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
13 resultados
Resultados de Busca
Agora exibindo 1 - 10 de 13
- Analysis of the Correlation Between Central Obesity and Abdominal Aortic Diseases(2019) APOLONI, Rafael Correa; ZERATI, Antonio Eduardo; WOLOSKER, Nelson; SAES, Glauco Fernandes; WOLOSKER, Marina; CURADO, Taina; PUECH-LEAO, Pedro; LUCCIA, Nelson DeBackground: Atherosclerosis and abdominal aortic aneurysms (AAAs) have several similar risk factors but different pathogenesis. Inflammation of the arteries is common to both. Central obesity can act as an endocrine organ through the secretion of inflammatory cytokines, and the perivascular fat has a local effect that could contribute to diseases of the abdominal aorta. Although the relation between central obesity and atherosclerosis occlusive arterial disease has been demonstrated, the correlation with AAA has conflicting results. The aim of this study was to analyze the correlation between central obesity and the presence of abdominal aortic diseases using computed tomography. Methods: Six hundred thirty-nine consecutive patients classified into 3 groups (AAA, aortic atherosclerotic occlusive disease (AAOD), and without aortic disease [control group]) who underwent computed tomography had the aorta diameter, the visceral fat area (VFA), and the subcutaneous fat area (SFA) measured at the level of third and fourth lumbar vertebrae. Results: VFA showed no difference between the groups. SFA was lower in atherosclerotic group (AAOD) than control (P < 0.01 in general and P < 0.04 in male). In AAA group, we found in men that the first tertile of aorta diameter had higher VFA than third tertile (P = 0.02). Conclusions: There was no difference in VFA between patients in AAA, AAOD, and without aortic disease groups. In men with aneurysm, there was an inverse relationship between VFA and aortic diameter. In AAOD, visceral to subcutaneous ratio is higher due to lower SFA.
- 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.
- Imaging Signs of May-Thurner Syndrome in Asymptomatic Patients: Computed Tomography Angiography Analysis of Kidney Donors(2023) LOPES, Daniel F.; ZERATI, Antonio E.; LUCCIA, Nelson De; NAHAS, William C.; PUECH-LEAO, PedroBackground: The current study aimed to evaluate the distance between the right common iliac artery (RCIA) and lumbar vertebra in asymptomatic patients in order to determine whether such distance was statistically correlated with the left common iliac vein (LCIV) diameter (LCIVD) and to investigate if both measures were related to demographic characteristics and anthropometric data, such as sex, age, height, and body mass index (BMI).Methods: In this descriptive and uncontrolled anatomic study, data from high-definition computed tomography (CT) angiography images of living kidney donors without a medical history of chronic venous insufficiency or past deep vein thrombosis (DVT) were analyzed. The RCIA crossed over the LCIV in 311 individuals, who were then included in this study. CT scans were reviewed to measure (1) the narrowest space between the RCIA and fifth lumbar vertebral body and (2) the LCIVD. Measures were subjected to normality tests and were divided according to the sex of the study population. Correlations of measures with age, BMI, and height were calculated.Results: Of the 311 patients analyzed, 66.6% (n = 207) were female. The mean lumbar vertebral bodyeiliac artery distance (LVBIAD) was 7.2 mm, whereas the mean LCIVD was 8.5 mm; both were higher in men (P < 0.001). The statistical analysis of LVBIAD and LCIVD distributions revealed no normality pattern (P < 0.05). The analysis of the correlation between them showed a weak statistically significant relationship with age. A linear regression model considering the normality percentile interval indicated a strong positive correlation between LVBIAD and LCIVD (R2 = 0.884).Conclusions: The LVBIAD was <5 mm and <3 mm in 25% and 5% of asymptomatic individ-uals, respectively. The LCIVD correlated with the space between the RCIA and lumbar vertebra. The distance between the RCIA and lumbar vertebra and the LCIVD were higher in male sub-jects and older patients, but did not correlate with BMI and height.
