Biomedical subjects

G Corrao

Publications and source records attributed to G Corrao.

At least 73 records · Page 4Linked to original sources

PubMed1994

Amount and duration of alcohol intake in patients with chronic liver disease: an Italian multicentre study. AISF Group for the Study of Alcohol and Liver Disease.

We report the results of an Italian multicenter study aimed at measuring retrospectively the lifetime amount and duration of alcohol consumption in non-selected consecutive patients with chronic liver disease. We used a standardized, reproducible questionnaire for measuring the lifetime daily alcohol intake (globally and separately for wine, beer and spirits), total alcohol intake and duration of alcohol consumption in 1,258 patients recruited from 17 medical centers. Wine intake contributed to the total alcohol intake in a proportion ranging from 44% to 85% throughout the centers. Spirits and beer intake contributed in smaller proportions (15% to 56%; and 3% to 27%, respectively). Males showed higher alcohol intake: those from northern-central Italy showed significantly higher intake than their southern-insular counterparts; of these, younger patients also showed a higher alcohol intake, due to a higher beer and spirit intake. Older patients showed higher intakes in southern-insular Italy, whereas the opposite was found in northern-central Italy. In this area, a longer duration of alcohol consumption was found, reflecting an earlier start in the use of alcohol. In conclusion, we believe that measuring alcohol intake on a wide series of patients in a multicenter study is feasible. This should stimulate gastroenterologists to approach the relationship between alcohol and liver disease using standardized and epidemiologically correct methods, and form the basis for well-designed case-control studies on a large scale, aimed at clarifying the risk of both hepatic and extrahepatic diseases associated with alcohol intake.

Alcohol Drinking↗

PubMed1993

Alcohol-related problems within the family and global functioning of the children: a population-based study.

We carried out a population-based prevalence study to assess the association between the presence of alcohol-related problems within the family and the risk of disorders in the children's global functioning level. We enrolled 394 children attending nursery, primary and secondary schools and their parents living in two municipalities in Central Italy. Alcohol-related problems within the family were reported by registered records obtained from general practitioners and teachers, who were considered as preference raters. The children's level of functioning was assessed by teachers, who attributed to each school child a score according to the Children Global Assessment Scale (CGAS). The number of reports of alcohol-related problems within the family and the CGAS scores were considered, respectively, as independent and dependent variables in a multiple logistic regression model for ordinal outcome variables. The children's sex and age, and the age of their parents, the duration of the parents' education and family size were considered as covariates. We found a strong association between a poor level of functioning in the children in the social environment and alcohol-related problems within the family. The prevalence odds ratio (and 95% confidence interval) decreased from 0.5 (range 0.2-1.3) for children whose families were reported by one rater to 0.4 (range 0.2-0.8) for children whose families were reported by two raters, the non-reported families being the reference category, suggesting that the level of functioning of the child decreased as reports of alcohol-related problems in the family increased.

Adolescent↗

PubMed1993

Development of a scoring system to assess disability in an Italian elderly population. Evaluation of a disability questionnaire.

Functional disability was evaluated in a cross-section sample of 671 persons, aged > or = 60 years attending the Local Health Care Unit of Borgo San Dalmazzo, Cuneo, Italy, by the OECD (Organization for Economic Co-operation and Development) questionnaire. The unidimensionality of the item set and grading order of severity were studied by Multiple Correspondence Analysis; cumulativeness was examined by Guttman scale-analysis. The OECD set measured two dimensions of disability, physical and sensorial. By excluding the six items that caused the greatest loss of homogeneity, a reduced set of ten items was obtained that was cumulative (Reproducibility coefficient = 0.934 and Scalability coefficient = 0.778) and also produced a simpler score (0-10 points scale). Based on this score, 40% of the subjects presented no disability in running 100 metres (the most difficult task), and males were less disabled than females (p = 0.001). The level of functional disability was slightly decreased in males, and nearly uniform in females up to 70-74 years, after which a clear decrease appeared (p = 0.001). The more disabled aged state a need for a higher number of health services (injection and physical therapy, nursing hospital, nursing home, physician), but knowledge and use of these services are not clearly related to physical function. Based on our results, the choice of scaling appears irrelevant if the homogeneity of the item set is checked; if the cumulative criterion is identified, the use of a simplified cumulative score can be proposed as a sensitive measure of disability, and indirectly, the amount of personal assistance needed.

