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Biomedical subjects

L Giarelli

Publications and source records attributed to L Giarelli.

At least 37 records · Page 2Linked to original sources

Comparison between diagnoses on death certificates and autopsy reports in Trieste: gynaecological cancers.

We have compared autopsy results with the diagnosis reported on 759 death certificates for gynaecological cancers. High levels of discrepancies were noted for all sites. Surprisingly, complete agreement between death certificates and autopsy reports was found for only 30% of cervical and corpus tumours and for 50% of ovarian tumours. This low level of agreement was due partly to the poor quality of death certificates of older women. No difference in accuracy was found over the 15-year period considered. The most obvious causes of the discrepancies were of two types. The first was erroneous interpretation of codes; confusion between 180 (cervix) and 182 (corpus) was very frequent. The second type was associated with clinical factors, such as confusion of anatomical site, adjacent organs or metastases being diagnosed as primary tumours. A relatively frequent cause of inaccuracy on death certificates was consideration of patients who had been cured of a cancer as having died of the disease.

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Optic nerve head drusen: histopathological considerations--clinical features.

The histopathological features made on 18 autopsies have proved that the optic nerve head drusen are calcified formations situated within the margins of the optic nerve head. It has been supposed that not only an aberrant axoplasmic transport, but also the presence of local factors, partly depending on the Bruch's membrane, can play a determining role in the pathogenesis of the optic disc drusen. A spongiotic edema gives us the histopathological equivalent of the clinical aspect of the optic disc with indistinct margins and lack of the central cup and furthermore gives us an explanation about the perimetric alterations pathogenesis. Clinical observations confirm that the optic nerve head drusen are prevalently asymptomatic and that visual acuity remains unchanged. The threshold tests are able to quantify exactly the entity and the depth of the visual field defects and its possible changing within a certain period of time. As regards the diagnosis, the retinal fluoroangiography is of great importance allowing to distinguish clearly a pseudo-papillary edema from a papillary edema.

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Prevalence of hepatocellular carcinoma and relation to cirrhosis: comparison of two different cities of the world--Trieste, Italy, and Chiba, Japan.

A comparative, descriptive study on the prevalence of hepatocellular carcinoma either associated or not with cirrhosis was undertaken between the cities of Trieste, Italy, and Chiba, Japan. Data were derived from 12,340 and 2,052 autopsies consecutively performed in Trieste and Chiba during 1980 to 1984 and 1975 to 1985, respectively. During these years, more than 70% of all deaths were studied by autopsy in Trieste. Clinical cases of hepatocellular carcinoma admitted to the Chiba University Hospital were also analyzed to correct for the bias induced by the relatively small number of autopsies in Chiba. Serum hepatitis B surface antigen was more frequent in Chiba, whereas alcohol intake was greater in Trieste. From the comparison of the data, we conclude: (i) hepatocellular carcinoma was associated with cirrhosis in the large majority of the cases both in Trieste (87%) and Chiba (81%); (ii) in both sexes, the average age of hepatocellular carcinoma patients was significantly older (p less than 0.005) in Trieste than in Chiba; (iii) in the autopsy series, cirrhosis was more frequent in Trieste (9.7%) than in Chiba (1.5%); (iv) in Chiba, hepatocellular carcinoma was more frequent than cirrhosis not complicated by hepatocellular carcinoma (6.9 vs. 1.5%) at necroscopy, and (v) the age-standardized rate of hepatocellular carcinoma was significantly (p less than 0.01) higher in Trieste than in Chiba. These geographical differences might be related to the different type of cirrhosis observed in Trieste (alcoholic) and Chiba (postnecrotic).

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The pathology of optic nerve aging.

