Maria Vera Lúcia Moreira Leitão Cardoso

Investigação do reflexo vermelho em recém-nascidos e sua relação com fatores da história neonatal

El examen del reflejo rojo es parte importante del examen ocular del recien nacido. Se lo investigo en recien nacidos prematuros (RNPT) y su relacion con factores de la historia neonatal. Estudio descriptivo, cuantitativo realizado en una maternidad publica, en Fortaleza-CE, en marzo, abril y mayo de 2004 con 114 RNPT. Para el registro de los datos se utilizo un formulario propio y para realizacion del examen un oftalmoscopio directo. Se considero pertinente los siguientes hallazgos de la historia neonatal: un 68% de los RNPT obtuvieron Apgar inferior a siete en el primer minuto; 112 utilizaron oxigeno y 68 fototerapia. Cuanto al reflejo rojo, 13 (un 11%) presentaron alteracion, con asociacion estadistica significativa entre este y el Apgar en el primer minuto de vida (p= 0,041). Los hallazgos han causado preocupacion, ya que 10 de los 13 RNPT con alteracion en el reflejo rojo tenian retinopatia de la edad prematura.The red reflex test is an important part of the newborns ocular exam. This study investigated the relationship between red reflex in premature newborns (PN) and factors of the newborn history. Its a descriptive, exploratory, quantitative study conducted in a public maternity in Fortaleza, State of Ceará, with 114 PN between the months of April and May of 2004. For data registration was used a questionnaire, and for the ocular exam a direct ophthalmoscope. Data showed the following findings: 68% of PN had an Apgar under seven during the first minute; 112 were submitted to oxygen therapy; and 68 to phototherapy. As for the red reflex, 13 (11%) showed alterations, with significant statistical association between red reflex and the Apgar during the first minute of life (p = 0.041). The results cause concern because 10 of the 13 PN with red reflex showed retinopathy of prematurity.

Lesões de pele em recém-nascidos no ambiente hospitalar: tipo, tamanho e área afetada

Lesoes de pele podem ocorrer em recem-nascidos (RNs), na Unidade de Terapia Intensiva Neonatal (UTIN). Objetivou-se identificar lesoes de pele em recem-nascidos internados em uma UTIN, considerando tipo, area afetada e tamanho. Estudo prospectivo, descritivo, quantitativo, realizado de marco a maio de 2007, em uma instituicao publica de Fortaleza-CE, Brasil. A amostra foi composta de 137 recem-nascidos, destes 36 (26%) apresentaram lesoes. RESULTADOS: hematomas (24;46%), eritemas (9;18%), escoriacoes (6;12%), equimoses (5;10%), pustulas (3;6%) e outras (4;8%). Quanto a area: 40% eram < 1cm2. Quanto ao tamanho: 68% tinham entre 1 e 2cm. Predominou a forma geografica (38%) e distribuicao localizada (92%). Quanto a regiao afetada: membros (27; 52%), tronco (12; 24%), cabeca (8; 16%) e outras (4;8%). Concluiu-se que as lesoes de pele mais presentes sao os hematomas e a area mais afetada e a dos membros.UNLABELLED Skin lesions can occur in newborns (NBs) at the Neonatal Intensive Care Unit (NICU). The objective of this study was to identify skin lesions in newborns hospitalized at a NICU, considering the type, affected area and size. This prospective, descriptive, quantitative study was performed from March to May 2007 at a public institution in Fortaleza, Ceará, Brazil. The sample consisted of 137 newborns, 36 (26%) of which had lesions. RESULTS hematomas (24; 46%), erythemas (9; 18%), excoriations (6; 12%), ecchymoses (5; 10%), pustules (3; 6%) and others (4; 8%). Regarding the affected area: 40% were <1 cm². As for the size: 68% measured between 1 and 2 cm. Geographic form (38%) and localized distribution (92%) prevailed. As to the affected region, the distribution was: limbs (27; 52%), trunk (12; 24%), head (8; 16%) and others (4;8%). In conclusion, the most common skin lesions are hematomas and the limbs are the most affected area.

