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Environmental Science and Pollution... May 2022The relationship between toxic metals in the environment and clinical stroke risk remains unclear, although their role as immunotoxicants and carcinogens has been well... (Meta-Analysis)
Meta-Analysis Review
The relationship between toxic metals in the environment and clinical stroke risk remains unclear, although their role as immunotoxicants and carcinogens has been well established. We conducted a systematic review of the relationship between five metals (arsenic, mercury, copper, cadmium, and lead) and stroke. First, we comprehensively searched 3 databases (Pubmed, EMBASE, and Cochrane) from inception until June 2021. Random-effects meta-analyses, pooled relative risks (RR) and 95% confidence intervals (CI) were applied to evaluate the effect value. We finally identified 38 studies involving 642,014 non-overlapping participants. Comparing the highest vs. lowest baseline levels, chronic exposure to lead (RR = 1.07; 95%CI,1.00-1.14), cadmium (RR = 1.30; 95%CI,1.13-1.48), and copper (RR = 1.19; 95%CI,1.04-1.36) were significantly associated with stroke risks. However, the other two metals (arsenic and mercury) had less effect on stroke risk. Further analysis indicated that the association was likely in a metal dose-dependent manner. The results may further support the possibility that environmental toxic metal contaminants in recent years are associated with the increased risk of stroke.
Topics: Arsenic; Cadmium; Copper; Heavy Metal Poisoning; Humans; Lead; Mercury; Stroke
PubMed: 35190994
DOI: 10.1007/s11356-022-18866-z -
Clinical Oral Investigations Nov 2023This systematic review assessed the available evidence on the survival and success rate of zirconia and titanium implants. As secondary outcomes, aesthetic, radiographic... (Meta-Analysis)
Meta-Analysis Review
OBJECTIVE
This systematic review assessed the available evidence on the survival and success rate of zirconia and titanium implants. As secondary outcomes, aesthetic, radiographic and clinical parameters, as well as biological and mechanical complications, were considered.
MATERIALS AND METHODS
A systematic search was performed up to March 2022 to identify CCTs/RCTs comparing zirconia and titanium implants with a minimum of 12 months of follow-up. Meta-analysis was performed when ≥ 2 articles with similar characteristics were retrieved.
RESULTS
Four published articles with two RCTs (2 different patient populations) with 100 zirconia and 99 titanium implants that were followed up over 12-80 months were selected out of the 6040 articles. A non-statistically significant difference between zirconia and titanium implant survival at 12 months was suggested (P = 0.0938). The success rates were 57.5-93.3% and 57.1-100% for zirconia and titanium implants, respectively. The pink aesthetic score (PES) was higher for zirconia (10.33 ± 2.06 to 11.38 ± 0.92) compared to titanium implants (8.14 ± 3.58 to 11.56 ± 1.0).
CONCLUSION
Based on the 2 RCTs retrieved in the literature, similar survival rates were reported for zirconia and titanium implants in the short term (12 months of follow-up). Future RCTs are warranted to evaluate the long-term outcomes of zirconia implants.
CLINICAL RELEVANCE
Zirconia implants may be the procedure of choice, particularly in the aesthetic zone, since they show a similar survival and success rate as titanium implants on a short-term follow-up.
TRIAL REGISTRATION
Systematic review registration number-CRD42021288704 (PROSPERO).
Topics: Humans; Dental Implants; Titanium; Dental Restoration Failure; Esthetics, Dental; Zirconium; Dental Prosthesis Design
PubMed: 37740825
DOI: 10.1007/s00784-023-05242-5 -
Association Between Non-alcoholic Fatty Liver Disease and Heavy Metal Exposure: a Systematic Review.Biological Trace Element Research Dec 2023Non-alcoholic fatty liver disease (NAFLD) is a debilitating disease with adverse effects including cirrhosis and hepatocellular carcinoma. Heavy metals can cause severe... (Review)
Review
Non-alcoholic fatty liver disease (NAFLD) is a debilitating disease with adverse effects including cirrhosis and hepatocellular carcinoma. Heavy metals can cause severe dysfunction in different body organs including the liver. This review offers the study regarding the positive or negative association between heavy metals exposure and non-alcoholic fatty liver disease. The method used in this study is a systematic review based on searching in the PubMed, Scopus, and Science direct databases with the keywords of fatty liver, non-alcohol fatty liver, heavy metal, mercury, cadmium, arsenic, chromium, thallium, lead, iron, zinc, and nickel. There were 2200 articles searched in databases, and after assessment, 28 articles were selected. Positive association is established between arsenic, cadmium, iron, lead, mercury, and fatty liver disease. A negative relationship is found between zinc, copper, and progressive fatty liver disease. Furthermore, laboratory methods for NAFLD diagnosis were examined according to the obtained manuscripts. Among the different diagnostic methods, magnetic resonance imaging (MRI) is a sensitive method.
