Risk factors for the development of second primary tumors among men after laryngeal and hypopharyngeal carcinoma.

Background: Second primary tumors (SPT) constitute a major threat to the survival of patients with laryngeal carcinoma. However, to the authors' knowledge little is known regarding the risk factors for developing SPTs or about the strategy to be followed to avoid them.

Methods: Eight hundred seventy-six male patients with laryngeal/hypopharyngeal carcinoma enrolled in a population-based, case-control study in 5 centers from South Europe during 1979-1982 were followed up to ascertain the occurrence of SPTs.

Guidelines for preoperative assessment: impact on clinical practice and costs.

Objective: To describe preoperative evaluation in the San Giovanni Battista Hospital in Turin and to forecast the economic impact when preoperative assessment guidelines are implemented.

Design: We enrolled, in a month, 702 consecutive patients, excluding cardiac, thoracic, neuro- and vascular surgery, as well as emergency operations. Preoperative assessment data were collected individually, followed by simulating various applications of guidelines based on: (i) preoperative tests relying on full medical history and physical examination to discriminate preoperative risk patients; (ii) organization of a preoperative evaluation unit and tests before patient hospitalization.

European multi-centre case-control study on risk factors for rare cancers of unknown aetiology.

To search for occupational risk factors, we conducted a case-control study in nine European countries of cancers of the small intestine, male gall bladder, thymus, bone, male breast, melanoma of the eye, and mycosis fungoides. Recruitment was population based in Denmark, Latvia, France, Germany, Italy, and Sweden, from hospital areas in Spain and Portugal, and from one United Kingdom (UK) hospital. We recruited 1457 cases (84% interviewed).

Renal damage in patients with Type 2 diabetes: a strong predictor of mortality.

Aims: (i) To compare mortality rates in a cohort of Type 2 diabetic patients with those of the general population; (ii) to assess the prognostic role of pre-existing chronic conditions; (iii) to evaluate the impact of different severity of renal damage on mortality.

Methods: All 3892 patients with Type 2 diabetes attending our Diabetic Clinic during 1995 and alive on 1 January 1996 were identified and followed for 4.5 years.

Fibrinogen and AER are major independent predictors of 11-year cardiovascular mortality in type 2 diabetes: the Casale Monferrato Study.

Aims/hypothesis: Fibrinogen and elevated AER increase cardiovascular mortality, but few data are available in the type 2 diabetic population. We have conducted an 11-year follow-up study of the Casale Monferrato cohort to assess: (1) the long-term predictive role of AER independently of conventional risk factors; (2) the shape of its relationship with cardiovascular mortality; and (3) whether fibrinogen has a predictive effect independent of the increased cardiovascular risk associated with nephropathy.

Methods: During the follow-up period (1991-2001) a population-based cohort of 1,565 patients was regularly examined, and measurements of HbA1c were centralised.

Residual beta-cell function and male/female ratio are higher in incident young adults than in children: the registry of type 1 diabetes of the province of Turin, Italy, 1984-2000.

Objective: The hypothesis of age-dependent variations in epidemiologic and clinical features at onset of type 1 diabetes has been assessed in the registry of the province of Turin, Italy.

Research Design And Methods: The study base is the population 0-29 years of age of the province of Turin, in the period from 1984 to 2000. Islet cell antibody (ICA), GAD antibody (GADA), antibodies to protein tyrosine phosphatase (IA2), and C-peptide were measured in subgroups of the cohort.

Prevalence of human papillomavirus infection in women in Turin, Italy.

Human papillomavirus (HPV) is recognised as necessary for the development of cervical cancer. An age-stratified random sample of 1013 women, aged 25-70 years, participating in the organised cervical screening programme in Turin, Italy was tested for 36 HPV types using polymerase chain reaction (PCR) with the general primers GP5+/GP6+. The overall HPV prevalence was 8.

Effect of different approaches to treatment of smoking as a potential confounder in a case-control study on occupational exposures.

Aim: To evaluate the effect of different approaches to treatment of smoking as a potential confounder in an occupational study of lung cancer.

