Assuntos
Sorodiagnóstico da AIDS/métodos , Infecções por HIV/diagnóstico , Programas de Rastreamento , Fármacos Anti-HIV/uso terapêutico , Feminino , Infecções por HIV/prevenção & controle , Humanos , Recém-Nascido , New York , Assistência Perinatal , Gravidez , Fatores de Risco , Zidovudina/uso terapêuticoRESUMO
New York State introduced the first statewide program in the U.S. of expedited HIV testing (48-hour turn-around results) of mothers with unknown HIV status at the time of labor or delivery and their newborns on August 1, 1999. We evaluated the results of this program during its first 5 months at Lincoln Medical and Mental Health Center (Lincoln Hospital) in the Bronx, New York. There were 1,274 total live birth deliveries between August 1 and December 31, 1999. The HIV infection status of 539 mothers (42.3%) was unknown to medical providers in the labor-delivery suite, either due to lack of testing during the current pregnancy or unavailability of HIV documentation at the time of delivery. During labor and delivery, a total of 462 (85.7%) mothers with unknown HIV status consented to expedited HIV testing (Single Use Diagnostic System for HIV-1 antibody or SUDS). The newborns of 77 mothers (14.3%) who did not consent were tested immediately after birth. Seventeen tested positive for HIV-1 antibody by the SUDS test. The results of 10 of these infants (58.8%) were subsequently confirmed positive for HIV-1 antibody by Western Blot analysis. This new rapid HIV testing program facilitated early diagnosis of these previously unknown HIV-exposed infants, although the low positive predictive value of the test in our community calls for careful communication of these results pending confirmation.
Assuntos
Infecções por HIV/diagnóstico , Síndrome da Imunodeficiência Adquirida/diagnóstico , Síndrome da Imunodeficiência Adquirida/transmissão , Western Blotting , Parto Obstétrico , Reações Falso-Positivas , Feminino , Anticorpos Anti-HIV/sangue , HIV-1/imunologia , Humanos , Recém-Nascido , Transmissão Vertical de Doenças Infecciosas , Trabalho de Parto , New York , Gravidez , Complicações Infecciosas na Gravidez/virologia , Cuidado Pré-Natal , Transtornos Relacionados ao Uso de SubstânciasRESUMO
We report a new case of Rubinstein-Taybi syndrome with a hypoplastic right kidney, persistent pulmonary hypertension, and mitral valve regurgitation. Other pertinent features included broad thumbs, broad big toes, syndactyly of the third and fourth fingers bilaterally, beaked nose, broad columella of the nose, patent ductus arteriosus, and motor and mental retardation. The testes were descended. The 3 month old patient had delayed motor and mental development corresponding to a 1 month old infant.
Assuntos
Hipertensão Pulmonar/genética , Rim/anormalidades , Insuficiência da Valva Mitral/genética , Síndrome de Rubinstein-Taybi/patologia , Humanos , Recém-Nascido , Cariotipagem , Masculino , Síndrome de Rubinstein-Taybi/genéticaRESUMO
During the study years 1972--1974, 8 of 383 infants born to mothers with known narcotic dependency during pregnancy died unexpectedly within the first 4 mth of life; autopsies were compatible with the diagnosis of SIDS. This incidence of SIDS was 5.5 times that in our hospital populations (P < 0.001) and 8.7 times that of our borough within New York City (P < 0.001). Similar factors, such as sex ratio, age at time of death, and diurnal and seasonal variations suggest that narcotic-associated sudden death may be a relevant study model for sudden unexpected death in the general population. Intrauterine exposure to narcotics and its subsequent effect on central control of respiration in the young infant may be the underlying mechanism of drug related SIDS.