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Biomedical subjects

M Zappa

Publications and source records attributed to M Zappa.

137 records · Page 8Linked to original sources
PubMedDate not supplied

[Impact of replacement hormone therapy in menopause on breast radiologic density and possible complications of mammography in the assessment of breast masses].

PURPOSE: To analyse the association of hormone replacement therapy (HRT) and radiological density, defined as the fraction of breast volume occupied by fibroglandular opacity. MATERIAL AND METHODS: We considered 678 postmenopausal women, consecutively undergoing mammography within an organized screening program, 188 (27.7%) of whom were receiving HRT. Attribution of radiological density was performed prospectively and blind as to HRT status. RESULTS: Both radiological density (p = 0.12) and exposure to HRT (p < 0.001) were found to correlate with age (younger women are more likely to use HRT and to have denser breasts, even without HRT) so the analysis of the correlation between HRT and radiological density was adjusted for the possible confounding effect of age. After stratification by age group, univariate analysis showed a significant correlation between HRT and radiological density (density = > 50%: HRT+ = 34.0%, HRT- = 17.6%: F-value 18.86, df = 1, p < 0.001). Also the duration of HRT was significantly associated to radiological density (Pearson coeff. = 0.12: p = 0.0011). Multivariate analysis adjusting for the confounding effect of age showed an increased risk of dense breast (17% or 7% for a radiological density > 25% or > 50%, respectively) in HRT users with respect to non users. DISCUSSION: The study design, the adoption of a classification of breast density less exposed to intraobserver variability and multivariate analysis of a large series, allows a reliable evaluation of the association of HRT to breast density. As no threshold value is known for the masking effect of density on breast cancer, the negative effect of HRT on screening sensitivity cannot be accurately quantified. CONCLUSIONS: This study confirms the effect of HRT on radiological density in postmenopausal women, suggesting a possible reduction of screening sensitivity and efficacy. Such a hypothesis still needs validation by means of a prospective analysis of the correlation between HRT and the frequency of interval cancer occurrence (the best indicator of sensitivity).

Aged↗
PubMedDate not supplied

Atherosclerotic aortic-bisiliac aneurysms in two monocorial twins.

Two cases of aorto-bisiliac aneurysms in monocorial twins in their sixties were observed. We report experimental and clinical data from the literature about genetic involvement in the formation of aneurysms, especially when associated with other risk factors. In addition to the genetic factors in the twins we studied, we also found other risk factors, such as hypertension and smoking, which took a long time to affect the patients before the aneurysms were detected.

Aneurysm↗
PubMedDate not supplied

Characterization of asbestos fibers in pleural tissue from 21 cases of mesothelioma.

Pleural biopsies from 21 patients with pleural mesothelioma and different asbestos exposure were analyzed by means of analytical electron microscopy with the aim of investigating the presence, quantity, types and sizes of asbestos fibers in pleural tissue. The majority of fibers found consisted of ultrathin (< 0.3 micron) and short (< 5 microns) fibers regardless of asbestos types and subject exposure. Concentrations appeared to be poorly related to the estimated exposure level. Fiber dimensions appeared to be the most important characteristic which determined their translocation in the pleural region.

Adult↗
PubMedDate not supplied

[Personal experience in the treatment of intestinal carcinoids].

The authors report 7 cases of intestinal carcinoids. They examine the clinical aspects and describe and discuss both surgical and medical treatment strategies. They also critically evaluate the value of monitoring some oncological markers and their prognostic significance. Each patient underwent an in-depth evaluation of tumour evolution (CAT, ultrasonography, NMR, angiography) and urinary 5HIAA and platelet 5HT were monitored. Surgery took the form of ileal or ileocolic resection, gastric resection, exeresis of the tumour using a transanal route, ligature of the right branch of the hepatic artery afferent to the metastasised lobe of the liver. Five patients were treated using chemotherapy and three, also suffering from carcinoid syndrome, with octreotide. On the basis of their personal experience the authors underline the limited value of the study of 5HT and 5HIAA tumour markers in the diagnosis of small carcinoid tumours. This is compensated by the outstanding role of these markers in the diagnosis of the hepatic and/or lymphoglandular diffusion of the tumour. These markers were not influenced by octreotide treatment in cases in which longastatin was successfully used to combat carcinoid syndrome. Their behaviour allowed useful information to be acquired regarding the tumour evolution following surgery.

Aged↗
PubMedDate not supplied

[Risk factors associated with the phenomenon of long-term care in psychiatry. A case-control study conducted in the Servizio di Igiene Mentale of Cassentino (Arezzo)].

OBJECTIVE: This work has been carried out to identify any factor associated with the long-term treatment through the analysis of all the data concerning the sociodemographic, psychosocial, anamnestic and clinical variables existing before the disease. MATERIAL AND METHOD: The research, carried out by the Mental Health Service in Bibbiena (U.S.A. 21) is a retrospective "case-control" study using a sample of 140 patients (70 "cases" and 70 "controls") that had the first contact with the psychiatric service in the period 1973-1989. We have defined l'cases" those patients who have been treated by the Service on a continuing basis for at least 5 years without an interruption more than three months. The "controls" were patients selected at random from the same population of "cases", resident in the same districts (catchment area of Casentino), but treated for a period shorter than 5 years. "Cases" and "controls" were in pairs on the ground of sex, age (range +/-5 years) and year of admittance to the service. A doctor of the postgraduate school of psychiatry was aware of "case" or "control" state, collected all informations using a questionnaire filled in according to medical records, psychiatric admission registers and information received by the psychiatric service staff. RESULTS: The study suggests that significance risk factors for long-term patients are:--diagnosis of schizophrenia. --a history of past suicide attempts and assaultive behavior.

Adult↗
PubMedDate not supplied

[Cost-benefit analysis of a mammography screening program extended to all the national territory].

A cost-effectiveness analysis has been conducted in order to evaluate effects and costs of a nationwide mammographic breast cancer screening programme compared with no screening in a 30 years period. The analysis includes seven different phases of breast cancer, from the screening programme itself to the treatment of terminal illness. The estimates use italian published data and field studies. The calculations were performed with the Miscan computer simulation package: a programme providing for the screening of women aged 50-69 at two years intervals might be expected to result in a 1,650 deaths prevented and 14,500 years of life gained each year. The overall net costs of the programme were assessed at between 2,893 and 3,212 thousand million lire, the cost per life saved between 59.8 and 66.4 million lire and the cost per life-year gained between 6.6 and 7.3 million lire (between 10.7 and 11.5 million lire with a 5% discount rate, an estimate lower than that of German programme). The analysis produces important information for the Italian policy debate over mammography and it also contributes to the development of economic evaluation in our country.

Aged↗