Department of Health and Sport Science

Hypothesis: Bile duct injury (BDI) remains the most serious complication of cholecystectomy. With laparoscopic cholecystectomy (LC), the incidence has become more frequent. This study verifies the current incidence, mechanism, presentation, and treatment of BDI occurring during LC in general surgical practice.

Glucocorticoid (GC)-induced osteoporosis mostly affects trabecular bone of vertebrae. Only 30% of vertebral fractures are symptomatic, yet both clinical and radiological vertebral fractures have been associated with increased mortality and morbidity. The aims of this cross-sectional, outpatient-based study were to measure the prevalence of asymptomatic vertebral fractures in a large sample of post-menopausal women given GCs for different diseases; to compare prevalence of asymptomatic vertebral fractures according to disease, GC treatment and major risk factors; and to assess the quality of life in GC users with and without asymptomatic vertebral fractures. 551 patients referring to 39 centers as outpatients for their programmed follow-up and satisfying the inclusion criteria were included in the analysis. Each patient underwent structured medical interview (including dose and duration of GC therapy, major risk factors for osteoporosis, the quality of life questionnaire of the European Foundation for Osteoporosis (QUALEFFO) and a back function score questionnaire), thoraco-lumbar radiographs and subsequent morphometry; for 253 and 437 patients, respectively, lumbar spine bone mineral density (BMD) assessed by dual energy X-ray absorptiometry and calcaneal bone stiffness assessed by quantitative ultrasonometry were available. The prevalence of asymptomatic vertebral fractures resulted >37%, with >14% of patients having two or more asymptomatic vertebral fractures and was much higher than that found in epidemiological studies on healthy women. Distribution of asymptomatic vertebral fractures along the spine showed a bimodal pattern, with two peaks at T7 and T11. The prevalence of asymptomatic vertebral fractures clearly increased with age. Differences in prevalence among diseases were evidenced. When controlled for age, GC cumulative dose, duration of therapy and personal history of fractures, the adjusted prevalences were 30.77% for systemic lupus erythematosus, 33.78% for rheumatoid arthritis, 37.78% for asthma/chronic obstructive pulmonary disease, 43.20% for polymyalgia rheumatica and 43.36% for diseases grouped as "other vasculitides/connective tissue diseases". No significant association was found with GC cumulative dose and duration of therapy. Established risk factors for osteoporosis (except for age, years since menopause and personal history of fractures), lumbar spine BMD, calcaneal stiffness and QUALEFFO score were not associated with number and severity of asymptomatic vertebral fractures. Underlying disease is likely to contribute to the risk of fracture, but disease by itself could not be dissected from GC regimen. Vertebral fractures should be looked for carefully in all post-menopausal women receiving long-term systemic GCs since they can be asymptomatic and are scarcely predictable.

Purpose: In laboratory studies electromotive mitomycin C (MMC) demonstrated markedly increased transport rates compared with passive transport. We performed a prospective study in patients with high risk superficial bladder cancer to assess the efficacy of intravesical electromotive vs passive MMC using bacillus Calmette-Guerin (BCG) as a comparative treatment.

It is formed by two subunits, ␣-DG (extracellular) and ␤-DG (transmembrane), that bind to laminin in the matrix and dystrophin in the cytoskeleton, respectively. In this study we evaluated by Western blot analysis the expression of DG in a series of human cancer cell lines of various histogenetic origin and in a series of human primary colon and breast cancers. Decreased expression of DG was observed in most of the cell lines and in both types of tumors and correlated with higher tumor grade and stage. Analysis of the mRNA levels suggested that expression of DG protein is likely regulated at a posttranscriptional level. Evaluation of ␣-DG expression by immunostaining in a series of archival cases of primary breast carcinomas confirmed that ␣-DG expression is lost in a significant fraction of tumors (66%). Loss of DG staining correlated with higher tumor stage (P ‫؍‬ 0.022), positivity for p53 (P ‫؍‬ 0.033), and high proliferation index (P ‫؍‬ 0.045). A significant correlation was also observed between loss of ␣-DG and overall survival (P ‫؍‬ 0.013 by log-rank test) in an univariate analysis. These data indicate that DG expression is frequently lost in human malignancies and suggest that this glycoprotein might play an important role in human tumor development and progression.

