Precision management of pollination services to blueberry crops.

While the cultivated area of pollinator-dependent crops is increasing, pollinator availability is decreasing, leading to problems in many agroecosystems. For this reason, pollinator-dependent crop growers often rent beehives to support their pollination requirements to sustain fruit productivity. However, the efficiency of those pollination systems has not been extensively studied. Here, we compared the effect of "precision" pollination (i.e., application of pesticides coordinated with growers, audit of hives, dietary supplementation and individual distribution of hives) with conventional practices (i.e., pesticides applications without coordination with growers and no audit of hives, low maintenance of hives and hives distributed in large groups) on the mean level of pollination and fruit production and quality in blueberry crops. In nine blueberry fields, we measured bee visitation rate to flowers, fruit set, fruit firmness and fruit weight. On average, precision-pollinated plots had 70% more bee visits to flowers and produced 13% more fruits that were 12% heavier and 12% firmer than those obtained through conventional practices. These results showed that pollination efficiency could be improved if key management related to bee strength, distribution and health care are taken into account. Due to these results, we encourage growers and beekeepers to include precision pollination practices to both increase the productivity of blueberry fields and the wellbeing of honey bees within agroecosystems.

Index of Orthodontic Treatment Need (IOTN) and distribution of malocclusion traits in a population of growing patients attending a public orthodontic service in Perugia (Italy).

AIM: Malocclusions are widespread all over the world with high prevalence values and represent a social vulnerability and health problem because of the important burden of orthodontic treatment for both families and the public health service. The Italian Ministry of Health identified the principles for priority setting in dental care, i.e. patients with IOTN (Index of Orthodontic Treatment Need) 4-5 and those in particular conditions of health or social vulnerability. METHODS: A retrospective study was carried out to assess the IOTN and malocclusion in a population attending the public Orthodontic Health Service of Perugia (Italy) from September 2018 to February 2020. Medical charts, social income information, study models, photos and lateral cephalograms were examined to assess the orthodontic treatment need. CONCLUSION: Orthodontic health service in Italy tends to have many patients on the waiting list, while the 72% of subject under orthodontic treatment are not part of the orthodontic priority (IOTN grade 4-5). This study suggests the heath system to guarantee a priority of need for orthodontic treatment for patients with health vulnerabilities.

Worldwide prevalence of malocclusion in the different stages of dentition: A systematic review and meta-analysis.

AIM: The aim of this review is to quantify the prevalence and type of malocclusion among children and adolescents during the different stages of dentition worldwide. MATERIALS AND METHODS: Recent studies (from 2009 to 2019), published in Medline, Web of Science and Embase and orthodontic text-books have been comprehensively reviewed herein. The methodological quality of the included studies was assessed using STROBE criteria. RESULTS: After screening 450 records and analysing 284 relevant full-text publications, 77 studies were included in this review. A good degree of evidence was obtained due to the medium-high methodological quality level of included studies. The worldwide prevalence of malocclusion was 56% (95% CI: 11-99), without differences in gender. The highest prevalence was in Africa (81%) and Europe (72%), followed by America (53%) and Asia (48%). The malocclusion prevalence score did not change from primary to permanent dentition with a common score of 54%. Malocclusion traits such as Angle's classes, overjet, overbite, and asymmetrical midline shift essentially did not change their prevalence during different dentitions. Conversely, traits such as cross-bite and diastema reduced their prevalence during permanent dentition, while scissor-bite and dental crowding increased their scores. CONCLUSION: The worldwide high prevalence of malocclusion and its early onset during childhood should induce policymakers as well as paediatric physicians and dentists to devise policies and adopt clinical strategies for preventing malocclusion since younger children's ages.

Eculizumab treatment in patients with COVID-19: preliminary results from real life ASL Napoli 2 Nord experience.

OBJECTIVE: SARS-CoV-2 (Severe Acute Respiratory Syndrome Coronavirus 2)-related pneumonia, referred to as COVID-19 (Coronavirus Disease 19), is a public health emergency as it carries high morbidity, mortality, and has no approved specific pharmacological treatments. In this case series, we aimed to report preliminary data obtained with anti-complement C5 therapy with eculizumab in COVID-19 patients admitted to intensive care unit (ICU) of ASL Napoli 2 Nord. PATIENTS AND METHODS: This is a case series of patients with a confirmed diagnosis of SARS-CoV2 infection and severe pneumonia or ARDS who were treated with up to 4 infusions of eculizumab as an off-label agent. Patients were also treated with anticoagulant therapy with Enoxaparin 4000 IU/day via subcutaneous injection, antiviral therapy with Lopinavir 800 mg/day + Ritonavir 200 mg/day, hydroxychloroquine 400 mg/day, ceftriaxone 2 g/day IV, vitamine C 6 g/day for 4 days, and were on Non-Invasive Ventilation (NIV). RESULTS: We treated four COVID-19 patients admitted to the intensive care unit because of severe pneumonia or ARDS. All patients successfully recovered after treatment with eculizumab. Eculizumab induced a drop in inflammatory markers. Mean C Reactive Protein levels dropped from 14.6 mg/dl to 3.5 mg/dl and the mean duration of the disease was 12.8 days. CONCLUSIONS: Eculizumab has the potential to be a key player in treatment of severe cases of COVID-19. Our results support eculizumab use as an off-label treatment of COVID-19, pending confirmation from the ongoing SOLID-C19 trial.

