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Public Health Reports (Washington, D.C.... 2016Waterpipe tobacco smoking (WTS) is an emerging trend worldwide. To inform public health policy and educational programming, we systematically reviewed the biomedical... (Meta-Analysis)
Meta-Analysis Review
OBJECTIVE
Waterpipe tobacco smoking (WTS) is an emerging trend worldwide. To inform public health policy and educational programming, we systematically reviewed the biomedical literature to compute the inhaled smoke volume, nicotine, tar, and carbon monoxide (CO) associated with a single WTS session and a single cigarette.
METHODS
We searched seven biomedical bibliographic databases for controlled laboratory or natural environment studies designed to mimic human tobacco consumption. Included studies quantified the mainstream smoke of a single cigarette and/or single WTS session for smoke volume, nicotine, tar, and/or CO. We conducted meta-analyses to calculate summary estimates for the inhalation of each unique substance for each mode of tobacco consumption. We assessed between-study heterogeneity using chi-squared and I-squared statistics.
RESULTS
Sufficient data from 17 studies were available to derive pooled estimates for inhalation of each exposure via each smoking method. Two researchers working independently abstracted measurement of smoke volume in liters, and nicotine, tar, and CO in milligrams. All numbers included in meta-analyses matched precisely between the two researchers (100% agreement, Cohen's k=1.00). Whereas one WTS session was associated with 74.1 liters of smoke inhalation (95% confidence interval [CI] 38.2, 110.0), one cigarette was associated with 0.6 liters of smoke (95% CI 0.5, 0.7). One WTS session was also associated with higher levels of nicotine, tar, and CO.
CONCLUSIONS
One WTS session consistently exposed users to larger smoke volumes and higher levels of tobacco toxicants compared with one cigarette. These computed estimates may be valuable to emphasize in prevention programming.
Topics: Carbon Monoxide; Humans; Inhalation Exposure; Nicotine; Smoking; Tars
PubMed: 26843673
DOI: 10.1177/003335491613100114 -
The Science of the Total Environment Jun 2023Groundwater represents a critical water source for plants, especially during drought, with continuous groundwater availability widely associated with the presence of... (Review)
Review
Groundwater represents a critical water source for plants, especially during drought, with continuous groundwater availability widely associated with the presence of ecological refugia and the preservation of biodiversity during periods of adverse conditions. Here, we present a systematic quantitative literature review of global groundwater and ecosystem interactions to synthesise current knowledge and identify key knowledge gaps and research priorities through a management lens. Despite increasing research on groundwater dependent vegetation since the late 1990s, significant geographical and ecological biases are evident with papers focused on arid regions or areas with significant anthropogenic changes. Of the 140 papers reviewed, desert and steepe arid landscapes accounted for 50.7 % and desert and xeric shrublands were represented in 37.9 % of papers. A third of papers (34.4 %) quantified groundwater uptake by ecosystems and groundwater contributions to transpiration, with studies examining the influence of groundwater on vegetation productivity, distribution, and composition also well represented. In contrast, groundwater influences on other ecosystem functions are relatively poorly explored. The research biases introduce uncertainty in the transferability of findings between locations and ecosystems limiting the generality of our current understanding. This synthesis contributes to consolidating a solid knowledge base of the hydrological and ecological interrelationships for managers, planners, and other decision-makers that is relevant to the landscapes and environments they manage, so can more effectively deliver ecological and conservation outcomes.
Topics: Ecosystem; Groundwater; Biodiversity; Water; Plants
PubMed: 36898536
DOI: 10.1016/j.scitotenv.2023.162577 -
The Journal of Dermatological Treatment Dec 2023Seborrheic keratoses (SKs) are benign epidermal neoplasms presenting as waxy, brown to black papules and plaques. Patients often seek removal for cosmetic reasons or...
