Pilot safety study of intrabronchial instillation of bone marrow-derived mononuclear cells in patients with silicosis.

BACKGROUND: Silicosis is an occupational disease for which no effective treatment is currently known. Systemic administration of bone marrow-derived mononuclear cells (BMDMCs) has shown to be safe in lung diseases. However, so far, no studies have analyzed whether bronchoscopic instillation of autologous BMDMCs is a safe route of administration in patients with silicosis. METHODS: We conducted a prospective, non-randomized, single-center longitudinal study in five patients. Inclusion criteria were age 18-50 years, chronic and accelerated silicosis, forced expiratory volume in 1 s <60 % and >40 %, forced vital capacity ≥60 % and arterial oxygen saturation >90 %. The exclusion criteria were smoking, active tuberculosis, neoplasms, autoimmune disorders, heart, liver or renal diseases, or inability to undergo bronchoscopy. BMDMCs were administered through bronchoscopy (2 × 10(7) cells) into both lungs. Physical examination, laboratory evaluations, quality of life questionnaires, computed tomography of the chest, lung function tests, and perfusion scans were performed before the start of treatment and up to 360 days after BMDMC therapy. Additionally, whole-body and planar scans were evaluated 2 and 24 h after instillation. RESULTS: No adverse events were observed during and after BMDMC administration. Lung function, quality of life and radiologic features remained stable throughout follow-up. Furthermore, an early increase of perfusion in the base of both lungs was observed and sustained after BMDMC administration. CONCLUSION: Administration of BMDMCs through bronchoscopy appears to be feasible and safe in accelerated and chronic silicosis. This pilot study provides a basis for prospective randomized trials to assess the efficacy of this treatment approach. CLINICAL TRIALS. GOV IDENTIFIER: NCT01239862 Date of Registration: November 10, 2010.

Effects of Feeding Level and Breed Composition on Intake, Digestibility, and Methane Emissions of Dairy Heifers.

The dairy Nutrients Requirements of Cattle (NRC) was developed using data from purebred Holsteins and it might not accurately predict the performance of crossbred cattle. Our objectives were to evaluate the effects of two feeding levels (FLs) and three breed compositions (BCs) on nutrient intake, digestibility, performance, and methane (CH4) emissions of prepubertal dairy heifers. We used thirty-six heifers from three BCs: purebred Holstein (H), purebred Gyr (G), and F1 Holstein × Gyr (HG). Each BC had 12 animals and the experiment was designed as twelve incomplete three by three Latin squares, in a factorial arrangement three by two, with three BCs and two FLs (400 and 800 g/day). Total tract nutrient digestibility was determined using total fecal collection and DMI was individually measured. The data were analyzed using the PROC MIXED in SAS. Dry matter intake of all nutrients increased from the medium to high feeding level and the nutrients digestibility coefficients did differ among BCs. Achieved body weight gain in the medium FL treatment was greater than those predicted using the NRC, suggesting that crossbred and Gyr heifers have similar performance to Holsteins. Breed composition does not influence body weight gain of confined dairy heifers, but Holstein heifers fed a medium FL had higher feed efficiency and reduced CH4 emissions intensity.

Em busca de um paradigma de programaçäo local em saúde bucal mais resolutivo no SUS / In search of more efficient paradigm of planning oral health services within the Unified Health System

Discute a história dos modelos assistenciais e de programaçäo nos serviços públicos de saúde bucal, e aponta propostas que em novos moldes, visem o aumento da resolutividade. Faz um resgate histórico apontando para a necessidade de uma nova postura programática articulada politico-gerencialmente no nível local, que provoque mudanças no esgotado paradigma de programaçäo sanitário-bucal instituido a mais de quarenta anos, fortalecendo as possibilidades de desenvolvimento do paradigma assistencial vigente nas experiências mais avançadas