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Biomedical subjects

D Serraino

Publications and source records attributed to D Serraino.

At least 109 records · Page 6Linked to original sources
PubMed1994

AIDS-associated Kaposi's sarcoma and non-Hodgkin's lymphomas reporting in Italy: a linkage study.

To evaluate the completeness and accuracy in the reporting of AIDS-associated Kaposi's sarcoma (KS) and non-Hodgkin's lymphomas (NHL) in Italy, a linkage study of the notifications to the Italian AIDS Registry (RAIDS--the national compulsory AIDS surveillance system) and the clinical and pathological records of the Italian Cooperative Group on AIDS-related tumors (GICAT--a nationwide voluntary reporting system for HIV-infected individuals who develop cancer) was carried out. A total of 288 cases of KS and 258 cases of NHL fulfilling the AIDS definition criteria, histologically diagnosed by the GICAT centers between January 1987 and March 1992, were matched with the 16,860 AIDS cases reported to the RAIDS up to March 1993. The linkage procedure, based on name, gender, and date of birth, identified 276 cases of KS (96%) and 241 cases of NHL (93%) present in both files ("linked" cases). The diagnosis of KS did not appear among the clinical manifestations of AIDS in the RAIDS file in 67 out of the 276 linked KS (24%), either with coincident dates of KS diagnosis and of case notification (19 cases) or when the KS diagnosis followed by > or = 2 months the case notification to RAIDS (48 cases). Of the 241 linked NHL, 84 (33%) had no such neoplastic complications of AIDS listed in the RAIDS file, 23 with coincident dates of NHL diagnosis and of case notification and 61 with the NHL diagnosis made > or = 2 months after the notification. A noteworthy discrepancy in the classification of the three histologic subtypes of NHL emerged between the GICAT and the RAIDS. The degree of underreporting of AIDS-associated cancers that emerged from the present study suggests that augmentation with other sources of oncological information is important to better estimate the burden of AIDS-related tumors and to study the interaction between HIV infection and cancer.

Acquired Immunodeficiency Syndrome↗
PubMed1993

Cancer risk in farmers: results from a multi-site case-control study in north-eastern Italy.

The relationship between farming and cancer risk was investigated in an integrated series of case-control studies conducted from 1985 to 1991 in the Friuli Venezia Giulia region, north-east Italy. Patients with cancer of the oral cavity and pharynx, larynx, oesophagus, colon and rectum, pancreas, breast, thyroid gland, kidney and urinary tract, bladder, prostate, soft-tissue sarcomas, Hodgkin's diseases, non-Hodgkin's lymphomas and multiple myelomas, and controls admitted to hospital for acute, non-neoplastic conditions, were interviewed. For males, a significantly elevated relative risk was seen for oral cavity and pharynx. Farming, however, was associated with a significant protection against cancer of the colon and rectum and bladder. In females, only one significant association emerged, for multiple myeloma. A few significant interactions between cancer risk and year of birth (i.e., before 1930 or 1930 and after) were observed. The risk of cancer of the larynx was significantly elevated in younger male farmers but not in older ones. Our multi-site case-control study confirms that farmers have, for some cancer sites, a distinctive pattern. Excesses of cancer of the oral cavity and pharynx in farmers are characteristic of the present study area and, possibly, of similar European rural populations who have in common high levels of alcohol consumption and, at least in the past, unbalanced diets.

Adolescent↗
PubMed1993

Cigarette smoking recidivism after participation in the "Five-Day Plan to Stop Smoking" in northeastern Italy.

BACKGROUND: This study was designed to evaluate the efficacy of the "Five-Day Plan to Stop Smoking" (the "Five-Day Plan") in helping smokers to give up the habit and to identify the characteristics of those smokers who succeeded in quitting. METHODS: Five hundred and forty-five smokers (363 men, mean age 41 years, and 182 women, mean age 37 years) of a total of 683 (80%) who participated in eight courses of the Five-Day Plan, held in northeastern Italy between October 1985 and April 1988, constitute the study group. They were contacted from 28 to 70 months after their participation in the Five-Day Plan. RESULTS: Approximately 70% of smokers tried to stop smoking for fear of smoking-related health hazards, and 15% (18% of men and 9% of women, P < 0.001) of these stopped because of smoking-related diseases or symptoms. Overall, 18% of the participants interviewed relapsed to cigarette smoking within 1 month after having taken the course, 44% within 1 year, and 59% after 5 years. Higher rates of recidivism after the Five-Day Plan were recorded among women than among men (55 and 39% after 1 year, respectively). Among men, older age and heavy smoking were significantly associated with a reduced probability of relapsing. Among women, a high level of education was the only significant predictor of smoking recidivism. CONCLUSIONS: These data indicate that the Five-Day Plan is useful in helping smokers who are already predisposed to quit their habit, but its efficacy seems to be largely restricted to men, in particular to older and heavier smokers.

