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At least 1,621 records · Page 90Linked to original sources
PubMed2004

The call from the newborn screening laboratory: frustration in the afternoon.

Newborn screening programs in the United States are evolving in concert with technologic advances in analytic chemistry and medicine. Many more disorders are being identified on dried filter paper blood spots without fundamentally altering the basic principles first put forward in the 1960s. Some disorders have been added without researchers knowing if there is a true benefit to early diagnosis and treatment; some disorders currently being detected will merit little or no follow-up in the future. The general principles underlying newborn screening are discussed, as are the individual disorders screened in most programs. The expanding and evolving impact of tandem mass spectrometry on newborn screening is also explored.

Blood Chemical Analysis↗
PubMed1999

Neurocysticercosis and acquired cerebral toxoplasmosis in children.

Neurocysticercosis, prevalent wherever pigs are raised in the presence of poor sanitation, is the most common identifiable cause of new-onset epilepsy throughout the developing world. As immigration patterns have changed, children with neurocysticercosis are seen throughout the United States. Acute cysticercosis, the most common manifestation in children, reflects the host response to the dying parasite. Children typically present with seizures and have an excellent prognosis. Neuroimaging demonstrates a single ring or nodular enhancing lesion surrounded by edema. Short-term anticonvulsant therapy is indicated, but treatment with antiparasitic agents is not required. Other forms, such as active cysts (intact organism), intraventricular or subarachnoid racemous cysticercosis, and cysticercal meningoencephalitis, are less common manifestations of parasitic infection. Toxoplasmosis, caused by the parasite Toxoplasma gondii, can be acquired by ingestion of infected undercooked meat or from oocytes shed in cat feces. Acquired cerebral toxoplasmosis, due to primary or reactivated infections, rarely occurs in immunocompetent children. In children who are immunodeficient as the result of AIDS, chemotherapy, tissue transplantation, or congenital immunodeficiency, toxoplasmosis may be difficult to distinguish from cerebral lymphoma. A variety of techniques, including neuroimaging, Thallium-201 SPECT, polymerase chain reaction analysis of CSF, and special histological methods, may be used to diagnose acquired toxoplasmosis. Antiparasitic therapy, using pyrimethamine and sulfadiazine, and serial neuroimaging often enable clinicians to differentiate toxoplasmosis from other central nervous system lesions. Toxoplasmosis may respond to other antimicrobials, including macrolide antibiotics, dapsone, clinidamycin, and atovaquone. Suppressive treatment is generally required for life in immunodeficient patients. Immunodeficient children with acquired toxoplasmosis have high rates of mortality and neurological sequelae.

Anti-Inflammatory Agents↗
PubMed2000

Seroprevalence of cytomegalovirus, toxoplasma and parvovirus in pregnancy.

AIM OF STUDY: The aim of our study was to determine the seroprevalence of cytomegalovirus (CMV), toxoplasma and parvovirus infection in our local antenatal population, and to see the effects, if any, of age, race, parity and nationality on its seroprevalence. METHODOLOGY: The sera of 120 consecutive antenatal women seen in KK Women's and Children's Hospital between the period of October 1997 and March 1998 were screened for cytomegalovirus (CMV) IgG, toxoplasma IgG and parvovirus B19 IgG and IgM. An antibody titer greater than 1:32 was regarded as positive. RESULTS: A total of 87.0% of patients were tested seropositive for CMV IgG, 17.2% seropositive for toxoplasma IgG and 30.0% seropositive for parvovirus IgG. There seemed to be a trend of increasing seropositivity with age in all three groups, however only parovirus B19 reached statistical significance. The incidence of all three infections were higher among the Malays, Indians and other races compared to the Chinese. CONCLUSION: CMV is endemic in our population and hence the most common infection. Toxoplasmosis and parvovirus is relatively low in our population but this implies that a large proportion of our antenatal women are still susceptible to these infections. Prevention of congenital CMV, toxoplasmosis and parvovirus infection is mainly by educating the antenatal population.

Adult↗
PubMed1995

[Cyst-forming Coccidia: Toxoplasma, Neospora, Sarcocystis].

The most important cyst-forming coccidian parasites in human and veterinary medicine belong the genera of Toxoplasma, Neospora and Sarcocystis. Toxoplasma gondii shows its clinical relevance in congenital infections and opportunistic infections in immunodeficient patients. In veterinary medicine the parasite is predominantly the cause of important economic loss in livestock production. Neospora causes diseases resembling toxoplasmosis; neosporosis is one of the most important causes of bovine abortion in the US. Neospora caninum leads to myositis and paralysis in dogs. The potential implication of Neospora in toxoplasmosis-like diseases in humans is not yet known. Sarcocystis is usually a relatively harmless intestinal parasite in humans. Recent data from tropical areas suggest that man can also become an intermediate host for certain Sarcocystis species, which potentially represents a source of opportunistic infection and disease in areas with increasing HIV prevalence. In veterinary medicine, Sarcocystis causes muscle diseases and also abortion or myeloencephalitis with lethal outcome in certain animal species. Molecular-epidemiological investigations have resulted in a new understanding of biological and population-genetic mechanisms relevant to the disease. Recently developed molecular techniques, such as transfection in protozoan parasites, are presently used not only to elucidate molecular-pathogenetic events in the course of disease, but also to prepare potential new immuno-therapeutic tools for future vaccination against infection or disease.

Animals↗
PubMed1985

Prospective serological and clinical studies on infants born in Kuwait with an elevated IgM in cord blood.

Little is known about congenital viral and toxoplasmal infections in the developing countries. This study attempts to provide preliminary data on such infections among Arab mothers and infants in Kuwait. Babies born with an elevated IgM in cord blood were selected at birth and then studied prospectively during the first year of life for serological and clinical evidence of viral and toxoplasmal infections. There appeared to be a significant association between the elevation of total cord blood IgM and the selection of cases with cytomegalovirus infection. Demonstration of specific IgM in cord sera was attempted, whenever possible, to provide further evidence of congenital infection and to exclude early postnatal infections. In 18.5% of cases there was an association between serological evidence of infection and certain clinical abnormalities. Apart from cytomegalovirus and rubella virus, no evidence was found for congenital infection by other viruses or toxoplasma in this study.

Congenital Abnormalities↗
PubMed1995

Congenital infection.

The past year has shed much new light on congenital infection. A key development has been the application of polymerase chain reaction technology to the diagnosis of intrauterine infection. This technique appears to be the diagnostic tool of choice for toxoplasmosis and cytomegalovirus. Pharmacologic treatment appears to reduce the sequellae of toxoplasmosis when treated either in utero or postnatally. Obstetric interventions may reduce vertical transmission. Education has been shown to reduce the incidence of seroconversion for toxoplasmosis, and HIV-positive women treated with zidovudine have a dramatically reduced rate of transmission to their offspring.

Chickenpox↗