Seborrheic keratoses (SKs) are benign epidermal neoplasms presenting as waxy, brown to black papules and plaques. Patients often seek removal for cosmetic reasons or irritation. The objective of this systematic review is to assess the efficacy and safety of topical treatments for SKs. Studies involving any topical medication indicated for SK removal were retrieved from Embase, Scopus, PubMed, and Cochrane. The final search was conducted on November 9, 2021, and 26 reports met inclusion criteria. A quality rating scheme was utilized to assess evidence quality. Heterogeneity of treatments and outcome measures precluded meta-analysis. Topical treatments that yielded a good-to-excellent response include hydrogen peroxide, Maxacalcitol 25 µg/g, BID Tazarotene 0.1% cream, 5% potassium dobesilate cream, 1% diclofenac sodium solution, urea-based solution, and 65% and 80% trichloroacetic acid. Local skin reactions were often mild and transient. Topical hydrogen peroxide showed the greatest evidence for clinical clearance of SKs, although there are no studies to our knowledge that directly compared hydrogen peroxide to current first-line treatments (e.g. cryotherapy or shave excision). The results of this review suggest viable and safe treatment of SK with topical therapies; however, there remains demand for topical treatments that reliably equate or exceed the efficacy of current first-line therapies.Key Points Are safe and efficacious topical treatments for seborrheic keratoses available? Topical treatments for seborrheic keratoses yield different responses and may be associated with local skin reactions. Topical hydrogen peroxide shows the greatest evidence for clinical clearance of seborrheic keratoses and may be a viable option for patients requesting noninvasive removal. No studies to our knowledge directly compare hydrogen peroxide to current first-line treatments. There remains demand for topical treatments that reliably equate or exceed the efficacy of current first-line therapies.
Topics: Humans; Administration, Topical; Cryotherapy; Hydrogen Peroxide; Keratosis, Seborrheic; Treatment Outcome
PubMed: 36215682
DOI: 10.1080/09546634.2022.2133532 -
Journal of Medicine and Life Mar 2022The COVID-19 pandemic has tremendously increased the production and sales of disinfectants. This study aimed to systematically review and analyze the efficacy and safety... (Review)
Review
The COVID-19 pandemic has tremendously increased the production and sales of disinfectants. This study aimed to systematically review and analyze the efficacy and safety of chlorine dioxide as a disinfectant. The literature relating to the use of chlorine dioxide as a disinfectant was systematically reviewed in January 2021 using databases such as PubMed, Science Direct, and Google Scholar. Inclusion criteria were studies that investigated the use of chlorine dioxide to assess the efficacy, safety, and impact of chlorine dioxide as a disinfectant. Out of the 33 included studies, 14 studies focused on the disinfectant efficacy of chlorine dioxide, 8 studies expounded on the safety and toxicity in humans and animals, and 15 studies discussed the impact, such as water treatment disinfection using chlorine dioxide. Chlorine dioxide is a safe and effective disinfectant, even at concentrations as low as 20 to 30 mg/L. Moreover, the efficacy of chlorine dioxide is mostly independent of pH. Chlorine dioxide can be effectively used to disinfect drinking water without much alteration of palatability and can also be used to destroy pathogenic microbes, including viruses, bacteria, and fungi from vegetables and fruits. Our review confirms that chlorine dioxide is effective against the resistant , H1N1, and other influenza viruses. Studies generally support the use of chlorine dioxide as a disinfectant. The concentration deemed safe for usage still needs to be determined on a case-by-case basis.
Topics: Animals; COVID-19; Chlorine; Chlorine Compounds; Disinfectants; Humans; Influenza A Virus, H1N1 Subtype; Oxides; Pandemics
PubMed: 35449999
DOI: 10.25122/jml-2021-0180 -
International Journal of Molecular... Jul 2023Salivary myeloperoxidase (MPO) is a key mediator of the oral immune system, acting as an enzyme that utilises HO to generate molecules with high bactericidal activity.... (Review)
Review
Salivary myeloperoxidase (MPO) is a key mediator of the oral immune system, acting as an enzyme that utilises HO to generate molecules with high bactericidal activity. While MPO determination in plasma is quite common, the use of saliva is still rare. Our systematic review was designed to answer the question "Are salivary levels of myeloperoxidase altered in patients with systemic diseases?". Following the inclusion and exclusion criteria, we included twenty-six studies. Altered MPO levels in saliva were most commonly found in patients with cardiovascular and gastrointestinal diseases. Most studies concerned unstimulated whole saliva, and only a few of them stimulated, mainly by chewing paraffin. Enzyme-linked immunosorbent assay (ELISA) was the most common method for determination of MPO concentrations in saliva. Increased salivary MPO levels were more often observed for inflammatory diseases, except patients with inflammatory bowel diseases who were eligible for biologic therapy. In conclusion, MPO could be altered in the saliva of patients with systematic diseases, especially cardiovascular or gastrointestinal diseases. However, further investigations are recommended to validate these outcomes.
