Northern Italy Population Research Articles

Use of hidden Markov capture-recapture models to estimate abundance in the presence of uncertainty: Application to the estimation of prevalence of hybrids in animal populations.

Estimating the relative abundance (prevalence) of different population segments is a key step in addressing fundamental research questions in ecology, evolution, and conservation. The raw percentage of individuals in the sample (naive prevalence) is generally used for this purpose, but it is likely to be subject to two main sources of bias. First, the detectability of individuals is ignored; second, classification errors may occur due to some inherent limits of the diagnostic methods. We developed a hidden Markov (also known as multievent) capture–recapture model to estimate prevalence in free‐ranging populations accounting for imperfect detectability and uncertainty in individual's classification. We carried out a simulation study to compare naive and model‐based estimates of prevalence and assess the performance of our model under different sampling scenarios. We then illustrate our method with a real‐world case study of estimating the prevalence of wolf (Canis lupus) and dog (Canis lupus familiaris) hybrids in a wolf population in northern Italy. We showed that the prevalence of hybrids could be estimated while accounting for both detectability and classification uncertainty. Model‐based prevalence consistently had better performance than naive prevalence in the presence of differential detectability and assignment probability and was unbiased for sampling scenarios with high detectability. We also showed that ignoring detectability and uncertainty in the wolf case study would lead to underestimating the prevalence of hybrids. Our results underline the importance of a model‐based approach to obtain unbiased estimates of prevalence of different population segments. Our model can be adapted to any taxa, and it can be used to estimate absolute abundance and prevalence in a variety of cases involving imperfect detection and uncertainty in classification of individuals (e.g., sex ratio, proportion of breeders, and prevalence of infected individuals).

Prevalence of and risk factors for fatty liver in the general population of Northern Italy: the Bagnacavallo Study

BackgroundThe estimation of the burden of disease attributable to fatty liver requires studies performed in the general population.MethodsThe Bagnacavallo Study was performed between October 2005 and March 2009. All the citizens of Bagnacavallo (Ravenna, Italy) aged 30 to 60 years as of January 2005 were eligible. Altered liver enzymes were defined as alanine transaminase > 40 U/l and/or aspartate transaminase > 37 U/l.ResultsFour thousand and thirty-three (58%) out of 6920 eligible citizens agreed to participate and 3933 (98%) had complete data. 393 (10%) of the latter had altered liver enzymes and 3540 had not. After exclusion of subjects with HBV or HCV infection, liver ultrasonography was available for 93% of subjects with altered liber enzymes and 52% of those with normal liver enzymes. The prevalence of fatty liver, non-alcoholic fatty liver disease (NAFLD) and alcoholic fatty liver disease (AFLD) was 0.74 (95%CI 0.70 to 0.79) vs. 0.35 (0.33 to 0.37), 0.46 (0.41 to 0.51) vs. 0.22 (0.21 to 0.24) and 0.28 (0.24 to 0.33) vs. 0.13 (0.11 to 0.14) in citizens with than in those without altered liver enzymes. Ethanol intake was not associated and all the components of the metabolic syndrome (MS) were associated with fatty liver. All potential risk factors were associated with a lower odds of normal liver vs. NAFLD while they were unable to discriminate AFLD from NAFLD.ConclusionsFatty liver as a whole was highly prevalent in Bagnacavallo in 2005/9 and was more common among citizens with altered liver enzymes.

Mycobacterium aviumsubsp. paratuberculosis isolated from wild red deer (Cervus elaphus) in Northern Italy

Paratuberculosis (or Johne’s disease) is an infectious disease which affects mainly ruminants and it is caused by Mycobacterium avium subsp. paratuberculosis (MAP). During a culling program (years 2011–2015) aimed at controlling the red deer (Cervus elaphus) population in Stelvio National Park (Italian Alps), where paratuberculosis was already described in this species, 382 tissue samples from the Lombardy Region and 102 fecal specimens from the Autonomous Province of Bolzano were analyzed by PCR. Of these, 77 samples (20.16%) from the Lombardy area and 19 specimens (18.63%) from the Bolzano area resulted PCR positive. The cultural test was carried out on PCR positive samples (n = 96), enabling the isolation of 19 MAP field strains which were genotyped using MIRU-VNTR typing and Short Sequence repeats (SSRs).Our results suggest that all isolates share an identical VNTR profile corresponding to the INMV1 genotype. The only variation was on the locus SSR2, but the utility of this last locus has already been questioned because of its instability. Overall, these data suggest a common clonal origin and host adaptation during the diffusion of paratuberculosis in this population. Finally, this profile is the same as that which has already been described in the cattle population in Northern Italy, suggesting a possible inter-species disease transmission pattern from wildlife to domestic ruminants and vice versa.

