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Clinical Oral Investigations May 2023Sodium hypochlorite, a gold standard for irrigation in endodontics, has disadvantages like toxicity and root dentin weakening. Alternatives derived from natural products... (Review)
Review
CONTEXT
Sodium hypochlorite, a gold standard for irrigation in endodontics, has disadvantages like toxicity and root dentin weakening. Alternatives derived from natural products are being explored.
AIMS
This systematic review was done to understand the clinical benefits of natural irrigants when compared with a standard irrigant, sodium hypochlorite.
SETTINGS AND DESIGN REGISTRATION
This systematic review was registered with PROSPERO (2018 CRD42018112837) METHODS AND MATERIAL: This review was done in conformation to the Preferred Reporting Items for Systematic Reviews and Meta-analysis (PRISMA 2020) statement. In vivo studies using at least one natural irrigant and sodium hypochlorite (NaOCl) were included. Studies using them as medicaments were excluded. PubMed, Cochrane and SCOPUS were searched. RevMan tool for Risk of Bias 2 (RoB 2) and risk-of-bias tool to assess non-randomized studies of interventions (ROBINS-I) were used. GRADEpro was used to assess certainty of evidence.
RESULTS
Ten articles (6 RCTs and 4 clinical studies) on approximately 442 patients were included. Seven natural irrigants were evaluated clinically. Due to the heterogeneity, meta-analysis could not be conducted. Antimicrobial efficacy was found to be similar for castor oil, neem, garlic-lemon, noni, papaine and NaOCl. Neem, papaine-chloramine, neem-NaOCl and neem-CHX were superior, while propolis, miswak and garlic were inferior to NaOCl. Post-operative pain was less for neem. There was no significant difference between papaine-chloramine, garlic extract and sodium hypochlorite in clinical/radiographic success.
CONCLUSIONS
The studied natural irrigants are not more efficacious than NaOCl. At the moment, they cannot replace NaOCl routinely and may only substitute in select cases.
Topics: Humans; Sodium Hypochlorite; Chloramines; Root Canal Irrigants; Anti-Infective Agents; Dental Pulp Cavity
PubMed: 36808559
DOI: 10.1007/s00784-023-04913-7 -
Operative Dentistry Jan 2021The literature reviewed suggests that airborne particle abrasion has no negative effects on the bond strength of resin-based materials to dentin and that a positive... (Meta-Analysis)
Meta-Analysis
CLINICAL RELEVANCE
The literature reviewed suggests that airborne particle abrasion has no negative effects on the bond strength of resin-based materials to dentin and that a positive influence on dentin bond strength was only achieved in specific air-abrasion conditions.
SUMMARY
In this systematic review the authors investigated how airborne-particle abrasion (APA) using aluminum oxide affects the bond strength of resin-based materials to dentin. The search was performed in three databases. In vitro studies (Type of study) comparing the bond strength of resin-based materials (Outcome) to air-abraded (Intervention) compared with non-air-abraded (Comparison) human dentin (Population) were included (the PICOT elements are given parenthetically). From 5437 unique articles, 65 were read in full, 33 were included in the qualitative synthesis, and 32 were included in the meta-analysis. Methodologic quality and risk of bias were assessed. Comparisons were performed between air-abraded and control dentin groups by adopting a random-effects model (α=0.05). Additional analyses were carried out for the different parameters used in APA: type of surface treatment in the control group, particle size, air pressure, and APA duration. The bond strength to air-abraded dentin was favored only when the control surface was treated with a hand excavator. For particle size, APA was favored when the particle size was >30 μm and the controls were no treatment or hand excavator or when the particle size was ≤30 μm and the control was bur. In addition, the results favored air-abraded groups only when the pressure was > 5 bar and bur was used in the control group. No significant differences were observed for duration of APA. No comparison on bond strength considering the presence of aging conditions was possible in the included studies due to the low number of studies that aged the specimens. In conclusion, APA had no negative effects on the bond strength of resin-based materials to dentin and was able to improve the dentin bond strength only when the particle size was > 30 μm and air pressure was > 5 bar. PROSPERO registration protocol: CRD42018096128.
