Breast cancer registry in Palermo and its Province: incidence in 1999

The incidence of breast cancer in the city of Palermo and its Province was investigated. The cancer rate was higher in the city of Palermo (100.8/100,000/year), a great southern urban area, than in the 81 municipalities of the Province (79.2/100,000/year). Rates were also compared with those in other geographic areas of Italy, showing a smaller than expected negative north-south gradient in incidence, especially in the young age group, as shown by the cumulative risk observed in the 0-54-year-old group. These findings confirm the role of recent life style changes in the cancer risk distribution.

Double valve Implantation. Long-term evaluation of 8 different bioprostheses

From January 1976 through December 1987, 194 patients with a mean age of 43.3 +/- 13.7 years (range, 11 to 74 years) underwent double (mitral and aortic) replacement of native valves with 8 types of bioprostheses: Carpentier-Edwards, 127 valves; Hancock, 76 valves; Liotta-Bioimplant, 57 valves; Ionescu-Shiley, 53 valves; Vascor, 27 valves; Carpentier-Edwards Pericardial, 22 valves; Angell-Shiley, 20 valves; and Implamedic, 6 valves. Concomitant cardiac procedures were performed in 25 patients (12.8%). There were 18 operative deaths (9.27%). Our retrospective analysis was restricted to 352 bioprostheses implanted in the 176 patients who survived surgery and were considered at risk for valve tissue failure. The overall cumulative duration of follow-up was 1,174.1 patient-years (range, 1 to 13 years). The durations of follow-up for specific valves were: Carpentier-Edwards, 920.2 valve-years; Hancock, 383.8 valve-years; Liotta-Bioimplant, 310.2 valve-years; Ionescu-Shiley, 357.7 valve-years; Vascor, 131.2 valve-years; Carpentier-Edwards Pericardial, 52.0 valve-years; Angell-Shiley, 167.0 valve-years; and Implamedic, 31.0 valve-years. Thirty patients had thromboembolic accidents, for a linearized incidence of 2.5% per patient-year. At 13 years, the actuarial freedom from thromboembolic accidents was 85.8% +/- 10.7%. Nine patients had endocarditis, for a linearized incidence of 0.7% per patient-year. At 13 years, the actuarial freedom from endocarditis was 92.0% +/- 1.5%. Twenty-four patients had valve tissue failure, for a cumulative linearized incidence of 1.87% per valve-year. The cumulative actuarial probability of freedom from valve tissue failure was 78.6% +/- 3.7% at 10 years and 51.2% +/- 10.7% at 13 years. The 24 patients with valve tissue failure all underwent reoperation: 20 of these had double valve replacement, 3 had aortic valve replacement alone, and 1 had mitral valve replacement alone. The mean interval between initial valve implantation and reoperation was 66.9 +/- 28.8 months. At reoperation, the hospital mortality was 15.1% (5 patients). This study showed that the long-term results of valve implantation are not significantly influenced by either prosthesis design or material. Moreover, the incidence of degenerative change was similar in the aortic and mitral positions.

[Study of the thyroid function in a representative sample of the population of 3 islands of the Eolian archipelago: Filicudi, Alicudi and Panarea]

The thyroid function has been subject of study on a casual and significant sample consisting of 189 individuals living in Filicudi, Alicudi and Panarea, the smallest of the inhabited islands in the Eolian archipelago. The prevalence of palpable thyroid (group 1) has resulted to be of 26.45% while the one of the visible goitre (group 2) has resulted of 5.29%. The T3 has resulted significantly lower, in the subjects with thyroid of group 2, than in the ones with thyroid of the group 0 or 1 (p less than 0.02). In the subject who are over sixty years old the circulating fT3 has resulted significantly lower and the T3 significantly more elevated than in the people who are in their twenties. Seven cases of thyrotoxicosis have been ascertained. These data show an unexpected frequency of hypertrofic thyroid in a population among which the jodic deficiency hasn't reason to be; the presence of thyrotoxicosis could be connected with the prevalence of the goitre.

[Behavior of the somatotroph in prepubertal subjects with underdeveloped gonads]

After a rapid review of the reciprocal effects of hGH and testosterone in somatic development during puberty, the behaviour of the growth hormone after appropriate stimulation was examined in prepuberal subjects with underdeveloped gonads. These subjects revealed defective secretion of the hormone which may be explained by a reduction in the efficiency of the diencephalohypophyseal factors controlling puberty and sexual function.

[Characteristics of the "tache noire" of boutonneuse fever]

Humans show little sensitivity to the bites of healthy Rhipicephalus sanguineus and the skin lesion is extremely slight. The "tache noire" - innoculation eschar - corresponding to the infecting bite of the tick with R. conori is discussed and histopathological findings reported. The patient is frequently unaware of the eschar on his body and elements relating to the duration of the infecting bite are deduced. Apart from its typical features, the tache noire may be very small, with surrounding hyper-ergic reaction, or it may even not be present, depending on different conditions of tissue reactivity. The pathogenesis is mentioned and the need for careful research for diagnostic purposes stressed.