We emphasize the high degree of reliability of prenatal ultrasound in the establishment of diagnosis of urinary tract malformations and the prediction of postnatal outcomes.

The purpose of this study was to investigate the antibodies to Toxoplasma gondii in human immunodeficiency virus (HIV)-infected pregnant women and to determine the association between serological profile and the risk of congenital toxoplasmosis. The study, conducted in a public maternity ward from May 2002 to April 2005, included all HIV-infected women who delivered live infants during the 36 months, and, as a control group, all HIV-negative women that delivered live infants in the first 12 months of the study. Antibodies to T. gondii were detected in 1,624 of 2,421 HIV-negative women (67%; 95% confidence interval [CI] 65-69%) and in 121 of 168 HIV-infected patients (72%; 95% CI 65-79%). A total of 547 HIV-negative and 103 HIV-infected patients were tested at delivery and had positive T. gondii-specific IgG. In HIV-negative women, the median of the specific IgG concentration was 79 (interquartile range 38-160), and in HIV-infected patients, it was 283 (interquartile range 94-704) (P < 0.001). In the group of co-infected women, the only infant with congenital toxoplasmosis was born to a mother with acute toxoplasmosis infection acquired during pregnancy who did not have a high specific IgG concentration or a positive result for specific IgM. We concluded that high T. gondii-specific IgG values were much more frequent among HIV-infected pregnant women, but it did not translate into an increased risk of maternal-fetal transmission of toxoplasmosis.

Objetivos: determinar o valor preditivo positivo de um teste rápido para anticorpos contra o HIV denominado Determine™ (Abott) em gestantes internadas em trabalho de parto entre 1º de agosto de 2001 e 5 de outubro de 2002. Métodos: foram incluídas neste estudo as parturientes que não haviam sido submetidas a exames para a detecção do HIV durante a gestação ou que não apresentavam os resultados disponíveis no momento da internação. A amostra de sangue foi colhida no momento da internação, na sala de admissão, e o teste rápido foi realizado e comparado com o padrão ouro (ELISA e Western blot). Resultados: entre as 298 gestantes avaliadas, o teste rápido foi positivo em 16 pacientes (5,3%). Os resultados foram confirmados pelos testes de ELISA e Western blot em 12 pacientes (4%). Todos os exames negativos foram avaliados pelos testes ELISA e Western blot. O teste apresentou sensibilidade de 100%, especificidade de 98%, valor preditivo positivo de 75% e valor preditivo negativo de 100%. Conclusões: estes dados mostram o valor do teste rápido para a detecção de infecção por HIV em situações de emergência, como o parto, de gestantes não testadas previamente PALAVRAS-CHAVE: Infecções na gravidez. AIDS. Transmissão vertical. HIV.

We report a successful case of persistent urogenital sinus associated with a duplicated nonsyndromic form of hydrometrocolpos and ascites diagnosed prenatally. Though urogenital malformations are extremely rare and variable in presentation, the conjugation of those anomalies in a newborn is reported here for the first time. Prenatal ultrasound diagnosis was suspected at 25 weeks’ gestation and MRI imaging supported the diagnosis. Periodic ultrasound surveillance was conducted until birth at 35 weeks’ gestation by cesarean section. The presumptive diagnosis was confirmed after birth. One month later, the newborn underwent reconstructive surgical intervention with good outcome.

In this paper we model the dynamics of a spreading pandemic over a country using a new dynamical and decentralised differential model with the main objective of studying the effect of different policies of social isolation (social distancing) over the population to control the spread of the pandemic. A probabilistic infection process with time lags is introduced in the dynamics with the main contribution being the proposed model to explicitly look at levels of interaction between towns and regions within the considered country. We believe the strategies and findings here will help practitioners, planners and Governments to put in place better strategies to control the spread of pandemics, thus saving lives and minimizing the impact of pandemia on socio-economic development and the populations livelihood.