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International Journal of Environmental... Apr 2022(1) Background: Globally there is a vast legacy of contaminated sites from past industrial, commercial and military activity, waste disposal, and mineral extraction.... (Review)
Review
(1) Background: Globally there is a vast legacy of contaminated sites from past industrial, commercial and military activity, waste disposal, and mineral extraction. This review examined the extent to which the remediation of contaminated sites reduces health risks to new and existing populations. (2) Methods: Standard academic databases were searched for papers that reported on health-related outcomes in humans following remediation and redevelopment of contaminated sites. Title/abstract screening, followed by full-text screening identified sixteen papers that met the eligibility criteria. (3) Results: Most studies were set in the United States of America and reported changes in blood lead concentrations in children, following soil remediation and, in some cases, public health campaigns to reduce exposure. Two further studies examined the impacts of remediation on soil contaminated with chromium and sediments contaminated with polychlorinated biphenyls (PCBs). (4) Conclusions: Overall, the evidence suggests that remediation via removal, capping, and replacing soil, and planting vegetation is effective at reducing concentrations of lead and chromium in blood and urine in children. There is also evidence that sediment dredging can reduce PCB concentrations in umbilical cords in infants. Study designs are relatively weak and some recommendations are provided for those wishing to examine the health impacts of remediation.
Topics: Child; Chromium; Environmental Restoration and Remediation; Humans; Lead; Polychlorinated Biphenyls; Soil; Soil Pollutants
PubMed: 35564674
DOI: 10.3390/ijerph19095278 -
Clinical Oral Investigations Sep 2023The aim of this systematic review and meta-analysis is to assess the comparative clinical success and survival of intracoronal indirect restorations using gold, lithium... (Meta-Analysis)
Meta-Analysis Review
OBJECTIVES
The aim of this systematic review and meta-analysis is to assess the comparative clinical success and survival of intracoronal indirect restorations using gold, lithium disilicate, leucite, and indirect composite materials.
MATERIAL AND METHODS
This systematic review and meta-analysis were conducted following the Cochrane Handbook for Systematic Reviews of Interventions and PRISMA guidelines. The protocol for this study was registered in PROSPERO (registration number: CRD42021233185). A comprehensive literature search was conducted across various databases and sources, including PubMed/Medline, Embase, Cochrane Library, Web of Science, ClinicalTrials.gov, and gray literature. A total of 7826 articles were screened on title and abstract. Articles were not excluded based on the vitality of teeth, the language of the study, or the observation period. The risk difference was utilized for the analyses, and a random-effects model was applied. All analyses were conducted with a 95% confidence interval (95% CI). The calculated risk differences were derived from the combined data on restoration survival and failures obtained from each individual article. The presence of heterogeneity was assessed using the I statistic, and if present, the heterogeneity of the data in the articles was evaluated using the non-parametric chi-squared statistic (p < 0.05).
RESULTS
A total of 12 eligible studies were selected, which included 946 restorations evaluated over a minimum observation period of 1 year and a maximum observation period of 7 years. Results of the meta-analysis indicated that intracoronal indirect resin composite restorations have an 18% higher rate of failure when compared to intracoronal gold restorations over 5-7 years of clinical service (risk difference = - 0.18 [95% CI: - 0.27, - 0.09]; p = .0002; I = 0%). The meta-analysis examining the disparity in survival rates between intracoronal gold and leucite restorations could not be carried out due to methodological differences in the studies.
CONCLUSIONS
According to the currently available evidence, medium-quality data indicates that lithium disilicate and indirect composite materials demonstrate comparable survival rates in short-term follow-up. Furthermore, intracoronal gold restorations showed significantly higher survival rates, making them a preferred option over intracoronal indirect resin-composite restorations. Besides that, the analysis revealed no statistically significant difference in survival rates between leucite and indirect composite restorations. The short observation period, limited number of eligible articles, and low sample size of the included studies were significant limitations.
CLINICAL SIGNIFICANCE
Bearing in mind the limitations of the reviewed literature, this systematic review and meta-analysis help clinicians make evidence-based decisions on how to restore biomechanically compromised posterior teeth.
Topics: Dental Porcelain; Aluminum Silicates; Composite Resins; Gold
PubMed: 37597003
DOI: 10.1007/s00784-023-05050-x -
The Cochrane Database of Systematic... Oct 2017Recognition of some of the limitations of titanium plates and screws used for the fixation of bones has led to the development of plates manufactured from bioresorbable... (Review)
Review
BACKGROUND
Recognition of some of the limitations of titanium plates and screws used for the fixation of bones has led to the development of plates manufactured from bioresorbable materials. Whilst resorbable plates appear to offer clinical advantages over metal plates in orthognathic surgery, concerns remain about the stability of fixation and the length of time required for their degradation and the possibility of foreign body reactions. This review compares the use of titanium versus bioresorbable plates in orthognathic surgery and is an update of the Cochrane Review first published in 2007.