Adult↗
PubMed1993

Increased frequency of lymphocyte depletion and mixed cellularity subtypes of Hodgkin's disease in HIV-infected patients. Italian Cooperative Group on AIDS and Tumours.

To assess whether the histological pattern of Hodgkin's disease (HD) in human immunodeficiency virus (HIV)-infected patients differs from that among HD patients without HIV infection, the observed (O) number of HD cases according to histological subtype [i.e. lymphocyte predominance (LP), nodular sclerosis (NS), mixed cellularity (MC) and lymphocyte depletion (LD)] among 92 Italian HIV-infected patients was compared with the expected (E) number derived from two case series of HD from Europe and the U.S.A. (14,315 cases of HD) and Italy (125 cases). After age standardisation, the O/E ratio was computed, along with its 95% confidence interval (CI). In comparison with 125 Italian HD patients not infected with HIV, a 4-fold higher frequency of the MC histological subtype (95% CI: 2.9-5.1) and an approximately 12-fold higher frequency of the LD subtype (95% CI: 7.0-18.0) emerged among HIV-infected patients. These results were substantially confirmed when the comparison was made with the case series from Europe and the U.S.A. These data show different histological patterns of HD between a group of HIV-infected patients and HD patients from the general population. Although caution is needed in their interpretation, the study results seem to indicate that HD of the MC or LD subtypes may be considered an AIDS-related malignancy.

Adult↗
PubMed1992

Occupation and soft-tissue sarcoma in northeastern Italy.

The influence of occupation and exposure to different agents on the risk of developing soft-tissue sarcoma (STS) was assessed in a case-control study based on 93 cases of STS (53 men and 40 women) and 721 controls (371 men and 350 women), conducted in northeastern Italy. No risk elevation was found in subjects employed in agriculture (odds ratio [OR] for greater than 10 years = 0.8, 95 percent confidence interval [CI] = 0.4-1.5), nor in those who reported exposure to pesticides or herbicides (OR = 0.4, CI = 0.1-1.2). Similarly, neither occupation in the furniture, upholstery, and mechanics industries, nor exposure to livestock or meat processing, wood dust, metal dust, and dyes or paints were associated with STS risk. Workers who reported exposure to chemical agents or to benzene or other solvents for more than 10 years had, respectively, a 1.8-fold (CI = 0.7-4.4) and a 2.2-fold (CI = 0.9-5.5) higher risk of developing STS. Although the small number of STS cases limits the interpretation of the study results, these findings weigh against the hypothesis that pesticides, herbicides, or other exposures related to agriculture, play an important role in the etiology of STS. The direct associations with exposure to chemical agents and benzene or other solvents, albiet not statistically significant, may provide a useful hint for future investigations.

Adolescent↗
PubMed1992

Condom use and sexual habits of heterosexual intravenous drug users in northern Italy.

In order to assess modes of human immunodeficiency virus (HIV) transmission from heterosexual intravenous drug users (IVDUs) to their partners, condom use and sexual habits with both steady and occasional partners were investigated. A total of 349 heterosexual IVDUs (247 men and 102 women) who ignored, at the time of interview, their HIV serostatus were interviewed. Respondents were asked for information on condom use and sexual habits for the three year period prior to the interview. Nearly 40% of IVDUs reported sexual intercourse with both steady partners and occasional partners. Fifty-four percent of their steady partners and 48% of their occasional partners were individuals who did not belong to groups at risk for HIV infection. Anal intercourse with steady partners was reported by 29% of IVDUs and 24% of IVDUs with occasional partners. Condom use during vaginal intercourse was seldom reported: 83% of IVDUs never used a condom with steady partners and 75% did not use one with occasional partners. IVDUs who were 1) unmarried, 2) enrolled in the study after 1986, 3) partners of not at-risk individuals, 4) partners of a foreigner and, 5) aware of their partners HIV seropositivity showed significantly higher, albeit still low, frequencies of condom use with steady partners. Conversely, all these factors seemed to have little impact on condom use with occasional partners. Condom use and sexual habits were similarly reported by HIV-positive and HIV-negative IVDUs. The present study shows that high-risk sexual behaviours among IVDUs are very widespread and it stresses the need for intensive counselling to promote condom use among IVDUs.

