9 research outputs found
Obtenção de extrato de erva baleeira (Cordia verbenacea D.C.) por diferentes técnicas: medida da atividade biológica, modelagem matemática e determinação do equilíbrio de fases
No full textTese (doutorado) - Universidade Federal de Santa Catarina, Centro Tecnológico. Programa de Pós-Graduação em Engenharia de Alimentos.A erva baleeira (Cordia verbenacea) é uma planta da Família das Borraginaceae, encontrada nas restingas marítimas de quase todo o litoral brasileiro, sendo mais comumente encontrada no trecho compreendido entre os Estados de Santa Catarina e São Paulo. Devido ao seu perfil de composição, a erva baleeira possui propriedades antiinflamatória e cicatrizante sendo indicada para o tratamento de reumatismo, artrite reumatóide, tendinite, dores lombares e musculares e nevralgias. Os compostos da classe dos sesquiterpenos encontrados em seus extratos como a-humuleno e trans-cariofileno são os principais responsáveis pela sua atividade antiinflamatória. Assim, o presente trabalho tem como objetivo avaliar a qualidade dos extratos de erva baleeira obtidos a partir da tecnologia supercrítica através da comparação, em termos de rendimento de processo, composição dos extratos e atividade biológica, com os extratos obtidos a partir das técnicas convencionais de extração (maceração seguida de fracionamento com solventes orgânicos, extração soxhlet e hidrodestilação) e também com o uso de etanol e acetato de etila como co-solventes junto à ESC. Os extratos supercríticos de erva baleeira foram obtidos numa faixa de pressão de 100 a 300 bar e temperatura de 30, 40 e 50ºC com densidade do solvente variando de 0,385 a 0,948 g/cm3 sendo o maior rendimento de 5,0% para a condição de extração de 300 bar e 50ºC. Foram utilizados solventes orgânicos de diferentes polaridades na extração convencional como: hexano, diclorometano, acetato de etila, etanol, acetona e misturas aquosas de 25 e 50% (etanol/água). O etanol e o acetato de etila foram utilizados nas concentrações de 2, 5 e 8% em massa como co-solventes na ESC, proporcionando rendimentos de até 8,6%. Foram identificados importantes compostos nos extratos de erva baleeira como a-humuleno, trans-cariofileno, espatulenol, cariofileno óxido, b-sitosterol e artemetina. Também foi avaliada, através do método DPPH (2,2-difenil-1-picrilhidrazil), método ABTS (2,2#-azino-bis-(3-etil-benzotiazolna-6-ácido sulfônico), radical ânion superóxido e proteção contra a peroxidação lipídica a atividade antioxidante dos extratos obtidos com as diferentes tecnologias. O conteúdo de compostos fenólicos presente nos extratos foi determinado através do método de Folin-Ciocalteau. A erva baleeira se mostrou uma importante fonte de compostos com atividade antioxidante com destaque para os extratos: fração acetato de etila da maceração, misturas aquosas etanol/água e extrato acetato de etila da soxhlet que apresentaram as maiores capacidades antioxidantes. A atividade antimicrobiana foi avaliada e os extratos supercríticos mostraram forte inibição antimicrobiana principalmente contra bactérias Gram-positivas com destaque para o extrato obtido com CO2 puro a 30ºC e 300 bar. Para a descrição da cinética de extração do sistema extrato de erva baleeira + CO2 supercrítico foram empregados diferentes modelos de transferência de massa apresentados na literatura. O modelo de Sovová (1994) foi o que melhor se ajustou aos dados experimentais e a convecção se mostrou como principal mecanismo de transferência de massa e a difusão como fator limitante. Foi investigado experimentalmente o comportamento de fases dos sistemas binários contendo a-humuleno + CO2 e trans-cariofileno + CO2 e do sistema ternário formado por a-humuleno + trans-cariofileno + CO2, através do método estático sintético. Os resultados experimentais obtidos no estudo do equilíbrio de fases apresentaram transições de fases do tipo líquidovapor, líquido-líquido e líquido-líquido-vapor. Cordia verbenacea is a plant from the Borraginaceae family, widely find along the southeastern coast of Brazil, especially between the states of Santa Catarina and São Paulo. Due to its composition profile, Cordia verbenacea presents anti-inflammatory and healing properties, being indicated for treatment of rheumatism, rheumatoid arthritis, tendonitis, muscle and back pain and neuralgia. The compounds from the sesquiterpene class present in Cordia verbenacea extracts, such as a-humulene and trans-caryophyllene, are the main responsible for its antiinflammatory activity. Therefore, the aim of this study is to evaluate the quality of Cordia verbenacea extracts obtained by supercritical technology and compare, in terms of process yield, extracts composition and biological activity, with extracts