Methods: Data were used from a case-control study on 956 men with lung cancer and 1253 population controls recruited in two northern Italian areas during 1990-1992. The risk of lung cancer associated with 11 selected job titles and eight selected industrial activities was estimated using seven different methods to treat smoking history.

Patients with type 2 diabetes had higher rates of hospitalization than the general population.

Objective: We describe the rate, causes, and predictors of hospitalization for all patients with type 2 diabetes in a diabetes clinic in Turin, Italy and compare their hospitalization rates with those of the general population.

Study Design And Setting: All patients were recruited and followed up for hospital admissions from January 1996 to June 2000. The role of risk factors was analyzed with a conditional proportional hazard model for repeated events.

[Life expectancy as an indicator of outcome].

Usually survival studies evaluate the percentage of subjects alive or disease-free at a given point in time (cumulative survival percentage). These studies require a lengthy period both for follow up and for the collection of an exhaustive number of cases. In addition, for cancer types with a sharp gradient of cumulative mortality, the estimate may be unstable.

Metabolic syndrome as a predictor of all-cause and cardiovascular mortality in type 2 diabetes: the Casale Monferrato Study.

Objective: The aim of this study was to assess in an 11-year survival follow-up of a population-based cohort of type 2 diabetes the predictive role of World Health Organization-defined metabolic syndrome, independent of conventional cardiovascular risk factors.

Research Design And Methods: During the follow-up (1991-2001), 1,565 patients were regularly examined with centralized measurements of HbA(1c). The independent role of the metabolic syndrome as a predictor of all-cause and cardiovascular mortality was assessed with multivariate Cox proportional hazards modeling.

Time trends of childhood cancer mortality rates: a report from the Childhood Cancer Registry of Piedmont, Italy, 1971-1998.

Time changes in mortality rates can be used to suggest future trends in the prognosis of childhood cancer. Estimates provided from recent studies led to divergent previsions of future trends. In this study we used data from the population-based Childhood Cancer Registry of Piedmont (CCRP) in order to measure the decrease in mortality.

Meta-analysis of non-sentinel node metastases associated with micrometastatic sentinel nodes in breast cancer.

Background: The need for further axillary treatment in patients with breast cancer with low-volume sentinel node (SN) involvement (micrometastases or smaller) is controversial.

Methods: Twenty-five studies reporting on non-SN involvement associated with low-volume SN involvement were identified using Medline and a meta-analysis was performed.

Results: The weighted mean estimate for the incidence of non-SN metastases after low-volume SN involvement is around 20 per cent, whereas this incidence is around 9 per cent if the SN involvement is detected by immunohistochemistry (IHC) alone.

Early deaths from childhood cancer. A report from the Childhood Cancer Registry of Piedmont, Italy, 1967-1998.

Unlabelled: The population-based Childhood Cancer Registry of Piedmont (CCRP) has collected data on incidence since 1967. The occurrence of early death (i.e.

Isolated systolic hypertension in a cohort of type 2 diabetic patients.

Background And Aims: Previous studies of the adverse effects of isolated and borderline isolated systolic hypertension excluded or under-represented type 2 diabetic patients. The aim of this study was to evaluate the prevalence and role of isolated and borderline isolated systolic hypertension in a cohort of 3892 type 2 diabetic patients.

Methods And Results: The hypertensive patients were classified as treated (n= 1806; 46.

The cumulative risk of lung cancer among current, ex- and never-smokers in European men.

Recent analyses based on UK data indicate that people who stop smoking, even well into middle age, avoid most of their subsequent risk of lung cancer. We investigated whether similar absolute risks of lung cancer in men are found in other European countries with different smoking patterns and at different stages of their lung cancer epidemic. Using data for men from a multicentre case-control study of lung cancer in the UK, Germany, Italy and Sweden, and including 6523 lung cancer cases and 9468 controls, we combined odds ratio estimates with estimates of national lung cancer incidence rates to calculate the cumulative risk of lung cancer among men by age 75.

Alcohol drinking may increase risk of breast cancer in men: a European population-based case-control study.

