EDUARDO MAZZUCCHI
Projetos de Pesquisa
Unidades Organizacionais
Instituto Central, Hospital das Clínicas, Faculdade de Medicina - Médico
LIM/55 - Laboratório de Urologia, Hospital das Clínicas, Faculdade de Medicina - Líder
LIM/55 - Laboratório de Urologia, Hospital das Clínicas, Faculdade de Medicina - Líder
8 resultados
Resultados de Busca
Agora exibindo 1 - 8 de 8
- Percutaneous nephrolithotomy in patients with solitary kidney: a critical outcome analysis(2015) TORRICELLI, Fabio C. M.; PADOVANI, Guilherme P.; MARCHINI, Giovanni S.; VICENTINI, Fabio C.; DANILOVIC, Alexandre; REIS, Sabrina T.; SROUGI, Miguel; MAZZUCCHI, EduardoPurpose: To describe our experience with percutaneous nephrolithotomy (PCNL) in patients with solitary kidneys and analyze factors that can impact on intra-operative bleeding and postoperative complications. Materials and Methods: We reviewed our stone database searching for patients with solitary kidney who underwent PCNL from Jan-05 through Oct-13. Demographic data, stone characteristics, and intra-and postoperative outcomes were recorded. Spearman correlation was performed to assess which variables could impact on bleeding and surgical complications. Linear and logistic regressions were also performed. Results: Twenty-seven patients were enrolled in this study. The mean age and BMI were 45.6 years and 28.8Kg/m(2), respectively; 45% of cases were classified as Guys 3 (partial staghorn or multiple stones) or 4 (complete staghorn) - complex cases. Stone-free rate was 67%. Eight (29.6%) patients had postoperative complications (five of them were Clavien 2 and three were Clavien 3). On univariate analysis only number of tracts was associated with increased bleeding (p=0.033) and only operative time was associated with a higher complication rate (p=0.044). Linear regression confirmed number of access tracts as significantly related to bleeding (6.3, 95% CI 2.2-10.4; p=0.005), whereas logistic regression showed no correlation between variables in study and complications. Conclusions: PCNL in solitary kidneys provides a good stone-free rate with a low rate of significant complications. Multiple access tracts are associated with increased bleeding.
- Polymorphism in the PBX1 gene is related to cystinuria in Brazilian families(2019) REIS, Sabrina T.; LEITE, Katia R. M.; MARCHINI, Giovanni S.; GUIMARAES, Ronaldo M.; VIANA, Nayara I.; PIMENTA, Ruan C. A.; TORRICELLI, Fabio C.; DANILOVIC, Alexandre; VICENTINI, Fabio Carvalho; NAHAS, William Carlos; SROUGI, Miguel; MAZZUCCHI, EduardoThe aim of our study was to determine regions of loss of heterozygosity, copy number variation analysis, and single nucleotide polymorphisms (SNPs) in Brazilian patients with cystinuria. A linkage study was performed using DNA samples from six patients with cystinuria and six healthy individuals. Genotyping was done with the Genome-Wide Human SNP 6.0 arrays (Affymetrix, Inc., Santa Clara, CA, USA). For validation, SNPs were genotyped using a TaqMan (R) SNP Genotyping Assay Kit. The homozygote polymorphic genotype of SNP rs17383719 in the gene PBX1 was more frequent (P = 0.015) in cystinuric patients. The presence of the polymorphic allele for this SNP increased the chance of cystinuria by 3.0-fold (P = 0.036). Pre-B-cell leukaemia transcription factor 1 (PBX1) was overexpressed 3.3-fold in patients with cystinuria. However, when we compared the gene expression findings with the genotyping, patients with a polymorphic homozygote genotype had underexpression of PBX1, while patients with a heterozygote or wild-type homozygote genotype had overexpression of PBX1. There is a 3-fold increase in the risk of the development of cystinuria among individuals with this particular SNP in the PBX1 gene. We postulate that the presence of this SNP alters the expression of PBX1, thus affecting the renal absorption of cystine and other amino acids, predisposing to nephrolithiasis.
