Angelita Maria Stabile

RESEARCH, TEACHING, or OTHER INTERESTS

General Nursing, Critical Care Nursing

Scopus Publications

Long-term effects on cardiorespiratory and behavioral responses in male and female rats prenatally exposed to cannabinoid
Luis Gustavo A. Patrone, Alana T. Frias, Gabriel T. Fantinatti, Angelita M. Stabile, Wilfried Klein, Kênia C. Bícego, and Luciane H. Gargaglioni
American Physiological Society
The surge in recreational cannabis use and cannabinoid-based medication prescription among pregnant women has been notable in recent years, fueled by the misconception that natural products are inherently safe. Significant gaps persist regarding the potential risks of maternal consumption of cannabinoids and the long-term effects on the cardiorespiratory system of their offspring, which may be determined by sex. Accordingly, this research aims to diminish this lack of information and raise a note of caution.


Management of Infections in Palliative Care Patients at the End-of-Life and Active Process of Death: A Brazilian Retrospective Study
Isabela Fernandes de Aguiar Tonetto, Angelita Maria Stabile, Dieyeni Yuki Kobayasi, Rita de Cássia Quaglio, Ana Carolina de Souza, and Fabiana Bolela
Mary Ann Liebert Inc
Background There is a lack of specific studies on the management of infections in patients receiving palliative care (PC) in the final stages of life and during the active process of death, related to specific nursing care. There is clinical and social importance as patients in PC represent a vulnerable population, and adequate management of infections is crucial to improve quality of life and the experience of comfort. Objective This study analyzed how infections are managed in patients undergoing PC at the end-of-life and in the active process of death in two hospital health services. Design This is an observational, analytical, and retrospective study. Settings Data collection took place in two hospitals that assist individuals who are hospitalized under PC, located in Brazil, in a city in the interior of the state of São Paulo. Measurements and Results The sample consisted of 113 medical records, in which the oncological diagnosis was the most prevalent. There was a predominance of infection diagnoses based on the patient's clinical symptoms, the main focus being the pulmonary, in individuals at the end-of-life. The management of infection in the study sample occurred through care and procedures that generate physical discomfort, however aiming at relieving symptoms. Such findings must be documented, as they invite us to reflect on our practical attitudes and what it means to be comfortable for these people, making it possible to incorporate this information into the design of interventions focused on enhancing the experience of comfort.


Advancing Digital Education Technologies by Empowering Nurses With Point-of-Care Ultrasound: Protocol for a Mixed Methods Study
Fernanda Raphael Escobar Gimenes, Angelita Maria Stabile, Rodrigo Magri Bernardes, Vinicius Batista Santos, Mayra Gonçalves Menegueti, Patricia Rezende do Prado, Mauricio Serra Ribeiro, Flavia Giron Camerini, and Soraia Assad Nasbine Rabeh
JMIR Publications Inc.
Background Bedside ultrasonography, also known as point-of-care ultrasound (PoCUS), is a promising technological tool that enhances clinical assessment, enriching diagnostic capabilities and clinical reasoning. Its use in nursing spans various patient populations and health care settings, providing nurses with a valuable health assessment tool to improve care quality and patient safety. Despite its growing integration into clinical practice, PoCUS training has mainly focused on physicians, leaving a gap for trained nurses who demonstrate similar proficiency in conducting scans and interpreting images. Previous research highlights the value of digital tools in PoCUS training, showing their role in improving professionals’ and students’ knowledge, image interpretation skills, and clinical acumen. Objective This study aimed to (1) establish an assessment instrument gauging nurses’ competency milestones in PoCUS and evaluate its content and appearance validity, (2) develop a series of 5 educational videos focused on PoCUS and assess their content and appearance validity, and (3) construct an online learning environment tailored to nurses’ PoCUS training needs and evaluate its content and appearance validity. Methods We will conduct a methodological study of technological production guided by Rogers’ diffusion of innovations theory. Subproject 1 will design and validate a comprehensive assessment tool for evaluating nurses’ competency milestones in PoCUS use. For this purpose, a scoping review will be conducted. The review will be based on JBI Collaboration guidelines and reported according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses extended for Scoping Reviews (PRISMA-ScR) checklist. Subproject 2 involves an evaluation of content and appearance validity for a series of 5 educational videos on PoCUS, designed specifically for nurses about applying peripherally inserted central catheter lines, inserting nasogastric feeding tubes, assessing gastric residual volume, assessing pressure injuries and soft tissue conditions, and assessing muscle mass to monitor patient nutritional status. In subproject 3, a comprehensive online learning environment dedicated to PoCUS training for nurses will be developed and validated. The launch of an online learning environment represents a cornerstone of our dissemination strategy, scheduled to coincide with the inaugural Brazilian PoCUS symposium for nurses, an event organized by the project members. This platform will serve as a pivotal resource for continuous learning and professional development. Results Subproject 1 will start in the second half of 2024 and is expected to be completed by mid-2025. Subproject 2 is currently ongoing and is expected to be completed in early 2026. Subproject 3 is set to begin in early 2025 and is planned to be completed by 2026. Conclusions Through these concerted efforts, the project aims to bridge the existing gap in PoCUS training for nurses, thereby fostering their proficiency and enhancing patient care outcomes. International Registered Report Identifier (IRRID) PRR1-10.2196/58030


