-
Journal of Public Health Dentistry Jun 2024This systematic review aimed to review the safety and effectiveness of professionally applied fluorides for preventing and arresting dental caries in low- and... (Meta-Analysis)
Meta-Analysis
OBJECTIVES
This systematic review aimed to review the safety and effectiveness of professionally applied fluorides for preventing and arresting dental caries in low- and middle-income countries (LMICs).
METHODS
Randomized controlled trials conducted in LMICs, in which professionally applied fluorides were compared with placebo/no treatment/health education only or usual care with a minimum one-year follow-up period, were included. Any topically applied fluoride agents such as sodium fluoride (NaF), acidulated phosphate fluoride, silver diamine fluoride (SDF), and nano silver fluoride (NSF) were included. Five databases (PubMed, Embase, Scopus, Web of Science, and Cochrane Library) were searched in May 2022. Meta-analysis was conducted using a random effect model.
RESULTS
This review included 33 studies for qualitative synthesis, encompassing 16,375 children aged between 1.5 and 14 years. Nevertheless, the meta-analysis focused on only 17 studies, involving 4067 children. Fourteen papers assessed potential adverse events, none of which was reported as major adverse events. SDF and NSF were identified as effective in arresting caries on primary teeth (p < 0.05) compared with a placebo or no treatment. Fluoride varnish and gel were identified as effective in reducing new caries development on primary teeth (p < 0.05) but not on permanent teeth (p > 0.05). The certainty of the generated evidence obtained is low.
CONCLUSION
The review provides valuable insights into the use of professionally applied fluorides in LMICs and contributes to recommendations for their use. However, the limited rigorous evidence suggests the need for further research to strengthen these findings and draw more robust conclusions.
Topics: Humans; Dental Caries; Developing Countries; Fluorides, Topical; Child; Child, Preschool; Adolescent; Cariostatic Agents; Infant; Fluorides; Silver Compounds; Randomized Controlled Trials as Topic; Quaternary Ammonium Compounds
PubMed: 38623701
DOI: 10.1111/jphd.12617 -
Nutrients Mar 2024Water consumption is believed to be a key factor in weight management strategies, yet the existing literature on the subject yields inconsistent findings. To... (Meta-Analysis)
Meta-Analysis Review
BACKGROUND
Water consumption is believed to be a key factor in weight management strategies, yet the existing literature on the subject yields inconsistent findings. To systematically assess the scientific evidence regarding the effect of water intake on adiposity, we conducted a systematic review and meta-analysis of randomized controlled trials (RCTs) among overweight and obese populations.
METHODS
PubMed and Embase were searched for relevant articles published up to December 2023. The summary weighted mean difference (WMD) and 95% confidence interval (CI) were estimated using the DerSimonian-Laird random-effects model.
RESULTS
In this meta-analysis of eight RCTs, interventions to promote water intake or to substitute water for other beverages as compared to the control group resulted in a summary WMD of -0.33 kg (95% CI = -1.75-1.08, = 78%) for body weight, -0.23 kg/m (95% CI = -0.55-0.09, = 0%) for body mass index (BMI), and 0.05 cm (95% CI = -1.20-1.30, = 40%) for waist circumference (WC). Among RCTs substituting water for artificially sweetened beverages, summary WMD was 1.82 kg (95% CI = 0.97-2.67, = 0%) for body weight and 1.23 cm (95% CI = -0.03-2.48, = 0%) for WC. Conversely, among RCTs substituting water for sugar-sweetened beverages, summary WMD was -0.81 kg (95% CI = -1.66-0.03, = 2%) for body weight and -0.96 cm (95% CI = -2.06-0.13, = 0%) for WC.
CONCLUSIONS
In conclusion, water intake may not significantly impact adiposity among overweight and obese individuals. However, replacing sugar-sweetened beverages with water might offer a modest benefit in inducing weight loss.
Topics: Humans; Overweight; Adiposity; Drinking; Randomized Controlled Trials as Topic; Obesity; Body Weight; Water
PubMed: 38612997
DOI: 10.3390/nu16070963 -
Frontiers in Public Health 2024The global emergence of coronavirus disease 2019 (COVID-19) posed unprecedented challenges, jeopardizing decades of progress in healthcare systems, education, and...
