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Critical Care (London, England) May 2023Cytokine adsorption using the CytoSorb® adsorber has been proposed in various clinical settings including sepsis, ARDS, hyperinflammatory syndromes, cardiac surgery or... (Meta-Analysis)
Meta-Analysis
INTRODUCTION
Cytokine adsorption using the CytoSorb® adsorber has been proposed in various clinical settings including sepsis, ARDS, hyperinflammatory syndromes, cardiac surgery or recovery after cardiac arrest. The aim of this analysis is to provide evidence for the efficacy of the CytoSorb® adsorber with regard to mortality in various settings.
METHODS
We searched PubMed, Cochrane Library database and the database provided by Cytosorbents™ (01.1.2010-29.5.2022). We considered randomized controlled trials and observational studies with control groups. The longest reported mortality was defined as the primary endpoint. We computed risk ratios and 95%-confidence intervals and used DerSimonian and Lairds random effects model. We analysed all studies combined and divided them into the subgroups: sepsis, cardiopulmonary bypass surgery (CPB), other severe illness, SARS-CoV-2 infection and recovery from cardiac arrest. The meta-analysis was registered in advance (PROSPERO: CRD42022290334).
RESULTS
Of an initial 1295 publications, 34 studies were found eligible, including 1297 patients treated with CytoSorb® and 1314 controls. Cytosorb® intervention did not lower mortality (RR [95%-CI]: all studies 1.07 [0.88; 1.31], sepsis 0.98 [0.74; 1.31], CPB surgery 0.91 [0.64; 1.29], severe illness 0.95 [0.59; 1.55], SARS-CoV-2 1.58 [0.50; 4.94]). In patients with cardiac arrest, we found a significant survival advantage of the untreated controls (1.22 [1.02; 1.46]). We did not find significant differences in ICU length of stay, lactate levels, or IL-6 levels after treatment. Of the eligible 34 studies only 12 were randomized controlled trials. All observational studies showed moderate to serious risk of bias.
INTERPRETATION
To date, there is no evidence for a positive effect of the CytoSorb® adsorber on mortality across a variety of diagnoses that justifies its widespread use in intensive care medicine.
Topics: Cytokines; Adsorption; Thoracic Surgery; Cardiopulmonary Bypass; Postoperative Complications
PubMed: 37259160
DOI: 10.1186/s13054-023-04492-9 -
Critical Care (London, England) Jul 2023The oXiris is a novel filter for continuous renal replacement therapy (CRRT) featuring an adsorption coating to adsorb endotoxins and remove inflammatory mediators.... (Meta-Analysis)
Meta-Analysis Review
BACKGROUND
The oXiris is a novel filter for continuous renal replacement therapy (CRRT) featuring an adsorption coating to adsorb endotoxins and remove inflammatory mediators. Given that no consensus has been reached on its potential benefits in treating sepsis, a meta-analysis was conducted to assess its impact on the clinical outcomes of this patient population.
METHODS
Eleven databases were retrieved to find relevant observational studies and randomized controlled trials. The Newcastle-Ottawa Scale and the Cochrane Risk of Bias Tool were used to assess the quality of the included studies. The Grading of Recommendations, Assessment, Development, and Evaluation (GRADE) process was employed to assess the certainty of evidence. The 28-day mortality was the primary outcome. Secondary outcomes were 7-, 14-, and 90-day mortality, length of intensive care unit (ICU) and hospital stay, ICU and hospital mortality, norepinephrine (NE) dose, interleukin-6 (IL-6) and lactate levels, and Sequential Organ Failure Assessment (SOFA) score.
RESULTS
The meta-analysis, pooling data from 14 studies, involving 695 patients, showed significant reductions in 28-day mortality [odds ratio (OR) 0.53; 95% confidence interval (CI) 0.36-0.77, p = 0.001] and length of ICU stay [weighted mean difference (WMD) - 1.91; 95% CI - 2.56 to - 1.26, p < 0.001)] in patients with sepsis using the oXiris filter compared to other filters. Besides, the SOFA score, NE dose, IL-6 and lactate levels, and 7- and 14-day mortalities were lower in the oXiris group. However, the 90-day mortality, ICU and hospital mortality, and length of hospital stay were comparable. The quality assessment of the ten observational studies indicated intermediate to high quality (average Newcastle-Ottawa score: 7.8). However, all four randomized controlled trials (RCTs) had an unclear risk of bias. The evidence for all outcomes had a low or very low level of certainty because the original study design was mainly observational studies and the RCTs included had an unclear risk of bias and a small sample size.
