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BMC Public Health Feb 2024Our study aimed to investigate the impact of urinary concentrations of personal care products (PCPs)-related phenols (PNs) and parabens (PBs), including Triclosan (TCS),...
BACKGROUND
Our study aimed to investigate the impact of urinary concentrations of personal care products (PCPs)-related phenols (PNs) and parabens (PBs), including Triclosan (TCS), Bisphenol A (BPA), Benzophenone-3 (BP-3), Butylparaben (BPB), Ethylparaben (EPB), Methylparaben (MPB), and Propylparaben (PPB), on urinary incontinence (UI) occurrence.
METHOD
We conducted a cross-sectional analysis using data from the National Health and Nutrition Examination Survey (NHANES) spanning the years 2007 to 2016. Regression analysis was employed to investigate the relationship between exposure to PCPs-related substances, various levels of exposure, and UI within both the general population and the female demographic. Additionally, the Bayesian Kernel Machine Regression (BKMR) model was used to assess the effects of mixtures on UI.
RESULTS
Our analysis comprised 7,690 participants who self-reported their diagnosis. Among them, 12.80% experienced stress urinary incontinence (SUI), 11.80% reported urge urinary incontinence (UUI), and 10.22% exhibited mixed urinary incontinence (MUI). In our fully adjusted multivariable models, BP-3 exposure exhibited a positive association with SUI (OR 1.07, 95% CI 1.02-1.14, p = 0.045). BPA exposure correlated with an increased risk of UUI (OR 1.21, 95% CI 1.01-1.44, p = 0.046) and MUI (OR 1.26, 95% CI 1.02-1.54, p = 0.029). TCS exposure displayed a negative correlation with the incidence of MUI (OR 0.87, 95% CI 0.79-0.97, p = 0.009). No significant links were observed between parabens and urinary incontinence. Notably, among the female population, our investigation revealed that BPA exposure heightened the risk of MUI (OR 1.28, 95% CI 1.01-1.63, p = 0.043). Participants in the highest tertile of BP-3 exposure demonstrated elevated likelihoods of SUI and MUI compared to those in the lowest tertile. In the BKMR analysis, negative trends were observed between the mixture and the risks of UUI and MUI when the mixture ranged from the 25th to the 40th and 35th to the 40th percentiles or above, respectively. Additionally, a positive trend was identified between the mixture and MUI when it was in the 40th to 55th percentile.
CONCLUSION
In conclusion, our findings suggest that exposure to BPA, TCS, and BP-3 may contribute to the development of urinary incontinence.
Topics: Humans; Female; Nutrition Surveys; Parabens; Cross-Sectional Studies; Bayes Theorem; Urinary Incontinence; Urinary Incontinence, Stress
PubMed: 38373965
DOI: 10.1186/s12889-024-17872-9 -
The Journal of Arthroplasty Jun 2024This modified Delphi study aimed to develop a consensus on optimal wound closure and incision management strategies for total hip arthroplasty (THA). Given the critical...
BACKGROUND
This modified Delphi study aimed to develop a consensus on optimal wound closure and incision management strategies for total hip arthroplasty (THA). Given the critical nature of wound care and incision management in influencing patient outcomes, this study sought to synthesize evidence-based best practices for wound care in THA procedures.
METHODS
An international panel of 20 orthopedic surgeons from Europe, Canada, and the United States evaluated a targeted literature review of 18 statements (14 specific to THA and 4 related to both THA and total knee arthroplasty). There were 3 rounds of anonymous voting per topic using a modified 5-point Likert scale with a predetermined consensus threshold of ≥ 75% agreement necessary for a statement to be accepted.
RESULTS
After 3 rounds of voting, consensus was achieved for all 18 statements. Notable recommendations for THA wound management included (1) the use of barbed sutures over non-barbed sutures (shorter closing times and overall cost savings); (2) the use of subcuticular sutures over skin staples (lower risk of superficial infections and higher patient preferences, but longer closing times); (3) the use of mesh-adhesives over silver-impregnated dressings (lower rate of wound complications); (4) for at-risk patients, the use of negative pressure wound therapy over other dressings (lower wound complications and reoperations, as well as fewer dressing changes); and (5) the use of triclosan-coated sutures (lower risk of surgical site infection) over standard sutures.
