Non-cytotoxic Root Canal Dressing with Improved Antimicrobial Efficacy.

INTRODUCTION: Recurrent endodontic infections are primarily caused by Enterococcus faecalis and are more challenging to treat, compared with primary infection of the root canal system. Calcium hydroxide (CH) is used as an interappointment dressing in endodontics despite its inefficacy against E. faecalis and other pathogens. To improve antimicrobial properties and limit cytotoxicity of CH, we added salicylic acid to CH (CASA) to disinfect the canal. CASA overcomes the main pathogen responsible for recurrent endodontic infections. The aim of this study was to evaluate the antimicrobial activity of CASA and its cytotoxicity against dental pulp stem cells (DPSCs) and its effect on the differentiation potential of DPSCs. METHODS: Mature E. faecalis biofilm cultured on dentin chips was exposed to CASA and studied using confocal laser scanning microscopy. The dose-dependency of CASA was also studied using the liquid suspension test. The cytotoxicity was tested against DPSCs, and its effect on the expression of osteocalcin and alkaline phosphatase was studied. RESULTS: CASA produced larger zones of inhibition than CH for all species tested and demonstrated superior efficacy than CH against E. faecalis biofilm. Cytotoxicity studies indicated DPSC's high tolerance for CASA; addition of CASA to DPSCs was observed to increase the expression of biological markers related to mineralization. CONCLUSIONS: CASA was proved to have superior antibacterial efficacy against E. faecalis when compared with CH. It also increased the expression of some DPSC differentiation markers involved in mineralization.

The Exosomes: Staring Biomarkers and Novel Therapeutic Strategies.

Extracellular vesicles (EVs, formerly known as exosomes) are small, extracellular membrane-bound particles that play a role in cellular communication via transporting different cargos, including proteins, DNAs, RNAs, etc. Their role has been shown in different endocrine/paracrine signaling in different organs, such as the cardiovascular system. Currently, mortality and morbidity rates caused by cardiovascular disease (CVD) have become an important issue among healthcare systems all over the world. EVs great potentials for clinical diagnosis and treatment offer a bright future in assessing different types of CVDs. In this review, we have summarized the variable roles of these nano-sized biological membrane-enclosed vesicles in myocardial injury, repair, and regeneration. We have also reviewed the value of EVs as diagnostic and prognostic biomarkers in cardiology medicine and emphasized the promising capabilities of EVs as natural drug-delivery vehicles as a novel targeting treatment.

Current, New and Future Therapeutic Targets in Inflammatory Bowel Disease: A Systematic Review.

Inflammatory bowel disease (IBD), including Crohn's disease (CD) and ulcerative colitis (UC), are chronic relapsing conditions resulting from immune system activity in a genetically predisposed individual. IBD is based on progressive damage to the inflamed gut tissue. As its pathogenesis remains unknown, recent accumulating data have demonstrated that IBD is a complex and multi-factorial disorder correlated with host luminal factors, which lead to an imbalance between pro- and anti-inflammatory signaling. The growing understanding of the molecular mechanisms responsible for IBD has suggested a wide range of potential therapeutic targets to treat this condition. Some patients do not have a satisfactory response to current therapeutic medications such as antitumor necrosis factor (TNF) agents, or their response decreases over time. As a result, IBD therapeutics have been changed recently, with several new agents being evaluated. The identification of various inflammatory cascades has led to forming the idea to have novel medications developed. Medications targeting Janus kinases (JAK), leukocyte trafficking Interleukin (IL) 12/23, and Sphingosine 1 phosphate (S1P) are among these newly developed medications and highlight the role of microbial-host interaction in inflammation as a safe promising strategy. This systematic review aims to summarize different molecular targeting therapeutics, the most potent candidates for IBD treatment in recent studies.

Comparison of the changes in blood glucose level during sedation with midazolam and propofol in implant surgery: a prospective randomized clinical trial.

STATEMENT OF THE PROBLEM: Reducing the patients' stress can prevent, or at least, limit the increase in blood glucose level. PURPOSE: The study compares the effect of propofol and midazolam on blood glucose level in the patients undergoing dental implant surgery. The effect of pre-operational stress on blood glucose level during the surgery is also evaluated. MATERIALS AND METHOD: This prospective randomized clinical trial recruited 33 patients undergoing dental implant surgery and divided into two groups. Conscious sedation was performed by midazolam in one group and with propofol in another group. The pre-operational stress was scored and the blood glucose level was measured in 4 different stages; before the operation, two minutes after the local anesthetic injection; thirty minutes after the onset of operation and at the end of the operation. The results were analyzed by employing ANOVA and Pearson test. The p Value was adopted 0.05 and the confidence coefficient was assumed 95%. RESULTS: The average levels of the blood glucose in midazolam and propofol group were 93.82 mg/dl and 94 mg/dl before the operation which displayed a meaningful increase of blood glucose level in both groups as the operation went on. The values were 103.76 mg/dl for midazolam and 108.56 mg/dl for the propofol group (p< 0.05) at the end of the operation. No statistically significant difference was found in the average blood glucose level between two groups in the different stages of the operation (p= 0.466). The Pearson correlation coefficient test revealed a higher increase in the blood glucose level in the patients with a higher pre-operational stress score (r= 0.756, p< 0.001). CONCLUSION: Based on the results yielded by this study, patients who receive venous sedation, either by midazolam or propofol, experience increase in the blood glucose level while undergoing an operation. No statistically significant difference was detected between midazolam and propofol.