Ablation of an idiopathic left ventricular tachycardia originating from the posterior mitral annulus in a toddler

Ablation of a mitral annulus (MA)-ventricular tachycardia (VT), a rare form of idiopathic left VT, has not yet been described in patients <2 years of age. We describe a case of a toddler with an incessant, poorly tolerated idiopathic VT (190 bpm) refractory to medical therapy, which was successfully ablated in the left ventricle at the infero-posterior part of the MA. Different diagnostic and ablation steps are described. Mitral annulus-ventricular tachycardia, a rare form of idiopathic left VT, can safely and successfully be ablated in very young children

Positive correlation between fluoride release and acid erosion of restorative glass-ionomer cements.

OBJECTIVE: The aim of this study was to determine whether there is a correlation between acid erosion and fluoride release of conventional glass ionomer cements. METHODS: Ten specimens for each material were prepared for fluoride release tests and five for acid erosion tests separately. After placed in pH cycling solution, concentration of fluoride was measured by a fluoride-ion selective electrode each day for 15 days. For the acid erosion test, specimens were immersed in a lactic acid solution and their depth measured with a spring-loaded dial gauge. The data were submitted to 3-way ANOVA, followed by Tukey's test (p0.05). The highest acid erosion values were registered for Magic Glass, Ion Z, VitroFil and Maxxion R, which exceeded the maximum stipulated by the relevant ISO test (ISO 9917-1). A positive linear correlation (r2=0.4886) was found for both properties, i.e., higher fluoride release is related to higher acid erosion. SIGNIFICANCE: Acid erosion and fluoride release are related properties of GICs, though factors such as pH and P/L ratio lead to differences between actual values for individual brands of these materials

Immediate vs. deferred switching from a boosted protease inhibitor (PI/r) based regimen to a Dolutegravir (DTG) based regimen in virologically suppressed patients with high cardiovascular risk or Age ≥50 years: final 96 weeks results of NEAT 022 study

Background Both immediate and deferred switching from a ritonavir-boosted protease inhibitor (PI/r)–based regimen to a dolutegravir (DTG)–based regimen may improve lipid profile. Methods European Network for AIDS Treatment 022 Study (NEAT022) is a European, open-label, randomized trial. Human immunodeficiency virus (HIV)–infected adults aged ≥50 years or with a Framingham score ≥10% were eligible if HIV RNA was <50 copies/mL. Patients were randomized to switch from PI/r to DTG immediately (DTG-I) or to deferred switch at week 48 (DTG-D). Week 96 endpoints were proportion of patients with HIV RNA <50 copies/mL, percentage change of lipid fractions, and adverse events (AEs). Results Four hundred fifteen patients were randomized: 205 to DTG-I and 210 DTG-D. The primary objective of noninferiority at week 48 was met. At week 96, treatment success rate was 92.2% in the DTG-I arm and 87% in the DTG-D arm (difference, 5.2% [95% confidence interval, –.6% to 11%]). There were 5 virological failures in the DTG-I arm and 5 (1 while on PI/r and 4 after switching to DTG) in the DTG-D arm without selection of resistance mutations. There was no significant difference in terms of grade 3 or 4 AEs or treatment-modifying AEs. Total cholesterol and other lipid fractions (except high-density lipoprotein) significantly (P < .001) improved both after immediate and deferred switching to DTG overall and regardless of baseline PI/r strata. Conclusions Both immediate and deferred switching from a PI/r to a DTG regimen in virologically suppressed HIV-infected patients ≥50 years old or with a Framingham score ≥10% was highly efficacious and well tolerated, and improved the lipid profile