ERIKA YOSHIE SHIMODA
Projetos de Pesquisa
Unidades Organizacionais
LIM/48 - Laboratório de Imunologia, Hospital das Clínicas, Faculdade de Medicina
4 resultados
Resultados de Busca
Agora exibindo 1 - 4 de 4
- Detection of Trypanosoma cruzi DTUs TcI and TcIV in two outbreaks of orally-transmitted Chagas disease in the Northern region of Brazil(2023) FREITAS, Vera Lucia Teixeira de; PIOTTO, Mariana Ramos; ESPER, Helena Rangel; NAKANISHI, Erika Yoshie Shimoda; FONSECA, Claudia de Abreu; ASSY, Joao Guilherme Pontes Lima; BERRETA, Olivia Campos Pinheiro; FRANCA, Francisco Oscar de Siqueira; LOPES, Marta HeloisaThis study describes the laboratory investigation of two acute Chagas disease outbreaks that occurred in the riverside communities of Marimarituba and Cachoeira do Arua, in the Santarem municipality, Para State, located in the Northern region of Brazil, and occurred in March 2016 and August 2017, respectively. The generation of data regarding the diversity of Trypanosoma cruzi parasites circulating in the Amazon region is key for understanding the emergence and expansion of Chagas disease. This study aimed to identify T. cruzi Discrete Typing Units (DTUs) involved in two outbreaks of acute Chagas disease (ACD) directly from the patient's biological sample. Nested and multiplex PCR targeting the symbolscript (rRNA) and mini-exon genes, respectively, were used to identify T. cruzi DTU in blood samples from patients diagnosed with ACD. The samples with positive cPCR were submitted for analysis for T. cruzi DTUs, which included 13 samples from the patients with ACD by oral transmission and two samples collected from two newborns of two women with ACD, from Marimarituba and Cachoeira do Arua. The samples were classified as T. cruzi TcIV, from Marimarituba's outbreak, and T. cruzi TcI, from Cachoeira do Arua's outbreak. The molecular identification of T. cruzi may increase understanding of the role of this parasite in Chagas disease's emergence within the Amazon region, contributing to the improvement of the management of this important, but also neglected, disease.
- Effects of DPP4 Inhibitor in Platelet Reactivity and Other Cardiac Risk Markers in Patients with Type 2 Diabetes and Acute Myocardial Infarction(2022) GENESTRETI, Paulo R. Rizzo; FURTADO, Remo H. M.; SALSOSO, Rocio; DALCOQUIO, Talia F.; FRANCI, Andre; MENEZES, Fernando R.; CAPORRINO, Cesar; FERRARI, Aline G.; NAKASHIMA, Carlos A. K.; SCANAVINI FILHO, Marco A.; LIMA, Felipe G.; V, Roberto R. C. Giraldez; BARACIOLI, Luciano M.; NICOLAU, Jose C.Background: The management of acute myocardial infarction (AMI) presents several challenges in patients with diabetes, among them the higher rate of recurrent thrombotic events, hyperglycemia and risk of subsequent heart failure (HF). The objective of our study was to evaluate effects of DPP-4 inhibitors (DPP-4i) on platelet reactivity (main objective) and cardiac risk markers. Methods: We performed a single-center double-blind randomized trial. A total of 70 patients with type 2 diabetes (T2DM) with AMI Killip <= 2 on dual-antiplatelet therapy (aspirin plus clopidogrel) were randomized to receive sitagliptin 100 mg or saxagliptin 5 mg daily or matching placebo. Platelet reactivity was assessed at baseline, 4 days (primary endpoint) and 30 days (secondary endpoint) after randomization, using VerifyNow Aspirin (TM) assay, expressed as aspirin reaction units (ARUs); B-type natriuretic peptide (BNP) in pg/mL was assessed at baseline and 30 days after (secondary endpoint). Results: Mean age was 62.6 +/- 8.8 years, 45 (64.3%) male, and 52 (74.3%) of patients presented with ST-segment elevation MI. For primary endpoint, there were no differences in mean platelet reactivity (p = 0.51) between the DPP-4i (8.00 {-65.00; 63.00}) and placebo (-14.00 {-77.00; 52.00}) groups, as well in mean BNP levels (p = 0.14) between DPP-4i (-36.00 {-110.00; 15.00}) and placebo (-13.00 {-50.00; 27.00}). There was no difference between groups in cardiac adverse events. Conclusions: DPP4 inhibitor did not reduce platelet aggregation among patients with type 2 diabetes hospitalized with AMI. Moreover, the use of DPP-4i did not show an increase in BNP levels or in the incidence of cardiac adverse events. These findings suggests that DPP-4i could be an option for management of T2DM patients with acute MI.
