Smoking Prevalence, Knowledge and Perceptions on Tobacco Control Among Healthcare Professionals: A Survey in an Italian Cancer Center.

Smoking is recognized as the major cause of lung cancer. Healthcare professionals play an important role in lung cancer prevention policies, as they act as a source of guidance for patients and advocates. The following survey evaluated prevalence, knowledge, and attitudes toward tobacco smoking among a sample of workers in "IRCCS Istituto Tumori "Giovanni Paolo II" of Bari, an Italian cancer hospital. An anonymous questionnaire was completed by 104 healthcare professionals to collect personal and occupational data about smoking status, knowledge about the harms of smoking, current legislation in place, Second-Hand Smoke (SHS) awareness, and, for ex-smokers, the reasons for quitting. Among participants, 17.8% were current smokers, 26.2% former smokers, and 56% never smoked. Only 40% acknowledged that the smoking ban is generally respected, and 63.2% reported that they smoke during working hours. Most of the participants perceived tobacco control policy as an efficient way to protect public health. Currently, the implementation of Italian anti-smoking legislation has so far improved neither smoking cessation rates nor the will to quit smoking completely. Our experience highlights that to date the anti-smoking strategies have limited efficacy even in a cancer center; in fact, there is still a large prevalence of smokers among hospital personnel. Therefore, it is strongly suggested that interventions be shared with all healthcare workers, specifically aimed at developing a culture of health promotion.

Impact of tobacco control interventions on smoking initiation, cessation, and prevalence: a systematic review.

This article investigates the effects of tobacco control policies on smoking initiation, cessation and prevalence by examining the papers published in the last 5 years. Twenty-one articles have been selected by two authors and sorted by four types of tobacco control: tobacco prices, anti-smoking campaigns for young people, mass media intervention and public smoking bans. Price/tax increase has deterrent effect on smoking initiation but does not promote smoking cessation; intervention on young people could reduce the smoking initiation if carried out at an early age and if acted on social skills and with peer-led approach, as opposed to restraining measures which hare generally easily circumvented by young people. The mass media campaigns showed positive effect on attempts to quit among smokers if carried forward over time and by involving multiple communication channels (TV, internet, radio). The bans in public have little effect on smoking cessation but could improve the overall well-being of non-smokers. Heterogeneous results have been described by different studies probably because of different research methodologies, cultural aspects and the really effective implementation of the rules for each country. In conclusion, comprehensive tobacco control interventions to reduce smoking prevalence and modify the smoking behavior are recommended. Moreover, the use of e-cigarettes and heat-not-burn (HnB) products, as possible helping tool for smoke cessation, currently remains controversial.

Vepris macrophylla (Baker) I. Verd Essential Oil: An Antifungal Agent against Phytopathogenic Fungi.

Rutaceae are widely used in ethnomedicine to treat infectious diseases in humans and plants. In this study, the antifungal activity of the Vepris macrophylla leaf essential oil (VEO) and its main components, citral and citronellol, was evaluated against six phytopathogenic fungi. In addition, the possible action of VEO on the synthesis of mycotoxins was evaluated as well. To determine the antifungal activity of VEO we used the agar dilution method and VEO showed inhibitory activity against all the tested fungi. In particular, VEO resulted to be fungicidal against Phytophthora cryptogea and Fusarium avenaceum. For all other fungi VEO exhibited fungistatic activity and the weakest effect was observed on Alternaria solani. Citral was very effective against P. cryptogea, F. avenaceum, F. poae and F. graminearum. On the other hand, citronellol showed good activity towards P. cryptogea and F. avenaceum and weaker activity towards F. poae and F. graminearum. It can be concluded that VEO can be considered a promising antifungal agent, especially against P. cryptogea and F. avenaceum, suggesting a possible use in the formulation of new selective and natural fungicides.

Tobacco control in Europe: A review of campaign strategies for teenagers and adults.

BACKGROUND: In Europe the prevalence of tobacco use in adults and adolescents is among the highest within the WHO regions. Many resources have been allocated toward the prevention and support for smoking cessation. However, the implemented strategies in Europe have not been systematically evaluated. METHODS: A systematic literature review was carried out to identify studies that analyzed the efficacy of the main smoking-prevention campaigns conducted in Europe. PRISMA guidelines were used to systematically review and extract data. RESULTS: A total of 24 studies meeting inclusion criteria were identified. Each article was thoroughly reviewed and evaluated for quality, design, and methodology, with reference to the main areas of intervention: school (8); mass media (4) and technological tools (4); smoke-free environments (3); packaging (2) and taxes (3). The school programmes focusing on building skills to recognize and resist negative influences, the intensive use of media and technological equipments, health warnings and excise taxes have showed to be effective tools in reducing the tobacco use. CONCLUSIONS: Intervention programmes to implement tobacco control policies and smoking cessation are active in many European countries. However, these programmes need to be constantly sustained to achieve a long term efficacy.

