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Toxics Feb 2023N-nitroso compounds (NOCs) are a class of chemical carcinogens found in various environmental sources such as food, drinking water, cigarette smoke, the work... (Review)
Review
N-nitroso compounds (NOCs) are a class of chemical carcinogens found in various environmental sources such as food, drinking water, cigarette smoke, the work environment, and the indoor air population. We conducted a systematic review and meta-analysis to investigate the links between nitrate, nitrite, and NOCs in food and water and the risk of gastrointestinal (GI) cancers, including esophageal cancer (EC), gastric cancer (GC), colorectal cancer (CRC), and pancreatic cancer (PC). A systematic search of the literature in Scopus, PubMed, Google Scholar, Web of Science, ScienceDirect, and Embase was performed for studies on the association between NOCs in drinking water and food sources and GI cancers. Forest plots of relative risk (RR) were constructed for all the cancer sites and the intake sources. The random-effects model was used to assess the heterogeneity between studies. Forty articles were included after removing duplicate and irrelevant articles. The meta-analysis indicated that the intake of high dose vs. low dose of these compounds was significantly associated with the overall GI cancer risk and nitrite (RR = 1.18, 95% CI = 1.07-1.29), and N-nitrosodimethylamine (NDMA) (RR = 1.32, 95% CI = 1.06-1.65). We found that dietary nitrite intake increased GC (RR = 1.33, 95% CI = 1.02-1.73), and EC (RR = 1.38, 95% CI = 1.01-1.89). Additionally, dietary NDMA intake increased the risk of CRC (RR = 1.36, 95% CI = 1.18-1.58). This meta-analysis provides some evidence that the intake of dietary and water nitrate, nitrite, and NOCs may be associated with GI cancers. In particular, dietary nitrite is linked to GC and EC risks and dietary NDMA intake is associated with CRC.
PubMed: 36851064
DOI: 10.3390/toxics11020190 -
Environment International May 2014Persistent organic pollutants (POPs) have been used in a wide range of agricultural and industrial commodities, resulting in vigorous deterioration of environment and... (Review)
Review
Persistent organic pollutants (POPs) have been used in a wide range of agricultural and industrial commodities, resulting in vigorous deterioration of environment and human health. A number of studies on the occurrence of POPs confirm their presence in various environmental compartments and human body. In order to deal with this global concern, India has recently prepared the National Implementation Plan (NIP) of the Stockholm Convention. Common beliefs point at India as a hot spot of POP contamination and human exposure; however no systematic analysis was ever performed so far considering all available past data on POP occurrence. This review aims to examine the distribution pattern of POPs in multicompartment environment and human samples, meta-analysis of time trends in exposure levels to environment and humans, and cross country comparison of POP contamination with China. Based on this review, it can be concluded that the Indian environment and human population are highly contaminated by DDTs and HCHs; however scarcity of data on other POPs makes it challenging to assess their nationwide human and environmental exposure. No evidence of a general decline in DDT and HCH residues in the environment and human body come out from the meta-analysis of time trend. While comparing contamination levels between India and China, tendency towards decline in POP contamination is visible in China, unlike India.
Topics: Animals; Aquatic Organisms; Environmental Exposure; Environmental Monitoring; Environmental Pollutants; Geologic Sediments; Humans; India; Organic Chemicals; Water
PubMed: 24525153
DOI: 10.1016/j.envint.2014.01.022 -
Addiction (Abingdon, England) Jul 2016Since its market release, gabapentin has been presumed to have no abuse potential and subsequently has been prescribed widely off-label, despite increasing reports of... (Review)
Review
BACKGROUND AND AIMS
Since its market release, gabapentin has been presumed to have no abuse potential and subsequently has been prescribed widely off-label, despite increasing reports of gabapentin misuse. This review estimates and describes the prevalence and effects of, motivations behind and risk factors for gabapentin misuse, abuse and diversion.
METHODS
Databases were searched for peer-reviewed papers demonstrating gabapentin misuse, characterized by taking a larger dosage than prescribed or taking gabapentin without a prescription, and diversion. All types of studies were considered; grey literature was excluded. Thirty-three papers met inclusion criteria, consisting of 23 case studies and 11 epidemiological reports. Published reports came from the United States, the United Kingdom, Germany, Finland, India, South Africa and France, and two analyzed websites not specific to a particular country.
RESULTS
Prevalence of gabapentin misuse in the general population was reported to be 1%, 40-65% among individuals with prescriptions and between 15 and 22% within populations of people who abuse opioids. An array of subjective experiences reminiscent of opioids, benzodiazepines and psychedelics were reported over a range of doses, including those within clinical recommendations. Gabapentin was misused primarily for recreational purposes, self-medication or intentional self-harm and was misused alone or in combination with other substances, especially opioids, benzodiazepines and/or alcohol. Individuals with histories of drug abuse were most often involved in its misuse.
