Low-risk diet for breast cancer in Italy

To define a low-risk diet for breast cancer in Italy, a multicentric case-control study of 2569 incident cases of breast cancer and 2588 controls from Italy was analyzed. A logistic regression model was applied to the estimated intake of five macronutrients and used to compute a diet-related risk score (RS). The pattern of macronutrient and food group intake across RS deciles was defined. The mean of diet-related RSs across subsequent risk deciles ranged from 0.83 to 1.44. Total energy intake first decreased slightly, from the first to the second decile, and then increased, mostly in the last three risk deciles. Intake of starch increased in absolute and relative terms, whereas saturated fat intake rose in absolute terms but remained stable as a proportion. A relative decline was observed for unsaturated fat and sugars, with a hint, however, of U-shape effect. From a food group viewpoint, there was a marked increase in the intake of bread and cereal dishes, cakes and desserts, and refined sugar across subsequent deciles, whereas the consumption of vegetables, olive and seed oils, and fruit decreased.     

Health in a population of eighteen-year-old males in Italy

A population of 18-year-old males were studied in order to investigate which biohumoral parameters were modified with respect to the so-called "reference values." To achieve our end, we analyzed the distribution curves of some biohumoral parameters, so selected to test various organs and apparatuses. Our results showed a clear incidence of hepatic affections and dislipidemias.     

Race-ethnicity and determinants of carotid atherosclerosis in a multiethnic population. The Northern Manhattan Stroke Study

BACKGROUND AND PURPOSE: Risk factors for carotid atherosclerosis have been studied in white populations but infrequently in multiethnic cohorts. The aim of this study was to determine the importance of race-ethnicity and other factors associated with carotid atherosclerosis in a mixed population of Hispanics, blacks, and whites. METHODS: As part of the Northern Manhattan Stroke Study, 526 stroke-free community residents (aged > or = 40 years; 41% men, 59% women; 46% Hispanic, 31% black, 23% white) were recruited through random-digit dialing and had vascular risk factor evaluations. Maximum internal carotid artery plaque thickness (MICPT) was measured with B-mode ultrasound. The frequency distribution of MICPT was examined in the three race-ethnic groups, and multivariate regression was performed to identify factors that were independently associated with MICPT. RESULTS: Mean MICPT in the entire sample was 1.5 +/- 1.4 mm, increased directly with age, and was greater in whites and blacks than Hispanics. Other independent determinants of MICPT included smoking, glucose, LDL cholesterol, and hypertension. After we controlled for these covariates, Hispanic (versus non-Hispanic) race-ethnicity was still an independent determinant of less carotid plaque. There was a significant interaction between race-ethnicity and LDL cholesterol, with a greater effect of increasing LDL cholesterol among Hispanics. CONCLUSIONS: Atherosclerotic risk factors were predictive of MICPT in this mixed-ethnic cohort. Hispanics had significantly less carotid plaque after adjustment for other known risk factors, but they also had a greater impact of increasing LDL cholesterol.     

High prevalence of overweight in a children population living in Naples (Italy)

Spontaneous coronary artery rupture resulted in cardiac tamponade in a man with Ehlers-Danlos syndrome (type IV) presenting with acute onset of cardiac chest pain. Electrocardiograms suggested acute myocardial infarction. The haemopericardium was drained and angiography showed a ruptured distal branch of the left circumflex coronary artery. The patient remains well.     

Estimation of reference intervals from a SENIEUR protocol compatible aged population for immunogerontological studies

Because many laboratory values change with age, the study of healthy aging as well as diagnosis of disease in geriatric patients requires specific age-corrected reference intervals. We have established such reference intervals for a healthy population aged 65-74 years by selection of a sample group applying the clinical criteria of the SENIEUR protocol and we have compared them with those of a young control group (20-33 years) fulfilling the same criteria. Significant or minor elevations were seen, e.g. for plasma concentrations of fasting glucose, urea, total and LDL-cholesterol, triglycerides, gamma-glutamyl-transferase, alkaline phosphatase, erythrocyte sedimentation rate and serum neopterin levels. These reference intervals can be used for selecting a SENIEUR compatible population aged between 65 and 74 years. Additionally, plasma lipid parameters (cholesterol, triglycerides) are proposed to be included in the SENIEUR protocol.     

