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Corticosteroids for severe influenza pneumonia: A critical appraisal

World Journal of Critical Care Medicine 2016年第1期5卷 89-95页

作者： wagner luis nedel David Garcia Nora Jorge Ibrain Figueira Salluh Thiago Lisboa Pedro Póvoa Intensive Care Unit Hospital Nossa Senhora da Concei??o Intensive Care Unit Vila Franca de Xira Hospital D’or Institute for Research and Education Critical Care Department Hospital de Clinicas de Porto Alegre Post-Graduation Program (PPG) Pneumology Universidade Federal do Rio Grande do Sul Polyvalent Intensive Care Unit S?o Francisco Xavier Hospital Centro Hospitalar de Lisboa Ocidental Nova Medical School CEDOC New University of Lisbon

Influenza pneumonia is associated with high number of severe cases requiring hospital and intensive care unit(ICU) admissions with high mortality. Systemic steroids are proposed as a valid therapeutic option even though its effects are still controversial. Heterogeneity of published data regarding study design, population demographics, severity of illness, dosing, type and timing of corticosteroids administered constitute an important limitation for drawing robust conclusions. However, it is reasonable to admit that, as it was not found any advantage of corticosteroid therapy in so diverse conditions, such beneficial effects do not exist at all. Its administration is likely to increase overall mortality and such trend is consistent regardless of the quality as well as the sample size of studies. Moreover it was shown that corticosteroids might be associated with higher incidence of hospital-acquired pneumonia and longer duration of mechanical ventilation and ICU stay. Finally, it is reasonable to conclude that corticosteroids failed to demonstrate any beneficial effects in the treatment of patients with severe influenza infection. Thus its current use in s evere influenza pneumonia should be restricted to very selected cases and in the setting of clinical trials.

关键词： Influenza Mechanical ventilation Pneumonia Corticosteroids Respiratory failure

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Sepsis-induced mitochondrial dysfunction:A narrative review

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World Journal of Critical Care Medicine 2023年第3期12卷 139-152页

作者： wagner nedel Caroline Deutschendorf luis Valmor Cruz Portela Intensive Care Unit Grupo Hospitalar ConceiçãoPorto Alegre 91350200Brazil Laboratory of Neurotrauma and Biomarkers Departamento de BioquímicaICBSUniversidade Federal do Rio Grande do SulPorto Alegre 90035-003Brazil Brazilian Research in Intensive Care Network-BRICNet São Paulo 04039-002Brazil Infection Control Committee Hospital de Clínicas de Porto AlegrePorto Alegre 90410-000Brazil

Sepsis represents a deranged and exaggerated systemic inflammatory response to infection and is associated with vascular and metabolic abnormalities that trigger systemic organic *** function has been shown to be severely impaired during the early phase of critical illness,with a reduction in biogenesis,increased generation of reactive oxygen species and a decrease in adenosine triphosphate synthesis of up to 50%.Mitochondrial dysfunction can be assessed using mitochondrial DNA concentration and respirometry assays,particularly in peripheral mononuclear *** of monocytes and lymphocytes seems to be the most promising strategy for measuring mitochondrial activity in clinical settings because of the ease of collection,sample processing,and clinical relevance of the association between metabolic alterations and deficient immune responses in mononuclear *** have reported alterations in these variables in patients with sepsis compared with healthy controls and non-septic ***,few studies have explored the association between mitochondrial dysfunction in immune mononuclear cells and unfavorable clinical *** improvement in mitochondrial parameters in sepsis could theoretically serve as a biomarker of clinical recovery and response to oxygen and vasopressor therapies as well as reveal unexplored pathophysiological mechanistic *** features highlight the need for further studies on mitochondrial metabolism in immune cells as a feasible tool to evaluate patients in intensive care *** evaluation of mitochondrial metabolism is a promising tool for the evaluation and management of critically ill patients,especially those with *** this article,we explore the pathophysiological aspects,main methods of measurement,and the main studies in this field.

