Comparative in vitro and ex vivo studies on the bactericidal activity of Tetraclean, a new generation endodontic irrigant, and sodium hypochlorite

The aim of this study was to compare the efficacy of a new generation endodontic irrigant, Tetraclean, to the widely used sodium hypochlorite. Tetraclean combines a powerful detergent effect with a strong antimicrobial efficacy, whereas sodium hypochlorite has several drawbacks and is sometimes ineffective in preventing microbial-mediated endodontic failure. The bactericidal activity of both irrigants against Enterococcus faecalis, the most commonly isolated species from root canals of teeth with post-treatment disease, was assessed i) in vitro, according to the European Standard lines for the evaluation of the bactericidal activity of chemical disinfectants, and ii) with an ex vivo model of extracted and decoronated human teeth, infected with E. faecalis and subsequently irrigated with either of the irrigants. Both irrigants display very similar bactericidal activity against E. faecalis in vitro. However, the ex vivo model shows that only in the teeth irrigated with Tetraclean did the bacterial burden gradually drop until no bacteria were detectable a few days post-irrigation. Vice versa, in the teeth irrigated with sodium hypochlorite, the drop in the bacterial burden was rapid but temporary and most of the teeth were colonized again by 48 hours post-irrigation

COMPARAZIONE DELLA EFFICACIA ANTIBATTERICA DI TETRACLEAN, UN IRRIGANTE ENDODONTICO DI NUOVA GENERAZIONE, CON IPOCLORITO DI SODIO.

COMPARAZIONE DELLA EFFICACIA ANTIBATTERICA DI TETRACLEAN, UN IRRIGANTE ENDODONTICO DI NUOVA GENERAZIONE, CON IPOCLORITO DI SODIO.A. Ardizzoni1, R. Neglia1, L. Giardino2, E. Ambu3, S. Grazi1, S. Calignano1, C. Rimoldi1, S. Peppoloni1, E. Blasi1.1Dipartimento di Scienze di Sanità Pubblica, Università di Modena e Reggio Emilia; 2Dipartimento di Periodontologia, Università di Brescia; 3Dipartimento di Neuroscienze, Testa, Collo e Riabilitazione, Unità Operativa di Odontoiatria e Chirurgia Maxillo-Facciale, Università di Modena e Reggio Emilia.L’efficacia di un irrigante endodontico consiste nella sua capacità di penetrare in aree difficili da raggiungere, come i canalicoli dentinali, e di uccidere i microrganismi ivi residenti, causando un danno minimo ai tessuti dell’ospite. Pertanto, la scelta di un irrigante endodontico dovrebbe assicurare un adeguato effetto detergente ed una completa disinfezione dei canali endodontici e dei tubuli dentinali. Lo scopo di questo lavoro è di confrontare l’efficacia antibatterica di un irrigante endodontico di nuova generazione, Tetraclean®, con quella di ipoclorito di sodio al 5,25%. Quest’ultimo, nonostante oggi venga ampiamente utilizzato nella pratica clinica endodontica, presenta molti svantaggi e a volte risulta inefficace nel prevenire fallimenti endodontici associati a colonizzazione microbica dei canali endodontici e dei tubuli dentinali. Esperimenti condotti in vitro hanno mostrato come entrambi gli irriganti testati esercitino attività battericida simile nei confronti di Enterococcus faecalis, il patogeno più frequentemente causa di infezioni a carico del sistema radicolo-canalicolare. Tuttavia, test condotti ex vivo su denti estratti, sterilizzati e re-infettati con E. faecalis e successivamente irrigati con l’uno o l’altro degli irriganti, hanno messo in luce come solo nei denti trattati con Tetraclean® la carica batterica diminuisce gradualmente, finchè a partire da alcuni giorni dopo l’irrigazione non sono più determinabili cellule batteriche vitali. Al contrario, nei denti irrigati con sodio ipoclorito, l’abbattimento della carica batterica è più rapido, ma solo transitorio e la maggior parte dei denti viene ricolonizzata a partire da 48 ore dopo l’irrigazione. Questi risultati indicano come Tetraclean® abbia tutte le potenzialità per l’impiego, come irrigante di nuova generazione, nella pratica clinica quotidiana

The small intestinal mucosa and its stem cells

In the first part of this review a brief summary of the embryology and histology of the gastrointestinal tract is provided. In the second part intestinal stem cells (ISCs) are discussed. Several signaling pathways play a crucial role in the crypt base in the regulation of ISC proliferation and self-renewal; Wnt, Notch, BMP, Ephrin, JAK/STAT1, PTEN, AKT, PI3K and many more. Numerous investigators are involved in studying the location, number, and behavior of ISCs within the base of the intestinal crypts. Several markers are espressed by ISCs. Among these, Leucine-rich-repeat-containing G-protein-coupled receptor-5 (Lgr5), Sox9, Prominin-1, DCAMKL-1, EphB2, p-PTEN, p-AKT, Fgfr3, m-TER, and CD44. Stem cell therapy has shown promise for the treatment of some diseases characterized by tissue damage with ischemic and inflammatory lesions like inflammatory bowel disease (IBD) and necrotizing enterocolitis (NEC). Proceedings of the 2nd International Course on Perinatal Pathology (part of the 11th International Workshop on Neonatology · October 26th-31st, 2015) · Cagliari (Italy) · October 31st, 2015 · Stem cells: present and future Guest Editors: Gavino Faa, Vassilios Fanos, Antonio Giordan

