DENISE AYA OTSUKI
Projetos de Pesquisa
Unidades Organizacionais
LIM/08 - Laboratório de Anestesiologia, Hospital das Clínicas, Faculdade de Medicina
31 resultados
Resultados de Busca
Agora exibindo 1 - 10 de 31
- 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.
- Comparison of Epidural and Systemic Tramadol for Analgesia Following Ovariohysterectomy(2012) MASTROCINQUE, Sandra; ALMEIDA, Tatiana F.; TATARUNAS, Angelica C.; IMAGAWA, Viviani H.; OTSUKI, Denise A.; MATERA, Julia M.; FANTONI, Denise T.The objective of the study was to compare epidural and systemic tramadol for postoperative analgesia in bitches undergoing ovariohysterectomy. Twenty animals, randomly divided into two groups, received either epidural (EPI) or intramuscular (IM) tramadol (2 mg/kg) 30 min before anesthetic induction. Analgesia, sedation, cardiorespiratory parameters, end-tidal isoflurane, blood catecholamines and cortisol, and arterial blood gases were measured at different time points up to 24 hr after agent administration. There were no differences between the two groups regarding cardiorespiratory parameters, end-tidal isoflurane, and pain scores. Two dogs in the IM and one in the EPI group required supplemental analgesia. Cortisol was increased (P<0.05) at 120 min (3.59 mu g/dL and 3.27 mu g/dL in the IM and EPI groups, respectively) and 240 min (2.45 mu g/dL and 2.54 mu g/dL in the IM and EPI groups, respectively) compared to baseline. Norepinephrine was also increased (P<0.05) at 120 min in both groups compared to baseline values. Epinephrine values were higher (P<0.05) in the IM group compared with the EPI group at 50 min, 120 min, and 1,440 min after tramadol administration. Epidural tramadol is a safe analgesic, but does not appear to have improved analgesic effects compared with IM administration. (J Am Anim Hosp Assoc 2012; 48:310-319. DOI 10.5326/JAAHA-MS-5795)
conferenceObject RESUSCITATION WITH FLUID OR TERLIPRESSLN DOES NOT INFLUENCE COAGULATION STATUS IN A MODEL OF SEVERE CONTROLLED HAEMORRHAGIC SHOCK(2012) SASAKI, A. T. C.; OTSUKI, D. A.; IDA, K. K.; AULER JR., J. O. C.; MALBOUISSON, L. M. S.- PULSE PRESSURE VARIATION IS COMPARABLE WITH CENTRAL VENOUS PRESSURE TO GUIDE FLUID RESUSCITATION IN EXPERIMENTAL HEMORRHAGIC SHOCK WITH ENDOTOXEMIA(2013) NOEL-MORGAN, Jessica; OTSUKI, Denise Aya; AULER JR., Jose Otavio Costa; FUKUSHIMA, Julia Tizue; FANTONI, Denise TabacchiIntroduction: Pulse pressure variation (PPV) has been proposed as a promising resuscitation goal, but its ability to predict fluid responsiveness has been questioned in various conditions. The purpose of this study was to assess the performance of PPV in predicting fluid responsiveness in experimental hemorrhagic shock with endotoxemia, while comparing it with goals determined by a conventional set of guidelines. Methods: Twenty-seven pigs were submitted to acute hemorrhagic shock with intravenous infusion of endotoxin and randomized to three groups: (i) control; (ii) conventional treatment with crystalloids to achieve and maintain central venous pressure (CVP) 12 to 15 mmHg, mean arterial pressure of 65 mmHg or greater, and SvO(2) (mixed venous oxygen saturation) of 65% or greater; (iii) treatment to achieve and maintain PPV of 13% or less. Parametric data were analyzed by two-way analysis of variance and Tukey test and differences in crystalloid volumes by t test. Predictive values of variables regarding fluid responsiveness were evaluated by receiver operating characteristic curves and multiple logistic regression. Results: Both treatments produced satisfactory hemodynamic recovery, without statistical differences in fluid administration (P = 0.066), but conventional treatment induced higher CVP (P = 0.001). Areas under receiver operating characteristic curves were larger for CVP (0.77; 95% confidence interval, 0.68-0.86) and PPV (0.74; 95% confidence interval, 0.65-0.83), and these variables were further selected by multiple logistic regression as independent predictors of responsiveness. Optimal PPV cutoff was 15%, with false-positive results involving mean pulmonary arterial pressure of 27 mmHg or greater. Conclusions: Acute resuscitation guided by PPV was comparable with the strategy guided by CVP, mean arterial pressure, and SvO(2). Central venous pressure and PPV were individually limited but independently predictive of fluid responsiveness.