Topics: Humans; Enzyme-Linked Immunosorbent Assay; Hydrogen Peroxide; Peroxidase; Saliva
PubMed: 37569455
DOI: 10.3390/ijms241512078 -
The Cochrane Database of Systematic... Aug 2017Persistent pulmonary hypertension in the neonate (PPHN) is associated with high mortality. Currently, the therapeutic mainstay for PPHN consists of assisted ventilation... (Meta-Analysis)
Meta-Analysis Review
BACKGROUND
Persistent pulmonary hypertension in the neonate (PPHN) is associated with high mortality. Currently, the therapeutic mainstay for PPHN consists of assisted ventilation and administration of inhaled nitric oxide (iNO). However, nitric oxide is costly, and its use may not be appropriate in resource-poor settings. Approximately 30% of patients fail to respond to iNO. High concentrations of phosphodiesterases in the pulmonary vasculature have led to the use of phosphodiesterase inhibitors such as sildenafil or milrinone.
OBJECTIVES
To assess the efficacy and safety of sildenafil for treatment of pulmonary hypertension in neonates.
SEARCH METHODS
We used the standard search strategy of Cochrane Neonatal to search the Cochrane Central Register of Controlled Trials (CENTRAL; 2017, Issue 3), MEDLINE via PubMed (1966 to 18 April 2017), Embase (1980 to 18 April 2017), and the Cumulative Index to Nursing and Allied Health Literature (CINAHL; 1982 to 18 April 2017). We searched clinical trials databases, conference proceedings, and reference lists of retrieved articles for randomised controlled trials and quasi-randomised trials.
SELECTION CRITERIA
We included randomised and quasi-randomised controlled trials of sildenafil compared with placebo or other pulmonary vasodilators, irrespective of dose, route, and duration of administration, in neonates with pulmonary hypertension, if investigators reported any of the prespecified outcomes.
DATA COLLECTION AND ANALYSIS
We assessed the methodological quality of trials regarding how bias was minimised at study entry, during study intervention, and at outcomes measurement. We extracted data on relevant outcomes; we estimated the effect size and reported it as risk ratio (RR), risk difference (RD), or mean difference (MD), as appropriate. We applied the I test of heterogeneity and used GRADE to assess the quality of evidence.
MAIN RESULTS
For this update, we identified two additional studies, for a total of five eligible trials that enrolled 166 infants. The methodological quality of these studies ranged from low to high risk of bias. Three studies were performed in resource-limited settings, where iNO and high-frequency ventilation were not available at the time of the study. One study compared sildenafil versus active controls, and another study evaluated sildenafil as adjuvant therapy to iNO. When comparing sildenafil with placebo, investigators noted significant reduction in mortality in the sildenafil alone group (three studies, 77 participants; typical RR 0.20, 95% confidence interval (CI) 0.07 to 0.56; I = 0% - none; typical RR -0.36, 95% CI -0.53 to -0.18; number needed to treat for an additional beneficial outcome 3, 95% CI 2 to 6; I = 39% - low). Trials reported no significant differences in mortality upon comparison of the sildenafil group versus the active control group (one study, 65 participants; typical RR 0.55, 95% CI 0.05 to 5.75), or when iNO was administered to both groups (one study, 24 participants; typical RR 1.27, 95% CI 0.26 to 6.28). Physiological parameters of oxygenation (oxygenation index, partial pressure of oxygen in arterial blood (PaO)) suggested steady improvement after the first dose of sildenafil. None of the included trials identified any clinically important side effects. We rated the quality of evidence as low to very low owing to imprecision related to small sample size and unclear methodological features.
