-
Clinical Oral Investigations Mar 2022To systematically review the literature on the efficacy of interdental cleaning devices (ICDs) used with active substances, as adjuncts to toothbrushing, in comparison... (Review)
Review
OBJECTIVES
To systematically review the literature on the efficacy of interdental cleaning devices (ICDs) used with active substances, as adjuncts to toothbrushing, in comparison with toothbrushing alone or with ICDs without active substances.
MATERIALS AND METHODS
Searches for randomized clinical trials were performed in PubMed, Embase, Scopus, Cochrane (CENTRAL), and Web of Science. Two independent researchers performed study selection, data extraction, and risk-of-bias assessment; a third one resolved any disagreement. Meta-analysis was not feasible, and a narrative approach was used to synthesize the evidence.
RESULTS
Seven studies were included. Dental floss with chlorhexidine was used in five studies, whereas interdental brushes with chlorhexidine and cetylpyridinium chloride were used in one study each. ICDs with active substances resulted in significantly higher antiplaque and antigingivitis efficacies than without ICDs (n = 3). ICDs with and without active substances demonstrated contrasting results. For this comparison, six studies were included for each outcome. Significantly higher antigingivitis efficacy of ICDs with active substances was noted in four studies, whereas significantly higher antiplaque efficacy of ICDs with active substances was reported in three studies. All comparisons demonstrated a very low certainty of evidence.
CONCLUSIONS
There is no robust evidence for the additional clinical efficacy of ICDs with active substances regarding their antiplaque and antigingivitis efficacies. These devices may have additional clinical efficacy when compared with the absence of interproximal hygiene.
CLINICAL RELEVANCE
The use of ICDs helps maintain or achieve periodontal health. However, the adjunct use of active substances may not provide additional benefits.
Topics: Cetylpyridinium; Dental Devices, Home Care; Dental Plaque; Gingivitis; Humans; Toothbrushing
PubMed: 34999990
DOI: 10.1007/s00784-021-04327-3 -
BMC Geriatrics Jan 2017For immobile patients, a body wash in bed is sometimes the only bathing option. Traditionally, the bed bath is performed with water and soap. However, alternatives are... (Review)
Review
BACKGROUND
For immobile patients, a body wash in bed is sometimes the only bathing option. Traditionally, the bed bath is performed with water and soap. However, alternatives are increasingly used in health care. Washing without water is one such alternative that has been claimed to offer several advantages, such as improved hygiene and skin condition. This systematic review aims to provide a comprehensive overview of the evidence on outcomes of the washing without water concept compared to the traditional bed bath.
METHODS
Controlled trials about washing without water outcomes published after 1994 were collected by means of a systematic literature search in CINAHL, Embase, MEDLINE, and PUBMED at the 25th of February, 2016. Additionally, references and citations were searched and experts contacted. Studies were eligible if (1) the study designs included outcomes of washing without water products developed for the full body wash compared to the traditional bed bath, and (2) they were controlled trials. Two researchers independently used a standardized quality checklist to assess the methodological quality of the eligible studies. Finally, outcomes were categorized in (1) physiological outcomes related to hygiene and skin condition, (2) stakeholder-related outcomes, and (3) organizational outcomes in the data synthesis.
RESULTS
Out of 33 potentially relevant articles subjected to full text screening, six studies met the eligibility criteria. Only two studies (of the same research group) were considered of high quality. The results of these high quality studies show that washing without water performed better than the traditional bed bath regarding skin abnormalities and bathing completeness. No differences between washing without water and the traditional bed bath were found for outcomes related to significant skin lesions, resistance during bathing and costs in the studies of high quality.
CONCLUSIONS
There is limited moderate to high quality evidence that washing without water is not inferior to the traditional bed bath. Future research on washing without water is needed and should pay special attention to costs, hygiene, and to stakeholder-related outcomes, such as experiences and value perceptions of patients, nursing staff and family.
Topics: Baths; Disabled Persons; Humans; Hygiene; Sanitation; Soaps; Water
PubMed: 28118815
DOI: 10.1186/s12877-017-0425-4 -
Contact Dermatitis Jan 2021The use of alcoholic-based hand rubs (ABHRs) is an important tool for hand hygiene, especially in times of the COVID-19 pandemic. Possible irritant effects of ABHR may...
BACKGROUND
The use of alcoholic-based hand rubs (ABHRs) is an important tool for hand hygiene, especially in times of the COVID-19 pandemic. Possible irritant effects of ABHR may prevent their use by persons at risk of infection.
METHODS
This systematic review is based on a PubMed search of articles published between January 2000 and September 2019 in English and German, and a manual search, related to the irritation potential of alcohol-based disinfectants restricted to n-propanol (1-propanol) and its structural isomer isopropanol (isopropyl alcohol, 2-propanol).
