RESUMEN
Infection with severe acute respiratory syndrome coronavirus 2 results in coronavirus disease 2019 (COVID-19), which was declared an official pandemic by the World Health Organization on March 11, 2020. COVID-19 has been reported in most countries, and as of August 15, 2020, there have been over 21 million cases of COVID-19 reported worldwide, with over 800 000 COVID-19-associated deaths. Although COVID-19 predominantly affects the respiratory system, it has become apparent that many other organ systems can also be involved. Imaging plays an essential role in the diagnosis of all manifestations of the disease and its related complications, and proper utilization and interpretation of imaging examinations is crucial. A comprehensive understanding of the diagnostic imaging hallmarks, imaging features, multisystem involvement, and evolution of imaging findings is essential for effective patient management and treatment. In part 1 of this article, the authors described the viral pathogenesis, diagnostic imaging hallmarks, and manifestations of the pulmonary and peripheral and central vascular systems of COVID-19. In part 2 of this article, the authors focus on the key imaging features of the varied pathologic manifestations of COVID-19, involving the cardiac, neurologic, abdominal, dermatologic and ocular, and musculoskeletal systems, as well as the pediatric and pregnancy-related manifestations of the virus. Online supplemental material is available for this article. ©RSNA, 2020.
Asunto(s)
Infecciones por Coronavirus/complicaciones , Infecciones por Coronavirus/diagnóstico por imagen , Neumonía Viral/complicaciones , Neumonía Viral/diagnóstico por imagen , Adolescente , Adulto , Anciano , Enfermedades Asintomáticas , Betacoronavirus , Encéfalo/diagnóstico por imagen , COVID-19 , Sistema Cardiovascular/diagnóstico por imagen , Niño , Infecciones por Coronavirus/diagnóstico , Femenino , Tracto Gastrointestinal/diagnóstico por imagen , Humanos , Recién Nacido , Pulmón/diagnóstico por imagen , Imagen por Resonancia Magnética , Masculino , Persona de Mediana Edad , Pandemias , Neumonía Viral/diagnóstico , Embarazo , Complicaciones Infecciosas del Embarazo/diagnóstico por imagen , Radiografía , SARS-CoV-2 , Evaluación de Síntomas , Tomografía Computarizada por Rayos XRESUMEN
Infection with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) results in coronavirus disease 2019 (COVID-19), which was declared an official pandemic by the World Health Organization on March 11, 2020. The infection has been reported in most countries around the world. As of August 2020, there have been over 21 million cases of COVID-19 reported worldwide, with over 800 000 COVID-19-associated deaths. It has become apparent that although COVID-19 predominantly affects the respiratory system, many other organ systems can also be involved. Imaging plays an essential role in the diagnosis of all manifestations of the disease, as well as its related complications, and proper utilization and interpretation of imaging examinations is crucial. With the growing global COVID-19 outbreak, a comprehensive understanding of the diagnostic imaging hallmarks, imaging features, multisystemic involvement, and evolution of imaging findings is essential for effective patient management and treatment. To date, only a few articles have been published that comprehensively describe the multisystemic imaging manifestations of COVID-19. The authors provide an inclusive system-by-system image-based review of this life-threatening and rapidly spreading infection. In part 1 of this article, the authors discuss general aspects of the disease, with an emphasis on virology, the pathophysiology of the virus, and clinical presentation of the disease. The key imaging features of the varied pathologic manifestations of this infection that involve the pulmonary and peripheral and central vascular systems are also described. Part 2 will focus on key imaging features of COVID-19 that involve the cardiac, neurologic, abdominal, dermatologic and ocular, and musculoskeletal systems, as well as pediatric and pregnancy-related manifestations of the virus. Vascular complications pertinent to each system will be also be discussed in part 2. Online supplemental material is available for this article. ©RSNA, 2020.
