Biomedical subjects
Publications and source records attributed to L Minelli.
Skin metastases from internal malignancies are rare, particularly those originating from carcinoma of the cervix: only 11 cases have been reported in the medical literature since 1940. We describe the case of a cutaneous metastases from a squamous-cell carcinoma of the cervix that was solitary, unusual for its location, and with the longest survival reported so far.
Our first laparoscopic hysterectomy is reported. Our report includes the following surgical actions: coagulation and dissection of the round ligament: opening of the front-large ligament; hydrodissection of the connective tissue between the two peritoneal pellicles of the large ligament; coagulation and dissection of the salpinx for tissues and uterine-ovarian vessels; dissection of the large back ligament as far as the uterines and sacrals; detachment of the bladder by means of forceps and hydrodissection; the same operations on the opposite side; visualisation of uterine vessels and dissection; dissection of uterines and sacrals; completion of the operation and removal of the ill part through the vaginal way. Laparoscopic hysterectomy or vaginal-laparoscopic hysterectomy could, in some cases, substitute abdominal hysterectomy or be less risky than vaginal operations. We point out the need for more complete laparoscopic instrumentation and more practical laparoscopic experience for surgeons and assistants.
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The redistribution with the time of concanavalin A (Con A) receptors at one pole of the cell after addition of FITC-Con A - so-called capping - in the peripheral blood lymphocytes from 13 aged subjects (mean: 84 +/- 1 years old), and of 16 noninstitutionalized patients affected by a syndrome of precocious aging, such as Down's syndrome (mean: 17 +/- 2 years old), was studied and compared with a group of 15 normal young people (mean: 23 +/- 2 years old). An opposite alteration in the percentage of capped cells, i.e. a decrease in aged subjects and an increase in Down's syndrome patients, was observed. A derangement of lymphocyte membrane fluidity appears to be present in both groups even if the underlying biochemical defect may be different. However, a similar alteration of the kinetics of the phenomenon was present either in aged or in Down's syndrome subjects. Both groups did not show any significant increase with time of the percentage of capped cells, suggesting that they were lacking a lymphocyte subpopulation(s) which start capping later.
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We analyzed the 10-year survival of 1,512 women with breast cancer in relation to age at diagnosis. The incident cases were from an ad hoc investigation in Umbria, a region of central Italy, for the period 1978-1982. The follow-up was carried out by an automatic link with the RENCAM (Nominative register of causes of death) and verified at the Register's Offices of the various towns of the region. Observed survival at 1 year was 0.89, at 3 years 0.75, at 5 years 0.64 and at 10 years 0.47. Median survival was 9.0 years. Relative survival at 1, 3, 5, 10 years was respectively 0.91, 0.79, 0.71 and 0.59. Women < 35 years of age had a better prognosis both at 5 (0.83) and 10 years (0.69) from diagnosis. Thereafter, survival decreased with increasing age. The exception to this trend was women in the 45-49 and 60-64 year age ranges, for which survival was greater than the previous age range classes by 6% and 13%, respectively, at 5 years from diagnosis and 6% and 14% at 10 years. Comparison of data from Umbria and Italian and European Registries shows that the prognosis for Umbrian women with breast cancer is quite good.
Hygiene education for dental students is crucial in order to control and reduce the risk of infections in their future professional practices. The aim of this study was to evaluate the improvement in university students' knowledge of infectious disease prevention, dental instruments and environmental decontamination following the Course in Dental Hygiene and Prevention. 595 questionnaires were submitted to dental students at twelve Italian Universities; 335 were filled out before the Course began and 260 at the end of the same course. The students in both the PRE-course and at the POST-course evaluations demonstrated adequate knowledge regarding the transmission of infections in dental practices, knowledge improved following the Hygiene course.
The aim of the study is to show the colorectal cancer trend in Umbria, a central Italian region, from 1978 to 1999. Data concerning regional incidence, mortality and survival derived from an ad hoc survey carried out in Umbria in the period 1978-1982 and from Umbria Population-based Registry (RTUP) for the years 1994-1999. The incidence of colorectal cancer increases in both sexes, expecially for the age class > 75 years. Mortality rises slightly, without no difference between sexes. Survival of patients with colorectal cancer has improved in the two sexes from 45 to 74 years-age, while the lower survival has registered for age between 75 and 84 years. We concluded that the situation in Umbria is quiet good, but it is affected by aging of Umbrian population. Delaying in diagnosis or inefficacy in therapy can explain shorter survival in older patients.