Topics: Humans; Non-alcoholic Fatty Liver Disease; Cadmium; Arsenic; Metals, Heavy; Mercury; Iron; Zinc
PubMed: 36929113
DOI: 10.1007/s12011-023-03629-9 -
Nutrients Feb 2022Manganese (Mn) is an essential element acting as a co-factor of superoxide dismutase, and it is potentially beneficial for cardiometabolic health by reducing oxidative... (Meta-Analysis)
Meta-Analysis Review
Manganese (Mn) is an essential element acting as a co-factor of superoxide dismutase, and it is potentially beneficial for cardiometabolic health by reducing oxidative stress. Although some studies have examined the relationship between Mn and metabolic syndrome (MetS), no systematic review and meta-analysis has been presented to summarize the evidence. Therefore, the present review examined the association between dietary and environmental Mn exposure, and MetS risk. A total of nine cross-sectional studies and three case-control studies were included, which assessed Mn from diet, serum, urine, and whole blood. The association of the highest Mn level from diet (three studies, odds ratio (OR): 0.83, 95% confidence interval (C.I.) = 0.57, 1.21), serum (two studies, OR: 0.87, 95% C.I. = 0.66, 1.14), urine (two studies, OR: 0.84, 95% C.I. = 0.59, 1.19), and whole blood (two studies, OR: 0.92, 95% C.I. = 0.53, 1.60) were insignificant, but some included studies have suggested a non-linear relationship of urinary and blood Mn with MetS, and higher dietary Mn may associate with a lower MetS risk in some of the included studies. While more evidence from prospective cohorts is needed, future studies should use novel statistical approaches to evaluate relative contribution of Mn on MetS risk along with other inter-related exposures.
Topics: Cross-Sectional Studies; Diet; Humans; Manganese; Metabolic Syndrome; Prospective Studies
PubMed: 35215474
DOI: 10.3390/nu14040825 -
International Journal of Environmental... Jul 2021The intrauterine environment is critical for healthy prenatal growth and affects neonatal survival and later health. Mercury is a toxic metal which can freely cross the... (Review)
Review
The intrauterine environment is critical for healthy prenatal growth and affects neonatal survival and later health. Mercury is a toxic metal which can freely cross the placenta and disrupt a wide range of cellular processes. Many observational studies have investigated mercury exposure and prenatal growth, but no prior review has synthesised this evidence. Four relevant publication databases (Embase, MEDLINE/PubMed, PsycINFO, and Scopus) were systematically searched to identify studies of prenatal mercury exposure and birth weight, birth length, or head circumference. Study quality was assessed using the NIH Quality Assessment Tool, and results synthesised in a narrative review. Twenty-seven studies met the review criteria, these were in 17 countries and used 8 types of mercury biomarker. Studies of birth weight (total = 27) involving populations with high levels of mercury exposure, non-linear methods, or identified as high quality were more likely to report an association with mercury, but overall results were inconsistent. Most studies reported no strong evidence of association between mercury and birth length (n = 14) or head circumference (n = 14). Overall, our review did not identify strong evidence that mercury exposure leads to impaired prenatal growth, although there was some evidence of a negative association of mercury with birth weight.
Topics: Biomarkers; Birth Weight; Diagnostic Tests, Routine; Female; Humans; Infant, Newborn; Maternal Exposure; Mercury; Placenta; Pregnancy
PubMed: 34281082
DOI: 10.3390/ijerph18137140 -
The Journal of Craniofacial Surgery Jan 2018The present study aimed to present 4 cases and to undertake a systematic review on the current knowledge of the impact of cone beam computed tomographic (CBCT) artifacts... (Review)
Review
OBJECTIVES
The present study aimed to present 4 cases and to undertake a systematic review on the current knowledge of the impact of cone beam computed tomographic (CBCT) artifacts on oral and maxillofacial surgical planning and follow-up.
METHODS
The MEDLINE (PubMed) database was searched for the period from February 2004 to February 2017, for studies on the impact of CBCT artifacts on surgical planning of oral and maxillofacial surgeries. The PRISMA statement was followed during data assessment and extraction. As a result, data extraction included information regarding: the use of CBCT to plan or follow-up oral and maxillofacial surgeries, presence and type identification of a CBCT artifact, and details on the impact of artifacts on image quality and/or surgical planning. Four cases were selected to illustrate the topic.
RESULTS
The search strategy yielded 408 publications in MEDLINE (PubMed). An initial screening of the publications was performed using abstracts and key words. After application of exclusion criteria, a total of 11 studies were finally identified as eligible to be discussed. Studies revealed 3 main types of artifact: beam hardening, streak, and motion artifacts. Most of the studies suggest that artifacts significantly affect oral and maxillofacial surgical planning and follow-up, despite of allowing for identification of metal projectiles in cases of maxillofacial trauma.
