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Journal of Environmental Health Science... Dec 2023Pollution of the environment with all kinds of plastics has become a growing problem. The problem of microplastics is mainly due to the absorption of stable organic...
PURPOSE
Pollution of the environment with all kinds of plastics has become a growing problem. The problem of microplastics is mainly due to the absorption of stable organic pollutants and metals into them, and as a result, their environmental toxicity increases. The main purpose of this study is to investigate the appropriate and efficient methods of removing microplastics from aqueous environments through a systematic review.
METHODS
Present study designed according to PRISMA guidelines. Two independent researchers followed all process from search to final analysis, for the relevant studies using international databases of PubMed, Scopus and ISI/WOS (Web of Science), without time limit. The search strategy developed based on the main axis of "microplastics", "aqueous environments" and "removal". This research was carried out from 2017 until the March of 2022. All relevant observational, analytical studies, review articles, and a meta-analysis were included.
RESULTS
Through a comprehensive systematic search we found 2974 papers, after running the proses of refining, 80 eligible papers included to the study. According to the results of the review, the methods of removing microplastics from aquatic environments were divided to physical (12), chemical (18), physicochemical (27), biological (12) and integrated (11) methods. In different removal methods, the most dominant group of studied microplastics belonged to the four groups of polyethylene (PE), polystyrene (PS), polypropylene (PP) and polyethylene tetra phthalate (PET). Average removal efficiency of microplastics in different processes in each method was as: physical method (73.76%), chemical method (74.38%), physicochemical method (80.44%), biological method (75.23%) and integrated method (88.63%). The highest removal efficiency occurred in the processes based on the integrated method and the lowest efficiency occurred in the physical method. In total, 80% of the studies were conducted on a laboratory scale, 18.75% on a full scale and 1.25% on a pilot scale.
CONCLUSION
According to the findings; different processes based on physical, chemical, physicochemical, biological and integrated methods are able to remove microplastics with high efficiency from aqueous environments and in order to reduce their hazardous effects on health and environment, these processes can be easily used.
PubMed: 37869596
DOI: 10.1007/s40201-023-00872-z -
Journal of Obstetrics and Gynaecology... Jan 2024Surgical site infections (SSI) are common causes of postoperative morbidity at cesarean delivery (CD). The objective of this study was to compare the risk of SSI and... (Meta-Analysis)
Meta-Analysis Review
OBJECTIVES
Surgical site infections (SSI) are common causes of postoperative morbidity at cesarean delivery (CD). The objective of this study was to compare the risk of SSI and other wound complications associated with different suture materials for subcuticular skin closure at CD.
DATA SOURCES
We searched Cochrane Library, MEDLINE, Embase, and Clinicaltrials.gov from inception to June 3, 2021, and limited our search to English, peer-reviewed, randomized controlled trials and cohort studies.
STUDY SELECTION
Of 1541 titles identified, 4 studies met the selection criteria and were included. Studies were included if the population was pregnant individuals undergoing transverse incision primary or repeat, elective or emergent CD with subcuticular skin closure, and if outcomes related to SSI, wound seroma, hematoma, or dehiscence were reported. We completed the assessment using Covidence review management software.
DATA EXTRACTION AND SYNTHESIS
Two authors independently reviewed studies and assessed the risk of bias using the Cochrane 'Risk of bias' tool for randomized trials (RoB 2.0) and the Cochrane Risk of Bias in Non-Randomized Studies-of Interventions (ROBINS-I) tools for cohort studies. We compared SSI risk and secondary outcomes of hematoma, seroma, and dehiscence between skin closure with monofilament (poliglecaprone 25 or polypropylene) versus multifilament (polyglactin 910) sutures using a fixed-effects meta-analysis. Statistical heterogeneity was estimated using the I statistic. Monofilament sutures were associated with a reduced risk of SSI (RR = 0.71, 95% CI 0.52-0.98, I = 0%) compared to multifilament sutures. There was no difference in the risk of secondary outcomes.
CONCLUSION
Monofilament suture for subcuticular skin closure at CD was associated with decreased risk of SSI compared to multifilament suture.
