Congenital Toxoplasmosis: Missed Opportunities for Diagnosis and Prevention

2020 ◽  
Author(s):  
Raquel Aitken Soares Mueller ◽  
Ana Cristina Cisne Frota ◽  
Daniela Durão Menna Barreto ◽  
Daniela Pires Ferreira Vivacqua ◽  
Gabriela Bueno Loria ◽  
...  
Keyword(s):  
Antenatal Care ◽  
Congenital Toxoplasmosis ◽  
First Trimester ◽  
University Hospital ◽  
Serological Testing ◽  
Missed Opportunities ◽  
Clinic Appointment ◽  
History Of ◽  
Acute Toxoplasmosis ◽  
Made In

Abstract Objectives Identify missed opportunities for the prevention and early diagnosis of congenital toxoplasmosis (CT) in infants followed up in a reference center for pediatric infectious diseases (PID) in Rio de Janeiro between January 2007 and December 2016. Methods Descriptive study including infants with CT, diagnosis established based on Brazil’s Ministry of Health’s criteria. All data regarding the infants and their mother’s prenatal care were collected from the medical records of the Instituto de Puericultura e Pediatria Martagão Gesteira (IPPMG)—a tertiary public pediatric university hospital. The study enrolled infants aged between 0 and 12 months followed up in the PID department of IPPMG and with confirmed infection by Toxoplasma gondii in the period between January 2007 and December 2016. All patients with diagnosis of CT registered in the PID database of the IPPMG and admitted in the above-mentioned period were included in the study. Patients whose records were not available, or who went to just one clinic appointment were excluded. Results The obstetric history of all 44 women, whose infants (45) were diagnosed with CT, was analyzed. Their median age was 22 years. None had undergone preconception serological testing for toxoplasmosis. Only 20 (45%) of them started antenatal care during the first trimester of gestation, a total of 24 (55%) had more than six antenatal care visits, and 16% of those did not undergo serological testing for toxoplasmosis. None were adequately informed of preventive measures. The diagnosis of acute toxoplasmosis was made in 50% of these pregnancies but 32% of the women were not treated. Only 10 children of these mothers were adequately screened and treated at birth. Conclusion Despite the existence of national recommendations, several opportunities were missed to prevent CT during the antenatal period and to diagnose and treat this condition in the neonatal period.

Toxoplasma gondii

1990 ◽  
Vol 11 (4) ◽  
pp. 207-213 ◽  
Author(s):  
Deborah J. Zygmunt
Keyword(s):  
United States ◽  
Toxoplasma Gondii ◽  
Mammalian Species ◽  
Congenital Toxoplasmosis ◽  
Immune Deficiency Syndrome ◽  
First Trimester ◽  
The United States ◽  
Deficiency Syndrome ◽  
Immunocompromised Patients ◽  
Acute Toxoplasmosis

Toxoplasma gondii is an obligate intracellular parasite that is a worldwide cause of infections in virtually all mammalian species, including humans. Although toxoplasmosis is extremely common in humans, most cases are subclinical and are revealed only by the presence of antibodies to this parasite. Prior to the use of immunosuppresive therapy and the recognition of the acquired immune deficiency syndrome (AIDS), the most devastating consequence of toxoplasmosis was seen in children of women who acquired acute toxoplasmosis in their first trimester of pregnancy.In the past two decades, this pathogen has become increasingly recognized in immunocompromised patients as a common cause of encephalitis. The tragedy of toxoplasmosis is that it is a preventable disease. French investigators, have clearly defined the risk and range of severity of congenital toxoplasmosis, the value of systemic screening and patient education, and the value of treatment of the mother during pregnancy to prevent transmission to the fetus. Prevention of a large portion of cerebral toxoplasmosis cases in immunocompromised patients might be possible if congenital toxoplasmosis was better controlled in the United States. The first step in controlling toxoplasmosis in the United States is a better appreciation of this infection.

scholarly journals Seroprevalence of Toxoplasmosis in Pregnant Women Attending Antenatal Care at Sir Yahaya Memorial Hospital, Birnin Kebbi, Northwestern Nigeria

2020 ◽  
Vol 1 (1) ◽  
pp. 73-76
Author(s):  
Nuhu Hussaini Shehu ◽  
Abdullahi Alhaji Magaji ◽  
Abdulkadir Usman Junaidu ◽  
Abubakar Abubakar Panti ◽  
Makun Babazhitsu
Keyword(s):  
Antenatal Care ◽  
Pregnant Women ◽  
Congenital Toxoplasmosis ◽  
Congenital Infection ◽  
Protozoan Parasite ◽  
First Trimester ◽  
Cross Sectional Study ◽  
Memorial Hospital ◽  
Enzyme Linked Immunosorbent Assay ◽  
Cross Sectional

