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Biomedical subjects

A Verdecchia

Publications and source records attributed to A Verdecchia.

68 records · Page 4Linked to original sources
PubMed1984

General hospital psychiatry in Italy: on the hospitalization of psychiatric patients and consultation-liaison psychiatry after Law 180, 1978.

The type of psychiatric assistance carried out in Italy before Basaglia's views gained ground--that is, before 1968, when his book L'Istituzione Negata was published--is first described. The "Democratic Psychiatry" movement he launched was the mainspring of Law 180 (1978), known to have led to the closing of asylums. This law has brought about moves to create new mental health community services covering wide areas, the setting up of special diagnosis and care sections in general hospitals responsible for compulsory admissions--and overcrowding in private clinics and University clinics within general hospitals. The role of the psychiatric ward (opposed by the supporters of "Democratic Psychiatry") and of consultation-liaison psychiatry within the ambit of the general hospital is then discussed in the light of our experience.

Commitment of Persons with Psychiatric Disorders↗
PubMed1982

Evaluation of risk factor variations in relation to their baseline values in a controlled preventive trial. Application to the Rome Project of CHD Prevention.

This paper proposes a method for separating intervention impact, regression to the mean and spontaneous evolution effects in a controlled preventive trial. Variation dependence on baseline values is estimated by means of corresponding regression lines. Regression line slopes are adjusted to eliminate bias due to the difference between observed and 'true' values. Intervention impact is then evaluated using the control group as reference. Possible differences in factor baseline values are adjusted for. The method is used to analyse variation patterns for body mass index, serum cholesterol, systolic blood pressure, diastolic blood pressure and cigarette smoking in four years in the Rome Project of Coronary Heart Disease Prevention cohorts. All regression lines of variations vs baseline values show a negative slope. A highly significant improvement due to treatment is observed for blood pressure and body mass index, a less substantial but significant improvement is observed for serum cholesterol, and no effect is observed for cigarette smoking.

Adult↗
PubMed1981

Risk factors changes and coronary heart disease in an observational study.

Data from the Seven Countries Study are analysed to examine the relationship between the observed incidence of Coronary Heart Disease in the second 5-year period of follow-up and the major entry risk factors and their changes over the first 5 years. The analysis, using the Multiple Logistic Function model, shows that changes in systolic blood pressure and smoking habits are significant factors associated with incidence, while changes in cholesterol and body mass index do not play this role. This conclusion applies to the population as a whole. A more detailed analysis, stratifying the population by estimated risk at entry and changes of risk over 5 years, shows that incidence is related to changes of risk in low and medium entry risk groups. Moreover, a univariate analysis of data limited to systolic blood pressure and cholesterol indicates that changes in blood pressure are related to incidence in the group with highest entry level of blood pressure, while changes in cholesterol are irrelevant to subsequent incidence.

Adult↗
PubMed1977

[Identification of subjects at high coronary risk in the Roman Project of Coronary Heart Disease Prevention (author's transl)].

In the Roman Project of Coronary Heart Disease Prevention two different techniques were employed for the identification of individuals at high coronary risk within the treatment groups of the Project. The "risk score" is a simple additive system developed by the working groups of WHO, while the "multiple logistic function" is a complex mathematical model of multivariate analysis. Both of them consider 5 risk factors (age, systolic blood pressure, serum cholesterol, smoking habits and physical activity at work) and are applied for the identification of individuals belonging to the upper 20% of a risk rank list. The two techniques apparently provide similar predictive performances when applied to epidemiological prospective material collected in other studies where the morbid events are already known. When employed in the study population groups they identify, as high risk individuals, different subgroups of population, which overlap only partially. On the basis of theoretical and practical considerations, it has been decided to employ both techniques and to extend, as a consequence, the proportion of high risk individual, eligible for individual treatment, from 20% to about 30% of the total.

Adult↗
PubMedDate not supplied

Studying survival of cancer patients in different populations: its potential and role.

RATIONALE: Survival figures from a population-based study incorporate the overall practice in diagnosis, cure and clinical follow-up for a specific disease within a given health care system. Being the outcome of a number of individual, social and economical aspects, population-based survival may be thought as index for measuring the level of a country's development. DATA: The EUROCARE project, a European Cancer Registries (CR) concerted action, provided reliable information on survival for more than 800,000 cancer patients from 11 European countries. A great deal of epidemiologic information has derived from EUROCARE. Women had a longer survival than men for all studied tumour sites, except for the colon. European survival variability was fairly high for several cancers, but it was lower for cancers with a relatively good prognosis and those sensitive to treatment. The ranking of populations of cancer survival tended to be fairly stable for many cancers: CR of Switzerland and Finland ranked high and Polish CR low. Denmark, Italian and France CR did not substantially differ from the European survival average. For most cancers, prognosis improved during the studied period (years of diagnosis: 1978-1985). Survival figures for colon (r = 0.74, males; r = 0.73, women) and female breast cancer (r = 0.57) well correlated with the national health expenditure of different participating countries. The ITACARE study, a new Italian Cancer Registries collaborative project involving more than 100,000 cancer patients, was set up to study survival differences within the country. Survival of cancer patients was not homogeneous in 7 studied Italian regions (the estimated 5-year relative survival for all malignant neoplasms combined ranked from 37.8% in CR of Sicily to 42.1% in those of Emilia-Romagna). The lowest levels of regional health expenditures were accompanied by the lowest levels of prognosis for overall cancers. However, a relatively low correlation among patient cancer survival and the regional health expenditure (r = 0.21) was found, suggesting that other factors such as different efficiency in managing cancer may play a role in explaining the intracountry differences. CONCLUSIONS: Population-based survival figures may be used to study epidemiologic aspects, comparing different health systems, and may be interpreted as indexes for discussing inequalities in health in different populations.

