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S Cecchini

Publications and source records attributed to S Cecchini.

At least 37 records · Page 2Linked to original sources
PubMed1989

Fine needle aspiration cytology and breast cancer diagnosis.

The authors report on 315 histologically confirmed consecutive breast cancer (BC) cases undergoing fine needle aspiration cytology (FNAC). Inadequate smears were infrequent (7%), particularly when reaspiration of inadequate cases was employed (1-2%). FNAC suspected BC in 81% of the total or 88% of adequate smears. Univariate and multivariate (Cox's model) analyses showed no correlation between inadequacy or suspect/positive FNAC rate and patient age, T category or histologic type. Differences in the inadequacy and suspect/positive rate were recorded among 30 operators (surgeons, oncologists, radiologists) performing the sampling, but the average results were consistent with literature reports. FNAC was found to be a useful diagnostic tool for BC diagnosis, and proper training of the highest number of operators is recommended to allow the widest diffusion of this diagnostic technique.

Adult↗
PubMed1989

Telethermography and breast cancer risk prediction.

The authors report on 4,624 noncancer women classified by telethermography (TH1-2 vs TH3) and followed for an average of 6.6 years (range, 2-12). Breast cancer occurring beyond the sixth month from TH were recorded according to a Cancer Registry, and the association between breast cancer incidence and thermographic class or patient age was evaluated. Univariate analysis showed a significant association of age and thermography with further cancer incidence, but multivariate analysis (Cox's model) confirmed a significant association only for age. Thermography (TH3) showed a nonsignificant odds ratio of 1.6 with respect to TH1-2 cases. Thus thermography did not show any practical role as a breast cancer risk indicator. Possible biases affecting previous reports suggesting the use of thermography as a breast cancer risk indicator are discussed.

Adult↗
PubMed1989

"T" category and operable breast cancer prognosis.

The authors report on 4,034 consecutively operated breast cancer cases, evaluating the correlation between clinical T category and long term survival. Age and pathologic nodal status were also considered as independent prognostic factors. Univeriate and multivariate (Cox's) analysis confirmed N status as the most powerful single prognostic indicator and did not reveal any prognostic correlation with age. T category was a strong prognostic indicator, independently of N status, the 10 year overall survival of T1, T2 or T3-4 cases being 0.86, 0.76 and 0.73 in N- and 0.73, 0.56 and 0.35 in N+ subgroups respectively. T category should be carefully considered not only in deciding the extent of surgical excision but also in planning adjuvant postoperative treatment.

Adult↗
PubMed1989

Sensitivity of the screening program for cervical cancer in the Florence District.

Cervical cancer screening has been ongoing in the Florence district since 1966. All invasive cervical cancers occurring from 1975 to 1985 in the district have been considered and their screening histories have been investigated to estimate screening sensitivity. In the years 1975-1984, 236,045 women were screened initially. In this population all interval cancers have been recorded to estimate first screening sensitivity values according to the length of the interval since the first Pap test: 0.90 at 1 year, 0.78 at 3 years, and 0.68 at 5 years. Sensitivity values for subsequent screenings were lower than those for the first screening (0.68 at 1 year, 0.43 at 3 years), probably due to a lower number of prevalent cancers and to a progressive selection of cancers which are difficult to detect. The high sensitivity values confirm our choice of a screening frequency of 3 years.

Adolescent↗
PubMed1989

Chest X-ray survey in the follow-up of breast cancer patients.

The authors report on 182 cases of intrathoracic metastases (ITM = lung, pleura or mediastinum) observed as first single recurrences in the course of the follow-up of patients treated for primary breast cancer. ITM were detected on standard two-views chest X-ray (CXR) at regular follow-up visits and in absence of subjective symptoms (102 A cases) or in the interval between two consecutive planned controls because of the onset of subjective symptoms (80 S cases). The average disease-free interval since primary treatment was significantly shorter in A with respect to S cases (40.3 vs. 28.5 months, P less than 0.001) as a consequence of the early detection achieved by CXR survey. On the contrary, prognosis was not influenced by ITM early diagnosis as the 10-year survival since primary treatment did not differ significantly between A or S cases (12% vs. 10%, P = 0.68). Results were confirmed on multivariate (Cox's) analysis, adjusting for potential confounders such as age or nodal status. Periodic CXR survey looks a very questionable policy as it does not seem to have any favourable impact on prognosis. Its routine use in breast cancer patients should thus be carefully reconsidered.

Adult↗
PubMed1989

Association of estrogen receptors with parenchymal pattern at mammography.

