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Biomedical subjects

F Levi

Publications and source records attributed to F Levi.

At least 199 records · Page 11Linked to original sources

Trends in mortality from bronchial asthma in Switzerland, 1969-1993.

Several unfavourable trends and epidemics of fatal asthma have been registered in various developed countries of Europe, the United States and New Zealand over the last three decades. These have been related to problems in the treatment of the disease, following the introduction and/or inappropriate utilization of selected beta-agonist treatments. Thus, trends in mortality rates from bronchial asthma have been analyzed in Switzerland, where the Eighth Revision of the International Classification of Diseases has been in operation from 1969 to 1993. Overall age-standardized mortality rates (world standard) declined, from 4.3/100,000 males in 1969-73 to 2.8 in 1989-93, and from 2.0 to 1.5/100,000 females. The declines were consistent in both sexes for the age group 35 to 64 years, and some downward trend was observed also above age 65, particularly in males. Asthma mortality trends were inconsistent in children and young adults ( < 35 years), with some increase in males aged 15 to 34 after 1983, in the absence however of any significant linear trend in rates. Thus, trends in asthma mortality in Switzerland showed a moderate and steady decline in rates, particularly in middle aged males, in the absence of any systematic upward trend or epidemic peak. Still, the trends were only moderately favourable, and in the early 1990's about 250 deaths per year were attributed in Switzerland to bronchial asthma, i.e. an avoidable, in principle, cause of death.

Adolescent↗

Cancer incidence and mortality in young adults in Vaud, Switzerland, 1974-1992.

Trends in cancer incidence and mortality in young adults (aged 20 to 44 years) over the period 1974-1992 were analyzed using data from the Vaud Cancer Registry, Switzerland. A total of 1,497 cancers were registered in males, after excluding non melanomatous skin cancers. The most common neoplasms were testis, lymphomas, lung, skin melanoma and oral cavity and pharynx. The overall age-standardized (world population) incidence was 750 per million males, and increased from 676 in 1974-1979 to 808 in 1986-1992. These upward trends were due mainly to cancers of the oral cavity and pharynx, lung, skin melanoma and colorectum, while testicular cancer rates remained stable. For females, a total of 1,899 malignant neoplasms was notified, corresponding to an overall age-standardized incidence of 914 per million. The overall rate increased from 818 in 1974-1979 to 1,003 in 1986-1992. The most frequent neoplasms were breast, skin melanoma, ovary, thyroid and lymphomas. The major types of cancer responsible for these upward trends were breast cancer, skin melanoma and lung cancer. In the period studied there were 458 cancer deaths in males and 408 in females, corresponding to an overall age-standardized rate of 227 per million males and 193 per million females. Death rates in males tended to decline, to reach 194 per million in 1986-1992, but no consistent trend was observed in females. The decline in males was essentially due to the fall in rates for testicular cancer and Hodgkin's disease. In females, falls in death rates were observed for cancer of the cervix uteri, ovary and Hodgkin's disease. Death rates were upwards for lung cancer in both sexes, and for skin melanoma and breast cancer in females.

Adult↗

Cancer incidence and mortality among teenagers in Vaud, Switzerland, 1974-1992.

Data from the Vaud Cancer Registry, Switzerland, were used to analyse incidence and mortality from cancer in teenagers (aged 10 to 19 years) over the period 1974-1992. A total of 113 males and 87 females were registered. Of these, 23% were lymphomas, 16% leukaemias, about 15% central nervous system neoplasms, 10% germ cell tumours and bone neoplasms and 8% soft tissue sarcomas. The overall incidence rate (age-adjusted, world standard population) for all cancers combined was 167 per million boys and 128 per million girls. In both sexes, there was some indication of rising trends over time, to reach 196 per million males and 141 per million females in 1986-1992. The only types of cancer showing consistent upward trends in both sexes were lymphomas. A total of 53 cancer deaths were certified, due to leukaemias in about 40% of cases in both sexes and to lymphomas and brain tumours in 15%-20%. The overall mortality rate at age 10-19 years (age-standardised, world standard) was 47 per million boys and 31 per million girls, and no trend in mortality was observed over time. The 2 main findings of our analysis are (i) the absence of major trends in cancer incidence in adolescents, with the sole exception of a possible increasing incidence of lymphomas, and (ii) the lack of appreciable trends in mortality, in view of the declines in cancer mortality observed in children and young adults over the same calendar period.

