ARTUR FIGUEIREDO DELGADO
Projetos de Pesquisa
Unidades Organizacionais
Instituto da Criança, Hospital das Clínicas, Faculdade de Medicina
LIM/36 - Laboratório de Pediatria Clínica, Hospital das Clínicas, Faculdade de Medicina
LIM/36 - Laboratório de Pediatria Clínica, Hospital das Clínicas, Faculdade de Medicina
102 resultados
Resultados de Busca
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- Lymphocyte count as a sign of immunoparalysis and its correlation with nutritional status in pediatric intensive care patients with sepsis: A pilot study(2016) MANZOLI, Talita Freitas; DELGADO, Artur Figueiredo; TROSTER, Eduardo Juan; CARVALHO, Werther Brunow de; ANTUNES, Ana Caroline Barreto; MARQUES, Desiree Mayara; ZAMBERLAN, PatriciaOBJECTIVES: Developing malnutrition during hospitalization is well recognized worldwide, and children are at a relatively higher risk for malnutrition than adults. Malnutrition can lead to immune dysfunction, which is associated with a higher mortality rate due to sepsis, the most frequent cause of death in pediatric intensive care units (PICUs). The aim of this study was to investigate whether malnourished patients are more likely to have relative or absolute lymphopenia and, consequently, worse prognoses. METHODS: We enrolled 14 consecutive patients with sepsis whose legal representatives provided written informed consent. Patients were classified as normal or malnourished based on anthropometric measurements. As an additional evaluation of nutritional status, serum albumin and zinc were measured on the 1 st and 7 th days of hospitalization. Lymphocyte count was also measured on the 1 st and 7 th days. Clinicaltrials. gov: NCT02698683. RESULTS: Malnutrition prevalence rates were 33.3% and 42.8% based on weight and height, respectively. Laboratory analyses revealed a reduction of serum albumin in 100% of patients and reduction of zinc in 93.3% of patients. A total of 35% of patients had fewer than 500 lymphocytes/mm(3) on their first day in the PICU. Lymphocyte counts and zinc concentrations significantly increased during hospitalization. CONCLUSIONS: Nutritional evaluations, including anthropometric measurements, were not correlated with lymphocyte counts. Lymphocyte counts concomitantly increased with zinc levels, suggesting that micronutrient supplementation benefits patients with sepsis.
- Are Children Similar to Adults When There Is Fluid Overload?(2013) RODRIGUES, Priscila Correa; MENEZES, Aline Motta; CARVALHO, Werther Brunow; DELGADO, Artur Figueiredo
- Infections in Pediatric Living Donor Transplantation in Undernourished Patients in a Developing Country: Aspects to Consider(2019) RAMOS, Gabriel F.; SANTOS, Maria Lucia M. B.; CARVALHO, Werther Brunow de; DELGADO, Artur Figueiredo
- Is the Obesity Paradox Valid in Pediatric Intensive Care?(2017) ZAMBERLAN, Patricia; DELGADO, Artur Figueiredo; CARVALHO, Werther Brunow de
- Fluid Overload: A Question in Pediatric Intensive Care Spotlight?(2016) LUGLIO, Michele; DELGADO, Artur Figueiredo; CARVALHO, Werther Brunow de
- Stress Ulcer Prophylaxis Remains a Controversial Management in the PICU(2020) RAMOS, Gabriel F.; LUGLIO, Michele; CARVALHO, Werther Brunow de; DELGADO, Artur Figueiredo
bookPart Insuficiência cardíaca(2018) SPESSOTO, Andréa Beolchi; COSTA, Graziela de Araújo; DELGADO, Artur Figueiredo- Miocardite fulminante associada ao vírus influenza H1N1: relato de caso e revisão de literatura(2014) LOBO, Maria Lúcia Saraiva; TAGUCHI, Ângela; GASPAR, Heloísa Amaral; FERRANTI, Juliana Ferreira; CARVALHO, Werther Brunow de; DELGADO, Artur FigueiredoCaso de miocardite fulminante associada ao vírus influenza H1N1, em que foi descrita a evolução clínica do paciente e enfatizada a importância do ecocardiograma à beira do leito como auxílio no diagnóstico precoce e manejo de crianças com disfunção miocárdica grave, além de terem sido discutidos