- Influence of Criteria Used in Determining Prevalence of Metabolic Syndrome (NCEP-ATPIII versus IDF) in Patients with Intermittent Claudication(2014) ZERATI, Antonio Eduardo; GUIMARAES, Ana Lucia Monteiro; CARVALHO, Heitor Andrei Miranda de; SAES, Glauco Fernandes; RAGAZZO, Luciana; WOLOSKER, Nelson; LUCCIA, Nelson deBackground: In patients with peripheral arterial disease, metabolic syndrome is associated with less favorable evolution of intermittent claudication. Methods: The aims of this study were to determine the prevalence of metabolic syndrome in claudicant patients using the IDF and the NCEP-ATPIII criteria, and to assess the level of agreement between the two definitions. Results: In this cross-sectional study, 200 consecutive patients with intermittent claudication (65% male) were classified with or without metabolic syndrome according both criteria. The kappa coefficient was used to assess the level of agreement. Prevalence of metabolic syndrome was 60.5% when using the NCEP-ATPIII definition and 66.5% when using the IDF definition (P = 0.088). Among men, the prevalence of MetS was 55.4% according to the NCEP-ATPIII and 63.1% according to the IDF (P = 0.110) and, among women, 70.0% according to the NCEP-ATPIII and 72.9% according to the IDF (P = 0.754). Conclusion: Although the prevalence rates were similar, the reliability analysis showed that the agreement was substantial only among women and just moderate in the total population and among men.
- Endovascular Treatment of Penetrating Injury to the Vertebral Artery by a Stab Wound: Case Report and Literature Review(2017) LEIDERMAN, Dafne Braga Diamante; ZERATI, Antonio Eduardo; WOLOSKER, Nelson; MELO, Henry Augusto Hoffmann; SILVA, Erasmo Simao da; LUCCIA, Nelson DeBackground: We describe a unique case of a patient with penetration of the cervical region by a stab wound, who required emergency care for the controlled removal of the knife and for vertebral artery trauma (VAT) treatment. Although rare, VAT causes high morbidity and mortality. Methods: A patient admitted for emergency care was diagnosed with traumatic complete section of the vertebral artery by a knife and underwent removal of the knife under radioscopic supervision and vertebral artery embolization with coils. Results: The knife was removed successfully, the bleeding was controlled, and the patient did not present any sequelae. Conclusions: In the authors' experience, a patient in an emergent state due to VAT can be treated effectively and quickly with proximal embolization.
- Does Creatine Supplementation Affect Renal Function in Patients with Peripheral Artery Disease? A Randomized, Double Blind, Placebo-controlled, Clinical Trial(2020) DOMINGUES, Wagner Jorge Ribeiro; RITTI-DIAS, Raphael Mendes; CUCATO, Gabriel Grizzo; WOLOSKER, Nelson; ZERATI, Antonio Eduardo; PUECH-LEAO, Pedro; NUNHES, Pollyana Mayara; MOLITERNO, Andre Alberto; AVELAR, AdemarBackground: Case studies and reviews have shown that creatine supplementation can affect kidney function. The objective of this study is to verify the effects of 8 weeks of creatine supplementation on renal function (creatinine clearance: primary outcome) in patients with symptomatic peripheral arterial disease. Methods: Twenty-nine patients, of both genders, were randomized (1:1) in a double-blind manner for administration of Placebo (PLA; n = 15) or creatine monohydrate (Cr; n = 14). The supplementation protocol consisted of 20 g/day for 1 week divided into 4 equal doses (loading phase), followed by single daily doses of 5 g in the subsequent 7 weeks (maintenance phase). Before and after the supplementation period, markers of renal function, serum creatinine, creatinine excretion rate, and creatinine clearance were evaluated. The Generalized Estimation Equation Model was used for comparison between groups. The level of significance was P < 0.05. Results: No significant differences were found between groups before and after the intervention for serum creatinine (Cr: pre 1.00 +/- 0.15 mL/dL vs. post 1.07 +/- 0.16 mL/dL; PLA: pre 1.30 +/- 0.53 mL/dL vs. post 1.36 +/- 0.47 mL/dL, P = 0.590), creatinine excretion rate (Cr: pre 81.73 +/- 43.80 mg/dL vs. post 102.92 +/- 59.57 mg/dL; PLA: pre 74.37 +/- 38.90 mg/dL vs. post 86.22 +/- 39.94 mg/dL, P = 0.560), or creatinine clearance (Cr; pre 108 +/- 59 mL/min/1.73 m(2) vs. post 117 +/- 52 mL/min/1.73 m(2); PLA: pre 88 +/- 49 mL/min/1.73 m(2) vs. post 82 +/- 47 mL/ min/1.73 m(2), P = 0.366). Conclusions: Eight weeks of creatine supplementation is safe and does not compromise the renal function of patients with peripheral arterial disease.