Skin lesions in newborns in the hospital setting: type, size and affected area

Lesoes de pele podem ocorrer em recem-nascidos (RNs), na Unidade de Terapia Intensiva Neonatal (UTIN). Objetivou-se identificar lesoes de pele em recem-nascidos internados em uma UTIN, considerando tipo, area afetada e tamanho. Estudo prospectivo, descritivo, quantitativo, realizado de marco a maio de 2007, em uma instituicao publica de Fortaleza-CE, Brasil. A amostra foi composta de 137 recem-nascidos, destes 36 (26%) apresentaram lesoes. RESULTADOS: hematomas (24;46%), eritemas (9;18%), escoriacoes (6;12%), equimoses (5;10%), pustulas (3;6%) e outras (4;8%). Quanto a area: 40% eram < 1cm2. Quanto ao tamanho: 68% tinham entre 1 e 2cm. Predominou a forma geografica (38%) e distribuicao localizada (92%). Quanto a regiao afetada: membros (27; 52%), tronco (12; 24%), cabeca (8; 16%) e outras (4;8%). Concluiu-se que as lesoes de pele mais presentes sao os hematomas e a area mais afetada e a dos membros.UNLABELLED Skin lesions can occur in newborns (NBs) at the Neonatal Intensive Care Unit (NICU). The objective of this study was to identify skin lesions in newborns hospitalized at a NICU, considering the type, affected area and size. This prospective, descriptive, quantitative study was performed from March to May 2007 at a public institution in Fortaleza, Ceará, Brazil. The sample consisted of 137 newborns, 36 (26%) of which had lesions. RESULTS hematomas (24; 46%), erythemas (9; 18%), excoriations (6; 12%), ecchymoses (5; 10%), pustules (3; 6%) and others (4; 8%). Regarding the affected area: 40% were <1 cm². As for the size: 68% measured between 1 and 2 cm. Geographic form (38%) and localized distribution (92%) prevailed. As to the affected region, the distribution was: limbs (27; 52%), trunk (12; 24%), head (8; 16%) and others (4;8%). In conclusion, the most common skin lesions are hematomas and the limbs are the most affected area.

Investigation of the related factors between newborn history and red reflex

El examen del reflejo rojo es parte importante del examen ocular del recien nacido. Se lo investigo en recien nacidos prematuros (RNPT) y su relacion con factores de la historia neonatal. Estudio descriptivo, cuantitativo realizado en una maternidad publica, en Fortaleza-CE, en marzo, abril y mayo de 2004 con 114 RNPT. Para el registro de los datos se utilizo un formulario propio y para realizacion del examen un oftalmoscopio directo. Se considero pertinente los siguientes hallazgos de la historia neonatal: un 68% de los RNPT obtuvieron Apgar inferior a siete en el primer minuto; 112 utilizaron oxigeno y 68 fototerapia. Cuanto al reflejo rojo, 13 (un 11%) presentaron alteracion, con asociacion estadistica significativa entre este y el Apgar en el primer minuto de vida (p= 0,041). Los hallazgos han causado preocupacion, ya que 10 de los 13 RNPT con alteracion en el reflejo rojo tenian retinopatia de la edad prematura.The red reflex test is an important part of the newborns ocular exam. This study investigated the relationship between red reflex in premature newborns (PN) and factors of the newborn history. Its a descriptive, exploratory, quantitative study conducted in a public maternity in Fortaleza, State of Ceará, with 114 PN between the months of April and May of 2004. For data registration was used a questionnaire, and for the ocular exam a direct ophthalmoscope. Data showed the following findings: 68% of PN had an Apgar under seven during the first minute; 112 were submitted to oxygen therapy; and 68 to phototherapy. As for the red reflex, 13 (11%) showed alterations, with significant statistical association between red reflex and the Apgar during the first minute of life (p = 0.041). The results cause concern because 10 of the 13 PN with red reflex showed retinopathy of prematurity.

Recém-nascidos com reflexo vermelho "suspeito": seguimento em consulta oftalmológica

