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Paumgartten FJR, De Grava Kempinas W, Shiota K. Viral infections, vaccines and antiviral drugs in pregnancy and the development of the conceptus. Reprod Toxicol 2023; 115:36-39. [PMID: 36403853 DOI: 10.1016/j.reprotox.2022.11.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Affiliation(s)
| | - Wilma De Grava Kempinas
- Laboratory of Reproductive and Developmental Biology and Toxicology, Department of structural and Functional Biology, Institute of Biosciences, Sao Paulo State University (UNESP), Botucatu, SP, Brazil
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Foley PB, Gee CE, Talley Ac NJ. The MJA in 2019: a long tradition and increasingly high and broad impact. Med J Aust 2019; 211:101-102. [PMID: 31304597 DOI: 10.5694/mja2.50273] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
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ENGLER M. A Comparative Study of the Causation of Mongolism, Peristatic Amentia, and Other Types of Mental Defect. ACTA ACUST UNITED AC 2018; 98:316-25. [PMID: 14917993 DOI: 10.1192/bjp.98.411.316] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Abstract
Mental deficiency has been defined by Tredgold as a state of arrested or incomplete development of the mind. Numerous scientists have for long endeavoured to ascertain the cause or causes of this frequent abnormality. The protagonists of one school of thought made exaggerated claims that the great majority, if not all cases, were due to hereditary factors. Other investigators were able to demonstrate that certain special types of mental defectives owed their deficiency to agents acting after fertilization, and so came to the conclusion that genetic elements were only concomitant and not primary causative factors in many, if not in all types of defectives, and that research on these lines should eventually establish extrinsic causation in all these cases.Thus one has gradually come to distinguish between two main groups of mentally abnormal individuals; those in whom endogenous or hereditary factors could be proved or at least suspected. (Tredgold speaks of primary aments, Strauss of endogenous types, and those in whom exogenous noxious influences could be demonstrated or suspected, and whom Tredgold termed secondary aments, Strauss calls exogenous types.) According to Tredgold and many other investigators, from between 70 to 80 per cent. of all defectives are to be found in the first group, while roughly 20 to 30 per cent. belong to the second. Penrose's figures in support of a hereditary causation are even higher.
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Boland MR, Polubriaginof F, Tatonetti NP. Development of A Machine Learning Algorithm to Classify Drugs Of Unknown Fetal Effect. Sci Rep 2017; 7:12839. [PMID: 28993650 PMCID: PMC5634437 DOI: 10.1038/s41598-017-12943-x] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/05/2017] [Accepted: 09/08/2017] [Indexed: 12/11/2022] Open
Abstract
Many drugs commonly prescribed during pregnancy lack a fetal safety recommendation - called FDA 'category C' drugs. This study aims to classify these drugs into harmful and safe categories using knowledge gained from chemoinformatics (i.e., pharmacological similarity with drugs of known fetal effect) and empirical data (i.e., derived from Electronic Health Records). Our fetal loss cohort contains 14,922 affected and 33,043 unaffected pregnancies and our congenital anomalies cohort contains 5,658 affected and 31,240 unaffected infants. We trained a random forest to classify drugs of unknown pregnancy class into harmful or safe categories, focusing on two distinct outcomes: fetal loss and congenital anomalies. Our models achieved an out-of-bag accuracy of 91% for fetal loss and 87% for congenital anomalies outperforming null models. Fifty-seven 'category C' medications were classified as harmful for fetal loss and eleven for congenital anomalies. This includes medications with documented harmful effects, including naproxen, ibuprofen and rubella live vaccine. We also identified several novel drugs, e.g., haloperidol, that increased the risk of fetal loss. Our approach provides important information on the harmfulness of 'category C' drugs. This is needed, as no FDA recommendation exists for these drugs' fetal safety.
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Affiliation(s)
- Mary Regina Boland
- Department of Biostatistics, Epidemiology and Informatics, University of Pennsylvania, Philadelphia, USA.
- Institute for Biomedical Informatics, University of Pennsylvania, Philadelphia, USA.
- Center of Excellence in Environmental Toxicology, University of Pennsylvania, Philadelphia, USA.
- Department of Biomedical and Health Informatics, Children's Hospital of Philadelphia, Philadelphia, USA.
- Department of Biomedical Informatics, Columbia University, New York, USA.
