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Gastrointestinal Endoscopy Jun 2024Serrated polyps (SPs) are precursors to 15-20% of colorectal cancers (CRCs). However, there are uncertainties regarding which SPs require surveillance and at what... (Review)
Review
BACKGROUND AND AIMS
Serrated polyps (SPs) are precursors to 15-20% of colorectal cancers (CRCs). However, there are uncertainties regarding which SPs require surveillance and at what intervals, with recommendations adapted from those for adenomas in the absence of solid evidence. Our aim was to assess which SP risk characteristics relate to a higher risk of metachronous CRC or advanced polyps.
METHODS
We systematically searched PubMed, EMBASE, and Cochrane for cohort, case-control studies, and clinical trials from inception to Dec 31, 2023, for CRC or advanced polyps [advanced adenoma (AA) or advanced SP] incidence at surveillance stratified by baseline SP size, dysplasia, location, and multiplicity. We defined advanced SPs as those >10mm or with dysplasia. CRC and advanced polyp incidence per 1,000 person-years (p-y) were estimated. We performed a meta-analysis by calculating pooled relative risks (RR) using a random-effects model.
RESULTS
5,903 studies were reviewed and 14 included, with 493,949 patients (mean age 59·5 years, 55% men). Mean follow-up was 4·9 years. CRC incidence per 1,000 p-y was 2·09 (95%CI 1·29-2·90) for advanced SP, 1·52 (0·78-2·25) for SP>10mm, 5·86 (2·16-9·56) for SP with dysplasia, 1·18 (0·77-1·60) for proximal SP, 0·52 (0·08-1·12) for >3SP, 0·50 (0·35-0·66) for non-advanced SP, and 0·44 (0·41-0·46) for normal colonoscopy. Metachronous CRC risk was higher in advanced SP vs non-advanced SP (RR 1·84, 95%CI 1·11-3·04), and vs normal colonoscopy (RR 2·92, 2·26-3·77); in SP>10mm vs <10mm (RR 2·61, 1·43-4·77), and vs normal colonoscopy (RR 3·52, 2·17-5·69); and in SP with dysplasia vs normal colonoscopy (RR 2·71, 2·00-3·67). No increase in CRC or advanced polyp risk was found in patients with proximal vs distal SP, nor in >3SP vs 1-2SP.
CONCLUSIONS
CRC risk is significantly higher in patients with baseline advanced SP after 4·9 years of follow-up, with risk magnitudes similar to those described for AA, supporting the current recommendation for 3-year surveillance in patients with advanced SP.
PubMed: 38851458
DOI: 10.1016/j.gie.2024.05.021 -
BMC Geriatrics Feb 2024Mild Cognitive Impairment (MCI) is frequently a precursor to dementia, affecting aspects of cognition such as language, thinking, or memory. Lifestyle interventions are...
BACKGROUND
Mild Cognitive Impairment (MCI) is frequently a precursor to dementia, affecting aspects of cognition such as language, thinking, or memory. Lifestyle interventions are increasingly studied as potential means to slow the progression from MCI to dementia.
OBJECTIVE
A systematic review was conducted to investigate the effectiveness of home-based lifestyle interventions in reducing cognitive decline in older adults with MCI.
METHODS
A systematic review of randomized controlled trials (RCTs) was conducted to identify home-based lifestyle interventions for individuals with MCI from 1980 to 2023. These interventions were either single-component or multi-component and included diet, physical activity, stress-reduction, or cognitive stimulation treatments to assess their impact on cognition. We performed a comprehensive search in the PubMed, Web of Science, Google Scholar, Embase, and MEDLINE databases.
RESULTS
From 320 abstracts, 20 (6.25%) studies met the criteria for inclusion, with five multi-component and fifteen single-component studies. Eighteen home-based lifestyle interventions for MCI patients were focused on physical activity, diet, and/or cognitive training, while two studies were identified that incorporated stress reduction training as a method to improve cognitive function. Nineteen studies reported significant improvements in cognitive performance between the experimental and control groups post-intervention for at least one aspect of cognition. Four studies reported nonsignificant improvements in cognitive function between the two groups for at least one area of cognition.
CONCLUSIONS
Home-based lifestyle interventions have the potential to improve cognition in elderly patients with MCI. However, future RCTs with larger sample sizes and longer intervention durations are needed to confirm these findings.
