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Bioengineering (Basel, Switzerland) Oct 2021The inherent resistance of synthetic plastics to degradation has led to an increasing challenge of waste accumulation problem and created a pollution issue that can only... (Review)
Review
The inherent resistance of synthetic plastics to degradation has led to an increasing challenge of waste accumulation problem and created a pollution issue that can only be addressed with novel complementary methods such as biodegradation. Since biocontrol is a promising eco-friendly option to address this challenge, the identification of suitable biological agents is a crucial requirement. Among the existing options, organisms of the genus have been reported to biodegrade several complex polymeric macromolecules such as chitin, lignin, and cellulose. Therefore, this systematic review aimed to evaluate the potential of strains for the biodegradation of synthetic plastics. The results showed that although strains are widely distributed in different ecosystems in nature, few studies have explored their capacity as degraders of synthetic polymers. Moreover, most of the research in this field has focused on strains with promising biotransforming potential against polyethylene-like polymers. Our findings suggest that this field of study is still in the early stages of development. Moreover, considering the diverse ecological niches associated with , these actinobacteria could serve as complementary agents for plastic waste management and thereby enhance carbon cycle dynamics.
PubMed: 34821720
DOI: 10.3390/bioengineering8110154 -
PloS One 2020Microplastics (MPs) are omnipresent in the environment, including the human food chain; a likely important contributor to human exposure is drinking water.
BACKGROUND
Microplastics (MPs) are omnipresent in the environment, including the human food chain; a likely important contributor to human exposure is drinking water.
OBJECTIVE
To undertake a systematic review of MP contamination of drinking water and estimate quantitative exposures.
METHODS
The protocol for the systematic review employed has been published in PROSPERO (PROSPERO 2019, Registration number: CRD42019145290). MEDLINE, EMBASE and Web of Science were searched from launch to the 3rd of June 2020, selecting studies that used procedural blank samples and a validated method for particle composition analysis. Studies were reviewed within a narrative analysis. A bespoke risk of bias (RoB) assessment tool was used.
RESULTS
12 studies were included in the review: six of tap water (TW) and six of bottled water (BW). Meta-analysis was not appropriate due to high statistical heterogeneity (I2>95%). Seven studies were rated low RoB and all confirmed MP contamination of drinking water. The most common polymers identified in samples were polyethylene terephthalate (PET) and polypropylene (PP), Methodological variability was observed throughout the experimental protocols. For example, the minimum size of particles extracted and analysed, which varied from 1 to 100 μm, was seen to be critical in the data reported. The maximum reported MP contamination was 628 MPs/L for TW and 4889 MPs/L for BW, detected in European samples. Based on typical consumption data, this may be extrapolated to a maximum yearly human adult uptake of 458,000 MPs for TW and 3,569,000 MPs for BW.
CONCLUSIONS
This is the first systematic review that appraises the quality of existing evidence on MP contamination of drinking water and estimates human exposures. The precautionary principle should be adopted to address concerns on possible human health effects from consumption of MPs. Future research should aim to standardise experimental protocols to aid comparison and elevate quality.
Topics: Drinking Water; Environmental Monitoring; Food Chain; Microplastics; Polyethylene Terephthalates; Polypropylenes; Public Health; Water Pollutants, Chemical
PubMed: 32735575
DOI: 10.1371/journal.pone.0236838 -
British Journal of Sports Medicine Jan 2011The authors examined the most current evidence for treatment options in athletes with osteitis pubis and osteomyelitis pubis, attempting to determine which options... (Review)
Review
OBJECTIVES
The authors examined the most current evidence for treatment options in athletes with osteitis pubis and osteomyelitis pubis, attempting to determine which options provide optimal pain relief with rapid return to sport and prevention of symptom reoccurrence.
METHODS
Three databases-MEDLINE, Cochrane Database of Systematic Reviews and CINAHL-were searched using the OVID interface for all years between 1985 and May 2008. References were analysed from included studies, and additional relevant articles were obtained for inclusion. Inclusion criteria included (1) humans only, (2) subjects had no apparent risk factors for development of osteitis pubis or osteomyelitis of the pubic symphysis other than athletic involvement, (3) both physical exam findings and diagnostic imaging were used to confirm either diagnosis, and (4) a definitive treatment strategy was identifiable for management of osteitis pubis or osteomyelitis of the pubic symphysis. In total, 25 articles were included in the review.