Asunto(s)
Betacoronavirus/fisiología , Infecciones por Coronavirus/diagnóstico por imagen , Pulmón/diagnóstico por imagen , Pandemias , Neumonía Viral/diagnóstico por imagen , Tromboembolia/diagnóstico por imagen , Trombosis/diagnóstico por imagen , Angiografía/métodos , Enzima Convertidora de Angiotensina 2 , COVID-19 , Infecciones por Coronavirus/complicaciones , Infecciones por Coronavirus/epidemiología , Infecciones por Coronavirus/virología , Síndrome de Liberación de Citoquinas/etiología , Síndrome de Liberación de Citoquinas/fisiopatología , Progresión de la Enfermedad , Productos de Degradación de Fibrina-Fibrinógeno/análisis , Humanos , Inflamación , Peptidil-Dipeptidasa A/fisiología , Neumonía Viral/complicaciones , Neumonía Viral/epidemiología , Neumonía Viral/virología , Arteria Pulmonar/diagnóstico por imagen , Receptores Virales/fisiología , Síndrome de Dificultad Respiratoria/diagnóstico por imagen , Síndrome de Dificultad Respiratoria/etiología , SARS-CoV-2 , Evaluación de Síntomas , Tromboembolia/sangre , Tromboembolia/etiología , Trombosis/sangre , Trombosis/etiología , Microangiopatías Trombóticas/diagnóstico por imagen , Microangiopatías Trombóticas/etiología , Tomografía Computarizada por Rayos X/métodos , Ultrasonografía/métodosRESUMEN
Understanding differences in social-emotional behavior can help identify atypical development. This study examined the differences in social-emotional development in children at increased risk of an autism spectrum disorder (ASD) diagnosis (infant siblings of children diagnosed with the disorder). Parents completed the Brief Infant-Toddler Social-Emotional Assessment (BITSEA) to determine its ability to flag children with later-diagnosed ASD in a high-risk (HR) sibling population. Parents of HR (n = 311) and low-risk (LR; no family history of ASD; n = 127) children completed the BITSEA when their children were 18 months old and all children underwent a diagnostic assessment for ASD at age 3 years. All six subscales of the BITSEA (Problems, Competence, ASD Problems, ASD Competence, Total ASD Score, and Red Flags) distinguished between those in the HR group who were diagnosed with ASD (n = 84) compared to non-ASD-diagnosed children (both HR-N and LR). One subscale (BITSEA Competence) differentiated between the HR children not diagnosed with ASD and the LR group. The results suggest that tracking early social-emotional development may have implications for all HR children, as they are at increased risk of ASD but also other developmental or mental health conditions.
Asunto(s)
Trastorno del Espectro Autista , Preescolar , Emociones , Humanos , Lactante , Hermanos , Conducta Social , Habilidades SocialesRESUMEN
BACKGROUND: Children with autism spectrum disorder (ASD) often experience impairments in adaptive behavior. METHODS: Developmental trajectories of adaptive behavior in ASD were examined in children from high-risk (siblings of children diagnosed with ASD, n = 403) and low-risk (no family history of ASD, n = 163) families. Children were assessed prospectively at 12, 18, 24, and 36 months of age using the Vineland Adaptive Behavior Scales and underwent a blind independent diagnostic assessment for ASD at 36 months of age. RESULTS: The semi-parametric group-based modeling approach using standard scores on the Adaptive Behavior Composite revealed three distinct developmental trajectories: (a) Group 1 (21.2% of sample) showed average performance at 12 months and a declining trajectory; (b) Group 2 (52.8% of the sample) showed average performance at 12 months with a slightly declining trajectory; and (c) Group 3 (26.0% of the sample) showed a higher level of adaptive behavior at 12 months and a stable trajectory. The Mullen Scales of Early Learning Early Learning Composite and the Autism Observation Scale for Infants total score at 6 and 12 months predicted trajectory membership. CONCLUSIONS: The results emphasize heterogeneous development associated with ASD and the need for interventions tailored to individual presentations.
Asunto(s)
Adaptación Psicológica/fisiología , Trastorno del Espectro Autista/fisiopatología , Conducta Infantil/fisiología , Canadá , Preescolar , Femenino , Humanos , Lactante , Masculino , Riesgo , HermanosRESUMEN
Animal studies suggest that hypertension leads to cardiac tissue hypothyroidism, a condition that can by itself lead to heart failure. We have previously shown that short-term thyroid hormone treatment in Spontaneously Hypertensive Heart Failure (SHHF) rats near heart failure is beneficial. This study tested the hypothesis that therapeutic, long-term T3 treatment in SHHF rats can prevent or attenuate cardiac dysfunction. Female SHHF rats were treated orally with a physiological T3 dose (0.04 µg/ml) from 12 to 24 mo of age. Age-matched female SHHF and Wistar-Kyoto rats served as hypertensive and normotensive controls, respectively. SHHF rats had reduced serum free thyroid hormone levels and cardiac tissue T3 levels, LV dysfunction, and elevated LV collagen content compared with normotensive controls. Restoration of serum and cardiac tissue thyroid hormone levels in T3-treated rats was associated with no change in heart rate, but strong trends for improvement in LV systolic function and collagen levels. For instance, end-systolic diameter, fractional shortening, systolic wall stress, and LV collagen levels were no longer significantly different from controls. In conclusion, longstanding hypertension in rats led to chronic low serum and cardiac tissue thyroid hormone levels. Long-term treatment with low-dose T3 was safe. While cardiac dysfunction could not be completely prevented in the absence of antihypertensive treatment, T3 may offer additional benefits as an adjunct therapy with possible improvement in diastolic function.
