Outcome of Contemporary Nonsurgical Endodontic Retreatment: A Systematic Review of Randomized Controlled Trials and Cohort Studies

INTRODUCTION

The success rates of NS-ReTx have varied across decades of prior research. Nonetheless, recent endodontic advances have substantially enhanced case management. This systematic review aimed to identify rigorous studies on contemporary NS-ReTx, investigating both periapical healing-evaluated strictly for complete resolution or loosely for size reduction of periapical radiolucency-and success, denoting clinical normalcy combined with periapical healing.

METHODS

We systematically searched MEDLINE, Embase, Web of Science, the Cochrane Library, and gray literature from January 1988 to December 2022. Article selection and data extraction were independently conducted by 3 reviewers. Selected studies underwent risk of bias assessment, and evidence quality using the Grading of Recommendations, Assessment, Development, and Evaluation approach. Meta-analysis and meta-regression established pooled outcome rates, 95% confidence intervals (CIs), and significant clinical prognostic factors (P < .05).

RESULTS

Twenty-nine articles were included. Pooled periapical healing rates using strict and loose criteria were 78.8% (95% CI: 75.2-82.4) and 87.5% (95% CI: 83.8-91.2), respectively. Pooled success rates using strict and loose criteria were 78.0% (95% CI: 74.9-81.2) and 86.4% (95% CI: 82.6-90.1), respectively. Meta-regression analyses revealed significant influences on NS-ReTx outcomes (P < .05), including periapical status, lesion size, apical root filling extent, and follow-up duration.

CONCLUSIONS

Contemporary NS-ReTx shows encouraging outcomes, achieving periapical healing and success rates ranging from approximately 78% (strict criteria) to 87% (loose criteria). The absence of or smaller preoperative lesions, adequate root filling length, and extended follow-ups significantly improve NS-ReTx outcomes. Integrating these factors into treatment planning is pivotal for optimizing the outcome of NS-ReTx.

Proteomics approach to investigating osmotic stress effects on pistachio

Osmotic stress can occur due to some stresses such as salinity and drought, threatening plant survival. To investigate the mechanism governing the pistachio response to this stress, the biochemical alterations and protein profile of PEG-treated plants was monitored. Also, we selected two differentially abundant proteins to validate via Real-Time PCR. Biochemical results displayed that in treated plants, proline and phenolic content was elevated, photosynthetic pigments except carotenoid decreased and MDA concentration were not altered. Our findings identified a number of proteins using 2DE-MS, involved in mitigating osmotic stress in pistachio. A total of 180 protein spots were identified, of which 25 spots were altered in response to osmotic stress. Four spots that had photosynthetic activities were down-regulated, and the remaining spots were up-regulated. The biological functional analysis of protein spots exhibited that most of them are associated with the photosynthesis and metabolism (36%) followed by stress response (24%). Results of Real-Time PCR indicated that two of the representative genes illustrated a positive correlation among transcript level and protein expression and had a similar trend in regulation of gene and protein. Osmotic stress set changes in the proteins associated with photosynthesis and stress tolerance, proteins associated with the cell wall, changes in the expression of proteins involved in DNA and RNA processing occur. Findings of this research will introduce possible proteins and pathways that contribute to osmotic stress and can be considered for improving osmotic tolerance in pistachio.

Bacterial coinfection among coronavirus disease 2019 patient groups: an updated systematic review and meta-analysis

The pandemic of severe acute respiratory syndrome coronavirus 2 raised the attention towards bacterial coinfection and its role in coronavirus disease 2019 (COVID-19) disease. This study aims to systematically review and identify the pooled prevalence of bacterial coinfection in the related articles. A comprehensive search was conducted in international databases, including MEDLINE, Scopus, Web of Science, and Embase, to identify the articles on the prevalence of bacterial coinfections in COIVD-19 patients from 1 December 2019 until 30 December 2020. All observational epidemiological studies that evaluated the prevalence of bacterial coinfections in patients with COVID-19 were included without any restriction. Forty-two studies including a total sample size of 54,695 were included in the analysis. The pooled estimate for the prevalence of bacterial coinfections was 20.97% (95% CI: 15.95-26.46), and the pooled prevalence of bacterial coinfections was 5.20% (95% CI: 2.39-8.91) for respiratory subtype and 4.79% (95% CI: 0.11-14.61) for the gastrointestinal subtype. The pooled prevalence for Eastern Mediterranean Regional Office and South-East Asia Regional Office was 100% (95% CI: 82.35-100.00) and 2.61% (95% CI: 1.74-3.62). This rate of coinfection poses a great danger towards patients, especially those in critical condition. Although there are multiple complications and adverse effects related to extensive use of antibiotics to treat patients with COVID-19, it seems there is no other option except applying them, and it needs to be done carefully.

