Isac Castro - Academia.edu (original) (raw)

Papers by Isac Castro

Introduction. We sought to evaluate 2 single-nucleotide polymorphisms (SNPs) in the C-reactive pr... more Introduction. We sought to evaluate 2 single-nucleotide polymorphisms (SNPs) in the C-reactive protein (CRP) gene promoter region for their effects on CRP levels in chronic kidney disease (CKD) patients before and after a successful kidney transplantation. Methods. Fifty CKD patients were evaluated before and at the first and second years after the graft. Two SNPs were studied, a bi-allelic (G¡A) at the Ϫ409 and a tri-allelic (C¡T¡A) variation at the Ϫ390 position in the CRP gene. Results. All patients presented the Ϫ409GG genotype. At the Ϫ390 position, the "A" allele was not found; there were 15 "CC" patients, 11 "TT" patients, and 24 "CT" patients. CRP levels were different among patients with various genotypes (P Ͻ .019). Also the presence of the allele "T" was sufficient to determine differences in CRP levels both in pretransplantation (P ϭ .045) and at 1 year posttransplantation (P ϭ .011), but not at the second year (P ϭ .448). Conclusion. SNPs at the Ϫ390 position of the CRP gene promoter region influence CRP basal levels in such a way that the "C" allele correlated with the lowest and the "T" with the highest. We did not observe this influence in our patients at the second year posttransplantation.

Avaliação antropométrica segmentar comparativa de triatletas e maratonistas Comparative segmental... more Avaliação antropométrica segmentar comparativa de triatletas e maratonistas Comparative segmental anthropometric evaluation of triathlon and marathon athletes Evaluación antropométrica segmentaria comparativa de los atletas de triatlón y maratón RESUMO: O objetivo do estudo foi realizar avaliação da composição corporal segmentar comparativa de atletas competitivos de maratona e triatletismo para determinar diferenças na composição corporal segmentar. Participaram do estudo 17 indivíduos do sexo masculino (9 maratonistas e 8 triatletas), sendo o protocolo aprovado pelo Comitê de Ética (Protocolo 226/08). Foram mensurados peso, estatura e realizado exame de bioimpedância tetrapolar (Tanita Ironman BCC 558) para análise segmentar da composição corporal. Como prin-cipais resultados observou-se que apesar de não haver diferença estatística no percentual de gordura entre maratonistas e triatletas, 15,2 ± 2,6 vs 15,4 ± 1,5% respectivamente, ocorreram diferenças estatisticamente significati...

This research manuscript reports the heavy metal accumulation in four marine seaweeds sp. 1) Caul... more This research manuscript reports the heavy metal accumulation in four marine seaweeds sp. 1) Caulerpa sertlatioides (Cuba); 2) Caulerpa cf. brachypus; (Bali, Indonesia); 3) Undaria pinnatifida (West-Donegal, Ireland); 4) Ulva lactuca (Easters-Scheldt, the Netherlands). Mechanical pressure at 10 bar of fresh seaweed fronds casu quo biomass in the laboratory delivered seaweed moisture which was analyzed by Inductively Coupled Plasma Spectroscopy (ICP)-techniques for heavy-metals = [HM], (Al, As, Cd, Co, Cr, Cu, Fe, Mo, Ni, Pb & Zn). Three important observations were made: 1) The [HM] in the seaweed moisture is higher than in the surrounding seawater which directs to mechanism(s) of bio-accumulation; 2) The accumulation factor [AF] is varying per metallic-cation with an overall trend for our four seaweeds and sampling locations for [HM] are:

European Journal of Clinical Nutrition

Clinical Neurology and Neurosurgery, 2021

Verst-Maldaun Language Assessment (VMLA) is a new intraoperative neuropsychological test (NT) wit... more Verst-Maldaun Language Assessment (VMLA) is a new intraoperative neuropsychological test (NT) within our local culture, e.g., native Portuguese speaking Brazilians. It aims to fill the specific need of an objective and dynamic approach for assessing the language network during awake craniotomies. The test includes object naming (ON) and semantic functions. This paper describes the process of validation, allowing for other centers to create their own language assessment. The validation process included 248 volunteers and the results were associated with age, gender and educational level (EL). The factor with the greatest impact was EL, followed by age. Intraoperative image learning by repetition is unlikely, since it is composed of 388 items and 70 combinations. The test will be available for free use under http://www.vemotests.com/ (beginning in February 2021).

