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Environmental Health : a Global Access... Mar 2018In the last decade unconventional oil and gas (UOG) extraction has rapidly proliferated throughout the United States (US) and the world. This occurred largely because of...
BACKGROUND
In the last decade unconventional oil and gas (UOG) extraction has rapidly proliferated throughout the United States (US) and the world. This occurred largely because of the development of directional drilling and hydraulic fracturing which allows access to fossil fuels from geologic formations that were previously not cost effective to pursue. This process is known to use greater than 1,000 chemicals such as solvents, surfactants, detergents, and biocides. In addition, a complex mixture of chemicals, including heavy metals, naturally-occurring radioactive chemicals, and organic compounds are released from the formations and can enter air and water. Compounds associated with UOG activity have been linked to adverse reproductive and developmental outcomes in humans and laboratory animal models, which is possibly due to the presence of endocrine active chemicals.
METHODS
Using systematic methods, electronic searches of PubMed and Web of Science were conducted to identify studies that measured chemicals in air near sites of UOG activity. Records were screened by title and abstract, relevant articles then underwent full text review, and data were extracted from the studies. A list of chemicals detected near UOG sites was generated. Then, the potential endocrine activity of the most frequently detected chemicals was explored via searches of literature from PubMed.
RESULTS
Evaluation of 48 studies that sampled air near sites of UOG activity identified 106 chemicals detected in two or more studies. Ethane, benzene and n-pentane were the top three most frequently detected. Twenty-one chemicals have been shown to have endocrine activity including estrogenic and androgenic activity and the ability to alter steroidogenesis. Literature also suggested that some of the air pollutants may affect reproduction, development, and neurophysiological function, all endpoints which can be modulated by hormones. These chemicals included aromatics (i.e., benzene, toluene, ethylbenzene, and xylene), several polycyclic aromatic hydrocarbons, and mercury.
CONCLUSION
These results provide a basis for prioritizing future primary studies regarding the endocrine disrupting properties of UOG air pollutants, including exposure research in wildlife and humans. Further, we recommend systematic reviews of the health impacts of exposure to specific chemicals, and comprehensive environmental sampling of a broader array of chemicals.
Topics: Air Pollutants; Animals; Endocrine Disruptors; Environmental Exposure; Environmental Monitoring; Humans; Oil and Gas Fields
PubMed: 29558955
DOI: 10.1186/s12940-018-0368-z -
Ear, Nose, & Throat Journal Mar 2018The use of alternative medicine in chronic rhinosinusitis (CRS) continues to increase in popularity, for the most part without meeting the burden of being based on sound... (Review)
Review
The use of alternative medicine in chronic rhinosinusitis (CRS) continues to increase in popularity, for the most part without meeting the burden of being based on sound clinical evidence. New and emerging treatments, both natural and developed, are numerous, and it remains a challenge for otolaryngologists as well as general practitioners to keep up to date with these therapies and their efficacy. In this systematic review, we discuss a number of alternative therapies for CRS, their proposed physiologic mechanisms, and evidence supporting their use. This analysis is based on our review of the English-language literature on alternative therapies for CRS (we did not include any therapies that are already recommended by accepted professional bodies). Data collection was performed using the PubMed database (not restricted to MEDLINE due to the nature of the subject matter), the Cochrane databases, and bibliography searches. We found that while many of the alternative therapies we reviewed might have a firm basis in science, they lack any clinical evidence to support their use specifically for CRS. Some emerging therapies, such as therapeutic ultrasonography and phonophoresis, show some promise, based on a growing body of positive evidence. In addition, the use of baby shampoo, thyme honey, and bromelain additives to saline lavage in CRS are all supported by clinical evidence, as is Sinupret, an oral preparation that contains echinacea. However, higher levels of evidence gleaned from large, well-designed, prospective, randomized, controlled trials are needed before any of these therapies can be recommended.
