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World Neurosurgery Jul 2018Dexamethasone has been used to treat cerebral edema associated with brain abscess. Whereas some argue that dexamethasone might aid antibiotic treatment, others believe... (Meta-Analysis)
Meta-Analysis Review
BACKGROUND
Dexamethasone has been used to treat cerebral edema associated with brain abscess. Whereas some argue that dexamethasone might aid antibiotic treatment, others believe that because of its immunosuppressive characteristics, it might have a negative impact on outcomes. How corticosteroid use affects overall mortality of brain abscess patients remains unclear.
METHODS
A systematic search of the literature was conducted in accordance with PRISMA guidelines. PubMed, Embase, and Cochrane databases were utilized to identify all studies related to patients diagnosed with a brain abscess treated with dexamethasone. The main outcome of interest was mortality. Pooled effect estimates were calculated using fixed-effects (FE) and random-effects (RE) models.
RESULTS
After removal of duplicates, 1681 articles were extracted from the literature of which 11 were included. These included 7 cohort studies and 4 case series. Indications to administer dexamethasone were either hospital brain abscess protocol or clinical presentation of cerebral edema. The 7 cohort studies involving 571 patients with brain abscesses comprised of 330 patients treated with standard of care (SOC) plus dexamethasone and 241 patients treated with SOC alone, after aspiration or surgical management of the abscess in either group. Pooling results from all seven cohort studies demonstrated a nonsignificant mortality benefit comparing SOC and dexamethasone patients to SOC patients (FE: risk ratio [RR], 0.94; 95% confidence interval [CI], 0.64-1.37; RE: RR, 0.95; 95% CI, 049-1.82; I = 53.9%; P for heterogeneity = 0.04).
CONCLUSIONS
In patients with a brain abscess treated with antibiotics, the use of dexamethasone was not associated with increased mortality.
Topics: Anti-Bacterial Agents; Anti-Inflammatory Agents; Brain Abscess; Dexamethasone; Humans; Mortality
PubMed: 29705232
DOI: 10.1016/j.wneu.2018.04.130 -
Frontiers in Public Health 2022Nanomaterials are suspected of causing health problems, as published studies on nanotoxicology indicate. On the other hand, some of these materials, such as... (Review)
Review
BACKGROUND
Nanomaterials are suspected of causing health problems, as published studies on nanotoxicology indicate. On the other hand, some of these materials, such as nanostructured pyrogenic and precipitated synthetic amorphous silica (SAS) and silica gel, have been used for decades without safety concerns in industrial, commercial, and consumer applications. However, in addition to many and studies that have failed to demonstrate the intrinsic toxicity of SAS, articles periodically emerge, in which biological effects of concern have been described. Even though most of these studies do not meet high-quality standards and do not always use equivalent test materials or standardized test systems, the results often trigger substance re-evaluation. To put the results into perspective, an extensive literature study was carried out and an example of amorphous silica will be used to try to unravel the reliability from the unreliable results.
METHODS
A systematic search of studies on nanotoxicological effects has been performed covering the years 2013 to 2018. The identified studies have been evaluated for their quality regarding material and method details, and the data have been curated and put into a data collection. This review deals only with investigations on amorphous silica.
RESULTS
Of 18,162 publications 1,217 have been selected with direct reference to experiments with synthetically produced amorphous silica materials. The assessment of these studies based on defined criteria leads to a further reduction to 316 studies, which have been included in this systematic review. Screening for quality with well-defined quantitative criteria following the GUIDE nano concept reveals only 27.3% has acceptable quality. Overall, the and data showed low or no toxicity of amorphous silica. The data shown do not support the hypothesis of dependency of biological effects on the primary particle size of the tested materials.
CONCLUSION
This review demonstrates the relatively low quality of most studies published on nanotoxicological issues in the case of amorphous silica. Moreover, mechanistic studies are often passed off or considered toxicological studies. In general, standardized methods or the Organization for Economic Cooperation and Development (OECD) guidelines are rarely used for toxicological experiments. As a result, the significance of the published data is usually weak and must be reevaluated carefully before using them for regulatory purposes.
Topics: Nanostructures; Particle Size; Reproducibility of Results; Silicon Dioxide
PubMed: 35784253
DOI: 10.3389/fpubh.2022.902893 -
Pharmacology Research & Perspectives Aug 2020Severe hyperthermia from classical or exertional heatstroke, or from drug ingestion or other noninfective pyrogens, is associated with a high mortality and morbidity. A...
