scholarly journals Persistent environmental pollutants and couple fecundity: an overview

Reproduction ◽  
2014 ◽  
Vol 147 (4) ◽  
pp. R97-R104 ◽  
Author(s):  
Germaine M Buck Louis
Keyword(s):  
Statistical Significance ◽  
Environmental Pollutants ◽  
Environmental Chemicals ◽  
Current Evidence ◽  
Limited Attention ◽  
Longitudinal Measurement ◽  
Data Gaps ◽  
Cadmium Lead ◽  
Persistent Environmental Pollutants ◽  
Unique Study

Speculation has arisen that human fecundity may be declining, possibly a function of exposure to persistent environmental chemicals that resist degradation resulting in various pathways for human exposure. In contrast to considerable animal evidence suggesting adverse effects of such chemicals on reproduction, limited human research has been undertaken. To date, available data stem largely from ten unique study cohorts that have quantified individual chemical exposures in relation to time-to-pregnancy (TTP), which is a measure of couple fecundity. Diminished fecundability odds ratios indicative of longer TTP were observed in all but two studies, although not all findings achieved statistical significance. Persistent chemicals associated with reduced couple fecundity as measured by a longer TTP included βHCH, cadmium, lead, mercury, 1,1-dichloro-2,2-bis(p-chlorophenyl)ethylene, TCCD dioxin, and select polybrominated diethers, polychlorinated biphenyls, and perfluorochemicals. Important methodologic limitations need to be considered in weighing the evidence: i) reliance on pregnant women, which may exclude women with the highest exposures if related to the inability to conceive; ii) retrospectively reported TTP, which may be associated with bidirectional reporting errors; and iii) limited attention to male partners or couples' exposures. While current evidence is not inconsistent with animal evidence, concerted efforts to address lingering data gaps should include novel strategies for recruiting couples, the longitudinal measurement of TTP, and the continued enrollment of couples across successive pregnancies. This latter strategy will provide a more complete understanding of the toxicokinetics of chemicals during sensitive windows and their implications for fecundity and its related impairments.

Environmental exposures to endocrine disrupting chemicals (EDCs) and their role in endometriosis: a systematic literature review

2020 ◽  
Vol 0 (0) ◽  
Author(s):  
Diksha Sirohi ◽  
Ruqaiya Al Ramadhani ◽  
Luke D. Knibbs
Keyword(s):  
Bisphenol A ◽  
Phthalate Esters ◽  
Endocrine Disrupting Chemicals ◽  
Environmental Pollutants ◽  
Positive Association ◽  
Environmental Chemicals ◽  
Reproductive Age ◽  
Organochlorinated Pesticides ◽  
Endocrine Disrupting ◽  
The Relationship

AbstractPurposeEndocrine-related diseases and disorders are on the rise globally. Synthetically produced environmental chemicals (endocrine-disrupting chemicals (EDCs)) mimic hormones like oestrogen and alter signalling pathways. Endometriosis is an oestrogen-dependent condition, affecting 10–15% of women of the reproductive age, and has substantial impacts on the quality of life. The aetiology of endometriosis is believed to be multifactorial, ranging from genetic causes to immunologic dysfunction due to environmental exposure to EDCs. Hence, we undertook a systematic review and investigated the epidemiological evidence for an association between EDCs and the development of endometriosis. We also aimed to assess studies on the relationship between body concentration of EDCs and the severity of endometriosis.MethodFollowing PRISMA guidelines, a structured search of PubMed, Embase and Scopus was conducted (to July 2018). The included studies analysed the association between one or more EDCs and the prevalence of endometriosis. The types of EDCs, association and outcome, participant characteristics and confounding variables were extracted and analysed. Quality assessment was performed using standard criteria.ResultsIn total, 29 studies were included. Phthalate esters were positively associated with the prevalence of endometriosis. The majority (71%) of studies revealed a significant association between bisphenol A, organochlorinated environmental pollutants (dioxins, dioxin-like compounds, organochlorinated pesticides, polychlorinated biphenyls) and the prevalence of endometriosis. A positive association between copper, chromium and prevalence of endometriosis was demonstrated in one study only. Cadmium, lead and mercury were not associated with the prevalence of endometriosis. There were conflicting results for the association between nickel and endometriosis. The relationship of EDCs and severity of endometriosis was not established in the studies.ConclusionWe found some evidence to suggest an association between phthalate esters, bisphenol A, organochlorinated environmental pollutants and the prevalence of endometriosis. Disentangling these exposures from various other factors that affect endometriosis is complex, but an important topic for further research.

