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LIM/29 - Laboratório de Nefrologia Celular, Genética e Molecular, Hospital das Clínicas, Faculdade de Medicina

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Agora exibindo 1 - 10 de 41
  • article 1 Citação(ões) na Scopus
    Patient suspected susceptibility to malignant hyperthermia: impact of the disease
    (2023) RODRIGUES, Gislene; ANDRADE, Pamela Vieira; SANTOS, Joilson Moura dos; CASTRO, Isac de; AMARAL, José Luiz Gomes do; SILVA, Helga Cristina Almeida da
    Abstract Introduction Malignant Hyperthermia (MH) is an inherited hypermetabolic syndrome triggered by exposure to halogenated anesthetics/succinylcholine. The lack of knowledge regarding this condition might be associated with the rare occurrence of MH reaction and symptoms. Methods This observational study evaluated 68 patients from 48 families with confirmed or suspected MH susceptibility due to medical history of MH reaction or idiopathic increase of creatine kinase or MH-related myopathies. Participants were assessed by a standardized questionnaire and submitted to physical/neurological examination to assess the characteristics of patients with MH, their knowledge about the disease, and the impact suspected MH had on their daily lives. Results Suspected MH impacted the daily life of 50% of patients, creating difficulties in performing surgical/clinical/dental treatment and problems related to their family life/working/practicing sports. The questionnaire on MH revealed a correct answer score of 62.1 ± 20.8 (mean ± standard deviation) on a scale 0 to 100. Abnormal physical/neurological examination findings were detected in 92.6% of susceptible patients. Conclusions Suspected MH had impacted the daily lives of most patients, with patients reporting problems even before MH investigation with IVCT. Patients showed a moderate level of knowledge about MH, suggesting the need to implement continuing education programs. MH susceptible patients require regular follow-up by a health team to detect abnormalities during physical and neurological examination.
  • article 45 Citação(ões) na Scopus
    The duration of acute kidney injury after cardiac surgery increases the risk of long-term chronic kidney disease
    (2017) PALOMBA, Henrique; CASTRO, Isac; YU, Luis; BURDMANN, Emmanuel A.
    Background Acute kidney injury (Dasta et al., Nephrol Dial Transplant 23(6): 1970-1974, 2008) following cardiac surgery is associated with higher perioperative morbidity and mortality, but its impact on long term development of chronic kidney disease (CKD) is uncertain. Methods A total of 350 patients submitted to elective cardiac surgery were evaluated for AKI, defined as an increase in serum creatinine (SCr) = 0.3 mg/dL over baseline value. Univariate and multivariate analysis were used to study pre, intra and postoperative parameters associated with occurrence CKD after 12 months of follow-up. Results AKI incidence was 41 % (n = 88). The 12-month prevelence of CKD was 9 % (n = 19) in non-AKI patients versus 25 % (n = 54, p < 0.0001) in the AKI group. The factors identified as independent risk factors for long-term CKD development in the multivariate logistic regression model were age > 60 years, hospitalization serum creatinine > 0.8 mg/dL, peripheral artery disease, hemorrhage and AKI duration > 3 days. Conclusion Patients developing AKI after cardiac surgery presented high prevalence of long-term incident CKD. The duration of AKI was a strong independent risk factor for this late CKD development. Recognition of predictive factors for CKD development following cardiac surgery-associated AKI may help to develop strategies to prevent or halt CKD progression in this population.
  • conferenceObject
    A phase III, randomized, double-blind, placebo-controlled trial to evaluate the efficacy and safety of pregabalin in the prevention and reduction of oxaliplatin-induced painful neuropathy (PreOx)
    (2015) ANDRADE, Daniel Ciampi de; TEIXEIRA, Manoel Jacobsen; GALHARDONI, Ricardo; FERREIRA, Karine A. S. L.; MALIENO, Paula Braz; SCISCI, Nathalia; RIECHELMANN, Rachel Pimenta; TEIXEIRA, William G. J.; SARAGIOTTO, Daniel Fernandes; SILVA, Valquiria Aparecida; RAICHER, Irina; CASTRO, Isac de; PARRAVANO, Daniella; FUKUSHIMA, Julia Tizue; LEFAUCHEUR, Jean-Pascal; BOUHASSIRA, Didier; MACARENCO, Ricardo Silvestre e Silva; MELLO, Evandro Sobroza de; HOFF, Paulo Marcelo
  • article 25 Citação(ões) na Scopus
    Late onset multiple sclerosis: concerns in aging patients
    (2017) LOTTI, Claudia Beatriz de Campos; OLIVEIRA, Acary Souza Bulls; BICHUETTI, Denis Bernardi; CASTRO, Isac de; OLIVEIRA, Enedina Maria Lobato
    Late onset multiple sclerosis (LOMS) is when the first symptom starts after 50 years of age, representing 4.5% of multiple sclerosis (MS) patients. This study describes the clinical characteristics of patients with LOMS followed at a specialized MS center in Sao Paulo. Data was obtained from medical records of 742 patients with MS. The LOMS frequency was 4.18%, median age at onset was 54 years and the predominant disease course was primary progressive (64.3%). The patients reached the disability landmarks of EDSS grades 3.0, 6.0 and 7.0 in the following proportion and time: EDSS 3.0: 77.42% of patients in 3.7 years; EDSS 6.0: 58.06% in 5.1 years and EDSS 7.0: 32.26% in 5.7 years.The comparative analysis with a matched control group of patients with early onset MS showed that late onset, associated with a progressive course, were predictors of reaching EDSS 3.0 and 6.0 in a shorter time.