EXPERIMENTAL VALIDATION OF ALGORITHMS USED TO ESTIMATE EFFECTIVE DOSE DURING INTERVENTIONAL RADIOLOGY PROCEDURES.

In IR procedures, in order to evaluate the effective dose, the importance of the double dosemeter has been recognised, one worn above and one under the apron. Over the last few decades several algorithms have been developed to combine the readings of the dosemeters, however currently there is no international consensus on which is the best one. In this work, eight irradiations, corresponding to typical interventional radiology procedures, were carried out in order to experimentally verify the accuracy of the algorithms. The patient was substituted by solid water-equivalent (RW3) layers, while effective dose to personnel was calculated by TLDs inside the Alderson Rando phantom. The results show that most of the algorithms, with a few exceptions, are too conservative, however there are many factors which can affect their accuracy, so it is impossible to achieve a high level of precision in the evaluation of the effective dose.

Biological effects of resin monomers on oral cell populations: descriptive analysis of literature.

AIM: Recently, the application of restorative materials containing metacrilate monomers in the conservative and paediatric dentistry has focused on the possible negative effects due to the use of these composites. In particular the release of monomers from reconstructions as a result of an insufficient polymerisation, can spread along the mucosal and dental tissues with potential immunological ed cytotoxic effects. Regarding to the importance of this issue, the aim of this study is to provide a descriptive review of the literature on potential local and systemic interactions of metacrylic and acrylic monomers with the immune system, both in vitro and in vivo. RESULTS: The most highly used monomers in composite materials applied in conservative dentistry include: 2-hydroessietil- methacrylate (HEMA), triethylene glycol-dimethacrylate (TEGDMA), bisphenol A glycidyl-methacrylate (BisGMA) and urethane- dimethacrylate (UDMA). Different investigations have been performed for better understanding of the potential side effects of metacrylic monomers on immune system cells. Different factors such as cell population, exposure time and parameters more strictly connected to these materials, such as molecular weight, chemical composition and mechanical characteristics, seem to be directly involved in these reactions.

Sub-ablative laser irradiation to prevent acid demineralisation of dental enamel. A systematic review of literature reporting in vitro studies.

AIM: Caries lesions begin with enamel acid demineralisation mediated by microorganisms. Lasers with sub-ablative energy might act as a prophylactic intervention to reinforce enamel against lesions caused by acid. MATERIALS AND METHODS: A systematic review of the literature was performed evaluating only in vitro studies published from 2010 to 2018. The research was performed using the following databases: Medline, Embase and the Web Of Science. A further search was performed consulting the list of references of the included studies as well as book chapters which dealt with this topic. RESULTS: A total of 347 records were retrieved and, after their evaluation, 36 studies were included. CO2 lasers were the most described and effective device in preventing acid demineralisation. This type of laser was unique in improving the already positive results obtained with fluoride-based interventions. Er,Cr:YSGG (with fluencies > 8.5J/cm2), diode and argon lasers also improved enamel acid resistance (p-values ranging from 0.05 to 0.001) producing similar effects with fluoride-based interventions. Regarding the sealant retention outcome, the Er:YAG laser was able to perform an enamel etching which was as effective as the traditional acid etching with the advantage of being easier and usually well accepted by low-compliant patients (i.e. younger children). Nd:YAG presented the worst results. The most common structural changes after the laser irradiation were water and carbonate reduction in the enamel combined with a phosphate and calcium enamel content increase. Moreover, the calcium/phosphate ratio was found to reach the 1.67 ideal ratio. CONCLUSION: The in vitro studies that examined the prophylactic use of lasers for increasing enamel acid resistance presented interesting results that are enough to support a further in vivo experiment. This would entail the use of a clinical laser as an alternative or in combination with fluoride-based interventions.

A controlled multicenter pediatric study in the treatment of acute respiratory tract diseases with the aid of a new specific compound, erdosteine (IPSE, Italian Pediatric Study Erdosteine).

