Search PubMed⌕ Search

Biomedical subjects

G Tognoni

Publications and source records attributed to G Tognoni.

At least 253 records · Page 14Linked to original sources
PubMed1984

Risk factors for endometrial cancer at different ages.

The importance of the major risk factors for endometrial cancer in women of different ages was evaluated with the use of data from a hospital-based case-control study conducted in Milan, Italy, on 283 women with endometrial cancer and 566 age-matched controls. Current weight was related strongly to the risk of endometrial cancer both in younger (premenopausal) and in older women (with risk estimates for the heaviest categories of 20.3 and 7.7, respectively), thus confirming that obesity is the major cause of endometrial cancer in Northern Italy. Endometrial cancer risk appeared to be approximately proportional to the second power of body mass index. Early menarche and nulliparity were associated with an increased risk of endometrial cancer in premenopausal women, the point estimate for nulliparity rising to 35.1 (with lower confidence limit of 10.2) after adjustment for marital status. However, no association with these factors was evident in postmenopausal women. Combination oral contraceptives were used by 2 cases and 19 controls only [relative risk (RR) = 0.2, with 95% confidence interval = 0.1-0.8]. The use of noncontraceptive estrogens was associated with an elevated risk, which was greater in perimenopausal women (RR = 5.1 for greater than 2 yr of use), and decreased progressively with increasing time after menopause. Late menopause was also related to endometrial cancer. However, the risk estimates for late menopause apparently were more elevated in older women (greater than or equal to 65 yr) than in perimenopausal women. Most of the risk factors identified (excluding late menopause) apparently act on one of the later stages of the process of carcinogenesis, because the excess risk drops after cessation of exposure.

Adolescent↗
PubMed1984

Plasma levels of salicylate and aspirin in healthy volunteers: relevance to drug interaction on platelet function.

Salicylate can prevent the inhibitory effect of aspirin on platelet cyclooxygenase activity. We investigated whether salicylate and aspirin interact in platelets in humans at doses and plasma levels of clinical relevance. In our first experiment in healthy volunteers, the lowest dose of intravenously administered aspirin that suppressed arachidonate-induced platelet aggregation and serum immunoreactive thromboxane B2 generation was 40 mg. In our second experiment, volunteers given oral doses of sodium salicylate (250 or 1000 mg) had peak plasma salicylate levels averaging 20 and 76 micrograms/ml, respectively. Neither platelet aggregation or thromboxane B2 formation was modified by either salicylate treatment. Forty minutes later, all six volunteers received 40 mg of aspirin intravenously. Aspirin levels were not affected by previous salicylate ingestion, but inhibition by aspirin of both platelet aggregation and thromboxane B2 generation was significantly prevented by the higher salicylate dose. In our last experiment, peak plasma levels of aspirin and salicylate were measured in healthy volunteers after ingestion of either 320 mg of compressed or 800 mg of enteric-coated aspirin. Salicylate levels averaged 19 and 51 micrograms/ml, respectively, after the lower and higher doses of aspirin, whereas aspirin averaged 3 micrograms/ml after either dose. Serum thromboxane B2 generation was almost completely inhibited 1 hour after either aspirin dose.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗
PubMed1983

Lung cancer care in general hospitals.

Diagnostic procedure, therapeutic care and degree of follow-up delivered to 1692 lung cancer patients over 2 years (1978-79) in 31 Italian hospitals were reviewed. The data show marked deficiencies in the various indicators analysed: staging by standard methods was recorded only in 13% of patients; reliable histocytologic classification in 54% of patients. A group of commonly accepted protocols was adopted as first-line therapy only in 49% of treated cases; 19% of patients were regularly followed according to standard programs, whereas 49% had been dropped without any information in the charts. Better performance, although not satisfactory, was found in hospitals with oncologic facilities and wards compared to centers without "ad hoc" organizations. The discussion focussed on the limits of organizational measures and efforts to determine widespread improvement in care for a disease such as lung cancer for which real therapeutic gains are still hard to achieve.

Adult↗
PubMed1983

Delayed diagnosis of endometrial cancer in Italy.