Topics: Bromelains; Chronic Disease; Complementary Therapies; Honey; Humans; Plant Extracts; Rhinitis; Sinusitis; Soaps; Therapeutic Irrigation; Thymus Plant; Treatment Outcome
PubMed: 29554408
DOI: No ID Found -
The Journal of Dermatological Treatment Nov 2018Washing and over-the-counter cleansers are common interventions in acne vulgaris (AV), but the clinical evidence for their benefit is poorly understood. This systematic... (Review)
Review
PURPOSE
Washing and over-the-counter cleansers are common interventions in acne vulgaris (AV), but the clinical evidence for their benefit is poorly understood. This systematic review presents clinical studies of washing and cleanser efficacy in acne vulgaris to guide treatment recommendations of dermatologists.
MATERIALS AND METHODS
We surveyed English-language articles indexed in MEDLINE (1951-March 2017) and EMBASE (1974-March 2017). Articles were required to be prospective studies of a single over-the-counter cleanser or washing intervention in AV with an objective AV outcome measurement published in a peer-reviewed journal.
RESULTS AND CONCLUSIONS
Fourteen prospective studies representing 671 participants were included in this review. Modalities investigated included face washing frequency, true soap/syndet cleansing bars, antiseptic cleansers, alpha and beta-hydroxy (i.e. salicylic) acid cleansers, and several proprietary formulations. Given the low number of well-performed clinical studies of cleansers and washing, it is difficult to formulate reliable recommendations. We hope that our findings highlight the necessity of further investigation in this area.
Topics: Acne Vulgaris; Anti-Infective Agents, Local; Benzoyl Peroxide; Detergents; Face; Glycolates; Humans; Propionibacterium acnes; Salicylic Acid
PubMed: 29460655
DOI: 10.1080/09546634.2018.1442552 -
Journal of Animal Physiology and Animal... Apr 2018The ruminal ecosystem is a fermentative milieu which is interesting to discuss in terms of its redox status as a reflection of an intense bacterial activity. The... (Review)
Review
The ruminal ecosystem is a fermentative milieu which is interesting to discuss in terms of its redox status as a reflection of an intense bacterial activity. The objective of this systematic literature review is to quantitatively analyze data collected on redox potential (Eh) in the rumen and to explore relationship between ruminal Eh, nature of the diet fed to ruminants, and ruminal fermentation parameters. Data obtained from 15 studies comprising 24 different diets was used in the analysis. Studies included in the data file were selected based on the criteria of: (i) the nature of the reference electrode was specified, (ii) the ruminal Eh was recorded simultaneously to pH, (iii) animal body weight (BW) and dry matter intake (DMI) were reported and (iv) the composition of the diet was precisely described. Results showed a high variability in ruminal Eh values. However, all recorded values are markedly negative reflecting the absence of oxygen and the strong reducing power of the rumen environment. The main factors contributing to the variation were the method of Eh measurement and the nature of the diet fed to ruminants. Redox potential was positively correlated with DMI and proportion of concentrate in the diet, and tended to be positively correlated with soluble carbohydrates content. In contrast, it was negatively correlated with neutral detergent fibre from forages. The hierarchical ascendant classification discriminated two groups of diets leading to significant change in ruminal Eh level. Ruminal Eh was negatively correlated with pH, total volatile fatty acids produced and proportion of acetate, and positively correlated with proportion of propionate. This review revealed Eh to be dependent on the diet composition and DMI, at least within the range of diets included in the database.
