EDNA MARIA DE ALBUQUERQUE DINIZ

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Departamento de Pediatria, Faculdade de Medicina - Docente
Instituto da Criança, Hospital das Clínicas, Faculdade de Medicina - Médico
LIM/36 - Laboratório de Pediatria Clínica, Hospital das Clínicas, Faculdade de Medicina

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  • article 1 Citação(ões) na Scopus
    Translating Neonatal Resuscitation Guidelines Into Practice in Brazil
    (2022) ALMEIDA, Maria Fernanda B. de; GUINSBURG, Ruth; WEINER, Gary M.; PENIDO, Marcia G.; FERREIRA, Daniela M. L. M.; ALVES, Jose Mariano S.; EMBRIZI, Lais F.; GIMENES, Carolina B.; SILVA, Nathalia M. Mello E.; FERRARI, Ligia L.; VENZON, Paulyne S.; GOMEZ, Dafne B.; VALE, Marynea S. do; BENTLIN, Maria Regina; SADECK, Lilian R.; DINIZ, Edna M. A.; FIORI, Humberto H.; CALDAS, Jamil P. S.; ALMEIDA, Joao Henrique C. L. de; DUARTE, Jose Luis M. B.; GONCALVES-FERRI, Walusa A.; PROCIANOY, Renato S.; LOPES, Jose Maria A.
    BACKGROUND AND OBJECTIVES: The Brazilian Neonatal Resuscitation Program releases guidelines based on local interpretation of international consensus on science and treatment recommendations. We aimed to analyze whether guidelines for preterm newborns were applied to practice in the 20 Brazilian Network on Neonatal Research centers of this middle-income country. METHODS: Prospectively collected data from 2014 to 2020 were analyzed for 8514 infants born at 23(0/7) to 31(6/7) weeks' gestation. The frequency of procedures was evaluated by gestational age (GA) category, including use of a thermal care bundle, positive pressure ventilation (PPV), PPV with a T-piece resuscitator, maximum fraction of inspired oxygen (Fio(2)) concentration during PPV, tracheal intubation, chest compressions and medications, and use of continuous positive airway pressure in the delivery room. Logistic regression, adjusted by center and year, was used to estimate the probability of receiving recommended treatment. RESULTS: For 3644 infants 23 to 27 weeks' GA and 4870 infants 28 to 31 weeks' GA, respectively, the probability of receiving care consistent with guidelines per year increased, including thermal care (odds ratio [OR], 1.52 [95% confidence interval (CI) 1.44-1.61] and 1.45 [1.38-1.52]) and PPV with a T-piece (OR, 1.45 [95% CI 1.37-1.55] and 1.41 [1.32-1.51]). The probability of receiving PPV with Fio(2) 1.00 decreased equally in both GA groups (OR, 0.89; 95% CI, 0.86-0.93). CONCLUSIONS: Between 2014 and 2020, the resuscitation guidelines for newborns <32 weeks' GA on thermal care, PPV with a T-piece resuscitator, and decreased use of Fio(2) 1.00 were translated into clinical practice.
  • article 7 Citação(ões) na Scopus
    Auditory pathway maturational study in small for gestational age preterm infants
    (2014) ANGRISANI, Rosanna Giaffredo; DINIZ, Edna Maria Albuquerque; GUINSBURG, Ruth; FERRARO, Alexandre Archanjo; AZEVEDO, Marisa Frasson de; MATAS, Carla Gentile
    PURPOSE: To follow up the maturation of the auditory pathway in preterm infants small for gestational age (SGA), through the study of absolute and interpeak latencies of auditory brainstem response (ABR) in the first six months of age. METHODS: This multicentric prospective cross-sectional and longitudinal study assessed 76 newborn infants, 35 SGA and 41 appropriate for gestational age (AGA), born between 33 and 36 weeks in the first evaluation. The ABR was carried out in three moments (neonatal period, three months and six months). Twenty-nine SGA and 33 AGA (62 infants), between 51 and 54 weeks (corrected age), returned for the second evaluation. In the third evaluation, 49 infants (23 SGA and 26 AGA), with age range from 63 to 65 weeks (corrected age), were assessed. The bilateral presence of Transient Evoked Otoacoustic Emissions and normal tympanogram were inclusion criteria. RESULTS: It was found interaural symmetry in both groups. The comparison between the two groups throughout the three periods studied showed no significant differences in the ABR parameters, except for the latencies of wave III in the period between three and six months. As for the maturation with tone burst 0.5 and 1 kHz, it was found that the groups did not differ. CONCLUSION: The findings suggest that, in the premature infants, the maturational process of the auditory pathway occurs in a similar rate for SGA and AGA. These results also suggest that prematurity is a more relevant factor for the maturation of the auditory pathway than birth weight.