OBJECTIVES
To compare the effects of bioresorbable fixation systems with titanium systems used during orthognathic surgery.
SEARCH METHODS
Cochrane Oral Health's Information Specialist searched the following databases: Cochrane Oral Health's Trials Register (to 20 January 2017); the Cochrane Central Register of Controlled Trials (CENTRAL; 2016, Issue 11) in the Cochrane Library (searched 20 January 2017); MEDLINE Ovid (1946 to 20 January 2017); and Embase Ovid (1980 to 20 January 2017). We searched the US National Institutes of Health Ongoing Trials Register ClinicalTrials.gov (clinicaltrials.gov; searched 20 January 2017), and the World Health Organization International Clinical Trials Registry Platform (searched 20 January 2017) for ongoing trials. No restrictions were placed on the language or date of publication when searching the electronic databases.
SELECTION CRITERIA
Randomised controlled trials comparing bioresorbable versus titanium fixation systems used for orthognathic surgery in adults.
DATA COLLECTION AND ANALYSIS
Two review authors independently screened the results of the electronic searches, extracted data and assessed the risk of bias of the included studies. We resolved disagreement by discussion. Clinical heterogeneity between the included trials precluded pooling of data, and only a descriptive summary is presented.
MAIN RESULTS
This review included two trials, involving 103 participants, one comparing titanium with resorbable plates and screws and the other titanium with resorbable screws. Both studies were at high risk of bias and provided very limited data for the primary outcomes of this review. All participants in one trial suffered mild to moderate postoperative discomfort with no statistically significant difference between the two plating groups at different follow-up times. Mean scores of patient satisfaction were 7.43 to 8.63 (range 0 to 10) with no statistically significant difference between the two groups throughout follow-up. Adverse effects reported in one study were two plate exposures in each group occurring between the third and ninth months. Plate exposures occurred mainly in the posterior maxillary region, except for one titanium plate exposure in the mandibular premolar region. Known causes of infection were associated with loosened screws and wound dehiscence with no statistically significant difference in the infection rate between titanium (3/196), and resorbable (3/165) plates.
AUTHORS' CONCLUSIONS
We do not have sufficient evidence to determine if titanium plates or resorbable plates are superior for fixation of bones after orthognathic surgery. This review provides insufficient evidence to show any difference in postoperative pain and discomfort, level of patient satisfaction, plate exposure or infection for plate and screw fixation using either titanium or resorbable materials.
Topics: Absorbable Implants; Bone Plates; Bone Screws; Device Removal; Humans; Internal Fixators; Mandible; Maxilla; Osteotomy; Randomized Controlled Trials as Topic; Titanium
PubMed: 28977689
DOI: 10.1002/14651858.CD006204.pub3 -
The Cochrane Database of Systematic... Jun 2017Measles is an important cause of childhood morbidity and mortality globally, despite increasing vaccine coverage. Zinc plays a significant role in the maintenance of... (Review)
Review
BACKGROUND
Measles is an important cause of childhood morbidity and mortality globally, despite increasing vaccine coverage. Zinc plays a significant role in the maintenance of normal immunological functions, therefore supplements given to zinc-deficient children will increase the availability of zinc and could reduce measles-related morbidity and mortality. This is an update of a review first published in 2015.
OBJECTIVES
To assess the effects of zinc supplementation in reducing morbidity and mortality in children with measles.
SEARCH METHODS
We searched CENTRAL (03 February 2017, Issue 2), MEDLINE (1946 to 03 February 2017), Embase (1974 to 03 February 2017), CINAHL (1981 to 03 February 2017), LILACS (1982 to 03 February 2017), Web of Science (1985 to 03 February 2017), and BIOSIS Previews (1985 to 27 June 2014). We also searched ClinicalTrials.gov, the Australian New Zealand Clinical Trials Registry and the World Health Organization (WHO) International Clinical Trials Registry Platform (ICTRP) on 03 February 2017 to identify unpublished and ongoing studies.
SELECTION CRITERIA
Randomised controlled trials (RCTs) and quasi-RCTs evaluating the effects of zinc in reducing morbidity and mortality in children with measles.