Scientific Reports, 2020

Defective KLOTHO gene expression in mice led to a syndrome resembling human ageing. This study ev... more Defective KLOTHO gene expression in mice led to a syndrome resembling human ageing. This study evaluated three KLOTHO polymorphisms, namely G395A, C1818T, and C370S, in an elderly population (mean age of 73 years) and their associations with ageing-related outcomes (cardiovascular events, kidney function, osteoporosis, sarcopenia) and mortality. Estimated glomerular filtration rates (eGFR) was lower in subjects with 1818TT (P = 0.047) and 370SS (P = 0.046) genotypes. The 1818TT genotype (P = 0.006) and 1818T allele were associated with higher frequency of myocardial infarction (MI) (CC:1.7% vs. CT + TT:7.0%; P = 0.002). The 370SS genotype was associated with lower stroke frequency (P = 0.001). MI (OR 3.35 [95% CI: 1.29–8.74]) and stroke (OR 3.64 [95% CI: 1.48–8.97]) were associated with mortality. Regarding MI, logistic regression showed 1818T allele was a risk factor for death-related MI (OR 4.29 [95% CI: 1.60–11.52]; P = 0.003), while 370C was protective (OR 0.03 [95% CI: 0.01–0.0...

Aesthetic Surgery Journal, 2020

Background Autologous fat grafting (AFG) has been used in surgical practice as a filling method. ... more Background Autologous fat grafting (AFG) has been used in surgical practice as a filling method. However, controversies remain on the specifics of this technique. So far, few relevant experimental large animal studies have objectively assessed factors related to AFG integration. Objectives This study uses an experimental medium-sized animal model to compare the feasibility of AFG collected using two different techniques with instruments of distinct thicknesses. Methods Twenty minipigs (Sus scropha domesticus) were subjected to AFG harvesting via en bloc resection using 3 (Group I) and 5 mm diameter (Group II) round punch blades (PB) and liposuction (LS) with 3 (Group III) and 5 mm diameter cannulas (Group IV). Both samples were grafted intramuscularly (biceps femoralis). Hematoxylin and eosin (HE) staining was used to identify intact adipocytes, fat necrosis, fibrosis, inflammation, and oil cysts. Immunohistochemical staining (IHC) (perilipin-A, TNF-α, CD31) were utilized to quantif...

BMC Palliative Care, 2020

Background Spirituality can give meaning to life, providing support and guidance in complex situa... more Background Spirituality can give meaning to life, providing support and guidance in complex situations. Despite its importance in palliative care, the role of spirituality for family caregivers of patients under exclusive palliative care has not received enough attention in the literature. We aimed to address the correlation between spirituality and the emotional burden of family members of patients under exclusive palliative care. Methods This transversal study was conducted in a tertiary private teaching hospital, in São Paulo, Brazil. The study comprised family members of patients receiving palliative care exclusively. Only one caregiver who cared for the patient for at least 2 months was invited to participate. Family members answered the following questionnaires: WHOQOL spirituality, religiousness and personal beliefs (SRPB), Zarit Burden Interview (ZBI) and Self-Reporting Questionnaire (SRQ-20). They were excluded if patients were residing in a Long Stay Institution. Continuou...