关键词： Sepsis Mitochondria Mitochondrial dysfunction Oxidative phosphorylation Inflammation Respirometry

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Assessing the prognosis of cirrhotic patients in the intensive care unit:What we know and what we need to know better

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World Journal of Hepatology 2021年第10期13卷 1341-1350页

作者： Fernando da Silveira Pedro H R Soares Luana Q Marchesan Roberto S A da Fonseca wagner L nedel Programa de Pos-Graduacao em Pneumologia Universidade Federal do Rio Grande do SulPorto Alegre 91430835Brazil Intensive Care Unit Grupo Hospitalar ConceiçãoPorto Alegre 91430835Brazil Programa de Pos-Graduacao em Neurociencias Universidade Federal do Rio Grande do SulPorto Alegre 91430835Brazil Programa de Pos-Graduacao em Ciencias da Saude Universidade Federal de Santa MariaSanta Maria 97105900Brazil Programa de Pos-Graduacao em Bioquimica Universidade Federal do Rio Grande do SulPorto Alegre 91430835Brazil

Critically ill cirrhotic patients have high in-hospital mortality and utilize significant health care resources as a consequence of the need for multiorgan *** this fact,their mortality has decreased in recent decades due to improved care of critically ill ***-on-chronic liver failure(ACLF),sepsis and elevated hepatic scores are associated with increased mortality in this population,especially among those not eligible for liver *** score is superior to another in the prognostic assessment of these patients,and both liver-specific and intensive care unit-specific scores have satisfactory predictive *** sequential assessment of the scores,especially the Sequential Organ Failure Assessment(SOFA)and Chronic Liver Failure Consortium(CLIF)-SOFA scores,may be useful as an auxiliary tool in the decision-making process regarding the benefits of maintaining supportive therapies in this population.A CLIF-ACLF>70 at admission or at day 3 was associated with a poor prognosis,as well as SOFA score>19 at baseline or increasing SOFA score>*** studies addressing the prognostic assessment of these patients are necessary.

关键词： Cirrhosis Extrahepatic organ failure Organ replacement therapy Mortality Prognostic scores Chronic Liver Failure Consortium-Sequential Organ Failure Assessment Sequential Organ Failure Assessment Model for End-stage Liver Disease

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Geostatistical seismic inversion and 3D modelling of metric flow units,porosity and permeability in Brazilian presalt reservoir

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Petroleum Science 2024年第3期21卷 1699-1718页

作者： Rodrigo Penna wagner Moreira Lupinacci Exploratory Interpretation and Reservoir Characterization Group(GIECAR) Department of Geology and GeophysicsUniversidade Federal FluminenseNiteroiRJ24210-346Brazil Petrobras Rio de JaneiroRJ20031-912Brazil

Flow units(FU)rock typing is a common technique for characterizing reservoir flow behavior,producing reliable porosity and permeability estimation even in complex geological ***,the lateral extrapolation of FU away from the well into the whole reservoir grid is commonly a difficult task and using the seismic data as constraints is rarely a subject of *** paper proposes a workflow to generate numerous possible 3D volumes of flow units,porosity and permeability below the seismic resolution limit,respecting the available seismic data at larger *** methodology is used in the Mero Field,a Brazilian presalt carbonate reservoir located in the Santos Basin,who presents a complex and heterogenic geological setting with different sedimentological processes and diagenetic *** generated metric flow units using the conventional core analysis and transposed to the well log ***,given a Markov chain Monte Carlo algorithm,the seismic data and the well log statistics,we simulated acoustic impedance,decametric flow units(DFU),metric flow units(MFU),porosity and permeability volumes in the metric *** aim is to estimate a minimum amount of MFU able to calculate realistic scenarios porosity and permeability scenarios,without losing the seismic lateral *** other words,every porosity and permeability volume simulated produces a synthetic seismic that match the real seismic of the area,even in the metric *** achieved 3D results represent a high-resolution fluid flow reservoir modelling considering the lateral control of the seismic during the process and can be directly incorporated in the dynamic characterization workflow.

关键词： Flowunits Geostatistical inversion Presalt reservoir 3D reservoir modelling Petrophysical modelling

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Manufacture and characterization of graphene membranes with suspended silicon proof masses for MEMS and NEMS applications

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Microsystems & Nanoengineering 2020年第1期6卷 1050-1066页

