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S Rosso

Publications and source records attributed to S Rosso.

At least 37 records · Page 2Linked to original sources

Prognostic value of quality of life scores in terminal cancer patients.

A multicenter cross-sectional study of 115 terminal cancer patients in eight home-care units assessed the prognostic value of quality of life scores, as measured by the Therapy Impact Questionnaire (TIQ). The analysis of the questionnaires completed by 100 patients revealed an association between survival and many of the scales: fatigue, gastrointestinal symptoms, global health status, functional impairment, emotional status, and cognitive status. This association was also observed for some specific physical symptoms, such as confusion, weakness, and loss of appetite, and the overall number of symptoms reported by the patient. Adjusting for some possible confounding factors, only confusion (among the physical symptoms), cognitive status, and global health status (among TIQ primary scales) showed independent prognostic value. As regards the latter two scales, median survival time was distributed differently for patients with no impairment of either (137 days), with impairment of one scale (50 days) and with impairment of both scales (17 days). The judgment expressed by the patient about subjective perception of general malaise and cognitive difficulties can give the clinician important prognostic information.

Aged↗

The multicentre south European study 'Helios'. I: Skin characteristics and sunburns in basal cell and squamous cell carcinomas of the skin.

The aim of this study was to investigate constitutional and environmental determinants of non-melanocytic skin cancer among different populations from south Europe. Between 1989 and 1993 we interviewed incident cases and a random population sample of controls from five centres where a cancer registry was operating, whereas we selected a sample of hospital-based cases and controls from three other centres. Controls were stratified according to the age and sex distribution of cases. In all, 1549 cases of basal cell carcinoma (BCC), 228 of squamous cell carcinoma (SCC) and 1795 controls were interviewed. Both cancers affected primarily sun-exposed sites such as face, head and neck, but the prevalence of BCC on the trunk was higher than for SCC. Pigmentary traits such as hair and eye colour as well as tendency to sunburn were strong and independent indicators of risk for both BCC and SCC. In SCC, adjusted odds ratios (ORs) ranged from 1.6 for fair hair colour to 12.5 for red hair. Light-blonde hair entailed a risk of about 2 for BCC. Pale eye colour was associated with a risk of 1.8 for SCC and 1.4 for BCC. Subjects who always burn and never tan showed an adjusted OR of 2.7 for BCC and 2.0 for SCC. A history of sunburns and a young age at first sunburn were associated with an increased risk for BCC only (OR 1.7). Pigmentary traits and sun sensitivity of the skin confirmed their role as risk indicators. The effect of sunburns, as an indicator of both exposure and sun sensitivity of the skin, is less clear. Nevertheless, its association with BCC suggests, by analogy with melanoma, a relationship with intense sun exposure. Conversely, SCC would require prolonged exposure to sunlight.

Adolescent↗

The multicentre south European study 'Helios'. II: Different sun exposure patterns in the aetiology of basal cell and squamous cell carcinomas of the skin.

The role of sun exposure in development of basal cell and squamous cell carcinomas among different populations from south Europe was investigated. Between 1989 and 1993 we interviewed incident cases and a random population sample of controls from five centres where a cancer registry was operating, whereas we selected a sample of hospital-based cases and controls from the other three centres. We gathered information on life-long exposure to sunlight during different activities. Results are analysed for 1549 basal cell carcinoma (BCC) cases and 228 squamous cell carcinoma (SCC) cases compared with 1795 controls. We observed a statistically significant increase of risk of SCC with increasing sun exposure beyond a threshold of 70,000 cumulated hours of exposure in a lifetime. Sun exposures during work and holidays were, however, inversely correlated. Odds ratios (ORs) of SCC were up to eight or nine times the reference for the highest exposures (200,000 cumulated hours or more). BCC exhibited a 2-fold increase of risk for lower exposure (8000-10,000 cumulated hours in a lifetime) with a plateau and a slight decrease of risk for the highest exposures (100,000 cumulated hours or more). Outdoor work showed a significantly increased risk of SCC (OR 1.6 for more than 54,000 cumulated hours of exposure in a lifetime), whereas recreational activities such as sun exposure during holidays at the beach (OR 1.6 for more than 2600 cumulated hours of exposure in a lifetime) or during water sports (OR 1.6 for more than 2600 cumulated hours of exposure in a lifetime) were associated with an increased risk of BCC. Risk patterns were different in poor or good tanners with a significant risk trend for good tanners, whereas poor tanners were on a plateau of increased risk at any level of exposure. Solar radiation is associated with a risk of BCC even for relatively short periods of exposure such as during holidays and sports, whereas SCC develops later if exposure continues. The skin's ability to tan modulates the risk of BCC; subjects who tan poorly have a steady risk increase, whereas people who tan easily develop cancer only after prolonged exposures.

