The assessment of transdiagnostic dimensions of emotional disorders: Validation of the Multidimensional Emotional Disorders Inventory (MEDI) in adolescents with subthreshold anxiety and depression.

BACKGROUND: The transdiagnostic approach to psychopathology has emerged as an alternative to traditional taxonomic approaches. The Multidimensional Emotional Disorders Inventory (MEDI) is a specifically designed self-report to measure the transdiagnostic dimensions proposed by Brown and Barlow (2009). This study aims to analyse the psychometric properties of the MEDI scores in adolescents with subthreshold anxiety and depression. METHOD: The sample consisted of a total of 476 students. The mean age was 13.77 years (SD = 1.43) (range 10 to 18 years), 73.9 % were females. Several questionnaires assessing positive affect, negative affect, mental health difficulties, and quality of life were used. RESULTS: The original 9-factor structure of the MEDI was confirmed with good fit indices. Satisfactory levels of internal consistency were observed in most of the MEDI scores using McDonald's Omega, ranging from 0.58 to 0.87. The MEDI dimensions were associated with psychopathology, positive affect, negative affect, and quality of life. LIMITATIONS: Reliance on self-reported data, a cross-sectional design limiting temporal assessment, and a 73.9 % female gender imbalance. CONCLUSION: The MEDI scores showed adequate psychometric properties among adolescents with subclinical emotional symptoms. The results found might have potential clinical implications for conceptualization, assessment, intervention, and prevention of emotional disorders at both clinical and research levels.

Celecoxib Decreases the Need for Rescue Analgesics after Total Knee Arthroplasty: A Meta-Analysis.

This systematic review and meta-analysis aimed to evaluate the analgesic efficacy and adverse effects of celecoxib after total knee arthroplasty. Keywords in the PubMed and Scopus databases were used to find article abstracts. Each included clinical trial was assessed using the Cochrane Collaboration risk of bias tool, and we extracted data on postoperative pain assessment using the Visual Analogue Scale (VAS) at rest, ambulation, and active range of motion, rescue analgesic intake, and adverse effects. Inverse variance tests with mean differences were used to analyze the numerical variables. The Mantel-Haenszel statistical method and the odds ratio were used to evaluate the dichotomous data. According to this qualitative assessment (n = 482), two studies presented conclusions in favor of celecoxib (n = 187), one showed similar results between celecoxib and the placebo (n = 44), and three clinical trials did not draw conclusions as to the effectiveness of celecoxib versus the placebo (n = 251). Moreover, the evaluation of the rescue analgesic intake showed that the patients receiving celecoxib had a lower intake compared to patients receiving a placebo (n = 278, I2 = 82%, p = 0.006, mean difference = -6.89, 95% IC = -11.76 to -2.02). In conclusion, the pooled analysis shows that administration of celecoxib alone results in a decrease in rescue analgesic consumption compared to a placebo after total knee surgery.

Minimal impacts of invasive Scaevola taccada on Scaevola plumieri via pollinator competition in Puerto Rico.

Introduction: Scaevola taccada and Scaevola plumieri co-occur on shorelines of the Caribbean. Scaevola taccada is introduced in this habitat and directly competes with native dune vegetation, including S. plumieri, a species listed as locally endangered and threatened in Caribbean locations. This study addresses whether the invasive S. taccada also impacts the native S. plumieri indirectly by competing for pollinators and represents the first comparative study of insect visitation between these species. Methods: Insect visitation rates were measured at sites where species co-occur and where only the native occurs. Where species cooccur, insect visitors were captured, identified and analyzed for the pollen they carry. Pollen found on open-pollinated flowers was analyzed to assess pollen movement between the two species. We also compared floral nectar from each species by measuring volume, sugar content, and presence and proportions of amine group containing constituents (AGCCs). Results: Our results demonstrate that both species share insect visitors providing the context for possible pollinator competition, yet significant differences in visitation frequency were not found. We found evidence of asymmetrical heterospecific pollen deposition in the native species, suggesting a possible reproductive impact. Insect visitation rates for the native were not significantly different between invaded and uninvaded sites, suggesting that the invasive S. taccada does not limit pollinator visits to S. plumieri. Comparisons of nectar rewards from the invasive and the native reveal similar volumes and sugar concentrations, but significant differences in some amine group containing constituents that may enhance pollinator attraction. Conclusion: Our analysis finds no evidence for pollination competition and therefore S. taccada's main impacts on S. plumieri are through competitive displacement and possibly through reproductive impacts as a consequence of heterospecific pollen deposition.

