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Biomedical subjects

R Micciolo

Publications and source records attributed to R Micciolo.

At least 91 records · Page 5Linked to original sources
PubMed1990

[The problem of false positives in bone scintigraphy in patients with breast neoplasms. A follow-up at 10 years].

Bone scanning plays a pre-eminent role in tumor staging procedures, but its reliability is often questioned because of the high incidence of false positive results; not even bone biopsy can always clarify these questionable findings. To verify what actually becomes of the pathological hot spots lacking radiological evidence, we studied 49 patients with this discrepancy and followed them for an average period of 10 years (range: 8-11). The patients were divided into 3 subgroups: 1) 13 N+ patients with multiple hot spots (greater than 2) (N+ IM); 2) 24 N+ patients with single hot spots (less than or equal to 2) (N+ IS); 3) 12 N- patients with single hot spots (less than or equal to 2) (N- IS). Bone metastasis-free survival rate (SLMO) was calculated, which was confirmed by radiology, and overall survival rate (SG). SLMO was considered to coincide with the percentage of "true" false positives. At 10 years SLMO was 7%, 65%, and 83%, whereas SG was 15%, 70%, and 90%, respectively, in the 3 subgroups N+ IM, N+ IS, and N- IS. The Log-rank test demonstrated a highly significant difference (p less than 0.001) between SLMO and SG in these subgroups, due to the poor prognosis of N+ IM patients. The cumulative examination of all N+ N- patients with single hot spots (36 patients) demonstrated 75% probability of "true" false positives at 10 years. Moreover, the risk of bone metastases resulted higher in the hot spots of the spine than in those of the skull and ribs. The possible role is discussed of microfractures and bone traumatisms in the genesis of "true" false positives.

Adult↗
PubMed1989

The demand for extramural psychiatric intervention in a community-based service.

Using a psychiatric case register, patients who had extramural contacts with the South-Verona Community Psychiatric Service in 1983 (N = 549) were selected for this study and followed-up for 3 years, from the date of their first 1983 contact. Out of the total number of extramural contacts made in 3 years (N = 12,429) 16% were unplanned (drop-in) contacts. A linear-logistic model was used to investigate the joint effects of sociodemographic and clinical variables on the frequency of unplanned extramural contacts. The model to fit the data was complex, confirming that many interactions among the variables considered in the study significantly affect the probability of using the community services on an urgent or unplanned basis.

Aged↗
PubMed1989

Seasonal variation in suicide: is there a sex difference?

Seasonal variation in suicide in Italy for the years 1969-81 has been assessed in males and females by means of harmonic analysis. Cyclical fluctuations in the number of suicides, reasonably consistent over the 13 years of the study, have been observed in both sexes. Seasonal harmonics accounted for 65.3 and 48.4% of the variance in male and female suicides respectively. While in males the only important seasonal harmonic was the first (one cycle per year), in females there was an important first harmonic and a second harmonic (two cycles per year). In both sexes the peak of the first harmonic occurred in May, while in females the subsidiary peak occurred in October-November.

Cross-Sectional Studies↗
PubMed1989

Psychotropic drug prescription in general practice in Italy: a two-week prevalence study.

A study on psychotropic drug monitoring was carried out in Verona over a 2-week period using information obtained during consultation with 3 GPs. Psychotropic drugs accounted for 23.4% and 24.3% of all prescriptions in men and women respectively. Benzodiazepines were the most frequently prescribed: 76% and 72% of all psychotropic prescriptions respectively in women and in men. No significant association between psychotropic drug prescription and age, sex, marital status and occupation was found in the present survey. In men only, those patients with higher educational level were more likely to receive a prescription for psychotropic drugs than those with a lower educational level. About 70% of men and 60.4% of women diagnosed by the GP as having a psychiatric problem were prescribed a psychotropic drug. However, the probability of a psychotropic being prescribed, when a psychiatric problem is identified by the GP, was significantly higher (p less than 0.05) in men than in women: odds ratio 39.37 and 16.33 respectively. Psychotropic drugs were prescribed in 35% of men and in about 48% of women in which a social problem was identified by the GP. Women were about 5 times more likely to receive a prescription than men: odds ratio 12 and 2.75 respectively. A significant influence of physical ill-health and educational level on psychotropic prescription emerged: both effects were independent of sex, psychiatric morbidity and social problems. Using a logistic regression analysis, an interactive effect between sex and conspicuous psychiatric morbidity and between sex and social problems was also found.

