HIV-1 vertical transmission in Rio Grande, Southern Brazil.

The aim of this study was to determine the rate and risk factors of HIV-1 mother-to-child transmission (MTCT), the timing of transmission and the transmitted subtype in a population where subtypes B and C co-circulate. One hundred and forty-four babies born to HIV-1-infected mothers were studied. Subtype and timing of transmission were determined by a nested polymerase chain reaction of the gp41 gene. Seven children were infected (4.9%): four were infected intrautero and one intrapartum. The higher frequency of intrautero transmission was statistically significant (P = 0.001). Use of antiretrovirals (ARVs) in the three stages of gestation was a protective risk factor for MTCT (PR = 0.42; CI: 0.21-0.83; P = 0.013). A higher HIV viral load at delivery was the only independent risk factor for MTCT. Early and universal access to ARVs during pregnancy are the most important measures to decrease vertical HIV-1 transmission even in areas where HIV clade distribution differs.

Long and short-term effect of prednisolone in hospitalized infants with acute bronchiolitis.

OBJECTIVE: To assess long and short-term effect of prednisolone in hospitalized infants with bronchiolitis. METHODOLOGY: A randomized and controlled trial was carried out at the Federal University of Rio Grande, Rio Grande-RS, Brazil. Twenty-eight patients were randomly allocated prednisolone (1 mg/kg/day for 5 days) plus standard care, and 24 patients allocated standard care alone. The primary endpoint was the prevalence of post-bronchiolitis wheezing at 1, 3, 6 and 12 months after hospital discharge. The secondary endpoints were: length of hospital stay, duration of oxygen therapy and time to clinical improvement during the hospitalization. RESULTS: There were no significant differences between the prednisolone and control group in the prevalence of post-bronchioltis wheezing at 1 month (73.1 vs 83.3%, P = 0.5), 3 months (73.1 vs 79.2%, P = 0.7), 6 months (65.4 vs 66.7%, P = 0.9) and 12 months (50.0 vs 58.3%, P = 0.5) after hospital discharge. No reduction was observed in the prednisolone group, compared with the control group, in terms of length of hospital stay (6.0 vs 5.0 days, P = 0.7), duration of oxygen therapy (24.0 vs 24.0 h, P = 0.4) and time to clinical resolution (4.0 vs 4.0 days, P = 0.8). CONCLUSIONS: Prednisolone has no significant effect on reducing the prevalence of post-bronchiolitis wheezing and on improving the acute course of illness in hospitalized infants with bronchiolitis.

[Trends in hospital admissions for pediatric asthma in childrenduring a period of eighteen years] / A tendência das hospitalizações por crises de asma em crianças em um período de dezoito anos.

OBJECTIVE: To study trends in hospital admissions for acute pediatric asthma in the Hospital da Santa Casa do Rio Grande during the period of 1979 to 1996. METHODS: This is a study of a series of cases. We reviewed all the discharge records of pediatric patients with diagnosis of acute asthma, pneumonia, and bronchiolitis within the period mentioned above. The main variable in this study was the percentage of admissions for acute asthma in relation to the total amount of hospital admissions. The percentages of admissions for bronchiolitis and pneumonia in relation to the total amount of hospital admissions were also calculated as reference values. RESULTS: There were 3,493 admissions for acute asthma in 3,122 patients during the studied period, with an average of 194 admissions per year. The percentage of admissions for acute asthma to total hospital admissions increased from 5,5% to 14,7% between 1983/84 and 1991/92. Half of this increase occurred during the period 1987-1992 in which hospitalizations for bronchiolitis and pneumonia were stable. This percentage decreased from 14,7% to 10,6% in the period of 1991/92 - 1995/96. CONCLUSIONS: There was a significant increase in hospital admissions for acute pediatric asthma in the Hospital da Santa Casa do Rio Grande during the period of 1983 - 1992. From then on, hospital admissions for asthma showed downward trends.