- Effect of phyllanthus niruri on metabolic parameters of patients with kidney stone: a perspective for disease prevention(2018) PUCCI, Nidia D.; MARCHINI, Giovanni S.; MAZZUCCHI, Eduardo; REIS, Sabrina T.; SROUGI, Miguel; EVAZIAN, Denise; NAHAS, William C.Phyllanthus niruri (P.niruri) or stone breaker is a plant commonly used to reduce stone risk, however, clinical studies on this issue are lacking. Objective: To prospectively evaluate the effect of P. niruri on the urinary metabolic parameters of patients with urinary lithiasis. Materials and Methods: We studied 56 patients with kidney stones < 10mm. Clinical, metabolic, and ultrasonography assessment was conducted before (baseline) the use of P. niruri infusion for 12-weeks (P. niruri) and after a 12-week (wash out) Statistical analysis included ANOVA for repeated measures and Tukey's/McNemar's test for categorical variables. Significance was set at 5%. Results: Mean age was 44 +/- 9.2 and BMI was 27.2 +/- 4.4kg/m2. Thirty-six patients (64%) were women. There were no significant changes in all periods for anthropometric and several serum measurements, including total blood count, creatinine, uric acid, sodium, potassium, calcium, urine volume and pH; a significant increase in urinary potassium from 50.5 +/- 20.4 to 56.2 +/- 21.8 mg/24-hour (p=0.017); magnesium/creatinine ratio 58 +/- 22.5 to 69.1 +/- 28.6mg/gCr24-hour (p=0.013) and potassium/creatinine ratio 39.3 +/- 15.1 to 51.3 +/- 34.7mg/gCr24hour (p=0.008) from baseline to wash out. The kidney stones decreased from 3.2 +/- 2 to 2.0 +/- 2per patient (p<0.001). In hyperoxaluria patients, urinary oxalate reduced from 59.0 +/- 11.7 to 28.8 +/- 16.0mg/24-hour (p=0.0002), and in hyperuricosuria there was a decrease in urinary uric acid from 0.77 +/- 0.22 to 0.54 +/- 0.07mg/24-hour (p=0.0057). Conclusions: P. niruri intake is safe and does not cause significant adverse effects on serum metabolic parameters. It increases urinary excretion of magnesium and potassium caused a significant decrease in urinary oxalate and uric acid in patients with hyperoxaluria and hyperuricosuria. The consumption of P. niruri contributed to the elimination of urinary calculi.
conferenceObject SNP RS17383719 IN THE PBX1 GENE IS ASSOCIATED WITH CYSTINURIA(2017) REIS, Sabrina; GUIMARAES, Ronaldo; VIANA, Nayara; LEITE, Katia; MARCHINI, Giovanni; TORRICELLI, Fabio; NAHAS, William; SROUGI, Miguel; MAZZUCCHI, EduardoconferenceObject GENETIC ALTERATIONS RELATED TO CYSTINURIA - A GENOME WIDE ASSOCIATION ANALYSIS(2016) REIS, Sabrina; VIANA, Nayara; LEITE, Katia; MAGIONI, Felipe; TORRICELLI, Fabio; MARCHINNI, Giovanni; SROUGI, Miguel; MAZZUCCHI, EduardoconferenceObject SEVERE AND EARLY BEGINNING OF UROLITHIASIS RELATED TO THE INHERITANCE OF SLC7A9 MUTATIONS(2019) REIS, Sabrina; PIMENTA, Ruan; MARCHINI, Giovanni; LEITE, Katia; VIANA, Nayara; SIMOES, William; TORRICELLI, Fabio; VICENTINI, Fabio; DANILOVIC, Alexandre; NAHAS, William; SROUGI, Miguel; MAZZUCCHI, EduardoconferenceObject ANALYS MICRORNAS EXPRESSION IN CYSTINURIA PATIENTS(2020) AYRES, Daniel; SANTOS, Gabriel; PIMENTA, Ruan; VIANA, Nayara; GUIMARAES, Vanessa; SILVA, Iran; MARCHINI, Giovanni; BATAGELLO, Carlos; TORRICELLI, Fabio; VICENTINI, Fabio; DANILOVIC, Alexandre; LEITE, Katia; REIS, Sabrina; NAHAS, William; SROUGI, Miguel; MAZZUCCHI, Eduardo- The challenge of cystine and struvite stone formers: clinical, metabolic and surgical assessment(2016) YAMACAKE, Kleiton G. R.; MARCHINI, Giovanni S.; REIS, Sabrina; DANILOVIC, Alexandre; VICENTINI, Fabio C.; TORRICELLI, Fabio C. M.; SROUGI, Miguel; MAZZUCCHI, EduardoPurpose: To compare the clinical, metabolic, and calculi characteristics of cystine and struvite stone patients after percutaneous nephrolithotripsy (PCNL). Material and Methods: Between January/2006-July/2013, 11 cystine stone patients were treated in our clinic. Of those, 3 were excluded due to incomplete follow-up. Eight cystine stone patients (2 with bilateral disease; 10 renal units-RU) were considered for further analysis. A cohort of 8 struvite stone formers (10RU) was matched having the same age, gender, body mass index (BMI) and Guys stone score. Analyzed parameters comprised demographic data, serum/urinary metabolic evaluation and surgical outcomes. Results: Both groups had 6 female patients. Groups were similar in regards to age, gender, BMI, stone burden, and serum creatinine (p=NS). All patients had PCNL as the first surgical treatment modality. Stone free rate (SFR) after the first PCNL tended to be lower (0%) in the cystine compared to the struvite group (40%)(p=0.08). Final SFR after secondary procedures increased to 70% in cystine and 80% in struvite patients (p=1.0); mean number of procedures to achieve stone free status was higher in the first group (3.57 vs. 2.0; p=0.028). Hypocitraturia was found in all patients, but struvite cases presented with lower mean urinary citrate levels (p=0.016). Other common abnormalities were elevated urinary pH (cystine 75% and struvite 62.5%; p=1.0) and low urinary volume (62.5%, 37.5%; p=0.63). Conclusion: Multiple interventions and suboptimal stone free rates are trait of the significant stone burden of struvite and cystine patients. Underlying metabolic abnormalities characterized by increased urinary pH, hypocitraturia and low urinary volume are often encountered in both populations.