Adesão ao pré-natal de mulheres HIV+ que não fi zeram profi laxia da transmissão vertical: um estudo sócio-comportamental e de acesso ao sistema de saúde Adherence to prenatal care by HIV-positive women who failed to receive prophylaxis for mother-to-child transmission: social and behavioral factors and healthcare access issues
A cohort of 297 HIV-infected pregnant women was followed from January 1996 to December 2001. The overall transmission rate was 3.57% and remained constant over time. Low birth-weight was independently associated with a higher risk of vertical transmission (P=0.0072), whereas a longer duration of antiretroviral drugs during pregnancy was independently associated with a lower risk of transmission (P=0.0084). Further decreases in transmission should be obtained by initiating prophylaxis earlier in pregnancy.
The lymphocyte responsiveness to leishmanial antigens and its influence on the course of cutaneous leishmaniasis was studied in a patient with AIDS-associated American cutaneous leishmaniasis caused by Leishmania braziliensis. The patient had cutaneous disseminated erythematous papules or nodules and mucosal lesions as well as moniliasis and weight loss. The patient had a poor delayed-type hypersensitivity to leishmanial antigens, showing 3 mm of induration. The cellular immune responses were studied in vitro by lymphocyte proliferative assays induced by leishmanial antigens and concanavalin A. The T cell phenotypes were analysed by flow cytometry. The peripheral blood mononuclear cells before proliferation showed an inversion of the CD4/CD8 ratio (0.28:1). The lymphoproliferative responses to antigen and mitogen were very low (indices < 2.5). The blast-like cell phenotypes after antigen stimulation in culture were: CD3+ 44.8%, CD4+ 7.53% and CD8+ 17.45%. In AIDS patients the decrease in the pool of CD4+ cells, and consequent diminution of the CD4/CD8 ratio, produced by HIV infection provokes a generalized immune depression. The patient's disseminated clinical picture was probably related to the inability of his T cell-mediated immune responses to control the spread of Leishmania infection.
O objetivo do trabalho foi avaliar a qualidade das águas da Bacia Hidrográfica do Rio São Domingos (BHRSD), correlacionando-a com as possíveis fontes poluidoras advindas das características naturais e antrópicas da área. Alguns parâmetros físico-químicos foram analisados em 65 pontos (superficiais e subterrâneos) de amostragem. Os resultados foram confrontados com os limites estabelecidos pelas Resoluções CONAMA 357/05 (classe 2), que trata das águas superficiais, e CONAMA 396/08 (consumo humano), que contempla as águas subterrâneas. Foram analisados diversos cátions e ânions, temperatura, alcalinidade, pH, condutividade elétrica (CE), sólidos totais dissolvidos (STD), oxigênio dissolvido (OD), demanda bioquímica de oxigênio (DBO), coliformes termotolerantes e alguns agrotóxicos organoclorados e organofosforados. Os parâmetros que apresentaram inconformidades, com maior frequência, foram: alumínio dissolvido, boro total, ferro dissolvido, manganês total, nitratos, pH, OD, DBO e alguns organoclorados e organofosforados. Embora a área esteja situada em terreno cristalino tropical úmido, o que pode justificar os teores elevados de alumínio, manganês e ferro, os resultados apontam que o comprometimento da qualidade das águas da BHRSD é influenciado pela prática agrícola.
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