ALFREDO ELIAS GILIO
Projetos de Pesquisa
Unidades Organizacionais
Departamento de Pediatria, Faculdade de Medicina - Docente
PAINT-62, Hospital Universitário
PAINT-62, Hospital Universitário
11 resultados
Resultados de Busca
Agora exibindo 1 - 10 de 11
- Number Needed to Treat in Fluconazole Prophylaxis in the Neonatal Intensive Care Unit(2011) SHIEH, Huei Hsin; IBIDI, Silvia Maria; GILIO, Alfredo Elias
- Risk factors for neurological complications and sequelae in childhood acute bacterial meningitis(2012) SHIEH, Huei H.; RAGAZZI, Selma L. B.; GILIO, Alfredo E.
- High Frequency of Staphylococcus Saprophyticus Urinary Tract Infections Among Female Adolescents(2015) LO, Denise Swei; SHIEH, Huei Hsin; BARREIRA, Eliane Roseli; RAGAZZI, Selma Lopes Betta; GILIO, Alfredo EliasStaphylococcus saprophyticus is a rarely reported agent of urinary tract infection (UTI) in the pediatric population. In our retrospective 3-year study, S. saprophyticus comprised 24.5% of 106 isolates of UTIs in female adolescents 12-15 years of age who attended an emergency department. Clinicians should be aware of the high prevalence of this etiology when empirically treating UTIs in female adolescents.
conferenceObject Ventilatory Practices And Adjunctive Therapies In Children With Ards: A Prospective Observational Study(2014) BARREIRA, E. R.; SHIEH, H. H.; SUZUKI, A. S.; DEGASPARE, N. V.; CAVALHEIRO, P. O.; MUNOZ, G. O. C.; MARTINES, J. A. D. S.; LANE, C.; CARVALHO, W. B.; GILIO, A. E.; PRECIOSO, A. R.- Impacto do uso da prova rápida para estreptococo beta-hemolítico do grupo A no diagnóstico e tratamento da faringotonsilite aguda em pronto-socorro de Pediatria(2013) CARDOSO, Débora Morais; GILIO, Alfredo Elias; HSIN, Shieh Huei; MACHADO, Beatriz Marcondes; PAULIS, Milena De; LOTUFO, João Paulo B.; MARTINEZ, Marina Baquerizo; GRISI, Sandra Josefina E.OBJECTIVE: To evaluate the impact of the routine use of rapid antigen detection test in the diagnosis and treatment of acute pharyngotonsillitis in children. METHODS: This is a prospective and observational study, with a protocol compliance design established at the Emergency Unit of the University Hospital of Universidade de São Paulo for the care of children and adolescents diagnosed with acute pharyngitis. RESULTS: 650 children and adolescents were enrolled. Based on clinical findings, antibiotics would be prescribed for 389 patients (59.8%); using the rapid antigen detection test, they were prescribed for 286 patients (44.0%). Among the 261 children who would not have received antibiotics based on the clinical evaluation, 111 (42.5%) had positive rapid antigen detection test. The diagnosis based only on clinical evaluation showed 61.1% sensitivity, 47.7% specificity, 44.9% positive predictive value, and 57.5% negative predictive value. CONCLUSIONS: The clinical diagnosis of streptococcal pharyngotonsillitis had low sensitivity and specificity. The routine use of rapid antigen detection test led to the reduction of antibiotic use and the identification of a risk group for complications of streptococcal infection, since 42.5% positive rapid antigen detection test patients would not have received antibiotics based only on clinical diagnosis.
- Analysis of invasive pneumonia-causing strains of Streptococcus pneumoniae: serotypes and antimicrobial susceptibility(2011) YOSHIOKA, Cristina R. M.; MARTINEZ, Marina B.; BRANDILEONE, Maria C. C.; RAGAZZI, Selma B.; GUERRA, Maria L. L. S.; SANTOS, Silvia R.; SHIEH, Huei H.; GILIO, Alfredo E.Objectives: To identify the most common pneumococcal serotypes in children hospitalized with invasive pneumonia, correlate isolated serotypes with those included in conjugate vaccines, and ascertain the sensitivity of the isolated pneumococcal strains to penicillin and other antibiotics. Methods: From January 2003 to October 2008, a retrospective study of hospitalized children with a diagnosis of Streptococcus pneumoniae pneumonia was conducted at the university hospital of Universidade de Sao Paulo. Criteria for inclusion were: age greater than 29 days and less than 15 years, radiological and clinical diagnosis of pneumonia, and isolation of Streptococcus pneumoniae in blood cultures and/or pleural effusion. Results: The study included 107 children. The most common serotypes were 14 (36.5%), 1 (16%), 5 (14.6%), 6B (6.3%) and 3 (4.2%). The proportion of identified serotypes contained in the heptavalent, 10-valent and 13-valent conjugate vaccines was 53.1, 86.5, and 96.9%, respectively. Pneumococcal strains were sensitive to penicillin (minimum inhibitory concentration, MIC <= 2 mu g/mL) in 100 cases (93.5%) and displayed intermediate resistance (MIC = 4 mu g/mL) in 7 cases (6.5%). No strains were penicillin-resistant (MIC >= 8 mu g/mL) according to the Clinical and Laboratory Standards Institute 2008 standards. Tested isolates were highly sensitive to vancomycin, rifampicin, ceftriaxone, clindamycin, erythromycin, and chloramphenicol. Conclusions: Our results confirm a significant potential impact of conjugate vaccines, mainly 10-valent and 13-valent, on invasive pneumonia. Furthermore, susceptibility testing results show that penicillin is still the treatment of choice for invasive pneumonia in our setting.
