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Battisti F, Petronio MG, Bernardeschi P, Bianchi F, Cori L, Crocetti E, Minichilli F, Manneschi G, Mugnaini E, Scala D, Vigotti M, Miligi L. [Reporting a cluster of lymphohaematopoietic cancers and management of the communication process with the community: the experience of a Local health Authority in Tuscany, Italy]. Ig Sanita Pubbl 2019; 75:98-104. [PMID: 31377755] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/10/2023]
Abstract
In 2008, some general practitioners (GPs) in the area of Empoli (Tuscany Region, Central Italy), reported to the Local Health Authority (LHA), an unusually high frequency of leukemia deaths among their patients residing in a one of the municipalities of the area. The LHA decided to carry out an epidemiological investigation. An interdepartmental working group was set up, led by the Department of Prevention of the LHA, and made up of representatives of the Institute for Study, Prevention and Cancer Network (ISPRO, Florence), the G. Monasterio Foundation/ Institute of Clinical Physiology of the National Council for Research (CNR) of Pisa, the University of Pisa, the Regional Environmental Protection Agency and community members. Several epidemiological analyses were carried out (namely incidence and mortality analysis, assessment of the residential history of all cases and micro-geographical incidence evaluation, assessment and quantification of local environmental pressures, evaluation of congenital abnormalities). The investigation took over two years to be completed. The work agenda was shared with community members, who contributed to decision-making, study design and the communication plan. Thanks to the interaction with community members, researchers had the chance to become aware of their information needs and of local knowledge concerning the research issues. The final report was published online and presented to citizens in several public meetings. Direct involvement of the local community during project development was found to be useful to reduce the perceived distance between public authorities and the local population, as highlighted in the guidelines on cancer cluster investigations.
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Affiliation(s)
- Francesca Battisti
- SS Epidemiologia dell'Ambiente e del Lavoro, Istituto per lo Studio, la Prevenzione e la Rete Oncologica, Firenze, Italia
| | - Maria Grazia Petronio
- GL Ambiente e Salute, Dipartimento di Prevenzione Azienda Usl Toscana Centro, Italia
| | - Paolo Bernardeschi
- UOS Ematologia, Ospedale San Giuseppe, Empoli - Azienda Usl Toscana Centro, Italia
| | - Fabrizio Bianchi
- Unità di ricerca in Epidemiologia ambientale e registri di patologia, Istituto di Fisiologia Clinica -Consiglio Nazionale delle Ricerche, Pisa, Italia
| | - Liliana Cori
- Unità di ricerca in Epidemiologia ambientale e registri di patologia, Istituto di Fisiologia Clinica -Consiglio Nazionale delle Ricerche, Pisa, Italia
| | - Emanuele Crocetti
- Registro Tumori Romagna, Istituto Scientifico Romagnolo per lo Studio e la Cura dei Tumori IRCCS (IRST), Meldola, (FC), Italia
| | - Fabrizio Minichilli
- Unità di ricerca in Epidemiologia ambientale e registri di patologia, Istituto di Fisiologia Clinica -Consiglio Nazionale delle Ricerche, Pisa, Italia
| | - Gianfranco Manneschi
- Registro Tumori Toscano, Unità di Epidemiologia Clinica e Descrittiva, Istituto per lo studio, la Prevenzione e la Rete Oncologica, Firenze, Italia
| | - Elisabetta Mugnaini
- UOS Ematologia, Ospedale San Giuseppe, Empoli - Azienda Usl Toscana Centro, Italia
| | - Danila Scala
- Settore Valutazione di Impatto Ambientale/Valutazione Ambientale Strategica, Agenzia regionale per la protezione ambientale della Toscana, Italia
| | | | - Lucia Miligi
- SS Epidemiologia dell'Ambiente e del Lavoro, Istituto per lo Studio, la Prevenzione e la Rete Oncologica, Firenze, Italia
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Gianicolo EAL, Mangia C, Cervino M, Bruni A, Portaluri M, Comba P, Pirastu R, Biggeri A, Vigotti M, Blettner M. Long-term effect of arsenic exposure: Results from an occupational cohort study. Am J Ind Med 2019; 62:145-155. [PMID: 30609098 DOI: 10.1002/ajim.22939] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/10/2018] [Indexed: 01/01/2023]
Abstract
BACKGROUND In 1976 in Manfredonia (Italy), arsenic was released into the atmosphere due to an accident in a petrochemical plant. We aimed to analyze the mortality of workers involved in the factory for the site cleaning activities. METHODS The cohort consisted of 1467 workers grouped into contract, fertilizer, and plastic workers. The outcome of interest was mortality for specific causes. Standardized mortality ratios (SMR) and 95% confidence intervals (95%CI) were computed. RESULTS For all workers and all causes of death combined, the SMR was less than 1.0. Mortality ratios were increased for malignant neoplasms of the pleura, bone and melanoma of the skin. Contract workers, the group mostly exposed to arsenic, showed statistically significant SMRs for several malignancies, in particular for lung cancer (SMR = 1.26; 95%CI: 1.05-1.54). CONCLUSIONS Overall, the results reported here on mortality among persons occupationally exposed to arsenic are consistent with the literature and biologically plausible.