CONCLUSIONS
Through a structured modified Delphi approach, a panel of 20 orthopedic surgeons reached consensus on all 18 statements pertaining to wound closure and incision management in THA. This study provides a foundational framework for establishing evidence-based best practices, aiming to reduce variability in patient outcomes and to enhance the overall quality of care in THA procedures.
Topics: Humans; Arthroplasty, Replacement, Hip; Delphi Technique; Consensus; Surgical Wound Infection; Wound Healing; Wound Closure Techniques; Europe; Canada; Sutures; United States
PubMed: 38325531
DOI: 10.1016/j.arth.2024.01.047 -
Toxics Dec 2023The extensive use of the parabens triclosan (TCS) and bisphenol A (BPA) has potential adverse effects on human health and aquatic organisms. However, their monitoring...
The extensive use of the parabens triclosan (TCS) and bisphenol A (BPA) has potential adverse effects on human health and aquatic organisms. However, their monitoring information in freshwater lakes is still limited. This study simultaneously summarized the concentrations, spatial distribution characteristics, and correlations of four types of parabens, TCS, and BPA in the surface water and sediment of Baiyang Lake. Finally, the potential risks of target pollutants were evaluated from two aspects: human health risks and ecological risks. The average contaminations of target compounds in surface water and sediment-BPA, TCS, and ∑ parabens-was 33.1, 26.1, 0.7 ng/L and 24.5, 32.5, 2.5 ng/g, respectively. The total concentration of target compounds at the inlet of the upstream Fu River and Baigouyin River is significantly higher than that near Hunan and the outlet. In addition, Spearman's correlation analysis showed a significant positive correlation between compounds. The health hazards of target compounds in surface water were all within safe limits. However, the risk quotient results indicate that in some locations in surface water, TCS poses a high risk to algae and a moderate risk to invertebrates and fish, and appropriate attention should be paid to these areas.
PubMed: 38250987
DOI: 10.3390/toxics12010031 -
The Journal of Arthroplasty Apr 2024The purpose of this modified Delphi study was to obtain consensus on wound closure and dressing management in total knee arthroplasty (TKA). (Review)
Review
BACKGROUND
The purpose of this modified Delphi study was to obtain consensus on wound closure and dressing management in total knee arthroplasty (TKA).
METHODS
The Delphi panel included 20 orthopaedic surgeons from Europe and North America. There were 26 statements identified using a targeted literature review. Consensus was developed for the statements with up to three rounds of anonymous voting per topic. Panelists ranked their agreement with each statement on a five-point Likert scale. An a priori threshold of ≥ 75% was required for consensus.
RESULTS
All 26 statements achieved consensus after three rounds of anonymous voting. Wound closure-related interventions that were recommended for use in TKA included: 1) closing in semi-flexion versus extension (superior range of motion); 2) using aspirin for venous thromboembolism prophylaxis over other agents (reduces wound complications); 3) barbed sutures over non-barbed sutures (lower wound complications, better cosmetic appearances, shorter closing times, and overall cost savings); 4) mesh-adhesives over other skin closure methods (lower wound complications, higher patient satisfaction scores, lower rates of readmission); 5) silver-impregnated dressings over standard dressings (lower wound complications, decreased infections, fewer dressing changes); 6) in high-risk patients, negative pressure wound therapy over other dressings (lower wound complications, decreased reoperations, fewer dressing changes); and 7) using triclosan-coated over non-antimicrobial-coated sutures (lower risks of surgical site infection).
CONCLUSIONS
Using a modified Delphi approach, the panel achieved consensus on 26 statements pertaining to wound closure and dressing management in TKA. This study forms the basis for identifying critical evidence supported by clinical practice for wound management to help reduce variability, advance standardization, and ultimately improve outcomes during TKA. The results presented here can serve as the foundation for knowledge, education, and improved clinical outcomes for surgeons performing TKAs.
