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BACKGROUND: The number and projections of cancer survivors are necessary to meet the healthcare needs of patients, while data on cure prevalence, that is, the percentage of patients who will not die of cancer by time since diagnosis, are lacking. MATERIALS AND METHODS: Data from Italian cancer registries (duration of registration ranged from 9 to 40 years, with a median of 22 years) covering 47% of the population were used to calculate the limited-duration prevalence, the complete prevalence in 2018, projections to 2030, and cure prevalence, by cancer type, sex, age, and time since diagnosis. RESULTS: A total of 3 347 809 people were alive in Italy in 2018 after a cancer diagnosis, corresponding to 5.6% of the resident population. They will increase by 1.5% per year to 4 012 376 in 2030, corresponding to 6.9% of the resident population, 7.6% of women and â¼22% after age 75 years. In 2030, more than one-half of all prevalent cases (2 million) will have been diagnosed by ≥10 years. Those with breast (1.05 million), prostate (0.56 million), or colorectal cancers (0.47 million) will be 52% of all prevalent patients. Cure prevalence was 86% for all patients alive in 2018 (87% for patients with breast cancer and 99% for patients with thyroid or testicular cancer), increasing with time since diagnosis to 93% for patients alive after 5 years and 96% after 10 years. Among patients who survived at least 5 years, the excess risk of death (1 - cure prevalence) was <5% for patients with most cancer types except for those with cancers of the breast (8.3%), lung (11.1%), kidney (13.2%), and bladder (15.5%). CONCLUSIONS: Study findings encourage the implementation of evidence-based policies aimed at improving long-term clinical follow-up and rehabilitation of people living after cancer diagnosis throughout the course of the disease. Updated estimates of complete prevalence are important to enhance data-driven cancer control planning.
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Neoplasias , Humanos , Italia/epidemiología , Femenino , Masculino , Prevalencia , Neoplasias/epidemiología , Neoplasias/terapia , Anciano , Persona de Mediana Edad , Adulto , Adolescente , Adulto Joven , Niño , Anciano de 80 o más Años , Sistema de Registros , Supervivientes de Cáncer/estadística & datos numéricos , Preescolar , Lactante , Predicción , Recién NacidoAsunto(s)
Amianto , Neoplasias Pulmonares , Mesotelioma , Humanos , Italia , Textiles , Proteínas Supresoras de Tumor , Ubiquitina TiolesterasaRESUMEN
In recent decades, the possibility that use of mobile communicating devices, particularly wireless (mobile and cordless) phones, may increase brain tumour risk, has been a concern, particularly given the considerable increase in their use by young people. MOBI-Kids, a 14-country (Australia, Austria, Canada, France, Germany, Greece, India, Israel, Italy, Japan, Korea, the Netherlands, New Zealand, Spain) case-control study, was conducted to evaluate whether wireless phone use (and particularly resulting exposure to radiofrequency (RF) and extremely low frequency (ELF) electromagnetic fields (EMF)) increases risk of brain tumours in young people. Between 2010 and 2015, the study recruited 899 people with brain tumours aged 10 to 24 years old and 1,910 controls (operated for appendicitis) matched to the cases on date of diagnosis, study region and age. Participation rates were 72% for cases and 54% for controls. The mean ages of cases and controls were 16.5 and 16.6 years, respectively; 57% were males. The vast majority of study participants were wireless phones users, even in the youngest age group, and the study included substantial numbers of long-term (over 10 years) users: 22% overall, 51% in the 20-24-year-olds. Most tumours were of the neuroepithelial type (NBT; n = 671), mainly glioma. The odds ratios (OR) of NBT appeared to decrease with increasing time since start of use of wireless phones, cumulative number of calls and cumulative call time, particularly in the 15-19 years old age group. A decreasing trend in ORs was also observed with increasing estimated cumulative RF specific energy and ELF induced current density at the location of the tumour. Further analyses suggest that the large number of ORs below 1 in this study is unlikely to represent an unknown causal preventive effect of mobile phone exposure: they can be at least partially explained by differential recall by proxies and prodromal symptoms affecting phone use before diagnosis of the cases. We cannot rule out, however, residual confounding from sources we did not measure. Overall, our study provides no evidence of a causal association between wireless phone use and brain tumours in young people. However, the sources of bias summarised above prevent us from ruling out a small increased risk.
