-
ASAIO Journal (American Society For... Mar 2023This systematic review summarizes the major developments in extracorporeal membrane oxygenation (ECMO) circuitry in pediatrics over the past 20 years and demonstrates...
This systematic review summarizes the major developments in extracorporeal membrane oxygenation (ECMO) circuitry in pediatrics over the past 20 years and demonstrates the impacts of those developments on clinical outcomes. This systematic review followed structured Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. A total of 1987 studies were retrieved, of which 82 were included in the final analysis. Over the past 20 years, ECMO pumps have shifted from roller pumps to centrifugal pumps. Silicone and polypropylene hollow fiber membrane oxygenators were initially used but have been replaced by polymethylpentene hollow fiber membrane oxygenators, with other ECMO components poorly reported. Considerable variability in mortality was found across studies and there was no statistical difference in mortality rates across different periods. The duration of ECMO and other outcome measures were inconsistently reported across studies. This systematic review demonstrated technological developments in pumps and oxygenators over the last two decades, although patient mortality rates remained unchanged. This could be because of ECMO support applied to patients in more critical conditions over the years. We also highlighted the limitations of methodology information disclosure and outcome measures in current ECMO studies, showing the need of reporting standardization for future ECMO studies.
Topics: Humans; Child; Extracorporeal Membrane Oxygenation; Oxygenators
PubMed: 35749749
DOI: 10.1097/MAT.0000000000001785 -
European Journal of Trauma and... Dec 2022High clinical success rates have been reported with the Masquelet technique in the treatment of traumatic bone loss. An increasing number of studies suggest that various... (Review)
Review
PURPOSE
High clinical success rates have been reported with the Masquelet technique in the treatment of traumatic bone loss. An increasing number of studies suggest that various factors can influence the properties of induced membranes. Goal of this systematic review is to answer the following questions: (1) which are the ideal spacer properties (material, surface topography, antibiotic supplementation) to booster the quality and osteogenic potential of induced membranes? (2) what is the ideal time to perform the second-stage operation?
METHODS
A systematic search using the keywords "((Masquelet) OR (Induced Periosteum)) AND ((Spacer) OR (Time))" was performed in PubMed, Embase and Cochrane Library according to PRISMA guidelines. Studies published up to the 23rd of February 2022 were included and assessed independently by two reviewers.
RESULTS
Thirteen animal and 1 clinical studies were identified to address the above questions. Spacer materials used were PMMA, silicone, titanium, polypropylene, PVA, PCL and calcium sulfate. With the exception of PVA sponges, all solid materials could induce membranes. Low union rates have been reported with titanium and rough surfaced spacers. Scraping of the inner surface of the IM also increased bony union rates. In terms of the ideal timing to perform the second-stage evidence suggests that membranes older than 8 weeks continue to have regenerative capacities similar to younger ones.
CONCLUSION
Membranes induced by smooth PMMA spacers loaded with low concentrations of antibiotics showed powerful osteogenic properties. Other materials such as Polypropylene or Calcium sulfate can also be used with good results. Despite current recommendation to perform the second stage operation in 4-8 weeks, membranes older than 8 weeks seem to have similar regenerative capacities to younger ones.
Topics: Animals; Polymethyl Methacrylate; Titanium; Calcium Sulfate; Polypropylenes
PubMed: 35726029
DOI: 10.1007/s00068-022-02005-x -
Hernia : the Journal of Hernias and... Apr 2022The surgical implantation of polypropylene (PP) meshes has been linked to the occurrence of systemic autoimmune disorders. We performed a systematic review to determine... (Meta-Analysis)
Meta-Analysis Review
PURPOSE
The surgical implantation of polypropylene (PP) meshes has been linked to the occurrence of systemic autoimmune disorders. We performed a systematic review to determine whether PP implants for inguinal, ventral hernia or pelvic floor surgery are associated with the development of systemic autoimmune syndromes.
METHODS
We searched Embase, Medline, Web of Science, Scopus, Cochrane library, clinicaltrialsregister.eu, clinicaltrails.gov and WHO-ICTR platform. Last search was performed on November 24th 2021. All types of studies reporting systemic inflammatory/autoimmune response in patients having a PP implant for either pelvic floor surgery, ventral or inguinal hernia repair were included. Animal studies, case reports and articles without full text were excluded. We intended to perform a meta-analysis. The quality of evidence was assessed with the Newcastle-Ottawa Scale. This study was registered at Prospero (CRD42020220705).