RESULTS
The majority of the included studies show a low irritation potential of n-propanol alone. However, recent studies provide evidence for significant barrier damage effects of repeated exposure to 60% n-propanol in healthy, as well as atopic skin in vivo. The synergistic response of combined irritants, (ie, a combination of n-propanol or isopropanol with detergents such as sodium lauryl sulfate) is greater, compared with a quantitatively identical application of the same irritant alone.
CONCLUSION
While recent studies indicate a higher risk of skin irritation for n-propanol and isopropanol than reported in the past, this risk still seems to be lower than that for frequent handwashing with detergents, as recommended by some to prevent COVID-19 infections.
Topics: 1-Propanol; 2-Propanol; Anti-Infective Agents, Local; COVID-19; Dermatitis, Irritant; Hand Disinfection; Humans
PubMed: 33063847
DOI: 10.1111/cod.13722 -
Environmental Pollution (Barking, Essex... Oct 2023The overwhelming concerns of water pollution, industrial discharges and environmental deterioration by various organic and inorganic substances, including dyes, heavy... (Review)
Review
The overwhelming concerns of water pollution, industrial discharges and environmental deterioration by various organic and inorganic substances, including dyes, heavy metals, pesticides, pharmaceuticals, and detergents, intrinsically drive the search for urgent and efficacious decontamination techniques. This review illustrates the various approaches to remediation, their fundamentals, characteristics and demerits. In this manner, the advantageous implementation of nature-based adsorbents has been outlined and discussed. Different types of lignocellulosic compounds (cellulose, lignin, chitin, chitosan, starch) have been introduced, and the most used biopolymeric materials in bioremediation have been highlighted; their merits, synthesis methods, properties and performances in aqueous medium decontamination have been described. The literature assessment reveals the genuine interest and dependence of academic and industrial fields to valorize biopolymers in the adsorption of various hazardous substances. Yet, the full potential of this approach is still confined by certain constraints, such as the lack of reliable, substantial, and efficient extraction of biopolymers, as well as their modest and inconsistent physicochemical properties. The futuristic reliance on such biomaterials in all fields, rather than adsorption, is inherently reliable on in-depth investigations and understanding of their features and mechanisms, which can guarantee a real-world application and green technologies.
Topics: Polymers; Water; Adsorption; Decontamination; Water Pollutants, Chemical; Biopolymers; Metals, Heavy; Water Purification
PubMed: 37562526
DOI: 10.1016/j.envpol.2023.122349 -
Spinal Cord Jul 2022Systematic Review. (Review)
Review
STUDY DESIGN
Systematic Review.
OBJECTIVES
To review systematically the clinical evidence of the effectiveness of various intermittent catheter cleaning methods that have been proposed as methods to prepare catheters for reuse.
METHODS
A keyword search in Medline, Excerpta Medica dataBASE, the Cumulative Index to Nursing and Allied Health Literature, Web of Science and Cochrane Central Register of Controlled Trials, was undertaken to identify all English, Russian and German language literature evaluating the effectiveness of various intermittent catheter cleaning methods. Studies selected for review included analytical experimental, prospective cohort and cross-sectional. Cleaning methods reviewed included heat-based sterilization, chemical cleaning solutions, mechanical abrasion, photocatalytic sterilization, and combined methods.
RESULTS
Overall, 12 studies were included. Heat-based sterilization and mechanical abrasion methods were either not effective or damaged the physical properties of catheters. Two studies reported evidence that their chemical cleaning methods (i.e., soaked catheters in a 70% alcohol solution for 5 min or combined approach detergent wash followed by soaking in Milton sterilizing fluid also known as the Milton method) both preserved the structural integrity of their catheters and were bactericidal.
CONCLUSIONS
Numerous cleaning methods resulted in the destruction of catheters. However, there are two reported cleaning methods, submersion for 5 min in 70% alcohol and the "Milton method", that eliminate bacterial colonization while leaving the physical properties of the catheters unchanged. While these cleaning methods are promising, each was published in just one study, therefore higher-powered / longitudinal studies confirming the safety and efficacy of these cleaning methods must be obtained before current clinical recommendations can be modified.
Topics: Catheterization; Catheters; Cross-Sectional Studies; Humans; Prospective Studies; Spinal Cord Injuries
PubMed: 35066573
DOI: 10.1038/s41393-021-00740-3 -
International Journal of Colorectal... May 2023Symptomatic internal hemorrhoids affect up to 40% of people in Western society. Patients with grade I-III hemorrhoids, who fail lifestyle and medical management, may... (Meta-Analysis)
Meta-Analysis Review
PURPOSE
Symptomatic internal hemorrhoids affect up to 40% of people in Western society. Patients with grade I-III hemorrhoids, who fail lifestyle and medical management, may benefit from office-based procedures. As per the American Society of Colon and Rectum Surgeons (ASCRS), rubber band ligation (RBL) is the first-line office-based treatment. Polidocanol sclerotherapy is a relatively new approach for these patients. The aim of this systematic review is to compare the efficacy of RBL and polidocanol sclerotherapy with the treatment of symptomatic grade I-III internal hemorrhoids.