Resumen El examen del reflejo rojo en recién nacidos es una forma de evaluación visual, que permite la identificación precoz de leucocorias, presentes frecuentemente, en la catarata congénita, en el retinoblastoma y en la retinopatía de la prematuridad. El objetivo fue evaluar, en consulta con el oftalmólogo, el resultado de la evaluación a través del examen del reflejo rojo realizado por enfermeras, considerado “sospechoso” en un grupo de recién nacidos. Estudio descriptivo, realizado en una institución pública, en Fortaleza-CE, de noviembre/2005 a marzo/2006. El examen del reflejo rojo fue realizado por dos enfermeras, una alumna de enfermería a un grupo de 180 recién nacidos; 24 de estos presentaron matices del reflejo fuera del padrón, sobresaliendo amarillo con áreas más blanquecinas al centro o con presencia de rayas . Sin embargo, solamente fue posible encaminar a seis niños al oftalmólogo. Después de la fundoscopia, los hallazgos encontrados en el examen del reflejo rojo fueron comprobados, pero fueron considerados variaciones de la normalidad. Las inter venciones multiprofesionales favorecen el desarrollo de acciones eficaces destinadas a la prevención de la ceguera y a dar continuidad al proceso de atención de estos niños. Palabras Claves: Salud ocular. Ceguera. Recién Nacido. 1Enfermeira, Doutora, Professora Adjunta do Depar tamento de Enfermagem da Universidade Federal do Ceará – UFC, Pós-Doutora pela Escola de Enfermagem da Universidade de Victoria/Canadá. Pesquisador 2 CNPq. Coordenadora da área Saúde Ocular da Criança do Projeto Saúde Ocular/UFC/ CNPq. Rua Ipê, 250. Apto 802 Torre II. São Gerardo For taleza. Brasil. E-mail: cardoso@ufc.br, 2Enfermeira, Mestranda da Programa de Pós-Graduação em Enfermagem do Departamento de Enfermagem UFC, Bolista FUNCAP, Membro do Projeto Saúde Ocular/ UFC/CNPq. Brasil. Email: adrianaufc@gmail.com, 3Enfermeira, Doutora, Professora Titular da Faculdade Integrada da Grande For taleza FGF, Membro do Projeto Saúde Ocular, UFC/UFC/CNPq. Brasil. Email: ingrid@fgf.edu.br, 4 Médica oftalmologista. Presidente da Sociedade Brasileira de Oftalmologia Pediátrica. Diretora Clínica do Centro de Aperfeiçoamento Visual Islane Verçosa. Oftalmologista do Hospital Geral de For taleza. Brasil. E-mail: islaneverc@gmail.com PESQUISA RESEARCH INVESTIGACIÓN The red reflex test in newborns is a visual screening way, allowing the early identification of leukokorias which are present, often on congenital cataract, on retinoblastoma and on retinopathy of prematurity. It aimed to evaluate, during ophthalmologist consultation, the suspect result of the screening through the red reflex test made by nurses in a group of newborns. Descriptive study carried out in a public institution in Fortaleza-CE, from November 2005 to March 2006. The red reflex test was performed by two nurses and one nursing student with 180 newborns; from these, 24 showed coloration of the reflex out of standard, standing out yellow color with whitish areas on center or with presence of stripe. However, it was possible to follow to ophthalmologist, only six babies. After fundoscopy, the findings detected on red reflex test made by nurses were confirmed, but considered variations of normality. Multiprofessionals interventions benefit the development of effective actions to prevention of blindness and the continuity of the care process for these babies.

Lesiones de piel en recién nacidos en el ámbito hospitalario: tipo, tamaño y área afectada

Lesoes de pele podem ocorrer em recem-nascidos (RNs), na Unidade de Terapia Intensiva Neonatal (UTIN). Objetivou-se identificar lesoes de pele em recem-nascidos internados em uma UTIN, considerando tipo, area afetada e tamanho. Estudo prospectivo, descritivo, quantitativo, realizado de marco a maio de 2007, em uma instituicao publica de Fortaleza-CE, Brasil. A amostra foi composta de 137 recem-nascidos, destes 36 (26%) apresentaram lesoes. RESULTADOS: hematomas (24;46%), eritemas (9;18%), escoriacoes (6;12%), equimoses (5;10%), pustulas (3;6%) e outras (4;8%). Quanto a area: 40% eram < 1cm2. Quanto ao tamanho: 68% tinham entre 1 e 2cm. Predominou a forma geografica (38%) e distribuicao localizada (92%). Quanto a regiao afetada: membros (27; 52%), tronco (12; 24%), cabeca (8; 16%) e outras (4;8%). Concluiu-se que as lesoes de pele mais presentes sao os hematomas e a area mais afetada e a dos membros.UNLABELLED Skin lesions can occur in newborns (NBs) at the Neonatal Intensive Care Unit (NICU). The objective of this study was to identify skin lesions in newborns hospitalized at a NICU, considering the type, affected area and size. This prospective, descriptive, quantitative study was performed from March to May 2007 at a public institution in Fortaleza, Ceará, Brazil. The sample consisted of 137 newborns, 36 (26%) of which had lesions. RESULTS hematomas (24; 46%), erythemas (9; 18%), excoriations (6; 12%), ecchymoses (5; 10%), pustules (3; 6%) and others (4; 8%). Regarding the affected area: 40% were <1 cm². As for the size: 68% measured between 1 and 2 cm. Geographic form (38%) and localized distribution (92%) prevailed. As to the affected region, the distribution was: limbs (27; 52%), trunk (12; 24%), head (8; 16%) and others (4;8%). In conclusion, the most common skin lesions are hematomas and the limbs are the most affected area.

