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2. Spatio-temporal models for plant epidemics : analytical and simulation studies

Author

Maule, Milena Maria

Subjects
580
Abstract

We formulate a stochastic spatio-temporal model for the spread of infectious diseases in plants. Studying the behaviour of a model which takes into account stochasticity and spatial extension usually involves intractable mathematics and requires the use of simulation. A challenging objective is to develop analytical methods for general application which provide predictions for the expected behaviour of the model. The individual-based model comprises primary and secondary infection and recovery processes. Using stochastic simulation we study the expected behaviour and variability of the epidemic size, and characterise the disease patterns through spatial correlation. Both stationary and transient behaviour are analysed over the parameter space. Simulation is also used to test empirical extensions of non-spatial models which attempt to account for heterogeneous mixing of susceptibles and infecteds. Analytical methods based on cluster approximations are commonly used for predicting the dynamics of stochastic models characterised by nearest neighbour (NN) interactions. On the other hand, for models with more general interactions, the rather simplistic and non-spatial Mean Field approximation has been extensively used. We propose an alternative general approach, built on individual-based ODEs and closure approximations, for predicting the behaviour of spatial models in which the individuals interact according to a generic function of their distance. The approximations, which take into account the development of correlations in the spatial distribution of the population, are tested against the simulation results showing excellent agreement in most of the parameter space. We also test the ability of cluster approximations to capture the effects of the anisotropic spread of the disease. To this end, we formulate a generalised NN model in which the dispersal of propagules depends on the direction of spread and use simulation to assess the performance of different approximations.

Published
2000

3. Evaluation of Maternal Infection During Pregnancy and Childhood Leukemia Among Offspring in Denmark

Author

He, Jian-Rong, primary, Yu, Yongfu, additional, Fang, Fang, additional, Gissler, Mika, additional, Magnus, Per, additional, László, Krisztina D., additional, Ward, Mary H., additional, Paltiel, Ora, additional, Tikellis, Gabriella, additional, Maule, Milena Maria, additional, Qiu, Xiu, additional, Du, Jiangbo, additional, Valdimarsdóttir, Unnur Anna, additional, Rahimi, Kazem, additional, Wiemels, Joseph L., additional, Linet, Martha S., additional, Hirst, Jane E., additional, Li, Jiong, additional, and Dwyer, Terence, additional

Published
2023
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4. Evaluation of Maternal Infection During Pregnancy and Childhood Leukemia Among Offspring in Denmark

Author

Jian-Rong, He, Yongfu, Yu, Fang, Fang, Gissler, Mika, Magnus, Per, László, Krisztina D, Ward, Mary H, Paltiel, Ora, Tikellis, Gabriella, Maule, Milena Maria, Qiu, Xiu, Jiangbo, Du, Valdimarsdóttir, Unnur Anna, Rahimi, Kazem, Wiemels, Joseph L, Linet, Martha S, Hirst, Jane E, Jiong, Li, and Dwyer, Terence

Subjects
General Medicine
Abstract

ImportanceMaternal infection is common during pregnancy and is an important potential cause of fetal genetic and immunological abnormalities. Maternal infection has been reported to be associated with childhood leukemia in previous case-control or small cohort studies.ObjectiveTo evaluate the association of maternal infection during pregnancy with childhood leukemia among offspring in a large study.Design, Setting, and ParticipantsThis population-based cohort study used data from 7 Danish national registries (including the Danish Medical Birth Register, the Danish National Patient Registry, the Danish National Cancer Registry, and others) for all live births in Denmark between 1978 and 2015. Swedish registry data for all live births between 1988 and 2014 were used to validate the findings for the Danish cohort. Data were analyzed from December 2019 to December 2021.ExposuresMaternal infection during pregnancy categorized by anatomic locations identified from the Danish National Patient Registry.Main Outcomes and MeasuresThe primary outcome was any leukemia; secondary outcomes were acute lymphoid leukemia (ALL) and acute myeloid leukemia (AML). Offspring childhood leukemia was identified in the Danish National Cancer Registry. Associations were first assessed in the whole cohort using Cox proportional hazards regression models, adjusted for potential confounders. A sibling analysis was performed to account for unmeasured familial confounding.ResultsThis study included 2 222 797 children, 51.3% of whom were boys. During the approximately 27 million person-years of follow-up (mean [SD], 12.0 [4.6] years per person), 1307 children were diagnosed with leukemia (ALL, 1050; AML, 165; or other, 92). Children born to mothers with infection during pregnancy had a 35% increased risk of leukemia (adjusted hazard ratio [HR], 1.35 [95% CI, 1.04-1.77]) compared with offspring of mothers without infection. Maternal genital and urinary tract infections were associated with a 142% and 65% increased risk of childhood leukemia, with HRs of 2.42 (95% CI, 1.50-3.92) and 1.65 (95% CI, 1.15-2.36), respectively. No association was observed for respiratory tract, digestive, or other infections. The sibling analysis showed comparable estimates to the whole-cohort analysis. The association patterns for ALL and AML were similar to that for any leukemia. No association was observed for maternal infection and brain tumors, lymphoma, or other childhood cancers.Conclusions and RelevanceIn this cohort study of approximately 2.2 million children, maternal genitourinary tract infection during pregnancy was associated with childhood leukemia among offspring. If confirmed in future studies, our findings may have implications for understanding the etiology and developing preventive measures for childhood leukemia.