Adult↗
PubMed1989

Patterns of psychiatric care in south Verona and Groningen. A case-register follow-up study.

The pattern of utilization of mental health services in south Verona (Italy) and in Groningen (the Netherlands) was studied. The local psychiatric case registers were used to select patients aged 15 years or more who had at least one contact in 1982 and no contacts in the previous 365 days. Each patient was followed for 36 months after the first contact in 1982. The 2 cohorts differed in size (373 in south Verona and 590 in Groningen), age, diagnosis and pattern of care, whereas the sex distribution was similar. The cohort in Groningen was characterized by a higher number of elderly people, suffering from organic psychoses. Drug dependence prevailed in south Verona, while alcohol dependence was predominant in Groningen. The pattern of care was classified according to 2 basic measures, the gross duration of care and the net duration of care. In south Verona single consulters were almost 3 times more common than in Groningen. In general, patients in Groningen tended to depend more on the mental health services. Linear regression analysis was used to determine the extent to which the pattern of care was predicted by the sociodemographical and clinical characteristics of the patients. Only the site where the contacts were made (south Verona or Groningen) and the diagnosis were significantly associated with the pattern of care.

Adult↗
PubMed1989

Psychotropic drug prescription in Italy. A survey in general practice.

A survey of psychotropic drug prescription was conducted in Verona using information obtained from 92 GPs. A total of 2559 patients consulted their GPs on the day of the study and 14.2% of them received a prescription for a psychotropic drug. Benzodiazepines were the most frequently prescribed: 72.8% and 70.4% of all psychotropic prescriptions in women and men respectively. The prevalence of prescription was higher in women than in men (15.8% vs 11.2%) and the difference was statistically significant (P less than 0.001). Subjects aged 45-64 had the highest chance of receiving prescriptions for psychotropics. Occupational status seems related to psychotropic drug prescription only in women. A strong association was found between psychotropic drug prescription and conspicuous psychiatric morbidity. This association was independent of sex, age, and occupational status. An interactive effect between social problems and sex on psychotropic drug prescription was found. The perception by the GP of a social problem increases the risk that a psychotropic will be prescribed about twice in women, but not in men.

Adolescent↗
PubMed1988

High-density lipoprotein composition in obesity: interrelationships with plasma insulin levels and body weight.

Hyperinsulinism may play a role in the development of atherosclerosis. In this study we analyzed the interrelationships between plasma glucose, insulin, body weight and high-density lipoproteins (HDL) in a group of obese women and faced the question of what is the effect of obesity on insulin, glucose and HDL relationships. HDL cholesterol was significantly lower, while HDL triglycerides resulted significantly higher in the obese women than in the controls. The two groups did not show any difference in the serum concentration of HDL apoprotein A-I and apoprotein A-II. There was an inverse correlation between fasting plasma glucose and summated means of glucose and insulin levels after an oral glucose tolerance test and HDL cholesterol in the two groups; on the contrary a positive relationship between the same parameters and HDL triglyceride occurred. HDL cholesterol was inversely related also to the weight index, while HDL triglyceride concentration was directly correlated with this parameter in the two groups. Partial correlation analysis demonstrates that, when exposed to similar plasma insulin and glucose levels, HDL cholesterol and triglyceride concentrations were no longer correlated with the weight index, and therefore that the significant correlations between these variables are likely to be due to the significant correlations of each of them with plasma glucose and insulin levels. Further studies clarifying the role of glucose and insulin in determining HDL composition would appear important.

Adult↗
PubMed1987

Long-stay and long-term psychiatric patients in an area with a community-based system of care. A register follow-up study.

