-
Journal of Pharmacy & Pharmaceutical... 2023Hyperkalemia is a common electrolyte disorder in patients with chronic kidney disease (CKD) that increases in prevalence with the decline of glomerular fltration rate... (Review)
Review
Hyperkalemia is a common electrolyte disorder in patients with chronic kidney disease (CKD) that increases in prevalence with the decline of glomerular fltration rate (GFR). Another risk of hyperkalemia is the use of renin-angiotensin-aldosterone system inhibitors (RAASi) and/or mineralocorticoid receptor antagonists (MRAs) in managing CKD and proteinuria. The treatment of chronic hyperkalemia is challenging especially for outpatients. Treatment options for hyperkalemia include the potassium exchange resins of which two new potassium binders, Patiromer Sorbitex Calcium, and Sodium Zirconium Cyclosilicate (SZC) have demonstrated their clinical efficacy in reducing serum potassium with a positive safety profile. The old potassium exchange resin sodium polystyrene sulfonate (Kayexalate™) has some negative side effects including colonic necrosis, hypomagnesemia, and hypernatremia. In this review and literature search, we compare the available oral potassium exchange resins, highlight their advantages and disadvantages and comment on efficacy and safety parameters specifically in CKD patients.
Topics: Humans; Hyperkalemia; Mineralocorticoid Receptor Antagonists; Potassium; Renal Insufficiency, Chronic; Renin-Angiotensin System
PubMed: 38173862
DOI: 10.3389/jpps.2023.11892 -
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 -
Polymers Jun 2023Poly(3,4-ethylenedioxythiophene):polystyrene sulfonate (PEDOT:PSS) has been mostly used as a counter electrode to give a high performance of dye-sensitized solar cell... (Review)
Review
Poly(3,4-ethylenedioxythiophene):polystyrene sulfonate (PEDOT:PSS) has been mostly used as a counter electrode to give a high performance of dye-sensitized solar cell (DSSC). Recently, PEDOT doped by carrageenan, namely PEDOT:Carrageenan, was introduced as a new material to be applied on DSSC as an electrolyte. PEDOT:Carrageenan has a similar synthesis process as PEDOT:PSS, owing to their similar ester sulphate (-SOH) groups in both PSS and carrageenan. This review provides an overview of the different roles between PEDOT:PSS as a counter electrode and PEDOT:Carrageenan as an electrolyte for DSSC applications. The synthesis process and characteristics of PEDOT:PSS and PEDOT:Carrageenan were also described in this review. In conclusion, we found that the primary role of PEDOT:PSS as a counter electrode is to transfer electrons back to cell and accelerate redox reaction with its superior electrical conductivity and high electrocatalytic activity. PEDOT:Carrageenan as an electrolyte has not shown the main role for regenerating the dye sensitized at the oxidized state, probably due to its low ionic conductivity. Therefore, PEDOT:Carrageenan still obtained a low performance of DSSC. Additionally, the future perspective and challenges of using PEDOT:Carrageenan as both electrolyte and counter electrode are described in detail.
PubMed: 37376370
DOI: 10.3390/polym15122725 -
Heliyon May 2023The present study was carried out in the two phases of systematic review and experimental research. First, for the systematic review phase, Web of Science, Scopus, and...
The present study was carried out in the two phases of systematic review and experimental research. First, for the systematic review phase, Web of Science, Scopus, and PubMed as electronic databases were utilized to find research articles distributed up to March 5, 2021, related to the removal of microplastics by coagulation. In total, 104 publications were found, of which 14 were reviewed for deriving the variables and research design. Then, in the experimental phase, the experiment was carried out based on the variables derived from the systematic phase for three microplastic types (polyethylene, polystyrene, and polyamide) and five coagulants (polyaluminum chloride (PAC), ferric chloride (FeCl), aluminum chloride (AlCl), alum (Al(OH)) and aluminum sulfate (Al(SO))) in bench scale study. The differences between removal efficiencies in terms of type, shape, concentration, and size of microplastics within the looked into article was analyzed utilizing ANOVA or Kruskal-Wallis test (for parametric or nonparametric analysis, respectively). The results of experimental phase show that the removal efficiency of different microplastics was significantly different, and it was equal to 65, 22, and 12% on average for PA, PS, and PE, respectively. These averages are much lower than the average removal efficiency calculated in the reviewed articles (78 and 52% for PS and PE, respectively). The removal efficiency of microplastics types by coagulants was not significantly different. As a result, a coagulant that has the lowest dose can be selected as the most suitable coagulant, which is Al(OH) in this study.
