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Infections in pregnancy

Valentina Talarico, Monica Aloe, Alice Monzani, Roberto Miniero, Gianni Bona
Hemolytic uremic syndrome (HUS) is a thrombotic microangiopathy defined by thrombocytopenia, non-immune microangiopathic hemolytic anemia and acute renal failure. HUS is typically classified into two primary types: 1) HUS due to infections, often associated with diarrhea (D+HUS, Shiga toxin-producing Escherichia Coli-HUS), with the rare exception of HUS due to a severe disseminated infection caused by Streptococcus; 2) HUS related to complement, such HUS is also known as "atypical HUS" and is not diarrhea associated (D-HUS, aHUS); but recent studies have shown other forms of HUS, that can occur in the course of systemic diseases or physiopathological conditions such as pregnancy, after transplantation or after drug assumption...
December 2016: Minerva Pediatrica
Maria do Carmo Leal, Ana Paula Esteves-Pereira, Marcos Nakamura-Pereira, Jacqueline Alves Torres, Mariza Theme-Filha, Rosa Maria Soares Madeira Domingues, Marcos Augusto Bastos Dias, Maria Elizabeth Moreira, Silvana Granado Gama
BACKGROUND: The rate of preterm birth has been increasing worldwide, including in Brazil. This constitutes a significant public health challenge because of the higher levels of morbidity and mortality and long-term health effects associated with preterm birth. This study describes and quantifies factors affecting spontaneous and provider-initiated preterm birth in Brazil. METHODS: Data are from the 2011-2012 "Birth in Brazil" study, which used a national population-based sample of 23,940 women...
October 17, 2016: Reproductive Health
Ana Gabriela Travassos, Eveline Xavier Pereira de Souza, Eduardo Netto, Eda Vinhaes Dantas, Maiara Timbó, Isabella Nóbrega, Tatiana Haguihara, Júlia Maria de Oliveira Neumeyer, Nathalia Araújo Lisboa, Maria Angela Soidan, Fábio Ferreira, Carlos Brites
BACKGROUND: Infections caused by Chlamydia trachomatis and Neisseria gonorrhoeae are the most common bacterial sexually transmitted infections throughout the world. These sexually transmitted infections are a growing problem in people living with HIV/AIDS. However, the presence of these agents in extra genital sites, remains poorly studied in our country. The objective of this study was to estimate the prevalence of Chlamydia trachomatis and Neisseria gonorrhoeae anal and genital infection in people living with HIV/AIDS followed in a reference center in Salvador, Brazil...
October 17, 2016: Brazilian Journal of Infectious Diseases
Marta Crous-Bou, Laura B Harrington, Christopher Kabrhel
Venous thromboembolism (VTE) includes deep vein thrombosis and pulmonary embolism, and a combination of environmental and genetic risk factors contributes to VTE risk. Within environmental risk factors, some are provoking (e.g., cancer, surgery, trauma or fracture, immobilization, pregnancy and the postpartum period, long-distance travel, hospitalization, catheterization, and acute infection) and others are nonprovoking (e.g., age, sex, race/ethnicity, body mass index and obesity, oral contraceptive or hormone therapy use, corticosteroid use, statin use, diet, physical activity, sedentary time, and air pollution)...
October 20, 2016: Seminars in Thrombosis and Hemostasis
Jessica M Healy, M Catherine Burgess, Tai-Ho Chen, W Thane Hancock, Karrie-Ann E Toews, Magele Scott Anesi, Ray T Tulafono, Mary Aseta Mataia, Benjamin Sili, Jacqueline Solaita, A Christian Whelen, Rebecca Sciulli, Remedios B Gose, Vasiti Uluiviti, Morgan Hennessey, Fara Utu, Motusa Tuileama Nua, Marc Fischer
During December 2015-January 2016, the American Samoa Department of Health (ASDoH) detected through surveillance an increase in the number of cases of acute febrile rash illness. Concurrently, a case of laboratory-confirmed Zika virus infection, a mosquito-borne flavivirus infection documented to cause microcephaly and other severe brain defects in some infants born to women infected during pregnancy (1,2) was reported in a traveler returning to New Zealand from American Samoa. In the absence of local laboratory capacity to test for Zika virus, ASDoH initiated arboviral disease control measures, including public education and vector source reduction campaigns...
October 21, 2016: MMWR. Morbidity and Mortality Weekly Report
Alicia Martinez-Varea, Roberto Romero, Yi Xu, Derek Miller, Ahmed I Ahmed, Piya Chaemsaithong, Noppadol Chaiyasit, Lami Yeo, Majid Shaman, Kia Lannaman, Benjamin Cher, Sonia S Hassan, Nardhy Gomez-Lopez
OBJECTIVES: 1) To characterize the cellular composition of the amniotic fluid of patients diagnosed with clinical chorioamnionitis at term, as a function of the presence or absence of microorganisms determined by cultivation techniques, and 2) to characterize the cytokine production by white blood cells present in the amniotic fluid using flow cytometry-based techniques. MATERIALS AND METHODS: Amniotic fluid samples from 20 women who had the diagnosis of clinical chorioamnionitis at term were analyzed using cultivation techniques (for aerobic and anaerobic bacteria as well as genital Mycoplasmas)...
