LUZ MARINA GOMEZ GOMEZ
Projetos de Pesquisa
Unidades Organizacionais
LIM/51 - Laboratório de Emergências Clínicas, Hospital das Clínicas, Faculdade de Medicina
7 resultados
Resultados de Busca
Agora exibindo 1 - 7 de 7
- Performance of NEWS, qSOFA, and SIRS Scores for Assessing Mortality, Early Bacterial Infection, and Admission to ICU in COVID-19 Patients in the Emergency Department(2022) ALENCAR, Julio; GOMEZ, Luz Marina Gomez; CORTEZ, Andre Lazzeri; SOUZA, Heraldo Possolo de; LEVIN, Anna Sara; SALOMAO, Matias ChiarastelliSARS-CoV-2 infection has a wide spectrum of presentations, from asymptomatic to pneumonia and sepsis. Risk scores have been used as triggers for protocols that combine several interventions for early management of sepsis. This study tested the accuracy of the score SIRS, qSOFA, and NEWS in predicting outcomes, including mortality and bacterial infection, in patients admitted to the emergency department (ED) during the COVID-19 pandemic. We described 2,473 cases of COVID-19 admitted to the ED of the largest referral hospital for severe COVID-19 in Brazil during the pandemic. SIRS, qSOFA and NEWS scores showed a poor performance as prognostic scores. However, NEWS score had a high sensitivity to predict in-hospital death (0.851), early bacterial infection (0.851), and ICU admission (0.868), suggesting that it may be a good screening tool for severe cases of COVID-19, despite its low specificity.
- Timing to Intubation COVID-19 Patients: Can We Put It Off until Tomorrow?(2022) ALENCAR, Julio Cesar Garcia de; STERNLICHT, Juliana Martes; VEIGA, Alicia Dudy Muller; MARCHINI, Julio Flavio Meirelles; FERREIRA, Juliana Carvalho; CARVALHO, Carlos Roberto Ribeiro de; MARCILIO, Izabel; SILVA, Katia Regina da; COBELLO JUNIOR, Vilson; FELIX, Marcelo Consorti; GOMEZ, Luz Marina Gomez; SOUZA, Heraldo Possolo de; MAUA, Denis DerataniBackground: The decision to intubate COVID-19 patients receiving non-invasive respiratory support is challenging, requiring a fine balance between early intubation and risks of invasive mechanical ventilation versus the adverse effects of delaying intubation. This present study analyzes the association between intubation day and mortality in COVID-19 patients. Methods: We performed a unicentric retrospective cohort study considering all COVID-19 patients consecutively admitted between March 2020 and August 2020 requiring invasive mechanical ventilation. The primary outcome was all-cause mortality within 28 days after intubation, and a Cox model was used to evaluate the effect of time from onset of symptoms to intubation in mortality. Results: A total of 592 (20%) patients of 3020 admitted with COVID-19 were intubated during study period, and 310 patients who were intubated deceased 28 days after intubation. Each additional day between the onset of symptoms and intubation was significantly associated with higher in-hospital death (adjusted hazard ratio, 1.018; 95% CI, 1.005-1.03). Conclusion: Among patients infected with SARS-CoV-2 who were intubated and mechanically ventilated, delaying intubation in the course of symptoms may be associated with higher mortality. Trial registration: The study protocol was approved by the local Ethics Committee (opinion number 3.990.817; CAAE: 30417520.0.0000.0068).
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.- Carotid intima-media thickness and metabolic syndrome in a rural population: Results from the Baependi Heart Study(2020) GEOVANINI, G.R.; SOUSA, I. Pinheiro de; TEIXEIRA, S.K.; FRANCISCO NETO, M.J.; GóMEZ, L.M. Gómez; GUERRA, G.C. Del; PEREIRA, A.C.; KRIEGER, J.E.Background and aims: Carotid intima-media thickness (cIMT) is a strong predictor of cardiovascular events and associated with metabolic syndrome (MetS). MetS is a cluster of cardiovascular risk factors, but the association structure between specific factors and disease development is not well-established in rural populations. We described the association structure between MetS factors and cIMT in a sample from rural Brazil. Methods: We studied 1937 participants from the Baependi Heart Study who underwent carotid ultrasound exam. We used ATP–III–2001 for MetS definition and linear mixed-effects models, adjusting by the family structure, to assess independent associations between the cardiovascular risk factors which define MetS and cIMT. Results: The sample's mean age was 46 ± 16y, 61% female, 73% white, mean body-mass-index 26±5 kg/m2, mean cIMT 0.53 ± 0.16 mm, with 35% of the sample classified with MetS. As expected, cIMT demonstrated a linear relationship with increasing age, and cIMT higher values were observed for MetS (0.58 ± 0.16 mm) compared to non-MetS (0.49 ± 0.14 mm). Considering models for cIMT with MetS and all of its factors, we found that blood pressure, glucose and obesity were independently associated with cIMT, but not HDL or triglycerides. Conclusions: cIMT showed a linear relationship with increasing age. Blood pressure, obesity, and glucose were independently associated with cIMT, but not HDL-cholesterol or triglycerides. In a rural population, hypertension, diabetes and obesity play a more important role than lipids in determining cIMT interindividual variability. © 2020 The Authors
- 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).