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5. A urine-based ELISA with recombinant non-glycosylated SARS-CoV-2 spike protein for detecting anti-SARS-CoV-2 spike antibodies

Author

Ramos, Fernanda F., Bagno, Flávia F., Vassallo, Paula F., Oliveira-da-Silva, João A., Reis, Thiago A. R., Bandeira, Raquel S., Machado, Amanda S., Lage, Daniela P., Martins, Vivian T., Fernandes, Ana P., Christodoulides, Myron, Ravetti, Cecilia G., Nobre, Vandack, da Fonseca, Flávio G., Coelho, Eduardo A. F., and Ludolf, Fernanda

Published
2023
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8. Corrigendum: Assessment of risk scores to predict mortality of COVID-19 patients admitted to the intensive care unit

Author

Nogueira, Matheus Carvalho Alves, primary, Nobre, Vandack, additional, Pires, Magda Carvalho, additional, Ramos, Lucas Emanuel Ferreira, additional, Ribeiro, Yara Cristina Neves Marques Barbosa, additional, Aguiar, Rubia Laura Oliveira, additional, Vigil, Flavia Maria Borges, additional, Gomes, Virginia Mara Reis, additional, Santos, Camila de Oliveira, additional, Miranda, Davi Mesquita, additional, Durães, Pamela Andrea Alves, additional, Costa, Josiane Moreira da, additional, Schwarzbold, Alexandre Vargas, additional, Gomes, Angélica Gomides dos Reis, additional, Pessoa, Bruno Porto, additional, Matos, Carolina Cunha, additional, Cimini, Christiane Corrêa Rodrigues, additional, Carvalho, Cíntia Alcântara de, additional, Ponce, Daniela, additional, Manenti, Euler Roberto Fernandes, additional, Cenci, Evelin Paola de Almeida, additional, Anschau, Fernando, additional, Costa, Flávia Carvalho Cardoso, additional, Nascimento, Francine Janaina Magalhães, additional, Bartolazzi, Frederico, additional, Grizende, Genna Maira Santos, additional, Vianna, Heloisa Reniers, additional, Nepomuceno, Jomar Cristeli, additional, Ruschel, Karen Brasil, additional, Zandoná, Liege Barella, additional, Castro, Luís César de, additional, Souza, Maíra Dias, additional, Carneiro, Marcelo, additional, Bicalho, Maria Aparecida Camargos, additional, Vilaça, Mariana do Nascimento, additional, Bonardi, Naiara Patrícia Fagundes, additional, Oliveira, Neimy Ramos de, additional, Lutkmeier, Raquel, additional, Francisco, Saionara Cristina, additional, Araújo, Silvia Ferreira, additional, Delfino-Pereira, Polianna, additional, and Marcolino, Milena Soriano, additional

Published
2024
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10. B-Cell Epitopes-Based Chimeric Protein from SARS-CoV-2 N and S Proteins Is Recognized by Specific Antibodies in Serum and Urine Samples from Patients

Author

Ramos, Fernanda F., primary, Pereira, Isabela A. G., additional, Cardoso, Mariana M., additional, Bandeira, Raquel S., additional, Lage, Daniela P., additional, Scussel, Rahisa, additional, Anastacio, Rafaela S., additional, Freire, Victor G., additional, Melo, Marina F. N., additional, Oliveira-da-Silva, Joao A., additional, Martins, Vivian T., additional, Tavares, Grasiele S. V., additional, Vale, Danniele L., additional, Freitas, Camila S., additional, Chaves, Ana Thereza, additional, Caporali, Júlia F. M., additional, Vassallo, Paula F., additional, Ravetti, Cecilia G., additional, Nobre, Vandack, additional, Fonseca, Flavio G., additional, Christodoulides, Myron, additional, Machado-de-Ávila, Ricardo A., additional, Coelho, Eduardo A. F., additional, and Ludolf, Fernanda, additional

Published
2023
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11. Compartmentalized Regulation of Pulmonary and Systemic Inflammation in Critical COVID-19 Patients

Author

Santiago, Luciana, primary, Gonçalves-Pereira, Marcela Helena, additional, Vieira, Mariana Sousa, additional, Gómez Ravetti, Cecilia, additional, Vassallo, Paula Frizera, additional, Silva e Castro, Rafael, additional, Costa Pimenta, Pedro Pires, additional, Andrade, Marcus Vinícius Melo de, additional, Santiago, Helton da Costa, additional, and Nobre, Vandack, additional

Published
2023
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12. Efficacy of an Anticoagulation Clinic in Low-Income Brazilian Patients with Heart Disease: A Randomized Clinical Trial

Author

Martins, Maria Auxiliadora Parreiras, primary, Oliveira, João Antonio de Queiroz, additional, Ribeiro, Daniel Dias, additional, César, Cibele Comini, additional, Nobre, Vandack Alencar, additional, Palhares, Daniel Moore Freitas, additional, Rocha, Manoel Otávio da Costa, additional, and Ribeiro, Antonio Luiz Pinho, additional

Published
2023
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13. Assessment of risk scores to predict mortality of COVID-19 patients admitted to the intensive care unit.

Author

Alves Nogueira, Matheus Carvalho, Nobre, Vandack, Carvalho Pires, Magda, Ferreira Ramos, Lucas Emanuel, Marques Barbosa Ribeiro, Yara Cristina Neves, Oliveira Aguiar, Rubia Laura, Borges Vigil, Flavia Maria, Reis Gomes, Virginia Mara, de Oliveira Santos, Camila, Mesquita Miranda, Davi, Alves Durães, Pamela Andrea, Moreira da Costa, Josiane, Schwarzbold, Alexandre Vargas, dos Reis Gomes, Angélica Gomides, Porto Pessoa, Bruno, Cunha Matos, Carolina, Rodrigues Cimini, Christiane Corrêa, Alcântara de Carvalho, Cíntia, Ponce, Daniela, and Fernandes Manenti, Euler Roberto

Published
2024
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14. Assessment of risk scores to predict mortality of COVID-19 patients admitted to the intensive care unit