This study considers the prevalence of early bleeding in a series of 173 cases of endometrial cancer, with particular reference to the lag time between the onset of symptoms and diagnosis. The length of this interval is examined in the light of patients' and tumor characteristics. Findings show a general delay in endometrial cancer diagnosis in the population studied. In addition there was a significant trend towards worsening of the tumor stage, depth of myometrial invasion and histological differentiation with increasing delay, thus underlining the need for more care in detection of endometrial cancer.

Adenocarcinoma↗
PubMed1983

Care of cancer patients in thirty-one Italian general hospitals. Methodological aspects and general findings.

A large sample of cancer patients was reviewed over a two-year period (1978-1979) in 31 general and community hospitals representing five Italian regions, differing in terms of health care organization. Two thousand four hundred and six patients had breast cancer, 1692 lung cancer, 303 non-Hodgkin's lymphomas, 277 ovarian cancer and 235 Hodgkin's lymphoma. Relevant information was collected from medical records through specific pre-standardized and tested forms. The paper discusses the results obtained with respect to (a) general descriptive data of the population; (b) completeness and reliability of recorded data (e.g. staging, histological classification, therapy); and (c) accuracy and completeness of the follow-up. Consistency of the information obtained on selected items with published series of patients suggests that this methodology is worth a wider testing as a simple, inexpensive tool for routinely monitoring the care of cancer patients and the impact on it of organizational and educational interventions.

Adolescent↗
PubMed1983

Incessant ovulation and ovarian cancer: a critical approach.

The total duration of 'ovulatory activity' or 'ovulatory age' has been reported to be the strongest indicator of the risk of ovarian cancer. In the case-control study examined in this paper this variable was found to be a strong correlate of the risk of ovarian cancer. However, the finding that in older women the major determinant of 'ovulatory age' was age at menopause (which is a very unreliable indicator of 'ovarian activity'), and that age at menopause by itself was related to the risk of ovarian cancer as strongly as the total duration of ovulatory age, threw doubt on the biological consistency of that model. Furthermore, the protection conferred by pregnancies was different at different ages, and age at first pregnancy was more strongly associated with the risk of ovarian cancer than the actual number of pregnancies. The model of carcinogenesis for epithelial ovarian cancer appears, therefore, to be more complex than is indicated simply by the total duration of 'ovarian activity.'

Adult↗
PubMed1983

'Cerebroactive' drugs. Clinical pharmacology and therapeutic role in cerebrovascular disorders.

While their importance in the market-place is steadily increasing in developed (mainly continental Europe) and even in developing countries, compounds included in the broad category of 'cerebroactive' drugs hardly rate a mention in reference pharmacology and therapeutics textbooks. It is an undeniable fact, however, that the principal users or targets of this drug class, mainly elderly people, represent an increasingly worrying problem, with their often puzzling cohort of ill-definable and even less predictable neurological and mental symptoms. The combination of the above factors cannot but produce a rather confused situation, in which the pressure to treat and the adherence to scientifically rigorous assessment are likely to prevail alternately, on a purely casual basis. This review aims to provide sound methodological guidelines for assessment of 'cerebroactive' drugs in a not always easily accessible literature. It covers firstly the general problems of stroke, dementia and 'common symptoms' of the elderly, and then looks in detail at those compounds which have to date attracted most attention (ergot derivatives, cinnarizine, flunarizine, vincamine, eburnamonine, naftidrofuryl, oxpentifylline, piracetam and citicoline), as well as those which are currently considered investigational (choline and lecithin). The pharmacology and available clinical studies of each drug are examined. No therapeutic indication can be derived from the available evidence, as the few positive results do not go beyond random improvement of symptoms. More fundamentally, the lines of research which need to be pursued most intensively relate to better preliminary definition of diagnostic and prognostic criteria and, with the establishment of adequate testing tools for the assessment of behaviour and neuropsychological performance, those basal conditions which are modified 'naturally' or by drugs.

Adult↗
PubMed1983

Acute overdosage of amiodarone in a suicide attempt.

Clinical and biochemical variables and blood levels of amiodarone and its metabolite are reported after acute self-intoxication in a young woman. Despite the huge amount of drug ingested no clinical side effects were documented over the monitored period of 3 months.

Adult↗
PubMed1983

Drug utilization studies and epidemiology.

