22 research outputs found
Rationale, study design, and analysis plan of the Alveolar Recruitment for ARDS Trial (ART): Study protocol for a randomized controlled trial
Background: Acute respiratory distress syndrome (ARDS) is associated with high in-hospital mortality. Alveolar recruitment followed by ventilation at optimal titrated PEEP may reduce ventilator-induced lung injury and improve oxygenation in patients with ARDS, but the effects on mortality and other clinical outcomes remain unknown. This article reports the rationale, study design, and analysis plan of the Alveolar Recruitment for ARDS Trial (ART). Methods/Design: ART is a pragmatic, multicenter, randomized (concealed), controlled trial, which aims to determine if maximum stepwise alveolar recruitment associated with PEEP titration is able to increase 28-day survival in patients with ARDS compared to conventional treatment (ARDSNet strategy). We will enroll adult patients with ARDS of less than 72 h duration. The intervention group will receive an alveolar recruitment maneuver, with stepwise increases of PEEP achieving 45 cmH(2)O and peak pressure of 60 cmH2O, followed by ventilation with optimal PEEP titrated according to the static compliance of the respiratory system. In the control group, mechanical ventilation will follow a conventional protocol (ARDSNet). In both groups, we will use controlled volume mode with low tidal volumes (4 to 6 mL/kg of predicted body weight) and targeting plateau pressure <= 30 cmH2O. The primary outcome is 28-day survival, and the secondary outcomes are: length of ICU stay; length of hospital stay; pneumothorax requiring chest tube during first 7 days; barotrauma during first 7 days; mechanical ventilation-free days from days 1 to 28; ICU, in-hospital, and 6-month survival. ART is an event-guided trial planned to last until 520 events (deaths within 28 days) are observed. These events allow detection of a hazard ratio of 0.75, with 90% power and two-tailed type I error of 5%. All analysis will follow the intention-to-treat principle. Discussion: If the ART strategy with maximum recruitment and PEEP titration improves 28-day survival, this will represent a notable advance to the care of ARDS patients. Conversely, if the ART strategy is similar or inferior to the current evidence-based strategy (ARDSNet), this should also change current practice as many institutions routinely employ recruitment maneuvers and set PEEP levels according to some titration method.Hospital do Coracao (HCor) as part of the Program 'Hospitais de Excelencia a Servico do SUS (PROADI-SUS)'Brazilian Ministry of Healt
Efeito de diferentes doses de flavonóides em ratos hiperlipidêmicos
O objetivo deste estudo foi avaliar o efeito de diferentes doses de baicaleína, morina, naringenina, naringina, quercetina e rutina no aumento dos níveis de colesterol-HDL e trigliceróis em ratos hiperlipidêmicos. Tais flavonóides foram administrados em 3 doses (5, 10, 15 mg/animal) a ratos machos da raça Wistar, com 30 dias de vida, alimentados com dieta não purificada de fórmula da marca Labina®. A hiperlipidemia foi induzida pela administração de Triton, na dose de 300 mg/kg de peso vivo. Após 24 horas, os flavonóides foram administrados, sendo cada dose aplicada em grupos de 8 animais. Após 48 horas da aplicação do Triton, os animais foram anestesiados e, por punção cardíaca, amostras de sangue foram coletadas para realização das análises de colesterol, colesterol-HDL e triacilgliceróis no soro. Os melhores resultados para a redução do colesterol foram obtidos com os flavonóides quercetina e rutina, na dose de 5 mg, e naringenina, na dose de 10 mg. A baicaleína, nas doses de 5 e 10 mg, foi a que apresentou as menores reduções para colesterol-HDL. Já para as concentrações de triacilgliceróis, a baicaleína foi a que mais reduziu este parâmetro, independentemente da dose utilizada.The objective of this study was to evaluate the effect of different doses of baicalein, morin, naringenin, naringin, quercetin and rutin on the increase of HDL cholesterol and triglycerols levels in hyperlipidemic rats. These flavonoids were administered in three doses (5, 10, 15 mg/animal) to male rats of the Wistar strain, with 30 days of life, fed non-purified diet of formula Labina®. The hyperlipidemia was induced by the administration of Triton, in the dose of 300 mg/kg of rat body weight. After 24 hours, the flavonoids were administered, each dose applied in groups of 8 animals. After 48 hours of Triton application, the animals were anesthetized and samples of blood were collected, by heart puncture, in order to determine cholesterol, cholesterol-HDL and triacylglycerols in the serum. The best results in the reduction of the cholesterol were obtained with quercetin and rutin, in the dose of 5.mg, and naringenin, in the dose of 10 mg. Baicalein in the doses of 5 and 10 mg, showed the best responses for cholesterol-HDL. For triacylglycerols, baicalein also presented the best effects, independently of the dose applied
Associations of flavonoids and natural dyes in the control of lipidic metabolism
