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Objective To determine the effect of primary cytomegalovirus (CMV) infection in the third trimester on fetal outcome. Design Observational study. Setting Four perinatal departments in tertiary hospitals in Israel. Population Twenty-eight women with primary CMV infection acquired after 25 weeks of gestation. Methods Prenatal evaluation included amniocentesis and ultrasonographic examinations. Maternal infection was determined from seroconversion and presence of low avidity anti-CMV immunoglobulin G after 25 weeks of gestation. Fetal CMV infection was diagnosed from CMV isolated or CMV DNA amplified from the amniotic fluid. Neonatal infection was established from CMV presence in their urine or anti-CMV IgM was in their peripheral blood immediately after birth. All liveborn neonates underwent cerebral ultrasonography, hearing assessment, and psychomotor development evaluation. Infected neonates were followed up for a median of 36 months (range 6–36 months). Main outcome measures Intrauterine CMV infection and neonatal CMV disease throughout follow up. Results Vertical transmission of CMV was documented in 21 (75%) of the 28 pregnancies. None of the 20 live infected newborn had symptomatic congenital infection. One pregnancy was terminated at 34 weeks following evidence of prenatal infection. Most of the patients (75%) had CMV serology test due to clinical signs of CMV disease. Conclusions Although CMV infection during the third trimester of pregnancy is highly transmissible, sequelae were not found among infected offspring. [ABSTRACT FROM AUTHOR]

Introduction Current tests for diagnosing HIV-associated neurocognitive dysfunction (HAND) consume time and energy and are not very practical as a screening tool in the busy clinic. The clock-drawing test (CDT) was reported sensitive to subcortical pathology associated with periventricular and deep white matter. In addition, CDT has shown to be sensitive to executive dysfunction. Aim The aim of this study was to determine the value of a clock-drawing test as a screening tool for diagnosing HAND. Methods: The CDT that we used was largely based on Rouleau et al. (1992). The patient is asked to draw a clock, first the frame, than the numbers, and than the hands showing the time 10 to 2. The interpretation is based on the following criteria: frame, numbers, hands, center, general impression. If acceptable-2 points, non-acceptable-0, and acceptable but deviating-1 point. Other validated neurocognitive tests (e.g. TMA, TMB, DSST, etc) were used as the 'gold standard'. Results In the primary analysis 54 patients were included: 47 men and 7 women. Sensitivity was 77%, specificity 90%, positive predictive value 71.4%, negative predictive value 92.5%. In this preliminary study we found CDT to be a valid screening tool for HAND. It correlates highly with other well-established screening tools, but demands less resources (human and technological). It is especially good for ruling out the disease. [ABSTRACT FROM AUTHOR]

The immunogenicity and safety of Pfizer-BioNTech BNT162b2 mRNA vaccine in allogeneic haematopoietic stem cell transplantation (HSCT) recipients are unknown. We prospectively followed 152 HSCT recipients who were at least six months following transplantation and with no active acute graft-versus-host disease (GVHD). Blood samples were taken 2-4 weeks after the second vaccination and analyzed for receptor-binding domain (RBD) antibodies and neutralizing antibodies (NA). 272 immunocompetent healthcare workers served as controls. At a median of 28 days after the second vaccination, 118 patients (77·6%) developed RBD immunoglobulin G (IgG) with a geometric mean titre (GMT) of 2·61 [95% CI (confidence interval), 2·16-3·16]. In the control group 269/272 (98·9%) developed RBD IgG, with a GMT of 5·98 (95% CI 5·70-6·28), P < 0·0001. The GMT of NA in HSCT recipients and controls was 116·0 (95% CI 76·5-175·9), and 427·9 (95% CI 354·3-516·7) respectively (P < 0001). Multivariate logistic regression analysis revealed that HSCT recipients with no chronic GVHD and no immunosuppressive therapy at the time of vaccination had significantly higher levels of NA following the second vaccination. Adverse events were minimal and were less common than in healthy controls. In conclusion; the BNT162b2 mRNA vaccination is safe and effective in HSCT recipients, especially those who are immunosuppression-free. A significant fraction developed protecting NA., (© 2021 British Society for Haematology and John Wiley & Sons Ltd.)

