Daily Cosmetic Research Analysis
A randomized cross-over trial found chlorhexidine superior to ethanol for disinfecting buttonhole cannulation sites in arteriovenous fistulas, supporting protocol changes in dialysis units. A systematic review synthesized mechanistic evidence that micro- and nanoplastics can impair the male reproductive system, highlighting public health implications from consumer exposures (including cosmetics). A large French survey of actinic keratosis patients revealed knowledge gaps, suboptimal photoprotect
Summary
A randomized cross-over trial found chlorhexidine superior to ethanol for disinfecting buttonhole cannulation sites in arteriovenous fistulas, supporting protocol changes in dialysis units. A systematic review synthesized mechanistic evidence that micro- and nanoplastics can impair the male reproductive system, highlighting public health implications from consumer exposures (including cosmetics). A large French survey of actinic keratosis patients revealed knowledge gaps, suboptimal photoprotection, and a need for more acceptable topical treatments and improved access to dermatologic care.
Research Themes
- Infection prevention in hemodialysis access care
- Micro/nanoplastics and male reproductive toxicity
- Dermatology patient education, photoprotection, and treatment acceptability
Selected Articles
1. Disinfection with chlorhexidine is more effective than ethanol for buttonhole cannulation in arteriovenous fistula: a randomized cross-over trial.
In a randomized cross-over trial in hemodialysis patients using buttonhole AVFs, 5 mg/mL chlorhexidine in 70% ethanol achieved significantly greater immediate and sustained reduction of skin flora than 70% ethanol alone. Microbiological regrowth at 2–4 hours was lower with chlorhexidine, and scab flora matched normal skin flora, underscoring infection origin.
Impact: This registered randomized cross-over trial provides actionable comparative effectiveness data favoring chlorhexidine over ethanol for AVF buttonhole disinfection, potentially informing dialysis unit protocols to prevent infections.
Clinical Implications: Dialysis units using buttonhole cannulation should preferentially adopt chlorhexidine-based disinfection to reduce viable skin flora and potential infection risk; implementation studies should evaluate infection endpoints and cost.
Key Findings
- Chlorhexidine yielded fewer positive haematin plates immediately after disinfection than ethanol (1.4% vs 10.8%; p=0.032).
- At 2 and 4 hours, bacterial regrowth was lower with chlorhexidine (e.g., 60 vs 170 CFU/mL at 2 h; p=0.046) than ethanol with arm washing.
- Buttonhole scab bacteria mirrored normal skin flora (Cohen’s kappa=0.97), implicating skin flora as the infection source.
Methodological Strengths
- Randomized cross-over design with within-participant comparisons across four interventions
- Prospective serial sampling at multiple timepoints and trial registration (CTIS)
Limitations
- Microbiological surrogate outcomes rather than clinical infection rates
- Sample size and blinding details not specified; likely single-center with short follow-up
Future Directions: Conduct multicenter RCTs powered for infection endpoints, assess the role of arm washing, compare different chlorhexidine formulations, and perform implementation and cost-effectiveness studies.
2. Unravelling the potential mechanisms of nano- and microplastic toxicity to the male reproductive system: A systematic review.
This systematic review synthesizes preclinical evidence that micro- and nanoplastics bioaccumulate in the testis and epididymis, disrupt the blood-testis barrier, and impair spermatogenesis via oxidative stress and inflammation. Sertoli and Leydig cell dysfunction and hormone imbalance were consistently observed, with toxicity modulated by particle size, shape, composition, surface properties, and exposure route.
Impact: By consolidating mechanistic pathways linking ubiquitous micro/nanoplastic exposure (including from cosmetics) to male reproductive toxicity, this review sets priorities for exposure regulation and human translational research.
Clinical Implications: While clinical data are limited, the mechanistic evidence supports precautionary reduction of micro/nanoplastic exposures, informs counseling for fertility concerns, and motivates biomonitoring and epidemiologic studies.
Key Findings
- Micro- and nanoplastics bioaccumulate in the testis and epididymis in rodent models.
- Disruption of the blood-testis barrier, increased germ cell apoptosis, sperm malformations, and reduced motility are frequently observed.
- Sertoli and Leydig cell dysfunction with hormone imbalance occurs via oxidative stress and inflammation; toxicity depends on particle characteristics and exposure route.
Methodological Strengths
- Systematic synthesis across multiple organ targets and barriers with mechanistic framing
- Comparative analysis of particle characteristics (size, shape, composition, surface properties) and exposure routes
Limitations
- Predominantly rodent studies; human translational relevance uncertain
- Heterogeneity in particle characterization, doses, and outcome measures limits meta-analysis and causal inference
Future Directions: Standardize particle characterization and exposure metrics, conduct dose-response and barrier-focused mechanistic studies, and launch human biomonitoring and epidemiologic cohorts linking exposure to fertility outcomes.
3. Awareness, Patient Behaviour, and Treatment Expectations in a French Cohort with Actinic Keratosis (REAKT Survey).
In a representative French cohort of 639 adults with physician-diagnosed actinic keratosis, knowledge about AK and treatments was limited, access to dermatologists was perceived as delayed, and sun protection behaviors were suboptimal. Many reported lesion persistence post-treatment and cosmetic or painful side effects, prioritizing effective, easy-to-use, and cosmetically acceptable therapies and regular skin exams.
Impact: This large, population-based survey identifies actionable gaps in education, access, and treatment acceptability in AK care, guiding patient-centered interventions and health service planning.
Clinical Implications: Dermatology programs should enhance patient education on AK and photoprotection, improve access (e.g., triage/teledermatology), and develop/offer topical therapies with better tolerability and cosmetic outcomes.
Key Findings
- Only 52.0% reported knowing much about treatments; correct knowledge about AK rarely exceeded 50%.
- 85.3% perceived dermatologist waiting times as excessive; 40.8% reported lesion persistence after treatment.
- 35.3% reported treatments made skin painful or unsightly; sun protection was suboptimal (22.7% rarely/never went out with protection; 52.3% rarely/never applied morning sunscreen).
Methodological Strengths
- Large sample (n=639) drawn from a representative general population panel
- Comprehensive assessment covering awareness, behavior, care experience, and treatment expectations
Limitations
- Cross-sectional self-reported data subject to recall and social desirability biases
- Findings are specific to the French healthcare context; causality cannot be inferred
Future Directions: Test targeted educational and behavioral interventions, evaluate teledermatology pathways to reduce wait times, and develop patient-reported outcome measures emphasizing tolerability and cosmetic acceptability of AK treatments.