obtained by conventional extraction techniques (maceration followed by fractionation with organic solvents, soxhlet extraction and hydrodistillation). The supercritical method was also improved by using ethanol and acetate ethyl as co-solvents. The supercritical extracts of Cordia verbenacea were obtained in a range of pressure from 100 to 300 bar and 30, 40 and 50°C of temperature with density of solvent varying from 0.385 a 0.948 g/cm3, being the largest extraction yield of 5.0% for the extraction condition of 300 bar and 50°C. The organic solvents of different polarity, used in conventional methods were: hexane, dichloromethane, ethyl acetate, ethanol, acetone and aqueous mixtures of 25 and 50% (ethanol / water). Ethanol and ethyl acetate were used in concentrations of 2.5 and 8% in mass as co-solvents in the supercritical extraction, providing yields up to 8.6%. Relevant compounds were identified in extracts of Cordia verbenacea as a-humulene, trans-caryophyllene, spathulenol, caryophyllene oxide, b-sitosterol and artemetin. The potential of the extracts were evaluated by the methods DPPH (2,2 - diphenyl - 1 - picrylhydrazyl), ABTS (2,2#- azinobis - 3 - ethylbenzothiazoline 6 - ulfonate), superoxide anion radical and protection against lipid peroxidation, in order to detect the antioxidant activity of extracts obtained by the different extraction technologies. The content of phenolic compounds present in the extracts was determined by the method of Folin-Ciocalteau. Cordia verbenacea has showed itself an important source of compounds with antioxidant activity, especially for the ethyl acetate fraction (maceration), ethanol/water mixtures and ethyl acetate from soxhlet method which presented the highest antioxidant capacity. The antimicrobial activity was evaluated and the supercritical extracts showed high antimicrobial inhibition, especially against gram-positive bacteria with emphasis to the extract obtained by CO2 at 30ºC and 300 bar. The kinetic description of the system Cordia verbenacea + supercritical CO2 was performed by different mass transfer models, presented in literature. The Sovová (1994) model show the best adjustment with experimental data and the convection was indicated as the main mass transfer mechanism, with diffusion as a limiting factor. The phase behavior was investigated for the binary systems containing a-humulene + CO2 and trans-caryophyllene + CO2 and for the binary system formed by a-humulene + trans-caryophyllene + CO2, through the static synthetic method. The experimental results obtained in the study of equilibrium phases showed transition of phases of the type liquid-vapour, liquid-liquid and iquid-liquid-vapour
Correction: Epidemiology and outcomes of early-onset AKI in COVID-19-related ARDS in comparison with non-COVID-19-related ARDS: insights from two prospective global cohort studies (Critical Care, (2023), 27, 1, (3), 10.1186/s13054-022-04294-5)
No full textFollowing publication of the original article [1], the authors identified that the collaborating authors part of the collaborating author group CCCC Consortium was missing. The collaborating author group is available and included as Additional file 1 in this article
netMUG: a novel network-guided multi-view clustering workflow for dissecting genetic and facial heterogeneity.
No full text[en] UNLABELLED: Multi-view data offer advantages over single-view data for characterizing individuals, which is crucial in precision medicine toward personalized prevention, diagnosis, or treatment follow-up. Here, we develop a network-guided multi-view clustering framework named netMUG to identify actionable subgroups of individuals. This pipeline first adopts sparse multiple canonical correlation analysis to select multi-view features possibly informed by extraneous data, which are then used to construct individual-specific networks (ISNs). Finally, the individual subtypes are automatically derived by hierarchical clustering on these network representations. We applied netMUG to a dataset containing genomic data and facial images to obtain BMI-informed multi-view strata and showed how it could be used for a refined obesity characterization. Benchmark analysis of netMUG on synthetic data with known strata of individuals indicated its superior performance compared with both baseline and benchmark methods for multi-view clustering. In addition, the real-data analysis revealed subgroups strongly linked to BMI and genetic and facial determinants of these classes. NetMUG provides a powerful strategy, exploiting individual-specific networks to identify meaningful and actionable strata. Moreover, the implementation is easy to generalize to accommodate heterogeneous data sources or highlight data structures.