Topics: Female; Pregnancy; Humans; Surgical Wound Dehiscence; Seroma; Surgical Wound Infection; Polyglactin 910; Sutures; Hematoma; Suture Techniques
PubMed: 37595945
DOI: 10.1016/j.jogc.2023.07.010 -
Aesthetic Plastic Surgery Mar 2024Implant-based breast reconstruction (IBBR) can be performed using a variety of biological and synthetic meshes. However, there has yet to be a consensus on the optimal... (Meta-Analysis)
Meta-Analysis
BACKGROUND
Implant-based breast reconstruction (IBBR) can be performed using a variety of biological and synthetic meshes. However, there has yet to be a consensus on the optimal mesh. This study investigates the safety and patient satisfaction of using TiLOOP® Bra in IBBR and compares its postoperative complication risk with that of porcine acellular dermal matrix (ADM) and SERAGYN® BR.
METHODS
The literature review was performed via PRISMA criteria, 23 studies met the inclusion criteria for the TiLOOP® Bra review, and 5 studies met the inclusion criteria for the meta-analysis. Patient characteristics and per-breast complications were collected. Data were analyzed using Cochrane RevMan and IBM SPSS.
RESULTS
In 3175 breasts of 2685 patients that underwent IBBR using TiLOOP® Bra, rippling was observed as the most common complication, followed by seroma and capsular contracture. No significant difference in the overall complication rate between pre- and sub-pectoral IBBR using TiLOOP® Bra. However, the meta-analysis showed that the TiLOOP® Bra group had significantly lower odds of implant loss, seroma, wound dehiscence, and the need for reoperation or hospitalization than the ADM group. Additionally, the TiLOOP® Bra group had a significantly lower seroma rate compared to the SERAGYN® BR group, while the other outcome indicators were similar between the two groups.
CONCLUSION
TiLOOP® Bra has become increasingly popular in IBBR in recent years. This review and meta-analysis support the favorable safety profile of TiLOOP® Bra reported in the current literature. The meta-analysis revealed that TiLOOP® Bra has better safety than ADM and a comparable risk of complications compared to SERAGYN® BR. However, as most studies had low levels of evidence, further investigations are necessary.
LEVEL OF EVIDENCE III
This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors www.springer.com/00266 .
Topics: Animals; Female; Humans; Acellular Dermis; Breast Implantation; Breast Implants; Breast Neoplasms; Mammaplasty; Polypropylenes; Postoperative Complications; Retrospective Studies; Seroma; Surgical Mesh; Swine; Titanium; Treatment Outcome
PubMed: 37464216
DOI: 10.1007/s00266-023-03500-1 -
European Journal of Obstetrics,... May 2023Synthetic materials have been used for the surgical treatment of stress urinary incontinence (SUI) and pelvic organ prolapse (POP). During the last 25 years, these... (Meta-Analysis)
Meta-Analysis Review
OBJECTIVES
Synthetic materials have been used for the surgical treatment of stress urinary incontinence (SUI) and pelvic organ prolapse (POP). During the last 25 years, these materials were composed mostly of polypropylene (PP), whereas recently the use of polyvinylidene difluoride (PVDF) is of increasing interest due to its characteristics. This study aimed to compare the results after SUI/POP surgery using PVDF versus PP materials by synthesizing the data of relevant existing literature.
STUDY DESIGN
This systematic review and meta-analysis included clinical trials, case-control studies, or cohort studies written in the English language. The search strategy included the electronic databases MEDLINE, EMBASE, and Cochrane, and grey literature (congresses IUGA, EUGA, AUGS, FIGO). All studies have to provide numeric data or odds ratios (OR) of developing a specific outcome in surgeries with PVDF compared with outcomes of other used materials. No restrictions of race or ethnicity were applied, nor chronological restrictions. Exclusion criteria were studies that included patients with cognitive impairment, dementia, stroke, or central nervous system trauma. All studies were screened by two reviewers, initially by title and abstract, and afterward by full text. Disagreements were resolved through mutual consent. All studies were assessed for their quality and bias risk. Data were extracted using a data extraction form formulated in a Microsoft Excel spreadsheet. Our results were divided into studies dealing only with SUI patients, studies dealing only with POP patients, and cumulative analysis of variables expressed in both SUI and POP surgery. The primary outcomes were the rates of post-operative recurrence, mesh erosion, and postoperative pain after surgery with PVDF compared to PP. The secondary outcomes were post-operative sexual dissatisfaction, overall satisfaction rates, hematoma, urinary tract infection, de novo urge incontinence, and reoperation rate.
