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R Capocaccia

Publications and source records attributed to R Capocaccia.

90 records · Page 5Linked to original sources
PubMed1985

Recent trends in coronary heart disease and other cardiovascular diseases in Italy.

Trends in death rates from coronary heart disease (CHD) in Italy in the period 1970-1979 suggest a continuous rising of mortality in males until 1976-1977 followed by a plateau or a slight decrease in the next 2 years; whereas an 11.5% decrease has been observed in females aged 35-74. Looking at the whole group of cardiovascular diseases it appears that a continuous and clear decline in stroke mortality (-14.6% in males and -22.0% in females aged 35-74) explains almost completely the overall decrease of cardiovascular mortality observed during the period 1970-1979 which corresponds to -8.4% in males and -24.3% in females. Limited and unrepresentative data from population samples studied between 1960 and 1980 suggest an increasing incidence of CHD which is compatible with parallel changes of some risk factor levels. In the 1970s a continuous increase of fat consumption and of cigarette consumption has been balanced by an increase of prevalence of controlled hypertensives, by an increase of leisure physical activity, by an increasing availability of coronary care units and consumption of beta-blockers. It is likely that in the late 1970s a plateau was reached in the coronary epidemic.

Adult↗
PubMed1982

Evaluation of risk factor variations in relation to their baseline values in a controlled preventive trial. Application to the Rome Project of CHD Prevention.

This paper proposes a method for separating intervention impact, regression to the mean and spontaneous evolution effects in a controlled preventive trial. Variation dependence on baseline values is estimated by means of corresponding regression lines. Regression line slopes are adjusted to eliminate bias due to the difference between observed and 'true' values. Intervention impact is then evaluated using the control group as reference. Possible differences in factor baseline values are adjusted for. The method is used to analyse variation patterns for body mass index, serum cholesterol, systolic blood pressure, diastolic blood pressure and cigarette smoking in four years in the Rome Project of Coronary Heart Disease Prevention cohorts. All regression lines of variations vs baseline values show a negative slope. A highly significant improvement due to treatment is observed for blood pressure and body mass index, a less substantial but significant improvement is observed for serum cholesterol, and no effect is observed for cigarette smoking.

Adult↗
PubMed1982

Further considerations on alcohol intake and coronary risk factors in a Rome working population group: HDL-cholesterol.

A study on the relationships between habitual alcohol consumption and the main coronary risk factors was carried out in 520 consecutive high-risk men examined during an annual rescreening of a working population group within the Rome Project of Coronary Heart Disease Prevention. Alcohol intake was determined by means of a semiquantitative questionnaire. The mean daily wine intake was about 0.5 liter, the consumption of other alcoholic beverages being negligible. No statistically significant correlations were found between average daily wine consumption and the main coronary risk factors, while a strongly positive correlation (p less than 0.001) was observed with plasma HDL-cholesterol levels. Also differences in HDL-cholesterol between occasional drinkers and moderate drinkers were statistically significant. No differences were observed in total cholesterol and triglycerides. The findings suggest that habitual moderate amounts of alcohol may increase HDL-cholesterol between occasional drinkers and moderate drinkers were statistically significant. No differences were observed in total cholesterol and triglycerides. The findings suggest that habitual moderate amounts of alcohol may increase HDL-cholesterol levels.

Adult↗
PubMed1981

Risk factors changes and coronary heart disease in an observational study.

Data from the Seven Countries Study are analysed to examine the relationship between the observed incidence of Coronary Heart Disease in the second 5-year period of follow-up and the major entry risk factors and their changes over the first 5 years. The analysis, using the Multiple Logistic Function model, shows that changes in systolic blood pressure and smoking habits are significant factors associated with incidence, while changes in cholesterol and body mass index do not play this role. This conclusion applies to the population as a whole. A more detailed analysis, stratifying the population by estimated risk at entry and changes of risk over 5 years, shows that incidence is related to changes of risk in low and medium entry risk groups. Moreover, a univariate analysis of data limited to systolic blood pressure and cholesterol indicates that changes in blood pressure are related to incidence in the group with highest entry level of blood pressure, while changes in cholesterol are irrelevant to subsequent incidence.

Adult↗
PubMed1977

[Identification of subjects at high coronary risk in the Roman Project of Coronary Heart Disease Prevention (author's transl)].