Final data of an Italian multicentric survey about counseling for smoking cessation in patients with diagnosis of a respiratory disease.

INTRODUCTION: Smoking is the major risk factor for cancer and several respiratory diseases. Quitting smoking at any point of life may increase the effectiveness of treatments and improve prognosis of patients with any pulmonary disease, including lung cancer. However, few institutions in Europe offer to patients adequate counseling for smoking cessation. OBJECTIVES: Aim of this study was to investigate the level of counseling for smoking cessation offered by healthcare professionals to patients and their appreciation towards the intervention itself. METHODS: Between January 2013 and February 2016, 490 patients, diagnosed with a respiratory diseases, were prospectively evaluated with an anonymous survey developed by WALCE (Women Against Lung Cancer in Europe). RESULTS: The majority of patients enrolled (76%) declared to have stopped smoking after the diagnosis of a respiratory disease, 17% to smoke less, 7% to continue smoking. Patients who reported to have never received any counseling for smoking cessation were 38%. Almost 73% of the other patients reported a positive judgment about the quality of healthcare's intervention. Despite these favorable considerations, 83% of patients have disclosed they simply quit smoking overnight without help, 5% have used electronic cigarettes, 5% nicotine replacement treatments, 4% dedicated books, 3% have attended a referral clinic. CONCLUSIONS: Considering all the smoking-related side effects, greater efforts should be made in order to better support patients in smoking cessation. Smoking should be considered as a real physical disorder and similar surveys should be encouraged with the aim to fight the 'stigma' of smoking that still exists among patients.

The Essential Oil of Monarda didyma L. (Lamiaceae) Exerts Phytotoxic Activity in Vitro against Various Weed Seed.

The chemical composition of the essential oil of the flowering aerial parts of Monarda didyma L. cultivated in central Italy was analyzed by Gas Chromatography/Mass Spectrometry (GC/MS). The major compounds of the oil were thymol (59.3%), p-cymene (10.3%), terpinolene (9.2%), δ-3-carene (4.4%), myrcene (3.7%), and camphene (3.4%). The essential oil was tested in vitro for its anti-germination activity against Papaver rhoeas L., Taraxacum officinale F. H. Wigg., Avena fatua L., Raphanus sativus L. and Lepidium sativum L. seeds, demonstrating good inhibitory activity in a dose-dependent way. The exposure of the employed weed seeds to M. didyma essential oil and thymol solution (59.3%) increased the level of hydrogen peroxide (H2O2) and malondialdehyde (MDA), markers of oxidative stress, in emerging 5-day-old rootlets.

High Triterpenic Acids Production in Callus Cultures from Fruit Pulp of Two Apple Varieties.

INTRODUCTION: Very rarely fruit pulp has been used in in vitro culture to produce secondary metabolites useful in promoting health. OBJECTIVES: The aims of this work were the study of the best conditions to obtain the callus cultures from the pulp of two varieties of apples, Golden Delicious (GD) and "Mela Rosa Marchigiana" (MRM), and the quali-quantitative analysis of secondary metabolites produced by the two in vitro callus cultures. METHODOLOGY: Callus was induced on both Murashige and Skoog and Gamborg B5 media containing various combinations of supplements. To achieve the maximum recovery of secondary metabolites produced, preliminary extraction tests were carried out on GD apple culture using two different organic solvents (MeOH and EtOAc). The quali-quantitative analysis of the methanolic extract of both cultures was carried out by ESI-MSn and GC-MS techniques. RESULTS: The GC-MS analysis revealed the presence of triterpenic acids, in particular, oleanolic, ursolic, maslinic, pomolic, tormentic, corosolic and annurcoic acid along with a phytosterol, ß-sitosterol. In addition, GD callus culture produced phloridzin, absent in the MRM culture. In this last culture, however, the total amount of secondary metabolites was markedly higher. The in vivo production of these bioactive compounds were also quantified in the GD and MRM apple pulps. CONCLUSION: Apple pulps produced higher amounts of triterpenic acids in vitro than in vivo. The present work can be considered a method to amplify the production of important secondary metabolites which exert beneficial effects on human health. Copyright © 2016 John Wiley & Sons, Ltd.

