237 research outputs found
Risk factors for mother-to-child transmission of HIV-1.
No full textChildren born to women known to be infected with human immunodeficiency virus type 1 (HIV-1) before delivery were followed prospectively from birth in nineteen European centres. This analysis, encompassing the period end-December, 1984, to beginning-August, 1991, focuses on risk factors for mother-to-child transmission of HIV-1 infection. Rate of vertical transmission, based on 721 children born to 701 mothers more than 18 months before the time of analysis, was 14.4% (95% Cl 12.0-17.1%). Transmission was associated with maternal p24-antigenaemia and a CD4 count of less than 700/microliters. In a multivariate analysis, odds ratios of transmission were: 2.25 (95% Cl 0.97-5.23) in breastfed children vs never-breastfed children; 3.80 (1.62-8.91) in children born before 34 weeks' gestation; and 0.56 (0.30-1.04) in children delivered by caesarean section. Transmission was higher with vaginal deliveries in which episiotomy, scalp electrodes, forceps, or vacuum extractors were used, but only in centres where these procedures were not routine. On the basis of these results, HIV-infected women contemplating pregnancy should be counselled according to their immunological findings and, if they have p24-antigenaemia or a low CD4 count, warned of an increased risk of viral transmission. Caesarean deliveries may have a protective effect, although it is premature to recommend routine operative delivery. The mechanism for the higher infection rate in children born before 34 weeks' gestation is unclear, but could reflect inadequate passive or active immunity at that age, combined with substantial transmission during labour or delivery. The balance of evidence suggests that mothers with established infection can transmit HIV infection through breastmilk, although the relative importance of this route remains to be define
IAS/IFRS and "Capital Accounting System": a literature analysis
No full textThe purpose of this study is to analyse the “capital accounting system” and its evolution in the
National and International literature to point out which are the elements that mainly affect
International Accounting Standards.
This work, starting from the theorization of Besta (the most important author modelling the
“classic capital accounting system” at the beginning of ‘900) and following with De Dominicis
(the author of the “variante corrente” of the capital accounting system), analyses the theorizations
arising from the International literature, reaching to point out some specific characteristics of the
capital accounting system that specifically affect International Accounting Standards Ias/Ifrs
Short-term therapy for recurrent abortion using intravenous immunoglobulins: results of a double-blind placebo-controlled Italian study
No full textFrom “capital accounting system” to Ias/Ifrs through a National and International literature analysis
No full textThe purpose of this study is to analyse the “capital accounting system” and its evolution in the National and International literature to point out which are the elements that mainly affect International Accounting Standards.
This work, starting from the theorization of Besta (the most important author modelling the “classic capital accounting system” at the beginning of ‘900) and following with De Dominicis (the author of the “variante corrente” of the capital accounting system), analyses the theorizations arising from the International literature, reaching to point out some specific characteristics of the capital accounting system that specifically affect International Accounting Standards Ias/Ifrs
Vertical transmission of HIV-1: maternal immune status and obstetric factors. The European Collaborative Study.
No full textOBJECTIVE: To estimate the effect of maternal factors and events around the time of delivery on HIV-1 vertical transmission risk.
DESIGN: Prospective study.
SETTING: Twenty-two obstetric and paediatric clinics in seven European countries.
PATIENTS OR OTHER PARTICIPANTS: Mothers identified as HIV-infected before or at delivery and their children.
MAIN OUTCOME MEASURE: Paediatric HIV infection.
RESULTS: By November 1995, 1846 mothers with 1945 children had been enrolled. The vertical transmission rate was 16.4% (95% confidence interval, 14.5-18.3). Parity, maternal age, race, mode of HIV acquisition, injecting drug use and sex of infant were not statistically significantly associated with risk of transmission. Children delivered vaginally were more likely to be infected than those delivered by Caesarean section. However, in vaginal deliveries the procedures used, duration of ruptured membranes or length of second-stage labour were not related to transmission. Transmission increased almost linearly with decreasing CD4 cell count, but there was no such trend for CD8 cell count. Women with CD4 cell counts below 200 x 10(6)/l were significantly more likely to deliver early (chi 2 for trend, 14.02; P < 0.001). Very premature infants were at increased risk of infection, but after about 35 weeks gestation the transmission rate remained stable, with no increase in late pregnancy. This trend was confirmed after allowing for maternal CD4 cell count.
CONCLUSIONS: The rate of vertical transmission increases linearly with decreasing maternal CD4 cell count. Women with fewer than 200 x 10(6) CD4 cells/l have an increased risk of premature delivery, which would affect timing of interventions. The stable transmission rate after 35 weeks gestation suggests little acquisition of infection during late pregnanc
Perinatal findings in children born to HIV-infected mothers. The European Collaborative Study
No full textOBJECTIVE: To explore in children born to HIV-infected women, the association between a child's HIV infection status and birthweight, gestational age, congenital abnormalities and other perinatal findings.
DESIGN: A prospective study of children born to women known to be HIV-infected at or before the time of delivery enrolled in the European Collaborative Study.
SETTING: Nineteen European centres.