Neonatal olfactory bulbectomy causes dendritic spine retraction in dorsal hippocampal CA3 neurons in female rats and spatial learning deficits in male rats.

Olfactory bulbectomy (OBX) is an experimental strategy that is widely employed because it produces changes at different levels (from behavioral to molecular) that can be related to symptoms of depression in humans. This procedure has been widely studied in adult rats, but little information has been obtained of its effect in neonatal rats. The objective of the present study was to evaluate learning and memory capacity and dendritic spine density in dorsal hippocampal CA3 neurons. Seven-day-old male and female Wistar rats were subjected to nOBX by suction, we included an intact group as a control (CON) and a sham-operated group (SHAM), too. Spatial learning and memory were measured at 56 days of age using a Morris water maze. A different cohort of experimental groups was used to measure dendritic spine density by Golgi-Cox impregnation. Male rats with nOBX showed a pronounced spatial learning deficit than female rats. Also, there was a significant decrease in basilar dendritic spine density in female rats with nOBX compared to the CON group. No changes were observed in this variable in male rats with nOBX. Our results allow us to suggest that there is sexual dimorphism in the effect of nOBX on the dorsal hippocampus and its relationship with spatial learning and memory processes.

Youth screening depression: Validation of the Patient Health Questionnaire-9 (PHQ-9) in a representative sample of adolescents.

BACKGROUND: Depression symptoms and mood disorders constitute one of the major public health challenges among youths. Thus, early prevention and intervention for depression should be a priority. The main goal of the present study was to validate the Patient Health Questionnaire-9 (PHQ-9) scores in a school-based sample of non-clinical adolescents. METHOD: Stratified random sampling was conducted. Participants were 2235 students (M = 14.49, SD =1.76, range= 12-18 years), 52.9 % were female, from 34 secondary schools in Spain. Several previously validated self-reported questionnaires of mental health and psychopathology were administrated. RESULTS: The unidimensional factorial model of the PHQ-9 items showed adequate goodness of fit indices. Strong measurement invariance across gender was found. Omega for the PHQ-9 total score was 0.87. The PHQ-9 total score was positively associated with anxiety symptoms and emotional and behavioral problems, and negatively associated with prosocial behavior and quality of life. CONCLUSIONS: The PHQ-9 is a brief, easy, and reliable tool for assessing self-reported depressive symptoms in both clinical and school settings. PHQ-9 may be used as a screening tool for universal early detection and monitorization of depression symptoms during adolescence.

Analgesic Efficacy and Safety of Tapentadol Immediate Release in Bunionectomy: A Meta-Analysis.

The aim of this systematic review and meta-analysis was to evaluate the analgesic effect of different doses of tapentadol immediate release (IR) and its adverse effects after a bunionectomy. Pubmed, Cochrane, Lilacs, Medline, and Imbiomed were used to identify abstracts of scientific publications related to the keywords of this systematic review (PROSPERO ID CRD42023437295). Moreover, the risk of bias in all included articles was assessed using the Cochrane Collaboration risk of bias tool. Data on the sum of pain intensity, total pain relief, global assessment, and adverse effects were extracted. The statistical method of inverse variance with means difference was used to evaluate the numerical data and the Mantel-Haenszel and Odd Ratio test to analyze the dichotomous data. In addition, the number needed to treat, the number needed to harm, and the 95% confidence intervals were calculated. A qualitative evaluation (n = 2381) was carried out according to the conclusions of the authors. Tapentadol (n = 1772) was more effective in relieving postoperative pain than the placebo (n = 609) after a bunionectomy. In addition, the analgesic efficacy of IR tapentadol (n = 1323) versus the placebo (n = 390) was evaluated in a total of 1713 patients using a global evaluation of the treatments. All three doses of IR tapentadol showed better results compared to the placebo after a bunionectomy. Finally, the adverse effects have a direct relationship with the dose, and the greatest number of adverse effects are most observed with tapentadol IR 100 mg (n = 2381). It is concluded that tapentadol IR (100 mg) leads to the best satisfaction score in this meta-analysis.

