DENISE AYA OTSUKI
Projetos de Pesquisa
Unidades Organizacionais
LIM/08 - Laboratório de Anestesiologia, Hospital das Clínicas, Faculdade de Medicina
8 resultados
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Agora exibindo 1 - 8 de 8
- TREATMENT WITH HUMAN UMBILICAL CORD-DERIVED MESENCHYMAL STEM CELLS IN A PIG MODEL OF SEPSIS-INDUCED ACUTE KIDNEY INJURY: EFFECTS ON MICROVASCULAR ENDOTHELIAL CELLS AND TUBULAR CELLS IN THE KIDNEY(2023) MAIA, Debora Rothstein Ramos; OTSUKI, Denise Aya; RODRIGUES, Camila Eleuterio; ZBORIL, Sabrina; SANCHES, Talita Rojas; NETO, Amaro Nunes Duarte; ANDRADE, Lucia; AULER, Jose Otavio CostaBackground: Approximately 50% of patients with sepsis develop acute kidney injury (AKI), which is predictive of poor outcomes, with mortality rates of up to 70%. The endothelium is a major target for treatments aimed at preventing the complications of sepsis. We hypothesized that human umbilical cord-derived mesenchymal stem cells (hUC-MSCs) could attenuate tubular and endothelial injury in a porcine model of sepsis-induced AKI. Methods: Anesthetized pigs were induced to fecal peritonitis, resulting in septic shock, and were randomized to treatment with fluids, vasopressors, and antibiotics (sepsis group; n = 11) or to that same treatment plus infusion of 1 x 106 cells/kg of hUC-MSCs (sepsis+MSC group; n = 11). Results: At 24 h after sepsis induction, changes in serum creatinine and mean arterial pressure were comparable between the two groups, as was mortality. However, the sepsis+MSC group showed some significant differences in comparison with the sepsis group: lower fractional excretions of sodium and potassium; greater epithelial sodium channel protein expression; and lower protein expression of the Na-K-2Cl cotransporter and aquaporin 2 in the renal medulla. Expression of P-selectin, thrombomodulin, and vascular endothelial growth factor was significantly lower in the sepsis+MSC group than in the sepsis group, whereas that of Toll-like receptor 4 (TLR4) and nuclear factor-kappa B (NF-kappa B) was lower in the former. Conclusion: Treatment with hUC-MSCs seems to protect endothelial and tubular cells in sepsis-induced AKI, possibly via the TLR4/NF-kappa B signaling pathway. Therefore, it might be an effective treatment for sepsis-induced AKI.
- Atrofia progressiva generalizada da retina em cães da raça Cocker Spaniel(2013) GOMES, Debora; OTSUKI, Denise Aya; LISAK, Ricardo; SAFATLE, Angelica de Mendonca VazGeneralized progressive retinal atrophy (GPRA) is a common disease in Cocker Spaniels dogs characterized by progressive loss of retinal function and disappearance of photoreceptors. The disease is bilateral, hereditary, autosomal recessive, has no sexual predisposition and is frequently associated with cataracts. According to molecular studies the degeneration occurs by a mutation in different genes. In American Cocker Spaniels dogs the disease is observed between three and five years of age and in English Cocker Spaniels between four and eight years old. The clinical signs are: nyctalopia, tapetal hyperreflexia and cataracts. The diagnosis is based on clinical history, ophthalmologic examination and complementary exams such as electroretinography, ocular ultrasound and genetic testing. This article aimed to conduct a review of literature on the generalized progressive retinal atrophy (GPRA) in Cocker Spaniel dogs with cataracts.