Adolescent↗

Patterns of childhood cancer mortality: America, Asia and Oceania.

Age-standardised mortality rates for childhood cancers for the calendar period 1950-1989 were reviewed for 22 countries (Canada, U.S.A., 10 Latin American countries or territories, Egypt, seven countries or territories from Asia, Australia and New Zealand) using data from the World Health Organization database. The highest mortality rates (between 6 and 7.5/100,000 boys, between 5 and 6/10,000 girls) for all childhood neoplasms were registered in Latin American countries (Uruguay, Cuba, Argentina, Costa Rica), Kuwait, New Zealand and Singapore. Rates were low in most developed countries, such as Canada, U.S.A., Australia, Japan and Israel (3.5 to 4.5/100,000). The pattern was similar for leukaemias, which account for approximately 50% of all childhood cancer mortality. From the 1960s onwards, a 50% decline in childhood cancer mortality was observed in the U.S.A. and Canada, and substantial declines were also observed in other developed countries, such as Australia, Israel and Japan. The pattern was much less favourable for other areas of the world, including Latin America and a few countries from Asia for which there were data. These declines in childhood cancer mortality are essentially attributable to improved management of the disease. The delay observed in the decline in mortality for most developing countries emphasises the scope and the importance of extending adequate treatments for childhood cancers to these areas of the world.

Adolescent↗

Trends in mortality from nonneoplastic gallbladder disease.

Trends in mortality rates from gallstones and other nonneoplastic gallbladder and biliary tract diseases between 1955 and 1990 for 38 countries (8 from America, 3 from Asia, 25 from Europe, Australia, and New Zealand) were analyzed. Age-adjusted mortality rates standardized on the world population were computed from official death certifications derived from the World Health Organization database. There were generalized and substantial declines in the rates in both sexes and all countries considered, except for males in Czechoslovakia and Poland. Over the calendar period considered, the average declines were over 70% for males and over 80% for females in North America, over 60% for males and 70% for females in Latin America, although mortality remained relatively high in Chile. The declines were 80% for both sexes in Japan and over 70% for males and 80% for females in Australia. The pattern was more heterogeneous in Europe, with decreases of approximately 70 to 80% in northern Europe, but more modest in central and southern Europe, with particularly moderate downward trends for males. In several countries the decreases were rather steady over the calendar period considered, but in a few others the decline was restricted or larger during the most recent calendar period. The trends in gallstone and other gallbladder disease mortality in various areas are affected by differences and potential biases in death certification reliability, and by underlying variations and changes in the prevalence of gallstones and gallbladder surgical removal. A likely interpretation for the generalized decline in mortality over the last calendar period is, however, improved diagnosis and treatment of gallstone disease.

Adult↗

Trends of skin cancer in the Canton of Vaud, 1976-92.

Trends in incidence and mortality for basal cell carcinomas (BCC), squamous cell carcinomas (SCC) and cutaneous malignant melanoma (CMM) for the period 1976-92 were analysed using data from the Cancer Registry of the Swiss Canton of Vaud. Among the 12,473 cases registered, 63% were basal cell carcinomas, 25% squamous cell cancers, 9% cutaneous malignant melanomas and 3% other miscellaneous histological types. Age-standardised incidence rates increased substantially for all histological types considered, from 44% increase for BCC in males to a more than 3-fold increase for SCC in females, with only signs of a levelling off in 1991-92, following a peak of incidence rates in 1986-90. From 1976-80 to 1991-92 CMM incidence increased by approximately 80% in both sexes. In 1991-92, age-standardised (world) incidence rates per 100,000 were 69.3 for basal cell, 29.1 for squamous cell cancers and 11.5 for melanomas in males, and, respectively, 62.2, 18.0 and 12.3 in females. With respect to mortality, in males rates increased for both non-melanocytic cancer (> 40%) and CMM (> 53%) whereas in females CMM, BCC and SCC rates remained approximately stable over the calendar periods examined. In 1991-92, age-standardised mortality rates per 100,000 were 2.6 for melanoma and 0.7 for other skin cancers in males, and, respectively, 1.6 and 0.2 in females. Upward trends in incidence were also present, and relatively homogeneous across, various age groups examined. However, SCC and CMM levelled off over the last period, and some decline was apparent in males below age 45. Separate analysis by anatomical site showed substantial increases in the head and neck for SCC and BCC, and in the trunk for CMM. In 1991-92, middle-aged women had almost equalled male incidence rates of BCC and SCC. A female excess of CMM incidence seemed to have disappeared since 1981-86. The increase in skin cancer incidence thus continued in this population up to the late 1980s, with a plateau only after 1990.

