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Rubella during pregnancy
Reviews I Abstracts Edited by LOUIS
1\L
HELLMAN,
M.D.
Selected abstracts
Acta paediatrica
the disease; ( 5) 29 women who had rubella shortly before the last menstrual period; (6) 98 women who were treated with convalescent serum; (7) a group of 99 patients having abortions or stillborn infants. The results of pregnancy were recorded and the children were restudied at ages 1 to 3 years. The material is complete and extensive. The tables and graphs are quite clear and the explanations are acceptable. There is much valuable and apparently reliable information gathered in this monograph. Almost any question one ponders is discussed in light of the results of this investigation and those that have preceded it. I find it to be a rewarding monograph and expect to refer to it frequently. The major findings were: ( 1) the frequency of spontaneous abortion appears to be higher in patients who had rubella than in the controls; (2) fetal death and neonatal mortality rates were higher in the first trimester of individuals who had rubella than in the controls; ( 3) the first trimester rubella group showed a higher incidence of congenital defects than the controls; (4) deafness and chorioretinitis were found only in children of mothers who had rubella in whom there was a higher incidence of congenital heart defects and congenital cataracts; ( 5) these children also showed higher frequencies of immunity, subnormal length and weight at birth and at follow-up, subnormal circumference of the head, retarded functional development; ( 6) the incidence of rubella syndrome of conge~tal defects in children whose mothers had rubella in
Suppl. 133, 1962.
*Lundstrom, R.: Rubella During Pregnancy, pp.
1-110. Lundstrom: Rubella During Pregnancy, pp. 1-110. Rolf Lundstrom has presented a follow-up study of children born after an epidemic of rubella in Sweden in the spring of 1951. The report includes the results of some investigations of prophylaxis and treatment. Through the National Board of Health and the National Health Services, the following was recorded for patients admitted for delivery or abortion during the period July 1, 1951, to June 30, 1952: ( 1) did the mother have contact with any person infected with rubella, and (2) had she· contracted rubella during the current pregnancy. A positive response identified a patient for further detailed epidemiologic study. It also identified her child for further study and followup. There were assembled the following groups for study: ( 1 ) 1,146 women with rubella during the current pregnancy; ( 2) 951 women who gave a history of exposure to rubella in the current pregnancy and had no knowledge of a previous
attack of rubella; (3) 398 women exposed to rubella in this pregnancy but considered immune as a result of previous infection; (4) 2,580 controls--women who had not had rubella in the current pregnancy and had not been exposed to *These articles have been abstracted.
1910
Volume 84 Number 12
the first trimester is estimated to be between 7 and 17 per cent; ( 7) treatment with convalescent gamma globulin is inefficacious for the prevention of rubella syndrome defects in the children; ( 8) passive immunization after exposure seemed to have an appreciable protective effect; (9) the author believes that the 1'0 per cent incidence of incapacitating congenital defects does not constitute a valid reason for legal abortion. Schuyler G. Kohl
American Journal of the Medical Sciences Vol. 243, No. 6, June, 1962. Kievit, Harvey D.: The Sex Chromosomes in Abnormalities of Sexual Differentiation, p. 790. Duhring, John L.: Blood Volume in Pregnancy, p. 808.
American Journal of Medicine Vol. 32, March, 1962. *Judge, R. D., Currier, R. D., Gracie, W. A., and Figley, M. M.: Takayasu's Arteritis and the Aortic Arch Syndrome, p. 379. Judge et al.: Takayasu's Arteritis and the Aortic Arch Syndrome, p. 379. Takayasu's arteritis, an idiopathic aortitis usually affecting young women, is considered under the general classification of the aortic arch syndrome. Four patients, aged 28, 32, 39, and 61 years, who were affected with Takayasu's disease are considered as illustrative of the ocular and cardiovascular manifestations of the disease. One patient had menorrhagia but this was considered unrelated to the disease process. The etiology of the aortic arch syndrome encompasses such major entities as arteriosclerosis, syphilitic aortitis, arteritis in young women, and others. The clinical diagnosis of Takayasu's arteri~is can be made with certainty only by exclusion or pathologic study. Ocular manifestations of the disease include transitory visual disturbances, cataracts, arteriovenous fistulas, iris atrophy, retina hemorrhages, and others. Misnomers, such as "pulseless disease" and "pulseless syndrome," have been used to describe the cardiovascular rnanifestation of the disease. Pathologically, the thoracic aorta and the proximal segments of its branches are involved by a stenosing inflammatory process. The clinical manifestations of this process result in the disappearance of radial pulsations and blood pressure, as
Selected abstracts
1911
well as the previously mentioned ocular signs. Microscopically, various phases of a panarteritis have been described. The authors feel that t\vo factors in the localization of the lesion may be important: an autoimmunopathy affecting vascular elastin, and hemodynamic stress. In certain respects the disease is considered akin to systemic lupus erythematosis. Factors helpful as diagnostic aids include an abnormal serum electrophoretic pattern, persistent elevation in the erythrocyte sedimentation rate, and angiocardiographic changes obtained by some type of aortography. Treatment consists of using anticoagulants whenever feasible to prevent final thrombotic occlusion. Steroids have also been reported helpful. Several patients have had reconstructive operations.