Severe hyperthermia from classical or exertional heatstroke, or from drug ingestion or other noninfective pyrogens, is associated with a high mortality and morbidity. A systemic pro-inflammatory response occurs during heatstroke, characterized by elevated cytokines with endotoxemia from elevated lipopolysaccharide (LPS) levels. Corticosteroids reduce LPS and cytokine levels, suggesting that they may improve outcome. A systematic review searching Embase, MEDLINE, and PubMed from the earliest date available until September 2019 was conducted, according to the PRISMA guidelines, with five papers identified. In four studies, systemic steroids administered before or at the onset of heat stress improved mortality or reduced organ dysfunction. Survival time was greatest when steroid administration preceded heat stress. In one study, a nonsignificant increase in mortality was seen. A dose response was observed, with higher doses extending survival time. Animal studies suggest that steroids improve mortality and/or organ dysfunction after an episode of heat stress or extreme hyperthermia.
Topics: Animals; Cytokines; Dose-Response Relationship, Drug; Glucocorticoids; Heat Stroke; Humans; Hyperthermia; Lipopolysaccharides; Randomized Controlled Trials as Topic; Severity of Illness Index
PubMed: 32666709
DOI: 10.1002/prp2.626 -
The Science of the Total Environment May 2024The recent scientific focus on polycyclic aromatic hydrocarbons (PAHs) has stemmed from their recognized genotoxic, mutagenic, and carcinogenic properties. This... (Review)
Review
The recent scientific focus on polycyclic aromatic hydrocarbons (PAHs) has stemmed from their recognized genotoxic, mutagenic, and carcinogenic properties. This systematic review seeks to evaluate the nexus between exposure to water sources contaminated with PAHs and the associated cancer risk among global populations, encompassing both children and adults. Web of Science (WoS), Cochrane Library, PubMed, ProQuest, Scopus, and Google Scholar, were searched following the PRISMA guidelines, until December 31, 2023. Quality assessment of the selected studies was performed using the Newcastle-Ottawa Scale. The increased lifetime cancer risk (ILCR) attributed to PAH exposure through ingestion and dermal absorption was thoroughly examined across diverse age groups. After extensive searching, screening, and eligibility, 30 articles were included in this review, which was conducted in different parts of the world, including Nigeria (n = 11), China (n = 7), India (n = 4), Iran (n = 3), South Africa (n = 2), Italy (n = 1), Colombia (n = 1), and Iraq (n = 1). Our analysis underscores Nigeria's alarming prevalence of PAH contamination in its rivers, groundwaters, and seawater. Remarkably, the highest cancer risk was identified among children and adults, notably in proximity to the Atlas Cove jetty (seawater) and various Nigerian rivers. This elevated risk is primarily attributed to the combined effects of ingestion and dermal absorption. Furthermore, our findings emphasize the prominent role of combustion-derived and pyrogenic sources of PAH in the examined aquatic ecosystems. This study unequivocally establishes that PAH-contaminated water sources significantly amplify the risk of cancer among both children and adults. The extent of risk variation is influenced by the specific water source, duration of exposure, and age group. Consequently, proactive identification of contaminated water sources and their pollution origins, coupled with targeted educational campaigns, holds promise for reducing the global burden of PAH-related cancer.
Topics: Child; Adult; Humans; Environmental Monitoring; Polycyclic Aromatic Hydrocarbons; Water; Ecosystem; Risk Assessment; Neoplasms; China
PubMed: 38417520
DOI: 10.1016/j.scitotenv.2024.171261 -
International Journal of Environmental... May 2024In Nigeria, environmental pollution linked with PAHs has been increasing, and PAHs in fish pose a threat to all, especially those that rely upon fish. This systematic...
In Nigeria, environmental pollution linked with PAHs has been increasing, and PAHs in fish pose a threat to all, especially those that rely upon fish. This systematic review aimed at evaluating human health effect of PAHs concentration in dried and fresh fish in Nigeria. A systematic literature search was carried out on PubMed, MedLine, Web of Science and Science Direct, etc. From the total of 31 articles reviewed, 19 studies reported on fresh fish and 9 on dried fish. 54.8% of the selected research reported on high-level PAH accumulation in fresh fish. PAH contamination was mainly from petrogenic and pyrogenic sources. The major health outcomes from this study were cancer and non-carcinogenic risks, skin irritations, gastrointestinal, child deformities, respiratory disorders, emotional distresses, neurological and haematological effects. It is recommended that regulations be made to abate and monitor the environmental exposure of humans to PAHs to ameliorate the public health effects.