scholarly journals Environmental pollutants-dependent molecular pathways and carcinogenesis

Biodiscovery ◽  
2019 ◽  
Vol 22 ◽  
Author(s):  
Myriam El Helou ◽  
Pascale A. Cohen ◽  
Mona Diab-Assaf ◽  
Sandra Ghayad
Keyword(s):  
Gene Expression ◽  
Environmental Pollutants ◽  
Environmental Chemicals ◽  
Gene Repair ◽  
Hormone Production ◽  
Aryl Hydrocarbon ◽  
Repair Mechanisms ◽  
Cellular Signal ◽  
And Function ◽  
G Protein Coupled

Exposure to environmental pollutants can modulate many biological and molecular processes such as gene expression, gene repair mechanisms, hormone production and function and inflammation, resulting in adverse effects on human health including the occurrence and development of different types of cancer. Carcinogenesis is a complex and long process, taking place in multiple stages and is affected by multiple factors. Some environmental molecules are genotoxic, able to damage the DNA or to induce mutations and changes in gene expression acting as initiators of carcinogenesis. Other molecules called xenoestrogens can promote carcinogenesis by their mitogenic effects by possessing estrogenic-like activities and consequently acting as endocrine disruptors causing multiple alterations in cellular signal transduction pathways. In this review, we focus on recent research on environmental chemicals-driven molecular functions in human cancers. For this purpose, we will be discussing the case of two receptors in mediating environmental pollutants effects: the established nuclear receptor, the Aryl hydrocarbon receptor (AhR) and the emerging membrane receptor, G-protein coupled estrogen receptor 1 (GPER1).

scholarly journals The gut microbiota: a major player in the toxicity of environmental pollutants?

2016 ◽  
Vol 2 (1) ◽  
Author(s):  
Sandrine P Claus ◽  
Hervé Guillou ◽  
Sandrine Ellero-Simatos
Keyword(s):  
Gut Microbiota ◽  
Environmental Contaminants ◽  
Environmental Pollutants ◽  
Gut Bacteria ◽  
Environmental Chemicals ◽  
Immune Functions ◽  
Gastrointestinal Microbiota ◽  
Major Player ◽  
Gastrointestinal Bacteria ◽  
Bidirectional Relationship

Abstract Exposure to environmental chemicals has been linked to various health disorders, including obesity, type 2 diabetes, cancer and dysregulation of the immune and reproductive systems, whereas the gastrointestinal microbiota critically contributes to a variety of host metabolic and immune functions. We aimed to evaluate the bidirectional relationship between gut bacteria and environmental pollutants and to assess the toxicological relevance of the bacteria–xenobiotic interplay for the host. We examined studies using isolated bacteria, faecal or caecal suspensions—germ-free or antibiotic-treated animals—as well as animals reassociated with a microbiota exposed to environmental chemicals. The literature indicates that gut microbes have an extensive capacity to metabolise environmental chemicals that can be classified in five core enzymatic families (azoreductases, nitroreductases, β-glucuronidases, sulfatases and β-lyases) unequivocally involved in the metabolism of >30 environmental contaminants. There is clear evidence that bacteria-dependent metabolism of pollutants modulates the toxicity for the host. Conversely, environmental contaminants from various chemical families have been shown to alter the composition and/or the metabolic activity of the gastrointestinal bacteria, which may be an important factor contributing to shape an individual’s microbiotype. The physiological consequences of these alterations have not been studied in details but pollutant-induced alterations of the gut bacteria are likely to contribute to their toxicity. In conclusion, there is a body of evidence suggesting that gut microbiota are a major, yet underestimated element that must be considered to fully evaluate the toxicity of environmental contaminants.

