Adipose-derived mesenchymal stem cells (AdMSC) for the treatment of secondary-progressive multiple sclerosis: A triple blinded, placebo controlled, randomized phase I/II safety and feasibility study.

BACKGROUND: Currently available treatments for secondary progressive multiple sclerosis(SPMS) have limited efficacy and/or safety concerns. Adipose-mesenchymal derived stem cells(AdMSCs) represent a promising option and can be readily obtained using minimally invasive procedures. PATIENTS AND METHODS: In this triple-blind, placebo-controlled study, cell samples were obtained from consenting patients by lipectomy and subsequently expanded. Patients were randomized to a single infusion of placebo, low-dose(1x106cells/kg) or high-dose(4x106cells/kg) autologous AdMSC product and followed for 12 months. Safety was monitored recording adverse events, laboratory parameters, vital signs and spirometry. Expanded disability status score (EDSS), magnetic-resonance-imaging, and other measures of possible treatment effects were also recorded. RESULTS: Thirty-four patients underwent lipectomy for AdMSCs collection, were randomized and thirty were infused (11 placebo, 10 low-dose and 9 high-dose); 4 randomized patients were not infused because of karyotype abnormalities in the cell product. Only one serious adverse event was observed in the treatment arms (urinary infection, considered not related to study treatment). No other safety parameters showed changes. Measures of treatment effect showed an inconclusive trend of efficacy. CONCLUSION: Infusion of autologous AdMSCs is safe and feasible in patients with SPMS. Larger studies and probably treatment at earlier phases would be needed to investigate the potential therapeutic benefit of this technique.

Representación social de la consulta estomatológica en jóvenes de un área de salud de Santiago de Cuba / Social representation of the stomatological services in young people from a health area in Santiago de Cuba

Se efectuó un estudio descriptivo de 80 jóvenes en las edades de 19 a 25 años, pertenecientes al Consultorio Médico de la Familia No. 11 del área de salud del Policlínico Docente "Ramón López Peña" de Santiago de Cuba, desde febrero hasta mayo del 2015, para lo cual se empleó una metodología mixta, con una estrategia de triangulación de datos en un sentido cuanticualitativo, a fin de determinar las representaciones sociales de estos jóvenes sobre la consulta estomatológica, luego de aplicar un cuestionario y una entrevista elaborados a tal efecto. Los principales resultados indicaron que la representación social de la consulta estomatológica en dicho grupo poblacional, estaba conformada por un núcleo figurativo que comprendió el reconocimiento de la importancia y necesidad del mencionado servicio, mayormente influenciado por los familiares de los encuestados, así como la existencia de estados emocionales como la tensión y el miedo. El campo representacional estuvo asociado a las molestias ocasionadas por los procedimientos estomatológicos, a la presencia de caries dental como motivo principal de visita a la consulta y a la demanda de asistencia en el Cuerpo de Guardia de Estomatología.

A descriptive study of 80 young people from 19 to 25 years, belonging to the doctor´s office Number 11 from "Ramón López Peña" Teaching Polyclinic health area in Santiago de Cuba was carried out from February to May, 2015, for which a mixed methodology was used, with a triangulation strategy of data in a quantitative-qualitative sense, in order to determine the social representations of these young people on the stomatological services, after applying a questionnaire and an interview elaborated for this aim. The main results indicated that the social representation of the stomatological services in this population group, was conformed by a figurative nucleus including the recognition of the importance and necessity of the aforementioned service, mostly influenced by the relatives of those interviewed, as well as the existence of emotional states as the tension and fear. The representative field was associated with the discomfort caused by the stomatological procedures, to the presence of tooth decay as main reason for visiting the department and to the demand of care in the Stomatology emergency room.