AUTHOR SUMMARY: In recent years, we see the increasing possibility of collecting data from multiple modalities in various fields, requesting novel methods to exploit the consensus among different data types. As exemplified in systems biology or epistasis analyses, the interactions between features may contain more information than the features themselves, thereby necessitating the use of feature networks. Furthermore, in real-life scenarios, subjects, such as patients or individuals, may originate from diverse populations, which underscores the importance of subtyping or clustering these subjects to account for their heterogeneity. In this study, we present a novel pipeline for selecting the most relevant features from multiple data types, constructing a feature network for each subject, and obtaining a subgrouping of samples informed by a phenotype of interest. We validated our method on synthetic data and demonstrated its superiority over several state-of-the-art multi-view clustering approaches. Additionally, we applied our method to a real-life, large-scale dataset of genomic data and facial images, where it effectively identified a meaningful BMI subtyping that complemented existing BMI categories and offered new biological insights. Our proposed method has wide applicability to complex multi-view or multi-omics datasets for tasks such as disease subtyping or personalized medicine
Association between augmented renal clearance and clinical outcomes in patients receiving β-lactam antibiotic therapy by continuous or intermittent infusion: a nested cohort study of the BLING-II randomised, placebo-controlled, clinical trial
No full textThe INTOXICATE study: methodology and preliminary results of a prospective observational study
No full textBackground
There is currently no practice-based, multicenter database of poisoned patients admitted to intensive care units (ICUs). The INTOXICATE study, endorsed by the ESICM and EAPCCT, aimed to determine the rate of eventful admissions among acutely intoxicated adult ICU patients.
Methods
Ethical approval was obtained for this multicenter, prospective observational study, and data-sharing agreements were signed with each participating center. An electronic case report form was used to collect data on patient demographics, exposure, clinical characteristics, investigations, treatment, and in-hospital mortality data. The primary outcome, ‘eventful admission’, was a composite outcome defined as the rate of patients who received any of the following treatments in the first 24 h after the ICU admission: oxygen supplementation with a FiO2 > 40%, mechanical ventilation, vasopressors, renal replacement therapy (RRT), cardiopulmonary resuscitation, antidotes, active cooling, fluid resuscitation (> 1.5 L of intravenous fluid of any kind), sedation, or who died in the hospital.
Results
Seventy-eight ICUs, mainly from Europe, but also from Australia and the Eastern Mediterranean, participated. A total of 2,273 patients were enrolled between November 2020 and June 2023. The median age of the patients was 41 years, 72% were exposed to intoxicating drugs. The observed rate of patients with an eventful ICU admission was 68% (n = 1546/2273 patients). The hospital mortality was 4.5% (n = 103/2273).
Conclusions
The vast majority of patients survive, and approximately one third of patients do not receive any ICU-specific interventions after admission in an intensive care unit for acute intoxication. High-quality detailed clinical data have been collected from a large cohort of acutely intoxicated ICU patients, providing information on the pattern of severe acute poisoning requiring intensive care admission and the outcomes of these patients.