Accuracy of a Patient-Specific Total Ankle Arthroplasty Instrumentation.

BACKGROUND: Total ankle arthroplasty (TAA) is a preferred surgical option for end-stage ankle osteoarthritis; however, it is a demanding procedure with a higher historical rate of revision compared with ankle fusion. Patient-specific instrumentation (PSI) has been introduced to optimize prosthesis alignment and theoretically overall improve TAA outcomes. The goal of this study is to report on the experience and surgical outcomes of one implant with specific evaluation of the accuracy and reproducibility of the system with respect to prosthesis alignment and prediction of implant size. METHODS: A retrospective, multicentered study involving 4 foot and ankle fellowship-trained orthopaedic surgeon's patients undergoing TAA between January 1, 2015, and December 31, 2018, using the PROPHECY PSI system. RESULTS: 80 TAA procedures were performed. On average the postoperative tibial component alignment was 89.9 (range, 86.1-96.5) degrees in the coronal plane, with a mean sagittal alignment of 88.1 (range, 81.3-96.7) degrees. The mean deviation from neutral sagittal alignment improved from 4.9 ± 3.9 degrees preoperatively to 2.7 ± 1.7 degrees postoperatively, whereas the mean coronal alignment improved from 3.3 ± 2.5 degrees to 1.3 ± 1.1 degrees. The PSI software correctly determined the tibial implant size in 70 patients (89%). Prediction of talar implant sizing was less accurate than the tibial component, with 56 patients (71%) using the predicted sized implant. The overall implant survival at a mean follow-up of 45 months (range, 27-76) was 97.5%. CONCLUSION: We found that this PSI system accurately and reliably assisted in implant total ankle prosthesis positioning within a clinically acceptable margin and without significant outliers. Prediction of implant size was not as accurate as component orientation. LEVEL OF EVIDENCE: Level III, retrospective study.

Profesionales de la Psicología en Contextos Educativos: Una Necesidad Ineludible / Psychology Professionals in Educational Contexts: An Unavoidable Necessity

Los problemas de salud mental y las dificultades de ajuste psicológico entre los adolescentes se erigen como un desafío personal, familiar, educativo y socio-sanitario. Se hace necesario abordar este reto social emergente mediante el estudio y la implementación de estrategias de promoción del bienestar psicológico y prevención de los problemas de salud mental en contextos educativos. El objetivo del presente trabajo es poner de manifiesto, a la luz de los datos epidemiológicos derivados del proyecto PSICE (Psicología Basada en la Evidencia en Contextos Educativos), la importancia de abordar la salud mental en entornos educativos. En primer lugar, se realiza una introducción al estudio del comportamiento humano y los problemas de ajuste psicológico. En segundo lugar, se aborda la importancia de los centros educativos como el lugar natural donde promocionar el bienestar psicológico y la salud mental infanto-juvenil. En tercer lugar, se mencionan los resultados de prevalencia derivados del estudio PSICE. Se finaliza con un apartado de recapitulación señalando la ineludible necesidad de promover, proteger y cuidar la salud mental durante la infancia y la adolescencia en los entornos educativos. La promoción del bienestar psicológico y la prevención de los problemas de salud mental en contextos educativos supone la mejor inversión por parte de la sociedad, los gobiernos y las instituciones.(AU)

Mental health problems and psychological adjustment difficulties among young people are emerging as a personal, family, educational, social, and health challenge. It is necessary to address this rising social challenge by studying and implementing strategies to promote emotional well-being and prevent psychological problems in natural contexts. The aim of this work is to highlight, based on the epidemiological data derived from the PSICE (Evidence-based Psychology in Educational Contexts) project, the importance of addressing mental health in school settings. Firstly, an introduction to the study of human behavior and psychological adjustment problems is presented. Secondly, the importance of schools as the natural place to promote the psychological well-being and mental health of children and adolescents is discussed. Thirdly, the prevalence results derived from the PSICE study are mentioned. To conclude, a summary section underscores the imperative need to promote, protect, and care for mental health during childhood and adolescence in educational settings. The promotion of psychological well-being and the prevention of mental health problems in educational contexts is the best investment on the part of societies, governments, and institutions.(AU)

Inventory of chiton species (Polyplacophora) from the rocky intertidal of the Northern Gulf of California, with an illustrated taxonomic key.

