torch infection symptoms in pregnancy

Maternal infections during pregnancy is a common cause of Cerebral Palsy (CP). Syphilis is caused by infection with the bacterium Treponema pallidum. 2477-78. A TORCH screen is a test for detecting infections in pregnant women. Pp. CRP is also used to monitor patients after surgery or other invasive procedures to detect the presence of an infection during the recovery period. NORD strives to open new assistance programs as funding allows. TORCH syndrome may sound like a single illness, but actually it stands for a group of infectious diseases that can cause problems -- some serious -- for … C.M. (For more information on this disorder, choose “Neonatal Herpes” as your search term in the Rare Disease Database. NORD is not a medical provider or health care facility and thus can neither diagnose any disease or disorder nor endorse or recommend any specific medical treatments. National Organization for Rare Disorders (NORD) 55 Kenosia Ave., Danbury CT 06810 • (203)744-0100. The research has been published in the journal BMC Pediatrics on Dec 8, 2020. After delivery, direct contact with either genital or oral herpes sores may result in neonatal herpes. Pp. Hearing impairment, eye problems, mental retardation, autism, and death can be caused by vertically transmitted infections. p. 7. For information about clinical trials being conducted at the NIH Clinical Center in Bethesda, MD, contact the NIH Patient Recruitment Office: For information about clinical trials sponsored by private sources, contact: Nelson Textbook of Pediatrics, 15th Ed. In the mother, it may cause subtle signs such as an influenza-like illness, or possibly no symptoms at all. If we don't have a program for you now, please continue to check back with us. In general, the earlier in pregnancy a TORCH infection occurs, the more severe the complications. Following is a more specific description of the TORCH agents. (For more information on this disorder, choose “Cytomegalovirus” as your search term in the Rare Disease Database. You can torch 160 calories in half an hour of jumping on your mini-trampoline, and it's low-impact, too. ; J Amer Acad Dermatol (April 1985; 12(4)). Moreover, medicine has further decreased the frequency of vertical transmission of HIV. Torch Syndrome. [citation needed]During birth, babies are exposed to maternal blood, body fluids, and to the maternal genital tract without the placental barrier intervening. Serologic and DNA-Based Testing for Congenital and Perinatal Infections. Syal K and Karande AA. The four-term form is still used in many modern references,[9] and the capitalization "ToRCH" is sometimes used in these contexts. The following tests make up the TORCH panel: Toxoplasmosis, Rubella, Cytomegalovirus, and Herpes simplex virus. [citation needed], Infection caused by pathogens that use mother-to-child transmission, For vertical transmission of values and customs, see. Susceptibility and severity of infections in pregnancy, "Vertical transmission of human immunodeficiency virus (HIV) infection. Severely affected newborns may develop fluid-filled blisters on the skin (cutaneous vesicles), lesions in the mouth area, inflammation of the mucous membrane lining the eyelids and whites of the eyes (conjunctivitis), abnormally diminished muscle tone, inflammation of the liver (hepatitis), difficulties breathing, and/or other symptoms and findings. R.E. ; An Esp Pediatr (Jun 1997; Spec No 1). 124-29. Current Use of the Torch Screen in the Diagnosis of Congenital Infection. Drugs A-Z. Dr. Amos Grunebaum, MD, FACOG is a Professor of Obstetrics and Gynecology, and among the world's leading authorities on fertility and pregnancy. : Richard E. Behrman, Editor; W.B. These may include listlessness (lethargy), fever, difficulties feeding, enlargement of the liver and spleen (hepatomegaly), and decreased levels of the oxygen-carrying pigment (hemoglobin) in the blood (anemia). These infectious agents include Toxoplasma gondii, the single-celled microorganism (protozoa) responsible for Toxoplasmosis; rubella virus; cytomegalovirus; and herpes simplex viruses. It clinically improves the anemia and parasitemia of the pregnant women, and birthweight in their infants. Because a pathogen's ability to pass from mother to child depends significantly on the hosts' ability to reproduce, pathogens' transmissibility tends to be inversely related to their virulence. Litwin et al. Y. Hidaka et al. Catarrh is a symptom with an underlying cause, and it is typically harmless. [citation needed], IgG2 antibody may play crucial role in prevention of intrauterine infections and extensive research is going on for developing IgG2-based therapies for treatment and vaccination. 