Topics: Aged; Aluminum Oxide; Composite Resins; Dental Bonding; Dentin; Humans; Materials Testing; Resin Cements; Shear Strength; Surface Properties
PubMed: 32926155
DOI: 10.2341/19-216-L -
Transsulfuration and folate pathways in rheumatoid arthritis: A systematic review and meta-analysis.European Journal of Clinical... Apr 2024Metabolomic assessment of the transsulfuration and folic acid biochemical pathways could lead to the identification of promising biomarkers of nitric oxide dysregulation... (Meta-Analysis)
Meta-Analysis Review
BACKGROUND
Metabolomic assessment of the transsulfuration and folic acid biochemical pathways could lead to the identification of promising biomarkers of nitric oxide dysregulation and oxidative stress in rheumatoid arthritis (RA).
METHODS
We conducted a systematic review and meta-analysis of transsulfuration (methionine, homocysteine, and cysteine) and folic acid (folic acid, vitamin B , and vitamin B ) metabolites in RA patients in remission and healthy controls. Electronic databases were searched from inception to 15 July 2023 for relevant articles. We assessed the risk of bias using the JBI checklist and the certainty of evidence using GRADE.
RESULTS
In 28 eligible studies, compared to controls, RA patients had significantly higher concentrations of homocysteine (standardized mean difference, SMD = 0.74, 95% CI 0.54-0.93, p < 0.001; low certainty of evidence) and methionine (SMD = 1.00, 95% CI 0.57-1.44, p < 0.001; low certainty) and lower concentrations of vitamin B (SMD = -6.62, 95% CI -9.65 to -3.60, p < 0.001; low certainty). By contrast, there were non-significant between-group differences in vitamin B and folic acid. In meta-regression and subgroup analysis, there were no associations between the effect size and several study and patient characteristics except for homocysteine (year of publication, C-reactive protein, triglycerides, and analytical method) and folic acid (biological matrix).
CONCLUSIONS
The results of our study suggest that homocysteine, methionine, and vitamin B are promising biomarkers to assess nitric oxide dysregulation and oxidative stress in RA. (PROSPERO registration number: CRD42023461081).
Topics: Humans; Folic Acid; Nitric Oxide; Vitamin B 12; Vitamin B 6; Methionine; Vitamins; Arthritis, Rheumatoid; Biomarkers; Homocysteine
PubMed: 38214126
DOI: 10.1111/eci.14158 -
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 -
Yeast (Chichester, England) Jun 2022The plant phyllosphere is one of the largest sources of microorganisms, including yeasts. In bromeliads, the knowledge of yeasts is dispersed and still incipient. To... (Review)
Review
The plant phyllosphere is one of the largest sources of microorganisms, including yeasts. In bromeliads, the knowledge of yeasts is dispersed and still incipient. To understand the extent of our knowledge of the subject, this review proposes to compile and synthesize existing knowledge, elucidating possible patterns, biotechnological and taxonomic potentials, bringing to light new knowledge, and identifying information gaps. For such, we systematically review scientific production on yeasts in bromeliads using various databases. The results indicated that the plant compartments flowers, fruits, leaves, and water tank (phytotelma) have been studied when focusing on the yeast community in the bromeliad phyllosphere. More than 180 species of yeasts and yeast-like fungi were recorded from the phyllosphere, 70% were exclusively found in one of these four compartments and only 2% were shared among all. In addition, most of the community had a low frequency of occurrence, and approximately half of the species had a single record. Variables such as bromeliad subfamilies and functional types, as well as plant compartments, were statistically significant, though inconclusive and with low explanatory power. At least 50 yeast species with some biotechnological potentials have been isolated from bromeliads. More than 90% of these species were able to produce extracellular enzymes. In addition, other biotechnological applications have also been recorded. Moreover, new species have been described, though yeasts were only exploited in approximately 1% of the existing bromeliads species, which highlights that there is still much to be explored. Nevertheless, it appears that we are still far from recovering the completeness of the diversity of yeasts in this host. Furthermore, bromeliads proved to be a good ecological model for prospecting new yeasts and for studies on the interaction between plants and yeasts. In addition, the yeast community diverged among plant compartments, establishing bromeliads as a microbiologically complex and heterogeneous mosaic.