Building the Momentum for A Stronger Pharmaceutical System in Africa

Despite impressive progress, nearly two billion people worldwide have no access to essential medicines. The COVID-19 pandemic revealed Africa’s vulnerability due to its reliance on imports for most vaccines, medicines, and other health product needs. The vaccine manufacturing is complex and requires massive financial investments, with global, regional, and national regulatory structures introducing consistent and urgent reforms to assure the quality and safety of medicines. In 2020, there were approximately 600 pharmaceutical manufacturers in Africa, 80% of which were concentrated in eight countries: Egypt, Algeria, Morocco, Tunisia, Nigeria, Ghana, Kenya, and South Africa. Only 4 countries had more than 50 manufacturers, while 22 countries had no local production. Out of the 600, around 25% were multinational companies. Africa is equally affected by modest scaled capacities substantially engaging in packaging and labelling, and occasionally fill and finish steps, facing criticalities in terms of solvent domestic markets. This article discusses the challenges in the development of a local pharmaceutical manufacturing in Africa and reflects on the importance of the momentum for strengthening the local medical production capacity in the continent as a critical opportunity for advancing universal health coverage (UHC)

Practice guidelines for the treatment of hepatitis C: recommendations from an AISF/SIMIT/SIMAST Expert Opinion Meeting

It is increasingly clear that a tailored therapeutic approach to patients with hepatitis C virus infection is needed. Success rates in difficult to treat and low-responsive hepatitis C virus patients are not completely satisfactory, and there is the need to optimise treatment duration and intensity in patients with the highest likelihood of response. In addition, the management of special patient categories originally excluded from phase III registration trials needs to be critically re-evaluated. This article reports the recommendations for the treatment of hepatitis C virus infection on an individual basis, drafted by experts of three scientific societies

Awareness, discussion and non-prescribed use of HIV pre-exposure prophylaxis among persons living with HIV/AIDS in Italy: a Nationwide, cross-sectional study among patients on antiretrovirals and their treating HIV physicians

Background: Before Pre-Exposure Prophylaxis (PrEP) was officially recommended and made available, a few surveys among gay and bisexual men, and persons living with HIV/AIDS (PLWHA), identified an informal use of antiretrovirals (ARVs) for PrEP among HIV-negative individuals. Before PrEP availability in Italy, we aimed to assess whether PLWHA in Italy shared their ARVs with HIV-negative individuals, whether they knew people who were on PrEP, and describe the level of awareness and discussion on this preventive measure among them and people in their close circle. Methods: Two anonymous questionnaires investigating personal characteristics and PrEP awareness, knowledge, and experience were proposed to HIV specialists and their patients on ARVs in a one-week, cross-sectional survey (December 2013-January 2014). Among PLWHA, a Multivariable Logistic Regression analysis was conducted to identify factors associated with PrEP discussion with peers (close circle and/or HIV associations), and experience (use in close circle and/or personal ARV sharing). Results: Eighty-seven specialists in 31 representative Infectious Diseases departments administered the questionnaire to 1405 PLWHA. Among specialists, 98% reported awareness, 65% knew the dosage schedule, and 14% had previously suggested or prescribed PrEP. Among PLWHA, 45.6% were somehow aware, discussed or had direct or indirect experience of PrEP: 38% "had heard" of PrEP, 24% were aware of studies in HIV-negative individuals demonstrating a risk reduction through the use of ARVs, 22% had discussed PrEP, 12% with peers; 9% reported PrEP use in close circle and 1% personal ARV sharing. Factors predictive of either PrEP discussion with peers or experience differed between men and women, but across all genders were mainly related to having access to information, with HIV association membership being the strongest predictor. Conclusions: At a time and place where there were neither official information nor proposals or interventions to guide public policies on PrEP in Italy, a significant number of PLWHA were aware of it, and approximately 10% reported PrEP use in their close circle, although they rarely shared their ARVs with uninfected people for this purpose. Official policies and PrEP availability, along with implementation programs, could avoid risks from uncontrolled PrEP procurement and self-administration practices

Practice guidelines for the treatment of hepatitis C: recommendations from an AISF/SIMIT/SIMAST Expert Opinion Meeting.

It is increasingly clear that a tailored therapeutic approach to patients with hepatitis C virus infection is needed. Success rates in difficult to treat and low-responsive hepatitis C virus patients are not completely satisfactory, and there is the need to optimise treatment duration and intensity in patients with the highest likelihood of response. In addition, the management of special patient categories originally excluded from phase III registration trials needs to be critically re-evaluated. This article reports the recommendations for the treatment of hepatitis C virus infection on an individual basis, drafted by experts of three scientific societies