ALFREDO ELIAS GILIO
Projetos de Pesquisa
Unidades Organizacionais
Departamento de Pediatria, Faculdade de Medicina - Docente
PAINT-62, Hospital Universitário
PAINT-62, Hospital Universitário
31 resultados
Resultados de Busca
Agora exibindo 1 - 10 de 31
- Health worker recommended vaccination rates among medical students in Brazil(2021) LEME, Mateus Deckers; GILIO, Alfredo EliasHealth workers are a risk population for many infectious diseases, which leads to a number of vaccines being routinely recommended for health care staff. Medical students are also prone to such hazards. This study accesses undergraduate medicine students' compliance to recommended health-staff vaccination, and their reasons for noncompliance. Method: An online questionnaire was sent to all undergraduates in a major public medical school in Brazil, asking about vaccination status to Hepatitis B, Measle-mumps-rubella, Varicella, Pertussis and Influenza, and reasons in case of noncompliance Results: 146 students answered the questionnaire, (response rate 14,6%). Overall vaccination status showed 74,7% of students with incomplete vaccination in some way, with an increase in vaccination status toward the end of the course. The highest noncompliance rates were Pertussis (49,3%), Varicella (47,3%) and Influenza (30,1%) vaccines. The vaccine with the lowest noncompliance rate was measles (9,6%). During the course, the greatest increases in adequate vaccination status were Hepatitis B, from 53,2% in first-years to 93,2% by the end sixth year (chi-sq 21, p < 0,0001), and Influenza, from 48,9% to 91,5% (chi-sq 22,5, p < 0,00009). Main reasons given not to vaccinate were vaccination hesitancy for influenza and varicella (respectively 61% and 46%), and lack of awareness of the need to vaccinate for pertussis (53%). Conclusions: Overall vaccine coverage in medical students in Brazil is still far from optimal. There is a markedly high level of vaccine hesitancy and unawareness of need to vaccinate for some diseases, particularly pertussis and influenza. (C) 2021 Published by Elsevier Ltd.
- Number Needed to Treat in Fluconazole Prophylaxis in the Neonatal Intensive Care Unit(2011) SHIEH, Huei Hsin; IBIDI, Silvia Maria; GILIO, Alfredo Elias
- Chronic medical conditions associated with invasive pneumococcal diseases in inpatients in teaching hospitals in Sao Paulo city: Estimating antimicrobial susceptibility and serotype-coverage of pneumococcal vaccines(2023) KFOURI, Renato A.; BRANDILEONE, Maria-Cristina C.; SAFADI, Marco Aurelio P.; RICHTMANN, Rosana; GILIO, Alfredo E.; ROSSI, Flavia; GUIMARAES, Thais; BIERRENBACH, Ana Luiza; MORAES, Jose C.; IPD, Sao Paulo Study Grp I. P. D. Sa Paulo Study GrpBackground: Chronic conditions increase the risk of invasive pneumococcal diseases (IPD). Pneumococcal vaccination remarkably reduced IPD morbimortality in vulnerable popula-tions. In Brazil, pneumococcal vaccines are included in the National Immunization Pro-gram (PNI): PCV10 for < 2 years-old, and PPV23 for high risk-patients aged >= 2 years and institutionalized >= 60 years. PCV13 is available in private clinics and recommended in the PNI for individuals with certain underlying conditions. Methods: A retrospective study was performed using clinical data from all inpatients from five hospitals with IPD from 2016 to 2018 and the corresponding data on serotype and