1,720,996 research outputs found
Mortality risk in alcoholic patients in northern Italy: comorbidity and treatment retention effects in a 30-Year follow-up study
No full textAims: to analyse the general and cause-specific mortality over the course of 30 years among subjects treated for alcohol use disorders (AUD) in Northern Italy.Methods: cohort of 2499 subjects followed-up for mortality until 31 December 2012. Standardized mortality ratios (SMRs) and 95% confidence intervals (CI) were computed to compare the mortality in the cohort with the general population. Cox regression was used to study the effect of psychiatric disorders, burden of physical comorbidity and retention in treatment on mortality, controlling for socio-demographic factors.Results: during the follow-up, 435 deaths occurred. Compared with the general population, alcoholics experienced a 5-fold increased mortality (SMR: 5.53; 95% CI: 5.03, 6.07). Significant excess mortality was observed for a range of specific causes: infections, cancers, cardiovascular, respiratory and digestive system diseases as well as violent causes. In multivariate analysis, the hazard of dying was lower for female gender (hazard ratio [HR]: 0.62; 95% CI: 0.46, 0.84) and for increasing length of retention in treatment (HR for third tertile vs first tertile: 0.43; 95% CI: 0.32, 0.57). Burden of physical comorbidity was associated with increased hazard of dying (HR for 3+ comorbidities vs no comorbidities: 4.40; 95% CI: 2.91, 6.66). Psychiatric comorbidity was not associated with mortality.Conclusions: despite the harmful effect of AUD, retention in treatment represented a protective factor against death, suggesting that strategies supporting primary medical- and social-care may effectively reduce premature mortalit
Gender difference and mortality in a cohort of heroin users in the Provinces of Modena and Ferrara, 1975-1999
No full textGender and socioeconomic conditions are important determinants of mortality among heroin users. The increase in deaths from heroin overdose in subjects enrolled in the recent years requires particular attentio
Analisi geografica dei tumori diagnosticati in provincia di Modena negli anni 2000-2005
No full textMonografia sui dati di incidenza e sopravvivenza delle neoplasie nella provincia di Modena negli anni 2000-200
Low exposure to lead and reproductive health: a cohort study of female workers in the ceramic industry of Emilia-Romagna (Northern Italy)
No full textAims: to assess the effects of low levels of lead exposure on reproductive health (miscarriage, fertility, multiple births, sex ratio at birth, incidence of some diseases during pregnancy), following a cohort of female workers exposed to lead in the ceramic tile industry in the Municipalities of Scandiano (RE) and Sassuolo (MO), Northern Italy.Design: a cohort of 2,067 female workers was considered. These workers repeatedly underwent blood lead levels testing at the Toxicology Laboratory of Scandiano (RE) in the period 1998-2004. Follow-up was performed for each subject for the 12 months following any blood lead testing. Data on miscarriages and live births were obtained through a linkage with hospital discharge records. Results were compared with the frequency of events in the general female population in the Emilia-Romagna Region (Northern Italy). The frequency of multiple births was also examined, as well as the ratio of male-to-female infants and maternal diseases during pregnancy. An internal analysis within the cohort was conducted to evaluate the associations with increasing lead levels.Results: the women under study accumulated 5,722 person-years of observation. The age distribution of study subjects was not different from the one observed in the Region. Thirty-one miscarriages and 212 live births were recorded. The miscarriage rate (5.42‰) among the study subjects was not different from the regional reference, while the fertility rate (37.05‰) was lower (RR: 0.72; 95%CI 0.63-0.83). The frequency of multiple births (1.9%) was similar to the regional rate (1.2%). Eighty-six females (40.57%) and 126 males (59.43%) were born, compared to regional percentages of 49% females and 51% males. Of all the indicators examined, only miscarriage showed a positive trend among women exposed to lead. In addition, women exposed to lead had a higher frequency of hypertension during pregnancy (RR: 1.34; 95%CI 1.07-1.68), problems with the amniotic cavity (RR: 1.16; 95%CI 1.02-1.33), and prolonged pregnancy (RR: 1.37; 95%CI 1.09-1.73).Conclusions: the cohort of female subjects under study showed rate of miscarriage similar to the general population and a lower fertility rate. There were a higher percentage of male births and an increase of some conditions during pregnancy possibly related to lead exposur
Second Malignancy After Treatment for Non-Hodgkin Lymphoma: a Systematic Review and a Meta-Analysis of Population-Based and Cohort Studies
No full textBackground: The risk of second malignancy in non-Hodgkin lymphoma (NHL) survivors have been described in several studies, but the available evidence have yielded conflicting results. Thus, we performed a systematic review and a meta-analysis on population-based and cohort studies to provide a quantitative assessment of the available evidence on the risk of secondary occurrence of cancer after treatment for NHL. Primary aims of our research were to evaluate the pooled Relative Risk (RR) of second cancer for overall malignancies and for every cancer.Methods: A Medline search from 1985 to 2008 was conducted for identification of relevant observational studies that provide estimates of RR, as measured by standardized incidence ratios (SIR) that is the observed-expected ratio of second malignancy appearing during follow up of NHL. The reference lists of identified articles were inspected to identify additional papers. Criteria for including studies in the meta-analysis were: a) studies on naïve patients with any stage of NHL, b) studies reporting measure of SIR or data allowing such outcome to be derived and c) English language. The article included, had to have been published in peer-reviewed literature. We did not exclude papers on the base