5 research outputs found
Review of the missed opportunities for the prevention of vertical transmission of HIV in Brazil
OBJECTIVE: The present literature review aims to highlight gaps in the treatment of preventative motherto-child HIV transmission and the risk factors in Brazil. METHODS: Among the 425 articles identified in SciELO and PubMed searches, 59 articles published between 1994 and 2016 were selected for reading and data extraction, and 33 articles were included in the present review. RESULTS: The rates of vertical HIV transmission described in the studies varied widely, from 1.8% to 27.8%, with a significant reduction over the years. However, recent rates were also found to be variable in different regions of Brazil, and despite the significant reduction in mother-to-child transmission, many gaps remain in prevention services. A failure to attend prenatal care is the main factor associated with the increased risk of vertical transmission of HIV, hindering early maternal diagnosis and the completion of preventative measures during the prenatal period and, often, the peripartum and postnatal periods. A small number of studies discussed the sociodemographic factors, including a low level of education for pregnant women and the inadequacies of health services, such as difficulties scheduling appointments and undertrained staff, associated with vertical transmission. As such, the current challenge is to better define the sociodemographic and infrastructural factors that increase the risk of mother-to-child transmission of HIV to provide the necessary investments to promote an earlier inclusion of these populations in prevention services. CONCLUSIONS: This review may serve as a guide for future programs to focus efforts on the prevention of vertical HIV transmission
Retrospective analysis of risk factors and gaps in prevention strategies for mother-to-child HIV transmission in Rio de Janeiro, Brazil
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Synaptic Organizing Complexes in the Modulation of Excitatory Transmission
The remarkable ability of the brain to interpret vast amounts of stimuli and adapt to new situations is dependent upon not only the proper formation, but also the functional specialization of synaptic connections between neurons. On the molecular level, we are just beginning to understand the networks that regulate synapse development, termed synaptic organizing complexes. Recent work has identified a number of different proteins required for the formation of synapses, i.e. synaptogenesis. However, much less is understood about the protein networks that guide the maintenance and maturation of these nascent synapses. Here, I describe a novel synaptic organizing complex comprised of the secreted protein LGI1 and its transmembrane partners, ADAM22 and ADAM23. I present data demonstrating that LGI1 mediates a transsynaptic complex, including pre- and postsynaptic ADAMs and members of the MAGUK family of intracellular scaffolding proteins. I go on to characterize the functional impact of this transsynaptic complex, revealing that ADAM22 and ADAM23 are essential to maintaining excitatory synapses, and that LGI1 acts as a paracrine signal originating from axons and dendrites to modulate the strength of these synapses. Finally, I address the function of the AMPAR-interacting protein SynDIG1 in synaptic organization, and show that, despite its previous implication in synaptic maturation and possible role as an AMPAR auxiliary subunit, it is specifically a synaptogenic molecule at excitatory synapses