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
12 resultados
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- 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.
- Cateteres venosos totalmente implantáveis: histórico, técnica de implante e complicações(2017) ZERATI, Antonio Eduardo; WOLOSKER, Nelson; LUCCIA, Nelson de; PUECH-LEÃO, PedroAbstract Access to the venous system is of vital importance for diagnosis and treatment of patients with the most varied range of clinical conditions, whether for taking blood samples or for infusion of solutions. In 1616, Harvey described the circulatory system on the basis of studies in animals and 4 decades later Sir Christopher Wren conducted the first intravenous infusions in living beings. Since then there has been constant evolution in access technique and infusion devices. Of particular note is the creation of long-term catheters in the 1970s, particularly totally implantable devices, which revolutionized cancer treatment, increasing both safety and comfort for oncology patients. The objectives of this article are to review historical data on vascular access and discuss the implantation technique and the main complications associated with procedures for placement and use of totally implantable venous access devices.
- Effect of Creatine Supplementation on Functional Capacity and Muscle Oxygen Saturation in Patients with Symptomatic Peripheral Arterial Disease: A Pilot Study of a Randomized, Double-Blind Placebo-Controlled Clinical Trial(2021) DOMINGUES, Wagner Jorge Ribeiro; RITTI-DIAS, Raphael Mendes; CUCATO, Gabriel Grizzo; WOLOSKER, Nelson; ZERATI, Antonio Eduardo; PUECH-LEAO, Pedro; COELHO, Daniel Boari; NUNHES, Pollyana Mayara; MOLITERNO, Andre Alberto; AVELAR, AdemarThe aim of the study was to verify the effects of creatine (Cr) supplementation on functional capacity (walking capacity; primary outcome) and calf muscle oxygen saturation (StO(2)) (secondary outcome) in symptomatic peripheral arterial disease (PAD) patients. Twenty-nine patients, of both sexes, 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 four equal doses (loading phase), followed by single daily doses of 5 g in the subsequent 7 weeks (maintenance phase). Functional capacity (total walking distance) was assessed by the 6 min walk test, and calf muscle StO(2) was assessed through near infrared spectroscopy. The measurements were collected before and after loading and after the maintenance phase. The level of significance was p < 0.05. No significant differences were found for function capacity (total walking distance (PLA: pre 389 +/- 123 m vs. post loading 413 +/- 131 m vs. post maintenance 382 +/- 99 m; Cr: pre 373 +/- 149 m vs. post loading 390 +/- 115 m vs. post maintenance 369 +/- 115 m, p = 0.170) and the calf muscle StO(2) parameters (p > 0.05). Short- and long-term Cr supplementation does not influence functional capacity and calf muscle StO(2) parameters in patients with symptomatic PAD.
- Epidemiological analysis of lower limb revascularization for peripheral arterial disease over 12 years on the public healthcare system in Brazil(2022) WOLOSKER, Nelson; SILVA, Marcelo Fiorelli Alexandrino da; PORTUGAL, Maria Fernanda Cassino; STABELLINI, Nickolas; ZERATI, Antônio Eduardo; SZLEJF, Claudia; AMARO JUNIOR, Edson; TEIVELIS, Marcelo PassosAbstract Background Worldwide, peripheral arterial disease (PAD) is a disorder with high morbidity, affecting more than 200 million people. Objectives Our objective was to analyze surgical treatment for PAD provided on the Brazilian Public Healthcare System over 12 years using publicly available data. Methods The study was conducted with analysis of data available on the Brazilian Health Ministry’s database platform, assessing distributions of procedures and techniques over the years and their associated mortality and costs. Results A total of 129,424 procedures were analyzed (performed either for claudication or critical ischemia, proportion unknown). The vast majority of procedures were endovascular (65.49%) and this disproportion exhibited a rising trend (p<0.001). There were 3,306 in-hospital deaths (mortality of 2.55%), with lower mortality in the endovascular group (1.2% vs. 5.0%, p=0.008). The overall governmental expenditure on these procedures was U$ 238,010,096.51, and endovascular procedures were on average significantly more expensive than open surgery (U$ 1,932.27 vs. U$ 1,517.32; p=0.016). Conclusions Lower limb revascularizations were performed on the Brazilian Public Healthcare System with gradually increasing frequency from 2008 to 2019. Endovascular procedures were vastly more common and were associated with lower in-hospital mortality rates, but higher procedure costs.
