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G Ciccone

Publications and source records attributed to G Ciccone.

At least 37 records · Page 2Linked to original sources
PubMed1999

Differences in parental- and self-report of asthma, rhinitis and eczema among Italian adolescents. SIDRIA collaborative group. Studi Italiani sui Disordini Respiratori dell' Infanzia e l'Ambiente.

Epidemiological and clinical information on respiratory and allergic disorders in adolescents has been collected from the adolescents themselves or from their parents, but little is known about the differences between these two sources of information. This study compared the responses to 10 identically worded questions from the International Study of Asthma and Allergies in Childhood (ISAAC) questionnaire on asthma, rhinitis and eczema between written self- and parent-completed questionnaires in a large sample of 21,068 adolescent Italians aged 13-14 yrs. The effects of sex, latitude of residence, urbanization, socioeconomic status, previous diagnosis of asthma, family history of allergic diseases and adolescent's smoking habits on the prevalence estimates obtained with the two questionnaires were analysed using multiple logistic regression. Prevalence of self-reported symptoms was significantly higher in self-reported for all questions except for lifetime eczema, which was higher in parental report. Agreement between the two sources of information was poor, although it was slightly better for questions relative to clinical diagnosis of asthma, hay fever or eczema than for related symptoms, and for respiratory with respect to cutaneous disorders. When compared with self-reported, parent-reported was consistently higher in males and was more affected by socioeconomic level and by a diagnosis of asthma or family history of allergic diseases, whereas self-reported was more sensitive to the effect of the adolescent's smoking habits. It is concluded that, in adolescents, parent- and self-reported respiratory and allergic symptoms differ significantly and are differently affected by several constitutional and environmental factors. Obtaining direct information from adolescents may be essential for a correct evaluation of respiratory symptoms.

Adolescent↗
PubMed1999

The impact of parental smoking on asthma and wheezing. SIDRIA Collaborative Group. Studi Italiani sui Disturbi Respiratori nell'Infanzia e l'Ambiente.

To evaluate the impact of parental smoking on childhood asthma and wheezing, we studied two random samples of subjects ages 6-7 and 13-14 years in ten areas of northern and central Italy. Standardized questionnaires were completed by parents of 18,737 children and 21,068 adolescents (response rates, 92.8% and 96.3%, respectively) about their smoking habits and the respiratory health of their children. Adolescents were asked about their respiratory health and personal smoking. We compared two groups of cases with healthy subjects: (1) "current asthma" (children, 5.2%; adolescents, 6.2%) and (2) "current wheezing" not labeled as asthma (children = 4.5%, adolescents = 8.5%). Exposure to smoke of at least one parent increased the relative risk of current asthma among children [odds ratio (OR) = 1.34; 95% confidence interval (CI) = 1.11-1.62] and of current wheezing among adolescents (OR = 1.24; 95% CI = 1.07-1.44). Maternal smoking had a stronger effect than paternal smoking. Maternal smoking during pregnancy was associated with current asthma (OR = 1.62; 95% CI = 1.34-1.96) and current wheezing in children (OR = 1.31; 95% CI = 1.06-1.62); the effects were lower among adolescents. Among subjects with a negative history of parental asthma, maternal smoking was associated with current wheezing in both age groups, whereas among those with a positive history of parental asthma it was associated with current asthma in children, but not in adolescents. We estimated that 15% (95% CI = 12-19) of the current asthma cases among children and 11% (95% CI = 8.3-14) of the current wheezing cases among adolescents are attributable to parental smoking in Italy.

Adolescent↗
PubMed1999

The concept of 'glomerulonephritis'. the fascinating history of evolution and emergence of a specialist's nosology focus on Italy and Torino.