Ascending aorta dimensions and clinic and 24 hours blood pressure in a general population in Northern Italy: The Vobarno study

BackgroundEpidemiological studies have suggested that even mild enlargement of the ascending aorta may have independent prognostic significance for cardiovascular events.Therefore, some Authors have proposed that dilatation of the ascending aorta could be considered as a form of preclinical vascular damage in hypertensive patients.AimTo assess the correlation between clinic and 24 hours BP values and the dimensions of the aorta, measured at level of the sinuses of Valsalva (Val), at the left ventricular outflow tract (LVOT), and at the level of the proximal ascending aorta (AscAO) in subjects from a general population.Methods250 subjects (43% males, mean age 56 ± 4 years, 42% hypertensives-HT) underwent laboratory examinations, clinic and 24 hours BP measurement, cardiac and carotid ultrasound, carotid-femoral pulse wave velocity measurement (AoPWV).Resultsaortic diameters were greater HT as compared to NT (Val: 3.41 ± 0.54 vs 3.25 ± 0.41 cm, LVOT 2.10 ± 0.28 vs 2.04 ± 0.26, AscAo 3.39 ± 0.45 vs 3.18 ± 0.38, all p < 0.05). Aortic diameters were all correlated to clinic and 24 hours BP values. The coefficients of correlation were greater for 24 hours BP (Tab). Val, AscAo, LVOT were also significantly correlated with left ventricular mass (r = 0.61, r = 0.48, and r = 0.43, all p < 0.001), mean max intima media thickness (r = 0.13, r = 0.24, and r = 0.13, all p < 0.05) and with AoPWV (r = 0.16, p < 0.05, r = 0.28 p < 0.001, r = 0.08 p = ns).Ao ValsalvaAscLVOTrprprpAo ValsalvaAscLVOTrprprpSBP0.148*0.0190.161*0.0160.135*0.037DBP0.253**0.00010.223**0.0010.189**0.003MBP0.220**0.00010.175**0.0060.208**0.002PP−0.0460.4700.0040.9480.0030.968HR−0.0050.933−0.0280.687−0.0040.949SBP 24 hrs0.231**0.00010.162*0.0170.1080.097DBP 24 hrs0.346**0.00010.264**0.00010.234**0.0001MBP 24 hrs0.267**0.00010.214**0.0020.164*0.011PP 24 hrs−0.0030.962−0.0310.645−0.0820.209HR 24 hrs−0.0580.370−0.0510.454−0.0260.687ConclusionsThe dimensions of the proximal ascending aorta are significantly related to BP values in normotensive subjects and in hypertensive patients. Aortic dimension are more strictly related to twenty-four hours BP values than to clinic BP values. In this sample of general population, a significant correlation between aortic dimensions and measures of cardiac and vascular organ damage was also observed, confirming the parallelism between different forms of organ damage.

P4560Myocardial mechanoenergetic efficiency is correlated with arterial stiffness in a general population in northern Italy

P4560Myocardial mechanoenergetic efficiency is correlated with arterial stiffness in a general population in northern Italy

Pseudomonas syringae pv. actinidiae isolated from Actinidia chinensis Var. deliciosa in Northern Italy: genetic diversity and virulence

Bacterial canker of kiwifruit, caused by Pseudomonas syringae pv. actinidiae, is responsible for significant economic losses, both in yield and quality. A collection of P.s. pv. actinidiae isolated in Northern and Central Italy, during the first severe outbreak (2008–2010) and a few years afterwards (2014), when the pathogen became endemic and established, was gathered. The genetic diversity was evaluated with rep-PCR, RAPD-PCR, and MLSA of six housekeeping and effector genes. On the same strains, the virulence was evaluated in vitro and in vivo, showing a higher disease index for the strains isolated in 2014, compared with the strains of 2010. The molecular fingerprinting, obtained by rep and RAPD analysis, revealed a high level of variability in the population of strains of P.s. pv. actinidiae from northern Italy. All the parameters considered – Na, Ne, H, I, polymorphic loci, and AMOVA – showed a higher genetic diversity within the population of northern Italy isolated in 2014, compared to the older population. The study of the genetic diversity and virulence permitted to show an increase of virulence and genetic diversity of the strains. The fast and dramatic epidemics caused by P. s. pv. actinidiae could be an interesting model to study the changes in the genetic diversity and virulence of a bacterial pathogen.