El presente trabajo estudia el efecto de rutina y naringenina, administradas en forma aislada o asociadas con antocianina y monascus, sobre el metabolismo lipídico de ratas. Para eso, dichos compuestos fueron disueltos en propilenglicol y suministrados dos veces por vía intraperitoneal a la dosis de 5 mgkg de peso. La primera dosis fué administrada inmediatamente después de la administración de Tritón, sustancia responsable por la inducción de la hiperlipidemia, y la segunda veinte horas después. Después de 43 horas de
la administración de la primera dosis y del Triton, se extrajo sangre y se determinó el contenido de colesterol total, colesterol-HDL y triacilglicéridos. Los resultados han evidenciado mayores porcentajes de reducción del colesterol para naringenina + monascus y naringenina + antocianina, rutina + monascus y rutina + antocianina. En el caso del colesterol-HDL los mejores resultados fueron obtenidos con naringenina sola y finalmente para los triacilglicérjdos las mayores reducciones fueron halladas con naringenina, naringenina + monascus y rutina + antocianina.The present work evaluates the effects of rutin and naringenin, isolated and in association with anthocyanin and monascus, on lipidic metabolism of rats. These compounds were dissolved in propylene glycol and administered by intraperitoneal route in two doses of 5mg/kg of body weight. The first dose was administered together with the Triton, compound responsible for induction of hyperlipidaemia, and the second, twenty hours later. After fourty three hours of the first dose and Triton administration, the blood was retreat and cliolesterol, HDL-cholesterol, and triacylglycerols were dosed. Results evidence the largest percentual reduction of cholesterol for naringenin + monascus, naringenin + anthocyanin, rutin + monascus and rutin + anthocyanin . On the other hand, for HDL-cholesterol, the best results were obtained with naringenin alone. Finally, the best reduction of triacylglycerols levels was showed for naringenin, naringenin + monascus and rutin + anthocyanin associations.Colegio de Farmacéuticos de la Provincia de Buenos Aire
Associations of flavonoids and natural dyes in the control of lipidic metabolism
El presente trabajo estudia el efecto de rutina y naringenina, administradas en forma aislada o asociadas con antocianina y monascus, sobre el metabolismo lipídico de ratas. Para eso, dichos compuestos fueron disueltos en propilenglicol y suministrados dos veces por vía intraperitoneal a la dosis de 5 mgkg de peso. La primera dosis fué administrada inmediatamente después de la administración de Tritón, sustancia responsable por la inducción de la hiperlipidemia, y la segunda veinte horas después. Después de 43 horas de
la administración de la primera dosis y del Triton, se extrajo sangre y se determinó el contenido de colesterol total, colesterol-HDL y triacilglicéridos. Los resultados han evidenciado mayores porcentajes de reducción del colesterol para naringenina + monascus y naringenina + antocianina, rutina + monascus y rutina + antocianina. En el caso del colesterol-HDL los mejores resultados fueron obtenidos con naringenina sola y finalmente para los triacilglicérjdos las mayores reducciones fueron halladas con naringenina, naringenina + monascus y rutina + antocianina.The present work evaluates the effects of rutin and naringenin, isolated and in association with anthocyanin and monascus, on lipidic metabolism of rats. These compounds were dissolved in propylene glycol and administered by intraperitoneal route in two doses of 5mg/kg of body weight. The first dose was administered together with the Triton, compound responsible for induction of hyperlipidaemia, and the second, twenty hours later. After fourty three hours of the first dose and Triton administration, the blood was retreat and cliolesterol, HDL-cholesterol, and triacylglycerols were dosed. Results evidence the largest percentual reduction of cholesterol for naringenin + monascus, naringenin + anthocyanin, rutin + monascus and rutin + anthocyanin . On the other hand, for HDL-cholesterol, the best results were obtained with naringenin alone. Finally, the best reduction of triacylglycerols levels was showed for naringenin, naringenin + monascus and rutin + anthocyanin associations.Colegio de Farmacéuticos de la Provincia de Buenos Aire
Acute toxicity of rutin and bixin of Bixa orellana
As substâncias rutina e bixina foram escolhidas para estudo uma vez que nosso laboratório de pesquisas busca efeitos farmacológicos de flavonóides e corantes naturais em várias plantas brasileiras. Foram avaliadas a toxidade aguda de bixina e rutina na dose diária de 0,01 mol/Kg em coelhos hiperlipidêmicos induzidos por colesterol a 0,5% e ácido cólico a 0,1%, durante vinte e oito dias, após os quais foram
dosadas uréia, creatinina, ácido úrico, proteínas totais, cálcio, transaminase glutâmico oxalacética (TGO) e transaminase glutâmico pirúvica (TGP). Os resultados evidenciaram que bixina e rutina reduziram os níveis desses parâmetros que permitem avaliar as alterações no metabolismo de aminoácidos, proteínas, dos ácidos nucleicos e mineral, ficando demonstrado a inocuidade da bixina e da rutina.Colegio de Farmacéuticos de la Provincia de Buenos Aire
Effect of the chemical constituents isolated from the fruit of Rheedia gardneriana on juveniles hatch of Meloidogyne incognita race 3
