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Práticas de ressuscitação volêmica em unidades de terapia intensiva brasileiras: uma análise secundária do estudo Fluid-TRIPS
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Freitas, Flavio Geraldo Rezende de
; Hammond, Naomi
; Li, Yang
; Azevedo, Luciano Cesar Pontes de
; Cavalcanti, Alexandre Biasi
; Taniguchi, Leandro
; Gobatto, André
; Japiassú, André Miguel
; Bafi, Antonio Tonete
; Mazza, Bruno Franco
; Noritomi, Danilo Teixeira
; Dal-Pizzol, Felipe
; Bozza, Fernando
; Salluh, Jorge Ibrahin Figueira
; Westphal, Glauco Adrieno
; Soares, Márcio
; Assunção, Murillo Santucci César de
; Lisboa, Thiago
; Lobo, Suzana Margarete Ajeje
; Barbosa, Achilles Rohlfs
; Ventura, Adriana Fonseca
; Souza, Ailson Faria de
; Silva, Alexandre Francisco
; Toledo, Alexandre
; Reis, Aline
; Cembranel, Allan
; Rea Neto, Alvaro
; Gut, Ana Lúcia
; Justo, Ana Patricia Pierre
; Santos, Ana Paula
; Albuquerque, André Campos D. de
; Scazufka, André
; Rodrigues, Antonio Babo
; Fernandino, Bruno Bonaccorsi
; Silva, Bruno Goncalves
; Vidal, Bruno Sarno
; Pinheiro, Bruno Valle
; Pinto, Bruno Vilela Costa
; Feijo, Carlos Augusto Ramos
; Abreu Filho, Carlos de
; Bosso, Carlos Eduardo da Costa Nunes
; Moreira, Carlos Eduardo Nassif
; Ramos, Carlos Henrique Ferreira
; Tavares, Carmen
; Arantes, Cidamaiá
; Grion, Cintia
; Mendes, Ciro Leite
; Kmohan, Claudio
; Piras, Claudio
; Castro, Cristine Pilati Pileggi
; Lins, Cyntia
; Beraldo, Daniel
; Fontes, Daniel
; Boni, Daniela
; Castiglioni, Débora
; Paisani, Denise de Moraes
; Pedroso, Durval Ferreira Fonseca
; Mattos, Ederson Roberto
; Brito Sobrinho, Edgar de
; Troncoso, Edgar M. V.
; Rodrigues Filho, Edison Moraes
; Nogueira, Eduardo Enrico Ferrari
; Ferreira, Eduardo Leme
; Pacheco, Eduardo Souza
; Jodar, Euzebio
; Ferreira, Evandro L. A.
; Araujo, Fabiana Fernandes de
; Trevisol, Fabiana Schuelter
; Amorim, Fábio Ferreira
; Giannini, Fabio Poianas
; Santos, Fabrício Primitivo Matos
; Buarque, Fátima
; Lima, Felipe Gallego
; Costa, Fernando Antonio Alvares da
; Sad, Fernando Cesar dos Anjos
; Aranha, Fernando G.
; Ganem, Fernando
; Callil, Flavio
; Costa Filho, Francisco Flávio
; Dall´Arto, Frederico Toledo Campo
; Moreno, Geovani
; Friedman, Gilberto
; Moralez, Giulliana Martines
; Silva, Guilherme Abdalla da
; Costa, Guilherme
; Cavalcanti, Guilherme Silva
; Cavalcanti, Guilherme Silva
; Betônico, Gustavo Navarro
; Betônico, Gustavo Navarro
; Reis, Hélder
; Araujo, Helia Beatriz N.