Activities of Daily Living↗

PubMed1993

Amount and duration of alcohol intake as risk factors of symptomatic liver cirrhosis: a case-control study.

We carried out a hospital based case-control study involving 320 patients with symptomatic liver cirrhosis (LC) and 320 pair-matched control individuals, in order to estimate the dose-response relationship between both the daily amount and the duration of alcohol intake and the risk of LC. Lifetime alcohol consumption was measured by a standardized and reproducible questionnaire, and expressed as lifetime daily alcohol intake (LDAI) and duration of alcohol consumption (DAC). The odds ratio (OR) for LC was estimated by the conditional logistic regression. It increased from 1.0 for lifetime abstainers to 4.2 for LDAI of 225 g or more. Comparing durations of alcohol consumption of < or = 10 and > or = 30 years in the model, the ORs consistently decreased for all the LDAI categories: from 4.1 to 0.6 in the 25-50 g category; from 15.1 to 0.9 in the 75-100 g category; from 67.2 to 1.5 in the 125 g or more category. Our results suggest that the dose-dependent relationship between alcohol and LC may be mediated by the degree of individual susceptibility to the detrimental effect of alcohol to the liver.

Alcohol Drinking↗

PubMed1993

Effect of age, birth cohort and period of death on Italian liver cirrhosis mortality, 1972-1986.

Liver cirrhosis is one of the main causes of death in Mediterranean countries. A trend towards a global reduction in the mortality rate has been recently reported. In order to clarify better this trend and in an attempt to hypothesize the future pattern of mortality, we analysed data from 254,834 Italian subjects aged 30-79 who died from liver cirrhosis during the period 1972-1986. We used a log-linear Poisson model to examine the effects of age, calendar period of death and birth cohort. Our data confirm that both in the population as a whole and after stratification for three geographical areas (Northern, Central and Southern Italy) the mortality rate is decreasing. The age-effect analysis showed an exponentially rising effect in the Southern population, in accordance with the viral aetiology of cirrhosis, whereas an increased effect followed by a decreased effect was observed in the Northern and Central population, suggesting the alcoholic aetiology for the disease. The results from the birth-cohort effect suggested that in the Northern and Central populations mortality should continue to decrease over the next decade, possibly due to the implementation of better prevention programmes for cirrhotics and to decreased alcohol consumption in Italy. In the Southern population, however, mortality is still rising and this will probably continue for the next decade, as the generations born between 1940 and 1950 who are at high risk of carrying chronic hepatitis B virus infection, reach the age of higher risk of death from liver cirrhosis.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗

PubMed1993

Early diagnosis of prostatic carcinoma may be achieved through in vitro culture of tumor cells harvested by prostatic massage.

As a new method for early diagnosis of prostatic carcinoma we succeeded in growing in vitro the epithelial cells which can be collected from prostatic fluid after rectal prostatic massage. We report here the updated and statistically analyzed series of data (174 patients) on this new approach, which allows all the harvested cells to express their biological features. The method reaches a sensitivity of 72-86% and a specificity of 88-100%. This noninvasive test, which is also suitable for mass screening, may be very useful for an early diagnosis of the neoplasm.

Adult↗

PubMed1993

[Reduction modality of a dietary questionnaire].