RESULTS
There were no randomised controlled trials identified with this study's search strategy. A total of 195 athletes were diagnosed as having osteitis pubis (186 males, nine females) and treated with either conservative measures/physical therapy, local injection with corticosteroids and/or local anaesthetic, dextrose prolotherapy, surgery or antibiotic therapy. Six case reports/series described conservative treatment measures (physical therapy, rest, non-steroid anti-inflammatory drugs). Four case series explored the use of corticosteroid injections in treatment. One case series described the use of dextrose prolotherapy as a treatment modality. Six case series described various surgical techniques (pubic symphysis curettage, polypropylene mesh placement and pubic bone stabilisation) in treatment. Ten case reports/series (10 subjects) outlined antibiotic treatment of osteomyelitis of the pubic symphysis.
CONCLUSIONS
The current medical literature shows only level 4 evidence of the treatment for osteitis pubis in 24 case reports/series in athletes. Without any direct comparison of treatment modalities, it is difficult to determine which individual treatment option is the most efficacious. Further study comparing the different treatment options is necessary to determine which modality provides the fastest return to sport.
Topics: Adolescent; Adult; Anti-Inflammatory Agents; Athletic Injuries; Female; Humans; Male; Osteitis; Osteomyelitis; Physical Therapy Modalities; Pubic Symphysis; Sports; Young Adult
PubMed: 18812419
DOI: 10.1136/bjsm.2008.050989 -
The Cochrane Database of Systematic... Nov 2016To minimise the rate of recurrent prolapse after traditional native tissue repair (anterior colporrhaphy), clinicians have utilised a variety of surgical techniques. (Meta-Analysis)
Meta-Analysis Review
BACKGROUND
To minimise the rate of recurrent prolapse after traditional native tissue repair (anterior colporrhaphy), clinicians have utilised a variety of surgical techniques.
OBJECTIVES
To determine the safety and effectiveness of surgery for anterior compartment prolapse.
SEARCH METHODS
We searched the Cochrane Incontinence Group Specialised Register, including the Cochrane Central Register of Controlled Trials (CENTRAL), MEDLINE, MEDLINE In Process (23 August 2016), handsearched journals and conference proceedings (15 February 2016) and searched trial registers (1 August 2016).
SELECTION CRITERIA
Randomised controlled trials (RCTs) that examined surgical operations for anterior compartment prolapse.
DATA COLLECTION AND ANALYSIS
Two review authors independently selected trials, assessed risk of bias and extracted data. Primary outcomes were awareness of prolapse, repeat surgery and recurrent prolapse on examination.
MAIN RESULTS
We included 33 trials (3332 women). The quality of evidence ranged from very low to moderate. Limitations were risk of bias and imprecision. We have summarised results for the main comparisons. Native tissue versus biological graft Awareness of prolapse: Evidence suggested few or no differences between groups (risk ratio (RR) 0.98, 95% confidence interval (CI) 0.52 to 1.82; five RCTs; 552 women; I = 39%; low-quality evidence), indicating that if 12% of women were aware of prolapse after biological graft, 7% to 23% would be aware after native tissue repair. Repeat surgery for prolapse: Results showed no probable differences between groups (RR 1.02, 95% CI 0.53 to 1.97; seven RCTs; 650 women; I = 0%; moderate-quality evidence), indicating that if 4% of women required repeat surgery after biological graft, 2% to 9% would do so after native tissue repair. Recurrent anterior compartment prolapse: Native tissue repair probably increased the risk of recurrence (RR 1.32, 95% CI 1.06 to 1.65; eight RCTs; 701 women; I = 26%; moderate-quality evidence), indicating that if 26% of women had recurrent prolapse after biological graft, 27% to 42% would have recurrence after native tissue repair. Stress urinary incontinence (SUI): Results showed no probable differences between groups (RR 1.44, 95% CI 0.79 to 2.64; two RCTs; 218 women; I = 0%; moderate-quality evidence). Dyspareunia: Evidence suggested few or no differences between groups (RR 0.87, 95% CI 0.39 to 1.93; two RCTs; 151 women; I = 0%; low-quality evidence). Native tissue versus polypropylene mesh Awareness of prolapse: This was probably more likely after native tissue repair (RR 1.77, 95% CI 1.37 to 2.28; nine RCTs; 1133 women; I = 0%; moderate-quality evidence), suggesting that if 13% of women were aware of prolapse after mesh repair, 18% to 30% would be aware of prolapse after native tissue repair. Repeat surgery for prolapse: This was probably more likely after native tissue repair (RR 2.03, 95% CI 1.15 to 3.58; 12 RCTs; 1629 women; I = 39%; moderate-quality evidence), suggesting that if 2% of women needed repeat surgery after mesh repair, 2% to 7% would do so after native tissue repair. Recurrent anterior compartment prolapse: This was probably more likely after native tissue repair (RR 3.01, 95% CI 2.52 to 3.60; 16 RCTs; 1976 women; I = 39%; moderate-quality evidence), suggesting that if recurrent prolapse occurred in 13% of women after mesh repair, 32% to 45% would have recurrence after native tissue repair. Repeat surgery for prolapse, stress urinary incontinence or mesh exposure (composite outcome): This was probably less likely after native tissue repair (RR 0.59, 95% CI 0.41 to 0.83; 12 RCTs; 1527 women; I = 45%; moderate-quality evidence), suggesting that if 10% of women require repeat surgery after polypropylene mesh repair, 4% to 8% would do so after native tissue repair. De novo SUI: Evidence suggested few or no differences between groups (RR 0.67, 95% CI 0.44 to 1.01; six RCTs; 957 women; I = 26%; low-quality evidence). No evidence suggested a difference in rates of repeat surgery for SUI. Dyspareunia (de novo): Evidence suggested few or no differences between groups (RR 0.54, 95% CI 0.27 to 1.06; eight RCTs; n = 583; I = 0%; low-quality evidence). Native tissue versus absorbable mesh Awareness of prolapse: It is unclear whether results showed any differences between groups (RR 0.95, 95% CI 0.70 to 1.31; one RCT; n = 54; very low-quality evidence), Repeat surgery for prolapse: It is unclear whether results showed any differences between groups (RR 2.13, 95% CI 0.42 to 10.82; one RCT; n = 66; very low-quality evidence). Recurrent anterior compartment prolapse: This is probably more likely after native tissue repair (RR 1.50, 95% CI 1.09 to 2.06; three RCTs; n = 268; I = 0%; moderate-quality evidence), suggesting that if 27% have recurrent prolapse after mesh repair, 29% to 55% would have recurrent prolapse after native tissue repair. SUI: It is unclear whether results showed any differences between groups (RR 0.72, 95% CI 0.50 to 1.05; one RCT; n = 49; very low-quality evidence). Dyspareunia: No data were reported.
AUTHORS' CONCLUSIONS
Biological graft repair or absorbable mesh provides minimal advantage compared with native tissue repair.Native tissue repair was associated with increased awareness of prolapse and increased risk of repeat surgery for prolapse and recurrence of anterior compartment prolapse compared with polypropylene mesh repair. However, native tissue repair was associated with reduced risk of de novo SUI, reduced bladder injury, and reduced rates of repeat surgery for prolapse, stress urinary incontinence and mesh exposure (composite outcome).Current evidence does not support the use of mesh repair compared with native tissue repair for anterior compartment prolapse owing to increased morbidity.Many transvaginal polypropylene meshes have been voluntarily removed from the market, and newer light-weight transvaginal meshes that are available have not been assessed by RCTs. Clinicans and women should be cautious when utilising these products, as their safety and efficacy have not been established.
Topics: Cystocele; Female; Gynecologic Surgical Procedures; Humans; Pelvic Organ Prolapse; Randomized Controlled Trials as Topic; Rectal Prolapse; Secondary Prevention; Surgical Mesh; Suture Techniques; Urinary Incontinence; Uterine Prolapse
PubMed: 27901278
DOI: 10.1002/14651858.CD004014.pub6 -
International Journal of Surgery... 2011To systematically analyse the effectiveness of delayed-absorbable (Polydioxanone; PDS) versus non-absorbable (Polypropylene; Prolene, and Nylon) for abdominal fascial... (Comparative Study)
Comparative Study Meta-Analysis Review
OBJECTIVE
To systematically analyse the effectiveness of delayed-absorbable (Polydioxanone; PDS) versus non-absorbable (Polypropylene; Prolene, and Nylon) for abdominal fascial closure in patients undergoing laparotomy.