INTRODUCTION: Erdosteine is an original drug which has been suggested as secretolytic compound and promoter of respiratory ventilation in the treatment of acute and chronic respiratory diseases. Moreover, the drug possesses also scavenging, antioxidant, and bacterial anti-adhesivity properties. From a clinical point of view the best results have been obtained by combined treatment with an antibiotic agent of useful spectrum activity. Aim of the present study was to evaluate the improvement induced in the risk/benefit ratio by erdosteine on the broad-spectrum antibiotic (ampicillin) in the treatment of acute lower respiratory tract diseases in the pediatric field. MATERIAL AND METHODS: A controlled multicenter double-blind parallel group trial was planned comparing erdosteine, supplied as syrup 3.5% or as sachets 225 mg, versus the relevant placebo. The tested compounds were administered in association with ampicillin. Two-hundred (n = 200) subjects entered the trial, randomly selected among patients monitored by the different centers, and were assigned to one of the treatments under evaluation, i.e. active compound or placebo with the aim to constitute two comparative homogeneous groups of 100 subjects each. Subsequently each group was again divided according to age in two equivalent subgroups of 50 patients each and treated with the syrup 3.5% (age from 2 to 4 years) or the sachet form (age from 5 to 10 years). The treatments administered in the two comparison groups were erdosteine (syrup 3.5% and 225 mg sachets) or the relevant placebo. The erdosteine posologies were adapted according to age. The lower dosage of the 5-10 years range in comparison with the 2-4 years range was established on the base of bioavailability characteristics of the two pharmaceutical forms. In all groups ampicillin was administered at the dosage of 100 mg/kg/day, according to a b.i.d. time schedule. The primary efficacy criterion was the cough score evaluated in a subjective way and expressed with the following scores: 1 = absent; 2 = mild; 3 = moderate; 4 = severe. The secondary efficacy end-points were: body temperature (expressed in degrees C); the polypnea, ronchi and rales estimation with a rating scale similar to that previously mentioned. These parameters were determined before starting of the treatment (VO); at the 3rd +/- 1 (V1) and at the 7th +/- 2 (V2) day of treatment. The body temperature was measured orally in the morning at awakening time with a mercury thermometer. Obtained data expressed in Celsius degrees are recorded by the investigator in the patient file during control visits. The safety of adopted treatments was evaluated with two different approaches. The clinical part was determined with the adverse drug reactions (ADRs) estimate. The biological safety was estimated at admission day (day 0) and at the final visit by means of a sophisticated statistical approach. RESULTS: The final results were the following: Erdosteine syrup 3.5%: concerning cough (primary end-point) in the group of patients (n = 50) treated with erdosteine it has been possible to point out a reduction of 23.8% at V1, i.e. after 3+/-1 days, and of 59.8% at V2, i.e. after 7+/-2 days. In the group of patients treated with placebo (n = 50) the reduction has been of 20.1% at V1 and of 36.6% at V2. The statistical analysis evidenced p values < 0.01 for times, treatments, time x treatments. The relevant results are summarized in Table 2. Erdosteine sachets 225 mg: concerning cough (primary end-point) in the group of patients (n = 50) treated with erdosteine it has been possible to point out a reduction of 17.6% at V1, i.e. after 3+/-1 days, and of 56.8% at V2, i.e. after 7+/-2 days. In the group of patients treated with placebo (n = 50) the reduction has been of 15.6% at V1 and of 31.8% at V2. The statistical analysis evidenced p values < 0.01 for times, treatments, time x treatments. (ABSTRACT TRUNCATED)

A clinical comparison between needle-through-needle and double-segment techniques for combined spinal and epidural anesthesia.

BACKGROUND AND OBJECTIVES: The goal of the present investigation was to compare the double-segment and the needle-through-needle techniques for combined spinal and epidural anesthesia (CSE) in a prospective, randomized, blinded study. METHODS: With Ethical Committee approval and patient's consent, 120 patients were randomized to receive CSE by the needle-through-needle (SST; n=60) or the double-segment technique (DST; n=60). A blind observer measured the time required from skin disinfection to readiness for surgery (loss of pinprick sensation up to T10), failure of dural puncture, need for epidural top-up before surgery, patient acceptance, and occurrence of complications. RESULTS: No neurologic complications were observed in either group. Time to readiness for surgery was 22.7+/-8.2 minutes in the SST group and 29.8+/-8.31 minutes in the DST one (P < .001). Dural puncture was unsuccessful in three patients in the SST group (5%) and in one patient in the DST group (1.6%) (ns); inadequate spread of spinal anesthesia was observed in five patients in the SST group (8.3%) and in eight patients in the DST group (13.3%) (ns). No difference in the incidence of hypotension, postdural puncture headache, and back pain was observed between the two groups. Acceptance of anesthetic procedure was better in the SST (85%) than in the DST group (66.6%) (P < .05). CONCLUSIONS: The needle-through-needle technique for CSE requires less time, has no greater failure rate, and results in greater patient satisfaction than the double-segment technique. The use of a spinal needle with an adjustable locking mechanism and protruding up to 15 mm beyond the Tuohy needle improved successful spinal block in the needle-through-needle technique compared with previous reports.

