Cristiane Kibune Nagasako
State University of Campinas
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Publication
Featured researches published by Cristiane Kibune Nagasako.
Journal of Clinical Gastroenterology | 2009
Cristiane Kibune Nagasako; Márcio Jansen de Oliveira Figueiredo; Jazon Romilson de Souza Almeida; Sônia Letícia Silva Lorena; Helena Midori Imamura Akasaka; Célia Regina Pavan; Ademar Yamanaka; Tiago Sevá Pereira; Elza Cotrim Soares; Maria Aparecida Mesquita
Background The presence of autonomic dysfunction in nonalcoholic cirrhosis and its influence on intestinal transit and disease outcome still need clarification. Goals To investigate the function of the autonomic nervous system in patients with nonalcoholic cirrhosis and the possible associations among autonomic dysfunction, severity of liver disease, disturbed intestinal transit, and the development of complications during follow-up. Study Measurements of heart rate variability obtained by analysis of 24-hour ambulatory electrocardiographic recordings to assess autonomic function and lactulose breath hydrogen test to determine orocecal transit time were performed in 32 patients with nonalcoholic cirrhosis divided into Child A and B. Results Child B patients showed significantly lower values (P<0.05) of those parameters reflecting parasympathetic (high frequency, log-transformed high frequency, pNN50) and sympathetic function (low frequency, log-transformed low frequency) in comparison with controls and Child A patients. Orocecal transit time values were significantly (P=0.02) higher in Child B patients than in controls, but no relationship was found between delayed orocecal transit time and autonomic dysfunction. During follow-up, 42% of Child B patients developed encephalopathy. This complication was significantly associated with autonomic dysfunction. In addition, in the 4 patients who died the parameters reflecting parasympathetic function were significantly reduced in comparison with those of survivors. Conclusions Autonomic dysfunction and delayed intestinal transit are related to the severity of disease in nonalcoholic cirrhosis. Autonomic dysfunction seems to predispose cirrhotic patients to the development of encephalopathy and may be associated with a poor prognosis of these patients.
Digestion | 2013
Juliana Custódio Lima; Ciro Garcia Montes; Cristiane Kibune Nagasako; Glaucia Fernanda Soares Ruppert Reis; José Olympio Meirelles dos Santos; Fabio Guerrazzi; Maria Aparecida Mesquita
Background/Aims: This prospective study investigated the performance of pre-endoscopy and the complete Rockall scores in predicting the occurrence of adverse outcomes and the need for endoscopic or surgical intervention in patients with nonvariceal upper gastrointestinal bleeding. Methods: All 656 consecutive patients who underwent endoscopy due to nonvariceal upper gastrointestinal bleeding between 2007 and 2011 were included. Receiver operating characteristic (ROC) curves were plotted for the outcomes of therapeutic intervention, rebleeding and death. The discriminative accuracy of the risk scores was assessed by the area under the ROC curve. Results: Endoscopic treatment was performed in 55.2% of the patients. Rebleeding and mortality rates were 7.6 and 3.8%, respectively. The pre-endoscopy Rockall scores showed unsatisfactory accuracy in predicting the need for intervention, rebleeding or death, as shown by the respective area under the ROC curve values of 0.52, 0.52 and 0.65. The accuracy of the complete Rockall score in predicting rebleeding was poor (area under ROC: 0.52), but it was higher for mortality (area under ROC: 0.69). Conclusions: The pre-endoscopy Rockall score was not useful for predicting the need for therapeutic intervention or adverse outcomes. The complete Rockall score showed an acceptable performance in predicting mortality, but was unable to predict rebleeding.
World Journal of Gastroenterology | 2012
Alexandre Khodr Furtado; Virginia Lucia Ribeiro Cabral; Thiago Nunes Santos; Eli Mansour; Cristiane Kibune Nagasako; Sônia L. Lorena; Rogerio Antunes Pereira-Filho
The case of a 52-year-old woman with a past history of thymoma resection who presented with chronic diarrhea and generalized edema is the focal point of this article. A diagnosis of Giardia lamblia infection was established, which was complicated by protein-losing enteropathy and severely low serum protein level in a patient with no urinary protein loss and normal liver function. After anti-helmintic treatment, there was recovery from hypoalbuminemia, though immunoglobulins persisted at low serum levels leading to the hypothesis of an immune system disorder. Goods syndrome is a rare cause of immunodeficiency characterized by the association of hypogammaglobulinemia and thymoma. This primary immune disorder may be complicated by severe infectious diarrhea secondary to disabled humoral and cellular immune response. This is the first description in the literature of an adult patient with an immunodeficiency syndrome who presented with protein-losing enteropathy secondary to giardiasis.