Adolescent↗

Cancer mortality in Europe, 1990-92.

Histograms of all age-standardized (world population) death certification rates for 23 cancers or groups of cancers for the period 1990-92 were produced for 35 countries of the European region (including a dozen new national entities) providing data to the World ealth Organization database. Substantial variations were observed in mortality from most common sites. For lung cancer the rate in males was 81/100,000 in Hungary, followed by Belgium, the Czech Republic, the Russian Federation and Poland, while in Sweden, Iceland and Norway, where comprehensive antismoking campaigns have been adopted over the last two decades, the rates were between 24 and 30 per 100,000 males. The lung cancer epidemic in European females is still in its early phases in most countries, with the sole exception of Scotland (29/100,000, ie the highest rates in the world), the rest of the UK, Denmark, Iceland, Ireland and Hungary. With reference to colorectal cancer, the highest rates were in the Czech Republic (38/100,000 males, 21/100,000 females) and other central European countries, and the lowest in Greece, Romania and a few Republics of the former Soviet Union, as well as Finland and Sweden. The highest gastric cancer mortality rates were in the Russian Federation (41/100,000 males, 18/100,000 females), followed by a few Republics of the former Soviet Union and Portugal in Western Europe. The highest breast cancer rates (25-29 per 100,000 females) were in the UK, Belgium, Ireland, The Netherlands, Denmark and other Scandinavian countries. For overall cancer mortality, the range of variation was between 260/100,000 in Hungary and 132/100,000 in Sweden for males, and between 142/100,000 in Denmark and 76/100,000 in Kyrgizstan for females, ie approximately a twofold variation in both sexes.

Breast Neoplasms↗

Mortality from benign prostatic hyperplasia: worldwide trends 1950-92.

STUDY OBJECTIVE: To provide a systematic overview of worldwide trends in mortality from benign prostatic hyperplasia (BPH) over the past four decades. DESIGN: This was a descriptive analysis based on age adjusted mortality rates for BPH between 1950 and 1992 for 41 countries from five continents. SETTING: Official death certifications from the World Health Organization database. MAIN RESULTS: In the 1950s, the highest age adjusted (on the world standard population) mortality rates for BPH in Europe were in Denmark (22.8/100,000) and Germany (18.1), followed by Scandinavian countries, the UK, and Switzerland. Italy had rates around 10/100,000, and rates were lower in eastern and southern Europe (5-8/100,000). Between 1950 and 1990, a fall of over 90%, or even 95%, was observed in most western European countries. Thus, in the early 1980s, overall mortality from BPH ranged between 0.5 and 1.5/100,000 in most western European countries. In proportional terms, similar reductions were registered in other developed countries of North America, Asia (that is, Japan or Singapore), and Oceania. A fall in rates was also observed in eastern Europe and in Latin America, particularly from the late 1970s onwards, although these reductions were generally much smaller. Thus, in the early 1990s, most countries in these areas had BPH rates between 1 and 5/100,000. The pattern of trends was, at least qualitatively, similar at younger ages, although most falls were proportionally greater. CONCLUSIONS: The most probable interpretation of these trends is that therapeutic improvements--including more widespread and timely surgery, introduction of less invasive techniques, such as transurethral prostatectomy, and possibly the development of medical treatments--have had a favourable and substantial impact on BPH mortality. There are, however, areas of the world, including several countries of western Europe and South America, where rates are still very high.