Os constituintes químicos isolados do fruto (pericarpo) de Rheedia gardneriana ("bacupari"), foram identificados como 7-epiclusianona (I), o ácido oleanólico (II) e uma mistura de sesquiterpenos (III) e testados, in vitro, quanto à sua atividade biológica sobre a eclosão de juvenis do nematóide Meloidogyne incognita raça 3 na concentração de 100 μg.mL-1 Os resultados mostraram que o ácido oleanólico foi o . mais eficiente, com uma taxa de inibição de eclosão de juvenis de 40,46%, caracterizada como um efeito nematostático, uma vez que a eclosão de juvenis ocorreu quando os ovos tratados pela substância foram transferidos para a água.The chemical constituents isolated from the fruit (pericarp) of Rheedia gardneriana (bacupari) and identified as 7-epiclusianone (I), oleanolic acid (II), and a mixture of sesquiterpenes (III) were tested to biological activity “in vitro” on juveniles hatch of Meloidogyne incognita race 3 shown nematode effect in 100 μg.mL–1 concentration. The results evidenced that oleanolic acid was most efficient because it showed highest inhibition levels of the juveniles hatch (40.46%), identified as nematostatic effect by the fact of the juveniles hatch had been occurred after translating the eggs for water.Colegio de Farmacéuticos de la Provincia de Buenos Aire
Control of hyperlipidemia in treated rabbits with flavonoids and natural dyes of urucum
Tendo em vista que a hiperlipidemia se constitui em fator de risco para o sistema cardiocirculatório, levando ao aparecimento da aterosclerose, o presente trabalho foi desenvolvido, objetivando o controle de lipídeos com os flavonóides luteolina e apigenina, bem como do corante natural do urucum, bixina 30% e bixina 95%, em coelhos hiperlipidemicos induzidos com triton. Decorridos 20 horas da aplicação o triton, foram administrados os compostos na dose de 10 mmol/Kg e, 24 horas após, dosados no soro dos animais, colesterol total, colesterol-HDL e triacilgliceróis. Os resultados mostram que os tratamentos foram eficazes em reduzir os níveis de colesterol total; a exceção de bixina 30%, mantiveram os níveis elevados de colesterol-HDL e a bixina 30% diminuiu significativamente os valores de triacilgliceróis.The hyperlipidaemia is a risk factor for the development of atherosclerosis in the cardiovascular system. The present work evaluated the effects of three compounds isolated from the urucum, the flavonoids luteolin and apigenin and the natural coloring bixin (30% and 95%), on the control of serum lipids in triton-induced hyperlipidaemic rabbits. After 20 hours triton 300mg/Kg weight was administered intraperitoneal(i.p.) the rabbits were injected ¡.p. with bixin 30%. bixiii 95%, luteolin or apigenin at the dose of 10 mmol/Kg weigth. 24 hours latter total cholesterol. cholesterol-HDL and triacylglycerols were dosed in the serum of the animals. The results showed that all compounds were effective in reducing the levels of total cholesterol. Except bixin 30% the treatments incresed the levels of cholesterol-HDL, notably apigenin by about three fold. Bixine 30% was the only treatment that reduced the levels of tracylglicerols. It may be suggested that these natural compounds may have beneficial effects in controlling serum lipids levels when used as flavoring or coloring of foods.Colegio de Farmacéuticos de la Provincia de Buenos Aire
Control of hyperlipidemia in treated rabbits with flavonoids and natural dyes of urucum
Tendo em vista que a hiperlipidemia se constitui em fator de risco para o sistema cardiocirculatório, levando ao aparecimento da aterosclerose, o presente trabalho foi desenvolvido, objetivando o controle de lipídeos com os flavonóides luteolina e apigenina, bem como do corante natural do urucum, bixina 30% e bixina 95%, em coelhos hiperlipidemicos induzidos com triton. Decorridos 20 horas da aplicação o triton, foram administrados os compostos na dose de 10 mmol/Kg e, 24 horas após, dosados no soro dos animais, colesterol total, colesterol-HDL e triacilgliceróis. Os resultados mostram que os tratamentos foram eficazes em reduzir os níveis de colesterol total; a exceção de bixina 30%, mantiveram os níveis elevados de colesterol-HDL e a bixina 30% diminuiu significativamente os valores de triacilgliceróis.The hyperlipidaemia is a risk factor for the development of atherosclerosis in the cardiovascular system. The present work evaluated the effects of three compounds isolated from the urucum, the flavonoids luteolin and apigenin and the natural coloring bixin (30% and 95%), on the control of serum lipids in triton-induced hyperlipidaemic rabbits. After 20 hours triton 300mg/Kg weight was administered intraperitoneal(i.p.) the rabbits were injected ¡.p. with bixin 30%. bixiii 95%, luteolin or apigenin at the dose of 10 mmol/Kg weigth. 24 hours latter total cholesterol. cholesterol-HDL and triacylglycerols were dosed in the serum of the animals. The results showed that all compounds were effective in reducing the levels of total cholesterol. Except bixin 30% the treatments incresed the levels of cholesterol-HDL, notably apigenin by about three fold. Bixine 30% was the only treatment that reduced the levels of tracylglicerols. It may be suggested that these natural compounds may have beneficial effects in controlling serum lipids levels when used as flavoring or coloring of foods.Colegio de Farmacéuticos de la Provincia de Buenos Aire