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Neoplasias Encefálicas , Teléfono Celular , Glioma , Adolescente , Adulto , Neoplasias Encefálicas/epidemiología , Neoplasias Encefálicas/etiología , Estudios de Casos y Controles , Niño , Campos Electromagnéticos/efectos adversos , Glioma/etiología , Humanos , Masculino , Ondas de Radio/efectos adversos , Adulto JovenRESUMEN
Nowadays the study of the potential applications of multifunctional materials for environmental remediation is one of the main goals of the materials engineering. Multifunctional porous materials, MPMs, incorporate, all in once, different and multiple functionalities that make them suitable for several uses and can satisfy many purposes at the same time. Multifunctional diatomite-based foams with a hierarchical porosity, already produced and characterized to be applied in building as well as aerospace sectors, are proposed as adsorbents for inorganic and organic pollutants removal from wastewaters. Then, the effect of the addition of different carbonaceous nanofillers (graphite, graphene and graphene oxide) on the water purification efficiency of the adsorbent was evaluated. Firstly, pristine MPM showed the best performance in adsorbing Indigo Carmine due to its intrinsic chemism and hierarchical porosity (at macro-, micro- and nano-level), but it is not the best with respect to the Cd2+ adsorption, if compared with the nanocomposites. Among the nanocomposite products, both graphene- and graphene oxide-MPM samples showed a significantly improved adsorption capacity towards Cd2+. This behavior is due to the synergistic effect of the finer morphology, higher available foam surface, and the highly exfoliated fillers, graphene and graphene oxide, which permit a better dispersion into the matrix.
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Grafito , Nanocompuestos , Contaminantes Químicos del Agua , Purificación del Agua , Adsorción , Tierra de Diatomeas , Contaminantes Químicos del Agua/análisisRESUMEN
Cutaneous myiasis in humans involving fly species endemic in Italy are uncommon and are not often present in the literature. In the present article we describe the case of cutaneous myiasis in a woman brought to the Emergency Department (ED) of the S. Croce e Carle General Hospital in Cuneo, northwest Italy. The patient was in precarious hygienic condition, and was suffering from localized ulcerated foot ulcers with significant inflammation extending up to the knee. Fly larvae, subsequently identified as Lucilia sericata (Meigen, 1826), were found in the lesions. The patient was admitted to the Department of Internal Medicine where she was treated with antibiotics and the lesions were medicated, resulting in full recovery.
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Dípteros , Úlcera de la Pierna/parasitología , Miasis/parasitología , Anciano , Animales , Antibacterianos/uso terapéutico , Dípteros/crecimiento & desarrollo , Abuso de Ancianos , Femenino , Humanos , Higiene , Italia , Desnutrición/complicaciones , Miasis/prevención & control , Miasis/terapia , Factores de Riesgo , Zapatos , Irrigación Terapéutica , Insuficiencia Venosa/complicacionesRESUMEN
BACKGROUND: Percutaneous vertebroplasty (PV) is largely employed in vertebral body compression fractures (VCF). PURPOSE: To evaluate the efficacy of PV on pain relief and functional status, and its complications rate. MATERIALS AND METHODS: A prospective observational study was conducted by the Division of Internal Medicine of St. Croce and Carle Hospital. INCLUSION CRITERIA: Diagnosis of osteoporosis, intense back pain, unresponsive to conservative treatment, associated with radiological evidence of recent VCF. Pain control and functional improvement were respectively assessed using Visual Analogue Scale (VAS) and Activity of Daily Living scale (ADL) on admission, 24 h after PV and at follow-up. PV complications were detected by an immediate computed tomography (CT) scan on the vertebra treated as well as the vertebrae above and below the treated level(s) and by CT chest scan to exclude pulmonary emboli. A magnetic resonance imaging (MRI) follow-up at 6 or 12 months was performed. RESULTS: Fifty-two (46 with primary osteoporosis) patients were enrolled (mean age 73.18 yr, range 44-92). Median follow-up was 20.4 months (range 6-24). Treated vertebrae were 124. VAS, mean value was 9.05 (range 6-10) before treatment, 5.95 (range 2-8) at 24 h after PV and 4.94 (range 2-9) at follow-up (p<0.001). Before PV, 18 patients (34.6%) were functionally impaired vs 8 patients (15.3%) at follow-up (p<0.003). Control MRI evidenced 9 (17.3%) new VCF adjacent and 13 (25%) non-adjacent to treated vertebras. There was one case of discitis. Seven cases (13%) of cement leakage in para-vertebral space were observed. CONCLUSION: PV is safe and effective in immediate pain reduction and functional improvement and at a median term follow-up.