Establishment and analysis of in vitro biomass from Salvia corrugata Vahl. and evaluation of antimicrobial activity.

Demethylfruticuline A and fruticuline A, the most abundant compounds from the surface extract of Salvia corrugata Vahl., have shown antibacterial, antitumor and cytotoxic activities. In order to obtain these icetexane diterpenes from in vitro cultures of S. corrugata, protocols were developed for callus production, micropropagation and shoot regeneration. Analysis of the regenerated shoots showed the presence of both icetexanes, micropropagated plants contained only fruticuline A, while the callus contained trace amounts of both diterpenes. The yield of fruticuline A was higher in the methanolic extract of regenerated shoots than in those of fresh leaves and fresh shoot tips. In addition to these diterpenes, the regenerated shoot and micropropagated plant extracts afforded seven other diterpenes, one icetexane and six abietanes, identified by UV, IR, 1D- and 2D-NMR and HR-MS analysis. Five compounds (19-acetoxy-7α-hydroxyroyleanone, 7ß,20-epoxy-11,12,19-trihydroxyabieta-8,11,13-triene, 7,20-dihydrofruticuline A, 7ß-acetoxy-20-hydroxy-19,20-epoxyroyleanone, 7ß-ethoxy-6ß,20:19,20-diepoxyroyleanone) were previously undescribed. Although the crude plant surface extract did not possess any antibacterial activity, methanolic extracts of in vitro tissues and two compounds, namely 7ß-acetoxy-20-hydroxy-19,20-epoxyroyleanone and 7ß-ethoxy-6ß,20:19,20-diepoxyroyleanone, isolated in suitable amounts, were active in varying degrees against multidrug resistant clinical strains of Staphylococcus aureus, Staphylococcus epidermidis, Enterococcus faecalis and Enterococcus faecium, displaying MIC values ranging from 32, 64 to 128µg/mL.

Essential Oil Composition and Antigermination Activity of Artemisia dracunculus (Tarragon).

The chemical composition of an Italian oil of tarragon (Artemisia dracunculus L.) was analyzed by GC/EIMS. The major compound of the oil was estragole (73.3%), followed by limonene (5.4%), (E)-ß-ocimene (5.3%), ß-pinene (3.4%) and (Z)-ß-ocimene (3.0%). The essential oil was tested "in vitro" for its antigermination activity against Raphanus sativus L., Lepidium sativum L, Papaver rhoeas L. and Avena fatua L. seeds and demonstrating a good inhibitory activity in a dose-dependent way.

Activity of Vitis vinifera Tendrils Extract Against Phytopathogenic Fungi.

The in vitro antifungal activity was determined of an ethanolic extract of Vitis vinifera L. tendrils (TVV) against ten plant pathogenic fungi, using the agar dilution method; activity was shown against all tested fungi. Fusarium species were the most sensitive with MIC values ranging from 250 to 300 ppm, while the basidiomycete fungus Rhizoctonia solani was the most resistant, with a MIC value of 500 ppm. Electrospray ionization tandem mass spectrometry (ESI-MS(n)) was used to obtain qualitative information on the main components of TVV. The high amount of polyphenolic compounds contained in TVV is likely to contribute significantly to its antifungal activity.

Antioxidant and antifungal activity of different extracts obtained from aerial parts of Inula crithmoides L.

The total phenolic content, antioxidant and antifungal activities of three Inula crithmoides extracts (n-hexane, methylene chloride and MeOH) were investigated. The methanolic extract showed the highest total phenolic content. In the DPPH assay, the methanolic and hexane extracts exhibited the highest DPPH-radical scavenging activity; in the 5-lipoxygenase assay, the hexane extract showed greater inhibitory effect with an IC50 similar to that of Trolox and ascorbic acid. The antifungal activity of the methanolic extract revealed a higher activity against Phytophtora cryptogea and Alternaria solani.

Flowers volatile profile of a rare red apple tree from Marche region (Italy).

In this paper, the volatiles emitted by flowers and various parts of the flower of a rare spontaneous Italian red (peel and flesh) apple named "Pelingo", were analyzed by SPME with the aim of identifying the contribution of each one to the whole aroma profile. Linalool was the most abundant volatile of flowers: from 43.0% in the flower buds, to 17.6% in the stylus and stigma headspace. The second most represented volatile was (E,E)-α-farnesene mainly emitted by the mature flowers (32.2%). Benzenoid compounds also have been identified: benzyl-alcohol is the most representative (1.0-16.5%) in all the samples except flower buds, while benzyl acetate (5.7%) and methyl salicylate (7.7%) are mainly present in the calyx and in the mature flowers respectively but not in the flower buds. Benzenoid compounds are the attractors for pollinator, probably for this reason were not detected in the headspace of flower buds.

