J. I. De Bruijne

Toxoplasmosis and pregnancy, with a long-term follow-up of the children

Abstract A prospective study was done on the incidence and effects of congenital infections with toxoplasmosis occurring during pregnancy. 3040 women were examined during pregnancy, 1821 of them were controlled at least twice, using the Sabin-Feldman dyetest. The frequency of infected children was 0.65%, total number 12. Of the 12 children only one child had clinical symptoms, she was squinting; three children had scars at the periphery of the retina, which were only found because of this study, and in one child without clinical symptoms the parasite was isolated from the placenta and the cerebrospinal fluid. The other children showed an asymptomatic form of the disease. A follow-up of the infected children for 7 years did not show serious abnormalities such as mental retardation, blindness, etc. No congenital infections were found in children with mothers who had had an old chronic infection. Statistically we did not find evidence that infections with toxoplasmosis of the mother occurring before pregnancy were the cause of abortion, habitual abortion or still-born children. One of the purposes of the study was to investigate the necessity for future routine control in all pregnant women on toxoplasmosis. We do not recommend this because of the problem in making a timely diagnosis, the unreliability of the medical treatment used until now and the expense of repeated serological control during all pregnancies.

New developments in the antiviral treatment of hepatitis C

Chronic hepatitis C virus (HCV) infection is a major cause of liver cirrhosis and hepatocellular carcinoma. HCV is endemic in most parts of the world, with an estimated 170 million people infected worldwide and 3–4 million new cases each year. HCV‐related end‐stage liver disease is now the main indication for liver transplantation in the USA and Western Europe. Unfortunately, no vaccine or immunoglobulin is available to prevent HCV infection. Currently, HCV treatment consists of the combined administration of pegylated interferon and ribavirin for a period of 24–48 weeks, resulting in complete viral eradication in 40–80% of patients, depending on genotype, viral load and patient characteristics. This therapy is often accompanied with side‐effects that affect compliance and reduce treatment outcomes.

Haemagglutination-inhibition antibodies against influenza A and influenza B in maternal and neonatal sera

Haemagglutination inhibition (HI) antibodies against the influenza viruses A/Hong Kong/8/68 (H3N2) and B/Nederland/77/66 were determined in 420 paired sera from mothers and newborns (umbilical cord sera), sampled in 1970-1. A higher concentration of antibodies against influenza A virus was found more frequently in neonatal than in maternal sera. By contrast, low titres against influenza B virus were more frequently observed in neonatal than in maternal sera. Maternal age, duration of pregnancy, and birth-weight did not affect the results of the tests. It is suggested that the titre of the newborn against an epidemic influenza virus can be predicted from that of the mother. Furthermore, the maternal titre may be an indication of the susceptibility of the newborn infant to influenza infections.

The passive electrical properties of spheroidal aggregates cultured from neonatal rat heart cells.

Membrane specific resistance and capacitance of non‐spontaneously active spheroidal aggregates, cultured from collagenase‐dissociated neonatal rat heart cells, were calculated from changes in membrane potential due to intracellularly injected rectangular hyper‐ and depolarizing current pulses during diastole. The relation between steady‐state membrane voltage displacement and injected current is linear for current pulses between +10 and ‐10 nA. No significant fall‐off of electrotonic potential is measured in an aggregate at increasing distances from the site of current injection. The aggregate membrane resistance (input resistance) was best fitted by an inverse square function of the aggregate radius. This suggests selective current flow through the outer membranes of the spheroidal aggregate. Taking this into account the membrane specific resistance was calculated to be 753 +/‐ 38 omega cm2 (S.E. of mean; n = 39). The time course of the change in membrane potential is exponential with a time constant ranging from 5 to 26 ms, depending on the aggregate radius. The aggregate membrane capacitance is calculated from the exponential transients for each aggregate and appears to be a cubic function of the radius, indicating that the membrane area of all cells in the preparation equally contributes to the input capacitance. The membrane specific capacitance is calculated to be 0.97 +/‐ 0.02 microF/cm2 (S.E. of mean; n = 100). It is concluded that myocytes in aggregates are electrically well coupled and that a resistance in series with the inner membranes, if present, is negligible compared to the membrane resistance of the internal cells. In order to explain the finding that the membrane resistance was not inversely related to the cube of the aggregate radius, it is postulated that the membrane specific resistance might be a function of aggregate radius.

Surgical treatment of pyloric stenosis in an infant with hemophilia A.

Summary The surgical treatment of a case of pyloric stenosis in an infant suffering from hemophilia A is described. All measures taken before and after operation to prevent bleeding are communicated in detail. The necessity of giving slow continuous infusion of whole blood or plasma, guided by estimation of AHF in the patients blood, for approximately ten days after operation is stressed.

Hyperbilirubinaemia in Dysmature Versus Premature Infants

In the many articles on dysmaturity which appeared in the last years, little is said about hyperbilirubinaemia. For a long time it is known that premature infants have higher serum bilirubin levels than full-term infants and that the hyperbilirubinaemia is of longer duration. The risk of kernicterus is probably correlated as well with the height of the bilirubin level as with the duration of the high bilirubin levels above 18–24 mg/100 ml, according to different authors.