Congenital cytomegalovirus infection among preterm and full-term newborn infants in a neonatal intensive care unit

Cytomegalovirus [CMV] is the most common cause of congenital infections in human. The aim of the present study was to determine the prevalence and the clinical manifestations of congenital CMV infection among preterm and full-term newborn infants under intensive care and to correlate this infection with some features linked to the infants and their mothers. Serum samples were taken from 90 newborn infants [including 47 preterm and 43 full-term infants] and from their mothers, and were subjected to testing for IgM antibodies to CMV [CMV-IgM] by ELISA test. Sera from the mothers were also tested for IgG antibodies to CMV [CMV-IgG] by ELISA test. In addition, urine samples were taken from the newborns and were investigated for the presence of CMV DNA by nested polymerase chain reaction. It was found that 16 of the 90 newborns [17.8%] had congenital CMV infection, [all of them were positive for both CMV-IgM in serum and CMV DNA in urine] including 11[12.2%] preterm and 5[5.6%] full-term infants, with a significantly higher prevalence of infection among preterm infants [P<0.05]. On comparing between preterm and full-term newborn infants with congenital CMV infection, no significant difference in sex was found between both groups of infants [P> 0.05], but the gestational age and the birth weight were significantly higher in infected full-term infants [P< 0.05], while the presence of symptomatic CMV infection at birth was significantly more frequent in infected preterm infants [P< 0.05]. This symptomatic infection was found in 7 of the 16[43.8%] congenitally infected infants, including 6[37.5%] preterm infants and 1[6.3%] full-term infant. The main clinical manifestations of this symptomatic infection were low birth weight, jaundice, hepatosplenomegaly, anaemia, thrombocytopenia, purpura and microcephaly. Furthermore, on comparing between newborn infants with and without congenital CMV infection for features related to the newborns and their mothers, no significant difference was found between these two groups of infants concerning sex, gestational age, birth weight, maternal age or parity [P> 0.05], but maternal CMV-IgG seropositivity was significantly more frequent among infected newborns' mothers [P< 0.01], while maternal prenatal care reception was significantly more frequent among non infected newborn's mothers [P<0.01]. Screening newborns under intensive care for congenital CMV infection is recommended to allow for early treatment of symptomatic cases and follow-up of asymptomatic ones, giving the chance for better prognosis for these infected infants. Adequate prenatal care is also recommended to decrease the risk of transmission of CMV infection from infected pregnant mothers to their fetuses and to reduce infants' perinatal mortality from this infection

Graded experimental myocardial contusion in rabbits: antemortem and postmortem diagnosis

A controlled animal model was used to clarify the role of serum total creatine phosphokinase [CPK] and creatine phosphokinase-MB [CPK-MB] fraction in the diagnosis of myocardial contusion in patients, as well as, the role of cardiac tissue levels of creatine phosphate [CP] and adenosine triphosphate [ATP] in the diagnosis of fatal myocardial injury on autopsy. Graded myocardial contusion was produced by a single blow with a weight pendulum in two groups of rabbits [group I received a moderate impact, 78 +/- 5 m Joules/g, group II received a major impact, 87 +/- 7 m Joules/g]. Gross and microscopic examinations on autopsy showed a minor pathologic entity in group I, while in group II a distinct pathological entity could be identified. 20 minutes after the impact, a very highly significant [p <0.001] increase in the serum total CPK appeared in both groups. CPK-MB fraction was not detected in the serum of control animals [uninjuried group], but its level and percentage were 10.9 +/- 0.80 IU/L, 6.98% in group I and 29.7 +/- 1.23 IU/L, 8.18% in group II. Cardiac tissue levels of CP and ATP, 25 minutes after impact, revealed a very highly significant [p <0.001] reduction in both groups. It is clear that, the increase in the serum enzyme and the decrease in the cardiac tissue levels of high-energy phosphates were proportional to the severity of the blow. These results suggested that the serum total CPK and CPK-MB fraction are most reliable indicators of myocardial contusion following blunt chest trauma. The cardiac tissue CP and ATP levels, also can be used as diagnostic criteria for a suspected fatal cardiac injury and clearly apparent on autopsy

Influence of protein malnutrition on susceptibility to gentamicin renal toxicity in young rats

The present study was conducted on 78 male albino rats which were divided into two main groups. One group received a standard protein diet [20% casein], while the other one received a low protein diet [5% casein]. Four weeks later, half of the animals in each group were treated by gentamicin [80 mg/kg i.m.] daily for 11 days. One day after the last dose, blood samples were withdrawn and evaluated for serum total proteins, creatinine, urea and protein fraction. The kidneys were examined histopathologically. The obtained results showed that protein malnutrition resulted in significant decrease in serum total protein and urea and insignificant change in serum creatinine. Alpha-2 and gamma globulins were significantly increased, while globulin was significantly decreased, albumin, and consequently A/G ratio, were significantly decreased. The growth rate and food consumption in protein malnourished rats showed significant decrease in comparison with normal rats. Administration of gentamicin to the normally fed rats resulted in manifestations of renal toxicity which was demonstrated by significant increase in serum creatinine, urea, and also by histopathological picture showing cloudy swelling and degeneration of tubular cells. Alpha-2 and B globulin showed significant decrease compared with normal rats. On administrating gentamicin to protein malnourished rats, the obtained changes in all studied parameters were still comparable with those produced in normally fed rats receiving gentamicin