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Journal of Neurology May 2021Anticoagulant therapy increases the risk that cerebral microbleeds (CMBs) progress to intracerebral hemorrhage, but whether the therapy increases risk of CMB occurrence... (Meta-Analysis)
Meta-Analysis Review
BACKGROUND
Anticoagulant therapy increases the risk that cerebral microbleeds (CMBs) progress to intracerebral hemorrhage, but whether the therapy increases risk of CMB occurrence is unclear. We performed a systematic review and meta-analysis to investigate the potential association between anticoagulant use and CMB occurrence in stroke and stroke-free individuals.
METHODS
We searched observational studies in PubMed, Ovid EMBASE, and Cochrane Library from their inception until September 2019. We calculated the pooled odds ratio (OR) and 95% confidence interval (CI) for the prevalence and incidence of CMBs in anticoagulant users relative to non-anticoagulant users.
RESULTS
Forty-seven studies with 25,245 participants were included. The pooled analysis showed that anticoagulant use was associated with CMB prevalence (OR 1.54, 95% CI 1.26-1.88). The association was observed in subgroups stratified by type of participants: stroke-free, OR 1.86, 95% CI 1.25-2.77; ischemic stroke/transient ischemic attack, OR 1.33, 95% CI 1.06-1.67; and intracerebral hemorrhage, OR 2.26, 95% CI 1.06-4.83. Anticoagulant use was associated with increased prevalence of strictly lobar CMBs (OR 1.68, 95% CI 1.22-2.32) but not deep/infratentorial CMBs. Warfarin was associated with increased CMB prevalence (OR 1.64, 95% CI 1.23-2.18), but novel oral anticoagulants were not. Anticoagulant users showed higher incidence of CMBs during long-term follow-up (OR 1.72, 95% CI 1.22-2.44).
CONCLUSION
Anticoagulant use is associated with higher prevalence and incidence of CMBs. This association appears to depend on location of CMBs and type of anticoagulants. More longitudinal investigations with adjustment for confounders are required to establish the causality.
Topics: Anticoagulants; Cerebral Hemorrhage; Humans; Ischemic Attack, Transient; Magnetic Resonance Imaging; Risk Factors; Stroke; Warfarin
PubMed: 31616992
DOI: 10.1007/s00415-019-09572-x -
International Journal of Environmental... Jul 2022Despite the fact that several cases of unsafe pesticide use among farmers in different parts of Africa have been documented, there is limited evidence regarding which... (Review)
Review
Despite the fact that several cases of unsafe pesticide use among farmers in different parts of Africa have been documented, there is limited evidence regarding which specific interventions are effective in reducing pesticide exposure and associated risks to human health and ecology. The overall goal of the African Pesticide Intervention Project (APsent) study is to better understand ongoing research and public health activities related to interventions in Africa through the implementation of suitable target-specific situations or use contexts. A systematic review of the scientific literature on pesticide intervention studies with a focus on Africa was conducted. This was followed by a qualitative survey among stakeholders involved in pesticide research or management in the African region to learn about barriers to and promoters of successful interventions. The project was concluded with an international workshop in November 2021, where a broad range of topics relevant to occupational and environmental health risks were discussed such as acute poisoning, street pesticides, switching to alternatives, or disposal of empty pesticide containers. Key areas of improvement identified were training on pesticide usage techniques, research on the effectiveness of interventions targeted at exposure reduction and/or behavioral changes, awareness raising, implementation of adequate policies, and enforcement of regulations and processes.
Topics: Agriculture; Farmers; Health Knowledge, Attitudes, Practice; Humans; Occupational Exposure; Pesticides
PubMed: 35897345
DOI: 10.3390/ijerph19158973 -
Environmental Research Feb 2023Endocrine disrupting chemicals (EDCs) are exogenous substances recognised as relevant tumourigenic chemicals. Studies show that even EDCs which were long abolished are... (Review)
Review
INTRODUCTION
Endocrine disrupting chemicals (EDCs) are exogenous substances recognised as relevant tumourigenic chemicals. Studies show that even EDCs which were long abolished are still contributing to the increasing incidence of neoplasia.