Basal Cell Carcinoma↗

Accuracy of the umbilical arteries Doppler flow velocity waveforms in detecting adverse perinatal outcomes in a high-risk population.

OBJECTIVE: To define the accuracy of the umbilical artery Doppler flow velocity waveforms, according to different cut-off values, in predicting adverse perinatal outcomes among fetuses at high risk of hypoxic complications. SUBJECTS: Two hundred and sixty-five pregnant women with diagnosis of small for gestational age fetus and/or pregnancy induced hypertension studied in four Italian ultrasound units. METHODS: Prospective study. Serial Doppler ultrasound measurements of the umbilical artery were performed. Results were not available for clinical management. Cut-off curves, corresponding to different age-specific centiles of the pulsatility index distribution among pregnancies resulting in healthy newborns, regardless of birthweight, were computed by regression methods. Sensitivity, specificity, positive predictive value and negative predictive value of such cut-off curves, and of absent/reverse end-diastolic flow, in predicting different adverse outcomes were estimated. The adverse outcomes were: perinatal or neonatal death (OUTCOME 1). Death or Apgar<7 at 5' or need for admission to intensive care unit or other hypoxic related abnormalities (OUTCOME 2). Either OUTCOME 2 or birthweight<l0th centile (OUTCOME 3). Both OUTCOME 2 and birthweight<10th centile (OUTCOME 4). RESULTS: The best accuracy was in predicting OUTCOMES 1 and 4. Positive predictive value increased strongly with higher cut-off curves while negative predictive value only decreased slightly. For absent/reverse end-diastolic flow, negative predictive value and positive predictive value were respectively 94% and 39% for death, and 81% and 72% respectively for OUTCOME 2. For the 95th centile curve the corresponding figures were 96%, 33% and 84%, 67%. The 60th centile curve had a 85% and 74% sensitivity value for death and OUTCOME 2 respectively, but the corresponding positive predictive values were 18% and 40% only. CONCLUSIONS: The findings of an absent end diastolic flow or of pulsatility index values above the 95th centile curve strongly suggest it is time to deliver the fetus. The 60th centile curve is the most suitable to recognize fetuses at risk for abnormal outcome, but early delivery should be avoided because of its low positive predictive value.

Apgar Score↗

Cancer incidence in Turin: the effect of migration.

AIMS AND BACKGROUND: Studies on migrant populations have been of great value in clarifying the role of environmental factors in cancer occurrence. Most of them consider migrants from other countries or continents. Turin, the target territory of this study, was an important area of internal migration initially from the East, and more recently from southern Italy. METHODS: The study compared incidence rates (age-standardized) of the native population, of the migrants and incidence rates of the Cancer Registries located in the four main areas of origin. RESULTS: Overall incidence rates in migrants from southern Italy were intermediate compared with those of the stable populations of the South and the North. The same effect was not true for people from the North-East, who migrated in earlier decades. In this population, migration towards lower-incidence areas did not reduce cancer incidence. Migrants from the South showed a significant increase in intestinal, breast, and tobacco-related tumors compared to the stable southern population. No effect of migration was found for cancer of the mouth, pharynx, esophagus, stomach or corpus uteri. Incidence of liver cancer in migrant southern males was significantly different from the stable and the native north-western population. CONCLUSIONS: The results, based on incidence data, validated previous findings based on mortality data on the effect of Italian internal migrations and showed that migrants underwent changes in some environmental exposures. In particular, migrants from the South to the North of Italy came into contact with new risk factors, with an increase in occurrence of cancer.

Female↗

Cutaneous melanoma and sunburns in childhood in a southern European population.

