Search PubMedSearch

Biomedical subjects

G Farchi

Publications and source records attributed to G Farchi.

At least 19 recordsLinked to original sources

Relationship between eating patterns meeting recommendations and subsequent mortality in 20 years.

OBJECTIVE: Study of the relationships of conformity to dietary recommendations and subsequent rates of total mortality and mortality from specific causes. DESIGN: Prospective investigation of risk factors related to cardiovascular disease. SETTING: Two Italian rural cohorts of the Seven Countries Study. SUBJECTS: The study populations are defined samples from two villages, Crevalcore in Northern Italy and Montegiorgio in Central Italy. The examination in 1965, which included an individual dietary survey, involved 1538 men aged 45-64 years. The 20-year follow-up system was able to track every participant. RESULTS: Conformity to recommended levels of intake of carbohydrates (55-75% of calories) is associated to the relative risks: 0.84 (0.68-1.03) for total mortality, 0.73 (0.50-1.07) for cancer mortality, 1.34 (0.90-1.99) for coronary heart disease mortality. Relative risks for other nutrients are reported. CONCLUSIONS: Overall, recommended levels of intake of macronutrients are associated with lower total mortality, but are not equally appropriate for specific causes of death, cancer and coronary heart disease. Diet-associated differences in mortality persisted after adjustment for confounding by age, smoking habit and physical activity. In this population, intakes meeting the principal recommendations (total carbohydrate and total fat) seem to involve automatically meeting the other recommendations. SPONSORSHIP: Research partly supported by the project 'ACRO-clinical uses of Oncological Research' (contract 93.02289.PF39) and by the project 'FATMA-Risk Factors and Disease Control' (contract 93.00773.PF41) of the Italian National Research Council, CNR.

Adult

AIDS as a leading cause of death among young adults in Italy.

The objective of this study is to describe the impact of AIDS on the mortality of young adult (aged 25 to 44 years) in Italy, at both the national and regional level. We analyzed the official mortality data for Italy: the most recent data available being from 1990. General mortality trends show that while mortality among young women is still decreasing (i.e. from a standardized rate of 83.8 per 100,000 in 1980 to 68.4 in 1990), mortality among young men began to rise in the mid-1980s, after a steady decrease over many years. Among the 25-34 year olds, however, this reversal in trend is more marked, notwithstanding a decrease or stabilization in most major causes of death. In fact it coincides with the appearance and spread of AIDS in Italy, which has affected young men in particular. (The peak age group for AIDS deaths is the 25-34 year olds). Mortality data from 1990 reveal that AIDS is the fourth leading cause of death in Italy among men between the ages of 25 and 44 years. Among 25-34 year-old men, however, AIDS is the second leading cause of death, after road accidents. AIDS also contributes greatly to the general mortality in individual regions, both among 25-44 year-old men (Lombardy, Liguria, Lazio, Emilia-Romagna, Tuscany), and especially among 25-34 year-old men (Lombardy, Liguria, Lazio, Sardinia, where it is the number one cause of death, Emilia-Romagna, Tuscany, and Veneto, where it is the number two cause of death).

AIDS-Related Complex

The prediction of coronary heart disease mortality as a function of major risk factors in over 30 000 men in the Italian RIFLE pooling Project. A comparison with the MRFIT primary screenees. The RIFLE research group.

BACKGROUND: Few risk functions for the prediction of coronary heart disease mortality have been produced in Italy. This study used a large population sample to evaluate the effect of major risk factors on coronary mortality. METHODS: Coronary deaths in 45 cohorts of men (n = 31317, aged 30-69 years) were studied and related to selected cardiovascular risk factors. RESULTS: After 6 years, 1089 men had died, of whom 239 were coronary fatalities. Univariate and multivariate (Cox model) analyses conducted on each age group (30-39, 40-49, 50-59, and 60-69 years) showed a positive association between coronary deaths and systolic blood pressure, serum cholesterol level and cigarette smoking, with few exceptions. A multiple logistic model was produced for men aged 35-57 years, assessing the role of age, serum cholesterol, cigarettes smoked per day and diastolic instead of systolic blood pressure, using the same endpoint as that employed in a similar model published from the analysis of MRFIT primary screenees in the USA to facilitate valid comparison. The coefficients in the present study were similar to those in the US cohort: no statistically significant differences could be detected when comparing the pairs of coefficients. CONCLUSION: Coefficients relating cholesterol, blood pressure and cigarette smoking to coronary mortality in Italian men are similar to those in American men from the same age groups.