BACKGROUND. Rituximab in sequential combination with fludarabine (Flu) allowed patients with B-cell chronic lymphocytic leukemia (B-CLL) to achieve higher remission rates and longer response duration. Based on their recent experience in indolent non-Hodgkin lymphomas, in this study, the authors attempted to demonstrate whether consolidation/maintenance therapy with rituximab could prolong the response duration in this patient population.

BACKGROUND. Clinical trials of monoclonal antibodies in combination with chemotherapy have reported previously unattained response rates in patients with B-cell chronic lymphocytic leukemia (B-CLL); however, the analysis of ZAP-70 protein and/or CD38 may explain better the discordant outcomes independent of treatment.

BACKGROUND. p27 Kip1 is a cyclin-dependent kinase inhibitor and is a potential tumor suppressor gene. Reduced expression of p27 Kip1 is a powerful negative prognostic marker in primary lung, breast, colon, bladder, and prostate carcinomas. In the current study, the prognostic value of p27 Kip1 in gastric cancer was evaluated and compared with other histopathologic parameters and p53 expression.

The relationship between physical activity and health status has been thoroughly investigated in several studies, while the relation between physical activity and socio-economic status (SES) is less investigated. The aim of this study was to measure the extra-curricular physical activity of adolescents related to the socio-economic status (SES) of their families.

type of oxidative DNA damage (3). The modified base 8hydroxy-2Ј-deoxyguanosine (8-OHdG) is a mutagenic lesion Human subjects in rising the risk of dysplasia was roughly constant through Thirty-six women undergoing a routine Papanicolaou smear were enrolled in SIL grades. In conclusion, the immunoperoxidase method, the study. After informed consent was obtained, cervical cells collected by applied to single human cervical cells, provides clear scraping were spread on slides precoated with 0.2% poly-D-lysine. For each patient, two exocervical smears were prepared: the first one was used for evidence that significant differences exist in 8-OHdG con-PAH-DNA adduct immunohistochemical evaluation, and the second smear,

We evaluated the feasibility of measuring health-related quality of life (HRQOL) in a gynecologic oncology clinic by using an instrument that is nonspecific for cancer patients. Our aim was to study whether the HRQOL perception of cancer patients differed from general population norms for the same age and gender and if it varied across cancer type, cancer status, age, health care setting, and reason for the encounter.

overexpression were evaluated in laryngeal biopsies from 38 patients by immunohistochemical methods. Samples were categorized as tumors (n ϭ 9), polyps (n ϭ 28) or normal tissue (n ϭ 1). 4-ABP-DNA adducts were evaluated with a quantitative immunoperoxidase method using monoclonal antibody 3C8 in both the lesion and adjacent tissue. Relative staining intensity data showed a log-normal distribution and values found in adjacent tissue from smokers were significantly higher (median: 173.5, geometric mean: 159.9) than those measured in adjacent tissue from non-smokers (median: 75.5, geometric mean: 7.40). Statistical significance was assessed both by non-parametric testing on raw data (P ϭ 0.0007 on rank sum test) and by parametric testing on log-transformed data (P ϭ 0.0002 on an unpaired t-test). Furthermore, relative staining intensity in the lesional tissue showed the same significant difference between smokers and non-smokers in patients affected by polyps, whereas no significant difference was detected in patients with laryngeal tumors. Overexpression of p53, also measured with an immunoperoxidase method, was observed in 44% of the malignant tumors and in 3.5% of the polyps. This work demonstrates that 4-ABP-DNA adducts can be evaluated in laryngeal tissue and are related to smoking exposure. *Abbreviations: 4-ABP, 4-aminobiphenyl; PAH, polycyclic aromatic hydrocarbons; HPLC, high-performance liquid chromatography; GC/MS, gas chromatography/mass spectroscopy; PBS, phosphate buffered saline.

