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Biomedical subjects

F Falcini

Publications and source records attributed to F Falcini.

At least 73 records · Page 4Linked to original sources
PubMed1997

Idiopathic limb edema in children with chronic arthritis: a multicenter report of 12 cases.

Lymphedema, a well known extraarticular manifestation of rheumatoid arthritis, has been rarely described in children with idiopathic chronic arthritis. We describe 12 cases of lymphedema and idiopathic arthritis of childhood seen at 4 different pediatric rheumatology centers. Eight patients were girls, 4 boys; the age at appearance of lymphedema ranged from 2.3 to 17 years. In all patients except one, lymphedema was localized to the lower limbs. The outcome of lymphedema was variable, but not always related to the arthritis course, and was mostly independent of any specific therapy. Lymphography was performed in only one patient, and revealed lack of lymphatic drainage in the affected leg. We conclude that the association of lymphedema and idiopathic arthritis of childhood is not rare; this association is unlikely to be coincidental, even though the pathogenetic mechanisms are currently not well understood.

Adolescent↗
PubMed1997

Catastrophic antiphospholipid antibody syndrome in pediatric systemic lupus erythematosus.

Catastrophic antiphospholipid antibody syndrome, reported in a minority of patients with circulating antiphospholipid antibodies, is characterized by widespread vascular occlusions. The term "catastrophic" has been used to describe the severity of symptomatology, sometimes leading to death. We describe a girl aged 11 years, fulfilling diagnostic criteria for systemic lupus erythematosus, with recurrent episodes of thromboembolic phenomena involving lung and skin, complicated with disseminated intravascular coagulation. Treatment with warfarin ultimately resulted in effective control of the disease.

Anticoagulants↗
PubMed1996

Intake of selected micronutrients and the risk of breast cancer.

To investigate the relation between selected micronutrients and breast cancer risk, we conducted a case-control study of breast cancer between June 1991 and April 1994 in 6 Italian areas. The study included 2569 women admitted to the major teaching and general hospitals of the study areas with histologically confirmed incident breast cancer and 2588 control women with no history of cancer, who were admitted to hospitals in the same catchment areas for acute, non-neoplastic, nongynecological conditions unrelated to hormonal or digestive tract diseases or to long-term modifications of the diet. Dietary habits, including alcoholic beverage consumption, were investigated using a validated food frequency questionnaire, including 78 foods or food groups, several types of alcoholic beverages, some "fat intake pattern" questions and some open sections for foods consumed frequently by the subject and not reported in the questionnaire. To control for potential confounding factors, several multiple logistic regression models were used. When major correlates, energy intake and the mutual confounding effect of the various micronutrients were taken into account, beta-carotene, vitamin E and calcium showed a significant inverse association with breast cancer risk. The estimated odds ratios of the 5th quintile compared to the lowest one were 0.84 for beta-carotene, 0.75 for vitamin E and 0.81 for calcium. No significant association emerged for retinol, vitamin C, thiamin, riboflavin, iron and potassium. Our results suggest that a diet rich in several micronutrients, particularly beta-carotene, vitamin E and calcium, may be protective against breast cancer.

Adult↗
PubMed1996

Intravenous administration of alendronate counteracts the in vivo effects of glucocorticoids on bone remodeling.

The purpose of the investigation was to test the use of alendronate in the therapy of children affected by chronic rheumatic diseases and symptomatic drug-induced osteoporosis. Two courses of alendronate were intravenously administered to four girls with vertebral fractures that were glucocorticoid induced. Improvement of back pain and bone mineral density increase evaluated by DXA and conventional spine X-rays were observed. Our study supports the ABD-induced improvement of the negative effects of long-term therapy on bone mineral density in children with chronic rheumatic diseases.

Adolescent↗
PubMed1996

The primary role of steroids on the osteoporosis in juvenile rheumatoid patients evaluated by dual energy X-ray absorptiometry.

Osteoporosis, a common clinical feature in children affected with Juvenile Rheumatoid Arthritis (JRA), is generally divided into two forms, a localized juxta-articular osteoporosis of the single joints and a generalized reduction of bone mass due to the disease itself, joint involvement and steroid treatment. Recently Dual Energy X-ray Absorptiometry (DEXA) has been suggested for Bone Mineral Density (BMD) measurement. In the present study DEXA has been used to investigate the lumbar spine BMD in JRA patients as compared to healthy children. Our results showed that BMD is reduced in JRA patients (BMD 0.685 g/cm2) when compared to healthy children (BMD 0.722 g/cm2), and it is significantly lower in the group of patients treated with steroids (BMD 0.623 g/cm2) when compared to those treated with nonsteroidal antiinflammatory drugs (BMD 0.710 g/cm2). The analysis of all risk factors of bone loss indicated that steroids represent the only parameter of significant negative correlation with BMD.

