au:Castro-Faria-Neto, Hugo C
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1. Práticas de ressuscitação volêmica em unidades de terapia intensiva brasileiras: uma análise secundária do estudo Fluid-TRIPS
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 .
Revista Brasileira de Terapia Intensiva apr 2021, Volume 33 N. 2 Pages 206 - 218
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.
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.
2. IL-6 and IL-8 in cerebrospinal fluid from patients with aseptic meningitis and bacterial meningitis: their potential role as a marker for differential diagnosis
Pinto Junior, Vitor Laerte Laerte ; Rebelo, Maria Cristina ; Gomes, Rachel Novaes ; Assis, Edson Fernandes de ; Castro-Faria-Neto, Hugo C ; Bóia, Marcio Neves .
Brazilian Journal of Infectious Diseases apr 2011, Volume 15 N. 2 Pages 156 - 158
Cytokines are molecules that act as mediators of immune response; cerebral spinal fluid (CSF) IL-6 is found in all meningeal inflammatory diseases, but IL-8 is associated with acute bacterial meningitis (ABM). A case control study was done to ascertain the discriminatory power of these cytokines in differentiating ABM from aseptic meningitis (AM); IL-6 and IL-8 CSF concentrations were tested through ELISA in samples collected from patients who underwent investigation for meningitis. Sixty patients, 18 with AM, nine with bacteriologic confirmed ABM and 33 controls, assisted in 2005 (MA and controls) and 2007 (ABM) were included. Differently from controls, IL-6 concentrations were increased both in MA and ABM patients (p < 0.05). CSF IL-8 levels were higher in ABM than in AM and controls (p < 0.05). Discriminatory power in ABM as assessed by the area under receiver operator (ROC) curve was 0.951 for IL-8, using a cut-off of 1.685 ng/dL (100% of sensitivity and 94% of specificity). The CSF concentration of both IL-6 and IL-8 are increased in the presence of meningeal inflammation, IL-8 could be an important tool to differentiate ABM from AM.
3. Revisiting steroid treatment for septic shock: molecular actions and clinical effects - a review
Japiassú, André M ; Salluh, Jorge IF ; Bozza, Patrícia T ; Bozza, Fernando A ; Castro-Faria-Neto, Hugo C .
Memórias do Instituto Oswaldo Cruz jul 2009, Volume 104 N. 4 Pages 531 - 548
Corticosteroids are widely used to treat a diversity of pathological conditions including allergic, autoimmune and some infectious diseases. These drugs have complex mechanisms of action involving both genomic and non-genomic mechanisms and interfere with different signal transduction pathways in the cell. The use of corticosteroids to treat critically ill patients with acute respiratory distress syndrome and severe infections, such as sepsis and pneumonia, is still a matter of intense debate in the scientific and medical community with evidence both for and against its use in these patients. Here, we review the basic molecular mechanisms important for corticosteroid action as well as current evidence for their use, or not, in septic patients. We also present an analysis of the reasons why this is still such a controversial point in the literature.
4. Analgesic and anti-inflammatory activity of the aqueous extract of Rheedia longifolia Planch & Triana
Frutuoso, Valber da Silva ; Monteiro, Márcia Magalhães ; Amendoeira, Fábio Coelho ; Almeida, Andressa Luiza Figueiredo ; Nascimento, Diogo Dibo do ; Bérenger, Ana Luiza Rangel ; Kaplan, Maria Auxiliadora Coelho ; Figueiredo, Maria Raquel ; Bozza, Patrícia T ; Castro-Faria-Neto, Hugo C .
Memórias do Instituto Oswaldo Cruz feb 2007, Volume 102 N. 1 Pages 91 - 96
Rheedia longifolia Planch et Triana belongs to the Clusiaceae family. This plant is widely distributed in Brazil, but its chemical and pharmacological properties have not yet been studied. We report here that leaves aqueous extract of R. longifolia (LAE) shows analgesic and anti-inflammatory effects. Oral or intraperitoneal administration of this extract dose-dependently inhibited the abdominal constrictions induced by acetic acid in mice. The analgesic effect and the duration of action were similar to those observed with sodium diclofenac, a classical non-steroidal analgesic. In addition to the effect seen in the abdominal constriction model, LAE was also able to inhibit the hyperalgesia induced by lipopolysaccharide from gram-negative bacteria (LPS) in rats. We also found that R. longifolia LAE inhibited an inflammatory reaction induced by LPS in the pleural cavity of mice. Acute toxicity was evaluated in mice treated with the extract for seven days with 50 mg/kg/day. Neither death, nor alterations in weight, blood leukocyte counts or hematocrit were noted. Our results suggest that aqueous extract from R. longifolia leaves has analgesic and anti-inflammatory activity with minimal toxicity and are therefore endowed with a potential for pharmacological control of pain and inflammation.