Harrison H. Sheld April, 1962. *Demartini, F. E., Wheaton, E. A., Healey, L. A., and Laragh, J. H.: Effect of Chi orothiazide on the Renal Excretion of Uric Acid, p. 572.
Demartini et al.: Effect of CWorothiazide on Renal Excretion of Uric Acid, p. 572. The purpose of this paper is to examine the effect of chlorothiazide on the renal clearance of uric acid and to define further the renal mechanism by which the serum uric acid concentration is modified by chlorothiazide. During prolonged oral administration of chlorothiazide, serum uric acid levels rise in a majority of patients. This elevation is not related to a change in either the glomerular filtration rate or the filtered load of urate. Following intravenous administration of chlorothiazide, uricosuria occurs despite a fall in the glomerular filtration rate. The writers postulate that there is both reabsorption and secretion in the renal tubule of man and that the oral administration of chlorothiazide suppresses secretion while intravenous administration suppresses reabsorption, the concurrent secretory effect being masked.
Harrison H. Sheld The American Jouinal of Pathology
Vol. 40, 1962. *Hicks, S. P., Cavanaugh, M. C., and O'Brien, E. D.: Effects of Anoxia on the Developing Cerebral Cortex in the Rat, p. 615.
1\L
HELLMAN,
M.D.
Selected abstracts
Acta paediatrica
the disease; ( 5) 29 women who had rubella shortly before the last menstrual period; (6) 98 women who were treated with convalescent serum; (7) a group of 99 patients having abortions or stillborn infants. The results of pregnancy were recorded and the children were restudied at ages 1 to 3 years. The material is complete and extensive. The tables and graphs are quite clear and the explanations are acceptable. There is much valuable and apparently reliable information gathered in this monograph. Almost any question one ponders is discussed in light of the results of this investigation and those that have preceded it. I find it to be a rewarding monograph and expect to refer to it frequently. The major findings were: ( 1) the frequency of spontaneous abortion appears to be higher in patients who had rubella than in the controls; (2) fetal death and neonatal mortality rates were higher in the first trimester of individuals who had rubella than in the controls; ( 3) the first trimester rubella group showed a higher incidence of congenital defects than the controls; (4) deafness and chorioretinitis were found only in children of mothers who had rubella in whom there was a higher incidence of congenital heart defects and congenital cataracts; ( 5) these children also showed higher frequencies of immunity, subnormal length and weight at birth and at follow-up, subnormal circumference of the head, retarded functional development; ( 6) the incidence of rubella syndrome of conge~tal defects in children whose mothers had rubella in
Suppl. 133, 1962.
*Lundstrom, R.: Rubella During Pregnancy, pp.
1-110. Lundstrom: Rubella During Pregnancy, pp. 1-110. Rolf Lundstrom has presented a follow-up study of children born after an epidemic of rubella in Sweden in the spring of 1951. The report includes the results of some investigations of prophylaxis and treatment. Through the National Board of Health and the National Health Services, the following was recorded for patients admitted for delivery or abortion during the period July 1, 1951, to June 30, 1952: ( 1) did the mother have contact with any person infected with rubella, and (2) had she· contracted rubella during the current pregnancy. A positive response identified a patient for further detailed epidemiologic study. It also identified her child for further study and followup. There were assembled the following groups for study: ( 1 ) 1,146 women with rubella during the current pregnancy; ( 2) 951 women who gave a history of exposure to rubella in the current pregnancy and had no knowledge of a previous
attack of rubella; (3) 398 women exposed to rubella in this pregnancy but considered immune as a result of previous infection; (4) 2,580 controls--women who had not had rubella in the current pregnancy and had not been exposed to *These articles have been abstracted.