- Department of Medicine, Columbia University, New York, USA.
- Department of Systems Biology, Columbia University, New York, USA.
- Observational Health Data Sciences and Informatics, Columbia University, New York, USA.
| | - Fernanda Polubriaginof
- Department of Biomedical Informatics, Columbia University, New York, USA
- Department of Medicine, Columbia University, New York, USA
- Department of Systems Biology, Columbia University, New York, USA
| | - Nicholas P Tatonetti
- Department of Biomedical Informatics, Columbia University, New York, USA.
- Department of Medicine, Columbia University, New York, USA.
- Department of Systems Biology, Columbia University, New York, USA.
- Observational Health Data Sciences and Informatics, Columbia University, New York, USA.
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Affiliation(s)
- J A Dudgeon
- The Hospitalfor Sick Children, Great Ormond Street, London
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Affiliation(s)
- J A Dudgeon
- The Hospital for Sick Children, Great Ormond Street, and Institute of Child Health, London
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Thompson KM, Simons EA, Badizadegan K, Reef SE, Cooper LZ. Characterization of the Risks of Adverse Outcomes Following Rubella Infection in Pregnancy. RISK ANALYSIS : AN OFFICIAL PUBLICATION OF THE SOCIETY FOR RISK ANALYSIS 2016; 36:1315-1331. [PMID: 25100307 DOI: 10.1111/risa.12264] [Citation(s) in RCA: 73] [Impact Index Per Article: 9.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/03/2023]
Abstract
Although most infections with the rubella virus result in relatively minor sequelae, rubella infection in early pregnancy may lead to severe adverse outcomes for the fetus. First recognized in 1941, congenital rubella syndrome (CRS) can manifest with a diverse range of symptoms, including congenital cataracts, glaucoma, and cardiac defects, as well as hearing and intellectual disability. The gestational age of the fetus at the time of the maternal rubella infection impacts the probability and severity of outcomes, with infection in early pregnancy increasing the risks of spontaneous termination (miscarriage), fetal death (stillbirth), birth defects, and reduced survival for live-born infants. Rubella vaccination continues to change the epidemiology of rubella and CRS globally, but no models currently exist to evaluate the economic benefits of rubella management. This systematic review provides an overall assessment of the weight of the evidence for the outcomes associated with rubella infections in the first 20 weeks of pregnancy. We identified, evaluated, and graded 31 studies (all from developed countries) that reported on the pregnancy outcomes of at least 30 maternal rubella infections. We used the available evidence to estimate the increased risks of spontaneous termination, fetal death, infant death, and CRS as a function of the timing of rubella infection in pregnancy and decisions about induced termination. These data support the characterization of the disability-adjusted life years for outcomes associated with rubella infection in pregnancy. We find significant impacts associated with maternal rubella infections in early pregnancy, which economic analyses will miss if they only focus on live births of CRS cases. Our estimates of fetal loss from increased induced terminations due to maternal rubella infections provide context that may help to explain the relatively low numbers of observed CRS cases per year despite potentially large burdens of disease. Our comprehensive review of the weight of the evidence of all pregnancy outcomes demonstrates the importance of including all outcomes in models that characterize rubella-related disease burdens and costs.