The global emergence of coronavirus disease 2019 (COVID-19) posed unprecedented challenges, jeopardizing decades of progress in healthcare systems, education, and poverty eradication. While proven interventions such as handwashing and mass vaccination offer effective means of curbing COVID-19 spread, their uptake remains low, potentially undermining future pandemic control efforts. This systematic review synthesized available evidence of the factors influencing vaccine uptake and handwashing practices in Kenya, Uganda, and Tanzania in the context of COVID-19 prevention and control. We conducted an extensive literature search across PubMed, Science Direct, and Google Scholar databases following Preferred Reporting Items for Systematic Review and Meta-Analysis (PRISMA) guidelines. Out of 391 reviewed articles, 18 were eligible for inclusion. Some of the common barriers to handwashing in Kenya, Uganda, and Tanzania included lack of trust in the government's recommendations or messaging on the benefits of hand hygiene and lack of access to water, while some of the barriers to vaccine uptake included vaccine safety and efficacy concerns and inadequate awareness of vaccination sites and vaccine types. Enablers of handwashing practices encompassed hand hygiene programs and access to soap and water while those of COVID-19 vaccine uptake included improved access to vaccine knowledge and, socio-economic factors like a higher level of education. This review underscores the pivotal role of addressing these barriers while capitalizing on enablers to promote vaccination and handwashing practices. Stakeholders should employ awareness campaigns and community engagement, ensure vaccine and hygiene resources' accessibility, and leverage socio-economic incentives for effective COVID-19 prevention and control. : [https://clinicaltrials.gov/], identifier [CRD42023396303].
Topics: Humans; COVID-19; COVID-19 Vaccines; Hand Disinfection; Kenya; Tanzania; Uganda; Water
PubMed: 38601496
DOI: 10.3389/fpubh.2024.1352787 -
PloS One 2024Numerous pre-clinical and observational studies have explored the potential effects of fluoride (F) at varying concentrations on diverse systems and organs. While some...
Numerous pre-clinical and observational studies have explored the potential effects of fluoride (F) at varying concentrations on diverse systems and organs. While some have assessed the endocrinological conditions of children and adults, a consensus regarding the interaction between F and the thyroid remains elusive. This systematic review aimed to gather primary evidence on the association between F and changes in the thyroid at optimal and high levels in water supply as stipulated by the World Health Organization. A search strategy, incorporating terms pertinent to the studies, was employed across PubMed, Scopus, Web of Science, Lilacs, and Google Scholar. Following the review of studies, data were extracted and analyzed using the Grading of Recommendations, Assessment, Development, and Evaluations to assess the quality of the evidence. Our results yielded 3,568 studies, of which seven met the inclusion criteria for this review. Five of the seven studies identified an association between high F exposure and thyroid function. In the analysis of methodological quality, every study was found to have major or minor methodological issues and significant risk of bias. The overall confidence in the evidence was deemed low for all outcomes in the seven studies. The evidence compiled in this review suggests a potential association between chronic high levels of F exposure and thyroid damage. Nonetheless, further studies with robust design and high methodological quality are required to provide evidence for policy makers and health care practitioners.
Topics: Child; Adult; Humans; Fluorides; Thyroid Gland
PubMed: 38593166
DOI: 10.1371/journal.pone.0301911 -
Environmental Geochemistry and Health Apr 2024Recent studies have found arsenic contamination of drinking water in some parts of Iran, as in many other countries. Thus, a comprehensive systematic review is necessary... (Meta-Analysis)
Meta-Analysis Review
Recent studies have found arsenic contamination of drinking water in some parts of Iran, as in many other countries. Thus, a comprehensive systematic review is necessary to assess the distribution and concentration of arsenic in drinking water sources. For this purpose, articles published from the first identification until December 2023, were retrieved from various national and international databases. Of all the studies examined (11,726), 137 articles were selected for review based on their conceptual relationship to this survey. A review of the extracted studies presented that ICP methods (ICP-MS, ICP-OES, 56%) and atomic absorption spectrophotometry (AAS, 34.1%) were the two most commonly used techniques for the analysis of arsenic in water samples. The order of arsenic content in the defined study areas is descending, as follows: northwest ˃ southeast ˃ southwest ˃ northeast. A review of studies performed in Iran depicted that provinces such as Kurdistan, Azerbaijan, and Kerman have the highest arsenic concentrations in water resources. Accordingly, the maximum concentration of arsenic was reported in Rayen, Kerman, and ranged from < 0.5-25,000 µg/L. The primary cause of elevated arsenic levels in water resources appears to be geologic structure, including volcanic activity, biogeochemical processes, sulfur-bearing volcanic rocks, Jurassic shale, the spatial coincidence of arsenic anomalies in tube wells and springs, and, to some extent, mining activities. The findings of the presented survey indicate that it is essential to take serious measures at the national level to minimize the health risks of arsenic contamination from drinking water consumption.