This work presents an inventory of the Polyplacophora species registered in December 2019 in the intertidal environment of 10 sampling sites of the Northern Gulf of California, México. Fifteen species were obtained from a total of 33 species previously reported throughout the Gulf. Acanthochitona avicula, Ischnochiton guatemalensis, Lepidozona serrata, and Dendrochiton lirulatus are rare with only 1 to 3 specimens recorded of each species. Stenoplax mariposa and Lepidozona subtilis were the most abundant with 162 and 284 specimens, respectively. Acanthochitona avicula, I. guatemalensis, Lepidozona serrata, and Lepidochitona beanii are rare and each was only recorded at one sampling site. For a better recognition of these species, we provide a dichotomous identification key, which is complemented with high-resolution photographs and images obtained by scanning electron microscopy. In addition, habitat data and taxonomic comments are included to facilitate a better understanding of the habitat preferences, relationships and current taxonomic position of these species.

Analgesic Efficacy of COX-2 Inhibitors in Periodontal Surgery: A Systematic Review and Meta-Analysis.

The objective of this systematic review and meta-analysis was to evaluate the analgesic efficacy of COX-2 inhibitors versus other drugs in periodontal surgery. Two researchers searched PubMed, Google Scholar, ACM Digital, BASE, EBSCOhost, Scopus, or Web of Science for clinical trials using various combinations of words. All articles that met the selection criteria were assessed using the Cochrane Collaboration's risk of bias tool. For data analysis, the inverse variance and mean difference statistical method was used with Review Manager 5.3 software for Windows. According to the conclusion of each study (qualitative evaluation), only one clinical trial had results in favor of a COX-2 inhibitor when compared to placebo, one clinical study informed that a COX-2 was better that an active control, four studies showed similar analgesic efficacy to active controls, and one clinical study informed the analgesic effect of one celecoxib-caffeine combination in comparison with celecoxib alone and placebo (n = 337). The COX-2 inhibitors showed a decrease in the rescue analgesic consumption (n = 138; I2 = 15%; mean difference = -0.31; 95%CIs = -0.6 to -0.01), and lower pain intensity at four hours (n = 178; I2 = 0%; mean difference = -2.25; 95%CIs = -2.94 to -1.55; p = 0.00001) when compared to active controls after periodontal surgery. In conclusion, the data indicate that COX-2 agents produce better pain relief in comparison to placebo and other drugs after periodontal surgery.

PSICE Project Protocol: Evaluation of the Unified Protocol for Transdiagnostic Treatment for Adolescents with Emotional Symptoms in School Settings / El protocolo del Proyecto PSICE: evaluación del protocolo unificado transdiagnóstico para adolescentes con síntomas emocionales en contextos educativos

Background: The aim of the PSICE (Evidence-based Psychology in Educational Contexts) Project is to examine the effectiveness of the Unified Protocol for Transdiagnostic Treatment of Adolescents (UP-A) with symptoms of anxiety and depression in school settings. The goal is to prevent emotional problems and to improve adolescents’ socioemotional adjustment, learning processes, and academic performance. Method: A randomized controlled trial with two groups will be performed: active control (progressive relaxation training) and experimental (UP-A). After screening, participants with subclinical emotional symptomatology will be selected for pre- and post-test evaluation and follow-up at 6, 12, and 18 months. Results: The impact of different indicators at behavioral, cognitive, affective, social and academic functioning levels will be analyzed, as well as their effects in the short, medium and long term. Conclusions: Examining the effectiveness of the UP-A in the Spanish educational context will, among other things, provide data for informed decision-making in the field of educational psychology. In addition, it will ensure that such interventions, using standardized protocols, are accessible to a large population at such an important stage of human development as adolescence. The PSICE project will provide leadership and guidance on the importance of psychology in schools. (AU)

