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Silvio Cavuto

Publications and source records attributed to Silvio Cavuto.

7 recordsLinked to original sources

The Italian surveillance system for occupational cancers: characteristics, initial results, and future prospects.

BACKGROUND: Occupational cancer monitoring is important for cancer prevention and public health protection. A surveillance system for identifying occupational cancer risks and cancer cases in Italy that are likely to be of occupational origin using information available in the Italian Social Security archives was created and assessed. Persons employed in the private sector, the employing company, its industrial sector, and years of employment are available in these archives. METHODS: A method to find known occupational hazards was first tested using a case-control approach. Cases were from six Italian cancer registries (CRs) and controls were sampled from source populations and as "exposure" the economic sector of the employing company was used. The potential of using hospital discharge records as case sources was subsequently assessed: these cover larger populations and are available more quickly than CR case series. RESULTS: In the CR-based study many known occupational cancer risks related to specific industrial sectors were identified. By using cases from hospital discharge records many industries at risk were identified, as well as cases of recent diagnosis likely to be of occupational origin. However, for some industrial sectors (e.g., the chemical industry) the approach was unable to detect any excess risk. Furthermore, information on employees in important areas like agriculture, self-employment, and the public sector is not available in the Social Security archives. CONCLUSIONS: This approach appears to be a promising low-cost method for occupational cancer surveillance, at least for some industries, and can be easily implemented in other countries.

Adult↗

The REALAB project: a new method for the formulation of reference intervals based on current data.

BACKGROUND: In a primary healthcare center concerned more with maintaining wellness than with diagnosing and monitoring illness, it is particularly important to compare patients' results with reference intervals derived from a matched population by use of defined statistical methods. METHODS: Laboratory results over a 3-year period (approximately 15,000,000 records; 197,350 individuals) were retrieved from our laboratory information system. An inclusion/exclusion procedure for individual patients was applied based on (a) presence of at least 1 of 23 previously defined "basic tests"; (b) only 1 measurement per test by the laboratory over the 3-year period; (c) for each test, absence of any abnormality in the correlated tests. Before the third step, correlations among quantities were assessed by a Spearman correlation matrix, comparing each of the 23 basic tests with all remaining tests by use of a novel multivariate algorithm. RESULTS: The initial sample group (n = 197,350) was reduced stepwise by the selection criteria outlined above to 166,027, then to 93,649, and finally to 61 246 individuals constituting our reference sample group. Results from the last 2 groups were used to calculate sex-specific, and in some cases age-related, reference limits for the 23 basic tests and for 13 additional quantities. Reference limits were calculated throughout this study by nonparametric estimation of percentiles. CONCLUSION: Reference values derived by retrospective analysis of large samples of data obtained at a given institution are particularly suitable for the evaluation of results for the presenting patient population at that institution.

Adolescent↗

The Pediatric Rheumatology International Trials Organization criteria for the evaluation of response to therapy in juvenile systemic lupus erythematosus: prospective validation of the disease activity core set.

OBJECTIVE: To validate and promulgate a core set of outcome measures for the evaluation of response to treatment in patients with juvenile systemic lupus erythematosus (SLE). METHODS: In 2001, a preliminary consensus-derived core set of measures for evaluating the response to therapy in juvenile SLE was established. In the present study, the core set was validated through an evidence-based, large-scale data collection process that led to the enrollment of 557 patients from 39 different countries. Consecutive patients with active disease were assessed at baseline and after 6 months. The validation procedures included assessment of feasibility, responsiveness, discriminant and construct ability, agreement in the evaluation of response to therapy between physicians and parents, redundancy, internal consistency, and ability to predict a therapeutic response. RESULTS: The following clinical measures were found to be feasible and to have good construct validity, discriminative ability, and internal consistency; furthermore, they were not redundant, proved responsive to clinically important changes in disease activity, and were associated strongly with treatment outcome and thus were included in the final core set: 1) physician's global assessment of disease activity, 2) global disease activity measure, 3) 24-hour proteinuria, 4) parent's global assessment of the patient's overall well-being, and 5) health-related quality of life assessment. CONCLUSION: The members of PRINTO propose a core set of criteria for the evaluation of response to therapy that is scientifically and clinically relevant and statistically validated. The core set will help standardize the conduct and reporting of clinical trials and assist practitioners in deciding whether a patient with juvenile SLE has responded adequately to therapy.

Activities of Daily Living↗

Results of blood pressure screening in a population of school-aged children in the province of Milan: role of overweight.

OBJECTIVES: To study the prevalence of high blood pressure (BP) in an Italian paediatric population, and to verify whether in this population elevated BP values are associated with overweight (OW). STUDY DESIGN: Children (1206 males, 1210 females) from the lower-grade public schools (ages 6-11 years) were studied. Body weight, height and BP were measured in each child. Elevated BP was defined if resting systolic and/or diastolic BP values equalled or exceeded the 95th percentile according to gender, age and height, based on the US normative BP tables. Overweight children were identified using four different methods: (1) the classification based on the relative body weight; (2) the French references by Rolland-Cachera et al. (Am J Clin Nutr 1982; 36:178-184); (3) the International Obesity Task Force charts; and (4) the Italian charts defined by Cacciari et al. (Eur J Clin Nutr 2002; 56:171-180). RESULTS: The prevalence of high BP in our population was 4.2% and was significantly higher in females (65/1210 = 5.4%) than in males (37/1206 = 3.1%), P = 0.005. The different methods used to define OW provide different estimates of OW prevalence (from 17.0 to 38.6%). The percentage of high BP subjects was significantly higher in OW than in normal-weight children regardless of the method used for the definition of the weight class (P < 0.0001), in both genders. In addition, for each age range, absolute systolic and diastolic BP values were higher in OW as compared to normal-weight children both in males and in females (P < 0.0001). CONCLUSIONS: Our study indicates the importance of performing BP screenings in the paediatric population, and to promote interventions that may reduce the prevalence of OW in children.

Age Distribution↗

[The active search for occupational cancer cases: bladder cancer in Lombardy Region].

OBJECTIVE: A study called OCCAM (OCcupational CAncer Monitoring) has been carried out in order to establish a nationwide surveillance system for occupational cancer. This project consists of population-based case control studies where information on past occupations are automatically gathered National Institute for Social Security's archive, cancer cases are obtained from Cancer Registries (CR) and controls are sampled from population files of the National Health Service. As previous results obtained using CR were encouraging, we tried to use regional hospital discharge records as a source of incident cases. DESIGN: We have conducted a population based case-control study with 1568 male bladder cancer cases occurred in the years 1999 and 2000 and 18818 controls randomly sampled from resident population in Lombardy region (Italy). RESULTS: Despite the limits of this approach the following industries were found at increased risk of bladder cancer: leather and shoes industry (OR=1.83; CI 90%: 1.01-3.33; observed: 10); transports (OR=1.28; CI 90%: 0.94-1.76; observed: 37), rubber industry (OR=1.22 CI 90% 0.80-1.85; observed: 19) and printing industry (OR=1.5 CI 90%: 1.10-2.05; observed: 38). CONCLUSION: The ability of OCCAM surveillance system to find known associations using routinely available data offers new opportunities to detect cancer cases likely to be of occupational origin.

Age Factors↗