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Antimicrobial Resistance and Infection... Oct 2021With the current COVID-19 pandemic, many healthcare facilities have been lacking a steady supply of filtering facepiece respirators. To better address this challenge,...
BACKGROUND
With the current COVID-19 pandemic, many healthcare facilities have been lacking a steady supply of filtering facepiece respirators. To better address this challenge, the decontamination and reuse of these respirators is a strategy that has been studied by an increasing number of institutions during the COVID-19 pandemic.
METHODS
We conducted a systematic literature review in PubMed, PubMed Central, Embase, and Google Scholar. Studies were eligible when (electronically or in print) up to 17 June 2020, and published in English, French, German, or Spanish. The primary outcome was reduction of test viruses or test bacteria by log3 for disinfection and log6 for sterilization. Secondary outcome was physical integrity (fit/filtration/degradation) of the respirators after reprocessing. Materials from the grey literature, including an unpublished study were added to the findings.
FINDINGS
Of 938 retrieved studies, 35 studies were included in the analysis with 70 individual tests conducted. 17 methods of decontamination were found, included the use of liquids (detergent, benzalkonium chloride, hypochlorite, or ethanol), gases (hydrogen peroxide, ozone, peracetic acid or ethylene oxide), heat (either moist with or without pressure or dry heat), or ultra violet radiation (UVA and UVGI); either alone or in combination. Ethylene oxide, gaseous hydrogen peroxide (with or without peracetic acid), peracetic acid dry fogging system, microwave-generated moist heat, and steam seem to be the most promising methods on decontamination efficacy, physical integrity and filtration capacity.
INTERPRETATION
A number of methods can be used for N95/FFP2 mask reprocessing in case of shortage, helping to keep healthcare workers and patients safe. However, the selection of disinfection or sterilization methods must take into account local availability and turnover capacity as well as the manufacturer; meaning that some methods work better on specific models from specific manufacturers.
SYSTEMATIC REGISTRATION NUMBER
CRD42020193309.
Topics: COVID-19; Decontamination; Equipment Reuse; Humans; N95 Respirators
PubMed: 34635165
DOI: 10.1186/s13756-021-00993-w -
Journal of Prosthodontics : Official... Dec 2022The aim of this review was to evaluate studies investigating the effect of cleansing methods on the artificially aged bond strength of resin to contaminated zirconia... (Review)
Review
PURPOSE
The aim of this review was to evaluate studies investigating the effect of cleansing methods on the artificially aged bond strength of resin to contaminated zirconia restorations and determine which cleansing method of contaminated zirconia for resin bonding improvement is more efficient.
METHODS
An electronic search of published studies in English language was carried out until July 2021 on Scopus, Web of Science, and Medline databases. Data from in vitro studies involving the evaluation of the artificially aged bond strength of resin to contaminated zirconia following different cleansing methods were included. In vitro studies in which samples were not subjected to at least 5000 thermocycles, were excluded.
RESULTS
Of 162 articles retrieved initially, 19 were eligible to be included in the systematic review, of which 5 articles were excluded. Therefore, the final sample was 14 in vitro studies. All of the included studies for air abrasion suggested this method as an effective cleansing method, but 6 of 8 included studies reported cleaning paste (Ivoclean) as an effective cleansing method. All of the included studies for NaOCl and a cleaning gel (AD Gel) reported their efficacy. Finally, the results of included studies showed the ineffectiveness of phosphoric acid, water, isopropanol, enzymatic detergents, hydrogen peroxide, and acetone.
CONCLUSIONS
Air abrasion has been reported as an effective cleansing method to improve the bond strength of resin to contaminated zirconia. To improve the effectiveness of cleaning paste in resin bonding, another efficient cleansing method should be followed after this method. However, the superior cleaning potential of air abrasion rather than cleaning paste has been reported. Sodium hypochlorite and cleaning gel seem to be as effective as air abrasion, but extensive water-rinsing is necessary after the application of these cleaning agents.
Topics: Resin Cements; Air Abrasion, Dental; Dental Bonding; Dental Stress Analysis; Materials Testing; Surface Properties; Zirconium
PubMed: 35912851
DOI: 10.1111/jopr.13580 -
Acta Ophthalmologica Dec 2023Glaucoma is a leading cause of the global prevalence of irreversible blindness. The pathogenesis of glaucoma is not entirely known, but the major risk factors include... (Meta-Analysis)
Meta-Analysis
The use of benzalkonium chloride in topical glaucoma treatment: An investigation of the efficacy and safety of benzalkonium chloride-preserved intraocular pressure-lowering eye drops and their effect on conjunctival goblet cells.