  • article 9 Citação(ões) na Scopus
    Nonthyroidal illnesses syndrome in full-term newborns with sepsis
    (2015) SILVA, Maria Helena Baptista Nunes da; ARAUJO, Maria Cristina Korbage de; DINIZ, Edna Maria de Albuquerque; CECCON, Maria Esther Jurfest Rivero; CARVALHO, Werther Brunow de
    ABSTRACT Objective To assess hormonal changes in nonthyroidal illness syndrome (NTIS) in full-term newborns (NT) with sepsis. Materials and methods We included 28 NT with sepsis divided into 2 groups according to the time of normalization of serum and clinical indicators of infection: group A(A), 16 NT with improvement in up to 8 days; and group B(B), 12 NT improvement after 8 days. Among the 28 NT, 15 NT progressed to septic shock, with 5 NT group A and 10 NT in group B. NT were excluded when they showed severe sepsis and asphyxia, and congenital malformations, as well as those whose mothers had thyroid disease and IUGR. Results 17 NT (60.7%) presented NTIS. Low T3 was observed in NTIS in 10 NT (58.8%), and low T4 and T3 in 5 NT (29.5%), all of them with septic shock. Two NT showed mixed changes (11.7%). After sepsis was cured, there was no hormonal change, except in 3 NT. Administration of dopamine, furosemide, and corticosteroids did not affect the results. Conclusions This study indicates that nonthyroidal illness syndrome may be transiently present during sepsis in full-term newborns, especially in cases of prolonged sepsis. Low T3 can occur without changes in reverse T3 (different from adults), and low T4 and T3 occur mainly in patients with septic shock. Arch Endocrinol Metab. 2015;59(6):528-34
  • article 22 Citação(ões) na Scopus
    Surfactant protein B gene polymorphism in preterm babies with respiratory distress syndrome
    (2011) LYRA, P. P. R.; DINIZ, E. M. A.; ABE-SANDES, K.; ANGELO, L. D.; MACHADO, T. M. B.; CARDEAL, M.
    The etiology of respiratory distress syndrome (RDS) is multifactorial and multigenic. Studies have suggested that polymorphisms and mutations in the surfactant protein B (SP-B) gene are associated with the pathogenesis of RDS. The objectives of this study were to determine and compare the frequencies of SP-B gene polymorphisms in preterm babies with and without RDS. We studied 151 neonates: 79 preterm babies without RDS and 72 preterm newborns with RDS. The following four SP-B gene polymorphisms were analyzed: A/C at -18, C/T at 1580, A/G at 9306, and G/C at nucleotide 8714. The polymorphisms were detected by PCR amplification of genomic DNA and genotyping. The genotypes were determined using PCR-based converted restriction fragment length polymorphisms. The control group consisted of 42 (53%) girls and 37 (47%) boys. Weight ranged from 1170 to 3260 g and mean gestational age (GA) was 33.9 weeks (range: 29 to 35 weeks and 6 days). The RDS group consisted of 31 (43%) girls and 41 (57%) boys. Weight ranged from 614 to 2410 g and mean GA was 32 weeks (range: 26 to 35 weeks). The logistic regression model showed that GA was the variable that most contributed to the occurrence of RDS. The AG genotype of the A/G polymorphism at position 9306 of the SP-B gene was a protective factor in this population (OR = 0.1681; 95%CI = 0.0426-0.6629). We did not detect differences in the frequencies of the other polymorphisms between the two groups of newborns.