DATA COLLECTION AND ANALYSIS
Two review authors independently assessed the studies for inclusion and extracted data on outcomes, details of the interventions, and other study characteristics using a standardised data extraction form. We used risk ratio (RR) and hazard ratio (HR) as measures of effect with 95% confidence intervals (CI). We included only one study, and did not conduct meta-analysis.
MAIN RESULTS
We did not identify any new studies for inclusion in this update. One RCT met our inclusion criteria. The study was conducted in India and included 85 children diagnosed with measles and pneumonia. The trial showed no significant difference in mortality between children with measles and pneumonia who received zinc supplements and those who received placebo (RR 0.34, 95% CI 0.01 to 8.14). There was no significant difference in time to absence of fever between children who received zinc supplements and those who did not (HR 1.08, 95% CI 0.67 to 1.74). No treatment-related side effects were reported in either group. We assessed the overall quality of the evidence as very low.
AUTHORS' CONCLUSIONS
We could not draw any definitive conclusions from this review about the effects of zinc supplementation on clinical outcomes of children with measles due to the very low quality of the evidence available. There is insufficient evidence to confirm or refute the effect of zinc supplementation in children with measles.
Topics: Child; Fever; Humans; Measles; Pneumonia; Randomized Controlled Trials as Topic; Zinc
PubMed: 28631310
DOI: 10.1002/14651858.CD011177.pub3 -
Environmental Health Perspectives Nov 2022The Minamata Convention on Mercury (Article 4) prohibits the manufacture, import, or export of skin-lightening products containing mercury concentrations above .... (Review)
Review
BACKGROUND
The Minamata Convention on Mercury (Article 4) prohibits the manufacture, import, or export of skin-lightening products containing mercury concentrations above . However, there is a lack of knowledge surrounding the global prevalence of mercury-added skin-lightening products.
OBJECTIVE
The objective of this study was to increase our understanding of worldwide human mercury exposure from skin-lightening products.
METHODS
A systematic search of peer-reviewed scientific literature was performed for relevant articles in four databases (PubMed, Web of Science Core Collection, Scopus, and TOXLINE). The search strategy, eligibility criteria, and data-extraction methods were established . The search identified 2,303 unique scientific articles, of which 41 were ultimately deemed eligible for inclusion after iterative screens at the title, abstract, and whole-text levels. To facilitate data extraction and synthesis, all papers were organized according to four data groups ) "Mercury in products," ) "Usage of products," ) "Human biomarkers of exposure," and ) "Health impacts."
RESULTS
This review was based on data contained in 41 peer-reviewed scientific papers from 22 countries worldwide published between 2000 and 2022. In total, we captured mercury concentration values from 787 skin-lightening product samples [overall pooled central median mercury level was ; interquartile range (IQR): 0.02-5.9] and 1,042 human biomarker measurements from 863 individuals. We also synthesized usage information from 3,898 individuals and self-reported health impacts associated with using mercury-added products from 832 individuals.
DISCUSSION
This review suggests that mercury widely exists as an active ingredient in many skin-lightening products worldwide and that users are at risk of variable and often high exposures. These synthesized findings identify data gaps and help increase our understanding of the health risks associated with the use of these products. https://doi.org/10.1289/EHP10808.
Topics: Humans; Mercury; Biomarkers
PubMed: 36367779
DOI: 10.1289/EHP10808 -
Clinical Orthopaedics and Related... Dec 2012Less than 1% of all primary TKAs are performed with an all-polyethylene tibial component, although recent studies indicate all-polyethylene tibial components are equal... (Meta-Analysis)
Meta-Analysis Review
BACKGROUND
Less than 1% of all primary TKAs are performed with an all-polyethylene tibial component, although recent studies indicate all-polyethylene tibial components are equal to or better than metal-backed ones.
QUESTIONS/PURPOSES
We asked whether the metal-backed tibial component was clinically superior to the all-polyethylene tibial component in primary TKAs regarding revision rates and clinical functioning, and which modifying variables affected the revision rate.
METHODS
We systematically reviewed the literature for clinical studies comparing all-polyethylene and metal-backed tibial components used in primary TKAs in terms of revision rates, clinical scores, and radiologic parameters including radiostereometric analysis (RSA). Meta-regression techniques were used to explore factors modifying the observed effect. Our search yielded 1557 unique references of which 26 articles were included, comprising more than 12,500 TKAs with 231 revisions for any reason.
RESULTS
Meta-analysis showed no differences between the all-polyethylene and metal-backed components except for higher migration of the metal-backed components. Meta-regression showed strong evidence that the all-polyethylene design has improved with time compared with the metal-backed design.