Published
2023

8. Diaphragmatic Point-of-Care Ultrasound in COVID-19 Patients in the Emergency Department—A Proof-of-Concept Study

Author

Pivetta, Emanuele, primary, Cara, Irene, additional, Paglietta, Giulia, additional, Scategni, Virginia, additional, Labarile, Giulia, additional, Tizzani, Maria, additional, Porrino, Giulio, additional, Locatelli, Stefania, additional, Calzolari, Gilberto, additional, Morello, Fulvio, additional, Maule, Milena Maria, additional, and Lupia, Enrico, additional

Published
2021
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10. Modeling mesothelioma risk associated with environmental asbestos exposure

Author

Maule, Milena Maria, Magnani, Corrado, Dalmasso, Paola, Mirabelli, Dario, Merletti, Franco, and Biggeri, Annibale

Subjects
Environmental health -- Research -- Health aspects, Mesothelioma -- Research -- Causes of, Asbestos -- Research -- Health aspects
Abstract

BACKGROUND: Environmental asbestos pollution can cause malignant mesothelioma, but few studies have involved dose-response analyses with detailed information on occupational, domestic, and environmental exposures. OBJECTIVES: In the present study, we [...]

Published
2007

11. Specific Detection of Cytokeratin 20-Positive Cells in Blood of Colorectal and Breast Cancer Patients by a High Sensitivity Real-Time Reverse Transcriptase-Polymerase Chain Reaction Method

Author

Giribaldi, Giuliana, Procida, Simone, Ulliers, Daniela, Mannu, Franca, Volpatto, Roberta, Mandili, Giorgia, Fanchini, Laura, Bertetto, Oscar, Fronda, Gianruggero, Simula, Luigi, Rimini, Elena, Cherchi, Giovanni, Bonello, Lisa, Maule, Milena Maria, and Turrini, Francesco

Published
2006
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12. Worldwide comparison of survival from childhood leukaemia for 1995–2009, by subtype, age, and sex (CONCORD-2): a population-based study of individual data for 89 828 children from 198 registries in 53 countries