; Hortiz Júnior, Helio Anjos
; Guimaraes, Helio Penna
; Urbano, Hugo
; Maia, Israel
; Santiago Filho, Ivan Lopes
; Farhat Júnior, Jamil
; Alvarez, Janu Rangel
; Passos, Joel Tavares
; Paranhos, Jorge Eduardo da Rocha
; Marques, José Aurelio
; Moreira Filho, José Gonçalves
; Andrade, Jose Neto
; Sobrinho, José Onofre de C
; Bezerra, Jose Terceiro de Paiva
; Alves, Juliana Apolônio
; Ferreira, Juliana
; Gomes, Jussara
; Sato, Karina Midori
; Gerent, Karine
; Teixeira, Kathia Margarida Costa
; Conde, Katia Aparecida Pessoa
; Martins, Laércia Ferreira
; Figueirêdo, Lanese
; Rezegue, Leila
; Tcherniacovsk, Leonardo
; Ferraz, Leone Oliveira
; Cavalcante, Liane
; Rabelo, Ligia
; Miilher, Lilian
; Garcia, Lisiane
; Tannous, Luana
; Hajjar, Ludhmila Abrahão
; Paciência, Luís Eduardo Miranda
; Cruz Neto, Luiz Monteiro da
; Bley, Macia Valeria
; Sousa, Marcelo Ferreira
; Puga, Marcelo Lourencini
; Romano, Marcelo Luz Pereira
; Nobrega, Marciano
; Arbex, Marcio
; Rodrigues, Márcio Leite
; Guerreiro, Márcio Osório
; Rocha, Marcone
; Alves, Maria Angela Pangoni
; Alves, Maria Angela Pangoni
; Rosa, Maria Doroti
; Dias, Mariza D’Agostino
; Martins, Miquéias
; Oliveira, Mirella de
; Moretti, Miriane Melo Silveira
; Matsui, Mirna
; Messender, Octavio
; Santarém, Orlando Luís de Andrade
; Silveira, Patricio Júnior Henrique da
; Vassallo, Paula Frizera
; Antoniazzi, Paulo
; Gottardo, Paulo César
; Correia, Paulo
; Ferreira, Paulo
; Torres, Paulo
; Silva, Pedro Gabrile M. de Barros e
; Foernges, Rafael
; Gomes, Rafael
; Moraes, Rafael
; Nonato filho, Raimundo
; Borba, Renato Luis
; Gomes, Renato V
; Cordioli, Ricardo
; Lima, Ricardo
; López, Ricardo Pérez
; Gargioni, Ricardo Rath de Oliveira
; Rosenblat, Richard
; Souza, Roberta Machado de
; Almeida, Roberto
; Narciso, Roberto Camargo
; Marco, Roberto
; waltrick, Roberto
; Biondi, Rodrigo
; Figueiredo, Rodrigo
; Dutra, Rodrigo Santana
; Batista, Roseane
; Felipe, Rouge
; Franco, Rubens Sergio da Silva
; Houly, Sandra
; Faria, Sara Socorro
; Pinto, Sergio Felix
; Luzzi, Sergio
; Sant’ana, Sergio
; Fernandes, Sergio Sonego
; Yamada, Sérgio
; Zajac, Sérgio
; Vaz, Sidiner Mesquita
; Bezerra, Silvia Aparecida Bezerra
; Farhat, Tatiana Bueno Tardivo
; Santos, Thiago Martins
; Smith, Tiago
; Silva, Ulysses V. A.
; Damasceno, Valnei Bento
; Nobre, Vandack
; Dantas, Vicente Cés de Souza
; Irineu, Vivian Menezes
; Bogado, Viviane
; Nedel, Wagner
; Campos Filho, Walther
; Dantas, Weidson
; Viana, William
; Oliveira Filho, Wilson de
; Delgadinho, Wilson Martins
; Finfer, Simon
; Machado, Flavia Ribeiro
.