- S100B protein and neuron-specific enolase as predictors of cognitive dysfunction after coronary artery bypass graft surgery A prospective observational study(2016) SILVA, Fernando P.; SCHMIDT, Andre P.; VALENTIN, Livia S.; PINTO, Katia O.; ZEFERINO, Suely P.; OSES, Jean P.; WIENER, Carolina D.; OTSUKI, Denise A.; TORT, Adriano B. L.; PORTELA, Luis V.; SOUZA, Diogo O.; AULER JR., Jose O. C.; CARMONA, Maria J. C.BACKGROUND Postoperative cognitive dysfunction (POCD) may be related to the systemic inflammatory response and an increase in serum markers of brain injury such as S100B protein and neuron-specific enolase (NSE). OBJECTIVE The study aims to evaluate the association between POCD and serum levels of S100B and NSE after coronary artery bypass grafting surgery (CABG). DESIGN Prospective observational study. SETTING Single university teaching hospital. PATIENTS We investigated 88 patients undergoing CABG. MAIN OUTCOMES MEASURES Cognitive function was measured preoperatively, and at the 21st and 180th postoperative days (i.e. 6 months after surgery). S100B protein and NSE serum levels were evaluated preoperatively, after induction of anaesthesia, at the end of surgery and at 6 and 24 h after surgery. RESULTS The incidence of POCD was 26.1% at 21 days after surgery and 22.7% at 6 months after surgery. Increased serum levels of S100B protein and NSE were observed postoperatively and may indicate brain damage. CONCLUSION Although serum levels of S100B protein and NSE are both significantly increased postoperatively, our findings indicate that serum levels of S100B protein may be more accurate than NSE in the detection of POCD after CABG.
- A comparison of the cardiopulmonary effects of pressure controlled ventilation and volume controlled ventilation in healthy anesthetized dogs(2016) FANTONI, Denise T.; IDA, Keila K.; LOPES, Thomas F. T.; OTSUKI, Denise A.; AULER JR., Jose Otavio C.; AMBROSIO, Aline M.Objective - To compare the effects of pressure controlled ventilation (PCV) with volume-controlled ventilation (VCV) on lung compliance, gas exchange, and hemodynamics in isoflurane-anesthetized dogs. Design - Prospective randomized study. Setting - Veterinary teaching hospital. Animals - Forty client-owned bitches undergoing elective ovariohysterectomy. Interventions - Dogs were randomly assigned to be ventilated with 100% oxygen using PCV (n = 20) or VCV (n = 20). The respiratory rate was 20/min and positive end-expiratory pressure (PEEP) was 5 cm H2O, with a tidal volume of 10 mL/kg. Cardiac output (CO) was measured using thermodilution. Cardiopulmonary and blood gas data were obtained during spontaneous ventilation and after 30 (T30) and 60 minutes (T60) of controlled ventilation. Measurements and Main Results - In dogs ventilated with PCV, at T30 and T60, PIP was lower (11.4 +/- 1.9 and 11.1 +/- 1.5 cm H2O, respectively) and static compliance (C-ST) was higher (51 +/- 7 and 56 +/- 6 mL/cm H2O, respectively) than in VCV group (PIP of 14.3 +/- 1.3 and 15.5 +/- 1.4 cm H2O; C-ST of 34 +/- 8 and 33 +/- 9 mL/cm H2O, P < 0.0001). Compared with spontaneous ventilation, both groups had decreased alveolar-arterial oxygen difference at T30 and T60 (PCV: 128 +/- 32 mm Hg vs 108 +/- 20 and 104 +/- 16 mm Hg, respectively; VCV: 131 +/- 38 mm Hg vs 109 +/- 19 and 107 +/- 14 mm Hg, respectively; P < 0.01), while CO was maintained at all time points. Conclusions - Compared to spontaneous ventilation, both ventilatory modes effectively improved gas exchange without hemodynamic impairment. PCV resulted in higher lung C-ST and lower PIP compared to VCV.