Evaluating the expression level of Survivin gene in different groups of B-cell acute lymphoblastic leukemia patients of Iran

Survivin is one of the major members of Inhibitory Apoptotic Proteins (IAP) family. The functional anti-apoptotic and regulatory role of Survivin in the cell cycle had made it as an interesting candidate for tumor studies. Acute lymphoblastic leukemia is one of the most common malignancies of children that accounts for 30% of all the childhood malignancies. The purpose of this study was to investigate the prognostic importance of Survivin level in B-cell acute lymphoblastic leukemia patients of Iran in four different steps of disease in order to follow up its impact on various treatment ways, the development of the disease, and the response to treatment in the patients. The expression level of Survivin was evaluated in 85 patients with B-cell acute lymphoblastic leukemia and 85 healthy controls using Quantitative Real-Time Polymerase Chain Reaction. Also, western blot analysis was done to confirm the results. Based on our findings, the expression of Survivin showed a significant up-regulation in patients compared to controls. Therefore, a correlation between Survivin expression and the development pattern of B-cell acute lymphoblastic leukemia with a strong diagnostic efficiency (AUC-ROC, 0.8562) was observed. Therefore, it can be introduced as a potential marker for prognosis B-cell Acute Lymphoblastic Leukemia in the future.

The association between metabolic syndrome and its components with systemic lupus erythematosus: a comprehensive systematic review and meta-analysis of observational studies

OBJECTIVES

Based upon inflammatory-related factors in chronic systemic lupus erythematosus (SLE), as well as the long-term prescription of corticosteroids, metabolic syndrome (MetS) prevalence is expected to be higher in SLE patients than among those without SLE. The aim of this study was to systematically analyze: (1) the worldwide prevalence of MetS in patients with SLE using different criteria, (2) the risk of MetS in patients with SLE compared with those without SLE, and (3) the risk of MetS component in patients with SLE compared with healthy controls.

METHODS

We searched international databases, such as: Web of Science, Medline, PubMed, Scopus, Embase, CABI, CINAHL, DOAJ and Google Scholar. The articles which reported the prevalence of MetS in SLE patients, between 2006 and 2017, were included in the study if they had a: clear study design, study time and location, sound sampling approach and appropriate statistical analyses. Studies without sufficient data to determine the prevalence of MetS were excluded. Also, studies in patients suffering from other clinical diseases were not included.

RESULTS

The meta-analyses of the prevalence (40 studies (n = 6085)) and risk (20 studies (n = 2348)) of MetS in SLE patients were conducted separately. The pooled prevalence of MetS among SLE patients was found to be 26% (95% confidence interval (CI): 22-30%), but varied from 18% (95% CI: 11-25%) to 34% (95% CI: 25-42%), depending upon the diagnostic criteria used. The overall pooled odds ratio (OR) of MetS in SLE patients, compared with healthy controls, was (OR = 2.50; 95% CI: 1.86-3.35), but this ranged from (OR = 1.23; 95% CI: 0.61-2.49) to (OR = 10.71; 95% CI: 1.33-86.48), depending upon the criteria used. Also, the risk of high fasting blood sugar (FBS; OR = 1.59; 95% CI: 1.05-2.40), low high-density lipoprotein cholesterol (HDL-C; OR = 1.43; 95% CI: 1.02-2.01), high blood pressure (BP; OR = 2.76; 95% CI: 2.19-3.47), high triglycerides (TG; OR = 2.85; 95% CI: 2.05-3.95) and high waist circumference (WC; OR = 1.37; 95% CI: 0.97-1.94) were all found to be higher in SLE patients compared with healthy controls.

CONCLUSIONS

The risk of MetS was significantly higher in SLE patients, compared with healthy controls, even after adjusting for publication bias. Among MetS components, high TG and high BP were most strongly associated with SLE. Considering that high TG and high BP are preventable, there is an international need to implement effective interventions to reduce MetS components in SLE patients in order to prevent serious outcomes such as cardiovascular diseases and mortality.

Scanning electron-microscopic study of sperm retention and migration in the vagino-cervical region of the rabbit

The pattern of sperm retention and migration in the vagino-cervical region of rabbit was studied by means of scanning electron microscopy. The following phenomena were observed: 1) Spermatozoa located in the vagina and at the orifice of the ectocervix are usually distributed diffusely. They appear to be resting on the epithelial surface; many are structurally abnormal or decapitated. 2) The great majority of spermatozoa, however, seems to be anchored or retained in narrow epithelial channels with their heads in close file formations. This phenomenon was observed particularly in the fornix vaginae as late as 24 h post coitum. 3) A great number of spermatozoa invading the cervix evidently migrates in groups along the mucosal surface. Their heads are oriented toward the uterus and contact the epithelial cells. Spermatozoa that migrate beyond the cervico-uterine junction are distributed in the same manner. 4) Spermatozoa colonizing the cervical crypts appear to be attached via the anterior margins of their heads to the epithelial cells or to the tips of kinocilia. Their tails project into the crypt lumen. It is suggested that mainly three factors may be responsible for these phenomena: (i) the fact that only motile spermatozoa overcome the vagino-cervical barrier; (ii) the tendency of spermatozoa to move along the mucosa in close vicinity to the epithelial cells; and (iii) the inability to recognize mechanical barriers on the migration route (e.g., cervical crypts) and to overcome them quickly. This may be one of many possible causes leading to sperm retention in the vagino-cervical region.