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A systematic review and meta-analysis of the literature was performed to assess the relationship between chocolate intake and cardio-cerebrovascular risk in the general population. A structured search of the literature was performed in the PubMed database up to September 26, 2016, using predetermined keywords. Epidemiologic studies evaluating the risk for cardiovascular diseases (CVDs; i.e., stroke, acute myocardial infarction [MI], heart failure, coronary heart disease) were included according to different rates of chocolate intake. The software ProMeta 3 was used to perform the meta-analysis. The systematic review identified 16 eligible studies. The majority of the studies showed a protective effect of chocolate intake compared with unexposed individuals. The overall risk ratio (effect size [ES]) of CVD for the highest versus the lowest category of chocolate consumption was 0.77 (95% confidence interval [CI], 0.71-0.84; P = 0.000) with a moderate heterogeneity. The risk related to subgroups of CVD and in particular, the risk for MI was further analyzed: ES = 0.78 (95% CI, 0.64-0.94; P = 0.009) without statistical heterogeneity (I-2 = 46.56%; P = 0.13). Moreover, the analysis performed based on sex found an ES = 0.85 (95% CI, 0.77-0.95; P = 0.003) for women, with a very low grade of heterogeneity (I-2 = 62.21%; P = 0.005). The results of the meta-analysis showed a potential protective effect of moderate consumption of chocolate on cardiovascular risk, especially for women, and against MI for both sexes.

Background Lifestyles profoundly determine the quality of an individual’s health and life since his childhood. Many diseases in adulthood are avoidable if health-risk behaviors are identified and improved at an early stage of life. The aim of the present research was to characterize a cohort of children aged 6–8 years selected in order to perform an epidemiological molecular study (the MAPEC_LIFE study), investigate lifestyles of the children that could have effect on their health status, and assess possible association between lifestyles and socio-cultural factors. Methods A questionnaire composed of 148 questions was administered in two different seasons to parents of children attending 18 primary schools in five Italian cities (Torino, Brescia, Pisa, Perugia and Lecce) to obtain information regarding the criteria for exclusion from the study, demographic, anthropometric and health information on the children, as well as some aspects on their lifestyles and parental characteristics. The results were analyzed in order to assess the frequency of specific conditions among the different seasons and cities and the association between lifestyles and socio-economic factors. Results The final cohort was composed of 1,164 children (50.9 boys, 95.4% born in Italy). Frequency of some factors appeared different in terms of the survey season (physical activity in the open air, the ways of cooking certain foods) and among the various cities (parents’ level of education and rate of employment, sport, traffic near the home, type of heating, exposure to passive smoking, ways of cooking certain foods). Exposure to passive smoking and cooking fumes, obesity, residence in areas with heavy traffic, frequency of outdoor play and consumption of barbecued and fried foods were higher among children living in families with low educational and/or occupational level while children doing sports and consuming toasted bread were more frequent in families with high socio-economic level. Conclusions The socio-economic level seems to affect the lifestyles of children enrolled in the study including those that could cause health effects. Many factors are linked to the geographical area and may depend on environmental, cultural and social aspects of the city of residence.

Background - Air pollution is a global problem: airborne or deposited pollutants are present everywhere on the planet, from highly polluted to remote areas. Twenty per cent of the EU urban population lives in areas where the EU air quality 24-hour limit value for particulate matter (PM10) is exceeded. At present, PM is Europe's most problematic pollutant in terms of harm to health, as reported by European Environmental Agency (EEA) in the EEA Technical Report on Air quality in Europe, 2011. Among the top 30 most polluted cities in Europe, more than half are Italian; in particular, the Po Valley is the most polluted area in Europe, with the concentrations of PM10, PM2,5 and NOx being well above the EU reference values for many days of the year. Epidemiological studies have found a consistent association between exposure to air pollution, especially to PM, and the incidence and mortality for several chronic diseases such as lung cancer, cardiovascular diseases and diabetes (Lanki et al., 2015). Among the mechanisms responsible for these adverse effects, genotoxic damage is of particular concern. Children are a high risk group with respect to the short- and long-term effects of air pollution. Indeed recent data suggest that genetic damage occurring early in childhood can increase the risk of chronic diseases, including cancer, in adulthood. The aim of the MAPEC (Monitoring Air Pollution Effects on Children for supporting public health policy) study is to evaluate the associations between air pollution and biomarkers of early biological effects in children, and to propose a model for estimating the global risk of early biological effects due to air pollutants and other factors in children (Feretti et al., 2013). Methods and analysis – Enrollment of children was performed in five Italian towns characterized by different concentrations of air polluntants: Brescia and Torino, in the Po Valley, in the Northern Italy, Pisa and Perugia located in Central Italy, and Lecce, in Southern Italy. The towns in Central and Southern Italy show lower PM values than towns in Northern Italy allowing us to make valuable comparisons between areas with higher and lower air pollution. About 1,000 children (200 children per town) aged 6-8 years were recruited in the study from first grade schools. The sample size of the study was determined in order to detect statistically significant differences in the studied parameters (i.e., primary DNA damage in lymphocytes from saliva and MN in buccal mucosa cells) among children living in towns with high air pollution and those living in less polluted towns. Biological samples were collected (1,000 × 2 = 2,000 samples) at two separate times, in winter and in late spring. In order to collect the cells for the comet assay, the children were asked to rinse their mouths twice with mineral water and the mouthwashes were then collected in tubes containing 25 ml of saline solution (NaCl 0.9%) to obtain leukocytes (Osswald et al., 2003). Leukocytes were processed in order to evaluate primary and oxidative (FPG) DNA damage caused by exposure to air pollutants. The comet assay in alkaline conditions (pH>13) was performed according to the standard protocol as well as to detect oxidative damage using FPG incubation (Azqueta et al., 2013). A medium-throughput approach (Shaposhnikov et al., 2010) was applied to the comet assay by using 12-gel units (Severn Biotech Ltd., UK). The slides (coded) were sent to the University of Parma for microscope analysis (blind). Results - The 12-gel slides were stained with ethidium bromide and examined under a fluorescence microscope; 50 randomly selected comets per spot (two spots/subject) were analysed. DNA damage was measured using the tail intensity (% DNA) parameter (Comet Assay IV, Perceptive Instruments, UK. Microscope analysis of cells sampled on winter 2014 is still ongoing. Preliminary data will be presented at the conference. Conclusions - The main objective of the MAPEC study is to evaluate the associations in children between air pollutants and early biological effects, and to propose a model for estimating the global genotoxic risk.