  • conferenceObject
    Dendrogram Analyses of Relative Expression Between Bladder Cancers and Controls Identify PTEN-HIF1 alpha Association as an Alteration Characteristic of Malignancy
    (2015) SCHULTZ, Luciana; COUTINHO-CAMILLO, Claudia; CASTRO, Isac; DAMM, Gilcy; SPAGNUL, Samuel; CUNHA, Isabela; ONUCHIC, Luiz; SOARES, Fernando
  • article 12 Citação(ões) na Scopus
    Salt intake during pregnancy alters offspring's myocardial structure
    Background and Aim: To evaluate the effects of low or high salt intake during pregnancy on left ventricle of adult male offspring. Methods and results: Low-(LS, 0.15%), normal-(NS, 1.3%) or high-salt (HS, 8% NaCl) diet was given to Wistar rats during pregnancy. During lactation all dams received NS as well as the offspring after weaning. To evaluate cardiac response to salt overload, 50% of each offspring group was fed a high-salt (hs, 4% NaCl) diet from the 21st to the 36th week of age (LShs, NShs, HShs). The remaining 50% was maintained on NS (LSns, NSns and HSns). Echocardiography was done at 20 and 30 weeks of age. Mean blood pressure (MBP), histology and left ventricular angiotensin II content (AII) were analyzed at 36 weeks of age. Interventricular septum, left ventricular posterior wall and relative wall thickness increased from the 20th to the 30th week of age only in HShs, cardiomyocyte mean volume was higher in HShs compared to NShs, LShs and HSns. AII and left ventricular fibrosis were not different among groups. Conclusions: HS during pregnancy programs adult male offspring to a blood pressure and angiotensin II independent concentric left ventricular hypertrophy, with no fibrosis, in response to a chronic high-salt intake.
  • article 4 Citação(ões) na Scopus
    When Is the Best Moment to Assess the Ankle Brachial Index: Pre- or Post-Hemodialysis?
    (2012) JIMENEZ, Zaida Noemy Cabrera; CASTRO, Lsac de; PEREIRA, Benedito Jorge; OLIVEIRA, Rodrigo Bueno de; ROMAO JR., Joao Egidio; ELIAS, Rosilene Motta
    Background: Cardiovascular disease is an important cause of death in patients on dialysis. Peripheral arterial disease (PAD) is a prognostic factor for cardiovascular disease. The ankle brachial index (ABI) is a noninvasive method used for the diagnosis of PAD. The difference between ABI pre- and post-dialysis had not yet been formally tested, and it was the main objective of this study. Methods:The ABI was assessed using an automated oscillometric device in incident patients on hemodialysis. All blood pressure readings were taken in triplicate pre- and post-dialysis in three consecutive dialysis sessions (times 1, 2, and 3). Results: One hundred and twenty-three patients (85 men) aged 53 +/- 19 years were enrolled. We found no difference in ABI pre- and post-dialysis on the right or left side, and there was no difference in times 1, 2, and 3. In patients with a history of PAD, the ABI pre- versus post-dialysis were of borderline significance on the right side (p = 0.088). Conclusion: ABI measured pre- and post-dialysis presented low variability. The ABI in patients with a history of PAD should be evaluated with caution. The applicability of the current method in predicting mortality among patients on hemodialysis therefore needs further investigation.
  • article 23 Citação(ões) na Scopus
    Cardiac dysfunction in Pkd1-deficient mice with phenotype rescue by galectin-3 knockout
    (2016) BALBO, Bruno E.; AMARAL, Andressa G.; FONSECA, Jonathan M.; CASTRO, Isac de; SALEMI, Vera M.; SOUZA, Leandro E.; SANTOS, Fernando dos; IRIGOYEN, Maria C.; QIAN, Feng; CHAMMAS, Roger; ONUCHIC, Luiz F.