In South-Verona, where a community-based system of care consonant with the provisions of the Italian psychiatric reform has been operating since 1978, case-register data show that Long-stay inpatient rates are decreasing, while rates of patients treated long-term outside the mental hospital (i.e. those in "continuous care for one year, receiving treatment in the community by the various out-patient and day-patient facilities and in some cases short spells of inpatient care") show a recent increasing trend. Long-stay inpatients on 31.12.1982 have been compared with long-term community patients on the same date. The two cohorts were similar in terms of basic sociodemographic variables and contained a similar proportion of psychotic patients. However, while 88% of the long-stay inpatients were still long-stay after two years, only 45% of the long-term patients in the community remained in long-term treatment over the same period. Using a log-linear model, diagnosis was found to be the variable with the highest association in the long-term cohort with subsequent pattern of use of mental health services.

Adolescent↗
PubMed1986

Conservative treatment of external pancreatic fistulas with parenteral nutrition alone or in combination with continuous intravenous infusion of somatostatin, glucagon or calcitonin.

Treatment with total parenteral nutrition (TPN) alone or combined with continuous intravenous infusion of either somatostatin or calcitonin or glucagon have been carried out upon 45 patients with a high output external pancreatic fistula. No significant difference among these treatment schedules was observed in the percentage of closure of fistulas (85 to 100 per cent of the patients), but patients treated with TPN plus somatostatin had the fistulas close within a significantly (p = 0.000028) shorter period of time. Moreover, this treatment was associated with the strongest inhibition of the output from the fistula (minus 82.3 per cent). Since treatment with somatostatin was not accompanied by any side effect, was followed by a quite rapid closure of the fistulas and allowed an estimated economic savings of about $2,100.00 dollars per patient, it seems to be advisable in the conservative treatment of external pancreatic fistulas.

Calcitonin↗
PubMed1985

Serum PABA and fluorescein in the course of Bz-Ty-PABA and pancreolauryl test as an index of exocrine pancreatic insufficiency.

Forty-six subjects (20 chronic pancreatitis, 7 chronic liver disease, 7 recovered from acute pancreatitis, 2 Crohn's disease, and 10 healthy controls) classified by S-C test as having normal pancreatic function (26 subjects), or moderate (10 subjects) and severe (10 cases) pancreatic insufficiency, were given, on different days, 1 g of oral PABA or 348 mg of oral fluorescein dilaurate. At the 1st, 2nd, and 4th hours (PABA) and the 2nd, 4th, and 6th hours (fluorescein) serum samples were taken for assay. In the presence of severe exocrine pancreatic insufficiency, the sensitivity of the fluorescein serum levels was higher than that observed for the PABA (100% and 80%, respectively), and quite similar to that shown by the urinary tests (100% and 70%, respectively). On the contrary, in presence of moderate pancreatic insufficiency, both the urinary test (pancreolauryl and (PABA) give a sensitivity higher than that found in the serum tests (30-40% and 10-30%, respectively). The parallel combination of both the serum or urinary tests does not significantly improve the sensitivity of the single test. These results suggest that the serum PABA and serum fluorescein tests can be valid choice when a prolonged urinary collection is difficult, i.e., in children and in elderly patients. However, the slight diagnostic gain does not justify the routine use of both urinary and serum tests.

4-Aminobenzoic Acid↗
PubMed1985

The use of historical controls in breast cancer. An assessment in three consecutive trials.

To evaluate the effectiveness of a new therapy some authors suggest the use of a retrospective control group, especially in cancer trials. In this article, by means of data collected in three consecutive randomized clinical trials on breast cancer performed at the Istituto Nazionale Tumori of Milan, the risks of a practice involving use of data from one trial as "historical controls" for the next one were investigated. The comparability between the baseline characteristics of different groups has been examined by resorting to univariate as well as multivariate statistical methods. The results of the final evaluation of the relative effectiveness of the treatments under study have also been investigated, using both randomized concurrent and historical controls. Although the eligibility criteria did not change, some differences between groups of consecutive trials were observed. The results attained by using historical control data, after adjusting for the differential composition in the baseline characteristics, made evident a biased conclusion in favor of the new treatment tested, which, in a historically controlled study, is always the last one. These results appear to be in agreement with those published by Sacks, Chalmers, and Smith (Am J Med 72:233-240, 1982).

