Living Alone, Patient Sex and Mortality After Acute Myocardial Infarction

BACKGROUND: Psychosocial factors, including social support, affect outcomes of cardiovascular disease, but can be difficult to measure. Whether these factors have different effects on mortality post-acute myocardial infarction (AMI) in men and women is not clear. OBJECTIVE: To examine the association between living alone, a proxy for social support, and mortality postdischarge AMI and to explore whether this association is modified by patient sex. DESIGN: Historical cohort study. PARTICIPANTS/SETTING: All patients discharged with a primary diagnosis of AMI in a major urban center during the 1998–1999 fiscal year. MEASUREMENTS: Patients’ sociodemographic and clinical characteristics were obtained by standardized chart review and linked to vital statistics data through December 2001. RESULTS: Of 880 patients, 164 (18.6%) were living alone at admission and they were significantly more likely to be older and female than those living with others. Living alone was independently associated with mortality [adjusted hazard ratio (HR) 1.6, 95% confidence interval (CI) 1.0–2.5], but interacted with patient sex. Men living alone had the highest mortality risk (adjusted HR 2.0, 95% CI 1.1–3.7), followed by women living alone (adjusted HR 1.2, 95% CI 0.7–2.2), men living with others (reference, HR 1.0), and women living with others (adjusted HR 0.9, 95% CI 0.5–1.5). CONCLUSIONS: Living alone, an easily measured psychosocial factor, is associated with significantly increased longer-term mortality for men following AMI. Further prospective studies are needed to confirm the usefulness of living alone as a prognostic factor and to identify the potentially modifiable mechanisms underlying this increased risk

Reinforcement effect of polyethylene fibre in root-filled teeth: comparison of two restoration techniques

Erdemir, Ali/0000-0002-6489-9620; yildirim, cihan/0000-0001-7218-9832; Erdemir, Ali/0000-0003-1140-3887WOS: 000235099100007PubMed: 16454794To compare in vitro two different fibre placement techniques on reinforcement of root-filled molar teeth with mesio-occluso-distal (MOD) cavities. Fifty sound extracted human mandibular molars were used (n = 10). Group 1 served as control. From group 2-5, endodontic access and standard MOD cavities were prepared. Following root canal treatment, group 2 was kept unrestored. In groups 3 and 4, the teeth were restored with composite resin (AP-X; Kuraray, Japan). A groove was prepared on occlusal surface of the finished restorations in group 4 from buccal to lingual direction. Polyethylene woven fibre (Ribbond; Seattle, WA, USA) was inserted in the groove in combination with flowable resin that was cured for 20 s and covered with composite resin. Cavity surfaces were covered with flowable resin in group 5, and polyethylene fibre was placed into the bed of resin in a buccal to lingual direction before the composite restoration was placed. All specimens were stored in 100% humidity at 37 degrees C for 24 h. Compressive loading of the teeth was performed by a universal testing machine at a crosshead speed of 0.5 mm min(-1) until failure. The data were recorded in Newton and submitted to ANOVA and Tukey post hoc test. The mean load necessary to fracture the samples in each group was: G1: 1671.57 +/- 131.54(a); G2: 375.21 +/- 34.30(b); G3: 749.47 +/- 124.54(c); G4: 1224.36 +/- 132.17(d); G5: 926.88 +/- 118.28(e). Different superscript letters demonstrate significant difference between groups. Polyethylene fibre use over or under MOD composite restorations significantly increased fracture strength. However, when the fibre was placed on the occlusal surface of the restoration in buccal to lingual direction, significantly higher fracture resistance was observed

A comparison of microhardness of indirect composite restorative materials Estudo comparativo da microdureza de materiais resinosos indiretos

The purpose of this study was to compare the microhardness of four indirect composite resins. Forty cylindrical samples were prepared according to the manufacturer’s recommendations using a Teflon mold. Ten specimens were produced from each tested material, constituting four groups (n=10) as follows: G1 - Artglass; G2 - Sinfony; G3 - Solidex; G4 - Targis. Microhardness was determined by the Vickers indentation technique with a load of 300g for 10 seconds. Four indentations were made on each sample, determining the mean microhardness values for each specimen. Descriptive statistics data for the experimental conditions were: G1 - Artglass (mean ±&#61472;standard deviation: 55.26 ± 1.15HVN; median: 52.6); G2 - Sinfony (31.22 ± 0.65HVN; 31.30); G3 - Solidex (52.25 ± 1.55HVN; 52.60); G4 - Targis (72.14 ± 2.82HVN; 73.30). An exploratory data analysis was performed to determine the most appropriate statistical test through: (I) Levene's for homogeneity of variances; (II) ANOVA on ranks (Kruskal-Wallis); (III) Dunn's multiple comparison test (0.05). Targis presented the highest microhardness values while Sinfony presented the lowest. Artglass and Solidex were found as intermediate materials. These results indicate that distinct mechanical properties may be observed at specific materials. The composition of each material as well as variations on polymerization methods are possibly responsibles for the difference found in microhardness. Therefore, indirect composite resin materials that guarantee both good esthetics and adequate mechanical properties may be considered as substitutes of natural teeth.<br>O objetivo deste estudo foi comparar a microdureza de 4 resinas compostas indiretas. Quarenta amostras cilíndricas foram obtidas com o auxílio de uma matriz de teflon, seguindo-se as recomendações dos fabricantes. Foram obtidas 10 amostras para cada material testado, contituindo-se 4 grupos (n=10) como se segue: G1-Artglass; G2-Sinfony; G3-Solidex; G4-Targis. A microdureza foi determinada pela técnica da indentação Vickers com uma carga de 300g por 10 segundos. Quatro indentações foram realizadas em cada amostra, obtendo-se um valor médio. Os dados da análise estatística descritiva para cada condição experimental foram: G1-Artglass (média ± desvio padrão:55,26 ± 1,15HVN; mediana: 52,6); G2- Sinfony (31,22 ± 0,65HVN; 31,30); G3- Solidex (52,25 ± 1,55HVN; 52,60); G4- Targis (72,14 ± 2,82HVN; 73,30). Uma análise exploratória dos dados foi realizada para determinar o teste estatístico mais apropriado: (I) Teste de Levene para variâncias homogêneas; (II) Teste de ANOVA (Kruskal-Wallis); (III) Teste de comparação múltipla de Dunn. O Targis apresentou os maiores valores de microdureza, enquanto que o Sinfony apresentou os menores valores. O Artglass e o Solidex se comportaram como materiais intermediários. Estes resultados indicaram que propriedades mecânicas distintas podem ser observadas nos materiais. A composição de cada material, bem como as variações nos métodos de polimerização são possivelmente responsáveis pelas diferenças observadas na microdureza. Portanto, materiais resinosos indiretos que garantam estética e propriedades mecânicas satisfatórias podem ser considerados como substitutos dos dentes naturais