Background: Antineoplastic drugs (ANDs) are a broad group of chemicals showing, at the same time, carcinogenic effects. The potential, albeit true, risk of side effects cannot be accepted, especially if resulting from occupational exposure. The aim of this study was to evaluate the association between occupational exposure to ANDs and the extent of primary DNA damage in health professionals. Methods: A systematic review and meta-analysis was conducted according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. PubMed/Medline, Web of Science, and Scopus were used to perform the literature search. The databases were examined in July 2019. Sub-group, moderator, and cumulative analyses were conducted. The trim and fill method was used in the case of potential publication bias. Results: Twenty studies were included in the qualitative analysis, and 19 in quantitative evaluation. The pooled effect size was 1.27 [(95% confidence interval (CI) = 0.66–1.88), p = 0.000] based on 1569 subjects. The moderator analysis by duration of exposure showed a positive association between duration of exposure and primary DNA damage. Conclusions: This systematic review clearly shows a significant association between occupational exposure to ANDs and the extent of primary DNA damage in health professionals. Considering these results, health professionals should be warned against this potential occupational risk.

Many studies have reported the occurrence of work-environment contamination by antineoplastic drugs (ANPD), with significant incorporation of trace amounts of these hazardous drugs in hospital personnel. Given the ability of most ANPD to actively bind DNA, thus inducing genotoxic effects, it is of pivotal importance to assess the degree of genotoxic damage (i.e., residual genotoxic risk) in occupationally exposed subjects. The lymphocyte cytokinesis-block micronucleus (L-CBMN) assay is largely used for biological effect monitoring in subjects occupationally exposed to ANPD. In this study, we identified and analyzed the studies published reporting the use of the L-CBMN assay as biomarker of genotoxic risk in health care workers exposed to ANPD with the aim of performing meta-analysis and providing a meta-estimate of the genotoxic effect of exposure. We retrieved 24 studies, published from 1988 to 2015, measuring MN in peripheral blood lymphocytes in health care workers occupationally exposed to ANPD. In 15 out of the 24 studies (62.5%), increased MN frequencies were recognized in exposed subjects as compared to controls. The meta-analysis of MN frequency of the combined studies confirmed an association between occupational exposure to ANPD and cytogenetic effects with an overall meta-estimate of 1.67 [95% CI: 1.41-1.98]. In 16 out of the 24 studies (66.6%) at least one other genotoxicity biomarker, besides L-CBMN assay, was employed for biological effect monitoring. In several studies the effect of exposure to ANPD was evaluated also in terms of MN in exfoliated buccal cells. Other studies focused on genotoxicity endpoints, such as sister chromatid exchanges (3 studies), chromosome aberrations (6 studies), or primary DNA damage investigated by comet assay (7 studies). Overall, there was good agreement between other genotoxicity tests employed and L-CBMN assay outcomes.

Colorectal cancer is the third most common cancer worldwide. Growing evidence shows that about 47% of cases of colorectal cancer can be prevented by a healthy lifestyle. We performed a systematic review and meta-analysis aimed to evaluate the association between dietary fibre intake and the risk of colon cancer. We performed a structured computer search on PubMed, including epidemiological studies reporting results of dietary fibre intake and risk of colon cancer in women or men. We compared subjects exposed to the highest versus the lowest consumption. The search strategy identified 376 papers. After screening, 25 datasets were included in our meta-analysis. Results suggest a protective role of dietary fibre intake on colon cancer risk ES = 0.74 (95% CI = 0.67–0.82), p value = .000, but, moderate statistical heterogeneity (χ2 = 42.73, p value = .011) was found. Due to the high mortality of colorectal cancer, it is important to identify effective preventive measures, especially those of a healthy lifestyle, such as a healthy diet.

Nowadays, more and more people surf the Internet seeking health-related information. Information and communication technologies (ICTs) can represent an important opportunities in the field of Public Health and vaccinology. The aim of our current research was to investigate a) how often people search the Internet for vaccination-related information, b) if this search is spontaneous or induced by media, and c) which kind of information is in particular searched. We used Google Trends (GT) for monitoring the interest for preventable infections and related vaccines. When looking for vaccine preventable infectious diseases, vaccine was not a popular topic, with some valuable exceptions, including the vaccine against Human Papillomavirus (HPV). Vaccines-related queries represented approximately one third of the volumes regarding preventable infections, greatly differing among the vaccines. However, the interest for vaccines is increasing throughout time: in particular, users seek information about possible vaccine-related side-effects. The five most searched vaccines are those against 1) influenza; 2) meningitis; 3) diphtheria, pertussis (whooping cough), and tetanus; 4) yellow fever; and 5) chickenpox. ICTs can have a positive influence on parental vaccine-related knowledge, attitudes, beliefs and vaccination willingness. GT can be used for monitoring the interest for vaccinations and the main information searched.