Rainfall, but not temperature, negatively affects the growth of Blue Tit Cyanistes caeruleus nestlings

ABSTRACTCapsule: Growth trajectories of Blue Tit Cyanistes caeruleus nestlings differed between sexes and were negatively affected by rain but not by temperature during the linear growth phase (LGP).Aims: To model the growth trajectories of Blue Tit nestlings and to identify the main ecological factors affecting them.Methods: Sixty-five nestling Blue Tits from a population in northern Italy were weighed at regular intervals and sexed using molecular genetic techniques. The LGP period was identified and analysed to test for the influence of age, sex, hatching date, brood size, temperature and rainfall on individual daily growth rates during the LGP.Results: Growth curves showed no pre-fledging mass loss. Body mass differed between the sexes, with males being 5% heavier than females at the pre-fledging stage. Daily growth rates during the LGP were higher for males and on non-rainy days, while they were not affected by other factors.Conclusion: The higher daily growth rate observed in males during the LGP may determine the extent of sexual size dimorphism at the pre-fledging stage. Susceptibility of growth trajectories to environmental conditions was limited to rainfall and was similar in the two sexes. This contrasts with findings from previous studies, which found sex-biased environmental sensitivity of Blue Tit nestlings.

Host preference and host colonization of the Asian long-horned beetle, Anoplophora glabripennis (Coleoptera Cerambycidae), in Southern Europe.

The Asian long-horned beetle (ALB), Anoplophora glabripennis (Motschulsky), is a highly polyphagous invasive pest with a broad range of host species, but showing relevant differences between infestation areas. Host preference and host colonization (female fecundity, egg and larval survival) were assessed in a population in Northern Italy by choice and no-choice experiments conducted in both field and laboratory conditions. During 5 years of field observations, ALB was found to infest seven genera of trees: Acer, Aesculus, Betula, Populus, Prunus, Salix and Ulmus. However, Acer, Betula, Ulmus and Salix resulted to be the preferred hosts corresponding to 97.5% (1112) of the 1140 infested trees. In both laboratory and field trials carried out on these four host genera, no-choice experiments recorded the highest host colonization of A. glabripennis on Acer trees, with the highest number of laid eggs and the lowest egg and larval mortality. Ulmus and Salix showed a lower number of laid eggs during laboratory choice test, but egg and larval mortality had mean values similar to Acer. On the contrary, despite the high number of Betula trees felled during the eradication plan carried out in the infestation area, this tree species showed the lowest beetle suitability in terms of number of laid eggs and insect survival. An overestimation of the number of infested Betula occurring during the tree survey may explain the discordance between high number of infested Betula and low beetle suitability. Instead, the large number of infested Acer recorded in the field was probably due to the high abundance of these trees occurring in parks and gardens within the infestation area and to the low adult dispersal of A. glabripennis. Overall, results from this study confirm that host species affects both beetle colonization and breeding performance. The study shows ALB host preference and host suitability varying between tree species, suggesting an ALB acceptance even of sub-optimal hosts.

A population-based study of active and drug-resistant epilepsies in Northern Italy.

Drug-resistant epilepsy (DRE) is defined by the International League Against Epilepsy as a failure of adequate trials of two tolerated, appropriately chosen, and used antiepileptic drugs to achieve sustained seizure freedom. Our aim was to calculate the following: (1) the prevalence of active epilepsy and DRE in a well-defined population of Northern Italy and (2) the proportion of incident cases developing DRE. The study population (146,506; year 2008) resided in the province of Lecco, Northern Italy. The medical records of 123 general practitioners were reviewed to identify patients with epilepsy, diagnosed by a neurologist during the period 2000-2008. The point prevalence of active epilepsy and DRE was calculated on December 31, 2008. A total of 747 prevalent patients with epilepsy, 684 patients with active epilepsy, and 342 incident cases were identified. The frequency of DRE was 15.6% (107/684) of all active epilepsies and 10.5% (36/342) of incident cases. The point prevalence was 0.73 per 1000. The standardized prevalence of DRE was 0.7 per 1000 (Italian population) and 0.8 per 1000 (world population). Our data indicate that 1/6 patients with active epilepsy in the general population has DRE, and 1/10 patients with newly diagnosed epilepsy will develop DRE within nine years from the diagnosis.

