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Biomedical subjects

R Zanetti

Publications and source records attributed to R Zanetti.

At least 73 records · Page 4Linked to original sources
PubMed1978

Special problems of zoonoses connected with urban areas.

The following items are discussed: 1) Zoonoses with an urban cycle: a) Salmonellosis; b) Dermatophytozoonoses; c) Toxoplasmosis; d) Larva migrans visceralis; 3) Flea and tick infections; f) Zoonoses of cities located on lakes, rivers and the sea. 2) Animalization of the urban environment. 3) Zoonoses which may be transferred from the rural to the urban environment: a) Rural zoonoses transmitted to urban animals; b) Rural zoonoses transmitted to man in cities. 4) Zoonoses which may be transmitted from the urban to the rural environment.

Animals↗
PubMedDate not supplied

Status epilepticus in benign rolandic epilepsy manifesting as anterior operculum syndrome.

We report the fourth case of partial status epilepticus (SE) in benign epilepsy of childhood with rolandic spikes (BECRS). The child suffered long-lasting attacks involving the mouth and pharynx, clinically manifest as speech arrest, sialorrhea, and drooling. Both clinical and electroencephalogram (EEG) data were compatible with the diagnosis of BECRS. Only during SE was the clinical picture similar to that observed in the operculum or Foix-Chavany-Marie syndrome. SE remission was obtained with the usual antiepileptic drug therapy (diazepam, clobazam, valproate). EEG records showed additional patterns of continuous spike-waves during slow sleep and specific inhibition and blocking of interictal centrotemporal spikes by mouth and/or tongue voluntary movements.

Brain↗
PubMedDate not supplied

Reproducibility of histopathologic diagnosis and classification of non-melanocytic skin cancer: a panel exercise in the framework of the multicenter southern European study HELIOS.

AIMS AND BACKGROUND: The reproducibility of histologic diagnoses, and in particular of the distinction between basal and squamous cell forms, has been evaluated in the framework of a multicenter case-control study (in Italy, France, Spain and Switzerland) aimed to assess the causes of non-melanocytic skin cancers. METHODS: A panel composed of 10 pathologists from the collaborating centers was appointed. A total of 1,774 slides of routine diagnoses were blindly reviewed by a second panelist; discordant diagnoses underwent a third examination. Controversial and interesting cases were discussed during general sessions. RESULTS: The results showed a high degree of concordance (99.5%), with a Cohen's kappa of 0.85 (95% CI, 0.77-0.94) in the assessment of malignancy of lesions. The concordance in the distinction between large morphologic groups, basal cell carcinoma and squamous cell carcinoma was also high (Cohen's kappa = 0.85; 95% CI, 0.82-0.89). The assessment of histologic subtypes, degree of invasion and differentiation showed a lower degree of concordance, presumably as a consequence of a weaker consistency in the relevant classifications. CONCLUSIONS: The reproducibility study has therefore validated the epidemiologic study and in particular allowed to correct some misclassifications that could have lessened the analysis of the case-control study. In general, because of its characteristics (number of pathologists and variety of their origins, the large number of cases examined, blind examination of histologic slides), the conclusions of the study may show a certain degree of generalization, at least with regard to the countries represented. Routine histologic diagnoses of cutaneous carcinoma showed a high degree of reliability with reference to the assessment of malignancy and the distinction between basal and squamous cell carcinoma morphotypes.

Adult↗
PubMedDate not supplied

Variations in the survival of adult cancer patients in Italy.

AIMS: As part of the ITACARE project, the present study analyzed and compared population-based data on the survival of adult cancer patients in Italy, according to sex, age, period of diagnosis and geographical area. METHODS: Nine Italian population-based cancer registries provided data on all their cancer patients (total 90,431 cases) followed for at least 5 years and diagnosed during the period 1978-1989. About 10% of the Italian population is covered by these registries. The data was analyzed by means of a multivariate model. RESULTS: The major findings were that there was a general improvement in 5-year relative survival over the study period (from 33% to 39%) and that there were significant differences in survival between different areas of the country, particularly for cancer sites which respond well to treatment. In general, the area covered by the Ragusa (Sicily) registry was characterized by significantly worse survival than other registry populations. Other important findings were that for all malignant cancer sites 5-year relative survival decreased with age from 50% for the youngest age class (15-44 years) to 27% for the oldest age class (75+ years) and that women have a better prognosis for most cancer sites (overall 5-year relative survival in women 48% vs 32% in men). CONCLUSIONS: The significant regional differences in survival may reflect unequal provision of care, particularly between northern-central Italy and the south. The reasons for the general survival improvement with time are not completely understood, whereas the marked overall sex difference is related to the fact that the commonest cancer in women (breast cancer) is eminently more treatable than the commonest malignancy in men (lung cancer). The unfavorable trend with increasing age may be due to increasing difficulty in applying complete therapy protocols as general health declines, sometimes in relation to an advanced cancer stage at diagnosis.