METHODS
Randomised trials evaluating PDS versus Prolene/Nylon for abdominal fascial closure were selected and analysed by using the statistical tool RevMan where summative data was expressed as odds ratio (OR).
RESULTS
Eight randomised trials encompassing 4261 patients undergoing laparotomy closure with either PDS or Prolene/Nylon were retrieved. There was no statistically significant heterogeneity among trials. In the fixed effect model PDS was comparable to Prolene/Nylon in terms of risk of incisional hernia (OR, 1.10; 95% CI, 0.87, 1.37; z = 0.79; p = 0.43), wound dehiscence (OR, 1.04; 95% CI, 0.67, 1.62; z = 0.19; p = 0.85), peri-operative complications (OR, 0.94; 95% CI, 0.66, 1.33; z = 0.37; p = 0.71), suture sinus formation (OR, 0.58; 95% CI, 0.33, 1.04; z = 1.84; p = 0.07) and surgical site infection (OR, 0.98; 95% CI, 0.68, 1.39; z = 0.14; p = 0.89). Subgroup analysis separately comparing Prolene and Nylon with PDS supported same outcome.
CONCLUSION
PDS and Prolene/Nylon are equally effective for the closure of abdominal fascia following laparotomy. Given that there are no significant differences between two suture materials, further studies may be conducted to evaluate their cost-effectiveness and measurement of health-related quality of life instead of analysing their effectiveness in laparotomy closure.
Topics: Abdominal Wound Closure Techniques; Absorbable Implants; Hernia, Abdominal; Humans; Laparotomy; Nylons; Polydioxanone; Polypropylenes; Postoperative Complications; Surgical Wound Dehiscence; Surgical Wound Infection; Sutures
PubMed: 22061310
DOI: 10.1016/j.ijsu.2011.09.006 -
Surgery Apr 2017Operative intervention to correct incisional hernia affects 150,000 patients annually, with 1 in 3 repairs recurring within 9 years. The aim of this study was to... (Meta-Analysis)
Meta-Analysis Review
BACKGROUND
Operative intervention to correct incisional hernia affects 150,000 patients annually, with 1 in 3 repairs recurring within 9 years. The aim of this study was to compare the incidence of incisional hernia and postoperative complications in elective midline laparotomy patients after the use of prophylactic mesh placement and primary suture closure.
METHODS
A systematic review was performed to identify studies comparing prophylactic mesh placement to primary suture closure in elective, midline laparotomy at index abdominal aponeurosis closure. The primary outcome was incisional hernia. Secondary outcomes included postoperative complications.
RESULTS
Fourteen studies were included (2,114 patients), with 1,152 receiving prophylactic mesh placement. Prophylactic mesh placement decreased the risk of incisional hernia overall when compared to primary suture closure (relative risk = 0.15; P < .00001) and in trials using only polypropylene mesh versus 4:1 primary suture closure (relative risk = 0.15; P = .003). Prophylactic mesh placement reduced the risk of incisional hernia regardless of mesh location or composition: onlay (relative risk = 0.07; P < .0001), retrorectus (relative risk = 0.04; P = .002), and preperitoneal (relative risk = 0.18; P = .02). Prophylactic mesh placement increased risk of seroma overall (relative risk = 1.95; P < .0001), onlay (relative risk = 2.43; P = .01) and preperitoneal (relative risk = 1.47; P = .01) but not retrorectus plane (relative risk = 1.55; P = .26). Polypropylene mesh increased seroma risk only in the onlay position (relative risk = 2.77; P = .04). Prophylactic mesh placement patients are at increased risk for chronic wound pain compared to primary suture closure (relative risk = 1.70; P = .03).