Epidemiological and clinical features of migraine in the pediatric population of Northern Italy.

The aim of this article is to analyze the epidemiological and clinical features of migraine in a pediatric headache center. A retrospective study was performed over six years. Hospital record databases were screened for the diagnosis of migraine with aura (MA) or without aura (MO), based on the ICHD-II criteria. Fisher's test or Mann-Whitney U test, significance at p < 0.05. Migraine was diagnosed in 495 children (29.7% MA, 70.3% MO). The majority of diagnoses were made between ages 9 and 14 years. After stratification for age into five groups, we observed an increase of diagnoses in females, with a peak after the age of 15 years, and an increase of MA. In both groups, the attacks were usually severe, infrequent (<1-3/month) lasting <2 hours, and associated with nausea/vomiting, photophobia, phonophobia (more frequent in MO). Osmophobia was reported in 24.7% of the patients with MO. Dizziness was more frequent in patients with MA. Visual auras were the most common occurrence (87.1%). Confusional state was observed in 10.88% of the patients. A positive family history of headache was observed in >88% of the patients. We describe the characteristics of pediatric migraine based on the ICHD-II criteria, showing a likely significant loss of diagnoses using the ICHD-III beta. The incidence of migraine increases with age. MO occurs more commonly and shows more frequent attacks and a higher prevalence of associated symptoms, in particular osmophobia. Although males are prevalent in the entire sample, the proportion of females is higher among patients with MA in all of the age groups. Phenotype and sexual prevalence of migraine acquire adult characteristics and become more frequent in females from the onset of puberty.

Prevalence of electrocardiographic and echocardiographic LVH in a general population in northern italy. The vobarno study

Background: A large number of studies have demonstrated that left ventricular hypertrophy (LVH) detected with standard electroand echocardiography is an independent predictor of future cardiovascular complications in various subsets of patients. Due its low cost and wide availability electrocardiography represents the first line test for the assessment of cardiac organ damage in hypertensive patients. However a significant limitation is represented by its low sensitivity in detecting LVH. Aim of this study was to evaluate the prevalence of LVH detected by electroor echocardiography and the relationship between these two measures in a general population sample(Vobarno study). Methods: A total of 385 subjects (mean age 57 10years,44%males,64% hypertensives,44% overweight and 16%obese)underwent clinical examination with blood pressure measurement,standard laboratory examinations,a 12 leads electrocardiogram standard and standard echocardiography.EKGLVH was defined as the presence of a Sokolow-Lyon voltage 38 mm and/ or a Cornell voltage QRS duration product>2440 mm*msec and/or R in aVL;Echo-LVH was defined as LVM>50 g/m2.7 in men and 47g/m2.7 in women. Results: LVH prevalence was 5.1% and 16.3% with EKG and Echo,respectively.LVH was detected by both methods only in 2.0% of patients.The prevalence of EKG-LVH was 1.7% with Sokolow-Lyon voltage,4.2% with Cornell product and 5.1% with both EKG criteria.In hypertensives the prevalence of LVH was significantly greater than normotensives(6.8% vs 2.2% with EKG-LVH and 22.7% vs 9.6% with Echo).The concordance of the two techniques in identifying patients with LVH was only partial,and in particular,among patients with EKG-LVH a significant proportion(39%) did not have echo-LVH.However,patients with EKG-LVH but without Echo-LVH had greater LV mass index(39.9 vs 34.4 gr/m2.7,p<0.01) and worse systolic and diastolic function (midwall fractional shortening:17.3 vs 19.5; E/Em 10.6 vs 8.1,all p<0.01)as compared with those without both EKG and Echo-LVH.A positive correlation was observed between LVMI and Sokolow-Lyon voltage(r1⁄40.13,p<0.015),Cornell product(r1⁄40.22,p<0.001),Cornell voltage(r1⁄40.45,p<0.001)and R in aVL(r1⁄40.38,p<0.001). Conclusions: Our data confirm the greater sensibility of echocardiography examination for detection of LVH.The presence of EKG-LVH is associated with greater LVMI and worse systolic and diastolic function,even in the absence of clear-cut echo-LVH.Our results confirm the importance of identifying cardiac organ damage with both methods for a better stratification of cardiovascular risk.

Prevalence and incidence of epilepsy in a well-defined population of Northern Italy.

