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Biomedical subjects

G Benzi

Publications and source records attributed to G Benzi.

At least 37 records · Page 2Linked to original sources

Role of reproductive factors on the risk of endometrial cancer.

We analyzed the role of reproductive factors on the risk of endometrial cancer using data from a case-control study conducted in Italy. Cases were 752 women with histologically confirmed endometrial cancer < 75 years of age. Controls were 2,606 patients < 75 years of age admitted for acute, non-gynecological non-hormone-related, non-neoplastic conditions to the same network of hospitals where cases had been identified. In comparison with nulliparae, the risk of endometrial cancer tended to be lower in parous women, and the estimated multivariate odds ratios (ORs) were 0.9, 0.8 and 0.7, respectively, for women reporting 1, 2 and 3 or more births (chi(2)(1) trend and 10.21). In comparison with women reporting no induced abortion, the ORs of endometrial cancer were 0.6 in women reporting 1 and 0.4 in those reporting 2 or more induced abortions. When considering parous women only, in comparison with women reporting their last birth 20 years before or longer, the ORs of endometrial cancer were 0.6 in those reporting their last birth 10-19 years before and 0.3 in those reporting their last birth < 10 years before. Our results confirm and further quantify a protective role of pregnancy on the risk of endometrial cancer and provide insights on the time-risk relationship between pregnancy and cancer of corpus uteri.

Adult↗

Is there a rationale for the use of acetylcholinesterase inhibitors in the therapy of Alzheimer's disease?

Since the 1980s, the cholinergic hypothesis of the pathogenesis of Alzheimer's disease has proven to be a strong stimulus to pharmacological strategies aimed at correcting the cognitive deficit by manipulating cholinergic neurotransmission. Among these strategies, the one based on acetylcholinesterase inhibition is currently the most extensively developed for the therapy of Alzheimer's disease. The inhibitors' mechanisms of action are complex, including changes in the release of acetylcholine, and modulation of acetylcholine receptors. Various clinical trials of various inhibitors have shown that, on the whole, their effects were modest and, in the case of some drugs, were associated with frequent adverse reactions. Among the conceivable reasons for the limited efficacy of these drugs, those related to the pharmacological target deserve particular attention. This review, therefore, focuses on the complex nature of the acetylcholine system, the alterations of acetylcholinesterase and muscarinic receptor signal transduction in Alzheimer's disease, and the involvement of other neurotransmitters.

Acetylcholinesterase↗

The 'drug value' in the European pharmaceutical system.

European regulatory authorities (EMEA, European Commission) and/or national pharmacological and medical decision-makers can utilise the drug value to help themselves to decide which drugs to define as really innovative instead of new, which regulations to implement, which drugs to include on formularies, or which restrictions to enforce. As economic research becomes widely accepted for pharmaceutical evaluation, it needs to utilise prospective rather than retrospective study design. Analyses conducted at the time of therapy have better access to patients and can obtain both more accurate information on consumption of resources and the impact of pharmacotherapy on non-monetary quality of life for patients, survival, comparative clinical effectiveness and economic outcomes within social health service or in wider economy.

Drug and Narcotic Control↗

Application of guidelines for occupational HIV infection control during delivery in Italy.

OBJECTIVE: We surveyed the attitudes of Italian obstetricians toward the application of HIV infection control guidelines during labour and delivery proposed by the Italian National Committee for HIV Infection. STUDY DESIGN: We identified 66 obstetric centres affiliated to the AOGOI (Association of Italian Gynecologists and Obstetricians). A postal questionnaire was sent to 752 physicians in charge in the centres. RESULTS: A total of 419 clinicians (55.7%) completed and returned the form to the coordinating centre. Obstetricians were directly asked about the need for routine adoption of the Italian guidelines for delivery of women with positive or unknown HIV status (indicating the routine use during delivery of protective glasses, impermeable garments, mask and sterile latex gloves, the washing of hands with detergent solution after using gloves and collection of needles and sharp instruments in suitable containers). A total of 319 (76.1%) clinicians agreed that all these procedures should be adopted. In clinical practice, however, obstetricians declared that the use of latex gloves and collecting needles in suitable containers were always adopted, 'washing hands after using gloves' less frequently, and other procedures such as protective impermeable garments, glasses and mask were infrequently applied.

Adult↗

Placental ratio in pregnancies at different risk for intrauterine growth.

OBJECTIVE: We have analyzed the placental/birthweight ratio in women at increased risk of intrauterine growth retardation and pregnancy-induced hypertension and in women with pregnancy 'complicated' by these conditions. STUDY DESIGN: A total of 89 women with small gestational age (SGA) infants, 355 with appropriate gestational age infants (200 in the uncomplicated pregnancy group) and 28 with large for gestational age (LGA) infants were considered. RESULTS AND CONCLUSION: The mean placental weight showed a significant increase from the SGA to the LGA in the two groups. The placental ratio tended to increase from the LGA group to the SGA one both in infants of women with uncomplicated pregnancy and with pregnancy complicated by intrauterine growth retardation or pregnancy-induced hypertension; these findings were statistically significant.