CONCLUSION
The treatment with the oXiris filter during CRRT in sepsis patients may be associated with lower 28-, 7-, and 14-day mortalities, lactate levels, SOFA score, NE dose, and shorter length of ICU stay. However, due to the low or very low quality of evidence, the effectiveness of oXiris filters was still uncertain. Besides, no significant difference was observed for the 90-day mortality, ICU and hospital mortality, and length of hospital stay.
Topics: Humans; Continuous Renal Replacement Therapy; Interleukin-6; Adsorption; Sepsis; Lactates
PubMed: 37424026
DOI: 10.1186/s13054-023-04555-x -
Iranian Journal of Public Health Jan 2023Selenium (Se) is an essential element playing a vital role in the metabolism of organisms. Se can generally be discharged in the potable water through natural and... (Review)
Review
BACKGROUND
Selenium (Se) is an essential element playing a vital role in the metabolism of organisms. Se can generally be discharged in the potable water through natural and anthropogenic activities. Both excess and shortage of Se can cause significant adverse health effects in humans. Excess values of se may toxicity, leading to selenosis and alkali disease in humans and grazing animals, respectively.
METHODS
A review search was systematically carried out from the databases Embase, PubMed/MEDLINE, Scopus, PubMed Central (PMC), Google Scholar, as well as medRxiv by using the following keywords: "waste water", "bioremediation", "selenium removal", "adsorption", and "drinking water". This study provides a review of the recent literature covering the period between 2011 and 2021. After screening the full text of the articles, 27 papers were enrolled. This study reviews the reported techniques for Se removal from water and wastewater, including adsorption, biological treatment, microbial reduction, bioreactors, fungal bioreactor, algal treatment, phytoremediation, and photocatalysis.
RESULTS
Biological and bioremediation techniques, such as microbial reduction, biotransformation, and fluidized bed reactor have removal efficiency about 100%. The highest Se concentration of 15-7600 μg/L was achieved in ground waters in Ethiopia and the lowest level of 0.07 μg/L in Finland.
CONCLUSION
The combination of biological treatment with chemical or physical technologies is envisaged to optimize se elimination and to ensure ecological protection and human health safety.
PubMed: 36824240
DOI: 10.18502/ijph.v52i1.11667 -
Journal of Clinical Medicine Oct 2020The accumulation of blood proteins and cells on extracorporeal membrane oxygenation (ECMO) circuits has been proposed as a contributing factor to the coagulopathic state... (Review)
Review
The accumulation of blood proteins and cells on extracorporeal membrane oxygenation (ECMO) circuits has been proposed as a contributing factor to the coagulopathic state of many patients. This systematic review aims to summarize and discuss the existing knowledge of blood components binding to the ECMO circuits in human patients. A systematic review was conducted using the Medline, PubMed and Embase databases following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. Seven studies were included in this review. Three studies identified a leukocyte adhesion, three studies observed von Willebrand factor accumulation and four studies identified bound platelets on the surface of the circuits. Other identified components included fibrin, albumin, hemoglobin, erythrocytes, progenitor cells, fibronectin and IgG. This systematic review demonstrates the limited state of knowledge when it comes to adsorption to the ECMO circuits in humans. Most of the studies lacked insight or detail into the mechanisms of binding and the interactions between different components bound to the ECMO circuits. Further research is required to comprehensively characterize surface adsorption to ECMO circuits in humans and to define the specific mechanisms of binding, enabling improvements that increase biocompatibility between the blood-circuit interface in this important clinical setting.
PubMed: 33053879
DOI: 10.3390/jcm9103272 -
Chemosphere Oct 2023This comprehensive study analysed 55 articles published between 2011 and 2022 on the use of metal organic frameworks (MOFs) for phosphate adsorption. The study found... (Meta-Analysis)
Meta-Analysis Review
This comprehensive study analysed 55 articles published between 2011 and 2022 on the use of metal organic frameworks (MOFs) for phosphate adsorption. The study found that the performance of MOFs in phosphate adsorption is influenced by various factors such as the type of MOF, synthesis method, modification/alteration, and operational conditions (initial concentration, adsorbent dose, pH, contact time, and temperature). Most of the MOFs have a wide range of theoretical maximum adsorption capacity for phosphate, but their long-term use in phosphorus recovery may be limited due to the adsorption mechanisms being dominated by inner sphere complexation. The study employed machine learning to construct artificial neural network (ANN) models for predicting phosphate adsorption capacity based on input features from operation and synthesis procedures. The initial phosphate concentration was the most important input from the operational features, while the modulator agent was consistently relevant during MOF synthesis. The models showed strong fitting for most MOF types recorded for the study, such as UIO-66, MIL-100, ZIF-8, Al-MOFs, La-MOFs, and Ce-MOFs. Overall, this study provides valuable insights for the design of MOF adsorbents for phosphate adsorption and offers guidance for future research in this area.
