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A descriptive study of cancers of the female genital tract (cervix, endometrium, ovary, labia, vulva and vagina) in the province of Ragusa (Sicily) was carried out using incidence and mortality data of the Ragusa Cancer Registry, covering the years 1981-1987. Corpus uteri was the most frequent site of cancer, followed by cervix utery and ovary; the highest mortality rates were exhibited by ovary cancer, whose survival at five years was 18.1 percent. A comparison of incidence and mortality rates with those observed by Italian and European registries shows that while in Ragusa rates for cancers of all sites were lower, female genital tract cancers, particularly of the uterus, were more frequent in Ragusa than in other Italian and European areas. In contrast with what has been reported by cancer registries of most developed countries, incidence of cervix cancer in Ragusa has apparently not decreased between 1981 and 1987, while mortality has increased.

In Sicily wastewater is being regarded as a supplemental source of water, especially for agricultural use, which represents the greatest demand at present and in the future. That is because water demand is already approaching total usable resources, and severe shortage is experienced almost everywhere and in every sector. To help overcome possible implementation problems due to high salinity and pollutant concentrations, lack in monitoring capabilities, and emotional public perception of possible health risks, major field research programs have been undertaken, including an experimental station with a pilot plant and a series of field plots.

Prevalence of HBV infection in Palermo was investigated in 1989, in comparison with similar data observed in 1982. Between September 1988 and April 1989, 1001 serum samples taken from healthy individuals or from patients with pathology unrelated to liver diseases, in the age groups 0 to 59 years, were collected. Prevalence of HBsAg and anti-HBc was, respectively, 2.7% and 24.3% in males, 2.3% and 19% in females. Prevalence was inversely related to socioeconomic level as defined by occupation, educational level and area of residence. Prevalence of HBV markers in 1989 was compared with that of a sample of sera taken in 1982 and stored at -20 degrees C. Prevalence was lower in 1989 for age groups under 20, while no difference was seen in older age groups.

The clinical data of 2 population-based registries, located in areas with different incidence rates of colorectal cancer, were used in order to assess the role of familial factors in the pathogenesis of these tumors. The occurrence of tumors in family members was investigated in 389 subjects with colorectal cancer registered in Modena (Northern Italy, an area characterized by a high incidence of colorectal malignancies) between 1984 and 1986; similar information was obtained in 213 patients with tumors of the large bowel registered in Ragusa (Sicily, Southern Italy, an area of similar magnitude and with low incidence rates for these tumors) in the 3-year period 1988 to 1990. In both series, colorectal cancer occurred significantly more often among relatives of patients. Controls were patients of the same sex and age (±5 years) hospitalized during the study periods, but not for gastrointestinal or neoplastic diseases. There were 89 cancer cases (3.1%) among 2,851 relatives of patients in Modena, vs. 17 cases among 1,744 relatives (1.0%) in Ragusa (p < 0.01). Apart from colorectal cancer, there was no excess of other types of tumors in patients' families (in both series). During the 3 years of registration, 17 cases of hereditary non-polyposis colorectal cancer (HNPCC, or Lynch syndrome) were diagnosed in Modena; in contrast, this syndrome was more rare in Ragusa (one case only during 3 years of observation). Similarly, many more families with clinical suspicion of HNPCC were recorded in Northern regions (44 vs. 10). Although incidence rates of colorectal cancer are appreciably higher in Northern than in Southern Italian regions, the excess of this cancer type among close relatives is similar. However, fullblown HNPCC or suspected Lynch syndrome were significantly more frequent in Northern Italy. © 1995 Wiley-Liss, Inc.

The reliability of the death certificates issued in Ragusa for 379 of the 909 cancer patients registered in 1986 by the Ragusa Cancer Registry, who had died within 31 october 1988, was investigated. Data were available for 365 cases deceased. A consistent proportion (32.8%) of disagreements between diagnosis of the Registry and cause of death reported on death certificate was observed, concerning errors of the second and third digit of ICD-9 (21.9%) and for lack of mention of cancer in the death certificate. The main causes of the loss of information were the issuing of the certificate by a M.D. of the permanent medical ward and not by the family doctor, and the lack of the document released by the hospital upon discharge of the patient, usually containing indication on diagnosis and treatment.