Topics: Drinking Water; Iran; Arsenic; Databases, Factual; Geology
PubMed: 38592550
DOI: 10.1007/s10653-024-01943-2 -
Journal of Environmental Management Apr 2024While phosphorus fertilizers contribute to food security, part of the introduced phosphorus dissipates into water bodies leading to eutrophication. At the same time,...
While phosphorus fertilizers contribute to food security, part of the introduced phosphorus dissipates into water bodies leading to eutrophication. At the same time, conventional mineral phosphorus sources are increasingly scarce. Therefore, closing phosphorus cycles reduces pollution while decreasing trade dependence and increasing food security. A major part of the phosphorus loss occurs during food processing. In this article, we combine a systematic literature review with investment and efficiency analysis to investigate the financial feasibility of recovering phosphorus from dairy processing wastewater. This wastewater is particularly rich in phosphorus, but while recovery technologies are readily available, they are rarely adopted. We calculate the Net Present Value (NPV) of investing in phosphorus recycling technology for a representative European dairy processing company producing 100,000 tonnes of milk per year. We develop sensitivity scenarios and adjust the parameters accordingly. Applying struvite precipitation, the NPV can be positive in two scenarios. First, if the phosphorus price is high (1.51 million EUR) or second if phosphorus recovery is a substitute for mandatory waste disposal (1.48 million EUR). However, for a variety of methodological specifications, the NPV is negative, mainly because of high input costs for chemicals and energy. These trade-offs between off-setting pollution and reducing energy consumption imply, that policy makers and investors should consider the energy source for phosphorus recovery carefully.
Topics: Wastewater; Phosphorus; Struvite; Refuse Disposal; Agriculture; Waste Disposal, Fluid; Phosphates
PubMed: 38583387
DOI: 10.1016/j.jenvman.2024.120606 -
BMC Oral Health Apr 2024Many instruments used in dentistry are rotary, such as handpieces, water syringes, and ultrasonic scalers that produce aerosols. The spray created by these instruments... (Meta-Analysis)
Meta-Analysis
BACKGROUND
Many instruments used in dentistry are rotary, such as handpieces, water syringes, and ultrasonic scalers that produce aerosols. The spray created by these instruments can carry, in addition to water, droplets of saliva, blood, and microorganisms, which can pose a risk of infections for healthcare professionals and patients. Due to the COVID-19 pandemic, this gained attention.
OBJECTIVE
The aim was to carry out a systematic review of the evidence of the scope of the aerosol produced by ultrasonic scaler in environmental contamination and the influence of the use of intraoral suction reduction devices.
DESIGN
Scientific literature was searched until June 19, 2021 in 6 databases: Pubmed, EMBASE, Web of science, Scopus, Virtual Health Library and Cochrane Library, without restrictions on language or publication date. Studies that evaluated the range of the aerosol produced by ultrasonic scaler during scaling/prophylaxis and the control of environmental contamination generated by it with the use of low (LVE) and high (HVE) volume evacuation systems were included.
RESULTS
Of the 1893 potentially relevant articles, 5 of which were randomized controlled trials (RCTs). The meta-analysis of 3 RCTs showed that, even at different distances from the patient's oral cavity, there was a significant increase in airborne bacteria in the dental environment with the use of ultrasonic scaler. In contrast, when meta-analysis compared the use of HVE with LVE, there was no significant difference (P = 0.40/CI -0.71[-2.37, 0.95]) for aerosol produced in the environment.
CONCLUSIONS
There is an increase in the concentration of bioaerosol in the dental environment during the use of ultrasonic scaler in scaling/prophylaxis, reaching up to 2 m away from the patient's mouth and the use of LVE, HVE or a combination of different devices, can be effective in reducing air contamination in the dental environment, with no important difference between different types of suction devices.
Topics: Humans; Ultrasonic Therapy; Ultrasonics; Respiratory Aerosols and Droplets; Aerosols; Water; Dental Scaling
PubMed: 38580933
DOI: 10.1186/s12903-024-03996-2 -
Journal of Dentistry Jun 2024Assessed the effect of dental products containing nano-hydroxyapatite (nano-HA) + fluoride on the remineralization of white spot lesions (WSL) in vivo or in situ.
OBJECTIVE
Assessed the effect of dental products containing nano-hydroxyapatite (nano-HA) + fluoride on the remineralization of white spot lesions (WSL) in vivo or in situ.