Adult↗
PubMed1992

The epidemiology of AIDS-associated non-Hodgkin's lymphoma in the World Health Organization European Region.

This paper describes the epidemiology of AIDS-associated non-Hodgkin's lymphoma (NHL) in the World Health Organization (WHO) European Region. Data, collected by the WHO Collaborating Centre on AIDS in Paris, France, were derived from the national AIDS surveillance systems of 21 countries. Among 53,042 cases reported as of the end of June 1991, 1,617 (3.0%) had NHL as the presenting clinical manifestation of AIDS. The proportion of cases presenting with NHL ranged from 1.1% in children infected perinatally to 3.9% among haemophiliacs. In comparison with intravenous drug users (IVDUs) (2.6% of whom had NHL), a moderate excess was found among homosexual or bisexual men (odds ratio - OR -:1.2, 95% confidence interval - CI -:1.0-1.3). Over time, the proportion of NHL was constant, but whereas among homosexual or bisexual men the frequency of NHL as AIDS-indicator disease significantly increased (9.7% per year), among IVDUs a significant downward trend emerged (17.1% per year). In respect to age, two peaks of NHL were seen at the age groups 10-19 (3.8%) and 50-59 (4.3%). The proportion of AIDS-associated NHL significantly increased with increasing age among homosexual and bisexual men and heterosexuals whereas it decreased among IVDUs. All these differences, however, have to be interpreted cautiously on account of the limitations of the reporting systems.

Acquired Immunodeficiency Syndrome↗
PubMed1992

Diet and prostatic cancer: a case-control study in northern Italy.

The relationship between intake of various indicator foods and beverages and risk of prostatic cancer was assessed in 271 cases of prostatic cancer and 685 hospital controls recruited in two areas of northern Italy, the province of Pordenone and the greater Milan area. Increased risks were found for more frequent intake of meat [odds ratio (OR) in the highest vs. lowest consumption tertile = 1.4, 95% confidence interval (CI) 1.0-2.0], milk (OR = 1.6, 95% CI 1.1-2.4), fresh fruit (OR = 1.4, 95% CI 1.0-2.1), and vegetables (OR = 1.4, 95% CI 0.9-2.2). After allowance for the reciprocal confounding effect of various dietary habits, only frequent intake of milk seemed to be a significant independent indicator of prostatic cancer risk. There was also a clue that the unfavorable influence of frequent intake of a few food items (i.e. meat, fish, liver, ham and salami, milk and butter, and retinol) may be greater or restricted to older individuals (i.e., > or = 70 yrs of age). In conclusion, the present study confirms the presence of a moderate adverse effect of high intake of foods of animal origin, chiefly milk, while it suggests that a diet rich in fresh fruit and vegetables does not convey a protection.

Aged↗
PubMed1992

Risk factors for adult soft tissue sarcoma in northern Italy.

The role of several potential risk factors in the etiology of soft-tissue sarcoma (STS) was examined in a hospital-based case-control study, conducted in the Friuli-Venezia Giulia region, northeast Italy, between 1985 and 1991. A total of 93 STS cases (53 males and 40 females, median age: 52 years) and of 721 controls (371 males and 350 females, median age: 54 years) were interviewed. Significant increased risks were associated with a history of herpes zoster infection (odds ratio (OR): 2.3, 95% confidence interval (CI): 1.1-4.9), chicken-pox (OR: 2.1, 95% CI: 1.2-4.1) and mumps (OR: 2.0, 95% CI: 1.1-3.8). None of the other medical conditions investigated - socio-economic and anthropometric indicators, tobacco smoking, consumption of alcoholic beverages, coffee and tea - seemed to affect STS risk. No risk elevation was found in subjects employed in agriculture (OR - for greater than 10 years employment = 0.8, 95% CI: 0.4-1.5), nor in those who reported exposure to pesticides or herbicides (OR = 0.4, 95% CI: 0.1-1.2). Workers who reported exposure to chemical agents or to benzene or other solvents for more than 10 years had, respectively, a 1.8-fold (95% CI: 0.7-4.4) and a 2.2-fold (95% CI: 0.9-5.5) higher risk of developing STS.

