Fatal COVID-19 in a neonate after probable late intrauterine transmission

We report the case of a 35-week gestation infant girl born by emergent cesarean section for fetal distress in a woman with recent coronavirus disease 2019 (COVID-19). Tests for severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) using polymerase chain reaction (PCR) on the infant at 24 and 48 hours of life were negative. However, at 72 hours of life, the infant's respiratory status worsened, and a repeat SARS-CoV-2 PCR was positive. The infant developed leukopenia, thrombocytopenia, and progressive respiratory failure, and died on the ninth day of life. Pathologic examination of the placenta revealed findings consistent with COVID-19 placentitis, and SARS-CoV-2 RNA staining was positive, suggesting intrauterine transmission of the infection.

Short stature and its treatment in Turner and Noonan syndromes

PURPOSE OF REVIEW

We review recent developments in the approach to the treatment of short stature in patients with Turner and Noonan syndromes.

RECENT FINDINGS

Turner syndrome and Noonan syndrome are clinically defined conditions associated with short stature. The Food and Drug Administration (FDA) approved treatment with recombinant human growth hormone (hGH) for patients with Turner syndrome in 1996 and for those with Noonan syndrome in 2007. Studies have shown that early appropriate use of hGH increases adult height in individuals with Turner syndrome. The combination of hGH and low-dose estrogen may also improve growth and adult height as well as possibly provide neurocognitive and behavioral benefits. Noonan syndrome is a genetically heterogeneous condition. In patients with Noonan syndrome phenotype, investigators have identified disease-associated genes (PTPN11, SOS1, RAF1, KRAS, and others). Treatment with hGH has been documented to result in short-term increases in growth velocity as well as modest gains in adult height.

SUMMARY

Our understanding and management of short stature in children with Turner syndrome and Noonan syndrome has greatly advanced over the years. Recent developments with focus on these two common syndromes will be reviewed.

Patterns of mandibular invasion in oral squamous cell carcinoma of the mandibular region

BACKGROUND

Mandibular resections are routinely carried out for achieving a R0 resection for oral cancers. However, the need of mandibular resection to achieve this has always been questioned. The present study was carried out to define the pattern of mandibular involvement in carcinoma of the mandibular region.

PATIENTS AND METHODS

A total of 25 consecutive patients who had undergone mandibular resection and were found to have mandibular invasion were studied in a prospective open fashion. After decalcification the specimens were serially sectioned at 1 cm interval to identify invasion of mandibular bone. Type of invasion, route of spread and host cell reactions were also recorded.

RESULTS

The mandibular involvement was infiltrative in 14(56%) and erosive in 11(44%). It was cortical in 5(20%), marrow involvement was seen in 15(60%) while 5(20%) had spread through the inferior alveolar canal. Of the 25, 24(96%) lesions were located with in 1 cm of the mandible.

CONCLUSION

The possibility of mandibular involvement is higher in patients where tumours are located with in 1 cm of the mandible. Involvement of mandible through the canal of inferior alveolar nerve in the present study was relatively high (20%). Therefore it is recommended that before a decision is taken to preserve the mandible it should be thoroughly screened for possible involvement.