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1.
Angew Chem Int Ed Engl ; : e202410828, 2024 Jul 09.
Artigo em Inglês | MEDLINE | ID: mdl-38981687

RESUMO

Graphene-like molecules with multiple zigzag edges are emerging as promising gain materials for organic lasers. Their emission wavelengths can vary widely, ranging from visible to near-infrared (NIR), as molecular size increases. Specifically, rhombus-shaped molecular graphenes with two pairs of parallel zigzag edges, known as [n]rhombenes, are excellent candidates for NIR lasers due to their small energy gaps. However, synthesizing large-size rhombenes with emission beyond 800 nm in solution remains a significant challenge. In this study, we present a straightforward synthesis of an aryl-substituted [4]rhombene derivative, [4]RB-Ar, using a method that combines intramolecular radical-radical coupling with Bi(OTf)3-mediated cyclization of vinyl ethers. The structure of [4]RB-Ar was confirmed through X-ray crystallographic analysis. Bond length analysis and theoretical calculations indicate that aromatic sextets are predominantly localized along the molecule's long axis. Significantly, [4]RB-Ar demonstrates narrow amplified spontaneous emission at around 834 nm when dispersed in polystyrene thin films. Moreover, solution-processed distributed feedback lasers employing [4]RB-Ar as the active gain material display tunable narrow emissions in the range of 830 to 844 nm.

2.
J Med Virol ; 95(5): e28786, 2023 05.
Artigo em Inglês | MEDLINE | ID: mdl-37212340

RESUMO

The aim of this study was to analyze whether the coronavirus disease 2019 (COVID-19) vaccine reduces mortality in patients with moderate or severe COVID-19 disease requiring oxygen therapy. A retrospective cohort study, with data from 148 hospitals in both Spain (111 hospitals) and Argentina (37 hospitals), was conducted. We evaluated hospitalized patients for COVID-19 older than 18 years with oxygen requirements. Vaccine protection against death was assessed through a multivariable logistic regression and propensity score matching. We also performed a subgroup analysis according to vaccine type. The adjusted model was used to determine the population attributable risk. Between January 2020 and May 2022, we evaluated 21,479 COVID-19 hospitalized patients with oxygen requirements. Of these, 338 (1.5%) patients received a single dose of the COVID-19 vaccine and 379 (1.8%) were fully vaccinated. In vaccinated patients, mortality was 20.9% (95% confidence interval [CI]: 17.9-24), compared to 19.5% (95% CI: 19-20) in unvaccinated patients, resulting in a crude odds ratio (OR) of 1.07 (95% CI: 0.89-1.29; p = 0.41). However, after considering the multiple comorbidities in the vaccinated group, the adjusted OR was 0.73 (95% CI: 0.56-0.95; p = 0.02) with a population attributable risk reduction of 4.3% (95% CI: 1-5). The higher risk reduction for mortality was with messenger RNA (mRNA) BNT162b2 (Pfizer) (OR 0.37; 95% CI: 0.23-0.59; p < 0.01), ChAdOx1 nCoV-19 (AstraZeneca) (OR 0.42; 95% CI: 0.20-0.86; p = 0.02), and mRNA-1273 (Moderna) (OR 0.68; 95% CI: 0.41-1.12; p = 0.13), and lower with Gam-COVID-Vac (Sputnik) (OR 0.93; 95% CI: 0.6-1.45; p = 0.76). COVID-19 vaccines significantly reduce the probability of death in patients suffering from a moderate or severe disease (oxygen therapy).


Assuntos
COVID-19 , Vacinas , Humanos , Vacinas contra COVID-19 , Oxigênio , ChAdOx1 nCoV-19 , Vacina BNT162 , Estudos de Coortes , Estudos Retrospectivos , COVID-19/prevenção & controle , RNA Mensageiro
3.
Am J Med Genet A ; 191(6): 1646-1651, 2023 06.
Artigo em Inglês | MEDLINE | ID: mdl-36965156