Abstract 18881: New Oral Anticoagulants for Periprocedural Management of Anticoagulation in Patients Undergoing Radiofrequency Catheter Ablation for Atrial Fibrillation: a Meta-analysis

Circulation ◽  
2014 ◽  
Vol 130 (suppl_2) ◽  
Author(s):  
Abdul Shokor Parwani ◽  
Daniel Blaschke ◽  
Alexander Wutzler ◽  
Martin Huemer ◽  
Phillip Attanasio ◽  
...  
Keyword(s):  
Atrial Fibrillation ◽  
Catheter Ablation ◽  
Odds Ratio ◽  
Observational Studies ◽  
Radiofrequency Catheter Ablation ◽  
Statistical Significance ◽  
Oral Anticoagulants ◽  
Current Evidence ◽  
Minor Bleeding ◽  
Warfarin Group

Introduction: Thromboembolic events are the most feared complication of radiofrequency catheter ablation (RFCA) of atrial fibrillation (AF). The traditional periprocedural anticoagulation approach is discontinuation of vitamin K antagonist and bridging with heparin. Newly procedures are done under therapeutic INR 2-3. Recent studies used periprocedural new direct oral anticoagulants (NOACs). Hypothesis: We evaluated the available evidence on the efficacy and safety of NOACs for periprocedural anticoagulation during RFCA of AF. Methods: Pubmed, Embase and Cochrane Central were searched. Retrospective and prospective studies published as peer-reviewed full-size articles were included if they reported embolic events and major and minor bleeding. Results: Fifteen studies were identified (14 observational studies, 1 small randomized trial). A total of 7050 patients were included (NOACs group: 2887 ). A total of 37 thromboembolic complications occurred (0,5%) with 17 events in the NOAC group (0,6%) and 20 in the warfarin group (0,5%) (odds ratio 0.97, 95% confidence interval (CI) 0.48 to 1.99). Major bleeding were numerically higher in the warfarin group compared to the NOACs group. However, the difference did not reach statistical significance (odds ratio 0.69, CI 0.43 to 1.10). Subgroup analysis did not reveal any differences in event rates. Conclusions: Our review suggests that dabigatran etexilate and rivaroxaban are as effective and safe as warfarin for periprocedural anticoagulation in patients undergoing RFCA of AF. However, it has to be acknowledged that the current evidence is mainly based on observational studies.

An Expanded Preoperative Component within an Enhanced Recovery Protocol Improves Outcomes in Colorectal Surgery

2017 ◽  
Vol 83 (8) ◽  
pp. 928-934
Author(s):  
Nathan M. Johnson ◽  
Sandy L. Fogel
Keyword(s):  
Colorectal Surgery ◽  
Length Of Stay ◽  
Enhanced Recovery ◽  
Statistical Significance ◽  
Current Evidence ◽  
P Value ◽  
Postoperative Length ◽  
Enhanced Recovery Protocol ◽  
Recovery Protocols ◽  
Colorectal Procedures

Enhanced Recovery Protocols (ERPs) have been shown to lead to quicker recovery in colorectal surgery, with reduced postoperative length of stay (LOS). ERPs could potentially be improved with an expanded preoperative component reflecting current evidence. We hypothesize that an ERP with an expanded preoperative component will reduce LOS consistent with or exceeding that seen with traditional ERPs. Our ERP was implemented in June of 2014. Data was collected for two full years from July 2014 through June 2016. The protocol was employed in colorectal cases, both elective and emergent. Data from ERP cases were compared with contemporaneous controls that did not go through the ERP. Patients who underwent colorectal procedures and participated in the ERP with the expanded preoperative component had an average LOS of 5.33 days, whereas controls stayed for an average of 7.93 days (P value, <0.01). ERP cases also experienced fewer read-missions and complications, although statistical significance could not be established. The results demonstrate that an ERP with an enhanced preoperative component significantly reduces LOS and potentially decreases the rate of readmissions and total complications.