Though the term 'nephritis' first appeared in the 19th century, this word did not bear the same meaning as it does today; indeed, for many years it was used to indicate 'renal diseases' (in the sense of Bright's disease) in a larger sense. This review summarizes the long gestation of the concept of 'glomerulonephritis' from the prehistory of medicine up to the beginning of the second half of the 20th century with emphasis on Italy and, in particular, on Torino, which was the capital of the Kingdom of Italy from 1861 to 1865. To the best of our kowledge, this is the first study reporting an epidemiology survey of Bright's disease in Italy from 1880 up to 1960. Towards the end of the 19th century, Bright's disease accounted for 26 deaths/year/10(5) population (in comparison with more than 200 from tuberculosis) in Italy, roughly paralleling that reported in the USA. At the beginning of the 20th century, Bright's disease was the seventh cause of death (almost 1% of total deaths) in Italy. Furthermore, in Italy, as elsewhere, autopsy studies showed a higher percentage of deaths attributed to Bright's disease (5-7%) in comparison with those obtained from vital statistics. In 1960, just before the beginning of renal replacement therapy, Bright's disease accounted for 15.7 deaths/year/10(5) population (= 1.46% of all deaths), roughly paralleling that reported in the United Kingdom (13.8/10(5) population = 1.25% of deaths). Probably, it was difficult to recognize the real incidence of chronic renal diseases leading to death in the 1960s, and vital statistics were able to furnish only approximate estimates. However, noteworthy is the fact that these values were very close to those estimated as being the annual need for renal replacement therapy (10-20 cases/year/10(5) population).

Glomerulonephritis↗
PubMed1999

Correlation between cytomegalovirus infection and Raynaud's phenomenon in lupus nephritis.

Relationships between viruses and autoimmune diseases such as systemic lupus erythematosus (SLE) are still elusive. Recent reports demonstrated the association of some viral infections with peculiar clinical events in the general population, such as cytomegalovirus (CMV) with arterial damage and Parvovirus B19 (PV-B19) with hematologic abnormalities. We planned to look for this kind of viral imprinting in SLE, hypothesizing that traces of specific features of some viral infections might be found in some subsets of seropositive SLE patients. In 60 SLE patients recruited at our nephrologic center, serology for CMV, PV-B19, Epstein-Barr virus viral capsid antigen (EBV-VCA), Epstein-Barr nuclear antigen (EBNA) and Epstein-Barr virus early antigen (EBV-EA) was performed. chi2 and ANOVA were employed to compare the frequency and titers of antiviral antibodies in SLE patients with groups of transplant, hemodialysis and blood donor subjects. chi2, Fisher's test, Bonferroni and Scheffe's test were employed to compare the different biochemical/clinical features between seropositive and seronegative SLE patients. Univariate and multivariate analysis (logistic regression models) were employed to evaluate the odds ratio (OR) of different risk factors for vascular events (including Raynaud's phenomenon, deep venous thrombosis) and hematologic abnormalities (including severe anemia, leukopenia and thrombocytopenia). Anti-CMV (82%), anti-PV-B19 (60%), anti-EBV-VCA (92%) and EBV-EA (45%) IgG antibodies were frequent in SLE, with higher prevalence in comparison with the blood donor group and higher titers in comparison with transplant and hemodialysis groups. CMV seropositivity was a highly significant risk factor for Raynaud's phenomenon (OR +alpha in univariate and multivariate analysis = 13.51 using a correction of 0.5 in case of a zero event), but not for venous vascular events (OR = 1.31). An increased though not significant risk factor was found for antiphospholipid antibodies (OR = 2.71, p = 0.19), while the presence of nephrotic syndrome during the follow-up was a significant protective factor (OR = 0.15, p = 0.035). There was no significantly increased OR for PV-B19 seropositivity in cases with severe anemia (OR = 2.09, p = 0. 29). No significant associations were found with the status of EBV reactivation. In conclusion, our results support the hypothesis that viral infection may imprint the course of SLE leading to specific clinical subsets (i.e. CMV and 'vascular' SLE, with more frequent Raynaud's phenomenon and a less frequent typical histological renal picture responsible for nephrotic syndrome). Further prospective studies are justified to validate these correlations, mainly dealing with associations between acute viral infections and vascular events, thus eventually leading to a better understanding of mutual relationships between viruses and SLE.

Adult↗
PubMed1999

Risk factors for early, persistent, and late-onset wheezing in young children. SIDRIA Collaborative Group.