Adolescent↗
PubMedDate not supplied

The prevalence of cancer: a review of the available data.

AIMS AND BACKGROUND: Cancer prevalence in a population, defined as the proportion - or the number - of people who were diagnosed with a cancer during their lives and are still alive at a given date, is a crucial indicator for heath care planning and resource allocation. Long-term population-based cancer registries (CR) are the appropriate tools to produce prevalence figures, which, however, are scarcely available. This paper contains a review up to 1999 of the published data world-wide (reports and articles) on cancer prevalence: including measured and estimated figures. MATERIALS AND METHODS: Data on cancer prevalence from CRs are available for the Nordic countries, Connecticut, and Italy. In addition, electronic data are available for the European Union (EU). Data for the Nordic countries were first published in the mid-seventies, reporting the prevalence for 1970. The first data from Connecticut were available 10 years later. Estimates for all EU countries were published by the International Agency for Research on Cancer (IARC) in 1997. In Italy, observed and estimated data on the prevalence of respiratory and digestive tract cancer and breast cancer have been published during the nineties, followed by a systematic analysis for all cancers in 1999. By using information obtained from CRs, cancer prevalence data were calculated directly (observed prevalence) by means of incidence and follow-up information on individual cancer patients, or indirectly (estimated prevalence) by means of mathematical models, which generally use epidemiological information at the aggregate level. RESULTS: Cancer prevalence for all cancers combined (proportions per 100,000 inhabitants) showed values of less than 700 in males and less than 800 in females in 1970 (Finland) to over 2,300 in males and over 3,000 in females in 1992 (Italian registries). With few exceptions, in each country and period considered the cancer sites contributing most to cancer prevalence are lung, colon-rectum, prostate and bladder in males, colon-rectum, breast, uterus (both cervix and corpus) and ovary in females. At present, comparison of measurements from different areas is difficult because there exists no standardized mode of presentation. CONCLUSIONS: In spite of their being potentially useful for health care planning, prevalence data have been produced inconsistently and late by cancer registries, at least in comparison with the systematic availability of incidence and survival statistics. The available data can be compared only to a limited extent due to differences in completeness, in the choice of indicators, in the standard populations, and in the frequency of publication. It would be desirable that in the future data will be produced systematically, with a higher level of standardization compared to the past, and, most importantly, on the same geographic and administrative scale as health-care decision-making.

Europe↗
PubMedDate not supplied

Risk of basal and squamous cell carcinomas of the skin in Sion, Switzerland: a case-control study.

AIMS AND BACKGROUND: Non-melanocytic skin cancers are the most common cancers in white populations. Studies on populations of Anglo-Saxon and Mediterranean origins highlighted different patterns of risk of basal-cell carcinoma and squamous-cell carcinoma in relation to sunlight exposure, skin characteristics and phenotype susceptibility. In Sion, and in Switzerland as a whole, the high incidence suggests the possible presence of additional risk factors or of a different pattern of exposure to solar radiation as well as different composition of pigmentary traits and skin sensitivity to sun. METHODS AND STUDY DESIGN: We conducted a case-control study of 146 cases (73% of eligible cases) and 144 controls (81% of eligible subjects) to further evaluate the relationship between nonmelanocytic skin cancer and risk factors in the Sion population. Interviews were conducted by trained interviewers with a standardized questionnaire. RESULTS: Pigmentary characteristics such as blonde and red hair as well as tendency to sunburn without tanning and number of sunburns showed a statistically significant and independent risk increase in basal-cell carcinoma. Sun exposure during recreational activities (outdoor sports) showed a risk increase in basal-cell carcinoma with borderline statistical significance. Analysis of squamous-cell carcinoma risk was limited by the small number of cases, but it was positively associated with lifetime exposure to sun during outdoor work and with skin characteristics. CONCLUSIONS: Results confirmed previous suggestions of a different mechanism leading to malignant transformation of target cells from the basal and squamous epidermal layers, mediated by different phenotypes, and conditioning the ability to develop an effectively protective tan.