Antecedentes: El objetivo del Proyecto PSICE (Psicología basada en la evidencia en contextos educativos) es examinar la efectividad del protocolo unificado para el tratamiento transdiagnóstico de síntomas de ansiedad y depresión en adolescentes (UP-A) en contextos educativos. El objetivo es prevenir los problemas emocionales, así como mejorar el ajuste socioemocional, los procesos de aprendizaje y el rendimiento académico de los adolescentes. Método: Se implementa mediante un ensayo controlado aleatorizado con dos grupos: control activo (entrenamiento en relajación progresiva) y experimental (UP-A). Tras un cribado, se seleccionarán participantes con síntomas emocionales subclínicos a los que se realizará evaluación pretest, postest y seguimiento a los 6, 12 y 18 meses. Resultados: Se analizará el impacto de diferentes indicadores a nivel comportamental, cognitivo, afectivo y de funcionamiento social y académico, así como sus efectos a corto, medio y largo plazo. Conclusiones: Examinar la efectividad del UP-A en el contexto educativo español permitirá, entre otras cuestiones, disponer de datos en el campo de la psicología educativa de cara a la toma de decisiones informadas, además de garantizar que dichas intervenciones sean accesibles, empleando protocolos estandarizados, para un gran conjunto de la población y en una etapa del desarrollo humano tan relevante como es la adolescencia. El proyecto PSICE proporcionará liderazgo y orientación sobre la importancia de la Psicología en el contexto educativo. (AU)

Quantification of bowel ischaemia using real-time multispectral Single Snapshot Imaging of Optical Properties (SSOP).

BACKGROUND: Single snapshot imaging of optical properties (SSOP) is a relatively new non-invasive, real-time, contrast-free optical imaging technology, which allows for the real-time quantitative assessment of physiological properties, including tissue oxygenation (StO2). This study evaluates the accuracy of multispectral SSOP in quantifying bowel ischaemia in a preclinical experimental model. METHODS: In six pigs, an ischaemic bowel segment was created by dividing the arcade branches. Five regions of interest (ROIs) were identified on the bowel loop, as follows: ROI 1: central ischaemic; ROI 2: left marginal; ROI 3: left vascularised; ROI 4: right marginal; and ROI 5: right vascularised. The Trident imaging system, specifically developed for real-time tissue oxygenation imaging using SSOP, was used to image before (T0) and after ischaemia induction. Capillary and systemic lactates were measured at each time point (T0, T15, T30, T45, T60), as well as StO2 values acquired by means of SSOP (SSOP-StO2). RESULTS: The mean value of SSOP-StO2 in ROI 1 was 30.08 ± 6.963 and was significantly lower when compared to marginal ROIs (ROI 2 + ROI 4: 45.67 ± 10.02 p = < 0.0001), and to vascularised ROIs (ROI 3 + ROI 5: 48.08 ± 7.083 p = < 0.0001). SSOP-StO2 was significantly correlated with normalised lactates r = - 0.5892 p < 0.0001 and with histology r =- 0.6251 p = 0.0002. CONCLUSION: Multispectral SSOP allows for a contrast-free accurate assessment of small bowel perfusion identifying physiological tissue oxygenation as confirmed with perfusion biomarkers.

Antagonistic, synergistic, and additive antibacterial interaction between ciprofloxacin and amoxicillin against Staphylococcus aureus.

The aim of this in vitro study was to evaluate the interaction between ciprofloxacin and amoxicillin against beta-lactamase-producing Staphylococcus aureus. Concentration-dependent curves for each individual drug were carried out to obtain the mean inhibitory concentration in the agar well diffusion assay. Then, different ratios of the ciprofloxacin-amoxicillin combination (0.5:0.5, 0.8:0.2, 0.2:0.8, 0.9:0.1, 0.1:0.9, 0.95:0.05, and 0.05:0.95) were assessed. Data were analyzed using the isobolographic analysis and interaction index. The isobolographic evaluation shows that the 0.9:0.1 and 0.95:0.05 ratios of the ciprofloxacin-amoxicillin combination produced a synergistic antimicrobial interaction, the 0.8:0.2, 0.2:0.8, 0.1:0.9, and 0.05:0.95 proportions showed an additive antibacterial effect, and the 0.5:0.5 proportion induced antagonistic antimicrobial effects. The interaction index showed similar outcomes to the isobolographic analysis. In conclusion, the data of this study mainly show antimicrobial additive results of the ciprofloxacin-amoxicillin combination against beta-lactamase-producing S. aureus.