The authors report on a consecutive series of 1,003 breast cancer cases classified on the basis of Wolfe mammographic parenchymal patterns and estrogen receptor content. The association between these two variables was investigated to assess the reliability of parenchymal patterns in predicting the estrogen receptor status. No significant association was observed after adjustment for possible confounders such as age, menopausal status, and T category. Mammographic parenchymal patterns appear to have no role in predicting estrogen receptor status.

Adult↗
PubMed1988

Cervical cancer screening in Tuscany: a survey of the actual state of cervical cancer prevention in the Local Sanitary Units of the Tuscan region.

Every Local Sanitary Unit (USL) of the Tuscan Region was contacted to define screening variables, such as adequacy of the staff involved in prevention, smear technique, data collection and evaluation, laboratory quality control, and modalities of invitations to screening. The reported data show that 21 of 40 USL, but only 9 of 28 USL outside the Florence province (where a common screening program is performed), are performing active invitations to screening. The most serious staff inadequacies concern data evaluation and personnel performing the test. Sixteen of 28 USL outside Florence suggest an annual rescreening, which causes overcrowding of services and a poor availability for the unscreened population. Moreover, the poor quality of data collection makes it impossible to evaluate the benefit offered by the screening programs in the 28 USL outside Florence. Cytologic quality control is often lacking, and the smear technique is inadequate in 10 of 28 USL outside Florence. The lack in the USL of epidemiologic competence and of cost/benefit considerations and the need for political decisions about cancer prevention programs are stressed.

Cost-Benefit Analysis↗
PubMed1978

Relationship between clinical and electromyographic findings and exposure to solvents, in shoe and leather workers.

A very high prevalence of polyneuropathy was observed in shoe and leather workers from the area of Florence. In addition, normal workers showed abnormally low maximal nerve motor conduction velocity. A linear decrease of motor conduction velocity was observed as a function of age and of the length of exposure to solvents. The worker population showed a steeper decrease with age than controls. A higher prevalence of polyneuropathy was observed when the amount of glue used by each worker per day was higher, and when the air volume of the plant was smaller. The subjective symptoms most frequently associated with polyneuropathy were muscle spasms, leg weakness and pain, and arm paresthesiae. Cases of polyneuropathy were more frequent in the workers exposed to solvents and in the older age group. A solvent aetiology of the disease is suggested, and glue substitution and proper hygienic conditions are recommended.

Adhesives↗
PubMed1978

A comparative double-blind trial of the new antidepressant caroxazone and amitriptyline.

On the grounds of pharmacological properties and preliminary clinical trials the efficacy of the new antidepressant caroxazone was compared to amitriptyline in the management of depression. Forty patients mostly suffering from a neurotic or anxious-neurotic depression were admitted to a double-blind trial. All patients completed the study. The Hamilton Rating Scale for Depression was used for the clinical assessment at the beginning, during and at the end of treatment. The trial lasted three weeks. A significant improvement was seen for both drugs after seven days on most symptom scores and on total symptom score. No significant differences were found either at seven days of at the end of treatment between the two drugs. There were no significant differences in the incidence and severity of side-effects. In conclusion, caroxazone appears as an effective and well tolerated drug in the treatment of depression.

Adjustment Disorders↗
PubMed1977

[Duration of antidepressive treatment. Recurrences and their prevention].

The basic strategy for the pharmacological treatment of depression, with special regard to its continuance following the start of remission, is outlined. The problem of the prevention of recurrences of dysthymic symptomatology is discussed and emphasis laid on the importance of lithium about whose use a fair literature is already available. The results obtained to date demonstrate the undoubted advantages of lithium salts (particularly of carbonate) in the maintenance of good affective balance, above all in the case of those subjects in whom the frequency or gravity of dysthymia seriously handicaps working or social life.

Adult↗
PubMedDate not supplied

Contribution of cytology, colposcopy, target biopsy and conization to the early diagnosis of precancerous and cancerous lesions of the cervix uteri.

The study is based on 334 cytologic suspect or positive women observed in the area of Florence. Cytologic diagnoses of dysplasia, carcinoma in situ (CIS), and invasive carcinoma are related to the histologic reports. To the same histologic reports are related the colposcopic aspects. Lastly, diagnoses made by target biopsy are compared with the final diagnoses made by cone biopsy. The 3 diagnostic methods and their diagnostic accuracy are then compared. As regards dysplasia, the diagnostic precision of cytology is 40.2% and for target biopsy in 76.9%. In the diagnosis of CIS, cytology shows a diagnostic accuracy (77.7%) that is a little lower than that of target biopsy (81.7%). In invasive carcinoma, cytology has a good diagnostic precision (88.2%), which becomes 100% if the diagnosis is made by target biopsy. The correlation between colposcopic aspects and histologic reports is not very reliable. We conclude that cytology is a valid test in an extensive mass screening, that colposcopy is essential to execute target biopsy, and that the latter is useful in defining dysplasia and invasive carcinoma diagnoses. On the contrary, in the case of CIS, target biopsy does not greatly increase cytology diagnostic precision.