AUTHORS' CONCLUSIONS
Sildenafil used for treatment of pulmonary hypertension has potential for reducing mortality and improving oxygenation in neonates, especially in resource-limited settings where iNO is not available. However, large-scale randomised trials comparing sildenafil versus active controls (other pulmonary vasodilators) and providing follow-up for survivors are needed to assess the comparative effectiveness and long-term safety of sildenafil versus other pulmonary vasodilators.
Topics: Bronchodilator Agents; Cause of Death; Humans; Hypertension, Pulmonary; Infant, Newborn; Nitric Oxide; Randomized Controlled Trials as Topic; Sildenafil Citrate; Vasodilator Agents
PubMed: 28777888
DOI: 10.1002/14651858.CD005494.pub4 -
The Journal of Clinical Pediatric... 2014Methods of systematic review and meta analysis were employed to compare the success rate of pulpotomy of primary molars using mineral trioxide aggregate (MTA) and ferric... (Comparative Study)
Comparative Study Meta-Analysis Review
OBJECTIVE
Methods of systematic review and meta analysis were employed to compare the success rate of pulpotomy of primary molars using mineral trioxide aggregate (MTA) and ferric sulfate (FS) as two regenerative and preservative agents, respectively.
STUDY DESIGN
After raising a PICO question (In pulpotomy of vital carious-exposed primary molars, how does MTA compare to FS in terms of clinical and radiographic outcomes?) and determining the search strategy, MeSH-matching keywords were searched in four electronic databases and retrieved papers were examined in titles, and if necessary abstracts and full texts, to be relevant. Randomized clinical trials (RCTs) evaluating pulpotomy of vital primary molars after carious/traumatic exposure conducted with either FS or MTA, with at least a 6-month recall, tooth restorability, and those considering clinical and radiographic signs/symptoms, were included. The nonrandomized allocation and absence of comparison between the treatment groups caused the exclusion of the article. The quality of the RCTs and also their risk of bias (low, moderate, high), were assessed using a modification of van Tulder list; for meta-analysis of the matching studies, the extracted data were analyzed by Mantel Hanszel analysis.
RESULTS
A total number of 620 articles were found. After exclusion of the common titles and application of the eligibility criteria, 4 RCTs [12-month follow-up: n=3, 24-month follow-up: n=4, in total: 264 teeth) comparing MTA and FS, were selected. It was showed that the 12-month outcome of both materials were similar [RR= 0.642 (CI 95%: 0.225-1.833, P=0.407)], while the two-year follow-up results revealed significant differences in treatment outcome, in favor of MTA [RR was 0.300 (CI 95%: 0.132-0.683, P=0.004)].
CONCLUSION
MTA demonstrated superior long-term treatment outcomes in pulpotomy of primary molars than FS.
Topics: Aluminum Compounds; Calcium Compounds; Dental Pulp Exposure; Drug Combinations; Ferric Compounds; Humans; Molar; Oxides; Pulp Capping and Pulpectomy Agents; Pulpotomy; Randomized Controlled Trials as Topic; Silicates; Tooth, Deciduous; Treatment Outcome
PubMed: 25631717
DOI: 10.17796/jcpd.39.1.b454r616m2582373 -
Current Nutrition Reports Sep 2023PURPOSE OF REVIEW: Withania somnifera (L.) Dunal (Ws) is a common herb plant that has been used for centuries to treat a wide range of conditions, particularly certain... (Review)
Review
PURPOSE OF REVIEW: Withania somnifera (L.) Dunal (Ws) is a common herb plant that has been used for centuries to treat a wide range of conditions, particularly certain chronic diseases due to its antidiabetic, cardioprotective, antistress, and chondroprotective effects, among many others. No conclusive evidence, however, exists about the potential health effects of Ws in adults without chronic conditions. We aimed to evaluate the current evidence on the health benefits of Ws supplementation in healthy adults. RECENT FINDINGS: Based on the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines, we systematically reviewed studies indexed in Web of Science, Scopus, and PubMed to assess the effects of Ws on hematological and biochemical markers, hormonal behavior, and oxidant response in healthy adults. Original articles published up to March 5, 2022, with a controlled trial design or pre-post intervention design, in which supplementation of Ws was compared to a control group or data prior to intervention were included. Among 2,421 records identified in the search, 10 studies met the inclusion criteria. Overall, most of the studies reported beneficial effects of the Ws supplementation, and no serious adverse events were reported. Participants supplemented with Ws displayed reduced levels of oxidative stress and inflammation, and counterbalanced hormone levels. No evidence of the beneficial effects of Ws supplementation on hematological markers was reported. Ws supplementation appears to be safe, may regulate hormone levels, and has potent anti-inflammatory and antioxidant effects. However, further studies are needed to elucidate the relevance of its application.