RESUMO

Ryanodine receptor type 1-related disorder (RYR1-RD) is the most common subgroup of congenital myopathies with a wide phenotypic spectrum ranging from mild hypotonia to lethal fetal akinesia. Genetic testing for myopathies is imperative as the diagnosis informs counseling regarding prognosis and recurrence risk, treatment options, monitoring, and clinical management. However, diagnostic challenges exist as current options are limited to clinical suspicion prompting testing including: single gene sequencing or familial variant testing, multi-gene panels, exome, genome sequencing, and invasive testing including muscle biopsy. The timing of diagnosis is of great importance due to the association of RYR1-RD with malignant hyperthermia (MH). MH is a hypermetabolic crisis that occurs secondary to excessive calcium release in muscles, leading to systemic effects that can progress to shock and death if unrecognized. Given the association of MH with pathogenic variants in RYR1, a diagnosis of RYR1-RD necessitates an awareness of medical team to avoid potentially triggering agents. We describe a case of a unique fetal presentation with bilateral diaphragmatic eventrations who had respiratory failure, dysmorphic facial features, and profound global hypotonia in the neonatal period. The diagnosis was made at several months of age, had direct implications on her clinical care related to anticipated need to long-term ventilator support, and ultimately death secondary an arrhythmia as a result of suspected MH. Our report reinforces the importance of having high suspicion for a genetic syndrome and pursuing early, rapid exome or genome sequencing as first line testing in critically ill neonatal intensive care unit patients and further evaluating the pathogenicity of a variant of uncertain significance in the setting of a myopathic phenotype.


Assuntos
Hipertermia Maligna , Miopatia da Parte Central , Feminino , Humanos , Gravidez , Miopatia da Parte Central/diagnóstico , Miopatia da Parte Central/genética , Canal de Liberação de Cálcio do Receptor de Rianodina/genética , Hipotonia Muscular , Mapeamento Cromossômico , Apresentação no Trabalho de Parto , Hipertermia Maligna/diagnóstico , Hipertermia Maligna/genética , Mutação
4.
Molecules ; 28(19)2023 Sep 23.
Artigo em Inglês | MEDLINE | ID: mdl-37836619

RESUMO

Perylenediimide (PDI) compounds are widely used as the active units of thin-film organic lasers. Lately, PDIs bearing two sterically hindering diphenylphenoxy groups at the 1,7-bay positions have received attention because they provide a way to red-shift the emission with respect to bay-unsubstituted PDIs, while maintaining a good amplified spontaneous emission (ASE) performance at high doping rates. Here, we report the synthesis of a series of six PDI derivatives with different aryloxy groups (PDI 6 to PDI 10) or ethoxy groups (PDI 11) at the 1,7 positions of the PDI core, together with a complete characterization of their optical properties, including absorption, photoluminescence, and ASE. We aim to stablish structure-property relationships that help designing compounds with optimized ASE performance. Film experiments were accomplished at low PDI concentrations in the film, to resemble the isolated molecule behaviour, and at a range of increasing doping rates, to investigate concentration quenching effects. Compounds PDI 10 and PDI 7, bearing substituents in the 2' positions of the benzene ring (the one contiguous to the linking oxygen atom) attached to the 1,7 positions of the PDI core, have shown a better threshold performance, which is attributed to conformational (steric) effects. Films containing PDI 11 show dual ASE.

5.
Angew Chem Int Ed Engl ; 62(27): e202304197, 2023 Jul 03.
Artigo em Inglês | MEDLINE | ID: mdl-37133456

RESUMO

Large graphene-like molecules with four zigzag edges are ideal gain medium materials for organic near-infrared (NIR) lasers. However, synthesizing them becomes increasingly challenging as the molecular size increases. In this study, we introduce a new intramolecular radical-radical coupling approach and successfully synthesize two fused triangulene dimers (1 a/1 b) efficiently. X-ray crystallographic analysis of 1 a indicates that there is no intermolecular π-π stacking in the solid state. When the more soluble derivative 1 b is dispersed in polystyrene thin films, amplified spontaneous emission in the NIR region is observed. Using 1 b as the active gain material, we fabricate solution-processed distributed feedback lasers that exhibit a narrow emission linewidth at around 790 nm. The laser devices also exhibit low thresholds with high photostability. Our study provides a new synthetic strategy for extended nanographenes, which have diverse applications in electronics and photonics.