In the Roman Project of Coronary Heart Disease Prevention two different techniques were employed for the identification of individuals at high coronary risk within the treatment groups of the Project. The "risk score" is a simple additive system developed by the working groups of WHO, while the "multiple logistic function" is a complex mathematical model of multivariate analysis. Both of them consider 5 risk factors (age, systolic blood pressure, serum cholesterol, smoking habits and physical activity at work) and are applied for the identification of individuals belonging to the upper 20% of a risk rank list. The two techniques apparently provide similar predictive performances when applied to epidemiological prospective material collected in other studies where the morbid events are already known. When employed in the study population groups they identify, as high risk individuals, different subgroups of population, which overlap only partially. On the basis of theoretical and practical considerations, it has been decided to employ both techniques and to extend, as a consequence, the proportion of high risk individual, eligible for individual treatment, from 20% to about 30% of the total.

Adult↗
PubMed1975

[The prediction of coronary heart disease. A mathimatical model applied to Italian field studies (author's transl)].

The multiple logistic function (MLF) was applied for the estimation of coronary heart disease (CHD) - "hard criteria" in 5 years as a function of several risk factors in two rural Italian areas belonging to the "Seven Countries Study". CHD was estimated with solutions including 4, 5 and 11 factors respectively. Only serum cholesterol showed a statistically significant contribution; but other factors, like age and physical activity, very likely contributed to a better discrimination between "cases" and "non-cases". By increasing the number of factors the discrimination tends to improve anyway. In the solution with 11 factors, 46% of the observed cases was found in the upper 10% of the estimated risk probabilities; 57% in the upper 20%; while no cases were found in the lowest 20% of the same rank probability list. For practical purposes of selecting high risk individuals for preventive action, a simple 5 factor solution, including age, systolic blood pressure, serum cholesterol, consumption of cigarettes and physical activity is suggested.

Adult↗
PubMedDate not supplied

Effect of glucose and/or branched chain amino acid infusion on plasma amino acid imbalance in chronic liver failure.

The characteristic amino acid pattern observed in chronic liver failure with high aromatic and low branched chain amino acid levels is considered to be consequent to increased muscle protein catabolism. The main catabolic stimulus has been attributed to hyperglucagonemia and to a reduced insulin/glucagon molar ratio. Intravenous administration of a solution containing branched chain amino acids and glucose to patients with chronic liver cirrhosis rapidly normalizes the plasma amino acid pattern. This effect may result from either a change in the insulin/glucagon ratio, induced by glucose, or from the anticatabolic influence of branched chain amino acids on muscle protein turnover. To discriminate between these two possibilities, a crossover study was carried out to determine the effect of a 24-hour infusion of either glucose alone, or glucose plus branched chain amino acids, in seven patients with chronic liver failure. Blood glucose, insulin, glucagon, free fatty acids, and amino acid levels were determined. Branched chain amino acids were much more effective than glucose (p less than 0.01) in decreasing the levels of aromatic amino acids. Conversely, the insulin, glucagon, and free fatty acid levels with glucose alone were not altered with the addition of branched chain amino acids. These findings suggest an anticatabolic effect of branched chain amino acids on muscle protein turnover and suggest that factors other than insulin and glucagon may be responsible for the characteristic plasma amino acid pattern present in chronic liver failure.

Adult↗
PubMedDate not supplied

Incidence, mortality and prevalence of stomach cancer in Italian regions.

The basic descriptive epidemiologic data on stomach cancer occurrence in Italian regions are presented and discussed. Incidence and prevalence were estimated from official mortality and survival data provided by four population-based Italian cancer registries. Age-adjusted mortality, incidence, and prevalence rates are presented by region for the year 1990. Time trends of incidence and their projection for the year 2000 are also presented by region and three broad age classes. Although the occurrence of stomach cancer has been decreasing in Italy and most western countries over the last decades a substantial slowing down of this decrease was evidenced in Italy, especially for women under 65 and for the regions of southern Italy. A marked tendency towards a reduction of geographic heterogeneity in stomach cancer occurrence was also shown. Such a phenomenon is consistent with the observed changes of dietary habbits in Italian regions. The regions of Umbria and The Marches seem to emerge as new areas at relatively high risk of stomach cancer incidence and mortality. About 45,000 prevalent cases were estimated in Italy by 1990, half of which have been diagnosed before 1984.

Adolescent↗
PubMedDate not supplied

Interpreting survival differences and trends.