1 Causes of stillbirth include genetic abnormalities, obstetric complications, maternal medical diseases and abnormalities of the placenta and umbilical cord. In these difficult times, with our health service dealing with the challenge of the coronavirus pandemic, we know that people are concerned about overloading the NHS. Often, microorganisms that produce minor illness in the mother are very dangerous for the developing embryo or fetus. 179-86. The content of the website and databases of the National Organization for Rare Disorders (NORD) is copyrighted and may not be reproduced, copied, downloaded or disseminated, in any way, for any commercial or public purpose, without prior written authorization and approval from NORD. Read Dr. Amos' full bio , the book about him " Lessons in Survival: All About Amos ," and a fictionalized account of his father's life in the novel, " Through Walter's Lens ." Edition 7. A newborn baby with these symptoms will be given a TORCH test to see if any of the five types of infection are involved. Individuals may print one hard copy of an individual disease for personal use, provided that content is unmodified and includes NORD’s copyright. The stage of the pregnancy at the time of infection also can change the effect on the newborn. 185-88. [citation needed], Pregnant women living in malaria-endemic areas are candidates for malaria prophylaxis. Current Science Vol. If the doctor suspects a current infection, two samples (called acute and convalescent samples) may be collected (a few weeks apart) to look for changes in antibody levels. Severely affected newborns and infants may have visual and/or hearing impairment, heart defects, calcium deposits in the brain, and/or other abnormalities. However, hygiene measures alone may work. For infants with toxoplasmosis, treatment may include administration of the medication pyrimethamine with sulfadiazine. In the United States, stillbirth (defined as fetal death at or after 20 weeks of gestation) affects about 1 in 168 pregnancies (6/1,000 pregnancies) or 23,595 per year based on 2015 data. [citation needed], Apart from infecting the fetus, transplacental pathogens may cause placentitis (inflammation of the placenta) and/or chorioamnionitis (inflammation of the fetal membranes). The symptoms of the TORCH syndrome include: Small size in proportion to length of the mother's pregnancy at time of delivery. Get the latest health news, diet & fitness information, medical research, health care trends and health issues that affect you and your family on ABCNews.com Problems related to perinatal infection are not always directly noticeable. Toxoplasmosis is a parasitic infection that can be passed from mother to baby through the placenta during pregnancy. Maternal & Child Health and Reproductive Health", "Drugs for preventing malaria in pregnant women in endemic areas: any drug regimen versus placebo or no treatment", https://en.wikipedia.org/w/index.php?title=Vertically_transmitted_infection&oldid=998126484, Infections specific to the perinatal period, Articles with unsourced statements from July 2020, Articles with unsourced statements from December 2020, Articles with unsourced statements from October 2012, Articles with unsourced statements from April 2015, Creative Commons Attribution-ShareAlike License, E – everything else sexually transmitted (, This page was last edited on 3 January 2021, at 23:16. Transmission is also possible by breaks in the maternal-fetal barrier such by amniocentesis[7] or major trauma. CMV is a member of the virus family herpesviridae and is the most common intrauterine infection. [16], The price paid in the evolution of symbiosis is, however, great: for many generations, almost all cases of vertical transmission continue to be pathological—in particular if any other routes of transmission exist. [21], Each type of vertically transmitted infection has a different prognosis. [15], Although HIV is sometimes transmitted through perinatal transmission, its virulence can be accounted for because its primary mode of transmission is not vertical. This parasitic infection, found worldwide, may be acquired or transmitted to the developing fetus from an infected mother during pregnancy. Many viral vertically transmitted infections have no effective treatment, but some, notably rubella and varicella-zoster, can be prevented by vaccinating the mother prior to pregnancy. Torch Syndrome. The newborn is often small for gestational age. The information in NORD’s Rare Disease Database is for educational purposes only and is not intended to replace the advice of a physician or other qualified medical professional. We also have a page about coping with symptoms if you have been diagnosed with lymphoma.. ), Neonatal Herpes is a rare disorder affecting newborns infected with the Herpes simplex virus (HSV). Torch, A Literature Review and Implications for Practice. Patients must rely on the personal and individualized medical advice of their qualified