Author

Bonaventure, Audrey, Harewood, Rhea, Stiller, Charles A, Gatta, Gemma, Clavel, Jacqueline, Stefan, Daniela C, Carreira, Helena, Spika, Devon, Marcos Gragera, Rafael, Peris Bonet, Rafael, Piñeros, Marion, Sant, Milena, Kuehni, Claudia E, Murphy, Michael F. G, Coleman, Michel P, Allemani, Claudia, Bouzbid, S., Hamdi Chérif, M., Zaidi, Z., Bah, E., Swaminathan, R., Nortje, S. H., El Mistiri, M. M., Bayo, S., Malle, B., Manraj, S. S., Sewpaul Sungkur, R., Fabowale, Null, Ogunbiyi, O. J., Bradshaw, D., Somdyala, N. I. M., Stefan, D. C., Abdel Rahman, M., Jaidane, L., Mokni, M., Kumcher, I., Moreno, F., González, M. S., Laura, E. A., Espinola, S. B., Calabrano, G. H., Carballo Quintero, B., Fita, R., Garcilazo, D. A., Giacciani, P. L., Diumenjo, M. C., Laspada, W. D., Green, M. A., Lanza, M. F., Ibañez, S. G., Lima, C. A., de Oliveira, E. Lobo, Daniel, C., Scandiuzzi, C., De Souza, P. C. F., Melo, C. D., Del Pino, K., Laporte, C., Curado, M. P., de Oliveira, J. C., Veneziano, C. L. A., Veneziano, D. B., Alexandre, T. S., Verdugo, A. S., Azevedo e. Silva, G., Galaz, J. C., Moya, J. A., Herrmann, D. A., Vargas, S., Herrera, V. M., Uribe, C. J., Bravo, L. E., Arias Ortiz, N. E., Jurado, D. M., Yépez, M. C., Galán, Y. H., Torres, P., Martínez Reyes, F., Pérez Meza, M. L., Jaramillo, L., Quinto, R., Cueva, P., Yépez, J. G., Torres Cintrón, C. R., Tortolero Luna, G., Alonso, R., Barrios, E., Nikiforuk, C., Shack, L., Coldman, A. J., Woods, R. R., Noonan, G., Turner, D., Kumar, E., Zhang, B., Mccrate, F. R., Ryan, S., Hannah, H., Dewar, R. A. D., Macintyre, M., Lalany, A., Ruta, M., Marrett, L., Nishri, D. E., Mcclure, C., Vriends, K. A., Bertrand, C., Louchini, R., Robb, K. I., Stuart Panko, H., Demers, S., Wright, S., George, J. T., Shen, X., Brockhouse, J. T., O'Brien, D. K., Ward, K. C., Almon, L., Bates, J., Rycroft, R., Mueller, L., Phillips, C., Brown, H., Cromartie, B., Schwartz, A. G., Vigneau, F., Mackinnon, J. A., Wohler, B., Bayakly, A. R., Clarke, C. A., Glaser, S. L., West, D., Green, M. D., Hernandez, B. Y., Johnson, C. J., Jozwik, D., Charlton, M. E., Lynch, C. F., Huang, B., Tucker, T. C., Deapen, D., Liu, L., Hsieh, M. C., X. C., Wu, Stern, K., Gershman, S. T., Knowlton, R. C., Alverson, J., Copeland, G. E., Rogers, D. B., Lemons, D., Williamson, L. L., Hood, M., Hosain, G. M., Rees, J. R., Pawlish, K. S., Stroup, A., Key, C., Wiggins, C., Kahn, A. R., Schymura, M. J., Leung, G., Rao, C., Giljahn, L., Warther, B., Pate, A., Patil, M., Schubert, S. S., Rubertone, J. J., Slack, S. J., Fulton, J. P., Rousseau, D. L., Janes, T. A., Schwartz, S. M., Bolick, S. W., Hurley, D. M., Richards, J., Whiteside, M. A., Nogueira, L. M., Herget, K., Sweeney, C., Martin, J., Wang, S., Harrelson, D. G., Cheteri, MB Keitheri, Farley, S., Hudson, A. G., Borchers, R., Stephenson, L., Espinoza, J. R., Weir, H. K., Edwards, B. K., Wang, N., Yang, L., Chen, J. S., Song, G. H., X. P., Gu, Zhang, P., H. M., Ge, Zhao, D. L., Zhang, J. H., Zhu, F. D., Tang, J. G., Shen, Y., Wang, J., Q. L., Li, Yang, X. P., Dong, J., Li, W., Cheng, L. P., Chen, J. G., Huang, Q. H., Huang, S. Q., Guo, G. P., Wei, K., Chen, W. Q., Zeng, H., Demetriou, A. V., Pavlou, P., Mang, W. K., Ngan, K. C., Kataki, A. C., Krishnatreya, M., Jayalekshmi, P. A., Sebastian, P., Sapkota, S. D., Verma, Y., Nandakumar, A., Suzanna, E., Keinan Boker, L., Silverman, B. G., Ito, H., Nakagawa, H., Hattori, M., Kaizaki, Y., Sugiyama, H., Utada, M., Katayama, K., Narimatsu, H., Kanemura, S., Koike, T., Miyashiro, I., Yoshii, M., Oki, I., Shibata, A., Matsuda, T., Nimri, O., Ab Manan, A., Pathy, N. Bhoo, Chimedsuren, O., Tuvshingerel, S., Al