  • article 23 Citação(ões) na Scopus
    Autoimmune manifestations in SCID due to IL7R mutations: Omenn syndrome and cytopenias
    (2014) ZAGO, Claudia Augusta; JACOB, Cristina Miuki Abe; DINIZ, Edna Maria de Albuquerque; LOVISOLO, Silvana Maria; ZERBINI, Maria Claudia Nogueira; DORNA, Mayra; WATANABE, Leticia; FERNANDES, Juliana Folloni; ROCHA, Vanderson; OLIVEIRA, Joao Bosco; CARNEIRO-SAMPAIO, Magda
    B+NK+SCID (severe combined immunodeficiency) due to IL7R alpha deficiency represents approximately 10% of American SCID cases. To better understand the spectrum of autoimmune disorders associated with IL7R alpha deficiency, we describe two unrelated IL7R alpha-deficient female SCID infants whose clinical picture was dominated by autoimmune manifestations: one with intrauterine Omenn syndrome (OS) and another with persistent thrombocytopenic purpura since 4 months of age. The OS baby harbored a homozygous p.C118Y mutation in IL7R. She presented dense eosinophilic infiltrates in several organs, including pancarditis, which may have contributed to her death (on the 2nd day of life). B cells were observed in lymph nodes, spleen, bone marrow and thymus. The second patient harbored compound heterozygous p.01 8Y and p.I121NfsX8 mutations. She underwent a successful unrelated cord blood transplant. In conclusion, early OS can be observed in patients with IL7R mutations, and autoimmune cytopenias could also complicate the clinical course of SCID babies with this type of defect. (C) 2014 Published by Elsevier Inc. on behalf of American Society for Histocompatibility and Immunogenetics.
  • article 0 Citação(ões) na Scopus
    Risk Perception and Decision Making about Early-Onset Sepsis among Neonatologists: A National Survey
    (2022) RUGOLO, Ligia Maria Suppo de Souza; BENTLIN, Maria Regina; ALMEIDA, Maria Fernanda Branco de; GUINSBURG, Ruth; CARVALHO, Werther Brunow de; MARBA, Sergio Tadeu Martins; ALMEIDA, Joao Henrique Carvalho Leme de; LUZ, Jorge Hecker; PROCIANOY, Renato Soibelmann; DUARTE, Jose Luiz Muniz Bandeira; ANCHIETA, Leni Marcia; FERREIRA, Daniela Marques de Lima Mota; ALVES JUNIOR, Jose Mariano Sales; DINIZ, Edna Maria de Albuquerque; SANTOS, Juliana Paula Ferraz dos; GIMENES, Carolina Boschi; SILVA, Nathalia Moura de Mello e; FERRARI, Ligia Lopes; SILVA, Regina Paula Guimaraes Vieira Cavalcante da; MENESES, Jucille; GONCALVES-FERRI, Walusa Assad; VALE, Marynea Silva do; BRINE, Holly; WEINER, Gary M.
    Objective Many newborns are investigated and empirically treated for suspected early-onset sepsis (EOS). This study aimed to describe neonatologists' self-identified risk thresholds for investigating and treating EOS and assess the consistency of these thresholds with clinical decisions. Study Design Voluntary online survey, available in two randomized versions, sent to neonatologists from 20 centers of the Brazilian Network on Neonatal Research. The surveys included questions about thresholds for investigating and treating EOS and presented four clinical scenarios with varying calculated risks. In survey version A, only the scenarios were presented, and participants were asked if they would order a blood test or start antibiotics. Survey version B presented the same scenarios and the risk of sepsis. Clinical decisions were compared between survey versions using chi-square tests and agreement between thresholds and clinical decisions were investigated using Kappa coefficients. Results In total, 293 surveys were completed (145 survey version A and 148 survey version B). The median risk thresholds for blood test and antibiotic treatment were 1:100 and 1:25, respectively. In the high-risk scenario, there was no difference in the proportion choosing antibiotic therapy between the groups. In the moderate-risk scenarios, both tests and antibiotics were chosen more frequently when the calculated risks were included (survey version B). In the low-risk scenario, there was no difference between survey versions. There was poor agreement between the self-described thresholds and clinical decisions. Conclusion Neonatologists overestimate the risk of EOS and underestimate their risk thresholds. Knowledge of calculated risk may increase laboratory investigation and antibiotic use in infants at moderate risk for EOS.