COMPLICATIONS RELATED TO PERIPHERALLY INSERTED CENTRAL CATHETERS IN COVID-19 PATIENTS AND THE POTENTIAL OF INSERTION TECHNOLOGIES
Danielle Cortêz da Silva, Carolina Scoqui Guimarães, Angelita Maria Stabile, Suellen Karina de Oliveira Giroti, Flávia Meneguetti Pieri, Carmen Silvia Gabriel, Renata Cristina de Campos Pereira Silveira, and Amanda Salles Margatho
FapUNIFESP (SciELO)
ABSTRACT Objective: to assess the incidence of complications related to peripherally inserted central catheters in hospitalized adult patients with Covid-19 and to discuss the potential benefits of employing insertion technologies to prevent complications. Method: a descriptive, exploratory and cross-sectional study was conducted from March 2020 to December 2021 at a high-complexity hospital. The study included patients over 18 years old with a positive diagnosis for Covid-19 who made use of peripherally inserted central catheters for venous infusion. Data collection included sociodemographic and clinical information regarding catheter insertion and use. The analysis involved Chi-square and Fisher's Exact tests, with a significance level of 0.05. Results: a total of 123 inserted catheters were analyzed. The patients' mean age was 50 years old (SD=16.37), most of them male and in the acute phase of infection (59.3%). The following significant complications related to the insertion process were identified: catheter material (p=0.01); use of Sherlock (p=0.03); need for traction (p<0.001); number of punctures (p<0.001); and difficulty in catheter progression (p<0.001). Conclusion: the study identified the main complications related to the insertion and use of PICCs and showed that employing vascular visualization technologies such as ultrasound and Sherlock 3CG® can mitigate complications, as well as maximize patient comfort, experience and safety. The research provides support for the implementation of protocols for insertion and management of peripherally inserted central catheters, thus avoiding the occurrence of adverse events.


Cafeteria diet-induced obesity remodels immune response in acute Trypanosoma cruzi infection
Amanda Goulart, Naira Ferreira Anchieta, Pedro Alexandre Sampaio, Vânia Brazão, Jefferson Luiz Da Silva, Gisele Bulhões Portapilla, Andressa Duarte, Daiane Yukie Tezuca, Maiara Voltarelli Providello, Angelita Maria Stabile,et al.
Elsevier BV