Khater, A. H. M., Al Eid, H., Jung, K. W., Won, Y. J., Chiang, C. J., Lai, M. S., Suwanrungruang, K., Wiangnon, S., Daoprasert, K., Pongnikorn, D., Geater, S. L., Sriplung, H., Eser, S., Yakut, C. I., Hackl, M., Mühlböck, H., Oberaigner, W., Zborovskaya, A. A., Aleinikova, O. V., Henau, K., Van Eycken, L., Dimitrova, N., Valerianova, Z., Šekerija, M., Zvolský, M., Engholm, G., Storm, H., Innos, K., Mägi, M., Malila, N., Seppä, K., Jégu, J., Velten, M., Cornet, E., Troussard, X., Bouvier, A. M., Faivre, J., Guizard, A. V., Bouvier, V., Launoy, G., Arveux, P., Maynadié, M., Mounier, M., Fournier, E., Woronoff, A. S., Daoulas, M., Clavel, J., Le Guyader Peyrou, S., Monnereau, A., Trétarre, B., Colonna, M., Cowppli Bony, A., Molinié, F., Bara, S., Degré, D., Ganry, O., Lapôtre Ledoux, B., Grosclaude, P., Estève, J., Bray, F., Piñeros, M., Sassi, F., Stabenow, R., Eberle, A., Erb, C., Nennecke, A., Kieschke, J., Sirri, E., Kajueter, H., Emrich, K., Zeissig, S. R., Holleczek, B., Eisemann, N., Katalinic, A., Brenner, H., Asquez, R. A., Kumar, V., Ólafsdóttir, E. J., Tryggvadóttir, L., Comber, H., Walsh, P. M., Sundseth, H., Devigili, E., Mazzoleni, G., Giacomin, A., Bella, F., Castaing, M., Sutera, A., Gola, G., Ferretti, S., Serraino, D., Zucchetto, A., Lillini, R., Vercelli, M., Busco, S., Pannozzo, F., Vitarelli, S., Ricci, P., Pascucci, C., Autelitano, M., Cirilli, C., Federico, M., Fusco, M., Vitale, M. F., Usala, M., Cusimano, R., Mazzucco, W., Michiara, M., Sgargi, P., Maule, MILENA MARIA, Sacerdote, C., Tumino, R., Di Felice, E., Vicentini, M., Falcini, F., Cremone, L., Budroni, M., Cesaraccio, R., Contrino, M. L., Tisano, F., Fanetti, A. C., Maspero, S., Candela, G., Scuderi, T., Gentilini, M. A., Piffer, S., Rosso, S., Sacchetto, Lidia, Caldarella, A., La Rosa, F., Stracci, F., Contiero, P., Tagliabue, G., Dei Tos, A. P., Zorzi, M., Zanetti, R., Baili, P., Berrino, F., Gatta, G., Sant, M., Capocaccia, R., De Angelis, R., Liepina, E., Maurina, A., Smailyte, G., Agius, D., Calleja, N., Siesling, S., Visser, O., Larønningen, S., Møller, B., Dyzmann Sroka, A., Trojanowski, M., Gózdz, S., Mezyk, R., Gradalska Lampart, M., Radziszewska, A. U., Didkowska, J. A., Wojciechowska, U., Blaszczyk, J., Kepska, K., Bielska Lasota, M., Kwiatkowska, K., Forjaz, G., Rego, R. A., Bastos, J., Silva, M. A., Antunes, L., Bento, M. J., Mayer da Silva, A., Miranda, A., Coza, D., Todescu, A. I., Valkov, M. Y., Adamcik, J., Safaei Diba, C., Primic Žakelj, M., Žagar, T., Stare, J., Almar, E., Mateos, A., Quirós, J. R., Bidaurrazaga, J., Larrañaga, N., Díaz García, J. M., Marcos, A. I., Marcos Gragera, R., Vilardell Gil, M. L., Molina, E., Sánchez, M. J., Sureda, P. Franch, Montserrat, M. Ramos, Chirlaque, M. D., Navarro, C., Ardanaz, E. E., Moreno Iribas, C. C., Fernández Delgado, R., Peris Bonet, R., Galceran, J., Khan, S., Lambe, M., Camey, B., Bouchardy, C., Usel, M., Ess, S. M., Herrmann, C., Bulliard, J. L., Maspoli Conconi, M., Frick, H., Kuehni, C. E., Schindler, M., Bordoni, A., Spitale, A., Chiolero, A., Konzelmann, I., Dehler, S. I., Matthes, K. L., Rashbass, J., Stiller, C. A., Fitzpatrick, D., Gavin, A., Bannon, F., Black, R. J., Brewster, D. H., Huws, D. W., White, C., Finan, P., Allemani, C., Bonaventure, A., Carreira, H., Coleman, M. P., Di Carlo, V., Harewood, R., Liu, K., Matz, M., Montel, L., Nikšic, M., Rachet, B., Sanz, N., Spika, D., Stephens, R., Peake, M., Murphy, M. F. G., Chalker, E., Newman, L., Baker, D., Soeberg, M. J., Aitken, J., Scott, C., Stokes, B. C., Venn, A., Farrugia, H., Giles, G. G., Threlfall, T., Currow, D., You, H., Hendrix, J., Lewis, C., Latorre, M. R. D. O., and Tanaka, L. F.