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Affiliation(s)
- Kimberly M Thompson
- Kid Risk, Inc, 10524 Moss Park Road, Ste. 204-364, Orlando, FL 32832, USA
- University of Central Florida, College of Medicine, Orlando, FL, USA
| | - Emily A Simons
- Kid Risk, Inc, 10524 Moss Park Road, Ste. 204-364, Orlando, FL 32832, USA
- Harvard Medical School, Boston, MA, USA
| | - Kamran Badizadegan
- University of Central Florida, College of Medicine, Orlando, FL, USA
- Nemours Children's Hospital, Orlando, FL, USA
| | - Susan E Reef
- Centers for Disease Control and Prevention, Atlanta, GA, USA
| | - Louis Z Cooper
- Columbia University School of Medicine, New York City, NY, USA
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Simons EA, Reef SE, Cooper LZ, Zimmerman L, Thompson KM. Systematic Review of the Manifestations of Congenital Rubella Syndrome in Infants and Characterization of Disability-Adjusted Life Years (DALYs). RISK ANALYSIS : AN OFFICIAL PUBLICATION OF THE SOCIETY FOR RISK ANALYSIS 2016; 36:1332-1356. [PMID: 25115193 DOI: 10.1111/risa.12263] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/03/2023]
Abstract
Congenital rubella syndrome (CRS) continues to cause disability among unvaccinated populations in countries with no or insufficient rubella vaccine coverage to prevent transmission. We systematically reviewed the literature on birth outcomes associated with CRS to estimate the duration, severity, and frequency of combinations of morbidities. We searched PubMed, the Science Citation Index, and references from relevant articles for studies in English with primary data on the frequency of CRS manifestations for ≥20 cases and identified 65 studies representing 66 study populations that met our inclusion criteria. We abstracted available data on CRS cases with one or more hearing, heart, and/or eye defect following maternal rubella infection during the period of 0-20 weeks since the last menstrual period. We assessed the quality and weight of the available evidence using a modified Grading of Recommendations Assessment, Development and Evaluation (GRADE) approach. Most of the evidence originates from studies in developed countries of cohorts of infants identified with CRS in the 1960s and 1970s, prior to the development of standardized definitions for CRS and widespread use of vaccine. We developed estimates of undiscounted disability-adjusted life years (DALYs) lost per CRS case for countries of different income levels. The estimates ranged from approximately 19 to 39 for high-income countries assuming optimal treatment and from approximately 29 to 39 DALYs lost per CRS case in low- and lower- middle-income countries assuming minimal treatment, with the lower bound based on 2010 general global burden of disease disability weights and the upper bound based on 1990 age-specific and treatment-specific global burden of disease disability weights. Policymakers and analysts should appreciate the significant burden of disability caused by CRS as they evaluate opportunities to manage rubella.
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Affiliation(s)
- Emily A Simons
- Kid Risk, Inc, Orlando, FL, USA
- Harvard Medical School, Boston, MA, USA
| | - Susan E Reef
- Global Immunization Division, Centers for Disease Control and Prevention, Atlanta, GA, USA
| | - Louis Z Cooper
- Professor Emeritus of Pediatrics, Columbia University, New York, NY, USA
| | - Laura Zimmerman
- Global Immunization Division, Centers for Disease Control and Prevention, Atlanta, GA, USA
| | - Kimberly M Thompson
- Kid Risk, Inc, Orlando, FL, USA
- University of Central Florida, College of Medicine, Orlando, FL, USA
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Cavalheiro S, Lopez A, Serra S, Da Cunha A, da Costa MDS, Moron A, Lederman HM. Microcephaly and Zika virus: neonatal neuroradiological aspects. Childs Nerv Syst 2016; 32:1057-60. [PMID: 27080092 PMCID: PMC4882355 DOI: 10.1007/s00381-016-3074-6] [Citation(s) in RCA: 67] [Impact Index Per Article: 8.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/21/2016] [Accepted: 03/27/2016] [Indexed: 11/29/2022]
Abstract
PURPOSE The aim of this study is to describe some radiological features in the newborns with microcephaly caused by Zika virus infection during pregnancy. METHODS We radiologically analyzed 13 cases of newborns with microcephaly born to mothers who were infected by the Zika virus in the early stage of pregnancy. RESULTS The most frequently observed radiological findings were microcephaly and decreased brain parenchymal volume associated with lissencephaly, ventriculomegaly secondary to the lack of brain tissue (not hypertensive), and coarse and anarchic calcifications mainly involving the subcortical cortical transition, and the basal ganglia. CONCLUSIONS Although it cannot be concluded that there is a definitive pathognomonic radiographic pattern of microcephaly caused by Zika virus, gross calcifications and anarchic distribution involving the subcortical cortical transition and the basal ganglia, in association with lissencephaly and in the absence of hypertensive ventriculomegaly, are characteristic of this type of infection.