Adult↗
PubMedDate not supplied

[Social differences in cancer incidence, fatality, and mortality in Turin].

INTRODUCTION: The study of social differences in health is today focused on determinants. The knowledge of determinants is useful for the definition of policies to tackle inequities. The aim of this paper is to analyse the social distribution of cancer incidence, fatality and mortality in the city of Turin during the 80's and to estimate the amount of inequality produced within the health system. SOURCES OF DATA: The social distribution of the risk of death in Turin during 1981-1989, estimated from the Turin Longitudinal Study, is compared with incidence and fatality during approximately the same time period. RESULTS: Among men, the relative risks for all cancer sites, among social classes, appear to confirm the hypothesis of a multiplicative model of incidence and fatality. In particular, colo-rectal, prostatic, bladder cancers and lymphoma and leukaemia show relative risks similar to the expected ones. Cancers of larynx, lung and stomach seem to be less coherent. Among women, colon-rectum, lung, breast and lymphoma and leukaemia show coherent results, whereas relative risks for uterus are far from the expected. DISCUSSION: The coherence with the expected values of the social distribution of mortality suggests the adequacy of the multiplicative model for the provision of mortality from incidence and fatality. Therefore it is possible to state that the portion of inequality in health originated within the health system is big enough to suggest the need to put the equity in the access to health services in the agenda of interventions.

Adult↗
PubMedDate not supplied

[Estimate of the proportion of skin tumors attributable to sun exposure in 3 Italian populations].

Translation of recommendations on skin cancer prevention formulated by many national and international institutions into efficient steps requires measuring the potential impact in terms of preventable cases. This study analyses the proportion of skin cancers attributable to sun exposure in Turin, Trento and Ragusa. Estimates have been reached by applying the risk models calculated from the case-control study on melanoma in Turin and the Helios multi-centric study on skin carcinomas. The proportion of cases attributable to sun exposure has been subsequently calculated by correcting for the different proportion of skin characteristics among the populations taken into consideration. Attributable risks so calculated show medium to high values for melanoma in Turin (38%) and Trento (29%), while values are lower in Ragusa (17%). As for basal-cell carcinoma, attributable risk values are slightly inferior to those of melanoma. The risk of squamous-cell carcinoma attributable to sun exposure during outdoor work is the highest in Ragusa, with a value of 25%. Taking an annual incidence rate for melanoma of 9 cases per 100,000 inhabitants, and a preventive intervention with 50% of effectiveness, preventable cases should be 2 cases per 100,000 each year. This figure compared with 8 preventable cases of cervix cancer, in a similar population suggests an extremely cautious attitude in taking on programmes aiming to change life styles.

Humans↗
PubMedDate not supplied

[Methodological issues and first results of a record linkage between AIDS and Cancer Registries in Italy].

We report herein, the first results of a record linkage between the Italian AIDS Registry and 13 population-based Cancer Registries (about 8-million population in 1991). An anonymous linkage process was carried out on about 339,000 cancer notifications and 6,067 AIDS ones reported between 1982 and 1994. Out of 243 Kaposi's sarcomas (KS) below age 50 years recorded at either type of registry, 90 (37%) were reported as such by both. Sixty-eight percent of individuals with KS at Cancer Registries could be identified at the AIDS Registry. Sixty-two percent of individuals with KS and 65% of individuals reported as having non-Hodgkin's lymphoma (NHL) at RAIDS could be also found at Cancer Registries. Among 6,067 persons with AIDS 15-69 years old, observed and expected numbers of cancer and age-standardised incidence ratios (SIR) on a total of 25,759 person-years were computed. Significantly increased SIR was found for Hodgkin's disease (8.9; 95% CI: 4.4-16.0), invasive carcinoma of the cervix uteri (15.5; 95% CI: 4.0-40.1), and non-melanomatous skin cancer (3.0, 95%, CI: 1.3-5.9). As in previous studies, KS and NHL were greatly increased (SIR = 1,300 and 59, respectively). The risk for all cancer types, after exclusion of KS and NHL, was approximately twice the risk of the general population. An increased SIR of Hodgkin's disease in persons with AIDS is thus confirmed, though many-fold smaller than for NHL. An association with invasive carcinoma of the cervix is also shown at a population level. These data indicate the potential of AIDS and Cancer Registries for improving cancer assessment in individuals with HIV/AIDS and elucidating the role of immune system on cancer onset.

Acquired Immunodeficiency Syndrome↗