Age Factors↗

Ambulatory chronotherapy with 5-fluorouracil, folinic acid, and carboplatin for advanced non-small cell lung cancer. A phase II feasibility trial.

Thirty-two patients with advanced non-small cell lung carcinoma (NSCLC) received a chronomodulated 5-day venous infusion of 5-fluorouracil (5 FU) (700 mg/m2/day), folinic acid (F) (300 mg/m2/day), and carboplatin (C) (40, 50, or 55 mg/m2/day), as first chemotherapy. Courses were repeated every 21 days (after a 16-day interval). In total, 158 courses (median: 4, range: 1 through 16; 81 and 58 courses at, respectively, a 40 and 50 to 55 mg/m2 daily dosage of C) were delivered using a multichannel programmable in-time pump (Intelliject, Aguettant) connected to a double lumen implanted venous side-port. The administration was allowed in fully ambulatory convenience. Overall tolerance was excellent. Grade 3 of 4 hematologic toxicity was encountered in 4.6% of courses for thrombopenia and in 7.0% of courses for neutropenia. Nausea or vomiting (grade 3 or 4) occurred in 7.8% of courses. Mucositis, diarrhea, alopecia, or skin grade 3 or 4 toxicity were observed in less than 3% of courses. Treatment delay was needed in only 7.8% of courses and dose reductions were needed in 4.6% of courses for 5 FU and in 6.5% of courses for C. This good tolerance allowed a sustained quality of life and prompted further trials aiming to define the place of this protocol in the multidisciplinary treatment approach of NSCLC.

Adult↗

Trends in pancreatic cancer mortality in Europe, 1955-1989.

Trends in death certification rates from pancreatic cancer over the period 1955-1989 were analyzed for 25 European countries (excluding the former Soviet Union and a few smaller countries). In 1985-1989, rates for males ranged between 5.3/100,000 (age-standardized world population) in Spain and 10.3/100,000 in Hungary and Czechoslovakia. Other high-mortality areas were located in Northern Europe (Finland, Iceland, Ireland, Denmark) and Central Europe (Austria, Poland, Germany), whilst mortality was lower in Southern Europe (Portugal, Greece). Between 1955 and 1989, mortality rates increased in all the countries considered, the change ranging between 6% in Scotland and 279% in Spain; the rises were higher in the Mediterranean and Eastern European countries than in Northern Europe. Among females, Nordic countries such as Iceland, Sweden and Denmark had the highest mortality rates in 1985-1989 (over 6/100,000) and, as for males, Southern Europe (Spain, Portugal, Greece) appeared as a low-mortality area (around 3/100,000). During the 1955-1989 period, upward trends were observed in all the countries studied, with the highest increase in Greece, Italy, Bulgaria, Poland and Spain. A negative correlation was observed between the percent change in mortality rates between 1955-1959 and 1985-1989 and the rate in 1955-1959 among both males (r = -0.95, p < 0.001) and females (r = -0.81, p < 0.001). Thus, a systematic levelling of rates was observed in most countries, with the exception of the UK and some Nordic countries, whose rates were already high in the late 1950s. Tobacco smoking and dietary factors could account for some of the generalized upward trends. Improved diagnostic and death certification of the disease might also partially explain the observed figures.

Age Factors↗

Incidence of breast cancer in women with fibroadenoma.

There is a general agreement that fibroadenoma is associated with a certain increase in breast cancer risk, but the risk estimates appear heterogeneous according to various studies. To provide further quantitative and population-based estimates of breast cancer risk in women with histologically confirmed fibroadenomas, we linked data of 1,461 incident cases of fibroadenoma (median age, 37 years) to the Cancer Registry of the Swiss Canton of Vaud (about 600,000 inhabitants) over the period 1977-1991. After exclusion of 57 synchronous breast neoplasms, a total of 17 cases of breast cancer were observed vs. 10.9 expected (standardised incidence ratio, SIR, 1.6; 90% confidence interval: 1.1-2.1). The SIR was similar in the short term (3-5 years) and in the medium-long term (> 5 years) following diagnosis of fibroadenoma. The cumulative risk of invasive breast cancer was 0.7% after 5 years and 2.2% after 12 years following diagnosis of fibroadenoma. This is not negligible on account of the young age of our cohort.