- Epidemiology and Outcomes of Acute Respiratory Distress Syndrome in Children According to the Berlin Definition: A Multicenter Prospective Study(2015) BARREIRA, Eliane R.; MUNOZ, Gabriela O. C.; CAVALHEIRO, Priscilla O.; SUZUKI, Adriana S.; DEGASPARE, Natalia V.; SHIEH, Huei H.; MARTINES, Joao A. D. S.; FERREIRA, Juliana C.; LANE, Christianne; CARVALHO, Werther B.; GILIO, Alfredo E.; PRECIOSO, Alexander R.Objectives: In 2012, a new acute respiratory distress syndrome definition was proposed for adult patients. It was later validated for infants and toddlers. Our objective was to evaluate the prevalence, outcomes, and risk factors associated with acute respiratory distress syndrome in children up to 15 years according to the Berlin definition. Design: A prospective, multicenter observational study from March to September 2013. Setting: Seventy-seven PICU beds in eight centers: two private hospitals and six public academic hospitals in Brazil. Patients: All children aged 1 month to 15 years admitted to the participating PICUs in the study period. Interventions: None. Measurements and Main Results: All children admitted to the PICUs were daily evaluated for the presence of acute respiratory distress syndrome according to the American-European - Consensus Conference and Berlin definitions. Of the 562 patients included, acute respiratory distress syndrome developed in 57 patients (10%) and 58 patients (10.3%) according to the Berlin definition and the American-European Consensus Conference definition, respectively. Among patients with acute respiratory distress syndrome according to the Berlin definition, nine patients (16%) were mild, 21 (37%) were moderate, and 27 (47%) were severe. Compared with patients without acute respiratory distress syndrome, patients with acute respiratory distress syndrome had significantly higher severity scores, longer PICU and hospital length of stay, longer duration of mechanical ventilation, and higher mortality (p < 0.001). The presence of two or more comorbidities and admission for medical reasons were associated with development of acute respiratory distress syndrome. Comparisons across the three the Berlin categories showed significant differences in the number of ventilator-free days (21, 20, and 5 d, p = 0.001) and mortality for severe acute respiratory distress syndrome (41%) in comparison with mild (0) and moderate (15%) acute respiratory distress syndrome(p = 0.02). No differences in PICU or hospital stay were observed across the groups. Conclusions: The Berlin definition can identify a subgroup of patients with distinctly worse outcomes, as shown by the increased mortality and reduced number of ventilator-free days in pediatric patients with severe acute respiratory distress syndrome.
conferenceObject PEDIATRIC HYPOTENSION: QUANTIFICATION OF THE DIFFERENCES BETWEEN THE TWO CURRENT DEFINITIONS(2012) SHIEH, H. H.; GILIO, A. E.; BARREIRA, E. R.; TROSTER, E. J.; VENTURA, A. M. Cordeiro; GOES, P. F.; SOUZA, D. C.; SINIMBU FILHO, J. M.; BOUSSO, A.- Infecção urinária comunitária: etiologia segundo idade e sexo(2013) LO, Denise Swei; SHIEH, Huei Hsin; RAGAZZI, Selma Lopes Betta; KOCH, Vera Hermina Kalika; MARTINEZ, Marina Baquerizo; GILIO, Alfredo EliasINTRODUCTION: Choosing the antimicrobial agent for initial therapy of urinary tract infection (UTI) is usually empirical and should consider the prevalence of uropathogens in different age groups and gender. OBJECTIVE: To establish prevalence rates of uropathogens in community-acquired UTI in relation to age and gender. METHODS: Crosssectional study conducted in the emergency department (ED) of a general hospital, from January to December, 2010, in patients younger than 15 years old who had clinical suspicion of UTI and collected quantitative urine culture. UTI was defined as urine culture with growth of a single agent > 100.000 colony forming units (cfu)/mL in a midstream collection or > 50.000 cfu/mL in urethral catheterization. RESULTS: There were 63.464 visits to ED. 2577 urine cultures were obtained, of whom 291 were positive for UTI (prevalence = 11.3% of clinical suspicion and 0.46% of visits), 212 cases (72.8%) in females, median age = 2.6 years. The predominant uropathogen was E. coli (76.6%), followed by Proteus mirabilis (10.3%) and Staphylococcus saprophyticus (4.1%). Among infants < 3 months, prevalence rates of E. coli were significantly lower (50% vs 78.4%; OR = 0.276; p = 0.006). Higher prevalences of Staphylococcus saprophyticus occurred among patients > 10 years (24.4% vs 0.4%; OR = 79.265; p < 0.0001). Proteus mirabilis was significantly more prevalent in boys than girls (24.0% vs 5.2%; OR = 5.786; p < 0.001). CONCLUSIONS: E. coli was the most prevalent community-acquired uropathogen. Nevertheless, initial empiric antimicrobial treatment of UTI should consider the significant prevalence of other agents different from E. coli in infants < 3 months, the high prevalence of Staphylococcus saprophyticus in patients > 10 years and Proteus mirabilis in males.
conferenceObject Epidemiology And Outcomes Of Ards In Critically Ill Children According To The Berlin Definition: A Prospective Study(2014) BARREIRA, E. R.; SHIEH, H. H.; SUZUKI, A. S.; MUNOZ, G. O. C.; DEGASPARE, N. V.; CAVALHEIRO, P. O.; MARTINES, J. A. D. S.; LANE, C.; GILIO, A. E.; CARVALHO, W. B.; PRECIOSO, A. R.