Assuntos
Hamartoma/patologia , Doenças Musculares/patologia , Dermatopatias/patologia , Biópsia , Hamartoma/congênito , Humanos , Recém-Nascido , Masculino , Músculo Liso/anormalidades , Músculo Liso/patologia , Doenças Musculares/congênito , Couro Cabeludo/anormalidades , Couro Cabeludo/patologia , Dermatopatias/congênitoRESUMO
AIM: To determine the value of cord blood cardiac troponin I levels (cTnl) as an early prognostic factor in critically ill newborns, and to compare cord cTnl levels with the prognostic value of the score for neonatal acute physiology (SNAP). METHODS: Cord arterial samples were collected routinely for blood gas analysis, and cord venous samples for cTnl and cardiac-specific creatine kinase assay. The study group (n=109) comprised critically ill newborns who required mechanical ventilation. The control group (n = 96) comprised newborns who were either completely healthy (n = 48) or were followed in a level I neonatal care unit due to moderate-severity problems. RESULTS: The critically ill newborns had significantly higher cTnl levels than control babies (median [min-max] 1.4 [0-13] vs. 0 [0-1.8] ng/mL, respectively; P<0.001). In critically ill newborns, non-survivors had significantly higher cTnl levels than survivors (median [min-max] 6.6 [1.3-13.0] vs. 1.3 [0-8.0] ng/mL, respectively; P<0.001). Receiver-operator curve analysis revealed that, compared with SNAP, cTnl was a more sensitive predictor of mortality in critically ill newborns (area under curve=0.96; 95% CI=0.90-1.02). CONCLUSION: Significantly elevated cord cTnl may be a valuable predictor of mortality in critically ill newborns.
Assuntos
Asfixia Neonatal/sangue , Sangue Fetal/química , Troponina I/sangue , Asfixia Neonatal/mortalidade , Biomarcadores/sangue , Estudos de Casos e Controles , Estado Terminal , Feminino , Humanos , Recém-Nascido , Masculino , Valor Preditivo dos Testes , Estudos Prospectivos , Curva ROC , Sensibilidade e EspecificidadeRESUMO
Wilms' tumor in adults is rare, and no treatment guidelines have been established. Spinal cord compression has also been rarely reported in all age groups. In this case report, we present a 19-year-old adolescent with recurrent Wilms' tumor, a paraspinal dumbbell mass, metastatic involvement of the vertebral bodies, lung metastasis, and pregnancy. To our knowledge, this is the first report of a pregnant patient with Wilms' tumor who had to undergo immediate chemotherapy with vincristine and actinomycin-D owing to spinal cord compression at 25 weeks of pregnancy. After delivery, complete remission was maintained with a regimen of ifosfamide, carboplatin, and etoposide and vincristine, actinomycin-D, and cyclophosphamide. No teratogenic or other toxic effects of vincristine or actinomycin-D were observed in the fetus.
