Use of lung ultrasound in neonates during the COVID-19 pandemic.

In the current pandemic, caused by infection with severe acute respiratory syndrome coronavirus 2, ultrasound has played a fundamental role in patients who develop the resulting disease, designated coronavirus disease 2019 (COVID-19). In this study we present ultrasound images of the lungs of neonates with a suspected or confirmed diagnosis of COVID-19, distinguishing between the changes related to COVID-19 and those unrelated to the disease. Ultrasound examinations were performed by a pediatric sonographer. A total of 27 neonates were evaluated. Among those who presented no respiratory symptoms, some tested negative for COVID-19 and others tested positive. All of those who were pulmonary symptomatic, negative for COVID-19 presented transient tachypnea of the newborn and respiratory distress syndrome. Lung ultrasound images obtained in COVID-19-negative neonates showed, in some cases, a normal pattern (with A lines, few B lines, a thin, linear pleural line, and no pleural effusion), whereas in others showed coalescent B lines and areas of opacity. In two of the COVID-19-positive neonates, lung ultrasound examination showed several coalescent B lines, pleural thickening, and areas of opacity. Lung ultrasound in the neonatal period appears to be applicable within the context of the current pandemic, allowing efficient evaluation of COVID-19-related changes in neonates, as well as of pathologies inherent to the neonatal period.

Na pandemia atual causada pelo SARS-CoV-19, a ultrassonografia (US) tem apresentado papel fundamental nos pacientes com COVID-19. Neste trabalho são mostradas imagens ultrassonográficas de recém-nascidos (RNs) suspeitos ou positivos para COVID-19 e alterações pulmonares não relacionadas a essa doença. As imagens ultrassonográficas foram obtidas por médico especialista em US pediátrica. Foram avaliados 27 RNs, sendo incluídos RNs assintomáticos da parte respiratória, COVID negativos e positivos, e RNs sintomáticos para a parte respiratória, COVID-negativos, observados na taquipneia transitória do recém-nascido ou na síndrome do desconforto respiratório. As imagens ultrassonográficas dos RNs negativos para COVID-19 mostraram tanto o padrão normal (presença de linhas A, poucas linhas B, linha pleural fina e linear, ausência de efusão pleural) quanto a presença de linhas B coalescentes e áreas de condensação pulmonar. Destaca-se a presença de dois RNs COVID-19 positivos apresentando múltiplas linhas B coalescentes, espessamento pleural e com áreas de condensação. Com este trabalho, os autores procuram demonstrar a aplicabilidade da US pulmonar dentro do contexto da pandemia da COVID-19, incluindo as doenças inerentes ao período neonatal.

Focal hyperechoic liver lesions in children: far beyond hemangiomas - pictorial essay.

The aim of this report was to present a selection of focal hyperechoic liver lesions of different etiologies, illustrating the wide spectrum of diagnostic possibilities for such lesions in the pediatric population.

Apresentamos uma seleção de lesões focais hiperecogênicas hepáticas de diversas etiologias, que ilustram o grande espectro de diferentes possibilidades diagnósticas dessas lesões na faixa pediátrica, muito além dos hemangiomas.

Polycystic Ovary Syndrome among Obese Adolescents.

BACKGROUND AND AIMS: In adolescence and obesity, the pathophysiology of polycystic ovary syndrome (PCOS) is very difficult to distinguish. We aimed to assess the diagnosis of PCOS in the population of obese adolescent. METHODS: Cross-sectional study. SETTING: Pediatric Endocrinology Weight and Management Clinic from Children's Institute, São Paulo, Brazil. PARTICIPANTS: Forty-nine post-menarcheal obese adolescents with mean age of 14.7 years. INTERVENTIONS: Anthropometric assessment and review of medical records were done. Clinical and laboratory hyperandrogenism were quantified using Ferriman-Gallwey index and androgenic dosages, respectively. Ovarian morphology was evaluated through suprapubic ultrasonography. RESULTS: By the 2015 Witchel et al. guideline for PCOS in adolescence, 18.4% were diagnosed as having PCOS. When assessed by Rotterdam, Androgen Excess and PCOS Society, and American National Institute of Health criteria's, 26.4%, 22.4%, and 20.4% had PCOS, respectively. Irregular menstrual cycles were found in 65.3% of patients. Clinical hyperandrogenism was observed in 16.3% of girls and 18.4% had elevated serum androgen values. Suprapubic ultrasonography revealed enlarged ovaries in 18.4% of the adolescents. CONCLUSIONS: PCOS in all-comers obese adolescents from a Weight and Management Clinic in a quaternary hospital is more frequent when compared to adult women showed in the literature.

Study of trans-trans farnesol effect on hyphae formation by Yarrowia lipolytica.

Dimorphism is an ability of certain fungi related to its adaptation to the environment and provides a selective advantage under stress conditions and is associated to the development of human diseases. Hyphae inducing- and inhibitory-effect of farnesol on hyphae formation by the dimorphic yeast Yarrowia lipolytica was evaluated through digital image analysis. The agitation speed of the culture was the most effective hyphae inducer in comparison to bovine calf serum and N-acetylglucosamine. In low agitation system, bovine calf serum was more effective for hyphae formation inducing 57 % of hyphae transition. Farnesol inhibited hyphae formation even in low concentration (300 µM) and this effect increased with increasing concentrations. In the presence of N-acetylglucosamine, this effect was more evident in comparison to the presence of bovine calf serum, which might have protected the cells from farnesol. Digital image analysis was an important tool to evaluate this phenomenon.