Topics: Animal Feed; Animal Nutritional Physiological Phenomena; Animals; Diet; Oxidation-Reduction; Rumen; Ruminants
PubMed: 29352497
DOI: 10.1111/jpn.12855 -
MicrobiologyOpen Aug 2018From 2009, Candida auris has emerged as a multidrug-resistant ascomycete yeast pathogen with the capacity for easy transmission between patients and hospitals, as well... (Meta-Analysis)
Meta-Analysis
From 2009, Candida auris has emerged as a multidrug-resistant ascomycete yeast pathogen with the capacity for easy transmission between patients and hospitals, as well as persistence on environmental surfaces. Its association with high mortalities, breakthrough and persistent candidaemia, inconsistencies in susceptibility testing results, misidentification by available commercial identification systems and treatment failure, complicates its management and detection. Within the last nine years, C. auris has been increasingly reported from far-Eastern Asia, the Middle East, Africa, Europe, South and North America with substantial fatalities and misidentification. Herein, I provide a systematic and thorough review of this emerging pathogen. Meta-analysis showed that at least 742 C. auris isolates have been reported in 16 countries, with most of these being from India (≥243), USA (≥232) and UK (≥103) (p-value = .0355) within 2013-2017. Most isolates were from males (64.76%) (p-value = .0329) and blood (67.48%) (p-value < .0001), with substantial crude mortality (29.75%) (p-value = .0488). Affected patients presented with other comorbidities: diabetes (≥52), sepsis (≥48), lung diseases (≥39), kidney diseases (≥32) etc. (p-value < .0001). Resistance to fluconazole (44.29%), amphotericin B (15.46%), voriconazole (12.67%), caspofungin (3.48%) etc. were common (p-value = .0059). Commonly used diagnostic tools included PCR (30.38%), Bruker MALDI-TOF MS (14.00%), Vitek 2 YST ID (11.93%), AFLP (11.55%) and WGS (10.04%) (p-value = .002). Multidrug resistance, high attributable mortality and persistence are associated with C. auris infections. Two novel drugs, SCY-078 and VT-1598, are currently in the pipeline. Contact precautions, strict infection control, periodic surveillance and cleaning with chlorine-based detergents, efficient, faster and cheaper detection tools are necessary for prevention, containment and early diagnosis of C. auris infections.
Topics: Antifungal Agents; Candida; Candidemia; Drug Resistance, Multiple, Fungal; Humans; Microbial Sensitivity Tests
PubMed: 29345117
DOI: 10.1002/mbo3.578 -
Regulatory Toxicology and Pharmacology... Nov 2017Research indicates a correlative relationship between asthma and use of consumer cleaning products. We conduct a systematic review of epidemiological literature on... (Review)
Review
Research indicates a correlative relationship between asthma and use of consumer cleaning products. We conduct a systematic review of epidemiological literature on persons who use or are exposed to cleaning products, both in occupational and domestic settings, and risk of asthma or asthma-like symptoms to improve understanding of the causal relationship between exposure and asthma. A scoring method for assessing study reliability is presented. Although research indicates an association between asthma and the use of cleaning products, no study robustly investigates exposure to cleaning products or ingredients along with asthma risk. This limits determination of causal relationships between asthma and specific products or ingredients in chemical safety assessment. These limitations, and a lack of robust animal models for toxicological assessment of asthma, create the need for a weight-of-evidence (WoE) approach to examine an ingredient or product's asthmatic potential. This proposed WoE method organizes diverse lines of data (i.e., asthma, sensitization, and irritation information) through a systematic, hierarchical framework that provides qualitatively categorized conclusions using hazard bands to predict a specific product or ingredient's potential for asthma induction. This work provides a method for prioritizing chemicals as a first step for quantitative and scenario-specific safety assessments based on their potential for inducing asthmatic effects. Acetic acid is used as a case study to test this framework.
Topics: Acetic Acid; Animals; Asthma; Consumer Product Safety; Detergents; Humans; Irritants; Models, Animal; Occupational Diseases; Occupational Exposure; Reproducibility of Results; Risk Assessment
PubMed: 28918194
DOI: 10.1016/j.yrtph.2017.09.013 -
Transfusion Sep 2017We estimated rates for common plasma-associated transfusion reactions and compared reported rates for various plasma types. (Meta-Analysis)
Meta-Analysis Review
BACKGROUND
We estimated rates for common plasma-associated transfusion reactions and compared reported rates for various plasma types.