METHODS
The systematic review was completed by searching MEDLINE, Embase, and CENTRAL databases from inception to August 2022 for prospective studies comparing RBL and polidocanol sclerotherapy or evaluating the efficacy of polidocanol sclerotherapy alone for adult (> 18 years) patients with grade I-III internal hemorrhoids. Treatments were evaluated for therapeutic success and post-procedure morbidity.
RESULTS
Of 155 citations obtained, 10 studies (3 comparative and 7 single-arm studies) and 4 abstracts (2 comparative and 2 single arm) were included in the study. The patients undergoing sclerotherapy had a 93% (151/163) therapeutic success rate compared to 75% (68/91) in the RBL group (OR 3.39, 95% CI 1.48-7.74, p < 0.01). The post-procedure morbidity was 8% (17/200) in the sclerotherapy group and 18% (23/128) in the RBL group (OR 0.53, 95% CI 0.15-1.82, p = 0.31).
CONCLUSION
This study highlights that polidocanol sclerotherapy may be associated with higher therapeutic success in patients with symptomatic grade I-III internal hemorrhoids. Further evaluations in the form of randomized trials are required to evaluate patient populations, which may benefit more from sclerotherapy.
Topics: Adult; Humans; Sclerotherapy; Polidocanol; Hemorrhoids; Prospective Studies; Ligation; Disease Management; Treatment Outcome
PubMed: 37133577
DOI: 10.1007/s00384-023-04394-w -
Infectious Diseases Now Jun 2022While the World Health Organization has recommended preoperative washing with plain or antimicrobial soap for surgical site infection (SSI) prevention, it has not... (Meta-Analysis)
Meta-Analysis Review
What is the benefit of preoperative washing with chlorhexidine gluconate-impregnated cloths on the incidence of surgical site infections? A systematic review and meta-analysis.
OBJECTIVES
While the World Health Organization has recommended preoperative washing with plain or antimicrobial soap for surgical site infection (SSI) prevention, it has not formulated recommendations on use of chlorhexidine gluconate (CHG)-impregnated cloths. The purpose of this systematic review was to evaluate the benefit of preoperative bathing with CHG-cloths on SSI incidence.
PATIENTS AND METHODS
Publications were searched on Medline, CENTRAL, Web of Science, Clinical Trial between 01/01/1990 and 30/06/2018. Randomized controlled trials (RCT), quasi-randomized, case-control and cohort studies on patients with surgery (Population) having preoperative bathing with CHG-cloths (Intervention) or antiseptic soap, plain soap, placebo, no washing, no instruction (Comparator) were included. The main outcome was SSI occurrence. The results were synthetized using the Odds-Ratio (OR) and 95% confidence interval [95%CI]. Study quality was assessed using the Cochrane and Newcastle-Ottawa tools and evidence quality with the GRADE method. Statistics were calculated on RevMan5.3.
RESULTS
All in all, 1108 publications were identified and 3 were included in the meta-analysis. OR of the 2 cohort studies was 0.25 [95%CI: 0.13-0.50] for use of CHG-cloths the evening and the morning before intervention versus non-compliance with preoperative washing. OR of the RCT was 0.12 [95%CI: 0.02-1.00] for use of CHG-cloths the evening and the morning before intervention versus a shower with antibacterial soap the evening before the intervention. Study quality was moderate.
CONCLUSIONS
While the available studies show a benefit for CHG-cloths on SSI occurrence in orthopaedic surgery, there is no comparison with usual practices. Further studies are needed to confirm the benefit of CHG-cloths for preoperative washing.
Topics: Chlorhexidine; Humans; Incidence; Preoperative Care; Soaps; Surgical Wound Infection
PubMed: 35172215
DOI: 10.1016/j.idnow.2022.01.007 -
Archives of Microbiology Sep 2019Proteases, one of the largest groups of industrial enzymes occupy a major share in detergent industry. To meet the existing demands, proteases with efficient catalytic...
