Lung cancer epidemiology in North Sardinia, Italy

Background The aim of this study was to analyze and describe the epidemiological characteristics and trends of lung cancer in North Sardinia, Italy, in the period 1992–2010. Methods Data were obtained from the tumor registry of Sassari province which is a part of a wider registry web, coordinated today by the Italian Association for Tumor Registries. Results The overall number of lung cancer cases registered was 4,325. The male-to-female ratio was 4.6:1 and the mean age 68.1 years for males and 67 years for females. The standardized incidence rates were 73.1/100,000 and 13.5/100,000 and the standardized mortality rates 55.7/100,000 and 9.9/100,000 for males and females, respectively. An increasing trend in incidence of lung cancer in women was evidenced. Conversely, incidence was found to decrease in males. Relative survival at 5 years from diagnosis was low (8.8% for males and 14.9% for females). Furthermore, an increase in mortality rates was observed in both sexes in the period under investigation. Conclusions Our data show an increasing trend of lung cancer incidence in women in North Sardinia in the last decades. Conversely, a reduction of incidence rates was observed in males. Furthermore, a slightly increasing trend in mortality rates was observed in both sexes, suggesting the need to enhance smoking control strategies, consider adoption of effective surveillance policies, and improve diagnosis and treatment methods

Progettazione di un sistema CAD per le colonscopie virtuali

Il lavoro di tesi &egrave consistito nella progettazione e nell'implementazione di un sistema di computer assisted diagnosis per l'ispezione e la manipolazione di dataset volumetrici di tipo biomedico. Il sistema &egrave stato inoltre specializzato e sperimentato su colonscopie virtuali

Role of BRCA2 mutation status on overall survival among breast cancer patients from Sardinia

Background: Germline mutations in BRCA1 or BRCA2 genes have been demonstrated to increase the risk of developing breast cancer. Conversely, the impact of BRCA mutations on prognosis and survival of breast cancer patients is still debated. In this study, we investigated the role of such mutations on breast cancer-specific survival among patients from North Sardinia. Methods: Among incident cases during the period 1997–2002, a total of 512 breast cancer patients gave their consent to undergo BRCA mutation screening by DHPLC analysis and automated DNA sequencing. The Hakulinen, Kaplan-Meier, and Cox regression methods were used for both relative survival assessment and statistical analysis. Results: In our series, patients carrying a germline mutation in coding regions and splice boundaries of BRCA1 and BRCA2 genes were 48/512 (9%). Effect on overall survival was evaluated taking into consideration BRCA2 carriers, who represented the vast majority (44/48; 92%) of mutation-positive patients. A lower breast cancer-specific overall survival rate was observed in BRCA2 mutation carriers after the first two years from diagnosis. However, survival rates were similar in both groups after five years from diagnosis. No significant difference was found for age of onset, disease stage, and primary tumour histopathology between the two subsets. Conclusion: In Sardinian breast cancer population, BRCA2 was the most affected gene and the effects of BRCA2 germline mutations on patients' survival were demonstrated to vary within the first two years from diagnosis. After a longer follow-up observation, breast cancer-specific rates of death were instead similar for BRCA2 mutation carriers and non-carriers

Diagnostic accuracy of clinical tests to rule out elbow fracture: a systematic review

Elbow traumas represent a relatively common condition in clinical practice. However, there is a lack of evidence regarding the most accurate tests for screening these potentially serious conditions and excluding elbow fractures. The purpose of this investigation was to analyze the literature concerning the diagnostic accuracy of clinical tests for the detection or exclusion of suspected elbow fractures. A systematic review was performed using the Preferred Reporting Items for a Systematic Review and Meta-analysis of Diagnostic Test Accuracy Studies (PRISMA-DTA) guidelines. Literature databases including PubMed, Cumulative Index to Nursing and Allied Health Literature, Diagnostic Test Accuracy, Cochrane Library the Web of Science, and ScienceDirect were searched for diagnostic accuracy studies of subjects with suspected traumatic elbow fracture investigating clinical tests compared to imaging reference tests. The risk of bias in each study was assessed independently by two reviewers using the Quality Assessment of Diagnostic Accuracy Studies 2 checklist. Twelve studies (4,485 patients) were included. Three different types of index tests were extracted. In adults, these tests were very sensitive, with values up to 98.6% (95% confidence interval [CI], 95.0%–99.8%). The specificity was very variable, ranging from 24.0% (95% CI, 19.0%–30.0%) to 69.4% (95% CI, 57.3%–79.5%). The applicability of these tests was very high, while overall studies showed a medium risk of bias. Elbow full range of motion test, elbow extension test, and elbow extension and point tenderness test appear to be useful in the presence of a negative test to exclude fracture in a majority of cases. The specificity of all tests, however, does not allow us to draw useful conclusions because there was a great variability of results obtained. Level of evidence IV