Glaucoma is a leading cause of the global prevalence of irreversible blindness. The pathogenesis of glaucoma is not entirely known, but the major risk factors include advancing age, genetic predisposition, and increased intraocular pressure (IOP). The only evidence-based treatment is a lowering of IOP through the use of eye drops, laser procedures, or surgical interventions. Although laser treatment is gaining recognition as a first-choice treatment option, the most common approach for managing glaucoma is IOP-lowering eye drops. A major challenge in the treatment is the occurrence of adverse events and poor adherence. In this context, the ocular surface is an area of great concern, as most glaucoma patients have dry eye disease (DED), which is largely caused by eye drops. Preservation with benzalkonium chloride (BAK) is a controversial topic due to its potential role as a significant cause of DED. A systematic review and meta-analyses investigate potential differences in efficacy and safety between BAK-preserved and BAK-free anti-glaucomatous eye drops (I). Many of the included studies report on ocular surface damage caused by the application of BAK-preserved eye drops. However, the meta-analyses addressing hyperemia, number of ocular adverse events, and tear break-up time did not identify any significant differences. The latter is likely due to varying measurement methods, different endpoints, and study durations. It is, therefore, possible that the large variations between the studies conceal differences in the safety profiles. The efficacy meta-analysis finds that there are no differences in the IOP-lowering effect between BAK-preserved and BAK-free eye drops, indicating that BAK is not necessary for the effectiveness of eye drops. To promote more homogeneous choices of endpoints and methods when evaluating BAK-preserved and BAK-free glaucoma treatments, a Delphi consensus statement was performed. In this study, glaucoma experts and ocular surface disease experts reached consensus on the key factors to consider when designing such studies (II). The hope is to have more studies with comparable endpoints that can systematically show the potentially adverse effects of BAK. The preclinical studies in the current Ph.D. research focus on conjunctival goblet cells (GCs). GCs are important for the ocular surface because they release the mucin MUC5AC, which is an essential component of the inner layer of the tear film. BAK preservation may damage the GCs and result in a low GC density, leading to an unstable tear film and DED. The most commonly used IOP-lowering drugs are prostaglandin analogs (PGAs). Thus, the conducted studies investigate the effect of PGAs preserved in different ways on GCs. BAK-preserved latanoprost is cytotoxic to primary cultured human conjunctival GCs and results in a scattered expression of MUC5AC, in contrast to negative controls, where MUC5AC is localized around the cell nucleus (III). Preservative-free (PF) latanoprost is not cytotoxic and does not affect the MUC5AC expression pattern. Furthermore, BAK-preserved travoprost is found to be cytotoxic in a time-dependent manner, while Polyquad®-preserved travoprost does not affect GC survival at any measured time point (IV). Both Polyquad and BAK induce scattered expression of MUC5AC. The cytotoxicity of BAK-preserved PGA eye drops is higher compared to the safer profile of PF and Polyquad-preserved PGA eye drops (V). Additionally, PF latanoprost does not increase the release of the inflammatory markers interleukin (IL)-6 and IL-8, unlike BAK-preserved latanoprost. A review highlights the active and inactive components of IOP-lowering eye drops (VI). Several preclinical and clinical studies have identified adverse effects of BAK. Although other components, such as the active drug and phosphates, can also cause adverse events, the review clearly states that BAK alone is a major source of decreased tolerability. The conclusion of this thesis is that BAK preservation is unnecessary and harmful to the ocular surface. The preclinical studies demonstrate that GCs die when exposed to BAK. Furthermore, they find that BAK induces a pro-inflammatory response. The review included in the thesis concludes that BAK should be phased out of eye drops for chronic use. Overall, the inclusion of BAK poses a risk of developing DED and poor adherence, which can ultimately lead to disease progression and blindness.
