Congenital cytomegalovirus infection and maternal systemic lupus erythematosus: a case report

We describe an infant with symptomatic congenital cytomegalovirus infection, who was born to a mother with active systemic lupus erythematosus. Infection in the child resulted from reactivation of maternal cytomegalovirus infection. The mother's use of prednisone may have contributed to the reactivation. The role of maternal immunosuppression in the acquisition of congenital viral infection by the neonate is discussed.     

Long-term weight patterns and risk for cholecystectomy in women

BACKGROUND: Obesity and rapid weight loss in obese persons are known risk factors for gallstones. However, the effect of intentional, long-term, moderate weight changes on the risk for gallstones is unclear. OBJECTIVE: To study long-term weight patterns in a cohort of women and to examine the relation between weight pattern and risk for cholecystectomy. DESIGN: Prospective cohort study. SETTING: 11 U.S. states. PARTICIPANTS: 47,153 female registered nurses who did not undergo cholecystectomy before 1988. MEASUREMENTS: Cholecystectomy between 1988 and 1994 (ascertained by patient self-report). RESULTS: During the exposure period (1972 to 1988), there was evidence of substantial variation in weight due to intentional weight loss during adulthood. Among cohort patients, 54.9% reported weight cycling with at least one episode of intentional weight loss associated with regain. Of the total cohort, 20.1% were light cyclers (5 to 9 lb of weight loss and gain), 18.8% were moderate cyclers (10 to 19 lb of weight loss and gain), and 16.0% were severe cyclers (> or = 20 lb of weight loss and gain). Net weight gain without cycling occurred in 29.3% of women; net weight loss without cycling was the least common pattern (4.6%). Only 11.1% of the cohort maintained weight within 5 lb over the 16-year period. In the study, 1751 women had undergone cholecystectomy between 1988 and 1994. Compared with weight maintainers, the relative risk for cholecystectomy (adjusted for body mass index, age, alcohol intake, fat intake, and smoking) was 1.20 (95% CI, 0.96 to 1.50) among light cyclers, 1.31 among moderate cyclers (CI, 1.05 to 1.64), and 1.68 among severe cyclers (CI, 1.34 to 2.10). CONCLUSION: Weight cycling was highly prevalent in this large cohort of middle-aged women. The risk for cholecystectomy associated with weight cycling was substantial, independent of attained relative body weight.     

Malumfashi Endemic Diseases Research Project. II. Malariometry in Malumfashi, Northern Nigeria.

Prior to longitudinal studies into the effects of malaria upon the immune response, nutritional status and haematological indices in young children in northern Nigeria, the degree of malarial endemicity in the area has been established. Field work was carried out in the wet seasons of 1976 and 1977 and the dry season of 1977 (April). Seasonal variation in transmission has been demonstrated. Age-specific parasite prevalence rates and splenic indices confirm previous studies that this northern part of the Guinea savannah belt of West Central Africa is an holoendemic area.     

The effect of meals of varying nutritional composition on subjective and physiological markers of nausea in response to optokinetic motion

BACKGROUND: Protein ingestion has been shown to decrease subjective and physiological markers of nausea. Aim: To elucidate the importance of drink palatability and nutritional composition in preventing subjective symptoms of nausea, decreased normal gastric electrogastrographic activity, and withdrawal of vagal tone in response to optokinetic motion. METHODS: Participants received a liquid high protein/low carbohydrate, moderate protein/high carbohydrate, low protein/high carbohydrate or water meal 30 min prior to exposure to an optokinetic drum. Subjective symptoms of nausea, electrogastrograms and cardiac vagal tone were measured during the 30-min post-drink rest period, a 10-min baseline period in the stationary drum, and during a 16-min drum rotation period. RESULTS: Regardless of nutritional composition, a pleasant taste predicted a reduction of the subjective experience of nausea. Subjective symptoms were significantly more severe in the moderate protein/high carbohydrate and water groups compared to the high protein/low carbohydrate and low protein/high carbohydrate groups. Electrogastrographic indicators of nausea were reduced in the high protein/low carbohydrate and low protein/high carbohydrate groups versus water, while cardiac vagal tone was reduced in the high protein/low carbohydrate and moderate protein/high carbohydrate groups versus the low protein/high carbohydrate and water groups. CONCLUSIONS: Palatability and high protein meals appear to be important factors in attenuating the nausea associated with exposure to optokinetic motion.