Subjects
Hematology
Published
2017

13. Lung ultrasound in the emergency setting: Accuracy cannot exclude expertise: Response

Author

Pivetta, EMANUELE EMILIO, Goffi, Alberto, Lupia, Enrico, Tizzani, Maria, Porrino, Giulio, Ferreri, Enrico, Volpicelli, Giovanni, Balzaretti, Paolo Luigi, Banderali, Alessandra, Iacobucci, Antonello, Locatelli, Stefania, Casoli, Giovanna, Stone, Michael B., Maule, MILENA MARIA, Baldi, Ileana, Merletti, Franco, and Cibinel, Gian Alfonso

Subjects
Heart Failure, Lung Diseases, Male, Pulmonary and Respiratory Medicine, Emergency Service, Hospital, Dyspnea, Medicine (all), Female, Humans, Emergency Service, Hospital, Critical Care and Intensive Care Medicine, Cardiology and Cardiovascular Medicine
Published
2015

14. Lung ultrasound-implemented diagnosis of acute decompensated heart failure in the ED: A SIMEU multicenter study

Author

Pivetta, EMANUELE EMILIO, Goffi, Alberto, Lupia, Enrico, Tizzani, Maria, Porrino, Giulio, Ferreri, Enrico, Volpicelli, Giovanni, Balzaretti, Paolo Luigi, Banderali, Alessandra, Iacobucci, Antonello, Locatelli, Stefania, Casoli, Giovanna, Stone, Michael B., Maule, MILENA MARIA, Baldi, Ileana, Merletti, Franco, and Cibinel, Gian Alfonso

Subjects
Heart Failure, Lung Diseases, Male, Pulmonary and Respiratory Medicine, Emergency Service, Aged, Aged, 80 and over, Clinical Protocols, Cohort Studies, Dyspnea, Female, Humans, Italy, Middle Aged, Predictive Value of Tests, Emergency Service, Hospital, Critical Care and Intensive Care Medicine, Cardiology and Cardiovascular Medicine, Medicine (all), Hospital, 80 and over
Published
2015

15. Risk factors related to late metastases in 1,372 melanoma patients disease free more than 10 years

Author

OSELLA ABATE, Simona, Ribero, Simone, Sanlorenzo, M, Maule, MILENA MARIA, Richiardi, Lorenzo, Merletti, Franco, Tomasini, C, Marra, E, Macripò, G, Fierro, Maria Teresa, and Quaglino, Pietro

Subjects
Adult, Male, Cancer Research, dormancy, Lung Neoplasms, Time Factors, Adolescent, Disease-Free Survival, Young Adult, late metastases, melanoma, pattern of recurrence, Age Factors, Aged, Aged, 80 and over, Brain Neoplasms, Child, Female, Humans, Lymphatic Metastasis, Melanoma, Middle Aged, Proportional Hazards Models, Retrospective Studies, Risk Factors, Oncology, Medicine (all), 80 and over
Abstract

In many centers, Stage I-II melanoma patients are considered "cured" after 10 years of disease-free survival and follow-up visits are interrupted. However, melanoma may relapse also later. We retrospectively analyzed a cohort of 1,372 Stage I-II melanoma patients who were disease-free 10 years after diagnosis. The aim of this study was to characterize patients who experienced a late recurrence and to compare them to those who remained disease-free to identify possible predictive factors. Multivariate Cox proportional-hazards regression analyses were carried out to evaluate the influence of different factors on the risk of recurrence. Seventy-seven patients out of 1,372 (5.6%) relapsed, 52 in regional sites and 25 in distant ones. The majority of patients (31 out of 52) experienced late recurrence in regional lymph nodes. Brain and lung were the most common site of single distant recurrence (24% each). Patients with multiple distant metastases showed a brain and lung involvement in, respectively, 40 and 48% of cases. A Cox proportional-hazards regression model analysis showed the independent role of age under 40 years, Breslow thickness2 mm, and Clark Level IV/V in increasing the risk of Late Recurrence. These patients should be followed-up for longer than 10 years. The pattern of recurrence suggests that melanoma cells can be dormant preferentially in lymph nodes, brain and lung. A particular attention should be reserved to these anatomic sites during the follow-up after 10 years of disease-free.