Red relex "suspect" in newborn: follow up in ophtalmologic consultation

Resumen El examen del reflejo rojo en recién nacidos es una forma de evaluación visual, que permite la identificación precoz de leucocorias, presentes frecuentemente, en la catarata congénita, en el retinoblastoma y en la retinopatía de la prematuridad. El objetivo fue evaluar, en consulta con el oftalmólogo, el resultado de la evaluación a través del examen del reflejo rojo realizado por enfermeras, considerado “sospechoso” en un grupo de recién nacidos. Estudio descriptivo, realizado en una institución pública, en Fortaleza-CE, de noviembre/2005 a marzo/2006. El examen del reflejo rojo fue realizado por dos enfermeras, una alumna de enfermería a un grupo de 180 recién nacidos; 24 de estos presentaron matices del reflejo fuera del padrón, sobresaliendo amarillo con áreas más blanquecinas al centro o con presencia de rayas . Sin embargo, solamente fue posible encaminar a seis niños al oftalmólogo. Después de la fundoscopia, los hallazgos encontrados en el examen del reflejo rojo fueron comprobados, pero fueron considerados variaciones de la normalidad. Las inter venciones multiprofesionales favorecen el desarrollo de acciones eficaces destinadas a la prevención de la ceguera y a dar continuidad al proceso de atención de estos niños. Palabras Claves: Salud ocular. Ceguera. Recién Nacido. 1Enfermeira, Doutora, Professora Adjunta do Depar tamento de Enfermagem da Universidade Federal do Ceará – UFC, Pós-Doutora pela Escola de Enfermagem da Universidade de Victoria/Canadá. Pesquisador 2 CNPq. Coordenadora da área Saúde Ocular da Criança do Projeto Saúde Ocular/UFC/ CNPq. Rua Ipê, 250. Apto 802 Torre II. São Gerardo For taleza. Brasil. E-mail: cardoso@ufc.br, 2Enfermeira, Mestranda da Programa de Pós-Graduação em Enfermagem do Departamento de Enfermagem UFC, Bolista FUNCAP, Membro do Projeto Saúde Ocular/ UFC/CNPq. Brasil. Email: adrianaufc@gmail.com, 3Enfermeira, Doutora, Professora Titular da Faculdade Integrada da Grande For taleza FGF, Membro do Projeto Saúde Ocular, UFC/UFC/CNPq. Brasil. Email: ingrid@fgf.edu.br, 4 Médica oftalmologista. Presidente da Sociedade Brasileira de Oftalmologia Pediátrica. Diretora Clínica do Centro de Aperfeiçoamento Visual Islane Verçosa. Oftalmologista do Hospital Geral de For taleza. Brasil. E-mail: islaneverc@gmail.com PESQUISA RESEARCH INVESTIGACIÓN The red reflex test in newborns is a visual screening way, allowing the early identification of leukokorias which are present, often on congenital cataract, on retinoblastoma and on retinopathy of prematurity. It aimed to evaluate, during ophthalmologist consultation, the suspect result of the screening through the red reflex test made by nurses in a group of newborns. Descriptive study carried out in a public institution in Fortaleza-CE, from November 2005 to March 2006. The red reflex test was performed by two nurses and one nursing student with 180 newborns; from these, 24 showed coloration of the reflex out of standard, standing out yellow color with whitish areas on center or with presence of stripe. However, it was possible to follow to ophthalmologist, only six babies. After fundoscopy, the findings detected on red reflex test made by nurses were confirmed, but considered variations of normality. Multiprofessionals interventions benefit the development of effective actions to prevention of blindness and the continuity of the care process for these babies.

Los recién nacidos con reflejo rojo "sospechoso": seguimiento en la consulta oftalmológica

