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Background: Inconsistent findings have been reported regarding the relationship between dietary iron intake and the risk of gastric cancer (GC). Methods: We pooled data from 11 case-control studies from the Stomach Cancer Pooling (StoP) Project. Total dietary iron intake was derived from food frequency questionnaires combined with national nutritional tables. We derived the odds ratios (ORs) and 95% confidence intervals (CIs) for quartiles of dietary iron through multivariable unconditional logistic regression models. Secondary analyses stratified by sex, smoking status, caloric intake, anatomical subsite and histological type were performed. Results: Among 4658 cases and 12247 controls, dietary iron intake was inversely associated with GC (per quartile OR 0.88; 95% CI: 0.83-0.93). Results were similar between cardia (OR = 0.85, 95% CI = 0.77-0.94) and non-cardia GC (OR = 0.87, 95% CI = 0.81-0.94), and for diffuse (OR = 0.79, 95% CI = 0.69-0.89) and intestinal type (OR = 0.88, 95% CI = 0.79-0.98). Iron intake exerted an independent effect from that of smoking and salt intake. Additional adjustment by meat and fruit/vegetable intake did not alter the results. Conclusions: Dietary iron is inversely related to GC, with no difference by subsite or histological type. While the results should be interpreted with caution, they provide evidence against a direct effect of iron in gastric carcinogenesis.

Objective: The aim of this study is to assess the efficacy of a very low-calorie ketogenic diet (VLCKD) method vs a Mediterranean low-calorie diet (LCD) in obese polycystic ovary syndrome (PCOS) women of a reproductive age. Design: Randomized controlled open-label trial was performed in this study. The treatment period was 16 weeks; VLCKD for 8 weeks then LCD for 8 weeks, according to the Pronokal® method (experimental group; n = 15) vs Mediterranean LCD for 16 weeks (control group; n = 15). Ovulation monitoring was carried out at baseline and afte r 16 weeks, while a clinical exam, bioelectrical impedance analysis (BIA), anthropometry, and biochemical analyses were performed at baseline, at week 8, and at week 16. Results: BMI decreased significantly in both groups and to a major extent in the experimental group (−13.7% vs −5.1%, P = 0.0003). Significant differences between the experimental and the control groups were also observed in the reduction of waist circumference (−11.4% vs −2.9%), BIA-measured body fat (−24.0% vs −8.1%), and free testosterone (−30.4% vs −12.6%) after 16 weeks (P = 0.0008, P = 0.0176, and P = 0.0009, respectively). Homeostatic model assessment for insulin resistance significantly decreased only in the experimental group (P = 0.0238) but without significant differences with respect to the control group (−23% vs −13.2%, P > 0.05). At baseline, 38.5% of participants in the experimental group and 14.3% of participants in the control group had ovulation, which increased to 84.6% (P = 0.031) and 35.7% (P > 0.05) at the end of the study, respectively. Conclusion: In obese PCOS patients, 16 weeks of VLCKD protocol with the Pronokal® method was more effective than Mediterranean LCD in reducing tot al and visceral fat, and in ameliorating hyperandrogenism and ovulatory dysfunction. Significance statements: To the best of our knowledge, this is the first randomized contr olled trial on the use of the VLCKD method in obese PCOS. It demonstrates the superiority of VLCKD with respect to Mediterranean LCD in reducing BMI with an almost selective reduction of fat mass and a unique effect of VLCKD in reducing v isceral adiposity, insulin resistance, and in increasing SHBG with a consequent reduction of free testosterone. Interestingly, this study also demonstrates the superiority of the VLCKD protocol in improving ovulation, whose occurrence increased by 46.1% in the group treated by the VLCKD method against a rise of 21.4% in the group treated by Mediterranean LCD. This study extends the therapeutic approach possibilities in obese PCOS women.