RESUMO Objetivo: Descrever as práticas de ressuscitação volêmica em unidades de terapia intensiva brasileiras e compará-las com as de outros países participantes do estudo Fluid-TRIPS. Métodos: Este foi um estudo observacional transversal, prospectivo e internacional, de uma amostra de conveniência de unidades de terapia intensiva de 27 países (inclusive o Brasil), com utilização da base de dados Fluid-TRIPS compilada em 2014. Descrevemos os padrões de ressuscitação volêmica utilizados no Brasil em comparação com os de outros países e identificamos os fatores associados com a escolha dos fluidos. Resultados: No dia do estudo, foram incluídos 3.214 pacientes do Brasil e 3.493 pacientes de outros países, dos quais, respectivamente, 16,1% e 26,8% (p < 0,001) receberam fluidos. A principal indicação para ressuscitação volêmica foi comprometimento da perfusão e/ou baixo débito cardíaco (Brasil 71,7% versus outros países 56,4%; p < 0,001). No Brasil, a percentagem de pacientes que receberam soluções cristaloides foi mais elevada (97,7% versus 76,8%; p < 0,001), e solução de cloreto de sódio a 0,9% foi o cristaloide mais comumente utilizado (62,5% versus 27,1%; p < 0,001). A análise multivariada sugeriu que os níveis de albumina se associaram com o uso tanto de cristaloides quanto de coloides, enquanto o tipo de prescritor dos fluidos se associou apenas com o uso de cristaloides. Conclusão: Nossos resultados sugerem que cristaloides são usados mais frequentemente do que coloides para ressuscitação no Brasil, e essa discrepância, em termos de frequências, é mais elevada do que em outros países. A solução de cloreto de sódio 0,9% foi o cristaloide mais frequentemente prescrito. Os níveis de albumina sérica e o tipo de prescritor de fluidos foram os fatores associados com a escolha de cristaloides ou coloides para a prescrição de fluidos.
Abstract Objective: To describe fluid resuscitation practices in Brazilian intensive care units and to compare them with those of other countries participating in the Fluid-TRIPS. Methods: This was a prospective, international, cross-sectional, observational study in a convenience sample of intensive care units in 27 countries (including Brazil) using the Fluid-TRIPS database compiled in 2014. We described the patterns of fluid resuscitation use in Brazil compared with those in other countries and identified the factors associated with fluid choice. Results: On the study day, 3,214 patients in Brazil and 3,493 patients in other countries were included, of whom 16.1% and 26.8% (p < 0.001) received fluids, respectively. The main indication for fluid resuscitation was impaired perfusion and/or low cardiac output (Brazil: 71.7% versus other countries: 56.4%, p < 0.001). In Brazil, the percentage of patients receiving crystalloid solutions was higher (97.7% versus 76.8%, p < 0.001), and 0.9% sodium chloride was the most commonly used crystalloid (62.5% versus 27.1%, p < 0.001). The multivariable analysis suggested that the albumin levels were associated with the use of both crystalloids and colloids, whereas the type of fluid prescriber was associated with crystalloid use only. Conclusion: Our results suggest that crystalloids are more frequently used than colloids for fluid resuscitation in Brazil, and this discrepancy in frequencies is higher than that in other countries. Sodium chloride (0.9%) was the crystalloid most commonly prescribed. Serum albumin levels and the type of fluid prescriber were the factors associated with the choice of crystalloids or colloids for fluid resuscitation.
https://doi.org/10.5935/0103-507x.20210028
273 downloads
2.
COVID-19 diagnosis by RT-qPCR in alternative specimens
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Gonçalves, Cássia Cristina Alves
; Barroso, Shana Priscila Coutinho
; Herlinger, Alice Laschuk
; Galliez, Rafael de Mello
; de Almeida, Tailah Bernardo
; Boullosa, Lidia Theodoro
; Nascimento, Erica Ramos dos Santos
; de Almeida, Jessica M
; da Costa, Raissa Mirella dos Santos Cunha
; da Paixão, Tatiana Monteiro
; Couceiro, José Nelson dos Santos Silva
; Frauches, Thiago Silva
; de Souza Jr, Wilson Rodrigues
; Costa, Andréa Ribeiro
; Faffe, Débora Souza
; Leitão, Isabela de Carvalho
; da Silva, Bianca Ortiz
; de Lira, Guilherme Sant’Anna
; de Almeida, Isabela Labarba Carvalho
; Ferreira Jr, Orlando da Costa
; Castiñeiras, Terezinha Marta Pereira Pinto
; Mariani, Diana
; Tanuri, Amilcar
.