PubMed: 37187907
DOI: 10.1016/j.heliyon.2023.e15664 -
The Science of the Total Environment Apr 2023Over the last years there has been significant research on the presence and effects of plastics in terrestrial systems. Here we summarize current research findings on... (Review)
Review
Over the last years there has been significant research on the presence and effects of plastics in terrestrial systems. Here we summarize current research findings on the effects of nano- and microplastics (NMPs) on terrestrial plants, with the aim to determine patterns of response and sensitive endpoints. We conducted a systematic review (based on 78 studies) on the effects of NMPs on germination, plant growth and biochemical biomarkers. This review highlights that the majority of studies to date have used pristine polystyrene or polyethylene particles, either in a hydroponic or pot-plant setup. Based on these studies we found that effects on plants are widespread. We noted similar responses between and within monocots and dicots to NMPs, except for consistent lower germination seen in dicots exposed to NMPs. During early development, germination and root growth are more strongly affected compared to shoot growth. NMPs induced similar adverse growth effects on plant biomass and length in the most tested plant species (lettuce, wheat, corn, and rice) irrespective of the polymer type and size used. Moreover, biomarker responses were consistent across species; chlorophyll levels were commonly negatively affected, while stress indicators (e.g., ROS or free radicals) and stress respondents (e.g., antioxidant enzymes) were consistently upregulated. In addition, effects were commonly observed at environmentally relevant levels. These findings provide clear evidence that NMPs have wide-ranging impacts on plant performance. However, as most studies have been conducted under highly controlled conditions and with pristine plastics, there is an urgent need to test under more environmentally realistic conditions to ensure the lab-based studies can be extrapolated to the field.
Topics: Microplastics; Plastics; Plants; Biomass; Germination
PubMed: 36634785
DOI: 10.1016/j.scitotenv.2022.161211 -
The Science of the Total Environment Dec 2022This systematic review aims to summarize the current knowledge on biological effects of micro- and nanoplastics (MNPs) on human health based on mammalian systems. An...
This systematic review aims to summarize the current knowledge on biological effects of micro- and nanoplastics (MNPs) on human health based on mammalian systems. An extensive search of the literature led to a total of 133 primary research articles on the health relevance of MNPs. Our findings revealed that although the study of MNP cytotoxicity and inflammatory response represents a major research theme, most studies (105 articles) focused on the effects of polystyrene MNPs due to their wide availability as a well characterised research material that can be manufactured with a large range of particle sizes, fluorescence labelling as well as various surface modifications. Among the 133 studies covered in this review, 117 articles reported adverse health effects after being exposed to MNPs. Mammalian in vitro studies identified multiple biological effects including cytotoxicity, oxidative stress, inflammatory response, genotoxicity, embryotoxicity, hepatotoxicity, neurotoxicity, renal toxicity and even carcinogenicity, while rodent in vivo models confirmed the bioaccumulation of MNPs in the liver, spleen, kidney, brain, lung and gut, presenting adverse effects at different levels including reproductive toxic effects and trans-generational toxicity. In contrast, the remaining 16 studies indicated an insignificant impact of MNPs on humans. A few studies attempted to investigate the mechanisms or factors driving the toxicity of MNPs and identified several determining factors including size, concentration, shape, surface charge, attached pollutants and weathering process, which, however, were not benchmarked or considered by most studies. This review demonstrates that there are still many inconsistencies in the evaluation of the potential health effects of MNPs due to the lack of comparability between studies. Current limitations hindering the attainment of reproducible conclusions as well as recommendations for future research directions are also presented.