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Affiliation(s)
- Sergio Cavalheiro
- Department of Neurosurgery, Federal University of Sao Paulo, Rua Botucatu, 591, conj 41, Sao Paulo, SP, 04023-062, Brazil.
| | - Amanda Lopez
- Neurosurgery Service of Hospital da Restauração, Recife, Pernambuco, Brazil
| | - Suzana Serra
- Neurosurgery Service of Hospital da Restauração, Recife, Pernambuco, Brazil
| | - Arthur Da Cunha
- Neurosurgery Service of Hospital da Restauração, Recife, Pernambuco, Brazil
| | - Marcos Devanir S da Costa
- Department of Neurosurgery, Federal University of Sao Paulo, Rua Botucatu, 591, conj 41, Sao Paulo, SP, 04023-062, Brazil
| | - Antonio Moron
- Department of Obstetrics, Federal University of Sao Paulo, Sao Paulo, SP, Brazil
| | - Henrique M Lederman
- Department of Diagnostic Imaging, Federal University of Sao Paulo, Sao Paulo, SP, Brazil
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References. Acta Otolaryngol 2009. [DOI: 10.3109/00016487209121126] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register]
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Rapin I, Graziani L, Lyttle M. Summated Auditory Evoked Responses for Audiometry: Experience in 51 children with congenital rubella. ACTA ACUST UNITED AC 2009. [DOI: 10.3109/05384916909079080] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
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Bardram M, Braendsdrup P. MATERNAL RUBELLA DURING PREGNANCY AS CAUSE OF CONGENITAL CATARACT AND OTHER CONGENITAL MALFORMATIONS. Acta Ophthalmol 2009. [DOI: 10.1111/j.1755-3768.1947.tb07573.x] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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Oliveira CA, Sampaio AL, Bahmad FM, Araújo MFS. Viral etiology for inner ear diseases: proven, unproven, unlikely. ORL J Otorhinolaryngol Relat Spec 2008; 70:42-50; discussion 50-1. [PMID: 18235205 DOI: 10.1159/000111047] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
Abstract
This is a revision article that deals with the broad field of inner ear disease caused by viral infections. Some of these entities have been proven to have a viral etiology. Others have strong evidence in favor of a viral causation but still cannot be considered as a viral disease. Finally, other entities are suggestive of a viral etiology but when the whole body of evidence is considered one concludes that a viral etiology is indeed unlikely. We review the literature and add our own experience in this subject. Clearly, the most important evidence about this subject came from the study of temporal bone histopathology. Certainly, we can learn much more if we continue to collect and study temporal bone specimens histopathologically.
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Affiliation(s)
- Carlos A Oliveira
- Department of Otolaryngology, Brasília University Medical School, Brasília, Brazil.
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Abstract
On the 65th anniversary of Gregg's observation "Congenital cataract following German measles in the mother", rubella has retired as the leading cause of congenital cataract, from 87% of Gregg's cohort to less than 3% over the last 25 years and almost zero now in Australia and other developed countries. However, people must keep vigilance in maintaining immunization rates and encourage immunization in developing countries. At least one-fifth of congenital cataract is familial. Understanding the genetics of familial cataract will lead to better treatment of congenital as well as age-related cataract.
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Affiliation(s)
- David A Mackey
- Eye Clinic, Royal Hobart Hospital, University of Tasmania, Hobart, Tasmania, Australia.
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Forrest JM, Turnbull FM, Sholler GF, Hawker RE, Martin FJ, Doran TT, Burgess MA. Gregg's congenital rubella patients 60 years later. Med J Aust 2002; 177:664-7. [PMID: 12463994 DOI: 10.5694/j.1326-5377.2002.tb05003.x] [Citation(s) in RCA: 34] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/26/2002] [Accepted: 11/06/2002] [Indexed: 11/17/2022]
Abstract
BACKGROUND In 1941, a Sydney ophthalmologist, Norman McAlister Gregg, correctly identified the link between congenital cataracts in infants and maternal rubella early in pregnancy. Fifty of Gregg's subjects with congenital rubella, born in 1939-1944, were reviewed in 1967 and again in 1991. We reviewed this cohort in 2000-2001, 60 years after their intrauterine infection. METHODS The subjects underwent full clinical assessment, plus pathology tests, an ophthalmological and cardiological review (including electrocardiography and echocardiography) and HLA histocompatibility testing. RESULTS Since they were first seen in 1967, 10 have died (cardiovascular causes [4], malignant disease [4], AIDS [1], and hepatitis C-related cirrhosis [1]). All surviving men came for review (19) and 13 women (eight women declined). Echocardiography showed mild aortic valve sclerosis in 68%. The prevalence of diabetes (22%), thyroid disorders (19%), early menopause (73%) and osteoporosis (12.5%) was increased compared with the Australian population; 41% had undetectable levels of rubella antibodies. The frequency of HLA-A1 (44%) and HLA-B8 (34%) antigens was increased, and the haplotype HLA-A1, B8, DR3, said to be highly associated with many autoimmune conditions, was present in 25%. CONCLUSIONS This cohort of people with congenital rubella has illuminated our understanding of viral teratogenesis.
