ANTONIO EDUARDO ZERATI
Projetos de Pesquisa
Unidades Organizacionais
Instituto do Câncer do Estado de São Paulo, Hospital das Clínicas, Faculdade de Medicina - Médico
LIM/02 - Laboratório de Anatomia Médico-Cirúrgica, Hospital das Clínicas, Faculdade de Medicina - Líder
LIM/02 - Laboratório de Anatomia Médico-Cirúrgica, Hospital das Clínicas, Faculdade de Medicina - Líder
6 resultados
Resultados de Busca
Agora exibindo 1 - 6 de 6
- En bloc vertebrectomy for the treatment of spinal lesions. Five years of experience in a single institution: a case series(2018) ARAUJO, Alex Oliveira de; NARAZAKI, Douglas Kenji; TEIXEIRA, William Gemio Jacobsen; GHILARDI, Cesar Salge; ARAUJO, Pedro Henrique Xavier Nabuco de; ZERATI, Antonio Eduardo; MARCON, Raphael Martus; CRISTANTE, Alexandre Fogaca; BARROS FILHO, Tarcisio Eloy Pessoa deOBJECTIVES: The objective of this study is to describe the experience of a Brazilian public university hospital regarding the treatment of metastatic or benign spine lesions with en bloc vertebrectomy of the thoracic and lumbar spines. METHODS: This study was a retrospective case series and included all medical records of patients with benign aggressive, primary malignant, or metastatic spine lesions who underwent en bloc vertebrectomy from 2010 to 2015. RESULTS: A total of 17 patients were included in the analysis. Most of them (71%) were indicated for surgery based on an oncologic resection for localized disease cure. Overall, 10 of the 17 patients (59%) underwent vertebrectomy via an isolated posterior approach using the technique described by Roy-Camille et al. and Tomita et al., while 7 patients (41%) underwent double approach surgeries. Of the 17 patients who underwent the en bloc resection, 8 are still alive and in the outpatient follow-up (47%), and almost all patients with metastatic lesions (8/9) died. The average survival time following the surgical procedure was 23.8 months. Considering the cases of metastatic lesions and the cases of localized disease (malignant or benign aggressive disease) separately, we observed an average survival time of 15 months and 47.6 months respectively. CONCLUSION: This study demonstrates and reinforces the reproducibility of the en bloc vertebrectomy technique described by Tomita et al.
- Paraplegia of Lower Limbs Caused by a Segmental Thrombosis of the Descending Thoracic Aorta Reversed with Endovascular Treatmentd-A Case Report and Literature Review(2018) LEIDERMAN, Dafne Braga Diamante; WOLOSKER, Nelson; OLIVEIRA, Marcos Vieira de Melo; CARVALHO, Heitor Andrei Miranda de; BARAO, Felipe Trajano de Freitas; ZERATI, Antonio Eduardo; LUCCIA, Nelson De; PUECH-LEAO, PedroBackground: Transient paraplegia of the lower limbs is a rare condition and, when has a vascular etiology, is usually associated with thromboembolic events, aortic dissection, aortic aneurysms, or as a complication of the surgical correction of those diseases. There is no case reported of acute paraplegia caused by a segmental thrombotic subocclusion of the descending thoracic aorta. Case Report: We report a not yet described clinical situation of a young patient (51 years) admitted to the emergency care department for treatment of systemic arterial hypertension of difficult control with 4 antihypertensive medication classes. At the intensive care unit for treatment with intravenous antihypertensive medication, the patient evolved with acute paraplegia and a segmental thrombotic subocclusion of the descending thoracic aorta was diagnosed. He was submitted to endovascular treatment with total recovery of the deficits. Conclusions: The previously normal descending thoracic aorta may be a site of segmental thrombosis and may lead to paraplegia. Early endovascular treatment can reverse this type of situation.
- Prevalence of signs of celiac axis compression by the median arcuate ligament on computed tomography angiography in asymptomatic patients(2018) PETNYS, Alexandre; PUECH-LEAO, Pedro; ZERATI, Antonio Eduardo; RITTI-DIAS, Raphael Mendes; NAHAS, William Carlos; NETO, Elias David; LUCCIA, Nelson DeObjective: The increasing use of computed tomography (CT) angiography has led to more frequent diagnoses of celiac artery compression (CAC) by the median arcuate ligament (MAL). The signs of CAC by the MAL have been described as stenosis and a hook or J appearance on sagittal views. The importance of the ""hook signal,"" however, has not been documented by studies of the normal anatomy of the celiac axis. Methods: CT angiography images of 344 completely asymptomatic, live kidney donors (without history of chronic abdominal pain or weight loss) were reviewed. The angle of emergence (AE) of the celiac axis from the aorta and the angle of upward or downward shifting of the celiac axis before its first branch (fold angle [ FA]) were measured. Weight, height, and body mass index were obtained from our electronic database, and correlations with the angles measured were tested. The occurrence of stenosis >50% at the origins of the celiac axis was also determined in the sample. Results: Measurements were possible in 321 cases. The celiac axis was found to leave the aorta at an angle of <90 degrees in all patients (AE range, 7-83 degrees) and < 45 degrees in 292 (90%) patients. The FA ranged from 66 to 208 degrees. Before the first branch, the celiac trunk shifted upward in 306 (95%) patients, remained straight in just one of them, and shifted downward in 14 (4%). The AE was positively correlated with weight in women. The FA was negatively correlated with weight in men and women. Body mass index was positively correlated with AE and negatively correlated with FA in both men and women. In 11 cases (3.4%), stenosis >50% was found at the origin of the celiac axis. In only two patients, the celiac axis had an upward slope after the stenosis, which could be interpreted as a hook shape. Conclusions: The normal anatomy of the celiac axis, when seen on CT angiography images, demonstrates that it exits the aorta downward and then shifts upward. This hook or J shape should not be interpreted as resulting from external compression. CAC by the MAL occurs in 3.42% of the normal asymptomatic population; a hook or J shape is not visible in most cases in that subgroup.
