Long-term Outcomes of Congenital Cytomegalovirus Infection in Sweden and the United Kingdom

Background. Congenital cytomegalovirus (CMV) is an important cause of neurological problems, particularly sensorineural hearing loss, but data on long-term sequelae and the impact of nonprimary maternal infection are limited. We report updated findings on childhood outcomes from 2 large prospective studies. Methods. Pregnant women in Malmö, Sweden, and London, United Kingdom, were included between 1977 and 1986, and newborns were screened for CMV (virus culture of urine or saliva). Cases and matched controls underwent regular, detailed developmental assessments up to at least age 5 years. Results. One hundred seventy-six congenitally infected infants were identified among >50 000 screened (Malmö: 76 [4.6/1000 births]; London: 100 [3.2/1000 births]); 214 controls were selected. Symptoms were recorded in 11% of CMV-infected neonates (19/176) and were mostly mild; only 1 neonate had neurological symptoms. At follow-up, 7% of infants (11/154) were classified as having mild, 5% (7/154) moderate, and 6% (9/154) severe neurological sequelae. Four of 161 controls (2%) had mild impairment. Among children symptomatic at birth, 42% (8/19) had sequelae, versus 14% (19/135) of the asymptomatic infants (P = .006). All moderate/severe outcomes were identified by age 1; mild sequelae were first identified at age 2-5 years in 6 children, and age 6-7 years in 3. Among the 16 children with moderate/severe outcomes, 2 had mothers with confirmed and 7 with presumed nonprimary infection. Conclusions. Moderate or severe outcomes were reported in 11% of children with congenital CMV identified through population screening, all by 1 year; all impairment detected after this age was mild. Nonprimary infections contributed substantially to the burden of childhood congenital CMV disease

Reovirus type 1 associated with meningitis

A previously healthy 3-month-old girl presented with symptoms of meningitis, diarrhoea, vomiting and fever. Green monkey kidney (GMK) cells inoculated with cerebrospinal fluid (CSF) revealed reovirus-like particles by electron microscopy. RNA-gel electrophoresis, immunofluorescence and virus neutralization identified the pathogen isolated from CSF as reovirus type 1. Antibody determination by immunofluorescence of paired sera showed a significant antibody titre rise to the CSF isolate and neutralization test revealed a greater than 4-fold antibody titre rise to the CSF isolate. The CSF isolate was also neutralized by reovirus type 1 antibodies. This report represents one of a few associating reovirus with CNS symptoms in humans

Long-term Outcomes of Congenital Cytomegalovirus Infection in Sweden and the United Kingdom

Background. Congenital cytomegalovirus (CMV) is an important cause of neurological problems, particularly sensorineural hearing loss, but data on long-term sequelae and the impact of nonprimary maternal infection are limited. We report updated findings on childhood outcomes from 2 large prospective studies. Methods. Pregnant women in Malmo, Sweden, and London, United Kingdom, were included between 1977 and 1986, and newborns were screened for CMV (virus culture of urine or saliva). Cases and matched controls underwent regular, detailed developmental assessments up to at least age 5 years. Results. One hundred seventy-six congenitally infected infants were identified among >50 000 screened (Malmo: 76 [4.6/1000 births]; London: 100 [3.2/1000 births]); 214 controls were selected. Symptoms were recorded in 11% of CMV-infected neonates (19/176) and were mostly mild; only 1 neonate had neurological symptoms. At follow-up, 7% of infants (11/154) were classified as having mild, 5% (7/154) moderate, and 6% (9/154) severe neurological sequelae. Four of 161 controls (2%) had mild impairment. Among children symptomatic at birth, 42% (8/19) had sequelae, versus 14% (19/135) of the asymptomatic infants (P =.006). All moderate/severe outcomes were identified by age 1; mild sequelae were first identified at age 2-5 years in 6 children, and age 6-7 years in 3. Among the 16 children with moderate/severe outcomes, 2 had mothers with confirmed and 7 with presumed nonprimary infection. Conclusions. Moderate or severe outcomes were reported in 11% of children with congenital CMV identified through population screening, all by 1 year; all impairment detected after this age was mild. Nonprimary infections contributed substantially to the burden of childhood congenital CMV disease

Reaching Full Density of 100Cr6 PM Steel by Capsule Free Hot Isostatic Pressing of High-Velocity Compacted Material

Spherical gas atomised 100Cr6 steel powder, processed with the MMS-Scanpac\uae process to 95% density (agglomeration, followed by conventional pressing, low temperature sintering and re-strike using high velocity adiabatic compaction) has been fully compacted using capsule-free hot isostatic pressing. The material is characterised at different steps of the process and the results are discussed in this paper. Sintering steel powder with high content of carbon requires carbon control at sintering. By continuously measuring the atmosphere at sintering the ingoing gases are adjusted so that carbon control is achieved. Computational work has been made in order to determine how the sintering atmosphere should be adjusted based on the oxygen release and moisture content in the furnace at sintering

Reaching Full Density of 100Cr6 PM Steel by Capsule Free Hot Isostatic Pressing of High-Velocity Compacted Material

Spherical gas atomised 100Cr6 steel powder, processed with the MMS-Scanpac\uae process to 95% density (agglomeration, followed by conventional pressing, low temperature sintering and re-strike using high velocity adiabatic compaction) has been fully compacted using capsule-free hot isostatic pressing. The material is characterised at different steps of the process and the results are discussed in this paper. Sintering steel powder with high content of carbon requires carbon control at sintering. By continuously measuring the atmosphere at sintering the ingoing gases are adjusted so that carbon control is achieved. Computational work has been made in order to determine how the sintering atmosphere should be adjusted based on the oxygen release and moisture content in the furnace at sintering

As-HIP Microstructure Of EBM Fabricated Shell Components

Electron Beam Melting (EBM) was used to build Ti-6Al-4V cylindrical shell samples with different wall thickness filled with powder. Built shell samples were HIPed and the difference in microstructure between the EBM-built walls and densified powder inside the shell components was studied as well as the cohesion between these two regions. Components characterization utilizing LOM and SEM+EBSD indicates that columnar grain growth was consistent before and after HIP in the EBM-built part of the components (walls), whereas the densified material in the center of the component had a fine isotropic microstructure, characteristic for HIPed material. The combination of EBM and HIP is shown to be an attractive way of manufacturing complex-shape full density components for high performance applications, involving shortening of built time in the EBM-processing and lead time in capsule fabrication for HIP

As-HIP Microstructure Of EBM Fabricated Shell Components

Electron Beam Melting (EBM) was used to build Ti-6Al-4V cylindrical shell samples with different wall thickness filled with powder. Built shell samples were HIPed and the difference in microstructure between the EBM-built walls and densified powder inside the shell components was studied as well as the cohesion between these two regions. Components characterization utilizing LOM and SEM+EBSD indicates that columnar grain growth was consistent before and after HIP in the EBM-built part of the components (walls), whereas the densified material in the center of the component had a fine isotropic microstructure, characteristic for HIPed material. The combination of EBM and HIP is shown to be an attractive way of manufacturing complex-shape full density components for high performance applications, involving shortening of built time in the EBM-processing and lead time in capsule fabrication for HIP