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Biomedical subjects

E Paci

Publications and source records attributed to E Paci.

124 records · Page 7Linked to original sources
PubMedDate not supplied

Screening of lung cancer with low dose spiral CT: results of a three year pilot study and design of the randomised controlled trial ''Italung-CT''.

PURPOSE: To report the results of a three-year observational pilot study of lung cancer screening with low dose computed tomography (CT) and to present the study design of a randomised clinical trial named as ''Italung-CT''. MATERIALS AND METHODS: Sixty (47 males and 13 females, mean age 64+/-4.5 years) heavy smokers (at least 20 packs-year) underwent three low-dose spiral CT screening tests one year apart on a single slice or multislice CT scanner. Indeterminate nodules were managed according to the recommendations of the Early Lung Cancer Action Project. RESULTS: and Indeterminate nodules were observed in 33 (55%) of the subjects (60% at the baseline screening test, 24% at the first annual test and 16% at the second annual test). The size of the largest indeterminate nodule was <5 mm in diameter in 20 subjects, 10 of whom showed the nodule at the baseline test. Forty-five subjects (75%) completed the first annual test and 42 (70%) the second annual test. One (1.6%) prevalent lung cancer (adenosquamous carcinoma) and one (2.2%) incident lung cancer (small cell cancer at the first annual examination) were observed, as well as a pulmonary localisation of Hodgkin's lymphoma (at the second annual test). In addition, one subject underwent lung surgery for a chondromatous hamartoma. CONCLUSIONS: The results of the pilot study are substantially in line with those of other observational studies of greater sample size. This justifies optimism about the reliability of the results in the screened arm of the ''Italung CT'' trial which has just begun.

Female↗
PubMedDate not supplied

[Determination of free and total S-phenylmercapturic acid in the biologic monitoring of exposure to benzene].

One of the biomarkers suggested by the ACGIH to assess the professional exposure to benzene is the S-phenylmercapturic acid in the end-shift urine. The existence in the urine of N-acetyl-S(1,2-dihydro-2hydroxypHenyl)-L-Cysteine, a precursor of SPMA that can be turned into it by acid hydrolysis, is a possible cause of miscorrelation between environmental and biological monitoring. The amount of measured SPMA depends on the degree of hydrolysis and therefore it is a function both of the urine PH and of the storage conditions of the sample. 40 urine samples have been collected from workers exposed to benzene, both smokers and not smokers, and for each sample the percentage of SPMA measurable at pH 2 and without pH correction (free SPMA) has been calculated with respect to the SPMA measured after quantitative hydrolysis, with the objectives to determine if a correct assessment of the exposure requires the determination of total SPMA and which concentration value could correspond to the BEI of 25 microg/g of creatinine established by the ACGIH. An aliquot of the urine samples has been treated with 9M H2SO4, a second one is brought to pH 2 and a third one is analyzed as it is. All samples are analyzed by HPLC/MS/MS in negative ions/MRM mode, and quantitative analysis is performed using the internal standard method. The percentage found in samples treated at pH 2 is on average 45% of the total SPMA for smokers and 60% for non smokers, while the free SPMA varies from 1% to 66% due to the urine pH variability and to the lower concentrations detected. The determination of total SPMA allows the standardization of the preanalyticalfactors and the dosage with analytical methods less sensitive than HPLC/MS/MS.

Acetylcysteine↗
PubMedDate not supplied

[Carcinogenic risk and epidemiology: thoughts on experience in the tanning and shoe industries].

An epidemiological method is described that was applied to the study of cancer risk in tanning and shoe industries. The limitations of the epidemiological research carried out so far are stressed and priorities are discussed. In particular, methods for the surveillance of cancer risk need to be implemented and etiological studies with adequate statistical power should be planned for the future.

Epidemiologic Methods↗
PubMedDate not supplied

[Magnetic resonance in the diagnosis of lesions of the carpal triangular fibrocartilage. The experience with 49 patients with chronic pain at the wrist].