BACKGROUND The high demand for adequate material for the gold standard reverse transcription real-time polymerase chain reaction (RT-qPCR)-based diagnosis imposed by the Coronavirus disease 2019 (COVID-19) pandemic, combined with the inherent contamination risks for healthcare workers during nasopharyngeal swab (NP) sample collection and the discomfort it causes patients, brought the need to identify alternative specimens suitable for the diagnosis of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). OBJECTIVES The aim of this work was to compare saliva and gingival fluid swabs to NP swabs as specimens for RT-qPCR-based SARS-CoV-2 diagnosis. METHODS We compared gingival fluid swabs (n = 158) and saliva (n = 207) to the rayon-tipped NP swabs obtained from mild-symptomatic and asymptomatic subjects as specimens for RT-qPCR for SARS-CoV-2 detection. FINDINGS When compared to NP swabs, gingival fluid swabs had a concordance rate of 15.4% among positive samples, zero among inconclusive, and 100% among negative ones. For saliva samples, the concordance rate was 67.6% among positive samples, 42.9% among inconclusive, and 96.8% among negative ones. However, the concordance rate between saliva and NP swabs was higher (96.9%) within samples with lower cycle threshold (Ct) values (Ct > 10 ≤ 25). MAIN CONCLUSIONS Our data suggests that whereas gingival fluid swabs are not substitutes for NP swabs, saliva might be considered whenever NP swabs are not available or recommended.
https://doi.org/10.1590/0074-02760210085
205 downloads
3.
Metabolic effects of β-glucans (Saccharomyces cerevisae) per os administration in rats with streptozotocin-induced diabetes
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Vieira Lobato, Raquel
; Silva, Viviam de Oliveira
; Francelino Andrade, Eric
; Ribeiro Orlando, Débora
; Zangerônimo, Márcio Gilberto
; Souza, Raimundo Vicente de
; Pereira, Luciano José
.
Introduction: beta-glucans (BG) derived from plant tissues are reported to show metabolic effects. In contrast, those fibers isolated from yeast seem to be more related to immune response modulation. Since diabetic individuals are more susceptible to exacerbation of inflammatory signs, the ingestion of fibers that could conjugate both metabolic and immune effects would be of great importance. Objective: we investigated the effect of BG - Saccharomyses cerevisae - ingestion on glycemic and lipoprotein profile of diabetic rats. Design: twenty-four adult Wistar rats were used, distributed into 4 groups in a design of entirely casualized delineation with a 2 x 2 factorial model (with and without diabetes; with and without BG). Diabetes Mellitus was induced by an intraperitoneal injection of 80mg/kg of strepzotocin. Thus, animals with fasting glycemia of over 250 mg/dl were considered diabetic. Forty-eight hours after induction, the rats received daily doses of 30 mg/kg of BG or saline solution by gavage during 28 days. Results and discussion: the Groups with DM presented a higher glycemic index and lower C peptide levels than the control groups, in addition to lower weight gain and higher ration consumption, water ingestion and urinary volume. Total cholesterol levels (CT), LDL-C + VLDL-C, plasma triacylglycerides (TAG) and alanine aminotransferase (ALT) were also higher in the diabetic animals (p < 0.05), and there were no alterations in the HDL-C levels. The ingestion of BG reduced blood glucose concentrations (30%), TAG (32%) and ALT (41%) (p < 0.05). No histopathological hepatic alterations were observed in any of the groups. Furthermore, the diabetic animals present increase in villous:crypt ratio (V:C) in the duodenum, without interference of BG. No alterations in the carcass were observed between the groups. Conclusion: it was concluded that the use of BG significantly reduced the glycemic, TAG and ALT levels, showing its therapeutic potential.