AIM
To investigate the association between human exposure to EDCs and the risk of endocrine-related tumours: breast, prostate, thyroid, uterus, testis, and ovary.
METHODS
A systematic review using PubMed, Scopus, and Embase was conducted, searching for original observational studies published between 1980 and 2020, approaching EDCs exposure and endocrine tumourigenic risk in humans. We comprised neoplasia of six endocrine organs. We included all the studies on EDCs reporting tumour odds ratio, risk ratio, or hazard ratio. Study levels of confidence and risk of bias were accessed applying accredited guidelines. Human-made accidents and natural EDCs were not considered in the present study.
RESULTS
Our search returned 3271 papers. After duplicate removal and screening, only 237 papers were included (corresponding to 268 records). EDCs were grouped from the most frequently (pesticides) to the least frequently studied (salts). The most tumourigenic EDC groups were phthalates (63%), heavy metals (54%), particulate matter (47%), and pesticides (46%). Pesticides group comprised the highest number of retrieved studies (n = 133). Increased neoplasia risk was found in 43-67% of the studies, with a lower value for ovary (43%) and a higher value for thyroid (67%).
CONCLUSIONS
The innovative nature of our review comes from including human studies of six endocrine-related neoplasia aiming to understand the contribution of specific EDCs groups to each organ's tumourigenesis. Thyroid was the organ presenting the highest cancer risk after EDC exposure which may explain the increasing thyroid cancer incidence. However, detailed and controlled works reporting the effects of EDCs are scarce, probably justifying conflicting results. Multinational and multicentric human studies with biochemical analysis are needed to achieve stronger and concordant evidence.
Topics: Male; Female; Humans; Endocrine Disruptors; Endocrine System; Pesticides; Testis; Metals, Heavy
PubMed: 36460069
DOI: 10.1016/j.envres.2022.114869 -
European Journal of Ophthalmology Nov 2022Radiation optic neuropathy (RON) generally follows radiation therapy that exceed 50 Gy to the visual axis and occurs within three years of therapy. Currently, there are... (Meta-Analysis)
Meta-Analysis Review
PURPOSE
Radiation optic neuropathy (RON) generally follows radiation therapy that exceed 50 Gy to the visual axis and occurs within three years of therapy. Currently, there are no universally accepted treatments or prophylaxis for RON. The review aimed to examine the efficacy of all treatments and prophylaxis for RON.
METHODS
MEDLINE, Embase, the Cochrane Library, and gray literature were searched to December 2020. Studies on treatment(s) and/or prophylaxis of RON were included. Results were meta-analyzed using a random-effects model. Primary outcomes included the proportions of patients who experienced improvement, no change, or worsening of visual acuity (VA) for each treatment. Secondary outcome was the incidence of RON for studies on prophylaxis.
RESULTS
Overall, 50 studies (n = 5397) were included. Meta-analysis (n = 1752) showed significantly lower incidence of RON in patients who underwent intravitreal anti-VEGF prophylaxis compared to control (RR 0.64, 95%CI [0.48, 0.86]) for uveal melanoma. Intravitreal anti-VEGF injections (n = 68), hyperbaric oxygen therapy alone (n = 14), and pentoxifylline (n = 5) resulted in improved or stable vision ≤1 logMAR in 54.5%, 42.9%, and 40.0% of patients, respectively. Systemic corticosteroids (n = 82), anticoagulants (n = 12), and systemic bevacizumab (n = 7) showed improved or stable vision ≤1 logMAR in 17.1%, 33.3%, and 14.3% of patients, respectively. Overall risk of bias was low, but evidence was limited to retrospective studies.
CONCLUSION
Intravitreal anti-VEGF injections reduced incidence of RON in irradiated uveal melanoma patients. Systemic corticosteroids, systemic bevacizumab, and warfarin alone are likely ineffective treatments. Early hyperbaric oxygen therapy and intravitreal anti-VEGF injections were most effective among those investigated and require further investigation.