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Affiliation(s)
- Jill M Forrest
- Royal Alexandra Hospital for Children, Locked Bag 4001, Westmead, NSW.
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SHAPIRO RN, EDDY W, FITZGIBBON J, O'BRIEN G. The incidence of congenital anomalies discovered in the neonatal period. Am J Surg 2000; 96:396-400. [PMID: 13571516 DOI: 10.1016/0002-9610(58)90932-2] [Citation(s) in RCA: 23] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
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Abstract
It is apparent that there are many unanswered questions about the pathogenesis of CRS. For instance, the chance of embryonic infection decreases in the second semester only to increase again in the third trimester. This is presumably due to unspecified changes in the placenta. When the embryo is infected early in the first trimester it does not appear to have any conventional immunological response to prevent spread of the virus. Yet it has been suggested that only 1 in 10(3) to 10(5) of its cells become infected. If this is true, what controls the spread of the virus in the early embryo? Why does the virus not affect major morphogenetic processes? There is considerable evidence that the virus spreads through the vascular system of the infected fetus and the observed cardiovascular, CNS, and hearing defects may be primarily due to focal cytopathic damage to the walls of blood vessels and lining of the heart; subsequent organ infection and/or ischemia may lead to further damage. Damage to blood vessels is probably extensive throughout the fetus and may be the cause of the generalized growth retardation. The effects in the eye appear to be due to a direct cytopathic effect, particularly on the lens. The short susceptible period for cataract formation is consistent with the protective effect of the lens capsule. Deafness, cardiovascular and neurological damage, and retinopathy all occur when infection takes place in the first 16 weeks of gestation and are rare after this time, despite the absence of any obvious morphological or functional changes in the susceptible structures. This termination of susceptibility in the second trimester is consistent with development of the fetal immune response and increased transfer of maternal IgG. The effect on blood vessels in particular may be limited by antibody production, although existing endothelial infection and damage may be progressive. The fetus seems unable to rid itself of established intracellular virus. The causes of the well-established late manifestations remain unknown. If these serious late-appearing effects are due to prenatal damage, then it is possible that other human teratogens may also cause unexpected late symptoms. This should also be a concern in the area of animal reproductive toxicology testing.
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Affiliation(s)
- W S Webster
- Department of Anatomy and Histology, University of Sydney, Australia
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Stanley FJ. Prenatal determinants of motor disorders. ACTA PAEDIATRICA (OSLO, NORWAY : 1992). SUPPLEMENT 1997; 422:92-102. [PMID: 9298803 DOI: 10.1111/j.1651-2227.1997.tb18355.x] [Citation(s) in RCA: 16] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/05/2023]
Abstract
Cerebral palsies (CP) are the commonest childhood motor disorders, originating in early childhood as a result of interference in the developing brain. Identifying prenatal factors in CP is a challenge because there is a considerable period of time (years) between the causal event(s) and diagnosis. Four fascinating "natural" situations provided a unique opportunity to identify and measure prenatal exposures in relation to motor disorders, thus establishing the unequivocal role of some factors. However, the majority of studies determining adverse reproductive effects of environmental factors require a retrospective case-control approach, which present considerable problems. Studies based on the Western Australian CP register suggest that prenatal factors singly or in complex sequences are more common as causes than those occurring perinatally or postnatally. In future, better diagnosis of motor disorders, use of sophisticated scientific techniques to identify markers of neuronal development and the accurate linkage of these findings to clinical patterns of motor dysfunction are required.