Wheezing in childhood is not a single disorder and different wheezing-associated respiratory illnesses have been recently described. We investigated the association between wheezing conditions and familial, pre-, peri-, and postnatal risk factors. We studied 16,333 children, 6 to 7 yr old, enrolled in a population-based study. Standardized questionnaires were filled in by parents. A total of 1,221 children had transient early wheezing, 671 had persistent wheezing, 918 had late-onset wheezing, and 13,523 never had wheezing or asthma (control group). Maternal asthma or chronic obstructive airway disease were significantly (p < 0.0001) more associated with persistent wheezing than with transient early and late-onset wheezing. The same pattern was observed for exposure to maternal smoke during pregnancy. Having a mother > 35 yr old was protective against transient early wheezing (odds ratio [OR]: 0.68, 95% confidence intervals [95% CI]: 0.53 to 0.86). Breast feeding >/= 6 mo was slightly protective against transient early wheezing (OR: 0.82, 95% CI: 0.68 to 0.97), whereas it was a moderate risk factor for late-onset wheezing (OR: 1.22, 95% CI: 0.99 to 1.50). On the contrary, having siblings and attending a day care center were both risk factors for transient early wheezing (OR: 1.41 [95% CI: 1.21 to 1.64] and 1.70 [95% CI: 1.48 to 1.96], respectively) and protective factors against wheezing of late onset (OR: 0.83 [95% CI: 0.70 to 0.97] and 0.72 [95% CI: 0.59 to 0.88]). There was a stronger (p < 0.0001) positive association between personal history of eczema or allergic rhinitis and persistent and late-onset wheezing than transient early wheezing. Our findings suggest a different contribution of risk factors to wheezing conditions in childhood.

Asthma↗
PubMed1999

[Necrotizing fasciitis. A diagnostic and therapeutic challenge].

A case of necrotizing fasciitis of the upper limb caused by group A streptococcal infection and a case with an abscess of the hand caused by staphylococcus aureus, are presented. The anatomo-pathological and clinical differences between the two different types of infection are underlined and stress is laid on the excruciating pain, the high temperature and the rapidly spreading inflammatory-necrotizing evolution of the first case. More than the anatomo-pathological findings of a necrotic area the authors consider more important, the rapidity and the severity of the infection, that can evolve into a toxic shock-like syndrome, and the microbiological isolation of the streptococcus type A. On the basis of personal experience and of an accurate review of the literature, a therapeutical protocol is proposed based on an aggressive surgical approach, prompt specific antibiotic treatment and daily control of the lesions.

Adult↗
PubMed1998

Road traffic and adverse respiratory effects in children. SIDRIA Collaborative Group.

OBJECTIVES: To investigate the relation between traffic indicators in the area of residence and the occurrence of chronic respiratory disorders in children. METHODS: A population based survey was conducted in 10 areas of northern and central Italy (autumn 1994 to winter 1995) in two age groups (6-7 and 13-14 years). Information on several respiratory disorders and on traffic near residences was collected with a questionnaire given to children and to their parents. The sample analysed included 39,275 subjects (response rate 94.4%). Outcomes were: (a) early (first 2 years of life) respiratory diseases, and (b) current respiratory disorders (asthma, wheeze, cough, or phlegm in the past year). Odds ratios (ORs) and 95% confidence intervals (95% CIs), adjusted for several potential confounders, were estimated from logistic regression models. Main results were stratified by level of urbanisation (metropolitan areas, other centres). RESULTS: In the metropolitan areas, high frequency of lorry traffic in the street of residence was associated with significantly increased risks for many adverse respiratory outcomes. Among early respiratory diseases, the strongest associations were found for recurrent bronchitis (OR 1.69, 95% CI 1.24 to 2.30), bronchiolitis (1.74, 1.09 to 2.77) and pneumonia (1.84, 1.27 to 2.65), although no association was detected for episodes of wheezing bronchitis. All the current respiratory disorders were positively and consistently associated with frequency of lorry traffic, particularly the most severe bronchitic and wheezing symptoms: persistent phelgm for > 2 months (1.68; 1.14 to 2.48), and severe wheeze limiting speech (1.86; 1.26 to 2.73). No or weaker associations with heavy vehicular traffic were detected in urban and rural areas and no increased risks were found in the whole sample with the reported traffic density in the zone of residence. After extensive evaluations, the potential of reporting bias seems unlikely. CONCLUSION: Exposure to exhausts from heavy vehicular traffic may have several adverse effects on respiratory health of children living in metropolitan areas, increasing the occurrence of lower respiratory tract infections early in life and of wheezing and bronchitic symptoms at school age.