Topics: Phosphates; Metal-Organic Frameworks; Adsorption; Phosphorus; Neural Networks, Computer
PubMed: 37517668
DOI: 10.1016/j.chemosphere.2023.139674 -
RSC Advances Mar 2022The novel human coronavirus pandemic is one of the most significant occurrences in human civilization. The rapid proliferation and mutation of Severe Acute Respiratory... (Review)
Review
The novel human coronavirus pandemic is one of the most significant occurrences in human civilization. The rapid proliferation and mutation of Severe Acute Respiratory Syndrome-Coronavirus 2 (SARS-CoV-2) have created an exceedingly challenging situation throughout the world's healthcare systems ranging from underdeveloped countries to super-developed countries. The disease is generally recognized as coronavirus disease 2019 (COVID-19), and it is caused by a new human CoV, which has put mankind in jeopardy. COVID-19 is death-dealing and affects people of all ages, including the elderly and middle-aged people, children, infants, persons with co-morbidities, and immunocompromised patients. Moreover, multiple SARS-CoV-2 variants have evolved as a result of genetic alteration. Some variants cause severe symptoms in patients, while others cause an unusually high infection rate, and yet others cause extremely severe symptoms as well as a high infection rate. Contrasting with a previous epidemic, COVID-19 is more contagious since the spike protein of SARS-CoV-2 demonstrates profuse affection to angiotensin-converting enzyme II (ACE2) that is copiously expressed on the surface of human lung cells. Since the estimation and tracking of viral loads are essential for determining the infection stage and recovery duration, a quick, accurate, easy, cheap, and versatile diagnostic tool is critical for managing COVID-19, as well as for outbreak control. Currently, Reverse Transcription Polymerase Chain Reaction (RT-PCR) testing is the most often utilized approach for COVID-19 diagnosis, while Computed Tomography (CT) scans of the chest are used to assess the disease's stages. However, the RT-PCR method is non-portable, tedious, and laborious, and the latter is not capable of detecting the preliminary stage of infection. In these circumstances, nano-biosensors can play an important role to deliver point-of-care diagnosis for a variety of disorders including a wide variety of viral infections rapidly, economically, precisely, and accurately. New technologies are being developed to overcome the drawbacks of the current methods. Nano-biosensors comprise bioreceptors with electrochemical, optical, or FET-based transduction for the specific detection of biomarkers. Different types of organic-inorganic nanomaterials have been incorporated for designing, fabricating, and improving the performance and analytical ability of sensors by increasing sensitivity, adsorption, and biocompatibility. The particular focus of this review is to carry out a systematic study of the status and perspectives of synthetic routes for nano-biosensors, including their background, composition, fabrication processes, and prospective applications in the diagnosis of COVID-19.
PubMed: 35424900
DOI: 10.1039/d2ra01293f -
RSC Advances Apr 2023The ecosystem and human health are both significantly affected by the occurrence of potentially harmful heavy metals in the aquatic environment. In general, wastewater... (Review)
Review
The ecosystem and human health are both significantly affected by the occurrence of potentially harmful heavy metals in the aquatic environment. In general, wastewater comprises an array of heavy metals, and the existence of other competing heavy metal ions might affect the adsorptive elimination of one heavy metal ion. Therefore, to fully comprehend the adsorbent's efficiency and practical applications, the abatement of heavy metals in multicomponent systems is important. In the current study, the multicomponent adsorption of heavy metals from different complex mixtures, such as binary, ternary, quaternary, and quinary solutions, utilizing various adsorbents are reviewed in detail. According to the systematic review, the adsorbents made from locally and naturally occurring materials, such as biomass, feedstocks, and industrial and agricultural waste, are effective and promising in removing heavy metals from complex water systems. The systematic study further discovered that numerous studies evaluate the adsorption characteristics of an adsorbent in a multicomponent system using various important independent adsorption parameters. These independent adsorption parameters include reaction time, solution pH, agitation speed, adsorbent dosage, initial metal ion concentration, ionic strength as well as reaction temperature, which were found to significantly affect the multicomponent sorption of heavy metals. Furthermore, through the application of the multicomponent adsorption isotherms, the competitive heavy metals sorption mechanisms were identified and characterized by three primary kinds of interactive effects including synergism, antagonism, and non-interaction. Despite the enormous amount of research and extensive data on the capability of different adsorbents, several significant drawbacks hinder adsorbents from being used practically and economically to remove heavy metal ions from multicomponent systems. As a result, the current systematic review provides insights and perspectives for further studies through the thorough and reliable analysis of the relevant literature on heavy metals removal from multicomponent systems.