Author

Nogueira, Matheus Carvalho Alves, primary, Nobre, Vandack, additional, Pires, Magda Carvalho, additional, Ramos, Lucas Emanuel Ferreira, additional, Ribeiro, Yara Cristina Neves Marques Barbosa, additional, Aguiar, Rubia Laura Oliveira, additional, Vigil, Flavia Maria Borges, additional, Gomes, Virginia Mara Reis, additional, Santos, Camila de Oliveira, additional, Miranda, Davi Mesquita, additional, Durães, Pamela Andrea Alves, additional, Costa, Josiane Moreira da, additional, Schwarzbold, Alexandre Vargas, additional, Gomes, Angélica Gomides dos Reis, additional, Pessoa, Bruno Porto, additional, Matos, Carolina Cunha, additional, Cimini, Christiane Corrêa Rodrigues, additional, Carvalho, Cíntia Alcântara de, additional, Ponce, Daniela, additional, Manenti, Euler Roberto Fernandes, additional, Cenci, Evelin Paola de Almeida, additional, Anschau, Fernando, additional, Costa, Flávia Carvalho Cardoso, additional, Nascimento, Francine Janaina Magalhães, additional, Bartolazzi, Frederico, additional, Grizende, Genna Maira Santos, additional, Vianna, Heloisa Reniers, additional, Nepomuceno, Jomar Cristeli, additional, Ruschel, Karen Brasil, additional, Zandoná, Liege Barella, additional, Castro, Luís César de, additional, Souza, Maíra Dias, additional, Carneiro, Marcelo, additional, Bicalho, Maria Aparecida Camargos, additional, Vilaça, Mariana do Nascimento, additional, Bonardi, Naiara Patrícia Fagundes, additional, Oliveira, Neimy Ramos de, additional, Lutkmeier, Raquel, additional, Francisco, Saionara Cristina, additional, Araújo, Silvia Ferreira, additional, Delfino-Pereira, Polianna, additional, and Marcolino, Milena Soriano, additional

Published
2023
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15. Plasmin and plasminogen prevent sepsis severity by reducing neutrophil extracellular traps and systemic inflammation

Author

Vago, Juliana P., primary, Zaidan, Isabella, additional, Perucci, Luiza O., additional, Brito, Larissa F., additional, Teixeira, Lívia C.R., additional, Silva, Camila M.S., additional, Miranda, Thaís C., additional, Melo, Eliza M., additional, Bruno, Alexandre S., additional, Queiroz-Junior, Celso M., additional, Sugimoto, Michelle A., additional, Tavares, Luciana P., additional, Grossi, Laís C., additional, Borges, Isabela N., additional, Baik, Nagyung, additional, Talvani, André, additional, Ferreira, Raphael G., additional, Alves-Filho, José C., additional, Nobre, Vandack, additional, Teixeira, Mauro M., additional, Parmer, Robert J., additional, Miles, Lindsey A., additional, and Sousa, Lirlândia P., additional

Published
2023
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17. Additional file 1 of Use of C-reactive protein to guide the antibiotic therapy in hospitalized patients: a systematic review and meta-analysis

Author

Dias, Raphael Figuiredo, de Paula, Ana Clara Rivetti Bitencourt, Hasparyk, Ursula Gramiscelli, de Oliveira Rabelo Bassalo Coutinho, Marcos, Alderete, João Rafael Assis, Kanjongo, Júlia Chihondo, Silva, Renata Aguiar Menezes, Guimarães, Nathalia Sernizon, Simões e Silva, Ana Cristina, and Nobre, Vandack

Abstract

Additional file 1.

Published
2023
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18. guide to clinicians

Author

Póvoa, Pedro, Coelho, Luís, Dal-Pizzol, Felipe, Ferrer, Ricard, Huttner, Angela, Conway Morris, Andrew, Nobre, Vandack, Ramirez, Paula, Rouze, Anahita, Salluh, Jorge, Singer, Mervyn, Sweeney, Daniel A., Torres, Antoni, Waterer, Grant, Kalil, Andre C., and NOVA Medical School|Faculdade de Ciências Médicas (NMS|FCM)

Subjects
Antibiotic stewardship, Sepsis, Diagnosis, Intensive care unit, Critical Care and Intensive Care Medicine, Biomarkers
Abstract

Funding This work received an unrestricted grant from GSK Portugal and was supported by Sociedade Portuguesa de Ginecologia (SPG). Sepsis is defined as a life-threatening organ dysfunction caused by a dysregulated host response to infection. In this context, biomarkers could be considered as indicators of either infection or dysregulated host response or response to treatment and/or aid clinicians to prognosticate patient risk. More than 250 biomarkers have been identified and evaluated over the last few decades, but no biomarker accurately differentiates between sepsis and sepsis-like syndrome. Published data support the use of biomarkers for pathogen identification, clinical diagnosis, and optimization of antibiotic treatment. In this narrative review, we highlight how clinicians could improve the use of pathogen-specific and of the most used host-response biomarkers, procalcitonin and C-reactive protein, to improve the clinical care of patients with sepsis. Biomarker kinetics are more useful than single values in predicting sepsis, when making the diagnosis and assessing the response to antibiotic therapy. Finally, integrated biomarker-guided algorithms may hold promise to improve both the diagnosis and prognosis of sepsis. Herein, we provide current data on the clinical utility of pathogen-specific and host-response biomarkers, offer guidance on how to optimize their use, and propose the needs for future research. publishersversion epub_ahead_of_print

Published
2023

19. Additional file 2 of Use of C-reactive protein to guide the antibiotic therapy in hospitalized patients: a systematic review and meta-analysis

Author

Dias, Raphael Figuiredo, de Paula, Ana Clara Rivetti Bitencourt, Hasparyk, Ursula Gramiscelli, de Oliveira Rabelo Bassalo Coutinho, Marcos, Alderete, João Rafael Assis, Kanjongo, Júlia Chihondo, Silva, Renata Aguiar Menezes, Guimarães, Nathalia Sernizon, Simões e Silva, Ana Cristina, and Nobre, Vandack

Abstract

Additional file 2.