Adolescent↗
PubMed1998

Chromosome 8, occupational exposures, smoking, and acute nonlymphocytic leukemias: a population-based study.

In a previous epidemiological study on acute myelocytic leukemia (M. M. Crane et al., Cancer Epidemiol. Biomark. Prev., 5: 639-644, 1996), clonal aberrations in chromosome 8 have been reported to be in excess in smokers and in workers exposed to paints. In that study, cytogenetics was performed after therapy. In our report, we describe a population-based survey on nonlymphocytic leukemias in northern Italy, in which 79 patients (acute myelocytic leukemia, myelodysplastic syndromes, or other nonlymphocytic leukemias) were studied before cytotoxic therapy. We found 9 aberrations involving chromosome 8 (six +8, two -8, and one translocation), whereas abnormalities involving chromosomes 5 and 7 occurred with a low frequency compared with previous studies. Aberrations involving chromosome 8 were associated with smoking (odds ratio, 6.3; 95% confidence interval, 0.9-42.3; among smokers of 10 or more cigarettes/day: odds ratio, 14.2; 95% confidence interval, 1.4-142.3); +8 aberrations were found in 1 of 24 nonsmokers and in 5 of 38 smokers. Three +8 aberrations were found in 22 subjects potentially exposed to solvents or polycyclic aromatic hydrocarbons. The low frequency of chromosome 5 and 7 aberrations in our population-based series (compared with other studies) can be attributed to the recruitment before cytotoxic therapies. Aberrations involving chromosome 8 (particularly +8) were associated with smoking habits. Chromosome 8 includes the c-myc oncogene.

Chromosome Aberrations↗
PubMed1997

Significance of lymph node sampling in epithelial carcinoma of the ovary.

From 1979 to 1984, 127 patients operated on for ovarian cancer underwent pelvic, para-aortic, or pelvic and para-aortic lymph node sampling. Forty-seven patients proved to be stage I(14 IA and 33 IC), 14 were stage II(3 IIA, 8 IIB, and 3 IIC), 58 were stage III (7 IIIA, 13 IIIB, and 38 IIIC), and 8 were stage IV. Positive lymph nodes were found in 4.2% of patients at stage I, 35.7% at stage II, 41.3% at stage III, and 87.5% at stage IV. With regard to grading, positive lymph nodes were found in 4.4% of G1, in 21.6% of G2, and in 49.1% of G3. A significant increase in survival (P = 0.04) was found for patients classified as stage IIIC only according to lymph node involvement compared to patients in peritoneal stage IIIC with positive lymph nodes (3-year survival: 46% vs 12%). A small increase in survival was observed for N- patients compared to N+ patients, at both stage III and IV, even with same residual tumor size, but the difference is not statistically significant. All other things being equal, because the prevalence of lymph node positivity depends closely on the number of lymph nodes removed and examined (OR = 3.9 for >10 lymph nodes removed compared to 1-5 lymph nodes removed), lymph node sampling does not seem to be a reliable method for evaluating the retroperitoneal status. With regard to the therapeutic role of systematic lymphadenectomy, few data in literature are available and, most important, are not derived from experimental studies. Probably, only randomized studies with a large number of patients will provide useful answers.

Adult↗
PubMed1997

Prevalence of myocarditis at autopsy in Turin, Italy.

OBJECTIVE: To evaluate the prevalence of myocarditis in a general hospital in Turin, Italy. DESIGN: We retrospectively reviewed 17162 postmortem records from autopsies routinely performed at San Giovanni Battista General Hospital, Turin, between 1965 and 1994. RESULTS: Applying the so-called Dallas criteria, myocarditis was histologically found in 91 cases (0.53%, 95% CI 0.4 to 0.7). The prevalence increased, reaching a peak between 1985 and 1994 (1.2%, 95% CI 0.9 to 1.6). The disease was found more frequently in patients from 20 to 39 years of age, with no difference between males and females. The present data were compared to those of a previous study, performed in 1985 and 1993 to 1994, in which we had prospectively taken into account 605 autopsies (not comprised in the present retrospective study) with standardized myocardial sampling for histological examination: a 5.1% prevalence was found (nearly five times as high as that retrospectively detected in the same period). CONCLUSIONS: If a standardized method of myocardial samples for microscopic examination is not followed, it is possible that myocarditis is overlooked in an unsuspected number of cases.