antimicro-bial-non-susceptibility of pneumococcus. Vaccine-serotype-coverage was estimated. Patients were classified according to presence of comorbidities: healthy, without comorbidities; at-risk, included immunocompetent persons with specific medical conditions; high-risk, with immu-nocompromising conditions and others Results: 406 IPD cases were evaluated. Among 324 cases with information on medical condi-tions, children < 5 years were mostly healthy (55.9%), while presence of comorbidity pre-vailed in adults >= 18 years old (> 82.0%). Presence of >= 1 risk condition was reported in >= 34.8% of adults. High-risk conditions were more frequent than at-risk in all age groups. Among high-risk comorbidity (n = 211), cancer (28%), HIV/AIDS (25.7%) and hematological dis-eases (24.5%) were the most frequent. Among at-risk conditions (n = 89), asthma (16.5%) and diabetes (8.1%) were the most frequent. Among 404 isolates, 42.9% belonged to five serotypes: 19A (14.1%), 3 (8.7%), 6C (7.7%), 4 and 8 (6.2% each); 19A and 6C expressed antimicrobial-non -susceptibility. The vaccine-serotype-coverage was: PCV10, 19.1%, PCV13, 43.8%; PCV15, 47.8%; PCV20, 62.9%; PCV21, 65.8%, and PPV23, 67.3%. Information on hospital outcome was available for 283 patients, of which 28.6% died. Mortality was 54.2% for those with meningitis. Conclusion: Vaccine with expanded valence of serotypes is necessary to offer broad preven-tion to IPD. The present data contribute to pneumococcal vaccination public health policies for vulnerable patients, mainly those with comorbidity and the elderly. (c) 2023 Sociedade Brasileira de Infectologia.
- Risk factors for neurological complications and sequelae in childhood acute bacterial meningitis(2012) SHIEH, Huei H.; RAGAZZI, Selma L. B.; GILIO, Alfredo E.
- Lipid profiles of children and adolescents with inflammatory response in a paediatric emergency department(2016) MURAMOTO, Giovana; DELGADO, Artur Figueiredo; SOUZA, Eloisa Correa de; GILIO, Alfredo Elias; CARVALHO, Werter Brunow de; MARANHAO, Raul CavalcanteBackground: To compare the lipid profile between patients with and without inflammatory process in according nutritional status, gender and age. Methods: One hundred and twenty-four children and adolescents in the emergency department were separated into two groups according to the levels of C-reactive protein (CRP). Total cholesterol, high-density lipoprotein (HDL) and low-density lipoprotein (LDL), triglycerides (TG) and albumin in patients with CRP < 5 mg/L were compared with patients with CRP >= 5 mg/L. Nutritional status was assessed by anthropometric measurements. Results: Patients were mostly classified as well-nourished (76.5%) and had low levels of HDL (70%). There was no significant difference in lipid profile between the two groups of CRP. Linear regression analysis, however, it became clear that for each increase of 1 mg/L in the values of CRP expected an average reduction of 0.072 mg/dL of HDL, the 0.083 mg/dL of LDL, the 0.002 g/dL albumin and an average increase of 0.564 mg/dL of TG. Conclusions: Patients with an inflammatory process exhibit changes in the serum levels of the lipids HDL, LDL and TG that are related to the degree of inflammation. These changes occurred regardless of nutritional status.
- 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.
- 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.