aspectos relevantes relacionados à terapêutica e ao prognóstico da miocardite fulminante. Trata-se de paciente do sexo feminino, 4 anos e 8 meses, previamente hígida, com história de quadro gripal há 2 semanas. Admitida no pronto-socorro com sinais de instabilidade hemodinâmica, necessitando de suporte ventilatório e drogas vasoativas. Exames laboratoriais, radiografia de tórax e ecocardiograma sugestivos de miocardite. Pesquisa positiva para H1N1 em secreção de nasofaringe. Evoluiu com choque cardiogênico refratário a despeito das medidas clínicas, indo a óbito em 48 horas após admissão na unidade de terapia intensiva. O vírus influenza H1N1 é agente etiológico associado a quadros de miocardite aguda, porém poucos são os casos relatados de miocardite fulminante pelo vírus H1N1. A identificação de sinais e sintomas sugestivos de evolução fulminante deve ser imediata e o ecocardiograma à beira do leito é uma ferramenta útil para detecção precoce de disfunção miocárdica e orientação terapêutica. O uso de terapia imunossupressora, em casos de miocardite fulminante de etiologia viral, é controverso, bem como o de terapia antiviral, de tal forma que o tratamento baseia-se em suporte hemodinâmico e ventilatório. O uso de suporte hemodinâmico, por meio de oxigenação por membrana extracorpórea, aparece como terapia promissora.
- Acute petrified myocardium associated with meningococcal sepsis in childhood-onset systemic lupus erythematous: a fatal case(2019) SANTOS, Ana Carolina Etrusco Zaroni; LUGLIO, Michele; DELGADO, Artur Figueiredo; SCHUWARTZ, Constance Dell Santo Vieira; MARQUES, Heloisa Helena Sousa; VALOES, Clarissa Carvalho de Miranda; DOMINGUEZ, Maria Andreina Cabrera; CARVALHO, Werther Brunow de; SILVA, Clovis Artur; DUARTE-NETO, Amaro NunesAcute petrified myocardium associated with septic shock, diagnosed by autopsy has rarely been described. A 15-year-old adolescent male was diagnosed with childhood-onset systemic lupus erythematosus. One year later, he was hospitalized with fever, myalgia, headache, arthritis, vomiting, dyspnea and was diagnosed with sepsis secondary to bronchopneumonia and meningitis. Blood culture identified Neisseria meningitidis serogroup Y. Despite antibiotics and intensive therapeutic measures, he died after 29 days of hospitalization. The autopsy revealed necrotic cardiomyocytes with dystrophic calcification and interstitial fibrosis.
- Lipid profiles of children and adolescents with inflammatory response in a paediatric emergency department(2016) MURAMOTO, Giovana; DELGADO, Artur Figueiredo; SOUZA, Eloisa Correa de; GILIO, Alfredo Elias; CARVALHO, Werter Brunow de; MARANHAO, Raul CavalcanteBackground: To compare the lipid profile between patients with and without inflammatory process in according nutritional status, gender and age. Methods: One hundred and twenty-four children and adolescents in the emergency department were separated into two groups according to the levels of C-reactive protein (CRP). Total cholesterol, high-density lipoprotein (HDL) and low-density lipoprotein (LDL), triglycerides (TG) and albumin in patients with CRP < 5 mg/L were compared with patients with CRP >= 5 mg/L. Nutritional status was assessed by anthropometric measurements. Results: Patients were mostly classified as well-nourished (76.5%) and had low levels of HDL (70%). There was no significant difference in lipid profile between the two groups of CRP. Linear regression analysis, however, it became clear that for each increase of 1 mg/L in the values of CRP expected an average reduction of 0.072 mg/dL of HDL, the 0.083 mg/dL of LDL, the 0.002 g/dL albumin and an average increase of 0.564 mg/dL of TG. Conclusions: Patients with an inflammatory process exhibit changes in the serum levels of the lipids HDL, LDL and TG that are related to the degree of inflammation. These changes occurred regardless of nutritional status.