EDUARDO MEKITARIAN FILHO
Projetos de Pesquisa
Unidades Organizacionais
Instituto da Criança, Hospital das Clínicas, Faculdade de Medicina
10 resultados
Resultados de Busca
Agora exibindo 1 - 10 de 10
- Perioperative Factors Associated with Prolonged Intensive Care Unit and Hospital Length of Stay after Pediatric Neurosurgery(2011) MEKITARIAN FILHO, Eduardo; CARVALHO, Werther Brunow de; CAVALHEIRO, Sergio; HORIGOSHI, Nelson Kazunobu; FREDDI, Norberto AntonioObjectives: This study aims to describe the association between different postoperative complications and the length of hospital stay among children undergoing neurosurgical procedures. Methods: A retrospective cohort study was carried out between May 2004 and May 2009 in a tertiary community hospital. All postoperative complications following neurosurgical procedures and their association with the main outcomes [length of intensive care unit (ICU) and hospital stay] were investigated in a univariate and multivariate analysis. Results: The medical records of 198 patients treated during the study period were reviewed. The most frequently performed surgeries were ventriculoperitoneal shunting (16.7%), correction of craniosynostosis (30%) and brain tumor resections (28.3%). Of the 198 patients eligible for this analysis, 79 (39.9%) suffered from at least one complication. The most frequent complications were fever (30.3%), hypothermia (16%), postextubation laryngitis (15.1%) and postoperative bleeding (7%). Factors independently associated with a longer pediatric ICU stay were fever (odds ratio 1.39, 95% confidence interval 1.1-3.2; p = 0.001), laryngitis (odds ratio 2.24, 95% confidence interval 1.8-5.2; p = 0.001), postoperative bleeding requiring reoperation (odds ratio 1.8, 95% confidence interval 1.4-3.9; p < 0.001) and infection (odds ratio 3.71, 95% confidence interval 1.8-12.4; p = 0.033). Fever (odds ratio 2.54, 95% confidence interval 2-7.4; p = 0.001) and infection (odds ratio 11.23, 95% confidence interval 4-22.4; p = 0.003) were related to the total length of the patient's hospital stay. Conclusions: In this study population, most elective neurosurgical procedures were not associated with significant complications, and morbidity and mortality were low. Some complications significantly influenced patients' outcomes and should be monitored for early diagnosis. This study may improve our understanding and identification of postoperative outcomes in pediatric neurosurgery.
- THE BACTERIAL MENINGITIS SCORE TO DISTINGUISH BACTERIAL FROM ASEPTIC MENINGITIS IN CHILDREN FROM SAO PAULO, BRAZIL(2013) MEKITARIAN FILHO, Eduardo; HORITA, Sergio Massaru; GILIO, Alfredo Elias; ALVES, Anna Claudia Dominguez; NIGROVIC, Lise E.In a retrospective cohort of 494 children with meningitis in Sao Paulo, Brazil, the Bacterial Meningitis Score identified all the children with bacterial meningitis (sensitivity 100%, 95% confidence interval: 92-100% and negative predictive value 100%, 95% confidence interval: 98-100%). Addition of cerebrospinal fluid lactate to the score did not improve clinical prediction rule performance.
article Assessment of Children in Pain in the Emergency Department Are We Doing Things the Right Way?(2022) MEKITARIAN FILHO, Eduardo- Current management of occult bacteremia in infants(2015) MEKITARIAN FILHO, Eduardo; CARVALHO, Werther Brunow deObjectives: To summarize the main clinical entities associated with fever without source (FWS) in infants, as well as the clinical management of children with occult bacteremia, emphasizing laboratory tests and empirical antibiotics. Sources: A non-systematic review was conducted in the following databases - PubMed, EMBASE, and SciELO, between 2006 and 2015. Summary of the findings: The prevalence of occult bacteremia has been decreasing dramatically in the past few years, due to conjugated vaccination against Streptococcus pneumoniae and Neisseria meningitidis. Additionally, fewer requests for complete blood count and blood cultures have been made for children older than 3 months presenting with FWS. Urinary tract infection is the most prevalent bacterial infection in children with FWS. Some known algorithms, such as Boston and Rochester, can guide the initial risk stratification for occult bacteremia in febrile infants younger than 3 months. Conclusions: There is no single algorithm to estimate the risk of occult bacteremia in febrile infants, but pediatricians should strongly consider outpatient management in fully vaccinated infants older than 3 months with FWS and good general status. Updated data about the incidence of occult bacteremia in this environment after conjugated vaccination are needed.