Topics: Animals; Humans; Environmental Pollutants; Mammals; Microplastics; Particle Size; Plastics; Polystyrenes
PubMed: 35987230
DOI: 10.1016/j.scitotenv.2022.158111 -
Toxics Jul 2022Emerging contaminants such as nanoplastics (NPs), as well as manufacturing by-products such as plasticizers, have gained global attention and concern due to their... (Review)
Review
Emerging contaminants such as nanoplastics (NPs), as well as manufacturing by-products such as plasticizers, have gained global attention and concern due to their limited biodegradability and their potential impact on human health, in particular the effects on respiratory tissue. In parallel, cell culture techniques are key to the assessment and characterization of toxic effects and cellular mechanisms in different types of tissues and should provide relevant information to understand the hazardous potential of these emergent contaminants. This systematic review presents the main results on the current knowledge of the effects of NPs and plasticizers on lung cells, as assessed with the use of cell culture techniques. From the selected studies ( = 10), following the PRISMA approach, it was observed that cell viability was the most frequently assessed endpoint and that most studies focused on epithelial cells and exposures to polystyrene (PS). It was observed that exposure to NPs or plasticizers induces cytotoxicity in a dose-dependent manner, regardless of the size of the NPs. Furthermore, there is evidence that the characteristics of NPs can affect the toxic response by promoting the association with other organic compounds. As such, further studies focusing on the combination of NPs with plasticizers will be essential for the understanding of mechanisms of NPs toxicity.
PubMed: 35878307
DOI: 10.3390/toxics10070402 -
Food Chemistry: X Mar 2022The ingredients in food packaging migrate to the food inside. One of the most common compounds used for packaging of food is polystyrene. This systematic review aimed to... (Review)
Review
The ingredients in food packaging migrate to the food inside. One of the most common compounds used for packaging of food is polystyrene. This systematic review aimed to investigate the level of styrene's pollution in food packed with polystyrene. The original articles include keywords styrene, polystyrene, food, contamination, pollution, "food packaging" were searched in Web of science, Medline, Scopus, and Science Direct. A total of 227 studies were achieved. The articles that did not meet the inclusion criteria were excluded with the initial evaluation. The quality assessment was conducted for full paper and finally data were extracted from 8 selected articles. Mata analysis, -regression, subgroup analysis, and publication bias was also conducted with comprehensive -analysis (CMA) software. Most of the examined samples were dairy products. The amount of fat in dairy products is an important factor in increasing the migration of styrene. The shelf life of product also had effect on migration of styrene. The overall average was estimated as 91.53 ± 26.18 µg/kg in food matrix. This amount is less than the permissible level. The results of meta regression showed that the type of food affects the pooled mean of styrene in the food. There was no publication bias for the selected articles.
PubMed: 35499016
DOI: 10.1016/j.fochx.2022.100238 -
Frontiers in Medicine 2021This manuscript presents findings from the first dichotomous data pooling analysis on clinical trials (CT) regarding the effectiveness of binding potassium. The results...
Binding Potassium to Improve Treatment With Renin-Angiotensin-Aldosterone System Inhibitors: Results From Multiple One-Stage Pairwise and Network Meta-Analyses of Clinical Trials.
This manuscript presents findings from the first dichotomous data pooling analysis on clinical trials (CT) regarding the effectiveness of binding potassium. The results emanated from pairwise and network meta-analyses aiming evaluation of response to commercial potassium-binding polymers, that is, to achieve and maintain normal serum potassium ( = 1,722), and the association between this response and an optimal dosing of renin-angiotensin-aldosterone system inhibitors (RAASi) needing individuals affected by heart failure (HF) or resistant hypertension, who may be consuming other hyperkalemia-inducing drugs (HKID) (e.g., β-blockers, heparin, etc.), and frequently are affected by chronic kidney disease (CKD) ( = 1,044): According to the surface under the cumulative ranking area (SUCRA), sodium zirconium cyclosilicate (SZC) (SUCRA >0.78), patiromer (SUCRA >0.58) and sodium polystyrene sulfonate (SPS) (SUCRA <0.39) were different concerning their capacity to achieve normokalemia (serum potassium level (sK+) 3.5-5.0 mEq/L) or acceptable kalemia (sK+ ≤ 5.1 mEq/L) in individuals with hyperkalemia (sK+ >5.1 mEq/L), and, when normokalemia is achieved, patiromer 16.8-25.2 g/day (SUCRA = 0.94) and patiromer 8.4-16.8 g/day (SUCRA = 0.41) can allow to increase the dose of spironolactone up to 50 mg/day in subjects affected by heart failure (HF) or with resistant hypertension needing treatment with other RAASi. The potential of zirconium cyclosilicate should be explored further, as no data exists to assess properly its capacity to optimize dosing of RAASi, contrarily as it occurs with patiromer. More research is also necessary to discern between benefits of binding potassium among all type of hyperkalemic patients, for example, patients with DM who may need treatment for proteinuria, patients with early hypertension, etc. https://www.crd.york.ac.uk/PROSPERO/, identifier: CRD42020185614, CRD42020185558, CRD42020191430.