6.
Proc Natl Acad Sci U S A ; 116(24): 11640-11645, 2019 06 11.
Artigo em Inglês | MEDLINE | ID: mdl-31138693

RESUMO

Northern hemisphere evergreen forests assimilate a significant fraction of global atmospheric CO2 but monitoring large-scale changes in gross primary production (GPP) in these systems is challenging. Recent advances in remote sensing allow the detection of solar-induced chlorophyll fluorescence (SIF) emission from vegetation, which has been empirically linked to GPP at large spatial scales. This is particularly important in evergreen forests, where traditional remote-sensing techniques and terrestrial biosphere models fail to reproduce the seasonality of GPP. Here, we examined the mechanistic relationship between SIF retrieved from a canopy spectrometer system and GPP at a winter-dormant conifer forest, which has little seasonal variation in canopy structure, needle chlorophyll content, and absorbed light. Both SIF and GPP track each other in a consistent, dynamic fashion in response to environmental conditions. SIF and GPP are well correlated (R2 = 0.62-0.92) with an invariant slope over hourly to weekly timescales. Large seasonal variations in SIF yield capture changes in photoprotective pigments and photosystem II operating efficiency associated with winter acclimation, highlighting its unique ability to precisely track the seasonality of photosynthesis. Our results underscore the potential of new satellite-based SIF products (TROPOMI, OCO-2) as proxies for the timing and magnitude of GPP in evergreen forests at an unprecedented spatiotemporal resolution.


Assuntos
Fotossíntese/fisiologia , Ciclo do Carbono/fisiologia , Clorofila/fisiologia , Clima , Ecossistema , Monitoramento Ambiental/métodos , Fluorescência , Florestas , Complexo de Proteína do Fotossistema II/fisiologia , Estações do Ano , Luz Solar
7.
Pediatr Radiol ; 51(10): 1798-1808, 2021 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-34009407

RESUMO

BACKGROUND: As the safety and efficacy of fetal magnetic resonance imaging (MRI) at 3 tesla (T) continues to evolve, understanding its potential benefits and limitations is becoming increasingly important. OBJECTIVE: We aim to compare the image quality of fetal MRI between 1.5 T and 3 T in routine clinical practice. MATERIALS AND METHODS: Fetal MRIs performed at 3 T between Jan. 1, 2019, and Dec. 31, 2019, at our institution were retrospectively reviewed by four fellowship-trained subspecialty radiologists. Imaging quality by system, sequence and artifacts were compared with matched controls at 1.5 T and rated using a modified Likert scale. RESULTS: Thirty-three fetal MRIs at 3 T were reviewed, and a control group of studies for the same clinical indication and equivalent gestational age were selected for comparison. Two of the four radiologists preferred 3-T image quality of the brain with slight agreement among the four reviewers (k=0.19, P=0.01). Three of the four radiologists had no preference for 1.5 T vs. 3 T in the majority of cases in evaluating the chest and abdomen. In the overall assessment, 3 T was preferred in less than half of cases by all four radiologists (k=0.07, P=0.26). In the evaluation of standing wave, moire fringe and magnetic susceptibility artifacts, 3 T was not preferred in the majority of studies by all four radiologists. Total exam time was significantly longer in the 3-T fetal MRIs (75.0±15.1 min) compared to the 1.5-T fetal MRIs (55.5±13.3 min, P<0.001). CONCLUSION: While 3 T is a feasible alternative to 1.5 T for fetal MRI, the increased artifacts and longer exam times observed at 3 T without clear improvement in overall image quality make 1.5 T preferable for fetal MRI in routine clinical practice.


Assuntos
Artefatos , Imageamento por Ressonância Magnética , Encéfalo , Feto/diagnóstico por imagem , Humanos , Estudos Retrospectivos
8.
Pediatr Radiol ; 50(8): 1131-1138, 2020 07.
Artigo em Inglês | MEDLINE | ID: mdl-32358676