The pathology of the optic nerve in the advanced elderly has been investigated at autopsy in a sample of 50 subjects (43 males, 7 females), aged 95-103 years. Septal fibrous thickness and slendering of nerve fibers were the most frequently encountered lesions as well as degenerative processes involving the cribriform lamina. Other significant features included gliosis, demyelination, and corpora amylacea. Complete arteriosclerotic disease was rarely observed. The results of the present study suggest that optic nerve pathology in aged people is almost the consequence of an inadequate blood supply; nevertheless, the degree of these lesions does not seem to parallel that usually observed in other sites particularly injured by ischemic disease.

Aged↗

Intratracheal thyroid.

A case of intratracheal ectopic thyroid tissue in the absence of clinical symptoms is described. It was an incidental finding observed at autopsy.

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Atherosclerosis and aging. A morphometric study on arterial lesions of elderly and very elderly necropsy subjects.

A histomorphometric study was performed on arterial wall lesions of different arterial regions (arch, thoracic, abdominal parts of the aorta; right and left common and internal carotid arteries; coronary arteries; and basilar and middle cerebral arteries), collected from 108 elderly and very elderly (greater than 90 years of age) subjects who underwent necropsy. Lumen stenosis percentage, mean intimal thickening, and mean thickness of the media were measured by means of a computerized system using a manual input and graphic printout; statistical tests were performed using variance and regression analysis. Results showed that the arterial wall lesions in patients over 60 years of age tend to be stabilized in all regions studied except for the cerebral region, where the lesions tend to have a continuous progression related to age, even in a group of subjects over 90 years of age.

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[Posterior uveitis in systemic diseases. A pathologic and epidemiologic study].

In the course of 2943 autopsies, during which the eyes were also removed, investigations were carried out concerning inflammatory lesions of the posterior uveal tract. Posterior uveitis was found in 202 cases (6.9%) of subjects whose mean age was 74.5 years. In 98% of the cases this was a non-granulomatous inflammation. The frequency of the associated systemic diseases in the cases of uveitis was compared with the frequency of such diseases in an accurately chosen control group. The results of our investigation showed that diabetes mellitus and inflammatory diseases, particularly rheumatoid arthritis, myocarditis, endocarditis and hepatitis are more frequently found in patients with uveitis.

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Optic nerve in diabetes mellitus: a case control study.

The pathology of optic nerve in 80 diabetic subjects has been investigated in a morphologic study performed on autoptic material. Gliosis and demyelination resulted as the most frequently observed lesions (respectively 19 and 18 cases) and were associated to long history of diabetes. Additional findings were focal infarctions, atrophy, and broad spectrum of vascular lesions, mostly affecting the microcirculation, including thickening, hyalinosis, microaneurysms, as well as thromboses. An age-sex-matched control group, made of non diabetic subjects, did not share significantly lesions with the diabetics. Therefore, the authors suggest that diabetes mellitus plays an important role in the development of pathological changes in the optic nerves, thus claiming the marked vascular damage of early age onset diabetes as a possible pathogenetic factor.

Aged↗

Incidence of hepatocellular carcinoma in the Trieste area over a 15-year period (1968-1982).

An analysis of 26,700 unselected autopsies performed consecutively over a 15-year period was made to establish the incidence of hepatocellular carcinoma (HCC) and its relationship to cirrhosis of the liver in the Trieste area. In our series, considering the period 1968-1980, the average value of the annual age and sex incidence rates of HCC standardized to the European population proved to be 10.58/100,000 in cirrhotic males and 1.3/100,000 in cirrhotic females, whereas in non-cirrhotics it was 1.14/100,000 and 0.34/100,000, respectively. In cirrhotic males autopsied during the period 1977-1980 the above incidence increases, its average value being 16.53/100,000.

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Early (stage A) prostatic cancer. V. Stereotopography.

In 67 prostates, collected at autopsy, besides length, the following measures were taken or calculated (Leitz, ASM): width, thickness (antero-posterior axis) and correlative half-diameters, mean area and ratio area/perimeter. When prostatic microcarcinoma was present, the angle to the antero-posterior axis and the mean percent distance from the urethral barycentre were calculated; over 74% of all cancer foci were in the lateral sextants between iso-distances 50-90.

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