Absorptiometry, Photon↗
PubMed1996

The role of reproductive and menstrual factors in cancer of the breast before and after menopause.

The aim of the study was to elucidate the role of reproductive and menstrual factors in the aetiology of breast cancer, overall and by menopausal status. A cooperative case-control study was conducted between 1991 and 1994 in six different Italian areas (including three from the centre and the south). The study included 2569 histologically confirmed incident cases of breast cancer (median age 55 years, range 23-78 years) and 2588 control women (median age 56 years, range 20-79 years) admitted to the same hospitals for a variety of acute conditions unrelated to the hypotheses in study. A trend of increasing risk with increasing age at menopause (odds ratio (OR) for age at menopause > or = 53 versus < 45 years = 1.8; 95% confidence interval (CI) = 1.4-2.2). High parity reduced cancer risk (OR for > or = 4 versus 1 birth = 0.7; 95% CI = 0.5-0.9). Overall, nulliparous women showed a 20% lower risk than uniparous ones (OR = 0.8; 95% CI = 0.7-1.0). Late age at first birth (or pregnancy) had an independent adverse effect (OR for first birth at > or = 32 versus < 20 years = 1.7; 95% CI = 1.3-2.1) both before and after menopause. An approximately 2-fold elevation of breast cancer risk was evident up to 10 years after the last birth. No trend in risk was evident for induced abortions (OR = 1.2 for 1 and 1.1 for > or = 2 induced abortions versus 0). Other examined menstrual and reproductive characteristics did not seem important. Multiparity, early age at first birth and early age at menopause were therefore the most important determinants of breast cancer risk. The effects of the timing of births was significantly heterogeneous in pre- and postmenopausal women because of the transient adverse effect of such events, evident only in premenopausal women.

Adult↗
PubMed1996

Validation of a food-frequency questionnaire to assess dietary intakes in cancer studies in Italy. Results for specific nutrients.

The validity of a 77-item food-frequency questionnaire (FFQ) developed for a multicenter case-control study on diet and cancer in Italy was assessed. Trained interviewers administered the same FFQ to 452 volunteers from three Italian provinces (Pordenone, Genoa, and Forli) completed in two different seasons, at an interval of 3 to 10 months. For 395 (130 males, 265 females; median age = 52 years; range = 35 to 69 years) volunteers, two 7-day dietary (7-DD) records were available. Average intake obtained by means of the FFQ was overestimated by approximately 18% in comparison with the corresponding values based on the two 7-DD records (reference method). Pearson partial correlation coefficients, adjusted for total energy intake between the nutrient intakes assessed by the FFQ and reference method, ranged from 0.19 for vegetable fat to 0.64 for sugar (median value r = 0.46). The unadjusted deattenuated coefficients, which took into account the interindividual variability of consumption, estimated by means of the two 7-DD records, ranged from 0.29 for vegetable fat to 0.72 for starch (median value r = 0.54). The proportion of subjects correctly classified within the lowest two quintiles ranged between 59% for vegetable fat and vitamin E, and 96% for alcohol, and those correctly classified within the highest two quintiles ranged between 44% for vegetable fat and 94% for alcohol. The average proportion of subjects correctly classified within one quintile was 73%. These data indicate that this FFQ provides valid estimates of intakes for major nutrients, comparable to those reported from other studies in North America and other European countries.

Adult↗
PubMed1996

Prevalence of celiac disease in patients with juvenile chronic arthritis.

We estimated the prevalence of celiac disease in children with juvenile chronic arthritis (JCA), using antiendomysium antibodies as the screening test to select patients for intestinal biopsy. We studied 119 children with JCA and found four patients with antiendomysium antibodies. In three of these patients (2.5%), intestinal biopsy revealed villous atrophy; in the fourth the intestinal mucosa was normal. We conclude that the prevalence of celiac disease is increased in patients with JCA.

Adolescent↗
PubMed1996

Increased circulating nerve growth factor is directly correlated with disease activity in juvenile chronic arthritis.