A case-control study on 133 consecutive incident cases of nonmelanoma skin cancer registered by Cancer Registry of Ragusa (Sicily) was carried out in order to evaluate the correspondence between risk factors observed in other geographic areas with those of a Latin country with a strong solar exposure. A multivariate analysis showed that family history of skin cancer, cancer-related cutaneous diseases, fair skin color, residence more than 400 meters above sea level, and prolonged solar exposure without protection, significantly and independently increase the risk of skin cancer. Ease of suntanning was an important protective factor. Solar exposure was a stronger risk factor for squamous cell than for basal cell cancer. The results of the study enable us to identify a high risk group of people to whom simple methods of protection against solar exposure may be suggested to reduce the risk of skin cancer.

Survival of 1747 patients with cancer of the stomach, colon/rectum, lung and female breast was investigated on incident cases registered by the Ragusa Cancer Registry, covering the Province of Ragusa (275,000 inhabitants) between 1981 and 1986. Cases known from the death certificate only were excluded. Date of death was obtained by a linkage with death certificates issued for Ragusa residents. Living status was assessed directly at the Registrar's Office. Analysis was performed also by sex, age group and presence of histologic verification. Relative survival at 5 years of Ragusa cancer cases was of the same order of magnitude as that observed in the U.S.A. (1980) and in Switzerland (1970-1980). However, the slight differences observed were mostly in favor of the Swiss and American patients. Sex did not significantly influence survival, but younger patients survived longer than older ones. Lack of histologic verification was associated with poor survival.

In 1988 in Palermo, Italy, the prevalence of antibodies to hepatitis A virus (anti-HAV) in a sample of 490 children 6-13 years old was 10.6%; it increased from 6.3% among children 6-10 years old to 14.7% in children 11-13 years old (P less than 0.01). Compared with findings from a survey conducted in 1978 in the same area, the results of the present study show a significant (P less than 0.01) reduction in the anti-HAV prevalence in both age groups. Anti-HAV prevalence was inversely related to the father's years of education and positively related to the family size. Children of fathers with less than 6 years of schooling had a 3.2-fold risk (C.I. 95% = 1.3-8.1), and children with five or more members in their households had a 2.7-fold risk (C.I. 95% = 1.1-6.4) of previous exposure to hepatitis A virus (HAV) infection. Our findings indicate that exposure of children in Palermo to HAV is decreasing significantly, probably because of improvements in socio-economic conditions during recent years; however socio-demographic factors appear to be important determinants of infection.

A case-control study on breast, cervix and endometrium cancer cases registered in Ragusa between January 1, 1983 and June 30, 1985 has been conducted. Information on risk factors has been obtained by means of a structured questionnaire. Risk factors for endometrium cancer were: few children (1–2 vs > 4 OR 15.18, 95%CL 1.96–117.64), oestrogenic treatment (OR 2.20, 95%CL 1.05–4.90), obesity (Quetelet index >30 vs 2 vs 0 OR 9.87, 95%CL 1.46–66.66), no contraception (OR 8.33, 95%CL 2.38–25.00), younger age of mother at birth (OR 6.89, 95%CL 1.71–27.70). Age at menarche, age at menopause and years of fertile life were not found to be related to either endometrium or cervix uteri cancer. The existence of influencing differences (ancestry, environment, lifestyle) has been postulated.

1810 serum samples obtained from 315 patients with various liver diseases, 44 with miscellaneous non-hepatic diseases and 1133 healthy subjects were assayed for Australia antigen by complement fixation (CF) and immunodiffusion (ID) tests.

This paper deals with a cooperative study, fostered by Associazione Italiana per lo Studio del Fegato, concerning the distribution of Australia antigen in patients with chronic aggressive hepatitis, chronic persistent hepatitis, and primary biliary cirrhosis in Italy.

