[TREATMENT WITH INO OF INFANTS WITH PPHN.]

PPHN is a life threatening disease that appears as a result of high pulmonary vascular resistance and persistent right to left shunt across foramen ovale and ductus arteriosus. The treatment of PPHN is complex and often ineffective. iNO is important part of the pathogenetic treatment of the disease. We present six infants with PPHN treated with iNO. The clinical effect of the drug was quick and the hemodynamics stabilized. All infants survived without side effects and with better neurodevelopment outcome.

[Treatment of PPHN with iNO in an Infant with Trombophilia and Thrombus in PDA. Clinical Case.]

PPHN is common in 1-2/1000 newborn infants. The morbidity and mortality accompanying the disease are extremely high. The treatment is frequently ineffective. The therapy with iNO is the fir l strategy based therapy of PPHN. We present the clinical case of an infant with congenital pneumonia and secondary PPHN treated with iNO. During the clinical observation of the infant congenital trombophilia was diagnosed, due to the presence of a thrombus in PDA. The outcome was favorable.

[TREATMENT OF EXTREMELY PREMATURE NEWBORN INFANT WITH INO. CLINICAL CASE].

Prolonged inhaled nitric oxide (iNO) from birth in preterm neonates with BPD improves endogenous surfactant function as well as lung growth, angiogenesis, and alveologenesis. As a result there is a reduction in the frequency of the "new" form of BPD in neonates under 28 weeks of gestation and birth weight under 1000 gr. Delivery of inhaled nitric oxide is a new method of prevention of chronic lung disease. According to a large number of randomized trials iNO in premature neonates reduces pulmonary morbidity and leads to a reduction of the mortality in this population of patients. This new therapy does not have serious side effects. We represent a clinical case of extremely premature newborn infant with BPD treated with iNO.

[The importance of some factors which endanger the eradication of malaria in Moldavia]. / Ponderea unor factori care pericliteaza eradicarea paludismului în Moldova.

The present paper reports on the results of a haematologic and serologic survey carried out for assessing quantitatively and qualitatively the importation of malaria, in terms of the two routes of penetration of plasmodia in Moldavia. Examination of peripheral blood droplets and testing by indirect immunofluorescence showed the higher proportions recorded in subjects coming from endemic malarial areas (6.6% and 70.9% respectively) than in our citizens travelling abroad in malarial areas (0.1% and 3.3% respectively). Attention is drawn to the essential components of the epidemiologic situation today: the existence of a dynamic reservoir of import plasmodia that can only be partly detected and is added to the residual autochtonous reservoir of P. malariae, to the receptivity of the human population and the presence of the natural transmitter vector P. vivax.

[Effectiveness of radical treatment in infections with antochthonous strains of P. malariae]. / Eficacitatea tratamentului în cura radicala în infectii cu suse autohtone de P. malariae.

The present paper reports on the results obtained in longitudinal serological investigations (indirect immunofluorescence and species homologous antigen) carried out with a review to evaluating the efficiency of the radical treatment in malaria caused by residual autochtonous P. malariae strains. In acute infections the treatment was followed by progressive decrease in the antibody level, tending towards zero in the course of a year; in the latent, asymptomatic infection, antibodies persisted at high levels for several years after the treatment, indicating persistence of the parasite and, hence, inefficiency of the treatment.

[Dynamics of the immune response in a familial focus of toxoplasmosis]. / Dinamica raspunsului imunitar intr-un focar familial de toxoplasmoza

Immunoepidemiological investigations were carried out in a family in which a child with congenital toxoplasmosis was born in 1972. The following were determined: total fluorescent antibodies and their G and M fractions and G and M serum immunoglobulins. The results showed: --the existence of a familial focus if infection with T. gondii, the risk of infection in the course of pregnancy and its consequences on the product of conception; --the normal evolution of the following pregnancy in the presence of anti-T. gondii fluorescent antibodies and the birth of a normal child; --value of the indirect immunofluorescence test for the diagnosis of congenital toxoplasmosis and of the longitudinal immunologic investigation; --determination of the antibody M fraction and serum immunoglobulins did not prove as useful as expected; --persistance of fluorescent antibodies in significant titers over a long period in the absence of a clinical symptomatology or with clinical manifestations of another etiology might lead to a false diagnosis of toxoplasmosis -- hence the necessity of a test for differentiating the carrier of specific antibodies from the toxoplasmosis patient.

[Prospective evaluation of the risk of congenital toxoplasmosis. II. Further data on the immune response during pregnancy]. / Evaluarea prospectiva a riscului toxoplasmozei congenitale. II. Date suplimentare asupra raspunsului imunitar în timpul sarcinii.

The indirect immunofluorescence test was carried out in 500 pregnant women in urban and rural areas, with a view to following conversion to seronegative values. The evolution of the immune background in infection with T. gondii was followed up by comparative analysis of the seroepidemiological data obtained in 1976 and 1977. It was found that:--Variations in the intensity of endogenous and exogenous factors bring about changes in the frequency and intensity of the immune response in toxoplasmosis.--Postnatal evolution of the child can be correlated with the age of pregnancy when seroconversion accurred and with the intensity of the latter.--The predominance of seroconversion in the 6th and 7th month of pregnancy and negativation of some of the responses during pregnancy suggest the need of an additional serological control during these months.--The effect of optimal conditions during springtime resulted in seasonal appearance of seroconversions, offering an additional orientation.--In the neonates of seropositive mothers no cases of manifest disease were observed; the presence of infection has to be subsequently confirmed or invalidated.