Epidemiology of acute lymphoblastic leukaemia in Sardinia, Italy:Age, sex, and environmental correlates

Using a database of 1974–2003 incident cases of haematological malignancies, we explored the time trend, geographic spread and socio-economic and environmental correlates of ALL incidence in Sardinia, Italy, by sex and age. The age- and sex-standardized (World population) ALL incidence rate was 2.0 per 100,000 (95% CI 1.8 – 2.1) and showed variable trend patterns by sex and age. In the total population, ALL incidence showed an annual per cent change of −1.4% (95% CI -0.59 – -3.34) over the study period, with a knot separating a downward slope in 1974–1996 from an increase in 1996–2003. ALL incidence replicated such pattern in women but not men, whose incidence did not substantially vary over the study period (APC = −2.57%, 95% CI -5.45 – 0.26). Among women, the spatial analysis suggested a clustering of ALL in the southwestern part of the region, whilst only a commune had a high posterior probability of a high ALL incidence among men. Three unrelated communes showed a high posterior probability of ALL at age ≤ 24; only the most populated urban centre showed excess cases at age ≥ 25 years. There was no correlation between the geographic spread of ALL at ages ≤ 24 and ≥ 25 years (p = 0.082). Urban residence was a risk factor for the younger age group. Residences near industrial settlements and in the most populated urban centre were risk factors for subjects aged ≥ 25 years. Our findings suggest age-related differences in ALL aetiology

Incidence of non-Hodgkin’s lymphoma among adults in Sardinia, Italy

The causes of the peculiar time trend in the incidence of non-Hodgkin’s lymphoma (NHL) in most parts of the world and of its geographic distribution are still unknown. We used the data base of 1974–2003 incident cases of hematological malignancies to explore the time trend of NHL incidence in the region of Sardinia, Italy, and we used Bayesian methods to plot the probability of NHL incidence by residential unit on the regional map. In 1974–2003, 4109 NHL cases were diagnosed among resident adults in Sardinia, with an incidence rate of 13.38 x 10(−5) (95% CI 12.97–13.80). NHL incidence showed an upward trend along the study period with an average annual percent change (APC) of 4.94 (95% CI -5.39–16.4), which did not vary by gender or by age-group. Cancer registry data, covering part of the region starting from 1993, suggest that the increasing trend did not persist in the subsequent years. Areas with the highest probability of an excess incidence tended to cluster in the north-eastern part of the region and in two major urban centers, with the low incidence areas located in the south, confirming previous observations. Prevalence of viral infections, environmental and occupational exposures, or socio-economic deprivation would not explain the peculiar geographic distribution we observed. These findings provide convincing arguments for extending the coverage of routine cancer registration over the whole Sardinian population, while prompting further research on the genetic and environmental determinants of NHL in the risk areas

Haemolymphatic cancer among children in Sardinia, Italy: 1974-2003 incidence

Objectives To explore the time trend and geographical distribution of childhood leukaemia incidence over the territory of the Italian region of Sardinia. Setting All hospitals departments, diagnostic centres and social security agencies in Sardinia were regularly screened in 1974-2003 to identify, register and review the diagnoses of incident cases of haematological malignancies (HM). Participants The whole child population aged 0-14 resident in Sardinia. Primary and secondary outcome measures Incidence and time trend of childhood HM and childhood acute lymphoblastic leukaemia (ALL) over the study period, and use of Bayesian methods to plot the probability of areas with excess incidence on the regional map. Results Overall, 675 HM cases, including 378 ALL cases, occurred among children aged 0-14 years resident in Sardinia in 1974-2003, with an incidence rate of 6.97×10-5 (95% CI 6.47 to 7.51) and 3.85×10-5 (95% CI 3.48 to 4.26), respectively. Incidence of HM and ALL showed an upward trend along the study period especially among females. Three communes out of the 356 existing in 1974, namely Ittiri, Villa San Pietro and Carbonia, stand out as areas with excess incidence of HM and ALL in particular and another, Carloforte, for ALL only. Conclusions Our results might serve as convincing arguments for extending the coverage of routine cancer registration over the whole Sardinian population, while prompting further research on the genetic and environmental determinants in the areas at risk

Time trend and Bayesian mapping of multiple myeloma incidence in Sardinia, Italy

A few reports have described increasing trends and spatial distribution of multiple myeloma (MM). We used a validated database including the 1606 cases of MM diagnosed in Sardinia in 1974–2003 to explore its time trend, and we applied Bayesian methods to plot MM probability by administrative unit on the regional map. Over the 30 years of observation, the MM standardized incidence rate (standard world population, all ages) was 2.17 × 10(–5) (95% CI 2.01–2.34), 2.29 (95% CI 2.06–2.52) among men, and 2.06 (95% CI 1.83–2.28) among women. MM incidence increased by 3.3%/year in 1974–2003, in both males and females, particularly among the elderly and in the high incidence areas. Areas at risk tended to cluster in the north-eastern part of the region. A higher proportion of elderly in the resident population, but not socioeconomic factors, nor livestock farming, was associated with higher incidence rates. The steep upward time trend and the spatial clustering of MM suggest interactions between genetic and environmental determinants that might be more efficiently investigated in the areas at risk

