Consistency and accuracy of diagnostic cancer codes generated by automated registration: comparison with manual registration

BACKGROUND: Automated procedures are increasingly used in cancer registration, and it is important that the data produced are systematically checked for consistency and accuracy. We evaluated an automated procedure for cancer registration adopted by the Lombardy Cancer Registry in 1997, comparing automatically-generated diagnostic codes with those produced manually over one year (1997). METHODS: The automatically generated cancer cases were produced by Open Registry algorithms. For manual registration, trained staff consulted clinical records, pathology reports and death certificates. The social security code, present and checked in both databases in all cases, was used to match the files in the automatic and manual databases. The cancer cases generated by the two methods were compared by manual revision. RESULTS: The automated procedure generated 5027 cases: 2959 (59%) were accepted automatically and 2068 (41%) were flagged for manual checking. Among the cases accepted automatically, discrepancies in data items (surname, first name, sex and date of birth) constituted 8.5% of cases, and discrepancies in the first three digits of the ICD-9 code constituted 1.6%. Among flagged cases, cancers of female genital tract, hematopoietic system, metastatic and ill-defined sites, and oropharynx predominated. The usual reasons were use of specific vs. generic codes, presence of multiple primaries, and use of extranodal vs. nodal codes for lymphomas. The percentage of automatically accepted cases ranged from 83% for breast and thyroid cancers to 13% for metastatic and ill-defined cancer sites. CONCLUSION: Since 59% of cases were accepted automatically and contained relatively few, mostly trivial discrepancies, the automatic procedure is efficient for routine case generation effectively cutting the workload required for routine case checking by this amount. Among cases not accepted automatically, discrepancies were mainly due to variations in coding practice

Descriptive epidemiology of selected birth defects, areas of Lombardy, Italy, 1999

<p>Abstract</p> <p>Background</p> <p>Birth defects are a leading cause of neonatal and infant mortality in Italy, however little is known of the etiology of most defects. Improvements in diagnosis have revealed increasing numbers of clinically insignificant defects, while improvements in treatment have increased the survival of those with more serious and complex defects. For etiological studies, prevention, and management, it is important to have population-based monitoring which provides reliable data on the prevalence at birth of such defects.</p> <p>Methods</p> <p>We recently initiated population-based birth defect monitoring in the Provinces of Mantova, Sondrio and Varese of the Region of Lombardy, northern Italy, and report data for the first year of operation (1999). The registry uses all-electronic source files (hospital discharge files, death certificates, regional health files, and pathology reports) and a proven case-generation methodology, which is described.</p> <p>The data were checked manually by consulting clinical records in hospitals. Completeness was checked against birth certificates by capture-recapture. Data on cases were coded according to the four-digit malformation codes of the International Classification of Diseases, Ninth Revision (ICD-9). We present data only on selected defects.</p> <p>Results</p> <p>We found 246 selected birth defects in 12,008 live births in 1999, 148 among boys and 98 among girls. Congenital heart defects (particularly septal defects) were the most common (90.8/10,000), followed by defects of the genitourinary tract (34.1/10, 000) (particularly hypospadias in boys), digestive system (23.3/10,000) and central nervous system (14.9/10,000), orofacial clefts (10.8/10,000) and Down syndrome (8.3/10,000). Completeness was satisfactory: analysis of birth certificates resulted in the addition of two birth defect cases to the registry.</p> <p>Conclusion</p> <p>This is the first population-based analysis on selected major birth defects in the Region. The high birth prevalences for septal heart defect and hypospadias are probably due to the inclusion of minor defects and lack of coding standardization; the latter problem also seems important for other defects. However the data produced are useful for estimating the demands made on the health system by babies with birth defects.</p

Is "option B+" also being adopted in pregnant women in high-income countries? Temporal trends from a national study in Italy

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Association between solar insolation and a history of suicide attempts in bipolar I disorder

In many international studies, rates of completed suicide and suicide attempts have a seasonal pattern that peaks in spring or summer. This exploratory study investigated the association between solar insolation and a history of suicide attempt in patients with bipolar I disorder. Solar insolation is the amount of electromagnetic energy from the Sun striking a surface area on Earth. Data were collected previously from 5536 patients with bipolar I disorder at 50 collection sites in 32 countries at a wide range of latitudes in both hemispheres. Suicide related data were available for 3365 patients from 310 onset locations in 51 countries. 1047 (31.1%) had a history of suicide attempt. There was a significant inverse association between a history of suicide attempt and the ratio of mean winter solar insolation/mean summer solar insolation. This ratio is smallest near the poles where the winter insolation is very small compared to the summer insolation. This ratio is largest near the equator where there is relatively little variation in the insolation over the year. Other variables in the model that were positively associated with suicide attempt were being female, a history of alcohol or substance abuse, and being in a younger birth cohort. Living in a country with a state-sponsored religion decreased the association. (All estimated coefficients p <0.01). In summary, living in locations with large changes in solar insolation between winter and summer may be associated with increased suicide attempts in patients with bipolar disorder. Further investigation of the impacts of solar insolation on the course of bipolar disorder is needed.Peer reviewe

