Pectoralis major muscle quantification by cardiac MRI is a strong predictor of major events in HF.

Clinical overt cardiac cachexia is a late ominous sign in patients with heart failure (HF) and reduced left ventricular ejection fraction (LVEF). The main goal of this study was to assess the feasibility and prognostic significance of muscle mass quantification by cardiac magnetic resonance (CMR) in HF with reduced LVEF. HF patients with LVEF < 40% (HFrEF) referred for CMR were retrospectively identified in a single center. Key exclusion criteria were primary muscle disease, known infiltrative myocardial disease and intracardiac devices. Pectoralis major muscles were measured on standard axial images at the level of the 3rd rib anteriorly. Time to all-cause death or HF hospitalization was the primary endpoint. A total of 298 HF patients were included (mean age 64 ± 12 years; 76% male; mean LVEF 30 ± 8%). During a median follow-up of 22 months (IQR: 12-33), 67 (22.5%) patients met the primary endpoint (33 died and 45 had at least 1 HF hospitalization). In multivariate analysis, LVEF [Hazard Ratio (HR): 0.950; 95% Confidence Interval (CI): 0.917-0.983; p = 0.003), NYHA class I-II vs III-IV (HR: 0.480; CI: 0.272-0.842; p = 0.010), creatinine (HR: 2.653; CI: 1.548-4.545; p < 0.001) and pectoralis major area (HR: 0.873; 95% CI: 0.821-0.929; p < 0.001) were independent predictors of the primary endpoint, when adjusted for gender and NT-pro-BNP levels. Pectoralis major size measured by CMR in HFrEF was independently associated with a higher risk of death or HF hospitalization. Further studies to establish appropriate age and gender-adjusted cut-offs of muscle areas are needed to identify high-risk subgroups.

Evaluation of the integrity of dental sealants by optical coherence tomography.

OBJECTIVES: The purpose of the present research was to demonstrate images of failures into the structure of pit and fissure sealants using optical coherence tomography (OCT). METHODS: Five human third molars were selected and the sealant ALPHA SEAL LIGHT/DFL was applied according to the manufacturer instructions. For evaluation of the structure of pit and fissure sealants, twenty OCT images of each tooth were performed before and after application of sealant. A total of 200 images were evaluated. A home built spectral OCT system used was operating in spectral domain (SD-OCT), at 840 nm and a measured spatial resolution of 10 µm. The system is based on the Michelson interferometer set-up and is controlled by the software OCT 800--Complex Square/LabView, that collects data and generates the image. The occlusal surfaces were scanned in a bucco-lingual direction and tomographic images parallel to long axis of tooth were obtained. After the achievement of the images by OCT, the crown of each tooth was sectioned in a occlusogingival direction (buccolingually). Images from each section were obtained and evaluated by an optical microscope. OCT and microscopic images were compared. RESULTS: Representative images showed that OCT image provides the insight into sealant material. It was possible to clearly identify the internal structure of sealant and the subjacent enamel. Sealant and enamel are very well distinguished, and failures at the interior and at surface are well detected. SIGNIFICANCE: OCT could generate images of the features of fissures, bubbles and failures in the adaptation of sealants, opening up possibilities in the future to monitoring sealant application and retention in short and long term.

Radiological evaluation of the morphological changes of root canals shaped with ProTaper for hand use and the ProTaper and RaCe rotary instruments.

This study evaluated, by means of the radiography examination, the occurrence of deviations in the apical third of root canals shaped with hand and rotary instruments. Sixty mandibular human molars were divided into three groups. The root canals in group 1 were instrumented with ProTaper (Dentsply/Maillefer, Ballaigues, Switzerland) for hand use, group 2 with ProTaper and group 3 with RaCe. The images obtained by double superimposition of the pre- and postoperative radiographs were evaluated by two endodontists with the aid of a magnifier-viewer and a fivefold magnifier. Statistical analysis was performed using the Fisher-Freeman-Halton. The instrumentation using the ProTaper for hand use showed 25% of the canals with a deviation in the apical third, as did the ProTaper, while the corresponding figure for the RaCe (FKG Dentaire, La-Chaux-de-Fonds, Switzerland) was 20%, but these results were not statistically significant. There was no correlation between the occurrence of deviations in the apical third and the systems used.