- Cyclooxygenases 1 and 2 inhibition and analgesic efficacy of dipyrone at different doses or meloxicam in cats after ovariohysterectomy(2021) PEREIRA, Marco A. A.; CAMPOS, Karina D.; GONCALVES, Lucas A.; SANTOS, Rosana S. T. dos; FLOR, Patricia B.; AMBROSIO, Aline M.; OTSUKI, Denise A.; MATERA, Julia M.; GOMES, Cristina O. M. S.; FANTONI, Denise T.Objective To evaluate the cyclooxygenases (COX) inhibition, adverse effects and analgesic efficacy of dipyrone or meloxicam in cats undergoing elective ovariohysterectomy. Study design Prospective, blinded, randomized, clinical study. Animals A total of 30 healthy young cats. Methods The cats were randomly assigned to three postoperative groups: D25 (dipyrone 25 mg kg(-1) every 24 hours), D12.5 (dipyrone 12.5 mg kg(-1) every 12 hours) and M (meloxicam 0.1 mg kg(-1) every 24 hours). In the first 24 hours, the drugs were administered intravenously (IV), and then orally for 6 (dipyrone) or 3 days (meloxicam). Prostanoids thromboxane B-2 and prostaglandin E-2 concentrations served as indicators of COX activity and, with physiological variables and pain and sedation scores, were measured for 24 hours after first analgesic administration. Rescue analgesia (tramadol, 2 mg kg(-1) IV) was provided if Glasgow feline composite measure pain scale (CMPS-Feline) >= 5. Laboratory tests included symmetric dimethylarginine and adverse effects were evaluated regularly up to 7 and 10 days after surgery, respectively. Parametric and nonparametric data were analyzed with two-way ANOVA and Kruskal-Wallis tests, respectively (p < 0.05). Results In the first half hour after analgesic administration, COX-1 activity was close to zero and remained significantly lower than before drug administration for 24 hours in all groups. The inhibition of COX-2 activity was significant for 30 minutes in all groups and up to 4 hours in group M. No alterations in laboratory tests or significant adverse effects were observed. Pain scores and need for rescue analgesia did not differ statistically among groups. Conclusions Dipyrone at both doses and meloxicam provided a nonselective inhibition of COX-1 and -2 activities and effective analgesia without causing significant adverse effects or laboratory tests alterations.
- Effects of bilateral topical administration of repeated doses of rocuronium bromide as a mydriatic agent in Amazon parrots (Amazona aestiva and Amazona amazonica)(2021) DONGO, Pamela S. J.; PINTO, Debora G.; GUIMARAES, Marta B.; OTSUKI, Denise A.; SAFATLE, Angelica M. V.; BOLZAN, Aline A.The effects of bilateral topical application of repeated doses of rocuronium in parrots are unknown, motivating this research. These effects were evaluated in 24 healthy adult Amazon parrots (12 Amazona aestiva and 12 Amazona amazonica). Three different doses of rocuronium bromide (10 mg/mL) were applied with a micropipette onto the cornea: a single instillation of 20 mu L/eye; two instillations of 20 mu L/eye, spaced 15 minutes apart; and three instillations of 20 mu L/eye, spaced 15 minutes apart. Pupillary diameter (PD) was measured with a digital caliper before treatments (TO), every 15 minutes during the first hour postadministration (T15, T30, T45, T60), hourly for 6 hours (T120, T180, T240, T300, T360), and after 24 hours (T24h). Significant differences were observed between TO and T15 -T120 with a single instillation and between TO and T15-T360 with double and triple instillations. The maximum median PDs were 3.47 mm (T45 one instillation), 3.88 mm (T45 two instillations), and 4.09 mm (T30 three instillations). PD returned to baseline at T180 with one instillation and at T24h with double and triple instillations. All protocols showed similar PD values at TO and T24h. Transient lower eyelid paresis was the only adverse effect observed. Bilateral topical administrations of two and three repeated rocuronium bromide doses produced adequate mydriasis in Amazon parrots and may be indicated for longer ophthalmic procedures.
