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We hypothesized that cancer patients using an Internet website would show an improvement in the knowledge about healthy eating habits, and this might be enhanced by social media interaction. A 6-month randomized intervention was set up. Eligible subjects were allocated in intervention (IG) and control groups (CG). IG had access to the website, and CG was provided with printed versions. All enrolled participants filled in Nutrition Questionnaire (NQ), Quality of Life Questionnaire (QoL) and Psychological Distress Inventory (PDI), at baseline and after 6 months. The difference between post- vs pre-questionnaires was calculated. Seventy-four subjects (CG 39; IG 35) completed the study. There was an increase in the score after the intervention in both groups for the NQ, even if not statistically significant. Dividing the IG into three categories, no (NI), low (LI) and high interactions (HI), we found a decreased score (improvement) in the CG (-0.2) and in the HI (-1.7), and an increased score (worsening) in the NI (+3.3) (p = NS) analysing the PDI. We found an increased score in the QoL both in CG and IG (adjusted LSMeans +3.5 and +2.8 points, respectively; p = NS). This study represents an example for support cancer patients. Despite the lack of significant effects, critical points and problems encountered may be of interest to researchers and organization working in the cancer setting. Intervention strategies to support patients during the care process are needed in order to attain the full potential of patient-centred care on cancer outcomes.

The aims of this study were (1) to explore the behavioral and sociodemographic factors influencing urinary cotinine (COT-U) levels in active smokers and in environmental tobacco smoke (ETS)-exposed individuals, (2) to assess the specificity and sensitivity of the questionnaire for identifying active smokers and nonsmokers, and (3) to derive the upper reference value of COT-U in non-ETS exposed individuals. The COT-U levels of 495 adults (age range 18-69 years) who classified themselves as active smokers (29%) or as nonsmokers with (17%) or without (83%) ETS exposure were quantified by LC-MS-MS (quantification limit: 0.1µg/L, range of linearity: 0.1-4000µg/L). Median COT-U levels in these groups were 883, 1.38, and 0.39µg/L, respectively. Significant determinants of COT-U levels in active smokers were the number of cigarettes per day, type of smoking product, smoking environment, as well as time between the last cigarette and urine collection. Among ETS-exposed nonsmokers, significant determinants were living with smokers, being exposed to smoke at home, ETS exposure duration, as well as time between the last exposure and urine collection. When a 30-µg/L COT-U cut-off value was used to identify active daily smoking, the sensitivity and specificity of the questionnaire were 94% and 98%, respectively. For ETS exposure, the COT-U value of 1.78 (0.90 confidence interval 1.75-1.78) µg/L, corresponding to the 95th percentiles of the COT-U distribution in non-ETS-exposed participants, is proposed as upper reference value to identify environmental exposure., (Copyright © 2016 Elsevier Inc. All rights reserved.)

Objective: To assess exposure to benzene (BEN) and other aromatic compounds (toluene, ethylbenzene, m+p-xylene, o-xylene) (BTEX), methyl tert-butyl ether (MTBE), and ethyl tert-butyl ether (ETBE) in petrol station workers using air sampling and biological monitoring and to propose biological equivalents to occupational limit values., Methods: Eighty-nine petrol station workers and 90 control subjects were investigated. Personal exposure to airborne BTEX and ethers was assessed during a mid-week shift; urine samples were collected at the beginning of the work week, prior to and at the end of air sampling., Results: Petrol station workers had median airborne exposures to benzene and MTBE of 59 and 408 µg m(-3), respectively, with urinary benzene (BEN-U) and MTBE (MTBE-U) of 339 and 780 ng l(-1), respectively. Concentrations in petrol station workers were higher than in control subjects. There were significant positive correlations between airborne exposure and the corresponding biological marker, with Pearson's correlation coefficient (r) values of 0.437 and 0.865 for benzene and MTBE, respectively. There was also a strong correlation between airborne benzene and urinary MTBE (r = 0.835). Multiple linear regression analysis showed that the urinary levels of benzene were influenced by personal airborne exposure, urinary creatinine, and tobacco smoking [determination coefficient (R(2)) 0.572], while MTBE-U was influenced only by personal exposure (R(2) = 0.741)., Conclusions: BEN-U and MTBE-U are sensitive and specific biomarkers of low occupational exposures. We propose using BEN-U as biomarker of exposure to benzene in nonsmokers and suggest 1457 ng l(-1) in end shift urine samples as biological exposure equivalent to the EU occupational limit value of 1 p.p.m.; for both smokers and nonsmokers, MTBE-U may be proposed as a surrogate biomarker of benzene exposure, with a biological exposure equivalent of 22 µg l(-1) in end shift samples. For MTBE exposure, we suggest the use of MTBE-U with a biological exposure equivalent of 22 µg l(-1) corresponding to the occupational limit value of 50 p.p.m., (© The Author 2015. Published by Oxford University Press on behalf of the British Occupational Hygiene Society.)