作者： Xuge Fan Anderson D.Smith Fredrik Forsberg Stefan wagner Stephan Schroder Sayedeh Shirin Afyouni Akbari Andreas C.Fischer luis Guillermo Villanueva Mikael Ostling Max C.Lemme Frank Niklaus Division of Micro and Nanosystems School of Electrical Engineering and Computer ScienceKTH Royal Institute of TechnologySE-10044 StockholmSweden Division of Integrated Devices and Circuits School of Electrical Engineering and Computer ScienceKTH Royal Institute of TechnologySE-16440 KistaSweden Faculty of Electrical Engineering and Information Technology RWTH Aachen UniversityOtto-Blumenthal-Str.2552074 AachenGermany Advanced NEMS Group École Polytechnique Fédérale de Lausanne(EPFL)1015 LausanneSwitzerland Silex Microsystems AB 17526 JärfällaSweden AMO GmbH Advanced Microelectronic Center Aachen(AMICA)Otto-Blumnethal-Str.2552074 AachenGermany

Graphene’s unparalleled strength,chemical stability,ultimate surface-to-volume ratio and excellent electronic properties make it an ideal candidate as a material for membranes in micro-and nanoelectromechanical systems(MEMS and NEMS).However,the integration of graphene into MEMS or NEMS devices and suspended structures such as proof masses on graphene membranes raises several technological challenges,including collapse and rupture of the *** have developed a robust route for realizing membranes made of double-layer CVD graphene and suspending large silicon proof masses on membranes with high *** have demonstrated the manufacture of square graphene membranes with side lengths from 7µm to 110µm,and suspended proof masses consisting of solid silicon cubes that are from 5µm×5µm×16.4µm to 100µm×100µm×16.4µm in *** approach is compatible with wafer-scale MEMS and semiconductor manufacturing technologies,and the manufacturing yields of the graphene membranes with suspended proof masses were>90%,with>70%of the graphene membranes having>90%graphene area without visible *** measured resonance frequencies of the realized structures ranged from tens to hundreds of kHz,with quality factors ranging from 63 to *** graphene membranes with suspended proof masses were extremely robust,and were able to withstand indentation forces from an atomic force microscope(AFM)tip of up to~*** proposed approach for the reliable and large-scale manufacture of graphene membranes with suspended proof masses will enable the development and study of innovative NEMS devices with new functionalities and improved performances.

关键词： proof characterization hundreds

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Impact of cytomegalovirus reactivation just before liver transplantation:A prospective cohort study

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World Journal of Gastrointestinal Pathophysiology 2021年第3期12卷 51-58页

作者： Claudio Marcel B Stadnik Cassia Ferreira B Caurio Edison M Rodrigues-Filho wagner L nedel Guido PC Cantisani Maria L Zanotelli Alessandro C Pasqualotto Infection Control Department Santa Casa de Misericordia de Porto AlegrePorto Alegre 90075075RSBrazil Molecular Biology Laboratory Santa Casa de Misericordia de Porto AlegrePorto Alegre 90075075RSBrazil Intensive Care Santa Casa de Misericordia de Porto AlegrePorto Alegre 90075075RSBrazil Liver Transplant Unit Santa Casa de Misericordia de Porto AlegrePorto Alegre 90075075RSBrazil Infectious Diseases Unit Universidade Federal de Ciencias da Saude de Porto AlegrePorto Alegre 90035075RSBrazil

BACKGROUND Cytomegalovirus(CMV)is the most common viral pathogen after liver transplantation(LT).Although reactivation of CMV infection is generally described in the context of immunosuppression,it has also been described in critically ill immunocompetent patients including cirrhotic *** To determine the incidence of reactivated CMV prior to *** This was a prospective cohort study evaluating adult patients who underwent LT between 2014 and 2016.A plasma sample was obtained from all patients for CMV quantitative real-time PCR testing right before *** were followed for at least 1 year to assess the following outcomes:Incidence of CMV infection,organ rejection and overall *** A total of 72 patients were *** patients died before transplantation,thus 68 patients were followed up for a median of 44 mo(20-50 mo).In 23/72 patients(31.9%)CMV was reactivated before ***-transplantation,16/68(23.5%)patients had CMV infection and that was significantly associated with the recipient being CMV negative and a CMV-positive *** CMV reactivation was not associated with overall mortality(log rank:0.9).CONCLUSION This study shows that CMV infection is common in patients with chronic liver disease just before LT,but the clinical impact of this infection seems to be negligible.

