JULIO CESAR GARCIA DE ALENCAR
Índice h a partir de 2011
8
Projetos de Pesquisa
Unidades Organizacionais
BAO, FOB - Docente
LIM/51 - Laboratório de Emergências Clínicas, Hospital das Clínicas, Faculdade de Medicina
LIM/51 - Laboratório de Emergências Clínicas, Hospital das Clínicas, Faculdade de Medicina
6 resultados
Resultados de Busca
Agora exibindo 1 - 6 de 6
- A Rare Case of Hyperlactatemia in The Emergency Department(2022) STUMPF, Matheo Augusto Morandi; SIMOES, Ademar Lima; ALENCAR, Julio Cesar Garcia deGlycogen storage disease type 1a is a rare autosomal recessive syndrome characterized by hypoglycemia, hyperuricemia, hyperlipidemia, hepatomegaly, among other features. Case report: A 31-year-old woman genetically diagnosed with this disease in childhood was admitted to the Emergency Department with tachypnea. Her arterial lactate was 179 mg/dL, bicarbonate of 2 mmol/L, pH of 7.0 and pCO2 2.2 mmHg. She received IV glucose, isotonic bicarbonate, and antibiotics. Her urine culture was positive for Escherichia coli. She had a complete recovery from acidosis in 12 hours and was discharged three days later. Conclusion: This case highlights a rare differential of lactic acidosis that can, sometimes, be present in the Emergency Department.
conferenceObject Brazilian Airway Registry COoperation: The First 1,000 Emergency Intubations of the BARCO Study(2023) MAIA, I. W. A.; ALENCAR, J.; MARCHINI, J.; SILVA, E. L. O. J.; GOMES, L.; MARINO, L.; VAISBERG, V.; STANZANI, G.; NOGUEIRA, C.; KROEFF, B.; SOUZA, H.conferenceObject Brazilian Airway Registry COoperation: Comparison Between Intubations Performed by Emergency Physicians or Non-Emergency Physicians(2023) BETONI, H.; MAIA, I. W. A.; MARCHINI, J.; ALENCAR, J.; MARINO, L.; OLIVEIRA, G.; ALONSO, G.; STANZANI, G.; VAISBERG, V.; GOMEZ, L.; SOUZA, H.conferenceObject Brazilian Airway Registry COoperation: Comparison Between Intubations Performed With or Without Videolaryngoscope(2023) OLIVEIRA, G.; MAIA, I. W. A.; ALENCAR, J.; ALONSO, G.; BETONI, H.; GOMES, L.; MARCHINI, J.; MARINO, L.; SOUZA, H.; VAISBERG, V.; STANZANI, G.- Association Between Gut Microbiota and Delirium in Acutely Ill Older Adults(2023) GARCEZ, Flavia Barreto; ALENCAR, Julio Cesar Garcia de; FERNANDEZ, Shirley Steffany Munoz; AVELINO-SILVA, Vivian Iida; SABINO, Ester Cerdeira; MARTINS, Roberta Cristina Ruedas; FRANCO, Lucas Augusto Moyses; RIBEIRO, Sandra Maria Lima; SOUZA, Heraldo Possolo de; AVELINO-SILVA, Thiago JunqueiraOur aim was to investigate the association between gut microbiota and delirium occurrence in acutely ill older adults. We included 133 participants 65+ years consecutively admitted to the emergency department of a tertiary university hospital, between September 2019 and March 2020. We excluded candidates with >= 24-hour antibiotic utilization on admission, recent prebiotic or probiotic utilization, artificial nutrition, acute gastrointestinal disorders, severe traumatic brain injury, recent hospitalization, institutionalization, expected discharge <= 48 hours, or admission for end-of-life care. A trained research team followed a standardized interview protocol to collect sociodemographic, clinical, and laboratory data on admission and throughout the hospital stay. Our exposure measures were gut microbiota alpha and beta diversities, taxa relative abundance, and core microbiome. Our primary outcome was delirium, assessed twice daily using the Confusion Assessment Method. Delirium was detected in 38 participants (29%). We analyzed 257 swab samples. After adjusting for potential confounders, we observed that a greater alpha diversity (higher abundance and richness of microorganisms) was associated with a lower risk of delirium, as measured by the Shannon (odds ratio [OR] = 0.77; 95% confidence interval [CI] = 0.60-0.99; p = .042) and Pielou indexes (OR = 0.69; 95% CI = 0.51-0.87; p = .005). Bacterial taxa associated with pro-inflammatory pathways (Enterobacteriaceae) and modulation of relevant neurotransmitters (Serratia: dopamine; Bacteroides, Parabacteroides: GABA) were more common in participants with delirium. Gut microbiota diversity and composition were significantly different in acutely ill hospitalized older adults who experienced delirium. Our work is an original proof-of-concept investigation that lays a foundation for future biomarker studies and potential therapeutic targets for delirium prevention and treatment.
- Brain injury biomarkers do not predict delirium in acutely ill older patients: a prospective cohort study(2023) ALENCAR, Julio Cesar Garcia de; GARCEZ, Flavia Barreto; PINTO, Agnes Araujo Sardinha; SILVA, Lucas Oliveira Junqueira e; SOLER, Lucas de Moraes; FERNANDEZ, Shirley Steffany Munoz; VAISBERG, Victor Van; GOMEZ, Luz Marina Gomez; RIBEIRO, Sandra Maria Lima; AVELINO-SILVA, Thiago Junqueira; SOUZA, Heraldo PossoloDelirium is a common, serious, and often preventable neuropsychiatric emergency mostly characterized by a disturbance in attention and awareness. Systemic insult and inflammation causing blood-brain-barrier (BBB) damage and glial and neuronal activation leading to more inflammation and cell death is the most accepted theory behind delirium's pathophysiology. This study aims to evaluate the relationship between brain injury biomarkers on admission and delirium in acutely ill older patients. We performed a prospective cohort study which analyzed plasma S100B levels at admission in elderly patients. Our primary outcome was delirium diagnosis. Secondary outcomes were association between S100B, NSE and Tau protein and delirium diagnosis and patients' outcomes (admissions to intensive care, length of hospital stay, and in-hospital mortality). We analyzed 194 patients, and 46 (24%) developed delirium, 25 on admission and 21 during hospital stay. Median of S100B at admission in patients who developed delirium was 0.16 and median was 0.16 in patients who didn't develop delirium (p: 0.69). Levels S100B on admission did not predict delirium in acutely ill elderly patients.Trial registration: The study was approved by the local institutional review board (CAPPESq, no. 77169716.2.0000.0068, October 11, 2017) and registered in Brazilian Clinical Trials Registry (ReBEC, no. RBR-233bct).