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Affiliation(s)
- Emilio Antonio L. Gianicolo
- Italian National Research Council; Institute of Clinical Physiology; Lecce Italy
- University of Mainz; Institute of medical Biostatistics, Epidemiology and Informatics; Mainz Germany
| | - Cristina Mangia
- Italian National Research Council; Institute of Atmospheric Sciences and Climate; Lecce Italy
| | - Marco Cervino
- Italian National Research Council; Institute of Atmospheric Sciences and Climate; Bologna Italy
| | - Antonella Bruni
- Epidemiological and Statistical Unit; Azienda Sanitaria Locale; Taranto Italy
| | | | - Pietro Comba
- Department of Environment and Health; Istituto Superiore di Sanità; Rome Italy
| | | | - Annibale Biggeri
- Department of Statistics, Computer Science, Applications; University of Florence; Florence Italy
- Epidemiologia e Prevenzione Social Enterprise; Torino Italy
| | - Mariangela Vigotti
- Italian National Research Council; Institute of Clinical Physiology; Lecce Italy
| | - Maria Blettner
- University of Mainz; Institute of medical Biostatistics, Epidemiology and Informatics; Mainz Germany
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Minotti GC, Cortese F, Corsonello A, Guadalupi G, D`Arcangelo AP, Palumbo SD, Naio R, Clemente OD, Aurelio A, Carone S, Gelsumino T, Gemignani V, Bianchini E, Vigotti M, Faita F, Greco L, Primerano R, Incalzi RA, Ciccone MM. The Influence of Dietary Components on Early Signs of Atherosclerosis in Apparently Healthy Young-adult Males: An Observational Study of 615 Subjects. Curr Vasc Pharmacol 2017; 15:482-490. [DOI: 10.2174/1570161115666170201111809] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/08/2016] [Revised: 01/12/2017] [Accepted: 01/24/2017] [Indexed: 11/22/2022]
Affiliation(s)
| | - Francesca Cortese
- Cardiovascular disease Section, Department of Organ and Transplantation, University of Bari, Bari, Italy
| | - Andrea Corsonello
- Istituto Nazionale di Ricovero e Cura per Anziani (INCA), Cosenza, Italy
| | | | | | | | - Rita Naio
- San Raffaele Fondation, Cittadella della Carita, Taranto, Italy
| | | | - Andrea Aurelio
- San Raffaele Fondation, Cittadella della Carita, Taranto, Italy
| | - Simona Carone
- San Raffaele Fondation, Cittadella della Carita, Taranto, Italy
| | | | - Vincenzo Gemignani
- Istituto di Fisiologia Clinica, Consiglio Nazionale delle Ricerche (IFC-CNR), Pisa University, Pisa, Italy
| | - Elisabetta Bianchini
- Istituto di Fisiologia Clinica, Consiglio Nazionale delle Ricerche (IFC-CNR), Pisa University, Pisa, Italy
| | - Mariangela Vigotti
- Istituto di Fisiologia Clinica, Consiglio Nazionale delle Ricerche (IFC-CNR), Pisa University, Pisa, Italy
| | - Francesco Faita
- Istituto di Fisiologia Clinica, Consiglio Nazionale delle Ricerche (IFC-CNR), Pisa University, Pisa, Italy
| | - Luciano Greco
- Industria per la Lavorazione dell'Acciaio (ILVA), Taranto, Italy
| | - Roberto Primerano
- Agenzia Regionale per la Protezione dell'Ambiente (ARPA) Apulia Region, Taranto, Italy
| | | | - Marco Matteo Ciccone
- Cardiovascular Disease Section, Department of Organ and Transplantation, University of Bari, Bari, Italy
