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The Cochrane Database of Systematic... Sep 2012Surgical site infections (SSIs) are wound infections that occur after invasive (surgical) procedures. Preoperative bathing or showering with an antiseptic skin wash... (Meta-Analysis)
Meta-Analysis Review
BACKGROUND
Surgical site infections (SSIs) are wound infections that occur after invasive (surgical) procedures. Preoperative bathing or showering with an antiseptic skin wash product is a well-accepted procedure for reducing skin bacteria (microflora). It is less clear whether reducing skin microflora leads to a lower incidence of surgical site infection.
OBJECTIVES
To review the evidence for preoperative bathing or showering with antiseptics for preventing hospital-acquired (nosocomial) surgical site infections.
SEARCH METHODS
For this fourth update we searched the Cochrane Wounds Group Specialised Register (searched 29 June 2012); the Cochrane Central Register of Controlled Trials (The Cochrane Library 2012 Issue 6); Ovid MEDLINE (2010 to June Week 3 2012), Ovid MEDLINE (In-Process & Other Non-Indexed Citations June 27, 2012); Ovid EMBASE (2010 to 2012 Week 25), EBSCO CINAHL (1882 to 21 June 2012) and reference lists of articles.
SELECTION CRITERIA
Randomised controlled trials comparing any antiseptic preparation used for preoperative full-body bathing or showering with non-antiseptic preparations in people undergoing surgery.
DATA COLLECTION AND ANALYSIS
Two review authors independently assessed studies for selection, risk of bias and extracted data. Study authors were contacted for additional information.
MAIN RESULTS
We did not identify any new trials for inclusion in this fourth update. Seven trials involving a total of 10,157 participants were included. Four of the included trials had three comparison groups. The antiseptic used in all trials was 4% chlorhexidine gluconate (Hibiscrub/Riohex). Three trials involving 7791 participants compared chlorhexidine with a placebo. Bathing with chlorhexidine compared with placebo did not result in a statistically significant reduction in SSIs; the relative risk of SSI (RR) was 0.91 (95% confidence interval (CI) 0.80 to 1.04). When only trials of high quality were included in this comparison, the RR of SSI was 0.95 (95%CI 0.82 to 1.10). Three trials of 1443 participants compared bar soap with chlorhexidine; when combined there was no difference in the risk of SSIs (RR 1.02, 95% CI 0.57 to 1.84). Three trials of 1192 patients compared bathing with chlorhexidine with no washing, one large study found a statistically significant difference in favour of bathing with chlorhexidine (RR 0.36, 95%CI 0.17 to 0.79). The smaller studies found no difference between patients who washed with chlorhexidine and those who did not wash preoperatively.
AUTHORS' CONCLUSIONS
This review provides no clear evidence of benefit for preoperative showering or bathing with chlorhexidine over other wash products, to reduce surgical site infection. Efforts to reduce the incidence of nosocomial surgical site infection should focus on interventions where effect has been demonstrated.
Topics: Anti-Infective Agents, Local; Baths; Chlorhexidine; Disinfection; Female; Humans; Male; Preoperative Care; Randomized Controlled Trials as Topic; Soaps; Surgical Wound Infection
PubMed: 22972080
DOI: 10.1002/14651858.CD004985.pub4 -
BMC Gastroenterology Nov 2019Bile acid malabsorption (BAM) and bile acid-related diarrhea represent an under-recognized cause of chronic diarrhea mainly because of limited guidance on appropriate...
BACKGROUND
Bile acid malabsorption (BAM) and bile acid-related diarrhea represent an under-recognized cause of chronic diarrhea mainly because of limited guidance on appropriate diagnostic and laboratory tests. We aimed to perform a systematic review of the literature in order to identify and compare the diagnostic accuracy of different diagnostic methods for patients with BAM, despite a proven gold standard test is still lacking.
METHODS
A PubMed literature review and a manual search were carried out. Relevant full papers, evaluating the diagnostic accuracy of different methods for BAM, were assessed. Available data were analyzed to estimate the sensitivity and specificity of each published test.
RESULTS
Overall, more than one test was considered in published papers on BAM. The search strategy retrieved 574 articles; of these, only 16 were full papers (with a total of 2.332 patients) included in the final review. Specifically, n = 8 studies used Selenium-homotaurocholic-acid-test (SeHCAT) with a < 10% retention threshold; n = 8 studies evaluated fasting serum 7-α-hydroxy-4-cholesten-3-one (C4); n = 3 studies involved total fecal bile acid (BA) excretion over 48 h; n = 4 studies assessed fibroblast growth factor 19 (FGF19). SeHCAT showed an average sensitivity and specificity of 87.32 and 93.2%, respectively, followed by serum C4 (85.2 and 71.1%) and total fecal BA (66.6 and 79.3%). Fasting serum FGF19 had the lowest sensitivity and specificity (63.8 and 72.3%). All the extracted data were associated with substantial heterogeneity.