CONCLUSION
CBCT artifacts have a significant impact on oral and maxillofacial surgical planning and follow-up.
Topics: Artifacts; Cone-Beam Computed Tomography; Humans; Metals; Surgery, Oral
PubMed: 29194265
DOI: 10.1097/SCS.0000000000004088 -
Biological Trace Element Research Feb 2022Metals, many of which are potentially toxic, are present in the aquatic environment originated from both natural and anthropogenic sources. In these ecosystems, these... (Review)
Review
Metals, many of which are potentially toxic, are present in the aquatic environment originated from both natural and anthropogenic sources. In these ecosystems, these elements are mostly deposited in the sediment, followed by water dissolution, potentially contaminating resident biota. Among several aquatic animals, crustaceans are considered excellent bioindicators, as they live in close contact with contaminated sediment. The accumulation of metal, whether they are classified as essential, when in excessive quantities or nonessential, not only cause damage to the health of these animals, but also to the man who consumes seafood. Among the main toxic elements to animal and human health are aluminum, arsenic, cadmium, chromium, copper, lead, mercury, nickel and silver. In this context, this systematic review aimed to investigate the dynamics of these metals in water, the main bioaccumulative tissues in crustaceans, the effects of these contaminants on animal and human health, and the regulatory limits for these metals worldwide. A total of 91 articles were selected for this review, and an additional 68 articles not found in the three assessed databases were considered essential and included, totaling 159 articles published between 2010 and 2020. Our results indicate that both chemical speciation and abiotic factors such as pH, oxygen and salinity in aquatic environments affect element bioavailability, dynamics, and toxicity. Among crustaceans, crabs are considered the main bioindicator biological system, with the hepatopancreas appearing as the main bioaccumulator organ. Studies indicate that exposure to these elements may result in nervous, respiratory, and reproductive system effects in both animals and humans. Finally, many studies indicate that the concentrations of these elements in crustaceans intended for human consumption exceed limits established by international organizations, both with regard to seafood metal contents and well as daily, weekly, or monthly intake limits set for humans, indicating consumer health risks.
Topics: Animals; Ecosystem; Environmental Biomarkers; Environmental Monitoring; Humans; Metals; Risk Assessment; Seafood; Water Pollutants, Chemical
PubMed: 33788164
DOI: 10.1007/s12011-021-02685-3 -
Dental Materials : Official Publication... Oct 2022The goal of this systemic review and meta-analysis was to evaluate the longevity of indirect adhesively-luted ceramic compared to conventionally cemented metal single... (Meta-Analysis)
Meta-Analysis
OBJECTIVES
The goal of this systemic review and meta-analysis was to evaluate the longevity of indirect adhesively-luted ceramic compared to conventionally cemented metal single tooth restorations.
DATA
Randomized controlled trials (RCT) investigating indirect adhesively-luted ceramic restorations compared to metal or metal-based cemented restorations in permanent posterior teeth.
SOURCES
Three electronic databases (PubMed, CENTRAL (Cochrane) and Embase) were screened. No language or time restrictions were applied. Study selection, data extraction and quality assessment were done in duplicate. Risk of Bias and level of evidence was graded using Risk of Bias 2.0 tool and Grade Profiler 3.6.
RESULTS
A total of 3056 articles were found by electronic databases. Finally, four RCTs were selected. Overall, 443 restorations of which 212 were adhesively-luted ceramic restorations and 231 conventionally cemented metal restorations have been placed in 314 patients (age: 22-72 years). The highest annual failure rates were found for ceramic restorations ranging from 2.1% to 5.6%. Lower annual failure rates were found for metal (gold) restorations ranging from 0% to 2.1%. Meta-analysis could be performed for adhesively-luted ceramic vs. conventionally cemented metal restorations. Conventionally cemented metal restoration showed a significantly lower failure rate than adhesively-luted ceramic ones (visual-tactile assessment: Risk Ratio (RR)[95%CI]=0.31[0.16,0.57], low level of evidence). Furthermore, all studies showed a high risk of bias.
CONCLUSION
Conventionally cemented metal restorations revealed significantly lower failure rates compared to adhesively-luted ceramic ones, although the selected sample was small and with medium follow-up periods with high risks of bias.