A new and optimized solid-phase microextraction method using pipette tips is proposed as a proof of concept for the extraction of sixteen veterinary drugs: antimicrobials (trimethoprim, enrofloxacin and sulfamethoxazole), external antiparasitics (thiamethoxam, clothianidin, imidacloprid, fipronil, clorpyrifos, lufenuron, and permethrin), internal antiparasitics (fenbendazole and albendazole), anti-inflammatories (prednisolone, diclofenac, and betamethasone), and an anticoccidial (robenidine). In this context, the device has been challenged by many analytes with very different structural and physicochemical properties, which presents a major difficulty in the simultaneous extraction of different APs. To this end, six carbon-based nanomaterials (multi-walled carbon nanotubes (MWCNTs), graphite, graphene oxide (GO), electrochemically expanded graphene (GEQE), electrochemically reduced graphene (ERGO), and commercial and synthetic graphene oxide) were evaluated packing sorbent in the extraction column. Several NMs (GEQE and ERGO) were used for the first time as sorbents in microextractions and were fabricated, synthesized, and characterized in the laboratory. Simple materials available in any laboratory were used to fabricate the devices, showing the simplicity, ease of preparation, and low cost of the proposed device. Optimization of the microextraction device (pipette tip) was performed using chemometric tools (design of experiments and reaction surface methodology) to obtain the sorbent mass and pH to improve retention rates. In addition, a comparative analysis of the extraction of single and multi-analytes and of a batch and a continuous system was performed. Real samples were examined to evaluate the proper performance of the instrument, which can be used in a preanalytical phase of sample handling to isolate analytes from complex samples. Furthermore, a very detailed and comparative study of the physicochemical properties of NM compared to the analytes was performed, providing valuable information on the interactions taking place and the experimental conditions required, which can be extrapolated to many analyses with similar properties. Additionally, the AGREE software was used to determine the environmental friendliness of the extraction methods and to compare them with the literature. Based on the latter considerations, this multi-analyte microextraction method holds great promise for future applications in the determination of novel environmental contaminants in water systems.

Background and objectiveSevere metabolic complications generally manifest at an early age in Berardinelli – Seip congenital lipodystrophy (BSCL) and their management is especially challenging. Nutritional intervention with low lipid diets is considered by experts to be fundamental in treating the disease when associated with medical therapy, however little is known about the beneficial effects of dietary interventions alone.AimTo underline the importance of a well-structured low-fat diet in BSCL patients.Methods and resultsA BSCL male patient strictly followed a hypocaloric hypolipemic diet (60% carbohydrates, 22% fats and 18% proteins) since clinical diagnosis at the age of one year. Interestingly, pharmacological interventions were not required at any point during the follow-up. Aged 16 years the patient was referred to our center. Biochemistry, hormonal evaluation, 75 mg oral glucose tolerance test, cardiac evaluation and abdominal ultrasound were performed, revealing no abnormalities. Genetic analysis and leptin dosage were carried out, confirming the diagnosis of BSCL type 1 (homozygosity for c.493-1G>C pathogenic variant in AGPAT2 gene) and showing undetectable circulating levels of leptin (< 0.2 mcg/L). Diet therapy alone was therefore maintained, scheduling follow-up visits every six months, with acceptable disease control ever since.ConclusionsThis report proves how a low-fat diet is of great help in the management of BSCL and its complications. In addition, a specific hypolipemic diet could be used alone as an effective treatment in selected cases with high compliance and, probably, a milder phenotype.

The facts that occupational cancer in women is under-investigated, with few in-depth analyses are well known. In recent decades the workforce has changed, with an increasing number of women employed. Therefore, the inclusion of women in occupational cancer studies has become more urgent and feasible than in the past decades. The difficulties to evaluate occupational causes of female gynecologic tumors in most past cohorts and the potential variation in outcome responses between men and women must be taken into consideration. This narrative review discusses women’s occupational cancer as a current area of research, focusing on three groups of workers characterized by peculiar exposure to occupational carcinogens and where women are often employed: beauticians and hairdressers; farmers; and healthcare workers. We discuss the most relevant cancers in each working category, with a particular focus on female breast cancer. In the three industries reviewed in detail, there are some risk factors which may affect primarily women, inducing breast cancer and cervical cancer, as well as risk factors that are carcinogenic in both genders, but whose effects are less well known in women.