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Baldacci S, Maio S, Viegi G, Forastiere F, Bisanti L, Randi G, Rognoni M, Simonato L, Tessari R, Berti G, Cadum E, Chiusolo M, Grosa MM, Ivaldi C, Pelosini R, Poncino S, Galassi C, Pacelli B, Pandolfi P, Scarnato C, Miglio R, Caranci N, Pace G, Zanini G, Grechi D, Chellini E, Mallone S, Accetta G, Barchielli A, Nuvolone D, Baccini M, Biggeri A, Baldacci S, Viegi G, Vigotti M, Colais P, Faustini A, Forastiere F, Perucci CA, Stafoggia M, Vigotti M, Minerba S, Serinelli M, Dessì PM, Cernigliaro A, Scondotto S. [Atmospheric pollution and human health.in the literature and interpretation of environmental. toxicological and epidemiologic studies]. Epidemiol Prev 2009; 33:1-72. [PMID: 20839608] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/29/2023]
Affiliation(s)
- Sandra Baldacci
- Unità di epidemiologia ambientale polmonare Istituto di fisiologia clinica, CNR, Via Trieste 41, 56126 Pisa.
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Forastiere F, Stafoggia M, Berti G, Bisanti L, Cernigliaro A, Chiusolo M, Mallone S, Miglio R, Pandolfi P, Rognoni M, Serinelli M, Tessari R, Vigotti M, Perucci CA. Particulate matter and daily mortality: a case-crossover analysis of individual effect modifiers. Epidemiology 2008; 19:571-80. [PMID: 18467959 DOI: 10.1097/ede.0b013e3181761f8a] [Citation(s) in RCA: 58] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
BACKGROUND Several time-series studies have established the relationship between particulate matter (PM10) and mortality. We adopted a case-crossover design to evaluate whether individual socio-demographic characteristics and chronic or acute medical conditions modify the PM10-mortality association. METHODS We selected all natural deaths (321,024 subjects) occurring among adult (aged 35+ years) residents of 9 Italian cities between 1997 and 2004. We had access to individual information on socio-demographic variables, location of death, and chronic conditions (hospital admissions in the preceding 2-year period). For in-hospital deaths, we collected information on treatment wards at time of death and acute medical conditions. In a case-crossover analysis we adjusted for time, population changes, and meteorological conditions. RESULTS PM10 was associated with mortality among subjects age 65 years and older (0.75% increase per 10 microg/m3 [95% confidence interval = 0.42% to 1.09%]), with a more pronounced effect among people age 85 and older. A weaker effect was found among the most affluent people. The effect was present for both out-of-hospital and in-hospital deaths, especially among those treated in general medicine and other less specialized wards. PM10 effects were stronger among people with diabetes (1.03% [0.28% to 1.79%]) and chronic obstructive pulmonary disease (0.84% [0.17% to 1.52%]). The acute conditions with the largest effect estimates were acute impairment of pulmonary circulation (4.56% [0.75% to 8.51%]) and heart failure (1.67% [0.30% to 3.04%]). CONCLUSIONS Several factors, including advanced age, type of hospital ward, and chronic and acute health conditions, modify the PM10-related risk of death. Altered pulmonary circulation and heart failure are important effect modifiers, suggesting that cardiac decompensation is a possible mechanism of the fatal PM10 effect.