Topics: Humans; Arthroplasty, Replacement, Knee; Bandages; Delphi Technique; Reoperation; Surgical Wound Infection; Sutures
PubMed: 38244638
DOI: 10.1016/j.arth.2023.12.032 -
Ecotoxicology and Environmental Safety Feb 2024Triclosan (TCS), a broad-spectrum, lipophilic, and antibacterial agent, has been commonly used in cosmetics, medical devices, and household products. The toxicity of TCS...
Triclosan (TCS), a broad-spectrum, lipophilic, and antibacterial agent, has been commonly used in cosmetics, medical devices, and household products. The toxicity of TCS has recently become a research hotspot. Emerging evidence has shown that TCS can easily migrate to humans and animals and cause adverse effects on various target organs. However, the effects of TCS exposure on nephrotoxicity and underlying mechanisms remain unknown. The aim of the present study was to explore TCS-induced nephrotoxicity. Therefore, we establish a mouse model based on adult male mice to explore the effects of 10-week TCS exposure (50 mg/kg) on kidney. After mice were sacrificed, their blood, feces, and renal tissues were harvested for further analysis. We found that TCS treatment dramatically caused kidney structural damage, and increased blood urea nitrogen (BUN) and creatinine (Cr) expression levels, which indicated renal dysfunction. In addition, TCS exposure increased the malondialdehyde (MDA) and decreased superoxide dismutase (SOD) and total cholesterol (TCHO) expression levels, which indicated oxidative stress and lipid metabolism changes. The RNA sequencing (RNA-seq) of kidney tissue identified 221 differentially expressed genes (DEGs) enriched in 50 pathways, including drug metabolism-other enzymes, oxidative phosphorylation, glutathione metabolism, and inflammatory mediator regulation of TRP channels signaling pathways. The full-length 16S rRNA gene sequencing results showed that TCS exposure altered the community of gut microbiota, which was closely related to renal function damage. The above findings provide new insights into the mechanism of TCS-induced nephrotoxicity.
Topics: Humans; Adult; Male; Mice; Animals; Triclosan; Gastrointestinal Microbiome; Dysbiosis; RNA, Ribosomal, 16S; Kidney; Kidney Diseases
PubMed: 38199221
DOI: 10.1016/j.ecoenv.2023.115866 -
Ecotoxicology and Environmental Safety Jan 2024Biocides have emerged as a contributor to the rising cases of atopic dermatitis among children and adolescents. Previous animal studies suggested that phenols, parabens,...
BACKGROUND
Biocides have emerged as a contributor to the rising cases of atopic dermatitis among children and adolescents. Previous animal studies suggested that phenols, parabens, and pyrethroid insecticides present in these products might play a role in atopic dermatitis. However, there's limited epidemiological evidence confirming the individual or combined effects of exposure to these chemicals on atopic dermatitis in young populations. This study aimed to investigate the association between phenol, paraben, and pyrethroid metabolite levels in urine and atopic dermatitis among Korean children and adolescents METHODS: We analyzed 556 preschool children (3-5 years), 701 schoolchildren (6-11 years), and 731 adolescents (12-17 years) enrolled in the 4th Korean National Environmental Health Survey (KoNEHS) (2018-2020). We used logistic regression and Bayesian kernel machine regression to evaluate the association between atopic dermatitis and individual or mixed exposure to urinary triclosan (TCS), parabens (methylparaben, ethylparaben, propylparaben, and butylparaben), and 3-phenoxybenzoic acid (3-PBA) levels.
RESULTS
Urinary TCS levels were positively associated with atopic dermatitis in schoolchildren. When stratified by sex, male schoolchildren exhibited an increasing prevalence of atopic dermatitis as their urinary TCS and 3-PBA levels increased. The combined effect of biocide mixtures on atopic dermatitis was also significantly increased in male schoolchildren, with TCS as the main contributor.
CONCLUSIONS
These study findings suggest that biocides at levels found in Korean children and adolescents affect atopic dermatitis.
Topics: Animals; Child, Preschool; Humans; Male; Adolescent; Child; Parabens; Dermatitis, Atopic; Cross-Sectional Studies; Disinfectants; Bayes Theorem; Triclosan; Phenols; Republic of Korea; Pyrethrins; Benzoates
PubMed: 38181603
DOI: 10.1016/j.ecoenv.2023.115926 -
Environment International Jan 2024Synthetic chemicals are increasingly being recognized for potential independent contributions to preterm birth (PTB) and low birth weight (LBW). Bisphenols, parabens,...