[Transient cerebral ischemia and the risk factors]. / Ischemia cerebrale transitoria e fattori di rischio.

A retrospective study was carried out in a general medicine ward of 100 male patients suffering from their first transient ischemic attack (TIA) in order to evaluate the incidence of different cerebrovascular risk factors. The results were then compared with those from another group of 100 patients suffering from initial cerebral ischemic softening (CIS) in order to identify a cerebrovascular risk population taking into account clinical similarities and common and divergent features. The study revealed that age is the prime risk factor in the genesis of TIA, followed by arterial hypertension and hypercholesterolemia. From a comparison with the group of patients affected by initial CIS it was clear that TIA is typical of senility and is more closer correlated to age than other risk factors; therefore, che TIA population is an expression of those who have "survived" cerebrovascular death due to the lesser exposure to risk factors.

[Changes in plasma levels of androgens and SHBG in patients with polycystic ovary syndrome (PCOs) treated with oral contraceptives containing desogestrel]. / Modificazione dei livelli plasmatici degli androgeni e della SHBG in pazienti con sindrome dell'ovaio policistico (PCOs) trattate con contraccettivi orali contenenti desogestrel.

PIP: 8 women, aged 17-25, with polycystic ovary syndrome (PCO) were treated with Practil 21 (Organon) containing 30 mcg of ethinyl estradiol and 150 mcg of desogestrel, or with Planum (Menarini). Checkups were conducted 3 and 6 months later to measure hormone levels. The average level of testosterone dropped significantly from 121.5 (+ or - 50.9) ng/dl to 23.1 (+ or - 10.6) ng/dl after 3 months. The level of androstenedione also decreased significantly from 265.2 (+ or - 101.4) ng.dl to 96.7 (+ or - 22.5) ng/dl. Similarly, the level of 17-hydroxyprogesterone declined from 120.5 (+ or - 69.8) ng/dl to 24.5 (+ or - 10.7) ng/dl . On the other hand, the level of sex hormone binding globulin rose from 1.3 (+ or - .6) mcg/100 ml to 3.9 (+ or - 1.8) mcg/100 ml. Cortisone level increased significantly from 15 (+ or - 3.2) mcg/100 ml to 30.6 (+ or - 10.4) mcg/100 ml after 3 months, but the normal range (5-20 mcg/100 ml) was attained at the end. Ecographic evaluation of the size of the ovaries indicated a 18.2-66.5% reduction after 3 months. In 3 cases, the number and dimension of follicles also diminished conspicuously. Acne, hirsutism, and other symptoms of hyperandrogenism also declined. Side effects were minor and included slight weight gain, spotting and headache; treatment was suspended in only 1 case because of a grand mal seizure. The administration of this new monophasic OC proved to be a valid alternative therapy for PCO.^ieng

[Plasma exchange in a case of HELLP syndrome associated with disseminated intravascular coagulation]. / Plasma exchange in un caso di sindrome Hellp associata a coagulazione intravascolare disseminata.

The Authors describe a case of HELLP syndrome associated with disseminated intravascular coagulation occurred after delivery in a patient with late hypertension without any sign or symptom of preeclampsia during pregnancy. The use of plasma exchange has contributed to the recovery from the pathology.

Effective management of a suprasellar extending prolactinoma during pregnancy.

A patient with mild hyperprolactinemia and a CT-scanned 6 x 9 mm pituitary adenoma is described. Pregnancy occurred spontaneously. During pregnancy severe headache and rapidly increasing visual field defects due to suprasellar extension of the adenoma were observed. The patient was treated with bromocriptine in a dose of 5 mg daily which resulted in dramatic improvement of symptoms in 2 weeks and a normalization of the visual field within 3 weeks.

In vitro evaluation of four adhesive materials in the treatment of cervical lesions.