Recent Advances in Bioconjugated Transition Metal Complexes for Cancer Therapy

The introduction of biologically relevant organic moieties in the coordination sphere of transition metal complexes has recently become a well-established strategy to increase the selectivity and biocompatibility of metallodrugs. In this review, the major advances achieved in this area of research in the last three years are described in detail. Particular attention is given to the metal complexes bearing the main biomolecules of life: carbohydrates, lipids, nucleotides, proteins and vitamins. Each paragraph summarizes the synthetic strategy employed to obtain the complexes of interest as well as the most interesting biological results obtained with these potential metallodrugs. Moreover, the structure–activity relationships observed by the different research groups are described and discussed, with the goal of suggesting to the reader the ligand/metal centre combinations that provide the most promising results in the fight against cancer. Some of the compounds examined in this review as well as other bioconjugated metal complexes published in recent decades exhibit interesting selectivity towards cancer cells over normal ones and a specific mode of action. These latter aspects are the basis of what is commonly known as anticancer target therapy

Microperimetry and fundus autofluorescence in patients with early age‐related macular degeneration

Microperimetry and fundus autofluorescence in patients with early age-related macular degeneration. Midena E, Vujosevic S, Convento E, Manfre' A, Cavarzeran F, Pilotto E. SourceDepartment of Ophthalmology, University of Padova, Via Giustiani 2, 35128 Padova, Italy. [email protected] Abstract BACKGROUND: Early age-related macular degeneration (AMD) has been correlated with different functional alterations, but the exact relationship between fundus lesions and overlying sensitivity is not well known. The aim of this study was to compare fundus-related sensitivity (microperimetry) and fundus autofluorescence (FAF) of the macular area with drusen and pigment abnormalities in early AMD. METHODS: 13 consecutive patients with early AMD and visual acuity of 20/20 were studied by means of microperimetry, which automatically analyses macular light differential threshold and fixation patterns. Fundus colour photo and FAF of the macular area were recorded on the same day. Microperimetry was exactly (topographically) superimposed over FAF images. RESULTS: Macular sensitivity significantly decreased over large drusen (11.2 +/- 5.6 dB, p<0.0001) and over pigment abnormalities (13.1 +/- 3.6 dB, p<0.0001). When both characteristics were present the reduction was greater if compared with its absence (9.6 +/- 4.3 versus 15.0 +/- 4.5 dB, p<0.0001). Sensitivitity reduction was significant in areas with altered FAF when compared with areas with normal FAF (p<0.0001). CONCLUSIONS: Increased FAF in early AMD has a functional correlate exactly quantified by microperimetry. In retinal areas affected by early AMD retinal sensitivity deteriorates, despite good visual acuity. Microperimetry may allow the early detection of functional impairment caused by these lesions. Both microperimetry and FAF may be useful to monitor AMD progression. PMID: 17504849 [PubMed - indexed for MEDLINE] PMCID: PMC209542

Audiometria vocale adattiva e abilità linguistiche ricettive in bambini con impianto cocleare: risultati a lungo termine.

Razionale: I risultati a lungo termine in bambini con impianto cocleare (IC) sono importanti per guidare le famiglie e i professionisti nel processo terapeutico e di consulenza sulle aspettative e sui fattori coinvolti nei processi di sviluppo delle capacità comunicative, educative e occupazionali dei bambini che cresceranno con IC. Pochi studi in letteratura correlano gli esiti audiologici e il vocabolario recettivo e/o morfosintassi a lungo termine con i risultati all’ audiometria vocale adattiva. Materiali e metodi: Studio osservazionale retrospettivo su 52 soggetti con uso di IC a lungo termine, 34 unilaterali e 18 bilaterali (età media 19,5 anni; età media all’IC 33 mesi); follow-up medio 14,8. 34 soggetti sono stati impiantati con Advanced Bionics, 12 con Cochlear e 6 con dispositivi MedEl. I dati personali e audiologici sono stati correlati con l'audiometria vocale in quiete e con SNR +10/+5 e con i risultati dell' It-Matrix Sentence Test (It-MST). Il vocabolario ricettivo (PPVT) e la morfosintassi (TROG 2) sono stati correlati ai risultati dell' It-MST. Risultati: 51/52 soggetti sono stati valutati con It-MST, 7/52 con It-Matrix semplificato. L'età all'impianto era correlata positivamente agli esiti all’It-MST (r=0,3; p=0,032). Età all’It-MST e FF non erano correlati al It-MST mentre, come aspettato erano correlati all’età all’IC. I risultati dell' It-MST erano correlati negativamente a parole e frasi in silenzio (r=-5 / -0,7) e solo nel rumore con SNR +10 (r=-4). Il vocabolario ricettivo e la morfosintassi erano correlati negativamente ai risultati di It-MST (TROG 2 r=-0,6; p&lt;0,001) (PPVT r=-0,5; p&lt;0,001). Conclusioni: Questi dati a lungo termine contribuiscono ad aumentare la conoscenza degli effetti di variabili quali l’età all’IC sugli outcomes della riabilitazione uditiva con IC, e di come questo a lungo termine influenzi le abilità linguistiche