- Associação entre fadiga e capacidade funcional em pacientes com claudicação intermitente(2015) BATISTA, Letícia de Carvalho; ASSIS, Caroline Shihara de; WOLOSKER, Nelson; ZERATI, Antonio Eduardo; SILVA, Rita de Cassia Gengo eABSTRACTObjective:to characterize fatigue and exertion fatigue in patients with intermittent claudication (IC), and to test their association with sociodemographic and clinical variables, walking capacity and level of physical activity.Method:forty-nine participants (66.6 years; 70% male) were studied. Validated questionnaires were used to assess fatigue (DUFS), exertion fatigue (DEFS), level of physical activity (BASIC) and walking capacity (WIQ).Results:participants had substantial fatigue (DUFS = 20.4+8.8) and substantial exertion fatigue (DEFS = 20.4+10.8). There was an association between the DUFS and marital status (p = 0,008). There was a statically significant association between DEFS with scores of the BASIC (r = .331; p = .02) and among DEFS with WIQ domains - walking distance (r=.359; p = .011) and climbing stairs (r=.331; p = .02).Conclusion:patients with IC have fatigue and exertion fatigue. Exertion fatigue might compromise the engagement of these patients in physical activity, one of the main components of IC treatment.
- Relationship between gait speed and physical function in patients with symptomatic peripheral artery disease(2019) CORREIA, Marilia de Almeida; CUCATO, Gabriel Grizzo; LANZA, Fernanda Cordoba; PEIXOTO, Roger Andre Oliveira; ZERATI, Antonio Eduardo; PUECH-LEAO, Pedro; WOLOSKER, Nelson; RITTI-DIAS, Raphael MendesOBJECTIVE: The aim of the study was to analyze the relationship between gait speed and measurements of physical function in patients with symptomatic peripheral artery disease (PAD). METHODS: One hundred sixty-nine patients (age 66.6 +/- 9.4 years) with symptomatic PAD were recruited. Usual and fast gait speeds were assessed with a 4-meter walk test. Objective (balance, sit-to-stand, handrip strength, and six-minute walk test) and subjective (WIQ - Walking Impairment Questionnaire and WELCH - Walking Estimated-Limitation Calculated by History) measurements of physical function were obtained. Crude and adjusted linear regression analyses were used to confirm significant associations. RESULTS: Usual and fast gait speeds were significantly correlated with all objective and subjective physical function variables examined (r < 0.55, p < 0.05). In the multivariate model, usual gait speed was associated with six-minute walking distance (beta=0.001, p<0.001), sit-to-stand test score (beta=-0.005, p=0.012), and WIQ stairs score (beta=0.002, p=0.006) adjusted by age, ankle brachial index, body mass index, and gender. Fast gait speed was associated with six-minute walking distance (beta=0.002, p < 0.001), WIQ stairs score (beta=0.003, p=0.010), and WELCH total score (beta=0.004, p=0.026) adjusted by age, ankle brachial index, body mass index, and gender. CONCLUSION: Usual and fast gait speeds assessed with the 4-meter test were moderately associated with objective and subjective measurements of physical function in symptomatic PAD patients.
- Physical Activity Levels in Peripheral Artery Disease Patients(2019) GERAGE, Aline Mendes; CORREIA, Marilia de Almeida; OLIVEIRA, Paulo Mesquita Longano de; PALMEIRA, Aline Cabral; DOMINGUES, Wagner Jorge Ribeiro; ZERATTI, Antonio Eduardo; PUECH-LEAO, Pedro; WOLOSKER, Nelson; RITTI-DIAS, Raphael Mendes; CUCATO, Gabriel GrizzoBackground. Increases in daily physical activity levels is recommended for patients with peripheral artery disease (PAD). However, despite this recommendation, little is known about the physical activity patterns of PAD patients. Objective: To describe the physical activity patterns of patients with symptomatic peripheral artery (PAD) disease. Methods; This cross-sectional study included 174 PAD patients with intermittent claudication symptoms. Patients were submitted to clinical, hemodynamic and functional evaluations. Physical activity was objectively measured by an accelerometer, and the time spent in sedentary, low-light, high-light and moderate-vigorous physical activities (MVPA) were obtained. Descriptive analysis was performed to summarize patient data and binary logistic regression was used to test the crude and adjusted associations between adherence to physical activity recommendation and sociodemographic and clinical factors. For all the statistical analyses, significance was accepted at p < 0.05. Results: Patients spent in average of 640 +/- 121 min/day, 269 +/- 94 min/day, 36 +/- 27 min/day and 15 +/- 16 min/day in sedentary, low-light, high-light and MVPA, respectively. The prevalence of patients who achieved physical activity recommendations was 3.4%. After adjustment for confounders, a significant inverse association was observed between adherence to physical activity recommendation and age (OR = 0.925; p = 0.004), while time of disease, ankle brachial index and total walking distance were not associated with this adherence criteria (p > 0.05). Conclusion: The patterns of physical activity of PAD patients are characterized by a large amount of time spent in sedentary behaviors and a low engagement in MVPA. Younger patients, regardless of the clinical and functional factors, were more likely to meet the current physical activity recommendations.