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Affiliation(s)
- F J Stanley
- TVW Telethon Institute for Child Health Research, Perth, Western Australia
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Abstract
OBJECTIVE To review the incidence of congenital rubella syndrome (CRS) and the acceptance of schoolgirl rubella vaccination in Western Australia (WA), and to determine whether any groups in the community are at increased risk of having a child affected by CRS. DESIGN Review of records of the WA Birth Defects Registry for cases of CRS; survey of obstetricians for terminations of pregnancy for maternal rubella infection; survey of schoolgirls eligible for the 1991 annual rubella vaccination campaign; review of Perth Immunisation Clinic and rural community and child health records; review of the rubella immune status of women tested antenatally. MAIN OUTCOME MEASURES The incidence rate of CRS per 10,000 live births in WA 1980-1990; the incidence of rubella-associated terminations of pregnancy during 1990 and 1991; trends in rubella vaccine acceptance among WA schoolgirls between 1971 and 1991; and the proportion of women attending antenatal clinics who showed satisfactory immunity against rubella, stratified by country of birth. RESULTS The incidence rate of CRS in WA remains below 2 cases per 10,000 live births. Approximately 86% of Perth schoolgirls have been vaccinated against rubella. Rubella vaccine acceptance fell in some country areas during the late 1980s, but is now returning to acceptable levels. Women born in Asia are at greater risk of having a baby affected by CRS than women born in Australia. Babies with CRS may be born to women who have previously been vaccinated against rubella. CONCLUSIONS The incidence of CRS has fallen dramatically since the introduction of the schoolgirl vaccination program, but there is still a need for mechanisms to identify and vaccinate non-immune women.
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Affiliation(s)
- R J Condon
- Health Department of Western Australia, East Perth
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Yoser SL, Forster DJ, Rao NA. Systemic viral infections and their retinal and choroidal manifestations. Surv Ophthalmol 1993; 37:313-52. [PMID: 8387231 DOI: 10.1016/0039-6257(93)90064-e] [Citation(s) in RCA: 79] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/30/2023]
Abstract
Viruses are one of the most common causes of infections involving the posterior segment of the eye. Such infections can occur either on a congenital or an acquired basis, and may affect primarily the retina or the choroid. Congenital cytomegalovirus (CMV) and rubella infections may result in retinitis. CMV retinitis is also the most common cause of acquired viral retinitis, primarily because of the acquired immunodeficiency syndrome (AIDS). Other types of viral retinitis, such as those caused by herpes simplex or herpes zoster, can occur in immunocompromised or immunocompetent individuals. Retinitis or choroiditis caused by viruses such as measles, influenza, Epstein-Barr virus, and Rift Valley fever virus, typically occurs subsequent to an acute viral systemic illness. The systemic and ocular manifestations, as well as the histopathology, laboratory tests, differential diagnoses, and treatment regimens for each of the individual viruses are discussed in detail.
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Affiliation(s)
- S L Yoser
- Doheny Eye Institute, University of Southern California School of Medicine, Los Angeles
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Lee IS, Kim CH, Lee SJ, Cho TH. Measurement of serum rubella antibody titers in Korean children, female adolescents, and pregnant women. ASIA-OCEANIA JOURNAL OF OBSTETRICS AND GYNAECOLOGY 1992; 18:345-53. [PMID: 1492808 DOI: 10.1111/j.1447-0756.1992.tb00330.x] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/27/2022]
Abstract
IgG antibody titers to rubella virus in serum of 322 nuchal cord blood, 1,473 children, and 1,103 reproductive and pregnant women were detected in Soonchunhyang University Hospital in Korea. Positive rate of IgG antibody to rubella virus was 86.3% (278/322) in nuchal cord blood, 68.0% (991/1,458) in children. The IgG antibody from the mother disappeared between the 7th to 11th month after birth, and then the positive rate increased as age increased. In the reproductive age group including pregnant women, positive rate of IgG antibody was 81.8% (894/1,103). Therefore, it was known that there was a possibility that 18.9% of this group would be attacked with rubella in Korea.
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Affiliation(s)
- I S Lee
- Department of Obstetrics and Gynecology, Soonchunhyang University, Seoul, Korea
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Abstract
Fifty years ago in New South Wales the late Sir Norman Gregg [1] described congenital cataracts in 78 babies, 67 of whose mothers had had clinical rubella in early pregnancy; he concluded that the disease in the mother caused the abnormality in the baby. Gregg [1–3] and Swan [4, 5] and their colleagues reported that deafness, heart disease and microcephaly were also major components of the congenital rubella syndrome. The need to prevent this tragic outcome stimulated intensive work on laboratory diagnosis and vaccine development, leading to the isolation of rubella virus in 1962 and then to methods for antibody detection. These complementary advances established the two traditional pillars of virological diagnosis and opened the way to immunization, with the result that some countries are now on the verge of eliminating a disease which for over 100 years was regarded as no more than a mild and harmless exanthem of childhood.