CONCLUSIONS
Our systematic review indicates that SeHCAT has the highest diagnostic accuracy for BAM, followed by serum C4 assay. The diagnostic yield of fecal BA and FGF19 assays is still under investigation. Our review reinforces the need for novel biomarkers aimed to an objective detection of BAM and therefore improving the management of this condition.
Topics: Bile Acids and Salts; Biomarkers; Humans; Intestinal Reabsorption; Malabsorption Syndromes; Sensitivity and Specificity; Taurocholic Acid
PubMed: 31726982
DOI: 10.1186/s12876-019-1102-1 -
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 -
Journal of Food Protection Jun 2016Hands can be a vector for transmitting pathogenic microorganisms to foodstuffs and drinks, and to the mouths of susceptible hosts. Hand washing is the primary barrier to... (Review)
Review
Hands can be a vector for transmitting pathogenic microorganisms to foodstuffs and drinks, and to the mouths of susceptible hosts. Hand washing is the primary barrier to prevent transmission of enteric pathogens via cross-contamination from infected persons. Conventional hand washing involves the use of water, soap, and friction to remove dirt and microorganisms. The availability of hand sanitizing products for use when water and soap are unavailable has increased in recent years. The aim of this systematic review was to collate scientific information on the efficacy of hand sanitizers compared with washing hands with soap and water for the removal of foodborne pathogens from the hands of food handlers. An extensive literature search was carried out using three electronic databases: Web of Science, Scopus, and PubMed. Twenty-eight scientific publications were ultimately included in the review. Analysis of this literature revealed various limitations in the scientific information owing to the absence of a standardized protocol for evaluating the efficacy of hand products and variation in experimental conditions. However, despite conflicting results, scientific evidence seems to support the historical skepticism about the use of waterless hand sanitizers in food preparation settings. Water and soap appear to be more effective than waterless products for removal of soil and microorganisms from hands. Alcohol-based products achieve rapid and effective inactivation of various bacteria, but their efficacy is generally lower against nonenveloped viruses. The presence of food debris significantly affects the microbial inactivation rate of hand sanitizers.
Topics: Hand; Hand Disinfection; Hand Sanitizers; Humans; Soaps; Water
PubMed: 27296611
DOI: 10.4315/0362-028X.JFP-15-492 -
BMJ Open Aug 2021To compare the effectiveness of hand hygiene using alcohol-based hand sanitiser to soap and water for preventing the transmission of acute respiratory infections (ARIs)... (Meta-Analysis)
Meta-Analysis
OBJECTIVE
To compare the effectiveness of hand hygiene using alcohol-based hand sanitiser to soap and water for preventing the transmission of acute respiratory infections (ARIs) and to assess the relationship between the dose of hand hygiene and the number of ARI, influenza-like illness (ILI) or influenza events.
DESIGN
Systematic review and meta-analysis.
DATA SOURCES
Cochrane Central Register of Controlled Trials (CENTRAL), PubMed, Embase, Cumulative Index of Nursing and Allied Health Literature (CINAHL) and trial registries were searched in April 2020.
INCLUSION CRITERIA
We included randomised controlled trials that compared a community-based hand hygiene intervention (soap and water, or sanitiser) with a control, or trials that compared sanitiser with soap and water, and measured outcomes of ARI, ILI or laboratory-confirmed influenza or related consequences.
DATA EXTRACTION AND ANALYSIS
Two review authors independently screened the titles and abstracts for inclusion and extracted data.
RESULTS
Eighteen trials were included. When meta-analysed, three trials of soap and water versus control found a non-significant increase in ARI events (risk ratio (RR) 1.23, 95% CI 0.78 to 1.93); six trials of sanitiser versus control found a significant reduction in ARI events (RR 0.80, 95% CI 0.71 to 0.89). When hand hygiene dose was plotted against ARI relative risk, no clear dose-response relationship was observable. Four trials were head-to-head comparisons of sanitiser and soap and water but too heterogeneous to pool: two found a significantly greater reduction in the sanitiser group compared with the soap group and two found no significant difference between the intervention arms.
CONCLUSIONS
Adequately performed hand hygiene, with either soap or sanitiser, reduces the risk of ARI virus transmission; however, direct and indirect evidence suggest sanitiser might be more effective in practice.