Essential oil composition and antifungal activity of aerial parts of Ballota nigra ssp foetida collected at flowering and fruiting times.

The present study reports the results of gas chromatographic-mass spectrometric (GC/MS) analyses of the essential oils from the aerial parts of Ballota nigra L. ssp foetida (Lamiaceae) collected at flowering and fruiting times, as well as their in vitro antifungal activity against nine plant pathogenic fungi. Moreover, the essential oils were evaluated for their antifungal activity using the agar dilution method, and also MICs (minimum inhibitory concentrations) and MFCs (minimum fungicidal concentrations) were determined. The major compounds identified in the flowering and fruiting aerial parts oils respectively were beta-caryophyllene (22.6% and 21.8%), caryophyllene oxide (18.0% and 20.5%) and germacrene-D (16.5 and 13.1%). The oils showed in vitro antifungal activity against some species of Fusarium, Botrytis cinerea, and Alternaria solani. Our study indicates that the oil of B. nigra ssp foetida could be used as a control agent for plant pathogenic fungi in natural formulations.

Polyphenols profile and antioxidant activity of skin and pulp of a rare apple from Marche region (Italy).

BACKGROUND: Apples are an important source of polyphenols in the human diet and the consumption of this fruit has been linked to the prevention of degenerative diseases. RESULTS: CATECHINS, PROCYANIDINS, HYDROXYCINNAMIC ACIDS, FLAVONOL GLYCOSIDES, DIHYDROCHALCONE GLYCOSIDES AND ONE ANTHOCYANIN: cyanidin-3-O-galactoside, were identified both in the peel and pulp. Procyanidins, catechins and flavonols represent the main constituents of peel. Concerning the antioxidant activity, in the reduction of the stable DPPH radical and in the inhibition of lipid peroxidation, the ethanolic extracts of red peel and red pulp showed a good similar activity comparable to ascorbic acid in the DPPH test and about ten times more active than BHT in the lipoxygenase test, and were much more active than aqueous extracts. The ORAC value of red pulp aqueous extract resulted comparable to that of red berries: vaccinium, rubus and ribes, foods appreciated for their health value. CONCLUSION: This apple contains an appreciable amount of polyphenols also in the flesh; this variety with red flesh can also be useful for researchers engaged in apples varietal innovation in addition to being used as food apple.

Essential oil composition and antimicrobial activity of Angelica archangelica L. (Apiaceae) roots.

In this paper, the chemical composition and the antimicrobial activity of the essential oil of Angelica archangelica L. (Apiaceae) roots from central Italy were analyzed. The major constituents of the oil were α-pinene (21.3%), δ-3-carene (16.5%), limonene (16.4%) and α-phellandrene (8.7%). The oil shows a good antimicrobial activity against Clostridium difficile, Clostridium perfringens, Enterococcus faecalis, Eubacterium limosum, Peptostreptococcus anaerobius, and Candida albicans with minimum inhibitory concentration (MIC) values of 0.25, 0.25, 0.13, 0.25, 2.25, and 0.50% v/v, respectively. A weaker antimicrobial activity against bifidobacteria and lactobacilli-very useful in the intestinal microflora-has also been shown with MIC values >4.0% v/v.

Essential oil composition and antimicrobial activity of aerial parts and ripe fruits of Echinophora spinosa (Apiaceae) from Italy.

The chemical composition and antimicrobial activity of the essential oils obtained from the flowering aerial parts and ripe fruits of Echinophora spinosa L. (Apiaceae) from central Italy were analyzed by GC/MS. The major constituents of the oil from the aerial parts were beta-phellandrene (34.7%), myristicin (16.5%), delta3-carene (12.6%), alpha-pinene (6.7%) and alpha-phellandrene (6.2%), and of the oil from the ripe fruits p-cymene (50.2%), myristicin (15.3%), alpha-pinene (15.1%) and alpha-phellandrene (8.1%). The two oils showed good antimicrobial activity against Clostridium difficile, C. perfringens, Enterococcus faecalis, Eubacterium limosum, Peptostreptococcus anaerobius and Candida albicans with MIC values respectively of 0.25, 0.25, 0.25, 0.25, 2.25, and 0.50%, v/v, and 0.13, 0.13, 0.13, 0.13, 2.25, 0.50%, v/v, for aerial parts and ripe fruits respectively. A less significant antimicrobial activity against bifidobacteria and lactobacilli, very important in the intestinal microflora, was also detected, with MIC values higher than 4.0%, v/v.