Effects of warmer and drier climate conditions on plant composition and biomass production in a Mediterranean shrubland community

The last IPCC report predicts warmer and drier conditions for the future European climate and the Mediterranean basin could be highly sensible to future climatic change. In order to investigate how the forecast more stressing factors could affect Mediterranean shrubland ecosystems, an appropriate manipulation of the microclimate was carried out in an area covered by Mediterranean maquis aimed at extending the drought period and increasing the night-time temperature. Soil cover, plant growth, litterfall, leaf water status, and leaf nutritional status were monitored over three growing seasons. The manipulation altered the microclimate according to common scenarios, increasing mean annual night-time air temperature by about 1 °C and mean annual temperature by about 0.5 °C, and decreasing precipitation between 6-46% of the total rainfall during the growing seasons. A general increase of vegetation cover was observed in the whole community during the three years of experimentation. This positive temporal pattern was mainly observed in control and warming treatment, whereas in the drought treatment it was less evident. At species-specific level, a clear negative effect of drought treatment was observed for C. monspeliensis percentage cover. Shoot elongation was not significantly affected by the warming treatment. A significant negative effect of drought treatment was noticed in the 2001-2002 and 2002-2003 growing seasons. An increase of N and P concentrations in the drought treatment in Cistus was observed and it can be explained by the reduced shoot growth induced by the water shortage that we had observed in the same treatment. The absence of a concentration effect on the other two species could be the signal of the different behaviour with regard to a drier climate, and therefore could be a symptom of future change in species composition. We underline the need of longterm observation, because of the different responses of plants in the short and long- term conditions

Una Nuova area sperimentale di lungo termine, per lo studio degli effetti dell'incremento della temperatura e del periodo di aridità in formazioni di sclerofille mediterranee

A new long-term experimental area for studying the effects of climate warming and seasonal drought on a Mediterranean shrubland community. Global changes, such as land use changes, altered atmosphere composition, and climate changes, have been altering the functioning of ecosystems with possible impacts on the degree of biodiversity. Temperature and water availability are the two main determinants of the functional processes of terrestrial ecosystems. Climatic changes could have strong effects on vulnerable ecosystems as Mediterranean shrublands/garrigue/maquis, where the growth and survival of the plants are strictly dependent on the drought and to the high summer temperature. Furthermore, other pressures, such as grazing and wildfires, occur frequently in the Mediterranean area. In order to assess the impacts of the temperature increase and precipitation reduction on Mediterranean shrublands, a new experimental area was established in Sardinia at the Porto Conte forest, Alghero (SS). A system of automatic roofs covers 6 experimental plots (20 m2), in order to simulate an increase of temperature during the night (3 plots) or to intercept the precipitations during a 2-3 months period (3 plots). Three additional plots are used as control. All the observations were conducted in other five European shrubland ecosystems, according to common protocols developed in the context of the European project VULCAN (www.vulcanproject.com). The studies of the different ecological and physiological processes are organised in working packages (Plant, Soil, Fauna, Water) and integrated in a risk assessments evaluation. The aim of this paper is to analyse the first two years of data, to demonstrate the microclimatic modifications induced by the experimental system

Epidemiology of thyroid cancer in an area of epidemic thyroid goiter

The aim of this study was to analyze and describe the epidemiological characteristics and trends of thyroid cancer in the province of Sassari (Sardinia, Italy), an area with epidemic thyroid goiter, in the period 1992–2010. Data were obtained from the local tumor registry whichmakes part of a wider registry web, coordinated today by the Italian Association for Tumor Registries. An increasing trend in the incidence of thyroid cancer in the province of Sassari was evidenced. This trend seems to follow the general worldwide trend and does not seem to be related to the high incidence of thyroid goiter in the area. The frequencies of the different histological subtypes were similar to those reported in numerous national and international reports.Women are affected earlier than men and, therefore, suffer greater professional, economic, and social impacts.Overallmortality is lowand a relative 5-year survival is excellent, especially in comparison to other malignancies