- Graduated Compression Stockings Does Not Decrease Walking Capacity and Muscle Oxygen Saturation during 6-Minute Walk Test in Intermittent Claudication Patients(2017) CAVALCANTE, Bruno Remigio; RITTI-DIAS, Raphael Mendes; SOARES, Antonio Henrique Germano; DOMINGUES, Wagner Jorge Ribeiro; SAES, Glauco Fernandes; DUARTE, Flavio Henrique; CRUZ, Aline de Paula da; WOLOSKER, Nelson; PUECH-LEAO, Pedro; CUCATO, Gabriel Grizzo; ZERATI, Antonio EduardoBackground: We analyze the effects of graduated compression stoking (GCS) on walking capacity and oxygen saturation in intermittent claudication (IC) patients. Methods: Eighteen patients with IC performed the 6-minute walking test in 2 conditions in random order: GCS or placebo sock. Onset claudication distance and total walking distance were obtained. The calf muscle oxygen saturation was continuously monitored before, during, and after 6-minute walk test. Comparisons of the walking capacity and StO(2) parameters between GCS and placebo conditions were analyzed by Wilcoxon rank-sum test. Results: The onset claudication distance (GCS: 120 +/- 99 meters vs. placebo: 150 +/- 126 meters; P= 0.798) and total walking distance (GCS: 330 +/- 108 meters vs. placebo: 324 +/- 60 meters; P= 0.130) were similar between conditions. There were no differences in StO(2) parameters between conditions (P > 0.05). Conclusions: GCS does not decrease walking performance and calf muscle oxygenation saturation during 6-minute walk test in patients with IC.
- 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.
- Endovascular Treatment of Late Aortic Erosive Lesion by Pedicle Screw without Screw Removal: Case Report and Literature Review(2017) ZERATI, Antonio Eduardo; LEIDERMAN, Dafne Braga Diamante; TEIXEIRA, William Gemio Jacobsen; NARAZAKI, Douglas Kenji; CRISTANTE, Alexandre Fogaca; WOLOSKER, Nelson; LUCCIA, Nelson de; BARROS FILHO, Tarcisio Eloy PessoaBackground: Aortic lesions are uncommon complications in spine surgery, but potentially fatal, because they can cause massive bleeding and hemodynamic instability. We report the endovascular treatment of late aortic erosive lesion by pedicle screw without screw removal. Methods: A breast cancer patient had a pathological fracture on T10, with spinal cord compression, and a pseudoaneurysm of the aorta in contact with an anterolateral pedicle screw. Endovascular surgery corrected the aortic lesion and allowed decompression, a week later, by posterior arthrodesis (T7-L1), with screw maintenance. Results: There was no contrast leakage at thorax angiotomography in 2 years, and she died of meningeal carcinomatosis. Conclusion: Screw maintenance was safe in the endovascular treatment of aortic lesion by erosion.
- Cardiac Autonomic Modulation Is Associated with Arterial Stiffness in Patients with Symptomatic Peripheral Artery Disease(2019) GERMANO-SOARES, Antonio Henrique; CUCATO, Gabriel Grizzo; LEICHT, Anthony Scott; ANDRADE-LIMA, Aluisio; PECANHA, Tiago; CORREIA, Marilia de Almeida; ZERATI, Antonio Eduardo; WOLOSKER, Nelson; RITTI-DIAS, Raphael MendesBackground: The objective of this study was to analyze the association between cardiac autonomic modulation and arterial stiffness in patients with peripheral artery disease (PAD). Methods: This cross-sectional study included one hundred fourteen patients with symptomatic PAD (67.5% men; 65 +/- 7 years; body mass index: 26.8 +/- 4.5 kg/m(2)). Heart rate variability (HRV) was measured within time (standard deviation of all RR intervals [beat to beat heart interval] [SDNN], root mean square of the successive differences between adjacent normal RR intervals [RMSSD], and the proportion of successive RR intervals that differed by more than 50 msec [pNN50]) and frequency (low frequency [LF] and high frequency [HF]) domains. Arterial stiffness was assessed by carotid-femoral pulse wave velocity (cfPWV). Crude and adjusted linear regression analyses examined the relationship between HRV and cfPWV. Results: Nonsignificant crude associations were identified among cfPWV and RMSSD (P = 0.181), SDNN (P = 0.105), pNN50 (P = 0.087), LF (P = 0.376), HF (P = 0.175), and LF/HF ratio (P = 0.426). After adjustments for age, sex, smoking, body mass index, ankle-brachial index, and use of beta-blockers, significant associations were identified among cfPWV and RMSSD (P = 0.037), SDNN (P = 0.049), and pNN50 (P = 0.049). Conclusions: Cardiac autonomic modulation was significantly associated with arterial stiffness in patients with PAD after adjustment for confounding factors. This relationship may contribute to the enhanced cardiovascular disease risk for PAD patients and provides a target for strategies to improve patient clinical outcomes.