Incidence rates of lip cancer in males in Ragusa (Sicily) are amongst the highest in Europe [age-standardized rate (world) for 1980-82: 7.5 per 100,000]. A case-control study was conducted on 53 male cases and 106 controls matched for sex, age (+/- 2 1/2 years), residence and hospital from which cases had been drawn. Individual interviews were carried out for the evaluation of ethnic, environmental, pathologic and occupational risk factors. Lip cancer was significantly associated with: fair, brown, or red hair (relative odds = 2.3), blue eyes (r.o. = 5.3), fair skin (r.o. = 8.0), sensitivity to sunburns (r.o. = 4.1), working outdoors (r.o. = 4.9), coexistence of non-specific lesions of exposed body parts (r.o. = 12,2), low socioeconomic status (r.o. = 15.8), farming (r.o. = 2.6) and working in greenhouses (r.o. = 12.0). Recall of recurrent Herpes labialis was not significantly associated; also association with tobacco smoking was not significant after adjustment for socioeconomic status. Risk increased exponentially with the number of ethnic characteristics of northern European populations.

A case-control study on breast, cervix and corpus uteri cancer cases registered in Ragusa between January 1, 1983 and June 30, 1985 has been conducted. Information on risk factors has been obtained by means of a structured questionnaire. Risk factors for breast cancer were: few pregnancies (1-2 vs greater than 4 OR 2.14, 95% CL 1.13-4.04), few children (for postmenopausal only, chi trend 4.84), previous breast disease (OR 1.97, 95% CL 1.20-3.23), family history (OR 3.57, 95% CL 1.92-6.63), alcohol (OR 1.68, 95% CL 1.12-2.53), high socioeconomical status (1 vs 4 OR 2.93, 95% CL 1.22-70.03). A protective role was evident for: early age at first birth (for premenopausal only, less than 20 vs greater than 20 OR 0.11, 95% CL 0.01-0.90), previous ovary disease (OR 0.26, 95% CL 0.08-0.88). Age at menarche, age at menopause, years of fertile life and breast feeding were not found to be related to breast cancer. A different distribution of risk factors among cases with and without family history has been suggested. A synoptic table shows the distribution of the most important risk factors of the three investigated female cancers in the Ragusa population, reported in the present and in an accompanying paper.

Prevalence of HBV infection markers and its association with some risk factors has been studied on hospital staff of the University Polyclinic of Palermo. The results show that male sex, job category (technicians, nurses, cleaners) and age are significantly associated with a higher prevalence of HBV infection markers; length of service and working in departments with a presumably higher exposure to blood did not result as a risk factor of higher prevalence of HBV infection when submitted to multiple regression logistic analysis. It is suggested that results of this study may be affected by the elevated spread of HBV infection in this area, and extra risk associated to hospital exposure is too small to be demonstrated.

Epidemiological investigations were carried out during a viral hepatitis outbreak occurring in a Sicilian town of 30,000 inhabitants with poor sanitary standards, with the aim to study the mode of spread of HAV and HBV in conditions of high incidence of infections. HBsAg, anti HBs, anti HAV (RIA), HBeAg, anti HBe and anti HBc were investigated in serum samples from patients, their family contacts and from healthy individuals of different age groups. Morbidity was inferred from case notifications; search of unreported cases among school children, through the study of absenteeism, did not reveal further cases. In all 148 cases, occurred from August 1976 through July 1977 with a peak in January, 44% were under 5 and 93% under 10 years of age. All but 8 of 59 cases in which laboratory data were available were due to HAV. Anti HAV antibodies were highly prevalent in serum samples obtained in February through April 1977: 62% were positive in the 1 to 3 years age group, and more than 90% among school children. Prevalence of HBsAg was age and sex dependent, ranging from 4% to 15%; anti HBs was present in 8% of the children 1-10 years and in 30% or more in age groups 30-41 and over. It is suggested that direct contact between very young children was the main mode of spread of HAV, and inapparent cases the main source of infection, although ambient diffusion through water contamination could not ruled out. HBV was probably propagated mostly by intrafamilial spread with little overt pathology.