Trial registration: OSF registration ID: osf.io/7e5uy
Twelve-Month Outcomes of the AFFINITY Trial of Fluoxetine for Functional Recovery After Acute Stroke: AFFINITY Trial Steering Committee on Behalf of the AFFINITY Trial Collaboration
No full textBackground and Purpose: The AFFINITY trial (Assessment of Fluoxetine in Stroke Recovery) reported that oral fluoxetine 20 mg daily for 6 months after acute stroke did not improve functional outcome and increased the risk of falls, bone fractures, and seizures. After trial medication was ceased at 6 months, survivors were followed to 12 months post-randomization. This preplanned secondary analysis aimed to determine any sustained or delayed effects of fluoxetine at 12 months post-randomization. Methods: AFFINITY was a randomized, parallel-group, double-blind, placebo-controlled trial in adults (n=1280) with a clinical diagnosis of stroke in the previous 2 to 15 days and persisting neurological deficit who were recruited at 43 hospital stroke units in Australia (n=29), New Zealand (4), and Vietnam (10) between 2013 and 2019. Participants were randomized to oral fluoxetine 20 mg once daily (n=642) or matching placebo (n=638) for 6 months and followed until 12 months after randomization. The primary outcome was function, measured by the modified Rankin Scale, at 6 months. Secondary outcomes for these analyses included measures of the modified Rankin Scale, mood, cognition, overall health status, fatigue, health-related quality of life, and safety at 12 months. Results: Adherence to trial medication was for a mean 167 (SD 48) days and similar between randomized groups. At 12 months, the distribution of modified Rankin Scale categories was similar in the fluoxetine and placebo groups (adjusted common odds ratio, 0.93 [95% CI, 0.76–1.14]; P =0.46). Compared with placebo, patients allocated fluoxetine had fewer recurrent ischemic strokes (14 [2.18%] versus 29 [4.55%]; P =0.02), and no longer had significantly more falls (27 [4.21%] versus 15 [2.35%]; P =0.08), bone fractures (23 [3.58%] versus 11 [1.72%]; P =0.05), or seizures (11 [1.71%] versus 8 [1.25%]; P =0.64) at 12 months. Conclusions: Fluoxetine 20 mg daily for 6 months after acute stroke had no delayed or sustained effect on functional outcome, falls, bone fractures, or seizures at 12 months poststroke. The lower rate of recurrent ischemic stroke in the fluoxetine group is most likely a chance finding. REGISTRATION: URL: http://www.anzctr.org.au/ ; Unique identifier: ACTRN12611000774921
Impact of Hemoglobin Levels on Composite Cardiac Arrest or Stroke Outcome in Patients With Respiratory Failure Due to COVID-19
No full textOBJECTIVES:. Anemia has been associated with an increased risk of both cardiac arrest and stroke, frequent complications of COVID-19. The effect of hemoglobin level at ICU admission on a composite outcome of cardiac arrest or stroke in an international cohort of COVID-19 patients was investigated.
DESIGN:. Retrospective analysis of prospectively collected database.
SETTING:. A registry of COVID-19 patients admitted to ICUs at over 370 international sites was reviewed for patients diagnosed with cardiac arrest or stroke up to 30 days after ICU admission. Anemia was defined as: normal (hemoglobin ≥ 12.0 g/dL for women, ≥ 13.5 g/dL for men), mild (hemoglobin 10.0–11.9 g/dL for women, 10.0–13.4 g/dL for men), moderate (hemoglobin ≥ 8.0 and < 10.0 g/dL for women and men), and severe (hemoglobin < 8.0 g/dL for women and men).
PATIENTS:. Patients older than 18 years with acute COVID-19 infection in the ICU.
INTERVENTIONS:. None.
MEASUREMENTS AND MAIN RESULTS:. Of 6926 patients (median age = 59 yr, male = 65%), 760 patients (11.0%) experienced stroke (2.0%) and/or cardiac arrest (9.4%). Cardiac arrest or stroke was more common in patients with low hemoglobin, occurring in 12.8% of patients with normal hemoglobin, 13.3% of patients with mild anemia, and 16.7% of patients with moderate/severe anemia. Time to stroke or cardiac arrest by anemia status was analyzed using Cox proportional hazards regression with death as a competing risk. Covariates selected through clinical knowledge were age, sex, comorbidities (diabetes, hypertension, obesity, and cardiac or neurologic conditions), pandemic era, country income, mechanical ventilation, and extracorporeal membrane oxygenation. Moderate/severe anemia was associated with a higher risk of cardiac arrest or stroke (hazard ratio, 1.32; 95% CI, 1.05–1.67).
CONCLUSIONS:. In an international registry of ICU patients with COVID-19, moderate/severe anemia was associated with increased hazard of cardiac arrest or stroke
Health-related quality of life in survivors of septic shock: 6-month follow-up from the ADRENAL trial
No full textHealth-related quality of life in survivors of septic shock: 6-month follow-up from the ADRENAL tria