October 20, 2016: Journal of Perinatal Medicine
Michele Trotta, Beatrice Borchi, Lorenzo Zammarchi, Gaetana Sterrantino, Michela Brogi, Seble Tekle Kiros, Chiara Lorini, Guglielmo Bonaccorsi, Maria Grazia Colao, Alessandro Bartoloni
AIM: The aim of this study was to evaluate immunoglobulin M indirect-fluorescent antibody test (IgM IFAT) for the diagnosis of acute or chronic Toxoplasma infection in pregnancy. METHODS: Pregnant women with suspected acute toxoplasmosis referred to the Tuscany Reference Center for Infectious Diseases in Pregnancy during the period 1998-2012 were retrospectively enrolled. All women were tested with a panel of serological tests, including enzyme-linked immunosorbent assay for IgG avidity and IgM IFAT...
October 20, 2016: Journal of Obstetrics and Gynaecology Research
Aurélie Smets, Thomas Fauchier, Grégory Michel, Pierre Marty, Christelle Pomares
A maternal Toxoplasma gondii infection during pregnancy is a risk for congenital infection through maternal-fetal transplacental transmission. Estimation of the date of infection is of the utmost importance for management and treatment recommendations. In this setting, IgG avidity has been shown to be useful as high avidity rules out an infection dating less than 4 months. The estimated date of infection can also be obtained by the ratio of T. gondii IgG titers measured by the Vidas (bioMérieux) assay versus T...
2016: Parasite: Journal de la Société Française de Parasitologie
A L Wilkinson, S H Pedersen, M Urassa, D Michael, A Andreasen, J Todd, S M Kinung'hi, J Changalucha, J M McDermid
OBJECTIVES: HIV infection is associated with chronic systemic inflammation, with or without antiretroviral therapy. Consequences for fetal growth are not understood, particularly in settings where multiple maternal infections and malnutrition are common. The study was designed to examine maternal systemic circulating and umbilical cord blood cytokine concentrations in relation to birth anthropometry in a Tanzanian prospective cohort. METHODS: A 9-plex panel of maternal plasma cytokines in HIV-positive (n=44) and HIV-negative (n=70) mothers and the same cytokines in umbilical cord blood collected at delivery was assayed...
October 20, 2016: Tropical Medicine & International Health: TM & IH
B Lozano-Masdemont, L Gómez-Recuero-Muñoz, A Pulido-Pérez, I Molina-López, R Suárez-Fernández
Hepatitis B virus (HBV) infection in pregnant women is very rare in western countries, thus, cutaneous manifestation of HBV infection may be confused with a dermatosis specific of pregnancy. We report a 39-year-old woman who presented in her 20th week of pregnancy with a pruritic rash, which consisted of generalized erythematous plaques, some of them with a purple centre. Serology testing showed acute HBV infection, and a biopsy revealed a superficial and interstitial perivascular inflammatory infiltrate of lymphocytes and eosinophils...
October 20, 2016: Clinical and Experimental Dermatology
Tamsin Phillips, Annibale Cois, Robert H Remien, Claude A Mellins, James A McIntyre, Greg Petro, Elaine J Abrams, Landon Myer
BACKGROUND: Antiretroviral therapy (ART) regimens containing efavirenz (EFV) are recommended as part of universal ART for pregnant and breastfeeding women. EFV may have appreciable side effects (SE), and ART adherence in pregnancy is a major concern, but little is known about ART SE and associations with adherence in pregnancy. METHODS: We investigated the distribution of patient-reported SE (based on Division of AIDS categories) and the association of SE with missed ART doses in a cohort of 517 women starting EFV+3TC/FTC+TDF during pregnancy...
2016: PloS One
Wang Nai Dong, Li Jing Jun, Wang Ai Bing, Zhu Zhe, Chang Yan, Mao Yu, Zan Yang, Wang Zan Feng, Deng Zhi Bang
In order to investigate whether PCV2b can be transmitted across the placenta in sows thereby causing vertical infection of fetuses, six sows in 75 day of pregnancy were either intramuscularly inoculated with a PCV2b culture supernatant (n = 4) or mock infected with cell culture supernatant (n = 2). At parturition, 3 newborn piglets from each litter were randomly selected and euthanatized prior to suckling. Samples of the mesenteric lymph nodes, spleens, kidneys, hearts and lungs were collected for PCR, histopathological and immunohistochemical assays...
September 1, 2016: Polish Journal of Veterinary Sciences
G Chistyakova, I Gazieva, I Remizova, L Ustyantseva, V Lyapunov, S Bychkova
We conducted a study of markers of endothelial dysfunction and angiogenesis regulation, as well as the identification of the main lymphocyte populations, activated CD3 (+) CD95(+)-cells and cytokine-producing CD4 (+) IFN-γ(+)-, CD4 (+) IL-4(+ )-lymphocytes in the 1st trimester of gestation in women with ART-induced pregnancy and spontaneous pregnancy. We used the same indicators to assess the immune status of ELBW infants at birth and at the post-conceptual age of 38-40 weeks. It was determined that the risk factors of very early preterm delivery are: threatened miscarriage, chronic placental insufficiency, endothelial dysfunction, increased spontaneous production of intracellular cytokines...
