GLAUCO FERNANDES SAES
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
LIM/02 - Laboratório de Anatomia Médico-Cirúrgica, Hospital das Clínicas, Faculdade de Medicina
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- 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.
- Validation of a Brazilian Portuguese Version of the Walking Estimated-Limitation Calculated by History (WELCH)(2016) CUCATO, Gabriel Grizzo; CORREIA, Marilia de Almeida; FARAH, Breno Quintella; SAES, Glauco Fernandes; LIMA, Aluisio Henrique de Andrade; RITTI-DIAS, Raphael Mendes; WOLOSKER, NelsonBackground: The Walking Estimated-Limitation Calculated by History (WELCH) questionnaire has been proposed to evaluate walking impairment in patients with intermittent claudication (IC), presenting satisfactory psychometric properties. However, a Brazilian Portuguese version of the questionnaire is unavailable, limiting its application in Brazilian patients. Objective: To analyze the psychometric properties of a translated Brazilian Portuguese version of the WELCH in Brazilian patients with IC. Methods: Eighty-four patients with IC participated in the study. After translation and back-translation, carried out by two independent translators, the concurrent validity of the WELCH was analyzed by correlating the questionnaire scores with the walking capacity assessed with the Gardner treadmill test. To determine the reliability of the WELCH, internal consistency and test-retest reliability with a seven-day interval between the two questionnaire applications were calculated. Results: There were significant correlations between the WELCH score and the claudication onset distance (r = 0.64, p = 0.01) and total walking distance (r = 0.61, p = 0.01). The internal consistency was 0.84 and the intraclass correlation coefficient between questionnaire evaluations was 0.84. There were no differences in WELCH scores between the two questionnaire applications. Conclusion: The Brazilian Portuguese version of the WELCH presents adequate validity and reliability indicators, which support its application to Brazilian patients with IC.
- Barriers and Levels of Physical Activity in Patients With Symptomatic Peripheral Artery Disease: Comparison Between Women and Men(2019) SOUSA, Adilson Santos Andrade de; CORREIA, Marilia A.; FARAH, Breno Quintella; SAES, Glauco; ZERATI, Antonio Eduardo; PUECH-LEAO, Pedro; WOLOSKER, Nelson; CUCATO, Gabriel G.; RITTI-DIAS, Raphael M.This cross-sectional study compared physical activity levels and barriers between 212 men and women with symptomatic peripheral artery disease. Physical activity was objectively measured by an accelerometer. Barriers to physical activity were obtained using a validated questionnaire. Women reported higher amounts of light physical activity (p <.001) and lower moderate-vigorous physical activity (p < .001) than men. Women more often reported barriers such as ""not having anyone to accompany"" (p = .006), ""lack of money"" (p = .018), ""fear of falling or worsening the disease"" (p = .010), ""lack of security"" (p = .015), ""not having places to sit when feeling leg pain"" (p = .021), and ""difficulty in getting to a place to practice physical activity"" (p = .015). In conclusion, women with symptomatic peripheral artery disease presented with lower amounts of moderate-vigorous activity and more barriers to activity than men. Strategies to minimize the barriers, including group actives and nonpainful exercises, are recommended for women with peripheral artery disease.
- 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.
bookPart Etiologia, quadro clínico, diagnóstico, classificação e tratamento(2017) SAES, Glauco Fernandes; ZERATI, Antonio Eduardo- Vascular Access(2022) SAES, G. F.; ZERATI, A. E.; WOLOSKER, M. B.; BARBOSA, J. A. S.; SILVA, T. C. do CampoIn this chapter, we deal with vascular accesses in cancer patients, complications associated with those devices, and nursery care. Long-term venous catheters, especially tunneled catheters, are essential for cancer treatment, with wide applicability in various stages of treatment. In addition to enabling the infusion of drugs and blood products, they also allow the collection of blood samples for laboratory analysis, the monitoring of hemodynamic parameters, parenteral nutrition, and the performance of essential procedures for maintaining life, such as hemodialysis sessions.The indications and types of catheters are discussed, taking into account the time of use, the compatibility of the drug with the peripheral venous system, and the risk of infection. Most frequent complications and how to avoid them are also a subject in this chapter. © Springer Nature Switzerland AG 2022.
conferenceObject Graduated Compression Stockings Do Not Improve Walking Capacity and Calf Muscle Oxygen Saturation Parameters During Six-Minute Walk Test in Intermittent Claudication Patients(2016) CUCATO, Gabriel G.; RITTI-DIAS, Raphael; CAVALCANTE, Bruno R.; SAES, Glauco; DOMINGUES, Wagner; WOLOSKER, Nelson; ZERATI, Antonio- Reproducibility of Anaerobic and Pain Thresholds in Male Patients With Intermittent Claudication(2016) CHEHUEN, Marcel da Rocha; CUCATO, Gabriel Grizzo; SAES, Glauco Fernandes; COSTA, Luiz Augusto Riani; LEICHT, Anthony Scott; RITTI-DIAS, Raphael Mendes; WOLOSKER, Nelson; FORJAZ, Claudia Lucia de MoraesPURPOSE: Maximal and submaximal parameters assessed during treadmill tests are used to prescribe exercise training and assess exercise-induced adaptations in patients with intermittent claudication (IC). Although reproducibility of maximal parameters is well documented, the reproducibility of submaximal is not clear. The aim of this study was to identify the reproducibility (reliability and agreement) of heart rate (HR) and oxygen uptake (o(2)) measured at the anaerobic (AT) and the pain (PT) thresholds assessed during a maximal test in patients with IC. METHODS: Twenty male patients with IC underwent 2 cardiopulmonary treadmill tests to maximal pain. The HR ando(2) at the AT and PT were identified, and differences between repeat tests were compared. Reliability was determined by intraclass coefficient correlation (ICC). Agreement was assessed by coefficient of variation (CV), standard error of measurement (SEM), smallest detectable difference (SDD), and limits of agreement (LOA). RESULTS: The o(2) at AT and PT exhibited moderate reliability and moderate/good agreement (ICC = 0.73 and 0.70; CV = 9.6% and 11.1%, respectively). The HR at the AT and PT exhibited high reliability and good agreement (ICC = 0.87 and 0.92; SEM = 3.9 and 3.2 bpm; SDD = 10.8 and 8.8 bpm, respectively). The LOA for o(2) at AT and PT were 20% and for HR 11 bpm. CONCLUSIONS: The o(2) and HR measured at the AT and PT were moderately to highly reproducible in male patients with IC. The HR and o(2) at AT and PT may be used to establish training intensity and evaluate training effectiveness for these patients in clinical practice and research.
- 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.