Adult

Alcohol and mortality in the Italian rural cohorts of the Seven Countries Study.

The relation of alcohol consumption to mortality is examined using the data of the Italian rural cohorts of the Seven Countries Study, a prospective investigation of factors related to cardiovascular disease (CVD). The present analysis includes 1536 men aged 45-64, whose dietary habits and food consumption, including alcoholic beverages, were measured in 1965. Of them, 463 men died in a follow-up period of 15 years. The analysis shows a J-shaped relationship between alcohol consumption, expressed as percentage of total daily energy intake, and both overall mortality and cardiovascular mortality; this J-shaped relationship is evident even after adjusting for age, cigarette smoking and occupation. The inverse relationship for consumption of small quantities of alcohol, which is represented by the left side of the J-curve, is no longer significant when all men with previous cardiovascular manifestations are excluded from the analysis, yet it is never completely eliminated.

Alcohol Drinking

[The impact of AIDS on mortality in Italy].

Using the official mortality data, collected by ISTAT, and the data of the Italian Register of AIDS cases, in Istituto Superiore di Sanità, three arguments have been developed: 1) Study of causes according to which ISTAT could classify deaths from AIDS: the leading cause appears to be "Deficit of Cell Immunity" (I.C.D. 279.1). 2) Study of the under-estimation of official data with respect to those of the specific system. Under-estimation decreased over the years, reaching 20% in 1987 and 6% in 1988. 3) Analysis of the general mortality trend in all of Italy and in particular metropolitan areas, with a high concentration of cases, such as Rome and Milan; there is evidence of a possible influence of AIDS deaths on mortality of young age classes particularly notable among single males.

Acquired Immunodeficiency Syndrome

[Estimation of the impact of cigarette smoking reduction on mortality from tumors of the lung and larynx].

In 1987, in Italy, 27,106 men and 4,159 women died from lung cancer or larynx cancer. Taking into consideration the smoking habits of the Italian population and the relative risks for pulmonary cancer, of smokers and ex-smokers versus nerve smokers, we estimate that 87% of deaths can be attributed to smoking. We know from previous studies that quitting smoking results in the reduction of the risk elapsed since quitting and that this reduction depends on the time and on the quantity of tobacco previously smoked before the cessation. We estimated the reduction in the number of deaths due to respiratory cancer if part of the population were to quit smoking. In males aged 35-74 years after 12 years, there would be 3,604 fewer deaths if 10% quit smoking and 11,915 fewer deaths if 100% quit smoking.

Adult

[Lymph nodes of the neck. Diagnosis using magnetic resonance with gradient-echo technique].

As for the pathologic conditions of neck lymph nodes, the clinician needs to know if the involved node is reactive, phlogistic, or neoplastic in nature. If accurate tumor staging is required, imaging techniques play a fundamental role. Our study was aimed at assessing the actual role of MR imaging in the evaluation of neck lymph node involvement. The study was performed using an MR Max Plus by General Electrics operating with an 0.5 T superconductive magnet. We employed gradient-echo (GE) pulse sequences with TR 500, TE 15 ms and 90 degrees flip angle for T1-weighted images, and with TR 500, TE 30 ms and 25-30 degrees flip angles for T2-weighted images; for Pd-T2-weighted images, TR was 520, TE 30 ms, and flip angles were 40-45 degrees. The results were correlated with histopathologic findings obtained at biopsy. The advantages of GE sequences were: 1) whole neck imaging--thus saving time, and reducing radiation dose and contrast media; 2) optimal anatomical and topographic evaluation of the lesion; 3) imaging of the longitudinal diameter of the node; 4) higher sensitivity for lymph node tissue modifications; 5) imaging of necrosis, hemorrhage, and/or fibrosis. GE sequences were especially useful for accurate tumor staging, in the follow-up, and to verify response to therapy. However, even though MR imaging has proven to have high sensitivity, its specificity was similar to that of contrast-enhanced CT. Further studies with the use of paramagnetic contrast media are needed to solve these problems.

Diagnosis, Differential

[Mortality from liver cirrhosis in Italy: a two-component model for estimation of the quota attributable to alcohol].

