Prevalence of latent tuberculosis infection in transplant candidates: A systematic review and meta-analysis.

INTRODUCTION: Tuberculosis (TB) is considered as a serious complication for organ transplant recipients; therefore, the detection and appropriate treatment of latent infection are recommended for preventing active TB infections in the future. The objective of this review is to conduct a systematic review and meta-analysis of studies assessing the prevalence of latent TB infection (LTBI) in transplant candidates. METHODS: Electronic databases, including MEDLINE (via PubMed), SCOPUS were searched until 30 June 2017. The prevalence of LTBI was estimated using the random effects meta-analysis. Heterogeneity was evaluated by subgroup analysis. Data were analyzed by STATA version 14. RESULTS: The pooled prevalence of LTBI based on tuberculin skin test (TST) in different transplant types was as follows: liver 24% (14%-33%, 95% CI), lung 22% (18%-26%), renal 21% (16%-27%, 95% CI) and hematopoietic stem cell transplantation (HCT) 14% (9%-19%). The prevalence of LTBI based on Interferon Gamma Release Assay (IGRA) tests in renal transplant candidates was 31% (95% CI; 25-37%), which was much higher than the prevalence of LTBI in liver transplant candidates (25%, 95% CI; 17-33%) and HCT transplant candidates (13%, 95% CI; 10-16%) and there was statistically significant differences between them. The pooled prevalence of indeterminate results based on IGRAs test in different transplant types was as follows: renal 6% (4%-8%, 95% CI) and liver 12% (2%-21%, 95% CI). Subgroup analysis revealed that there were statistically significant differences between the overall prevalence of indeterminate results by using IGRA tests in liver transplant candidates (12%, 95% CI; 2-21%) and renal transplant candidates (6%, 95% CI; 4-8%). The pooled prevalence of post-transplant TB was 2% (1%-2%, 95% CI) and its occurrence was more common in renal recipients (4% (2%-7%, 95% CI)) than in the liver transplant patients (1% (0%-2%, 95% CI)). The prevalence of LTBI in the subgroup (i.e. the patients' mean age was <50 years) was significantly higher than the prevalence of LTBI by using TST/IGRAs in the other subgroup (i.e. the patients' mean age was ≥50 years). CONCLUSION: Our study suggests fair overall agreement between IGRAs and TST in patients requiring liver and HCT transplantation, while a superiority of IGRAs over TST in patients requiring renal transplantation was seen.

Reduction of Enterococcus faecalis in curved root canals after various sizes and tapers of canal preparation.

AIMS: The aim of this study was to evaluate the reduction of Enterococcus faecalis in curved root canals after various sizes and tapers of the canal preparation. MATERIALS AND METHODS: Mandibular first molars (n = 103) with curved mesiobuccal canals were divided into one control (n = 5) and 7 experimental (n = 14) groups, were inoculated with E. faecalis (ATTC 29212) and prepared with the following RaCe files (FKG Dentaire) as master apical file: Groups: 25.04, 25.06, 30.04, 30.06, 35.04, 35.06 and 40.06. All the experimental groups were irrigated with 2 mL of 1% sodium hypochlorite during instrumentation and finally rinsed with 17% ethylenediaminetetraacetic acid (EDTA) (2 mL) followed by 5.25% NaOCl (2 mL) and sterile distilled water. Colony counting was performed after incubation. STATISTICAL ANALYSIS USED: Resulting data were analyzed using one-way ANOVA and Tukey's post-hoc test, (P < 0.05). RESULTS AND CONCLUSIONS: All the experimental groups showed significant bacterial reduction (P < 0.001). Although the greater the size/taper or both led to more decreased amount of bacteria, differences between the groups with the identical size and different tapers, and among the groups with the same taper and different sizes were not significant. Based on this study, 25.04 along with using 2 mL of 1% NaOCl during instrumentation, and using 17% EDTA and 5.25% NaOCl as final rinse successively after the termination of preparation, can effectively reduce intra-canal bacteria and preserve root structure.

The Effect of Size and Taper of Apical Preparation in Reducing Intra-Canal Bacteria: A Quantitative SEM Study.

INTRODUCTION: Bacteria and their byproducts are major etiologic factors in endodontic diseases. Prevention or reduction of root canal bacterial contamination is the main aim of endodontic treatment. The purpose of this in vitro study was to evaluate the effect of size and taper of master apical file (MAF) in reducing bacteria from the apical third of the curved canals using a quantitative scanning electron microscope (SEM) study. METHODS AND MATERIALS: Eighty-nine human mandibular first molars with curved MB canals (20(º)-35(º)) were divided into one control group (n=5) (without rotary instrumentation) and 6 experimental groups (n=14). The canals were prepared using RaCe rotary files to the MAF sizes 25/0.04, 25/0.06, 30/0.04, 30/0.06, 35/0.04 and 35/0.06, in groups 1 to 6, respectively. All the experimental groups were finally rinsed with 2 mL of 17% EDTA followed by 3 mL of 5.25% NaOCl. The mesial roots were split longitudinally. Remaining bacteria in the apical third of MB canals were evaluated using SEM (2000×). Data analysis was performed using one way ANOVA with Tukey's post hoc test. The level of significance was set at 0.05. RESULTS: All the experimental groups showed significant bacterial reduction (P<0.001). Although the greater size and/or taper resulted in decrease in bacteria, differences between the groups were not significant. CONCLUSION: Based on this in vitro study the MAF #25/0.04 had no significant difference compared to other groups with greater apical size/taper; all groups could effectively reduce intra-canal bacteria.

Effects of zearalenone and alpha-Zearalenol in comparison with Raloxifene on T47D cells.

Zearalenone (Zen) is a mycotoxin with estrogenic effect which contaminates cereals. In cell culture, Zen and its metabolite, alpha-Zearalenol (alpha-Zel), stimulate breast cancer cells growth. Today hormone-dependent cancers are important because of high incidence and death rate. Previous studies showed that Zen and alpha-Zel have an effect on hormone-dependent cancers. This study explains the effects of the mentioned compounds in comparison with Raloxifene as an anti-estrogen. Cell culture technique was used with MDA-MB-231 and T47D cells for evaluation of compounds. MDA-MB-231 cells were used as negative control and also for proving that treatment compounds merely affect, due to their proliferation activity in the applied doses. According to the Resazurine-based method, for toxicity assay, none of the test compounds have an effect on MDA-MB-231 cells but do effect the growth of T47D cells. Zen and alpha-Zel at low concentrations (10-8-10-9 M) stimulated T47D cell growth and Raloxifene strongly inhibited cell growth induced by Zen and alpha-Zel. There is a noticeable result in controlling diet of hormonal carcinogenic compounds and applying novel anti-estrogens for prevention and treatment of hormone-dependent cancers.