- Can a Therapeutic Strategy for Hypotension Improve Cerebral Perfusion and Oxygenation in an Experimental Model of Hemorrhagic Shock and Severe Traumatic Brain Injury?(2023) BALZI, Ana Paula de Carvalho Canela; OTSUKI, Denise Aya; ANDRADE, Lucia; PAIVA, Wellingson; SOUZA, Felipe Lima; AURELIANO, Luiz Guilherme Cernaglia; MALBOUISSON, Luiz Marcelo SaBackgroundRestoration of brain tissue perfusion is a determining factor in the neurological evolution of patients with traumatic brain injury (TBI) and hemorrhagic shock (HS). In a porcine model of HS without neurological damage, it was observed that the use of fluids or vasoactive drugs was effective in restoring brain perfusion; however, only terlipressin promoted restoration of cerebral oxygenation and lower expression of edema and apoptosis markers. It is unclear whether the use of vasopressor drugs is effective and beneficial during situations of TBI. The objective of this study is to compare the effects of resuscitation with saline solution and terlipressin on cerebral perfusion and oxygenation in a model of TBI and HS.MethodsThirty-two pigs weighing 20-30 kg were randomly allocated into four groups: control (no treatment), saline (60 ml/kg of 0.9% NaCl), terlipressin (2 mg of terlipressin), and saline plus terlipressin (20 ml/kg of 0.9% NaCl + 2 mg of terlipressin). Brain injury was induced by lateral fluid percussion, and HS was induced through pressure-controlled bleeding, aiming at a mean arterial pressure (MAP) of 40 mmHg. After 30 min of circulatory shock, resuscitation strategies were initiated according to the group. The systemic and cerebral hemodynamic and oxygenation parameters, lactate levels, and hemoglobin levels were evaluated. The data were subjected to analysis of variance for repeated measures. The significance level established for statistical analysis was p < 0.05.ResultsThe terlipressin and saline plus terlipressin groups showed an increase in MAP that lasted until the end of the experiment (p < 0.05). There was a notable increase in intracranial pressure in all groups after starting treatment for shock. Cerebral perfusion pressure and cerebral oximetry showed no improvement after hemodynamic recovery in any group. The groups that received saline at resuscitation had the lowest hemoglobin concentrations after treatment.ConclusionsThe treatment of hypotension in HS with saline and/or terlipressin cannot restore cerebral perfusion or oxygenation in experimental models of HS and severe TBI. Elevated MAP raises intracranial pressure owing to brain autoregulation dysfunction caused by TBI.
article 1 Citação(ões) na Scopus Normal values of b-wave responses of full-field electroretinogram in Lhasa Apso dogs with cataracts according to age(2015) GOES, Ana C. A.; VILLAR, Tatiane; OTSUKI, Denise A.; LISAK, Ricardo; PECORA, Ricardo A.; SAFATLE, Angelica M. V.Lhasa Apso dogs with immature, mature or hypermature cataracts were divided into four groups according to their age (G1: 1 to 3 years old, G2: 4 to 7 years old, G3: 8 to 11 years old, G4: more than 12 years old). All animals were evaluated under the same sedation protocol to allow the performance of the electroretinogram (ERG) exam to determine normal value of b-wave response of the full-field ERG according to age. Three ERG responses were recorded: rod, maximal and cone responses. The amplitude values and b-wave implicit time of the responses of all groups were compared and analyzed by Kruskal-Wallis test (variance analysis for non-repeated measures), followed by the Dunn post-test (when p<0,05). A significant decrease was observed in maximal responses' amplitude, when comparing the G4 group with G1 and G2. No statistically relevant differences were observed in the b-wave implicit time values between groups. The ERG values are directly influenced by the animal's age. Older patients presented a decrease in the amplitude of the maximal response. The study determined the normal parameters of ERG b-waves for Lhasa Apso dogs with cataract according to their age group.- Assessment of left ventricle myocardial deformation in a hemorrhagic shock swine model by two-dimensional speckle tracking echocardiography(2022) VASCONCELLOS, Henrique Doria de; SAAD, Karen Ruggeri; SAAD, Paulo Fernandes; OTSUKI, Denise Aya; CIUFFO, Luisa A.; LESTER, Laeben; KOIKE, Marcia Kiyomi; ARMSTRONG, Anderson da Costa; LIMA, Joao A. C.; MONTERO, Edna Frasson de SouzaBACKGROUND Trauma-induced secondary cardiac injury has been associated with significant adverse cardiovascular events. Speckle tracking echocardiography is a novel technology that allows an accurate and reproducible cardiac structure and function assessment. We evaluated the left ventricle (LV) myocardial deformation by speckle tracking echocardiography in a hemorrhagic shock (HS) swine model. METHODS Seven healthy male Landrace pigs were included in this study. Severe HS was reached through three sequentially blood withdraws of 20% of estimated blood volume, and it was maintained for 60 minutes. Volume resuscitation was performed using all precollected blood volume. A 1.8- to 4.2-MHz phased-array transducer was used to acquire the two-dimensional echocardiography images. Strain measurements were obtained semiautomatically by wall motion tracking software. Results are presented as medians and interquartile ranges and compared using Wilcoxon rank-sum test. A p value of <0.05 was considered statistically significant. RESULTS The median weight was 32 (26.1-33) kg, and the median total blood volume withdrawn was 1,100 (1,080-1,190) mL. During the severe HS period, the median arterial systemic pressure was 39 (36-46) mm Hg, and the cardiac index was 1.7 (1.6-2.0) L/min/m(2). There was statistically significant absolute decrease in the global longitudinal strain 2 hours postresuscitation comparing with the basal measurements (-9.6% [-10.7 to -8.0%] vs. -7.9% [-8.1 to -7.4%], p = 0.03). There were no statistically significant differences between the basal and 2 hours postresuscitation assessments in the invasive/noninvasive hemodynamic, other two-dimensional echocardiogram (LV ejection fraction, 49.2% [44-54.3%] vs. 53.2% [51.5-55%]; p = 0.09), and circumferential strain (-10.6% [-14.4 to -9.0%] vs. -8.5% [-8.6 to -5.2%], p = 0.06) parameters. CONCLUSION In this experimental swine model of controlled HS, LV global longitudinal strain analysis accurately characterizes the timing and magnitude of subclinical cardiac dysfunction associated with trauma-induced secondary cardiac injury.