Background and Objectives: The purpose of this study was to evaluate the usefulness of transesophageal echocardiography during the implantation of the CoreValve percutaneous aortic prosthesis and the influence of the learning curve in its indications., Methods: From April 2008 to January 2010, 53 patients were treated for symptomatic severe aortic stenosis with a CoreValve percutaneous aortic prosthesis. Transesophageal echocardiography was performed during the procedure for two reasons: if a discrepancy between the measures of the aortic annulus arose before the implantation and to provide visualization if a complication occurred during the procedure. Patients were divided in to two groups based on the learning curve (group I:the first 25 patients, group II: all of the subsequent patients)., Results: Thirty-six transesophageal echocardiographies were performed on 28 patients (53%).In 15 cases the indication was to assist us in determining the proper sized prosthesis, and in the other 21 cases it was performed due to a complication during the procedure. The numbers of intraprocedure transesophageal echocardiographies were similar in both learning-curve groups, (64% in group I vs. 71% in group II, P = 0.56) but the proportion of the studies indicated by serious complications was significantly lower in the second period of the learning curve (67% in group I vs. 17% in group II, P < 0.05)., Conclusions: In our experience, transesophageal echocardiography was very useful in more than one-half of the patients during the implantation of the CoreValve percutaneous aortic prosthesis. After overcoming the learning curve, its indication due to serious procedure-related complications decreased significantly., (Copyright © 2012 Wiley Periodicals, Inc.)

Introduction: Asphalt workers are potentially exposed to polycyclic aromatic hydrocarbons (PAHs). As some PAHs are classified as carcinogenic, the assessment of occupational exposure to these agents is of the utmost importance in preventing toxic effects., Objectives: To assess exposure to PAHs by urinary 1-hydroxypyrene (1-OHPyr)., Methods: We studied 22 asphalt workers (14 smokers) and 5 control subjects (1 smoker). Multiple samples of urine (up to 4per subject) were collected at the end of the shift for the measurement of 1-OHPyr by LCMS/MS. Univariate and multivariate linear models for repeated measurements were used to evaluate the differences between groups and to identify the variables influencing of exposure., Results: The median urinary excretion of 1-OHPyr in asphalt workers was low, but higher than that of control subjects (184 vs. <20 ng/L, or 106 vs. <20 ng/g creatinine, p < 0.001); cigarette smoking marginally increased 1-OHPyr in smoking asphalt workers in comparison to non-smokers (129 vs. 208 ng/L p= 0.09 or 94 vs. 121 ng/g creatinine, p = 0.06). The number of consecutive days at work significantly influenced the urinary excretion of l-OHPyr [+59% every day, CI: (2, 147), p = 0.04]. Subjects using paving machines had the highest exposure. A strong association between 1-OHPyr and urinary creatinine was observed., Conclusions: urinary 1-OHPyr is a useful indicator of occupational exposure to low levels of PAHs, such as those found in the subjects studied; in using this biomarker it is recommended to collect urine samples at the end of the working week and to express levels of the biomarker corrected for urinary creatinine.

Introduction: Conflicting opinions exist about urinary benzene (UB) as a reliable biomarker of exposure. Objective of our study is to evaluate the effect of low-level environmental exposure on UB levels., Methods: We monitored UB excretion in 74 non-smoking non- occupationally exposed subjects; a questionnaire interview gathered information on relevant exposures during the day of monitoring., Results: UB excretion was related (p < 0.05) to gender, sampling time, residence, and reported vehicular traffic, but not to passive smoking and body mass index., Conclusion: Our findings support the use of unmetabolized UB as a specific and sensitive biomarker of low-level exposure to benzene.

Aim of this work was the assessment of exposure to polycyclic aromatic hydrocarbons (PAHs) by urinary 1-hydroxypyrene (1-OHPyr) in asphalt workers. Median levels of 1-OHPyr resulted higher in asphalt workers than in controls (184 vs. < 20 ng/L, p < 0.001). The determinants of exposure of 1-OHPyr resulted smoking habit, the number of consecutive days at work and the job task; 1-OHPyr was also associated to urinary creatinine. End of work week 1-OHPyr is suggested as an useful indicator of occupational exposure to PAHs in bitumen fumes.

The validation of an analytical method for the measurement of the unnatural amino acid alpha-fluoro-beta-alanine (AFBA), the main metabolite of the antineoplastic drug 5-fluorouracil (5FU), in urine for the biological monitoring of the exposure of hospital workers to the drug when preparing the therapeutical doses and administering to cancer patients is described. The method employed a two-step extractive derivatization of the analyte from urine to the N-trifluoroacety-n-butyl ester derivative and detection by selected-ion monitoring gas chromatography-mass spectrometry of structurally specific fragments. The limit of detection was 20 ng/mL with quantification accuracy better than +/-20% and precision (CV%) better than +/-20% in the range 0.020-10 microg/mL. Norleucine was used as the internal standard and the sample-to-sample analysis time was less than 15 min. The validated method has been applied to the biological monitoring of some hospital workers potentially exposed to 5FU and to matched control subjects. On a total number of 65 analyzed urine samples from control and exposed subjects, only three, obtained from exposed subjects, were found to be positive, with values of 20, 30 and 1150 ng/mL, respectively., (Copyright 2005 John Wiley & Sons, Ltd.)