Published
2023
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20. Effect of procalcitonin-guided antibiotic treatment on clinical outcomes in intensive care unit patients with infection and sepsis patients: a patient-level meta-analysis of randomized trials

Author

Wirz, Yannick, Meier, Marc A., Bouadma, Lila, Luyt, Charles E., Wolff, Michel, Chastre, Jean, Tubach, Florence, Schroeder, Stefan, Nobre, Vandack, Annane, Djillali, Reinhart, Konrad, Damas, Pierre, Nijsten, Maarten, Shajiei, Arezoo, deLange, Dylan W., Deliberato, Rodrigo O., Oliveira, Carolina F., Shehabi, Yahya, van Oers, Jos A. H., Beishuizen, Albertus, Girbes, Armand R. J., de Jong, Evelien, Mueller, Beat, and Schuetz, Philipp

Published
2018
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22. Dysfunctional phenotype of systemic and pulmonary regulatory T cells associate with lethal COVID ‐19 cases

Author

Gonçalves‐Pereira, Marcela Helena, primary, Santiago, Luciana, additional, Ravetti, Cecilia Gómez, additional, Vassallo, Paula Frizera, additional, de Andrade, Marcus Vinicius Melo, additional, Vieira, Mariana Sousa, additional, de Fátima Souza de Oliveira, Fernanda, additional, Carobin, Natália Virtude, additional, Li, Guangzhao, additional, de Paula Sabino, Adriano, additional, Nobre, Vandack, additional, and da Costa Santiago, Helton, additional

Published
2022
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23. Impact of bedside ultrasound to reduce the incidence of acute renal injury in high-risk surgical patients: a randomized clinical trial.

Author

Ravetti, Cecilia Gómez, Vassallo, Paula Frizera, Ataíde, Thiago Bragança Lana Silveira, Bragança, Renan Detoffol, dos Santos Jr, Augusto Cesar Soares, Lima Bastos, Fabrício de, Rocha, Guilherme Carvalho, Muniz, Mateus Rocha, Borges, Isabela Nascimento, Marinho, Carolina Coimbra, and Nobre, Vandack

Abstract

Purpose: This study aimed to determine whether performing bedside ultrasound impacts the occurrence of acute kidney injury (AKI) in the immediate postoperative period (POP) of high-risk surgery patients. Methods: POP patients were randomly assigned to two groups: (i) ultrasound (US) group, in which hemodynamic management was guided with clinical parameters supplemented with the bedside US findings; (ii) control group, hemodynamic management based solely on clinical parameters. Two exams were performed in the first 24 h of admission. Results: Fifty-one patients were randomized to the US group and 60 to the control group. There was no significant difference for incidence of AKI in both groups assessed 12 h (31.4% vs 35.0%, P = 0.84), 24 h (27.5% vs 23.3%, P = 0.66), or 7 days (17.6 vs 8.3%, P = 0.16) after surgery. No difference was found in the amounts of volume administered over the first 12 h (1000 [500–2000] vs. 1000 [500–1500], P = 0.72) and 24 h (1000 [0–1500] vs. 1000 [0–1500], P = 0.95) between the groups. Patients without AKI in the control group received higher amounts of volume during the ICU stay. Conclusion: The use of bedside US in the immediate postoperative period of high-risk surgery did not show benefits in reducing AKI incidence. [ABSTRACT FROM AUTHOR]

Published
2023
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25. Risk factors for acute kidney injury after liver transplantation in intensive care unit: a retrospective cohort study

Author

Neves, Ana Paula Camargos de Figueirêdo, primary, Gomes, Angélica Gomides dos Reis, additional, Vassallo, Paula Frizera, additional, Silva, Ana Cristina Simões e, additional, Penna, Francisco Guilherme Cancela e, additional, Bastos, Fabrício de Lima, additional, Muniz, Mateus Rocha, additional, Rocha, Guilherme Carvalho, additional, Santos Júnior, Augusto Cesar Soares dos, additional, Ravetti, Cecilia Gómez, additional, and Nobre, Vandack, additional

Published
2022
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29. Detecting anti–SARS-CoV-2 antibodies in urine samples: A noninvasive and sensitive way to assay COVID-19 immune conversion

Author

Ludolf, Fernanda, primary, Ramos, Fernanda F., additional, Bagno, Flávia F., additional, Oliveira-da-Silva, João A., additional, Reis, Thiago A. R., additional, Christodoulides, Myron, additional, Vassallo, Paula F., additional, Ravetti, Cecilia G., additional, Nobre, Vandack, additional, da Fonseca, Flavio G., additional, and Coelho, Eduardo A. F., additional

Published
2022
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30. Dysfunctional phenotype of systemic and pulmonary regulatory T cells associate with lethal COVID‐19 cases.

Author

Gonçalves‐Pereira, Marcela Helena, Santiago, Luciana, Ravetti, Cecilia Gómez, Vassallo, Paula Frizera, de Andrade, Marcus Vinicius Melo, Vieira, Mariana Sousa, de Fátima Souza de Oliveira, Fernanda, Carobin, Natália Virtude, Li, Guangzhao, de Paula Sabino, Adriano, Nobre, Vandack, and da Costa Santiago, Helton

Subjects
REGULATORY T cells, MONONUCLEAR leukocytes, COVID-19 pandemic, COVID-19, BLOOD cells
Abstract

Severe cases of COVID‐19 present hyperinflammatory condition that can be fatal. Little is known about the role of regulatory responses in SARS‐CoV‐2 infection. In this study, we evaluated the phenotype of regulatory T cells in the blood (peripheral blood mononuclear cell) and the lungs (broncho‐alveolar) of adult patients with severe COVID‐19 under invasive mechanical ventilation. Our results show important dynamic variation on Treg cells phenotype during COVID‐19 with changes in number and functional parameters from the day of intubation (Day 1 of intensive care unit admission) to Day 7. We observed that compared with surviving patients, non‐survivors presented lower numbers of Treg cells in the blood. In addition, lung Tregs of non‐survivors also displayed higher PD1 and lower FOXP3 expressions suggesting dysfunctional phenotype. Further signs of Treg dysregulation were observed in non‐survivors such as limited production of IL‐10 in the lungs and higher production of IL‐17A in the blood and in the lungs, which were associated with increased PD1 expression. These findings were also associated with lower pulmonary levels of Treg‐stimulating factors like TNF and IL‐2. Tregs in the blood and lungs are profoundly dysfunctional in non‐surviving COVID‐19 patients. [ABSTRACT FROM AUTHOR]

Published
2023
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31. Prevalence and risk factors for post-traumatic stress, anxiety, and depression in sepsis survivors after ICU discharge

Author

Calsavara,Allan J., Costa,Priscila A., Nobre,Vandack, and Teixeira,Antonio L.

