Reaction rate of NaOCl in contact with bovine dentine: effect of activation, exposure time, concentration and pH.

AIM: To determine the influence of activation method (ultrasound or laser), concentration, pH and exposure time on the reaction rate (RR) of NaOCl when in contact with dentinal walls. METHODOLOGY: The walls from standardized root canals in bovine incisors were exposed to a standardized volume of sodium hypochlorite (NaOCl) with different concentrations (2% and 10%), pH (5 and 12) and exposure times (1 and 4min). Two irrigation protocols were tested: passive ultrasonic irrigation or laser activated irrigation with no activation as the control. The activation interval lasted 1min followed by a rest interval of 3 min with no activation. The RR was determined by measuring the iodine concentration using an iodine/thiosulfate titration method. RESULTS: Exposure time, concentration and activation method influenced the reaction rate of NaOCl whereas pH did not. CONCLUSIONS: Activation is a strong modulator of the reaction rate of NaOCl. During the rest interval of 3min, the consumption of available chlorine increased significantly. This effect seems to be more pronounced after irrigant activation by laser. pH did not affect the reaction rate of 2% NaOCl.

[Endoscopic treatment of polycystic ovary syndrome. Preliminary data]. / Trattamento endoscopico della sindrome dell'ovaio policistico. Dati preliminari.

Four women suffering from polycystic ovary syndrome recalcitrant to routine ovulation inducers have been submitted to electro-cauterization and ovarian resection. Hormonal changes after 24 hours and the incidence of ovulatory cycles in the 6 months subsequent to the execution of these surgical techniques are reported.

[Side effects and complications of intrauterine devices with special reference to pelvic infection]. / Effetti collaterali e complicanze dei dispositivi intrauterini con particolare riferimento alle infezioni pelviche.

PIP: Existing international literature concerning complications stemming from the use of the IUD is reviewed. They are either immediate or delayed. Immediate complications are (partial) perforation of the uterus, vagal reaction, bleeding, and pain. Perforation should be followed up by echography or radiography. Hysteroscopy or celioscopy allows for recovery of the device. Vagal reaction, manifested by bradycardia, hypotension, pallor, sudation, nausea, even cardiac arrest, occurs with stenosis of the cervical canal predominantly in emotive and/or nulliparous women. Bleeding occurs from trauma caused by the IUD to the mucus of the endocervix and/or endometrium. Pain is an almost constant symptom that appears at the moment of insertion, more frequently in young nulliparae than multiparae, and disappears spontaneously after 5-10 minutes. Delayed complications are menometrorrhagia, often accompanied by dysmenorrhea, lost IUD, total or partial expulsion, ectopic pregnancy and pelvic infections (PID). Menometrorrhagia seems imputable more to an increase of fibrinolytic activity of the endometrium in contact with the IUD than to plasmatic alterations of the progesterone, estradiol or gonadotropin. Lost IUD generally is due to rotation caused by uterine contractions, or the thread being cut off too close to the mouth of the external uterus. Fracture of the IUD as well as migration toward the fallopian tubes are very rare. The FDA reports, in 1979, that ectopic pregnancy is verified more frequently in women carrying the device medicated with progesterone. PID are 10 times more frequent in young women having used the IUD for at least 2 years. A significant increase in PID is also reported for women who use the device for more than 5 years.^ieng

[Antibiotic prophylaxis with cefotaxime in gynecological endoscopy]. / Profilassi antibiotica con cefotaxime nell'endoscopia ginecologica.

It is now well known that even short operations of limited scope lower the body's defences by influencing the immune system. As a result this leads to a change in microbial flora which encourages an increase in the number of Gram-negative, aerobic, anaerobic and enterococcal colonies. In order to prevent infective postoperative complications which might occur after endoscopic surgery, the authors suggest using a series of valuable recommendations which are reported in this paper. Among these the most important is antibiotic prophylaxis which is able to limit the episodes of infection, thus making a positive contribution to the postoperative iter. Cefotaxime was chosen by the authors since this molecule offers both reliable and efficacious prophylaxis as has also been shown by other studies in the obstetrics and gynecological field. The results obtained by this study fully concord with data reported in the literature.

[Role of viral infections in the genesis of dysplasias of the uterine cervix]. / Ruolo delle infezioni virali nella genesi delle displasie della cervice uterina.

A study of 80 cases of dysplasia of the uterine cervix showed the coexistence of HPV infections in 52 cases. This association (65%) shows the important role played by the human papilloma virus in the genesis of cancer of the cervix.

[Use of orgotein in the treatment of reactive damage to the use of high-energy radiation]. / Utilizzazione dell'orgoteina per la cura dei danni reattivi all'impiego di radiazioni ad alta energia.

A study has been carried out on 62 patients submitted to pre- and postoperative X-ray treatment, evaluating tolerance and effectiveness of orgotein administered i.m. The therapeutic results obtained may be considered very satisfactory.

[Perinatal mortality in placental insufficiency]. / La mortalità perinatale nella insufficienza placentare.

The review of 55 cases of placental failure and the results obtained reveal a 54% mortality rate.

PIP: 55 pregnant women admitted to the Gynecological Institute of the University of Torino were studied. The age range was 19 to 42 years with a median of 29.3 there were 25 nulliparae, 16 primiparae, and 14 pluriparae. The diagnosis of placental insufficiency was based on clinical and laboratory data consisting of accurate anamnesis, measurement of the height of the base of the uterus, ultrasonographic biometric measurements, and plasma serum human placental lactogen (HPL), and estriol (E3) values. A cardiotocographic check determined the fetal condition. The intrauterine mortality rate of the fetus was 3.5% (2 cases), and in 1 case the death of the newborn was verified 48 hours after birth. there were 34 (61.9%) spontaneous births and 21 (38.1%) with cesarean section. Pregnancy lasted 34 weeks in 23 cases and in the remaining instances it was 39-40 weeks. The weight of the newborn was less than the 10 percentile of the classic Lubchenko curve in 26 cases, while in 28 cases it ranged from 10 to 90 percentile. Recent indicated that the average weight of the newborn was 2246 gm with a standard deviation of 425 gm. An apparent correlation could be established between the weight of the placenta and that of the newborn as well as the high incidence of cesarean sections (38.1%) and perinatal mortality (54%).