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Fracturas por Compresión/cirugía , Osteoporosis/cirugía , Fracturas de la Columna Vertebral/cirugía , Vertebroplastia/métodos , Adulto , Anciano , Anciano de 80 o más Años , Dolor de Espalda/prevención & control , Distribución de Chi-Cuadrado , Humanos , Imagen por Resonancia Magnética , Persona de Mediana Edad , Estudios Prospectivos , Calidad de VidaRESUMEN
BACKGROUND: Particulate matter (PM) air pollution is a human lung carcinogen; however, the components responsible have not been identified. We assessed the associations between PM components and lung cancer incidence. METHODS: We used data from 14 cohort studies in eight European countries. We geocoded baseline addresses and assessed air pollution with land-use regression models for eight elements (Cu, Fe, K, Ni, S, Si, V and Zn) in size fractions of PM2.5 and PM10. We used Cox regression models with adjustment for potential confounders for cohort-specific analyses and random effect models for meta-analysis. RESULTS: The 245,782 cohort members contributed 3,229,220 person-years at risk. During follow-up (mean, 13.1 years), 1878 incident cases of lung cancer were diagnosed. In the meta-analyses, elevated hazard ratios (HRs) for lung cancer were associated with all elements except V; none was statistically significant. In analyses restricted to participants who did not change residence during follow-up, statistically significant associations were found for PM2.5 Cu (HR, 1.25; 95% CI, 1.01-1.53 per 5 ng/m(3)), PM10 Zn (1.28; 1.02-1.59 per 20 ng/m(3)), PM10 S (1.58; 1.03-2.44 per 200 ng/m(3)), PM10 Ni (1.59; 1.12-2.26 per 2 ng/m(3)) and PM10 K (1.17; 1.02-1.33 per 100 ng/m(3)). In two-pollutant models, associations between PM10 and PM2.5 and lung cancer were largely explained by PM2.5 S. CONCLUSIONS: This study indicates that the association between PM in air pollution and lung cancer can be attributed to various PM components and sources. PM containing S and Ni might be particularly important.
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Contaminantes Atmosféricos/análisis , Exposición a Riesgos Ambientales/análisis , Exposición por Inhalación/análisis , Neoplasias Pulmonares/epidemiología , Material Particulado/análisis , Adulto , Anciano , Estudios de Cohortes , Europa (Continente)/epidemiología , Femenino , Humanos , Incidencia , Neoplasias Pulmonares/etiología , Masculino , Persona de Mediana Edad , Tamaño de la Partícula , Modelos de Riesgos Proporcionales , Estudios Prospectivos , RiesgoRESUMEN
BACKGROUND: Asthma is a widespread chronic disorder in children and its prevalence has been on the increase in Europe. Only few studies have described the prevalence variation in respiratory symptoms in Italian regions. The aim of this study, conducted in Turin during the 1998/1999 school year, is to investigate the distribution of respiratory symptoms in a sample of Turin school children and to compare the obtained results with the findings of the SIDRIA study performed in 1994-95. METHODS: The sample in study is composed of all the children attending to three elementary schools in Turin. All of the selected schools had already participated in the 94-95 ISAAC-SIDRIA study. A total of 448 pupils aged 6-10 years received a standardised questionnaire to be filled by parents. RESULTS: Response rate is higher than 97% in all the studies. In 1999 we found that the prevalence of wheezing in the past 12 months was 7.3%. The 13.3% of children had asthma at least once in life and the 5.3% reported an attack in the last year. The comparison of our study results with the ISAAC-SIDRIA (1994-95) shows that the prevalence of asthma and asthma-like symptoms is rather stable among children, while the prevalence of bronchitis reveals a reduction of about 5.5%, but not statistically significant (p=0.094; 95%CI:-11.9;0.9). A considerable reduction in exposure to parents' passive smoke is shown: deltaP%=-4.7 (95%CI: -9.4;-0.1) for maternal smoking in pregnancy, deltaP%=-8.2 and -15.2, respectively for maternal and paternal smoking in the first two years of life. CONCLUSIONS: The results indicate a stable prevalence rate in asthma symptoms in children. A possible explanation of slight variation in asthma prevalence may be due to a reduced exposure to outdoor and indoor risk factors as reported in the questionnaires.