Subjects
intensive care units, Sepsis, depression, post-traumatic stress disorder, anxiety
Abstract

Objective: Sepsis survivors present a wide range of sequelae; few studies have evaluated psychiatric disorders after sepsis. The objective of this study was to define the prevalence of and risk factors for anxiety, depression and post-traumatic stress disorder (PTSD) symptoms in sepsis survivors. Method: Anxiety, depression and post-traumatic stress symptoms in severe sepsis and septic shock survivors 24 h and 1 year after intensive care unit (ICU) discharge were assessed using the Beck Anxiety/Depression Inventories and the PTSD Checklist-Civilian Version. Differences in psychiatric symptoms over time and the influence of variables on these symptoms were calculated with marginal models. Results: A total of 33 patients were enrolled in the study. The frequencies of anxiety, depression and PTSD 24 h after ICU discharge were 67%, 49%, and 46%, respectively and, among patients re-evaluated 1 year after ICU discharge, the frequencies were 38%, 50%, and 31%, respectively. Factors associated with PTSD included serum S100B level, age, and Informant Questionnaire on Cognitive Decline in the Elderly (IQCODE) score. Factors associated with depression included patient age and cumulative dose of dobutamine. IQCODE score and cumulative dose of haloperidol in the ICU were associated with anxiety after ICU discharge. Conclusion: Patients who survive sepsis have high levels of psychiatric symptoms. Sepsis and associated treatment-related exposures may have a role in increasing the risk of subsequent depression, anxiety, and PTSD.

Published
2021

35. Duration of antibiotic treatment using procalcitonin-guided treatment algorithms in older patients: a patient-level meta-analysis from randomized controlled trials

Author

Medische Staf Intensive Care, NVIC bedrijfsvoering, Brain, Infection & Immunity, Heilmann, Eva, Gregoriano, Claudia, Annane, Djillali, Reinhart, Konrad, Bouadma, Lila, Wolff, Michel, Chastre, Jean, Luyt, Charles-Edouard, Tubach, Florence, Branche, Angela R, Briel, Matthias, Christ-Crain, Mirjam, Welte, Tobias, Corti, Caspar, de Jong, Evelien, Nijsten, Maarten, de Lange, Dylan W, van Oers, Jos A H, Beishuizen, Albertus, Girbes, Armand R J, Deliberato, Rodrigo O, Schroeder, Stefan, Kristoffersen, Kristina B, Layios, Nathalie, Damas, Pierre, Lima, Stella S S, Nobre, Vandack, Wei, Long, Oliveira, Carolina F, Shehabi, Yahya, Stolz, Daiana, Tamm, Michael, Verduri, Alessia, Wang, Jin-Xiang, Drevet, Sabine, Gavazzi, Gaetan, Mueller, Beat, Schuetz, Philipp, Medische Staf Intensive Care, NVIC bedrijfsvoering, Brain, Infection & Immunity, Heilmann, Eva, Gregoriano, Claudia, Annane, Djillali, Reinhart, Konrad, Bouadma, Lila, Wolff, Michel, Chastre, Jean, Luyt, Charles-Edouard, Tubach, Florence, Branche, Angela R, Briel, Matthias, Christ-Crain, Mirjam, Welte, Tobias, Corti, Caspar, de Jong, Evelien, Nijsten, Maarten, de Lange, Dylan W, van Oers, Jos A H, Beishuizen, Albertus, Girbes, Armand R J, Deliberato, Rodrigo O, Schroeder, Stefan, Kristoffersen, Kristina B, Layios, Nathalie, Damas, Pierre, Lima, Stella S S, Nobre, Vandack, Wei, Long, Oliveira, Carolina F, Shehabi, Yahya, Stolz, Daiana, Tamm, Michael, Verduri, Alessia, Wang, Jin-Xiang, Drevet, Sabine, Gavazzi, Gaetan, Mueller, Beat, and Schuetz, Philipp

Published
2021

36. Does antibiotic selection impact patient outcome?

Author

Harbarth, Stephan, Nobre, Vandack, and Pittet, Didier

Subjects
Antibiotics -- Research, Antibiotics -- Usage, Antibiotics -- Health aspects, Drug therapy -- Research, Drug therapy -- Patient outcomes, Health, Health care industry
Published
2007

37. Dermatological findings in 3 generations of a family with a high prevalence of human T cell lymphotropic virus type 1 infection in Brazil

Author

Nobre, Vandack, Guedes, Antonio Carlos, Martins, Marina Lobato, Barbosa-Stancioli, Edel Figueiredo, Serufo, Jose Carlos, Proietti, Fernando Augusto, Ribas, Joao Gabriel, Ferreira, Cibele Eponina Sanchez, and Lambertucci, Jose Roberto

Subjects
Disease transmission -- Evaluation, T cells -- Diseases, T cells -- Physiological aspects, T cells -- Research, Brazilians -- Health aspects, Brazilians -- Research, Leukemia -- Research, Leukemia -- Development and progression, Lymphomas -- Research, Lymphomas -- Development and progression, Health, Health care industry
Published
2006

38. Duration of antibiotic treatment using procalcitonin-guided treatment algorithms in older patients: a patient-level meta-analysis from randomized controlled trials