BACKGROUND
Synthetic chemicals are increasingly being recognized for potential independent contributions to preterm birth (PTB) and low birth weight (LBW). Bisphenols, parabens, and triclosan are consumer product chemicals that act via similar mechanisms including estrogen, androgen, and thyroid disruption and oxidative stress. Multiple cohort studies have endeavored to examine effects on birth outcomes, and systematic reviews have been limited due to measurement of 1-2 spot samples during pregnancy and limited diversity of populations.
OBJECTIVE
To study the effects of prenatal phenols and parabens on birth size and gestational age (GA) in 3,619 mother-infant pairs from 11 cohorts in the NIH Environmental influences on Child Health Outcomes program.
RESULTS
While many associations were modest and statistically imprecise, a 1-unit increase in log pregnancy averaged concentration of benzophenone-3 and methylparaben were associated with decreases in birthweight, birthweight adjusted for gestational age and SGA. Increases in the odds of being SGA were 29% (95% CI: 5%, 58%) and 32% (95% CI: 3%, 70%), respectively. Bisphenol S in third trimester was also associated with SGA (OR 1.52, 95% CI 1.08, 2.13). Associations of benzophenone-3 and methylparaben with PTB and LBW were null. In addition, a 1-unit increase in log pregnancy averaged concentration of 2,4-dichlorophenol was associated with 43% lower (95% CI: -67%, -2%) odds of low birthweight; the direction of effect was the same for the highly correlated 2,5-dichlorophenol, but with a smaller magnitude (-29%, 95% CI: -53%, 8%).
DISCUSSION
In a large and diverse sample generally representative of the United States, benzophenone-3 and methylparaben were associated with lower birthweight as well as birthweight adjusted for gestational age and higher odds of SGA, while 2,4-dichlorophenol. These associations with smaller size at birth are concerning in light of the known consequences of intrauterine growth restriction for multiple important health outcomes emerging later in life.
Topics: Pregnancy; Child; Female; Humans; Infant, Newborn; United States; Parabens; Birth Weight; Phenol; Premature Birth; Phenols; Benzophenones; Chlorophenols
PubMed: 38181479
DOI: 10.1016/j.envint.2023.108378 -
Marine Pollution Bulletin Jan 2024Worldwide, coastal waters contain pollutants such as nutrients, plastics, and chemicals. Rivers export those pollutants, but their sources are not well studied. Our...
Worldwide, coastal waters contain pollutants such as nutrients, plastics, and chemicals. Rivers export those pollutants, but their sources are not well studied. Our study aims to quantify river exports of nutrients, chemicals, and plastics to coastal waters by source and sub-basin worldwide. We developed a new MARINA-Multi model for 10,226 sub-basins. The global modelled river export to seas is approximately 40,000 kton of nitrogen, 1,800 kton of phosphorous, 45 kton of microplastics, 490 kton of macroplastics, 400 ton of triclosan and 220 ton of diclofenac. Around three-quarters of these pollutants are transported to the Atlantic and Pacific oceans. Diffuse sources contribute by 95-100 % to nitrogen (agriculture) and macroplastics (mismanaged waste) in seas. Point sources (sewage) contribute by 40-95 % to phosphorus and microplastics in seas. Almost 45 % of global sub-basin areas are multi-pollutant hotspots hosting 89 % of the global population. Our findings could support strategies for reducing multiple pollutants in seas.