METHODS
Seven databases were explored using a two-pronged approach (intervention/treatment). After screening, full-text assessment, and further exclusion, the qualitative synthesis of five studies (four clinical and one in situ) was performed. Based on the Cochrane collaboration guidelines relevant data of the studies were collected and summarized. The Cochrane risk of bias tool for randomized trials (RoB 2.0) was used to appraise the studies' methodological quality and the GRADE guidelines to assess their level of evidence. The RoB 2.0 domains were rated on their risk of bias (RoB) as low, high, or with some concerns, and an adaptation of the tool was used to the in situ study.
RESULTS
The included studies assessed 151 WSL in anterior permanent teeth, on patients with varying ages. The protocol application, treatment length (7d-12 w), and control groups varied greatly between the studies making the performance of a quantitative analysis unfeasible. The general RoB of the clinical studies was classified as being of low risk (n = 2) or some concerns (n = 2). The in situ study was considered as being of low risk. The level of the evidence was moderate. Most of the studies found moderate evidence regarding the superiority of this association in clinical settings.
CONCLUSION
Even with the nano-HA + fluoride promising results for the remineralization treatment of WSL, due to the restricted number of studies and types of products, its extended use cannot be recommended based on the current systematic review, especially when considering the moderate level of the evidence found.
CLINICAL SIGNIFICANCE
Due to the biocompatibility and higher surface coverage of nano-HA and the remineralization capacity of fluoride formulations, the association of these elements to remineralize WSL has been positively reported. After the collection and qualitative appraise of the data, the clinical evidence of the use of these dental products is promising but limited.
Topics: Humans; Tooth Remineralization; Durapatite; Fluorides; Dental Enamel; Dental Caries; Cariostatic Agents
PubMed: 38556192
DOI: 10.1016/j.jdent.2024.104973 -
International Journal of Environmental... Mar 2024The prevalence of dementia increases with nearly 10 million new cases each year, with Alzheimer's disease contributing to 60-70% of cases. Environmental factors such as...
The prevalence of dementia increases with nearly 10 million new cases each year, with Alzheimer's disease contributing to 60-70% of cases. Environmental factors such as drinking water have been evaluated to determine if a relationship exists between trace elements in drinking water and the risk of developing cognitive disorders in the elderly. The purpose of the current systematic review was to evaluate an association between the composition of drinking water and cognitive function in the elderly. In accordance with the Preferred Reporting Items for Systematic Review and Meta-Analyses guidelines, a literature search was conducted using PubMed and CINAHL databases. A total of 10 studies were included in the current systematic review. Aluminum is the most commonly evaluated trace element in studies ( = 8), followed by silica ( = 5), calcium ( = 4), and fluoride ( = 4). Aluminum exposure showed an increased risk of cognitive decline in four studies, with no association reported in the other studies. Higher silica and pH levels were shown to be protective against a decline in cognitive function. A similar protective effect of calcium was found in two studies. Future research should measure multiple trace mineral levels in all water sources to evaluate the impact on cognitive function.
Topics: Aged; Humans; Aluminum; Calcium; Cognition; Cognitive Dysfunction; Drinking Water; Silicon Dioxide; Trace Elements
PubMed: 38541362
DOI: 10.3390/ijerph21030362 -
Environmental Pollution (Barking, Essex... May 2024Microplastics in drinking water captured widespread attention following reports of widespread detection around the world. Concerns have been raised about the potential... (Review)
Review
Microplastics in drinking water captured widespread attention following reports of widespread detection around the world. Concerns have been raised about the potential adverse effects of microplastics in drinking water on human health. Given the widespread interest in this research topic, there is an urgent need to compile existing data and assess current knowledge. This paper provides a systematic review of studies on microplastics in drinking water, their evidence, key findings, knowledge gaps, and research needs. The data collected show that microplastics are widespread in drinking water, with large variations in reported concentrations. Standardized methodologies of sampling and analysis are urgently needed. There were more fibrous and fragmented microplastics, with the majority being <10 μm in size and composed of polyester, polyethylene, polypropylene, and polystyrene. Little attention has been paid to the color of microplastics. More research is needed to understand the occurrence and transfer of microplastics throughout the water supply chain and the treatment efficiency of drinking water treatment plants (DWTPs). Methods capable of analyzing microplastics <10 μm and nanoplastics are urgently needed. Potential ecological assessment models for microplastics currently in use need to be improved to take into account the complexity and specificity of microplastics.
Topics: Humans; Microplastics; Plastics; Drinking Water; Water Pollutants, Chemical; Environmental Monitoring
PubMed: 38537794
DOI: 10.1016/j.envpol.2024.123857