Search PubMed⌕ Search

Biomedical subjects

E Paci

Publications and source records attributed to E Paci.

At least 109 records · Page 6Linked to original sources
PubMed1989

Time interval since last test in a breast cancer screening programme: a case-control study in Italy.

STUDY OBJECTIVE: To evaluate a population based screening programme for breast cancer. DESIGN: This was a case-control study of women dying of breast cancer between 1977 and 1987 who had been invited to take part in a screening programme. SETTING: Community based study of women aged between 40 and 70 years (total population about 35,000 at 1981 census), living in 23 small towns near Florence, Italy. PARTICIPANTS: 103 cases were identified from death certification, and 515 living controls (five per case) selected for year of birth and town of residence. MEASUREMENTS AND MAIN RESULTS: Screening history was obtained from computer archive. Sociodemographic information was obtained from town registry offices and directly from relatives of the deceased and from the controls by postal questionnaire, and if necessary telephone or personal interview. Analysis was carried out on two age groups--40-49 years and 50+ years at diagnosis--and considered the number of screening tests and the time interval since the last test, separately and together. In the older age group, women with at least one screening test in the previous 2 1/2 years showed a 50% reduction in risk (odds ratio 0.49, 95% confidence interval [CI] 0.25-0.95). If they had also had another previous negative screen the risk was reduced to one third (odds ratio 0.35, 95% CI 0.14-0.85). There was a significant trend of decreasing risk with increasing number of screens in older women. No clear evidence of a similar protective effect was shown for women in the 40-49 year age group. CONCLUSIONS: A significant protective effect of the screening programme is evident in older women but not in younger ones. The data do not allow an assessment of optimal screening interval because of the small number of previously screened cases.

Adult↗
PubMed1989

Cancer mortality among workers in the Tuscan tanning industry.

The mortality of 2926 male workers at the tanneries in the "leather area" of Tuscany was examined from 1950 to 1983 comparing it with the national mortality. Cancer mortality was of particular concern because of the many chemicals known to be definite or suspected carcinogens used in the tanning cycle, in particular chromate pigments, benzidine based dyes, formaldehyde, and organic solvents. There was no excess of deaths for cancers of all sites but slight increases in deaths from cancer of the lung (SMR = 131, CI 95% = 88-182), bladder (SMR = 150, CI 95% = 48-349), kidney (SMR = 323, CI 95% = 86-827), pancreas (SMR = 146, CI 95% = 39-373), and leukaemias (SMR = 164, CI 95% = 53-382) occurred. Two cases of soft tissue sarcomas were observed versus 0.09 expected (SMR = 2178, CI 95% = 250-8023).

Adult↗
PubMed1989

Aplastic anemia, leukemia and other cancer mortality in a cohort of shoe workers exposed to benzene.

Benzene is a well documented carcinogen for the hematic and lymphopoietic system, and experimental research confirms its carcinogenicity for tumors of other sites. This report presents the results of a historical cohort study in a shoe manufacturing plant in Florence where cases of aplastic anemia and leukemia were reported in the 1960s. A total of 1008 men and 1005 women were considered eligible members of the cohort. For total mortality, comparing the rates of the cohort with the national rates, the standardized mortality ratio (SMR) was 79 for the women and 95 for the men. For the men excesses of risk for aplastic anemia [SMR 1566; 95% confidence interval (95% CI) 547-3264] and leukemia (SMR 400, 95% CI 146-870) were observed. The increased risk occurred among workers first employed during the period in which benzene was used, but the expected number of cases in the subsequent period was too small to evaluate whether any reduction in risk had occurred. No increasing pattern with duration of employment was discernible.

Adhesives↗
PubMed1988

Selection of high-risk groups for breast cancer screening. Evidence from an Italian multicentric case control study.

In recent years techniques for the selection of risk groups for high priority breast screening have been evaluated. We used data from a large multicentric case control study in Italy, recently published, to fit a reduced logistic model for predictive purposes, using variables which are easily collected. The predicted probability of being a case obtained through the logistic analysis was then used to classify the same set of data by calculating values of sensitivity and specificity at different cutoff points of the predicted probability. The results showed the low predictive power of the model. The selection of higher risk groups in a screening population program is discussed.

Adult↗
PubMed1987

Malignant mesothelioma in non-asbestos textile workers in Florence.

By means of a review of histological diagnosis in the Pathology Department of the University of Florence, suspected cases of malignant mesothelioma, diagnosed in the period 1979-1984, were identified. Study of histological specimens permitted the selection of 13 cases of malignant mesothelioma resident in the Province of Florence. To these cases, referents were matched for age, sex, and year of hospital admission, with residence weighted for the general population of the Province. Both cases and referents (or their next of kin) completed an occupational questionnaire detailing possible occupational exposures. Out of the 13 cases of mesothelioma, 6 were textile workers and 5 of these were "rag-sorters". There were only 5 textile workers among the 52 controls. No asbestos cloth production plants have been in operation in the area from which the cases and referents are derived. Possible sources of exposure to asbestos in the textile industry of this area are discussed.