- Effects of dexmedetomidine on hemodynamic, oxygenation, microcirculation, and inflammatory markers in a porcine model of sepsis(2022) CARNICELLI, Paulo; OTSUKI, Denise Aya; MONTEIRO FILHO, Adalberto; KAHVEGIAN, Marcia Aparecida Portela; IDA, Keila Kazue; AULER-JR, Jose Otavio Costa; ROUBY, Jean-Jacques; FANTONI, Denise TabacchiPurpose: To determine whether dexmedetomidine aggravates hemodynamic, metabolic variables, inflammatory markers, and microcirculation in experimental septic shock. Methods: Twenty-four pigs randomized into: Sham group (n = 8), received saline; Shock group (n = 8), received an intravenous infusion of Escherichia coli O55 (3 x 10(9) cells/mL, 0.75 mL/kg, 1 hour); Dex-Shock group (n = 8), received bacteria and intravenous dexmedetomidine (bolus 0.5 mcg/kg followed by 0.7 mcg/kg/h). Fluid therapy and/ornorepinephrine were administered to maintain a mean arterial pressure > 65 mmHg. Hemodynamic, metabolic, oxygenation, inflammatory markers, and microcirculation were assessed at baseline, at the end of bacterial infusion, and after 60, 120, 180, and 240 minutes. Results: Compared to Shock group, Dex-Shock group presented a significantly increased oxygen extraction ratio at T180 (23.1 +/- 9.7 vs. 32.5 +/- 9.2%, P = 0.0220), decreased central venous pressure at T120 (11.6 +/- 1 vs. 9.61 +/- 1.2 mmHg, P = 0.0214), mixed-venous oxygen saturation at T180 (72.9 +/- 9.6 vs. 63.5 +/- 9.2%, P = 0.026), and increased plasma lactate (3.7 +/- 0.5 vs. 5.5 +/- 1 mmol/L, P = 0.003). Despite the Dex-Shock group having a better sublingual vessel density at T240 (12.5 +/- 0.4 vs. 14.4 +/- 0.3 mL/m(2); P = 0.0003), sublingual blood flow was not different from that in the Shock group (2.4 +/- 0.2 vs. 2.4 +/- 0.1 mL/kg, P = 0.4418). Conclusions: Dexmedetomidine did not worsen the hemodynamic, metabolic, inflammatory, or sublingual blood flow disorders resulting from septic shock. Despite inducing a better sublingual vessel density, dexmedetomidine initially and transitorily increased the mismatch between oxygen supply and demand.
