol based on much shorter periods of follow-up and few data on mortality.

Adult↗
PubMed1984

Multifactorial primary prevention trials of coronary heart disease.

The hypotheses of reversibility of risk and of prevention of increasing risk represent the theoretical basis for any attempt to prevent coronary heart disease. After the impressive but inconclusive trials of the first generation, conducted principally in the sixties and on single risk factors, the second-generation trials, begun in the seventies and focused mainly on multifactor intervention, are now producing preliminary results. Although many problems remain unresolved and many questions are as yet unanswered, several results indicate the feasibility of mass intervention aimed at changing the risk-factor levels and suggest an association of such action with a measurable reduction in the incidence of coronary heart disease.

Clinical Trials as Topic↗