Aged↗
PubMed1987

An asbestos hazard in the reprocessed textile industry.

Epidemiologic studies have identified an excess risk of lung cancer and mesothelioma among workers in the reprocessed textile industry in Prato, Italy. These studies suggested that there may have been asbestos hazard in this industry although exposure was not known to exist. An industrial hygiene investigation was conducted to determine whether there was previous or current asbestos exposure in the industry. Walk-through surveys, environmental sampling, process documentation, and management and worker interviews were conducted in 13 textile reprocessing establishments. Polypropylene bags that once contained asbestos were found in 2 of the 13. Asbestos bags were cut open and used to cover bales of rags which were then distributed throughout the world. Workers were exposed to asbestos while handling the bags which were contaminated with chrysotile, amosite, and crocidolite. Additional sources of asbestos exposure that may have existed in the past in the industry are also discussed.

Asbestos↗
PubMed1987

A case-referent study of lung tumors in non-asbestos textile workers.

A case series in the Province of Florence showed an increased risk of mesothelioma in textile workers (nonasbestos) and a survey of working conditions confirmed potential exposure to asbestos. In order to investigate the risk in textile workers, including some specific job titles, a case-referent study on lung tumors was carried out. The lung cancer cases included 441 males with histologically confirmed primary lung cancer during the period 1980-1983. Referents included 1,075 males selected from two hospitals and matched for age, sex, and smoking habits. Those who had "ever worked" in the textile industry showed an adjusted odds ratio of 1.52 (95% C.I. 1-2.25) compared with other "industrial workers." This moderately increased risk is maintained in selected jobs in the textile industry. An analysis of the modifying effect of time factors showed an increased risk in the period of 15-35 years from the date of first employment in the industry. The results support the hypothesis that a probable risk of lung cancer in textile workers in the Prato area was related to asbestos exposure.

Aged↗
PubMedDate not supplied

Quantitative MR imaging data in the evaluation of hepatic metastases during systemic chemotherapy.

To identify changes induced by chemotherapy in hepatic metastases, 34 patients with metastases underwent magnetic resonance (MR) imaging before the start of systemic chemotherapy and monthly thereafter. The number, size, and morphologic patterns of the lesions and changes in quantitative parameters (signal-to-noise ratio [S/N]], contrast-to-noise ratio, and signal intensity ratio) were evaluated and correlated with response to treatment and prognosis. After treatment, seven patients showed a partial response, 18 had stable disease, and nine had progressive disease. No relevant changes in the patterns of the lesions were observed. Quantitative data showed that patients with a good prognosis had an increase in S/N on T1-weighted images and a relative decrease on T2-weighted images; patients with a poor prognosis showed a decrease in S/N on T1-weighted images and an increase on T2-weighted images. The differences between patient groups were significant for both T1- and T2-weighted images. This study demonstrates the value of MR imaging in follow-up of liver metastases and suggests the usefulness of quantitative MR imaging data.

Adult↗
PubMedDate not supplied

MRI in characterization of focal liver lesions: comparison of T2 weighting by conventional spin-echo and turbo spin-echo sequences.

Forty-one patients with 61 proved focal liver lesions underwent MRI of the liver at 1.0 T, with the aim of evaluating the usefulness of turbo spin-echo (TSE) sequences in characterizing focal liver lesions, by comparing them with conventional spin-echo (CSE) sequences. Two different TSE protocols were employed. with constant echo time and varying repetition time: TSE-S (3000 msec) and TSE-L (5100 msec). All images were evaluated quantitatively (signal-to-noise ration 'SNR') and qualitatively: because benign lesions were all liquid (12 cysts and 10 hemangiomas), they were well characterized morphologically on the basis of signal intensity. Mean SNR was significantly different between metastases and benign lesions (P < .0001) with all T2 sequences. Among the single T2 sequences tested, logistic regression analysis showed TSE-L to have the best predictive ability of the nature of focal lesions, with a G value of 42.02, compared to 29.87 of TSE-S and 25.55 of CSE second echo (SE II). The combination of TSE-L with TSE-S did not modify these results, whereas the combination of TSE-L with CSE only resulted in slight improvement (G = 46.95). Comparison of the receiver operating characteristic (ROC) curves showed only SE II (area under the ROC curve of .8312) to be significantly inferior to the best single sequence, or TSE-L (area under the ROC curve of .9176; P = .027). All sequences were equivalent in qualitative evaluation with good reproducibility, sensitivity ranging from .94 to 1.0 and specificity ranging from .86 to .93. This study confirms the value of TSE sequences in characterization of focal liver lesions. Time of acquisition is strongly reduced with these sequences, whereas results are fairly similar to those obtained with CSE. TSE sequences could therefore replace CSE for the study of focal liver lesions.

Adult↗
PubMedDate not supplied

MR imaging of focal liver lesions: comparison between turbo spin-echo and conventional spin-echo pulse sequences.