Asunto(s)
Colágeno/efectos de los fármacos , Insuficiencia Cardíaca/etiología , Ventrículos Cardíacos/efectos de los fármacos , Corazón/efectos de los fármacos , Hipertensión/complicaciones , Hipotiroidismo/etiología , Triyodotironina/farmacología , Disfunción Ventricular Izquierda/etiología , Función Ventricular Izquierda/efectos de los fármacos , Animales , Colágeno/metabolismo , Femenino , Insuficiencia Cardíaca/metabolismo , Ventrículos Cardíacos/metabolismo , Hipertensión/metabolismo , Hipotiroidismo/metabolismo , Miosinas/efectos de los fármacos , Miosinas/metabolismo , Distribución Aleatoria , Ratas , Ratas Endogámicas SHR , Ratas Endogámicas WKY , Tiroxina/metabolismo , Disfunción Ventricular Izquierda/metabolismoRESUMEN
Autism is a severe neurodevelopmental disorder characterized by qualitative impairments in social behavior, communication, and aberrant repetitive behaviors. A major focus of animal models of autism has been to mimic the social deficits of the disorder. The present study assessed whether rats exposed prenatally to valproic acid (VPA) show deficits in social play as juveniles that are consistent with the social deficits observed in autism. Dams were exposed to an acute dose of VPA on gestational day 12.5. Later, the playful interactions and associated ultrasonic vocalizations of the juveniles were examined. It was predicted that VPA-treated rats should play less than the controls. Characteristic of neurobehavioral insult at this early age, the VPA-treated juveniles showed significant increases in the frequency of body shakes and sexual mounting, but played at the same frequency as the controls. However, when playing, they were less likely to use tactics that facilitated bodily contact and vocalized less. These data suggest that prenatal VPA exposure disrupts some aspects of being able to communicate effectively and engage partners in dynamic interactions - deficits that are consistent with those observed in autism.
Asunto(s)
Trastorno Autístico/inducido químicamente , Conducta Animal/efectos de los fármacos , Modelos Animales de Enfermedad , Efectos Tardíos de la Exposición Prenatal , Ácido Valproico/farmacología , Animales , Comunicación , Femenino , Masculino , Juego e Implementos de Juego , Embarazo , Ratas , Ratas Long-Evans , Trastorno de la Conducta Social/inducido químicamenteRESUMEN
Morbid obesity increases the average risk of a patient developing a paraesophageal or hiatal hernia. Paraesophageal hernias (PEH) include several types, and their treatment is indubitably one of the most contentious topics in minimally invasive surgery. Though it is rare for PEH to manifest as a strangulated, volatilized intrathoracic stomach with infection, the increased risk of mortality is an indication for many to pursue surgical repair. Moreover, morbidly obese individuals represent a substantial rate of failure of PEH repairs. The modes of confirmation diagnostics are barium swallow or upper endoscopy. This case study focuses on a 64-year-old female who presented with several comorbidities, was appropriately evaluated for laparoscopic sleeve gastrectomy, and was previously identified to have a severe type III PEH with grade IV configuration. Additionally, the pathological finding from the extracted specimen was significant for helicobacter pylori gastritis.
RESUMEN
BACKGROUND: The majority of research examining emotional difficulties in autism spectrum disorder (ASD) prior to age 2 relies on parent report. METHODS: We examined behavioral responses (affect and gaze) during emotionally salient tasks designed to elicit mildly positive and negative emotional states in infants. At 12 and 18 months, infants at an increased likelihood for an ASD diagnosis (IL; have an older sibling with ASD; n = 60) and low likelihood (LL; no family history of ASD; n = 21) completed the Emotion-Evoking (EE) Task and parents completed the Infant Behavior Questionnaire-Revised (IBQ-R). All children received an Autism Diagnostic Observation Scale-second Edition assessment for ASD symptomatology at 24 months. RESULTS: The main findings were (1) the IL group displayed higher rates of negative affect and spent less time looking at the task objects compared to the LL group, and (2) affect and gaze scores at 12 and 18 months, but not scores on the IBQ-R, predicted ASD symptoms at 24 months. LIMITATIONS: The data were drawn from an IL sample and may not be generalizable to the general ASD population, and the children were not followed to determine a diagnosis of ASD. CONCLUSION: These results suggest that behavioral responses can provide important information that complements parent reports of emotional regulation in IL infants as early as 12 months of age.