Topics: Humans; Adult; Withania; Oxidants; Biomarkers; Hormones
PubMed: 37428341
DOI: 10.1007/s13668-023-00481-0 -
Journal of Thermal Biology Jan 2024Cold water immersion (CWI) evokes the life-threatening reflex cold shock response (CSR), inducing hyperventilation, increasing cardiac arrhythmias, and increasing... (Meta-Analysis)
Meta-Analysis Review
Cold water immersion (CWI) evokes the life-threatening reflex cold shock response (CSR), inducing hyperventilation, increasing cardiac arrhythmias, and increasing drowning risk by impairing safety behaviour. Repeated CWI induces CSR habituation (i.e., diminishing response with same stimulus magnitude) after ∼4 immersions, with variation between studies. We quantified the magnitude and coefficient of variation (CoV) in the CSR in a systematic review and meta-analysis with search terms entered to Medline, SportDiscus, PsychINFO, Pubmed, and Cochrane Central Register. Random effects meta-analyses, including effect sizes (Cohen's d) from 17 eligible groups (k), were conducted for heart rate (HR, n = 145, k = 17), respiratory frequency (f, n = 73, k = 12), minute ventilation (V, n = 106, k = 10) and tidal volume (V, n = 46, k=6). All CSR variables habituated (p < 0.001) with large or moderate pooled effect sizes: ΔHR -14 (10) bt. min (d: -1.19); Δf -8 (7) br. min (d: -0.78); ΔV, -21.3 (9.8) L. min (d: -1.64); ΔV -0.4 (0.3) L . Variation was greatest in V (control vs comparator immersion: 32.5&24.7%) compared to V (11.8&12.1%). Repeated CWI induces CSR habituation potentially reducing drowning risk. We consider the neurophysiological and behavioural consequences.
Topics: Humans; Cold-Shock Response; Habituation, Psychophysiologic; Drowning; Water; Respiratory Rate; Cold Temperature; Immersion
PubMed: 38211547
DOI: 10.1016/j.jtherbio.2023.103775 -
Journal of Community Health Jun 2023Adult drowning is a complex and multifactorial public health challenge requiring community, national and global efforts to mitigate impacts. This study updates the... (Review)
Review
Adult drowning is a complex and multifactorial public health challenge requiring community, national and global efforts to mitigate impacts. This study updates the evidence base for public health interventions that address adult fatal and non-fatal drowning. A systematic review was undertaken of the peer-reviewed literature for English-language primary studies published between 2011 and 2021describing a drowning intervention with adults. Twenty-two studies were included. Most studies (n = 16) were conducted in high-income countries. Yearly trends in drowning prevention intervention publications were analysed with 2015 (n = 6) the peak publishing year. Over half of the study designs were pre-post (n = 15). Intervention duration ranged from 4 hours to 11 years. Ten studies described either behaviour change theory or formative evaluation to inform design. Thirteen studies targeted interventions at a population level, seven at a group level and two at individual level. Studies identified a range of prevention strategies, categorised as behavioural (n = 9) (e.g., swimming lessons), socio-ecological (n = 8) (e.g., mandatory personal flotation devices) and mixed (n = 5) (e.g., awareness campaign and barriers to prevent access to water). A range of outcomes were described including changes in awareness, water safety knowledge, attitudes, water safety behaviours and skills, environmental, policy and regulation changes and drowning rates. Findings indicate a small but important increase in the evaluation and publication of effective interventions to prevent adult drowning. The complexity of the issues surrounding drowning requires multi-strategy and context -specific adult focused prevention interventions. Contemporary evidence that identifies effective interventions that contribute to prevention efforts is an essential first step in addressing the challenge.
Topics: Humans; Adult; Drowning; Swimming; Research Design; Water
PubMed: 36653593
DOI: 10.1007/s10900-023-01189-6