Metabolic syndrome has been associated in many studies with working in shifts. Even if the mechanistic details are not fully understood, forced sleep deprivation and exposure to light, as happens during night shifts, or irregular schedules with late or very early onset of the working program, lead to a sleep–wake rhythm misalignment, metabolic dysregulation and oxidative stress. The cyclic melatonin secretion is regulated by the hypothalamic suprachiasmatic nuclei and light exposure. At a central level, melatonin promotes sleep and inhibits wake-signals. Beside this role, melatonin acts as an antioxidant and influences the functionality of the cardiovascular system and of different metabolic processes. This review presents data about the influence of night shifts on melatonin secretion and oxidative stress. Assembling data from epidemiological, experimental and clinical studies contributes to a better understanding of the pathological links between chronodisruption and the metabolic syndrome related to working in shifts.

Introduction: The neutrophil to lymphocyte ratio (NLR) in peripheral blood was extensively studied for many chronic diseases, but there are few studies about the NLR significance in hypersensitivity pneumonitis (HP) and even fewer of the NLR in broncho-alveolar lavage (NLRBAL). Methods: BAL samples from 54 consecutive patients diagnosed with HP were retrospectively analysed in this study and clustered into 30 fibrotic HP (fHP) and 24 non fibrotic HP (nfHP). Results: The nfHP were mainly acute forms, whereas the fHP were predominantly chronic. Gender distribution and smoking habits were similar. The fHP patients were older (p= 0.001) and had longer onset of symptoms (p=0.004). There was no difference in the distribution of high NLR values in the two groups (c2= 0.29, p=0.58), but NLRBAL was significantly higher in fHP (p=0.0006). The NLRBAL correlation to the fibrotic status was statistically significant (Rho=0.58, p=0.0001). Even more, a higher NLRBAL at diagnosis anticipated a lower lung function of retrictive pattern at 3 months after the diagnosis. Conclusion: The relative increase of neutrophils cells in BAL, with a lower contribution of the lymphocyte population to the total cell count, as expressed by the NLRBAL should be considered a marker of fibrosis in HP. The utility of NLRBAL to assess the prognostic and in the antifibrotic response should be further investigated.

Introduction: For lung cancer, the total interval time to diagnosis (TITD) is very important. If not detected by the screening program, the actual guidelines emphasize the need for a short delay to assure the initiation of treatment before 2 months from the initial symptoms. In order to shorten TITD, the individual risk has to be properly assessed by the primary physician. Objective: The assessment of the influence of the occupational exposure on the diagnostic delay—from the onset of symptoms to confirmed diagnosis—in a population of patients with lung cancer. Material and methods: A total of 110 cases were recruited and were divided into two groups based on the individual assessment by an occupational physician. Results: There were 38 cases (34.55%) at high risk according to their occupational exposure and 72 controls. On average, the TITD was 3.41 +/−5.12 months. The TITD was significantly longer in the high-risk group (p = 0.03). A larger proportion cases had longer TITD: 55.17% of cases vs. 44.83% of controls (p = 0.006). In a multivariate analysis including covariates’ age, sex, level of education, health literacy, number of packs-years, family history of cancer, and previous lung diseases associated with a high risk of lung cancer, the highest risk derived from the previous occupational exposure was the only variable statistically associated with TITD (OR = 10.57, 2.06–54.34, p = 0.01). Discussion: Awareness about the occupational risk in workers who are or have been exposed and in health providers could reduce the total interval time to diagnosis.