RESULTS
No differences in the post-operative rates of SUI/POP recurrence, mesh erosion, and pain were found after surgery with PVDF vs surgery with PP. Patients after SUI surgery with PVDF tapes had statistically significant lower rates of de-novo urgency compared to the PP group [OR = 0.38 (0.18, 0.88), p = 0.01]; patients after POP surgery with PVDF materials had statistically significant lower rates of de-novo sexual dysfunction compared to the PP group [OR = 0.12 (0.03, 0.46), p = 0.002].
CONCLUSIONS
This study provided evidence that the use of PVDF in SUI/POP surgeries could be a valid alternative to PP. However our results are limited by uncertainty due to the overall low quality of the existent data. Further research and validation would contribute to better surgical techniques.
Topics: Humans; Pelvic Organ Prolapse; Polyvinyls; Urinary Incontinence, Stress; Cohort Studies; Surgical Mesh
PubMed: 36966589
DOI: 10.1016/j.ejogrb.2023.03.018 -
Environmental Research May 2023Food waste (FW) contains many nutritional components such as proteins, lipids, fats, polysaccharides, carbohydrates, and metal ions, which can be reused in some... (Review)
Review
Food waste (FW) contains many nutritional components such as proteins, lipids, fats, polysaccharides, carbohydrates, and metal ions, which can be reused in some processes to produce value-added products. Furthermore, FW can be converted into biogas, biohydrogen, and biodiesel, and this type of green energy can be used as an alternative to nonrenewable fuel and reduce reliance on fossil fuel sources. It has been demonstrated in many reports that at the laboratory scale production of biochemicals using FW is as good as pure carbon sources. The goal of this paper is to review approaches used globally to promote turning FW into useable products and green energy. In this context, the present review article highlights deeply in a transdisciplinary manner the sources, types, impacts, characteristics, pre-treatment strategies, and potential management of FW into value-added products. We find that FW could be upcycled into different valuable products such as eco-friendly green fuels, organic acids, bioplastics, enzymes, fertilizers, char, and single-cell protein, after the suitable pre-treatment method. The results confirmed the technical feasibility of all the reviewed transformation processes of FW. Furthermore, life cycle and techno-economic assessment studies regarding the socio-economic, environmental, and engineering aspects of FW management are discussed. The reviewed articles showed that energy recovery from FW in various forms is economically feasible.
Topics: Refuse Disposal; Food; Waste Management; Cost-Benefit Analysis; Biofuels; Bibliometrics
PubMed: 36842700
DOI: 10.1016/j.envres.2023.115558 -
World Journal of Surgery Jun 2023Surgical mesh infection (SMI) after abdominal wall hernia repair (AWHR) is a challenging and highly debated clinical problem with no current consensus. The purpose of... (Meta-Analysis)
Meta-Analysis
BACKGROUND
Surgical mesh infection (SMI) after abdominal wall hernia repair (AWHR) is a challenging and highly debated clinical problem with no current consensus. The purpose of this review was to analyze the literature about the use of negative pressure wound therapy (NPWT) in the management of the conservative treatment of SMI and report results about infected mesh salvage.
METHODS
A systematic review of EMBASE and PUBMED was performed describing the use of NPWT in patients with SMI following AWHR. Reviewed articles evaluating data about the association between clinical, demographic, analytic and surgical characteristics about SMI after AWHR were analyzed. The high heterogeneity of these studies did not allow a meta-analysis of outcomes.