Topics: Adrenal Cortex Hormones; Angiogenesis Inhibitors; Anticoagulants; Bevacizumab; Humans; Intravitreal Injections; Melanoma; Optic Nerve Diseases; Pentoxifylline; Ranibizumab; Retrospective Studies; Uveal Neoplasms; Vascular Endothelial Growth Factor A; Warfarin
PubMed: 35262423
DOI: 10.1177/11206721221085409 -
Reviews on Environmental Health Jun 2023Most agricultural products are exposed to pesticides. Organochlorine (OCPs) insecticides have been banned for years due to their persistence in the environment and... (Review)
Review
Most agricultural products are exposed to pesticides. Organochlorine (OCPs) insecticides have been banned for years due to their persistence in the environment and lipophilic properties. On the other hand, some carcinogenic organophosphates are used in high amounts. Therefore, this systematic review was performed with the keywords; pesticide, carcinogenic, carcinogen, residue, contamination, pollution, and food to determine the type of food and pesticide. 663 manuscripts were found by searching in databases. After initial screening and quality assessment of full text, 26 manuscripts were selected. In this study, by reviewing selected manuscripts, about 13 pesticides were associated with carcinogenic effects. These pesticides were Chlorothalonil, Glyphosate, Tetrachlorvinphos, Parathion, Malathion, Diazinon, heptachlor, Hexachlorobenzene, aldrin, dieldrin, DDT, chlordane, Lindane. Most of these pesticides were organochlorine. The organochlorine pesticides are primarily detected in foods of animal origin. In some studies, the amount of carcinogenic organochlorine was higher than the permissible levels. From the carcinogenic herbicide, Glyphosate. An important finding of this systematic review is that carcinogenic organochlorines are still a threat to cancer incidence.
PubMed: 37272608
DOI: 10.1515/reveh-2022-0253 -
International Journal of Hygiene and... Jan 2022Experimental evidence suggests that p,p'-DDE might be involved in the development of diabetes and hypertension (HTN); however, the evidence in humans is inconclusive. (Meta-Analysis)
Meta-Analysis Review
BACKGROUND
Experimental evidence suggests that p,p'-DDE might be involved in the development of diabetes and hypertension (HTN); however, the evidence in humans is inconclusive.
OBJECTIVE
To summarize the epidemiological evidence for the association of p,p'-DDT exposure and its breakdown products with the risk of diabetes and HTN from prospective studies.
METHODS
We performed a systematic review and meta-analysis based on the Preferred Reporting Items for Systematic Reviews and Meta-analyses (PRISMA) statement. Eligible studies (prospective) were search in PubMed, Web of Science, EBSCO, and SciELO databases (July 11, 2020). Different search algorithms were used for diabetes and HTN. Pooled odds ratios (ORs) were estimated from meta-analysis with random effects for each exposure and outcome.
RESULTS
A total of 23 prospective studies were included in this review, 16 assessed diabetes and seven HTN; very few measured p,p'-DDT. Exposure to p,p'-DDE was associated with a slightly increased risk of type 2 diabetes (T2D) (pooled OR = 1.44; 95%CI: 1.00, 2.07; p = 0.049) and HTN (pooled OR = 1.21; 95%CI: 1.07, 1.38). Dose-response meta-analysis suggested a non-linear relation between p,p'-DDE and T2D. Exposure to p,p'-DDE was not associated with gestational diabetes (pooled OR = 1.01; 95%CI: 0.94, 1.09); similarly, p,p'-DDT was not associated with T2D (pooled OR = 1.03; 95%CI: 0.79, 1.35).
CONCLUSIONS
Evidence from prospective studies suggests that exposure to p,p'-DDE, the main breakdown product of p,p'-DDT, might increase the risk of developing T2D; such increase may be apparent only at low levels. Exposure to p,p'-DDE may also increase the risk of having HTN; however, further evidence is required.
