Influence of exposure and vertical transmission of HIV-1 on the neuropsychomotor development in children

Abstract INTRODUCTION: Exposure to human immunodeficiency virus (HIV)-1 during pregnancy is a major risk factor for neurodevelopmental delay and deleterious effects in children. However, limited information about these conditions exists in poor geographical areas in Brazil. Prevention of vertical transmission of HIV-1 is dealt differently in different regions of the country and in poorer areas it is more difficult to evaluate the impact of the prevention methods. The outcomes of the exposure to HIV-1 and the impact of vertical HIV-1 transmission on neuropsychomotor development was evaluated for the first time in children born to HIV-infected mothers in the North region of Brazil, where the majority of the population has poor access to health services. METHODS: Sixty children born to HIV-1-infected mothers (case group) and 58 born to non-infected mothers (control group) were followed for the first 12 months of life in a prospective case-control study. Neuropsychomotor development was assessed using the Denver II test. RESULTS: Suspected neuropsychomotor developmental delays were more frequent in the case group (33.3%), namely in language (38.9%) and gross motor skills (27.8%). These delays were reversed in most children after 12 months of life due to therapeutic intervention. The delays were not reversed in three children, all of whom belonged to the case group. Only one of these was infected with HIV-1, and this child had the poorest neuropsychomotor outcomes. CONCLUSIONS: Maternal HIV-1 infection negatively affected the neuropsychomotor development in children, although other factors may have played a role

Mothers' perspective on violence against children: constructing meanings

ABSTRACT Objective: To explore the construct elaborated by the mother on the meaning of violence against the child and to identify, according to the mother's perspective, which measures are most used for the prevention of this phenomenon. Method: This is a qualitative research, with the participation of thirty mothers, in a health service in the city of Ananindeua, in the state of Pará, Brazil. The methodology consisted of the categorical content analysis, which identified three categories: Violence, Threats of violence and Protective measures. Results: The research showed that mothers attribute different meanings to violence, but the physical and sexual violence were markedly the most highlighted, and the dialogue was the most used protective measure. Conclusion: It is essential to strengthen public policies through effective interventions, seeking solutions to address this phenomenon in all segments of society

O DIREITO AO CONHECIMENTO DA ORIGEM GENÉTICA EM FACE DA INSEMINAÇÃO ARTIFICIAL COM SÊMEN DE DOADOR ANÔNIMO

A paternidade biológica advinda da inseminação artificial heteróloga não deve ser confundida com a paternidade socioafetiva. Esta, construída através de laços de carinho, amor e atenção, prevalece sobre aquela. Ao tratar-se da geração de um filho através de procedimento efetuado com sêmen proveniente de um doador anônimo, deve-se saber que este não possui nenhuma relação, a não ser congênita, com o concebido. Portanto, o doador do sêmen não pode ser considerado “pai”, na atual conotação do termo, eximindo-se da obrigação de prestar alimentos ou até mesmo de conceder afeto ao indivíduo gerado a partir do seu material genético. No entanto, o concebido tem o direito de conhecer sua origem biológica paterna, mesmo a título de curiosidade, pois, de forma contrária, teria sua personalidade e autodeterminação atingidas, o que contrariaria princípio fundamental do Direito. Ademais, as probabilidades de relações incestuosas entre irmãos ou entre pai/doador e filha, da mesma forma, laboram para uma conclusão favorável à quebra do anonimato do indivíduo cedente do material genético masculino