CONCLUSION
Prophylactic mesh placement is associated with an 85% postoperative incisional hernia risk reduction when compared to primary suture closure in at-risk patients undergoing elective, midline laparotomy closure. This technique appears to be safe with comparable complication profiles, barring an increased risk of seroma, especially with the onlay technique, and the possibility for an increased risk of chronic pain. Despite this verification, evidence from large domestic trials that sufficiently addresses major knowledge gaps is simply lacking.
Topics: Adult; Aged; Elective Surgical Procedures; Female; Humans; Incisional Hernia; Laparotomy; Male; Middle Aged; Primary Prevention; Prognosis; Randomized Controlled Trials as Topic; Risk Assessment; Surgical Mesh; Suture Techniques; Treatment Outcome; Wound Healing
PubMed: 28040255
DOI: 10.1016/j.surg.2016.09.036 -
Journal of Abdominal Wall Surgery : JAWS 2023Groin hernia literature often uses the terms light- and heavyweight and small or large pores to describe meshes. There is no universal definition of these terms, and... (Review)
Review
Groin hernia literature often uses the terms light- and heavyweight and small or large pores to describe meshes. There is no universal definition of these terms, and the aim of this scoping review was to assess how mesh weight and pore sizes are defined in the groin hernia literature. In this systematic scoping review, we searched PubMed, Embase, and Cochrane CENTRAL. We included randomised controlled trials with adults undergoing groin hernia repair with the Lichtenstein or laparoscopic techniques using a flat permanent polypropylene or polyester mesh. Studies had to use the terms lightweight, mediumweight, or heavyweight to be included, and the outcome was to report how researchers defined these terms as well as pore sizes. We included 48 studies with unique populations. The weight of lightweight meshes ranged from 28 to 60 g/m with a median of 39 g/m, and the pore size ranged from 1.0 to 4.0 mm with a median of 1.6 mm. The weight of heavyweight meshes ranged from 72 to 116 g/m with a median of 88 g/m, and the pore size ranged from 0.08 to 1.8 mm with a median of 1.0 mm. Only one mediumweight mesh was used weighing 55 g/m with a pore size of 0.75 mm. There seems to be a consensus that meshes weighing less than 60 g/m are defined as lightweight and meshes weighing more than 70 g/m are defined as heavyweight. The weight terms were used independently of pore sizes, which slightly overlapped between lightweight and heavyweight meshes.
PubMed: 38312405
DOI: 10.3389/jaws.2023.11179 -
Hernia : the Journal of Hernias and... Jun 2021To evaluate safety and efficacy of a mesh reinforcement following stoma reversal to prevent stoma site incisional hernia (SSIH) and differences across the prostheses... (Meta-Analysis)
Meta-Analysis Review
PURPOSE
To evaluate safety and efficacy of a mesh reinforcement following stoma reversal to prevent stoma site incisional hernia (SSIH) and differences across the prostheses used.
METHODS
A systematic search of PubMed/MEDLINE, EMBASE, SCOPUS and Cochrane databases was conducted to identify comparative studies until September 2020. A meta-analysis of postoperative outcomes and a network meta-analysis for a multiple comparison of the prostheses with each other were performed.
RESULTS
Seven studies were included in the analysis (78.4% ileostomy and 21.6% colostomy) with a total of 1716 patients with (n = 684) or without (n = 1032) mesh. Mesh placement was associated with lower risk of SSIH (7.8%vs18.1%, OR0.266,95% CI 0.123-0.577, p < 0.001) than no mesh procedures but also with a longer operative time (SMD 0.941, 95% CI 0.462-1.421, p < 0.001). There was no statistically significant difference in terms of Surgical Site infection (11.5% vs 11.1%, OR 1.074, 95% CI 0.78-1.48, p = 0.66), seroma formation (4.4% vs 7.1%, OR 1.052, 95% CI 0.64-1.73, p = 0.84), anastomotic leakage (3.7% vs 2.7%, OR 1.598, 95% CI 0.846-3.019, p = 0.149) and length of stay (SMD - 0.579,95% CI - 1.261 to 0.102, p = 0.096) between mesh and no mesh groups. Use of prosthesis was associated with a significant lower need for a reoperation than no mesh group (8.1% vs 12.1%, OR 0.332, 95% CI 0.119-0.930, p = 0.036). Incidence of seroma is lower with biologic than polypropylene meshes but they showed a trend towards poor results compared with polypropylene or biosynthetic meshes.