In order to evaluate the diagnostic capabilities of MR Imaging in defining triangular fibrocartilage (TFC) lesions, 49 selected patients--21 with rheumatoid arthritis, 13 with traumatic injury and 15 with wrist fracture--presenting chronic wrist pain were examined with MR Imaging. The wrists of 12 healthy subjects were also studied as a control group. MR examinations were performed by means of a superconductive 1.0 T unit (Magnetom-Siemens); SE and GE T1- and T2-weighted pulse sequences were employed to acquire images of the wrists on the coronal, axial and, if necessary, sagittal planes. The results showed peripheral TFC tears in 10 cases, central TFC lesions in 12 cases and TFC lesions with collateral insertion involvement in 9 cases. In 4 patients focal thickening of TFC without disruption was observed. The correct diagnosis was made in all the 19 surgically verified cases. Our experience confirms the clinical value of MR Imaging in the evaluation of TFC lesions in patients with chronic ulnar pain syndrome.

Adolescent↗
PubMedDate not supplied

[Cost-benefit analysis of a mammography screening program extended to all the national territory].

A cost-effectiveness analysis has been conducted in order to evaluate effects and costs of a nationwide mammographic breast cancer screening programme compared with no screening in a 30 years period. The analysis includes seven different phases of breast cancer, from the screening programme itself to the treatment of terminal illness. The estimates use italian published data and field studies. The calculations were performed with the Miscan computer simulation package: a programme providing for the screening of women aged 50-69 at two years intervals might be expected to result in a 1,650 deaths prevented and 14,500 years of life gained each year. The overall net costs of the programme were assessed at between 2,893 and 3,212 thousand million lire, the cost per life saved between 59.8 and 66.4 million lire and the cost per life-year gained between 6.6 and 7.3 million lire (between 10.7 and 11.5 million lire with a 5% discount rate, an estimate lower than that of German programme). The analysis produces important information for the Italian policy debate over mammography and it also contributes to the development of economic evaluation in our country.

Aged↗
PubMedDate not supplied

[Evaluation of migratory intraregional flow for the surgical treatment of breast cancer].

The migratory intraregional flows for the treatment of breast cancer have been analyzed in Tuscany. The analysis has been carried out taking the province of Pistoia as a sample and the main sanitarian Florentine structures as a pole of migration in the years 1992-93. The patients suffering from breast cancer were 269 in the two years. The expected number of cases of breast cancer in the province is of 137.25/year. In the period considered the patients that addressed to Florence were 41.63% while the women remained in the province were 58.36%. The migration toward Florence seems to have been mainly affected by age, since most of the hospitalization in this pole referred to patients younger than 54. The sick women choose to be admitted to Florence irrespective of their residence municipality. The provincial hospitals in which the investigation has been carried out are those of Pistoia and Pescia. As far as concerns the type of intervention carried out in the three sanitarian poles, the surgery of conservative type prevails in Florence, the mastectomies in Pescia, while in Pistoia the two types of interventions show a comparable frequency. From such evidences we can assume the choice of the Florentine pole as a structure for the treatment of breast cancer; also in relation to the fact that in the examined province, in the years considered, a service of radiotherapy was not still active.

Adult↗
PubMedDate not supplied

[The desire for information and informed consent in general anesthesia].

BACKGROUND: In the last years the interest for Informed Consent (IC) in anaesthesia has been growing and it has been debated on the adequate explanations in order to obtain a consent. The purpose of the present study was to assess patients' desire for information about anaesthesia. METHODS: In this prospective study a form has been given to consecutive patients waiting for surgical operation in general surgery or ear nose throat surgery and able to read and write, to inform them about the necessity of General Anaesthesia (GA); they were asked to complete a questionnaire concerning their desire for information about the following six items concerning anaesthesia: "the duration of anaesthesia"; "what type of pain will I have when I come round, and what pain-killers will I be given"; "details on the various types of anaesthesia, how and where will I be anaesthetized"; "what are the most common complications of general anaesthesia"; "where and how will I come round from general anaesthesia"; "what is artificial respiration in general anaesthesia". RESULTS: 107 patients participated in the study, 24 of whom were undergoing surgery for malignant cancer and 83 for benign non-oncological diseases. More than two-thirds of patients expressed their wish to receive information, and the trend of desire to know was inversely related to age (p < 0.05). There was no significant statistical difference in the desire to know according either to sex or to the kind of disease (benign or malignant). The demand for information about pain was particularly high (85%), also in the older group of patients. The results and the difficulties for obtaining IC are debated. CONCLUSIONS: The growth of patients' desire for information about anaesthesia is an aspect of the evolving doctor-patient relationship in Italy. Efforts should be directed at improving reciprocal communication.

Anesthesia↗