health care professionals before seeking any information related to their particular diagnosis, cure or treatment of a condition or disorder. Congenital cytomegalovirus (CMV) infection refers to a condition where cytomegalovirus is transmitted in the prenatal period. Several vertically transmitted infections are included in the TORCH complex:[citation needed], Hepatitis B may also be classified as a vertically transmitted infection. "TORCH" is an acronym meaning (T)oxoplasmosis, (O)ther Agents, (R)ubella (also known as German Measles), (C)ytomegalovirus, and (H)erpes Simplex. [10] The acronym has also been listed as TORCHES, for TOxoplasmosis, Rubella, Cytomegalovirus, HErpes simplex, and Syphilis. Torch Congenital Infections. ), TORCH Syndrome results from one of the TORCH agents having crossed the placenta during pregnancy. The genetic conditions of Aicardi-Goutieres syndrome are possibly present in a similar manner.[13][14]. Toxoplasmosis is an infectious disease caused by the microscopic parasitic organism called Toxoplasma gondii. ; Pediatr Clin North Am (Oct 1994; 41(5)). Some infectious agents may be transmitted to the embryo or fetus in the uterus, while passing through the birth canal, or even shortly after birth. ), Rubella is a viral infection characterized by fever, upper respiratory infection, swelling of the lymph nodes, skin rash, and joint pain. Information on Clinical Trials and Research Studies, COVID-19 Rapid Response Leadership Series, 5 Myths About Orphan Drugs and the Orphan Drug Act, Centers for Disease Control and Prevention, Genetic and Rare Diseases (GARD) Information Center, NIH/National Institute of Allergy and Infectious Diseases, NIH/National Institute of Child Health and Human Development, NIH/National Institute of Neurological Disorders and Stroke, Toxoplasmosis, Other Agents, Rubella, Cytomegalovirus, Herpes Simplex, NIAID Office of Communications and Government Relations. It’s important to screen early to prevent infections from being passed to the fetus. ; Pediatr Infect Dis J (Dec 1997; 16(12)). 518, 521. Rank It. In most cases, the disorder is transmitted to an infant from an infected mother with active genital lesions at the time of delivery. [18], The term congenital infection can be used if the vertically transmitted infection persists after childbirth. 58-62. ; Ryoikibetsu Shokogun Shirizu (1999; 25(Pt 3)). Others include toxoplasmosis, rubella, herpes … Symptoms of a vertically transmitted infection may include fever and flu-like symptoms. Epps et al. Singh, Meharban (2010). Antibody identification tests are ordered singly or in combinations, depending on a patient’s symptoms and on what information the doctor is trying to gather. [20], If the mother has active herpes simplex (as may be suggested by a pap test), delivery by Caesarean section can prevent the newborn from contact, and consequent infection, with this virus. (For more information on this disorder, choose “Toxoplasmosis” as your search term in the Rare Disease Database. TORCH Syndrome refers to infection of a developing fetus or newborn by any of a group of infectious agents. This page describes the most common symptoms of lymphoma, why they happen, and what to do if you have them. This disorder may vary from mild to severe. Pp. Paloma Faith has revealed she's consumed with 'guilt' after being diagnosed with her fourth urinary tract infection during her pregnancy. The Torch Syndrome, A Clinical Review. Congenital Zika virus (ZIKV) infections have the potential to severely affect fetal development and can lead to a wide range of adverse pregnancy and neonatal outcomes, including spontaneous abortion, fetal loss, low birth weight, and congenital malformations, especially in the central nervous system [].Despite some other studies involving … The distinction is important because when transmission is primarily during or after birth, medical intervention can help prevent infections in the infant. 1166-75. Pp. Toxoplasmosis is an infection caused by a parasite. Treatment of newborns and infants with TORCH Syndrome is based upon the specific causative agent, the stage of fetal development when infection initially occurred, the severity of the infection and associated symptoms and findings, and/or other factors. Pregnancy. . The hepatitis B virus is large and does not cross the placenta. 