STUDY DESIGN AND METHODS
We performed a systematic review and meta-analysis of peer-reviewed articles that reported plasma transfusion reaction rates. Random-effects pooled rates were calculated and compared between plasma types. Meta-regression was used to compare various plasma types with regard to their reported plasma transfusion reaction rates.
RESULTS
Forty-eight studies reported transfusion reaction rates for fresh-frozen plasma (FFP; mixed-sex and male-only), amotosalen INTERCEPT FFP, methylene blue-treated FFP, and solvent/detergent-treated pooled plasma. Random-effects pooled average rates for FFP were: allergic reactions, 92/10 units transfused (95% confidence interval [CI], 46-184/10 units transfused); febrile nonhemolytic transfusion reactions (FNHTRs), 12/10 units transfused (95% CI, 7-22/10 units transfused); transfusion-associated circulatory overload (TACO), 6/10 units transfused (95% CI, 1-30/10 units transfused); transfusion-related acute lung injury (TRALI), 1.8/10 units transfused (95% CI, 1.2-2.7/10 units transfused); and anaphylactic reactions, 0.8/10 units transfused (95% CI, 0-45.7/10 units transfused). Risk differences between plasma types were not significant for allergic reactions, TACO, or anaphylactic reactions. Methylene blue-treated FFP led to fewer FNHTRs than FFP (risk difference = -15.3 FNHTRs/10 units transfused; 95% CI, -24.7 to -7.1 reactions/10 units transfused); and male-only FFP led to fewer cases of TRALI than mixed-sex FFP (risk difference = -0.74 TRALI/10 units transfused; 95% CI, -2.42 to -0.42 injuries/10 units transfused).
CONCLUSION
Meta-regression demonstrates that the rate of FNHTRs is lower for methylene blue-treated compared with FFP, and the rate of TRALI is lower for male-only than for mixed-sex FFP; whereas no significant differences are observed between plasma types for allergic reactions, TACO, or anaphylactic reactions. Reported transfusion reaction rates suffer from high heterogeneity.
Topics: Detergents; Female; Furocoumarins; Humans; Kinetics; Male; Methylene Blue; Plasma; Sex Factors; Solvents; Transfusion Reaction
PubMed: 28766723
DOI: 10.1111/trf.14245 -
JBI Database of Systematic Reviews and... May 2017Incontinence-associated dermatitis (IAD) is inflammation of the skin resulting from repeated contact with urine and/or feces. It causes pain, redness, swelling and... (Review)
Review
BACKGROUND
Incontinence-associated dermatitis (IAD) is inflammation of the skin resulting from repeated contact with urine and/or feces. It causes pain, redness, swelling and excoriation, and may lead to complications such as fungal skin infections and pressure injuries. It is important to prevent and treat IAD to avoid complications and improve patient outcomes. A number of products are available for protecting skin, but evidence on their effectiveness is limited.
OBJECTIVES
The current review aimed to establish the effectiveness of topical skin products in reducing the occurrence and/or severity of IAD.
INCLUSION CRITERIA TYPES OF PARTICIPANTS
Adult patients over the age of 18 years with incontinence and/or diarrhea.
TYPES OF INTERVENTION
Topical skin products as individual interventions or part of a skin care regimen.
TYPES OF STUDIES
Both published and unpublished study designs including randomized controlled trials, non-randomized controlled trials, quasi-experimental, before and after, prospective and retrospective cohort, case-control, analytical cross-sectional, descriptive study designs including case series, individual case reports and descriptive cross-sectional studies across all care settings for inclusion.
OUTCOMES
The primary outcome of interest was the absence or non-development, reduction or resolution, new development or increase in the occurrence of IAD or the increase in severity of IAD. The secondary outcome was any adverse effect caused by the skin care products used.
SEARCH STRATEGY
A three-step search strategy to find both published and unpublished papers was utilized in this review. Studies were limited to those published in English from 1980 to 2016.