Liver cirrhosis is considered as a double etiology disease, being its incidence and mortality associated either to alcohol consumption or to a previous viral hepatitis infection of type "B" or "neither A nor B". A two components mathematical model is here used to estimate the proportion of liver cirrhosis mortality attributable to alcohol consumption and the proportion from hepatitis. The model has been fitted to mortality data of the 95 Italian provinces in 5 periods of three years each from 1969 to 1983. In 1981-83, the first-component (interpretable as due to alcohol) is estimated to account for 31% in males and 28% in females of total mortality from liver cirrhosis. Estimates are given also for large geographical areas, regions and provinces.

Adult

[Staging of spinal metastasis using special techniques of magnetic resonance imaging].

The diagnosis of spine metastasis is a problem of great interest which leaves many questions unanswered. In this field MR imaging plays a fundamental role, as the only technique able to directly demonstrate the changes in bone marrow tissue, bound to tumoral activity. The introduction of gradient-echo (GE) sequences has helped reduce examination time. Moreover, with the accurate choice of pulse-sequence parameters (TR, TE, flip angle) additional information is acquired which is not yielded by conventional spin-echo (SE) sequences. Our study was aimed at evaluating MR sensitivity in the different stages of bone metastatic evolution. The comparative adequacy was evaluated of combined bone scintigraphy and conventional radiology versus MR imaging in 62 patients with vertebral metastases. Time interval between bone scan and/or radiological study and MR exam ranged from 10 days to 8 months. SE and GE T1-weighted images, and SE and GE T2-weighted images on the sagittal plane were employed, and axial images; coronal images were rarely acquired. Metastases were demonstrated by MR imaging at 122 vertebral levels, versus 88 true positives of combined scintigraphy and conventional radiology. Scintigraphic false-positives were observed at 15 vertebral levels, versus 9 with radiography. GE sequences were superior to SE ones in detecting vertebral morphologic lesions and bone marrow involvement thanks to their improved resolution and sensitivity. Moreover, GE sequences demonstrated tumoral bone marrow spread and persistent tumoral activity in the follow-up of spine metastases. Our results point to GE sequences as those of choice because of their higher resolution and sensitivity, which also allow response to treatment to be evaluated.

Humans

[The relationship between the receptor status and the mammographic picture in operable breast cancer].

To verify the relationship of mammographic (Mx) patterns of breast cancer to hormone receptor content (ER, PgR) we studied 129 women (59% in postmenopause; average age 55) in the last 3 years. All women had operable breast cancer and were submitted to mammography before surgery. The tumors were classified, according to Mx characteristics, in 5 classes (Broberg, 1983). ER and PgR contents (cut-off for positivity: 10 fmol/mg prot cyt) were analyzed in all patients by means of DCC method. The percentage of ER+ cases was significantly higher in class I than in all other Mx classes (85% vs 57%; p = 0.02), whereas it was lowest in class IV (51% vs 70%; p = 0.03). The percentage of PgR+ cases was significantly different only in class I with respect to class IV (70% vs 41%; p = 0.002). As for ER and PgR mean tumor content, no statistically significant difference was observed between the 5 classes. When the 2 receptors were simultaneously considered the percentage of ER+ PgR+ cases was higher in class I than in all the extant classes (p = 0.01), and the percentage of ER- PgR- was higher in class IV than in the extant ones (p = 0.02). In selected subgroups of patients, Mx classification of breast cancer can help the physician predict the hormone receptor tumor status with sufficient reliability.

Adult

Diet and 20-y mortality in two rural population groups of middle-aged men in Italy.

The relationships between individual diet, measured in 1965 on the two Italian rural cohorts of the Seven Countries Study on Cardiovascular Disease, and subsequent mortality from all and specific causes of death in 20 y are studied. The analysis covers 1536 men aged 45-64 y at entry to the study. By using a cluster analysis technique, individuals are aggregated into four groups so that the elements within a group have a higher degree of similarity in dietary nutrients than between groups. Impressive differences in death rates between groups are found especially at the 10- and 15-y anniversaries. The relative risk between the least and the most favored group in 15-y mortality from coronary heart disease is 4.7; in 10 y the relative risk for cancer mortality is 2.9 and for liver cirrhosis approximately 4.

Cardiovascular Diseases

Mortality from liver cirrhosis in Italy: proportion associated with consumption of alcohol.