- Concluding Which Glucocorticoid Is More Reliable for Children With Asthma's Exacerbation(2023) MEKITARIAN FILHO, Eduardo
article 0 Citação(ões) na Scopus Emergency Screening of Febrile Neonates Is It Time to Rediscuss the Matter?(2016) MEKITARIAN FILHO, Eduardo; LUPPI, Juliana Bronzato- Aerosolized Intranasal Midazolam for Safe and Effective Sedation for Quality Computed Tomography Imaging in Infants and Children(2013) MEKITARIAN FILHO, Eduardo; CARVALHO, Werther Brunow de; GILIO, Alfredo Elias; ROBINSON, Fay; MASON, Keira P.This pilot study introduces the aerosolized route for midazolam as an option for infant and pediatric sedation for computed tomography imaging. This technique produced predictable and effective sedation for quality computed tomography imaging studies with minimal artifact and no significant adverse events.
- Acute pancreatitis in pediatrics: a systematic review of the literature(2012) MEKITARIAN FILHO, Eduardo; CARVALHO, Werther Brunow de; SILVA, Felipe DuarteObjective: To describe the main epidemiological, clinical, diagnostic and treatment aspects of children with acute pancreatitis. Sources: Systematic review of MEDLINE and SciELO databases in the last 5 years about acute pancreatitis in children, as well as consultation of relevant references on the texts obtained. Summary of the findings: Cases of acute pancreatitis in children have received growing attention in recent years, and an increase in the number of cases has been reported in several studies. The main etiologies in children involve biliary disease, drug-induced pancreatitis, recurrent hereditary pancreatitis and trauma, and up to 30% of cases have no defined etiology. The diagnosis is based on the combination of clinical and laboratory aspects with the increase of acinar enzymes and radiologic tests. Initial support treatment, with proper volume replacement and correction of the metabolic disturbances, besides specific nutritional therapy, are the fundamental points in the handling of acute conditions. Long term complications are unusual, and mortality rates are inferior to the rates for the adult population. Conclusions: The early diagnosis and the appropriate handling can contribute to a better outcome for the child with pancreatitis and to prevent the immediate and late complications related to the disease. More studies are required to better explain aspects related to the clinical and radiological diagnosis of pancreatitis in children, as well as aspects related to the nutritional therapy for this age group.
- Intranasal Dexmedetomidine for Sedation for Pediatric Computed Tomography Imaging(2015) MEKITARIAN FILHO, Eduardo; ROBINSON, Fay; CARVALHO, Werther Brunow de; GILIO, Alfredo Elias; MASON, Keira P.This prospective observational pilot study evaluated the aerosolized intranasal route for dexmedetomidine as a safe, effective, and efficient option for infant and pediatric sedation for computed tomography imaging. The mean time to sedation was 13.4 minutes, with excellent image quality, no failed sedations, or significant adverse events.
- Estado nutricional, autopercepção do estado nutricional e experimentação de drogas lícitas em adolescentes(2015) GARCIA, Denise Máximo; MEKITARIAN FILHO, Eduardo; GILIO, Alfredo Elias; LOTUFO, João Paulo Becker; LO, Denise SweiAbstractObjective:To associate the nutritional status and the self-perception of nutritional status with the use of licit drugs among adolescents.Methods:A cross-sectional study was conducted in which 210 adolescents answered a questionnaire on alcohol and tobacco experimentation and self-perceptions about their nutritional status. The correspondence between the adolescents' perception of their own nutritional status and actual nutritional status was analyzed, as well as associations between nutritional status, self-perception of nutritional status, gender, age, and presence of smokers at home with alcohol and tobacco use. The variables were analyzed separately in a bivariate analysis and, subsequently, a multivariate analysis determined the factors associated with drug use.Results:The study included 210 adolescents with a median age of 148 months; 56.6% were females. Of the total sample, 6.6% have tried cigarettes, and 20% have tried alcohol; 32.3% had BMI Z-Score ≥1, 12.85% had BMI Z-Score ≥2, and 50.7% had a correct perception of his/her weight. After a multivariate analysis, only the self-perception about weight statistically influenced experimentation of tobacco, and patients who identified themselves as having very high weight were more likely to experiment tobacco (odds ratio (OR) 13.57; confidence interval (95% CI) 2.05-89.8; p=0.007); regarding alcohol use, adolescents who identified themselves as having high weight were 2.4 times more likely to experiment with alcohol than adolescents that identified themselves as having normal weight (95% CI 1.08-5.32, p=0.031).Conclusions:Adolescents with self-perception of excess weight may constitute a risk group for alcohol and tobacco use.