Bayesian optimal design in population models for haematologic data

We introduce a population model to design optimal apheresis schedules to collect blood stem cells from cancer patients. Blood stem cells are collected prior to the patient undergoing high-dose chemoradiotherapy and are returned after this treatment to enable reconstitution of the white blood cell components. Maximizing the number of cells collected in as few apheresis as possible is desirable. We use a longitudinal data model with random effects to describe profiles of individual patients. A hierarchical prior model introduces common mean profiles for patients undergoing different treatments. We find the optimal apheresis schedule for a new patient by minimizing an expected loss over the posterior predictive distribution of the patient's predicted CD34 profile. We implement estimation of the model and solution of the optimal design problem by a simulation approach, which allows us to accommodate arbitrary shapes for the profiles and realistic loss functions that include relative penalties for the number of scheduled stem cell collections and for collecting fewer than a specified target quantity of total collected stem cells.     

Dietary profiles and anti-oxidants in a rural population of central Italy with a low frequency of cancer

Cell aging and the degree of cellular differentiation are thought to be important variables governing uptake of oligonucleotides but remain poorly understood. The Caco-2 colon carcinoma cell line has the ability to spontaneously differentiate into enterocytes in vitro and serves as a useful model to further investigate the effect of differentiation on oligonucleotide binding and uptake. In this study, we report that the extent of oligonucleotide association and the expression of cell surface binding proteins are governed by the age and thus the degree of differentiation of Caco-2 epithelial cells in culture. Cellular association (normalized for cell number) of an all phosphodiester (PO), all phosphorothioate (PS), and a phosphodiester oligonucleotide containing two terminal phosphorothioate internucleotide linkages at the 3' end (EC-PO) gradually increased from day 3 to around day 17 of the culture, followed by a plateau, or slight decrease, up to day 21 of the cell aging study. Overall, a threefold to fourfold increase in binding was observed from day 3 to day 17. Oligonucleotide binding was temperature and pH dependent, but the magnitude of the effect was influenced by cell aging and the degree of differentiation. PS oligonucleotides exhibited greater binding (up to threefold) at the basolateral surface compared with the apical surface within the pH range 5-7. These findings could be directly correlated with the expression levels of cell surface oligonucleotide binding proteins during the aging study. A Caco-2 cell surface protein binding complex of around 46 kDa was identified as the major site of binding for both PO and PS oligonucleotides, although the latter also bound to several other proteins, especially at low pH.     

Childhood poisoning: a population study in Trieste, Italy, 1975-1994

We describe the epidemiology of 1918 cases of childhood poisoning referred to the emergency room in Trieste, Italy, from 1975 to 1994. The incidence rate of emergency room referral and subsequent hospitalization was calculated on the basis of the distribution of children resident in Trieste by calendar year. The occurrence of childhood poisoning was described according to time trends, age and gender of the child, route of exposure, symptoms at presentation to the emergency room, role of the child or others, intention, and substance involved in the poisoning. The association between presence of symptoms and characteristics of referral, host factors and substances involved was evaluated by estimating the odds ratio in multivariate models. Possible determinants of the clinical decision to treat certain cases were evaluated using logistic regression. Despite an increasing incidence of referral (from 155 per 100,000 persons per year in 1975-79 to 352 per 100,000 in 1990-94), hospital admission rates showed a two-fold decrease. Younger children (age 0-4 years) were more likely to be asymptomatic and required treatment and hospitalization less often than older children (age > or = 10 years). Trends show a decrease in pharmaceutical poisonings due probably to the introduction of child-resistant containers and an increase in domestic poisons. We also observed a steady increase in carbon monoxide inhalation and alcohol poisonings, mostly among teenagers.     

Attributable risk for symptomatic liver cirrhosis in Italy. Collaborative Groups for the Study of Liver Diseases in Italy

BACKGROUNDS/AIMS: Knowledge of the proportion of liver cirrhosis attributable to the main risk factors is largely based on methodologically questionable clinical reports. METHODS: The proportion of newly diagnosed cases of symptomatic liver cirrhosis attributable to known risk factors was estimated by a case-control study performed during 1989-1996 in 23 medical divisions of several hospitals distributed throughout Italy. Cases were 462 inpatients with cirrhosis admitted for the first time for liver decompensation. Controls were 651 patients admitted during the same period and to the same hospitals as the cases, for acute diseases unrelated to alcohol and virus infection. The proportion of symptomatic liver cirrhosis cases due to alcohol intake and hepatitis B and C viruses and the combination of these was expressed as the population attributable risk. RESULTS: Attributable risks were 67.9% (95% confidence interval (CI): 53.8-79.4) for alcohol, 40.1% (95% CI: 35.3-45.2) for hepatitis C virus and 4.4% (95% CI: 2.5-7.6) for hepatitis B virus. The three factors together explained 98.1% (95% CI: 81.6-99.6) of cases in men and 67.0% (95% CI: 50.4-85.8) in women. CONCLUSIONS: Alcohol is the risk factor with the highest impact on symptomatic liver cirrhosis risk in Italy. From a public health viewpoint, with the elimination of the well-known risk factors (particularly alcohol and hepatitis C virus), liver cirrhosis should become a rare disease.     