Adolescent↗
PubMed1992

Hodgkin's disease in 92 patients with HIV infection: the Italian experience. GICAT (Italian Cooperative Group on AIDS & Tumors).

Ninety-two cases of Hodgkin's disease (HD) in patients with HIV infection have been collected by the Italian Cooperative Group on AIDS and Tumors (G.I.C.A.T.). In accordance with the epidemiology of HIV infection in Italy, 82% were intravenous drug users (IVDU), 8% homosexual men, 5% IVDU+homosexuals and 5% heterosexuals. At diagnosis of HD, 16% had AIDS, 20% AIDS related complex (ARC), 33% persistent generalized lymphadenopathy (PGL) and 31% were asymptomatic. Fifty-three percent of the patients had stage IV disease and 70% mixed cellularity and lymphocytic depletion. Forty-six patients were treated with MOPP or MOPP [symbol: see text] ABVD +/- radiotherapy (zidovudine was not given) with complete remission (CR) in 54% and partial remission (PR) in 46% of the patients. Fifty-six percent of these patients developed opportunistic infections (OI) during therapy or follow-up. Sixteen patients were treated with epirubicin, bleomycin and vinblastine (EBV) and concomitant zidovudine, with CR in 44% and PR in 38%. However, only one of these patients developed OI during therapy or follow-up. The clinico-pathological features and natural history of HD in HIV setting are peculiar and quite distinct from those observed in HD in the general population. Better combined chemotherapy and antiretroviral therapy is needed in order to ameliorate the CR rate and decrease the OI in patients with HIV infection and HD.

Acquired Immunodeficiency Syndrome↗
PubMed1992

Prospective study with combined low-dose chemotherapy and zidovudine in 37 patients with poor-prognosis AIDS-related non-Hodgkin's lymphoma. French-Italian Cooperative Study Group.

The French-Italian Cooperative Study Group included patients with poor-prognosis AIDS-related non-Hodgkin's lymphoma (NHL), defined as those with performance status (PS) > or = 3 and/or opportunistic infections (OI), in a prospective study with a 50% reduced-dose combination chemotherapy regimen: CHVmP-Vincristine-bleo (cyclophosphamide 300 mg/m2 i.v. day 1, doxorubicin 25 mg/m2 i.v. day 1, teniposide 30 mg/m2 i.v. day 1, prednisone 20 mg/m2 per os days 1-5, vincristine 2 mg i.v. day 15, and bleomycin 10 mg i.v. day 15), given every 21 days for eight cycles, and concomitant zidovudine 500 mg per os per day. The aims of this combined treatment were to reduce bone marrow toxicity and infectious complications related to chemotherapy (with a low-dose chemotherapy regimen), and to control the HIV and related infectious complications (with zidovudine therapy). Thirty-seven patients entered this prospective study. At the time of the NHL diagnosis, 41% of the patients had asymptomatic HIV infection, 27% had ARC and 32% had already had CDC-defined diagnoses of AIDS. The median CD4+ cell count was 35 mm3. Only 29 patients are evaluable for response, since 8 received only one cycle of chemotherapy. Fifteen of 29 (52%) patients obtained objective responses, with only 4 (14%) achieving complete remissions (CR) of 1, 4, 14 and 29+ months. Three (16%) CRs were achieved in 19 evaluable patients included in the study because of poor PS, and only one CR was observed in 10 evaluable patients with histories of OI, either alone or with poor PS. The most common side effect was bone marrow toxicity with 2 related toxic deaths.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗
PubMed1992

The epidemiology of acquired immunodeficiency syndrome and associated tumours in Europe.

By the end of September 1991, more than 60,000 cases of acquired immunodeficiency syndrome (AIDS) had been reported to the World Health Organization (WHO) by 31 countries in the WHO European region. Most of the cases (58,280/60,485-96%) were recorded in western Europe, chiefly in five countries: France (16,552 cases), Italy (10,584), Spain (10,101), Germany (6,968) and the United Kingdom (5,065). From the first reports in 1981 of European cases of AIDS until 1987, AIDS spread faster in the northern and central areas than elsewhere in the European region. Since then, the spread of the epidemic has been remarkably more rapid in southern Europe, while in eastern Europe AIDS is still in an early phase. More than 70% of the cases among homosexual or bisexual men were from the northern part of Europe, while the cases among intravenous drug users (IVDUs) were concentrated in the southern European countries, principally Italy and Spain. Over time, an increasing proportion of cases was recorded among IVDUs and in heterosexuals. More than 10,000 patients in Europe were diagnosed as having Kaposi's sarcoma (KS) (14% of all AIDS cases) or non-Hodgkin's lymphoma (NHL) (3%) as the presenting clinical manifestation of AIDS. The possibility of predicting the evolution of the epidemic in Europe depends heavily on the development of unbiased monitoring systems for HIV infection in the general population (i.e. anonymous unlinked testing).