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Franco F, Chellini E, Seniori Costantini A, Gioia A, Carra G, Paolinelli F, Martelli C, Vigotti M. Mortality in the coke oven plant of Carrara, Italy. Med Lav 1993; 84:443-7. [PMID: 8177128] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 01/29/2023]
Abstract
A mortality study was undertaken on a cohort of 538 male workers employed at a coke plant in Carrara in the period 1960-1985. The follow-up period ranged from January 1 1960 to December 31 1990, with 10,665 person-years accumulated. A significant excess in mortality for lung cancer was observed: 19 observed deaths vs 10.02 expected deaths using national rates, SMR 190 (C.I. 95% = 114-296), and vs 11.19 expected deaths using regional rates, SMR 170 (C.I. 95% = 102-265). The results suggest the possible influence of this occupation on mortality from lung cancer, as was observed in previous studies performed on larger cohorts of coke oven workers.
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Affiliation(s)
- F Franco
- Servizio di Prevenzione Igiene e Sicurezza nei Luoghi di Lavoro, USL 2, Massa Carrara
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Montecchio GP, Samaden A, Carbone S, Vigotti M, Siragusa S, Piovella F. Centella Asiatica Triterpenic Fraction (CATTF) reduces the number of circulating endothelial cells in subjects with post phlebitic syndrome. Haematologica 1991; 76:256-9. [PMID: 1743599] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/28/2022] Open
Abstract
Here we report a study performed in order to assess the number of circulating endothelial cells (EC) in normal subjects and in patients with postphlebitic syndrome (PPS), and the effect of treatment with Centella Asiatica Triterpenic Fraction (CATTF), a drug which has been demonstrated to be effective in promoting wound healing in vivo. EC counts were determined by means of differential centrifugation and phase contrast microscopy. Patients with PPS showed an increased number of circulating EC in comparison to normal subjects (3.8 +/- 1.2 cells versus 1.5 +/- 0.6 per counting chamber). Treatment for three weeks with CATTF caused a statistically significant reduction of circulating EC (1.80 +/- 0.6 cells per counting chamber).
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Affiliation(s)
- G P Montecchio
- Clinica Medica II, IRCCS Policlinico San Matteo, Pavia, Italy
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Piovella F, Samaden A, Carbone S, Vigotti M, Siragusa S, Ricetti MM. Endothelium and inflammation. Ann Cardiol Angeiol (Paris) 1991; 40:255-8. [PMID: 1859126] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/29/2022]
Affiliation(s)
- F Piovella
- Istituto di Clinica Medica, 2 IRCCS Policlinico S. Matteo, University of Pavia, Italy
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Bertolino G, Vigotti M, Noris P, Piletta GC, Piovella F, Balduini CL. Effect of endothelial cells on platelet aggregation in platelet rich plasma (PRP) and whole blood. Thromb Res 1990; 59:407-12. [PMID: 2237818 DOI: 10.1016/0049-3848(90)90145-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/30/2022]
Affiliation(s)
- G Bertolino
- Department of Internal Medicine, University of Pavia-IRCCS S. Matteo, Italy
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Di Ricco G, Melillo E, Rindi M, Marini C, Vigotti M, Giuntini C. [Short-term prognosis of pulmonary embolism]. G Ital Cardiol 1988; 18:578-84. [PMID: 3234657] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 01/04/2023]
Abstract
Seven hundred fifty four consecutive cases of pulmonary embolism, diagnosed between 1969 and 1982 at S. Chiara Hospital in Pisa, were examined in order to assess the causes and the rate of the early mortality. Full documentation was not obtained in 47 cases (6.2%) and they were excluded from the study; 81 (11.4%) of the remaining 707 died within 30 days of diagnosis, and in 56.8% of them pulmonary embolism was the primary cause of death. The survival rate was 90.6% in patients with apparently primary pulmonary embolism, 89.8% in post surgical cases, 81.5% in cardiac patients and 75% in patients affected by neoplasm. Twenty five per cent of patients were not treated during the acute phase, because the diagnosis was made more than one month after the onset of symptoms or because the fear of bleeding precluded anticoagulant treatment. The incidence of fatal haemorrhage during treatment was 0.5% overall, and 0.4% in surgical patients. Mortality was 9.2% in patients who received treatment, versus 25.2% in untreated patients. Sixteen fatal recurrent embolisms occurred after the end of treatment: 11 were observed in patients not treated with oral anticoagulants. Routine autoptic examinations, performed in 44.4% of the cases, often demonstrated both recent and organized emboli, especially in cardiac patients. Recurrence of pulmonary embolism may account for both the severity of clinical patterns and the high mortality rate in the early phase of treatment.
