scholarly journals Pregnancy Outcomes of Mothers with Detectable CMV-Specific IgM Antibodies: A Three-Year Review in a Large Irish Tertiary Referral Maternity Hospital

2015 ◽  
Vol 2015 ◽  
pp. 1-5 ◽  
Author(s):  
Richard J. Drew ◽  
Patrick Stapleton ◽  
Hala Abu ◽  
Eibhlín Healy ◽  
Wendy Ferguson ◽  
...  
Keyword(s):  
Rotunda Hospital ◽  
Acute Infection ◽  
Maternity Hospital ◽  
Initial Screening ◽  
Neurological Damage ◽  
Tertiary Referral ◽  
Avidity Index ◽  
Retrospective Audit ◽  
Biparietal Diameter ◽  
Positive Results

A retrospective audit was performed for all obstetric patients who had positive CMV IgM results between January 2012 and December 2014 in the Rotunda Hospital, Ireland. In total, 622 CMV IgM positive tests were performed on samples from 572 patients. Thirty-seven patients had a positive CMV IgM result (5.9%) on the Architect system as part of the initial screening. Three patients were excluded as they were not obstetric patients. Of the 34 pregnant women with CMV IgM positive results on initial screening, 16 (47%) had CMV IgM positivity confirmed on the second platform (VIDAS) and 18 (53%) did not. In the 16 patients with confirmed positive CMV IgM results, four (25%) had acute infection, two (12.5%) had infection of uncertain timing, and ten (62.5%) had infection more than three months prior to sampling as determined by the CMV IgG avidity index. Two of the four neonates of women with low avidity IgG had CMV DNA detected in urine. Both these cases had severe neurological damage and the indication for testing their mothers was because the biparietal diameter (BPD) was less than the 5th centile at the routine 20-week gestation anomaly scan.

scholarly journals A Retrospective Audit of Clinically Significant Maternal Bacteraemia in a Specialist Maternity Hospital from 2001 to 2014

2015 ◽  
Vol 2015 ◽  
pp. 1-4 ◽  
Author(s):  
Richard John Drew ◽  
Zara Fonseca-Kelly ◽  
Maeve Eogan
Keyword(s):  
Blood Culture ◽  
Positive Blood Culture ◽  
Maternal Blood ◽  
Maternity Hospital ◽  
E Coli ◽  
Live Births ◽  
Retrospective Audit ◽  
Group A ◽  
Clinically Significant ◽  
Group B

Maternal sepsis is a significant problem in obstetrics, with almost one in four maternal deaths related to severe sepsis. We carried out a retrospective review of clinically significant bacteraemia in obstetric patients attending Rotunda Hospital over 14 years. From 2001 to 2014, there were 252 clinically significant positive blood culture episodes in obstetric patients. There were 112,361 live births >500 g during the study period giving an overall rate of 2.24 clinically significant positive maternal blood culture episodes per 1000 live births >500 g. The median rate over the 14 years was 2.12 episodes per 1000 live births >500 g, with an interquartile range of 1.74–2.43 per 1000 live births >500 g. There was no discernable increasing or decreasing trend over the 14 years.E. coliwas the most commonly isolated organism (n= 92/252, 37%), followed by group BStreptococcus(n= 64/252, 25%),Staphylococcus aureus(n= 28/252, 11%), and anaerobes (n= 11/252, 4%). These top four organisms represented three-quarters of all positive blood culture episodes (n= 195/252, 77.3%). Of note, there were only five cases of listeriosis, representing a rate of 4.4 cases per 100,000 live births >500 g. The rate of invasive group A streptococcal infection was also very low at 5.3 cases per 100,000 live births >500 g.

scholarly journals Long COVID in Inflammatory Bowel Diseases

2021 ◽  
Vol 10 (23) ◽  
pp. 5575
Author(s):  
Silvia Salvatori ◽  
Francesco Baldassarre ◽  
Michelangela Mossa ◽  
Giovanni Monteleone
Keyword(s):  
Inflammatory Bowel Diseases ◽  
Negative Impact ◽  
Acute Infection ◽  
Demographic Characteristics ◽  
University Hospital ◽  
Tertiary Referral ◽  
Tertiary Referral Center ◽  
Bowel Diseases ◽  
Inflammatory Bowel