RESUMO

BACKGROUND: The current staging system of twin-twin transfusion syndrome (TTTS) is based on the ultrasound criteria and does not consider the cerebral injury. OBJECTIVE: To assess the incidence of cerebral damage on fetal MRI and correlate abnormal cerebral diffusion-weighted imaging (DWI) findings with survival outcome and the ultrasound staging of TTTS. MATERIALS AND METHODS: We conducted a retrospective review of MRI/DWI of fetal brains and the electronic medical records in monochorionic diamniotic twin gestations. Axial DWI of each fetal brain was performed on 1.5-tesla (T) clinical magnet with b values of 0 s/mm2 and 700 s/mm2. We correlated MRI/DWI abnormalities with the Quintero staging system and survival outcomes of the fetuses. RESULTS: Thirty-four pregnancies (68 fetuses) with 42 fetal cerebral abnormalities were identified by MRI/DWI alone. Of these 42 fetal cerebral abnormalities, 33 fetal brain lesions were visible only on DWI (n=25 donor, n=8 recipients; n=30 unilateral, n=3 bilateral; n=26 diffuse, n=7 focal). Quintero staging in these 34 pregnancies was as follows: 9 Stage I, 7 Stage II, 13 Stage III, 4 Stage IV, 1 Stage V. There was no significant correlation between the presence of cerebral infarction or hemorrhage using MRI/DWI and ultrasound staging (P=0.138). The overall survival rate was 63.2% (43/68). There was a significant correlation between the presence of cerebral infarction or hemorrhage on MRI/DWI and delivery status (P=0.009). CONCLUSION: Abnormal cerebral imaging findings on MRI/DWI from hypoxic-ischemic injury or hemorrhage can be seen at the beginning of the second trimester and do not correlate with the current ultrasound staging system; however, they do correlate with decreased survival. Fetal cerebral abnormalities could be incorporated into the TTTS staging system as an independent risk factor.


Assuntos
Encéfalo/anormalidades , Imagem de Difusão por Ressonância Magnética/métodos , Transfusão Feto-Fetal/diagnóstico por imagem , Ultrassonografia Pré-Natal , Feminino , Morte Fetal , Humanos , Recém-Nascido , Gravidez , Resultado da Gravidez , Gravidez de Gêmeos , Estudos Retrospectivos , Gêmeos Monozigóticos
9.
Pediatr Radiol ; 50(2): 224-233, 2020 02.
Artigo em Inglês | MEDLINE | ID: mdl-31776601

RESUMO

BACKGROUND: Fetal magnetic resonance imaging (MRI) is obtained for prenatal diagnosis and prognostication of skeletal dysplasias; however, related literature is limited. OBJECTIVE: The purpose of this study was to define the utility of fetal MRI for skeletal dysplasias and to report MRI findings associated with specific diagnoses. MATERIALS AND METHODS: This retrospective study was approved by the institutional review board; informed consent was waived. Women referred for suspected fetal skeletal dysplasia who underwent MRI between January 2003 and December 2018 were included. Definitive diagnoses were determined by genetic testing, autopsy, physical examination and/or postnatal/postmortem imaging. Fetal MRI examinations and reports were reviewed. Descriptive statistics were used to summarize imaging findings. RESULTS: Eighty-nine women were referred for fetal MRI for possible skeletal dysplasia. Forty-three (48%) were determined to have a diagnosis other than skeletal dysplasia and nine were excluded for lack of specific skeletal dysplasia diagnosis. Thirty-seven cases of skeletal dysplasia with available fetal MRI and specific diagnosis were included for analysis. Diagnoses included achondrogenesis (n=2), achondroplasia (n=5), Boomerang dysplasia (n=1), campomelic dysplasia (n=2), Jeune syndrome (n=1), Kniest dysplasia (n=1), osteogenesis imperfecta (n=15) and thanatophoric dysplasia (n=10). A specific skeletal dysplasia diagnosis was mentioned in 17/37 (46%) of MRI imaging reports and correct for 14/17 (82%). MRI findings were reported for each specific skeletal dysplasia diagnosis. CONCLUSION: Fetal MRI is a useful diagnostic tool for skeletal dyplasias and excluded the diagnosis in nearly half of referred pregnancies. In addition to providing fetal lung volumes, fetal MRI demonstrates findings of the brain in achondroplasia and thanatophoric dysplasia, of the spine in achondroplasia and achondrogenesis, of the calvarium in osteogenesis imperfecta and thanatophoric dysplasia, and of the cartilage in Kniest dysplasia.