CONCLUSION
Despite longer operative time, mesh prophylactic reinforcement at the site of stoma seems a safe and effective procedure with lower incidence of SSIH, need for reoperation and comparable short-term outcomes than standard closure technique. A significant superiority of a specific mesh type was not identified.
Topics: Herniorrhaphy; Humans; Incisional Hernia; Prostheses and Implants; Surgical Mesh; Surgical Stomas
PubMed: 33713204
DOI: 10.1007/s10029-021-02393-w -
Environmental Pollution (Barking, Essex... May 2024Microplastics pose a significant environmental threat, with potential implications for toxic chemical release, aquatic life endangerment, and human food chain... (Review)
Review
Microplastics pose a significant environmental threat, with potential implications for toxic chemical release, aquatic life endangerment, and human food chain contamination. In Asia, rapid economic growth coupled with inadequate waste management has escalated plastic pollution in rivers, positioning them as focal points for environmental concern. Despite Asia's rivers being considered the most polluted with plastics globally, scholarly attention to microplastics in the region's freshwater environments is a recent development. This study undertakes a systematic review of 228 scholarly articles to map microplastic hotspots in Asian freshwater systems and synthesize current research trends within the continent. Findings reveal a concentration of research in China and Japan, primarily investigating riverine and surface waters through net-based sampling methods. Polyethylene (PE), polypropylene (PP), and polyethylene terephthalate (PET) emerge as the predominant microplastic types, frequently observed as fibers or fragments. However, the diversity of sampling methodologies and reporting metrics complicates data synthesis, underscoring the need for standardized analytical frameworks to facilitate comparative analysis. This paper delineates the distribution of microplastic hotspots and outlines the prevailing challenges and prospects in microplastic research within Asian freshwater contexts.
Topics: Microplastics; Rivers; Environmental Monitoring; Water Pollutants, Chemical; Asia; China; Japan; Plastics
PubMed: 38621450
DOI: 10.1016/j.envpol.2024.123985 -
Hernia : the Journal of Hernias and... Dec 2020Laparoscopic intraperitoneal onlay mesh in hernia repair can result in adhesions leading to intestinal obstruction and fistulation. The aim of this systematic review is... (Meta-Analysis)
Meta-Analysis
PURPOSE
Laparoscopic intraperitoneal onlay mesh in hernia repair can result in adhesions leading to intestinal obstruction and fistulation. The aim of this systematic review is to compare the effects of mesh coatings reducing the tissue-to-mesh adhesion in animal studies.
METHODS
Pubmed and Embase were systematically searched. Animal experiments comparing intraperitoneally placed meshes with coatings were eligible for inclusion. Only studies with comparable follow-up, measurements, and species were included for data pooling and subsequent meta-analysis.
RESULTS
A total of 131 articles met inclusion criteria, with four studies integrated into one comparison and five studies integrated into another comparison. Compared to uncoated polypropylene (PP) mesh, PP mesh coated with hyaluronic acid/carboxymethyl cellulose (HA/CMC) showed significantly reduced adhesion formation at follow-up of 4 weeks measured with adhesion score of extent (random effects model, mean difference,- 0.96, 95% CI - 1.32 to - 0.61, P < 0.001, I = 23%; fixed effects model, mean difference,- 0.94, 95% CI - 1.25 to - 0.63, P < 0.001, I = 23%). Compared to PP mesh, polyester mesh coated with collagen (PC mesh) showed no significant difference at follow-up of 4 weeks regarding percentage of adhesion-area on a mesh, using random effects model (mean difference - 11.69, 95% CI - 44.14 to 20.76, P = 0.48, I = 92%). However, this result differed using fixed effects model (mean difference - 25.55, 95% CI - 33.70 to - 7.40, P < 0.001, I = 92%).
CONCLUSION
HA/CMC coating reduces adhesion formation to PP mesh effectively at a follow-up of 4 weeks, while the anti-adhesive properties of PC mesh are inclusive comparing all study data.
Topics: Animals; Disease Models, Animal; Female; Herniorrhaphy; Surgical Mesh; Treatment Outcome
PubMed: 31659548
DOI: 10.1007/s10029-019-02071-y