BACKGROUND: The aim of this study was the evaluation of four adhesive restorative materials regarding the possible microleakage along margins of cervical lesions (class V lesions). METHODS: The comparative in vitro experience was performed in 24 healthy inferior human molars previously extracted and stored in saline. We realized 24 class V lesions with standard dimensions, occlusal margins placed in enamel, cervical margins placed in dentin/cement. The teeth were randomly divided into four groups (six each) and were filled with two light-cured glass ionomer cements (Fuji II LC and Fuji II LC Improved-GC) and with two enamel-dentin adhesive systems/composite resins (Scotchbond MP-3M-/Enamel Plus-Mice-rium-; Prodigy/Optibond-Kerr). All materials were treated according to manufacturers' instructions. After thermocycling the restorations were placed in 2% methylene-blue aqueous solutions for 24 hours. Then we performed a SEM observation of the surface of margin restorations and a light-microscopy observation, after longitudinal section of specimens, to evaluate the marginal infiltration of the colouring solution. RESULTS: We submitted to statistical analysis the results of the light-microscopy observation. Differences in microleakage scores between materials were compared using Kruskall Wallis test. Although higher values of dye penetration were found at gingival margins all groups showed minimal microleakage. No statistical significative differences were seen between materials. Our results are in agreement with those of present in recent literature. CONCLUSIONS: On the basis of our results we can state that the treatment of cervical lesions is a safe and predictable clinical procedure either using light-cured glass ionomer cements or composite resins. Clinicians must take particular care of gingival margins of these lesions.

[Microanalytical determinations of gold alloys for fixed dentures]. / Determinazioni microanalitiche di leghe auree per protesi fisse.

In this work the authors analyse gold alloys for fixed prosthesis by X-ray spectrometry in energy dispersion (EDS). The results of this analysis, given in graphic and table form, show remarkable differences in alloy composition. For this reason recommended dentists are to be attentive and severe in the control of gold alloys for fixed prosthesis.

[A rare odontogenic calcifying epithelial tumor, or Pindborg tumor. Report of a clinical case nd review of the literature]. / Raro tumore odontogeno epiteliale calcificante o tumore di Pindborg. Presentazione di un caso clinico e revisione della letteratura.

Clinical, histological and embryogenetic features of calcifying epithelial odontogenic tumor or Pindborg's tumor are described. A case of Pindborg's tumor in the molar region of the right mandible in a 66 year old male patient is presented. Standard X-ray examinations and CT scan were performed in order to obtain information about tumor's size. The histologic features revealed the presence of a homogeneous substance resembling amyloid and many cells filled by calcified material in the form of concentric Liesegang's rings. Treatment methods are also discussed.

[Dental pulp diseases. Ultramicroscopic studies]. / Patologie pulpari. Indagini ultramicroscopiche.

After the description of the anatomic and histologic aspects of the healthy dental pulp, stress is laid on pulpal pathologies and on the use of ultramicroscopic techniques to analyze the cytologic modifications in normal and pathologic dental pulp tissues. The results obtained are presented.

[ELISA analysis of salivary cotinine in smokers]. / Determinazioni ELISA della cotinina salivare in pazienti fumatori.

BACKGROUND: The presence in saliva of cotinine, the main and inactive metabolite of nicotine, reflects the extent of systemic distribution of nicotine and explains the increased susceptibility to periodontal disease in smokers. The aim of this study was to investigate the comparative amount of cotinine in the saliva of habitual cigarette smokers, non-smokers and passive smokers. METHODS: Saliva sample were obtained from 14 cigarette smokers and 13 non-smokers (8 passive-smokers), all without periodontal disease, and analyzed by Microplate EIA (a variation of ELISA based on cross-reactivity of cotinine with anti-cotinine antibody revealed by absorbance in spectrophotometry) to determine the presence and the amount of cotinine. RESULTS: Cotinine was detected in the saliva of smokers with a mean of 92.3 +/- 4.15 ng/ml and, unexpectedly, there was evidence of cotinine also in the saliva of non-smokers (mean 5.4 +/- 1.22 ng/ml), particularly, in passive-smokers (mean 12.9 +/- 6.67 ng/ml). CONCLUSIONS: The salivary concentration of cotinine can be used to estimate nicotine intake and its possible role in the pathogenesis of periodontal disease also in passive-smokers.

[Acute cholecystitis and gallbladder neoplasms: the experience of 2215 cases]. / Colecistite acuta e neoplasia della colecisti: esperienza su 2215 casi.

The authors have retrospectively analysed 2215 surgical procedures for gallbladder stones. The global incidence of gallbladder neoplasm has been 5%. This rate rises to 11% considering female patients over 60 years old. In this group, a gallbladder carcinoma was contemporary present in 17.4% of acute cholecystitis. Cholecystectomy may be suggested in every patients with gallstones, even asymptomatic, particularly if some risk factors are present.