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Affiliation(s)
- G Di Ricco
- Istituto di Fisiologia Clinica del CNR, Pisa
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Di Ricco G, Marini C, Rindi M, Melillo E, Vigotti M, Giuntini C. [Cases of pulmonary embolism diagnosed in Pisa from 1969 to 1984]. G Ital Cardiol 1987; 17:113-9. [PMID: 3609613] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 01/06/2023]
Abstract
Starting from 1969, the yearly number of patients with pulmonary embolism documented in the S. Chiara Hospital of Pisa is increased, in spite of the unchanged diagnostic procedures. Aim of this work is to verify if this trend is accompanied by earlier diagnosis with an improvement in the clinical outcome of pulmonary embolism, and if a relevant diagnostic failure is still present in our hospital. A comparison of pulmonary embolism cases collected from 1969 to 1971 and from 1980 to 1982 showed that the number of diagnoses made within one week from the onset of symptoms is increased (+24.8%), whereas the number of diagnoses made after more than one month is reduced (-18.1%). At the same time we observed that cases with a standard PaO2 less than 40 mmHg are reduced (-23.1%) while cases with a standard PaO2 greater than 50 mmHg are increased (+29.9%). An earlier diagnosis of pulmonary embolism contributed to treat a larger percentage of patients (+29.7%) and to lower the early mortality (-17.4%). This diagnostic trend can be ascribed to an increased readiness in raising the clinical suspicion of pulmonary embolism and to the prompt availability of perfusion lung scan, that is the center of our diagnostic strategy. Data of our 1,010 patients, compared with those of autoptic series and with the number of admissions, surgical operations and deaths in the wards of our hospital, suggest some persistent diagnostic failure in patients with well documented embolic risk; such as injured, burned, patients affected by neoplasm or motor lesion, patients operated for orthopedic or gynaecologic problems.
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Candelise L, Vigotti M, Fieschi C, Brambilla GL, Bono G, Conforti P, De Zanche L, Inzitari D, Mariani F, Prencipe M. Italian multicenter study on reversible cerebral ischemic attacks: VI--Prognostic factors and follow-up results. Stroke 1986; 17:842-8. [PMID: 3764952 DOI: 10.1161/01.str.17.5.842] [Citation(s) in RCA: 16] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/07/2023]
Abstract
A total of 462 patients (mean age 52 years) affected by reversible focal ischemic attacks (RIAs) were followed prospectively in 8 neurologic institutions in Italy for 4 years. All cases were evaluated with a cerebral angiography and 21% of angiograms were normal. At the end of the follow-up period the cumulated probability for death, stroke, cardiac event and new RIA was respectively 7%, 8%, 3% and 36%. The predictive value of the baseline characteristics of this series was evaluated by a multifactorial analysis which showed that RIA and stroke (specific cerebrovascular risk) were more likely to develop in patients with a history of more than one RIA and in those in whom multiple vascular territories were involved. Moreover, previous myocardial infarction, intermittent claudication, angina pectoris, time elapsed since the first attack, and duration and severity of the attack itself were independently associated with general cardiovascular risk (death, stroke and myocardial infarction). We conclude that predictive factors, and thus also pathogenetic mechanisms, may be different for general cardiovascular risk and specific cerebrovascular risk in RIA patients.
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Mussi A, Janni A, Menconi GF, Vigotti M, Angeletti CA. [Results of the surgical resection of pulmonary cancer: actuarial analysis according to TNM]. MINERVA CHIR 1985; 40:1623-8. [PMID: 3831835] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/07/2023]
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