Effect of fentanyl on the success of inferior alveolar nerve block for teeth with symptomatic irreversible pulpitis: a randomized clinical trial

Aim: The purpose of this prospective, randomized, double-blind study was to evaluate the effect of adding fentanyl to lidocaine 2% with epinephrine 1:80,000 on the success of the inferior alveolar nerve block in mandibular molar teeth with symptomatic irreversible pulpitis. Methodology: 100 healthy adult patients with diagnosis of symptomatic irreversible pulpitis in one of the mandibular molar tooth were selected and randomly divided in two groups of 50 patients each. In the first group (fentanyl group), 0.25 ml of a cartridge of 1.8 ml of 2% lidocaine with 1:80,000 epinephrine solution was drained and the same amount from 50μg/ ml fentanyl solution was added to the cartridge. In the second group (non-fentanyl group) 0.25 ml of a cartridge of 1.8 ml of 2% lidocaine with 1:80,000 epinephrine solution was drained and the same amount from saline solution was added to the cartridge. Each group received two cartridges of prepared soloution with inferior alveolar nerve block injection technique. Access cavity preparation started 15 minautes after injection and after confirming the lip numbness. Success defined as no pain or mild pain on the basis of Heft-Parker visual analog scale during access cavity preparation or initial instrumentation. Data were analyzed by T-test and Chi-square Results: The success rate of inferior alveolar nerve block injection was 58% for Fentanyl group and 46% for Non-Fentanyl group. There was no significant difference between the two groups (P=0.23). Conclusions: The addition of fentanyl to lidocaine 2% with epinephrine 1:80,000 did not increase the success rate of the inferior alveolar nerve block in mandibular molar teeth with symptomatic irreversible pulpitis

Nandrolone decanoate: Use, abuse and side effects

Background and Objectives: Androgens play a significant role in the development of male reproductive organs. The clinical use of synthetic testosterone derivatives, such as nandrolone, is focused on maximizing the anabolic effects and minimizing the androgenic ones. Class II anabolic androgenic steroids (AAS), including nandrolone, are rapidly becoming a widespread group of drugs used both clinically and illicitly. The illicit use of AAS is diffused among adolescent and bodybuilders because of their anabolic proprieties and their capacity to increase tolerance to exercise. This systematic review aims to focus on side effects related to illicit AAS abuse, evaluating the scientific literature in order to underline the most frequent side effects on AAS abusers’ bodies. Materials and Methods: A systematic review of the scientific literature was performed using the PubMed database and the keywords “nandrolone decanoate”. The inclusion criteria for articles or abstracts were English language and the presence of the following words: “abuse” or “adverse effects”. After applying the exclusion and inclusion criteria, from a total of 766 articles, only 148 were considered eligible for the study. Results: The most reported adverse effects (found in more than 5% of the studies) were endocrine effects (18 studies, 42%), such as virilization, gynecomastia, hormonal disorders, dyslipidemia, genital alterations, and infertility; cardiovascular dysfunctions (six studies, 14%) such as vascular damage, coagulation disorders, and arteriosus hypertension; skin disorders (five studies, 12%) such as pricking, acne, and skin spots; psychiatric and mood disorders (four studies, 9%) such as aggressiveness, sleep disorders and anxiety; musculoskeletal disorders (two studies, 5%), excretory disorders (two studies, 5%), and gastrointestinal disorders (two studies, 5%). Conclusions: Based on the result of our study, the most common adverse effects secondary to the abuse of nandrolone decanoate (ND) involve the endocrine, cardiovascular, skin, and psychiatric systems. These data could prove useful to healthcare professionals in both sports and clinical settings

The impact of COVID-19 pandemic on surgical residency programmes in Italy: a nationwide analysis on behalf of the Italian Polyspecialistic Young Surgeons Society (SPIGC)

Introduction: Recently, Italy has been heavily hit by COVID-19 pandemic and today it is still one of the most affected countries in the world. The subsequent necessary lockdown decreed by the Italian Government had an outstanding impact on the daily life of the entire population, including that of Italian surgical residents\u2019 activity. Our survey aims to evaluate the impact of COVID-19 on the training programme of Italian surgical residents. Materials and methods: We designed a 12-item-electronic anonymous questionnaire on SurveyMonkey\ua9 web application. The survey was composed of different sections concerning demographic characteristics and impacts of COVID-19 on the concrete participation in clinical, surgical and research activities. Future perspectives of responders after the pandemic were also investigated. Results: Eighty hundred responses were collected, and 756 questionnaires were considered eligible to be included in the study analysis. Almost 35 and 27% of respondents experienced, respectively, complete interruption of surgical and clinical activities. A subgroup analysis, comparing the COVID-19 impact on clinical activities with demographics data, showed a statistically significant difference related to specialties (p = 0.0062) and Italian regions (p < 0.0001). Moreover, 112 residents have been moved to non-surgical units dealing with COVID-19 or, in some case, they voluntarily decided to interrupt their residency programme to support the ongoing emergency. Conclusion: Our survey demonstrated that COVID-19 pandemic has severely impacted the educational programme of Italian surgical residents. Despite many regional differences, this survey highlighted the overall shortage of planning in the re-allocation of resources facing this unexpected health emergency

Quantitative ultrasound criteria for risk stratification in clinical practice: a comparative assessment

This study aimed to compare two different classifications of the risk of fracture/osteoporosis (OP) based on quantitative ultrasound (QUS). Analyses were based on data from the Epidemiological Study on the Prevalence of Osteoporosis, a cross-sectional study conducted in 2000 aimed at assessing the risk of OP in a representative sample of the Italian population. Subjects were classified into 5 groups considering the cross-classification found in previous studies; logistic regression models were defined separately for women and men to study the fracture risk attributable to groups defined by the cross-classification, adjusting for traditional risk factors. Eight-thousand six-hundred eighty-one subjects were considered in the analyses. Logistic regression models revealed that the two classifications seem to be able to identify a common core of individuals at low and at high risk of fractures, and the importance of a multidimensional assessment in older patients to evaluate clinical risk factors together with a simple, inexpensive, radiation-free device such as QUS

Quantitative ultrasound criteria for risk stratification in clinical practice: a comparative assessment.

This study aimed to compare two different classifications of the risk of fracture/osteoporosis (OP) based on quantitative ultrasound (QUS). Analyses were based on data from the Epidemiological Study on the Prevalence of Osteoporosis, a cross-sectional study conducted in 2000 aimed at assessing the risk of OP in a representative sample of the Italian population. Subjects were classified into 5 groups considering the cross-classification found in previous studies; logistic regression models were defined separately for women and men to study the fracture risk attributable to groups defined by the cross-classification, adjusting for traditional risk factors. Eight-thousand six-hundred eighty-one subjects were considered in the analyses. Logistic regression models revealed that the two classifications seem to be able to identify a common core of individuals at low and at high risk of fractures, and the importance of a multidimensional assessment in older patients to evaluate clinical risk factors together with a simple, inexpensive, radiation-free device such as QUS