Salvia x jamensis J. Compton: Trichomes, essential oil constituents and cytotoxic-apoptotic activity.

Salvia x jamensis J. Compton is a hybrid between Salvia greggii A. Gray and Salvia microphylla Kunt. In this study, we describe three hair types identified by Scanning Electron Microscopy. In the essential oil of the aerial parts of S. jamensis 56 different compounds were identified. The two main constituents were ß-caryophyllene (14.8%) and ß-pinene (6.8%). Cytotoxic-apoptotic activity of S. x jamensis essential oil has been investigated by using U937 cell line. The essential oil EC50 for cell number and for cell apoptosis have been shown to be 360 and 320 µg mL(-1), respectively. Among the constituents of the oil examined, only ß-caryophyllene, ß-pinene and α-pinene displayed cytotoxic and apoptotic activities. For the first time, it has been demonstrated that some of the pure constituents identified within S. x jamensis essential oil are responsible for its cytotoxic-apoptotic activity when properly combined.

Total polyphenol content, in vitro antifungal and antioxidant activities of callus cultures from Inula crithmoides.

This is the first report on the antioxidant and antifungal activities of callus cultures from Inula crithmoides L. (Asteraceae). Callus cultures were initiated from leaf sections, on initial culture MS basal medium supplemented with various concentrations of 2,4-D (2,4-dichlorophenoxyacetic acid), NAA (1-naphthaleneacetic acid) and IBA (indole-3-butyric acid) and a 72% survival was achieved. Significant differences between the various auxins used as phytohormones on callus growth were found. Maximum callusing was noticed on the leaf explants grown on MS basal medium supplemented with 1 mgL(-1) 2,4-D. Subsequently the antioxidant and antimicrobial activities of the methanol extract from calli were investigated. Antioxidant studies suggested that the methanol extracts of dark-grown and light-grown callus were able to reduce the stable free radical 2,2-diphenyl-1-picrilhydrazyl (DPPH). In the inhibition against lipid peroxidation, extracts of dark-grown callus showed the strongest effect with IC50 values better than those of the standards. The methanol extract of callus cultures had significant antifungal activity only against two of the fungi tested: Alternaria solani and Phytophthora cryptogea. Against all the other tested fungi, the I. crithmoides calli extracts showed fungistatic activity.

Cytotoxic activity of essential oils of aerial parts and ripe fruits of Echinophora spinosa (Apiaceae).

The cytotoxic effects of the essential oils obtained from the flowering aerial parts (APO) and ripe fruits (RFO) of Echinophora spinosa L. (Apiaceae) from central Italy toward human U937 promonocytoid cells were studied; the contribution of each of the major constituents to the whole cytotoxic activity of either APO or RFO was also characterized. The major components of APO were beta-phellandrene (34.7%), myristicin (16.5%), p-cymene (16.3%), delta3-carene (12.6%), alpha-pinene (6.7%) and alpha-phellandrene (6.2%); those of RFO p-cymene (50.2%), myristicin (15.3%), alpha-pinene (15.1%) and alpha-phellandrene (8.1%). Both oils tested were toxic to U937 cells, but RFO was much more cytotoxic: indeed, the IC50 values calculated from the linear regression curves of RFO and APO were 14.5 +/- 0.85 and 43.4 +/- 2.81 microg/mL, respectively. alpha-Pinene and alpha-phellandrene were identified as the most toxically relevant constituents: however, they did not completely account for the toxic effects of genuine APO and RFO. Interestingly, we found that p-cymene, although per se devoid of toxicity within the tested range of concentrations, was capable of significantly sensitizing U937 cells to the cytotoxic activity of alpha-pinene and alpha-phellandrene, and that specific mixtures of these three terpenes were as toxic as genuine APO and RFO.

Chemical composition and antimicrobial activity of Salvia x jamensis essential oil.

This is the first report about the composition of the essential oil of Salvia x jamensis. The major compounds identified by GC-MS were beta-caryophyllene (14.8 %), beta-pinene (6.8 %), caryophyllene oxide (6.0 %), delta-cadinene (5.5 %), alpha-pinene (5.2 %) and spatulenol (5.2 %). The oil showed antimicrobial activity against three Gram (+) bacteria: Bacillus cereus, Staphylococcus aureus, and S. epidermidis, and three Candida strains: C. albicans, C. glabrata and C. tropicalis, while it was inactive against three Gram (-) bacteria: Pseudomonas aeruginosa, Escherichia coli and Enterobacter cloacae.