PubMed: 37124024
DOI: 10.1039/d3ra01660a -
International Journal of Environmental... Feb 2022Kapok fiber () belongs to a group of natural fibers that are mainly composed of cellulose, lignin, pectin, and small traces of inorganic compounds. These fibers are... (Review)
Review
Kapok fiber () belongs to a group of natural fibers that are mainly composed of cellulose, lignin, pectin, and small traces of inorganic compounds. These fibers are lightweight with hollow tubular structure that is easy to process and abundant in nature. Currently, kapok fibers are used in industry as filling material for beddings, upholstery, soft toys, and nonwoven materials. However, kapok fiber has also a potential application in the adsorptive removal of heavy metal ions and dyes from aqueous systems. This study aims to provide a comprehensive review about the recent developments on kapok fiber composites including its chemical properties, wettability, and surface morphology. Effective and innovative kapok fiber composites are analyzed with the help of characterization tools such as scanning electron microscopy, X-ray diffraction, X-ray photoelectron spectroscopy, thermogravimetric analysis, Fourier transform infrared spectroscopy, energy-dispersive X-ray spectroscopy, and Brunauer-Emmett-Teller analysis. Different pre-treatment methods such as alkali and acid pre-treatment, oxidation pre-treatment, and Fenton reaction are discussed. These techniques are applied to enhance the hydrophilicity and to generate rougher fiber surfaces. Moreover, surface modification and synthesis of kapok fiber-based composites and its environmental applications are examined. There are various methods in the fabrication of kapok fiber composites that include chemical modification and polymerization. These procedures allow the kapok fiber composites to have higher adsorption capacities for selective heavy metal and dye removal.
Topics: Adsorption; Ceiba; Coloring Agents; Ions; Metals, Heavy; Spectroscopy, Fourier Transform Infrared; Water; Water Pollutants, Chemical
PubMed: 35270400
DOI: 10.3390/ijerph19052703 -
Polymers May 2023In recent decades, hydrogels, as adsorption materials, have received important attention due to their characteristics and properties, such as mechanical strength,... (Review)
Review
In recent decades, hydrogels, as adsorption materials, have received important attention due to their characteristics and properties, such as mechanical strength, biocompatibility, biodegradability, swellability, and stimuli sensitivity. In the actual framework of sustainable development, it has been imperative to develop practical studies of hydrogels in the treatment of actual industrial effluents. Accordingly, the current work has, as its objective, to make evident hydrogels' applicability in the treatment of actual industrial effluents. For this purpose, a bibliometric analysis and systematic review based on the PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) method were conducted. The relevant articles were selected from the Scopus and Web of Science databases. Some important findings were that: (1) China is the leading country when it comes to hydrogel application in actual industrial effluents, (2) the motor studies are focalized on the treatment of wastewater by hydrogels, (3) the fixed-bed columns are suitable unit equipment for the treatment of industrial effluents of using hydrogels, and (4) the hydrogels show excellent adsorption capacities of ion and dye contaminants present in industrial effluents. In summary, since the implementation of sustainable development in 2015, the progress of practical hydrogel applications in the treatment of industrial effluent has been receiving more attention, and the selected studies demonstrate the implementation viability of these materials.
PubMed: 37299216
DOI: 10.3390/polym15112417 -
Marine Drugs Jan 2015Chitosan is considered to be one of the most promising and applicable materials in adsorption applications. The existence of amino and hydroxyl groups in its molecules... (Review)
Review
Chitosan is considered to be one of the most promising and applicable materials in adsorption applications. The existence of amino and hydroxyl groups in its molecules contributes to many possible adsorption interactions between chitosan and pollutants (dyes, metals, ions, phenols, pharmaceuticals/drugs, pesticides, herbicides, etc.). These functional groups can help in establishing positions for modification. Based on the learning from previously published works in literature, researchers have achieved a modification of chitosan with a number of different functional groups. This work summarizes the published works of the last three years (2012-2014) regarding the modification reactions of chitosans (grafting, cross-linking, etc.) and their application to adsorption of different environmental pollutants (in liquid-phase).
Topics: Adsorption; Chitosan; Coloring Agents; Cross-Linking Reagents; Environmental Restoration and Remediation; Metals; Microscopy, Electron, Scanning
PubMed: 25584681
DOI: 10.3390/md13010312