- Role of Lock Therapy for Long-Term Catheter-Related Infections by Multidrug-Resistant Bacteria(2018) FREIRE, Maristela P.; PIERROTTI, Ligia C.; ZERATI, Antonio E.; BENITES, Luciana; MOTTA-LEAL FILHO, Joaquim Mauricio da; IBRAHIM, Karim Y.; ARAUJO, Pedro H.; ABDALA, EdsonThe management of long-term central venous catheter (LTCVC) infections by multidrug-resistant (MDR) bacteria in cancer patient is a challenge. The objectives of this study were to analyze outcomes in cancer patients with LTCVC-associated infection, identify risks for unfavorable outcomes, and determine the impact of MDR bacteria and antibiotic lock therapy (ALT) in managing such infections. We evaluated all LTCVC-associated infections treated between January 2009 and December 2016. Infections were reported in accordance with international guidelines for catheter-related infections. The outcome measures were 30-day mortality and treatment failure. We analyzed risk factors by Cox forward-stepwise regression. We identified 296 LTCVC-associated infections; 212 (71.6%) were classified as bloodstream infections (BSIs). The most common agent was Staphylococcus aureus. Forty-six (21.7%) infections were due to MDR Gram-negative bacteria. ALT was used in 62 (29.2%) patients, with a 75.9% success rate. Risk factors identified for failure of the initial treatment were having a high sequential organ failure assessment (SOFA) score at diagnosis of infection and being in palliative care; introduction of ALT at the start of treatment was identified as a protective factor. Risk factors identified for 30-day mortality after LTCVC-associated infection were a high SOFA score at diagnosis, infection with MDR bacteria, and palliative care; introduction of ALT at the start of treatment, hematological malignancies, and adherence to an institutional protocol for the management of LTCVC-associated infection were identified as protective factors. Despite the high incidence of infection with MDR bacteria, ALT improves the outcome of LTCVC-associated infection in cancer patients.
- Calf Muscle Oxygen Saturation during 6-Minute Walk Test and Its Relationship with Walking Impairment in Symptomatic Peripheral Artery Disease(2018) ANDRADE-LIMA, Aluisio; CUCATO, Gabriel G.; DOMINGUES, Wagner J. R.; GERMANO-SOARES, Antonio H.; CAVALCANTE, Bruno R.; CORREIA, Marilia A.; SAES, Glauco F.; WOLOSKER, Nelson; GARDNER, Andrew W.; ZERATI, Antonio E.; RITTI-DIAS, Raphael M.Background: Impaired microcirculation is associated with poor walking capacity in symptomatic peripheral artery disease (PAD) patients during treadmill test; however, this test does not simulate the efforts of daily walking of these patients. Thus, the aim of the study was to describe the microcirculation responses during a 6-minute walk test (6MWT) and to analyze the relationship between microcirculation indicators and walking impairment in symptomatic PAD patients. Methods: Thirty-four patients were included (mean age = 67.6 +/- 11.2 years). Their clinical characteristics were collected, and they performed a 6MWT, in which the initial claudication distance (ICD) and total walking distance (TWD) were recorded. During and after the 6MWT, calf muscle oxygen saturation (StO(2)) parameters were monitored continuously to measure microcirculation behavior. The association between calf muscle StO(2) parameters and walking impairment were analyzed by Pearson or Spearman correlations. Results: Walking impairment was not associated with any StO(2) parameters during exercise. In contrast, after 6MWT, recovery time of StO(2) (r = -0.472, P = 0.008) and recovery time to maximal StO(2) (r = -0.402, P = 0.019) were negatively correlated with ICD. Furthermore, the distance walked under claudication symptoms (ATWD-ICD) was positively correlated with recovery time to maximal StO(2) (r = 0.347, P = 0.048). Conclusions: In symptomatic PAD patients, shorter ICD values during a 6MWT are associated with a delayed recovery in calf muscle StO(2) after exercise. Calf muscle StO(2) parameters decrease subtly during 6MWT, suggesting that the degree of ischemia in the calf muscle during ground walking, simulating efforts of the daily walking, is relatively low.
- Edoxaban for Venous Thromboembolism Treatment-The New Kid on The Block for Latin America. A Practical Guide(2018) RAMACCIOTTI, Eduardo; AGUIAR, Valeria Cristina Resende; CASTELLI JUNIOR, Valter; CASELLA, Ivan Benaducce; ZERATI, Antonio Eduardo; FAREED, JawedEdoxaban, a direct factor Xa inhibitor (FXa), is the fourth direct oral anticoagulant (DOAC) approved for clinical use in the treatment of venous thromboembolism (VTE) in Latin America, following global approvals for this indication. Edoxaban features some particular characteristics when compared to the previously approved DOACs. This review summarizes the main properties of edoxaban, the outcomes results of its pivotal global clinical trials and the peculiar clinical features of this compound. This practical guide aims to help Latin America clinicians understand edoxaban, its proper indication and its use for the appropriate patients with VTE.