Topics: Bromeliaceae; Flowers; Plants; Water; Yeasts
PubMed: 35715939
DOI: 10.1002/yea.3804 -
CJEM Jun 2023The objective of this study was to synthesize indication-based evidence for NO for distress and pain in children. (Meta-Analysis)
Meta-Analysis
OBJECTIVES
The objective of this study was to synthesize indication-based evidence for NO for distress and pain in children.
STUDY DESIGN
We included trials of NO in participants 0-21 years, reporting distress or pain for emergency department procedures. The primary outcome was procedural distress. Where meta-analysis was not possible, we used Tricco et al.'s classification of "neutral" (p ≥ 0.05), "favorable," or "unfavorable" (p < 0.05, supporting NO or comparator, respectively). We used the Cochrane Collaboration's Risk of Bias tool and the Grading of Recommendations Assessment, Development, and Evaluation system to evaluate risk of bias and quality of evidence, respectively.
RESULTS
We included 30 trials. For pain using the Visual Analog Scale (0-100 mm) during IV insertion, 70% NO (delta:-16.5; 95%CI:-28.6 to -4.4; p = 0.008; three trials; I = 0%) and 50% NO plus eutectic mixture of local anesthetics (EMLA) (delta:-1.2; 95%CI:-2.1 to -0.3; p = 0.007; two trials; I = 43%) were superior to EMLA. 50% NO was not superior to EMLA (delta:-0.4; 95%CI:-1.2 to 0.3; p = 0.26; two trials; I = 15%). For distress and pain during laceration repair, NO was "favorable" versus each of SC lidocaine, oxygen, and oral midazolam but "neutral" versus IV ketamine (five trials). For distress and pain during fracture reduction (three trials), NO was "neutral" versus each of IM meperidine plus promethazine, regional anesthesia, and IV ketamine plus midazolam. For distress and pain during lumbar puncture (one trial), NO was "favorable" versus oxygen. For distress and pain during urethral catheterization (one trial), NO was "neutral" versus oral midazolam. For pain during intramuscular injection (one trial), NO plus EMLA was "favorable" versus NO and EMLA alone. Common adverse effects of NO included nausea (4.4%), agitation (3.7%), and vomiting (3.6%) AEs were less frequent with NO alone (278/1147 (24.2%)) versus NO plus midazolam (48/52 (92.3%)) and NO plus fentanyl (123/201 (61.2%)).
CONCLUSIONS
There is sufficient evidence to recommend NO plus topical anesthetic for IV insertion and laceration repair. Adverse effects are greater when combined with other sedating agents.
Topics: Child; Adolescent; Humans; Nitrous Oxide; Midazolam; Ketamine; Lacerations; Pain; Anesthetics, Local; Lidocaine, Prilocaine Drug Combination; Oxygen
PubMed: 37171705
DOI: 10.1007/s43678-023-00507-0 -
Phytomedicine : International Journal... Dec 2022Melanin plays an important role in protecting human skin, while excessive synthesis of melanin can cause abnormal pigmentation and induce skin diseases. Long-term use of... (Review)
Review
BACKGROUND
Melanin plays an important role in protecting human skin, while excessive synthesis of melanin can cause abnormal pigmentation and induce skin diseases. Long-term use of commercial whitening agents in managing skin melanin such as kojic acid and arbutin can lead to some negative effects such as dermatitis and liver cancer. Although past studies have researched the melanin inhibitory effect of plant extracts, the effective dose and mechanisms are not well summarized and discussed. This study aims to explore the melanin inhibitory property of phytochemicals and tries to answer the following research questions: (1) Which plant extracts and phytochemicals could inhibit melanin biosynthesis in the skin? what is the mechanism of action? (2) Have human trials been conducted to confirm their melanin inhibitory effect? (3) If not, which phytochemicals are recommended for further human trials? This article would provide information for future research to develop natural and safe skin whitening products.
METHODS
A preferred reporting items for systematic reviews and meta-analyses (PRISMA) systematic review method and OHAT risk-of-bias tool were applied to screen literature from 2000 to 2021 and 50 research articles met the selection criteria.