关键词： Liver transplantation Cytomegalovirus infection Quantitative real-time PCR Risk factors Liver cirrhosis Molecular biology

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基于可再生能源的全球电气化路径与远景分析

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中国电力 2020年第3期53卷 159-166页

作者：洪博文 MIKETA Asami GIELEN Dolf RUSSO Daniel JANEIRO luis BOSHELL Francisco wagner Nicholas TAIBI Emanuele 国际可再生能源署创新与技术中心波恩53175 国网能源研究院有限公司北京102209 国家电网有限公司能源互联网经济研究院北京102209

为满足清洁能源转型的深度脱碳要求,描绘一幅基于可再生能源电气化的蓝图,全面阐述了基于可再生能源的电气化路径,分析其在工业、交通、建筑等部门面对的挑战,评估不同技术路径的应用前景和效益,提出政策、技术和市场方面的措施建议。... 详细信息

为满足清洁能源转型的深度脱碳要求,描绘一幅基于可再生能源电气化的蓝图,全面阐述了基于可再生能源的电气化路径,分析其在工业、交通、建筑等部门面对的挑战,评估不同技术路径的应用前景和效益,提出政策、技术和市场方面的措施建议。研究结果表明,基于可再生能源的电气化路径不仅技术可行,同时也会产生重要的经济和社会效益。

关键词：可再生能源电气化路径远景终端应用

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Increased incidence of and microbiologic changes in pyogenic liver abscesses in the Mexican population

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World Journal of Hepatology 2020年第10期12卷 816-828页

作者： Juanita Pérez-Escobar wagner Ramirez-Quesada Daniel Alejandro Calle-Rodas luis Alberto Chi-Cervera Nalu Navarro-Alvarez Jorge Aquino-Matus Juan Pablo Ramírez-Hinojosa Carlos Moctezuma-Velázquez Aldo Torre Department of Gastroenterology Instituto Nacional de Ciencias Médicas y Nutrición Salvador ZubiránMexico City 14080Mexico Department of Internal Medicine Hospital General Dr.Manuel Gea GonzálezMexico City 14080Mexico

BACKGROUND Pyogenic liver abscess(PLA)is a rare disease with an estimated incidence that varies widely across the globe,being as high as 115.4/100000 habitants in Taiwan and as low as 1.1-1.2/100000 habitants in Europe and *** though there are multiple microorganisms capable of producing an abscess in the liver,including Entamoeba histolytica,fungi,and viruses,most abscesses are derived from bacterial *** epidemiology of PLA in Mexico is currently *** To describe the clinical,demographic and microbiologic characteristics of PLA in *** This is a retrospective study carried out in two centers,and included patients seen between 2006 and 2018 with the diagnosis of pyogenic *** collected demographic,clinical,and microbiological information,treatment,complications,and outcomes.A logistic regression analysis was used to determine the association between different variables and mortality *** A total of 345 patients were included in this study.233(67.5%)had confirmed PLA,133(30%)patients had no positive culture and negative serology and 9(2.5%)had mixed *** mean age was 50 years(ranging from 16-97 years)and 63%were female.65%of the patients had positive cultures for Extended Spectrum Beta-Lactamases(ESBL)-Escherichia coli and Klebsiella *** was administered in 60%of *** most common sources of infection were ascending cholangitis and cholecystitis in 34(10%)and 31(9%),*** median length of hospital stay was 14 d.165 patients underwent percutaneous catheter *** inpatient mortality rate was 63%.Immunocompromised state[OR 3.9,95%CI:1.42-10.46],ESBL-Escherichia coli[OR 6.7,95%CI:2.7-16.2]and Klebsiella pneumoniae[OR 4-8,95%CI:1.6-14.4]predicted inpatient mortality by multivariate *** The prevalence of PLA is increasing in Mexico and has a very high mortality ***-Escherichia coli and Klebsiella pneumoniae are the most common microorganisms causing PLA

关键词： Liver abscess Pyogenic Mexican population Epidemiology Complications Outcomes Mortality

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Sex-specific effects of Eugenia punicifolia extract on gastric ulcer healing in rats

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World Journal of Gastroenterology 2018年第38期24卷 4369-4383页