Platinum(0)-η²-1,2-(<i>E</i>)ditosylethene Complexes Bearing Phosphine, Isocyanide and <i>N</i>-Heterocyclic Carbene Ligands: Synthesis and Cytotoxicity towards Ovarian and Breast Cancer Cells

A wide range of platinum(0)-η2-(E)-1,2-ditosylethene complexes bearing isocyanide, phosphine and N-heterocyclic carbene ancillary ligands have been prepared with high yields and selectivity. All the novel products underwent thorough characterization using spectroscopic techniques, including NMR and FT-IR analyses. Additionally, for some compounds, the solid-state structures were elucidated through X-ray diffractometry. The synthesized complexes were successively evaluated for their potential as anticancer agents against two ovarian cancer cell lines (A2780 and A2780cis) and one breast cancer cell line (MDA-MB-231). The majority of the compounds displayed promising cytotoxicity within the micromolar range against A2780 and MDA-MB-231 cells, with IC50 values comparable to or even surpassing those of cisplatin. However, only a subset of compounds was cytotoxic against cisplatin-resistant cancer cells (A2780cis). Furthermore, the assessment of antiproliferative activity on MRC-5 normal cells revealed certain compounds to exhibit in vitro selectivity. Notably, complexes 3d, 6a and 6b showed low cytotoxicity towards normal cells (IC50 > 100 µM) while concurrently displaying potent cytotoxicity against cancer cells

Cationic palladium(II)-indenyl complexes bearing phosphines as ancillary ligands: synthesis, and study of indenyl amination and anticancer activity

The reactivity of palladium(ii) indenyl derivatives and their applications are topics relatively less studied, though in recent times these compounds have been used as pre-catalysts able to promote challenging cross-coupling processes. Herein, we propose the first systematic study concerning the nucleophilic attack on the palladium(ii) coordinated indenyl fragment and, for this purpose, we have prepared a library of new Pd-indenyl complexes bearing mono- or bidentate phosphines as spectator ligands, developing specific synthetic strategies. All novel compounds are thoroughly characterized, highlighting that the indenyl ligand presents always a hapticity intermediate between eta(3) and eta(5). Secondary amines have been chosen as nucleophiles for the present study and indenyl amination has been monitored by UV-Vis and NMR spectroscopies, deriving a second order rate law, with dependence on both complex and amine concentrations. The rate-determining step of the process is the initial attack of the amine to the coordinated indenyl fragment, and this conclusion has been supported also by DFT calculations. The determination of second order rate constants has allowed us to assess the impact of the phosphine ligands on the kinetics of the process and identify the steric and electronic descriptors most suitable for predicting the reactivity of these systems. Finally, in vitro tests have proven that these organometallic compounds promote antiproliferative activity towards ovarian cancer cells better than cisplatin and possibly by adopting a different mechanism of action

Cochlear implant and tinnitus: a narrative literature review and evidence for clinical use

INTRODUCTION: Tinnitus is one of the major complaints in patients with bilateral hearing loss or single-sided deafness (SSD). Several studies describe that cochlear implantation may play a role in tinnitus suppression. Results in the literature are heterogeneous for the role and level of success that Cochlear Implants (CI) plays in tinnitus suppression. The purpose of this review is to summarize all of the significant evidence and outcomes documented as to CI effects on tinnitus perception in unilateral/bilateral CI users and SSD patients, as well as to report on tinnitus findings and fitting strategies currently used to optimize the results for supporting a clear counselling process. EVIDENCE ACQUISITION: A comprehensive literature search was undertaken using the following databases: PubMed, Embase, Cochrane Library, Scopus, CINAHL and Web of Science. Included articles are published through to November 2022 and referenced by relevant literature. The eligible studies and data results were summarized in this narrative review. EVIDENCE SYNTHESIS: The review was organized to deliver a summary of: CI pathophysiologic mechanisms and prognostic factors in- volved in tinnitus suppression; CI outcomes for both unilateral and bilateral implantation in bilateral symmetrical hearing loss, as well as in asymmetrical hearing loss and in SSD patients; the relevant findings concerning CI fitting in managing tinnitus suppression. Finally, the effects of CI on quality of life and psychological status of patients with tinnitus were addressed. CONCLUSIONS: The present review is a targeted contribution to support clinical procedures regarding the applicability and the outcomes of CI in tinnitus treatment. Further studies and specific guidelines are needed to broaden knowledge and understanding in this specific research field