Author

Heilmann, Eva, primary, Gregoriano, Claudia, additional, Annane, Djillali, additional, Reinhart, Konrad, additional, Bouadma, Lila, additional, Wolff, Michel, additional, Chastre, Jean, additional, Luyt, Charles-Edouard, additional, Tubach, Florence, additional, Branche, Angela R, additional, Briel, Matthias, additional, Christ-Crain, Mirjam, additional, Welte, Tobias, additional, Corti, Caspar, additional, de Jong, Evelien, additional, Nijsten, Maarten, additional, de Lange, Dylan W, additional, van Oers, Jos A H, additional, Beishuizen, Albertus, additional, Girbes, Armand R J, additional, Deliberato, Rodrigo O, additional, Schroeder, Stefan, additional, Kristoffersen, Kristina B, additional, Layios, Nathalie, additional, Damas, Pierre, additional, Lima, Stella S S, additional, Nobre, Vandack, additional, Wei, Long, additional, Oliveira, Carolina F, additional, Shehabi, Yahya, additional, Stolz, Daiana, additional, Tamm, Michael, additional, Verduri, Alessia, additional, Wang, Jin-Xiang, additional, Drevet, Sabine, additional, Gavazzi, Gaetan, additional, Mueller, Beat, additional, and Schuetz, Philipp, additional

Published
2021
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39. Risk factors for acute kidney injury after liver transplantation in intensive care unit: a retrospective cohort study.

Author

Camargos de Figueirêdo Neves, Ana Paula, dos Reis Gomes, Angélica Gomides, Frizera Vassallo, Paula, Simões e Silva, Ana Cristina, Cancela e Penna, Francisco Guilherme, de Lima Bastos, Fabrício, Rocha Muniz, Mateus, Carvalho Rocha, Guilherme, Soares dos Santos Júnior, Augusto Cesar, Gómez Ravetti, Cecilia, and Nobre, Vandack

Published
2022
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41. Resuscitation fluid practices in Brazilian intensive care units: a secondary analysis of Fluid-TRIPS

Author

Freitas, Flavio Geraldo Rezende de, primary, Hammond, Naomi, additional, Li, Yang, additional, Azevedo, Luciano Cesar Pontes de, additional, Cavalcanti, Alexandre Biasi, additional, Taniguchi, Leandro, additional, Gobatto, André, additional, Japiassú, André Miguel, additional, Bafi, Antonio Tonete, additional, Mazza, Bruno Franco, additional, Noritomi, Danilo Teixeira, additional, Dal-Pizzol, Felipe, additional, Bozza, Fernando, additional, Salluh, Jorge Ibrahin Figueira, additional, Westphal, Glauco Adrieno, additional, Soares, Márcio, additional, Assunção, Murillo Santucci César de, additional, Lisboa, Thiago, additional, Lobo, Suzana Margarete Ajeje, additional, Barbosa, Achilles Rohlfs, additional, Ventura, Adriana Fonseca, additional, Souza, Ailson Faria de, additional, Silva, Alexandre Francisco, additional, Toledo, Alexandre, additional, Reis, Aline, additional, Cembrane, Allan, additional, Rea Neto, Alvaro, additional, Gut, Ana Lúcia, additional, Justo, Ana Patricia Pierre, additional, Santos, Ana Paula, additional, Albuquerque, André Campos D. de, additional, Scazufka, André, additional, Rodrigues, Antonio Babo, additional, Fernandino, Bruno Bonaccorsi, additional, Silva, Bruno Goncalves, additional, Vida, Bruno Sarno, additional, Pinheiro, Bruno Valle, additional, Pinto, Bruno Vilela Costa, additional, Feijo, Carlos Augusto Ramos, additional, Abreu Filho, Carlos de, additional, Bosso, Carlos Eduardo da Costa Nunes, additional, Moreira, Carlos Eduardo Nassif, additional, Ramos, Carlos Henrique Ferreira, additional, Tavares, Carmen, additional, Arantes, Cidamaiá, additional, Grion, Cintia, additional, Mendes, Ciro Leite, additional, Kmohan, Claudio, additional, Piras, Claudio, additional, Castro, Cristine Pilati Pileggi, additional, Lins, Cyntia, additional, Beraldo, Daniel, additional, Fontes, Daniel, additional, Boni, Daniela, additional, Castiglioni, Débora, additional, Paisani, Denise de Moraes, additional, Pedroso, Durval Ferreira Fonseca, additional, Mattos, Ederson Roberto, additional, Brito Sobrinho, Edgar de, additional, Troncoso, Edgar M. V., additional, Rodrigues Filho, Edison Moraes, additional, Nogueira, Eduardo Enrico Ferrari, additional, Ferreira, Eduardo Leme, additional, Pacheco, Eduardo Souza, additional, Jodar, Euzebio, additional, Ferreira, Evandro L. A., additional, Araujo, Fabiana Fernandes de, additional, Treviso, Fabiana Schuelter, additional, Amorim, Fábio Ferreira, additional, Giannini, Fabio Poianas, additional, Santos, Fabrício Primitivo Matos, additional, Buarque, Fátima, additional, Lima, Felipe Gallego, additional, Costa, Fernando Antonio Alvares da, additional, Sad, Fernando Cesar dos Anjos, additional, Aranha, Fernando G., additional, Ganem, Fernando, additional, Callil, Flavio, additional, Costa Filho, Francisco Flávio, additional, Dall´Arto, Frederico Toledo Campo, additional, Moreno, Geovani, additional, Friedman, Gilberto, additional, Moralez, Giulliana Martines, additional, Silva, Guilherme Abdalla da, additional, Costa, Guilherme, additional, Cavalcanti, Guilherme Silva, additional, Betônico, Gustavo Navarro, additional, Reis, Hélder, additional, Araujo, Helia Beatriz N., additional, Hortiz Júnior, Helio Anjos, additional, Guimaraes, Helio Penna, additional, Urbano, Hugo, additional, Maia, Israel, additional, Santiago Filho, Ivan Lopes, additional, Farhat Júnior, Jamil, additional, Alvarez, Janu Rangel, additional, Passos, Joel Tavares, additional, Paranhos, Jorge Eduardo da Rocha, additional, Marques, José Aurelio, additional, Moreira Filho, José Gonçalves, additional, Andrade, Jose Neto, additional, C Sobrinho, José Onofre de, additional, Bezerra, Jose Terceiro de Paiva, additional, Alves, Juliana Apolônio, additional, Ferreira, Juliana, additional, Gomes, Jussara, additional, Sato, Karina Midori, additional, Gerent, Karine, additional, Teixeira, Kathia Margarida Costa, additional, Conde, Katia Aparecida Pessoa, additional, Martins, Laércia Ferreira, additional, Figueirêdo, Lanese, additional, Rezegue, Leila, additional, Tcherniacovsk, Leonardo, additional, Ferraz, Leone Oliveira, additional, Cavalcante, Liane, additional, Rabelo, Ligia, additional, Miilher, Lilian, additional, Garcia, Lisiane, additional, Tannous, Luana, additional, Hajjar, Ludhmila Abrahão, additional, Paciência, Luís Eduardo Miranda, additional, Cruz Neto, Luiz Monteiro da, additional, Bley, Macia Valeria, additional, Sousa, Marcelo Ferreira, additional, Puga, Marcelo Lourencini, additional, Romano, Marcelo Luz Pereira, additional, Nobrega, Marciano, additional, Arbex, Marcio, additional, Rodrigues, Márcio Leite, additional, Guerreiro, Márcio Osório, additional, Rocha, Marcone, additional, Alves, Maria Angela Pangoni, additional, Rosa, Maria Doroti, additional, Dias, Mariza D’Agostino, additional, Martins, Miquéias, additional, Oliveira, Mirella de, additional, Moretti, Miriane Melo Silveira, additional, Matsui, Mirna, additional, Messender, Octavio, additional, Santarém, Orlando Luís de Andrade, additional, Silveira, Patricio Júnior Henrique da, additional, Vassallo, Paula Frizera, additional, Antoniazzi, Paulo, additional, Gottardo, Paulo César, additional, Correia, Paulo, additional, Ferreira, Paulo, additional, Torres, Paulo, additional, Silva, Pedro Gabrile M. de Barros e, additional, Foernges, Rafael, additional, Gomes, Rafael, additional, Moraes, Rafael, additional, Nonato filho, Raimundo, additional, Borba, Renato Luis, additional, Gomes, Renato V, additional, Cordioli, Ricardo, additional, Lima, Ricardo, additional, López, Ricardo Pérez, additional, Gargioni, Ricardo Rath de Oliveira, additional, Rosenblat, Richard, additional, Souza, Roberta Machado de, additional, Almeida, Roberto, additional, Narciso, Roberto Camargo, additional, Marco, Roberto, additional, waltrick, Roberto, additional, Biondi, Rodrigo, additional, Figueiredo, Rodrigo, additional, Dutra, Rodrigo Santana, additional, Batista, Roseane, additional, Felipe, Rouge, additional, Franco, Rubens Sergio da Silva, additional, Houly, Sandra, additional, Faria, Sara Socorro, additional, Pinto, Sergio Felix, additional, Luzzi, Sergio, additional, Sant’ana, Sergio, additional, Fernandes, Sergio Sonego, additional, Yamada, Sérgio, additional, Zajac, Sérgio, additional, Vaz, Sidiner Mesquita, additional, Bezerra Bezerra, Silvia Aparecida, additional, Farhat, Tatiana Bueno Tardivo, additional, Santos, Thiago Martins, additional, Smith, Tiago, additional, Silva, Ulysses V. A., additional, Damasceno, Valnei Bento, additional, Nobre, Vandack, additional, Dantas, Vicente Cés de Souza, additional, Irineu, Vivian Menezes, additional, Bogado, Viviane, additional, Nedel, Wagner, additional, Campos Filho, Walther, additional, Dantas, Weidson, additional, Viana, William, additional, Oliveira Filho, Wilson de, additional, Delgadinho, Wilson Martins, additional, Finfer, Simon, additional, and Machado, Flavia Ribeiro, additional