RESULTS
Flavonoids, phenolic acids, stilbenes and terpenes are main classes of phytochemicals responsible for the melanin inhibitory effects. The in vitro/in vivo melanin inhibitory effects of these plant extracts/phytochemicals are achieved via three main mechanisms: (1) the ethyl acetate extract of Oryza sativa Indica cv., and phytochemicals such as galangin and origanoside could manage melanin biosynthesis through competitive inhibition, non-competitive inhibition or mixed-type inhibition of tyrosinase; (2) phytochemicals such as ginsenoside F1, ginsenoside Rb1 and 4‑hydroxy-3-methoxycinnamaldehyde could inhibit melanogenesis through down-regulating microphthalmia-related transcription factor (MITF) gene expression via different signalling pathways; (3) the ethanolic extracts of Dimorphandra gardneriana, Dimorphandra gardneriana, Lippia microphylla and Schinus terebinthifolius have a good ultraviolet absorption ability and high sun protective factor (SPF) values, thereby inhibiting UV induced melanogenesis in the skin.
CONCLUSION
Although many plant extracts and phytochemicals have been found to inhibit melanin production, most of the results were only proved in cellular and/or animal models. Only the ethyl acetate extract of Oryza sativa Indica cv. panicle, and ginsenoside F1 were proved effective in human trials. Animal studies proved the effectiveness of galangin, origanoside, ginsenoside Rb1 and 4‑hydroxy-3-methoxycinnamaldehyde with effective dose below 3 mM, and therefore recommended for future human trial. In addition, cellular studies have demonstrated the effectiveness of oxyresveratrol, mulberroside A, kurarinol, kuraridinol, plumbagin, (6aR,11aR)-3,8-dihydroxy-9‑methoxy pterocarpan, ginsenoside Rh4, cardamonin, nobiletin, curcumin, β-mangostin and emodin in inhibiting melanin synthesis at low concentrations of 20 µM and proved the low SPF values of Dimorphandra gardneriana, Dimorphandra gardneriana, Lippia microphylla and Schinus terebinthifolius extracts, and therefore recommended for further animal and human trials.
Topics: Acetates; Acrolein; Animals; Arbutin; Bleaching Agents; Cell Line, Tumor; Curcumin; Emodin; Flavonoids; Ginsenosides; Glucosides; Humans; Hydroxybenzoates; Melanins; Microphthalmia-Associated Transcription Factor; Monophenol Monooxygenase; Phytochemicals; Plant Extracts; Pterocarpans; Stilbenes; Transcription Factors
PubMed: 36126406
DOI: 10.1016/j.phymed.2022.154449 -
International Journal of Environmental... Apr 2020: We conducted this systematic review and meta-analysis to address the crucial public health issue of the suspected association between air pollution exposure during... (Meta-Analysis)
Meta-Analysis
: We conducted this systematic review and meta-analysis to address the crucial public health issue of the suspected association between air pollution exposure during pregnancy and the risk of infant mortality. : We searched on MEDLINE databases among articles published until February, 2019 for case-control, cohort, and ecological studies assessing the association between maternal exposure to Nitrogen Dioxide (NO) or Particular matter (PM) and the risk of infant mortality including infant, neonatal, and post-neonatal mortality for all-and specific-causes as well. Study-specific risk estimates were pooled according to random-effect and fixed-effect models. : Twenty-four articles were included in the systematic review and 14 of the studies were taken into account in the meta-analysis. We conducted the meta-analysis for six combinations of air pollutants and infant death when at least four studies were available for the same combination. Our systematic review has revealed that the majority of studies concluded that death risk increased with increased exposure to air pollution including PM, PM, and NO. Our meta-analysis confirms that the risk of post-neonatal mortality all-causes for short-term exposure to PM increased significantly (pooled-OR = 1.013, 95% CI (1.002, 1.025). When focusing on respiratory-causes, the risk of post-neonatal death related to long-term exposure to PM reached a pooled-OR = 1.134, 95% CI (1.011, 1.271). Regarding Sudden Infant Death Syndrome (SIDS), the risk also increased significantly: pooled-OR = 1.045, 95% CI (1.01, 1.08) per 10 µg/m), but no specific gestational windows of exposure were identified. : In spite of a few number of epidemiological studies selected in the present literature review, our finding is in favor of a significant increase of infant death with the increase of air pollution exposure during either the pregnancy period or the first year of a newborn's life. Our findings have to be interpreted with caution due to weaknesses that could affect the strength of the associations and then the formulation of accurate conclusions. Future studies are called to overcome these limitations; in particular, (i) the definition of infant adverse outcome, (ii) exposure assessment, and (iii) critical windows of exposure, which could affect the strength of association.