Epidemiological surveillance of influenza was carried out in Palermo betwen 1970 and 1975. Antigenic structure of viral strains A/H3N2 isolated from influenza patients during winter outbreaks was studied in comparison with reference strains circulating in the same periods in other parts of the world. Antigenic drift of hemagglutinin, of neuraminidase, or of both, was observed in Palermo isolates, which were progressively different from Hong Kong/68 strain; 1973 and 1975 isolates were similar to A/England/72 and A/Port Chalmers/73. HI antibodies against Palermo isolates were titered in serum samples obtained from adults living in Palermo. Seronegativity for each strain progressively decreased from 1971 to 1975.

The kinetic parameters of a biological reactor, operating under monoculture and monosubstrate conditions, have been determined. Pure cultures of Nocardia corallina and Pseudomonas fluorescens species have been used with phenol as the only organic carbon source. The experimental runs have been carried out both in a batch and in a continuous stirred reactor. The batch results have been interpreted by zero order kinetics in phenol and first order kinetics in biomass. The kinetic-constants have also been calculated. The activation energy has been determined only for the Nocardia species. Using this strain, the continuous reactor, working without biomass recycle, has confirmed the first order kinetics with respect to biomass. On a determine les parametres cinetiques d'un reacteur biologique dans des conditions impliquant une monoculture et un monosubstrat. On a employe des cultures pures des especes Nocardia corallina et Pseudomonas fluorescent conjointement avec du phenol comme seule source de carbone organique. On a fait les experiences a la fois dans un reacteur a alimentation discontinue et dans un reacteur agite a alimentation continue. On a interprete les resultats obtenus en alimentation discontinue comme impliquant une cinetique d'ordre zero pour le phenol et de premier ordre vis-a-vis de la biomasse; on a aussi calcule les constantes cinetiques. On n'a determine l'energie d'activation que pour l'espece Nocardia. En employant cette valeur, le reacteur a alimentation continue, qui fonctionnait sans recyclage de biomasse, a permis de confirmer la cinetique de premier ordre par rapport a la biomasse.

Classification of different types of preventive measures for ischemic heart disease (IHD) has been much debated. In the classical use of terms “primary prevention” (prevention of occurrence) includes removal of risk factors in otherwise healthy individuals, while the attempts to change diet and life style in the very early age, in order to avoid the acquisition of risk factors, has been called “preprimary prevention” or “early prevention.”

A case-control study on breast, cervix and endometrium cancer cases registered in Ragusa between January 1, 1983 and June 30, 1985 has been conducted. Information on risk factors has been obtained by means of a structured questionnaire. Risk factors for endometrium cancer were: few children (1-2 vs greater than 4 OR 15.18, 95%CL 1.96-117.64), oestrogenic treatment (OR 2.20, 95%CL 1.05-4.90), obesity (Quetelet index greater than 30 vs less than 22 OR 10.42, 95%CL 1.30-83.86), family history (OR 2.87, 95% CL 1.05-7.83). Risk factors for cervix uteri cancer were: multiple abortions (greater than 2 vs 0 OR 9.87, 95%CL 1.46-66.66), no contraception (OR 8.33, 95%CL 2.38-25.00), younger age of mother at birth (OR 6.89, 95%CL 1.71-27.70). Age at menarche, age at menopause and years of fertile life were not found to be related to either endometrium or cervix uteri cancer. The existence of influencing differences (ancestry, environment, lifestyle) has been postulated.

The paper deals with clinical and epidemiological findings concerning persons showing skin lesions after release of TCDD at Seveso. A positive association was observed between geographical distribution of cases and levels of soil contamination. Gastro-intestinal tract impairments were more frequently observed in children with chloracne than in children from the same areas showing no skin lesions. To date, no major immunological involvement has been observed in samples of children exposed to TCDD.

It is well known that interference between two viruses simultaneously infecting the same host may bring about the exclusion of one. When administering attenuated viruses for immunization purposes this fact should be theoretically taken into account. The present tendency of associating attenuated virus into multiple vaccines (trivalent polio, mumps-rubella-measles) is supported by their proved effectiveness. The reasons of the non-operativity of the interference mechanism in such conditions are discussed.