RESULTS
The search strategy yielded 33 studies from PubMed, and 16 studies from EMBASE. NPWT was performed in 230 patients across 9 studies being achieved the mesh salvage in 196 (85.2%). Of these 230 cases, 46% were polypropylene (PPL), 9.9% polyester (PE), 16.8% polytetrafluoroethylene (PTFE), 4% biologic and 10.2% composite mesh (PPL and PTFE). Infected mesh location was onlay (43%), retromuscular (22%), preperitoneal (19%), intraperitoneal (10%) and between the oblique muscles (5%). The better option on salvageability with the use of NPWT was the combination of macroporous PPL mesh in an extraperitoneal position (19.2% onlay, 23.3% preperitoneal, 48.8% retromuscular).
CONCLUSION
NPWT is a sufficient approach to treat SMI following AWHR. In most cases, infected prostheses can be salvaged with this management. Further studies with a larger sample size are needed to confirm our analysis results.
Topics: Humans; Hernia, Ventral; Herniorrhaphy; Negative-Pressure Wound Therapy; Prostheses and Implants; Surgical Mesh
PubMed: 36802233
DOI: 10.1007/s00268-023-06943-4 -
Hernia : the Journal of Hernias and... Aug 2023There is an increasing number of patients following hernia surgery with implanted mesh reporting symptoms that could indicate autoimmune or allergic reactions to mesh.... (Review)
Review
BACKGROUND
There is an increasing number of patients following hernia surgery with implanted mesh reporting symptoms that could indicate autoimmune or allergic reactions to mesh. 'Allergy' to metals, various drugs, and chemicals is well recognised. However, hypersensitivity, allergy or autoimmunity caused by surgical mesh has not been proven by a scientific method to date. The aim of this study was twofold: to describe the pathophysiology of autoimmunity and foreign body reaction and to undertake a systematic review of surgical mesh implanted at the time of hernia repair and the subsequent development of autoimmune disease.
METHODS
A systematic review using the PRISMA guidelines was undertaken. Pubmed (Medline), Google Scholar and Cochrane databases were searched for all English-written peer-reviewed articles published between 2000 and 2021. The search was performed using the keywords "hernia", "mesh", "autoimmunity", "ASIA", "immune response", "autoimmune response".
RESULTS
Seven papers were included in the final analysis-three systematic reviews, three cohort studies and one case report. Much of the current data regarding the association of hernia mesh and autoimmunity relies on retrospective cohort studies and/or case reports with limited availability of cofounding factor data linked to autoimmune disease such as smoking status or indeed a detailed medical history of patients. Three systematic reviews have discussed this topic, each with a slightly different approach and none of them has identified causality between the use of mesh and the subsequent development of autoimmune disease.
CONCLUSION
There is little evidence that the use of polypropylene mesh can lead to autoimmunity. A large number of potential triggers of autoimmunity along with the genetic predisposition to autoimmune disease and the commonality of hernia, make a cause and effect difficult to unravel at present. Biomaterials cause foreign body reactions, but a chronic foreign body reaction does not indicate autoimmunity, a common misunderstanding in the literature.
Topics: Humans; Retrospective Studies; Herniorrhaphy; Hernia, Inguinal; Foreign-Body Reaction; Surgical Mesh; Autoimmune Diseases
PubMed: 36739352
DOI: 10.1007/s10029-023-02749-4 -
Environmental Pollution (Barking, Essex... Dec 2022Coastal lagoons are transitional environments between continental and marine aquatic systems. Globally, coastal lagoons are of great ecological and socioeconomic... (Review)
Review
Coastal lagoons are transitional environments between continental and marine aquatic systems. Globally, coastal lagoons are of great ecological and socioeconomic importance as providers of valuable ecosystem services. However, these fragile environments are subject to several human pressures, including pollution by microplastics (MPs). The aim of this review was to identify and summarize advances in MP pollution research in coastal lagoons across the world. We consider peer-reviewed publications on this topic published in English and Spanish between 2000 and April 21, 2022, available in Scopus and Google Scholar. We found 57 publications with data on MP abundances and their characteristics in 50 coastal lagoons from around the world, 58% of which have some environmental protection status. The number of publications on this type of pollution in lagoons has increased significantly since 2019. Methodological differences amongst studies of MPs in coastal lagoons were nevertheless a limiting factor for wide-ranging comparisons. Most studies (77%) were conducted in single environmental compartments, and integration was limited, hampering current understanding of MP dynamics in such lagoons. MPs were more abundant in lagoons with highly populated shores and watersheds, which support intensive human activities. On the contrary, lagoons in natural protected areas had lower abundances of MPs, mostly in sediments and organisms. Fiber/filament and fragment shapes, and polyethylene, polyester, and polypropylene polymers were predominant. MPs had accumulated in certain areas of coastal lagoons, or had been exported to the sea, depending on the influence of seasonal weather, hydrodynamics, anthropogenic pressures, and typology of MPs. It is advised that future research on MP pollution in coastal lagoons should focus on methodological aspects, assessment/monitoring of pollution itself, MP dynamics and impacts, and prevention measures as part of a sound environmental management.