1910
Volume 84 Number 12
the first trimester is estimated to be between 7 and 17 per cent; ( 7) treatment with convalescent gamma globulin is inefficacious for the prevention of rubella syndrome defects in the children; ( 8) passive immunization after exposure seemed to have an appreciable protective effect; (9) the author believes that the 1'0 per cent incidence of incapacitating congenital defects does not constitute a valid reason for legal abortion. Schuyler G. Kohl
American Journal of the Medical Sciences Vol. 243, No. 6, June, 1962. Kievit, Harvey D.: The Sex Chromosomes in Abnormalities of Sexual Differentiation, p. 790. Duhring, John L.: Blood Volume in Pregnancy, p. 808.
American Journal of Medicine Vol. 32, March, 1962. *Judge, R. D., Currier, R. D., Gracie, W. A., and Figley, M. M.: Takayasu's Arteritis and the Aortic Arch Syndrome, p. 379. Judge et al.: Takayasu's Arteritis and the Aortic Arch Syndrome, p. 379. Takayasu's arteritis, an idiopathic aortitis usually affecting young women, is considered under the general classification of the aortic arch syndrome. Four patients, aged 28, 32, 39, and 61 years, who were affected with Takayasu's disease are considered as illustrative of the ocular and cardiovascular manifestations of the disease. One patient had menorrhagia but this was considered unrelated to the disease process. The etiology of the aortic arch syndrome encompasses such major entities as arteriosclerosis, syphilitic aortitis, arteritis in young women, and others. The clinical diagnosis of Takayasu's arteri~is can be made with certainty only by exclusion or pathologic study. Ocular manifestations of the disease include transitory visual disturbances, cataracts, arteriovenous fistulas, iris atrophy, retina hemorrhages, and others. Misnomers, such as "pulseless disease" and "pulseless syndrome," have been used to describe the cardiovascular rnanifestation of the disease. Pathologically, the thoracic aorta and the proximal segments of its branches are involved by a stenosing inflammatory process. The clinical manifestations of this process result in the disappearance of radial pulsations and blood pressure, as
Selected abstracts
1911
well as the previously mentioned ocular signs. Microscopically, various phases of a panarteritis have been described. The authors feel that t\vo factors in the localization of the lesion may be important: an autoimmunopathy affecting vascular elastin, and hemodynamic stress. In certain respects the disease is considered akin to systemic lupus erythematosis. Factors helpful as diagnostic aids include an abnormal serum electrophoretic pattern, persistent elevation in the erythrocyte sedimentation rate, and angiocardiographic changes obtained by some type of aortography. Treatment consists of using anticoagulants whenever feasible to prevent final thrombotic occlusion. Steroids have also been reported helpful. Several patients have had reconstructive operations.
Harrison H. Sheld April, 1962. *Demartini, F. E., Wheaton, E. A., Healey, L. A., and Laragh, J. H.: Effect of Chi orothiazide on the Renal Excretion of Uric Acid, p. 572.
Demartini et al.: Effect of CWorothiazide on Renal Excretion of Uric Acid, p. 572. The purpose of this paper is to examine the effect of chlorothiazide on the renal clearance of uric acid and to define further the renal mechanism by which the serum uric acid concentration is modified by chlorothiazide. During prolonged oral administration of chlorothiazide, serum uric acid levels rise in a majority of patients. This elevation is not related to a change in either the glomerular filtration rate or the filtered load of urate. Following intravenous administration of chlorothiazide, uricosuria occurs despite a fall in the glomerular filtration rate. The writers postulate that there is both reabsorption and secretion in the renal tubule of man and that the oral administration of chlorothiazide suppresses secretion while intravenous administration suppresses reabsorption, the concurrent secretory effect being masked.
Harrison H. Sheld The American Jouinal of Pathology
Vol. 40, 1962. *Hicks, S. P., Cavanaugh, M. C., and O'Brien, E. D.: Effects of Anoxia on the Developing Cerebral Cortex in the Rat, p. 615.