Biopsy↗
PubMedDate not supplied

[Paralysis of the parasympathetic ocular nerve after influenza syndrome].

A 41 year-old-man developed diplopia, bilateral ptosis, paralysis of conjugate eye movement upwards and horizontal, with dilated and fixed pupils, after an influenza syndrome. Radiological, cerebrospinal fluid and electrophysiological data were normal, except BAEPs. The different aetiologies and pathogenesis are discussed.

Adult↗
PubMedDate not supplied

Routine colposcopic survey of patients with squamous atypia. A method for identifying cases with false-negative smears.

Routine colposcopy was performed on 376 women with cervical squamous atypia (originally reported as "inflammatory atypia"). Colposcopy showed no abnormalities in 240 cases and a lesion in 136 cases; the latter were sampled by colposcopy-guided biopsy. The biopsy samples showed evidence of human papillomavirus (HPV) infection and/or grade I cervical intraepithelial neoplasia (CIN I) in 42 cases (11.1%), CIN II in 4 cases (1.1%) and CIN III in 5 cases (1.3%); the other 85 biopsied cases were histologically negative. Most cases of HPV/CIN I (35 of 42) and all of the cases of CIN II-III occurred in women under the age of 40. The detection rates were 4.4% for CIN II-III in women under the age of 40, 4.0% for HPV/CIN I in women 40 and older and 17.2% for HPV/CIN I in women under the age of 40 (P less than .001). It thus appears that women under the age of 40 who show cytologic evidence of squamous atypia would benefit from colposcopic examination.

Adult↗
PubMedDate not supplied

"Nonclassic" cytologic signs of cervical condyloma. A case-control study.

The association between "nonclassic" cytologic signs of condyloma and human papillomavirus (HPV) infection in women with negative Papanicolaou smears was analyzed via a case-control study. The cytologic signs considered were mild koilocytosis, mild dyskeratosis, binucleation or multinucleation, cleared cytoplasm and nuclear hyperchromatism. The Papanicolaou smears of 166 cases that showed colposcopic and histologic evidence of HPV infection (but whose smears lacked the classic cytologic signs of condyloma) and 166 controls that were negative colposcopically were randomly admixed and blindly reviewed by a panel of cytologists. A significant association to HPV infection was observed for all of the nonclassic signs studied, but multivariate analysis showed a weakly independent association only for mild koilocytosis. The sensitivity (0.46) and the specificity (0.87) of these nonclassic signs were not satisfactory. The utility of selecting women with negative Papanicolaou smears for colposcopy on the basis of these signs is discussed.

Adult↗
PubMedDate not supplied

Positive predictive value of fine needle aspiration cytology of breast lesions.

The predictive value of fine needle aspiration (FNA) was assessed in 1,181 consecutive cases of breast lesions in which cytologic abnormalities were reported. The positive predictive value (PPV) of an FNA cytologic report of atypia, suspicious or positive was 0.49, 0.95 or 0.996, respectively. In the presence of a suspicious/positive report by both physical examination and mammography, the PPV of a cytologic report of suspicious was 0.99. The PPV was directly correlated with age, partly due to the incidence of fibroadenomas among younger patients; fibroadenomas were present in 53 of 146 cases with a false FNA report of atypia, in 10 of 19 cases with a false FNA report of suspicious and in 2 of 2 cases with a false FNA report of positive. Overall, 93 cases reported as benign by physical examination and mammography were biopsied on the basis of the FNA cytologic report; cancers were diagnosed in 33 of these 93 cases (6 cancers among 42 women less than 40 years old and 27 cancers among 51 women greater than 39 years old). The widespread use of FNA cytology to study breast lesions is thus recommended, without regard to patient age and even in the presence of clinically benign findings, since the increase in the rate of cancer detection is worth the excess of unnecessary biopsies. The predictive value of a positive report of FNA cytology, or even of a suspicious report in the presence of clinical suspicion, is so high that an intraoperative frozen section biopsy might be spared in such cases.

Adult↗