SUBJECTS: A cohort of 853 children with known HIV infection status.
RESULTS: There was no evidence for an HIV dysmorphic syndrome, and the frequency of congenital abnormalities was similar in infected and uninfected children with no consistent pattern of defects. Injecting drug use during pregnancy had the most marked effect on birthweight and gestational age. Multivariate analysis demonstrated a weak association between birthweight and the child's HIV infection status, but this could partly be explained by the confounding effect of maternal immunological HIV status. HIV infection in the infant was not associated with gestational age, and the mean and distribution of gestational age were similar for infected and noninfected children.
CONCLUSIONS: The finding that HIV-infected and noninfected children are of similar birthweight, the absence of a dysmorphic syndrome and no evidence of associated congenital abnormalities suggest that a substantial proportion of infection occurs late in pregnancy or at the time of delivery
Sources of toxoplasma infection in pregnant women: European multicentre case-control study
No full textHIV and reproduction care - a review of current practice
No full textIn developed countries, antiretroviral treatment has increased life quality and expectancy of HIV-infected individuals and led to a drop in mother-to-child transmission (MCT) risk to below 1%. Fertility has been shown to be reduced in both
men and women with HIV. As a result of these factors, the demand for reproductive care in this population is rising. In discordant couples where the man is positive, sperm washing significantly reduces viral transmission risk to the uninfected female partner over unprotected intercourse. Positive women do not necessarily need specialised
fertility treatment but should be monitored closely during pregnancy to minimise MCT
risk
Association between congenital toxoplasmosis and preterm birth, low birthweight and small for gestational age birth.
No full textOBJECTIVE: To determine the association between congenital toxoplasmosis and preterm birth, low birthweight and small for gestational age birth. DESIGN: Multicentre prospective cohort study. SETTING: Ten European centres offering prenatal screening for toxoplasmosis. POPULATION: Deliveries after 23 weeks of gestation in 386 women with singleton pregnancies who seroconverted to toxoplasma infection before 20 weeks of gestation. Deliveries after 36 weeks in 234 women who seroconverted at 20 weeks or later, and tested positive before 37 weeks. METHODS: Comparison of infected and uninfected births, adjusted for parity and country of birth. MAIN OUTCOME MEASURES: Differences in gestational age at birth, birthweight and birthweight centile. RESULTS: Infected babies were born or delivered earlier than uninfected babies: the mean difference for seroconverters before 20 weeks was -5.4 days (95% CI: -1.4, -9.4), and at 20 weeks or more, -2.6 days (95% CI: -0.5, -4.7). Congenital infection was associated with an increased risk of preterm delivery when seroconversion occurred before 20 weeks (OR 4.71; 95% CI: 2.03, 10.9). No significant differences were detected for birthweight or birthweight centile. CONCLUSION: Babies with congenital toxoplasmosis were born earlier than uninfected babies but the mechanism leading to shorter length of gestation is unknown. Congenital infection could precipitate early delivery or prompt caesarean section or induction of delivery. We found no evidence for a significant association between congenital toxoplasmosis and reduced birthweight or small for gestational age birth
Criteri per il trattamento e la gestione delle acque reflue nel Comune di Saludecio
No full textIl D.Lgs.11.5.1999, n.152 “Disposizioni sulla tutela delle acque dall'inquinamento e recepimento della direttiva 91/271/CEE concernente il trattamento delle acque reflue urbane....” definisce e raccomanda “trattamenti di tipo appropriato” per le acque di scarico provenienti da insediamenti abitativi inferiori a 2000 AE. Il D.M. 12.6.2003 n.185 rende altresì praticabile il recupero e il riuso delle acque reflue definendo gli standard di qualità in funzione del tipo di riutilizzo condizionando, di fatto, la scelta delle tecniche di trattamento.
Alla luce della vigente disciplina sugli scarichi, il territorio del Comune di Saludecio, riguar-do la produzione e smaltimento delle acque reflue, presenta al momento tre scenari principali: 1) gli agglomerati serviti dal depuratore attraverso collettori fognari esistenti e in costruzione 2) gli agglo-merati non serviti dal depuratore 3) le case sparse o nuclei isolati. Tale territorio di tipo collinare, per conformazione e distribuzione abitativa, si offre pertanto quale caso tipico cui applicare piani di risanamento idrico sanitario basati su trattamenti appropriati.
Raccomandato in via prioritaria il completamento dei lavori del collettore fognario di trasfe-rimento delle acque reflue dell’abitato storico di Saludecio al depuratore di Cattolica, la presente indagine ha analizzato lo stato di fatto complessivo igienico sanitario e tracciato alcune linee guida per il trattamento di nuclei isolati e case sparse alla luce del Dlgs 152/99 e DGR 1053/03. Per l’ag-glomerato di S.Ansovino è stato altresì studiato, quale trattamento appropriato, uno schema misto sistema naturale/percolatore, con l’obbiettivo di ottenere bassi costi di gestione, buona capacità operativa in presenza di forti variazioni giornaliere di portata e a consentire il riutilizzo irriguo
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