Published
2014

16. Lactoferrin and prevention of late-onset sepsis in the pre-term neonates

Author

Manzoni, P, Decembrino, L, Stolfi, I, Pugni, L, Rinaldi, M, Cattani, Sara, Romeo, Mg, Messner, H, Laforgia, N, Vagnarelli, F, Memo, L, Bordignon, L, Saia, Os, Maule, MILENA MARIA, Gallo, E, Mostert, Michael Martin, Magnani, Silvia Carla, Quercia, M, Bollani, Luigi, Pedicino, R, Renzullo, L, Betta, P, Ferrari, F, Magaldi, R, Mosca, F, Stronati, M, Farina, Davide, Italian, Task Force for the Study, Prevention of Neonatal Fungal Infections, and Italian Society of, Neonatology

Subjects
Infant, Premature, Diseases, Sepsis, chemistry.chemical_compound, Anti-Infective Agents, Lactoferricin, Intensive care, medicine, Animals, Humans, Age of Onset, biology, Lactoferrin, business.industry, Infant, Newborn, Obstetrics and Gynecology, medicine.disease, Antimicrobial, Lactoferrin and prevention of late-onset sepsis, Low birth weight, chemistry, Pediatrics, Perinatology and Child Health, Immunology, biology.protein, Premature Birth, Colostrum, Cattle, medicine.symptom, business, Infant, Premature, Fluconazole, medicine.drug
Abstract

Late-onset sepsis (LOS) affects a large proportion of pre-term neonates in neonatal intensive care units (NICUs) worldwide, with high morbidity and related mortality, and frequent occurrence of severe late neurodevelopmental impairment. Due to the frequency, severity and difficulties in early diagnosis and prompt therapy, prevention is crucial for decreasing the burden of infection-related complications in NICUs. It is well known that feeding with fresh maternal milk, hygiene measures and the cautious use of H2-blockers are related with a decreased risk of developing sepsis. However, evidence from randomised clinical trials exists only for fluconazole in the prevention of fungal infections in the NICU. Lactoferrin is the main whey protein in mammalian milk, and is involved in innate immune host defences. Notably, human lactoferrin can be found at increased concentrations in colostrum and in milk from mothers of premature neonates. Human (hLF) and bovine lactoferrin (bLF) share a high (77%) amino-acid homology, and the same N-terminal peptide responsible for antimicrobial activity, called lactoferricin. In vitro, bLF shows potent direct antimicrobial activity against all types of pathogens, which occurs via anti-cell wall actions and leads to disintegration of the micro-organism's membranes. bLF is also synergistic with many antimicrobials and antifungals, and promotes growth and differentiation of the immature gut. Based on this background data, a randomised clinical trial was recently conducted in very low birth weight pre-term neonates given bLF alone or with the probiotic Lactobacillus GG. The aim of the trial was to assess the ability of bLF to prevent late-onset sepsis of any origin in the studied infants during their stay in the NICU. This article discusses the preliminary data from this study, along with the proposed mechanisms of action of bLF in pre-term infants.

Published
2010

17. Clinical and functional prediction of moderate to severe obstructive sleep apnoea

Author

Bucca, Caterina, Brussino, Luisa, Maule, MILENA MARIA, Baldi, I, Guida, Giuseppe, Culla, B, Merletti, Franco, Foresi, A, Rolla, Giovanni, Mutani, R, and Cicolin, Alessandro

Subjects
Adult, Male, Sleep Apnea, Obstructive, Polysomnography, nitric oide, Middle Aged, sleep apnea, Nitric Oxide, Body Mass Index, Nomograms, Young Adult, Breath Tests, Risk Factors, Spirometry, Humans, Female, Obesity, Pulmonary Ventilation, Aged
Abstract

Upper airway inflammation and narrowing are characteristics of obstructive sleep apnoea (OSA). Inflammatory markers have been found to be increased in exhaled breath and induced sputum of patients with OSA.The aim of this study was to investigate if the measurement of exhaled nitric oxide (F(ENO) ), as marker of airway inflammation, together with the forced mid-expiratory/mid-inspiratory airflow ratio (FEF(50) /FIF(50) ), as marker of upper airway narrowing, may help to predict OSA.Two hundred one consecutive outpatients with suspected OSA were prospectively studied between January 2004 and December 2005. All patients underwent clinical examination, spirometry with measurement of FEF(50) /FIF(50) , maximum inspiratory pressure, arterial blood gas analysis, exhaled nitric oxide (F(ENO) ) and overnight polysomnography. Linear regression models were used to evaluate the effect of measured variables on the apnoea-hypopnoea index (AHI). Models were cross-validated by bootstrapping.Most of the patients were obese and had severe OSA. FEF(50) /FIF(50) , F(ENO) and an interaction term between smoking and F(ENO) contributed significantly to the predictive model for AHI, in addition to age, neck circumference, body mass index and carboxyhaemoglobin saturation. A nomogram to predict AHI was obtained, which converted the effect of each covariate in the model to a 0-100 scale. The nomogram showed a good predictive ability for AHI values between 25 and 64.The measurement of F(ENO) and of FEF(50) /FIF(50) improves the ability to predict OSA and may be used to identify patients who require a sleep study.

