Mother-child transmission of Chagas disease: could coinfection with human immunodeficiency virus increase the risk?

A study was conducted on all newborns from mothers with Chagas disease who were attended at Hospital Donación F. Santojanni between January 1, 2001, and August 31, 2007. Each child was investigated for the presence of Trypanosoma cruzi parasitemia through direct examination of blood under the microscope using the buffy coat method on three occasions during the first six months of life. Serological tests were then performed. Ninety-four children born to mothers infected with Trypanosoma cruzi were attended over the study period. Three of these children were born to mothers coinfected with the human immunodeficiency virus. Vertical transmission of Chagas disease was diagnosed in 13 children, in all cases by identifying parasitemia. The overall Chagas disease transmission rate was 13.8% (13/94). It was 100% (3/3) among the children born to mothers with HIV infection and 10.9% (10/91) among children born to mothers without HIV [Difference = 0.89; CI95 = 0.82-0.95; p = 0.0021]. We concluded that coinfection with HIV could increase the risk of vertical transmission of Chagas disease.

Cryptococcus gattii molecular type VGII as agent of meningitis in a healthy child in Rio de Janeiro, Brazil: report of an autochthonous case

Cryptococcus gattii causes meningoencephalitis in immunocompetent hosts, occurring endemically in some tropical and subtropical regions. Recently, this fungus was involved in an outbreak in Vancouver Island and British Columbia (Canada). In this temperate region, the VGII type is predominant. The paper describes an autochthonous case of meningoencephalitis by C. gattii VGII in a previously health child in Rio de Janeiro, considered nonendemic region of Brazil. The fungus was identified by biochemical tests and the molecular type was determined by URA5-RFLP. The present report highlights the need for clinical vigilance for primary cryptococcal meningitis in nonendemic areas.

Mother-to-child transmission of HIV infection in Manaus, State of Amazonas, Brazil

INTRODUCTION: Reduction in the vertical transmission of HIV is possible when prophylactic measures are implemented. Our objective was to determine demographic characteristics of HIV-infected pregnant women and the rate of mother-to-child transmission of HIV in Manaus, Amazonas, Brazil. METHODS: A descriptive study was conducted using notification, and investigating data from the Notifiable Diseases Data System in the Brazilian State of Amazonas, between 2007 and 2009. RESULTS: During the study period, notification was received of 509 HIV-positive pregnant women. The vertical transmission was 9.9% (95% CI: 7.2-12.6%). The mean age of women was 27 years (SD: 5.7), and the majority (54.8%) had not completed elementary school (eighth grade). Diagnosis of HIV seropositivity was made prior to pregnancy in 115 (22.6%) women, during prenatal care in 302 (59.3%), during delivery in 70 (13.8%), and following delivery in 22 (4.3%). Four hundred four of these women (79.4%) had had prenatal care, with 79.4% of patients receiving antiretroviral during pregnancy and 61.9% of the newborn infants receiving prophylaxis. In the final multivariate logistic regression model, living in urban area [OR = 0.7 (95% CI: 0.35-0.89)] and having had prenatal care [OR = 0.1 (95% CI: 0.04-0.24)] remained as protective factors against vertical HIV transmission in this population. CONCLUSIONS: The relevance of adequate compliance with the measures already established as being effective in guaranteeing a reduction in HIV transmission within the maternal and infant population should be emphasized.

Rebalancing frequency and the welfare cost of inflation

Cash-in-advance models usually require agents to reallocate money and bonds in fixed periods. Every month or quarter, for example. I show that fixed periods underestimate the welfare cost of inflation. I use a model in which agents choose how often they exchange bonds for money. In the benchmark specification, the welfare cost of 10 percent instead of 0 inflation increases from 0.1 percent of income with fixed periods to 1 percent with optimal periods. The results are robust to different references, to different compositions of income in bonds or money, and to the introduction of capital and labor.

Evaluation of the welfare impact of regulating mobile termination rates in Portugal

Following the European Commission’s 2009 Recommendation on the Regulatory Treatment of Fixed and Mobile Termination Rates in the EU, the Portuguese regulatory authority (ANACOM) decided to reduce termination prices in mobile networks to their long-run incremental cost (LRIC). Nevertheless, no serious quantitative assessment of the potential effects of this decision was carried out. In this paper, we adapt and calibrate the Harbord and Hoernig (2014) model of the UK mobile telephony market to the Portuguese reality, and simulate the likely impact on consumer surplus, profits and welfare of four different regulatory approaches: pure LRIC, reciprocal termination charges with fixed networks, “bill & keep”, and asymmetric termination rates. Our results show that reducing MTRs does increase social welfare, profits and consumer surplus in the fixed market, but mobile subscribers are seriously harmed by this decision.

Evaluation of preventive measures for mother-to-child transmission of HIV in Aracaju, State of Sergipe, Brazil

INTRODUCTION: The main route of human immunodeficiency virus (HIV) infection in children is from mother to child. The preventive measures established for the Aids Clinical Trial Group protocol 076 (ACTG 076) significantly reduces HIV vertical transmission rates. This study aims to evaluate the implementation of the ACTG 076 protocol in the maternity units of State of Sergipe, Brazilian northeast. METHODS: This is a descriptive, retrospective study with a quantitative approach, with HIV positive women and children exposed, attending a Maternity reference for high-risk pregnancies. Data were obtained from patient records registered in the years 1994 to 2010. RESULTS: Amongst the 110 pregnant women and exposed newborns, the ACTG 076 protocol was fully utilized in only 31.8% of the participants. During the prenatal period, zidovudine (ZDV) was taken by 79.1% of the pregnant women. Only 49.1% of HIV seropositive patients used ZDV during delivery. Two (1.8%) children were considered infected and 50 (45.5%) do not have a conclusive diagnosis to date. CONCLUSIONS: There were significant deficiencies in the prevention of mother-to-child transmission of HIV, including lack of compliance with the three phases of the ACTG 076 protocol; inadequacies in prenatal care; inappropriate mode of delivery and lack of adequate follow up of exposed children.