A descriptive analysis of the features of mortality from cirrhosis in Italy suggests that it is made up of two components which are characterized by different age trends. On the basis of this hypothesis, a model has been postulated and applied to the data for the 94 Italian provinces in order to identify the two components. When considering alcoholic drinking data, it appears that only one of these components is associated with the consumption of alcohol, both for men and for women. In this way an estimate can be made of the proportion of mortality in Italy which can be linked to alcohol consumption. For males, this is 40.4% (47.1% for the North, 29.7% for Central Italy, and 33% for the South/Islands). For females, the average is 24.6% (36.6% for the North, 16.2% for Central Italy, and 12.3% for the South/Islands). In absolute terms, these figures represent approx 5000 of the 13,000 deaths per year among males and around 1200 of the 5000 deaths from cirrhosis among females.

Adult

Coronary risk factors and survival probability from coronary and other causes of death.

The analysis concerns the two rural Italian cohorts of the Seven Countries Study and includes 1,712 men who, at the entry examination in 1960, were aged 40-59 years and whose 20-year follow-up examinations were complete for life status, dates, and causes of death. Excluded were 175 men because they lacked one or more of the risk factors selected for the study. A total of 517 deaths occurred in the remaining 1,537 men. The Cox proportional hazards regression model was applied with a forward procedure to include the entry risk factors in the model. First, total mortality was used as the endpoint. Then the risk factors identified as being related to total mortality were used to predict specific causes of death, i.e., coronary heart disease, stroke, cancer, violent death, and other causes. Blood pressure appeared as a nonspecific risk factor for all causes, including cancer and violence, forced expiratory volume and arm circumference appeared as nonspecific risk factors, smoking habits could not be easily classified, and cholesterol was definitely specific only for coronary deaths. Models for estimating survival probabilities from total mortality and from any of several causes of death are provided.

Adult

The prediction of future health in healthy middle-aged men.

Two cohorts of men aged 49-59 at entry, representing cluster samples of two rural areas in Northern and Central Italy, for a total of 1712 subjects have been followed-up for 20 years within an epidemiological study originally designed for cardiovascular disease. After 20 years, only 41 men have been judged to have remained substancially healthy throughout the observation period, i.e. free from a number of major diseases. Univariate and multivariate analyses trying to predict the maintenance of health status showed that among 21 selected characteristics only the following one had a significant power: age, cigarette smoking (adverse effect) and vital capacity (favourable effect). A minor role was also played by the body mass index (adverse effect) and forced expiratory volume (favourable effect). Those who did not remain healthy exibited a greater increase in blood pressure and body mass index.

Adult

Age, period, cohort and geographical area effects on the relationship between risk factors and coronary heart disease mortality. 15-year follow-up of the European cohorts of the Seven Countries study.

The effects of three major risk factors (i.e. serum cholesterol, systolic blood pressure and smoking habits) on prediction of coronary heart disease (CHD) mortality in relation to three nuisance variables--i.e. geographical location, age of subject at examination and period of examination--are analyzed using data from three different 5-year apart examinations of the Seven Countries Study and observations on CHD mortality in the corresponding 15-year follow-up period. First, a cross-classification exploratory analysis including both CHD-free subjects at entry and prevalence subjects, by different geographical areas, age classes and examination times is presented. Secondly, a logistic regression including the three major risk factors and the three nuisance variables, regarded both as confounders and effect modifiers is discussed. The prevalence status of the subjects is also considered as a nuisance variable in this second analysis. Results showed that: (a) there is a highly significant (p less than 0.001) marked decrease in the association between cholesterol level and CHD mortality with increasing age of subject; (b) a decreasing association with coronary heart disease mortality as age increases also holds for smoking habits (p less than 0.05). This association, however, tends to be reinforced with time (p less than 0.05), i.e. the relative risk of heavy smokers vs non-smokers is four times bigger in the period 1970-75, than in the period 1960-65, age and all other factors being equal; (c) a possible dependence of the association between systolic blood pressure and CHD on geographical area is suggested, although this finding could be the result of chance with a 10% probability.

Adult

[Risk factors between blood cholesterol and coronary disease].

Some risk functions are presented linking serum cholesterol to the development of coronary heart disease. They are produced from epidemiological studies on Italian population samples made of men aged 40-59 at entry and followed up to 20 years. The purpose is to provide a simple tool for the estimation of the expected risk and of that depending on changes of the risk factor.

Adult