Topics: Adult; Aged; Ceramics; Dental Restoration Failure; Gold; Humans; Middle Aged; Young Adult
PubMed: 36038401
DOI: 10.1016/j.dental.2022.08.002 -
Clinical Rheumatology Dec 2022The relationship between exposure to certain metals and the risk of hyperuricemia (HUA) has biological plausibility, yet prior studies have presented inconsistent... (Meta-Analysis)
Meta-Analysis Review
The relationship between exposure to certain metals and the risk of hyperuricemia (HUA) has biological plausibility, yet prior studies have presented inconsistent findings. We aim to clarify the relationship between exposure to certain metals and HUA using a systematic review and meta-analysis approach. We searched the Web of Science, Embase, MEDLINE, Pubmed, Corchrane and China National Knowledge Infrastructure databases from inception through December, 2021 in order to identify studies that assessed the relationships between metals and the risk of HUA. Data were pooled by random-effects models and expressed as pooled odds ratios (OR) and 95% confidence intervals (CIs). The risk of bias was assessed using a tool from Agency for Healthcare Research and Quality (AHRQ). Twenty eligible articles (nineteen cross-sectional studies and one cohort) were included in our analysis, involving 63,283 participants in total. The studies showed that arsenic (pooled OR = 1.702, 95% CI: 1.44, 2.011; n = 6, I = 29.5%), calcium (pooled OR = 1.765, 1.111, 2.804; 4, 82.3%), cadmium (pooled OR = 1.199,1.020, 1.410; 11, 38.5%) and lead (pooled OR = 1.564,1.205, 2.030; 11, 72.9%) exposure were, all linked to an increased risk of HUA. Exposure to molybdenum (pooled OR = 0.804, 0.724, 0.975, 3, 0%) was linked to a decreased risk of HUA, however. Exposure to arsenic, calcium, cadmium and lead is associated with an increased risk of HUA. Molybdenum exposure was associated with a decreased prevalence of HUA; however, aluminum, cobalt, copper, iron, magnesium, manganese, mercury, selenium, thallium and zinc are not associated with HUA risk. Further experimental studies are warranted to decipher the mechanisms by which exposure to the above metals affect HUA risk. The findings reinforced the importance of metals in the HUA risk, and provided a reference for legislation to prevent HUA and protect people's health.
Topics: United States; Humans; Cadmium; Arsenic; Molybdenum; Calcium; Hyperuricemia; Cross-Sectional Studies
PubMed: 36109472
DOI: 10.1007/s10067-022-06362-1 -
Knee Surgery, Sports Traumatology,... Nov 2017The aim of this systematic review was to evaluate the clinical outcomes, rate of revisions and complications of all-polyethylene tibial and metal-backed tibial... (Review)
Review
PURPOSE
The aim of this systematic review was to evaluate the clinical outcomes, rate of revisions and complications of all-polyethylene tibial and metal-backed tibial components in patients treated with knee arthroplasty for primary or secondary osteoarthritis.
METHODS
A systematic review of the literature according to the PRISMA guidelines was performed. A comprehensive search of PubMed, Medline, CINAHL, Cochrane, Embase, and Google Scholar databases using various combinations of the keywords such as "knee", "arthroplasty", "metal-backed", and "all-polyethylene", since inception of databases to 2016, was performed.
RESULTS
Thirty-two articles, describing patients with all-polyethylene tibial or metal-backed tibial components in the setting of osteoarthritis, were included. A total of 68,202 knees in 58,942 patients were included, with an average age at surgery of 69.3 years, ranging from a mean age of 57.9-82 years. The mean KSS was 82.4 and 81.3 (n.s.), the mean KSS(F) was 73.6 and 74.9 (p = 0.04), the mean ROM was 104.5 and 104.6 (n.s.), and the mean HSS was 87 and 86, each, respectively, for the metal-backed tibial components group and all-polyethylene tibial components group. The overall rate of revisions was 1.90 %. The rate of revision in the metal-backed tibial components group was 1.85 %, whilst the rate of revision in the all-polyethylene tibial components group was 2.02 % (p < 0.00001).
CONCLUSION
Metal-backed tibial and all-polyethylene tibial components did not show any significant difference in most of the included outcome scores, but statistical differences were found in terms of complications and revision rate. These items have a negative impact on the cost-effectiveness of all-polyethylene tibial components. Even if all-polyethylene tibial components show similar clinical outcome score, equivalent range of knee motion, and long-term survival compared to metal-backed tibial components, complications and revision rate seem to lead the surgeon to prefer the last ones. The clinical relevance of this study is that metal-backed tibial components should be preferred in TKA surgery because complications are higher using all-polyethylene tibial components. On the other hand, the quality of evidence, according to GRADE system, is low underling the necessity of more randomised study to clarify these items.
LEVEL OF EVIDENCE
III.
Topics: Arthroplasty, Replacement, Knee; Cost-Benefit Analysis; Humans; Knee Joint; Knee Prosthesis; Metals; Osteoarthritis, Knee; Polyethylene; Postoperative Complications; Prosthesis Design; Reoperation; Tibia
PubMed: 27209191
DOI: 10.1007/s00167-016-4168-0