A population-based case-control study of 260 patients (74 males and 186 females, mean age = 56) with cutaneous malignant melanoma and 416 controls (211 males and 205 females, mean age = 55) was conducted in Turin, north-west Italy, to examine the relation between timing of sunburns and sun exposure and melanoma risk within a southern European population, which is still relatively little investigated. Particularly elevated risk was associated with history of sunburns in childhood [odds ratio 5.9; 95% confidence interval (CI) 3.6-9.5], and such risk elevation persisted after allowance for other major melanoma risk covariates. Conversely, risk increase from history of severe sunburns lifelong was lower (odds ratio = 1.7; 95% CI: 1.1-2.4) and was eliminated by allowance for type of skin reaction to sun exposure and history of sunburns in childhood. A significant increase in the risk of cutaneous malignant melanoma was also associated with number of weeks spent on holiday at the beach not only as an adult, but also as a child.

Adolescent↗

A therapy impact questionnaire for quality-of-life assessment in advanced cancer research.

The first part of the validation procedure used for a Therapy Impact Questionnaire (TIQ) on quality-of-life assessment in advanced cancer patients is described. The TIQ is composed of 36 items which assess both disease and therapy impact according to four dimensions that operationally define quality of life: physical symptoms (24 items), functional status (3 items), concomitant emotional and cognitive factors (6 items) and social interaction (2 items). A global judgement expressed as "have you been feeling ill" further completes the TIQ. Patients answered each question using a 4-point verbal Likert scale: not at all, slight, a lot and very much. The TIQ was given to 1,000 consecutive patients who were no longer responsive to cancer treatment and presented symptoms due to disease progression. The compliance rate was quite high (87%). Results of confirmatory factor analysis were consistent with the operational dimensions identified during questionnaire construction. In particular, the dichotomized answers to 3 functional status items could be used as a Guttman scale. In a sub-sample of 50 patients, the reproducibility of functional status items was assessed using a 7-item parallel form. The intraclass correlation coefficient obtained indicated a reasonably high reproducibility. On the basis of the analyses conducted, the TIQ appears to be a reliable and concise instrument for studies aimed to assess the effectiveness of therapies in advanced cancer patients.

Adolescent↗

A randomized trial of smoking cessation interventions in general practice in Italy.

The purpose of this study was to examine the effectiveness of different practice-based approaches to assist patients of primary care physicians to quit smoking and sustain cessation. Forty-four nonsmoking general practitioners volunteered for the study. After a period of training, they randomized 923 smoking clients, unselected for motivation toward quitting, to four different intervention groups: (i) minimal intervention, consisting of one single counselling session and a brief handout on quitting techniques; (ii) repeated counselling including reinforcing sessions at Months 1, 3, 6, and 9; (iii) repeated counselling and use of nicotine gum; and (iv) repeated counselling and spirometry. Biochemically validated smoking status was assessed at six and 12 months after recruitment. The proportion of verified quitters at 12 months was 4.8 percent among subjects randomized to the minimal intervention group, compared to 5.5 percent, 7.5 percent, and 6.5 percent among those randomized to the three repeated-counselling groups. In no treatment group was the outcome significantly different from that for one-time counselling at the (P less than 0.05) level. Lack of power, contamination, and low attendance at reinforcing sessions should be taken into account in interpreting the results.

Adult↗

Two simple indexes used to evaluate the impact of therapy on the quality of life of patients receiving primary chemotherapy for operable breast cancer.

The psychometric characteristics of two indexes used to evaluate the subjective morbidity of chemotherapy regimens were analyzed. Both indexes assessed the duration of discomfort as perceived by the patient throughout therapy. The first index asked patients to state the number of days spent with 'discomfort', and the second index asked them which days they would like to eliminate altogether because of the unbearable symptoms experienced on those days. While the first index gives some idea of the duration of suffering, without defining it, the second highlights a specific time when the quality of her life was unacceptable to the patient. We studied these indexes in the form of a questionnaire completed by 168 women who had entered a cancer clinical trial. This trial evaluated the efficacy of primary chemotherapy in rendering conservative surgery feasible in women with operable breast cancer, but whose tumor size was greater than 3 cm. Four different treatment regimens were used: CMF, FAC, FEC, FNC (C = cyclophosphamide, M = methotrexate, F = fluorouracil, A = adriamycin, E = epirubicin, N = mitoxantrone). Seventy-nine patients were interviewed during chemotherapy and 89 during follow-up visits. Initial assessment of the reliability, discriminant and concurrent validity of the two indexes produced satisfactory results. Finally, we analyzed the responses given by 168 patients for a total of 600 treatment cycles. The average value of 'discomfort' was 3 days, whereas the average value of days 'to be eliminated' was 1. The range of subjective morbidity (for every cycle of treatment: 'discomfort = 0-30 days; 'to be eliminated' = 0-20 days) was very broad.(ABSTRACT TRUNCATED AT 250 WORDS)

