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Introduction: Surveillance of congenital anomalies receives importance in the world-wide context of eradicating the congenital rubella syndrome.Objective: To identify the congenital anomalies and to consider the low birth weight a criterion to test IgM for the complex TORCH.Methodology: Surveillance of the congenital specific and non specific anomalies of the congenital rubella syndrome(CRS) and low birth weight in ten hospitals. It was considered as case, everything new born with some congenital anomaly or low weight for the gestational age. Serum tests for rubella, toxoplasmosis, citomegalovirus, herpes and parvovirus were practiced. For the negative cases cariotype was performed.Results: A total of 840 cases were selected, 669 by low weight for the gestational age, 52 by anomalies not related to CRS, 52; by anomalies that could be related to the CRS, 105. The most frequent anomalies were congenital heart diseases, 5.1%; hepatosplenomegalies, 3.9%; and microcephalies, 1.2%. There were confirmatory IgM titles for rubella in 0.5% of cases; toxoplasmosis 1.4%; citomegalovirus 1.5%; parvovirus 1.2%; herpes 0.5%; and positive test for congenital syphilis, 3.7%. In total there were 8.8% positive results for any congenital infectious disease. The relative risk for low birth weight having IgM positive rubella was RR = 2.83 (IC: 1.26:6.36-0.95).Discussion and conclusions: The surveillance for CRS, through the monitoring of febrile in the first year and by the presence of some specific congenital anomalies, could be improved in sensitivity by means of the routine monitoring of congenital anomalies, with the inclusion of low birth weight, like a selecting criterion to study the infectious agents. [ABSTRACT FROM AUTHOR]

Objective: To estimate the prevalence of microcephaly and central nervous system (CNS) defects during the Zika virus (ZIKV) epidemic in Colombia and proportion attributable to congenital ZIKV infection., Study Design: Clinical and laboratory data for cases of microcephaly and/or CNS defects reported to national surveillance between 2015 and 2017 were reviewed and classified by a panel of clinical subject matter experts. Maternal and fetal/infant biologic specimens were tested for congenital infection and chromosomal abnormalities. Infants/fetuses with microcephaly and/or CNS defects (cases) were classified into broad etiologic categories (teratogenic, genetic, multifactorial, and unknown). Cases classified as potentially attributable to congenital ZIKV infection were stratified by strength of evidence for ZIKV etiology (strong, moderate, or limited) using a novel strategy considering birth defects unique or specific to ZIKV or other infections and laboratory evidence., Results: Among 858 reported cases with sufficient information supporting a diagnosis of microcephaly or CNS defects, 503 were classified as potentially attributable to congenital ZIKV infection. Of these, the strength of evidence was considered strong in 124 (24.7%) cases; moderate in 232 (46.1%) cases; and limited in 147 (29.2%). Of the remaining, 355 (41.4%) were attributed to etiologies other than ZIKV infection (syphilis, toxoplasmosis, rubella, cytomegalovirus, herpes 1 and herpes 2 viruses only, n = 32 [3.7%]; genetic, n = 16 [1.9%]; multifactorial, n = 42 [4.9%]; unknown, n = 265 [30.9%])., Conclusions: Fifty-eight percent of cases of microcephaly and/or CNS defects were potentially attributable to congenital ZIKV infection; however, the strength of evidence varied considerably. This surveillance protocol might serve as a model approach for investigation and etiologic classification of complex congenital conditions., (Published by Elsevier Inc.)

Introduction: Gestational trophoblastic disease includes a group of pathologies characterized by abnormal trophoblast growth and invasion. The molecular bases of the disease are largely unknown, due in part to the lack of appropriate biological models. The insulin-like growth factor (IGF) system plays a fundamental role in the growth and development of many tissues and is involved in the progression of several diseases., Objectives: Primary cell cultures derived from first trimester placenta were characterized from patients with complete hydatidiform mole and spontaneous non molar abortion by immunocytochemical and molecular methods., Materials and Methods: The immunocytochemical method used specific markers for trophoblastic cells, whereas RT-PCR was used to identify insulin-like growth factor gene expression., Results: Histochemical staining with hematoxilin-eosin revealed that the cultures contained heterogeneous cell types, including trophoblast and endometrial decidual cells. The ratio of trophoblast cells in the cultures varied between 16% and 37%, as detected by cytokeratine-7 as the specific trophoblast marker. Gene expression analysis corroborated the presence of trophoblasts by detecting insulin-like growth factor II mRNA, whereas GH-V transcripts were correlated with the presence of syncitiotrophoblasts. Insulin-like growth factor I and insulin-like growth factor binding protein 1 mRNAs were related to mesenchyimal and decidual cells, respectively. Higher insulin-like growth factor II expression levels were found in molar tissues in comparison with non-molar abortions., Conclusion: By combining three methodologies-morphology, immunocytochemistry and gene expression, characterization and follow-up of placenta cultures from abnormal tissues is found to facilitate diagnosis.