- Functional independence measure in patients with intermittent claudication(2015) ASSIS, Caroline Shihara de; BATISTA, Letcia de Carvalho; WOLOSKER, Nelson; ZERATI, Antonio Eduardo; SILVA, Rita de Cassia Gengo eObjective: of this study were to evaluate the functional independence of patients with intermittent claudication and to verify its association with sociodemographic and clinical variables, walking ability and physical activity level. Method: This was a descriptive, exploratory, cross-sectional study with a quantitative approach. Fifty participants (66.4 years; 68% male) were recruited from Claudication Unit of a tertiary hospital. Functional Independence Measure were used to evaluate functional incapacity; the Baltimore Activity Scale, to estimate the physical activity level and the Walking Impairement Questionnaire, the walking ability. Results: Participants had complete functional independence (124.8 +/- 2.0), low levels of physical activity (4.2 +/- 2.0), and impairment of walking ability; the worst performance was found in walking velocity domain (21.2 +/- 16.4). The functional independence score was associated with physical activity (r=0,402) and walking ability scores (distance, r=0,485; speed, r=0,463; stairs, r=0,337). Conclusion: In conclusion, the level of functionality is associated with functional capacity in these patients.
- Comparação entre os métodos subjetivo e objetivo para avaliação da capacidade funcional durante tratamento clínico em pacientes com claudicação intermitente(2013) CUCATO, Gabriel Grizzo; ZERATI, Antônio Eduardo; CHEHUEN, Marcel da Rocha; RITTI-DIAS, Raphael Mendes; SAEZ, Glauco; RAGAZZO, Luciana; PUECH-LEÃO, Pedro; WOLOSKER, NelsonOBJECTIVE: To analyze if there is any relation between functional capacity assessed by subjective and objective methods regarding the current state and after clinical treatment in patients with intermittent claudication. METHODS: A total of 500 patients with intermittent claudication were enrolled. All patients underwent clinical examination and a functional evaluation by subjective (clinical visit) and objective method (treadmill test). Additionally, 50 patients were selected to evaluate the effect of clinical treatment by subjective and objective methods in relation to functional capacity. RESULTS: Out of 500 patients, only 60 (12.0%) had similar results in both methods. The remaining, that is 440 patients (88.0%) had subject values in disagreement with stress test findings. Regarding the clinical effect of the treatment on the functional outcomes, results were similar in both methods (χ²=1.7; p=0.427). CONCLUSION: Although the subjective method overestimates the functional capacity when compared to the objective method, no significant differences were observed between both methods when analyzing the effect of clinical treatment. Thus, the subjective method provides similar information as compared with objective method, in monitoring the clinical treatment of patients with intermittent claudication.
- Remote ischemic preconditioning in patients with intermittent claudication(2013) SAES, Glauco Fernandes; ZERATI, Antonio Eduardo; WOLOSKER, Nelson; RAGAZZO, Luciana; ROSOKY, Ruben Miguel Ayzin; RITTI-DIAS, Raphael Mendes; CUCATO, Gabriel Grizzo; CHEHUEN, Marcelo; FARAH, Breno Quintella; PUECH-LEAO, PedroOBJECTIVE: Remote ischemic preconditioning (RIPC) is a phenomenon in which a short period of sub-lethal ischemia in one organ protects against subsequent bouts of ischemia in another organ. We hypothesized that RIPC in patients with intermittent claudication would increase muscle tissue resistance to ischemia, thereby resulting in an increased ability to walk. METHODS: In a claudication clinic, 52 ambulatory patients who presented with complaints of intermittent claudication in the lower limbs associated with an absent or reduced arterial pulse in the symptomatic limb and/or an ankle-brachial index <0.90 were recruited for this study. The patients were randomly divided into three groups (A, B and C). All of the patients underwent two tests on a treadmill according to the Gardener protocol. Group A was tested first without RIPC. Group A was subjected to RIPC prior to the second treadmill test. Group B was subjected to RIPC prior to the first treadmill test and then was subjected to a treadmill test without RIPC. In Group C (control group), both treadmill tests were performed without RIPC. The first and second tests were conducted seven days apart. Brazilian Clinical Trials: RBR-7TF6TM. RESULTS: Group A showed a significant increase in the initial claudication distance in the second test compared to the first test. CONCLUSION: RIPC increased the initial claudication distance in patients with intermittent claudication; however, RIPC did not affect the total walking distance of the patients.