Topics: Humans; Benzalkonium Compounds; Intraocular Pressure; Travoprost; Latanoprost; Ophthalmic Solutions; Goblet Cells; Prostaglandins F, Synthetic; Antihypertensive Agents; Glaucoma; Preservatives, Pharmaceutical; Conjunctiva; Prostaglandins, Synthetic; Blindness
PubMed: 38037546
DOI: 10.1111/aos.15808 -
Journal of Toxicology and Environmental... Oct 2021Water-only or soap and water solutions are considered a gold standard for skin decontamination. However, there is lack of conclusive data regarding their efficacy. The... (Comparative Study)
Comparative Study
Water-only or soap and water solutions are considered a gold standard for skin decontamination. However, there is lack of conclusive data regarding their efficacy. The aim of this study was to summarize animal model data on skin decontamination using water-only, and/or soap and water. Covidence, Embase, MEDLINE, PubMed, Web of Science, and Google Scholar were searched to identify relevant articles using water-only or soap and water decontamination methods in animals. Data extraction was completed from studies, representing three animal models, and 11 contaminants. Results demonstrated water-only decontamination solutions led to complete decontamination in 3.1% (n = 16/524) protocols, incomplete decontamination in 90.6% (n = 475/524) of protocols, and mortality in 6.3% (n = 33/524) of protocols. Soap and water decontamination solutions resulted in complete decontamination in 6.9% (n = 8/116) protocols, incomplete decontamination in 92.2% (n = 107/116) of protocols, and mortality in 6.9% (n = 8/116) of protocols. Although water only, or soap and water is considered a gold standard for skin decontamination, most papers investigated found that water only, and soap and water provided incomplete decontamination. Due to the insufficient data, and limitations that hinder the applicability of available data, evidence indicates that more contemporary studies investigating skin decontamination are needed, and compared to other model species, including humans, when practical.
Topics: Animals; Decontamination; Humans; Models, Animal; Skin; Soaps; Species Specificity; Water
PubMed: 34278982
DOI: 10.1080/10937404.2021.1943087 -
Planta Medica Apr 2022is a typical shrub from Brazil that has been used in traditional medicine. This is a systematic review on the effect of for controlling dental plaque, gingivitis, and...
is a typical shrub from Brazil that has been used in traditional medicine. This is a systematic review on the effect of for controlling dental plaque, gingivitis, and periodontitis. A database search through May 2021 in Medline/PubMed, SCOPUS, BVS, and Web of Science identified 711 reports of which 17 met our inclusion criteria. Five randomized controlled trials and three animal studies were included that compared -based products (toothpaste, mouthrinse, and gel) to cetylpyridinium chloride, chlorhexidine, and placebo products. Among the human studies, a significant antiplaque effect after treatment with -based products was observed in three studies and an antigingivitis effect in two studies, similar to chlorhexidine-based products. One study found superior dental plaque reduction compared to cetylpyridinium chloride mouthrinse. Only one study testing a gel found no antiplaque effect. Among the animal studies, an mouthrinse significantly reduced calculus in two studies, inflammatory infiltrate in one study, and plaque bacteria and gingivitis in one study. An gel significantly reduced alveolar bone loss and inflammatory response in one study in which mice were submitted to ligature-induced periodontal disease. In general, -based products were effective in reducing dental plaque and calculus formation, as well as clinical signs of gingivitis. As most studies present methodological limitations, these results should be interpreted carefully. Further clinical trials with greater methodological accuracy and control of biases are necessary for the use of -based products in humans to be viable in clinical practice.
Topics: Animals; Calculi; Cetylpyridinium; Chlorhexidine; Dental Plaque; Gingivitis; Lippia; Mice; Mouthwashes
PubMed: 34598290
DOI: 10.1055/a-1554-6947 -
Clinical and Experimental Allergy :... Mar 2021Hard domestic water has been reported to worsen atopic eczema (AE) and may contribute to its development in early life. (Meta-Analysis)
Meta-Analysis
BACKGROUND
Hard domestic water has been reported to worsen atopic eczema (AE) and may contribute to its development in early life.
OBJECTIVE
To review the literature on the relationship between the effect of water hardness (high calcium carbonate; CaCO ) on (a) the risk of developing AE, (b) the treatment of existing AE and (c) skin barrier function in human and animal studies.
DESIGN , DATA SOURCES AND ELIGIBILITY CRITERIA
We systematically searched databases (MEDLINE, Embase, Cochrane CENTRAL, GREAT and Web of Science) from inception until 30/6/2020. Human and animal observational and experimental studies were included. The primary outcomes were risk of AE and skin barrier function. Studies were meta-analysed using a random effects model. Evidence certainty was evaluated using the Grading of Recommendations, Assessment, Development and Evaluations (GRADE) approach.
