Assuntos
Cólera , Gastroenteropatias/microbiologia , Adulto , Pré-Escolar , Fezes/microbiologia , Feminino , Humanos , MasculinoAssuntos
Proteínas Adaptadoras de Transdução de Sinal/genética , Doenças do Desenvolvimento Ósseo/genética , Osteosclerose/genética , Proteínas Supressoras de Tumor/genética , Tumor de Wilms/genética , Doenças do Desenvolvimento Ósseo/diagnóstico por imagem , Doenças do Desenvolvimento Ósseo/fisiopatologia , Pré-Escolar , Feminino , Mutação em Linhagem Germinativa/genética , Humanos , Mutação com Perda de Função/genética , Osteosclerose/complicações , Osteosclerose/diagnóstico por imagem , Osteosclerose/fisiopatologia , Radiografia , Crânio/fisiopatologia , Tumor de Wilms/complicações , Tumor de Wilms/diagnóstico por imagem , Tumor de Wilms/fisiopatologiaRESUMO
PURPOSE: Prematurity and low birth weight are associated with a decrease in bone mass. Aim of the study was to investigate bone geometry, strength, and quality in children born at term small for gestational age (term SGA), premature appropriate for gestational age (prem AGA), and premature SGA (prem SGA). METHODS: 91 patients (46 f, 45 m), mean age 11.28 years, height SDS 0.03 ± 0.21, and BMI SDS -0.31 ± 0.19. 20 were term SGA, 22 prem SGA, and 49 prem AGA. Bone geometry was assessed on the 2nd metacarpal bone, by evaluating the outer and inner diameter, the cortical area, medullary area, metacarpal index, cross-sectional area, and bone strength. Bone quality was evaluated by ultrasound and expressed as amplitude-dependent speed of sound and bone transmission time (BTT). RESULTS: Term SGA, prem SGA, and prem AGA had values of bone geometry, strength, and quality significantly lower than our reference range (p < 0.05). Findings in the three groups were similar, apart from BTT, which was significantly reduced in prem SGA (p < 0.05). Fat percentage was the main determinant of BTT. CONCLUSIONS: Children born either prematurely or SGA seem to have smaller and weaker bones. Those born both premature and SGA were the most affected.
Assuntos
Osso e Ossos/diagnóstico por imagem , Recém-Nascido Prematuro , Recém-Nascido Pequeno para a Idade Gestacional , Adolescente , Criança , Estudos Transversais , Feminino , Humanos , Masculino , Radiografia , UltrassonografiaRESUMO
Transplacental transmission of HSV infection is rare, typically associated with Herpes Simplex Virus 2 (HSV-2) and often reported in term infants, whereas only a few cases of preterm infants with Herpes Simplex Virus 1 (HSV-1) infection are found in the literature. We report the case of a transplacental HSV-1 infection in preterm twins born at 27 weeks gestation. At 23 weeks gestation the mother had experienced primary gingivostomatitis and "flu-like" symptoms, which healed without specific treatment. At birth both infants presented disseminated ulcerated skin lesions at the head, trunk and extremities. Soon after birth, the infants required mechanical ventilation and showed multiple organ involvement. On the basis of the mother's positive HSV-1 serology, treatment was established before the Tzanck test, serological findings and polymerase chain reaction of the skin and blood had confirmed the neonatal infection. In spite of the early diagnosis within hours after birth and immediate treatment, the extensive skin involvement associated with rapidly progressing multiorgan failure resulted in death of both infants within 3 days. Although a primary HSV-1 infection during pregnancy is extremely rare, gingivostomatitis with general symptoms can lead to transplacental infection and should therefore be taken seriously. Prompt recognition and treatment in the mother are paramount and might be life-saving for the infants.
