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Regulatory Toxicology and Pharmacology... Jun 2021To conduct a systematic review and meta-analysis of lung cancer among acrylonitrile-exposed workers. (Meta-Analysis)
Meta-Analysis
PURPOSE
To conduct a systematic review and meta-analysis of lung cancer among acrylonitrile-exposed workers.
METHODS
A literature search through April 2020 was performed to identify relevant cohort and case-control studies. Data from these studies were meta-analyzed to generate summary relative risk estimates (SRREs). Heterogeneity was examined in sub-group and sensitivity analyses, and by meta-regression.
RESULTS
Twenty-two studies were reviewed systematically, and 10 cohort studies and one case-control study were meta-analyzed. Individual relative risk estimates reported across studies were heterogeneous, with most being relatively weak in statistical strength and non-statistically significant on both sides of the null value. Meta-analysis of these data resulted in an SRRE of 1.04 (95% CI: 0.89-1.21; overall model, largely consisting of all workers exposed to acrylonitrile). Sub-group analyses and meta-regression did not support patterns of positive dose-response relationships by duration of exposure/employment or cumulative exposure.
CONCLUSIONS
Although some positive associations have been reported in internal comparison analyses based on increasing exposure categories, few associations are statistically significant, there are no apparent or consistent patterns of dose-response, and the confounding influence of cigarette smoking was not adequately controlled. Thus, findings from this review and meta-analysis do not support an increased risk of lung cancer among acrylonitrile workers.
Topics: Acrylonitrile; Cigarette Smoking; Dose-Response Relationship, Drug; Humans; Lung Neoplasms; Occupational Exposure; Risk Factors
PubMed: 33617939
DOI: 10.1016/j.yrtph.2021.104896 -
World Neurosurgery Oct 2021The expanding use of three-dimensional (3D) printing in open vascular and endovascular neurosurgery presents a promising new tool in resident learning as well as...
BACKGROUND
The expanding use of three-dimensional (3D) printing in open vascular and endovascular neurosurgery presents a promising new tool in resident learning as well as operative planning. Recent studies have investigated the accuracy, efficacy, and practicality of 3D-printed models of patient-specific disease.
OBJECTIVE
To review the literature exploring 3D modeling in neurovascular and endovascular surgery for training, simulation, and surgical preparation.
METHODS
A systematic search of the PubMed database was conducted using keywords relating to 3D printing and neurovascular or endovascular surgery. Articles were manually screened to include those that focused on resident training, surgical simulation, or preoperative planning. Information on fabrication method, materials, cost, and validation measures was collected.
RESULTS
A total of 27 articles were identified that met inclusion criteria. Twenty-one studies used 3D printing to produce aneurysm models, 5 produced arteriovenous malformation models, and 1 produced aneurysm and arteriovenous malformation models. Stereolithography was the most common fabrication method used, with acrylonitrile butadiene styrene and VeroClearTangoPlus (Stratasys) being the most frequently used materials. The mean manufacturing cost per model was U.S. $624.83. Outcomes included model measurement accuracy, concordance of intraoperative devices with those selected preoperatively, and qualitative feedback.
CONCLUSIONS
Models generated by 3D printing are anatomically accurate and aid in resident learning as well as operative planning in open vascular and endovascular neurosurgery. As advancements in printing methods are made and manufacturing costs decrease, this tool may supplement training on a wider scale in a field in which direct exposure to cases is limited.
Topics: Education, Medical, Graduate; Endovascular Procedures; Humans; Models, Anatomic; Neurosurgery; Neurosurgical Procedures; Printing, Three-Dimensional; Vascular Surgical Procedures
PubMed: 34293525
DOI: 10.1016/j.wneu.2021.07.057 -
JAMA Network Open Aug 2019Cardiovascular adverse events (CVAEs) after treatment with BRAF and MEK inhibitors in patients with melanoma remain incompletely characterized. (Meta-Analysis)
Meta-Analysis
IMPORTANCE
Cardiovascular adverse events (CVAEs) after treatment with BRAF and MEK inhibitors in patients with melanoma remain incompletely characterized.