Birth Weight↗

Paternal and maternal smoking habits before conception and during the first trimester: relation to spontaneous abortion.

PURPOSE: This study examined the association between maternal smoking before and during the first trimester of pregnancy and spontaneous abortion. METHODS: We have been conducting a hospital-based case-control study on risk factors for spontaneous abortion in the greater Milan area. We collected information from 782 cases of spontaneous abortions and 1543 controls (women who delivered at term healthy infants). RESULTS: With respect to never smokers, the odds ratio (OR) were 0.7 (95%, confidence interval (CI), 0.5-1.0) for women who quit smoking and 1.3 (95% CI, 1.0-1.6) for those who continued during pregnancy. Women who smoked more than 10 cigarettes/day in the first trimester were at increased risk of miscarriage, with an OR of 1.4 (95% CI, 1.0-2.1). No relationship was evident between the number of cigarettes smoked before conception and the risk of abortion. Likewise, no association emerged between paternal smoking and miscarriage. Moreover, no significant interaction or modification effect was obtained when strata of age and other major characteristics were investigated. CONCLUSIONS: The risk of abortion associated with cigarette smoking during the first trimester of pregnancy was measurable and noticeable in this population, and accounted for 9% (95% CI, 6-13%) of all cases. The increased risk of spontaneous abortion in women smoking during pregnancy is a further reason to encourage pregnant women to quit.

Abortion, Spontaneous↗

Coffee consumption and risk of hospitalized miscarriage before 12 weeks of gestation.

In order to analyse the association between drinking coffee in pregnancy and risk of spontaneous abortion, a case-controlled study was conducted in Milan, Northern Italy. Cases were 782 women with spontaneous abortion within the 12th week of gestation. The control group was recruited from women who gave birth at term (> 37 weeks gestation) to healthy infants on randomly selected days at the same hospitals where cases had been identified: 1543 controls were interviewed. A total of 561 (72%) cases of spontaneous abortion and 877 (57%) controls reported coffee drinking during the first trimester of the index pregnancy. The corresponding multivariate odds ratios of spontaneous abortion, in comparison with non-drinkers, were 1.2, 1.8 and 4.0, respectively, for drinkers of 1, 2 or 3, and 4 or more cups of coffee per day. No relationship emerged between maternal decaffeinated coffee, tea and cola drinking in pregnancy, as well as paternal coffee consumption, and risk of spontaneous abortion. With regard to duration in years of coffee drinking, the estimated multivariate odds ratios of spontaneous abortion were, in comparison with non-coffee drinkers, 1.1 (95% confidence interval (CI) 0.9-1.4) and 1.9 (95% CI 1.5-2.6) for women reporting a duration of coffee consumption < or = 10 or > 10 years. In conclusion, coffee drinking early in pregnancy was associated with an increased risk of abortion. This has biological implications, but epidemiological inference on the causality is difficult and still open to debate.

Abortion, Spontaneous↗

Induced abortion in the first trimester of pregnancy and risk of miscarriage.

OBJECTIVE: To analyse the relation between induced abortion and risk of subsequent miscarriage. DESIGN: Case-control study conducted between February 1990 and May 1995. PARTICIPANTS: Case group included 782 women (median age 32 years, range 14-46) admitted for spontaneous abortion (within the 12th week of gestation) to a network of obstetric departments in the greater Milan area. The control group was recruited among women who gave birth at term (> 37 weeks of gestation) to healthy infants on randomly selected days at the hospitals where cases had been identified. A total of 1543 controls (median age 30 years, range 14-45) were interviewed. RESULTS: A total of 102 cases (13%) and 181 controls (12%) reported one or more induced abortions. No clear relation emerged between miscarriage and induced abortions. In comparison with women reporting no induced abortion the odds ratio (OR) for miscarriage were 1.1 (95% CI 0.8-1.4) in women reporting one induced abortion and 0.9 (95% CI 0.4-1.8) in women reporting two or more. Likewise, there was no association between time since last and age at first induced abortion and risk of miscarriage. CONCLUSIONS: This study did not find any strong association between induced and spontaneous abortion.

Abortion, Induced↗

Pharmacological features of an almitrine-raubasine combination. Activity at cerebral levels.