Blood cadmium levels in a general male population with special reference to smoking

Blood-cadmium (Cd-B) level, blood pressure, and several biological parameters in blood were measured in 440 men who were not occupationally exposed to cadmium and who had a detailed smoking history. No significant correlation was found between Cd-B and blood pressure. Among biological parameters, those known to be related to smoking appeared significantly correlated with Cd-B. Analysis of smoking history showed that Cd-B is strongly elevated in current smokers, with a dose-effect relationship between daily consumption of tobacco and Cd-B; moreover, exsmokers had significantly higher Cd-B than nonsmokers. This finding shows that Cd-B partly reflects past exposure to cadmium.     

Serum dioxin levels in Seveso, Italy, population in 1976

On July 10, 1976, an explosion at a chemical plant near Seveso, Italy, released a mixture of chemicals, including 2,3,7,8-tetrachlorodibenzo-p-dioxin and 2,4,5-trichlorophenol. As a result, several thousand people in the Seveso area may have been exposed to those chemicals. At that time, human exposure assessment was based primarily on soil levels of 2,3,7,8-tetrachlorodibenzo-p-dioxin. Medical examinations of this potentially exposed population and control subjects were begun in 1976 and in some cases continued until 1985. In 1988, we began assessing human exposure in this population by measuring 2,3,7,8-tetrachlorodibenzo-p-dioxin in small volumes of serum specimens remaining from the medical examinations. As expected, we found that the median serum dioxin levels were highest among people who lived closest to the explosion and were progressively lower among groups living farther away. These measurements have allowed us to assess exposure more accurately among individuals in this population and to relate exposure to various health effects. We found that some individuals in the exposed population had among the highest serum dioxin levels ever reported, yet chloracne was the only unequivocal effect found; cancer risks are still being investigated. We also found that other individuals with as high or higher serum dioxin levels did not develop chloracne. We also found that the serum half-life of dioxin in this population was 7-8 years, which agrees with other findings although we do report some differences in the serum half-life of TCDD for women and children. We also observed an increase in the percentage of female newborns to parents who resided in Zone A at the time of the explosion, and we also report on the 1976 serum dioxin levels in people who later developed cancer.     

Land Subsidence Spreading Factor of the Northern Adriatic Gas Fields, Italy

The land subsidence spreading factor χ provides a useful straightforward indication on how much of a gas/oil reservoir compaction induced by field development migrates to ground surface with a possible adverse impact on the stability of low‐lying coastal areas. This factor depends primarily on the ratio between the depth of burial and a representative horizontal dimension of the reservoir. However, an important influence is also exerted by the active bottom/lateral aquifer hydraulically connected to the field (called “waterdrive” in reservoir engineering) that may undergo an extensive depressurization also after the field abandonment, thus contributing to enhance the overall land settlement. In the Northern Adriatic basin, Italy, χ is evaluated using a nonlinear finite element model of three representative gas reservoirs (Chioggia Mare, Dorotea, and Dosso degli Angeli) surrounded by important bottom/lateral aquifers in the interval depth between 1000 and 3300 m. Results show that χ may easily approach and even exceed one for the deepest field as well, contrary to the prediction of land subsidence based on the compaction of the gas‐bearing formations alone, that can thus be largely underestimated.     

Prevalence of gastrointestinal symptoms in a multiracial Asian population, with particular reference to reflux-type symptoms