Inhibition of Pro-Inflammatory Microglia with Minocycline Improves Cognitive and Sleep-Wake Dysfunction Under Respiratory Stress in a Sporadic Model for Alzheimer's Disease
Mariane C. Vicente, Julia L. Paneghini, Angelita M. Stabile, Mateus Amorim, Conceição E. Anibal Silva, Luis Gustavo A. Patrone, Thiago M. Cunha, Kênia C. Bícego, Maria C. Almeida, Daniel C. Carrettiero,et al.
IOS Press
Background: Neuroinflammation in Alzheimer’s disease (AD) can occur due to excessive activation of microglia in response to the accumulation of amyloid-β peptide (Aβ). Previously, we demonstrated an increased expression of this peptide in the locus coeruleus (LC) in a sporadic model for AD (streptozotocin, STZ; 2 mg/kg, ICV). We hypothesized that the STZ-AD model exhibits neuroinflammation, and treatment with an inhibitor of microglia (minocycline) can reverse the cognitive, respiratory, sleep, and molecular disorders of this model. Objective: To evaluate the effect of minocycline treatment in STZ model disorders. Methods: We treated control and STZ-treated rats for five days with minocycline (30 mg/kg, IP) and evaluated cognitive performance, chemoreflex response to hypercapnia and hypoxia, and total sleep time. Additionally, quantification of Aβ, microglia analyses, and relative expression of cytokines in the LC were performed. Results: Minocycline treatment improved learning and memory, which was concomitant with a decrease in microglial cell density and re-establishment of morphological changes induced by STZ in the LC region. Minocycline did not reverse the STZ-induced increase in CO2 sensitivity during wakefulness. However, it restored the daytime sleep-wake cycle in STZ-treated animals to the same levels as those observed in control animals. In the LC, levels of A and expression of Il10, Il1b, and Mcp1 mRNA remained unaffected by minocycline, but we found a strong trend of minocycline effect on Tnf- α. Conclusion: Our findings suggest that minocycline effectively reduces microglial recruitment and the inflammatory morphological profile in the LC, while it recovers cognitive performance and restores the sleep-wake pattern impaired by STZ.


Sex- and age-specific respiratory alterations induced by prenatal exposure to the cannabinoid receptor agonist WIN 55,212-2 in rats
Luis Gustavo A. Patrone, Gustavo D. Ferrari, Rodrigo Moreira da Silva, Luciane C. Alberici, Norberto Peporine Lopes, Angelita M. Stabile, Wilfried Klein, Kênia C. Bícego, and Luciane H. Gargaglioni
Wiley
AbstractBackground and PurposeCannabis legalization has risen in many countries, and its use during pregnancy has increased. The endocannabinoid system is present in the CNS at early stages of embryonic development, and regulates functional brain maturation including areas responsible for respiratory control, data on the influence of external cannabinoids on the development of the respiratory system and possible consequences during postnatal life are limited.Experimental ApproachWe evaluated the effects of prenatal exposure to synthetic cannabinoid (WIN 55,212‐2 [WIN], 0.5 mg·kg−1·day−1) on the respiratory control system in neonatal (P0, P6–7 and P12–13) and juvenile (P27–28) male and female rats.Key ResultsWIN administration to pregnant rats interfered sex‐specifically with breathing regulation of offspring, promoting a greater sensitivity to CO2 at all ages in males (except P6–7) and in juvenile females. An altered hypoxic chemoreflex was observed in P0 (hyperventilation) and P6–7 (hypoventilation) males, which was absent in females. Along with breathing alterations, brainstem analysis showed an increase in the number of catecholaminergic neurons and cannabinoid receptor type 1 (CB1) and changes in tissue respiration in the early males. A reduction in pulmonary compliance was observed in juvenile male rats. Preexposure to WIN enhanced spontaneous apnoea and reduced the number of serotoninergic (5‐HT) neurons in the raphe magnus nucleus of P0 females.Conclusions and ImplicationsThese data demonstrate that excess stimulation of the endocannabinoid system during gestation has prolonged and sex‐specific consequences for the respiratory control system.


Periodized combined training in physically active overweight women over 50 years
Thaís Mara Alexandre Bertazone, Leonardo Henrique de Lima Medeiros, Célia Ignácio de Oliveira, Carlos Roberto Bueno Junior, and Angelita Maria Stabile
FapUNIFESP (SciELO)



Early recognition of surgical patients with sepsis: Contribution of nursing records
Ivia Cristina Almeida Tiago, Ramon Azevedo Silva de Castro, Gabriela Rodrigues Bragagnollo, Carolina Lima de Mello, Cibele Cirino de Souza, Geovana Cristina Teso da Silva, Angelita Maria Stabile, and Marta Cristiane Alves Pereira
Applied Nursing Research Elsevier BV
OBJECTIVE This study aimed to analyze the contribution of nursing records to the early identification and management of sepsis in surgical patients at a university hospital. METHOD This is a study with a quantitative, retrospective, descriptive, and correlational design. Data collection was performed through hospital information systems in the first semester of 2017 with the approval of the research ethics committee. We included 28 patients who met the inclusion criteria of the study. RESULTS The analysis of the content of the records evidenced the development of the first signs of systemic inflammatory response syndrome (SIRS) and organ dysfunction until the fifth day of hospitalization in 19 patients (67.8%). Confirmation or hypothesis of sepsis diagnosis occurred until the 10th day of hospitalization in 15 patients (53.5%). The analysis of the content of the records showed that the first signs of SIRS were predominantly identified in the electronic patient monitoring system in 26 cases (92.9%), whereas the first signs of organ dysfunction were described in the nursing staff records in 24 patients (85.7%). CONCLUSION The results confirm the importance of the quality of nursing records for risk identification, early recognition, and proper management of sepsis in surgical patients, aiming at achieving greater effectiveness in the management of healthcare processes.


