Value of Caesarian Section in HIV-Positive Women

The international main goal is to reduce mother-to-child HIV transmission. The appropriate birth delivery for seropositive woman has been analyzed since the beginning of the twenty-first century. Although at the beginning of HIV pandemic delivery by caesarian section (C-section) was considered mandatory in many studies and meta-analyses, recent information reveal limited benefits. Mother-to-child transmission is higher when mothers are diagnosed late during pregnancy, in advanced stages with a high HIV viral load, and labor with membranes ruptured for more than 4 h, especially when the antiretroviral treatment is not respected. During vaginal delivery, the risk of HIV transmitting to infant is due to microtransfusions during uterine contractions or by newborn exposure to cervicovaginal secretions or blood. Although the indication of C-section in HIV-positive women is controversial, there are some situations in which C-section remains mandatory. In mothers diagnosed late during pregnancy, in situation in which HIV viral load is not affordable in real time in the last trimester of pregnancy, and in mothers with poor adherence to antiretroviral treatment, C-section remains one of the most important measures of prevention for HIV mother-to-child transmission

Evolution of Different Bacterial Mningoencephalitis: Series of Case Presentations and Literature Review

Bacterial meningitis is one of the most important medical emergencies, a life-threatening condition that leads to death in all the cases in untreated patients. In infants and young children, especially under 5 years old, the most encountered and severe forms are caused by Streptococcus pneumoniae, Neisseria meningitidis and Hemophilus influenzae type b. The risk of neurological impairment after an acute episode of bacterial meningitis is relatively high. Worldwide, prevention through vaccination decreased dramatically incidence and mortality related to these disease. In Romania vaccination for Neisseria meningitides is optional available for just 6 months, vaccination for Streptococcus pneumoniae by one year, and for Haemophylus influenzae type B is available over 10 years