RESUMEN
RATIONALE AND OBJECTIVES: Neurological complications associated with coronavirus disease (COVID-19) have been reported in children; however, data on neuroimaging findings remain limited. This study aimed to comprehensively examine neuroimaging patterns of COVID-19 in children and their relationship with clinical outcomes. MATERIALS AND METHODS: This retrospective cross-sectional study involved reviewing the medical records and MRI scans of 95 children who developed new neurological symptoms within 2-4 weeks of clinical and laboratory confirmation of COVID-19. Patients were categorized into four groups based on guidelines approved by the Centers for Disease Control and Prevention (CDC). Initial brain/spinal MRI was performed. Images were reviewed by three blinded radiologists, and the findings were analyzed and categorized based on the observed patterns in the brain and spinal cord. Follow-up MRI was performed and analyzed to track lesion progression. RESULTS: Encephalopathy was the most common neurological symptom (50.5%). The most common initial MRI involvement patterns were non-confluent multifocal hyperintense white matter (WM) lesions (36.8%) and ischemia (18.9%). Most patients who underwent follow-up MRI (n = 56) showed complete resolution (69.9%); however, some patients developed encephalomalacia and myelomalacia (23.2% and 7.1%, respectively). Non-confluent hyperintense WM lesions were associated with good outcomes (45.9%, P = 0.014), whereas ischemia and hemorrhage were associated with poor outcomes (44.1%, P < 0.001). CONCLUSION: This study revealed diverse neuroimaging patterns in pediatric COVID-19 patients. Non-confluent WM lesions were associated with good outcomes, whereas ischemia and hemorrhage were associated with poorer prognoses. Understanding these patterns is crucial for their early detection, accurate diagnosis, and appropriate management.
Asunto(s)
Encéfalo , COVID-19 , Imagen por Resonancia Magnética , Neuroimagen , SARS-CoV-2 , Humanos , COVID-19/diagnóstico por imagen , COVID-19/complicaciones , Estudios Retrospectivos , Imagen por Resonancia Magnética/métodos , Niño , Masculino , Femenino , Preescolar , Neuroimagen/métodos , Estudios Transversales , Lactante , Adolescente , Encéfalo/diagnóstico por imagen , Encefalopatías/diagnóstico por imagenAsunto(s)
Infecciones por Citomegalovirus , Enteritis , Hipoalbuminemia , Inmunocompetencia , Humanos , Citomegalovirus/aislamiento & purificación , Citomegalovirus/inmunología , Infecciones por Citomegalovirus/complicaciones , Infecciones por Citomegalovirus/diagnóstico , Enteritis/virología , Enteritis/diagnóstico , Enteritis/complicaciones , Hipoalbuminemia/etiología , Índice de Severidad de la EnfermedadRESUMEN
Foram estudados 24 pacientes portadores de ulcera peptica pos-gastrectomia parcial tratados exclusivamente pela vagotomia troncular, usando-se preferencialmente a via toracica como acesso. Os resultados precoces demonstraram ausencia de mortalidade pos-operatoria e morbidade muito reduzida. Os resultados tardios apresentam baixos indices de recidiva ulcerosa e nao exibiram quadros importantes de diarreia, demonstrando, portanto, ser um metodo bastante eficiente e com amplas possibilidades de emprego no tratamento das ulceras pepticas pos-gastrectomias
Asunto(s)
Adulto , Persona de Mediana Edad , Humanos , Masculino , Femenino , Vagotomía , Úlcera PépticaRESUMEN
Sao revistas 35 observacoes de anastomose bilio-digestiva em doentes portadores de afeccoes nao malignas das vias biliares. Foram realizadas 30 anastomoses hepatico-jejunais com alca excluida e 5 anastomoses hepatico-duodenais em pacientes previamente gastrectomizados com exclusao do duodeno. Os resultados imediatos e tardios foram analisados e 80% dos doentes observados a longo prazo evoluiam bem, demonstrando desaparecimento da ictericia e do quadro infeccioso