RESULTS
Of 2137 records identified, 4 were eligible. Two retrospective matched cohort studies focused on mesh surgery for vaginal prolapse or inguinal hernia compared to hysterectomy and colonoscopy, respectively. One cohort study compared the incidence of systemic conditions in women having urinary incontinence surgery with and without mesh. These reports had a low risk of bias. A meta-analysis showed no association when comparing systemic disease between mesh and control groups. Calculated risk ratio was 0.9 (95% CI 0.82-0.98). The fourth study was a case series with a high risk of bias, with a sample of 714 patients with systemic disease, 40 of whom had PP mesh implanted.
CONCLUSION
There is no evidence to suggest a causal relationship between being implanted with a PP mesh and the occurrence of autoimmune disorders.
Topics: Animals; Autoimmune Diseases; Cohort Studies; Female; Hernia, Inguinal; Herniorrhaphy; Humans; Polypropylenes; Retrospective Studies; Surgical Mesh; Syndrome
PubMed: 35020091
DOI: 10.1007/s10029-021-02553-y -
Bioengineering (Basel, Switzerland) Oct 2021The inherent resistance of synthetic plastics to degradation has led to an increasing challenge of waste accumulation problem and created a pollution issue that can only... (Review)
Review
The inherent resistance of synthetic plastics to degradation has led to an increasing challenge of waste accumulation problem and created a pollution issue that can only be addressed with novel complementary methods such as biodegradation. Since biocontrol is a promising eco-friendly option to address this challenge, the identification of suitable biological agents is a crucial requirement. Among the existing options, organisms of the genus have been reported to biodegrade several complex polymeric macromolecules such as chitin, lignin, and cellulose. Therefore, this systematic review aimed to evaluate the potential of strains for the biodegradation of synthetic plastics. The results showed that although strains are widely distributed in different ecosystems in nature, few studies have explored their capacity as degraders of synthetic polymers. Moreover, most of the research in this field has focused on strains with promising biotransforming potential against polyethylene-like polymers. Our findings suggest that this field of study is still in the early stages of development. Moreover, considering the diverse ecological niches associated with , these actinobacteria could serve as complementary agents for plastic waste management and thereby enhance carbon cycle dynamics.
PubMed: 34821720
DOI: 10.3390/bioengineering8110154 -
Environmental Pollution (Barking, Essex... Jan 2022Over the past two decades, there has been a lot of discussion about the rapid increase of microplastics (MPs) due to their persistence, ubiquity, and toxicity. The... (Review)
Review
Over the past two decades, there has been a lot of discussion about the rapid increase of microplastics (MPs) due to their persistence, ubiquity, and toxicity. The widespread distribution of MPs in various freshwater ecosystems makes them available for different trophic levels biota. The ingestion and trophic transfer of MPs may induce potential impacts on freshwater food webs. Therefore, this systematic review is an in-depth review of 51 recent studies to confirm the spatial distribution of MPs in the Chinese freshwater ecosystem including water, sediment and biota, exposure pathways, and impacts on freshwater food webs. The result suggested the white, transparent and colored, Polypropylene (PP) and Polyethylene (PE) of <1 mm fibers were dominant in Chinese freshwaters. The uptake of MPs by various freshwater organisms as well as physiological, biological and chemical impacts on food webs were also elucidated. At last, some limitations were discussed for future studies to better understand the effects of MPs on food webs.
Topics: China; Ecosystem; Environmental Monitoring; Food Chain; Fresh Water; Microplastics; Plastics; Water Pollutants, Chemical
PubMed: 34780753
DOI: 10.1016/j.envpol.2021.118494 -
Water Research Dec 2021Microplastic contamination in reservoirs is receiving increasing attention worldwide. However, a holistic understanding of the occurrence, drivers, and potential risks... (Meta-Analysis)
Meta-Analysis
Microplastic contamination in reservoirs is receiving increasing attention worldwide. However, a holistic understanding of the occurrence, drivers, and potential risks of microplastics in reservoirs is lacking. Building on a systematic review and meta-analysis of 30 existing publications, we construct a global microplastic dataset consisting of 440 collected samples from 43 reservoirs worldwide which we analyze through a framework of Data processing and Multivariate statistics (DM). The purpose is to provide comprehensive understanding of the drivers and mechanisms of microplastic pollution in reservoirs considering three different aspects: geographical distribution, driving forces, and ecological risks. We found that microplastic abundance varied greatly in reservoirs ranging over 2-6 orders of magnitude. Small-sized microplastics (< 1 mm) accounted for more than 60% of the total microplastics found in reservoirs worldwide. The most frequently detected colors, shapes, and polymer types were transparent, fibers, and polypropylene (polyester within aquatic organisms), respectively. Geographic location, seasonal variation and land-use type were main factors influencing microplastic abundance. Detection was also dependent on analytical methods, demonstrating the need for reliable and standardized methods. Interaction of these factors enhanced effects on microplastic distribution. Microplastics morphological characteristics and their main drivers differed between environmental media (water and sediment) and were more diverse in waters compared to sediments. Similarity in microplastic morphologies decreased with increasing geographic distance within the same media. In terms of risks, microplastic pollution and potential ecological risk levels are high in reservoirs and current policies to mitigate microplastic pollution are insufficient. Based on the DM framework, we identified temperate/subtropical reservoirs in Asia as potential high-risk areas and offer recommendations for analytical methods to detect microplastics in waters and sediments. This framework can be extended and applied to other multi-scale and multi-attribute contaminants, providing effective theoretical guidance for reservoir ecosystems pollution control and management.