The aim of this study was to compare conventional spin-echo (CSE) T2-weighted (T2W) images with turbo spin-echo (TSE) T2W pulse sequences in their ability to detect focal liver lesions. Seventy-eight consecutive patients with focal liver lesions were entered into this study. All patients were imaged using the gradient-echo (GE) sequence with the breath-hold technique for T1-weighted (T1W) images, and CSE and TSE sequences for T2W images. Qualitative evaluation included lesion detection (number of lesions detected) and conspicuity (extent of visualization of lesional borders); quantitative evaluation included the signal-to-noise (S/N) ratio and the contrast-to-noise (C/N) ratio. TSE showed the best performance in terms of lesion detection; however, the difference between TSE and CSE was significant only in the case of benign cysts (p < 0.01). Conspicuity was higher with TSE and CSE, and lower with GE. The S/N and C/N ratios of the two T2W sequences were also comparable, and better than those of GE. However, the combined use of GE and TSE resulted in improved lesion detection. The results show that, because the acquisition time is greatly reduced with TSE sequences, these should be considered as first-line approach to magnetic resonance imaging of the liver for the study of focal lesions.

Adenoma↗
PubMedDate not supplied

Pseudoaneurysm of the common hepatic artery: treatment with a stent-graft.

We report a case of a pseudoaneurysm of the common hepatic artery treated with a stent-graft in a 67-year-old man. The patient presented with severe catheter bleeding through a drain following surgical and interventional procedures performed for therapeutic management of a choledochal cholangiocarcinoma. Selective hepatic arteriography showed a pseudoaneurysm close to the origin of the gastroduodenal artery. After a preliminary attempt at arterial embolization, it was decided to use a stent-graft to bridge the false aneurysm. Complete pseudoaneurysm exclusion was seen after the procedure with preservation of hepatic arterial flow.

Aged↗
PubMedDate not supplied

Long-term sequelae of breast cancer surgery.

BACKGROUND: Quality of care is today a major issue in oncology, and much attention is given to research on the outcome of breast cancer care. Too little attention has been devoted in the scientific literature to the consequences of treatment in long-term survivors, and in particular to the possible side effects. The specific aim of this contribution is to present population-based data about the long-term impact of breast cancer care in women who had an incident cancer in 1985/1986. PATIENTS AND METHODS: The cases are 476 breast cancers incident in the City of Florence in 1985-86. Women still living 5 years later were invited to have an interview and a physical examination. Lymphedema, peripheral nerve lesions and damage to the shoulder were assessed. RESULTS: Of the 346 5-year survivors, 238 accepted our invitation: 35.2% of the women reported some early postoperative sequelae, 30.2% had a chronic lymphedema and 18.9% a shoulder deficit. Comparing breast-conserving surgery with radical mastectomy, the risk of chronic lymphedema (OR = 1.62; 95% C1: 0.91-2.88) and other lesions was higher for women who had a radical surgery. Women who had a breast-conserving surgery more often reported an early lymphedema (OR = 1.60; 95% Cl: 0.88-2.88). CONCLUSIONS: The proportion of women who complained of (or manifested at the physical examination) a minor or major disability of the arm in our study was high. The impact of these functional problems in terms of quality of life should also be assessed, but it is our impression that there is need for much greater attention to the issue of long-term survivor sequelae.

Adult↗
PubMedDate not supplied

Measurement of the cost of screening for cervical cancer in the district of Florence, Italy.

AIMS AND BACKGROUND: To estimate the cost per woman examined and per CIN II or more severe lesion detected in a population-based cytologic screening program for cervical cancer prevention. An organized cytologic screening program has been ongoing in the Florence District since 1973, and a call-recall system using mail invitation has been ongoing since 1980. Smear reading and assessment of screening positives is centralized at the screening unit. METHODS AND STUDY DESIGN: All relevant resources (costs) consumed by the program were listed and measured. The unit cost per examined woman and per each CIN II or more severe lesion detected was estimated for each screening phase (recruitment, screening, assessment). RESULTS: The cost per examined woman was $24.60, whereas that per CIN II or more severe lesion detected was $13,600. Staff accounted for 80% of total amount. CONCLUSIONS: Although the cost for a single procedure is low, the cost per detected lesion is quite remarkable due to the low detection rate in a population screened for a long time. Different approaches and longer interval screening tests are discussed.

Adult↗
PubMedDate not supplied

[Quality of life at the end of life. Analysis of the quality of life of oncologic patients treated with palliative care. Results of a multicenter observational study (staging)].

Outcome in palliative care can be defined as patients' quality of life, quality of death and satisfaction with care. In an Italian multicentre prospectic study ('Staging') the quality of life of 571 palliative care patients with advanced cancer disease was assessed since the beginning of palliative care till the end of the study. We analyzed the tissue of quality of life missing data and the possibility to input the missing quality of life evaluation through the quality of life evaluation made by a proxy (doctor, nurse). The greatest functional impairment and an increasing level of some symptoms (fatigue, general malaise, emotional status) were observed during the last two weeks of life, whereas for other symptoms (gastro-intestinal, pain) some degree of control was possible. The quality of life analysis for palliative care patients should consider the different response of different quality of life components to the palliative care intervention.

Aged↗