Journal of Thoracic Imaging, 2020

Purpose: To evaluate the interobserver agreement of chest computed tomography (CT) findings in th... more Purpose: To evaluate the interobserver agreement of chest computed tomography (CT) findings in the diagnosis of expected changes and local recurrence after stereotactic body radiation therapy (SBRT) in patients with early-stage lung cancer or a single pulmonary metastasis. Materials and Methods: A total of 54 patients with early-stage lung cancer or pulmonary metastasis who were treated with SBRT from 2007 to 2015 were included. The exclusion criteria were patients who presented with pulmonary infection during follow-up and patients who underwent a single CT during follow-up. The imaging features on CT were assessed by 3 blinded radiologists at the following 2 time points after SBRT: (a) early follow-up and (b) late follow-up (≥6 mo). The radiologists classified the findings as expected changes after SBRT or recurrence. Interobserver agreement was assessed by kappa and Wilcoxon statistics. Results: A total of 13 women and 41 men with a mean age of 75.3 (±8.9) years were selected. The total and per fraction SBRT doses were 54 Gy (interquartile range: 45 to 54) and 18 Gy (interquartile range: 15 to 18), respectively. All expected changes and findings suggestive of recurrence had an almost perfect agreement (κ>0.85) among readers, except for diffuse consolidation in the early period (κ=0.65). Conclusion: CT findings demonstrate high interobserver agreement for expected changes and for findings indicating recurrence after SBRT.

European Journal of Clinical Nutrition, 2019

Background/objectives Obstruction of the nasoenteral tube is one of the complications of enteral ... more Background/objectives Obstruction of the nasoenteral tube is one of the complications of enteral nutrition therapy, and its causes and frequency of occurrence are not well understood. To evaluate the causes of enteral nutrition feeding tube obstruction. To study the time elapsed between the beginning of the nutrition therapy and the obstruction of the tube. Subjects/methods This was a retrospective cohort study of 1170 patients aged 18 years or older who were hospitalized at Sírio-Libanês Hospital between January 2015 and October 2017, and who were undergoing enteral nutrition therapy delivered using an infusion pump through a nasogastric or nasoenteral tube. The study population included 683 (58%) men and 487 (42%) women. The median age was 79 years. Of these, 1084 patients received enteral nutrition and medication through the feeding tube, and 86 received medication alone. Variables investigated as causes of feeding tube obstruction were the administration of medication through the tube, type of diet, and use of symbiotics. Results Obstruction rates were 4% for up to 40 days of observation and 8% for the total observation time. The time for obstruction of 10% of the tubes in patients receiving rivaroxaban, linagliptin, metformin, and nystatin was 16, 19, 20, and 28 days, respectively. Conclusions The main cause of nasoenteral tube obstruction (odds ratio) was the combination of metformin (2.0), nystatin (3.1), linagliptin (4.3), rivaroxaban (2.4), and a high-protein diet (1.9). Overall, proper tube care and strict compliance with tubal drug delivery guidelines can result in low tube obstruction rates.

Brazilian Journal of Medical and Biological Research, 2018

Genetic and functional aberrations of guanine nucleotide-binding protein, alpha stimulating (GNAS... more Genetic and functional aberrations of guanine nucleotide-binding protein, alpha stimulating (GNAS), aryl hydrocarbon receptor interacting protein (AIP), and pituitary tumor transforming gene (PTTG) are among the most prominent events in pituitary tumorigenesis. A cohort of Brazilian patients with somatotropinomas (n=41) and non-functioning pituitary adenomas (NFPA, n=21) from a single tertiary-referral center were evaluated for GNAS and AIP mutations and gene expression of AIP and PTTG. Results were compared to the clinical and biological (Ki67 and p53 expression) characteristics of tumors and their response to therapy, if applicable. Genetic analysis revealed that 27% of somatotropinomas and 4.8% of NFPA harbored GNAS mutations (P=0.05). However, no differences were observed in clinical characteristics, tumor extension, response to somatostatin analog therapy, hormonal/surgical remission rates, Ki67 index, and p53 expression between mutated and non-mutated somatotropinomas patients. PTTG overexpression (RQ mean=10.6, min=4.39, max=11.9) and AIP underexpression (RQ mean=0.56, min=0.46-max=0.92) were found in virtually all cases without a statistically significant relationship with clinical and biological tumor features. No patients exhibited somatic or germline pathogenic AIP mutations. In conclusion, mutations in GNAS and abnormal PTTG and AIP expression had no impact on tumor features and treatment outcomes in this cohort. Our data support some previous studies and point to the need for further investigations, probably involving epigenetic and transcriptome analysis, to improve our understanding of pituitary tumor behavior.