RESULTS
Sixteen studies were included. Pooled observational data from seven studies on 385,901 participants identified increased odds of AE in children exposed to harder versus softer water (odds ratio 1.28, 95% CI 1.09, 1.50; GRADE certainty: very low). Two mechanistic studies in humans reported higher deposition of the detergent sodium lauryl sulphate in those exposed to harder versus softer water. Two randomized controlled trials comparing water softeners with standard care did not show a significant difference in objective AE severity with softened water (standardized mean difference 0.06 standard deviations higher, 95% CI 0.16 lower to 0.27 higher; GRADE certainty: moderate).
CONCLUSIONS & CLINICAL RELEVANCE
There was a positive association between living in a hard water (range: 76 to > 350 mg/L CaCO ) area and AE in children. There is no evidence that domestic water softeners improve objective disease severity in established AE. There may be a role of water hardness in the initiation of skin inflammation in early life, but there is a need for further longitudinal and interventional studies.
Topics: Animals; Calcium Carbonate; Dermatitis, Atopic; Detergents; Humans; Severity of Illness Index; Skin; Sodium Dodecyl Sulfate; Surface-Active Agents; Water; Water Softening
PubMed: 33259122
DOI: 10.1111/cea.13797 -
PloS One 2023Parasitic contamination in vegetables is a reality in several countries and a challenge for food safety. The risk of consumption usually raw, associated with failures in... (Meta-Analysis)
Meta-Analysis
BACKGROUND
Parasitic contamination in vegetables is a reality in several countries and a challenge for food safety. The risk of consumption usually raw, associated with failures in good practices of production, transportation, and preparation further increase the possibility of ingesting contaminated food. Given this, a systematic review was carried out to scientifically demonstrate the effectiveness of sanitization protocols in the parasitic decontamination of plants.
METHODS
This review was conducted following the guidelines of the Cochrane Manual, being registered in the PROSPERO protocol base (CRD42020206929) and reported according to the PRISMA 2020 statement. The review evaluated studies published in the MEDLINE, Embase, Web of Science, FSTA, LILACS, and AGRIS databases, as well as manual searches of related articles, references, and theses and dissertations directories. The meta-analysis was performed using the Revman 5 software program, the bias assessment used the Robins I Tools with some adaptations, and the quality of the evidence was evaluated using GRADE.
DISCUSSION
The review included a total of 31 studies, most of which were carried out in countries with a high incidence of plant parasites, such as Brazil and Iran. Interventions combined with 200ppm chlorination preceded by brushing, rinsing, or immersion in detergent showed the greatest efficiency in parasitic decontamination. Despite the high heterogeneity and risk of bias in the primary studies, this review can inspire the planning of new studies which observe the critical and methodological evaluation for research in the field of food safety.
Topics: Animals; Acclimatization; Brazil; Databases, Factual; Parasites; Vegetables
PubMed: 37656694
DOI: 10.1371/journal.pone.0290447 -
International Journal of Epidemiology Aug 2019Limited data have been available on the global practice of handwashing with soap (HWWS). To better appreciate global HWWS frequency, which plays a role in disease... (Meta-Analysis)
Meta-Analysis
BACKGROUND
Limited data have been available on the global practice of handwashing with soap (HWWS). To better appreciate global HWWS frequency, which plays a role in disease transmission, our objectives were to: (i) quantify the presence of designated handwashing facilities; (ii) assess the association between handwashing facility presence and observed HWWS; and (iii) derive country, regional and global HWWS estimates after potential faecal contact.
METHODS
First, using data from national surveys, we applied multilevel linear modelling to estimate national handwashing facility presence. Second, using multilevel Poisson modelling on datasets including both handwashing facility presence and observed HWWS after potential faecal contact, we estimated HWWS prevalence conditional on handwashing facility presence by region. For high-income countries, we used meta-analysis to pool handwashing prevalence of studies identified through a systematic review. Third, from the modelled handwashing facility presence and estimated HWWS prevalence conditional on the presence of a handwashing facility, we estimated handwashing practice at country, regional and global levels.
RESULTS
First, approximately one in four persons did not have a designated handwashing facility in 2015, based on 115 data points for 77 countries. Second the prevalence ratio between HWWS when a designated facility was present compared with when it was absent was 1.99 (1.66, 2.39) P <0.001 for low- and middle-income countries, based on nine datasets. Third, we estimate that in 2015, 26.2% (23.1%, 29.6%) of potential faecal contacts were followed by HWWS.