Adult↗
PubMed1984

Psychological performance of workers with blood-lead concentration below the current threshold limit value.

The effects of lead exposure on psychological test performance and subjective feelings of well-being were investigated in 40 exposed workers whose PbB levels had never exceeded 60 micrograms/100 ml and in 20 controls matched for sex, age and educational level. The exposed workers were divided into two groups of 20, with recent PbB levels in the range 45-60 micrograms/100 ml or below 35 micrograms/100 ml. The group of workers with the higher PbB levels showed significantly poorer performance and reported more physical symptoms than the other two groups. These differences were unrelated to sociodemographic and personality characteristics. A principal component analysis suggested that the poorer performance was mainly due to an impairment of general functioning and only to some extent to a deterioration in specific functions, such as verbal reasoning and abstraction. Higher lead concentrations were correlated with poorer performance and a higher number of physical complaints. These results indicate that in exposed workers the threshold for impaired performance lies below the blood-lead concentration of 60 micrograms/100 ml, which is the current threshold limit value (TLV).

Adult↗
PubMed1984

Adipose tissue lipoprotein-lipase activity in obesity.

The activity of lipoprotein-lipase in heparin-eluates of adipose tissue (AT-LPLA) of three body regions was measured in 22 obese and 18 nonobese females under basal conditions. AT-LPLA in the obese women both before and after 10 d of caloric restriction was also measured. Basal LPLA correlated well with plasma insulin values and reduced significantly after caloric restriction. Relative body weight, body fat, fasting and glucose-stimulated insulin levels, triglycerides, total cholesterol, but not high-density lipoprotein cholesterol, significantly decreased after caloric restriction. Variation of insulin levels after caloric restriction was the best explanatory variable correlating with AT-LPLA variations. These results are consistent with a primary role of insulin in regulating AT-LPLA.

Adipose Tissue↗
PubMed1984

Metabolic and nutritional factors in the pathogenesis of idiopathic osteonecrosis of the head of the femur (preliminary results of a long-term follow-up investigation).

A double statistical study of a group of 56 patients affected by idiopathic osteonecrosis of the head of the femur is presented. A comparative investigation was undertaken into this group, taking into consideration the principal biochemical parameters, clinical findings, dietary and living habits. The statistical data that were analysed confirmed the role of some of the aetiological factors concerned. A long-term study was also undertaken, with a preliminary follow-up at 22 months, on the progress of the patients with monolateral idiopathic osteonecrosis of the femoral head who were subjected to a therapeutic programme of dietary correction and the administration of medicaments.

Adult↗
PubMed1983

Evolution of pain in chronic relapsing pancreatitis: a study of operated and nonoperated patients.

A group of 191 patients with chronic relapsing pancreatitis was followed for about 10 years. Ninety-three of them were selected for surgery because of incapacitating painful relapses or persistent pain and were submitted to side-to-side pancreaticojejunostomy. Ninety-eight were selected for medical management. Seventeen patients died during the follow-up. The cumulative probability of pain relief, 10 years after clinical onset of the disease was 62.9% in the patients who had been submitted to surgery and 42.8% in the nonoperated patients. In the operated group, no case of further relapse was observed after a 3-year pain-free interval, but in the nonoperated group some patients complained of further painful relapses. Complete and lasting alcohol withdrawal and/or steatorrhea were significantly associated with a more favorable result in the patients who had been submitted to surgery. However, the relationship between alcohol consumption, exocrine pancreatic insufficiency, and pain behavior did not reach statistical significance in the nonoperated patients. In patients selected for and submitted to surgery, whose disease before surgery was severe because of a high frequency of painful relapses, the chance of pain relief was similar to, and to some extent higher than, that observed in patients not selected for surgery and suffering from a mild or moderate disease. Alcohol withdrawal and exocrine pancreatic insufficiency have been confirmed as being adjunctive factors toward lessening pain in patients who had been submitted to pancreaticojejunostomy.

Adult↗