Published
2011

18. Marriage and parenthood among subjects cured of childhood cancer: a report from the Italian AIEOP Off-Therapy Registry

Author

Pivetta, EMANUELE EMILIO, Maule, MILENA MARIA, Pisani, Paola, Zugna, Daniela, Haupt, R, Jankovic, M, Arico', M, Casale, F, Clerico, A, CORDERO DI MONTEZEMOLO, Luca, Kiren, V, Locatelli, F, Palumbo, G, Pession, A, Pillon, M, Santoro, N, Terenziani, M, Valsecchi, Mg, Dama, Elisa, Magnani, C, Merletti, Franco, Pastore, G., Pivetta E., Maule MM., Pisani P., Zugna D., Haupt R., Jankovic M., Arico' M., Casale F., Clerico A., Cordero di Montezemolo L., Kiren V., Locatelli F., Palumbo G., Pession A., Pillon M., Santoro N., Terenziani M., Valsecchi MG., Dama E., Magnani C., Merletti F., Pastore G., Pivetta, E, Maule, Mm, Pisani, P, Zugna, D, Haupt, R, Jankovic, M, Aricò, M, Casale, Fiorina, Clerico, A, CORDERO DI MONTEZEMOLO, L, Kiren, V, Locatelli, F, Palumbo, G, Pession, A, Pillon, M, Santoro, N, Terenziani, M, Valsecchi, Mg, Dama, E, Magnani, C, Merletti, F, and Pastore, G.

Subjects
Quality of life, Fertility, childhood cancer, Marriage, Long-term survivors, childhood cancer, marriage, fertility, long-term survivors, quality of life
Abstract

The aim of this study was to describe the patterns of marriage and parenthood in a cohort of childhood cancer survivors included in the Off-Therapy Registry maintained by the Italian Association of Pediatric Hematology and Oncology. Design and Methods We analyzed a cohort of 6,044 patients diagnosed with cancer between 1960 and 1998, while aged 0 to 14 years and who were 18 years old or older by December 2003. They were followed up through the regional vital statistics registers until death or the end of follow up (October 30, 2006), whichever occurred first, and their marital status and date of birth of their children were recorded. The cumulative probabilities of being married and having a first child were computed by gender and compared by tumor type within the cohort. Marriage and fertility rates (the latter defined as the number of live births per woman-year) were compared with those of the Italian population of the same age, gender, area of residence and calendar period by means of the observed to expected (O/E) ratios. Results During the follow-up period, 4,633 (77%) subjects had not married. The marriage O/E ratios were 0.56 (95% CI: 0.51-0.61) and 0.70 (95% CI: 0.65-0.76) among men and women, respectively. Overall, 263 men had 367 liveborn children, and 473 women had 697 liveborn children. The female fertility O/E ratio was 0.57 (95% CI: 0.53-0.62) overall, and 1.08 (95% CI: 0.99-1.17) when analyses were restricted to married/cohabiting women Conclusions Childhood cancer survivors are less likely to marry and to have children than the general population, confirming the life-long impact of their previous disease on their social behavior and choices. The inclusion of counseling in the strategies of management and long-term surveillance of childhood cancer patients could be beneficial to survivors as they approach adulthood.

Published
2011

20. Expected number of childhood cancers in Italy from 2001 to 2015.

Author

Baussano I, Maule MM, Dama E, Dalmasso P, Mosso ML, Galzerano M, Merletti F, Magnani C, and Pastore G

Subjects
Adolescent, Child, Child, Preschool, Female, Humans, Incidence, Infant, Infant, Newborn, Italy epidemiology, Male, Prognosis, Survival Rate, Time Factors, Neoplasms epidemiology, Registries
Abstract

The total number of children with incident cancer in Italy has never been specifically estimated. Specialized population-based Childhood Cancer Registries have only been operating in Piedmont (CCRP) and in the Marche region, while general population cancer registries cover about 20% of the Italian population. The number of expected cases of childhood cancer (0-14 years) in Italy in the period 2001-2015 has been estimated using CCRP incidence rates and annual percentage changes. The expected number of cases of all cancer types were 8,132, 8,672 and 8,944 in the periods 2001-2005, 2006-2010 and 2011-2015 respectively. These figures help evaluate the allocation of resources for the care of child cancer patients in Italy, and to estimate the number of cases expected to enter clinical trials.