Topics: Humans; Aged; Cognitive Dysfunction; Cognition; Life Style; Cognitive Behavioral Therapy; Dementia
PubMed: 38413870
DOI: 10.1186/s12877-024-04798-5 -
The Science of the Total Environment May 2024The pervasive presence of poly- and perfluoroalkyl substances (PFAS) in diverse products has led to their introduction into wastewater systems, making wastewater... (Review)
Review
The pervasive presence of poly- and perfluoroalkyl substances (PFAS) in diverse products has led to their introduction into wastewater systems, making wastewater treatment plants (WWTPs) significant PFAS contributors to the environment. Despite WWTPs' efforts to mitigate PFAS impact through physicochemical and biological means, concerns persist regarding PFAS retention in generated biosolids. While numerous review studies have explored the fate of these compounds within WWTPs, no study has critically reviewed their presence, transformation mechanisms, and partitioning within the sludge. Therefore, the current study has been specifically designed to investigate these aspects. Studies show variations in PFAS concentrations across WWTPs, highlighting the importance of aqueous-to-solid partitioning, with sludge from PFOS and PFOA-rich wastewater showing higher concentrations. Research suggests biological mechanisms such as cytochrome P450 monooxygenase, transamine metabolism, and beta-oxidation are involved in PFAS biotransformation, though the effects of precursor changes require further study. Carbon chain length significantly affects PFAS partitioning, with longer chains leading to greater adsorption in sludge. The wastewater's organic and inorganic content is crucial for PFAS adsorption; for instance, higher sludge protein content and divalent cations like calcium and magnesium promote adsorption, while monovalent cations like sodium impede it. In conclusion, these discoveries shed light on the complex interactions among factors affecting PFAS behavior in biosolids. They underscore the necessity for thorough considerations in managing PFAS presence and its impact on environmental systems.
Topics: Wastewater; Sewage; Biosolids; Fluorocarbons; Water Pollutants, Chemical; Water Purification
PubMed: 38458438
DOI: 10.1016/j.scitotenv.2024.171559 -
Gynecologic Oncology Jul 2024Endometrial intraepithelial neoplasia (EIN) and atypical hyperplasia (AH) are recognized precursors for endometrial cancer (EC). Most current guidelines do not recommend... (Review)
Review
OBJECTIVE
Endometrial intraepithelial neoplasia (EIN) and atypical hyperplasia (AH) are recognized precursors for endometrial cancer (EC). Most current guidelines do not recommend the routine surgical evaluation of lymph nodes (LN), although recent studies indicate increased use of sentinel lymph node (SLN) biopsy in patients with a preoperative diagnosis of EIN/AH. We aimed to evaluate the rates of positive LN and its effect on the incidence of upstaging of EIN/AH patients, complications, and adjuvant treatment administration.
METHODS
A systematic review and meta-analysis was conducted in the following databases: MEDLINE(R) using the OvidSP interface and PUBMED, Embase, Web of Science, Clinicaltrials.gov and Cochrane Library. Included were studies investigating lymph node evaluation in patients diagnosed with EIN/AH, presenting results of LN assessment and/or comparisons of hysterectomy results with and without lymph node assessment. This analysis was registered at PROSPERO International prospective register of systematic reviews (CRD42023443598).
RESULTS
A total of 447 studies were initially identified through database searching. The current analysis includes 7 studies comprising 1791 atypical endometrial hyperplasia patients who underwent hysterectomy with lymph node assessment. The incidence of positive lymph nodes among those who had undergone any LN evaluation was found to be 1.1% (95% CI 0.3%-2%). The rate of positive LNs was 1.4% (95% CI 0.2%-1.9%) among those who had undergone specifically SLN. 319 (44.3%, 95% CI 34%-54.7%) patients of the patients initially diagnosed with EIN/AH (n = 699), were finally upgraded to EC diagnosis. Fifteen percent of the final EC diagnosed patients were treated with adjuvant treatment. No significant difference regarding complication rates was noticed.
CONCLUSIONS
Our review indicates that the rate of metastatic LNs is <2% in patients undergoing surgical nodal evaluation for EIN/AH. However, the rate of complication for SLN mapping is low and may have an impact on postoperative therapy decisions in those diagnosed with malignancy.
PubMed: 38964251
DOI: 10.1016/j.ygyno.2024.06.019 -
Nutrition Reviews May 2024Riboflavin (vitamin B2) is a water-soluble micronutrient considered to be a precursor of the nucleotides flavin adenine dinucleotide and flavin mononucleotide. This...
CONTEXT
Riboflavin (vitamin B2) is a water-soluble micronutrient considered to be a precursor of the nucleotides flavin adenine dinucleotide and flavin mononucleotide. This vitamin makes up mitochondrial complexes and participates as an enzymatic cofactor in several mechanisms associated with energy metabolism.
OBJECTIVE
This systematic review collected and discussed the most relevant results on the role of riboflavin in the energy metabolism of lipids, proteins, and carbohydrates.
DATA SOURCES
A systematic search was carried out in the PubMed-Medline, Scopus, Embase, and Web of Science databases using the PICOS (Population, Intervention, Comparison, Outcome, Study design) strategy.