Human milk as a protective factor for bronchopulmonary dysplasia: a systematic review and meta-analysis

2018 ◽  
Vol 104 (2) ◽  
pp. F128-F136 ◽  
Author(s):  
Jinglan Huang ◽  
Li Zhang ◽  
Jun Tang ◽  
Jing Shi ◽  
Yi Qu ◽  
...  
Keyword(s):  
Human Milk ◽  
Preterm Infants ◽  
Bronchopulmonary Dysplasia ◽  
Protective Factor ◽  
Meta Analysis ◽  
Statistical Significance ◽  
Current Evidence ◽  
Inclusion Criteria ◽  
Formula Group ◽  
Milk Feeding

ObjectiveTo summarise current evidence evaluating the effects of human milk on the risk of bronchopulmonary dysplasia (BPD) in preterm infants.DesignWe searched for studies on human milk and BPD in English and Chinese databases on 26 July 2017. Furthermore, the references of included studies were also screened. The inclusion criteria in this meta-analysis were the following: (1) preterm infants (<37 weeks); (2) human milk; (3) comparing with formula feeding; (4) the outcome included BPD; and (5) the type of study was randomised controlled trial (RCT) or cohort study.ResultA total of 17 cohort studies and 5 RCTs involving 8661 preterm infants met our inclusion criteria. The ORs and 95% CIs of six groups were as follows: 0.78 (0.68 to 0.88) for exclusive human milk versus exclusive formula group, 0.77 (0.68 to 0.87) for exclusive human milk versus mainly formula group, 0.76 (0.68 to 0.87) for exclusive human milk versus any formula group, 0.78 (0.68 to 0.88) for mainly human milk versus exclusive formula group, 0.83 (0.69 to 0.99) for mainly human milk versus mainly formula group and 0.82 (0.73 to 0.93) for any human milk versus exclusive formula group. Notably, subgroup of RCT alone showed a trend towards protective effect of human milk on BPD but no statistical significance.ConclusionBoth exclusive human milk feeding and partial human milk feeding appear to be associated with lower risk of BPD in preterm infants. The quality of evidence is low. Therefore, more RCTs of this topic are needed.

scholarly journals Is local anaesthesia superior to general anaesthesia in endovascular repair of abdominal aortic aneurysm?

2019 ◽  
Vol 29 (4) ◽  
pp. 599-603
Author(s):  
Amer Harky ◽  
Ciaran Grafton-Clarke ◽  
Jeremy Chan
Keyword(s):  
Abdominal Aortic Aneurysm ◽  
Aortic Aneurysm ◽  
Endovascular Repair ◽  
Statistical Significance ◽  
Current Evidence ◽  
Perioperative Outcomes ◽  
General Anaesthetic ◽  
Abdominal Aortic ◽  
Meta Analyses ◽  
Study Type

Summary A best evidence topic in cardiovascular surgery was written in accordance to a structured protocol. The question addressed was: in patients undergoing endovascular repair of abdominal aortic aneurysm (EVAR), is local anaesthetic (LA) superior to general anaesthetic in terms of perioperative outcomes? Altogether, 630 publications were found using the reported search protocol, of which 3 represented the best evidence to answer the clinical question. The authors, journal, date and country of publication, patient group studied, study type and primary outcomes were tabulated. The 3 included studies are systematic reviews with meta-analyses, with no randomized trials identified. Within the studies, there is a degree of heterogeneity in terms of surgical case-mix (elective or emergency EVAR or both) and anaesthetic technique (LA, regional anaesthetic, local-regional anaesthetic and general anaesthetic). With 1 study not providing pooled estimates, the second study demonstrated statistical significance in favour of local-regional anaesthetic within the elective setting in terms of mortality [pooled odds ratio (OR) 0.70, 95% confidence interval (CI) 0.52–0.95; P = 0.02], morbidity (pooled OR 0.73, 95% CI 0.55–0.96; P = 0.0006) and total length of hospital admission (pooled mean difference: −1.53, 95% CI −2.53 to −0.53; P = 0.00001). The third study failed to demonstrate a statistically significant mortality benefit with LA (pooled OR 0.54, 95% CI 0.21–1.41; P = 0.211). While the results of these studies fail to provide a clear answer to a complex surgical problem, it would be appropriate, in the light of current evidence, to recommend LA as non-inferior to general anaesthetic in both emergency and elective settings.