Topics: DDT; Diabetes Mellitus, Type 2; Dichlorodiphenyl Dichloroethylene; Humans; Hypertension; Pesticides; Prospective Studies
PubMed: 34700204
DOI: 10.1016/j.ijheh.2021.113865 -
The association between pesticide use and cutaneous melanoma: a systematic review and meta-analysis.Journal of the European Academy of... Apr 2020The incidence of cutaneous melanoma (CM), the deadliest form of skin cancer, has gradually increased in the last decades among populations of European origin.... (Meta-Analysis)
Meta-Analysis
BACKGROUND
The incidence of cutaneous melanoma (CM), the deadliest form of skin cancer, has gradually increased in the last decades among populations of European origin. Epidemiological studies suggested that farmers and agricultural workers are at an increased risk of CM because they were exposed to pesticides. However, little is known about the relationship between pesticides and CM.
OBJECTIVES
To investigate the association between exposure to pesticides and CM by systematically reviewing the literature. Secondary aim was to determine the categories of pesticides mainly involved in CM development.
METHODS
A systematic review of the literature was performed up to September 2018 using MEDLINE, Embase and Web of Science. Studies assessing CM risk in licensed pesticide applicators were considered. Strict criteria were established to select independent studies and risk estimates; random effect models, taking into account heterogeneity, were applied. A pooled risk estimate for CM was calculated for the use of each type of pesticide and type of exposure. Between-study and estimate heterogeneity was assessed and publication bias investigated.
RESULTS
A total of nine studies (two case-controls and seven cohorts) comprising 184 389 unique subjects were included. The summary relative risks for the categories 'herbicides - ever exposure', 'insecticides - ever exposure', 'any pesticide - ever exposure' and 'any pesticide - high exposure' resulted 1.85 [95% confidence interval (CI): 1.01, 3.36], 1.57 (95% CI: 0.58, 4.25), 1.31 (95% CI: 0.85, 2.04) and 2.17 (95% CI: 0.45, 10.36), respectively. Herbicides and insecticides had no between-study heterogeneity (I = 0%), while a significant heterogeneity (I > 50%) was detected for the high exposure to any pesticide. No indication for publication bias was found.
CONCLUSIONS
Individuals exposed to herbicides are at an increased risk of CM. Future properly designed observational studies are required to confirm this finding.
Topics: Humans; Melanoma; Occupational Diseases; Occupational Exposure; Pesticides; Skin Neoplasms; Melanoma, Cutaneous Malignant
PubMed: 31541557
DOI: 10.1111/jdv.15964 -
Journal of Hazardous Materials Apr 2022Fumigants have been used for decades to control soil-borne pathogens of high-value crops, and increasing evidence indicates they can affect non-target soil microbial... (Review)
Review
Fumigants have been used for decades to control soil-borne pathogens of high-value crops, and increasing evidence indicates they can affect non-target soil microbial communities. Understanding the impacts of these products on soil microorganisms is of critical importance not only for evaluating their environmental safety, but also because soil microbial communities have a central role in soil quality and nutrient cycling, plant growth, and crop production. Thus, we conducted a systematic review and metanalysis study of fumigant impacts on non-target soil microorganisms. In general, we found that fumigation decreases the bacterial diversity and abundance of total bacteria and nitrogen-cycling genes by approximately 10-50% during the first four weeks after application compared to non-treated soils. These decreases appear transient and tend to diminish or disappear after four weeks. Increases in bacterial diversity and abundance can occur after fumigation but are less common. Fumigant application can also alter bacterial community composition during the first six weeks after treatment by significantly increasing and/or decreasing the relative abundance of bacterial taxa involved in key soil functions such as N-cycling and plant-growth promotion. Knowledge gaps and areas where future research efforts should be prioritized to improve our understanding of the impact of organic fumigants on non-target soil microorganisms are discussed.