METHODOLOGICAL QUALITY
Papers selected were assessed by two independent reviewers using the Joanna Briggs Institute Meta-Analysis of Statistics Assessment and Review Instrument (JBI-MAStARI).
DATA EXTRACTION
Data were extracted using the standardized data extraction tool in JBI-MAStARI. The data extracted included specific details about the interventions, populations, study methods and outcomes.
DATA SYNTHESIS
Studies were assessed for methodological quality and statistical significance to determine validity and generalizability of study results. It was not possible to pool studies to conduct meta-analysis or test for heterogeneity.
RESULTS
There were a limited number of clinical trials that compared products for efficacy in preventing and treating IAD. Assessment tools and severity scores used to measure skin damage outcomes were dissimilar and prone to subjectivity. It was difficult to ascertain superiority of any individual product.
CONCLUSION
Information on barrier protective efficacy, side effects and cost can be valuable to both clinicians and care providers. More randomized controlled trials on product effectiveness for prevention and treatment of IAD are highly recommended.
Topics: Administration, Topical; Adult; Aged; Aged, 80 and over; Cross-Sectional Studies; Dermatitis; Dermatologic Agents; Fecal Incontinence; Female; Humans; Male; Middle Aged; Prospective Studies; Retrospective Studies; Severity of Illness Index; Skin; Skin Care; Skin Cream; Soaps; Treatment Outcome; Urinary Incontinence; Zinc Oxide
PubMed: 28498177
DOI: 10.11124/JBISRIR-2016-003015 -
BMC Geriatrics Jan 2017For immobile patients, a body wash in bed is sometimes the only bathing option. Traditionally, the bed bath is performed with water and soap. However, alternatives are... (Review)
Review
BACKGROUND
For immobile patients, a body wash in bed is sometimes the only bathing option. Traditionally, the bed bath is performed with water and soap. However, alternatives are increasingly used in health care. Washing without water is one such alternative that has been claimed to offer several advantages, such as improved hygiene and skin condition. This systematic review aims to provide a comprehensive overview of the evidence on outcomes of the washing without water concept compared to the traditional bed bath.
METHODS
Controlled trials about washing without water outcomes published after 1994 were collected by means of a systematic literature search in CINAHL, Embase, MEDLINE, and PUBMED at the 25th of February, 2016. Additionally, references and citations were searched and experts contacted. Studies were eligible if (1) the study designs included outcomes of washing without water products developed for the full body wash compared to the traditional bed bath, and (2) they were controlled trials. Two researchers independently used a standardized quality checklist to assess the methodological quality of the eligible studies. Finally, outcomes were categorized in (1) physiological outcomes related to hygiene and skin condition, (2) stakeholder-related outcomes, and (3) organizational outcomes in the data synthesis.
RESULTS
Out of 33 potentially relevant articles subjected to full text screening, six studies met the eligibility criteria. Only two studies (of the same research group) were considered of high quality. The results of these high quality studies show that washing without water performed better than the traditional bed bath regarding skin abnormalities and bathing completeness. No differences between washing without water and the traditional bed bath were found for outcomes related to significant skin lesions, resistance during bathing and costs in the studies of high quality.
CONCLUSIONS
There is limited moderate to high quality evidence that washing without water is not inferior to the traditional bed bath. Future research on washing without water is needed and should pay special attention to costs, hygiene, and to stakeholder-related outcomes, such as experiences and value perceptions of patients, nursing staff and family.
Topics: Baths; Disabled Persons; Humans; Hygiene; Sanitation; Soaps; Water
PubMed: 28118815
DOI: 10.1186/s12877-017-0425-4 -
The Cochrane Database of Systematic... Nov 2016Incontinence-associated dermatitis (IAD) is one of the most common skin problems in adults who are incontinent for urine, stool, or both. In practice, products and... (Review)
Review
BACKGROUND
Incontinence-associated dermatitis (IAD) is one of the most common skin problems in adults who are incontinent for urine, stool, or both. In practice, products and procedures are the same for both prevention and treatment of IAD.