To calculate prevalence and incidence of epilepsy using administrative records. Claim records from the administrative district of Lecco, Northern Italy (population 311,637; 2001 census), collected during the years 2000-2008, were the data source. Patients of all ages were included. Based on previous findings from our group, the most accurate algorithm to detect epilepsy was the combination of electroencephalography (EEG) (ad hoc code) (at least one during the study period) and antiepileptic drugs (AEDs) (ATC code) (taken in 2008). Using this algorithm, the prevalence of epilepsy for the year 2008 was calculated. The reference population for prevalence was the population residing in the study area during the year 2008. Incident epilepsy cases were a subset of prevalent cases among patients not traced in the years 2000 through 2003. Average annual incidence rates were calculated for 2004 through 2008, taking for reference the person-years of exposure in the resident population. We calculated crude, adjusted (using positive and negative predictive values), and standardized (to the Italian and World population) prevalence and incidence. In 2008, 1,504 patients met the inclusion criteria, giving a prevalence of 4.57 per 1,000 (women 4.26; men 4.89). Prevalence tended to rise slightly with age. There were 864 incident cases, giving an average annual incidence of 53.41 per 100,000 (women 50.98; men 55.95). Incidence rates peaked in the elderly. The adjusted prevalence was 4.42 and the adjusted incidence 47.05. Standardized prevalence and incidence were, respectively, 4.30 per 1,000 and 48.35 per 100,000 (Italian population) and 3.79 per 1,000 and 44.74 per 100,000 (World population). The prevalence of epilepsy in the Lecco district was comparable to other studies, whereas the incidence was among the highest. With adjustments, administrative records are a cost-effective instrument to monitor epilepsy frequency.

Relationship between left atrial volume, arterial stiffness and clinic and 24 hours blood pressure in a general population in Northern Italy. The Vobarno Study

Relationship between left atrial volume, arterial stiffness and clinic and 24 hours blood pressure in a general population in Northern Italy. The Vobarno Study

Assessment of aortic stiffness during a five-years follow up in a general population in Northern Italy

Assessment of aortic stiffness during a five-years follow up in a general population in Northern Italy

Age-associated alterations in cholesterol homeostasis: evidence from a cross-sectional study in a Northern Italy population

BackgroundThe modifications of cholesterol metabolism associated with aging are ill-defined. The objective of this study was to define age-associated alterations of the different metabolic pathways controlling cholesterol homeostasis by analyzing circulating sterols.MethodsWe analyzed serum samples collected from 201 adult (75 male, 126 female) subjects within the epidemiological MICOL study (Multicentrica Italiana Colelitiasi). The age range was 38–79 years; 103 had evidence of gallstones. The concentrations of the different sterols, recognized as markers of the main pathways of cholesterol homeostasis, were analyzed by gas chromatography-mass spectrometry, including lathosterol (synthesis), campesterol and sitosterol (absorption), and 7α-hydroxy-4-cholesten-3-one (degradation to bile acids).ResultsA significant direct correlation was detected between age and cholesterol levels (r =0.34, P<0.01). The lathosterol/cholesterol ratio was lower in older age quartiles (P<0.05 by analysis of variance), with an inverse correlation between the lathosterol/cholesterol ratio and age (r=−0.32, P<0.01). Such correlation was particularly evident in females. The campesterol/cholesterol and sitosterol/cholesterol ratios were inversely correlated with aging in control, but not in gallstone patients. The levels of 7α-hydroxy-4-cholesten-3-one were not correlated with age.ConclusionThese data show a reduction of cholesterol synthesis with aging which is associated with increased circulating cholesterol levels. The finding might be related to a reduced metabolic need for cholesterol in advancing age, leading to a downregulation of the main mechanisms of cholesterol intake in the liver. A different age-related behavior was observed in gallstone-free versus gallstone patients regarding cholesterol absorption. The possible implications in terms of the pharmacological management of hypercholesterolemia in the elderly remain to be defined.