Drug utilization studies have developed rapidly over the last ten years to become not only a new tool of investigation for clinical pharmacology but also a source of suggestive information for epidemiology. This paper begins by reviewing the general terms of reference, with special emphasis on the WHO-recommended methodology based on defined daily doses (D.D.D.), then focuses on antidiabetic treatment, and antihypertensive therapy, and on the use of drugs in psychiatry, in pregnancy, in elderly people and in cancer patients. These examples are given to show how drug utilization studies can be of use for epidemiological studies.

Adult↗
PubMed1982

Prognostic features of endometrial cancer in estrogen users and obese women.

In a case-control study to evaluate risk factors for endometrial cancer in Italy, use of noncontraceptive estrogens was associated with a moderately increased risk, whereas obesity appeared to be the most important single risk factor related to cancer of the endometrium. This report considers the estrogen and obesity-related relative risks with regard to various prognostic features of tumors (clinical stage, histologic grade, extent of myometrial invasion, lymph node involvement). In both estrogen users and obese women, the increase in relative risk was greater for earlier than for more advanced tumors. These findings, therefore, provide further support for a specific role of both exogenous and endogenous estrogens in endometrial cancer.

Adult↗
PubMed1982

Quality of breast-cancer care in Italian general hospitals.

The diagnostic and therapeutic care and degree of follow-up delivered to 2406 breast-cancer patients over two years (1978-79) in 31 Italian hospitals are reviewed. Although there was broad agreement about recommended treatment protocols, staging by standard methods was recorded in only 44% of patients, assessment and reporting of side-effects was considered in only 49% of all treated patients, follow-up data at two years were available for only 54% of living patients, and the dropout rate from chemotherapy protocols was 35%. Improvement of these unsatisfactory aspects of care would allow a better appreciation of the real benefit that could be achieved with recommended protocols and would result in a more effective use of health resources.

Female↗
PubMed1982

Caffeine disposition after oral doses.

Caffeine (TMX) disposition was studied in mean after 1, 5, and 10 mg/kg in water, as mocha coffee (1.54 mg/kg) and as a soft drink (0.22 mg/kg). TMX and its metabolites were analyzed in plasma and urine by high-pressure liquid chromatography. The design permitted confirmation of most of the partial results in various experimental settings and contributed new data on the metabolic disposition of TMX, with specific reference to main dimethylxanthine metabolite found in plasma, paraxanthine (1,7-dimethylxanthine). Different analysis methods were compared for the calculated parameters (absorption and elimination rate constants and renal clearance)to assess the consistency of results. The kinetics of TMX and of its dimethylated metabolites in plasma were described with a model that used an analogdigital hybrid computing system. In addition to providing a comprehensive profile of TMS disposition in the healthy adult, the results indicate tha TMX exhibits dose-independent kinetics at the levels at which man normally takes TMX.

Administration, Oral↗
PubMed1982

Oestrogens and obesity as risk factors for endometrial cancer in Italy.

In a case-control study to evaluate risk factors for endometrial cancer, obesity, history of various diseases, reproductive and menstrual characteristics, marital status, education, and lifetime use of female hormones were examined in 173 histologically proven endometrial cancers and 347 controls. Obesity, non-contraceptive oestrogen use, late menopause, low parity and history of uterine fibromyomas were associated with an increased risk of endometrial cancer. The relative risks of obesity and oestrogen use seem to fit well for an additive model. Histological differentiation was positively correlated both to oestrogen use and to level of overweight, supporting the hypothesis of a specific role of oestrogens in endometrial cancer.

Adult↗
PubMed1982

Risk factors for epithelial ovarian cancer in Italy.

In a case-control study conducted between May 1979 and February 1980, in Milan, Italy, to evaluate risk factors for ovarian cancer, various reproductive and menstrual characteristics, marital status, education, history of various diseases, and lifetime drug use were examined among 161 women with histologically proven epithelial cancer and 561 controls. Early menarche, late menopause, low parity, late age at first pregnancy and total ovulatory years were associated with an increased risk of ovarian cancer. The elevated risk associated with late age at first pregnancy was not accounted for by low parity. Many of the risk factors identified in this study are also accounted for by low parity. Many of the risk factors identified in this study are also related to the risk of adenocarcinoma of the endometrium and to breast cancer. Further exploration of these factors may lead to an improved understanding of the etiology of all three cancers.

Adult↗