Haemolymphatic cancer among children in Sardinia, Italy: 1974–2003 incidence

Objectives To explore the time trend and geographical distribution of childhood leukaemia incidence over the territory of the Italian region of Sardinia.Setting All hospitals departments, diagnostic centres and social security agencies in Sardinia were regularly screened in 1974–2003 to identify, register and review the diagnoses of incident cases of haematological malignancies (HM).Participants The whole child population aged 0–14 resident in Sardinia.Primary and secondary outcome measures Incidence and time trend of childhood HM and childhood acute lymphoblastic leukaemia (ALL) over the study period, and use of Bayesian methods to plot the probability of areas with excess incidence on the regional map.Results Overall, 675 HM cases, including 378 ALL cases, occurred among children aged 0–14 years resident in Sardinia in 1974–2003, with an incidence rate of 6.97×10-5 (95% CI 6.47 to 7.51) and 3.85×10-5 (95% CI 3.48 to 4.26), respectively. Incidence of HM and ALL showed an upward trend along the study period especially among females. Three communes out of the 356 existing in 1974, namely Ittiri, Villa San Pietro and Carbonia, stand out as areas with excess incidence of HM and ALL in particular and another, Carloforte, for ALL only.Conclusions Our results might serve as convincing arguments for extending the coverage of routine cancer registration over the whole Sardinian population, while prompting further research on the genetic and environmental determinants in the areas at risk

Biosorption Behaviour of an Arid Land Plant, Euphorbia Rigida, Towards to Heavy Metals: Equilibrium, Kinetic and Thermodynamic Studies

T he potential of an arid-land plant, Euphorbia rigida E. rigida , for the removal of heavy metals [Pb II , Zn II , Cu II , Cd II , Ni II ] from aqueous solutions was studied in the current work. Batch sorption experiments were conducted to investigate the effects of pH, particle size, initial metal ion concentration, contact time and temperature. Besides, biosorption data was analysed by different isotherm and kinetic models. Equilibrium studies showed that the biosorption closely follows the Langmuir and Freundlich isotherms. From the kinetic point of view, pseudo-second order model gave the best fitting with the experimental results. The evaluated thermodynamic parameters showed that biosorption onto E. rigida was a feasible, spontaneous and endothermic process. The affinities of metal ions onto E. rigida decreased as Pb II > Zn II > Cd II > Cu II > Ni II in single metal biosorption. Besides, binary and ternary metal sorption studies were conducted to investigate the co-ion effect. Experimental results showed that E. rigida can be used as an alternative and effective low cost biosorbent for the removal of heavy metals from aqueous solution

extremity arterial revascularization

Background: This study aims to evaluate the patency rates and long-term outcomes of femoro-popliteal bypass procedures with Omniflow II biosynthetic vascular grafts in patients with occlusive vascular disease.Methods: This retrospective, observational, clinical study included a total of 93 patients (61 males, 32 females; mean age 56.9 +/- 7.4 years; range, 43 to 83 years) who underwent femoro-popliteal bypass in which Omniflow II biosynthetic vascular grafts were used due to peripheral arterial disease. The patients were divided into two groups: 62 patients undergoing femoro-popliteal above-knee bypass and 31 patients undergoing the femoro-popliteal below-knee bypass. We evaluated preoperative clinical characteristics, postoperative graft patency rates, and other clinical results.Results: The mean follow-up was 44.9 +/- 18.8 months in the femoropopliteal above-knee bypass group and 47.3 +/- 22.3 months in the femoro-popliteal below-knee bypass group (p=0.302). The cumulative primary graft patency rates of the femoro-popliteal above-knee bypass and femoro-popliteal below-knee bypass groups at three, four, and five years were 98%, 95% and 78% and 86%, 75% and 45%, respectively (log-rank; p=0.312). The cumulative assisted graft patency rates of the femoro-popliteal above-knee bypass and femoro-popliteal below-knee bypass groups at five years were 87.9% and 65.3%, respectively (log-rank; p=0.530).Conclusion: The Omniflow II biosynthetic vascular graft is suitable for above- and below-knee femoro-popliteal bypass procedures. These grafts may be prefered due to high patency rates, low incidence of aneursym formations, and infections