Published
2021
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43. Hospital-acquired intestinal toxemia botulism in a newly diagnosed adult colon cancer patient

Author

Fonseca, Lucas José Sá da, Carvalho, Diogo Couto de, Moraes, Helena Providelli de, Feitosa, Izabela Dayany França, Pereira Neto, Gil, Vilela, Rodrigo Vasconcellos, Fernandes, Breno Franco Silveira, Gomez, Rodrigo Santiago, and Nobre, Vandack

Subjects
Diagnosis, Symmetrical descending flaccid paralysis, Clostridium botulinum, Neuromuscular junction, Intestinal colonization, Adult intestinal toxemia botulism, Neuropathy
Abstract

This manuscript reports a case of intestinal toxemia botulism in an adult with recently diagnosed metastatic colon cancer in whom botulism symptoms began 23 days after hospital admission. Representing the rarest form of botulism presentation in clinical practice, this infectious disease may have developed due to a cluster of predisposing factors that favored Clostridium botulinum colonization and the endogenous production of neurotoxins, among which are previous use of broad-spectrum antibiotics and colon changes related to the development of the neoplasia. This case highlights the importance of considering intestinal toxemia botulism in the differential diagnosis of a patient presenting with symmetrical descending flaccid paralysis, since immediate treatment with botulinum antitoxin may improve clinical outcomes.

Published
2019

44. Avaliação da interleucina 3 como marcador prognóstico na sepse

Author

Borges,Isabela Nascimento, Resende,Carolina Braga, Vieira,Érica Leandro Marciano, Silva,José Luiz Padilha da, Andrade,Marcus Vinícius Melo de, Souza,Andrea Jerusa de, Badaró,Eurípedes, Carneiro,Rafael Mourão, Teixeira Jr.,Antônio Lúcio, and Nobre,Vandack

Subjects
Biomarcadores, Choque séptico, Sepsis, Septic shock, lcsh:Medical emergencies. Critical care. Intensive care. First aid, Sepse, Interleukin-3, lcsh:RC86-88.9, Interleucina-3, Biomarkers
Abstract

