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Perpustakaan Keluarga Helmut Todo Tua Simamora dr. Olga Y.V Hutapea
TORCH Syndrome refers to infection of a developing fetus or newbornby any of a group of infectious agents. "TORCH" is an acronym meaning (T)oxoplasmosis, (O)ther Agents, (R)ubella (also known as German Measles), (C)ytomegalovirus, and (H)erpes Simplex. Infection with any of these agents (i.e., Toxoplasma gondii, rubella virus, cytomegalovirus,herpes simplex viruses) may cause a constellation of similar symptoms in affected newborns. These may include fever; difficulties feeding; small areas of bleeding under the skin, causing the appearance of small reddish or purplish spots; enlargement of the liver and spleen(hepatosplenomegaly); yellowish discoloration of the skin, whites of the eyes, and mucous membranes (jaundice); hearing impairment; abnormalities of the eyes; and/or other symptoms and findings. Each infectious agent may also result in additional abnormalities that may be variable, depending upon a number of factors (e.g., stage of fetal development).
Pregnant women are at particular risk from toxoplasmosis
Protein key to parasite potency
Toxoplasma is carried by cats and rats in the UK, and a large proportion of humans are also thought to carry the parasite, without any ill effects.
But it can cause toxoplasmosis, which can lead to brain damage or even death.
Stanford University scientists, writing in Nature, say the behaviour of a single protein determines what happens.
Toxoplasma is particularly dangerous for people with weakened immune systems, such as those with HIV, and for women in the first three months of pregnancy, as it can cause severe birth defects.
Its normal lifecycle starts in cats. It is then passed, usually via the cat's faeces, to rats and then back to cats when they catch and eat the infected rats.
Humans can become infected either when they come into contact with cat faeces, or by eating undercooked mutton, as sheep can also become carriers.
The Stanford researchers are interested in the ability of Toxoplasma to adapt genetically to a wide variety of hosts.
Their study reveals how the parasite injects a single protein into a cell it wants to invade, and how this protein makes its way to the nucleus of the cell and interferes with the ability of the cell to trigger an immune defence.
Susan Coller, one of the researchers leading the project, said that the strategy was very effective: "The nucleus is the heart of the cell, the ultimate prize. If you want to affect the cell in a dramatic way, go straight there."
The other finding was subtle differences in this key protein between different types of Toxoplasma - each different strain perhaps tailored to infecting different types of host cell with the minimum damage.
Severe toxoplasmosis may happen when the "wrong" strain, one not suited to infecting humans, tries to invade our cells with the protein either too powerful - overwhelming and destroying them, or ineffective - triggering a massive immune system response.
They suggest that their discoveries about how Toxoplasma is so successful could also apply to our parasite invaders - such as malaria.
Professor John Barrett, a senior lecturer in parasitology at the University of Aberystwyth, said that there were arguments for screening pregnant women for Toxoplasma to avoid birth defects.
"The effect on the foetus can be very serious and there is a reliable test for Toxoplasma, so in these higher risk groups, it may be worthwhile."
Women who are infected with a common parasite may be more likely to harm themselves or to attempt suicide, according to a study of more than 45,000 Danish women.
The infection, known as toxoplasmosis, is caused by the parasite Toxoplasma gondii. Humans can become chronically infected by eating undercooked meat or unwashed vegetables, or by handling cat litter, as the parasite is known to multiply in the gut of infected cats.
Some studies have linked the parasite to a higher chance of developing schizophrenia, and researchers believe that because the T. gondii parasite lives in the brain, it could have an effect on emotions and behavior.
"Women with a T gondii infection have an increased risk of self-directed violence," wrote study leader Teodor Postolache at the University of Maryland School of Medicine in Baltimore in the Archives of General Psychiatry.
For the study, Postolache and his colleagues used Danish medical registries to track 45,788 women who were originally included in a study that screened newborn babies for toxoplasmosis.
Toxoplasmosis is often symptom-free, but it can be dangerous in people with weak immune systems or during pregnancy, since the parasite may be passed to babies.
All of the infants in the screening were tested for antibodies against the parasite through a blood sample drawn five to 10 days after birth. Because the babies were still too young to make their own antibodies, any that showed up in their blood would have been passed from their mothers.
Just over one-quarter of the babies were positive for the antibodies, meaning their mothers likely had a chronic, underlying toxoplasmosis infection.
And over the next 11 to 14 years, infected women were about 50 percent more likely to cut, burn or otherwise hurt themselves, according to their medical records. They were 80 percent more likely to attempt suicide.
In total, 488 women hurt themselves for the first time during the study, or eight out of every 10,000 annually, and 78 tried to kill themselves.
Louis Weiss, who studies toxoplasmosis at Albert Einstein College of Medicine in New York but was not involved with the study, said the findings were "really quite interesting" but that the risk was not very high.
"There probably is an effect of this parasite on human behavior, which has been suspected" based on studies of animals infected with the parasite, Weiss added.
Overall, only 18 women in the study actually committed suicide, which was too small a number for the researchers to determine if the parasite put some women at higher risk.
Based on the studies, Postolache and his colleagues also could not say for sure whether toxoplasmosis infection caused the women to harm themselves or attempt suicide. It could be, for example, that women with underlying mental problems were more likely to pick up the parasite because they cooked their meat or washed their vegetables improperly.
But he also said the parasite could directly affect the brain, by making cells produce more or less of certain neurotransmitters that control mood and behavior. The immune system may also contain an infection at the cost of brain function.
Both researchers emphasized that pregnant women should not avoid or get rid of their housecats based on the findings, with Weiss noting that most of the parasites that cause infection are passed by feral cats and end up in the environment.