ANTI-RETROVIRAL TREATMENT IN PREGNANACY

The world affected with HIV is reaching trillions where the treatment for HIV especially with Pregnant Women is of current trends which hit the target successfully aiming with Progression. The main objective of this study is to describe the current trends in treating the HIV during Pregnancy and changes in Socio-demography among Pregnant Women with HIV over the past years.

The group of data Collected from the National Program on Surveillance on Antiretroviral Treatment in Pregnancy in Italy says that the changes were found and analysed in antiretroviral treatment, population characteristics, maternal immune-virologic status and new-born clinical parameters. A total of 981 HIV-infected mothers who delivered between the recent years of about 2008- 2015 were evaluated. The ratio of women receiving at least three antiretroviral drugs at delivery increased significantly from 63.0% into 95.5% in 2012–2014, paralleled by a similar upward trend in the proportion of women who achieved complete viral suppression at third.

The co-formulation of zidovudine plus lamivudine remained the most common nucleoside backbone in pregnancy, even if a significant increase in the use of tenofovir plus emtricitabine was observed in more recent years. Starting from 2003, nevirapine prescription declined, paralleled by a significant rise in the use of protease inhibitors (PI), which were present in more than 60% of regimens administered in recent years. Nelfinavir was progressively replaced by ritonavir-boosted PIs, mainly lopinavir. No significant changes in preterm delivery, Apgar score, birth weight, and birth defects were observed during the study period, and the rate of HIV transmission remained below 2%. These data demonstrate a significant evolution in the treatment of HIV in pregnancy. Constant improvements in the rates of HIV suppression were observed, probably driven by the adoption of stronger and more effective regimens and by the increasing options available for combination treatment.

PEDIATRIC THERAPEUTIC YOGA – IMPROVING THE QUALITY OF LIFE IN CHILDREN WITH CANCER

Children can benefit from a regular yoga practice. Children hospitalized with oncological diagnoses are at high risk for developing decreased mobility, fitness, balance, and strength due to decreased functional activity as they undergo treatment. Induction therapy is the first step in cancer treatment, which is followed by additional therapies such as chemotherapy, radiation, and stem cell transplants. Once cancer is in remission, maintenance therapy is used to prevent a relapse. Children with one of the most common childhood cancers, acute lymphoblastic leukemia, often receive chemotherapy for 2.5 to 3.5 years. Side effects of chemotherapy as a treatment for cancer include delayed growth and development, depression and anxiety, chronic pain, hearing loss, weakness in bone structure, cardiovascular and heart problems because of chemotherapy and radiation to the spine or chest wall, scarring of lung tissue and increased risk of lung inflammation and infection, and muscle wasting and decreased balance in the lower extremities.

Limited information on guidelines for physical activity for children undergoing oncology treatment is available. Children are likely to have individualized responses to exercise programs regardless of the type of cancer and stage of the disease and require an individual exercise prescription. Participation in a structured therapeutic exercise program can provide a safe environment in which Pediatric oncology patients can exercise at a level appropriate for their unique needs. Cancer survivors who participate in exercise programs during treatment may be more motivated to continue exercising if regular exercise is experienced as a positive change in quality of life and physical fitness. Low-impact exercise programs have been beneficial in improving physical activity level and reducing fatigue in cancer patients undergoing treatment for hematological malignancies. Children with oncological diagnoses who received stem cell transplants demonstrated improved maximal oxygen consumption as a response to exercise. Exercise programs that stress balance have been found to improve lower extremity balance, strength, and proprioception as much as more traditional exercise programs.  Results from previous studies on exercise for Pediatric oncology patients suggest that many patients had lower levels of physical activity and perceived quality of life during and after cancer treatment.

Yoga is a low-impact exercise that has been incorporated into Pediatric exercise programs for strength, balance, pain control, and quality of life. Studies are needed to determine the efficacy of yoga as part of a low-impact exercise program for children with cancer. Prolonged periods of treatment affect quality of life for children with oncological diagnoses. Information on how exercise affects quality of life must be gathered to support the development of appropriate exercise programs for this population.