Age Distribution↗
PubMedDate not supplied

Estimating relative survival of Italian cancer patients from sparse cancer registries data.

PURPOSE: A method is presented for estimating relative survival of cancer patients at the national level from survival data provided by cancer registries covering only a subset of the general population and referring to different, and not necessarily overlapping, incidence periods. METHODS: Relative survival rates are estimated as a function of the covariates sex, age, epoch of diagnosis, and registry area by means of a multiple regression model. National estimates are then computed by appropriate weighting of the sex-, age-, time- and registry-specific expected relative survival values. RESULTS: The method is illustrated by a sample application to survival data of female breast cancer patients in Italy. The national estimates of breast cancer survival pattern show a mild decrease of survival with age and a marked increase with period of diagnosis.

Adolescent↗
PubMedDate not supplied

Survival in adult Italian cancer patients, 1978-1989. ITACARE Working Group.

UNLABELLED: To present a systematic analysis of population-based cancer patient survival in Italy. METHODS: Population-based survival data have been made available from 10 Italian cancer registries within the ITACARE project. Data, collected and validated using a common protocol, included over 100,000 patients with cancer diagnosed between 1978 and 1989. Multivariate weighted analysis was used to provide relative survival estimates attributable to Italy at national level. RESULTS: Results are presented, according to a systematic frame, as the main object of the ITACARE study, involving crude and relative survival figures for adult Italian cancer patients, by age, sex, period of diagnosis and registry area. An estimate with reference to Italy as a whole is also presented by cancer site and for all malignant neoplasms combined. Age-standardized relative survival figures are presented to allow comparisons between Italian registries and also give a basis for international comparisons with countries involved in the EUROCARE study. CONCLUSIONS: For the fist time, population-based survival of cancer patients is made available in Italy on a large scale analysis of data from all the Italian cancer registries in a combined action. Estimates of cancer patient survival at a national level in Italy allow proper international comparisons with European countries and give elements of evaluation and discussion on the performance of the Italian health care system.

Adult↗
PubMedDate not supplied

Trends of colorectal cancer incidence and prevalence in Italian regions.

Incidence and prevalence of tumors of colon and rectum, estimated from mortality and survival data, are presented for Italian regions and for the period 1970-1990. Projected rates to the year 2000 are also given. Age-standardized incidence rates have increased during the considered period. The increase has been higher for southern regions, which had, during the 70's, the lowest incidence and mortality levels. Geographic heterogeneity of colorectal cancer occurrence across Italian regions is therefore decreasing. The phenomenon parallels a tendency towards the homogenization of dietary habits observed in the Italian population. Estimated incidence levels increased less for the younger generation and appear stable for people born after 1940. More than 150,000 prevalent cases were estimated by the year 1990. The number is likely to increase owing to the simultaneous increasing tendency in incidence and survival rates.

Adolescent↗
PubMedDate not supplied

Cancer prevalence in Italian regions with local cancer registries.

OBJECTIVE: To provide estimates and projections of cancer incidence and prevalence for those Italian regions whose population is partially covered by a cancer registry (CR) and to determine to what extent local CRs can be considered representative of the region, thus improving the potential of the information provided by CRs. METHODS: A statistical method, MIAMOD (mortality-incidence analysis model), was used to estimate regional cancer incidence and prevalence from regional cancer mortality data and patient survival data recorded by the cancer registries. Estimates of the cancer incidence and prevalence in the various regions have thus been obtained for a number of major cancer sitas. A first and important step in validating the regional estimates has been the comparison of the MIAMOD estimates in the areas covered by the cancer registries with empirical incidence and prevalence observed by CRs, in order to assess the consistency in data, methods and assumptions. Empirical prevalence has been calculated by counting patients with a diagnosis of cancer who were alive on the reference date by PREVAL method. A correction factor has been applied to include patients diagnosed before the period of activity of the registry. RESULTS: General consistency was found between empirical and estimated (by MIAMOD) incidence and prevalence in the registry areas, which is indicative of the quality and the completeness of all data involved as well as the appropriateness of model choices. The prevalence of all cancers combined for Italian regions with CRs was estimated and projected to the year 2000 as ranging between 1,240 per 100,000 in Sicilia and 2,781 in Emilia-Romagna for men, while for women these figures were 1,765 in Sicilia and 4,019 in Liguria. Comparison of cancer prevalence in CR areas with regional estimates shows quite good consistency for Piemonte, Liguria and Lombardia, which means that the local CRs (of Torino, Genova and Varese, respectively) are representative of their respective regions. Prevalence in Emilia-Romagna appears to be rather well represented by only one, the Parma CR, of the three local CRs. The southern Italian registries of Latina and Ragusa recorded a lower cancer prevalence than was actually estimated in their respective regions. DISCUSSION: Cancer registries with a longer period of activity showed better agreement between empirical and estimated figures due to the more precise information provided, particularly regarding survival and incidence trends. In conclusion, this work shows the potential of the cancer registries not only to represent their population with respect to cancer morbidity but also as an invaluable tool to extrapolate this information to the larger areas they represent.

Adolescent↗