Topics: Ecosystem; Environmental Monitoring; Geologic Sediments; Microplastics; Plastics; Water Pollutants, Chemical
PubMed: 34753090
DOI: 10.1016/j.watres.2021.117828 -
Current Neuropharmacology 2022Poloxamer 188 (P188) is an FDA-approved biocompatible block copolymer composed of repeating units of Poly(Ethylene Oxide) (PEO) and poly(propylene oxide) (PPO). Due to...
Poloxamer 188 (P188) is an FDA-approved biocompatible block copolymer composed of repeating units of Poly(Ethylene Oxide) (PEO) and poly(propylene oxide) (PPO). Due to its amphiphilic nature and high Hydrophile-Lipophile Balance (HLB) value of 29, P188 is used as a stabilizer/emulsifier in many cosmetics and pharmaceutical preparations. While the applications of P188 as an excipient are widely explored, the data on the pharmacological activity of P188 are scarce. Notably, the neuroprotective potential of P188 has gained a lot of interest. Therefore, this systematic review is aimed at summarizing evidence of neuroprotective potential of P188 in CNS disorders. The PRISMA model was used, and five databases (Google Scholar, Scopus, Wiley Online Library, ScienceDirect, and PubMed) were searched with relevant keywords. The search resulted in 11 articles, which met the inclusion criteria. These articles described the protective effects of P188 on traumatic brain injury or mechanical injury in cells, neurotoxicity, Parkinson's disease, Amyotrophic lateral sclerosis (ALS), and ischemia/ reperfusion injury from stroke. All the articles were original research in experimental or pre-clinical stages using animal models or in vitro systems. The reported activities demonstrated the potential of P188 as a neuroprotective agent in improving CNS conditions such as neurodegeneration.
Topics: Animals; Central Nervous System Diseases; Humans; Neuroprotective Agents; Poloxamer; Reperfusion Injury
PubMed: 34077349
DOI: 10.2174/1570159X19666210528155801 -
Hernia : the Journal of Hernias and... Jun 2021To evaluate safety and efficacy of a mesh reinforcement following stoma reversal to prevent stoma site incisional hernia (SSIH) and differences across the prostheses... (Meta-Analysis)
Meta-Analysis Review
PURPOSE
To evaluate safety and efficacy of a mesh reinforcement following stoma reversal to prevent stoma site incisional hernia (SSIH) and differences across the prostheses used.
METHODS
A systematic search of PubMed/MEDLINE, EMBASE, SCOPUS and Cochrane databases was conducted to identify comparative studies until September 2020. A meta-analysis of postoperative outcomes and a network meta-analysis for a multiple comparison of the prostheses with each other were performed.
RESULTS
Seven studies were included in the analysis (78.4% ileostomy and 21.6% colostomy) with a total of 1716 patients with (n = 684) or without (n = 1032) mesh. Mesh placement was associated with lower risk of SSIH (7.8%vs18.1%, OR0.266,95% CI 0.123-0.577, p < 0.001) than no mesh procedures but also with a longer operative time (SMD 0.941, 95% CI 0.462-1.421, p < 0.001). There was no statistically significant difference in terms of Surgical Site infection (11.5% vs 11.1%, OR 1.074, 95% CI 0.78-1.48, p = 0.66), seroma formation (4.4% vs 7.1%, OR 1.052, 95% CI 0.64-1.73, p = 0.84), anastomotic leakage (3.7% vs 2.7%, OR 1.598, 95% CI 0.846-3.019, p = 0.149) and length of stay (SMD - 0.579,95% CI - 1.261 to 0.102, p = 0.096) between mesh and no mesh groups. Use of prosthesis was associated with a significant lower need for a reoperation than no mesh group (8.1% vs 12.1%, OR 0.332, 95% CI 0.119-0.930, p = 0.036). Incidence of seroma is lower with biologic than polypropylene meshes but they showed a trend towards poor results compared with polypropylene or biosynthetic meshes.