Background and aims. SARS-CoV-2-infected patients can experience long-lasting symptoms even after the resolution of the acute infection. This condition, defined as Long COVID, is now recognized as a public health priority and its negative impact on the quality of life of the patients could be more relevant in individuals with debilitating pathologies. We here evaluated the frequency of Long COVID in patients with inflammatory bowel diseases (IBD). Methods. IBD patients afferent for scheduled visits to our tertiary referral center at the Tor Vergata University Hospital, Rome, were recruited from 7 September to 22 October 2021. During the visits, patients were investigated about previous COVID-19 infection and the possible development of Long COVID. Results. Fifty-three out of 528 IBD patients (10%) have had a SARS-CoV-2 infection. Of these, 21 patients (40%) developed Long COVID, and asthenia was the more frequent symptom as it occurred in nearly two-thirds of patients. Patients with Long COVID were more frequently females, while other clinical and demographic characteristics did not differ between patients with Long COVID and those without Long COVID. In particular, the IBD relapses occurred with the same frequency in the two groups. Conclusions. Long COVID appears to be common in IBD patients even though it does not influence the IBD course.

scholarly journals Serodiagnosis of Toxoplasmosis by Using ELISA and IgG Avidity Test in Relation to Some Risk Factors among Women at Childbearing Age in Zakho City, Duhok Province/ Iraq.

2021 ◽  
Vol 26 (4) ◽  
pp. 1-8
Author(s):  
Sarwin Sultan ◽  
Wijdan M. S. Mero
Keyword(s):  
Risk Factors ◽  
Pregnant Women ◽  
Acute Infection ◽  
Maternity Hospital ◽  
Married Women ◽  
Childbearing Age ◽  
Igg Avidity ◽  
Avidity Test ◽  
Hygienic Measures ◽  
The Relationship

This study intended to evaluate the seroprevalence of anti-Toxoplasma IgG and IgM antibodies in the sera of 630 women at childbearing age, and to link the outcomes with some risk factors. The enrolled women visited Zakho Maternity Hospital from July 2018 to July 2019. Their ages ranged from 15 to 45 years. All samples were examined using ELISA to detect immunoglobulin G and M, in addition to performing IgG Avidity test for seropositive pregnant women. The differences between seropositivity and age was significant (p<0.05), the highest rate (20.43%) for anti-Toxoplasma IgG antibodies in the age group 33-38 years. Women who had more contact with cats showed higher IgG and IgM seropositivity rates (16.45% and 1.26%, respectively). Married women had higher IgG Abs seropositivity than single ones (12.52% vs 6.31%, respectively), moreover, only married women were seropositive for IgM Abs. Pregnant women presented higher IgG Abs seropositivity than non-pregnant (15.21% versus 10.49%), with almost equal seropositivity for IgM Abs (0.65% and 0.86%, respectively). Anti-Toxoplasma IgG Abs seropositivity was higher in women underwent miscarriages than those with normal pregnancies (18.44 vs. 8.81%), however IgM Abs was only found among women who had miscarriages (0.97%). Women with triple miscarriages presented the highest IgG Abs seropositivity (37.03%). Chronic infection was found in 68.75% of pregnant women, whereas acute infection was found in 31.25 %. Following up the pregnancy resulted in 15 healthy births, 9 miscarriages, and 10 women did not show up. The findings of this study demonstrate the relationship between toxoplasmosis and risk factors in women at childbearing age, with the aim of decreasing infection rates through the health education and application of hygienic measures.

scholarly journals A retrospective audit of anaesthesia for caesarean section in parturients with eclampsia at a tertiary referral hospital in Cape Town

2020 ◽  
pp. 192-197
Author(s):  
M Jordaan ◽  
AR Reed ◽  
E Cloete ◽  
RA Dyer
Keyword(s):  
Caesarean Section ◽  
Cape Town ◽  
Tertiary Referral ◽  
Short Term ◽  
Tertiary Referral Hospital ◽  
Tertiary Referral Centre ◽  
Neonatal Deaths ◽  
Context Sensitive ◽  
Retrospective Audit ◽  
Postoperative Ventilation