CONCLUSIONS
Epidemiological and case report evidence suggests that the anti-epileptic and analgesic medication gabapentin is being misused internationally, with substance abuse populations at special risk for misuse/abuse.
Topics: Amines; Analgesics; Cyclohexanecarboxylic Acids; Gabapentin; Humans; Prescription Drug Diversion; Prescription Drug Misuse; Prevalence; Substance-Related Disorders; gamma-Aminobutyric Acid
PubMed: 27265421
DOI: 10.1111/add.13324 -
Toxicology Apr 2023Thyroid cancer incidence has been steadily rising since the 1970s and exposure to environmental pollutants, including persistent organic pollutants such as... (Review)
Review
Thyroid cancer incidence has been steadily rising since the 1970s and exposure to environmental pollutants, including persistent organic pollutants such as 2,3,7,8-tetrachlorodibenzo-p-dioxin (TCDD) and other dioxins, has emerged as a potential explanation for this increase. This study aimed to summarize available human studies on the association between TCDD exposure and thyroid cancer. A systematic review of the literature was performed searching the National Library of Medicine and National Institutes of Health PubMed, Embase, and Scopus databases, through January 2022, using the following keywords: "thyroid", "2,3,7,8-tetrachlorodibenzo-p-dioxin", "TCDD", "dioxin", and "Agent Orange". Six studies were included in this review. Three studies evaluated the acute exposure to the chemical factory accident in Seveso, Italy, and found a non-significant increase in the risk of thyroid cancer. Two studies investigating Agent Orange exposure among United States Vietnam War veterans found a significant risk of thyroid cancer following exposure. No association was found in one study evaluating TCDD exposure through herbicides. The current study highlights the limited information on the potential association between TCDD exposure and thyroid cancer and thus the need for future human studies, especially considering the persistent human exposure to dioxins in the environment.
Topics: Humans; Agent Orange; Dioxins; Environmental Exposure; Herbicides; Polychlorinated Dibenzodioxins; Thyroid Neoplasms; United States
PubMed: 36868552
DOI: 10.1016/j.tox.2023.153474 -
BMJ Open Respiratory Research Feb 2024Mycophenolate mofetil (MMF) and azathioprine (AZA) are immunomodulatory treatments in interstitial lung disease (ILD). This systematic review aimed to evaluate the... (Meta-Analysis)
Meta-Analysis
OBJECTIVES
Mycophenolate mofetil (MMF) and azathioprine (AZA) are immunomodulatory treatments in interstitial lung disease (ILD). This systematic review aimed to evaluate the efficacy of MMF or AZA on pulmonary function in ILD.
DESIGN
Population included any ILD diagnosis, intervention included MMF or AZA treatment, outcome was delta change from baseline in per cent predicted forced vital capacity (%FVC) and gas transfer (diffusion lung capacity of carbon monoxide, %DLco). The primary endpoint compared outcomes relative to placebo comparator, the secondary endpoint assessed outcomes in treated groups only.
ELIGIBILITY CRITERIA
Randomised controlled trials (RCTs) and prospective observational studies were included. No language restrictions were applied. Retrospective studies and studies with high-dose concomitant steroids were excluded.
DATA SYNTHESIS
The systematic search was performed on 9 May. Meta-analyses according to drug and outcome were specified with random effects, I evaluated heterogeneity and Grading of Recommendations, Assessment, Development and Evaluation evaluated certainty of evidence. Primary endpoint analysis was restricted to RCT design, secondary endpoint included subgroup analysis according to prospective observational or RCT design.
RESULTS
A total of 2831 publications were screened, 12 were suitable for quantitative synthesis. Three MMF RCTs were included with no significant effect on the primary endpoints (%FVC 2.94, 95% CI -4.00 to 9.88, I=79.3%; %DLco -2.03, 95% CI -4.38 to 0.32, I=0.0%). An overall 2.03% change from baseline in %FVC (95% CI 0.65 to 3.42, I=0.0%) was observed in MMF, and RCT subgroup summary estimated a 4.42% change from baseline in %DL (95% CI 2.05 to 6.79, I=0.0%). AZA studies were limited. All estimates were considered very low certainty evidence.
CONCLUSIONS
There were limited RCTs of MMF or AZA and their benefit in ILD was of very low certainty. MMF may support preservation of pulmonary function, yet confidence in the effect was weak. To support high certainty evidence, RCTs should be designed to directly assess MMF efficacy in ILD.
PROSPERO REGISTRATION NUMBER
CRD42023423223.