CONCLUSIONS
The all-polyethylene components were equivalent to metal-backed components regarding revision rates and clinical scores. The all-polyethylene components had better fixation (RSA) than the metal-backed components. The belief that metal-backed components are better than all-polyethylene ones seems to be based on studies from earlier TKAs. This might no longer be true for modern TKAs.
LEVEL OF EVIDENCE
Level II, therapeutic study. See Guidelines for Authors for a complete description of levels of evidence.
Topics: Aged; Arthroplasty, Replacement, Knee; Biomechanical Phenomena; Female; Foreign-Body Migration; Humans; Knee Joint; Knee Prosthesis; Male; Metals; Middle Aged; Polyethylene; Prosthesis Design; Prosthesis Failure; Recovery of Function; Reoperation; Risk Assessment; Risk Factors; Tibia; Time Factors; Treatment Outcome
PubMed: 22972656
DOI: 10.1007/s11999-012-2582-2 -
Current Environmental Health Reports Sep 2015Systematic review (SR) and meta-analysis (MA) have potential to contribute substantially to environmental health (EH) risk assessment and policy-making, provided study... (Review)
Review
Systematic review (SR) and meta-analysis (MA) have potential to contribute substantially to environmental health (EH) risk assessment and policy-making, provided study questions are clear and methods sound. We undertook a systematic review of the published epidemiological literature for studies using both SR and MA examining associations between chronic low-dose chemical exposures and adverse health outcomes in general populations and compared actual methods and reporting with a checklist based on available published guidelines. We identified 48 EH SRMAs meeting these criteria. Associations were mainly positive and statistically significant, often involving large populations. A majority of studies followed most general SRMA guidance, although we identified weaknesses in problem formulation, study search, selection and data extraction, and integrating policy implications. Fewer studies followed EH-specific SRMA recommendations, particularly regarding exposure heterogeneity and other risks of bias. Development and adoption of EH-specific SRMA guidelines would contribute to strengthening these tools for public health decision-making.
Topics: Air Pollution; Environmental Exposure; Environmental Health; Epidemiologic Studies; Evidence-Based Medicine; Guideline Adherence; Hazardous Substances; Humans; Meta-Analysis as Topic; Metals, Heavy; Neoplasms; Public Health; Review Literature as Topic; Risk Assessment
PubMed: 26231504
DOI: 10.1007/s40572-015-0062-z -
Environmental Research Jun 2021Toenails have been used as biomarkers of exposure to toxic metals, but their validity for this purpose is not yet clear and might differ depending on the specific agent.... (Review)
Review
Toenails have been used as biomarkers of exposure to toxic metals, but their validity for this purpose is not yet clear and might differ depending on the specific agent. To evaluate this issue, we reviewed the literature on: a) the time-window of exposure reflected by toenails; b) the reproducibility of toenail toxic-metal levels in repeated measures over time; c) their relationship with other biomarkers of exposure, and; d) their association with potential determinants (i.e. sociodemographic, anthropometric, or lifestyle characteristics) or with sources of exposure like diet or environmental pollution. Thus, we performed a systematic review, searching for articles that provided original data for levels of any of the following toxic metals in toenails: aluminum, beryllium, cadmium, chromium, mercury, nickel, lead, thallium and uranium. We identified 88 articles, reporting data from 67 different research projects, which were quite heterogeneous with regard to population profile, sample size and analytical technique. The most commonly studied metal was mercury. Concerning the time-window of exposure explored by toenails, some reports indicate that toenail cadmium, nickel and lead may reflect exposures that occurred 7-12 months before sampling. For repeated samples obtained 1-6 years apart, the range of intraindividual correlation coefficients of aluminum, chromium and mercury was 0.33-0.56. The correlation of toxic metal concentrations between toenails and other matrices was higher for hair and fingernails than for urine or blood. Mercury levels were consistently associated with fish intake, while other toxic metals were occasionally associated with specific sources (e.g. drinking water, place of residence, environmental pollution, and occupation). The most frequently evaluated health endpoints were cardiovascular diseases, cancer, and central nervous system diseases. Available data suggest that toenail mercury levels reflected long-term exposures and showed positive associations with fish intake. The lack of standardization in sample collection, quality control, analytical techniques and procedures - along with the heterogeneity and conflicting results among studies - mean it is still difficult to conclude that toenails are a good biomarker of exposure to toxic metals. Further studies are needed to draw solid conclusions about the suitability of toenails as biomarkers of exposure to toxic metals.
