Provincial Health Unit

Ragusa, Italy

Provincial Health Unit

Ragusa, Italy
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Gabutti G.,Health-U | Aquilina M.,Local Health Unit Of Agrigento N 1 | Cova M.,Local Health Unit of Ferrara | Giuffrida S.,Provincial Health Unit | And 6 more authors.
Journal of Preventive Medicine and Hygiene | Year: 2012

Introduction. Estimate the efficacy of oral anticholeric vaccine Dukoral® in subjects travelling to high-risk areas for traveler's diarrhoea and cholera. Methods. The study involved subjects of both genders who planned to travel to high-risk areas for traveler's diarrhoea and cholera. Immunization with oral anticholeric vaccine Dukoral® was offered to each one of them. Upon returning, all the participants in the study were asked to complete a self-administered questionnaire consisting of 40 close-ended questions mainly concerning: personal and health data, characteristics (length, destination, reason) of the travel, onset of gastrointestinal symptoms, data relating to the assumption of anticholeric vaccine and possible adverse reactions. Results. 296 questionnaires have been collected. Mean age was 38.2 years (55.4% males and 44.6% females). Mean travel length was 22.2 days. Reasons for the travel: 66.8% tourism and 33.2% work-cooperation. Most frequent destination was Africa (48.1%), followed by Asia (32.1%) and Central South- America (17.8%). 199 subjects (67.2%) properly executed vaccination with Dukoral®. The diarrhoea affected 14.1% of vaccinated subjects and 20.6% of non vaccinated ones. The following cohorts showed statistically significant differences in incidence of diarrhoea: < 35 years old age (13.7% vs. 27.1%), travel for work-cooperation (14.1% vs. 35%) and travel length > 28 days (12.1% vs. 40%). No serious adverse events were reported following vaccination. Discussion. Oral Anticholeric vaccine proved to be effective and safe in preventing fecal-oral diseases in travelers exposed to high risk conditions.


Tumino R.,Provincial Health Unit | Tumino R.,MP Arezzo Civic Hospital | Minicozzi P.,Instituto Nazionale dei Tumori | Frasca G.,Provincial Health Unit | And 12 more authors.
Cancer Epidemiology | Year: 2015

Aim: Our study aim was to investigate the degree of adherence to international recommendations for cutaneous melanoma pathology reports at the population level by a EUROCARE high resolution study. Methods: The availability of nine characteristics - predominant cell type, tumour-infiltrating lymphocytes, mitotic index, histological subtype, growth phase, Clark level, Breslow thickness, ulceration, and sentinel-node biopsy - was examined on pathology reports of a random sample of 636 cases diagnosed in 2003-2005 in seven Italian cancer registries: Biella, Ferrara, Firenze, Latina, Ragusa, Reggio Emilia, Romagna. The odds of having (versus not having) information for all four core characteristics (last four listed above) were estimated. Results: Sentinel node biopsy was available most often, followed by Clark level, Breslow thickness, histological subtype and ulceration. Information on all nine characteristics was more often available in Biella and Ferrara (northern Italy) than elsewhere. Information on all four core items was available for 78% of cases. Odds of four-core-item availability were higher (than mean) in Biella and lower in Latina (centre) and Ragusa (south). Conclusions: The availability of information important for staging and management was good overall on pathology reports, but varied with geography. It is likely to be improved by wider dissemination of reporting guidelines and adoption of a standardised synoptic reporting system. © 2015 Elsevier Ltd.


PubMed | Ferrara Cancer Registry, IRCCS Instituto Scientifico Romagnolo per lo Studio e la Cura dei Tumori, Clinical and Descriptive Epidemiology Unit, Quality and Clinical Studies Unit and 6 more.
Type: Journal Article | Journal: Cancer epidemiology | Year: 2015

Our study aim was to investigate the degree of adherence to international recommendations for cutaneous melanoma pathology reports at the population level by a EUROCARE high resolution study.The availability of nine characteristics - predominant cell type, tumour-infiltrating lymphocytes, mitotic index, histological subtype, growth phase, Clark level, Breslow thickness, ulceration, and sentinel-node biopsy - was examined on pathology reports of a random sample of 636 cases diagnosed in 2003-2005 in seven Italian cancer registries: Biella, Ferrara, Firenze, Latina, Ragusa, Reggio Emilia, Romagna. The odds of having (versus not having) information for all four core characteristics (last four listed above) were estimated.Sentinel node biopsy was available most often, followed by Clark level, Breslow thickness, histological subtype and ulceration. Information on all nine characteristics was more often available in Biella and Ferrara (northern Italy) than elsewhere. Information on all four core items was available for 78% of cases. Odds of four-core-item availability were higher (than mean) in Biella and lower in Latina (centre) and Ragusa (south).The availability of information important for staging and management was good overall on pathology reports, but varied with geography. It is likely to be improved by wider dissemination of reporting guidelines and adoption of a standardised synoptic reporting system.