OBJECTIVE
To determine the association of BRAF and MEK inhibitor treatment with CVAEs in patients with melanoma compared with BRAF inhibitor monotherapy.
DATA SOURCES
PubMed, Cochrane, and Web of Science were systematically searched for keywords vemurafenib, dabrafenib, encorafenib, trametinib, binimetinib, and cobinimetinib from database inception through November 30, 2018.
STUDY SELECTION
Randomized clinical trials reporting on CVAEs in patients with melanoma being treated with BRAF and MEK inhibitors compared with patients with melanoma being treated with BRAF inhibitor monotherapy were selected.
DATA EXTRACTION AND SYNTHESIS
Data assessment followed the Preferred Reporting Items for Systematic Reviews and Meta-analysis (PRISMA) guidelines. Pooled relative risks (RRs) and 95% CIs were determined using random-effects and fixed-effects analyses. Subgroup analyses were conducted to assess study-level characteristics associated with CVAEs.
MAIN OUTCOMES AND MEASURES
The selected end points were pulmonary embolism, a decrease in left ventricular ejection fraction, arterial hypertension, myocardial infarction, atrial fibrillation, and QTc interval prolongation. All-grade and high-grade (≥3) CVAEs were recorded.
RESULTS
Overall, 5 randomized clinical trials including 2317 patients with melanoma were selected. Treatment with BRAF and MEK inhibitors was associated with an increased risk of pulmonary embolism (RR, 4.36; 95% CI, 1.23-15.44; P = .02), a decrease in left ventricular ejection fraction (RR, 3.72; 95% CI, 1.74-7.94; P < .001), and arterial hypertension (RR, 1.49; 95% CI, 1.12-1.97; P = .005) compared with BRAF inhibitor monotherapy. The RRs for myocardial infarction, atrial fibrillation, and QTc prolongation were similar between the groups. These results were consistent when assessing high-grade CVAEs (left ventricular ejection fraction: RR, 2.79; 95% CI, 1.36-5.73; P = .005; I2 = 29%; high-grade arterial hypertension: RR, 1.54; 95% CI, 1.14-2.08; P = .005; I2 = 0%), but RRs for high-grade pulmonary embolism were similar between groups. A higher risk of a decrease in left ventricular ejection fraction was associated with patients with a mean age younger than 55 years (RR, 26.50; 95% CI, 3.58-196.10; P = .001), and the associated risk of pulmonary embolism was higher for patients with a mean follow-up time longer than 15 months (RR, 7.70; 95% CI, 1.40-42.12; P = .02).
CONCLUSIONS AND RELEVANCE
Therapy with BRAF and MEK inhibitors was associated with a higher risk of CVAEs compared with BRAF inhibitor monotherapy. The findings may help to balance between beneficial melanoma treatment and cardiovascular morbidity and mortality.
Topics: Acrylonitrile; Adult; Aged; Aged, 80 and over; Aniline Compounds; Antineoplastic Combined Chemotherapy Protocols; Cardiovascular Diseases; Female; Humans; Male; Melanoma; Middle Aged; Protein Kinase Inhibitors; Proto-Oncogene Proteins B-raf; Randomized Controlled Trials as Topic; Skin Neoplasms; Young Adult
PubMed: 31397860
DOI: 10.1001/jamanetworkopen.2019.8890 -
Toxicology and Industrial Health Sep 20213-Dimensional (3D) printing and bioprinting are the new technologies. In 3D printing, synthetic polymers such as acrylonitrile, butadiene, and styrene, polylactic acid,...
3-Dimensional (3D) printing and bioprinting are the new technologies. In 3D printing, synthetic polymers such as acrylonitrile, butadiene, and styrene, polylactic acid, nylon, and some metals are used as feedstocks. During 3D printing, volatile organic compounds (VOCs) and nanoparticles can be released. In the bioprinting process, natural polymers are most commonly used. All of these materials have direct and indirect toxic effects in exposed people. Therefore, the aim of this study was to provide a comprehensive review of toxicity risks due to occupational exposure to pollutants in the 3D printing and bioprinting industries. The Cochrane review method was used as a guideline for systematic review. Articles were searched in the databases including PubMed, Scopus, Web of Science, and Google Scholar. This systematic review showed that VOCs and ultra-fine particles are often released in fused deposition modeling and selective laser sintering, respectively. Asthma, chronic obstructive pulmonary disease, allergic rhinitis, and DNA damage were observed in occupational exposure to synthetic polymers. Metal nanoparticles can induce adverse health effects on the respiratory and nervous systems. This study emphasized the need to further study the toxicity of 3D printing and bioprinting-induced air pollutants. Also, consideration of safety and health principles is necessary in 3D printing and bioprinting workplaces.