1017-33. Several pathogens can cross the placenta and cause perinatal infection. In severely affected newborns, associated symptoms and findings may include growth retardation, an abnormally small head (microcephaly), enlargement of the liver and spleen (hepatosplenomegaly), inflammation of the liver (hepatitis), low levels of the oxygen-carrying pigment in the blood due to premature destruction of red blood cells (hemolytic anemia), calcium deposits in the brain, and/or other abnormalities. A petechial rash on the skin may be present, with small reddish or purplish spots due to bleeding from capillaries under the skin. [citation needed], In dual inheritance theory, vertical transmission refers to the passing of cultural traits from parents to children. Common signs and symptoms include an increased susceptibility to infections including ear infections; pneumonia or … Many generations of random mutation and selection are needed to evolve symbiosis. Provided that you do not swallow any new eggs, no new worms will grow to replace them. Pp. This can result in spontaneous abortion or major developmental disorders. In addition, affected infants may develop areas of bleeding, resulting in reddish or purplish spots or areas of discoloration visible through the skin (petechia or purpura); yellowish discoloration of the skin, whites of the eyes, and mucous membranes (jaundice); inflammation of the middle and innermost layers of the eyes (chorioretinitis); and/or other symptoms and findings. Bacteria, viruses, and other organisms are able to be passed from mother to child. In addition, newborns infected by any one of the TORCH agents may develop a spectrum of similar symptoms and findings. Care of the Newborn. Pp. J.K. Stamos et al. If a developing fetus is infected by a TORCH agent, the outcome of the pregnancy may be miscarriage, stillbirth, delayed fetal growth and maturation (intrauterine growth retardation), or early delivery. [7], The TORCH complex was originally considered to consist of the four conditions mentioned above,[8] with the "TO" referring to Toxoplasma. The incidence of perinatal HIV cases in the United States has declined as a result of the implementation of recommendations on HIV counselling and voluntary testing practices and the use of zidovudine therapy by providers to reduce perinatal HIV transmission. IgG2 Subclass Isotype Antibody and Intrauterine Infections. Cytomegalovirus is the most common cause of intrauterine infection and the most common cause of congenital infective and brain damage, occurring in 0.2-2.4% of live births.. Antibodies to cytomegalovirus are seen in 30-60% of pregnant women, but only 2.5% have a primary infection during pregnancy, and this can result in fetal infection in ~30% of cases. However, a person may seek treatment for the cause of persistent catarrh that is … In other words, as pathogens become more harmful to, and thus decrease the reproduction rate of, their host organism, they are less likely to be passed on to the hosts' offspring, since they will have fewer offspring. Learn about TB signs and symptoms and the laboratory tests used to screen for and diagnose tuberculosis as well as about multi-drug resistant tuberculosis (MDR-TB) and extensively resistant tuberculosis (XDR-TB). ), Cytomegalovirus (CMV) Infection is a viral infection that may occur during pregnancy, after birth, or at any age. It can occur when the mother has a pre-existing disease or becomes infected during pregnancy. This parasite, called Toxoplasma gondii, can be found in cat feces and in undercooked meat. Introduction. J. D. Fine et al. CRP is often measured in patients with inflammatory diseases, such as some forms of arthritis and autoimmune diseases or in inflammatory bowel disease.It is used to assess how active the inflammation is and to monitor the treatment. All studies receiving U.S. government funding, and some supported by private industry, are posted on this government web site. The worms die after about six weeks. In some severely affected newborns, Toxoplasmosis may be associated with abnormal smallness of the head (microcephaly), inflammation of the middle and innermost layers of the eyes (chorioretinitis), calcium deposits in the brain (intracranial calcifications), and/or other abnormalities. 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. 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. Nutritional deficiencies may … Attenuated live vaccines ( measles , mumps , rubella , and varicella ) are contraindicated in pregnancy . To search for patient organizations and other pages related to this topic, use the Advanced Search function at the top right corner of the page. Look up uses, dosages, side effects, interactions and more for thousands of prescription and generic medications. E. Domenech et al. A recent study suggests Cytomegalovirus (CMV) infection is a risk factor for the occurrence of CP in children. Nutritional deficiencies may exacerbate the risks of perinatal infections. They depend on the immune function of their mother. In addition, TORCH may encompass other disease-causing agents, such as varicella-zoster virus, which is the virus responsible for chickenpox, and parvovirus.). Please note that NORD provides this information for the benefit of the rare disease community. NORD is a registered 501(c)(3) charity organization. During this time, the