Assessment of arterial stiffness during a five-years follow up in a general population in northern Italy

Background: Carotid-femoral pulse wave velocity (cfPWV) is an independent predictor of cardiovascular events and its measurement is recommended by current hypertension guidelines. Very few data are available on the progression of PWV over time. The aim of the present longitudinal study was to compare the progression of aortic stiffness over a 5-year period in a general population in Northern Italy (Vobarno Study). Methods: 227 subjects, 42% males (age 50 4 years and hypertension in 51% at baseline visit), underwent a baseline (BL) and a follow up (FU) visit, after 5.1 0.4 years. In all subjects laboratory examinations, measurement of clinic and 24 hours blood pressure (BP) and of PWV were performed at BL and at FU. Results: In the overall population cfPWV increased from 8.28 1.27 at BL to 8.51 3.2 m/s at FU (p<0.05), change: 0.22 1.25. cfPWV significantly increased from BL to FU in hypertensive subjects (HT) (from 8.61 1.41 to 8.90 1.40, p<0.01) but not in normotensives (NT) (from 7.97 1.03 to 8.11 1.11, p n.s). The absolute change in cfPWV from BL to FU progressively increased from -0.052 0.108 in NT, to 0.480 0.163 in treated HT and to 0.483 0.138 in untreated HT (p for linear trend<0.01); after adjustment for possible confounders (age, gender, BMI, baseline cfPWV and change in mean BP from baseline) the difference remained statistically significant. At multivariate analysis the variables independently related to the progression of cfPWV were age (beta 0.18, p<0.01) and cfPWV, mean BP at BL (beta -0.55, p<0.01, and beta 0.18, p<0.01, respectively) and the change in mean BP during follow-up (beta 0.20, p1⁄40.001). Conclusions: In a general population sample in Northern Italy the main determinants of the increase in arterial stiffness during a 5 years FU were age, cfPWV and mean BP at BL and change in mean BP over time.

Assessment of the determinants of local carotid stiffness in a general population in northern Italy

Assessment of the determinants of local carotid stiffness in a general population in northern Italy

Extended phenotype description and new molecular findings in late onset glycogen storage disease type II: a northern Italy population study and review of the literature

Glycogen storage disease type II (GSDII) is a lysosomal storage disorder caused by acid alpha-1,4-glucosidase deficiency and associated with recessive mutations in its coding gene GAA. Few studies have provided so far a detailed phenotypical characterization in late onset GSDII (LO-GSDII) patients. Genotype-phenotype correlation has been previously attempted with controversial results. We aim to provide an in-depth description of a cohort (n = 36) of LO-GSDII patients coming from the north of Italy and compare our population's findings to the literature. We performed a clinical record-based retrospective and prospective study of our patients. LO-GSDII in our cohort covers a large variability of phenotype including subtle clinical presentation and did not differ significantly from previous data. In all patients, molecular analysis disclosed GAA mutations, five of them being novel. To assess potential genotype-phenotype correlations we divided IVS1-32-13T>G heterozygous patients into two groups following the severity of the mutations on the second allele. Our patients harbouring "severe" mutations (n = 21) presented a strong tendency to have more severe phenotypes and more disability, more severe phenotypes and more disability, higher prevalence of assisted ventilation and a shorter time of evolution to show it. The determination of prognostic factors is mandatory in order to refine the accuracy of prognostic information, to develop follow-up strategy and, more importantly, to improve the decision algorithm for enzyme replacement therapy administration. The demonstration of genotype-phenotype correlations could help to reach this objective. Clinical assessment homogeneity is required to overcome limitations due to the lack of power of most studies.

Association between dietary vitamin C and risk of cutaneous melanoma in a population of Northern Italy.

Cutaneous melanoma incidence has been increasing during the last few years, and diet has been suggested as one of the lifestyle factors responsible for this increase. Since antioxidant nutrients such as ascorbic acid might prevent skin carcinogenesis, we investigated the risk of cutaneous melanoma related to vitamin C intake in a population-based case-control study in Northern Italy based on 380 melanoma patients and 719 matched controls, to whom we administered a semiquantitative food-frequency questionnaire. After adjusting for potential confounders, odds ratio of melanoma were 0.86 (95 % confidence interval 0.65 - 1.15) and 0.59 (95 % confidence interval 0.37 - 0.94) in the intermediate and highest categories of vitamin C dietary intake respectively, compared with the bottom one. The association between vitamin C and decreased risk persisted after adjustment for some potential confounders. In age- and gender-stratified analyses, this association was seen in young females (< 60 years old), and was found to be enhanced in subjects with phototypes II and III. These results suggest a possible protective activity of vitamin C intake against cutaneous melanoma in specific subgroups of this population of Northern Italy.

Determinants of change in arterial stiffness in a general population in Northern Italy. The Vobarno study

Determinants of change in arterial stiffness in a general population in Northern Italy. The Vobarno study