Objective: It has been estimated that alcohol drinking increases the risk of breast cancer in women by approximately 7% for each increment of 10 g alcohol per day. However, the few studies conducted on breast cancer among men have failed to detect an association with quantitative measures of alcohol drinking, even if the alcohol intake is generally higher in men than in women. On the other hand, increased risks of male breast cancer were inconsistently reported in alcoholics or patients with liver cirrhosis.

Mortality among workers employed in the titanium dioxide production industry in Europe.

Objectives: To assess the risk of lung cancer mortality related to occupational exposure to titanium dioxide (TiO2).

Methods: A mortality follow-up study of 15,017 workers (14,331 men) employed in 11 factories producing TiO2 in Europe. Exposure to TiO2 dust was reconstructed for each occupational title; exposure estimates were linked with the occupational history.

EPO or not-EPO? An evidence based informed consent.

Background: Informed consent is crucial in therapeutic choices; however, the forms presented to patients are often locally developed and information may not be homogeneous.

Objective: To prepare an evidence-based model for informed consent, applied in the case of erythropoietin therapy (EPO) as a teaching tool for medical students.

Methods: Methodological tools of Evidence-Based Medicine (EBM) were developed within the EBM Course in the Medical School of Torino, Italy, as problem solving and patient information tools (5th year students work in small groups under the supervision of statisticians, epidemiologists and experts of internal medicine--nephrology in this case).

[Hospital mortality at a cardiosurgical unit in Torino: international comparisons and time trend].

Objective: To compare hospital mortality in a cardiac surgery unit with external data and to assess changes in time (patients undergoing surgery in two different periods).

Materials And Methods: Data on risk factors for hospital mortality were collected from clinical records (retrospectively for the first period and prospectively for the second) for all patients undergoing open heart surgery at the Heart Surgery Unit of the University of Turin (Italy) during 1991 and 1995 (n = 1794) and 1999 (n = 892). Comparisons of in-hospital mortality, expressed as Standardized Mortality Ratios (SMR), were adjusted for risk factors defined according to EuroSCORE (European System for Cardiac Operative Risk Evaluation).

Occupational risk factors for mycosis fungoides: a European multicenter case-control study.

Mycosis fungoides (MF) is a rare disease with an unknown etiology. Its distribution suggests that occupational exposures may play a role. In the present study, we searched for occupational factors associated with MF.

Occupational risk factors for lung cancer in men and women: a population-based case-control study in Italy.

Objective: We investigated the role of occupation in lung cancerogenesis in two Northern Italian areas.

Methods: During 1990-1992, occupational histories were obtained for 1171 incident lung cancer cases (956 men, 176 women) and 1553 population controls (1253 men, 300 women) and were evaluated for having been employed in jobs entailing exposure to known or suspected lung carcinogens. A further exploratory analysis on other job titles and branches of industry was conducted.

Secondhand smoke exposure in adulthood and risk of lung cancer among never smokers: a pooled analysis of two large studies.

The interpretation of the evidence linking exposure to secondhand smoke with lung cancer is constrained by the imprecision of risk estimates. The objective of the study was to obtain precise and valid estimates of the risk of lung cancer in never smokers following exposure to secondhand smoke, including adjustment for potential confounders and exposure misclassification. Pooled analysis of data from 2 previously reported large case-control studies was used.

Risk of oral squamous cell carcinoma in 402 patients with oral lichen planus: a follow-up study in an Italian population.

The most important complication of oral lichen planus (OLP) is the development of oral squamous cell carcinoma (OSCC) but this is a very controversial matter. The aim of the study was to estimate in a Northern Italian cohort of OLP patients the risk for OSCC. Four hundred and two patients with histologically confirmed OLP diagnosed from January 1988 to July 1999, were followed-up to the end of February 2001.

[Evaluation of quality of care through hospital discharge reports: an example of rectal cancer surgery].

This study was undertaken to evaluate the usefulness of hospital discharge data for monitoring the impact of a regional practice guideline on treatment of colorectal cancer. The aims of the study were: i) estimating process and outcome indicators; ii) exploring the relationship between patient and hospital characteristics and these indicators. Odds ratios (OR) and 95% confidence intervals (CI) were adjusted for all risk factors analysed.