The data relative to the average daily intake of 7 nutrients and total energy obtained through the answers to a dietary questionnaire, consisting of 152 items and administered to 200 patients (admitted for acute pathologies) has been analysed. The aim has been to elaborate a questionnaire consisting of a more limited number of items but maintaining a great part of the informative contents from the original questionnaire. For this aim, a multiple regression model with a selection procedure for independent variables, of the stepwise type, has been used, where the dependent variable is the daily average intake of the nutrient and the independent variables are the consumption of each food included in the complete questionnaire (QC). By combining the results of the model with the 7 nutrients and total energy, 3 reduced questionnaires have been produced (QR): the first two are based on the sole criteria of the inter-individual variance of the intake of the nutrient, explained by the consumption of the foods included in the QR, the third by adding the foods that offer an adequate contribution in order to explain the supply of the nutrient under examination. The application potentials of the 3 QRs have been analysed both by evaluating the inter-class correlation coefficient, deduced by an concordance/discordance matrix relative to the quintilis values of the nutrient deduced by the QC and by each QR, and by simulating their use in a case-control study; for this aim, the attenuation of the odds ratio trend and the increase of the sample dimension has been calculated following the use of a QR instead of a complete one.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗

PubMed1993

Non-invasive diagnosis of liver cirrhosis: a comparison between four discriminant functions.

We assessed the performance of 4 methods of discriminant analysis using as independent variables the age and 16 serum tests, for correctly identifying patients with liver cirrhosis among hospitalized patients affected by chronic liver disease without signs of liver failure; 290 patients entered this study: on the basis of laparoscopy with or without liver biopsy, 152 patients had a diagnosis of liver cirrhosis and 138 were classified as chronic hepatitic patients. Due to the non-multinormal distribution of the variables used and to the unequality of the variance-covariance matrices, we compared the following 4 methods: linear discriminant function, quadratic discriminant function, non-parametric discriminant function and logistic regression. The Receiver Operating Characteristic (ROC) analysis was used to compare diagnostic ability of the assessed methods: the quadratic discriminant function was the best performing method. The predictive ability of this function was compared to that reported for percutaneous liver biopsy, showing that this simple statistical method using age and biochemical tests can efficiently identify liver cirrhosis in the setting of chronic liver disease, reducing the need for invasive diagnostic procedures.

Adult↗

PubMed1992

Interaction between alcohol consumption and positivity for antibodies to hepatitis C virus on the risk of liver cirrhosis: a case-control study. Provincial Group for the Study of Chronic Liver Disease.

To assess the risk of developing liver cirrhosis associated with alcohol consumption, HBV and HCV infection markers, we carried out a case-control study involving 115 patients admitted to the medical departments of the general hospitals in the province of L'Aquila (Abruzzo, Italy) who received for the first time the diagnosis of liver cirrhosis, and 167 controls randomly selected among patients admitted to the same hospitals as the cases. Alcohol intake was measured in all 282 subjects using an already validated standardized questionnaire, and expressed as mean lifetime daily alcohol intake in grams. The mean lifetime daily alcohol intake showed a dose-dependent effect on the risk of cirrhosis: the relative risk significantly rose to 3.8 (95% CI: 2.0-7.3) for a mean daily intake of > or = 101 g alcohol; for HBsAg positivity the relative risk of cirrhosis was 23.0 (95% CI: 4.9-107.8) and for anti-HCV positivity it was 8.7 (95% CI: 4.3-17.6). After applying a multiple logistic regression analysis in a multivariate model including mean lifetime alcohol intake and anti-HCV status, both variables were significantly associated with the risk of cirrhosis (relative risks = 5.3-95% CI: 2.3-12.2 and 9.9-95% CI: 4.4-22.0, respectively). The combination of these two variables was found to fit an additive--but not multiplicative--model relative to the risk of cirrhosis: furthermore, the interaction of the anti-HCV status with the presence or absence of cirrhosis did not result in a significant source of variability for the mean lifetime daily alcohol intake.(ABSTRACT TRUNCATED AT 250 WORDS)

Alcohol Drinking↗

PubMed1992

Gliadin immune reactivity is associated with overt and latent enteropathy in relatives of celiac patients.

Antigliadin antibodies have been widely used in the screening of celiac disease. Using this test, candidates for jejunal biopsy were selected from 328 first-degree relatives of 128 adult celiac patients. All relatives geographically available were willing to participate in the study. Twenty-one turned out to be positive for antigliadin antibodies, and in 13 jejunal histology was consistent with celiac disease. In the remaining 8, the morphometric evaluation of jejunal biopsy specimens showed a mean surface to volume ratio that, although in the normal range, was significantly lower than that of other 10 relatives negative for antigliadin antibodies and 16 biopsied controls. It was concluded that antigliadin antibody testing is a valuable method for the screening of celiac disease among family members and that relatives with genetically predisposed gliadin sensitivity, without gross histological lesions but with minor morphometric abnormalities of the jejunal mucosa, may be regarded as subjects with latent celiac disease.

