Height and timing of growth spurt during puberty in young people living with vertically acquired HIV in Europe and Thailand.

OBJECTIVE: The aim of this study was to describe growth during puberty in young people with vertically acquired HIV. DESIGN: Pooled data from 12 paediatric HIV cohorts in Europe and Thailand. METHODS: One thousand and ninety-four children initiating a nonnucleoside reverse transcriptase inhibitor or boosted protease inhibitor based regimen aged 1-10 years were included. Super Imposition by Translation And Rotation (SITAR) models described growth from age 8 years using three parameters (average height, timing and shape of the growth spurt), dependent on age and height-for-age z-score (HAZ) (WHO references) at antiretroviral therapy (ART) initiation. Multivariate regression explored characteristics associated with these three parameters. RESULTS: At ART initiation, median age and HAZ was 6.4 [interquartile range (IQR): 2.8, 9.0] years and -1.2 (IQR: -2.3 to -0.2), respectively. Median follow-up was 9.1 (IQR: 6.9, 11.4) years. In girls, older age and lower HAZ at ART initiation were independently associated with a growth spurt which occurred 0.41 (95% confidence interval 0.20-0.62) years later in children starting ART age 6 to 10 years compared with 1 to 2 years and 1.50 (1.21-1.78) years later in those starting with HAZ less than -3 compared with HAZ at least -1. Later growth spurts in girls resulted in continued height growth into later adolescence. In boys starting ART with HAZ less than -1, growth spurts were later in children starting ART in the oldest age group, but for HAZ at least -1, there was no association with age. Girls and boys who initiated ART with HAZ at least -1 maintained a similar height to the WHO reference mean. CONCLUSION: Stunting at ART initiation was associated with later growth spurts in girls. Children with HAZ at least -1 at ART initiation grew in height at the level expected in HIV negative children of a comparable age

Height and timing of growth spurt during puberty in young people living with vertically acquired HIV in Europe and Thailand

Objective: The aim of this study was to describe growth during puberty in young people with vertically acquired HIV. Design: Pooled data from 12 paediatric HIV cohorts in Europe and Thailand. Methods: One thousand and ninety-four children initiating a nonnucleoside reverse transcriptase inhibitor or boosted protease inhibitor based regimen aged 1-10 years were included. Super Imposition by Translation And Rotation (SITAR) models described growth from age 8 years using three parameters (average height, timing and shape of the growth spurt), dependent on age and height-for-age z-score (HAZ) (WHO references) at antiretroviral therapy (ART) initiation. Multivariate regression explored characteristics associated with these three parameters. Results: At ART initiation, median age and HAZ was 6.4 [interquartile range (IQR): 2.8, 9.0] years and -1.2 (IQR: -2.3 to -0.2), respectively. Median follow-up was 9.1 (IQR: 6.9, 11.4) years. In girls, older age and lower HAZ at ART initiation were independently associated with a growth spurt which occurred 0.41 (95% confidence interval 0.20-0.62) years later in children starting ART age 6 to 10 years compared with 1 to 2 years and 1.50 (1.21-1.78) years later in those starting with HAZ less than -3 compared with HAZ at least -1. Later growth spurts in girls resulted in continued height growth into later adolescence. In boys starting ART with HAZ less than -1, growth spurts were later in children starting ART in the oldest age group, but for HAZ at least -1, there was no association with age. Girls and boys who initiated ART with HAZ at least -1 maintained a similar height to the WHO reference mean. Conclusion: Stunting at ART initiation was associated with later growth spurts in girls. Children with HAZ at least -1 at ART initiation grew in height at the level expected in HIV negative children of a comparable age

Exploring Cosmic Origins with CORE: Survey requirements and mission design

Future observations of cosmic microwave background (CMB) polarisation havethe potential to answer some of the most fundamental questions of modernphysics and cosmology. In this paper, we list the requirements for a future CMBpolarisation survey addressing these scientific objectives, and discuss thedesign drivers of the CORE space mission proposed to ESA in answer to the "M5"call for a medium-sized mission. The rationale and options, and themethodologies used to assess the mission's performance, are of interest toother future CMB mission design studies. CORE is designed as a near-ultimateCMB polarisation mission which, for optimal complementarity with ground-basedobservations, will perform the observations that are known to be essential toCMB polarisation scienceand cannot be obtained by any other means than adedicated space mission