DATA EXTRACTION
The screening of studies went through 2 stages following predefined eligibility criteria. The information extracted covered reference details, study design, population characteristics, experimental model, treatment parameters and dosage, route of administration, duration of treatment, and results found.
DATA ANALYSIS
The risk of bias was assessed using the SYRCLE Risk of Bias (RoB) tool for in vivo studies and the QUIN tool adapted for in vitro studies, utilizing 10 domains, including selection bias, performance bias, detection bias, attrition bias, reporting bias, and other biases, to evaluate the methodological quality of the included studies.
CONCLUSION
This review concludes that riboflavin regulates energy metabolism by activating primary metabolic pathways and is involved in energy balance homeostasis.
PubMed: 38719205
DOI: 10.1093/nutrit/nuae041 -
Nutrition Reviews Apr 2024Gestational weight gain (GWG) is known to be a risk factor for offspring obesity, a precursor of cardiometabolic diseases. Accumulating studies have investigated the...
CONTEXT
Gestational weight gain (GWG) is known to be a risk factor for offspring obesity, a precursor of cardiometabolic diseases. Accumulating studies have investigated the association of GWG with offspring cardiometabolic risk factors (CRFs), leading to inconsistent results.
OBJECTIVE
This study synthesized available data from cohort studies to examine the effects of GWG on offspring CRFs.
DATA SOURCE
Four electronic databases, including PubMed, Web of Science, Scopus, and Embase, were searched through May 2023.
DATA EXTRACTION
Cohort studies evaluating the association between GWG and CRFs (fat mass [FM], body fat percentage [BF%], waist circumference [WC], systolic blood pressure [SBP] and diastolic blood pressure, high-density-lipoprotein cholesterol [HDL-C] and low-density-lipoprotein cholesterol, triglyceride [TG], total cholesterol, fasting blood glucose, and fasting insulin levels) were included. Regression coefficients, means or mean differences with 95% confidence intervals [CIs], or standard deviations were extracted.
DATA ANALYSIS
Thirty-three cohort studies were included in the meta-analysis. Higher GWG (per increase of 1 kg) was associated with greater offspring FM (0.041 kg; 95% CI, 0.016 to 0.067), BF% (0.145%; 95% CI, 0.116 to 0.174), WC (0.154 cm; 95% CI, 0.036 to 0.272), SBP (0.040 mmHg; 95% CI, 0.010 to 0.070), and TG (0.004 mmol/L; 95% CI, 0.001 to 0.007), and with lower HDL-C (-0.002 mmol/L; 95% CI, -0.004 to 0.000). Consistently, excessive GWG was associated with higher offspring FM, BF%, WC, and insulin, and inadequate GWG was associated with lower BF%, low-density lipoprotein cholesterol, total cholesterol, and TG, compared with adequate GWG. Most associations went non-significant or attenuated with adjustment for offspring body mass index or FM.
CONCLUSIONS
Higher maternal GWG is associated with increased offspring adiposity, SBP, TG, and insulin and decreased HDL-C in offspring, warranting a need to control GWG and to screen for cardiometabolic abnormalities of offspring born to mothers with excessive GWG.
SYSTEMATIC REVIEW REGISTRATION
PROSPERO registration no. CRD42023412098.
PubMed: 38607346
DOI: 10.1093/nutrit/nuae027 -
The Science of the Total Environment May 2024Ammonia, a significant precursor for secondary inorganic aerosols, plays a pivotal role in new particle formation. Inventories and source apportionment studies have...
Ammonia, a significant precursor for secondary inorganic aerosols, plays a pivotal role in new particle formation. Inventories and source apportionment studies have identified vehicular exhaust as a primary source of atmospheric ammonia in urban regions. Existing research on the factors influencing ammonia emissions from gasoline vehicles exhibits substantial inconsistencies in both test results and analyses. The lack of a uniform pattern in ammonia emissions across different standard vehicles and the significant overlap in test results across diverse operational conditions highlight the complexities in this field of study. While individual results can be interpreted through a mechanistic lens, disparate studies often lack a common explanatory framework. To address this gap, our study leverages the robust and comprehensive approach of meta-analysis to reconcile these inconsistencies and provide a more precise understanding of the factors influencing ammonia emissions from gasoline vehicles. A large number (N = 537) of ammonia emission factors were extracted after screening >1628 publications. The combined ammonia emission factor was 23.57 ± 24.94 mg/km. Emission standards, engine type, ambient temperatures, mileage, vehicle speed, and engine displacement have a significant impact on ammonia emission factors, explaining the ammonia emission factor by up to 50.63 %, with speed being the most significant factor. All these factors are attributed to the interplay of catalyst properties, lambda, and residence time (space velocity). In the current fleet, ammonia emission control is relatively insufficient under low-speed and ultra-high speed, low temperature, and ultra-high mileage conditions. Since ammonia emission factors do not monotonically decrease with the upgrading of motor vehicle emission standards, it is called for the addition of ammonia emission factors indicators in motor vehicle emission standards, and stipulation of targeted testing procedures and testing instruments.