Introducción: los beta-glucanos (BG) derivados de tejidos vegetales se ha informado que muestran efectos metabólicos. Por el contrario, esas fibras aisladas de levadura parecen estar más relacionadas con la modulación de la respuesta inmune. Dado que los individuos con diabetes son más susceptibles a la exacerbación de los signos inflamatorios, la ingestión de fibras sí podría conjugar ambos efectos metabólicos e inmunológicos, lo cual sería de gran importancia. Objetivo: el objetivo de este estudio fue investigar los efectos de la ingestión de los BG -Saccharomyses cerevisiae- en el perfil glucémico y la lipoproteína de ratas diabéticas. Metodos: en el diseño de delineación, totalmente precario, fueron utilizadas 24 ratas Wistar macho adultas distribuidas en cuatro grupos, con un modelo factorial 2 x 2 (con y sin diabetes, con y sin BG). La diabetes mellitus fue inducida por la inyección intraperitoneal de un 80 mg/kg de estrepzotocina. Por lo tanto, los animales con glucemia en ayunas de más de 250 mg/dl fueron considerados diabéticos. Cuarenta y ocho horas después de la inducción, las ratas recibieron dosis diarias de 30 mg/kg de BG o solución salina mediante alimentación forzada durante 28 días. Resultados y discusión: los grupos con DM presentó el mayor índice glucémico y menores niveles de péptido C que los grupos de control, además de reducir el aumento de peso y un mayor consumo de la ración, la ingestión de agua y el volumen urinario. Los niveles de colesterol total (CT), LDL-C + VLDL-C, triacilglicéridos plasmáticos (TAG) y alanina aminotransferasa (ALT) también fueron más altos en los animales diabéticos (p < 0,05), y había alteraciones en los niveles de HDL-C. La ingestión de BG redujo las concentraciones de glucosa en sangre (30%), TAG (32%) y ALT (41%) (p < 0.05). No se observaron alteraciones hepáticas en ninguno de los grupos. Además, los animales diabéticos presentaron un aumento de la relación cripta:vellosidades (V:C) en el duodeno, sin interferencia de BG. No se observaron alteraciones en la carcasa entre los grupos. Discusión: se concluyó que el uso de BG redujo significativamente la glucemia, los niveles de TAG Y ALT, mostrando su potencial terapéutico.
https://doi.org/10.3305/nh.2015.32.1.9013
265 downloads
4.
Caracterização morfológica e imuno-histoquímica de lesões em casos de aborto bovino bacteriano e viral no sul de Minas Gerais
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Orlando, Débora Ribeiro
; Costa, Rafael Carneiro
; Abreu, Rafael Vitor S.
; Abreu, Camila Costa
; Nakagaki, Karen Yumi Ribeiro
; Wouters, Angelica T. Barth
; Raymundo, Djeison Lutier
; Varaschin, Mary Suzan
.