Background: Anaesthesia for caesarean section (CS) in women with eclampsia is a major clinical challenge, and there are limited data concerning the rationale for the choice of technique, and short-term outcomes. A retrospective audit was performed on practice at a tertiary referral centre in Cape Town. Methods: The primary outcome of the audit was the proportion of patients with eclampsia receiving either spinal anaesthesia (SA) or general anaesthesia (GA) for CS, and an assessment of the rationale for the choice of method. In addition, short-term maternal and neonatal outcomes were recorded. Results: There were 11 exclusions in 100 patient records screened, therefore 89 were analysed. Seven/89 (7.9%) patients received SA and 82/89 (92.1%) GA. Overall, 63/89 (70.8%) patients had a preoperative GCS < 14, and 26/89 (29.2%) ≥ 14. Seven/26 patients with GCS ≥ 14 had SA; the remaining 19/26 received GA. GA was performed because there was no platelet count available in three, pulmonary oedema in two, difficult airway due to a bitten tongue in two, fetal bradycardia in two, HELLP syndrome in one, renal failure in one, and patient refusal in one patient. In seven women, there was no clear reason for GA. Median (IQR) Apgar scores at 1 minute in SA patients (8 [8–9]) were higher than those in GA patients with GCS ≥ 14 (5 [3–6]) and < 14 (4 [2–6]), p = .008 and .001 respectively. At five minutes, neonates of SA patients had median scores of 10 [9–10], compared with 8 [7–8] in those of GA patients with GCS ≥ 14, and 8 [7–9] in those with GCS < 14, p = .007 and .019 respectively. There were two stillbirths and two neonatal deaths in the GA group. Patients with GCS ≥ 14 receiving GA required mechanical ventilation for 0 [0–1] days, and those with GCS < 14 were ventilated for 1 [1–2] days. No patients receiving SA required postoperative ventilation, compared with 5/19 (26.3%) patients with GCS ≥ 14 who received GA. Seven/63 patients with GCS < 14 had cerebral oedema, and two had a cerebral infarct. There were two maternal deaths. Conclusions: The small percentage of women with eclampsia who received SA for CS, experienced good maternal and fetal outcomes, and more patients could have safely received SA. Larger prospective audits in high- and low-resource environments are required to establish factors influencing the context-sensitive choice of method of anaesthesia, and risk versus benefit of GA versus SA for CS in women with eclampsia.

The value of radiological investigations in pre-endoscopic assessment of children with stridor

1995 ◽  
Vol 109 (9) ◽  
pp. 844-848 ◽  
Author(s):  
P. M. J. Tostevin ◽  
R. de Bruyn ◽  
A. Hosni ◽  
J. N. G. Evans
Keyword(s):  
Differential Diagnosis ◽  
Barium Swallow ◽  
Lateral Neck ◽  
Referral Centre ◽  
Tertiary Referral ◽  
Tertiary Referral Centre ◽  
Street Hospital ◽  
Great Ormond Street Hospital ◽  
Retrospective Audit ◽  
Endoscopic Assessment

AbstractThe differential diagnosis of stridor in an infant depends on a careful history and examination, followed by radiological and endoscopic investigations. Currently a chest, lateral neck and antero-posterior, high kilovolt (Cincinnatti) view radiographs in association with a diagnostic barium swallow are performed prior to the definitive diagnostic procedure of microlaryngobronchoscopy.Our impression was that some of the routinely ordered radiological investigations were of limited value in the differential diagnosis. We undertook a retrospective audit study to determine the value of radiological investigations in the pre-endoscopic assessment of infants with stridor. The radiological and endoscopic information of 100 infants presenting over the three-year period 1991–1993 at Great Ormond Street Hospital, London (a tertiary referral centre) was collected.It was found that only five out of 65 barium swallow investigations performed had consistent positive findings at diagnostic microlaryngobronchoscopy. The lateral neck and Cincinnatti views identified many of the more gross pathologies of the larynx and trachea e.g. the space occupying lesions, which occur infrequently. The more common diseases e.g. laryngomalacia or subglottic stenosis are rarely identified radiologically.Our results confirmed that radiology had a limited screening role and that in a child presenting with stridor the initial radiological assessment should be a chest radiograph with further imaging and a barium swallow only if an abnormality is found at microlaryngobronchoscopy.

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