PLOS ONE | 2016
Isabela Haddad Peron; Franqueline Reichert-Lima; Ariane Fidelis Busso-Lopes; Cristiane Kibune Nagasako; Luzia Lyra; Maria Luiza Moretti; Angélica Zaninelli Schreiber
Candida albicans caused 44% of the overall candidemia episodes from 2006 to 2010 in our university tertiary care hospital. As different antifungal agents are used in therapy and also immunocompromised patients receive fluconazole prophylaxis in our institution, this study aimed to perform an antifungal susceptibility surveillance with the C.albicans bloodstream isolates and to characterize the fluconazole resistance in 2 non-blood C.albicans isolates by sequencing ERG11 gene. The study included 147 C. albicans bloodstream samples and 2 fluconazole resistant isolates: one from oral cavity (LIF 12560 fluconazole MIC: 8μg/mL) and one from esophageal cavity (LIF-E10 fluconazole MIC: 64μg/mL) of two different patients previously treated with oral fluconazole. The in vitro antifungal susceptibility to amphotericin B (AMB), 5-flucytosine (5FC), fluconazole (FLC), itraconazole (ITC), voriconazole (VRC), caspofungin (CASP) was performed by broth microdilution methodology recommended by the Clinical and Laboratory Standards Institute documents (M27-A3 and M27-S4, CLSI). All blood isolates were classified as susceptible according to CLSI guidelines for all evaluated antifungal agents (MIC range: 0,125–1.00 μg/mL for AMB, ≤0.125–1.00 μg/mL for 5FC, ≤0.125–0.5 μg/mL for FLC, ≤0.015–0.125 μg/mL for ITC, ≤0.015–0.06 μg/mL for VRC and ≤0.015–0.125 μg/mL for CASP). In this study, we also amplified and sequenced the ERG11 gene of LIF 12560 and LIF-E10 C.albicans isolates. Six mutations encoding distinct amino acid substitutions were found (E116D, T128K, E266D, A298V, G448V and G464S) and these mutations were previously described as associated with fluconazole resistance. Despite the large consumption of antifungals in our institution, resistant blood isolates were not found over the trial period. Further studies should be conducted, but it may be that the very prolonged direct contact with the oral antifungal agent administered to the patient from which was isolated LIF E-10, may have contributed to the development of resistance.
Gastroenterology Research and Practice | 2013
Bianca Rosa Viana Freitas; Cristiane Kibune Nagasako; Célia Regina Pavan; Sônia Letícia Silva Lorena; Fabio Guerrazzi; Cláudio Saddy Rodrigues Coy; Maria de Lourdes Setsuko Ayrizono; Maria Aparecida Mesquita
Background. Fecal immunochemical tests (FITs) have been used for colorectal cancer (CRC) screening in several countries. There is lack of information concerning diagnostic performances of this method in Brazil. Methods. Patients scheduled for elective colonoscopy provided one stool sample one week before colonoscopy. The accuracy of a qualitative FIT for detection of CRC and advanced adenomas was determined. Results. Overall 302 patients completed the study. Among them, 53.5% were high risk patients referred for screening or surveillance. Nine (3%) CRCs and 11 (3.6%) advanced adenomas were detected by colonoscopy. Sensitivity and specificity for CRC were, respectively, 88.9% and 87.6%. For advanced adenomas, sensitivity was 63.6% and specificity 87.6%. Conclusion. Our results showed good sensitivity and specificity of the FIT for detecting advanced neoplasias. This method may be a valuable tool for future screening programs in Brazil.
Archives of Endocrinology and Metabolism | 2015
Mariza Faria; Elizabeth João Pavin; Maria Cândida Ribeiro Parisi; Cristiane Kibune Nagasako; Maria Aparecida Mesquita
OBJECTIVES To evaluate, in a group of patients with long-standing type 1 diabetes (DM1), an association of dyspepsia symptoms with: changes in the gastroduodenal mucosa, infection by Helicobacter pylori, glycemic control, and psychological and nutritional factors. SUBJECTS AND METHODS A total of 32 patient with DM1 were studied (age: 38 ± 9 years; females: 25; diabetes duration: 22 ± 5 years). All patients answered a standardized questionnaire for the evaluation of gastrointestinal symptoms and underwent upper gastrointestinal endoscopy, with gastric biopsies for the evaluation of Helicobacter pylori infection. The presence of anxiety and depression was evaluated by the HAD scale. Nutritional parameters were BMI, arm and waist circumference, skinfold measurement, and body fat percentage. RESULTS Upper endoscopy detected lesions in the gastric mucosa in 34.4% of the patients, with similar frequency in those with (n = 21) and without dyspepsia (n = 11). The patients with dyspepsia complaints showed greater frequency of depression (60% vs. 0%; p = 0.001), higher values for HbA1c (9.6 ± 1.7 vs. 8.2 ± 1.3%; p = 0.01) and lower values for BMI (24.3 ± 4.1 vs. 27.2 ± 2.6 kg/m2; p = 0.02), body fat percentage (26.6 ± 6.2 vs. 30.8 ± 7.7%; p = 0.04), and waist circumference (78.7 ± 8 vs. 85.8 ± 8.1 cm; p = 0.02). No association was found between the symptoms and the presence of Helicobacter pylori. CONCLUSIONS Dyspepsia symptoms in patients with long-standing DM1 were associated with glycemic control and depression, and they seem to negatively influence the nutritional status of these patients.
