Nitrous oxide and hypnotherapy in paediatric dentistry.

AIM: Patient compliance is of paramount importance for proper dental treatment, which can be difficult to achieve in children due to anxiety and fear, hindering the therapeutic procedure. In addition to well-known sedation methods (pharmacological and nitrous oxide), further methods of approach are being tested, such as hypnotherapy. MATERIALS: The sample consisted of 150 children (90 males, 60 females). Paper questionnaires, frequency meter, nitrous oxide dispenser in association with the use of the television were exploited. At the end of treatment, subjective pain was assessed using the VAS scale, while objective pain was assessed using the FLACC scale and heart rate. This made it possible to compare two experimental groups, one treated with nitrous oxide, and the other with hypnotherapy. The control group was treated with classic behavioural approach techniques. The results obtained were analysed by SPSS Software (Statistical Package for Social Science, version 27) and the inferences between the results were calculated for confirmation. CONCLUSION: Hypnotherapy can be a valid substitute for nitrous oxide in paediatric dentistry.

Clowntherapy in paediatric dentistry: The psychological approach to the paediatric patient.

AIM: Anxiety towards dental treatments and visits in children are often cause for the avoidance and/or failure of the treatment itself, as well as a reason for stress in both the patient and the orthodontist. The aim of the research is to understand if the use of clown therapy in dental waiting rooms is efficient in bringing down the level of preoperative anxiety in paediatric dental patients. METHODS: Two psychometric tests were used: CFSS-DS (Dental Subscale of the Children's Fear Survey Schedule) and FIS (Facial Image Scale), after the translation of the original versions, to both the patients and their parents. The CFSS-DS is the most used instrument in order to assess dental fear in children, it is composed by 15 questions that outline situations which children and adolescents will have to face while on the dental chair. The FIS is a visual analogical scale that uses faces as indicators of anxiety. CONCLUSION: Clowntherapy proves to be an efficient non-pharmacological method to reduce anxiety and dental fear in paediatric patients, offeringa valid and practical support for paediatric dentists.

[The anxiety of children before elective surgery: descriptive study]. / L'ansia nei bambini sottoposti ad intervento di chirurgia elettiva: indagine descrittiva.

Thirty-six children aged 7-14 years, scheduled for an elective surgery, were administered a questionnaire-interview in order to identify and measure fear and anxiety experienced before and after the surgery. The same questionnaire was administered also to the mothers. Fear and anxiety of the surgery itself and of pain are the main psychological reactions related to the surgery. The interview to the mother and the child represents an interesting study model that allows to identify problems too often underlooked-undertreated by the health care personnel. Problems related to a poor pre-operative psychological education of the children and their parents are discussed.

[Physiopathological and clinical features of hypernatremia]. / Aspetti fisiopatologici e clinici della sindrome ipernatremica.

The observation of hypernatriaemia in a large series under a variety of clinical conditions (gastrointestinal loss, increased "forced loss", and insufficiency parenteral feeding) is made the occasional for an overview of its main physiopathological and clinical features. From the physiopathological standpoint, the syndrome is rarely coupled with an absolute water deficiency. More commonly, sodium and water losses go together to bring about a fall in both intracellular and extracellular volume. The clinical significance of hypernatriaemia is essentially linked to increased osmolar content, not only of the extracellular liquid, but more particularly (due to water depletion) of the intracellular compartment, which underlies the establishment and progress of the anatomopathological lesions and the clinical symptoms.

Nephrotoxicity of chromium. Remarks on an experimental and epidemiological investigation.

Observations conducted on a group of workers exposed to chromium (who showed a rapid urinary excretion of the metal and progressive increase of clearance with cumulative years of exposure), induced the authors to evaluate the nephrotoxic action of chromium in rats exposed to acute and chronic intoxication. The progressive Cr accumulation in the renal cortex during the course of testing explains the increase of the excreted fraction of filtered Cr, and therefore, the clearance, of the metal through the reduction of the tubular lumen-epithelium gradient. Paralleling the anatomical lesions (demonstrated only at the level of the proximal tubular cells), are the increasing modifications of the cellular lesion or altered reabsorption registered by several urinary indicators. Similar changes were found in subjects chronically exposed to the metal; their reversibility is linked to the possibility of repairing the epithelial damage by stopping exposure.