Prematuridade entre recém-nascidos de mães com Amniorrexe Prematura Prematuridad entre recién nacidos de nadres com Amniorrexis Prematura Prematurity among new-borns of Mothers with Premature Amniorrexis

Estudo descritivo realizado em maternidade pública de Fortaleza-CE, com objetivo de caracterizar a prematuridade entre recém-nascidos (RNs) internados na Unidade Neonatal em decorrência da amniorrexe prematura. Analisaram-se 37 recém-nascidos e suas mães. Dos RNs, foram analisados: grau de prematuridade, Apgar e necessidade de reanimação. Das mães: idade gestacional, realização de pré-natal, patologias na gestação e tipo de parto. Verificou-se que 35,1% nasceram prematuros e 29,7% com Apgar entre 0 e 6 no 1º minuto de vida, necessitando de reanimação. Quanto à idade gestacional, 35,1% apresentaram ruptura das membranas antes da 37ª semana, 5,4% não realizaram pré-natal, 67,5% compareceram a 2 a 5 consultas e 27,1% referiram 6 ou mais; 16,2% das mães apresentaram doença hipertensiva específica da gestação (DHEG), e 51,3% tiveram parto normal. Conclui-se que a prematuridade foi elevada, podendo representar importante causa de morbimortalidade neonatal, como também acarretar complicações clínicas e obstétricas para a mãe. A DHEG ainda representa um risco para a gravidez. É preciso que novos estudos sobre a temática sejam realizados para se conhecer a verdadeira magnitude do problema.<br>Estudio descriptivo realizado en maternidad pública de Fortaleza-CE, con el objetivo de caracterizar la prematuridad entre recién nacido (RN) internados en la Unidad Neonatal debido al amniorrexis prematuro. Se analisaron 37 recién nacidos y sus madres. De los recién nacidos se analizó: el grado de la prematuridad, apgar y necesidad de reanimación. De las madres: edad gestacional, acompãnamiento pré-natal, tipo del parto y patologías de la gestación. Fué verificado que 31,1% nacieron prematuras, 29,7% con Apgar entre 0 y 6 en el primeiro minuto de vida, necesitando de reanimación. Con respecto a la edad gestational, 35,1% presentaron las rupturas de la membrana antes de la 37ª. Semana, 5,4% sin acompãnamiento pré-natal, 67,5% 2-5 consultas y 27,1% refieren 6 o más, 16,2% de las madres presentaron Dolencia Hipertensiva del Estado Gestacional (DHEG), y 51,3% tuvieran parto normal. Se concluye que la prematuridad fué elevada, representando importante causa de la morbimortalidad neonatal, como también acarretar complicaciones clínicas y obstétricas para la madre. La DHEG aún representa um risco para la gestación. És necesário que nuevos estúdios sobre la temática sean realizados para se conocer la verdadera magnitud del problema.<br>This is a descriptive study that took place in a public maternity in Fortaleza Ce, with objective to characterize the prematureness among newly born (RN) interned in the Unidade Neonatal due to the premature amniorrexe. It was analyzed 37 newborns along with their mothers. From the newborns it was analyzed: prematureness degree, Apgar and reanimation need; and from their mothers: gestational age, pre natal care, birth and gestational pathologies. It was found that 35,1% of the babies are premature and 29,7% had a 0-6 Agar during the first minute of life, needing reanimation. As for the gestational age, 35,1% presented membrane ruptures before the 37th week of birth, 5,4% did not go through pre natal care, 67,5% attended from 2 to 5 appointments and 27,1% attended to 6 or more, 16,2% of the mothers presented Gestational Specific Highblood Pressure Disease (GSHPD) and 51,3% of the mothers went through normal delivery. It was concluded that the prematureness was high, being a main cause of newborn morbid/mortality and that it also brings clinical and obstetric complications for the mothers. The GSHPD still represents a risk to pregnancy. More studies on the subject are needed in order to acknowledged the real magnitude of the problem