Adult↗

Trends in cancer mortality in the USSR, 1965-1990.

Trends in age-specific and age-standardized mortality from 10 major cancer sites and total cancer mortality in the USSR were analyzed for the period 1965-1990, on the basis of the World Health Organization mortality database. Gastric cancer mortality declined substantially. Still, these rates were among the highest registered in the world, and in 1990 stomach cancer accounted for over 85,000 deaths, being the second cause of cancer death (and the first one until 1980); further, there was some indication of a levelling of the declines in gastric-cancer rates for both sexes over most recent calendar years. Likewise, uterine-cancer mortality declined between 1965 and 1985, but there was no further decline over the last 5 years. Upward trends were registered for cancers of the intestine, of the breast and of the prostate. Mortality from these neoplasms, however, was still comparatively low by worldwide standards. Leukaemia rates were stable in both sexes. Substantial rises were observed for cancers of the oral cavity and pharynx, larynx and, chiefly, lung. Even more unfavourable was lung-cancer mortality in young and middle-aged males, since the truncated rate of 121/100,000 in 1990 was higher than the values reached by countries like England and Wales or Finland even at the top of their epidemic in the 1960s, and trends in the USSR were still upwards. Thus, total cancer mortality was 176/100,000 males in 1965, declined to 170 in 1970, but increased thereafter, particularly over the last decade, to reach 203/100,000, i.e., one of the highest rates on a worldwide scale. Among females, the overall cancer mortality rate declined between 1965 and 1975, but rose thereafter to a value intermediate on a worldwide scale. These recent unfavourable trends of cancer mortality in the USSR indicate that, in the absence of adequate intervention, particularly on the tobacco-related cancer epidemic, overall cancer mortality will continue to rise in the foreseeable future.

Adult↗

Periodic fluctuations in proliferation of SV-40 transformed human skin fibroblast lines with prolonged lifespan.

A human fibroblastic cell line transformed by the SV40-T antigen sequence and continuously cultured for 7 months displayed large periodic variations in cell proliferation. This contrasted with other characteristics of this cell line that remained constant: mosaic cell shape, absence of cell contact inhibition, and predominance of a hypodiploid population. Similar fluctuations in proliferative capacity were also found during the long-term growth of a transformed but nonimmortalized human fibroblastic line prior to senescence, and in the established hamster fibroblastic Nil cell line. This growth pattern suggests a recurrent stimulation of growth in these three transformed cell lines. The proliferation pattern from cultured transformed cells may thus be complex and requires further investigation. These variations presumably influence major cell functions. This observation has important implications for the analysis of data from such cell lines.

Animals↗

Worldwide pattern of mortality from motor vehicle accidents, 1950-1990.

Trends in age-specific and age-standardized death certification rates from motor vehicle accidents over the period 1950-1990 were analyzed for 48 countries from four continents (2 from North America, 10 from Latin America, 8 from Asia, 26 from Europe, Australia and New Zealand) on the basis of data produced by the World Health Organization mortality database. In most developed western and Asiatic countries, mortality rates increased until the late 1960's or early 1970's, and declined thereafter to reach values often lower than those of the early 1950's, although the number of circulating vehicles has substantially increased over the same calendar period. The extent of the decline was, however, different in various countries, as well as in the two sexes and in various age groups, thus leading to complex cohort and period patterns. In general, countries (like the U.S.A. or U.K.), where the number of motor vehicles had increased earlier, have now comparatively higher rates at younger than at middle and older age, while the opposite is observed in countries with later spread of motor vehicles. Further, there were a few countries, including Kuwait, Venezuela and several other Latin American countries, Australia and New Zealand, and several southern and eastern European countries, with exceedingly high rates from motor vehicle accidents, and where comprehensive interventions on this important cause of death are therefore a public health priority.

Accidents, Traffic↗