Topics: Hand Hygiene; Humans; Influenza, Human; Respiratory Tract Infections; Soaps; Virus Diseases
PubMed: 34408031
DOI: 10.1136/bmjopen-2020-046175 -
Sao Paulo Medical Journal = Revista... 2020Faced with a pandemic, all healthcare actions need to reflect best practices, in order to avoid high transmissibility, complications and even hospitalizations. For...
BACKGROUND
Faced with a pandemic, all healthcare actions need to reflect best practices, in order to avoid high transmissibility, complications and even hospitalizations. For hospital environments, the products recommended and authorized by regulatory institutions for environmental cleaning and disinfection need to be highly effective.
OBJECTIVE
To identify, systematically evaluate and summarize the best available scientific evidence on environmental cleaning to prevent COVID-19 infection.
DESIGN AND SETTING
A systematic review of studies analyzing cleaning products that inactivate coronavirus, conducted within the evidence-based health program of a federal university in São Paulo (SP), Brazil.
METHODS
A systematic search of the relevant literature was conducted in the PubMed, EMBASE, Cochrane Library, CINAHL and LILACS databases, for articles published up to May 27, 2020, relating to studies evaluating cleaning products that inactivate coronavirus in the environment.
RESULTS
Seven studies were selected. These analyzed use of 70% alcohol, detergent, detergent containing iodine, household bleach, sodium hypochlorite, hydrogen peroxide, chlorine dioxide, glutaraldehyde, ultraviolet irradiation and plasma air purifier. The effectiveness of treating sewage with sodium hypochlorite and chlorine dioxide was also evaluated.
CONCLUSION
Disinfection of environments, especially those in ordinary use, such as bathrooms, needs to be done constantly. Viral inactivation was achieved using chlorine-based disinfectants, alcohol, detergents, glutaraldehyde, iodine-containing detergents, hydrogen peroxide compounds and household bleaches. Alcohol showed efficient immediate activity. In sewage, sodium hypochlorite had better action than chlorine dioxide.
REGISTRATION NUMBER
DOI: 10.17605/OSF.IO/YC5P4 in the Open Science Framework.
Topics: Brazil; COVID-19; Disinfectants; Disinfection; Humans; Infection Control
PubMed: 33206913
DOI: 10.1590/1516-3180.2020.0417.09092020 -
Food and Waterborne Parasitology Mar 2022The cestode family Taeniidae consists of the genera and , both of which include zoonotic tapeworms of serious public health importance. Various environmental matrices...
The cestode family Taeniidae consists of the genera and , both of which include zoonotic tapeworms of serious public health importance. Various environmental matrices have been identified from which parasite transmission to animals and humans can occur, and many techniques for detecting taeniid eggs in different environments have been developed. However, the majority lack appropriate validation, and standardized egg isolation procedures are absent. This hampers interstudy comparisons and poses a challenge for future researchers when deciding which technique to implement for assessing taeniid egg contamination in a particular matrix. Therefore, the aim of this systematic review was to present an overview of the detection methods for taeniid eggs in the environment, to discuss and compare them, and to provide recommendations for future studies. In total, 1814 publications were retrieved from scientific databases, and, ultimately, data were systematically reviewed from 90 papers. The results provide an overview of numerous diagnostic tests for taeniid egg detection in (or on) water, food, soil, insects, objects, and air. These tools could be categorized as either conventional (light microscopy), molecular, or immunodetection tools. The relatively cheap microscopy techniques often lack sensitivity and are unable to identify a taeniid egg at the genus level. Nevertheless, several records ascribed a genus, or even species, to taeniid eggs that had been detected by light microscopy. Molecular and immunodetection tools offer better specificity, but still rely on the preceding egg recovery steps that also affect overall sensitivity. Finally, the majority of the methods lacked any attempt at performance evaluation and standardization, especially at the earlier stages of the analysis (e.g., sampling strategy, storage conditions, egg recovery), and viability was rarely addressed. As such, our review highlights the need for standardized, validated detection tools, that not only assess the extent of environmental contamination, but also the egg genus or species, and address viability.
PubMed: 35198745
DOI: 10.1016/j.fawpar.2022.e00145 -
Antimicrobial Resistance and Infection... Oct 2021With the current COVID-19 pandemic, many healthcare facilities have been lacking a steady supply of filtering facepiece respirators. To better address this challenge,...
BACKGROUND
With the current COVID-19 pandemic, many healthcare facilities have been lacking a steady supply of filtering facepiece respirators. To better address this challenge, the decontamination and reuse of these respirators is a strategy that has been studied by an increasing number of institutions during the COVID-19 pandemic.