Assuntos
Doenças do Desenvolvimento Ósseo/diagnóstico por imagem , Doenças do Desenvolvimento Ósseo/embriologia , Imageamento por Ressonância Magnética/métodos , Diagnóstico Pré-Natal/métodos , Adolescente , Adulto , Osso e Ossos/diagnóstico por imagem , Osso e Ossos/embriologia , Feminino , Humanos , Gravidez , Reprodutibilidade dos Testes , Adulto Jovem
10.
Angew Chem Int Ed Engl ; 59(21): 8113-8117, 2020 May 18.
Artigo em Inglês | MEDLINE | ID: mdl-32011764

RESUMO

The efficient synthesis and electronic properties of two large-size cove-edged nanographenes (NGs), CN1 and CN2, are presented. X-ray crystallographic analysis reveals a contorted backbone for both molecules owing to the steric repulsion at the inner cove position. Noticeably, the dominant structures of these molecules contain four (for CN1) or six (for CN2) localized C=C double bonds embedded in nine (for CN1) or twelve (for CN2) aromatic sextet rings according to Clar's formula, which is supported by bond length analysis and theoretical (NICS, ACID) calculations. Furthermore, Raman spectra exhibit a band associated with the longitudinal CC stretching mode of olefinic double bonds. Owing to the existence of the additional olefinic bonds, both compounds show a small band gap (1.84 eV for CN1 and 1.37 eV for CN2). They also display moderate fluorescence quantum yield (35 % for CN1 and 50 % for CN2) owing to the contorted geometry, which can suppress aggregation in solution.

11.
Angew Chem Int Ed Engl ; 59(35): 14927-14934, 2020 Aug 24.
Artigo em Inglês | MEDLINE | ID: mdl-32449801

RESUMO

Perylene-fused, aggregation-free polycyclic aromatic hydrocarbons with partial zigzag periphery (ZY-01, ZY-02, and ZY-03) were synthesized. X-ray crystallographic analysis reveals that there is no intermolecular π-π stacking in any of the three molecules, and as a result, they show moderate-to-high photoluminescence quantum yield in both solution and in the solid state. They also display the characteristic absorption and emission spectra of perylene dyes. ZY-01 and ZY-02 with a nearly planar π-conjugated skeleton exhibit amplified spontaneous emission (ASE) when dispersed in polystyrene thin films. Solution-processed distributed feedback lasers have been fabricated using ZY-01 and ZY-02 as active gain materials, both showing narrow emission linewidth (<0.4 nm) at wavelengths around 515 and 570 nm, respectively. In contrast, ZY-03 did not show ASE and lasing, presumably due to its highly twisted backbone, which facilitates nonradiative internal conversion and intersystem crossing.

12.
Molecules ; 24(3)2019 Feb 09.
Artigo em Inglês | MEDLINE | ID: mdl-30744125

RESUMO

The standard procedure to identify the hole- or electron-acceptor character of amorphous organic materials used in OLEDs is to look at the values of a pair of basic parameters, namely, the ionization potential (IP) and the electron affinity (EA). Recently, using published experimental data, the present authors showed that only IP matters, i.e., materials with IP > 5.7 (<5.7) showing electron (hole) acceptor character. Only three materials fail to obey this rule. This work reports ab initio calculations of IP and EA of those materials plus two materials that behave according to that rule, following a route which describes the organic material by means of a single molecule embedded in a polarizable continuum medium (PCM) characterized by a dielectric constant ε . PCM allows to approximately describe the extended character of the system. This "compound" system was treated within density functional theory (DFT) using several combinations of the functional/basis set. In the preset work ε was derived by assuming Koopmans' theorem to hold. Optimal ε values are in the range 4.4⁻5.0, close to what is expected for this material family. It was assumed that the optical gap corresponds to the excited state with a large oscillator strength among those with the lowest energies, calculated with time-dependent DFT. Calculated exciton energies were in the range 0.76⁻1.06 eV, and optical gaps varied from 3.37 up to 4.50 eV. The results are compared with experimental data.