Journal of feline medicine and surgery, 2018

Objectives The aim of this study was to establish ultrasound criteria for the diagnosis of autoso... more Objectives The aim of this study was to establish ultrasound criteria for the diagnosis of autosomal dominant polycystic kidney disease (ADPKD) in Persian cats. Methods Eighty-two Persian cats were assessed using renal ultrasound and genotyped for the C→A transversion in exon 29 of PKD1. The animals were also submitted to hematological characterization, serum biochemistry analyses and urinalysis. Results Age, sex and neutering status did not differ between ADPKD (n = 12) and non-ADPKD (n = 70) cats. After integrated molecular genetics/ultrasonographic analysis, the presence of at least one renal cyst was sufficient to establish a diagnosis of ADPKD in animals up to 15 months of age. Two or more cysts were required for diagnosis in cats aged 16-32 months, and at least three cysts warranted diagnosis of ADPKD in animals aged 33-49 months. Finally, four or more cysts led to diagnosis in cats aged 50-66 months. Although cats with ADPKD exhibited higher serum calcium levels than non-affe...

Heart failure reviews, 2018

Recent literature suggests that resistance training (RT) improves peak oxygen uptake ([Formula: s... more Recent literature suggests that resistance training (RT) improves peak oxygen uptake ([Formula: see text] peak), similarly to aerobic exercise (AE) in patients with heart failure (HF), but its effect on cardiac remodeling is controversial. Thus, we examined the effects of RT and AE on [Formula: see text] peak and cardiac remodeling in patients with heart failure (HF) via a systematic review and meta-analysis. MEDLINE, EMBASE, Cochrane Library and CINAHL, AMEDEO and PEDro databases search were extracted study characteristics, exercise type, and ventricular outcomes. The main outcomes were [Formula: see text] peak (ml kg-1 min-1), LVEF (%) and LVEDV (mL). Fifty-nine RCTs were included. RT produced a greater increase in [Formula: see text] peak (3.57 ml kg-1 min-1, P < 0.00001, I 2 = 0%) compared to AE (2.63 ml kg-1 min-1, P < 0.00001, I 2 = 58%) while combined RT and AE produced a 2.48 ml kg-1 min-1 increase in [Formula: see text]; I 2 = 69%) compared to control group. Compariso...

Journal of Nephrology, 2016

Acute kidney injury (Dasta et al., Nephrol Dial Transplant 23(6):1970-1974, 2008) following cardi... more 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. 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. 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 &amp;lt; 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 &amp;gt;60 years, hospitalization serum creatinine &amp;gt;0.8 mg/dL, peripheral artery disease, hemorrhage and AKI duration &amp;gt; 3 days. 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.

Cogent Medicine, 2016

Reports about relationship on renal function and vancomycin exposure are conflicted and limited. ... more Reports about relationship on renal function and vancomycin exposure are conflicted and limited. Goals: To identify if high serum vancomycin levels precede changes in serum creatinine or if it is secondary to reduced glomerular filtration and to analyze associated clinical conditions. Methods: retrospective cohort study, initially of 56.555 measurements of vancomycin levels from 511 patients admitted from December 2011 to June 2012 was analyzed. Patients with uncompleted dates were excluded and the correlation analysis was performed in 127 patients that were divided into four groups based on vancomycin levels (20 mg/mL) and creatinine (1.4 mg/dL) levels. After that, 80 medical charts of these patients was reviewed for the presence of comorbidities, sepsis, acute kidney injury and use of other nephrotoxic drugs. Results: there was a significant increase in vancomycin levels, when creatinine > 1.4 mg/dL and vancomycin ≤ 20 mg/mL (Group 3) on the first measurement. It was identified there was a significant association between creatinine > 1.4 mg/mL and vancomycin > 20 mg/mL, n = 7 (Group 4) in patients aged 50-59 years. Acute kidney injury was present in patients with previous higher vancomycin levels. Conclusions: Impaired renal function occurred before vancomycin levels measurements were taken, influencing the serum levels of vancomycin in the following days. In these patients the elevation of vancomycin did not lead to a worsening in renal function. There was a positive correlation between elevated creatinine