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Asma/epidemiología , Bronquitis/epidemiología , Niño , Exposición a Riesgos Ambientales/estadística & datos numéricos , Femenino , Humanos , Italia/epidemiología , Masculino , Embarazo , Complicaciones del Embarazo/epidemiología , Efectos Tardíos de la Exposición Prenatal , Prevalencia , Ruidos Respiratorios , Fumar/epidemiología , Contaminación por Humo de Tabaco/estadística & datos numéricosRESUMEN
INTRODUCTION: Interpretation of the tuberculin skin test (TST) may be complicated by prior bacille Calmette-Guérin (BCG) vaccination. The skin reaction to the vaccination interferes with the management of individuals who may be infected with Mycobacterium tuberculosis. OBJECTIVE: To discriminate between TST reactions due to infection and those due to vaccination in subjects with unknown BCG status. METHODS: Among 60200 subjects tested with 5TU PPD for screening purposes, 4987 contacts of infectious TB cases (Group A), 4962 BCG-vaccinated subjects (Group B) and 5000 subjects from the general population (Group C) were sampled. The frequencies of TST cut-off diameters were calculated for the three groups using a logistic regression model. The frequency of positive subjects in each group and the sensitivity, specificity and predictive values were also computed by means of these cut-offs. RESULTS: The risk of being a contact versus BCG-vaccinated increases 2.43-fold with every mm of TST diameter. The 11 mm cut-off point seems to be the best discriminating value. CONCLUSIONS: Using the traditional 10 mm cut-off, we can consider all vaccinated subjects with a positive TST to be infected. The TST remains a valuable tool for the evaluation of household contacts and suspected cases of tuberculosis in BCG-vaccinated subjects and in populations with high vaccination coverage.
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Vacuna BCG/administración & dosificación , Prueba de Tuberculina/métodos , Tuberculosis Pulmonar/diagnóstico , Tuberculosis Pulmonar/prevención & control , Adolescente , Adulto , Estudios Transversales , Reacciones Falso Negativas , Reacciones Falso Positivas , Femenino , Humanos , Masculino , Valor Predictivo de las Pruebas , Probabilidad , Estudios Retrospectivos , Medición de Riesgo , Sensibilidad y Especificidad , Tuberculosis Pulmonar/inmunología , Vacunación/métodosRESUMEN
Pasteurellosis is a zoonosis often caused by cat or dog bites or scratches, or by direct exposure to their secretions. Pasteurella multocida is the main pathogen involved in infections through domestic animal bites; generally a local infection characterized by its particular virulence with consequent rapid onset. Serious infection has also been reported in persons affected by comorbidity without domestic animal bite injuries. Here we report the case of a woman with lower limb exudating vesicular skin ulcers affected by liver cirrhosis, bilateral knee arthritis, septicemia with positive blood culture and synovial fluid culture for Pasteurella multocida. The etiology of Pasteurella multocida must be borne in mind in cases of sepsis in immunodeficient individuals, such as the cirrhotic patient, as well as exposure to domestic animals.
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Huésped Inmunocomprometido , Cirrosis Hepática/complicaciones , Infecciones por Pasteurella/complicaciones , Pasteurella multocida , Úlcera Cutánea/complicaciones , Anciano , Animales , Animales Domésticos/microbiología , Antibacterianos/uso terapéutico , Artritis Infecciosa/microbiología , Perros , Resultado Fatal , Femenino , Humanos , Cirrosis Hepática/microbiología , Extremidad Inferior , Infecciones Oportunistas/transmisión , Infecciones por Pasteurella/tratamiento farmacológico , Infecciones por Pasteurella/inmunología , Sepsis/etiología , Úlcera Cutánea/microbiología , Líquido Sinovial/microbiologíaRESUMEN
BACKGROUND: Epidemiological studies have documented large international variations in the prevalence of asthma, and 'westernization' seems to play an important role in the development of the disease. The aims of this study were to compare the prevalence of respiratory symptoms in migrant and nonmigrant children resident in Italy, and to examine the effect of length of time living in Italy. METHODS: Data were collected in a large cross-sectional study (SIDRIA-2) performed in 12 Italian centres, using standardized parental questionnaires. For the 29 305 subjects included in the analysis (6-7 and 13-14 years old), information about place of birth and parental nationality was available. RESULTS: There were 1012 children (3%) born outside of Italy, mainly in East Europe. Lifetime asthma and current wheeze were generally significantly less common among children born abroad than among children born in Italy (lifetime asthma: 5.4% and 9.7% respectively, P < 0.001; current wheeze: 5.2% and 6.9%, respectively, P = 0.04). Lower risks for lifetime asthma (prevalence odds ratio, POR = 0.39; 95% CI: 0.23-0.66) and current wheeze (POR = 0.72; 95% CI: 0.47-1.10) were found for children who had lived in Italy <5 years, while migrant children who had lived in Italy for 5 years or more had risks very similar to Italian children. CONCLUSIONS: Migrant children have a lower prevalence of asthma symptoms than children born in Italy. Prevalence increased with the number of years of living in Italy, suggesting that exposure to environmental factors may play an important role in the development of asthma in childhood.