RESUMO Objetivo: Avaliar a acurácia dos níveis de interleucina 3 para predizer prognóstico em pacientes sépticos. Métodos: Conduzimos uma coorte prospectiva que incluiu pacientes adultos internados em unidade de terapia intensiva, que apresentassem sepse ou choque séptico iniciados há até 48 horas. Mediram-se os níveis séricos de interleucina 3 quando da inclusão (dia 1) e nos dias 3 e 7. O desfecho primário analisado foi a mortalidade hospitalar por qualquer causa. Resultados: Foram incluídos 120 pacientes. Os níveis séricos de interleucina 3 dosados à inclusão foram significativamente mais elevados em pacientes que faleceram em comparação aos que sobreviveram à internação hospitalar (91,2pg/mL versus 36pg/mL; p = 0,024). Em modelo de sobrevivência de Cox com inclusão de idade e valores sequenciais de SOFA, os níveis de interleucina 3 mensurados na inclusão mantiveram-se independentemente associados à mortalidade hospitalar (HR 1,032; IC95% 1,010 - 1,055; p = 0,005). Em curva Característica de Operação do Receptor construída para investigação adicional da acurácia da interleucina 3 na predição do prognóstico, encontrou-se área sob a curva de 0,62 (IC95% 0,51 - 0,73; p = 0,024) para mortalidade hospitalar. Valores iniciais de interleucina 3 acima de 127,5pg/mL mostraram-se significativamente associados à mortalidade hospitalar (p = 0,019; OR = 2,97; IC95% 1,27 - 6,97; p = 0,019), entretanto com baixo desempenho (especificidade de 82%, sensibilidade de 39%, valor preditivo positivo de 53%, valor preditivo negativo de 72%, razão de verossimilhança negativa de 0,73 e razão de verossimilhança positiva de 2,16). Conclusão: Níveis elevados de interleucina 3 mostraram-se independentemente associados à mortalidade hospitalar em pacientes sépticos, entretanto com baixo desempenho clínico. ABSTRACT Objective: To evaluate the accuracy of IL-3 to predict the outcome of septic patients. Methods: Prospective cohort study with adult patients in an intensive care unit with sepsis or septic shock diagnosed within the previous 48 hours. Circulating IL-3 levels were measured upon inclusion (day 1) and on days 3 and 7. The primary outcome was hospital mortality. Results: One hundred and twenty patients were included. Serum levels of IL-3 on day 1 were significantly higher among patients who died than among patients who survived the hospital stay (91.2pg/mL versus 36pg/mL, p = 0.024). In a Cox survival model considering the IL-3 levels at inclusion, age and sequential SOFA, IL-3 values remained independently associated with mortality (HR 1.032; 95%CI 1.010 - 1.055; p = 0.005). An receiver operating characteristic curve was built to further investigate the accuracy of IL-3, with an area under the curve of 0.62 (95%CI 0.51 - 0.73; p = 0.024) for hospital mortality. A cutoff initial IL-3 value above 127.5pg/mL was associated with hospital mortality (OR 2.97; 95%CI: 1.27 - 6.97; p = 0.0019) but with a low performance (82% for specificity, 39% for sensibility, 53% for the positive predictive value, 72% for the negative predictive value, 0.73 for the negative likelihood and 2.16 for the positive likelihood ratio). Conclusion: Higher levels of IL-3 are shown to be independently associated with hospital mortality in septic patients but with poor clinical performance.

Published
2019

45. Streptococcus sinensis endocarditis outside Hong Kong

Author

Uckay, Ilker, Rohner, Peter, Bolivar, Ignacio, Ninet, Beatrice, Djordjevic, Marina, Nobre, Vandack, Garzoni, Christian, and Schrenzel, Jacques

Subjects
Company distribution practices, Endocarditis -- Drug therapy, Endocarditis -- Diagnosis, Streptococcal infections -- Distribution, Streptococcal infections -- Diagnosis, Streptococcal infections -- Drug therapy, Streptococcus -- Genetic aspects
Abstract

Streptococcus sinensis has been described as a causative organism for infective endocarditis in 3 Chinese patients from Hong Kong. We describe a closely related strain in an Italian patient with [...]

Published
2007

46. Vancomycin-associated nephrotoxicity in non-critically ill patients admitted in a Brazilian public hospital: A prospective cohort study

Author

de Almeida, Claudmeire Dias Carneiro, primary, Simões e Silva, Ana Cristina, additional, de Queiroz Oliveira, João Antonio, additional, Batista, Isabela Soares Fonseca, additional, Pereira, Fernando Henrique, additional, Gonçalves, José Eduardo, additional, Nobre, Vandack, additional, and Martins, Maria Auxiliadora Parreiras, additional

Published
2019
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47. DONORS (Donation Network to Optimise Organ Recovery Study): Study protocol to evaluate the implementation of an evidence-based checklist for brain-dead potential organ donor management in intensive care units, a cluster randomised trial

Author

Westphal, Glauco Adrieno, primary, Robinson, Caroline Cabral, additional, Biasi, Alexandre, additional, Machado, Flávia Ribeiro, additional, Rosa, Regis Goulart, additional, Teixeira, Cassiano, additional, de Andrade, Joel, additional, Franke, Cristiano Augusto, additional, Azevedo, Luciano Cesar Pontes, additional, Bozza, Fernando, additional, Guterres, Cátia Moreira, additional, da Silva, Daiana Barbosa, additional, Sganzerla, Daniel, additional, do Prado, Débora Zechmeister, additional, Madalena, Itiana Cardoso, additional, Rohden, Adriane Isabel, additional, da Silva, Sabrina Souza, additional, Giordani, Natalia Elis, additional, Andrighetto, Luiza Vitelo, additional, Benck, Patrícia Spessatto, additional, Roman, Fernando Roberto, additional, de Melo, Maria de Fátima Rodrigues Buarque, additional, Pereira, Thattyane Borba, additional, Grion, Cintia Magalhães Carvalho, additional, Diniz, Pedro Carvalho, additional, Oliveira, João Fernando Picollo, additional, Mecatti, Giovana Colozza, additional, Alves, Flávio André Cardona, additional, Moraes, Rafael Barberena, additional, Nobre, Vandack, additional, Hammes, Luciano Serpa, additional, Meade, Maureen O, additional, Nothen, Rosana Reis, additional, and Falavigna, Maicon, additional