Background Diesel exhaust exposure and cancer other than the lungs have been limitedly investigated. Aims To conduct a systematic review and meta-analysis on the association between occupational exposure to diesel exhaust and gastrointestinal cancers. Methods Two researchers performed a systematic literature review to identify all cohort studies on occupational exposure to diesel exhaust and risk of cancers other than lung. Of the 30 retained studies, 10 reported risk estimates for oesophageal, 18 on gastric, 15 on colon and 14 on rectal cancer. We performed random-effects meta-analyses to calculate summary relative risks (RRs) and 95% confidence intervals (CIs) for ever-exposure to diesel exhaust. Results We calculated summary RR = 1.08 (95% CI 0.97–1.21, P heterogeneity = 0.06) for oesophageal, 1.06 (95% CI 0.99–1.14, P  < 0.001) for gastric, 0.98 (95% CI 0.96–1.00, P  = 0.453) for colon, and RR = 1.04 (95% CI 0.97–1.11, P  = 0.013) for rectal cancer. Drivers showed an association with oesophageal (RR = 1.26, 95% CI 0.99–1.62), gastric (RR = 1.20, 95% CI 0.91–1.59) and rectal cancer (RR = 1.41, 95% CI 1.13–1.75); machine operators with oesophageal (RR = 1.09, 95% CI 1.00–1.20) and gastric (RR = 1.15, 95% CI 1.10–1.20) and handlers with oesophageal cancer (RR = 1.95, 95% CI 1.23–3.09). Studies from Europe revealed an association with gastric cancer while those from North America did not (P  < 0.05). No difference was found by quality score except for gastric cancer, where high-quality studies but not low-quality ones showed increased risk (P heterogeneity = 0.04). There was no evidence of publication bias. Conclusions An increased but insignificant risk of oesophageal, gastric and rectal, but not colon cancer, was suggested in workers exposed to diesel exhaust. Residual confounding cannot be excluded. [ABSTRACT FROM AUTHOR]

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Background: This study aimed to explore the association between occupational exposure to diesel exhaust (DE) and gynaecological and breast cancers. Methods: A systematic review was performed to identify cohort studies reporting results on the association between occupational exposure to DE and risk of gynaecological and breast cancers. STROBE guidelines and PECOS criteria were followed. We identified 6 studies for breast cancer (BC), 4 for cervical cancer (CC), 4 for endometrial cancer (EC) and 7 for ovarian cancer (OC). Random-effects meta-analyses were conducted on the relationship between DE exposure and BC, CC, EC, and OC risk; 95% Confidence Intervals (CI) and prediction intervals (PI) were reported. We investigated between-study heterogeneity and potential publication bias using Egger's test. Results: No associations were observed between occupational DE exposure and risk of BC [RR=0.93; CI: 0.77-1.13; PI:0.50-1.73, I2=80.31% (CI: 21.72-95.05%)], EC [RR=0.89; CI: 0.75-1.05; PI:0. 61-1.30, I2=0.78% (CI: 0-85.57%)], and OC [RR=1.08; CI: 0.89-1.32, PI: 0.76-1.56, I2=11.87% (CI: 0-74.42%)]. A weak association was observed for CC [RR=1.41; CI: 1.17-1.17; PI:0.85-2.30, I2=6.44% (CI: 0-86.40%)]. No between-study heterogeneity or publication bias was detected. Conclusions: This study identified an association between DE exposure and CC, which was not adjusted for potential confounders. No evidence of an association was found with BC, EC, and OC. [ABSTRACT FROM AUTHOR]

Background: Since the beginning of the SARS-CoV-2 pandemic, cancer patients affected by COVID-19 have been reported to experience poor prognosis; however, a detailed quantification of the effect of cancer on outcome of unvaccinated COVID-19 patients has not been performed. Methods: To carry out a systematic review of the studies comparing the outcome of unvaccinated COVID-19 patients with and without cancer, a search string was devised which was used to identify relevant publications in PubMed up to December 31, 2020. We selected three outcomes: mortality, access to ICU, and COVID-19 severity or hospitalization. We considered results for all cancers combined as well as for specific cancers. We conducted random-effects meta-analyses of the results, overall and after stratification by region. We also performed sensitivity analyses according to quality score and assessed publication bias. Results: For all cancer combined, the pooled odds ratio (OR) for mortality was 2.32 (95% confidence interval [CI] 1.82–2.94, I2 for heterogeneity 90.1%, 24 studies), that for ICU admission was 2.39 (95% CI 1.90–3.02, I2 0.0%, 5 studies), that for disease severity or hospitalization was 2.08 (95% CI 1.60–2.72, I2 92.1%, 15 studies). The pooled mortality OR for hematologic neoplasms was 2.14 (95% CI 1.87–2.44, I2 20.8%, 8 studies). Data were insufficient to perform a meta-analysis for other cancers. In the mortality meta-analysis for all cancers, the pooled OR was higher for studies conducted in Asia than studies conducted in Europe or North America. There was no evidence of publication bias. Conclusions: Our meta-analysis indicates a twofold increased risk of adverse outcomes (mortality, ICU admission, and severity of COVID-19) in unvaccinated COVID-19 patients with cancer compared to COVID-19 patients without cancer. These results should be compared with studies conducted in vaccinated patients; nonetheless, they argue for special effort to prevent SARS-CoV-2 infection in patients with cancer. Funding: No external funding was obtained.