Adolescent↗

PubMed1992

Failure of intrauterine insemination in male immunological infertility in cases in which all spermatozoa are antibody-coated.

OBJECTIVE: To determine if the overcoming of the cervical mucus barrier removes the interference of sperm-bound antibodies with fertility. DESIGN: Prospective case series. SETTINGS: University-based intrauterine insemination (IUI) homologous program. PATIENTS: Nineteen patients with all spermatozoa in the ejaculate coated by antisperm antibodies. As control group, 86 consecutive patients without antisperm antibodies, treated for oligoasthenozoospermia or mucus hostility. INTERVENTIONS: Intrauterine inseminations (at least 3 attempts per couple). MAIN OUTCOME MEASURES: The outcome of IUIs, demographic, and seminal parameters were compared between the two groups. RESULTS: No pregnancy occurred in the couples with male immunological infertility, treated by 110 IUIs. Twenty-three pregnancies occurred in 22 (25.6%) of the control group couples who were treated by 411 IUIs. In the group of patients without antisperm antibodies, we demonstrated that the pregnancy rate (PR)/couple in oligoasthenozoospermia without teratozoospermia was similar to that achieved in normozoospermia (35% versus 38.9%), whereas it was significantly affected by teratozoospermia (3.6%). Only three patients with antisperm antibodies had teratozoospermia. Comparing the PR per couple and per cycle between the two groups of patients (with and without antisperm antibodies), excluding the patients with teratozoospermia, significant differences resulted (P less than 0.005 and P less than 0.005, respectively). The motile sperm count was not significantly different between the two groups, which also resulted to be homogeneous for demographic data. Moreover, the motile sperm count was not different between the patients with and without antisperm antibodies, who had successful IUI. CONCLUSIONS: The analysis of this trial suggests that the failure of IUI in the treatment of male immunological infertility is imputable to antisperm antibodies when they involve all spermatozoa, regardless of semen quality.

Autoantibodies↗

PubMed1992

[Portacaval anastomosis in patients with liver cirrhosis. Study of prognostic factors of survival by multivariate analysis].

Seventeen preoperative variables were collected in order to assess their prognostic value on survival in 82 cirrhotic patients who underwent a portosystemic shunt for ruptured esophageal varices. Univariate analysis showed that the presence of encephalopathy, bad nutritional status, elevated serum bilirubin, low serum albumin, the presence of ascites and Child-Turcotte's or Child-Pugh's C class were significantly associated with a reduction of long-term survival. Multivariate analysis according to the Cox model showed that only encephalopathy and nutritional status were independently associated with survival. Six survival curves were proposed to estimate the survival probability with these 2 preoperative data; encephalopathy had a predominant effect on survival during the first 5 years after surgery.

Adult↗

PubMed1991

Alcohol consumption and non-cirrhotic chronic hepatitis: a case-control study.

We carried out a hospital-based case-control study to assess the association of both the daily amount and the duration of alcohol intake with the risk of developing non-cirrhotic chronic liver disease (chronic hepatitis) in 121 chronic hepatitis patients diagnosed by laparoscopy and liver biopsy, and in 242 matched 'controls' randomly selected from inpatients of the same hospital. Alcohol intake was quantified in all subjects using a standardized questionnaire administered by two doctors unaware of the aim of the study. The odds ratio (OR) for chronic hepatitis was estimated by conditional logistic regression and increased exponentially from 1.0 for non-drinkers to 11.4 for daily alcohol intake of 325 g or more. Considering duration of alcohol consumption from up to 10 to up to 30 years, the ORs for chronic hepatitis consistently decreased for the daily alcohol intake categories of 25-50 g (from 74.1 to 0.7 respectively), 75-100 g (from 149.7 to 0.7 respectively) and 125 g or more (from 212.0 to 1.8 respectively). Our results suggest the existence of a dose-dependent individual susceptibility to the damaging effect of alcohol on the liver.