Topics: Animals; Biomarkers; Environmental Exposure; Mercury; Metals; Nails; Reproducibility of Results
PubMed: 33753073
DOI: 10.1016/j.envres.2021.111028 -
PloS One 2014Cocktail effects and synergistic interactions of chemicals in mixtures are an area of great concern to both the public and regulatory authorities. The main concern is... (Review)
Review
Cocktail effects and synergistic interactions of chemicals in mixtures are an area of great concern to both the public and regulatory authorities. The main concern is whether some chemicals can enhance the effect of other chemicals, so that they jointly exert a larger effect than predicted. This phenomenon is called synergy. Here we present a review of the scientific literature on three main groups of environmentally relevant chemical toxicants: pesticides, metal ions and antifouling compounds. The aim of the review is to determine 1) the frequency of synergy, 2) the extent of synergy, 3) whether any particular groups or classes of chemicals tend to induce synergy, and 4) which physiological mechanisms might be responsible for this synergy. Synergy is here defined as mixtures with minimum two-fold difference between observed and predicted effect concentrations using Concentration Addition (CA) as a reference model and including both lethal and sub-lethal endpoints. The results showed that synergy occurred in 7%, 3% and 26% of the 194, 21 and 136 binary pesticide, metal and antifoulants mixtures included in the data compilation on frequency. The difference between observed and predicted effect concentrations was rarely more than 10-fold. For pesticides, synergistic mixtures included cholinesterase inhibitors or azole fungicides in 95% of 69 described cases. Both groups of pesticides are known to interfere with metabolic degradation of other xenobiotics. For the four synergistic metal and 47 synergistic antifoulant mixtures the pattern in terms of chemical groups inducing synergy was less clear. Hypotheses in terms of mechanisms governing these interactions are discussed. It was concluded that true synergistic interactions between chemicals are rare and often occur at high concentrations. Addressing the cumulative rather than synergistic effect of co-occurring chemicals, using standard models as CA, is therefore regarded as the most important step in the risk assessment of chemical cocktails.
Topics: Animals; Biofouling; Environmental Monitoring; Environmental Pollutants; Humans; Metals; Pesticides; Toxicity Tests
PubMed: 24794244
DOI: 10.1371/journal.pone.0096580 -
Molecules (Basel, Switzerland) Aug 2021The biosynthesis of silver nanoparticles and the antibacterial activities has provided enormous data on populations, geographical areas, and experiments with bio silver...
The biosynthesis of silver nanoparticles and the antibacterial activities has provided enormous data on populations, geographical areas, and experiments with bio silver nanoparticles' antibacterial operation. Several peer-reviewed publications have discussed various aspects of this subject field over the last generation. However, there is an absence of a detailed and structured framework that can represent the research domain on this topic. This paper attempts to evaluate current articles mainly on the biosynthesis of nanoparticles or antibacterial activities utilizing the scientific methodology of big data analytics. A comprehensive study was done using multiple databases-Medline, Scopus, and Web of Sciences through PRISMA (i.e., Preferred Reporting Items for Systematic Reviews and Meta-Analyses). The keywords used included 'biosynthesis silver nano particles' OR 'silver nanoparticles' OR 'biosynthesis' AND 'antibacterial behavior' OR 'anti-microbial opposition' AND 'systematic analysis,' by using MeSH (Medical Subject Headings) terms, Boolean operator's parenthesis, or truncations as required. Since their effectiveness is dependent on particle size or initial concentration, it necessitates more research. Understanding the field of silver nanoparticle biosynthesis and antibacterial activity in Gulf areas and most Asian countries also necessitates its use of human-generated data. Furthermore, the need for this work has been highlighted by the lack of predictive modeling in this field and a need to combine specific domain expertise. Studies eligible for such a review were determined by certain inclusion and exclusion criteria. This study contributes to the existence of theoretical and analytical studies in this domain. After testing as per inclusion criteria, seven in vitro studies were selected out of 28 studies. Findings reveal that silver nanoparticles have different degrees of antimicrobial activity based on numerous factors. Limitations of the study include studies with low to moderate risks of bias and antimicrobial effects of silver nanoparticles. The study also reveals the possible use of silver nanoparticles as antibacterial irrigants using various methods, including a qualitative evaluation of knowledge and a comprehensive collection and interpretation of scientific studies.
Topics: Animals; Anti-Bacterial Agents; Humans; Metal Nanoparticles; Particle Size; Silver
PubMed: 34443644
DOI: 10.3390/molecules26165057