Topics: Humans; Azathioprine; Immunosuppressive Agents; Lung Diseases, Interstitial; Lung; Mycophenolic Acid; Enzyme Inhibitors; Observational Studies as Topic
PubMed: 38413120
DOI: 10.1136/bmjresp-2023-002163 -
Gabapentin and pregabalin in the treatment of fibromyalgia: a systematic review and a meta-analysis.Journal of Clinical Pharmacy and... Dec 2010Fibromyalgia (FBM) is a common chronic pain disorder affecting up to 2% of the general population. Current treatment options are mostly symptom-based and limited both in... (Meta-Analysis)
Meta-Analysis Review
WHAT IS KNOWN AND OBJECTIVES
Fibromyalgia (FBM) is a common chronic pain disorder affecting up to 2% of the general population. Current treatment options are mostly symptom-based and limited both in efficacy and number. Two promising alternatives are gabapentin (GP) and pregabalin (PB). We aimed to estimate the efficacy and safety/tolerability of the two compounds in FBM through a systematic review and a meta-analysis of relevant randomized double-blind placebo-controlled (RCT) were performed.
DATA SOURCES, EXTRACTION AND ANALYSIS
A literature search was conducted through MEDLINE, EMBASE, Cochrane CENTRAL and the reference lists of relevant studies. Responders to treatment (>30% reduction in mean pain score) and dropouts due to lack of efficacy were used as primary outcome measures. Dropout rates and incidence of common adverse outcomes were also investigated. Four RCTs, reporting data on 2040 patients, were reviewed and three of them using PG were included in the meta-analysis.
RESULTS
Pregabalin at a dose of 600, 450 and 300 mg per day is effective in FBM compared to placebo (NNT: 7, upper 95% CI: 12, 450 mg). A number of adverse events (AE), such as dizziness, somnolence, dry mouth, weight gain, peripheral oedema, is consistently associated with treatment at any dose and could lead one out of four patients to quit treatment (NNH: 6, lower 95% CI: 4, 600 mg). Indirect comparison meta-analysis suggests that PB at a dose of 450 mg per day could result in more responders than at 300 mg, but this result needs to be interpreted with caution as there were no significant differences between 600 and 300 mg or between 600 and 450 mg. Data on GP is limited.
WHAT IS NEW AND CONCLUSIONS
The analysis indicates that PB at a dose of 450 mg per day is most likely effective in treating FBM, although AE are not negligible. Further evidence is necessary for more conclusive inferences.
Topics: Amines; Analgesics, Non-Narcotic; Cyclohexanecarboxylic Acids; Dose-Response Relationship, Drug; Female; Fibromyalgia; Gabapentin; Humans; Male; Outcome Assessment, Health Care; Pain; Pregabalin; Randomized Controlled Trials as Topic; Treatment Outcome; gamma-Aminobutyric Acid
PubMed: 21054455
DOI: 10.1111/j.1365-2710.2009.01144.x -
Clinical Laboratory May 2017Recently, the usefulness of thiol/disulfide homeostasis (TDH) in various diseases is being widely investigated. In this mini-review, our aim is to clarify the role of... (Review)
Review
BACKGROUND
Recently, the usefulness of thiol/disulfide homeostasis (TDH) in various diseases is being widely investigated. In this mini-review, our aim is to clarify the role of TDH in clinical practice in the light of current literature.
METHODS
We performed a systematic review of the existing literature describing the clinical utility of TDH in the clinical setting. MEDLINE, EMBASE, and CINAHL were used as data sources. Two reviewers conducted independent screening and data extraction. Use of TDH in each system was investigated separately.
RESULTS
A total of 35 studies were detected in this mini-review. Our results revealed the protective role of TDH and its utility as a diagnostic marker in many common diseases in clinical practice.
CONCLUSIONS
Maintenance of TDH as a crucial part of antioxidant defense system is critical in diagnosis and prognosis of potentially lethal diseases.
Topics: Diagnosis; Disulfides; Homeostasis; Humans; Prognosis; Sulfhydryl Compounds
PubMed: 28627824
DOI: 10.7754/Clin.Lab.2017.161117 -
Phytochemistry Apr 2022Natural products from plants have gained prominence in the search for therapeutic alternatives. Monoterpenes, such as carvone, are suggested as candidates for the... (Review)
Review
Natural products from plants have gained prominence in the search for therapeutic alternatives. Monoterpenes, such as carvone, are suggested as candidates for the treatment of several diseases. Therefore, the objective of this study is to review the pharmacological activities of carvone in experimental models in vitro and in vivo. For this, the searches were carried out in May 2020 (upgraded in July 2021) in the databases of PubMed, Web of Science and Scopus and gathered studies on the pharmacological activities of carvone. Two independent reviewers performed the selection of articles using the Rayyan application, extracted the relevant data and assessed the methodological quality of the selected studies using Syrcle's risk of bias tool. Ninety-one articles were selected that described 10 pharmacological activities of carvone, such as antimicrobial, antispasmodic, anti-inflammatory, antioxidant, antinociceptive, anticonvulsant, among others. The evaluation of the methodological quality presented an uncertain risk of bias for most studies. In light of that, carvone stands out as a viable and promising alternative in the treatment of several pathological conditions. However, carrying out studies to evaluate possible mechanisms of action and the safety of this monoterpene is recommended.
