A safety and feasibility study of cell therapy in dilated cardiomyopathy

The aim of this study was to determine if bone marrow mononuclear cell (BMMC) transplantation is safe for moderate to severe idiopathic dilated cardiomyopathy (IDC). Clinical trials have shown that this procedure is safe and effective for ischemic patients, but little information is available regarding non-ischemic patients. Twenty-four patients with IDC, optimized therapy, age 46 ± 11.6 years, 17 males, NYHA classes II-IV, and left ventricular ejection fraction <35 percent were enrolled in the study. Clinical evaluation at baseline and 6 months after stem cell therapy to assess heart function included echocardiogram, magnetic resonance imaging, cardiopulmonary test, Minnesota Quality of Life Questionnaire, and NYHA classification. After cell transplantation 1 patient showed a transient increase in enzyme levels and 2 patients presented arrhythmias that were reversed within 72 h. Four patients died during follow-up, between 6 and 12 weeks after therapy. Clinical evaluation showed improvement in most patients as reflected by statistically significant decreases in Minnesota Quality of Life Questionnaire (63 ± 17.9 baseline vs 28.8 ± 16.75 at 6 months) and in class III-IV NYHA patients (18/24 baseline vs 2/20 at 6 months). Cardiopulmonary exercise tests demonstrated increased peak oxygen consumption (12.2 ± 2.4 at baseline vs 15.8 ± 7.1 mL·kg-1·min-1 at 6 months) and walked distance (377.2 ± 85.4 vs 444.1 ± 77.9 m at 6 months) in the 6-min walk test, which was not accompanied by increased left ventricular ejection fraction. Our findings indicate that BMMC therapy in IDC patients with severe ventricular dysfunction is feasible and that larger, randomized and placebo-controlled trials are warranted.

Retention and penetration of a conventional resin-based sealant and a photochromatic flowable composite resin placed on occlusal pits and fissures.

This study compares the retention and penetration of a conventional resin-based sealant (Fluroshield) and a photochromatic flowable composite resin (Tetric Flow Chroma) placed on occlusal pits and fissures and submitted to thermal or chemical cycling regimens. Penetration assessment--ten premolars were sealed with each material, isolated (except for the sealed surface) and immersed in 0.2% Rhodamine B. The teeth were serially sectioned in a mesiodistal direction. The images of the sections were digitized and analyzed (ImageLab). The distance between the most superficial and the deepest points on the occlusal central groove was calculated to determine the groove's total depth. The length of the central groove filled with the sealant was divided by its total depth to obtain the percentage of sealing of the occlusal groove. Retention assessment--30 premolars were sealed, their occlusal surfaces were photographed and the area occupied by the sealing materials was demarcated (ImageLab). The teeth were submitted to different treatments: thermocycled, stored in artificial saliva and immersed in acetic acid and saliva (10 cycles/day protocol for 30 days). New photographs were taken to assess the final area occupied by the materials. The difference between the final and initial area was calculated to obtain the material loss. The data was analyzed (two-way ANOVA and Tukey's test P<0.05). Both materials presented similar penetration of the occlusal central groove. After thermal and chemical cycling, the materials did not differ with respect to retention, except for immersion in acetic acid. In this case, Tetric Flow Chroma presented greater retention than Fluoroshield.