PloS one, 2016

Previous studies from our laboratory demonstrated that dietary salt overload and salt restriction... more Previous studies from our laboratory demonstrated that dietary salt overload and salt restriction during pregnancy were associated with cardiac and renal structural and/or functional alterations in adult offspring. The present study evaluated renal and cardiac structure and the local renin-angiotensin system in newborns from dams fed high-, normal- or low-salt diets during pregnancy. Female Wistar rats were fed low- (LS, 0.15% NaCl), normal- (NS, 1.3% NaCl) or high- (HS, 8% NaCl) salt diets during pregnancy. Kidneys and hearts were collected from newborns (n = 6-8/group) during the first 24 hours after birth to evaluate possible changes in structure using stereology. Protein expression of renin-angiotensin system components was evaluated using an indirect enzyme-linked immunosorbent assay (ELISA). No differences between groups were observed in total renal volume, volume of renal compartments or number of glomeruli. The transverse diameter of the nuclei of cardiomyocytes was greater ...

Kidney international, Sep 27, 2016

Alterations in myocardial wall texture stand out among ADPKD cardiovascular manifestations in hyp... more 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);Lgals3(-/-) (CYG-) and Pkd1(+/-);Lgals3(-/-) (HTG-) mice displayed improved cardiac deformability and...

Clinical Neurophysiology, 2016

To study the reproducibility, diagnostic yield to detect denervation, and clinical correlations o... more To study the reproducibility, diagnostic yield to detect denervation, and clinical correlations of the Motor Unit Number Index (MUNIX) in subjects with Amyotrophic Lateral Sclerosis (ALS). MUNIX evaluation was performed in three muscles twice on the same day to assess reproducibility. Cut-off values for the MUNIX were based on data from 51 healthy subjects (controls) to evaluate the sensitivity of the technique to detect denervation in 30 subjects with ALS. The method had good reproducibility. The variability was greater in the ALS group. In 23 ALS subjects (77%), low MUNIX values were detected. Most of the muscles with low MUNIX had also low compound muscle action potential (CMAP) and strength, but these parameters were normal in 9% of muscles. According to ROC curve analysis, MUNIX was generally accurate (AUC=0.9504) for discriminating between healthy individuals and subjects with at least one denervated muscle. MUNIX variability was higher in the ALS group. The method showed good diagnostic performance for the detection of denervation in a sample of patients with ALS. This study demonstrated that in addition to being a quantitative tool MUNIX can detect denervation in subjects with ALS.

$Research paper thumbnail of Associations between OPG and RANKL polymorphisms, vertebral fractures, and abdominal aortic calcification in community-dwelling older subjects: the Sao Paulo Ageing & Health Study (SPAH)$

Osteoporosis international : a journal established as result of cooperation between the European Foundation for Osteoporosis and the National Osteoporosis Foundation of the USA, Jan 16, 2016

This is the first study analyzing concomitantly osteoprotegerin (OPG)/receptor activator of nucle... more This is the first study analyzing concomitantly osteoprotegerin (OPG)/receptor activator of nuclear factor kappa B ligand (RANKL) polymorphisms and OPG/RANKL serum levels and their association with bone mineral density (BMD), vertebral fractures, and vascular aortic calcification in a cohort of 800 subjects in community-dwelling older individuals. Osteoprotegerin (OPG) and RANKL play an important role in osteoclast activation and differentiation as well as in vascular calcification. At present, there are no studies of OPG or RANKL gene polymorphisms in Brazilian older populations. The aim of this study was to evaluate OPG/RANKL polymorphism and their association with vertebral fractures (VFs) and aortic calcification. Eight hundred subjects (497 women/303 men) were genotyped for the OPG 1181G>C (rs2073618), 163C>T (rs3102735), 245T>G (rs3134069), and 209G>A (rs3134070) and RANKL A>G (rs2277438) single-nucleotide polymorphisms (SNPs). VFs were evaluated by spine radiog...