Topics: Anti-Infective Agents; Anti-Inflammatory Agents; Cyclohexane Monoterpenes; Monoterpenes
PubMed: 34999510
DOI: 10.1016/j.phytochem.2021.113080 -
Burns : Journal of the International... Jun 2018Diphoterine is a hypertonic, amphoteric, polyvalent and chelating decontamination solution used in the treatment of cutaneous and ocular chemical burns. Due to...
OBJECTIVE
Diphoterine is a hypertonic, amphoteric, polyvalent and chelating decontamination solution used in the treatment of cutaneous and ocular chemical burns. Due to infrequent use by emergency physicians along with the small number of available studies, its debate in the literature as to its efficacy and safety remains inconclusive.
METHODS
A structured literature search was performed in MEDLINE, EMBASE BIOLOGICAL ABSTRACTS and TOXNET to June 2016 for original English-language studies reporting on the safety and effectiveness of Diphoterine. Methodological and reporting quality of pre-clinical animal studies was assessed using the Systematic Review Centre for Laboratory Animal Experimentation (SYRCLE) risk of bias tool and Animal Research: Reporting of In Vivo Experiments (ARRIVE) guidelines. Clinical studies were assessed using Chambers' criteria.
RESULTS
13 studies (seven in the pre-clinical, five in the clinical setting and one mixed) met the study inclusion criteria. Pre-clinical studies showed a faster resolution of pH and reduced tissue necrosis with Diphoterine. Clinical studies showed reduced tissue necrosis/severity of symptoms, faster pH resolution and a reduction in pain when using Diphoterine. No adverse events were attributable to Diphoterine. Reporting and methodology of the studies was poor or showed a high risk of bias.
CONCLUSIONS
Diphoterine appears to be safe to use and is probably superior to other rinsing solutions. However, immediate decontamination is imperative and if Diphoterine is not available a different rinsing solution should be used. The methodology of the published literature for Diphoterine is generally poor and future publications should use the frameworks given as templates.
Topics: Burns, Chemical; Eye Burns; Humans; Organic Chemicals; Skin
PubMed: 29029860
DOI: 10.1016/j.burns.2017.09.017 -
The Science of the Total Environment Nov 2021The persistent organic pollutants (POPs) are environmentally stable and highly toxic chemicals that accumulate in living adipose tissue and have a very destructive... (Meta-Analysis)
Meta-Analysis
The persistent organic pollutants (POPs) are environmentally stable and highly toxic chemicals that accumulate in living adipose tissue and have a very destructive effect on aquatic ecosystems. To analyze the evolution of the concentration and prevalence of POPs such as α-HCH, β-HCH, γ-HCH, ∑-HCH, Heptachlor, Aldrin, p,p'-DDE, p,p'-DDT, ∑-DDT, and ∑-OCP in water resources, a search between January 01, 1970, to February 10, 2020, was followed using a systematic review and meta-analysis prevalence. Among the 2306 explored articles in the reconnaissance step, 311 articles with 5315 exemplars, 56 countries, and 4 types of water were included in the meta-analysis study. Among all studied POPs, the concentration of p,p'-DDT in water resources was the highest, especially in drinking water resources. The overall rank order based on the concentration and prevalence of POPs were surface water > drinking water > seawater > groundwater. To identify POPs-contaminated areas, the distance from the mean relative to their distribution was considered. The most to the least polluted areas included: South Africa, India, Turkey, Pakistan, Canada, Hong Kong, and China. The highest carcinogenic risk was observed for β-HCH (Turkey and China), followed by α-HCH (Mexico). The highest non-carcinogenic risk was identified for Aldrin (all analyzed countries), followed by Dieldrin (Turkey) and γ-HCH (Mexico). The Monte Carlo analysis (under the assumption that γ-HCH has a normal distribution), the mean obtained was 8.22E-07 for children and 3.83E-07 for adults. This is in accordance with the standard risk assessment approach. In terms of percentiles, the Monte-Carlo approach indicates that 75% of child population is under the 1.07E-06 risk and 95% of adults under 7.35E-06.
Topics: Adult; Child; DDT; Ecosystem; Environmental Monitoring; Humans; Hydrocarbons, Chlorinated; Persistent Organic Pollutants; Risk Assessment; Water
PubMed: 34273825
DOI: 10.1016/j.scitotenv.2021.149000