Alcohol Drinking↗

PubMed1991

A case-control study on alcohol consumption and the risk of chronic liver disease.

We carried out a hospital based case-control study involving 655 patients with chronic liver disease encompassing chronic hepatitis, asymptomatic liver cirrhosis and symptomatic liver cirrhosis and 655 pair-matched control individuals in order to estimate the dose-response relationship between alcohol consumption and the occurrence of chronic liver disease. Alcohol intake was measured by a questionnaire and expressed as Daily Alcohol Intake (DAI) during the patient life. DAI estimates from patient interviews were in good agreement with those obtained by interviewing a sample of relatives. We found an exponential positive association between DAI and the risk of chronic hepatitis and cirrhosis. However, consuming less than 100g of alcohol every day did not increase the risk of developing chronic liver disease. For asymptomatic cirrhosis the risk was lower than for chronic hepatitis, especially at high DAI, probably because high consumption carried a high probability of liver decompensation. For symptomatic cirrhosis, the risk function showed a similar pattern as for chronic hepatitis. Chronic hepatitis patients were 6-7 years younger than cirrhotics. Our results suggest that the evolution towards cirrhosis once a chronic liver damage has occurred is probably time-dependent, but not or minimally dependent on alcohol intake.

Adult↗

PubMed1991

[Disability, perceived health, and risk of death in a cohort of elderly].

An elderly cohort has been submitted to a five-year mortality follow-up in order to evaluate the relationship between environment, social and health conditions and survival probability. Particular attention has been directed to disability measure proposed by OECD (Organization for Economic Co-operation and Development). An extension of Cox multiple regression model has been used. Results show that the social and living conditions are not associated with survival probability. On the contrary, disability is a strong determinant of mortality risk and subjective health status is a modifier of its effect. Following disability level is an indicator of long-term health status and health services needs.

Aged↗

PubMed1991

[Reproducibility of an alcohol questionnaire for a case-control study on chronic liver diseases].

During a pilot phase of a hospital based case-control study on chronic liver diseases, an evaluation of the reproducibility of a alcohologic questionnaire suitable to investigate on quantity and duration of alcohol intake in the course of the life, was carried. The study consisted in the interview of 15 cases, 20 controls and their 35 relatives. Significative agreement between patients and relatives responses was found; homogeneous level of agreement was found neither among different alcohol consumption measures or between cases and controls. Some hypotheses on the factors that reduce the questionnaire reproducibility and on validity of estimated association measures between alcohol dose, detectable from questionnaire, and risk of chronic hepatopathies are presented. The possibility of using the questionnaire in studies on other diseases and population-based case-control studies, is discussed.

Adolescent↗

PubMed1989

Cancer risk in a cohort of licensed pesticide users.

First admissions to the hospital among 25,945 men living in southern Piedmont and holding a license authorizing them to use pesticides were analyzed in a study of the cancer risk related to exposure to pesticides. Standardized incidence ratios significantly higher than one were encountered for malignant skin cancers and lymphomas. The risk of lymphoma was particularly high in predominantly arable areas. The standardized incidence ratios for tumors of the nervous system and hematopoietic tissue showed an interesting age-related pattern and a higher risk in areas primarily devoted to forest tree plantation, but did not reach significance. Certain hypotheses are advanced to explain these findings.

Aged↗

PubMed1989

[A method for evaluating the hepatitis B vaccination program].

Two mathematical models have been created in order to estimate the effectiveness (number and proportion of infections saved) and the cost/effectiveness ratio (cost per infection saved) of a hepatitis B vaccination strategy among hospital personnel. The aim of the models is to analyse the mathematical relationship between the measurement of strategy impact and some variables: theoretical effectiveness of vaccine, proportion of assent to the programme, epidemiological characteristics. Applying models to Piedmont situation it has been possible to identify factors which have negatively influenced the effectiveness and efficiency of strategy.

Cost-Benefit Analysis↗