PubMed: 38447721
DOI: 10.1016/j.scitotenv.2024.171467 -
Child Abuse & Neglect Jun 2024Individuals with a history of Adverse Childhood Experiences (ACEs) are at risk of subsequent cannabis use. However, at present no existing systematic review explores...
BACKGROUND
Individuals with a history of Adverse Childhood Experiences (ACEs) are at risk of subsequent cannabis use. However, at present no existing systematic review explores ACEs as they relate to cannabis use.
OBJECTIVE
The aim of this systematic review paper is to examine how adverse childhood experiences (ACEs) impact rates, patterns, and the nature of cannabis use in adulthood.
METHODS
Guided by the PRISMA statement, this systematic review focuses on longitudinal studies that report cannabis use in adulthood. Databases searched include PubMed and Embase.
RESULTS
Ultimately, 28 manuscripts were selected for inclusion, ranging in scope from smaller community-focused studies to nationally representative longitudinal surveys; 22 of 28 studies occurred in the United States, with sample size ranging from 303 to 15,960 participants. Instruments used to assess ACEs and cannabis use varied considerably across studies, leading to loss of consistency. Nevertheless, presence of ACEs-childhood sexual abuse in particular-was consistently associated with cannabis use later in life. Frequency and severity of ACEs was found to exert an additive cumulative effect on severity of cannabis use.
CONCLUSIONS
This systematic review lays the foundation of the current state of the science regarding ACEs and cannabis use, which can provide further insight into a better understanding of this relationship and provide potential intervention opportunities.
PubMed: 38889556
DOI: 10.1016/j.chiabu.2024.106889 -
Critical Reviews in Food Science and... 2024Acrylamide (AA) is a toxic substance formed in many carbohydrate-rich food products, whose formation can be reduced by adding some additives. Furthermore, the type of...
Acrylamide (AA) is a toxic substance formed in many carbohydrate-rich food products, whose formation can be reduced by adding some additives. Furthermore, the type of food consumed determines the AA intake. According to the compiled information, the first route causing AA formation is the Maillard reaction. Some interventions, such as reducing AA precursors in raw materials, (i.e., asparagine), reducing sugars, or decreasing temperature and processing time can be applied to limit AA formation in food products. The L-asparaginase is more widely used in potato products. Also, coatings loaded with proteins, enzymes, and phenolic compounds are new techniques for reducing AA content. Enzymes have a reducing effect on AA formation by acting on asparagine; proteins by competing with amino acids to participate in Maillard, and phenolic compounds through their radical scavenging activity. On the other hand, some synthetic and natural additives increase the formation of AA. Due to the high exposure to AA and its toxic effects, it is essential to recognize suitable food additives to reduce the health risks for consumers. In this sense, this study focuses on different additives that are proven to be effective in the reduction or formation of AA in food products.
Topics: Asparagine; Acrylamide; Hot Temperature; Carbohydrates; Asparaginase; Maillard Reaction
PubMed: 36194060
DOI: 10.1080/10408398.2022.2126428 -
Obstetrics and Gynecology Mar 2024To determine biomarkers other than CA 125 that could be used in identifying early-stage ovarian cancer.
OBJECTIVE
To determine biomarkers other than CA 125 that could be used in identifying early-stage ovarian cancer.
DATA SOURCES
Ovid MEDLINE ALL, EMBASE, Web of Science Core Collection, ScienceDirect, Clinicaltrials.gov , and CAB Direct were searched for English-language studies between January 2008 and April 2023 for the concepts of high-grade serous ovarian cancer, testing, and prevention or early diagnosis.
METHODS OF STUDY SELECTION
The 5,523 related articles were uploaded to Covidence. Screening by two independent reviewers of the article abstracts led to the identification of 245 peer-reviewed primary research articles for full-text review. Full-text review by those reviewers led to the identification of 131 peer-reviewed primary research articles used for this review.
TABULATION, INTEGRATION, AND RESULTS
Of 131 studies, only 55 reported sensitivity, specificity, or area under the curve (AUC), with 36 of the studies reporting at least one biomarker with a specificity of 80% or greater specificity or 0.9 or greater AUC.
CONCLUSION
These findings suggest that although many types of biomarkers are being tested in ovarian cancer, most have similar or worse detection rates compared with CA 125 and have the same limitations of poor detection rates in early-stage disease. However, 27.5% of articles (36/131) reported biomarkers with better sensitivity and an AUC greater than 0.9 compared with CA 125 alone and deserve further exploration.
Topics: Female; Humans; Fallopian Tubes; Ovarian Neoplasms; Biomarkers
PubMed: 38176019
DOI: 10.1097/AOG.0000000000005496