of therapeutic regimens. The Meta-analysis of Observational Studies in Epidemiology (MOOSE) guidelines were followed. Pooled RR and 95% confidence interval (CI) were calculated using random effect models. Tests on heterogeneity and sensitivity analysis was conducted. Also, the publication bias was evaluated. Results: Eleven papers meet the inclusion criteria reporting RRs for all malignancies. These studies included 223,593 patients affected by NHL of which 14,952 presented a second cancer. RRs ranged from 0.93-1.90 and the meta-RR for second malignancy was 1.24 (95%CI: 1.11-1.39). The analysis on solid tumours, excluding haematological malignancies, based on seven studies did not show a significantly higher risk for secondary cancer: the meta-RR was 1.06 (95%CI: 0.84-1.34). However, some kind of cancer showed a statistically significant excess of risk, as lung cancer (meta-RR on nine studies: 1.46 95%CI: 1.33-1.59) and bladder cancer (meta-RR on eight studies: 1.42 95%CI: 1.33-1.51). Prostate (meta-RR on ten studies: 1.08 95%CI: 0.93-1.24) and breast cancer (meta-RR on eleven studies: 0.99 95%CI: 0.83-1.19) has demonstrated no evidence of association with NHL therapy. Moreover, we found a higher risk of developing Hodgkin lymphoma and myeloid leukemia (respectively meta-RR on seven studies: 6.44 95%CI: 5.59-11.55 and meta-RR on five studies: 7.81 95%CI: 2.59-24.46). Regarding leukemia, however we have to consider that they include either acute or chronic leukemia and sometime could also include higher risk myelodisplastic syndrome . No evidence of publication bias was observed. Conclusion: Although there exist a number of paper on this topic, until now there are not been attempts to perform a meta-analysis on RR of second malignancies after treatment for NHL. Indeed comparative analysis on the incidence of second cancer presents several issues, including the heterogeneity of NHL, the source of data, the time during which the study was performed, the different schedule of chemotherapy, the dosage of radiotherapy used in the different period of time and the length of follow-up. Although these problems could reduce the accuracy of the meta-analysis, our results indicate that NHL treatment is associated with a significantly higher risk of second malignancy, in particular for some specific cancer like lung and bladder and same haematological malignancies as Hodgkin lymphoma and myeloid leukemia.Finally, we think that it is important to determine by meta-analysis the incidence of each second cancer in survivor of NHL as for some malignancies screening test could be performed and early diagnosis could be made
Potentially avoidable hospitalisation in Bologna, 1997-2000: temporal trend and differences by income level
No full textThe disadvantaged groups of the population experience the highest risk of hospitalisation for ACSCs, with differences by gender and age groups. Although it is difficult to specifically identify the mechanisms potentially involved in the relationship between socioeconomic status and excess of hospitalisation, the admissions for ACSCs may represent an interesting indicator of quality ofprimary car
Cancer incidence in people with residential exposure to a municipal waste incinerator: an ecological study in Modena (Italy), 1991-2005
No full textWe conducted a retrospective ecological study to assess cancer incidence during the period 1991-2005 in proximity of a municipal waste incinerator (MWI) in Modena (Italy). We identified three bands of increasing distance from the MWI, up to a radius of 5 km and used the residence as surrogate marker of the exposure. Residential history for Modena's population was reconstructed and residents were associated to the most appropriate census unit. Age-standardized incidence ratios (ASR) and standardized incidence ratios (SIR) were estimated for all cancers and selected sites. Variations in cancer incidence were investigated using space and space-time scan statistic. Deprivation index was taken into account as potential confounding factor. During the 15-year study period, 16,443 new cases of cancer were diagnosed among residents in Modena. The space-time clustering test identified three significant clusters but their shapes were not associable to the MWI exposition. The purely spatial analysis not showed statistically significant clusters. The SIR computed for all cancers and selected sites did not show any excess of risk in the area closest to the plant. Higher SIR for leukaemia was found in the second band from MWI (2-3.5 km) for females (SIR, age and DI adjusted: 1.35, 95%CI: 1.01-1.79) and for both sexes (SIR, age and DI adjusted: 1.28, 95%CI: 1.03-1.57), but not a spatial trend was observed, thus excluding a possible link with MWI. In conclusion, bearing in mind the intrinsic limits of the study, the results suggest that there is no detectable increase of cancer risk for people living in proximity to the Modena MWI
I tumori in provincia di Modena anni 1988-2006
No full textMonografia sui dati di incidenza e sopravvivenza delle neoplasie nella provincia di Moden
Going Beyond Counting First Authors in Author Co-citation Analysis
Full text linkThe present study examines one of the fundamental aspects of author co-citation analysis (ACA) - the way co-citation
counts are defined. Co-citation counting provides the data on which all subsequent statistical analyses and mappings
are based, and we compare ACA results based on two different types of co-citation counting - the traditional type that
only counts the first one among a cited work's authors on the one hand and a non-traditional type that takes into
account the first 5 authors of a cited work on the other hand. Results indicate that the picture produced through this non-traditional author co-citation counting contains more coherent author groups and is therefore considerably clearer. However, this picture represents fewer specialties in the research field being studied than that produced through the traditional first-author co-citation counting when the same number of top-ranked authors is selected and analyzed. Reasons for these effects are discussed
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