Treatment with the combination of almitrine-raubasine increases both arterial oxygen partial pressure and haemoglobin oxygen saturation, reflecting an actual increase in the oxygen content of arterial blood. Furthermore, at the trans-cerebral carotid artery/internal jugular vein level, the treatment increases cerebral arterio-venous oxygen and glucose differences, suggesting an actual increase both in oxygen and glucose availability and uptake in cerebral tissues. The increased glucose transfer to the brain is supported also by enhancement of the 3H-deoxyglucose uptake induced by drug pre-treatment both in normoxia and hypoxia. Both almitrine and raubasine act at cerebral mitochondrial levels by decreasing the 'loss' of the 'biological' free energy for phosphorylation supported by the age-related drop in the cerebral enzyme activities, such as phosphofructokinase, pyruvate dehydrogenase and citrate synthase. Furthermore, the components interfere with the alterations induced by peroxidative stress acting at the level of cytochrome c, cytochrome c oxidase and succinate dehydrogenase. Treatment with the combination almitrine-raubasine increases the concentration of noradrenaline metabolites, while alteration of the dopaminergic system is less important. The interference with the noradrenergic system is possibly linked to the electroencephalographic changes induced by drug treatment: increasing alpha-rhythm distribution and reactivity, and increases in beta-rhythm amplitude. Pharmacological effects of almitrine-raubasine, obtained in experimental conditions, correlate with clinical therapeutic efficacy, e.g., in the treatment of cognitive disorders associated with ageing and other cerebral and neurosensory impairments. It is difficult to summarise, in a few pages, the large number of papers related to the cerebral pharmacometabolic and pharmacodynamic activities of the almitrine-raubasine combination. Thus, this review presents in sequential steps some of the interrelated research in humans and laboratory animals which describes in a critical way preclinical to clinical results.

Almitrine↗

Exposure to video display terminals and risk of spontaneous abortion.

Clusters of spontaneous abortion among video display terminal (VDT) users in North America and Canada in the late 1970s aroused suspicion about the potential risk of an association between VDT. exposure and pregnancy outcome. This case-control study considered the association between VDT use and the risk of miscarriage. Cases were 508 women admitted for spontaneous abortion to the Clinica Luigi Mangiagalli and a network of obstetric departments in the Milan area. Controls were 1,148 women who gave birth at term to healthy infants on randomly selected days at the same hospitals where cases were identified. No association emerged between VDT exposure and spontaneous abortion, the estimated odds ratio being 1.0 (95% CI: 0.8-1.2). This evidence agrees with studies conducted in different countries by various authors.

Abortion, Spontaneous↗

Herbal medicines in European regulation.

Herbal medicines are assuming large use in the primary healthcare of individuals and communities consistently with the growing interest in traditional and alternative systems of medicine in many developed countries. Consumer surveys show a positive public attitude to complementary medicine. The regulation of herbal medicines is characterized by large differences depending on the ethnological, medical, and historical background of each country. The WHO Guidelines for the Assessment of Herbal Remedies, adopted by the International Conference of Drug Regulatory Authorities (Ottawa, October 1991), contain the basic elements of legislation designed to assist those countries wishing to develop an appropriate legislation and registration procedure for herbal medicines used. The WHO suggested that the different States should be urged: to give correct importance concerning the utilization of their traditional systems of medicine; to make a systematic inventory and assessment of the medical plants used by traditional practitioners and by the population; to intensify activities leading to cooperation between those providing traditional medicine and modern healthcare, respectively, especially as regards the use of scientifically proven, safe and effective traditional remedies. The goals of these suggestions are to facilitate the scientific evaluation and the eventual integration of traditional medicine into the national healthcare system, critically assisting an eventual rational use of traditional medicine through development of technical guidelines and international standards.

Europe↗

Determinants of risk of spontaneous abortions in the first trimester of pregnancy.

Several factors, such as socioeconomic status, obstetrical and menstrual history, and contraceptive methods, have been associated with risk of spontaneous abortion. We conducted a hospital case-control study to analyze risk factors for spontaneous abortion during the first trimester. Cases were 782 women admitted for spontaneous abortion. Controls included 1,543 women who gave birth at term in the same hospitals. Adjusted odds ratios (ORs) for spontaneous abortion were 0.9 and 0.6, respectively, for women reporting 7-11 and > or = 12 years of schooling, compared with women reporting < 7 years of education. A history of pelvic inflammatory disease increased the odds ratio fivefold [OR = 5.1; 95% confidence interval (CI) = 1.0-26.2]. The OR for spontaneous abortion was 1.7 (95% CI = 1.4-2.1) in women reporting previous spontaneous abortions.

Abortion, Spontaneous↗

The epidemiology of gestational trophoblastic disease.

Considerable progress has been made in the knowledge of the epidemiology of gestational trophoblastic disease (GTD) in the last few years. There are two main and widely known points related to this disease: its geographical distribution and the different frequency in the various classes of age. GTD is more frequent in South-East Asia, India and Africa, and is rare in European and North American populations. For example, in the United States, the frequency of GTD was 108 per 100,000 pregnancies in the 1970's. In Europe, particularly in Italy, frequencies are lower. In northern Italy, the frequency of hydatidiform mole, in the period 1979-1982, was equal to 62 per 100,000 pregnancies, but in Indonesia and in China, the reported rates were 993 and 667 per 100,000 pregnancies respectively. GTD disease is more frequent in the extreme classes of age (under 20 and over 40 years) and the risk may be more than 100 times greater over 50 years. Besides these risk factors, the possible role of both genetic (familiarity, blood groups) and environmental factors (diet, cigarette smoking, etc.) has been investigated on the onset of GTD. This paper reviews the epidemiologic knowledge on GTD.

Adolescent↗