Harnessing the Power of Technology to Improve Sexual and Reproductive Youth Health in Nicaragua: A Randomized Field Study.

Introduction: Nicaragua is among the poorest countries in Latin America and has one of the highest adolescent pregnancy rates in the region. One in four of pregnancies are adolescents and they are more likely to experience poverty and gender and economic inequality. Method: This pilot randomized field study assessed use, satisfaction, and impact of a brief e-learning short-term intervention to improve the sexual and reproductive health (SRH) knowledge, skills, motivations, and behaviors among 14-17-year-old Nicaraguan youth. Results: While access to technology and internet were significant barriers, App and email delivery channels were feasible means for communicating with youth who had access to the internet and mobile devices. Youth who used the app were most likely to complete the entire intervention. Youth were very satisfied with the intervention (98%) and significantly improved SRH knowledge, skills and motivations, and delayed age at the first sexual encounter. Conclusion: Results are promising and indicate potential for the scalability of this type of intervention.

New Method for Imputation of Unquantifiable Values Using Bayesian Statistics for a Mixture of Censored or Truncated Distributions: Application to Trace Elements Measured in Blood of Olive Ridley Sea Turtles from Mexico.

One recurring difficulty in ecotoxicological studies is that a substantial portion of concentrations are below the limits of detection established by analytical laboratories. This results in censored distributions in which concentrations of some samples are only known to be below a threshold. The currently available methods have several limitations because they cannot be used with complex situations (e.g., different lower and upper limits in the same dataset, mixture of distributions, truncation and censoring in a single dataset). We propose a versatile method to fit the most diverse situations using conditional likelihood and Bayesian statistics. We test the method with a fictive dataset to ensure its correct description of a known situation. Then we apply the method to a dataset comprising 25 element concentrations analyzed in the blood of nesting marine turtles. We confirm previous findings using this dataset, and we also detect an unexpected new relationship between mortality and strontium concentration.

Expression of DNA Methyltransferase 3B Isoforms Is Associated with DNA Satellite 2 Hypomethylation and Clinical Prognosis in Advanced High-Grade Serous Ovarian Carcinoma.

Alterations in DNA methylation are critical for the carcinogenesis of ovarian tumors, especially ovarian carcinoma (OC). DNMT3B, a de novo DNA methyltransferase (DNMT), encodes for fifteen spliced protein products or isoforms. DNMT3B isoforms lack exons for the catalytic domain, with functional consequences on catalytic activity. Abnormal expression of DNMT3B isoforms is frequently observed in several types of cancer, such as breast, lung, kidney, gastric, liver, skin, leukemia, and sarcoma. However, the expression patterns and consequences of DNMT3B isoforms in OC are unknown. In this study, we analyzed each DNMT and DNMT3B isoforms expression by qPCR in 63 OC samples and their association with disease-free survival (DFS), overall survival (OS), and tumor progression. We included OC patients with the main histological subtypes of EOC and patients in all the disease stages and found that DNMTs were overexpressed in advanced stages (p-value < 0.05) and high-grade OC (p-value < 0.05). Remarkably, we found DNMT3B1 overexpression in advanced stages (p-value = 0.0251) and high-grade serous ovarian carcinoma (HGSOC) (p-value = 0.0313), and DNMT3B3 was overexpressed in advanced stages (p-value = 0.0098) and high-grade (p-value = 0.0004) serous ovarian carcinoma (SOC). Finally, we observed that overexpression of DNMT3B isoforms was associated with poor prognosis in OC and SOC. DNMT3B3 was also associated with FDS (p-value = 0.017) and OS (p-value = 0.038) in SOC patients. In addition, the ovarian carcinoma cell lines OVCAR3 and SKOV3 also overexpress DNMT3B3. Interestingly, exogenous overexpression of DNMT3B3 in OVCAR3 causes demethylation of satellite 2 sequences in the pericentromeric region. In summary, our results suggest that DNMT3B3 expression is altered in OC.

Local Tramadol Improves the Anesthetic Success in Patients with Symptomatic Irreversible Pulpitis: A Meta-Analysis.