Topics: Humans; Microplastics; Plastics; Geologic Sediments; Ecosystem; Water; Environmental Monitoring; Water Pollutants, Chemical; Polyethylene
PubMed: 36240966
DOI: 10.1016/j.envpol.2022.120366 -
ANZ Journal of Surgery Oct 2022Mesh infection is the most feared postoperative complication after abdominal wall hernia repair, often needs mesh removal. Negative pressure wound therapy (NPWT) has... (Review)
Review
BACKGROUND
Mesh infection is the most feared postoperative complication after abdominal wall hernia repair, often needs mesh removal. Negative pressure wound therapy (NPWT) has been used in these situations with diverse results. The aim of this study was to investigate the efficacy of the NPWT in the treatment of mesh infection, the primary outcome was the mesh salvage rates of different type of meshes and mesh positions.
METHODS
Major databases were searched using the keywords negative pressure wound therapy, VSD, vacuum assisted, hernia, mesh infection, including various combinations of the terms. All relevant articles and reference lists in these original studies were also obtained from the above databases.
RESULTS
Ten articles containing 265 patients on the treatment of mesh infection after hernia repair with the use of NPWT method were included. The general infected mesh salvage rate with NPWT was 76.2%. The highest mesh salvage rate was achieved in polypropylene mesh (93.5%), followed by Proceed mesh (83.3%), and the mesh salvage rate was lower in polyester mesh (PCO) (0%) and the ePTFE mesh (14/3%). The salvage rate was higher when mesh placed in the onlay position (82.6%) or retromuscular/sublay position (98.5%), but lower in the IPOM position (55.6%).
CONCLUSION
The treatment of mesh infection after hernia repair should be individualized according to the mesh type, mesh position and the severity of infection. Infected mesh with favourable mesh materials (large pore and monofilament polypropylene) and favourable positions (onlay or sublay/retromuscular) can be salvaged with the use of NPWT based conservative method.
Topics: Herniorrhaphy; Humans; Negative-Pressure Wound Therapy; Polyesters; Polypropylenes; Surgical Mesh
PubMed: 36106686
DOI: 10.1111/ans.18040 -
Materials (Basel, Switzerland) Jul 2022The high cost of biofabricated titanium mesh plates can make them out of reach for hospitals in low-income countries. To increase the availability of cranioplasty, the... (Review)
Review
The high cost of biofabricated titanium mesh plates can make them out of reach for hospitals in low-income countries. To increase the availability of cranioplasty, the authors of this work investigated the production of polymer-based endoprostheses. Recently, cheap, popular desktop 3D printers have generated sufficient opportunities to provide patients with on-demand and on-site help. This study also examines the technologies of 3D printing, including SLM, SLS, FFF, DLP, and SLA. The authors focused their interest on the materials in fabrication, which include PLA, ABS, PET-G, PEEK, and PMMA. Three-dimensional printed prostheses are modeled using widely available CAD software with the help of patient-specific DICOM files. Even though the topic is insufficiently researched, it can be perceived as a relatively safe procedure with a minimal complication rate. There have also been some initial studies on the costs and legal regulations. Early case studies provide information on dozens of patients living with self-made prostheses and who are experiencing significant improvements in their quality of life. Budget 3D-printed endoprostheses are reliable and are reported to be significantly cheaper than the popular counterparts manufactured from polypropylene polyester.
PubMed: 35888198
DOI: 10.3390/ma15144731