Proteases, one of the largest groups of industrial enzymes occupy a major share in detergent industry. To meet the existing demands, proteases with efficient catalytic properties are being explored from bacteria residing in extreme habitats. Alkaline proteases are also considered as promising candidates for industrial sectors due to the activity and stability under alkaline and harsh environment. Therefore, a systematic review on experimental studies of bacterial proteases was conducted with emphasis on purification, characterization, cloning and expression and their suitability as detergent additive. Relevant searches using a combination of filters/keywords were performed in the online databases; PubMed, Science Direct, Scopus and Web of Science. Over thousands of research papers, 71 articles in Scopus, 48 articles in Science Direct, 18 articles in PubMed and 8 articles in Web of Science were selected with regard to bacterial extracellular proteases till date. Selected articles revealed majority of the studies conducted between the years 2015 and 17 and were focused on purification of proteases from bacteria. Among microbes, a total of 41 bacterial genera have been explored with limited studies from extreme habitats. Majority of the studies have reported the involvement of subtilisin-like serine proteases with effective properties for detergent industries. The studies revealed shifting of trend from purification to cloning to genetic engineering to meet the industrial demands. The present systematic review describes the proteases from extremophilic bacteria and use of biotechnological techniques such as site-directed mutagenesis and codon optimization to engineer enzymes with better hot spots in the active sites to meet industrial challenges.
Topics: Bacteria; Biotechnology; Detergents; Industrial Microbiology; Serine Proteases
PubMed: 31025057
DOI: 10.1007/s00203-019-01662-8 -
The British Journal of Ophthalmology Nov 2020This systematic review compared the efficacy and safety of benzalkonium chloride (BAK)-preserved eye-drops with alternatively preserved (AP) and preservative-free (PF)... (Comparative Study)
Comparative Study Meta-Analysis
Efficacy and safety evaluation of benzalkonium chloride preserved eye-drops compared with alternatively preserved and preservative-free eye-drops in the treatment of glaucoma: a systematic review and meta-analysis.
BACKGROUND/AIMS
This systematic review compared the efficacy and safety of benzalkonium chloride (BAK)-preserved eye-drops with alternatively preserved (AP) and preservative-free (PF) eye-drops.
METHODS
PubMed, EMBASE and MEDLINE were searched for randomised controlled trials in June and October 2019. Study selection, data extraction and risk of bias assessment were made by two independent reviewers using the Cochrane Handbook. Studies on prostaglandin analogue or beta-blocker eye-drops and patients with glaucoma or ocular hypertension were included. Primary outcome was change in intraocular pressure (IOP). Secondary outcomes were safety measures as assessed in original study.
RESULTS
Of 433 articles screened, 16 studies were included. IOP meta-analysis was conducted on 13 studies (4201 patients) ranging from 15 days to 6 months. No significant differences between BAK versus PF and AP were identified (95% CI -0.00 to 0.30 mm Hg, p=0.05). Meta-analyses revealed no differences between BAK versus AP and PF with regards to conjunctival hyperaemia (risk ratio (RR) 1.05, 95% CI 0.91 to 1.22, 3800 patients, 9 studies), ocular hyperaemia (RR 1.31, 95% CI 0.96 to 1.78, 2268 patients, 5 studies), total ocular adverse events (RR 1.03, 95% CI 0.88 to 1.20, 1906 patients, 5 studies) or tear break-up time (mean difference 0.89, 95% CI -0.03 to 1.81, 130 patients, 3 studies). Diverse reporting on safety measures made comparison challenging. Risk of bias was assessed as high or unclear in many relevant domains, suggesting potential selective reporting or under-reporting.
CONCLUSION
No clinically significant differences on efficacy or safety could be determined between BAK versus AP and PF. However, there were substantial uncertainties on safety.CRD42019139692.
Topics: Administration, Ophthalmic; Adrenergic beta-Antagonists; Antihypertensive Agents; Benzalkonium Compounds; Databases, Factual; Glaucoma, Open-Angle; Humans; Intraocular Pressure; Ocular Hypertension; Ophthalmic Solutions; Preservatives, Pharmaceutical; Prostaglandins, Synthetic; Tonometry, Ocular; Treatment Outcome
PubMed: 32051133
DOI: 10.1136/bjophthalmol-2019-315623 -
The Science of the Total Environment Nov 2021A year into the coronavirus disease 2019 pandemic, the role of washing hands with soap and hand disinfectants is unavoidable as a primary way to control the infection... (Review)
Review
A year into the coronavirus disease 2019 pandemic, the role of washing hands with soap and hand disinfectants is unavoidable as a primary way to control the infection spread in communities and healthcare facilities. The extraordinary surge in demand for handwashing products has led to environmental concerns. Since soaps are complex mixtures of toxic and persistent active ingredients, the prudent option is to promote eco-friendly replacements for the current products. On the other hand, with the increase in soap packaging waste production, soap packaging waste management and recycling become essential to reduce environmental impact. This systematic review aimed to collect some recent methods for identifying biodegradable and sustainable raw materials to produce and package cleaning agents, especially soap.
Topics: COVID-19; Environment; Hand Disinfection; Humans; Pandemics; SARS-CoV-2; Soaps
PubMed: 34271380
DOI: 10.1016/j.scitotenv.2021.149013