Adolescent↗
PubMed1996

[Audit of histopathological activities in the laboratories of 7 general hospitals. 1. Types of resources and quantitative aspects of the workload].

Following a major reorganization of the National Health Service, competition for resources will depend to a great extent on the quality of the service offered, and audit will be of increasing importance. The present investigation deals with the quantitative aspects of the histopathology workload. A retrospective analysis of the biopsy handling of 1,000 consecutive cases was conducted in each histopathology lab of seven general hospitals. The data collected included information on specimen type, diagnosis, block/section/stain details for each specimen, as well as information about human resources, total workload and technical equipment. Among the seven labs, the histopathology workload ranged between 6,600 and 15,600 cases/year. The workload per person/year ranged between 1,400 and 2,600 (mean 1,900) for pathologists, between 800 and 3,000 (mean 1,500) for technicians, and between 2,200 and 8,300 (mean 4,400) for secretarial staff. The prevalence of biopsy fragments (endoscopic, endometrial curettage , etc.), "small" surgery (skin, appendix, gallbladder, etc.) and surgery was, respectively, between 42 and 50%, 34 and 47%, 9 and 21%. In all labs but one, 80% of cases were within 1-3 blocks; the seven labs had a mean of blocks/case ranging from 1.8 to 4.0 (total mean = 2.8). Differences in performing special stains were astonishing: one lab performed special stains in about 40%, and another in only 0.6% of cases (mean of the seven labs = 15%). Finally, the labs performed immunohistochemical stains within a range of 2.7-8% of cases (mean of the seven labs = 4.6%). The data we have collected provided baseline information on the laboratory running, and this is likely to be an integral part of laboratory administration in the near future.

Biopsy↗
PubMed1996

[Audit of histopathology activities at the pathology departments of 7 general hospitals. 2. Response time].

A retrospective analysis of 1,000 consecutive cases was conducted in each histopathology lab of seven general hospitals. The collected information included the date of specimen withdrawal (six labs only), receipt in the laboratory, and reporting. Time intervals between withdrawal and receipt. Two labs, received 3/4 of cases the same day, while the others had a very low prevalence of receipt. All labs but one, received 80-90% of cases within 48 hours. In one lab, 17% of cases arrived five days after from the withdrawal. Time intervals between receipt and reporting. The mean observed in the seven labs ranged from 3.1 to 6.1 days. Two labs were able to report within 24 hours, but this occurred only in 6% of their cases. The reporting prevalence within three days ranged between 5 and 64%, with a mean for the seven labs of 37%. The reporting prevalence within 6 days was about 95% (four labs), 60-70% (two labs) and 20% (one lab). All labs but one reported 95-100% of cases within ten days. Time intervals between withdrawal and reporting. Our labs were not able to report within 24 hours from the withdrawal (frozen sections excluded). The reporting prevalence within 2-3 days was about 35-40% (three labs), 16% (one lab), 2% (two labs), and within six days it was about 90% (three labs), and 61%, 38% and 14% (the remaining). These latter reported 95% of their cases within twenty days. The turnaround times we found are unsatisfactory. Probably, there are many sources of delay, and these are multifactorial. However, a major factor involved in these delays seems to be related to poor arrangements in the allocation and managing of human resources.

Hospitals, General↗
PubMed1995

[SO2 air pollution and hospital admissions in Ravenna: a case-control study].

The association between air pollution and hospital admission for chronic respiratory and ischemic heart diseases was analyzed through a case-control approach. The study was based on routinely available data in Ravenna and covered the period 1986-88. A control group (n = 37250) was used to evaluate the specificity of the health effects of air pollution. It included all patients admitted into the hospital for conditions other than respiratory or heart diseases. The adjustment for confounding variables (climatic factors and time variables) was attained by multiple logistic regression. The risk of hospital admission for chronic bronchitis (n = 587) increased of 10% for a 10 ppb increase in SO2 concentration (in the range 0-60 ppb). A similar positive association (OR = 1.2) was observed for exposures to more than 10 ppb of SO2 and hospitalization for ischemic heart diseases (n = 1982). An apparently inverse relationship was found between SO2 pollution and hospitalization for asthma (n = 203). The case-control method can be a useful alternative tool to elucidate specific associations, in comparison with the statistical methods most frequently used in time-correlation analysis.