Bone tuberculosis: a case report on child

The authors report a case of a 12-year-old child with a complaint of pain and deformity in the lower thoracic region that had lasted for two years. Clinical, epidemiological and laboratory characteristics associated with images of apparent damage in the T9-T10 and T11-T12 vertebrae taken by radiography of the thoracic spine and nuclear magnetic resonance in addition to the positivity of the molecular test based on the polymerase chain reaction, led to tuberculous spondylitis being diagnosed and specific therapy was started. Culture of vertebral biopsy was positive for Mycobacterium tuberculosis after thirty days.

Evaluation of outpatient child-adolescent mental health services (CAMHS) in Attica-Greece

ABSTRACT: Background: Childhood is a critical time for social and emotional development, educational progress and mental health prevention. Mental health for children and adolescents is defined by the achievement of expected developmental, cognitive, social and emotional skills. The development of child-adolescent mental health services (CAMHS) is a necessity for each country, not only as a prevention measure for the wellbeing of people, but also as an investment to the future of countries. Qualitative evaluation of services is the only way to ensure whether services function under quality standards and increase the possibility of better outcomes for their patients. This study examines the greek outpatient CAMHS against the British Standards of National Institute of Excellence for community CAMHS. The Standards assessed refer to the areas of Assessment, Care and Intervention. Objectives: The main objectives of the study are 1) to evaluate Greek outpatient CAMHS in the Attica region 2) to promote the evaluation process for mental health services in Greece. Methods: Due to the fact that Greek services are based on the British model, the tool used was the British self-review questionnaire of Quality Network for Community CAMHS(QNCC).The tool was translated, adapted and posted to services. Twelve out of twenty outpatient CAMHS of Attica (including Athens) responded. Data was collected and performed by the Statistical Package for Social Sciences SPSS. Results: The study resulted that the CAMHS examined, meet moderately the British Standards of 1) Referral and Access, 2) Assessment & Care planning, 3) Care & Intervention. Two out of twelve services examined, meet the standards of "Assessment and Care" in a higher percentage between 75% and 100%. Conclusions: The paper describes a satisfactory function of CAMHS in Attica prefecture taking into consideration the extremely difficult political situation of Greece at the time of the research. Strong and weak domains are identified. Also the translation and adaptation of British tools promote the evaluation process and quality assurance of Greek CAMHS.

Dystrophic calcinosis in a child with a thumb sucking habit: case report

We present an uncommon case of a 3-year-old boy with a finger sucking habit who developed dystrophic calcification in his left thumb. Two years after excision, there was no recurrence, and the thumb retained full range of motion. We also discuss its probable pathogenesis and present a brief review of the literature about orthopedic complications in the hand due to this habit.

Canada, a child's play

Science4you, a Portuguese developer, producer and seller of scientific and educational toys, leveraged the worldwide growth of this category to successfully expand its operations abroad. Following a recent entry into the United States market, the purpose of this report is to help the company define the next step in its international expansion. A customized scoring model, based on a set of relevant macro and micro-criteria was developed for Anglo-Saxon and Asian countries, yielding Canada as the market with the highest potential. The recommended entry mode is direct exporting via an independent distributor, being complemented with a financial and risk analysis.

Annoyance and welfare costs from the presence of renewable energy power plants: an application of the contingent valuation method

Sustainability is frequently defined by its three pillars: economically viable, socially equitable, and environmentally bearable. Consequently the evaluation of the sustainability of any decision, public or private, requires information on these three dimensions. This paper focuses on social sustainability. In the context of renewable energy sources, the examination of social sustainability requires the analysis of not only the efficiency but also the equity of its welfare impacts. The present paper proposes and applies a methodology to generate the information necessary to do a proper welfare analysis of the social sustainability of renewable energy production facilities. This information is key both for an equity and an efficiency analysis. The analysis focuses on the case of investments in renewable energy electricity production facilities, where the impacts on local residents’ welfare are often significantly different than the welfare effects on the general population. We apply the contingent valuation method to selected facilities across the different renewable energy power plants located in Portugal and conclude that local residents acknowledge differently the damage sustained by the type, location and operation of the plants. The results from these case studies attest to the need of acknowledging and quantifying the negative impacts on local communities when assessing the economic viability, social equity and environmental impact of renewable energy projects.

Child abuse monitor system model: a health care critical knowledge monitor system

The Childhood protection is a subject with high value for the society, but, the Child Abuse cases are difficult to identify. The process from suspicious to accusation is very difficult to achieve. It must configure very strong evidences. Typically, Health Care services deal with these cases from the beginning where there are evidences based on the diagnosis, but they aren’t enough to promote the accusation. Besides that, this subject it’s highly sensitive because there are legal aspects to deal with such as: the patient privacy, paternity issues, medical confidentiality, among others. We propose a Child Abuses critical knowledge monitor system model that addresses this problem. This decision support system is implemented with a multiple scientific domains: to capture of tokens from clinical documents from multiple sources; a topic model approach to identify the topics of the documents; knowledge management through the use of ontologies to support the critical knowledge sensibility concepts and relations such as: symptoms, behaviors, among other evidences in order to match with the topics inferred from the clinical documents and then alert and log when clinical evidences are present. Based on these alerts clinical personnel could analyze the situation and take the appropriate procedures.

Mothers' beliefs concerning severity and need for intervention in child maltreatment

Dissertação de mestrado integrado em Psicologia Clínica e da Saúde