Published
2019
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48. Economic evaluation of procalcitonin-guided antibiotic therapy in acute respiratory infections: a US health system perspective

Author

Schuetz, Philipp, Balk, Robert, Briel, Matthias, Kutz, Alexander, Christ-Crain, Mirjam, Stolz, Daiana, Bouadma, Lila, Wolff, Michel, Kristoffersen, Kristina B., Wei, Long, Burkhardt, Olaf, Welte, Tobias, Schroeder, Stefan, Nobre, Vandack, Tamm, Michael, Bhatnagar, Neera, Bucher, Heiner C., Luyt, Charles-Edouard, Chastre, Jean, Tubach, Florence, Mueller, Beat, Lacey, Michael J., Ohsfeldt, Robert L., Scheibling, Cara M., Schneider, John E., Schuetz, Philipp, Balk, Robert, Briel, Matthias, Kutz, Alexander, Christ-Crain, Mirjam, Stolz, Daiana, Bouadma, Lila, Wolff, Michel, Kristoffersen, Kristina B., Wei, Long, Burkhardt, Olaf, Welte, Tobias, Schroeder, Stefan, Nobre, Vandack, Tamm, Michael, Bhatnagar, Neera, Bucher, Heiner C., Luyt, Charles-Edouard, Chastre, Jean, Tubach, Florence, Mueller, Beat, Lacey, Michael J., Ohsfeldt, Robert L., Scheibling, Cara M., and Schneider, John E.

Abstract

Background: Whether or not antibiotic stewardship protocols based on procalcitonin levels results in cost savings remains unclear. Herein, our objective was to assess the economic impact of adopting procalcitonin testing among patients with suspected acute respiratory tract infection (ARI) from the perspective of a typical US integrated delivery network (IDN) with a 1,000,000 member catchment area or enrollment. Methods: To conduct an economic evaluation of procalcitonin testing versus usual care we built a cost-impact model based on patient-level meta-analysis data of randomized trials. The meta-analytic data was adapted to the US setting by applying the meta-analytic results to US lengths of stay, costs, and practice patterns. We estimated the annual ARI visit rate for the one million member cohort, by setting (inpatient, ICU, outpatient) and ARI diagnosis. Results: In the inpatient setting, the costs of procalcitonin-guided compared to usual care for the one million member cohort was $2,083,545, compared to $2,780,322, resulting in net savings of nearly $700,000 to the IDN for 2014. In the ICU and outpatient settings, savings were $73,326 and $5,329,824, respectively, summing up to overall net savings of $6,099,927 for the cohort. Results were robust for all ARI diagnoses. For the whole US insured population, procalcitonin-guided care would result in $1.6 billion in savings annually. Conclusions: Our results show substantial savings associated with procalcitonin protocols of ARI across common US treatment settings mainly by direct reduction in unnecessary antibiotic utilization. These results are robust to changes in key parameters, and the savings can be achieved without any negative impact on treatment outcomes.

Published
2019

49. Factors associated with short and long term cognitive changes in patients with sepsis

Author

Calsavara, Allan Jefferson Cruz, Costa, Priscila A., Nobre, Vandack, and Teixeira, Antônio Lúcio

Abstract

This study aimed to assess cognition in patients with severe sepsis or septic shock and whether cognitive impairment was associated with clinical and laboratory parameters. We conducted a cohort study of patients with severe sepsis and septic shock evaluated within 24 h and one year after ICU discharge. Demographic, clinical and laboratory data were analyzed, and the following neuropsychological tests were applied: Consortium to Establish Registry for Alzheimer’s Disease, Mini- Mental State Examination, and Trail Making Test forms A and B. We included 33 patients, mean age of 49, 19% were female. Patients underperformed on most measures 24 h after ICU discharge, with improvement on follow-up. IQCODE, APACHE II scores, NSE and IFN-γ levels at ICU discharge were associated with poor cognitive performance, while higher educational level was associated with good cognitive performance. The time to first antibiotic dose, accumulated dose of haloperidol during UCI stay and mean glycemia were also associated with poor cognitive outcome. In general, patients with severe sepsis or septic shock have cognitive impairment that can improve over time. This improvement was associated with factors identified during their ICU stay, such as cognitive reserve, educational level, mean glycemia during ICU stay and NSE level.

Published
2018

50. Does Antibiotic Selection Impact Patient Outcome?

Author

Harbarth, Stéphan Juergen, Nobre, Vandack, and Pittet, Didier

Subjects
ddc:616, Pneumonia, Pneumococcal/drug therapy/microbiology/ mortality, Bacteremia/drug therapy/microbiology/ mortality, Prognosis, Aminoglycosides/therapeutic use, Survival Rate, Gram-Negative Bacterial Infections/drug therapy/microbiology/ mortality, Anti-Bacterial Agents/ therapeutic use, Gram-Negative Bacteria/drug effects, Humans, Drug Therapy, Combination, Female, Beta-Lactams/therapeutic use, Sepsis/drug therapy/ mortality
Abstract

Inadequate antibiotic therapy, generally defined as microbiologically ineffective anti-infective therapy against the causative pathogen, can influence patient outcome. However, the detrimental effects of inadequate antibiotic therapy seem to become weaker in the most severely ill patients with short life expectancies. In addition to severity of illness, other methodological issues should be carefully examined in studies assessing the excess mortality due to inadequate therapy. To adjust for confounding as much as possible in order to obtain an unbiased estimate of the magnitude of the effect of inadequate therapy is a key methodological challenge for future research. With regard to the choice of antibiotic agents, beta-lactam and aminoglycoside combination therapy does not seem to improve clinical outcome in most cases of sepsis caused by gram-negative bacteria, including Pseudomonas aeruginosa bacteremia. A potential benefit of combination therapy in the treatment of severe pneumococcal sepsis has been suggested in several observational studies, but recently published data have disputed this hypothesis. Finally, better risk scores and laboratory tools are urgently needed to improve the adequacy of empirical antibiotic therapy and patient outcomes.

Published
2017

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