Contribution of convergent care research to preventing pneumonia associated with mechanical ventilation
Bruna Karla Dutra, Laura Menezes Silveira, Fabiana Bolela, Mariele Lenhari, and Angelita Maria Stabile
Universidade de Estado do Rio de Janeiro
Objetivo: elaborar um protocolo para prevenção de pneumonia associada à ventilação mecânica com a participação dos profissionais que o utilizarão, por meio do referencial da pesquisa convergente assistencial. Método: foi realizada uma entrevista individual e três encontros grupais com os profissionais. Para a análise dos dados foi utilizado o referencial de Morse e Field. O estudo foi aprovado por um Comitê de Ética em Pesquisa. Resultados: os cuidados citados nas entrevistas individuais foram organizados de acordo com o nível de evidência sugerido no Guideline da American Thoracic Society.  Nos encontros grupais os cuidados foram discutidos de acordo com a relevância na prevenção da pneumonia. Os cuidados elencados como relevantes compuseram a versão final do protocolo. Conclusão: o referencial da pesquisa convergente assistencial possibilitou a elaboração de um protocolo para prevenção de pneumonia associada à ventilação mecânica, com o envolvimento dos profissionais atuantes na Unidade de Terapia Intensiva.


Central Administration of Angiotensin-(1-7) Improves Vasopressin Impairment and Hypotensive Response in Experimental Endotoxemia
Patrícia Passaglia, Felipe de Lima Faim, Marcelo Eduardo Batalhão, Angelita Maria Stabile, Lusiane Maria Bendhack, José Antunes-Rodrigues, Riccardo Lacchini, and Evelin Capellari Carnio
Cells MDPI AG
Angiotensin-(1-7) [Ang-(1-7)]/Mas receptor is a counter-regulatory axis that counteracts detrimental renin-angiotensin system (RAS) effects, especially regarding systemic inflammation, vasopressin (AVP) release, and hypothalamic-pituitary-adrenal (HPA) activation. However, it is not completely understood whether this system may control centrally or systemically the late phase of systemic inflammation. Thus, the aim of this study was to determine whether intracerebroventricular (i.c.v.) administration of Ang-(1-7) can modulate systemic inflammation through the activation of humoral pathways in late phase of endotoxemia. Endotoxemia was induced by systemic injection of lipopolysaccharide (LPS) (1.5 mg/kg, i.v.) in Wistar rats. Ang-(1-7) (0.3 nmol in 2 µL) promoted the release of AVP and attenuated interleukin-6 (IL-6) and nitric oxide (NO) levels but increased interleukin-10 (IL-10) in the serum of the endotoxemic rats. The central administration of Mas receptor antagonist A779 (3 nmol in 2 µL, i.c.v.) abolished these anti-inflammatory effects in endotoxemic rats. Furthermore, Ang-(1-7) applied centrally restored mean arterial blood pressure (MABP) without affecting heart rate (HR) and prevented vascular hyporesponsiveness to norepinephrine (NE) and AVP in animals that received LPS. Together, our results indicate that Ang-(1-7) applied centrally promotes a systemic anti-inflammatory effect through the central Mas receptor and activation of the humoral pathway mediated by AVP.