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Asma/epidemiología , Emigración e Inmigración , Ruidos Respiratorios , Adolescente , Niño , Estudios Transversales , Humanos , Italia/epidemiología , Prevalencia , Factores de Riesgo , Encuestas y Cuestionarios , Factores de TiempoRESUMEN
BACKGROUND: Several studies have provided evidence of a strong association between asthma and allergic or nonallergic rhinitis, leading to the hypothesis that allergic rhinitis (AR) and asthma represent a continuum of the same disease. THE AIMS OF OUR STUDY WERE: (i) to measure the comorbidity of AR and asthma and asthma-like symptoms and (ii) to assess whether asthma, AR, and their coexistence share a common pattern of individual risk factors. METHODS: The subjects are participants from the Italian multicentre, cross-sectional survey on respiratory symptoms in the young adult general population (Italian Study of Asthma in Young Adults, ISAYA). The relationship between individual risk factors and asthma, AR and their coexistence, was studied by means of a multinomial logistic regression. RESULTS: About 60% of asthmatics reported AR. On the other hand, subjects with AR presented an eightfold risk of having asthma compared to subjects without AR. Age was negatively associated with asthma [OR = 0.89, 95% confidence interval (CI): 0.82-0.96], AR (OR = 0.92, 95% CI: 0.86-0.98), and asthma associated with AR (OR = 0.83, 95% CI: 0.79-0.88). The risk of AR without asthma was significantly higher in the upper social classes (OR = 1.23, 95% CI: 1.08-1.39). Active current smoking exposure was positively associated with asthma alone (OR = 1.24, 95% CI: 1.09-1.41) and negatively associated with AR with (OR = 0.69, 95% CI: 0.54-0.88) or without (OR = 0.76, 95% CI: 0.69-0.84) asthma. CONCLUSIONS: Asthma and AR coexist in a substantial percentage of patients; bronchial asthma and AR, when associated, seem to share the same risk factors as AR alone while asthma without AR seems to be a different condition, at least with respect to some relevant risk factors.
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Asma/epidemiología , Rinitis Alérgica Perenne/epidemiología , Rinitis Alérgica Estacional/epidemiología , Adulto , Factores de Edad , Comorbilidad , Estudios Transversales , Femenino , Humanos , Italia/epidemiología , Modelos Logísticos , Masculino , Oportunidad Relativa , Factores de Riesgo , Fumar , Clase SocialRESUMEN
BACKGROUND: Variations in the prevalence of respiratory symptoms according to geo-climatic factors could provide important clues to the knowledge of the aetiology of asthma. METHODS: Geo-climatic variations in the prevalence of current asthma, allergic rhinitis and chronic cough, and phlegm were assessed on a random sample of 18 873 subjects (response rate = 72.7%) from different climatic regions of Italy. An ecological analysis, supported by robust statistical methods, was employed to investigate potential trends. RESULTS: The prevalence of all symptoms was significantly heterogeneous throughout the peninsula. Only asthma-like symptoms showed a north-south trend: the prevalence increased at a decreasing latitude [odds ratio (OR) varies from 0.92 to 0.96, P < 0.05], at a decreasing distance from the sea (OR: 0.90-0.93 for 30 km distance, P < 0.05), at higher annual mean temperatures (OR: 1.11-1.14, P < 0.05) and at smaller annual temperature ranges (OR: 0.94-0.95, P < 0.05). Of the geo-climatic variables considered, temperature range had the greatest influence on most asthma-like symptoms. No association was found between geo-climatic variables and allergic rhinitis or chronic cough and phlegm. CONCLUSIONS: Asthma prevalence seems to be significantly affected by climate as asthma-like symptoms were more common in central-southern Italy, with a Mediterranean climate, than in areas with a continental climate (northern Italy).