Topics: Water Pollutants, Chemical; Plastics; Microplastics; Environmental Monitoring; Environmental Pollutants; Nitrogen; Phosphorus; Rivers; Nutrients
PubMed: 38101060
DOI: 10.1016/j.marpolbul.2023.115902 -
Access Microbiology 2023poses a significant challenge in healthcare settings across the globe, with isolates exhibiting carbapenem resistance at unprecedented rates. Here, we characterized a...
poses a significant challenge in healthcare settings across the globe, with isolates exhibiting carbapenem resistance at unprecedented rates. Here, we characterized a collection of isolates (=64) recovered during the period September 2020 - November 2021 at a teaching hospital in Cochin, South India. The species identity of the isolates was confirmed with PCR. The major carbapenemase determinants identified were (45, 70.3 %) and (31, 48.4 %); co-occurrence of these genes was also observed in 27 (42.2 %) isolates. Other resistance genes identified included (34, 53.1 %), (42, 65.6 %), (25, 39.1 %), (32, 50 %), (33, 51.6 %), (36, 56.3 %), (35, 54.7 %) and (32, 50 %). Mapping PCR revealed the insertion element, IS upstream of in all isolates possessing this gene. Concerning disinfectant resistance, all isolates carried the quaternary ammonium compound (QAC) resistance gene, . Minimal inhibitory concentration (MIC) of benzalkonium chloride was high among the isolates and ranged from 8 to 128 µg ml. However, low MICs were observed for chlorhexidine and triclosan, with the majority (54, 80.6 %) of isolates showing an MIC of 2 µg ml for chlorhexidine and all isolates exhibiting MICs of ≤0.125 µg ml for triclosan. Further, all isolates were strong biofilm-producers, as assessed by the crystal violet-based microtitre plate assay. The I-pulsed-field gel electrophoresis (PFGE) revealed the multi-clonal nature of the isolates, with 16 clusters and 16 unique pulsotypes identified at a cut-off of 80 %. In short, this study provides useful data on the molecular features of from this region, which could be helpful to assess the local epidemiology of this pathogen and also to devise infection control strategies.
PubMed: 38074106
DOI: 10.1099/acmi.0.000662.v4 -
Chemosphere Feb 2024Evidence suggests that endocrine disrupting chemicals (EDCs), commonly used in plastics and personal care products, may be associated with reduced levels of vitamin D....
INTRODUCTION
Evidence suggests that endocrine disrupting chemicals (EDCs), commonly used in plastics and personal care products, may be associated with reduced levels of vitamin D. Therefore, this study examined the relationship between phthalate metabolites, 5-chloro-2-(2,4-dichlorophenoxy)phenol (triclosan; TCS) and bisphenols (BPs) with vitamin D (25(OH)D) and active 1,25-dihydroxyvitamin D (1,25(OH)D), and their relationship to calcium homeostasis.
METHODS
57 female participants (age 31.8 ± 4.6 years; BMI 25.6 ± 3.7 kg/m) were analyzed for urinary levels of phthalate metabolites, TCS and BPs, and serum levels of 25(OH)D and 1,25(OH)D determined by isotope-dilution liquid chromatography tandem mass spectrometry. Serum calcium/calmodulin-dependent (CaM) associated proteins were determined by Slow Off-rate Modified Aptamer (SOMA)-scan.
RESULTS
In the study cohort, 25(OH)D and 1,25(OH)D levels were 22.9 ± 11.2 ng/mL and 0.05 ± 0.02 ng/mL, respectively: mono-3-carboxypropyl-phthalate (MCPP) correlated negatively with 25(OH)D (ρ = -0.53, p = 0.01). 28 of the 57 women recruited were 25(OH)D deficient, <20 ng/mL (50 nmol/L): in this group, mono-iso-butylphthalate (MiBP) and mono-butylphthalate (MBP) negatively correlated with 25(OH)D; (ρ = -0.47, p = 0.049) and (ρ = -0.64, p = 0.005), respectively. EDCs did not correlate with 1,25(OH)D, measures of renal function or CaM proteins.
CONCLUSION
These putative data indicate that MCPP is related to 25(OH)D, while MiBP and MBP were related to vitamin D deficiency; however, no correlations were observed with TCS and BPs. No phthalate metabolites correlated with 1,25(OH)D, CaM associated proteins or renal function, suggesting that effects occur earlier in the vitamin D pathway and not through modulation of cellular calcium flux. The observed correlations are surprisingly strong compared to other predictors of 25(OH)D, and larger studies adjusting for potential confounders are warranted.
Topics: Humans; Female; Adult; Endocrine Disruptors; Triclosan; Pilot Projects; Calcium; Vitamin D; Vitamins
PubMed: 38070612
DOI: 10.1016/j.chemosphere.2023.140894