Topics: Animals; Child; Humans; Environmental Monitoring; Fishes; Nigeria; Polycyclic Aromatic Hydrocarbons; Public Health; Risk Assessment; Water Pollutants, Chemical
PubMed: 37417444
DOI: 10.1080/09603123.2023.2230915 -
Biomedical Instrumentation & Technology 2023The effect of sterilization on bacterial endotoxin is receiving greater attention within the medical device industry. Contributing factors to this increased attention...
The effect of sterilization on bacterial endotoxin is receiving greater attention within the medical device industry. Contributing factors to this increased attention include the growing popularity of transferring devices among sterilization modalities and the focus on aspects of microbiological quality other than sterilization. This systematic review examined the effects of sterilization on bacterial endotoxin, with attention drawn to industry standards and regulations to elucidate whether such documents are aligned with published data. In summary, numerous experiments have shown a reduction in pyrogenicity and/or limulus amebocyte lysate reactivity of endotoxin following sterilization, whereas a number of publications and industry standards have claimed (without data or references) that sterilization does not inactivate endotoxin. The results of this review would be useful for device manufacturers when selecting a sterilization modality or deciding whether to test for endotoxin pre- vs poststerilization, as well as for standards developers and regulators in aligning standards and regulations with peer-reviewed data.
Topics: Ethylene Oxide; Electrons; Steam; Endotoxins; Sterilization
PubMed: 37624937
DOI: 10.2345/0899-8205-57.3.98 -
Marine Pollution Bulletin Mar 2023Polycyclic aromatic hydrocarbons (PAHs) have gathered worldwide attention due to their carcinogenicity and toxicity. This paper aims to review and extend current...
Polycyclic aromatic hydrocarbons (PAHs) have gathered worldwide attention due to their carcinogenicity and toxicity. This paper aims to review and extend current knowledge on PAHs in aquatic environments in Turkey, where expansion of the marine industry has caused contamination concerns. To assess cancer and ecological risks associated with PAHs, we systematically reviewed 39 research articles. Mean measured concentrations of total PAHs ranged from 61 to 249,900 ng L in surface waters, 1 to 209,400 ng g in sediments, and 4 to 55,000 ng g in organisms. Estimated cancer risks from concentrations in organisms were higher than those from surface waters and sediments. Negative ecosystem impacts of petrogenic PAHs were estimated to be larger than those of pyrogenic origin, despite the predominance of the latter. Overall, the Marmara, Aegean, and Black seas are highly-polluted and need remedial action, while further study is needed to confirm the status of other water bodies.
Topics: Humans; Black Sea; Ecosystem; Neoplasms; Polycyclic Aromatic Hydrocarbons; Turkey
PubMed: 36860025
DOI: 10.1016/j.marpolbul.2023.114671 -
Journal of Thermal Biology Feb 2020Severe hyperthermia, for example, classical heatstroke or exertional heatstroke from heatwaves or exercise respectively, or from drug ingestion or other non-infective...
Severe hyperthermia, for example, classical heatstroke or exertional heatstroke from heatwaves or exercise respectively, or from drug ingestion or other non-infective pyrogens, is associated with a high mortality and morbidity, which may be chronic or permanent. Abolition of lipopolysaccharide, from gram-negative intestinal bacteria translocating into the systemic circulation via an intestinal wall rendered permeable from the hyperthermia, reduces the adverse effects, suggesting that antibiotics against the intestinal bacteria may have a similar effect. A systematic review searching Embase, MEDLINE and PubMed from the earliest date available until 2019 was conducted, according to PRISMA guidelines. Two papers were found which fit the criteria. In one, non-absorbable oral antibiotics were administered prior to the onset of heat stress, which reduced the cardiovascular dysfunction and rise in endotoxaemia, but animals succumbed at a lower temperature. In the second, non-absorbable oral antibiotics, in combination with a laxative and enema, given prior to the onset of heat stress, improved mortality; antibiotics administered after the heat stress did not, but the antibiotics used may have limited action against intestinal bacteria. Only two papers were found; both suggest an improvement in organ dysfunction or mortality after an episode of heat stress. No papers were found that investigate the sole use of antibiotics effective against intestinal bacteria given after the onset of heat stress, although biological plausibility suggest they warrant further research.
Topics: Animals; Anti-Bacterial Agents; Heat Stroke; Humans; Morbidity; Randomized Controlled Trials as Topic
PubMed: 32125990
DOI: 10.1016/j.jtherbio.2020.102509