Objective. The aim of the study was to analyze the Quality of life (QoL) scores in a single institution series of locally advanced cervical cancer patients (LACC) administered preoperative chemoradiation, compared to early stage disease (ECC) patients undergoing radical surgery.

AimThe aim of the study was to evaluate whether socio-economic inequalities in the practice of physical activity existed among children and adolescents, using different indicators of socio-economic status (SES).Subjects and methodsData were derived from the Italian National Health Interview Survey carried out in 2004–2005, which examined a large random sample of the Italian population using both an interviewer-administered and a self-compiled questionnaire. This study was based on a sample of 15,216 individuals aged 6–17 years. The practice of physical activity was measured on the basis of questions regarding frequency and intensity of activity during leisure time over the past 12 months. Parents’ educational and occupational level, as well as family’s availability of material resource, were used as indicators of SES. Multivariable logistic regression analyses were performed to estimate the contribution of each SES indicator to the practice of physical activity, adjusting for potential confounding factors. The results of the regression models are expressed as odds ratio (OR) with 95% confidence intervals (95% CI).ResultsAbout 64% of children and adolescents in the sample declared that they participated in moderate or vigorous physical activity at least once a week. After adjustment for gender, age, parental attitudes towards physical activity and geographical area, the practice of physical activity increased with higher parental educational and occupational level and greater availability of material resources. Children and adolescents whose parents held a middle or high educational title were 80% more likely to practice moderate or vigorous physical activity than subjects whose parents had a lower level of education (OR=1.80, 95% CI: 1.40–2.33), while subjects with unemployed parents had an odds of practicing moderate or vigorous physical activity 0.43 times that of those children whose parents belonged to the top job occupation category (administrative/professionals). Socio-economic differences were about the same when the practice of vigorous physical activity only was considered instead of that of moderate or vigorous physical activity.ConclusionInterventions that promote the practice of physical activity, and especially those aimed at the wider physical and social environment, are strongly needed to contrast socio-economic differences in physical activity among children and adolescents.

Background: Body Mass Index (BMI), which is defined as the ratio between weight (in kg) and height (in m 2 ), is often used in clinical practice as well as in large scale epidemiological studies to classify subjects as underweight, normal weight, overweight or obese. Although BMI does not directly measure the percentage of Body Fat (BF%), it is widely applied because it is strongly related with BF%, it is easy to measure and it is an important predictor of mortality. Among children, age and sex-specific reference values of BMI, known as percentiles, are used. However, it is not clear how strong the relationship between BMI and BF% is among children and whether the association is linear. We performed a cross-sectional study aiming at evaluating the strength and shape of the relationship between BMI and BF% among school-aged children aged 6-12 years. Findings: The study was conducted on a sample of 361 football-playing male children aged 6 to 12 years in Rome, Italy. Age, weight, height and skinfold thickness were collected. BF% was estimated using 4 skinfold equations whereas BMI was converted into BMI-for-age z-score. The relationship between these variables was examined using linear regression analyses. Mean BMI was 18.2 (± 2.8), whereas BF% was influenced by the skinfold equation used, with mean values ranging from 15.6% to 23.0%. A curvilinear relationship between BMI-for-age zscore and BF % was found, with the regression line being convex. The association between BMI-for-age zscore and BF% was stronger among overweight/obese children than among normal/underweight children. This curvilinear pattern was evident in all 4 skinfold equations used. Conclusions: The association between BMI-for-age zscore and BF% is not linear among male children aged 6-12 years and it is stronger among overweight and obese subjects than among normal and underweight subjects. In this age group, BMI is a valid index of adiposity only among overweight and obese subjects.