作者： Larissa Lucena Périco Vinícius Peixoto Rodrigues Rie Ohara Gabriela Bueno Vania Vasti Alfieri Nunes Raquel Cássia dos Santos Ana Carolina Lima Camargo luis Antuio Justulin Joior Sérgio Faloni de Andrade Viviane Miranda Bispo Steimbach Luísa Mota da Silva Lúcia Regina Machado da Rocha wagner Vilegas Catarina dos Santos Clélia Akiko Hiruma-Lima Department of Physiology Institute of BiosciencesSa Paulo State University(UNESP)Botucatu 18618-970Sa PauloBrazil Laboratory of Bioactive Compounds Sao Francisco UniversityBraganca Paulista 12916-900Sa PauloBrazil Department of Morphology Institute of BiosciencesSao Paulo State University(UNESP)Botucatu 18618-970Sao PauloBrazil Programa de Po-graduacao em Ciecias Farmaco-ticas Nuleo de Investigacoes Quiico-Farmaceticas(NIQFAR)Universidade do Vale do Itajai-UNIVALIItajai 88302-901Santa CatarinaBrazil Coastal Campus of Sa Vicente Sa Paulo State University(UNESP)Sa Vicente 11330-900Sa PauloBrazil Department of Biological Science Faculty of Sciences and LanguagesSa Paulo State University(UNESP)Assis 19806-900SaPauloBrazil

AIM To evaluate the sex-specific effects of a hydroalcoholic extract from Eugenia punicifolia(HEEP) leaves on gastric ulcer *** In this rat study involving males, intact(cycling) females, and ovariectomized females, gastric ulcers were induced using acetic acid. A vehicle, lansoprazole, or HEEP was administered for 14 d after ulcer induction. Body weight was monitored throughout the treatment period. At the end of treatment, the rats were euthanized and the following in vivo and in vitro investigations were performed: macroscopic examination of the lesion area and organ weights, biochemical analysis, zymography, and evaluation of protein expression levels. Additionally, the concentration-dependent effect of HEEP was evaluated in terms of subacute toxicity and *** Compared to the vehicle, HEEP demonstrated a great healing capacity by substantially reducing the ulcerative lesion area in males(52.44%), intact females(85.22%), and ovariectomized females(65.47%), confirming that HEEP accelerates the healing of acetic acidinduced gastric lesions and suggesting that this effect is modulated by female sex hormones. The antiulcer effect of HEEP was mediated by prostaglandin E2 only in male rats. Overall, the beneficial effect of HEEP was the highest in intact females. Notably, HEEP promoted the expression of vascular endothelial growth factor(intact vs ovariectomized females) and decreased the expression of Caspase-8 and Bcl-2(intact female vs male or ovariectomized female). Additionally, HEEP enhanced fibroblast proliferation and migration into a wounded area in vitro, confirming its healing effect. Finally, no sign of subacute toxicity or cytotoxicity of HEEP was *** In gastric ulcers, HEEP-induced healing(modulated by female sex hormones; in males, mediated by prostaglandin) involves extracellular matrix remodeling, with gastric mucosa cell proliferation and migration.

关键词： Eugenia punicifolia Gastric ulcer healing Acetic acid Sex difference Myrtaceae Toxicity

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Hair Analysis of Mammals of Brazilian Wildlife for Forensic Purposes

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Open Journal of Animal Sciences 2018年第3期8卷 335-345页

作者： Talia Missen Tremori Fernanda Marion Monteiro Garcia luis Mauricio Montoya Florez Bianca Picado Goncalves Barbara wagner Duarte Ferraz de Camargo Claire Gwinnett Carlos Roberto Teixeira Noeme Sousa Rocha Department of Veterinary Clinics School of Veterinary Medicine and Animal ScienceSao Paulo State UniversityBotucatuBrazil Department of Genetics Sao Paulo State UniversityBotucatuBrazil Faculty of Computing Engineering and SciencesUniversity of StaffordshireStaffordshireUK Department of Surgery and Anesthesiology School of Veterinary Medicine and Animal ScienceSao Paulo State UniversityBotucatuBrazil

Wildlife trafficking is classified as the fourth largest illegal commerce in the world. Taxonomic identification of wildlife is an ordinary process for forensics experts. The aim of this study was to analyze animal’s hair from Brazilian’s wildlife through microscopic and compare morphology of bristle among species analyzed. Hair samples of nine species were analyzed. Glass slides were analyzed through optical microscopy and following measurements were obtained: total length, medulla diameter, overall diameter and overall ratio diameter of the medulla’s diameter. The images obtained at identification of animals through the morphology of hair and the statistics analysis corroborates in favor for the validation of the technique.

关键词： Forensic Zoobiology Hair Analysis Veterinary Forensic Medicine Animal Expertise Animal Trafficking Smuggling

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