Topics: Air Pollutants; Air Pollution; Environmental Exposure; Humans; Infant; Infant Mortality; Infant, Newborn; Nitrogen Dioxide; Particulate Matter
PubMed: 32290393
DOI: 10.3390/ijerph17082623 -
Indoor Air Nov 2022Many working activities are carried out in office buildings that are located in urban areas. Several studies have shown that these workplaces are likely to present poor... (Review)
Review
Many working activities are carried out in office buildings that are located in urban areas. Several studies have shown that these workplaces are likely to present poor indoor environmental quality (IEQ) due to inadequate ventilation rates, compromised thermal comfort conditions, and/or high concentration of air pollutants, such as particulate matter. This study aimed to review ventilation conditions, based on carbon dioxide (CO ) concentrations, and indoor airborne particulate matter (PM and PM ) levels assessed in offices worldwide. The approach carried out in this work followed Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. Six databases (Scopus, Web of Science, PubMed, Inspec, Science Direct, and Dimensions) were used to search for peer-reviewed articles on the subject of IEQ, in particular, those reporting data for the levels of CO and particulate matter in offices, published during the last decade. Firstly, 394 records were identified, resulting in 23 articles included in the review after the screening process and the implementation of eligibility criteria. Based on the results and considering the mean concentration reported, office environments present, in general, acceptable ventilation conditions (mean: 665 ppm). However, the few cases of studies that reported CO values exceeding 1000 ppm identified situations of high occupancy density and inadequate operation of heating, ventilation, and air conditioning (HVAC) systems as the unequivocal causative factors. In turn, PM and PM seemed to be IEQ parameters that are even more critical to be tackled in offices, with the reported overall mean values (36 and 63 μg/m ) exceeding the current World Health Organization (WHO) guidelines (15 and 45 μg/m ). The highest aerosol concentrations were typically found in naturally ventilated buildings and were mostly associated with the influence of high levels of particles introduced indoors through the outdoor air. Overall, measures for improving IEQ in offices toward promoting healthy and safe environments for workers include strategies to periodically control IEQ, ensure the adequate percentage of fresh air and maintenance of the mechanical ventilation systems (operation, maintenance, and air filtration efficiency), and adjust occupancy to the room dimensions and ventilation conditions.
Topics: Humans; Particulate Matter; Air Pollution, Indoor; Carbon Dioxide; Ventilation; Air Pollutants
PubMed: 36437647
DOI: 10.1111/ina.13148 -
Journal of Hazardous Materials Jun 2022Organic phosphorus flame retardants (OPFRs), as a new type of emerging contaminant, have drawn great attention over the last few years, due to their wide distribution in... (Review)
Review
Organic phosphorus flame retardants (OPFRs), as a new type of emerging contaminant, have drawn great attention over the last few years, due to their wide distribution in aquatic environments and potential toxicities to humans and living beings. Various treatment methods have been reported to remove OPFRs from water or wastewater. In this review, the performances and mechanisms for OPFRs removal with different methods including adsorption, oxidation, reduction and biological techniques are overviewed and discussed. Each technique possesses its advantage and limitation, which is compared in the paper. The degradation pathways of typical OPFRs pollutants, such as Cl-OPFRs, alkyl OPFRs and aryl OPFRs, are also reviewed and compared. The degradation of those OPFRs depends heavily upon their structures and properties. Furthermore, the implications and future perspectives in such area are discussed. The review may help identify the research priorities for OPFRs remediation and understand the fate of OPFRs during the treatment processes.
Topics: Environmental Pollutants; Flame Retardants; Humans; Organophosphates; Phosphorus; Water
PubMed: 35217347
DOI: 10.1016/j.jhazmat.2022.128517