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Abstract
The first description of rubella in the UK was by an English physician, Dr William Maton, who reported an outbreak of an illness resembling a mild form of scarlatina in a boys' public school in 1815 [1]. Some years later, when observing the spread of a rash-associated illness in a large family, Maton described the characteristic clinical features of rubella, namely a mild prodromal illness followed by a generalized and often tingling rash lasting for a few days and associated with enlarged and tender glands in the occipital and postauricular regions. He also correctly identified the relatively long incubation period of rubella and noted the absence of fever and other signs of constitutional upset. Maton did not suggest an English name for this disease which had been previously described and called Rothëln by German physicians in the late 18th century. The term ‘rubella’ (Latin for ‘little red’) was first used in 1866 by another English physician, Dr Henry Veale, when describing an outbreak of Rothëln in a boys' school in India [2].
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Affiliation(s)
- E Miller
- Immunization Division, Public Health Laboratory Service, London
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Nakhasi HL, Meyer BC, Liu TY. Rubella virus cDNA. Sequence and expression of E1 envelope protein. J Biol Chem 1986. [DOI: 10.1016/s0021-9258(18)66611-6] [Citation(s) in RCA: 25] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
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Falser N, Bandtlow I, Haus M, Wolf H. Detection of pseudorabies virus DNA in the inner ear of intranasally infected BALB/c mice with nucleic acid hybridization in situ. J Virol 1986; 57:335-9. [PMID: 3001355 PMCID: PMC252731 DOI: 10.1128/jvi.57.1.335-339.1986] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/03/2023] Open
Abstract
Evidence for the pathogenicity of pseudorabies virus for the auditory and vestibular organs of experimentally infected mice is presented. We demonstrate viral genomes in cells of the peripheral sensory organs, the nerve structures, and the affected areas of the brain in single sections from an entire cranium of an adult mouse. The data were obtained by an in situ hybridization technique adapted for use with fixed, plastic-embedded materials. In contrast to conventional methods which use frozen sections, we were able to analyze cartilaginous and bony materials with high resolution.
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Hertzberg R. Congenital cataract following German measles in the mother. Abstracts from the publications of the late Sir Norman McAlister Gregg. AUSTRALIAN AND NEW ZEALAND JOURNAL OF OPHTHALMOLOGY 1985; 13:303-9. [PMID: 3907670 DOI: 10.1111/j.1442-9071.1985.tb00439.x] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/07/2023]
Abstract
This paper contains abstracts from publications of the late Sir Norman McAlister Gregg, published in 1941 and 1944, in which he demonstrated the association between rubella in pregnancy and defects in the baby. Besides cataract and retinopathy with which ophthalmologists are familiar, there occur deafness, deafmutism, cardiac defects, mental retardation, pulmonary and renal abnormalities and diabetes.
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Davis LE, Johnsson LG. Viral infections of the inner ear: clinical, virologic, and pathologic studies in humans and animals. Am J Otolaryngol 1983; 4:347-62. [PMID: 6314834 DOI: 10.1016/s0196-0709(83)80022-2] [Citation(s) in RCA: 56] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/19/2023]
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Cole SK. Evaluation of a neonatal discharge record as a monitor of congenital malformations. COMMUNITY MEDICINE 1983; 5:21-30. [PMID: 6839695 DOI: 10.1007/bf02548580] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/22/2023]
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Abstract
A retrospective study of 547 cases of meningitis was performed. Of these, 236 were bacterial, 304 were viral, and 7 were fungal in etiology. Of 110 survivors of bacterial meningitis over the age of 2 1/2 years, 23 or 21% suffered partial or complete sensorineural hearing loss. The site of auditory injury in cases of partial loss was the cochlea by audiologic criteria. A positive correlation with hearing loss was found for the species of organism, delay before treatment, low CSF sugar, and CSF pleocytosis. Of 7 patients with fungal meningitis, 3 suffered hearing loss with signs of a retrocochlear site. Of 304 cases of aseptic meningitis, none developed a hearing loss. The pathophysiology of hearing loss as a sequela of meningitis and the possible explanations for absence of hearing loss in viral meningitis are discussed.