European Journal of Clinical Nutrition | 2018
Isabela Solar; Larissa Ariel Oliveira Santos; Luciana Miyuki Yamashita; Jacqueline S. Barret; Cristiane Kibune Nagasako; Ciro Garcia Montes; Marcela Lanzoni Louzada; Marcela Silva Calsa; Ana Carolina Junqueira Vasques
This study investigated the association between fermentable oligo-di-mono-saccharides and polyols (FODMAPs) intake, problematic foods, body adiposity, and gastrointestinal symptoms in 44 women with irritable bowel syndrome (IBS). Around 84% reported to have excluded some food from their diet. Adiposity was not associated with the frequency of gastrointestinal symptoms and IBS severity. Controlling for BMI, there were significant correlations between number of problematic foods versus waist circumference (r = 0.306; p = 0.049) and protein intake (r = −0.378; p = 0.014). The IBS severity correlated to the carbohydrate intake (r = −0.320; p = 0.039). Patients with diarrhea demonstrated statistical tendency to restrict the intake of fat (p = 0.058), free fructose (p = 0.07), and oligosaccharides (p = 0.051). Patients with mucus in the stool had higher lactose intake (p = 0.025). The number of food considered problematic was higher for patients who reported stomach burning (p = 0.0001). Associations among adiposity, gastrointestinal symptoms, problematic food, and FODMAPs were identified and reaffirm the role of individualized nutritional treatment in the management of IBS.
Revista Espanola De Enfermedades Digestivas | 2017
Bárbara Corrêa; Cristiane Kibune Nagasako; Ciro Garcia Montes; Marlone Cunha-Silva; Maria Aparecida Mesquita
Amyloidosis of the gastrointestinal tract is usually a systemic disease. Localized gastrointestinal amyloidosis without evidence of extraintestinal involvement or an associated plasma cell dyscrasia is uncommon and does not usually cause death. We report a case of a patient with localized gastrointestinal amyloidosis who presented with protein-losing enteropathy and a fatal upper gastrointestinal bleed.
Case Reports in Medicine | 2014
Juliana Custódio Lima; Cristiane Kibune Nagasako; Ciro Garcia Montes; Irene Harumi Kamata Barcelos; Rita Barbosa de Carvalho; Maria Aparecida Mesquita
Lipoid proteinosis is a rare autosomal recessive disease characterized by the deposition of hyaline material in the skin and internal organs. The main clinical features are hoarseness and typical skin lesions. In this report we describe the endoscopic and radiologic findings in a Brazilian female patient presenting extensive gastrointestinal involvement and the evolution of the detected lesions in ten years of follow-up. Initial upper endoscopy and colonoscopy showed a similar pattern of multiple yellowish nodules throughout the esophagus, stomach, duodenum, and colons. Histological analysis confirmed the diagnosis of lipoid proteinosis. In addition, small bowel follow through demonstrated numerous well defined, round, small filling defects throughout the jejunum. Ten years later, the esophageal lesions remained the same, but none of the previous alterations were detected in the stomach, duodenum, and colons. In conclusion, lipoid proteinosis may affect all gastrointestinal organs with the same pattern of macroscopic and microscopic lesions. Some lesions may regress with increasing age.
Gastrointestinal Endoscopy | 2013
Cristiane Kibune Nagasako; Ciro Garcia Montes; Luiz Roberto Lopes; Marina da Silveira Bossi; Maria Aparecida Mesquita
Commentary Although first described more than a century ago, by Hellstrom in 1906, small intestinal lipomatosis remains a rare condition. Isolated lipomas are much more frequently encountered and, in the small intestine, are most common in the ileum. Lipomatosis affects both genders equally and typically occurs after the fourth decade of life. The lipomas in this condition are usually located in the submucosa but may extend through the bowel wall and into the serosal or mesenteric fat. Lipomas usually are silent, but they may ulcerate and bleed, or they may cause colicky abdominal pain because of intussusception. Jejunal lipomatosis has been reported in association with jejunal diverticulosis, ostensibly due to involvement and attenuation of the muscularis propria. CT scanning or CT enterography is the preferred diagnostic test for intestinal lipomatosis, although capsule endoscopy also can play a valuable role in demonstrating the lipomas. If the lipoma is within reach of the endoscope, a biopsy forceps may be used in several ways to prove the diagnosis. Before biopsy of the putative lipoma, however, the diagnosis might be suspected because of blood vessels that may be seen coursing over the lesion’s surface or an orange-red surface that changes to a more yellow color toward the base of the lesion. As the lesion is probed with a closed biopsy forceps, it indents and then springs back to its previous shape when the forceps is withdrawn: the so-called “pillow sign.” Immediately before the biopsy specimen is taken, the mucosa may be grasped with the forceps and pulled up: the so-called “tenting sign.” Upon biopsy, one may evoke the “naked fat sign,” a finding pathognomonic for lipoma during which fat spills out of the lesion after the biopsy. St Jerome said a fat stomach never breeds fine thoughts. Times have changed, and besides the insensitivity of the comment, I am sure he was referring to the abdomen, not the stomach, and that he had never heard of lipid islands in the stomach or gastrointestinal lipomatosis. Lawrence J. Brandt, MD Associate Editor for Focal Points