Assuntos
Modelos Teóricos , Compostos Orgânicos/química , Algoritmos , Elétrons , Modelos Moleculares
13.
Proc Biol Sci ; 285(1872)2018 02 14.
Artigo em Inglês | MEDLINE | ID: mdl-29445017

RESUMO

Agricultural intensification is one of the main causes for the current biodiversity crisis. While reversing habitat loss on agricultural land is challenging, increasing the farmland configurational heterogeneity (higher field border density) and farmland compositional heterogeneity (higher crop diversity) has been proposed to counteract some habitat loss. Here, we tested whether increased farmland configurational and compositional heterogeneity promote wild pollinators and plant reproduction in 229 landscapes located in four major western European agricultural regions. High-field border density consistently increased wild bee abundance and seed set of radish (Raphanus sativus), probably through enhanced connectivity. In particular, we demonstrate the importance of crop-crop borders for pollinator movement as an additional experiment showed higher transfer of a pollen analogue along crop-crop borders than across fields or along semi-natural crop borders. By contrast, high crop diversity reduced bee abundance, probably due to an increase of crop types with particularly intensive management. This highlights the importance of crop identity when higher crop diversity is promoted. Our results show that small-scale agricultural systems can boost pollinators and plant reproduction. Agri-environmental policies should therefore aim to halt and reverse the current trend of increasing field sizes and to reduce the amount of crop types with particularly intensive management.


Assuntos
Agricultura/métodos , Produtos Agrícolas/fisiologia , Meio Ambiente , Polinização , Produtos Agrícolas/crescimento & desenvolvimento , França , Alemanha , Reprodução , Espanha , Reino Unido
14.
Semin Neurol ; 38(2): 163-175, 2018 04.
Artigo em Inglês | MEDLINE | ID: mdl-29791942

RESUMO

Emerging viral infections of the nervous system represent a major global public health concern in the 21st century. They are caused primarily by RNA viruses and are mostly associated with acute or subacute encephalitis. The spectrum of associated central or peripheral nervous system disorders is broad, and results either from a direct viral effect or due to the host immune responses against the infection. Emerging viral infections impose substantial neurological morbidity and mortality, particularly in low- and middle-income regions. In the past five decades, vector-borne viruses primarily transmitted by arthropods, or arboviruses, have been responsible for epidemics with a high burden of neurological disease, like the 2015-2016 Zika virus epidemic in the Americas. Viruses that have become neurovirulent for humans after geographical expansion include West Nile, Dengue, and Zika viruses. Factors such as animal migration, disruption of ecological niches, and cross-species contact have caused old viruses to reappear and cause neurological disease, as is the case of Ebola virus. In addition to these biological challenges, current preventive strategies, vaccination, and diagnostic and therapeutic approaches remain limited. We review the clinical-virological features and global impact of the most relevant emerging viral infections of the nervous system as they are projected over the 21st century.


Assuntos
Serviços Médicos de Emergência/métodos , Saúde Global , Doenças do Sistema Nervoso , Viroses/complicações , Humanos , Doenças do Sistema Nervoso/epidemiologia , Doenças do Sistema Nervoso/etiologia , Doenças do Sistema Nervoso/virologia
15.
AJR Am J Roentgenol ; 210(5): 989-997, 2018 May.
Artigo em Inglês | MEDLINE | ID: mdl-29489402

RESUMO

OBJECTIVE: Screening the cavum septi pellucidi (CSP), more commonly referred to as the "cavum septum pellucidum," is a required component of the fetal anatomic survey during second-trimester ultrasound (US). The inability to identify the normal appearance of this structure warrants further evaluation because septal insufficiency is associated with multiple brain malformations. In this article, we discuss embryology, normal anatomy, and prenatal evaluation of the CSP as well as the differential diagnosis of associated abnormalities. CONCLUSION: The CSP is an essential part of the CNS evaluation on second-trimester US; if its normal appearance cannot be confirmed by 20 weeks' gestational age, further evaluation is warranted. Fetal MRI, in either the second or third trimester, has become an important tool in further characterization of the associated abnormalities. However, when fetal MRI is not possible, postnatal MRI can also be used and will help to differentiate primary from secondary absence and will aid in providing prognostic information and therapeutic options for patients.