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Trastorno del Espectro Autista , Trastorno del Espectro Autista/diagnóstico , Trastorno del Espectro Autista/psicología , Niño , Preescolar , Emociones/fisiología , Humanos , Lactante , Conducta del Lactante , Hermanos , Encuestas y CuestionariosRESUMEN
INTRODUCTION: Emotion regulation, the ability to regulate emotional responses to environmental stimuli, develops in the first years of life and plays an important role in the development of personality, social competence, and behavior. Substantial literature suggests a relationship between emotion regulation and cardiac physiology; specifically, heart rate changes in response to positive or negative emotion-eliciting stimuli. METHOD: This systematic review and meta-analysis provide an in-depth examination of research that has measured physiological responding during emotional-evoking tasks in children from birth to 4 years of age. RESULTS: The review had three main findings. First, meta-regressions resulted in an age-related decrease in baseline and task-related heart rate (HR) and increases in baseline and task-related respiratory sinus arrhythmia (RSA). Second, meta-analyses suggest task-related increases in HR and decreases in RSA and heart rate variability (HRV), regardless of emotional valence of the task. Third, associations between physiological responding and observed behavioral regulation are not consistently present in children aged 4 and younger. The review also provides a summary of the various methodology used to measure physiological reactions to emotional-evoking tasks, including number of sensors used and placement, various baseline and emotional-evoking tasks used, methods for extracting RSA, as well as percentage of loss and reasons for loss for each study. CONCLUSION: Characterizing the physiological reactivity of typically developing children is important to understanding the role emotional regulation plays in typical and atypical development.
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Regulación Emocional , Arritmia Sinusal Respiratoria , Niño , Preescolar , Emociones , Frecuencia Cardíaca , Humanos , Lactante , Habilidades SocialesRESUMEN
Social-emotional behavior in autism spectrum disorder (ASD) was examined among high-risk (HR; siblings of children diagnosed with ASD) and low-risk (LR; no family history of ASD) toddlers. Caregivers completed the Infant-Toddler Social Emotional Assessment (ITSEA) at 18 months, and blind diagnostic assessment for ASD was conducted at 36 months. Results indicated impairment in social-emotional functioning among HR toddlers subsequently diagnosed with ASD compared to other HR and LR toddlers, such that ITSEA domains (Internalizing, Dysregulation, Competence) and subdomains predicted later ASD symptoms and diagnosis. Receiver operating curves of optimal ITSEA cutoffs ranged from 0.23 to 0.44 for sensitivity, and 0.74 to 0.89 for specificity. Although classification accuracy for ASD was limited, group differences highlight the importance of considering social-emotional development when assessing ASD risk.
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Trastorno del Espectro Autista/psicología , Emociones/fisiología , Hermanos/psicología , Conducta Social , Trastorno del Espectro Autista/diagnóstico , Trastorno del Espectro Autista/epidemiología , Canadá/epidemiología , Preescolar , Femenino , Estudios de Seguimiento , Humanos , Lactante , Masculino , Tamizaje Masivo , Estudios Prospectivos , Medición de Riesgo/métodosRESUMEN
This study examined the potential of the short form of the Quantitative Checklist for Autism in Toddlers (Q-CHAT-10) to identify autism spectrum disorder (ASD) in a high-risk sibling cohort. High-risk (HR; siblings of children diagnosed with ASD) and low-risk (LR; no family history of ASD) toddlers were assessed prospectively at 18 and 24 months of age using the Q-CHAT-10 and underwent blind diagnostic assessment for ASD at 36 months of age. The results indicated that at 18 and 24 months, total score differentiated between HR toddlers subsequently diagnosed with ASD from other HR and LR toddlers. The sensitivity at both time points was acceptable; however, the specificity was below the level recommended for clinical application.
