Ventricular pre-excitation in primary care patients: Evaluation of the risk of mortality.

BACKGROUND: Ventricular pre-excitation is characterized by the presence of atrioventricular accessory pathways, predisposing to arrhythmias. Although it is well established that risk stratification in symptomatic patients should be invasive, there is a lack of evidence of the benefit in asymptomatic. OBJECTIVE: Evaluate ventricular pre-excitation in the electrocardiogram (ECG) as a risk factor for overall mortality in patients of Telehealth Network of Minas Gerais (TNMG), Brazil. METHODS: This observational study was developed with the database of digital ECGs (2010-2017) from TNMG. The electronic cohort was obtained by linking data from ECG exams and those from the national mortality information system. Only the first ECG was considered. Clinical data were self-reported, and ECGs were interpreted manually by cardiologists and automatically by the Glasgow University Interpreter software. Hazard ratio (HR) for mortality was estimated using weighted Cox regression. RESULTS: Nearly 1 665 667 patients were included (median age: 50 [Q1: 34; Q3: 63] years; 41.4% were male). In a mean follow-up of 3.7 years, the overall mortality rate was 3.1%. The prevalence of ventricular pre-excitation was 0.07%. In multivariate analysis, adjusting for sex and age, ventricular pre-excitation was not associated with an increased risk of mortality (HR: 1.41; 95% confidence interval [CI]: 0.56-3.57; p = .47) when compared to the whole sample or to patients with normal ECG (HR: 1.41; 95% CI: 0.53-4.36; p = .43). In a subanalysis on accessory pathway location, there was no evidence of a higher risk of death related to any location. CONCLUSION: Ventricular pre-excitation was not associated with an increased risk of mortality in a primary care cohort.

Effect of green tea extract and mouthwash without alcohol on Candida albicans biofilm on acrylic resin.

OBJECTIVE: To evaluate the effect of aqueous extract of green tea and the oral antiseptic without alcohol, on Candida albicans biofilm formation to heat-curing acrylic resin plates. BACKGROUND: Candida is associated with oral candidiasis in poorly cleaned dentures. MATERIAL AND METHODS: Standardised specimens of heat-cured (Conv; n = 30) or microwave-cured acrylic resin (Mw; n = 30) were obtained and divided into six groups (n = 10): G1 = Conv resin and green tea aqueous extract, G2 = Conv resin and mouthwash, G3 = control of Conv resin, G4 = Mw resin and green tea aqueous extract, G5 = Mw resin and mouthwash and G6 = control of Mw-cured resin. The specimens were contaminated with 10 ml of Sabouraud dextrose broth inoculated with 0.1 ml of standard suspension containing 1 × 10(6) cells/ml of C. albicans and incubated for 24 h at 37°C. After this period, they were immersed in the aqueous extract or in mouthwash for 15 min. The control groups were treated with sterile distilled water. Aliquots of 0.1 ml were plated on Sabouraud dextrose agar and incubated at 37°C for 24 h. The numbers of colony-forming units per test specimen (CFU/TS) were calculated, and the results statistically analysed by two-way anova and Tukey's tests (5%). RESULTS: Statistically significant difference was observed for the aqueous extract groups (G1; 33.65%) and mouthwash (G2; 17.06%), when compared to control (G3; 100%), for Conv resin. For the Mw resin, there was significant difference between mouthwash (G5; 43.16%) and control (G6; 100%). CONCLUSION: The aqueous extract of green tea and mouthwash led to a reduction in the number of viable fungal cells in biofilm formed on acrylic resin.

Effect of high-power-laser with and without graphite coating on bonding of resin cement to lithium disilicate ceramic.

The present study evaluated the effect of different high-power-laser surface treatments on the bond strength between resin cement and disilicate ceramic. Lithium disilicate ceramic specimens with truncated cones shape were prepared and divided into 5 groups: HF (hydrofluoric acid-etching), Er:YAG laser + HF, Graphite + Er:YAG laser + HF, Nd:YAG laser + HF, and Graphite + Nd:YAG laser + HF. The treated ceramic surfaces were characterized with scanning electron microscopy and surface roughness measurement. Hourglasses-shaped ceramic- resin bond specimens were prepared, thermomechanically cycled and stressed to failure under tension. The results showed that for both the factors "laser" and "graphite", statistically significant differences were observed (p < 0.05). Multiple-comparison tests performed on the "laser" factor were in the order: Er:YAG > Nd:YAG (p < 0.05), and on the "graphite" factor were in the order: graphite coating < without coating (p < 0.05). The Dunnett test showed that Er:YAG + HF had significantly higher tensile strength (p = 0.00). Higher surface roughness was achieved after Er:YAG laser treatment. Thus Er:YAG laser treatment produces higher bond strength to resin cement than other surface treatment protocols. Surface-coating with graphite does not improve bonding of the laser-treated lithium disilicate ceramic to resin cement.