- Estudo comparativo das estruturas do segmento anterior de olhos de cães normais e com catarata, portadores ou não de Diabetes mellitus, avaliados por biomicroscopia ultrassônica(2012) GALEGO, Marcia P.; SAFATLE, Angelica M. V.; OTSUKI, Denise; HVENEGAARD, Ana P.; CASTANHEIRA, Vera R.; BARROS, Paulo S. M.Galego M.P., Safatle A.M.V., Otsuki D., Hvenegaard A.P., Castanheira V.R. & Barros P.S.M. 2012. [Comparison of anterior ocular segment structures in healthy dogs, with diabetic or no diabetic cataract, by ultrasound biomicroscopy.] Estudo comparativo das estruturas do segmento anterior de olhos de caes normais e com catarata, portadores ou nao de Diabetes mellitus, avaliados por biomicroscopia ultrassonica. Pesquisa Veterinaria Brasileira 32(1): 66-71. Departamento de Cirurgia, Faculdade de Zootecnia e Medicina Veterinaria, Universidade de Sao Paulo, Av. Prof. Dr. Orlando de Marques de Paiva 87, Bloco 8 superior, Cidade Universitaria, Sao Paulo, SP 05508-270, Brazil. E-mail: mpgalego@uol.com.br Cataracts represent the leading cause of blindness in dogs. The second most common cause of cataract in dogs is a result of metabolic alterations caused by Diabetes mellitus (DM). Ultrasound biomicroscopy (UBM) is a high-frequency (50 MHz) ultrasonographic method that produces B mode images of microscopic quality. The objective of this study was, by means of UBM use, to compare the anterior segment structures of the canine eyes, both with diabetic and non-diabetic cataract, in order to detect changes caused by DM. The parameters evaluated were: cornea thickness, anterior chamber's depth, increased cellularity inside the anterior chamber, and iridocorneal angle measurement. Eighty-seven eyes of 47 dogs were examined, divided into three groups: control (GCO), non-diabetic cataract (GCAT) and diabetic cataract (GDM). The results showed that the diabetic group presented a higher cornea thickness than the other groups. The control group showed deeper anterior chambers without increased cellularity. When the iridocorneal angle measurements were analyzed, it was found that there were no statistically significant differences between the three groups. Based on these results, we can conclude that: the eyes of diabetic dogs with cataract showed a central cornea higher thickness compared to the eyes of dogs with cataract of different etiologies, and to dogs with normal eyes; there is a decrease of the anterior chamber depth and a increase of cellularity in the eyes of dogs with cataract compared to normal eyes, there is no significant difference between the iridocorneal angle measurement in the eyes of dogs with cataract, diabetic or not, and normal dogs.
- Sildenafil in endotoxin-induced pulmonary hypertension: an experimental study(2023) KEMPER, Daniella Aparecida Godoi; OTSUKI, Denise Aya; MAIA, Debora Rothstein Ramos; MOSSOCO, Cristina de Oliveira; MARCASSO, Rogerio Anderson; CUNHA, Ligia Cristina Camara; JR, Jose Otavio Costa Auler; FANTONI, Denise TabacchiBackground: Sepsis and septic shock still represent great challenges in critical care medicine. Sildenafil has been largely used in the treatment of pulmonary arterial hypertension, but its effects in sepsis are unknown. The aim of this study was to investigate the hypothesis that sildenafil can attenuate endotoxin-induced pulmonary hypertension in a porcine model of endotoxemia. Methods: Twenty pigs were randomly assigned to Control group (n = 10), which received saline solution; or to Sildenafil group (n = 10), which received sildenafil orally (100 mg). After 30 min-utes, both groups were submitted to endotoxemia with intravenous bacterial lipopolysaccharide endotoxin (LPS) infusion (4 & mu;g.kg-1.h-1) for 180 minutes. We evaluated hemodynamic and oxy-genation functions, and also lung histology and plasma cytokine (TNFa, IL-1(3, IL6, and IL10) and troponin I response. Results: Significant hemodynamic alterations were observed after 30 minutes of LPS contin-uous infusion, mainly in pulmonary arterial pressure (from Baseline 19 & PLUSMN; 2 mmHg to LPS30 52 & PLUSMN; 4 mmHg, p < 0.05). There was also a significant decrease in PaO2/FiO2 (from Baseline 411 & PLUSMN; 29 to LPS180 334 & PLUSMN; 49, p < 0.05). Pulmonary arterial pressure was significantly lower in the Sildenafil group (35 & PLUSMN; 4 mmHg at LPS30, p < 0.05). The Sildenafil group also presented lower values of systemic arterial pressure. Sildenafil maintained oxygenation with higher PaO2/FiO2 and lower oxygen extraction rate than Control group but had no effect on intrapulmonary shunt. All cytokines and troponin increased after LPS infusion in both groups similarly.Conclusion: Sildenafil attenuated endotoxin-induced pulmonary hypertension preserving the correct heart function without improving lung lesions or inflammation.& COPY; 2021 Published by Elsevier Editora Ltda. on behalf of Sociedade Brasileira de Anestesiologia. This is an open access article under the CC BY-NC-ND license (http://creativecommons.org/ licenses/by-nc-nd/4.0/).