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Abstract
The original concept of the rubella syndrome as a triad of abnormalities affecting the eye, heart, and hearing organs has changed dramatically in the past 30 years. This paper describes the various clinical manifestations of congenital rubella now recognized and the varied consequences of rubella virus infection upon the fetus. The pathogenesis of intrauterine rubella is discussed in relation to the immunologic response of the fetus and to possible mechanisms of cell and tissue damage. The need for preventive measures is discussed in relation to the total number of children damaged annually and the importance of multiple defects leading to severe handicaps. Active immunization procedures to prevent congenital rubella defects are reviewed, with comments on the differences between vaccination policies in the United Kingdom and in the United States. The importance of surveillance of congenital rubella defects is emphasized; details of the National Rubella Surveillance Scheme in the United Kingdom are discussed.
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Weil ML, Itabashi H, Cremer NE, Oshiro L, Lennette EH, Carnay L. Chronic progressive panencephalitis due to rubella virus simulating subacute sclerosing panencephalitis. N Engl J Med 1975; 292:994-8. [PMID: 47149 DOI: 10.1056/nejm197505082921903] [Citation(s) in RCA: 124] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Abstract
Late-onset chronic progressive panencephalitis developed in a 12-year-old boy with congenital rubella syndrome from whose brain rubella virus was isolated. Progressive dementia began at eight, and ataxia, choreiform movements, myoclonic seizures, and fine perimacular pigmentation appeared at 11 years of age. The cerebrospinal fluid was minimally pleocytotic and had a total protein of 156 mg per deciliter, of which 52 per cent was gamma globulin. Electroencephalography demonstrated generalized medium and occasional high-voltage slowing without burst suppression. The antibody titer to rubella virus (hemagglutination inhibition) was 1:8192 in serum and 1:256 in cerebrospinal fluid. Antibody titer to measles virus (complement fixation) was less than 1:8 in serum. Microscopical study of biopsied brain tissue at the age of 11 disclosed panencephalitis similar to subacute sclerosing panencephalitis, but with perivascular deposits and without inclusion bodies. Rubella virus was isolated from the brain by cocultivation with CV-1 cells.
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Connon AF. Risk of rubella in pregnancy. Med J Aust 1975; 1:199-201. [PMID: 1128402 DOI: 10.5694/j.1326-5377.1975.tb111327.x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/25/2022]
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Zytoplasmatische tubuloretikuläre Komplexe und Kernsphäridien in Zellen rötelninfizierter menschlicher Embryonen und Feten. ACTA ACUST UNITED AC 1975. [DOI: 10.1016/s0005-8165(75)80187-9] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
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Dudgeon JA. Rubella today. Public Health 1972; 86:207-14. [PMID: 4656539 DOI: 10.1016/s0033-3506(72)80049-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/11/2023]
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Affiliation(s)
- J. D. Harley
- Children's Medical Research FoundationRoyal Alexandra Hospital for Children Camperdown New South Wales
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Guggenheimer J, Nowak AJ, Michaels RH. Dental manifestations of the rubella syndrome. ORAL SURGERY, ORAL MEDICINE, AND ORAL PATHOLOGY 1971; 32:30-7. [PMID: 5282867 DOI: 10.1016/0030-4220(71)90247-7] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/14/2023]
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Chess S. Autism in children with congenital rubella. JOURNAL OF AUTISM AND CHILDHOOD SCHIZOPHRENIA 1971; 1:33-47. [PMID: 5172438 DOI: 10.1007/bf01537741] [Citation(s) in RCA: 243] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/14/2023]
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Elizan TS, Fabiyi A. Congenital and neonatal anomalies linked with viral infections in experimental animals. Am J Obstet Gynecol 1970; 106:147-65. [PMID: 4312333 DOI: 10.1016/0002-9378(70)90141-9] [Citation(s) in RCA: 13] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/10/2023]
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Stern H, Booth JC, Elek SD, Fleck DG. Microbial causes of mental retardation. The role of prenatal infections with cytomegalovirus, rubella virus, and toxoplasma. Lancet 1969; 2:443-8. [PMID: 4183900 DOI: 10.1016/s0140-6736(69)90162-7] [Citation(s) in RCA: 68] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/09/2023]
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