October 2016: Gynecological Endocrinology
A M Kurmanova, G M Kurmanova, V N Lokshin
The viral hepatitis abnormalities in the female reproductive system are due to hepatic and extrahepatic damage. On the background of HBV- and HCV-infections, menstrual disorders prevail in the structure of reproductive system pathology; disorders of reproductive function in the form of pregnancy loss and infertility are detected in each second case. Depression of T-cell immunity in the immune status is observed in the patients with intact reproductive function. When miscarriage was in past medical history then divergent changes subpopulations of lymphocytes are found...
October 2016: Gynecological Endocrinology
V Muller, M Makhmadalieva, I Kogan, I Fedorova, E Lesik, E Komarova, L Dzhemlikhanova, D Niauri, A Gzgzyan, E Ailamazyan
BACKGROUND: Ectopic pregnancy (EP) has been reported to occur in 1.4-5.4% of all clinical pregnancies resulting from in vitro fertilization (IVF) and embryo transfer (ET). Data on factors associated with abnormal embryo implantation following assisted conception are limited. MATERIALS AND METHODS: A systematic review and meta-analysis was performed to determine whether there is an association between the day (cleavage-stage, D3, versus blastocyst, D5) or the type (fresh versus frozen/thawed) of ET and EP rate...
October 2016: Gynecological Endocrinology
V R Badhwar, S Ganapathy, P P Prabhudesai, N K Tulara, A Y Varaiya, D Vyas
In community and family practice, infections are a common OPD presentation. In the management of common bacterial infections seen in community especially RTI, UTI, SSTI; cefuroxime a second generation cephalosporin with a broad spectrum of activity can be used for empirical treatment. To know current place of cefuroxime in the management of infections, physicians, surgeons, microbiologist, chest physician, gynecologist and pediatrician came together to discuss and debate their experience with cefuroxime and its place in today's world...
July 2016: Journal of the Association of Physicians of India
N M Scott, J F Lauzon-Joset, A C Jones, K T Mincham, N M Troy, J Leffler, M Serralha, S L Prescott, S A Robertson, C Pasquali, A Bosco, P G Holt, D H Strickland
Infection-associated inflammatory stress during pregnancy is the most common cause of fetal growth restriction and/or miscarriage. Treatment strategies for protection of at-risk mothers are limited to a narrow range of vaccines, which do not cover the bulk of the common pathogens most frequently encountered. Using mouse models, we demonstrate that oral treatment during pregnancy with a microbial-derived immunomodulator (OM85), currently used clinically for attenuation of infection-associated airway inflammatory symptoms in infants-adults, markedly reduces risk for fetal loss/growth restriction resulting from maternal challenge with bacterial lipopolysaccharide or influenza...
October 19, 2016: Mucosal Immunology
Hicham El Costa, Jordi Gouilly, Jean-Michel Mansuy, Qian Chen, Claude Levy, Géraldine Cartron, Francisco Veas, Reem Al-Daccak, Jacques Izopet, Nabila Jabrane-Ferrat
The outbreak of the Zika Virus (ZIKV) and its association with fetal abnormalities have raised worldwide concern. However, the cellular tropism and the mechanisms of ZIKV transmission to the fetus during early pregnancy are still largely unknown. Therefore, we ex vivo modeled the ZIKV transmission at the maternal-fetal interface using organ culture from first trimester pregnancy samples. Here, we provide evidence that ZIKV strain circulating in Brazil infects and damages tissue architecture of the maternal decidua basalis, the fetal placenta and umbilical cord...
October 19, 2016: Scientific Reports
Martin Kuete, HongFang Yuan, Aude Laure Tchoua Kemayou, Emmanuel Ancel Songo, Fan Yang, XiuLan Ma, ChengLiang Xiong, HuiPing Zhang
BACKGROUND: Integration of family planning services (FPS) into human immunodeficiency virus (HIV) care for HIV-infected women is an important aspect of the global prevention of mother-to-child transmission (PMTCT) strategy. We assessed the integration of FPS into routine care of HIV-infected mothers by evaluating the uptake and barriers of contraception and PMTCT services. METHODS: We conducted an interventional study using the interrupted time series approach in the health care facilities located in Yaounde, Cameroon...
2016: Patient Preference and Adherence
Edna O Kara, Helen Campbell, Sonia Ribeiro, Norman K Fry, David Litt, Seyi Eletu, Gayatri Amirthalingam
BACKGROUND: Highest rates of pertussis occur in infants <3 months old, too young to be fully vaccinated. The 2012 national outbreak provided a valuable opportunity to study sources of infection for these infants at highest risk of severe complications and death. METHODS: Households of infants <3 months old with laboratory-confirmed pertussis between 08/2012 and 10/2013 were invited to complete a questionnaire with information on household members' demographics, relationship with the infant, chronology of cough onset where relevant, and vaccination history...
October 17, 2016: Pediatric Infectious Disease Journal
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