    Alterations in myocardial wall texture stand out among ADPKD cardiovascular manifestations in hypertensive and normotensive patients. To elucidate their pathogenesis, we analyzed the cardiac phenotype in Pkd1(cond/cond) Nestin(cre) (CYG+) cystic mice exposed to increased blood pressure, at 5 to 6 and 20 to 24 weeks of age, and Pkd1(+/-) (HTG+) noncystic mice at 5-6 and 10-13 weeks. Echocardiographic analyses revealed decreased myocardial deformation and systolic function in CYG+ and HTG+ mice, as well as diastolic dysfunction in older CYG+ mice, compared to their Pkd1(cond/cond) and Pkd1(+/+) controls. Hearts from CYG+ and HTG+ mice presented reduced polycystin-1 expression, increased apoptosis, and mild fibrosis. Since galectin-3 has been associated with heart dysfunction, we studied it as a potential modifier of the ADPKD cardiac phenotype. Double-mutant Pkd1(cond/cond):Nestin(cre);Lgals(3-/-) (CYG-) and Pkd1(+/-);Lgals(3-/-) (HTG-) mice displayed improved cardiac deformability and systolic parameters compared to single -mutants, not differing from the controls. CYG- and HTG- showed decreased apoptosis and fibrosis. Analysis of a severe cystic model (Pkd1(v/v); VVG+) showed that Pkd1(v/v);Lgals(3-/-) (VVG-) mice have longer survival, decreased cardiac apoptosis and improved heart function compared to VVG+. CYG- and VVG- animals showed no difference in renal cystic burden compared to CYG+ and VVG+ mice. Thus, myocardial dysfunction occurs in different Pkdl-deficient models and suppression of galectin-3 expression rescues this phenotype.
  • conferenceObject
    Low Immunoexpression of phosAKT Correlates With Upregulation of mTOR Pathway and HIFI a Gene Expression
    (2015) COUTINHO-CAMILLO, Claudia; SCHULTZ, Luciana; CASTRO, Isac; DAMM, Gilcy; CUNHA, Isabela; ONUCHIC, Luiz; SOARES, Fernando
  • article 36 Citação(ões) na Scopus
    Performance of the third-generation models of severity scoring systems (APACHE IV, SAPS 3 and MPM-III) in acute kidney injury critically ill patients
    (2011) SILVA, Veronica Torres Costa e; CASTRO, Isac de; LIANO, Fernando; MURIEL, Alfonso; RODRIGUEZ-PALOMARES, Jose R.; YU, Luis
    Background. Severity scores are useful to guarantee similar disease severity among groups in clinical trials and to enable comparison between different studies. The aim of this study was to assess the performance of the third generation models of severity scoring systems [simplified acute physiology score (SAPS) 3, acute physiology and chronic health evaluation (APACHE) IV and mortality probability model (MPM)-III] in acute kidney injury (AKI) patients in the intensive care unit (ICU). Methods. Three hundred and sixty-six consecutive AKI critically ill patients were prospectively assessed in six ICUs of an academic tertiary care center. Scores were applied on AKI diagnosis day (DD) and on the day of nephrology consultation (NCD). Discrimination was assessed by area under the receiver operating characteristic curve (AUCROC) and calibration by Hosmer-Lemeshow (HL) goodness-of-fit test. Results. Hospital mortality rate was 67.8%. SAPS 3 general and Central and South America (CSA) customized equations presented identical good discrimination (AUCROC curve: 0.80 on NCD) and satisfactory HL tests on both analyzed days (P > 0.100). CSA SAPS 3 equation predicted mortality more accurately [standardized mortality ratio (SMR) on NCD = 1.00 (95% confidence interval (CI) 0.84-1.34)]. APACHE IV and MPM-III scores presented similar discrimination compared to SAPS 3 on both analyzed days (P > 0.05). APACHE IV presented satisfactory HL tests over time (P > 0.100) but underestimated mortality [SMR on DD 1.92 (95% CI 1.61-2.23); SMR on NCD 1.46 (95% CI 1.48-1.96)]. MPM-III showed unsatisfactory HL test results (P = 0.027 on DD; P = 0.045 on NCD) and underestimated mortality [SMR on NCD - 2.09 (95% CI 1.48-1.96)]. Conclusions. SAPS 3, especially the geographical customized equation, presented good discrimination and calibration performances, accurately predicting mortality in this group of AKI critically ill patients.