Resumen El examen del reflejo rojo en recién nacidos es una forma de evaluación visual, que permite la identificación precoz de leucocorias, presentes frecuentemente, en la catarata congénita, en el retinoblastoma y en la retinopatía de la prematuridad. El objetivo fue evaluar, en consulta con el oftalmólogo, el resultado de la evaluación a través del examen del reflejo rojo realizado por enfermeras, considerado “sospechoso” en un grupo de recién nacidos. Estudio descriptivo, realizado en una institución pública, en Fortaleza-CE, de noviembre/2005 a marzo/2006. El examen del reflejo rojo fue realizado por dos enfermeras, una alumna de enfermería a un grupo de 180 recién nacidos; 24 de estos presentaron matices del reflejo fuera del padrón, sobresaliendo amarillo con áreas más blanquecinas al centro o con presencia de rayas . Sin embargo, solamente fue posible encaminar a seis niños al oftalmólogo. Después de la fundoscopia, los hallazgos encontrados en el examen del reflejo rojo fueron comprobados, pero fueron considerados variaciones de la normalidad. Las inter venciones multiprofesionales favorecen el desarrollo de acciones eficaces destinadas a la prevención de la ceguera y a dar continuidad al proceso de atención de estos niños. Palabras Claves: Salud ocular. Ceguera. Recién Nacido. 1Enfermeira, Doutora, Professora Adjunta do Depar tamento de Enfermagem da Universidade Federal do Ceará – UFC, Pós-Doutora pela Escola de Enfermagem da Universidade de Victoria/Canadá. Pesquisador 2 CNPq. Coordenadora da área Saúde Ocular da Criança do Projeto Saúde Ocular/UFC/ CNPq. Rua Ipê, 250. Apto 802 Torre II. São Gerardo For taleza. Brasil. E-mail: cardoso@ufc.br, 2Enfermeira, Mestranda da Programa de Pós-Graduação em Enfermagem do Departamento de Enfermagem UFC, Bolista FUNCAP, Membro do Projeto Saúde Ocular/ UFC/CNPq. Brasil. Email: adrianaufc@gmail.com, 3Enfermeira, Doutora, Professora Titular da Faculdade Integrada da Grande For taleza FGF, Membro do Projeto Saúde Ocular, UFC/UFC/CNPq. Brasil. Email: ingrid@fgf.edu.br, 4 Médica oftalmologista. Presidente da Sociedade Brasileira de Oftalmologia Pediátrica. Diretora Clínica do Centro de Aperfeiçoamento Visual Islane Verçosa. Oftalmologista do Hospital Geral de For taleza. Brasil. E-mail: islaneverc@gmail.com PESQUISA RESEARCH INVESTIGACIÓN The red reflex test in newborns is a visual screening way, allowing the early identification of leukokorias which are present, often on congenital cataract, on retinoblastoma and on retinopathy of prematurity. It aimed to evaluate, during ophthalmologist consultation, the suspect result of the screening through the red reflex test made by nurses in a group of newborns. Descriptive study carried out in a public institution in Fortaleza-CE, from November 2005 to March 2006. The red reflex test was performed by two nurses and one nursing student with 180 newborns; from these, 24 showed coloration of the reflex out of standard, standing out yellow color with whitish areas on center or with presence of stripe. However, it was possible to follow to ophthalmologist, only six babies. After fundoscopy, the findings detected on red reflex test made by nurses were confirmed, but considered variations of normality. Multiprofessionals interventions benefit the development of effective actions to prevention of blindness and the continuity of the care process for these babies.

Investigación del reflejo rojo en recién nacidos y su relación con factores de la historia neonatal

El examen del reflejo rojo es parte importante del examen ocular del recien nacido. Se lo investigo en recien nacidos prematuros (RNPT) y su relacion con factores de la historia neonatal. Estudio descriptivo, cuantitativo realizado en una maternidad publica, en Fortaleza-CE, en marzo, abril y mayo de 2004 con 114 RNPT. Para el registro de los datos se utilizo un formulario propio y para realizacion del examen un oftalmoscopio directo. Se considero pertinente los siguientes hallazgos de la historia neonatal: un 68% de los RNPT obtuvieron Apgar inferior a siete en el primer minuto; 112 utilizaron oxigeno y 68 fototerapia. Cuanto al reflejo rojo, 13 (un 11%) presentaron alteracion, con asociacion estadistica significativa entre este y el Apgar en el primer minuto de vida (p= 0,041). Los hallazgos han causado preocupacion, ya que 10 de los 13 RNPT con alteracion en el reflejo rojo tenian retinopatia de la edad prematura.The red reflex test is an important part of the newborns ocular exam. This study investigated the relationship between red reflex in premature newborns (PN) and factors of the newborn history. Its a descriptive, exploratory, quantitative study conducted in a public maternity in Fortaleza, State of Ceará, with 114 PN between the months of April and May of 2004. For data registration was used a questionnaire, and for the ocular exam a direct ophthalmoscope. Data showed the following findings: 68% of PN had an Apgar under seven during the first minute; 112 were submitted to oxygen therapy; and 68 to phototherapy. As for the red reflex, 13 (11%) showed alterations, with significant statistical association between red reflex and the Apgar during the first minute of life (p = 0.041). The results cause concern because 10 of the 13 PN with red reflex showed retinopathy of prematurity.