Antineoplastic Combined Chemotherapy Protocols↗

[General practitioners and interventions against smoking: a critical review of interventions].

In this review we considered smoking cessation interventions delivered by general practitioners in consideration of their privileged position as health promoters. We selected 11 randomized trials on: a) counselling; b) nicotine gum; c) perception of health hazards in relationship with cigarette smoking. The interventions were delivered to smokers during clinical encounters. Amount of time spent by physicians during clinical encounters and number of reinforcing sessions emerged as the most important factors in a successful intervention. Nicotine gum prescription and perception of health hazards did not show any significant effect but the opportunity as reinforcing sessions.

Adolescent↗

[Prevalence of intestinal parasitoses in a sample of Italian and immigrant workers employed in the food sector of Turin].

We studied the prevalence of intestinal parasites in a random sample of immigrants and Italians employed in the food industry. Prevalence ranged from 20.8% among immigrants to 5.6% among Italians. Where helminths are widespread among Indochinese, protozoa are more common among africans. Three cases of Entamoeba histolytica in asymptomatic subjects were identified and successfully treated. We observed high levels of Giardia intestinalis both in Italians (2.2%) and immigrants (3.9%). Prevalence of intestinal protozoa was significantly associated with year of immigration, showing higher levels for new immigrants. The public health implications of parasite screening and treatment among recent immigrants were also discussed.

Africa↗

Cutaneous malignant melanoma in females: the role of hormonal and reproductive factors.

The role of hormonal and reproductive factors as risks for cutaneous malignant melanoma (CMM) was explored by means of a population-based case-control study conducted in Turin, north-western Italy, on 186 female CMM cases and 205 controls. Past use of oral contraceptives (OC) did not seem to exert any effect on CMM risk odds ratio (OR) = 1.12, 95% confidence interval (CI): 0.56-2.24). No association was found even for the longest duration of use, for superficial spreading melanoma cases and for CMM of lower limbs only. While age at first birth did not affect CMM risk, women who had had three or more children seemed to be significantly protected as compared to nulliparous ones. The association was, however, substantially diminished by adjustment for education and other CMM risk correlates (OR for at least three children versus none = 0.62; 95% Cl: 0.29-1.31).

Adolescent↗

[A case-control study of melanoma of the skin in the province of Torino, Italy].

A population based case-control study was conducted in the province of Torino (Northern Italy) where internal migration produced a population with mixed ethnicity and lifestyles. Two hundred and eight cases of histologically confirmed cutaneous malignant melanoma (CMM) and four hundred and sixteen controls were interviewed. Our results gave evidence to the role of skin reaction to the sun (OR 5.0 in men and 2.2 in women) as an indicator of a group at risk. The increased risk of intense and occasional sun exposure as can be inferred from sun exposure during holidays and outdoor sports, has been confirmed (OR 4.1 in men and 2.7 in women). Ethnic differences did not play an important role in our population, women who used oral contraceptives also did not show an increased risk.

Contraceptives, Oral↗

Cancer of the breast in women born in southern Italy and who migrated to the city of Torino.

Individual demographic data of 459 women living in Torino with incident breast cancer diagnosed in 1979 were compared with those of a random sample of 1800 women drawn from the list of residents in the same city. Among women aged 25-44 and 45+ years, age-adjusted odds ratios for birth in southern Italy were respectively 1.3 (95% CL, 0.1-2.1) and 0.7 (95% CL, 0.5-0.9). In women aged 45+ years, odds ratios increased with length of residence in Torino.

Adult↗