RESUMO
The COVID-19 pandemic represents the greatest challenge to date faced by the medical community in the 21st century. The rate of rapid dissemination, magnitude of viral contagiousness, person to person transmission at an asymptomatic phase of illness pose a unique and dangerous challenge for all patients, including neonatal and obstetric patients. Although scientific understanding of the pathophysiology of the disease, nature of transmission, and efficacy of mitigation strategies is growing, neither a cure or vaccine have been developed. While COVID-19 is primarily a disease of older patients, infection is now seen across all age demographics with reports of illness in pregnant patients and infants. Altered hormone status and predominance of Th-2 immune helper cells may result in increased predisposition to SARS-CoV-2. Case reports of pregnant patients demonstrate a clinical presentation comparable to non-pregnant adults, but evidence of vertical transmission to the fetus is controversial. Neonatal reports demonstrate an inconsistent and non-specific phenotype, and it is often difficult to separate COVID-19 from the underlying conditions of prematurity or bacterial infection. The development of international registries to enable risk profiling of COVID-19 positive pregnant mothers and/or their offspring may facilitate the development of enhanced mitigation strategies, medical treatments and effective vaccinations.
Assuntos
Infecções por Coronavirus , Transmissão Vertical de Doenças Infecciosas/prevenção & controle , Pandemias , Assistência Perinatal , Pneumonia Viral , Complicações Infecciosas na Gravidez , Betacoronavirus/isolamento & purificação , Betacoronavirus/patogenicidade , COVID-19 , Infecções por Coronavirus/diagnóstico , Infecções por Coronavirus/epidemiologia , Infecções por Coronavirus/prevenção & controle , Infecções por Coronavirus/terapia , Feminino , Humanos , Recém-Nascido , Pandemias/prevenção & controle , Assistência Perinatal/métodos , Assistência Perinatal/tendências , Pneumonia Viral/diagnóstico , Pneumonia Viral/epidemiologia , Pneumonia Viral/prevenção & controle , Pneumonia Viral/terapia , Gravidez , Complicações Infecciosas na Gravidez/diagnóstico , Complicações Infecciosas na Gravidez/epidemiologia , Complicações Infecciosas na Gravidez/prevenção & controle , Complicações Infecciosas na Gravidez/terapia , SARS-CoV-2RESUMO
BACKGROUND: This study explores whether objective, quantitative radiomic biomarkers derived from magnetic resonance (MR), positron emission tomography (PET), and computed tomography (CT) may be useful in reliably distinguishing malignant peripheral nerve sheath tumors (MPNST) from benign plexiform neurofibromas (PN). METHODS: A registration and segmentation pipeline was established using a cohort of NF1 patients with histopathological diagnosis of PN or MPNST, and medical imaging of the PN including MR and PET-CT. The corrected MR datasets were registered to the corresponding PET-CT via landmark-based registration. PET standard-uptake value (SUV) thresholds were used to guide segmentation of volumes of interest: MPNST-associated PET-hot regions (SUV≥3.5) and PN-associated PET-elevated regions (2.0Assuntos
Biomarcadores Tumorais/análise
, Transformação Celular Neoplásica
, Imageamento por Ressonância Magnética
, Neoplasias de Bainha Neural/diagnóstico por imagem
, Neoplasias de Bainha Neural/patologia
, Neurofibromatose 1/diagnóstico por imagem
, Neurofibromatose 1/patologia
, Tomografia por Emissão de Pósitrons combinada à Tomografia Computadorizada
, Diagnóstico Diferencial
, Feminino
, Humanos
, Interpretação de Imagem Assistida por Computador
, Masculino
, Reprodutibilidade dos Testes
, Estudos Retrospectivos
, Adulto Jovem
RESUMO
We report a rare and unique complication of ventriculoperitoneal (VP) shunt malfunction. A progressively expansile, CSF-containing occipital intradiploic cyst developed in a 15-year-old boy at the site of cystoperitoneal shunt draining a Dandy-Walker cyst; the shunt was placed when the boy was 4 years old. A proposed pathogenesis of the lesion is discussed.