Objective: To determine the effect of primary cytomegalovirus (CMV) infection in the third trimester on fetal outcome., Design: Observational study., Setting: Four perinatal departments in tertiary hospitals in Israel., Population: Twenty-eight women with primary CMV infection acquired after 25 weeks of gestation., Methods: Prenatal evaluation included amniocentesis and ultrasonographic examinations. Maternal infection was determined from seroconversion and presence of low avidity anti-CMV immunoglobulin G after 25 weeks of gestation. Fetal CMV infection was diagnosed from CMV isolated or CMV DNA amplified from the amniotic fluid. Neonatal infection was established from CMV presence in their urine or anti-CMV IgM was in their peripheral blood immediately after birth. All liveborn neonates underwent cerebral ultrasonography, hearing assessment, and psychomotor development evaluation. Infected neonates were followed up for a median of 36 months (range 6-36 months)., Main Outcome Measures: Intrauterine CMV infection and neonatal CMV disease throughout follow up., Results: Vertical transmission of CMV was documented in 21 (75%) of the 28 pregnancies. None of the 20 live infected newborn had symptomatic congenital infection. One pregnancy was terminated at 34 weeks following evidence of prenatal infection. Most of the patients (75%) had CMV serology test due to clinical signs of CMV disease., Conclusions: Although CMV infection during the third trimester of pregnancy is highly transmissible, sequelae were not found among infected offspring.

The incidence of infections among patients with thalassaemia and the role of risk factors for infection are uncertain. We studied the occurrence of infections necessitating hospitalisation in 92 homozygous beta-thalassaemia patients who had been followed longitudinally for decades, and investigated the role of potential risk factors for these infections. Pneumonia accounted for 26% of the infections and fever of unknown origin for 14%. Staphylococcus aureus was the major pathogen possibly related to injections associated with intensive chelation with deferoxamine. There was a significant increase in the rate of infection over time, notably after 15 years. Splenectomy correlated with the incidence of infection (P < 0.001) without being confounded by other variables and with highest frequencies of infections present after 10 years. A direct correlation between iron overload and infection was evident only before the initiation of iron-chelating treatment (P < 0.01). Following initiation of deferoxamine, paradoxically, the infection rate increased (P = 0.046). The combination of splenectomy and deferoxamine treatment was associated with the highest adjusted infection rate. Parathyroid dysfunction and glucose-6-phosphate dehydrogenase deficiency were significantly associated with infection (P = 0.02 and P = 0.04 respectively). The infection rate in thalassaemia is affected mainly by the duration of the disease and is increased by splenectomy and, in the long term, by treatment with deferoxamine.

The present study addresses the association between immigration from the former Soviet Union (FSU) and gender and alcohol consumption among a representative sample of young adults in Israel 2000. Previous studies that were conducted on FSU immigrants to Israel indicate higher consumption than that of resident Israelis and immigrants of earlier periods. The current study aims to assess alcohol consumption among FSU and resident Israelis five years later to determine whether the discrepancy in alcohol consumption stays consistent or reduces. In addition, gender differences in alcohol consumption among the Israeli society were examined as well, as a special case of socio-culture differences. The data came from the 2000 national survey of drinking in Israel. Of 5,004 Jewish Israelis, 532 were immigrants from the FSU who arrived since 1989, and 4,472 were resident Israelis. The FSU group was compared with resident Israelis, and males were compared to females on several drinking variables. Logistic regression was the principal method of analysis. Demographics and cultural variables as main effects or in interaction with FSU and gender were controlled. The FSU group was significantly more likely to report drinking in the last twelve months plus drinking in the last thirty days than resident Israelis. Women's reported drinking in the last twelve months was one fourth of men's and during the past thirty days was one fifth of men's. Further investigation on the associations between the success of FSU acculturation in the Israeli society and drinking patterns as well as attitudes toward women and gender differences in alcohol consumption may provide explanations for gender and immigration gaps in alcohol consumption.

Aims: To examine the consistency and/or variability of gender differences in drinking behavior cross-culturally., Design, Setting, Participants: Women's and men's responses in 16 general population surveys from 10 countries, analyzed by members of the International Research Group on Gender and Alcohol., Measurements: Comparable measures of drinking, versus abstention, typical drinking frequencies and quantities, heavy episodic drinking, intoxication, morning drinking, and alcohol-related family and occupational problems., Findings: Women and men differed little in the probability of currently drinking versus abstaining, but men consistently exceeded women in typical drinking frequencies and quantities and in rates of heavy drinking episodes and adverse drinking consequences, while women were consistently more likely than men to be life-time abstainers. In older age groups, both men and women drank smaller quantities of alcohol and were more likely to stop drinking altogether, but drinking frequencies did not change consistently with age., Conclusions: A theoretical synthesis proposes that gender roles may amplify biological differences in reactions to alcohol, and that gender differences in drinking behavior may be modified by macrosocial factors that modify gender role contrasts.