Topics: Air Pollutants; Bioprinting; DNA Damage; Humans; Inflammation Mediators; Neuromuscular Diseases; Occupational Exposure; Particulate Matter; Polymers; Printing, Three-Dimensional; Respiratory Tract Diseases
PubMed: 34399648
DOI: 10.1177/07482337211031691 -
Applied Ergonomics Nov 2021Additive Manufacturing (AM) facilitates product personalization and iterative design, which makes it an ideal technology for ergonomic product development. In this... (Review)
Review
Additive Manufacturing (AM) facilitates product personalization and iterative design, which makes it an ideal technology for ergonomic product development. In this study, a systematic review was conducted of the literature regarding the use of AM in ergonomic-product design, and methodological aspects of the studies were analyzed. A literature search was performed using the keywords "3D print*," "additive manufacturing," "ergonomic*" and "human factors". Included were studies reporting the use of AM specifically in ergonomic design of products/prototypes including the detailing of an ergonomic testing methodology used for evaluation. Forty studies were identified pertaining to the fields of medicine, assistive technology, wearable technology, hand tools, testing devices and others. The most commonly used technology was fused deposition modeling with polylactic acid, but the overall preferred material was acrylonitrile butadiene styrene. Various combinations of objective/subjective and qualitative/quantitative product evaluation methods were used. Based on the findings, recommendations were developed to facilitate the choice of most suitable AM technologies and materials for specific applications in ergonomics.
Topics: Ergonomics; Humans; Printing, Three-Dimensional; Technology
PubMed: 34256321
DOI: 10.1016/j.apergo.2021.103528 -
Phytotherapy Research : PTR Jan 2020Quercetin is one of the most abundant flavonoids in human diet that has been reported to exhibit a wide range of pharmacological properties. The biochemical and...
Quercetin is one of the most abundant flavonoids in human diet that has been reported to exhibit a wide range of pharmacological properties. The biochemical and molecular mechanisms involved in the hepatoprotective activity of quercetin were discussed in this review. Quercetin exhibited hepatoprotective activity against 2-butoxyethanol, acrylamide, acrylonitrile, aflatoxin B1, aroclor-1254, arsenic, sodium arsenite, azathioprine, cadmium chloride, carbon tetrachloride, chlorpyrifos, cyclosporine A, diazinon, dimethylnitrosamine, doxorubicin, epirubicin, ethanol, fenvalerate, isoniazide, rifampicin, lead acetate, lindane, D-galactosamine, methotrexate, methylmercury, nickel sulfate, paracetamol, perfluorooctanoic acid, polychlorinated biphenyls, pyrrolizidine alkaloid clivorine, rotenone, sodium fluoride, streptazotocin, tert-butyl hydroperoxide, thioacetamide, titanium dioxide, tumor necrosis factor-α, tripterygium glycoside, triptolide, ultraviolet A light, concavalin A, bisphenol, and ischemia-induced hepatotoxicity in various animal models due to its antioxidant, free radical-scavenging,anti-inflammatory, antiapoptotic, and cytochrome P450 2E1 (CYP2E1) inhibitory activities. In this review, we provide an overview of the possible mechanisms by which quercetin reduced the hepatotoxicity of different hepatotoxicants. This will help the toxicologists, pharmacologists, and chemists to develop new safer pharmaceutical products with quercetin and other hepatotoxicants.
Topics: Animals; Antioxidants; Humans; Liver; Male; Quercetin; Rats; Rats, Sprague-Dawley; Rats, Wistar
PubMed: 31617262
DOI: 10.1002/ptr.6503