Background: Toxoplasmosis is a protozoan infection caused by infection with the obligate intracellular protozoan parasite Toxoplasma gondii (T. gondii). Several studies have been reported of high seroprevalence of this parasite from various hospitals in Nigeria. Aim: The aim of this study was to determine the seroprevalence of toxoplasmosis among the pregnant women receiving antenatal care in Sir Yahaya Memorial Hospital, Birnin Kebbi. Methodology: This was a cross sectional study conducted at SYMH Birnin kebbi in 2015 using indirect Enzyme Linked Immunosorbent Assay (ELISA). Results: The overall seroprevalence of anti-Toxoplasma antibodies was 33.3%. 9.7% seropositivity was found at first trimester, 60.5% from second trimester and 29.8% from third trimester. Using a chi square logistic regression analysis, lack of education, lower age at pregnancy, and frequency of close contacts with cats were significantly associated with the prevalence of IgG antibodies. Conclusion: Most primary infections during pregnancy are asymptomatic, congenital toxoplasmosis can have serious effects on the developing fetus. Screening for primary infection is problematic, primary prevention is the most logical method to lower the risk of congenital infection. There is also a need to educate women on the safe handling of cat litter during pregnancy.

scholarly journals Opportunities Missed, Warnings Ignored: Re-discovering the History of Drug Safety in Great Britain following the Thalidomide Disaster 1961

2016 ◽  
pp. 49-72 ◽  
Author(s):  
Stuart Anderson
Keyword(s):  
Drug Safety ◽  
Spontaneous Reporting ◽  
Reporting System ◽  
Spontaneous Reporting System ◽  
Warning Signs ◽  
Regulatory Body ◽  
Missed Opportunities ◽  
History Of ◽  
Suspected Adverse Drug Reactions ◽  
Made In

Following the thalidomide disaster1961 many accounts of pre-thalidomide drug safety history appeared. Some identified events which represented missed opportunities or ignored warning signs. This paper reviews three assertions made in these accounts; that an opportunity to introduce a spontaneous reporting system for suspected adverse drug reactions in 1893 was missed; that concerns about dangers of drugs in pregnancy identified in 1904 were ignored; and that a proposal to establish a drug regulatory body made in 1914 was abandoned. The paper concludes that even if all had been acted upon it is unlikely that the thalidomide disaster could have been entirely avoided.http://dx.doi.org/10.14195/1647-6336_14_3

scholarly journals The Effect of Fat Emulsion Intralipid Infusion on Reproductive Outcome for Women with Unexplained First Trimester Habitual Abortion

2021 ◽  
pp. 276-283
Author(s):  
Mahmoud Abd Alsattar Al Mohasseb ◽  
Eltahera Mohsen Goda
Keyword(s):  
First Trimester ◽  
University Hospital ◽  
Second Trimester ◽  
Group Iii ◽  
Live Births ◽  
Habitual Abortion ◽  
Low Dose Aspirin ◽  
History Of ◽  
Group A ◽  
Maternal And Neonatal Outcomes

Objectives: To study the effect of the use of intralipid in management of women suffering from unexplained first trimester habitual abortion. Methods: The study was a prospective cohort study, which conducted in Tanta university Hospital; Egypt. It included 93 women with history of two or more unexplained recurrent abortion in the first trimester. They were divided into three groups: group Ι received only intralipid, group II received low molecular weight heparin (LMWH) and low dose aspirin, and group III served as controls and received only saline as placebo. The patients were followed up until continuation of pregnancy into the second trimester. Occurrence of complication and pregnancy outcomes were evaluated. Results: Ninety three women were included. After treatment, more pregnancy continued into the second trimester, more live births and less numbers of abortions in group A and B in comparison with group C (p=0.008, 0.008 and 0.035) respectively. Maternal and neonatal outcomes were comparable in all studied regimens. Conclusions: Management of women with unexplained first trimester habitual abortion (before 14 weeks) with intralipid or LMWH with small dose of aspirin may increase the proportion of pregnancy continued into the second trimester, more live births and less numbers of abortions. However, LMWH is more superior to the intralipid but with more side effect.

A history of botanical collections in the Luangwa Valley, Zambia

1998 ◽  
Vol 25 (2) ◽  
pp. 283-291
Author(s):  
P.S.M. PHIRI ◽  
D.M. MOORE
Keyword(s):  
Eighteenth Century ◽  
Environmental Impact ◽  
Impact Assessment ◽  
Vascular Plants ◽  
Central Africa ◽  
Peak Activity ◽  
Historical Account ◽  
History Of ◽  
The 1960S ◽  
Made In

Central Africa remained botanically unknown to the outside world up to the end of the eighteenth century. This paper provides a historical account of plant explorations in the Luangwa Valley. The first plant specimens were collected in 1897 and the last serious botanical explorations were made in 1993. During this period there have been 58 plant collectors in the Luangwa Valley with peak activity recorded in the 1960s. In 1989 1,348 species of vascular plants were described in the Luangwa Valley. More botanical collecting is needed with a view to finding new plant taxa, and also to provide a satisfactory basis for applied disciplines such as ecology, phytogeography, conservation and environmental impact assessment.