- Prevalence and Associated Factors of Cryptococcal Antigenemia in HIV-Infected Patients with CD4 < 200 Cells/mu L in Sao Paulo, Brazil: A Bayesian Analysis(2022) MIMICOS, Evanthia Vetos; FOSSALUZA, Victor; PICONE, Camila de Melo; SENA, Camila Caroline de; GOMES, Helio Rodrigues; LAZARI, Carolina dos Santos; SILVA, Fernanda Ferreira da; NAKANISHI, Erika Shimoda; NISIDA, Isabelle Vichr; FREITAS, Angela Carvalho; GRYSCHEK, Ronaldo Borges; LAGONEGRO, Eduardo Ronner; LAZERA, Marcia; SHIKANAI-YASUDA, Maria AparecidaCryptococcosis is a severe life-threatening disease and a major cause of mortality in people with advanced AIDS and CD4 <= 100 cells/ mu L. Considering the knowledge gap regarding the benefits of routine application of antigenemia tests in HIV-infected patients with 100-200 CD4 cells/mu L for the prevention of cryptococcal meningitis (CM), we aimed to evaluate the prevalence of positive antigenemia through lateral flow assay (LFA) and associated factors in HIV-infected patients with CD4 < 200 cells/ mu L. Our findings of 3.49% of positive LFA (LFA+) patients with CD4 < 100 cells/mu L and 2.24% with CD4 between 100-200 cells/mu L have been included in a Bayesian analysis with 12 other studies containing similar samples worldwide. This analysis showed a proportion of 3.6% LFA+ patients (95% credible interval-Ci [2.5-5.7%]) with CD4 < 100 cells/mu L and 1.1% (95%Ci [0.5-4.3%]) with CD4 between 100-200 cells/mu L, without statistical difference between these groups. The difference between mortality rates in LFA+ and negative LFA groups was e = 0.05013. Cryptococcoma and CM were observed in the LFA+ group with 100-200 and <100 CD4 cells/mu L, respectively. Considering the benefits of antifungal therapy for LFA+ patients, our data reinforced the recommendation to apply LFA as a routine test in patients with 100-200 CD4 cells/ mu L aiming to expand cost-effectiveness studies in this group.
- Aplastic Anemia and Chagas Disease: T. cruzi Parasitemia Monitoring by Quantitative PCR and Preemptive Antiparasitic Therapy(2022) CARVALHO, Noemia Barbosa; FREITAS, Vera Teixeira de; BEZERRA, Rita Cristina; NAKANISHI, Erika Shimoda; VELLOSO, Elvira Pereira; HIGASHINO, Hermes Ryoiti; BATISTA, Marjorie Vieira; FONSECA, Guilherme Henrique; ROCHA, Vanderson; COSTA, Silvia Figueiredo; SHIKANAI-YASUDA, Maria AparecidaBackground: Aplastic anemia is a rare and life-threatening condition, seldomly witnessed concomitantly with Chagas disease. We aim to discuss the management of these patients under risk of chronic Chagas disease reactivation (CDR), a severe condition with a high morbimortality that occurs in chronic Chagas disease patients under immunosuppression. Case reports: Trypanosoma cruzi (T. cruzi) parasitemia was monitored in three patients for 4-58 months by conventional PCR (cPCR), quantitative PCR (qPCR), microhematocrit/buffy coat, blood culture, and/or xenodiagnosis. One patient received antiparasitic treatment (benznidazole) and the other received allopurinol. Although parasitemia was controlled during and after benznidazole treatment at 300 mg/d for 51 days, in one patient, hematologic parameters worsened continuously before, during, and after treatment. Allopurinol led only to the temporary suppression of T. cruzi parasitemia in the second patient, but after danazol and hematological improvement, parasitemia became undetectable until the end of monitoring. Discussion and Conclusion: Unexpected undetectable or low parasitemia by cPCR/qPCR was reported. We show that the monitoring of parasitemia by qPCR and the use of preemptive therapy when the parasitemia was positive proved to be beneficial to our patients. As a result of the toxicity of more effective antiparasitics, shorter regimens of benznidazole or less toxic drugs in preemptive therapy are options that deserve future studies.