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Trastorno del Espectro Autista/diagnóstico , Lista de Verificación/normas , Tamizaje Masivo/métodos , Hermanos , Trastorno del Espectro Autista/genética , Conducta Infantil , Preescolar , Femenino , Predisposición Genética a la Enfermedad , Humanos , Lactante , Masculino , Tamizaje Masivo/normas , Encuestas y Cuestionarios/normasRESUMEN
Whereas environmental challenges during gestation have been repeatedly shown to alter offspring brain architecture and behavior, exploration examining the consequences of paternal preconception experience on offspring outcome is limited. The goal of this study was to examine the effects of preconception paternal stress (PPS) on cerebral plasticity and behavior in the offspring. Several behavioral assays were performed on offspring between postnatal days 33 (P33) and 101 (P101). Following behavioral testing, the brains were harvested and dendritic morphology (dendritic complexity, length, and spine density) were examined on cortical pyramidal cells in medial prefrontal cortex (mPFC), orbital frontal cortex (OFC), parietal cortex (Par1), and the CA1 area of the hippocampus. As anticipated, behavior was altered on both the activity box assay and elevated plus maze and performance was impaired in the Whishaw tray reaching task. Neuroanatomical measures revealed a heavier brain in stressed animals and dendritic changes in all regions measured, the precise effect varying with the measure and cerebral region. Thus, PPS impacted both behavior and neuronal morphology of offspring. These effects likely have an epigenetic basis given that in a parallel study of littermates of the current animals we found extensive epigenetic changes at P21.
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Conducta Animal , Región CA1 Hipocampal/crecimiento & desarrollo , Padre/psicología , Corteza Prefrontal/crecimiento & desarrollo , Células Piramidales/patología , Estrés Psicológico , Animales , Región CA1 Hipocampal/patología , Femenino , Masculino , Lóbulo Parietal/crecimiento & desarrollo , Lóbulo Parietal/patología , Corteza Prefrontal/patología , Ratas Long-Evans , Caracteres SexualesRESUMEN
New nephron formation (nephrogenesis) ceases in mammals around birth and is completely absent in adults. In contrast, postembryonic nephrogenesis is well documented in the mesonephric kidneys of fishes and amphibians. The transient mesonephros in reptiles (including birds) and mammals is replaced by the metanephros during embryogenesis. Thus, one may speculate that postembryonic nephrogenesis is restricted to the mesonephric kidney. Previous reports have suggested the metanephros of non-avian reptiles (hereafter reptiles) may continually form nephrons throughout life. We investigated the presence of adult nephrogenesis in reptiles by examining adult kidneys from several species including Trachemys scripta, Chrysemys picta, Boa constrictor, Tupinambis tegu, Anolis carolinensis, and Alligator mississipiensis among others. We found that all major reptilian groups (Testudines, Crocodylia, and Squamates) showed the presence of adult nephrogenesis. The total amount of nephrogenesis varied greatly between species with turtles displaying the highest density of nephrogenesis. In contrast, we were unable to detect adult nephrogenesis in monotremes, and in the iguanid A. carolinensis. Nephron progenitor cells express the transcription factor Six2, which in mammals, becomes downregulated as the progenitor cell population is exhausted and nephrogenesis ends. Using the alligator as a model, we were able to detect Six2-positive cap mesenchyme cells in the adult kidney, which spatially correlated with areas of nephrogenesis. These results suggest that the metanephric kidney of reptiles has maintained the ability to continually grow new nephrons during postembryonic life, a process lost early in mammalian evolution, likely due to the persistence of a Six2-expressing progenitor cell population.
Asunto(s)
Nefronas/crecimiento & desarrollo , Reptiles , Células Madre/citología , Transactivadores/metabolismo , AnimalesRESUMEN
BACKGROUND AND AIMS: Health professionals are frequently asked to advise on aspects of complementary feeding. This study aimed to describe the types of commercial infant foods available in the UK and provide an overview of their taste, texture and nutritional content in terms of energy, protein, carbohydrates, fat, sugar, iron, sodium and calcium. METHOD: All infant foods produced by four main UK manufacturers and two more specialist suppliers were identified during October 2010-February 2011. Nutritional information for each product was collected from manufacturers' websites, products in store and via direct email enquiry. RESULTS: Of the 479 products identified in this study 364 (79%) were ready-made spoonable foods; 44% (201) were aimed at infants from 4 months, and 65% of these were sweet foods. The mean (SD) energy content of ready-made spoonable foods was 282 (59) kJ per 100 g, almost identical to breast milk (283(16) kJ per 100 g). Similar spoonable family foods were more nutrient dense than commercial foods. Commercial finger foods were more energy dense, but had very high sugar content. CONCLUSIONS: The UK infant food market mainly supplies sweet, soft, spoonable foods targeted from age 4 months. The majority of products had energy content similar to breast milk and would not serve the intended purpose of enhancing the nutrient density and diversity of taste and texture in infants' diets.