[Hormonal contraception using estroprogestins]. / La contraccezione ormonale mediante estroprogestinici.

Today the estroprogestagen pill is the most valid method of contraception given that its benefits far outweigh its risks. The paper stresses the importance of a thorough anamnestic, clinical and laboratory examination so as to obtain correct and safe steroid contraception. The efficacy and excellent tolerance of the combined method currently make it the most widespread form of oral contraception.

PIP: Oral contraceptive (OCs) of high efficacy containing estroprogestins (EP) were introduced in the 1960's and since then more than 250 million used them. Their benefits include regular menstrual cycles and protection against genital tumors. Dosage seems to be directly related to risks and benefits, therefore new types of low-dose progestins have been developed. Their mechanism of action is based on hypothalamic- hypophysic control, EP suppress the production of luteinizing hormone (LH) and follicle-stimulating hormone (FSH). Their effects are as follows: the cervical mucus becomes more viscous providing a barrier against spermatozoa, regressive (atrophy) modifications and proliferative alterations of the endometrium, and metrorrhagia induced by estrogens and amenorrhea provoked by progestins. The sequential pill requires administration of estrogens in the 1st phase and estroprogestins in the 2nd phase. They minimize physiological and hormonal effects, but the failure rate is 2-3% per woman year. Combined methods of monophasic, biphasic, and triphasic design are used from the 1st to 5th day of menstruation. They block ovulation with a high degree of efficacy, but the stimulating action of EP on the endometrium produces spotting, premature or late metrorrhagia, and amenorrhea. OCs protect against malignant epithelial tumors of the ovaries. It is estimated that 1700 ovarian carcinomas and 2000 endometrial carcinomas are averted each year by the use of the pill in the US. Endometrial cancer risk is halved by EP. 7 epidemiological studies have found no association between the pill and breast cancer, and the risk of benign mammary lesions is also reduced. Accurate anamnesis is mandatory for prescribing safe OCs including screening for coagulation, hepatic function and glycemia tests, and colposcopic examination. Smoking and the pill as well as age under 16 and over 36 increase risks. Nonetheless, the benefits of EP contraceptives outweigh the risks.

[Uterine rupture in modern obstetrics]. / La rottura d'utero nella moderna ostetricia.

The paper reports 18 cases of womb rupture observed in the Institute of Gynecology and Obstetrics at the University of Turin from April 1978 to June 1988. Following an analysis of the data relating to the above cases, the paper concludes that in order to reduce the incidence of womb rupture it is important to hospitalize high-risk patients preferably before the start of labour so as to intervent using caesarian section.

[Uterine fibromyoma in pregnancy]. / Fibromiomi uterini in gravidanza.

Data are reported relating to the study of 100 pregnant women, aged between 30 and 49 years old, effected by one or more fibroma nodules on the body of the womb. From an analysis of results, it appears that appropriate obstetric care can significantly reduce the risk of both maternal and fetal complications.

[Effectiveness of povidone-iodine in the treatment of non-specific vaginitis]. / Efficacia del povidone-iodio nel trattamento delle vaginiti aspecifiche.

Thirty-two cases of aspecific vaginitis treated with a ready-to-use providone-iodine solution are reported. Results were highly positive with regard to the efficacy and safety of the treatment.

[Inflammation of the uterine corpus: endometritis]. / Le flogosi del corpo dell'utero: endometriti.

In industrialised countries endometritis is a problem which represents an increasing risk to personal health and to society. In almost all cases the inflammatory process which affects the uterine mucosa forms part of a more generalised infection which involves the entire internal genital system (PID). The most important problem associated with pelvic phlogosis is increased sterility, a greater number of ectopic pregnancies and chronic pelvic pain. In order to treat the symptoms of genito-pelvic infection, an early diagnosis and adequate medical therapy are indispensable. In this event it may be possible to prevent invalidating effects on fertility and chronic pelvic pain.

[Preliminary study of the use of s. adenosyl methionine in the management of male sterility]. / Studio preliminare sull'impiego della s. adenosil metionina nella sterilità maschile.

In a preliminary study 10 cases of male sterility were treated with 800 mg/day per os of Samyr-Bioresearch over three months. Increased basal motiligy of spermatozoa was observed in 6 out of 10 cases. The results of the study confirm the value and efficacy of SAM in the treatment of male sterility.

[Respiratory distress syndrome in premature births]. / Sindrome da distress respiratorio (RDS) nel parto prematuro.

The paper reports the results of a study of respiratory distress syndrome in premature birth, one of the most common and important forms of respiratory disorders affecting neonates during the first days of life. One hundred and fifty-six premature births from 1 January 1986 to 30 June 1988 were included in the study. From an analysis of results it emerges that there is a lower incidence of respiratory distress syndrome in both vaginal deliveries and cases treated with Ambroxol.

[Clinical study of the use of a new tri-phasic pill]. / Studio clinico sull'uso di una nuova pillola trifasica.

The paper reports the results of a study to assess the contraceptive efficacy of a new triphasic pill (Trinovum - Cilag AG). The pill was administered to 50 women aged between 18 and 41 years for 12 months, giving a total of 600 menstrual cycles. Data confirm the value of this pill which ensures excellent contraceptive efficacy and is well tolerated by patients with very few adverse effects.