CONCLUSIONS
Many people lack a designated handwashing facility, but even among those with access, HWWS is poorly practised. People with access to designated handwashing facilities are about twice as likely to wash their hands with soap after potential faecal contact as people who lack a facility. Estimates are based on limited data.
Topics: Communicable Disease Control; Developing Countries; Feces; Global Health; Hand Disinfection; Health Behavior; Humans; Sanitation; Soaps
PubMed: 30535198
DOI: 10.1093/ije/dyy253 -
Clinical Oral Investigations Feb 2021The present study aimed to systematically review the literature about the interproximal anti-plaque and anti-gingivitis efficacy of cetylpyrydinium chloride (CPC)... (Meta-Analysis)
Meta-Analysis
The effect of cetylpyridinium chloride mouthrinse as adjunct to toothbrushing compared to placebo on interproximal plaque and gingival inflammation-a systematic review with meta-analyses.
OBJECTIVES
The present study aimed to systematically review the literature about the interproximal anti-plaque and anti-gingivitis efficacy of cetylpyrydinium chloride (CPC) mouthrinse compared to placebo solution.
MATERIALS AND METHODS
Three databases (PUBMED, SCOPUS, and EMBASE) were searched for randomized clinical trials that compared the interproximal anti-plaque and anti-gingivitis effect of CPC and placebo mouthrinses as an adjunct to toothbrushing, after a minimum of 6 weeks. Individuals with any periodontal diagnosis were considered. Two meta-analyses were performed for the Turesky modification of the Quigley-Hein plaque index and the Löe and Silness gingival index. For both analyses, the mean differences (MD) between baseline and 6-weeks were calculated using a random-effect model.
RESULTS
Eight studies were included. All included studies showed significant improvement in at least one of the parameters, favoring the CPC mouthrinse when compared to placebo. The meta-analysis demonstrated that groups that used CPC displayed a significantly greater reduction in the plaque index score (MD; 95% confidence interval [95%CI]: - 0.70; - 0.83 to - 0.57) and in the gingival index (MD; 95%CI: - 0.38; - 0.47 to - 0.28) when compared to placebo. However, high heterogeneity was observed in both analyses (I = 89% and I = 98%, respectively).
CONCLUSIONS
When considering interproximal surfaces, CPC is efficacious both in plaque and gingival inflammatory parameters, demonstrating the potential to compensate for the limitations of interproximal plaque control.
CLINICAL RELEVANCE
CPC may be a good alternative to compensate interproximal plaque removal, improving interproximal gingivitis.
Topics: Anti-Infective Agents, Local; Cetylpyridinium; Dental Plaque Index; Gingivitis; Humans; Inflammation; Mouthwashes; Toothbrushing
PubMed: 33185736
DOI: 10.1007/s00784-020-03661-2 -
Restorative Dentistry & Endodontics May 2020This study aimed to summarize the outcome of in vitro studies comparing the antibacterial effectiveness of QMix with other irrigants against .
OBJECTIVES
This study aimed to summarize the outcome of in vitro studies comparing the antibacterial effectiveness of QMix with other irrigants against .
MATERIALS AND METHODS
The research question was developed by using population, intervention, comparison, outcome, and study design framework. The literature search was performed using 3 electronic databases: PubMed, Scopus, and EBSCOhost until October 2019. The additional hand search was performed from the reference list of the eligible studies. The risk of bias of the studies was independently appraised using the revised Cochrane Risk of Bias tool (RoB 2.0).
RESULTS
Fourteen studies were included in this systematic review. The overall risk of bias for the selected studies was moderate. QMix was found to have a higher antimicrobial activity compared to 2% sodium hypochlorite (NaOCl), 17% ethylenediaminetetraacetic acid (EDTA), 2% chlorhexidine (CHX), mixture of tetracycline isonomer, an acid and a detergent (MTAD), 0.2% Cetrimide, SilverSol/H2O2, HYBENX, and grape seed extract (GSE). QMix had higher antibacterial efficacy compared to NaOCl, only when used for a longer time (10 minutes) and with higher volume (above 3 mL).
CONCLUSIONS
QMix has higher antibacterial activity than 17% EDTA, 2% CHX, MTAD, 0.2% Cetrimide, SilverSol/H2O2, HYBENX, GSE and NaOCl with lower concentration. To improve the effectiveness, QMix is to use for a longer time and at a higher volume.
TRIAL REGISTRATION
PROSPERO International prospective register of systematic reviews Identifier: CRD42018096763.
PubMed: 32483540
DOI: 10.5395/rde.2020.45.e23