Assuntos
Imageamento por Ressonância Magnética/métodos , Septo Pelúcido/anormalidades , Septo Pelúcido/diagnóstico por imagem , Diagnóstico Diferencial , Feminino , Humanos , Gravidez , Segundo Trimestre da Gravidez , Terceiro Trimestre da Gravidez , Diagnóstico Pré-Natal , Prognóstico , Ultrassonografia Pré-Natal
16.
Prenat Diagn ; 38(13): 1028-1034, 2018 12.
Artigo em Inglês | MEDLINE | ID: mdl-30229955

RESUMO

BACKGROUND AND PURPOSE: To examine prenatal MRI and postnatal imaging in fetuses with congenital aqueductal stenosis (CAS) to determine the frequency of association of rhombencephalosynapsis (RES) and how it may affect neonatal intensive care unit (NICU) course. MATERIALS AND METHODS: A single center IRB-approved retrospective study of children with CAS was performed. Prenatal MRI, postnatal images, and clinical data were reviewed. Statistical analysis was performed with SAS statistical software package version 9.3. RESULTS: Aqueduct obstruction was confirmed for all 30 participants. Hydrocephalus required shunting in all but one (97%). Fifteen neonates had CAS with rhomboencephalosynapsis (RES) (50%). Although neonatal course between the two groups was comparable, 53% of CAS with RES neonates required feeding assistance versus 20% in CAS only (P = 0.128). Shunting in the CAS with RES group occurred at average of 6 days of life versus CAS group at 55 days (P = 0.196). Biometry measurements showed a statistically significant decrease in pons antero-posterior diameter in both groups (CAS only P = 0.0049 and CAS with RES P = 0.0003) when compared with norms for gestational age. CONCLUSION: CAS has a high association with RES. Feeding assistance in the NICU and earlier neurosurgical intervention may be required in patients with CAS who also have RES.


Assuntos
Cerebelo/anormalidades , Hidrocefalia/diagnóstico por imagem , Malformações do Sistema Nervoso/diagnóstico por imagem , Adulto , Métodos de Alimentação , Feminino , Humanos , Hidrocefalia/complicações , Hidrocefalia/congênito , Recém-Nascido , Unidades de Terapia Intensiva Neonatal , Terapia Intensiva Neonatal , Imageamento por Ressonância Magnética , Masculino , Malformações do Sistema Nervoso/complicações , Procedimentos Neurocirúrgicos , Ponte/diagnóstico por imagem , Gravidez , Diagnóstico Pré-Natal , Estudos Retrospectivos , Índice de Gravidade de Doença , Tomografia Computadorizada por Raios X , Adulto Jovem
17.
Prenat Diagn ; 38(11): 870-875, 2018 10.
Artigo em Inglês | MEDLINE | ID: mdl-30094854

RESUMO

OBJECTIVE: To evaluate rectal meconium signal in fetuses with open spinal dysraphism and correlate findings with postnatal exam. METHODS: This is a single-institution Institutional Review Board-approved Health Insurance Portability and Accountability Act (HIPAA) compliant retrospective analysis of fetal MRIs of open spinal dysraphism from 2004 to 2016. Fetuses with diagnostic T1-weighted images and postnatal follow-up at our institution were included. RESULTS: A total of 115 fetuses (average gestational age 23.9 ± 3.6 weeks) met inclusion criteria. Of these, 80% (92/115) had T1 hyperintense rectal meconium signal. Average height of the meconium column, measured from the base of the bladder to its most inferior extent, was 9.2 ± 4.3 mm in fetuses ≥20-week gestational age and 11.1 ± 4.4 mm in fetuses ≥23-week gestational age (n = 110) . None had bowel dilation. One of 115 fetuses had a simple form of anorectal malformation allowing complete repair in the neonatal period, but this fetus had a normal meconium column height on fetal MRI of 22 mm. The remaining 23/115 fetuses with lack of normal rectal meconium signal were born without evidence of anorectal malformation. CONCLUSION: Decreased or absent T1-hyperintense rectal meconium signal in fetuses with open spinal dysraphism does not correlate with imperforate anus postnatal and may be a reflection of neurogenic bowel in this patient population.