- Clinical and laboratory features of urinary tract infections in young infants(2018) LO, Denise Swei; RODRIGUES, Larissa; KOCH, Vera Hermina Kalika; GILIO, Alfredo EliasABSTRACT Introduction: Urinary tract infection (UTI) is the most common serious bacterial infection in young infants. Signs and symptoms are often nonspecific. Objectives: To describe clinical, demographic and laboratory features of UTI in infants ≤ 3 months old. Methods: Cross-sectional study of infants ≤ 3 months old with UTI diagnosed in a pediatric emergency department, for the period 2010-2012. UTI was defined as ≥ 50,000 colony-forming units per milliliter of a single uropathogen isolated from bladder catheterization. Paired urinalysis and urine culture from group culture-positive and group culture-negative were used to determine the sensitivity and specificity of pyuria and nitrite tests in detecting UTI. Results: Of 519 urine cultures collected, UTI was diagnosed in 65 cases (prevalence: 12.5%); with male predominance (77%). The most common etiologies were Escherichia coli (56.9%), Klebsiella pneumoniae (18.5%) and Enterococcus faecalis (7.7%). Frequent clinical manifestations were fever (77.8%), irritability (41.4%) and vomiting (25.4%). The median temperature was 38.7°C. The sensitivity of the nitrite test was 30.8% (95%CI:19.9-43.4%), specificity of 100% (95%CI:99.2-100%). Pyuria ≥ 10,000/mL had a sensitivity of 87.7% (95%CI:77.2-94.5%), specificity of 74.9% (95%CI:70.6 -78.8%). The median peripheral white blood cell count was 13,150/mm3; C-reactive protein levels were normal in 30.5% of cases. Conclusions: The male: female ratio for urinary tract infection was 3.3:1. Non-Escherichia coli etiologies should be considered in empirical treatment. Fever was the main symptom. Positive nitrite is highly suggestive of UTI but has low sensitivity; whereas pyuria ≥ 10,000/mL revealed good sensitivity, but low specificity. Peripheral white blood cell count and C-reactive protein concentration have limited usefulness to suggest UTI.
- Respiratory viral infections in infants with clinically suspected pertussis(2013) FERRONATO, Angela E.; GILIO, Alfredo E.; VIEIRA, Sandra E.Objective: to evaluate the frequency of respiratory viral infections in hospitalized infants with clinical suspicion of pertussis, and to analyze their characteristics at hospital admission and clinical outcomes. Methods: a historical cohort study was performed in a reference service for pertussis, in which the research of respiratory viruses was also a routine for infants hospitalized with respiratory problems. All infants reported as suspected cases of pertussis were included. Tests for Bordetella pertussis (BP) (polymerase chain reaction/culture) and for respiratory viruses (RVs) (immunofluorescence) were performed. Patients who received macrolides before hospitalization were excluded. Clinical data were obtained from medical records. Results: among the 67 patients studied, BP tests were positive in 44%, and 26% were positive for RV. There was no etiological identification in 35%, and RV combined with BP was identified in 5%. All patients had similar demographic characteristics. Cough followed by inspiratory stridor or cyanosis was a strong predictor of pertussis, as well as prominent leukocytosis and lymphocytosis. Rhinorrhea and dyspnea were more frequent in viral infections. Macrolides were discontinued in 40% of patients who tested positive for RV and negative for BP. Conclusion: the results suggest that viral infection can be present in hospitalized infants with clinical suspicion of pertussis, and etiological tests may enable a reduction in the use of macrolides in some cases. However, the etiological diagnosis of respiratory virus infection, by itself, does not exclude the possibility of infection with BP.
- Molecular epidemiology of the SH (small hydrophobic) gene of human respiratory syncytial virus (HRSV), over 2 consecutive years(2012) LIMA, Hildener Nogueira; BOTOSSO, Viviane Fongaro; OLIVEIRA, Danielle Bruna Leal; CAMPOS, Angelica Cristine de Almeida; LEAL, Andrea Lima; SILVA, Tereza Souza; BOSSO, Patricia Alves Ramos; MORAES, Claudia Trigo Pedroso; SILVA FILHO, Claudionor Gomes da; VIEIRA, Sandra Elisabete; GILIO, Alfredo Elias; STEWIEN, Klaus Eberhard; DURIGON, Edison LuizHuman respiratory syncytial virus (HRSV) strains were isolated from nasopharyngeal aspirates collected from 965 children between 2004 and 2005, yielding 424 positive samples. We sequenced the small hydrophobic protein (SH) gene of 117 strains and compared them with other viruses identified worldwide. Phylogenetic analysis showed a low genetic variability among the isolates but allowed us to classify the viruses into different genotypes for both groups, HRSVA and HRSVB. It is also shown that the novel BA-like genotype was well segregated from the others, indicating that the mutations are not limited to the G gene.