Loneliness among cancer caregivers: A narrative review

2019 ◽  
Vol 18 (3) ◽  
pp. 359-367 ◽  
Author(s):  
Tamryn F. Gray ◽  
Desiree R. Azizoddin ◽  
Paula V. Nersesian
Keyword(s):  
Health Outcomes ◽  
Cancer Patients ◽  
Well Being ◽  
Narrative Review ◽  
Current Evidence ◽  
Limited Attention ◽  
Inclusion Criteria ◽  
Negative Effects ◽  
Loved One ◽  
Cancer Caregivers

AbstractObjectiveProviding care to a loved one with cancer places demands on caregivers that result in changes to their daily routines and disruptions to their social relationships that then contribute to loneliness. Though caregivers’ psychosocial challenges have been well studied, loneliness — a determinant of health — has not been well studied in this population. This narrative review sought to describe the current evidence on loneliness among caregivers of cancer patients. We aimed to (1) define loneliness, (2) describe its prevalence, (3) describe the association between loneliness and health outcomes, (4) describe risks and consequences of loneliness among cancer caregivers, (5) identify ways to assess loneliness, and (6) recommend strategies to mitigate loneliness in this unique population.MethodWe used evidence from articles listed in PubMed, PsycINFO, and Cumulative Index to Nursing and Allied Health Literature (CINAHL) databases, book chapters, and reports. Articles were reviewed for the following inclusion criteria: (1) published in English, (2) caregivers of cancer patients, (3) loneliness as a study variable, and (4) peer-reviewed with no restriction on the timeframe of publication. Caregivers were defined as relatives, friends, or partners who provide most of the care and support for someone with cancer.ResultsEighteen studies met inclusion criteria and were included in the analysis. Caregivers’ experiences of loneliness can contribute to negative effects on one's social, emotional, and physical well-being. Social support interventions may not be sufficient to address this problem. Existing recommendations to mitigate loneliness include cognitive and psychological reframing, one-on-one and group therapy, befriending, resilience training, and technology-based interventions.Significance of resultsLimited attention to loneliness in cancer caregivers poses a twofold problem that impacts patient and caregiver outcomes. Interventions are critically needed to address loneliness as a determinant of health in caregivers, given their pivotal role in providing care and impacting health outcomes for people with cancer.

scholarly journals Role of Environmental Chemicals in Obesity: A Systematic Review on the Current Evidence

2013 ◽  
Vol 2013 ◽  
pp. 1-8 ◽  
Author(s):  
Roya Kelishadi ◽  
Parinaz Poursafa ◽  
Fahimeh Jamshidi
Keyword(s):  
Environmental Chemicals ◽  
Human Studies ◽  
Current Evidence ◽  
Laboratory Studies ◽  
Crucial Importance ◽  
Obesity Epidemic ◽  
Complex Disorder ◽  
Developmental Phases ◽  
Systemic Responses

The purpose of this paper is to systematically review the experimental and human studies on obesogenic chemicals and their mechanisms of action to provide a comprehensive view on the multifactorial aspects of obesity. The literatures were searched in available databases. The relevant papers were selected in three phases. After quality assessment, two reviewers extracted the data while another checked their extracted data. In this review, we summarized information regarding environmental chemicals that can be associated with obesity. Most evidence comes from experimental and laboratory studies; however a growing number of human studies also support the role of obesogenic chemicals. The current evidence proposes that the systemic responses to exposure to environmental factors could potentially increase the risk of excess weight. The effects of exposure to these chemicals are of crucial importance during developmental phases of life, when preprogramming for an adipogenic outcome may occur. By considering the adverse transgenerational effects of obesogen chemicals on human health, the global obesity epidemic should be considered as a multifactorial complex disorder necessitating the emphasis of public health interventions for environmental protection.

scholarly journals Persistent Environmental Pollutants and Couple Fecundity: The LIFE Study

2013 ◽  
Vol 121 (2) ◽  
pp. 231-236 ◽  
Author(s):  
Germaine M. Buck Louis ◽  
Rajeshwari Sundaram ◽  
Enrique F. Schisterman ◽  
Anne M. Sweeney ◽  
Courtney D. Lynch ◽  
...  
Keyword(s):  
Environmental Pollutants ◽  
Life Study ◽  
Persistent Environmental Pollutants
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