Gastric cancer, despite the decrease observed in the last 50 years, is yet the fourth cause of death for malignant tumor in Italy. Data from the Registro Tumori Umbro di Popolazione have been used to assess incidence, mortality and survival rates for this cancer over the period 1994-1999. The results have been compared with the data of an ad hoc study realized in the period 1978-1982 and with the ones of the other population-based cancer registries. Mortality and incidence rates are among the highest in Italy, confirming the existence of a high risk area for gastric cancer in central Italy; anyway, both mortality and incidence decrease during the study period. Also survival rates from gastric cancer recorded in Umbria over the period 94-99 were among the highest respect to other Italian cancer Registries. A case-control study carried out in a neighbouring area, aimed to explain the elevated incidence of gastric cancer, found that the consumption of a "traditional" diet--rich in proteins (particularly from sausages), nitritis and nitrous compound, alcohol, coffee, and fibres--was an important risk factor for gastric cancer. Survival over the period 94-99 is significantly improved, if compared to 1979-82 survival rate. The high survival rate recorded in the Umbria region could be related both to the number of cases treated in Umbria and to the quality of the regional oncologic system; in fact, in Umbria we reported high survival rates for several malignancies.
The aim of this study is to analyze the upper aerodigestive cancer survival in Umbria, a central Italian region, in the periods 1978-82 and 1994-98. The cases' data diagnosed in the period 1978-82 were derived from an ad hoc survey carried out in Umbria and for the years 1994-98 from Umbria Population-based Registry (RTUP). In the period 1994-98 the relative survival has lightly improved compared with the previous one. Comparison among five year relative standardized survival for head and neck, oesophagus and larynx, in Umbria region and in the other Italian registries, shows a quite high survival that could be further improved with an early diagnosis and, consequently, less destroying treatments.
In Umbria, region of Central Italy, lung cancer is the leading cause of death due to cancer in males. The aim of this work is to highlight decrease of mortality from lung cancer in males in Umbria, in the last 20 years and to describe relationship among incidence, mortality and survival of this cancer. The incidence data derived from an ad hoc survey carried out over the period 1978-1982 and for 1994-1999 from the Umbrian Population Cancer Registry (RTUP). The mortality data were derived from official publications of the Italian Central Institute for Statistics (ISTAT) and covered the entire period 1978-1999. Estimated annual percent change (EAPC) was calculated by joinpoint regression analysis. Decrease of mortality from male lung cancer in Umbria began in the 1990-ies due to reduced quantity of tar in cigarettes, decreasing consumption of tobacco and increasing of survival derived from the quality and the effectiveness of the oncological health care system.
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Thanks to large civil participation and to the women's movement in 1975 a law has been approved that institutes family health clinics. This law is dedicated in particular to health and general services for women and to family planning. The Hygiene Department of University of Perugia has studied during this time: the family health clinics (FHC) activity in order to determine how well it is meeting the institutional aims. The knowledge and the attitudes of women with respect their use of FHC which have been projected onto the community. Health Education has a very important role because it is quite often basis for acceptance of FHC by women. The identification of all aspects of cultural resistance is very important. To this point a research project has been completed. The focal point of this research concerns women and their ability to profit from available information, as well as their attitudes and evaluation of the FCH. This study has been using a representative sample of Umbrian women, aged 16-50 ys old, at March 1987; the sampling method was of two stage. On the whole 1647 observations have been made by means of a mail questionnaire. The responders were very low (about 25%), so the results obtained must be considered with extreme caution. Generally there is a positive opinion on family health clinic: women are linked to a service of the community. They express satisfaction with the service. They express opinions on both positive and negative aspects. Even if the first approach is generally determined by a gynecological visit, the users redefine the service in a less ambulatory manner and into a more consultative one. In fact, users consider the FHC as a reference for women's problems. They underline the lack of sexual and health consulting service. There is demand for counseling for infancy problems, sterility, health education and sexual education. Even the non-users have a sufficiently clear idea of the family health clinics. Non-users view the FHC as a service for women's problems as well as relationship problems.
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Twelve fetuses with renal pelvis dilatation < 15 mm have been followed up until a year after birth. Dilatation cleared up in 59% of the cases within the last weeks of pregnancy and in 33% in the first months of life, while was asymptomatically detected in one case only a year after birth. A grade I and II vesico-ureteral reflux was diagnosed in two babies. Scheduled ultrasonographic examinations together with routine biochemical tests only are suggested by the kidney anatomical-functional normal parameters. Possible recurrent infections may be prevented through urine culture. Voiding cystourethrography is performed only when a recurrent infection is present because a reflux may be detected. Lacking a definite prognostic parameter, pre- and postnatal ultrasonographic follow-up is necessary although the little renal pelvis dilatation is to be considered negligible.