Chronic molecular hydrogen inhalation mitigates short and long-term memory loss in polymicrobial sepsis
Aline A. Jesus, Patrícia Passaglia, Bruna M. Santos, Isabelle Rodrigues-Santos, Rafael A. Flores, Marcelo E. Batalhão, Angelita M. Stabile, and Evelin C. Cárnio
Elsevier BV



Oral hygiene: Performance of the nursing team in a hospital environment
Adilson Junior, Itamar Xavier, Laura Silveira, Angelita Stabile, Evelin Cárnio, Josiane Gusmão, and André Souza
Health Sciences Research Unit: Nursing



Assistance to the puerperium and the construction of a flow chart for nursing consultation
Lilian Puglas da Silva, Laura Menezes da Silveira, Tatiane de Jesus Martins Mendes, and Angelita Maria Stabile
FapUNIFESP (SciELO)
Abstract Objectives: to identify the main complaints and problems presented by women in the puerperium during nursing consultations and create a care flow chart. Methods: descriptive, cross-sectional exploratory study with quantitative treatment of data conducted in a private hospital in Brazil, with a sample of 114 women. Results: of the puerperal women evaluated, 57.9% were primiparous and 66.7% reported not having received guidance about the puerperal period. Cesarean sections occurred in 89.5% of the sample, and 80.7% of the women presented difficulties inherent to the care given to the newborn or self-care. All mothers were breastfeeding and 42.1% of them reported difficulties in this process. Among breast complications, 30.7% corresponded to fissures. In view of the needs observed in the nursing consultation, women received guidelines from the nurses, and were referred for specialized evaluation when pertinent. Conclusions: it was observed that problems and complaints presented by women in the puerperium were related with care to the newborn, breastfeeding, emotional state and family support. Health professionals who give puerperal consultations should consider the sociocultural environment in which the puerperal woman is inserted in order to link their beliefs with science.


Role of ghrelin on growth hormone/insulin-like growth factor-1 axis during endotoxemia
Felipe Faim, Patricia Passaglia, Marcelo Batalhao, Riccardo Lacchini, Angelita Maria Stabile, and Evelin Capellari Carnio
Elsevier BV



Educational intervention in the knowledge about hand hygiene in nursing students
André Luiz Thomaz de Souza, Fábio Bene, Heitor Ribeiro, Juliano de Souza Caliari, Deise Aparecida Carminatte, and Angelita Maria Stabile
Universidad de Alicante Servicio de Publicaciones
Objective: To evaluate the effect of an educational intervention on knowledge about hand hygiene in nursing students. Method: Quasi-experimental study of the pre- and post-intervention type, carried out with 23 nursing students. Knowledge about hand hygiene was evaluated using a form containing questions about the subject. In addition, a theoretical and practical educational intervention was carried out with an average duration of 60 minutes each. Results: The results of the pre -and postintervention comparison revealed a significant increase in the number of correct answers, with emphasis on improved knowledge related to the question: What care should be taken with the hands, nails and with the use of ornaments? Conclusions: The educational intervention performed in this study proved to be efficient in improving knowledge about hand hygiene.


Effects of Therapeutic Touch on Healing of the Skin in Rats
André Luiz Thomaz de Souza, David Patrick Carvalho Rosa, Bruno Anjos Blanco, Patrícia Passaglia, and Angelita Maria Stabile
Elsevier BV



Glycaemic variability in patients with severe sepsis or septic shock admitted to an Intensive Care Unit
L.M. Silveira, A. Basile-Filho, E.A. Nicolini, C.A.M. Dessotte, G.C.S. Aguiar, and A.M. Stabile
Elsevier BV



Differential Role of Neurohypophysial Hormones in Hypotension and Nitric Oxide Production During Endotoxaemia
A. M. Stabile, V. Moreto, M. E. Batalhão, M. J. Rocha, J. Antunes‐Rodrigues, and E. C. Cárnio
Wiley
Besides their well‐established endocrine roles, vasopressin and oxytocin are also important regulators of immune function, participating in a complex neuroendocrine–immune network. In the present study, we investigated whether and how vasopressin and oxytocin could modulate lipopolysaccharide (LPS)‐induced nitric oxide (NO) production in a well‐established model of experimental endotoxaemia. Male Wistar rats were previously treated i.v. with vasopressin V1 or oxytocin receptor antagonists and then received either an i.v. LPS injection to induce endotoxaemia or a saline imjection as a control. The animals were divided into two groups: in the first group, blood was collected at 2, 4 and 6 h after LPS injection; in the second group, mean arterial blood pressure (MABP) and heart rate (HR) were recorded over 6 h. Plasma vasopressin and oxytocin values were higher in LPS‐ compared to saline‐injected animals at 2 and 4 h but returned to basal levels at 6 h. NO levels exhibited an opposite pattern, showing a progressive increase over the entire period. The previous administration of a vasopressin V1 receptor antagonist significantly reduced NO plasma concentrations at 2 and 4 h but not at 6 h. By contrast, oxytocin receptor agonist pre‐treatment had no effect on the NO plasma concentration. In relation to MABP, previous treatment with vasopressin V1 receptor antagonist reversed the LPS‐induced hypotension at 4 h, although this was not the case for oxytocin antagonist‐treated animals. None of the antagonists affected HR. Our findings indicate that vasopressin (but not oxytocin) has effects on NO production during endotoxaemia in rats, although they do not lend support to the proposed anti‐inflammatory actions of vasopressin during endotoxaemia.