METHODS
We conducted a systematic literature review in PubMed, PubMed Central, Embase, and Google Scholar. Studies were eligible when (electronically or in print) up to 17 June 2020, and published in English, French, German, or Spanish. The primary outcome was reduction of test viruses or test bacteria by log3 for disinfection and log6 for sterilization. Secondary outcome was physical integrity (fit/filtration/degradation) of the respirators after reprocessing. Materials from the grey literature, including an unpublished study were added to the findings.
FINDINGS
Of 938 retrieved studies, 35 studies were included in the analysis with 70 individual tests conducted. 17 methods of decontamination were found, included the use of liquids (detergent, benzalkonium chloride, hypochlorite, or ethanol), gases (hydrogen peroxide, ozone, peracetic acid or ethylene oxide), heat (either moist with or without pressure or dry heat), or ultra violet radiation (UVA and UVGI); either alone or in combination. Ethylene oxide, gaseous hydrogen peroxide (with or without peracetic acid), peracetic acid dry fogging system, microwave-generated moist heat, and steam seem to be the most promising methods on decontamination efficacy, physical integrity and filtration capacity.
INTERPRETATION
A number of methods can be used for N95/FFP2 mask reprocessing in case of shortage, helping to keep healthcare workers and patients safe. However, the selection of disinfection or sterilization methods must take into account local availability and turnover capacity as well as the manufacturer; meaning that some methods work better on specific models from specific manufacturers.
SYSTEMATIC REGISTRATION NUMBER
CRD42020193309.
Topics: COVID-19; Decontamination; Equipment Reuse; Humans; N95 Respirators
PubMed: 34635165
DOI: 10.1186/s13756-021-00993-w -
Biochimica Et Biophysica Acta.... Mar 2021Structure determination of membrane proteins is critical to the molecular understanding of many life processes, yet it has historically been a technically challenging... (Meta-Analysis)
Meta-Analysis
Structure determination of membrane proteins is critical to the molecular understanding of many life processes, yet it has historically been a technically challenging endeavor. This past decade has given rise to a number of technological advancements, techniques, and reagents, which have facilitated membrane protein structural biology, resulting in an ever-growing number of membrane protein structures determined. To collate these advances, we have mined available literature to analyze the purification and structure determination specifics for all uniquely solved membrane protein structures from 2010 to 2019. Our analyses demonstrate the strong impact of single-particle cryo-electron microscopy on the field and illustrate how this technique has affected detergent and membrane mimetic usage. Furthermore, we detail how different structure determination methods, taxonomic domains and protein classes have unique detergent/membrane mimetic profiles, highlighting the importance of tailoring their selection. Our analyses provide a quantitative overview of where the field of membrane protein structural biology stands and how it has developed over time. We anticipate that these will serve as a useful tool to streamline future membrane protein structure determination by guiding the choice of detergent/membrane mimetic.
Topics: Biomimetic Materials; Cryoelectron Microscopy; Detergents; Lipid Bilayers; Membrane Proteins
PubMed: 33340490
DOI: 10.1016/j.bbamem.2020.183533 -
Planta Medica Apr 2022is a typical shrub from Brazil that has been used in traditional medicine. This is a systematic review on the effect of for controlling dental plaque, gingivitis, and...
is a typical shrub from Brazil that has been used in traditional medicine. This is a systematic review on the effect of for controlling dental plaque, gingivitis, and periodontitis. A database search through May 2021 in Medline/PubMed, SCOPUS, BVS, and Web of Science identified 711 reports of which 17 met our inclusion criteria. Five randomized controlled trials and three animal studies were included that compared -based products (toothpaste, mouthrinse, and gel) to cetylpyridinium chloride, chlorhexidine, and placebo products. Among the human studies, a significant antiplaque effect after treatment with -based products was observed in three studies and an antigingivitis effect in two studies, similar to chlorhexidine-based products. One study found superior dental plaque reduction compared to cetylpyridinium chloride mouthrinse. Only one study testing a gel found no antiplaque effect. Among the animal studies, an mouthrinse significantly reduced calculus in two studies, inflammatory infiltrate in one study, and plaque bacteria and gingivitis in one study. An gel significantly reduced alveolar bone loss and inflammatory response in one study in which mice were submitted to ligature-induced periodontal disease. In general, -based products were effective in reducing dental plaque and calculus formation, as well as clinical signs of gingivitis. As most studies present methodological limitations, these results should be interpreted carefully. Further clinical trials with greater methodological accuracy and control of biases are necessary for the use of -based products in humans to be viable in clinical practice.
Topics: Animals; Calculi; Cetylpyridinium; Chlorhexidine; Dental Plaque; Gingivitis; Lippia; Mice; Mouthwashes
PubMed: 34598290
DOI: 10.1055/a-1554-6947