Air Pollution↗
PubMed1994

Home injuries in children: a population-based intervention trial.

We conducted a population-based intervention trial to evaluate the effectiveness of a program to prevent home injuries in children. We recruited a population of 1,015 young parent couples. Among those couples, we measured attitudes toward prevention of home injuries to children before and after the intervention. The intervention had limited effectiveness, which was somewhat greater among white-collar families and families with a higher paternal educational level. We found an association between the occurrence of injuries and educational level of the fathers (odds ratio = 1.7 and 1.9 for 6-12 years and < 6 years of school completed, respectively, vs > or = 13 years).

Accidents, Home↗
PubMed1993

Asbestos exposure, physical activity and colon cancer: a case-control study.

AIMS AND BACKGROUND: An association between colon cancer and the occupation of model or pattern maker in the car industry has been repeatedly suggested. The aim of our study was to investigate colon cancer and occupational exposures (in particular in the car industry) in an industrialized area of northern Italy. METHODS: We conducted a hospital-based case-referent study on colon cancer (n = 131; hospital controls, n = 463). All subjects were interviewed, and jobs in the car industry were investigated. Occupational exposure to asbestos and the level of physical activity were blindly assessed. All the jobs were classified according to energy expenditure (less than 8, 8-12 and more than 12 kJ/min). RESULTS: We found no association between colon cancer and any job in the car industry. No subject had worked as a model or pattern maker. Sedentary work was associated with colon cancer in men but not in women. An excess risk was demonstrated among males for job titles involving putative exposure to asbestos (4 cases and 3 controls; OR = 4.8, 95% c.i. 1.05-21.5), in particular pipe fitters and boilermakers (3 cases and 1 control; OR = 10.7; 1.07-103).

Asbestos↗
PubMed1993

Myeloid leukemias and myelodysplastic syndromes: chemical exposure, histologic subtype and cytogenetics in a case-control study.

We conducted a case control study of 50 acute myeloid leukemias (AML), 17 chronic myeloid leukemias (CML), 19 myelodysplastic syndromes (MDS), and 246 controls. The cases were classified according to the French-American-British (FAB) classification, and chromosome aberrations were recorded according to the International System for Human Cytogenetic Nomenclature. Exposure to suspected leukemogenic agents was assessed blindly by an industrial hygienist. Increased risks were noted for mechanics, welders, electricians, and drivers among men and among farmers and textile workers among women. Increased SMRs for leukemias in a census-based cohort study conducted in the same area (Torino) were previously reported for electricians and drivers among men and for textile workers among women. We detected nonstatistically significant increased relative risks for exposure to benzene (odds ratio, OR = 1.7), petrol refining products (1.9), polycyclic aromatic hydrocarbons (1.7), and electromagnetic fields (1.6) in men; in women, a statistically significant association with exposure to pesticides was detected [OR = 4.4; 95% confidence interval (CI) 1.7-11.5]. Although exposure to pesticides was confined to AML, MDS cases included a high proportion of subjects exposed to benzene and electromagnetic fields. No particular histologic subtype of AML was associated with chemical exposures except for that of pesticides with the M4 category. Chromosome aberrations were not associated with chemical exposures (OR = 1.0), but a nonstatistically significant excess was noted in association with electromagnetic fields (OR = 2.1).

Adolescent↗
PubMed1993

Prevention of exposure of young children to parental tobacco smoke: effectiveness of an educational program.

AIMS AND BACKGROUND: We conducted a population-based trial to evaluate the efficacy of an intervention aimed at preventing exposure of young children to parental tobacco smoke. METHODS: Of the 1142 eligible couples (parents of newborn babies), 1015 were recruited; the intervention was offered to 402 and not to 613 families. RESULTS: A strong association was found between social class and smoking behavior, in particular smoking during meals at home. The intervention itself had limited effectiveness in decreasing the number of smokers. The effect was stronger in mothers and in higher social groups. Among the "white-collar" families belonging to the intervention group, the proportion of mothers who stopped smoking was 3 times higher than in the control group (not statistically significant). CONCLUSIONS: Educational interventions against smoking should be planned taking into account the difference in efficacy according to social class.

Adult↗