CONCLUSION
Despite longer operative time, mesh prophylactic reinforcement at the site of stoma seems a safe and effective procedure with lower incidence of SSIH, need for reoperation and comparable short-term outcomes than standard closure technique. A significant superiority of a specific mesh type was not identified.
Topics: Herniorrhaphy; Humans; Incisional Hernia; Prostheses and Implants; Surgical Mesh; Surgical Stomas
PubMed: 33713204
DOI: 10.1007/s10029-021-02393-w -
Journal of Cranio-maxillo-facial... Jan 2021Local and systemic toxic reactions to implanted materials can result in morbidities. However, little is reported about cranioplasty implants. Therefore, we performed a...
PURPOSE
Local and systemic toxic reactions to implanted materials can result in morbidities. However, little is reported about cranioplasty implants. Therefore, we performed a systematic review on the toxicity of different materials used for cranioplasty implants.
MATERIALS AND METHODS
A systematic search was conducted by browsing the Pubmed, Embase, and Cochrane Library databases. All human studies that identified toxic (aseptic) reactions to any types of material used as cranioplasty implants or onplants, published up to January 1, 2019, were included in the review.
RESULTS
Nineteen studies were identified. Collectively, 36 patients endured some type of toxic reaction to an implanted material. Eleven studies presented several types of toxicity for PMMA cranioplasties in several tissue types. One article highlighted the risk of neurotoxicity for PMMA cranioplasty. Three articles presented toxic reactions to calcium phosphate and titanium implants. Three additional articles presented toxic reactions to PEEK, polypropylene-polyester, and polyethylene.
CONCLUSION
All materials currently used for cranioplasty showed occasional toxicity and morbidities. Therefore, none can be considered completely biologically inert. We found that aseptic inflammatory reactions have been underreported in the literature due to a high incidence of infections with questionable evidence.
Topics: Dental Implants; Humans; Postoperative Complications; Prostheses and Implants; Plastic Surgery Procedures; Research Subjects; Retrospective Studies; Skull; Titanium
PubMed: 33257187
DOI: 10.1016/j.jcms.2020.10.002 -
International Urogynecology Journal Mar 2021The aim of this study is to systematically compare rates of erosion and chronic pain after mesh insertion for pelvic organ prolapse (POP) and stress urinary incontinence... (Review)
Review
BACKGROUND
The aim of this study is to systematically compare rates of erosion and chronic pain after mesh insertion for pelvic organ prolapse (POP) and stress urinary incontinence (SUI) surgery.
METHODS
A systematic electronic search was performed on studies that evaluated the incidence of erosion and chronic pain after mesh insertion for POP or SUI. The primary outcome measurement was to compare mesh erosion rates for POP and SUI surgery. Secondary outcome measurements were incidence of de novo pain and a comparison of patient demographics for both surgeries.
RESULTS
Twenty-six studies on 292,606 patients (n = 9077 for POP surgery and n = 283,529 for SUI surgery) met the inclusion criteria. Median follow-up was 26.38 ± 22.17 months for POP surgery and 39.33 ± 27.68 months for SUI surgery. Overall, the POP group were older (p < 0.0001) and had a lower BMI (p < 0.0001). Mesh erosion rates were significantly greater in the POP group compared to the SUI group (4% versus 1.9%) (OR 2.13; 95% CI 1.91-2.37; p < 0.0001). The duration from surgery to onset of mesh erosion was 306.84 ± 183.98 days. There was no difference in erosion rates between abdominal and transvaginal mesh for POP. There was no difference in erosion rates between the transobturator and retropubic approach for SUI. The incidence of chronic pain was significantly greater in the POP group compared to the SUI group (6.7% versus 0.6%) (OR 11.02; 95% CI 8.15-14.9; p < 0.0001). The duration from surgery to onset of chronic pain was 325.88 ± 226.31 days.
CONCLUSIONS
The risk of mesh erosion and chronic pain is significantly higher after surgery for POP compared to SUI. These significant complications occur within the first year after surgery.
Topics: Chronic Pain; Humans; Pelvic Organ Prolapse; Suburethral Slings; Surgical Mesh; Urinary Incontinence, Stress
PubMed: 33237357
DOI: 10.1007/s00192-020-04612-x