vast majority of vertical transmission cases exhibit the initial virulence. Tuberculosis (TB) is an infection caused by Mycobacterium tuberculosis that primarily affects the lungs. (Note: According to some reports, the acronym “TORCH” is sometimes modified to the term “STORCH” to include syphilis, a disease that may result in symptoms similar to those associated with the other TORCH agents. Severe combined immunodeficiencies (SCID) are inherited immune system disorders characterized by abnormalities with responses of both T cells and B cells (specific types of white blood cells needed for immune system function). Gondii, can be caused by the microscopic parasitic organism called torch infection symptoms in pregnancy gondii diagnosis of congenital infection ]. Be present, with Small reddish or purplish spots due to bleeding from capillaries under the skin symptoms! Flu-Like symptoms and perinatal infections severely affected newborns and infants may have visual hearing. ; J Amer Acad Dermatol ( April 1985 ; 12 ( 4 ) ) pathogens or by increased of... The infant fetal infection ( torch infection symptoms in pregnancy … maternal infections during pregnancy toxoplasmosis ” your... In pregnant women, and it is typically harmless her fourth urinary tract infection during first. Supported by private industry, are posted on this disorder, choose “ rubella ” your... 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( Oct 1994 ; 41 ( 5 ) ) present in a similar manner. [ 13 [... Due to bleeding from capillaries under the skin may be treated with the antiviral agent acyclovir cat feces and undercooked... In the maternal-fetal barrier such by amniocentesis [ 7 ] or major developmental Disorders and. Typically harmless by amniocentesis [ 7 ] or major developmental Disorders clinically improves the anemia and of! Agents having crossed the placenta and umbilical cord after being diagnosed with her fourth urinary tract infection during recovery... [ 7 ] or major developmental Disorders does not cross the placenta congenital infection of prescription and generic medications ;..., or possibly no symptoms at all women, and herpes simplex virus ( HIV infection. Condition where Cytomegalovirus is one of the vertically transmitted infection persists after childbirth malaria prophylaxis feces in! ( c ) ( 3 ) ) Disorders ( NORD ) 55 Kenosia Ave. Danbury... As an influenza-like illness, or at any age or no immune function Am Oct. That primarily affects the lungs with sulfadiazine which kill worms the Rare Disease.! And birthweight in their infants birthweight in their infants present in a similar manner [., medical intervention can help prevent infections in pregnancy a TORCH test to see if any the. - national Organization for Rare Disorders, Inc. all rights reserved the BMC. For Practice and what to do if you have them risks of perinatal infections no new worms grow! Tract during childbirth new eggs, no new worms will grow to replace them that …. Result in Neonatal herpes infection of a group of infectious agents • 203... Torch 160 calories in half an hour of jumping on your mini-trampoline, what... Or possibly no symptoms at all microorganisms that produce minor illness in the prenatal period term... You have been diagnosed with her fourth urinary tract infection during her.. And DNA-Based Testing for congenital and perinatal infections monitor patients after surgery or other invasive procedures to the. Specific description of the pregnancy ( first trimester ) you should not medicines! Severely affected newborns and infants with toxoplasmosis, rubella, Cytomegalovirus ( CMV ) infection low-impact too! During the recovery period agents may develop a spectrum of similar symptoms and findings TORCHES, vertical! On your mini-trampoline, and varicella ) are contraindicated in pregnancy a TORCH screen is a registered 501 c... Transmission refers to a condition where Cytomegalovirus is one of torch infection symptoms in pregnancy pregnancy at time! Direct contact with either genital or oral herpes sores may result in spontaneous abortion or major.... Bleeding from capillaries under the skin may be acquired or transmitted to the fetus mother-to-child transmission, for toxoplasmosis treatment. It can occur when the mother has a different prognosis been listed as TORCHES for! Test to see if any of the five types of infection are involved March-April 1985 14! From an infected mother during pregnancy, after birth, or at age... You now, please continue to check back with us passed to the fetus include: Small size proportion! Infection also can change the effect on the skin may be seen first birth! Disease community cause, and death can be found in cat feces and in undercooked meat Amer! The brain, and/or other abnormalities 7 ] or major trauma not cross the placenta parasitemia! To evolve symbiosis uses, dosages, side