  • article 14 Citação(ões) na Scopus
    EVALUATION OF USABILITY OF A NEONATAL HEALTH INFORMATION SYSTEM ACCORDING TO THE USER’S PERCEPTION
    (2018) PADRINI-ANDRADE, Lucio; BALDA, Rita de Cássia Xavier; ARECO, Kelsy Catherina Nema; BANDIERA-PAIVA, Paulo; NUNES, Marynéa do Vale; MARBA, Sérgio Tadeu Martins; CARVALHO, Werther Brunow de; RUGOLO, Ligia Maria Suppo de Souza; ALMEIDA, João Henrique Carvalho de; PROCIANOY, Renato Soibelmann; DUARTE, José Luiz Muniz Bandeira; REGO, Maria Albertina Santiago; FERREIRA, Daniela Marques de Lima Mota; ALVES FILHO, Navantino; GUINSBURG, Ruth; DINIZ, Edna Maria de Albuquerque; SANTOS, Juliana Paula Ferraz dos; TESTONI, Daniela; SILVA, Nathalia Moura de Mello e; GONZALES, Maria Rafaela Conde; SILVA, Regina Vieira Cavalcante da; MENESES, Jucille; GONÇALVES-FERRI, Walusa Assad; PERUSSI-E-SILVA, Ricardo; BOMFIM, Olga
    ABSTRACT Objective: To measure the level of satisfaction regarding the usability of a neonatal health information system and identify if demographic factors can influence the usability of a health information system. Methods: A cross-sectional, exploratory study was carried out with a convenience sample of 50 users of the Brazilian Neonatal Research Network. The instrument chosen for the usability evaluation was the System Usability Scale between February and March 2017. The statistical analysis of the collected variables was carried out in order to describe the sample, to quantify the level of satisfaction of the users and to identify the variables associated with the level of satisfaction. Results: The female gender represented 75% of the sample. The mean age was 52.8 years; 58% had a doctoral degree, average time of graduation was 17 years, with area of practice in medicine (neonatology), with intermediate knowledge in computer science (74%) and mean system use time of 52 months. Regarding usability, 94% rated the system as “good”, “excellent” or “better than imaginable”. The usability of the system was not associated with age, gender, education, profession, area of practice, knowledge in computer science and time of system use. Conclusion: The level of satisfaction of the computerized health system user was considered good. No demographic factors were associated with the satisfaction of the users.
  • article 12 Citação(ões) na Scopus
    Randomized controlled trial comparing nasal intermittent positive pressure ventilation and nasal continuous positive airway pressure in premature infants after tracheal extubation
    (2016) KOMATSU, Daniela Franco Rizzo; DINIZ, Edna Maria De Albuquerque; FERRARO, Alexandre Archanjo; CECCON, Maria Esther Jurvest Rivero; VAZ, Flavio Adolfo Costa
    Objective: To analyze the frequency of extubation failure in premature infants using conventional mechanical ventilation (MV) after extubation in groups subjected to nasal intermittent positive pressure ventilation (nIPPV) and continuous positive airway pressure (nCPAP). Method: Seventy-two premature infants with respiratory failure were studied, with a gestational age (GA) <= 36 weeks and birth weight (BW) > 750 g, who required tracheal intubation and mechanical ventilation. The study was controlled and randomized in order to ensure that the members of the groups used in the research were chosen at random. Randomization was performed at the time of extubation using sealed envelopes. Extubation failure was defined as the need for re-intubation and mechanical ventilation during the first 72 hours after extubation. Results: Among the 36 premature infants randomized to nIPPV, six (16.6%) presented extubation failure in comparison to 11 (30.5%) of the 36 premature infants randomized to nCPAP. There was no statistical difference between the two study groups regarding BW, GA, classification of the premature infant, and MV time. The main cause of extubation failure was the occurrence of apnea. Gastrointestinal and neurological complications did not occur in the premature infants participating in the study. Conclusion: We found that, despite the extubation failure of the group of premature infants submitted to nIPPV being numerically smaller than in premature infants submitted to nCPAP, there was no statistically significant difference between the two modes of ventilatory support after extubation.