Minicozzi P.,Fondazione IRCCS Instituto Nazionale Dei Tumori | Berrino F.,Fondazione IRCCS Instituto Nazionale Dei Tumori | Sebastiani F.,University of Modena and Reggio Emilia | Falcini F.,IRCCS Instituto Scientifico Romagnolo per Lo Studio e la Cura Dei Tumori | And 14 more authors.
European Journal of Cancer | Year: 2013

Purpose We investigated the effect of fasting blood glucose and body mass index (BMI) at diagnosis on risk of breast cancer death for cases diagnosed in five Italian cancer registries in 2003-2005 and followed up to the end of 2008. Methods For 1607 Italian women (≥15 years) with information on BMI or blood glucose or diabetes, we analysed the risk of breast cancer death in relation to glucose tertiles (≤84.0, 84.1-94.0, >94.0 mg/dl) plus diabetic and unspecified categories; BMI tertiles (≤23.4, 23.5-27.3, >27.3 kg/m 2, unspecified), stage (T1-3N0M0, T1-3N+M0 plus T4anyNM0, M1, unspecified), oestrogen (ER) and progesterone (PR) status (ER+PR+, ER-PR-, ER and PR unspecified, other), age, chemotherapy and endocrine therapy, using multiple regression models. Separate models for ER+PR+ and ER-PR- cases were also run. Results Patients often had T1-3N0M0, ER+PR+ cancers and received chemotherapy or endocrine therapy; only 6% were M1 and 17% ER-PR-. Diabetic patients were older and had more often high BMI (>27 kg/m2), ER-PR-, M1 cancers than other patients. For ER+PR+ cases, with adjustment for other variables, breast cancer mortality was higher in women with high BMI than those with BMI 23.5-27.3 kg/m2 (hazard ratio (HR) = 2.9, 95% confidence interval (CI) 1.2-6.9). Breast cancer mortality was also higher in women with high (>94 mg/dl) blood glucose compared to those with glucose 84.1-94.0 mg/dl (HR = 2.6, 95% CI 1.2-5.7). Conclusion Our results provide evidence that in ER+PR+ patients, high blood glucose and high BMI are independently associated with increased risk of breast cancer death. Detection and correction of these factors in such patients may improve prognosis. © 2013 The Authors. Published by Elsevier Ltd. All rights reserved.


Minicozzi P.,Fondazione IRCCS Instituto Nazionale Dei Tumori | Bella F.,Fondazione IRCCS Instituto Nazionale Dei Tumori | Toss A.,University of Modena and Reggio Emilia | Giacomin A.,Epidemiology Unit | And 10 more authors.
Journal of Cancer Research and Clinical Oncology | Year: 2013

Purpose: No population-based study has investigated breast cancer (BC) subtypes defined by including Ki67. The aim of this study was to evaluate the relative proportions of immunohistochemical subtypes and differences in relative and disease-free survival between subtypes, in relation to patient and other cancer characteristics in Italian BC patient. Methods: Information on estrogen, progesterone, human epidermal growth factor (HER2), Ki67, and relapses was obtained for 3,381 cases, sampled randomly and anonymously from cases diagnosed in 2003-2005 in nine Italian cancer registries. Relative excess risks (RERs) of death and risks of relapse 5 years after diagnosis were estimated. Results: Luminal A cancers were 42 % of the total, luminal B 27 %, luminal-HER2 14 %, triple-negative 11 %, and HER2-enriched 7 %. For non-metastatic (3,302) cases, 4 and 7 % developed locoregional and distant metastases, respectively. RERs of death and risks of relapse were significantly greater for all cancer subtypes than luminal A, particularly for triple-negative and HER2-enriched cancers, which were more frequent in women <40 years. Conclusions: Our population-based findings confirm that subtype is an independent prognostic factor for BC. Triple-negative and HER2-enriched subtypes would benefit from the development and wide application, respectively, of targeted treatments, which would also improve survival for younger patients. © 2013 Springer-Verlag Berlin Heidelberg.


Gabutti G.,University of Ferrara | Aquilina M.,Local Health Unit of Agrigento No 1 | Cova M.,Local Health Unit of Ferrara | Giuffrida S.,Provincial Health Unit | And 6 more authors.
Giornale Italiano di Medicina Tropicale | Year: 2010

Background: We analysed the data collected from questionnaires administered to air passengers at risk of travellers' diarrhea and cholera, most of whom had taken the oral anti-cholera vaccine Dukoral. Materials and Methods: Between 2008 and 2009, 182 questionnaires were collected at seven travel medicine clinics in Italy from 97 males, 84 females and one subjects of unspecified gender, with a mean age of 39.3 years. Results: Most of the trips were for tourism (78.6%), and the mean duration of the trips was 19.4 days. 87 of the travellers visited Africa, 61 Asia, 29 Central and Southern America, and 5 other Countries. Dukoral was taken by 123 subjects, and no serious adverse events were reported, with a good compliance. During the trips, 17 immunised subjects reported diarrhea (9 mild, 6 moderate and 2 severe cases); 5 subjects were prevented from carrying out their planned activities, 3 received medical care, but no one was hospitalised. Discussion: The incidence of diarrhea among vaccinated subjects was 13.8%, lower than the 17.4-23% reported in other recent studies and tolerability was more than satisfactory. In conclusion, the oral anti-cholera vaccine Dukoral could be an interesting proposal for the prevention of feco-oral diseases in travellers.

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