OBJECTIVE: Data on the epidemiology of chronic gastrointestinal symptoms in the East are limited. The aims of this study were to estimate the prevalence of chronic gastrointestinal symptoms in Singapore and to determine whether ethnic differences in the prevalence of these symptoms exist. METHODS: A cross-sectional survey, using a reliable and valid questionnaire, was carried out in a race-stratified random sample of residents aged 21-95 yr (mean+/-SD, 40+/-1 yr) in a Singaporean town; 93% responded (n=696). RESULTS: The ethnic-adjusted prevalence of chronic abdominal pain, frequent dyspepsia, irritable bowel syndrome, chronic constipation, chronic diarrhea, and frequent reflux were 5.7% (95% confidence interval [CI], 3.3-8.1), 7.9% (95% CI, 5.0-10.8), 2.3% (95% CI, 0.8-3.9), 3.9% (95% CI, 1.9-5.9), 4.5% (95% CI, 2.3-6.7), and 1.6% (95% CI, 0.6-2.6), respectively. There were no ethnic differences in the prevalence of any of these symptom categories except for reflux-type symptoms, which were more common among Indians (7.5%; 95% CI, 4.4-11.7) than Chinese (0.8%; 95% CI, 0.1-3.0) or Malays (3.0%; 95% CI, 1.26.1). CONCLUSION: The prevalence of all types of chronic gastrointestinal symptoms in the general population of Singapore was low compared with those in the West. Chronic gastrointestinal symptoms were equally prevalent in the three major ethnic groups except for reflux-type symptoms, which were more common among Indians than Chinese or Malays.     

An HPLC-GC/MS reference method for serum total cholesterol with control for ester hydrolysis

Currently used isotope-dilution mass spectrometry methods for serum total cholesterol are performed without control in each sample for completeness of hydrolysis of cholesterol esters. In order to monitor this step in the analysis, we developed a method based on both high-pressure liquid chromatography (HPLC) and gas chromatography/mass spectrometry (GC/MS). 13C3-cholesterol and cholesteryl [1-14C] oleate were added to serum that was saponified and extracted into hexane. The extract was subjected to HPLC with collection of the fractions corresponding to cholesterol and cholesteryl oleate. The radio-activity of the latter was counted in order to estimate the nonhydrolysed fraction that on average amounted to less than 0.1% for commonly used ester hydrolysis procedures. The cholesterol fraction was subjected to GC/MS for quantitation using the traditional isotope-dilution principle. Evaluation of accuracy by assaying sera from the National Institute of Standards and Technology showed a deviation from the target value of < 1% with a coefficient of variation of < or = 1.0%. In conclusion, the present reference method for serum total cholesterol assures results based on complete hydrolysis of the cholesterol ester fraction.     

Casing Influence in Reservoir Compaction Measurement by Radioactive Markers in the Northern Adriatic, Italy

The reliability of in situ compaction measurements made in producing gas/oil reservoirs with the aid of the radioactive marker technique (RMT) is a very important issue as an essential parameter controlling the geomechanical response of fluid extraction from the subsurface, i.e., the rock vertical compressibility cM, is obtained from RMT data. The validity of cM as provided by RMT has recently been questioned on the basis of the possible disturbance that a fully cased hole can induce on the actual reservoir compaction. By the use of a numerical approach and real casing information, the present paper addresses and discusses the reliability of RMT measurements performed in hole casings of the Northern Adriatic gas fields, Italy. The results show that the casing stiffness affects the RMT measurements only marginally, and especially so at a larger depth (i.e., 3,000?m), and does not significantly impact on the estimate of cM derived from RMT data.     

The Chinese total diet study in 1990. Part II. Nutrients

This paper reports the intakes of 72 nutrients and their dietary sources obtained from the Chinese total diet study in 1990. Most of the nutrient intakes are close or equal to their corresponding recommended daily allowances (RDAs). Both the total energy intake (2203 kcal) and the proportions contributed by protein, fat, and carbohydrate meet the current Chinese RDAs and the World Health Organization (WHO) nutrient goals. The average protein intake was 64 g/day. The intake of essential amino acids all exceeded the Chinese RDA, and their proportions were generally consistent with the WHO recommended pattern. The average fat intake was 51.2 g/day (21.2% of the total energy intake). However, the dietary fat intake has been increasing significantly in the Chinese diet and the proportion of animal fat has reached 53% of the total fat intake. The total saturated:total monounsaturated: total polyunsaturated fatty acid ratio was 1.0:1.5:1.0. Although the average cholesterol intake was only 179 mg/day, it was 248 mg/day in the South 1 region. The intakes of thiamine and riboflavin were below the RDA. Retinol intakes in all the 4 regions were low. Most (80%) of the retinol (equivalent) intakes were from carotenoids. The average intake of total tocopherol was 89% of the RDA, and among the 4 regions, only the South 2 region has relatively low intake. The intakes of iron, copper, manganese, sodium, and phosphorus were adequate. The intakes of calcium, zinc, and potassium were insufficient, and intakes of selenium and magnesium were a little low. High sodium and low potassium intake is a traditional problem in the Chinese diet.