OBJECTIVES: To assess the integration
of TB services into the prevention of mother-to-child transmission of HTV (PMTCT) programme and identify barriers to the integration of services. design: Cross-sectional survey using exit interviews with pregnant women attending 10 antenatal care (ANC) clinics. Review of ANC PMTCT facility routine data. Qualitative interviews with 26 key informants on barriers to integration of TB-PMTCT services. RESULTS: Of 150 women interviewed, 112 (75%) reported being educated on TB symptoms on the day of their visit; 56% were screened for TB symptoms and 27% were suspected to have TB; 26 (17%) women were HIV-positive and 2 (8%) were co-infected with TB. There was no check details record of provision of isoniazid prophylaxis for PMTCT clients with latent tuberculous infection. The predominant barriers to the integration of TB-PMTCT services included lack of skilled providers and their supervision, the physical layout of the TB-PMTCT services and the service delivery mechanisms. CONCLUSION: The integration of TB SB431542 purchase prevention and care into the PMTCT programme was inadequate. Integration of TB services into the ANC PMTCT programme will require strong leadership to address barriers such as training gaps, lack of supervision and service delivery mechanisms.”
“A nulligravida presented in
traumatic shock and suffered pelvic trauma, including an absolute uterine rupture at the isthmus. Her uterus was reconstructed by reconnecting the uterine corpus with the cervix in an emergency surgery. Two years later, the patient became pregnant
without any assisted technology.”
“We describe the lipoprotein and apolipoprotein profiles and their relationship to cardiovascular risk factors in Australian Aboriginal children. This cross-sectional study within a longitudinal birth cohort study involved Australian Aboriginal children born between 1987 and 1990 and re-examined between 1998 and 2001. Height, weight, blood pressure, waist circumference, body fat percentage, cholesterol, triglycerides, HDL-c, LDL-c, apolipoprotein B and AI were measured. Mean age was 11.4 years (52% male). Mean cholesterol, triglycericle, HDL-c and LDL-c did not differ from reference data. Measures of obesity, blood pressure and prevalence of the metabolic syndrome did not differ in those children PLX3397 with lipoproteins in the upper quartile of the cohort (lower quartile for HDL-c). Boys with an Apo-B/A1 ratio in the upper quartile of the cohort had higher BMI z-score, waist z-score, % body fat, diastolic blood pressure and frequency of the metabolic syndrome (p<0.05). In girls, waist circumference, % body fat and the prevalence of the metabolic syndrome was higher in those with an Apo-B/A1 ratio in the upper quartile (p<0.05).The Apo-B/A1 ratio may be useful to identify cardiovascular risk in Australian Aboriginal children and is suited to clinical practice as the assays are standardised, accurate, automated and a fasting sample is not required.