AIDS-Related Complex↗
PubMed1992

The epidemiology of AIDS-associated Kaposi's sarcoma in Italy.

OBJECTIVE: To describe the epidemiology of AIDS-associated Kaposi's sarcoma (KS) in Italy between January 1982 and September 1991. DESIGN: To make this study comparable with previous research from other countries, statistical analysis of data from the Italian AIDS surveillance system was performed. METHODS: Odds ratios (OR) and 95% confidence intervals (CI) were used to examine the association between several characteristics of AIDS cases and the presence of KS as the presenting clinical manifestation of AIDS. Trends in the frequency of AIDS-associated KS were also estimated. RESULTS: Of the 10,584 Italian AIDS cases reported up to September 1991, 720 (6.8%) had KS as the presenting clinical manifestation. In comparison with intravenous drug users (IVDU), of whom 2.6% had KS, homosexual or bisexual men had a nearly 10-fold higher risk of KS (OR, 10.2; 95% CI, 8.2-12.8), homosexual men who were also IVDU a nearly fourfold increased risk (OR, 4.4; 95% CI, 3.0-6.6) and heterosexuals a 2.6-fold risk (95% CI, 1.7-3.7). Men were more likely to have KS than women. The percentage of new AIDS cases with KS recorded each year in Italy declined from 12.0% in 1982-1986 to 5.8% in 1990-1991, a significant relative decrease of 19.0% per year (95% CI, 14.1-23.6%). The decline was observed among both IVDU (20% per year) and homosexual or bisexual men (11.4% per year). The frequency of KS was similar across age groups within each transmission category, whereas geographical differences emerged in the prevalence of AIDS-associated KS, especially among IVDU. CONCLUSIONS: Our data on the epidemiology of AIDS-associated KS in Italy are similar to reports from North America and Europe, which show that KS is more common among individuals who acquired HIV infection by sexual transmission rather than parenterally, and that the incidence of this neoplasm is declining over time. The still poorly understood aetiology of AIDS-associated KS needs to be investigated further.

Acquired Immunodeficiency Syndrome↗
PubMed1992

A prospective study of a new combination chemotherapy regimen in patients older than 70 years with unfavorable non-Hodgkin's lymphoma.

PURPOSE: A prospective trial with a new combination of etoposide, mitoxantrone, and prednimustine (VMP), specifically devised for elderly patients with non-Hodgkin's lymphoma (NHL), was undertaken. PATIENTS AND METHODS: Between January 1987 and April 1990, 52 consecutive unselected patients older than 70 years (median age, 75.6 years) with stage I to IV intermediate- and high-grade NHL, or with stage III to IV low-grade malignancy with symptomatic disease received etoposide and prednimustine 80 mg/m2 orally for 5 days and mitoxantrone 8 to 10 mg/m2 day 1 intravenously (IV), every 21 days. Fourteen patients were previously treated. RESULTS: Among the 48 assessable patients, the objective response rate was 81%; 46% of the patients achieved a complete response (CR). The overall toxicity seemed to be acceptable, with 15 (7%) episodes of grade 4 leukopenia and 41 (18%) episodes of grade 3, over a total of 226 administered cycles. The median survival was 12 months. The patients who obtained CR have a longer survival than those who did not (34 v 8 months; P less than .001). Fifty-eight percent of patients achieving CR were free from relapse at 24 months; up to 36 months from the start of therapy, 25% were free from relapse. As far as patients affected by diffuse histiocytic lymphoma, 66% of previously untreated patients obtained a CR, and 55% of them were still disease-free at 24 months from the start of therapy. CONCLUSION: We conclude that VMP is effective, well tolerated, and feasible on an outpatient basis in an unselected, elderly population affected by unfavorable NHL.

Age Factors↗