5. Regulating inflammation through the anti-inflammatory enzyme platelet-activating factor-acetylhydrolase
Memórias do Instituto Oswaldo Cruz mar 2005, Volume 100 Suppl. 1 Pages 83 - 91
Platelet-activating factor (PAF) is one of the most potent lipid mediators involved in inflammatory events. The acetyl group at the sn-2 position of its glycerol backbone is essential for its biological activity. Deacetylation induces the formation of the inactive metabolite lyso-PAF. This deacetylation reaction is catalyzed by PAF-acetylhydrolase (PAF-AH), a calcium independent phospholipase A2 that also degrades a family of PAF-like oxidized phospholipids with short sn-2 residues. Biochemical and enzymological evaluations revealed that at least three types of PAF-AH exist in mammals, namely the intracellular types I and II and a plasma type. Many observations indicate that plasma PAF AH terminates signals by PAF and oxidized PAF-like lipids and thereby regulates inflammatory responses. In this review, we will focus on the potential of PAF-AH as a modulator of diseases of dysregulated inflammation.
6. Beyond sepsis pathophysiology with cytokines: what is their value as biomarkers for disease severity?
Memórias do Instituto Oswaldo Cruz mar 2005, Volume 100 Suppl. 1 Pages 217 - 221
Sepsis is a major challenge in medicine. It is a common and frequently fatal infectious condition. The incidence continues to increase, with unacceptably high mortality rates, despite the use of specific antibiotics, aggressive operative intervention, nutritional support, and anti-inflammatory therapies. Typically, septic patients exhibit a high degree of heterogeneity due to variables such as age, weight, gender, the presence of secondary disease, the state of the immune system, and the severity of the infection. We are at urgent need for biomarkers and reliable measurements that can be applied to risk stratification of septic patients and that would easily identify those patients at the highest risk of a poor outcome. Such markers would be of fundamental importance to decision making for early intervention therapy or for the design of septic clinical trials. In the present work, we will review current biomarkers for sepsis severity and especially the use of cytokines as biomarkers with important pathophysiological role.
7. A role for lymphocytes and cytokines on the eosinophil migration induced by LPS
Castro-Faria-Neto, Hugo C ; Penido, Carmen M ; Larangeira, Andréa P ; Silva, Adriana R ; Bozza, Patrícia T .
Memórias do Instituto Oswaldo Cruz dec 1997, Volume 92 Suppl. 2 Pages 197 - 200
In the present work we review the existing evidence for a LPS-induced cytokine-mediated eosinophil accumulation in a model of acute inflammation. Intrathoracic administration of LPS into rodents (mice, rats or guinea pigs) induces a significant increase in the number of eosinophils recovered from the pleural fluid 24 hr later. This phenomenon is preceded by a neutrophil influx and accompanied by lymphocyte and monocyte accumulation. The eosinophil accumulation induced by LPS is not affected by inhibitors of cyclo or lipoxygenase nor by PAF antagonists but can be blocked by dexamethasone or the protein synthesis inhibitor cycloheximide. Transfer of cell-free pleural wash from LPS injected rats (LPS-PW) to naive recipient animals induces a selective eosinophil accumulation within 24 hr. The eosinophilotactic activity present on the LPS-PW has a molecular weight ranging between 10 and 50 kDa and its effect is abolished by trypsin digestion of the pleural wash indicating the proteic nature of this activity. The production of the eosinophilotactic activity depends on the interaction between macrophages and T-lymphocytes and its effect can not be blocked by anti-IL-5 monoclonal antibodies. Accumulated evidence suggest that the eosinophil accumulation induced by LPS is a consequence of a eosinophilotactic cytokine produced through macrophage and T-cell interactions in the site of a LPS-induced inflammatory reaction.
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