- Applicability of optical coherence tomography in blue-fronted parrots (Amazona aestiva)(2020) PECORA, Ricardo Augusto; WATANABE, Sung Song; GUIMARAES, Marta Brito; OTSUKI, Denise Aya; BARROS, Paulo Sergio de Moraes; SAFATLE, Angelica de Mendonca VazObjective Optical coherence tomography (OCT) measurement of adult blue-fronted parrots (Amazona aestiva), free from infectious, inflammatory or neoplastic systemic diseases and from any ophthalmological illness, aim at its characterization, as well as to standardize the examination technique for the species. Procedure Pupillary dilation was achieved with rocuronium bromide (5 mg/mL) at 0, 2, 15, 17, 30, and 32 minutes. The animals were sedated with midazolam maleate (0.5 mg/kg/IM) and anesthetized with propofol (5.0 mg/kg/IV). Measurements were made to evaluate the thickness of the total retina (TR), sensorineural retinal (SR), and ganglion cell complex (GCC), 2 millimeters (mm) from the pecten toward the fovea. OCT data were compared to measurements of retinal histological slides from enucleated eyes of blue-fronted parrots, scanned in automatic fluorescence microscope and measured with by the VS-ASW (R) software. Results Averages of measurements from the 43 retinas evaluated by OCT were TR: 279.40 micrometers (mu m), SR: 255.90 mu m, and GCC: 138.60 mu m, respectively, and the measurements of six retinas using fluorescence microscopy were 260.30 mu m for TR, 238.20 mu m for SR, and 129.30 mu m for GCC, demonstrating a high correlation coefficient between all measurements (r = .8698, P < .0001). It is also possible to evaluate the anatomy of the retina and to identify its layers, variations and abnormalities using OCT images. Variations were found between the different areas of the retina, both in the images of the histological slides and in the images of the OCT. Conclusion Optical coherence tomography is a valuable technique for in vivo evaluation of retinal structures in blue-front parrots, providing detailed and accurate images. This method improves the understanding of retinal diseases, monitoring the beginning, progression and therapy of retinal diseases, in the same individuals during longitudinal studies. In comparison to histological investigations, OCT enables imaging in vivo, therefore reducing the number of euthanized animals or enucleated eyes.
- Effect of pressure support ventilation during weaning on ventilation and oxygenation indices in healthy horses recovering from general anesthesia(2013) IDA, Keila K.; FANTONI, Denise T.; SOUTO, Maria T. M. R.; OTSUKI, Denise A.; ZOPPA, Andre L. V.; SILVA, Luis C. L. C.; AMBROSIO, Aline M.Objective To determine if pressure support ventilation (PSV) weaning from general anesthesia affects ventilation or oxygenation in horses. Study design Prospective randomized clinical study. Animals Twenty client-owned healthy horses aged 5 +/- 2years, weighing 456 +/- 90kg. Methods In the control group (CG; n=10) weaning was performed by a gradual decrease in respiratory rate (fR) and in the PSV group (PSVG; n=10) by a gradual decrease in fR with PSV. The effect of weaning was considered suboptimal if PaCO2>50 mmHg, arterial pH<7.35 plus PaCO2>50mmHg or PaO2<60mmHg were observed at any time after disconnection from the ventilator until 30minutes after the horse stood. Threshold values for each index were established and the predictive power of these values was tested. Results Pressure support ventilation group (PSVG) had (mean +/- SD) pH 7.36 +/- 0.02 and PaCO2 41 +/- 3mmHg at weaning and the average lowest PaO2 69 +/- 6mmHg was observed 15minutes post weaning. The CG had pH 7.32 +/- 0.02 and PaCO2 57 +/- 6mmHg at weaning and the average lowest PaO2 48 +/- 5mmHg at 15minutes post weaning. No accuracy in predicting weaning effect was observed for fR (p=0.3474), minute volume (p=0.1153), SaO2 (p=0.1737) and PaO2/PAO2 (p=0.1529). A high accuracy in predicting an optimal effect of weaning was observed for VT>10L (p=0.0001), fR/VT ratio0.60 breaths minute-1L-1 (p=0.0001), VT/bodyweight>18.5mL kg-1 (p=0.0001) and PaO2/FiO2>298 (p=0.0002) at weaning. A high accuracy in predicting a suboptimal effect of weaning was observed for VT<10L (p=0.0001), fR/VT ratio0.60 breaths minute-1L-1 (p= 0.0001) and PeCO238mmHg (p=0.0001) at weaning. Conclusions and clinical relevance Pressure support ventilation (PSV) weaning had a better respiratory outcome. A higher VT, VT/body weight, PaO2/FiO2 ratio and a lower fR/VT ratio and PeCO2 were accurate in predicting the effect of weaning in healthy horses recovering from general anesthesia.