OBJECTIVE: To determine the circulating serum concentrations of nerve growth factor (NGF) and compare them with indices of disease activity in juvenile chronic arthritis. METHODS: NGF concentrations were evaluated with a two site immunoenzymatic assay (ELISA), in 17 children with systemic, 39 with polyarticular, and 24 with pauciarticular onset juvenile chronic arthritis. Each subset was divided according to different variables, appropriate to each subset, reflecting active and inactive disease. RESULTS: NGF concentrations were significantly higher in children with systemic [254 (SD 256.1) pg ml-1; P < 0.001], polyarticular [165.2 (300.8) pg ml-1; P < 0.05], and pauciarticular [106.8 (111.8) pg ml-1; P < 0.005] onset juvenile chronic arthritis than in controls. In all subsets, NGF concentrations were higher in the active than in the inactive phase of the disease. A significant direct correlation between NGF concentrations and erythrocyte sedimentation rate was found both in the systemic and in the polyarticular onset juvenile chronic arthritis. CONCLUSIONS: The increase in NGF concentrations in all juvenile chronic arthritis subsets and the correlation with disease activity suggest that NGF may take an active part in joint inflammation.

Anti-Inflammatory Agents, Non-Steroidal↗
PubMed1996

Chronic lymphocytic leukaemias and non-Hodgkin's lymphomas by histological type in farming-animal breeding workers: a population case-control study based on a priori exposure matrices.

OBJECTIVES: A population based case-control study was conducted in a highly agricultural area in Italy to investigate the association between chronic lymphocytic leukaemias (CLLs) and non-Hodgkin's lymphomas (NHLs), and subtypes, and exposure to pesticides in farming-animal breeding workers. METHODS: 187 cases of CLLs and NHLs and 977 population controls were interviewed on medical, residential, family, and occupational history. Detailed information was collected about cultivated crops and animals bred from subjects who worked in farming and animal breeding. Information on crop diseases and pesticides used (and their quantity and duration) was also obtained. A priori job-exposure matrices were applied when a crop disease was reported, estimating the most probable pesticide and, when possible, an estimate of the cumulative dose. Odds ratios (ORs) were calculated by unconditional logistic analysis with adjustment for relevant confounders in farmers who bred animals and in farmers alone, for the main crops, types of animals, and pesticides categories. First recall and then the matrices were used for defining exposure, as it affected CLLs and NHLs and then separately on CLLs and low grade NHLs. Finally, the dose-response was investigated for those pesticides which had shown some association. RESULTS: No variable under study was associated with work in farming alone. In farming and animal breeding, no crop or animal showed an association with CLLs and NHLs when adjusted by exposure during childhood to farming and animal breeding (an indicator of life in a farming and animal breeding environment before the age of 13, which behaved as an independent risk variable). A non-significant association was found with stannates, arsenates, phosphates, and dichloro-diphenyl-trichloroethane (DDT) based on recall, and for stannates, arsenates, and DDT after the application of the matrices. When CLLs together with low grade NHLs were considered, the association with insecticides in general, carbamates, and phosphates became significant according to personal recall (ORs and 95% confidence intervals (95% CIs) 2.46, 1.07-5.63; 3.08, 1.05-9.00; 2.97, 1.28-6.91, respectively). The application of the matrices also showed a risk of borderline significance for stannates and dithiocarbamates. A significant dose-response effect was found for phosphates (for logarithmic unit increase, OR 1.17, 95% CI 1.00-1.57); a strong trend for stannates and carbamates did not reach significance. CONCLUSION: The association of CLLs and NHLs with work in farming-animal breeding is partially explained by exposure to pesticides-namely insecticides (carbamates, phosphates, and DDT) and stannates-possibly related to their use in animal breeding. The association is limited to cases of CLL and low grade NHL. The independent effect of the variable exposure during childhood suggests that early exposures, including possible contact with animals, may play a part in the pathogenic process of these neoplasms.

Animal Husbandry↗
PubMed1996

Nerve growth factor circulating levels are increased in Kawasaki disease: correlation with disease activity and reduced angiotensin converting enzyme levels.