Topics: Fumigation; Nitrogen Cycle; Pesticides; Soil; Soil Microbiology
PubMed: 34999405
DOI: 10.1016/j.jhazmat.2021.128149 -
Global Public Health Dec 2022The increase in pesticide consumption has a negative health impact. Studies point to an association between exposure to pesticides and cardiovascular disease (CVD), one...
The increase in pesticide consumption has a negative health impact. Studies point to an association between exposure to pesticides and cardiovascular disease (CVD), one of the leading causes of world mortality. This review synthesize evidence on the association between occupational exposure and environmental contamination by pesticides with CVDs from 1750 references databases (EBSCO, Medline, Science Direct, Scielo, Lilacs and Ovid) without date or language restriction. Selected 24 articles by PRISMA and Downs & Black methodologies, were included from inclusion criteria: original studies (case-control, cohort or cross-sectional design); clear CVD definition and exposure to pesticides; representative sample of the target population. The results show the occupational exposure to pesticides chlorpyrifos, coumafos, carbofuran, ethylene bromide, mancozeb, ziram, metalaxyl, pendimethalin and trifluralin was associated a risk of 1.8 to 3.2 for acute myocardial infarction. Primaphos, fenitrothion, malathion and deltamethrin pesticides were associated with a blood pressure increase. Environmental contamination by tetrachlorodibenzo-p-dioxin was associated with CVD with risk of 1.09 to 2.78 and organochlorine, 1.19 to 4.54; heavy metals, arsenic, trimethylarsine and dimethylarsinic acid with atherosclerosis and systemic arterial hypertension. These findings point to the association between exposure to pesticides and CVD, signaling the importance of greater rigor in the public policy related to pesticides.
Topics: Humans; Pesticides; Environmental Exposure; Cardiovascular Diseases; Cross-Sectional Studies; Occupational Exposure
PubMed: 32816635
DOI: 10.1080/17441692.2020.1808693 -
International Archives of Occupational... Jan 2023Human health risk assessments of glyphosate have focused on animal toxicology data for determining neurotoxic potential. Human epidemiological studies have not yet been... (Review)
Review
PURPOSE
Human health risk assessments of glyphosate have focused on animal toxicology data for determining neurotoxic potential. Human epidemiological studies have not yet been systematically reviewed for glyphosate neurotoxicity hazard identification. The objective of this systematic literature review was to summarize the available epidemiology of glyphosate exposure and neurological outcomes in humans.
METHODS
As of December 2021, 25 eligible epidemiological studies of glyphosate exposure and neurological endpoints were identified and assessed for five quality dimensions using guidance from the U.S. Environmental Protection Agency. Studies that assessed personal use of glyphosate were prioritized, whereas those assessing indirect exposure (other than personal use) were rated as low quality, since biomonitoring data indicate that indirect metrics of glyphosate exposure almost always equate to non-detectable glyphosate doses.
RESULTS
Overall, the scientific evidence on glyphosate and neurotoxicity in humans is sparse and methodologically limited, based on nine included epidemiological studies of neurodegenerative outcomes (two high quality), five studies of neurobehavioral outcomes (two high quality), six studies of neurodevelopmental outcomes (none high quality), and five studies of other and mixed neurological outcomes (one high quality). The five high-quality studies showed no association between glyphosate use and risk of depression, Parkinson disease, or peripheral nerve conduction velocity. Results were mixed among the eight moderate-quality studies, which did not demonstrate consistent associations with any neurological endpoints or categories. Low-quality studies were considered uninformative about possible neurotoxic effects due primarily to questionable assessments of indirect exposure.
CONCLUSIONS
No association has been demonstrated between glyphosate and any neurological outcomes in humans. To move the state of science forward, epidemiological studies should focus on scenarios involving direct and frequent use of glyphosate while collecting information on validated health outcomes, concomitant agricultural exposures, and relevant personal characteristics.
Topics: Animals; Humans; Environmental Exposure; Herbicides; Glycine; Risk Assessment; Neurotoxicity Syndromes; Glyphosate
PubMed: 35604441
DOI: 10.1007/s00420-022-01878-0