PubMed: 34490289
DOI: 10.3389/fmed.2021.686729 -
Canadian Journal of Kidney Health and... 2020Hyperkalemia is a potentially life-threatening electrolyte abnormality defined as a serum potassium above the lab reference range (usually >5.0-5.5 mEq/L). Polystyrene...
BACKGROUND
Hyperkalemia is a potentially life-threatening electrolyte abnormality defined as a serum potassium above the lab reference range (usually >5.0-5.5 mEq/L). Polystyrene resins, including sodium polystyrene sulfonate (SPS) and calcium polystyrene sulfonate (CPS), have long been used to treat hyperkalemia. Sodium polystyrene sulfonate/calcium polystyrene sulfonate act by exchanging a cation for potassium within the intestinal lumen. While SPS and CPS have been available since the 1960s, there are rising concerns about the validity of the data supporting its use and about serious adverse gastrointestinal effects.
OBJECTIVE
The objective of this systematic review was to quantify the efficacy and safety of polystyrene sulfonate resins (SPS/CPS) in the treatment of adults with hyperkalemia. This review focuses on the randomized control trial (RCT), interventional non-RCT, and observational data available on SPS/CPS use.
DESIGN
Systematic review.
SETTING
Any country of origin. Both inpatient and outpatient settings.
PATIENTS
Adults with hyperkalemia treated with polystyrene sulfonate resins.
MEASUREMENTS
The primary outcome was change in serum potassium. The secondary outcomes included adverse effects of SPS/CPS and prevention of recurrent hyperkalemia.
METHODS
We conducted a systematic review using Cochrane Library, EMBASE (1947-2019), and Medline (1946-2019) databases. Literature reviews, systematic reviews, case studies, case series, and editorial pieces were excluded. Included studies were assessed for risk of bias.
RESULTS
Four RCTs, 21 observational studies, and 5 quasi-experimental trials were included. A total of 212 351 patients were included. Two thousand and fifty-eight patients were studied for the primary outcome and 210 293 patients were studied for the secondary outcomes. Study designs were heterogeneous and not amenable to meta-analysis. Most studies included nonhemodialysis outpatients older than 65 years. Of the included studies, 22/25 (88%) demonstrated a reduction of serum potassium >0.5 mEq/L over the study period. The magnitude of reduction in serum potassium of potassium resin compared with placebo or matched controls in the 3 low-risk studies identified was 0.14 to 1.04 mEq/L. However, each study used different dosing regimens. Ten of 22 studies reported the effects of polystyrene resins on serum potassium within 24 hours. A few high-quality observational studies suggest an increased risk of serious adverse gastrointestinal events with a relative risk of 2.10 and a hazard ratio of 1.25 to 1.94; however, the absolute risk remains low. The incidence of adverse gastrointestinal events is 16 to 23 events per 1000 person-years.
LIMITATIONS
We acknowledge several limitations in this study. Case studies and case series were excluded from the search results. Large case series may have been excluded despite having comparable sample sizes to studies included due to lack of a comparator and calculated estimates. Due to the heterogeneity of the studies, the data were unable to be meta-analyzed and as such the potassium-lowering effect of polystyrene sulfonate resins remains founded on small studies with potential confounders.
CONCLUSIONS
This systematic review demonstrates a continued lack of high-quality evidence for the use of SPS/CPS in hyperkalemia. Studies investigated highly variable timelines and the most robust evidence for SPS/CPS use is in chronic hyperkalemia. While the absence of high-quality evidence does not exclude the possibility of benefit, prescribers must understand that the use of SPS/CPS in acute hyperkalemia is not supported by high-quality evidence.
TRIAL REGISTRATION
The protocol for this systematic review was not registered.
PubMed: 33240515
DOI: 10.1177/2054358120965838