OBJECTIVE: To investigate the serum levels of nerve growth factor (NGF) and their possible relationship with disease activity in Kawasaki disease. METHODS: Twelve children with Kawasaki disease, 12 healthy children (afebrile controls), and 12 children with high fever related to upper respiratory tract viral infections (URTVI) were enrolled in the study. Serum NGF levels were measured by an ELISA method before and after therapy. In addition, angiotensin converting enzyme (ACE), and erythrocyte sedimentation rate (ESR), complete hemochrome, and C-reactive protein were tested as indicators of endothelial injury and disease activity, respectively. RESULTS: NGF levels were strikingly increased in the acute phase of Kawasaki disease (1219.54 +/- 1660.29 pg/ml) and decreased in the inactive phase of the disease (277.08 +/- 245.64 pg/ml), while remaining significantly higher than controls (6.5 +/- 2.03 pg/ml). In febrile patients with URTVI, NGF levels (30.18 +/- 44.70 pg/ml) were moderately but significantly increased compared to afebrile controls, but remarkably lower in respect to active and inactive Kawasaki disease. In active Kawasaki disease, ACE values were significantly lower than in healthy children (2.8 +/- 1.7 vs 10.1 +/- 4.2 pmol/ml/min; p < 0.001) and increased during the inactive phase, but remaining lower than in controls (4.8 +/- 2.7 pmol/ml/min); ESR, hemoglobin level, and platelet count showed significant correlation with NGF, while ACE levels showed a significant inverse correlation with ESR and NGF. CONCLUSION: In Kawasaki disease, NGF increased together with decreased ACE may be linked to a diffuse vascular inflammatory process. NGF and ACE levels remained abnormal even when there was no clinical sign of disease activity. This may indicate that the disease process is not in complete remission and suggests careful and prolonged cardiac followup until their normalization.

Child, Preschool↗
PubMed1995

Chronic lymphocytic leukaemias and non-Hodgkin's lymphomas by histological type in farming-animal breeding workers: a population case-control study based on job titles.

OBJECTIVES: A population based case-control study was conducted in a highly agricultural area in the north east of Italy to evaluate the association between farming and animal breeding and the risk of developing non-Hodgkin's lymphoma (NHL) and chronic lymphocytic leukaemia (CLL). METHODS: Occupational histories and other data were collected by personal interview on 164 NHLs, 23 CLLs, diagnosed in 1988-90, and on 977 controls. This paper only reports the results of the analysis relative to the coding of job titles through the modified International Labour Office (ILO) classification. Estimates of odds ratios (ORs) for occupational variables were calculated, after adjustment for sex, age, altitude of municipality, first degree familiarity, and previous Herpes zoster infection. RESULTS: From the analysis of the most frequent occupational categories, no occupation showed a significantly high risk. When the two job titles farmers only and farmer-breeders who are also involved in animal breeding are classified within the extremely varied occupation of agriculture or animal-breeding or fishing, a high risk for NHLs and CLLs is seen in the farmer-breeders (OR 1.79, 95% CI 1.22 - 2.63). Analyses according to histological type show that the risks are concentrated in CLLs and in low grade NHLs. No effect or trend by period at work or duration of employment in farming and animal breeding was found. CONCLUSION: Subjects working in agriculture associated with animal breeding are at high risk of NHL/CLLs, particularly CLLs and low grade NHLs. This finding could be related to the use of chemicals in agriculture or to exposure to animal transmitted diseases or specific chemicals used in animal breeding.

Adolescent↗
PubMed1994

Kaposi's sarcoma in Italy before and after the AIDS epidemic.

The incidence of Kaposi's sarcoma (KS) in 1976-90 was assessed in Italy, taking advantage of a network of nine population-based cancer registries covering, at its maximum, approximately 5.6 million subjects. The first examined period (1976-84) substantially reflects the epidemiology of KS prior to the AIDS epidemic in the registration areas. Elevated incidence rates, standardised to the Italian population of 1981, of 1.05/100,000 men and 0.27/100,000 women emerged in 1976-84 (i.e. from two- to threefold higher than in the USA and Sweden, more than tenfold higher than in England and Wales). These high rates, especially remarkable in the Registry from the south of Italy (i.e. Ragusa, 3.01/100,000 men and 0.54/100,000 women) suggest that the prevalence of the still unknown causative agent for KS was high, at least in some parts of Italy, prior to the AIDS epidemic. In the most recent period (1985-90), an approximately twofold increase in KS incidence rates in Italian men below age 50 was observed (from 0.15 in 1976-84 to 0.47 in 1985-90). Conversely, declines in KS incidence were recorded in older men.

Acquired Immunodeficiency Syndrome↗