Chasing Angels: The Sweet Wine Angelica

2008 ◽  
Vol 8 (3) ◽  
pp. 74-78
Author(s):  
hank shaw
Keyword(s):  
The State ◽  
The Real ◽  
Mission Period ◽  
History Of ◽  
Uncertain Future ◽  
Sweet Wine ◽  
Made In

Portugal has port, Spain has sherry, Sicily has Marsala –– and California has angelica. Angelica is California's original wine: The intensely sweet, fortified dessert cordial has been made in the state for more than two centuries –– primarily made from Mission grapes, first brought to California by the Spanish friars. Angelica was once drunk in vast quantities, but now fewer than a dozen vintners make angelica today. These holdouts from an earlier age are each following a personal quest for the real. For unlike port and sherry, which have strict rules about their production, angelica never gelled into something so distinct that connoisseurs can say, ““This is angelica. This is not.”” This piece looks at the history of the drink, its foggy origins in the Mission period and on through angelica's heyday and down to its degeneration into a staple of the back-alley wino set. Several current vintners are profiled, and they suggest an uncertain future for this cordial.

Not as It Is Written

2020 ◽  
Vol 42 (2) ◽  
pp. 78-100
Author(s):  
Benjamin Houston
Keyword(s):  
African American ◽  
Civil Rights ◽  
Oral History ◽  
Civil Rights Movement ◽  
International Exhibition ◽  
Black Experience ◽  
American Perspective ◽  
History Of ◽  
Black Life ◽  
Made In

This article discusses an international exhibition that detailed the recent history of African Americans in Pittsburgh. Methodologically, the exhibition paired oral history excerpts with selected historic photographs to evoke a sense of Black life during the twentieth century. Thematically, showcasing the Black experience in Pittsburgh provided a chance to provoke among a wider public more nuanced understandings of the civil rights movement, an era particularly prone to problematic and superficial misreadings, but also to interject an African American perspective into the scholarship on deindustrializing cities, a literature which treats racism mostly in white-centric terms. This essay focuses on the choices made in reconciling these thematic and methodological dimensions when designing this exhibition.

RISHTAN SCHOOL OF CERAMICS

2019 ◽  
Vol 16 (2) ◽  
pp. 73-77
Author(s):  
Akmal Marozikov ◽  
Keyword(s):  
Central Asia ◽  
Building Materials ◽  
Works Of Art ◽  
The World ◽  
Ferghana Valley ◽  
History Of ◽  
Made In ◽  
National Style

Ceramics is an area that has a long history of making clay bowls, bowls, plates,pitchers, bowls, bowls, bowls, pots, pans, toys, building materials and much more.Pottery developed in Central Asia in the XII-XIII centuries. Rishtan school, one of the oldest cities in the Ferghana Valley, is one of the largest centers of glazed ceramics inCentral Asia. Rishtan ceramics and miniatures are widely recognized among the peoples of the world and are considered one of the oldest cities in the Ferghana Valley. The article discusses the popularity of Rishtan masters, their products made in the national style,and works of art unique to any region

The History of Missed Opportunities

2017 ◽  
Author(s):  
William H. Galperin
Keyword(s):  
Eighteenth Century ◽  
William Wordsworth ◽  
Jane Austen ◽  
Lord Byron ◽  
Missed Opportunities ◽  
Romantic Period ◽  
The Everyday ◽  
Everyday World ◽  
History Of ◽  
Multiple Levels

This study is about the emergence of the everyday as both a concept and a material event and about the practices of retrospection in which it came to awareness in the romantic period in “histories” of the missed, the unappreciated, the overlooked. Prior to this moment everyday life was both unchanging and paradoxically unpredictable. By the late eighteenth century, however, as life became more predictable and change on a technological and political scale more rapid, the present came into unprecedented focus, yielding a world answerable to neither precedent nor futurity. This alternative world soon appears in literature of the period: in the double takes by which the poet William Wordsworth disencumbers history of memory in demonstrating what subjective or “poetic” experience typically overlooks; in Jane Austen, whose practice of revision returns her to a milieu that time and progress have erased and that reemerges, by previous documentation, as something different. It is observable in Lord Byron, thanks to the “history” to which marriage and domesticity are consigned not only in the wake of his separation from Lady Byron but during their earlier epistolary courtship, where the conjugal present came to consciousness (and prestige) as foredoomed but an opportunity nonetheless. The everyday world that history focalizes in the romantic period and the conceptual void it exposes in so doing remains a recovery on multiple levels: the present is both “a retrospect of what might have been” (Austen) and a “sense,” as Wordsworth put it, “of something ever more about to be.”

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