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Short report: neonatal screening pilot study of Toxoplasma gondii congenital infection in Mexico.

Congenital toxoplasmosis is an obstetric problem in Mexico, but its actual frequency is unknown. Using a network for screening of non-infectious disorders, we performed a pilot study to determine the frequency of IgM antibodies to Toxoplasma gondii in 1,003 infants (53.1% male, mean +/- SD age = 18.3 +/- 13.0 days, birth weight = 3.116 +/- 0.453 kg) in Mexico City from March to April 2003. Blood samples embedded in filter paper were assayed for IgM antibodies using a capture enzyme-linked immunosorbent assay and results were confirmed by Western blot. Two asymptomatic newborns, one of them premature, had IgM and IgG antibodies in a serum sample taken from both the infant and the mother and were clinically followed. Our data suggest a frequency of approximately two cases of congenital T. gondii infection per 1,000 newborns in Mexico City.

Adult↗

Neonatal screening for inborn errors of metabolism: update.

Newborn screening for inborn errors of metabolism is an established practice that has shown its value in preventing the morbidity, mortality, and mental retardation that ravage the child suffering from an inherited disorder of intermediary metabolism. The American Academy of Pediatrics has taken a strong stand supporting newborn screening for PKU and hypothyroidism for all newborns and has repeatedly stressed the need for such screening to be part of an integrated program that incorporates screening, diagnosis, management, and support. As we enter the 21st century, the challenges of maintaining excellence in existing programs, developing new screening tests, and assuring optimal follow-up and management must be met for all children.

Congenital Hypothyroidism↗

[Sonographic neonatal screening of the hip joint--luxury or necessity?].

Based on the ultrasound investigation of 19,666 babies (1981-1988), 6341 of them directly at the maternity ward, we picked out the group of sonographically unstable or decentered hip joints, which must be treated instantly. Almost 50% of these hips did not show any clinical signs of instability! At follow-up the subgroup of sonographically screened hip joints showed optimal results after consequent earliest treatment: 100% physiological results of CE-angle (Wiberg and Engelhardt), no femoral head necrosis. Ultrasound screening is the only tool to detect definitely all newborn hips requiring therapy. Earliest treatment is the pre-condition of anatomical healing up. Thus--a general sonographic newborn screening is indispensable.

Follow-Up Studies↗

[Neonatal screening and follow-up of congenital hip luxation using echography. Review of the literature and personal contribution on 1421 newborns].

US screening for hip dysplasia was performed on 1421 full-term newborns. The study was aimed at: 1) evaluating US feasibility in an unselected maternity ward population; 2) determining the frequency of the different types of hips, and correlating ours with literature data; 3) evaluating the efficacy of both an early prevention and treatment. All US examinations were performed within the first week of life and the 2842 hips classified according to Graf. At birth, normal hips (Ia, Ib) were 2064 (72.6%) (group I); physiologically immature hips (IIa) were 721 (25.4%) (group II); pathological hips (group III) were: 43 (1.5%) IIc, 8 (0.3%) IId, 6 (0.2%) III. Hips in group B were checked at 3 months: 502 were normal, 51 were type IIb, and 1 was type IId: the latter 52 hips were treated and normalized in the following months. Hips in group C (types IIc, IId, and III = 57 hips) were treated and checked every seventh week until normalization. Our experience confirms US value in the evaluation of hip dysplasia in the newborn. In our opinion, the use of this method should be encouraged, although US screening of all newborns remains controversial on a cost-benefit ratio. Multicentric studies will better define US sensitivity, specificity and reliability. The correlation of our results with literature data was difficult, because study populations are not always homogeneous. As for therapy, we found the plastic splint very effective and easy to use. In 2 cases, Milgram devices were used for a few months.

Female↗

Experience with neonatal screening for congenital hypothyroidism in Hungary.

The experience obtained in one of two Hungarian screening centers for congenital hypothyroidism (CH) is reported which is based on the examinations of dried blood samples tested with the aid of TSH-RIA developed in this laboratory. During the past six years (1982-88) and CH was diagnosed in 54 cases out of a total of 306,265 newborns (prevalence: 1:5470). The recall rate because of increased TSH values was 0.28-0.29% within the last two years. The triple of this had to repeat for technical reasons (imperfect samples, borderline results). Within the last year the treatment of diagnosed infants with L-thyroxine was started at the average age of 13 days. The history of three missed cases is briefly reported. Four out of 54 patients (7.4%) died in infancy. Since the pituitary sensitivity for TSH suppression by replacement doses of L-thyroxine appeared to be decreased in several cases, the control of free thyroxine levels is preferred to avoid the clinical hypo- or hyperthyroidism. The shortening of the present three days TSH RIA method, the extension of systematic examination of TSH binding antibodies and psychological studies are in progress.

Congenital Hypothyroidism↗