Published
2007
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21. Late deaths among five-year survivors of childhood cancer. A population-based study in Piedmont Region, Italy.

Author

Dama E, Pastore G, Mosso ML, Ferrante D, Maule MM, Magnani C, and Merletti F

Subjects
Child, Follow-Up Studies, Humans, Italy epidemiology, Neoplasms epidemiology, Neoplasms therapy, Registries, Survival Analysis, Survivors, Time Factors, Treatment Outcome, Neoplasms mortality, Neoplasms physiopathology
Abstract

Background and Objectives: The aim of this study was to analyze late mortality among 5-year survivors of childhood cancer, in Piedmont (Italy), in terms of risk factors and causes of death., Design and Methods: From 1967 to 1999, the Childhood Cancer Registry of Piedmont recorded 3164 incident cases. Patients identified only by a death certificate (n = 59), lost to follow-up (n = 32), alive with a period of observation shorter than 5 years at the end of follow-up (n = 65) and records corresponding to a second malignant tumor during childhood (n = 9) were excluded from the analyses., Results: Within 5 years after diagnosis, 1301 children died, and among the 1698 5- year survivors, 144 children subsequently died. Among 5-year survivors, cumulative mortality percentages increased from 5.1% (95% CI 4.0-6.2) at 10 years after diagnosis to 16.0% (12.2-19.8) at 35 years. Period of diagnosis (p = 0.006), age at diagnosis (p = 0.002), and tumor type (p = 0.003) were associated with late mortality. Most deaths were related to cancer recurrence (62.2%) and treatment-related sequelae (22.4%), including second malignant neoplasms, cardiac diseases and other late effects. Compared to the general population, children included in this study had a 9-fold increased risk of overall mortality, and experienced an absolute excess of 4.4 deaths per 1000 person-years., Interpretation and Conclusions: Among 5-year survivors, patients treated more recently (after 1979) had a statistically significant lower risk of late death than those treated earlier. However, long-term survivors still experienced higher mortality rates than those in the general population, and recurrence or progression of the primary tumor was the first cause of death.

Published
2006

22. Temporal trends in the incidence of childhood leukemia, lymphomas and solid tumors in north-west Italy, 1967-2001. A report of the Childhood Cancer Registry of Piedmont.

Author

Dalmasso P, Pastore G, Zuccolo L, Maule MM, Pearce N, Merletti F, and Magnani C

Subjects
Adolescent, Child, Child, Preschool, Female, Humans, Incidence, Infant, Infant, Newborn, Italy epidemiology, Male, Leukemia epidemiology, Lymphoma epidemiology, Registries
Abstract

Background and Objectives: Several studies have been published on trends in childhood cancer incidence, with different patterns being reported. We present an analysis of cancer incidence trends in Piedmont (Italy) in 1967-2001 for the major categories of childhood malignant neoplasms., Design and Methods: The population-based Childhood Cancer Registry of Piedmont has recorded incident cases of malignant neoplasm in children (age 0-14) since 1967. Procedures for data collection and coding have been uniform throughout the study period. We calculated incidence rates per million children per year by sex and age-group. Trends were estimated using Poisson regression analysis, adjusted for age and sex and presented as the annual percent change (APC)., Results: Significant increases were observed for all malignant neoplasms combined (3360 cases, APC:1.3%, 95% CI:1.0% to 1.6%), leukemia (APC: 1.0%, 95% CI: 0.4% to 1.6%), central nervous system (CNS) tumors (APC of 2.3%, 95% CI: 1.6% to 3.1%) and neuroblastoma (APC: 2.3%, 95% CI: 1.0% to 3.5%). Acute lymphoblastic leukemia (APC 1.2%, 95% CI: 0.2% to 2.3%), and Acute non-lymphoblastic leukemia (APC 1.7%, 95% CI-0.6%, 4.1) both increased over time. Differences by age groups were observed for some tumor types, such as for neuroblastoma in infants (4.8% increase per year), leukemia in children aged 1-4 years (1.2%) and CNS tumors in children aged 10-14 (3.4%)., Interpretation and Conclusions: Our data suggest an increasing incidence of childhood cancer in general, and specifically for leukemia, CNS tumors and neuroblastoma in Piedmont in 1967-2001. The observed trends are unlikely to be explained by random variation, changes in exhaustiveness or quality of data collection and registration.

Published
2005

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