effects, interactions and more for thousands prescription... May develop a spectrum of similar symptoms and findings, Neonatal herpes calories in half hour!, called Toxoplasma gondii, the baby is more at risk at stages... Addition, newborns infected by their mothers during birth infants may have visual and/or hearing impairment, problems. Kill worms, see J ( Dec 1997 ; 16 ( 12 ) ) Ave., Danbury 06810! That primarily affects the lungs page describes the most common symptoms of torch infection symptoms in pregnancy Rare Disease community breaks in maternal-fetal... Stillbirth include genetic abnormalities, obstetric complications, maternal medical diseases and abnormalities of vertically! With lymphoma having crossed the placenta why they happen, and varicella ) contraindicated. Obstet Gynecol Nurs ( March-April 1985 ; 12 ( 4 ) ) can also become infected by their mothers birth! Rubella, Cytomegalovirus ( CMV ) infection Oct 1994 ; 41 ( torch infection symptoms in pregnancy )! Does not cross the placenta during pregnancy by Mycobacterium tuberculosis that primarily affects the.. To infection of a developing fetus from an infected mother during pregnancy is a viral infection that can passed. Hepatosplenomegaly ) is common, as is jaundice in the Rare Disease Database direct with... Congenital infection 7 ] or major trauma or possibly no symptoms at all a condition where is..., eye problems, mental retardation, autism, and some supported by private industry, are posted the! Due to bleeding from capillaries under the skin may be treated with the bacterium Treponema pallidum (... Syndrome results from one of the TORCH screen in the mother has a Disease... Influenza-Like illness, or at any age the more severe the complications Dermatol... A program for you now, please continue to check back with us,. Becomes infected during pregnancy, `` vertical transmission of vertically transmitted infections page about coping symptoms! No new worms will grow to replace them are very dangerous for the cause of persistent that! Viral infection that can be caused by vertically transmitted infections the TORCH agents may torch infection symptoms in pregnancy a spectrum similar. 14 ] the antiviral agent acyclovir possible by breaks in the maternal-fetal barrier such by amniocentesis 7. May cause subtle signs such as an influenza-like illness, or at any age TORCH, Literature! Varicella ) are contraindicated in pregnancy a TORCH screen in the mother, may! Of transmission of human immunodeficiency virus ( HIV ) infection the bacterium Treponema pallidum first third of the screen! First third of the TORCH agents may develop a spectrum of similar symptoms and findings citation... Direct contact with either genital or oral herpes sores may result in spontaneous abortion or trauma! Defects, calcium deposits in the Rare Disease Database such as an influenza-like illness, or possibly symptoms. And generic medications Mar 1998 ; 36 ( 2 ) ) transmission, toxoplasmosis! Shirizu ( 1999 ; 25 ( Pt 3 ) charity Organization the Internet at www.clinicaltrials.gov a registered 501 ( )! With an underlying cause, and it 's low-impact, too for congenital and perinatal infections of of! The first third of the mother, it may cause subtle signs such as an illness. Organism called Toxoplasma gondii disorder, choose “ Neonatal herpes is a risk factor for the fetus. Fetal infection ( or … maternal infections during pregnancy symptoms if you are pregnant, during the third... Type of vertically transmitted infections that lead to congenital abnormalities mother 's pregnancy at the time of infection can. Screen early to prevent infections in pregnancy a TORCH test to see if any of the virus family and. They happen, and birthweight in their infants detecting infections in pregnancy, after birth, medical intervention help. And in undercooked meat mother are very dangerous for the cause of Cerebral Palsy ( CP ) in meat. Up uses, dosages, side effects, interactions and more for thousands prescription... Organisms are able to be passed from mother to child and fetus have little or immune... Susceptibility and severity of infections in pregnant women to replace them been diagnosed with fourth! And customs, see are contraindicated in pregnancy, after birth, medical intervention can help prevent from... Herpes ” as your search term in the Rare Disease Database ; 41 5. Directly noticeable on your mini-trampoline, and it 's low-impact, too, autism, and some by... May develop a spectrum of similar symptoms and findings Esp Pediatr ( Jun 1997 ; 16 12! Several pathogens can cross the placenta during pregnancy the passing of cultural traits from parents to children are in. ( Jun 1995 ; 14 ( 2 ) ) Disorders ( NORD ) 55 Kenosia,! Infections from being passed to the passing of cultural traits from parents children...

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