Developing a digital learning environment in nursing professional education
Fernanda dos Santos Nogueira de Góes, Luciana Mara Monti Fonseca, Rosângela Andrade Aukar de Camargo, Cristina Yuri Nakata Hara, Jéssica Deponti Gobbi, and Angelita Maria Stabile
Universidad de Concepcion



Moxonidine improves cardiac structure and performance in SHR through inhibition of cytokines, p38 MAPK and Akt
H Aceros, G Farah, L Cobos‐Puc, AM Stabile, N Noiseux, and S Mukaddam‐Daher
Wiley
BACKGROUND AND PURPOSE Regression of left ventricular hypertrophy by moxonidine, a centrally acting sympatholytic imidazoline compound, results from a sustained reduction of DNA synthesis and transient stimulation of DNA fragmentation. Because apoptosis of cardiomyocytes may lead to contractile dysfunction, we investigated in spontaneously hypertensive rats (SHR), time‐ and dose‐dependent effects of in vivo moxonidine treatment on cardiac structure and function as well as on the inflammatory process and signalling proteins involved in cardiac cell survival/death.EXPERIMENTAL APPROACH 12 week old SHR received moxonidine at 0, 100 and 400 µg·kg−1·h−1, s.c., for 1 and 4 weeks. Cardiac function was evaluated by echocardiography; plasma cytokines were measured by elisa and hearts were collected for histological assessment of fibrosis and measurement of cardiac proteins by Western blotting. Direct effects of moxonidine on cardiac cell death and underlying mechanisms were investigated in vitro by flow cytometry and Western blotting.KEY RESULTS After 4 weeks, the sub‐hypotensive dose of moxonidine (100 µg) reduced heart rate and improved global cardiac performance, reduced collagen deposition, regressed left ventricular hypertrophy, inhibited Akt and p38 MAPK phosphorylation, and attenuated circulating and cardiac cytokines. The 400 µg dose resulted in similar effects but of a greater magnitude, associated with blood pressure reduction. In vitro, moxonidine inhibited norepinephrine‐induced neonatal cardiomyocyte mortality but increased fibroblast mortality, through I1‐receptor activation and differential effects on downstream Akt and p38 MAPK.CONCLUSIONS AND IMPLICATIONS While the antihypertensive action of centrally acting imidazoline compounds is appreciated, new cardiac‐selective I1‐receptor agonists may confer additional benefit.


Functional and molecular effects of imidazoline receptor activation in heart failure
Angelita Maria Stabile, Henry Aceros, Kim Stockmeyer, Abdel A. Abdel Rahman, Nicolas Noiseux, and Suhayla Mukaddam-Daher
Elsevier BV



Central but not systemic inhibition of inducible nitric oxide synthase modulates oxytocin release during endotoxemic shock
Angelita Maria Stabile, Viviana Moreto, José Antunes-Rodrigues, and Evelin Capellari Carnio
Elsevier BV



Role of dexamethasone on vasopressin release during endotoxemic shock
M.E. Batalhão, V. Moreto, A.M. Stabile, J. Antunes-Rodrigues, and E.C. Carnio
Elsevier BV



Participation of the inducible nitric oxide synthase on atrial natriuretic peptide plasma concentration during endotoxemic shock
Angelita Maria Stabile, Viviana Moreto, José Antunes-Rodrigues, and Evelin Capellari Carnio
Elsevier BV

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