Since 1990 a concerted action between European population-based cancer registries (the EUROCARE project) has been carried out with the aims of establishing whether there are differences in cancer patient survival in Europe, and the reasons for such differences. Survival differences actually exist for cancer sites for which the stage of disease at diagnosis is the major prognostic factor (such as breast, stomach and colon cancer). However, for most cancer sites, survival increases over time and the survival rates of different countries tend to converge towards higher values. Interpreting survival differences and trends is not an easy task. Longer survival may be achieved by postponing death through better treatment or by anticipating diagnosis. However, an earlier diagnosis may or may not make a treatment more effective in postponing death. The computation of stage-specific or stage-adjusted survival is not sufficient for interpretation of survival differences, because staging procedures change over time and may vary in different hospitals and countries. In addition to an early diagnosis and more effective treatment, a number of factors may bias survival estimates. They may be classified into factors that can be controlled in the analysis (at least partially), such as mortality from other causes, demographic factors, epoch of diagnosis, different statistical methodology, and factors depending on the validity of cancer registry data, such as definition of the illness, exhaustiveness and quality of registration, completeness of follow-up, definition of the data of diagnosis, and definition of disease stage including the diagnostic procedure used to establish stage. To help disentangle the effects of early diagnosis and better treatment, several statistical approaches are being developed: multivariate analysis on relative survival data, new modeling analysis to separately estimate the proportion of cured patients and the length of survival for those patients destined to die, and the standardized collection of information on stage at diagnosis and staging procedures.

Age Factors↗
PubMedDate not supplied

Estimating relative survival of Italian cancer patients from sparse cancer registries data.

PURPOSE: A method is presented for estimating relative survival of cancer patients at the national level from survival data provided by cancer registries covering only a subset of the general population and referring to different, and not necessarily overlapping, incidence periods. METHODS: Relative survival rates are estimated as a function of the covariates sex, age, epoch of diagnosis, and registry area by means of a multiple regression model. National estimates are then computed by appropriate weighting of the sex-, age-, time- and registry-specific expected relative survival values. RESULTS: The method is illustrated by a sample application to survival data of female breast cancer patients in Italy. The national estimates of breast cancer survival pattern show a mild decrease of survival with age and a marked increase with period of diagnosis.

Adolescent↗
PubMedDate not supplied

Correcting the completeness bias of observed prevalence.

AIMS AND BACKGROUND: The cancer prevalence in given areas can be estimated on the basis of data supplied by cancer registries. As the obtained estimate of prevalence depends on the length of the cancer registry's observation period, it is generally lower than the total prevalence in the considered area. In the present work we propose a method to calculate a correction factor of this bias in order to obtain an approximation to the total prevalence. METHODS & STUDY DESIGN: The method is based on the relationship between relative survival and incidence by age for a specific cancer site. RESULTS AND CONCLUSIONS: We provide values of the correction factor, the completeness index R, relative to the most important cancer sites, for specific ages and periods of observation of the cancer registries in Italy. In addition, we provide indications for extended use of the index when substantial variations from the basic pattern of relative survival are observed in practical situations. Furthermore, we give helpful suggestions to obtain approximate values of the correction factor to be used for ages and periods of observation that are intermediate between the ones presented in this paper.

Adult↗
PubMedDate not supplied

[An adjustment to the age structure of the Italian population in the 1971 census].

"Having verified, in the 1971 [Italian] census, the presence of certain anomalous data for cohorts born in 1900, 1911, 1920, 1924, 1930, 1936, 1940, 1948, 1950 and 1960, we assessed the size of the error and estimated the new population total which emerged both by age and year of birth. The method used [is similar] to more classical methods to correct biases in age structure in previous censuses and in those countries where the data available are somewhat lacking. The adjusted values, referring to Italy as a whole, are contained in the text...." (SUMMARY IN ENG AND FRE)

Age Distribution↗
PubMedDate not supplied

Asbestosis mortality in Italy.

A total of 204 deaths due to asbestosis occurred in Italy in the period 1970-1989, including 24 females; asbestosis death rates (per million) were 0.31 +/- 0.05 among males and 0.4 +/- 0.02 among females. The rates increased a little when comparing 1980-89 with 1970-79. Deaths were concentrated in a limited number of geographical areas where an extensive industrial use of asbestos is known to have occurred and where there were also high rates of mortality due to primary pleural tumours.

Adult↗