Symptomatic irreversible pulpitis is a painful clinical condition with a broad inflammatory component. Dental anesthesia in these patients is affected by the inflammatory process, reporting a high incidence of anesthesia failure. The aim of this systematic review and meta-analytical evaluation was to determine the effect of pre-treatment with tramadol in patients with symptomatic irreversible pulpitis, as well as for pain control and adverse effects. This study was registered in PROSPERO (ID: CRD42021279262). PubMed was consulted to identify clinical investigations comparing tramadol and placebo/local anesthetics in patients with symptomatic irreversible pulpitis. Data about the anesthesia, pain control, and adverse effects were extracted. Both the anesthetic success index and the adverse effects of local tramadol and placebo were compared with the Mantel−Haenszel test and odds ratio. Data analysis showed that the local administration of tramadol increased the anesthetic success rate when compared to placebo in patients with symptomatic irreversible pulpitis (n = 228; I2 = 0; OR = 2.2; 95% CIs: 1.30 to 3.79; p < 0.004). However, local administration of tramadol increased the risk of adverse effects when compared to placebo/local anesthetics (n = 288; I2 = 0; OR = 7.72; 95% CIs: 1.37 to 43.46; p < 0.02). In conclusion, this study shows that the local administration of tramadol increases the anesthetic success index when compared to placebo in patients with symptomatic irreversible pulpitis.

Viability and Adhesion of Periodontal Ligament Fibroblasts on a Hydroxyapatite Scaffold Combined with Collagen, Polylactic Acid-Polyglycolic Acid Copolymer and Platelet-Rich Fibrin: A Preclinical Pilot Study.

Background: Conventional periodontal therapy relies on bone regeneration strategies utilizing scaffolds made of diverse materials, among which collagen, to promote cell adhesion and growth. Objective: To evaluate periodontal ligament fibroblast (HPdLF) cell adhesion and viability for periodontal regeneration purposes on hydroxyapatite scaffolds containing collagen (HAp-egg shell) combined with polylactic acid−polyglycolic acid copolymer (PLGA) and Platelet-Rich Fibrin (PRF). Methods: Four variations of the HAp-egg shell were used to seed HPdLF for 24 h and evaluate cell viability through a live/dead assay: (1) (HAp-egg shell/PLGA), (2) (HAp-egg shell/PLGA + collagen), (3) (HAp-egg shell/PLGA + PRF) and (4) (HAp-egg shell/PLGA + PRF + collagen). Cell adhesion and viability were determined using confocal microscopy and quantified using central tendency and dispersion measurements; significant differences were determined using ANOVA (p < 0.05). Results: Group 1 presented low cell viability and adhesion (3.70−10.17%); groups 2 and 3 presented high cell viability and low cell adhesion (group 2, 59.2−11.1%, group 3, 58−4.6%); group 4 presented the highest cell viability (82.8%) and moderate cell adhesion (45%) (p = 0.474). Conclusions: The effect of collagen on the HAp-egg shell/PLGA scaffold combined with PRF favored HPdLF cell adhesion and viability and could clinically have a positive effect on bone defect resolution and the regeneration of periodontal ligament tissue.

Fournier's Gangrene: A Coexistence or Consanguinity of SGLT-2 Inhibitor Therapy.

BACKGROUND: Sodium-glucose cotransporter-2 inhibitors (SGLT2 inhibitors) are a relatively new class of medications used for the management of type II diabetes mellitus targeting the kidneys. Within the last decade, several warnings have been issued regarding the development of severe genitourinary infections, including necrotizing fasciitis, or Fournier's gangrene, in those with pre-existing type II diabetes and concomitant use of this drug class. OBJECTIVE: The purpose of this review is to highlight and discuss the factors contributing to the development of Fournier's gangrene, its pathogenesis, and a review of existing literature describing patient outcomes, treatment, and future directions regarding early detection of this complication. METHODS: Articles and studies addressing effective treatment adherence and key factors contributing to Fournier's gangrene with SGLT2 inhibitors were identified by effective keyword searches in PubMed Central, Google Scholar, and Cochrane, as well as the references found within these articles. RESULTS: Using the keywords provided, 55 case reports, review articles, and meta-analysis reports written within the last 20 years were utilized as the source of the data presented in this systematic review article.