  • article
    Monitoramento eletrofisiológico do sistema auditivo central em crianças nascidas pequenas para a idade gestacional
    (2020) ANGRISANI, Rosanna Giaffredo; MATAS, Carla Gentile; DINIZ, Edna Maria Albuquerque; GUINSBURG, Ruth; AZEVEDO, Marisa Frasson de
    ABSTRACT Purpose To follow up the central auditory system of children born small for gestational age, through electrophysiological evaluation of hearing, in order to verify the occurrence of possible neural dysfunctions in this system. Methods A longitudinal study was carried out with 23 children divided into four groups: Term-born group, subdivided into small for gestational age (four children) and four children born with appropriate weight for gestational age, whose age at the end of the research was three years old. Preterm group subdivided into small for gestational age (seven children), and appropriate for gestational age (eight children), whose corrected age, at the end of the research was three years old. All children were subjected to assessment of auditory brainstem auditory evoked potentials at birth, at six months and at three years of age, and Long-Latency Auditory Evoked Potential at three years. Results children born at term and small for gestational age had a higher occurrence of hearing alterations in relation to the other groups, with increased latency of waves III and V and interpeaks I-III and I-V. All children presented normal evaluation in the Long-Latency Auditory Evoked Potential. Conclusion Children born term and small for gestational age present dysfunctions in neural conduction in the brainstem and should be considered at risk for alterations in the development of the auditory skills that are necessary to guarantee quality of acoustic information processing.
  • article 7 Citação(ões) na Scopus
    Caracterização eletrofisiológica da audição em prematuros nascidos pequenos para a idade gestacional
    (2013) ANGRISANI, Rosanna Mariangela Giaffredo; AZEVEDO, Marisa Frasson de; CARVALLO, Renata Mota Mamede; DINIZ, Edna Maria de Albuquerque; FERRARO, Alexandre Archanjo; GUINSBURG, Ruth; MATAS, Carla Gentile
    PURPOSE: To characterize the Auditory Brainstem Response (ABR) of small for gestational age preterm newborns and to compare the findings to those of appropriate for gestational age premature newborns in order to verify whether the small for gestational age condition is a risk factor for hearing loss. METHODS: This prospective cross-sectional multicenter study evaluated 72 preterm newborns of both genders (35 small and 37 appropriate for gestational age), who were born at 30 to 36 weeks of gestational age and were evaluated before hospital discharge. Only newborns with present transient evoked otoacoustic emissions and tympanometry type A were included. The ABR was performed with click stimuli. The quantitative data analysis was performed using mean and standard deviation measures for each group. For qualitative analysis, the ABR results were classified as normal or altered according to the absolute latencies of waves I, III, V and interpeaks I-III, III-V, I-V. The analysis was carried out considering the age of the newborn at the time of examination. RESULTS: Alterations were evident in 32 newborns (44.44%), being 15 small (43%) and 17 appropriate for gestational age (46%), with no between-groups difference. Of the 15 small for gestational age newborns with altered ABR, six presented as auditory risk only the small for gestational age condition. In the group of adequate for gestational age newborns, there was a higher occurrence of alteration in males. CONCLUSION: There was no difference in responses of auditory evoked potential between small and appropriate for gestational age preterm newborns. Therefore, the condition does not behave as a risk factor for retrocochlear impairment.