O presente estudo avaliou a participação de agentes bacterianos e virais em abortos em bovinos de propriedades rurais do sul de Minas Gerais. Foi realizada análise histopatológica e imuno-histoquímica dos casos de aborto recebidos pelo Setor de Patologia Veterinária da Universidade Federal de Lavras no período de 1999 a 2013. De 60 fetos analisados, em 30 (50%) foram observadas lesões microscópicas. Destes, oito apresentavam lesões compatíveis com infecção por agentes bacterianos e três apresentaram lesões sugestivas de agentes virais. Dos abortos bacterianos, um feto tinha lesões compatíveis com leptospirose, caracterizadas por icterícia e colestase, nefrite intersticial linfoplasmocítica e nefrose tubular. Sete fetos apresentaram pneumonia ou broncopneumonia purulenta; num deles havia também pleurite e peritonite fibrinosas; e em dois desses fetos houve imunomarcação para Brucella abortus. Dos três fetos com lesões sugestivas de aborto viral ocorreu imunomarcação anti-Herpesvírus bovino em um. Os resultados demonstram a ocorrência de abortos de origem bacteriana e viral na Região do estudo e que medidas profiláticas devem ser adotadas nas propriedades. O trabalho demonstra também que a imuno-histoquímica (IHQ); associada à histopatologia; é uma ferramenta útil e viável para o diagnóstico, especialmente quando provas microbiológicas e/ou sorológicas não estão disponíveis.
The paper evaluates the participation of bacterial and viral agents in bovine abortions in farms of southern Minas Gerais state, Brazil. Histopathological and immunohistochemical analysis was performed in aborted fetuses of cattle received by the Setor de Patologia Veterinária, Universidade Federal de Lavras, from 1999 to 2013. From 60 fetuses studied, 30 (50%) had microscopic lesions. From these, eight had lesions consistent with bacterial agents and three had lesions suggestive of viral agents. In the bacterial abortions, one fetus presented lesions compatible with leptospirosis, characterized by jaundice, cholestasis, lymphoplasmacytic intersticial nephritis, and tubular nephrosis. Seven fetuses had purulent pneumonia or bronchopneumonia and one of them had also fibrinous pleuritis and peritonitis; two of them presented positive immunostaining for Brucella abortus. One of the three fetuses with lesions of viral infection revealed positive imunostaining for bovine herpesvirus. The results showed that abortions of bacterial and viral origin occur in the Region of this study and prophylactic measures should be adopted on the farms. This study also demonstrates that immunohistochemistry associated with histopathology is a useful and viable tool for the diagnosis, especially when microbiological and/or serological tests are not available.
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Cited 1 time in SciELO
5.
Occurrences of Eimeria spp. and gastrointestinal nematodes in dairy calves in southern Minas Gerais, Brazil
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Bruhn, Fábio Raphael Pascoti
; Silva Júnior, Fidelis Antônio
; Carvalho, André Henrique de Oliveira
; Orlando, Débora Ribeiro
; Rocha, Christiane Maria Barcellos Magalhães da
; Guimarães, Antônio Marcos
.
Revista Brasileira de Parasitologia Veterinária
- Journal Metrics
O objetivo deste estudo foi determinar a frequência e os fatores associados à infecção por Eimeria spp. e nematódeos gastrintestinais, em 356 bezerras provenientes de 20 rebanhos leiteiros, localizados no sul de Minas Gerais, Brasil. Foram identificadas dez espécies de Eimeria spp., sendo E. bovis (37,6%) e E. zuernii (17,9%) as mais frequentes. Nas coproculturas, foram recuperados quatro gêneros de nematódeos gastrintestinais, sendo os mais frequentes Cooperia spp. (74,6%) e Haemonchus spp. (19,4%).Variáveis relacionadas a um maior nível de tecnificação das propriedades leiteiras apresentaram associação significativa (p < 0,05), com maiores contagens de OoPG e OPG, e são discutidas neste estudo.
The aim of this cross-sectional observational study was to determine the frequency and factors associated with infection by Eimeria spp. and gastrointestinal nematodes in 356 calves on 20 dairy farms located in southern Minas Gerais, Brazil. Ten species of Eimeria spp. were identified, of which E. bovis (37.6%) and E. zuernii (17.9%) were the most frequent. From fecal cultures, four genera of gastrointestinal nematodes were recovered, of which Cooperia spp. (74.6%) and Haemonchus (19.4%) were the most frequent. Variables relating to higher levels of technology used on dairy farms showed a significant association (p < 0.05) with higher OPG and EPG counts, and are discussed in this study.
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