OBJECTIVES
The objective of this review was to assess the effectiveness of various products and procedures to preventand treat incontinence-associated dermatitis in adults.
SEARCH METHODS
We searched the Cochrane Incontinence Group Specialised Trials Register, which contains trials identified from the Cochrane Central Register of Controlled Trials (CENTRAL), MEDLINE, MEDLINE In-Process, MEDLINE Epub Ahead of Print, CINAHL, ClinicalTrials.gov, WHO ICTRP and handsearching of journals and conference proceedings (searched 28 September 2016). Additionally we searched other electronic databases: CENTRAL(2015, Issue 4), MEDLINE (January 1946 to May Week 3 2015), MEDLINE In-Process (inception to 26 May 2015), CINAHL(December 1981 to 28 May 2015), Web of Science (WoS; inception to 28 May 2015) and handsearched conference proceedings (to June 2015) and the reference lists of relevant articles, and contacted authors and experts in the field.
SELECTION CRITERIA
We selected randomised controlled trials (RCTs) and quasi-RCTs, performed in any healthcare setting, with included participants over 18 years of age, with or without IAD. We included trials comparing the (cost) effectiveness of topical skin care products such as skin cleansers, moisturisers, and skin protectants of different compositions and skin care procedures aiming to prevent and treat IAD.
DATA COLLECTION AND ANALYSIS
Two review authors independently screened titles, abstracts and full-texts, extracted data, and assessed the risk of bias of the included trials.
MAIN RESULTS
We included 13 trials with 1295 participants in a qualitative synthesis. Participants were incontinent for urine, stool, or both, and were residents in a nursing home or were hospitalised.Eleven trials had a small sample size and short follow-up periods. .The overall risk of bias in the included studies was high. The data were not suitable for meta-analysis due to heterogeneity in participant population, skin care products, skin care procedures, outcomes, and measurement tools.Nine trials compared different topical skin care products, including a combination of products. Two trials tested a structured skin care procedure. One trial compared topical skin care products alongside frequencies of application. One trial compared frequencies of application of topical skin care products.We found evidence in two trials, being of low and moderate quality, that soap and water performed poorly in the prevention and treatment of IAD (primary outcomes of this review). The first trial indicated that the use of a skin cleanser might be more effective than the use of soap and water (risk ratio (RR) 0.39, 95% confidence interval (CI) 0.17 to 0.87; low quality evidence). The second trial indicated that a structured skin care procedure, being a washcloth with cleansing, moisturising, and protecting properties, might be more effective than soap and water (RR 0.31, 95% CI 0.12 to 0.79; moderate quality evidence). Findings from the other trials, all being of low to very low quality, suggest that applying a leave-on product (moisturiser, skin protectant, or a combination) might be more effective than not applying a leave-on product. No trial reported on the third primary outcome 'number of participants not satisfied with treatment' or on adverse effects.
AUTHORS' CONCLUSIONS
Little evidence, of very low to moderate quality, exists on the effects of interventions for preventing and treating IAD in adults. Soap and water performed poorly in the prevention and treatment of IAD. Application of leave-on products (moisturisers, skin protectants, or a combination) and avoiding soap seems to be more effective than withholding these products. The performance of leave-on products depends on the combination of ingredients, the overall formulation and the usage (e.g. amount applied). High quality confirmatory trials using standardised, and comparable prevention and treatment regimens in different settings/regions are required. Furthermore, to increase the comparability of trial results, we recommend the development of a core outcome set, including validated measurement tools. The evidence in this review is current up to 28 September 2016.
Topics: Administration, Topical; Adult; Amitriptyline; Dermatitis; Dermatologic Agents; Fecal Incontinence; Humans; Petrolatum; Randomized Controlled Trials as Topic; Skin Care; Skin Cream; Soaps; Urinary Incontinence; Zinc Oxide
PubMed: 27841440
DOI: 10.1002/14651858.CD011627.pub2