Assuntos
Mecônio/diagnóstico por imagem , Reto/diagnóstico por imagem , Espinha Bífida Cística/diagnóstico por imagem , Feminino , Humanos , Gravidez , Estudos Retrospectivos , Ultrassonografia Pré-Natal
18.
Prenat Diagn ; 38(9): 706-712, 2018 08.
Artigo em Inglês | MEDLINE | ID: mdl-29927492

RESUMO

PURPOSE: To evaluate the effects of progressive hydrocephalus on the developing brain in a cohort of fetuses diagnosed with congenital aqueduct stenosis by comparing prenatal magnetic resonance imaging and postnatal imaging. METHODS: This IRB approved single center retrospective review of prenatally diagnosed children with congenital aqueduct stenosis interrogated changes in the brain between prenatal and postnatal imaging and analyzed statistics using SAS software package version 9.3. RESULTS: Thirty fetuses imaged at a mean gestational age of 26 weeks had aqueduct obstruction confirmed by postnatal imaging. Progressive hydrocephalus required shunting in all but one patient (97%). Those patients with increasing hydrocephalus showed increase in ventricular rupture (60%), loss of septal leaflets (47%), and reduction in white matter and corpus callosum volume (43%). Cerebellar ectopia developed in 27% with 6% meeting the criteria for Chiari I malformation. CONCLUSION: Hydrocephalus in the fetus results in enlarging ventricular rupture, loss of the septum pellucidum leaflets, volume reduction of brain parenchyma including corpus callosum, and risk for Chiari I anomaly. Given advances in fetal surgery and imaging in the last 3 decades, there may be cause to revisit the idea of in utero cerebral spinal fluid diversion as a means to potentially ameliorate progressive loss of the developing brain.


Assuntos
Feto/cirurgia , Idade Gestacional , Hidrocefalia/diagnóstico por imagem , Hidrocefalia/cirurgia , Imageamento por Ressonância Magnética , Diagnóstico Pré-Natal/métodos , Encéfalo/diagnóstico por imagem , Encéfalo/embriologia , Ventrículos Cerebrais/diagnóstico por imagem , Derivações do Líquido Cefalorraquidiano , Estudos de Coortes , Feminino , Humanos , Gravidez , Estudos Retrospectivos , Ruptura Espontânea/epidemiologia
19.
Pediatr Radiol ; 48(7): 1032-1034, 2018 07.
Artigo em Inglês | MEDLINE | ID: mdl-29541808

RESUMO

Fetal ventriculomegaly is a common referral for prenatal MRI, with possible etiologies being hydrocephalus and hydranencephaly. The underlying cause of hydranencephaly is unknown, but many have suggested that the characteristic supratentorial injury is related to idiopathic bilateral occlusions of the internal carotid arteries from an acquired or destructive event. Fowler syndrome is a rare genetic disorder that causes fetal akinesia and a proliferative vasculopathy that can result in an apparent hydranencephaly-hydrocephaly complex. On prenatal imaging, the presence of significant parenchymal loss in the supratentorial and infratentorial brain is a clue to the diagnosis, which should prompt early genetic testing.


Assuntos
Anormalidades Múltiplas/diagnóstico por imagem , Doenças Fetais/diagnóstico por imagem , Hidranencefalia/diagnóstico por imagem , Hidrocefalia/diagnóstico por imagem , Imageamento por Ressonância Magnética/métodos , Diagnóstico Pré-Natal/métodos , Anormalidades Múltiplas/genética , Aborto Induzido , Adulto , Diagnóstico Diferencial , Feminino , Doenças Fetais/genética , Testes Genéticos , Humanos , Hidranencefalia/genética , Hidrocefalia/genética , Mutação , Gravidez , Síndrome
20.
Angew Chem Int Ed Engl ; 56(11): 2898-2902, 2017 03 06.
Artigo em Inglês | MEDLINE | ID: mdl-28140501

RESUMO

Carbon-bridged bis(aminoaryl) oligo(para-phenylenevinylene)s have been prepared and their optical, electrochemical, and structural properties analyzed. Their radical cations are class III and class II mixed-valence systems, depending on the molecular size, and they show electronic couplings which are among the largest for the self-exchange reaction of purely organic molecules. In their dication states, the antiferromagnetic coupling is progressively tuned with size from quinoidal closed-shell to open-shell biradicals. The data prove that the electronic coupling in the radical cations and the singlet-triplet gap in the dications show similar small attenuation factors, thus allowing charge/spin transfer over rather large distances.

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