Ana Ferraz

The Central Bank released its latest Focus Report, a weekly survey on economic forecasts of top-rated market agents.

Inflation in Brazil has eased off from its painful peak in 2021-2022, but the forces pushing prices higher remain stubborn.

Mining giant Vale’s 2022 profit was down more than 30 percent compared to 2021. That raised expectations for Brazilian commodities in 2023.

The Brazilian government is reportedly negotiating the reopening of a car-making factory that belonged to Ford in Camaçari, in Bahia.

The uneasy dance between Brazil's government and monetary authority will get even less comfortable after the latest GDP reading.

The median forecast for year-end inflation in Brazil was unchanged at 5.9 percent in this week's Focus Report, a Central Bank-led survey.

A committee of experts presented the Senate with a comprehensive study on AI regulation for Brazil. But proposals haven't advanced.

Craniotabes is characterized by the softening of skull bones in newborns. It can be associated with conditions like rickets, congenital syphilis, and osteogenesis imperfecta. In otherwise healthy newborns, craniotabes is often linked to in utero vitamin D deficiency.We report four cases of term infants diagnosed with craniotabes at birth. For all cases, laboratory tests confirmed vitamin D deficiency with serum 25-hydroxyvitamin D levels below 20 ng/mL, alongside maternal vitamin D deficiency. While three cases showed no complications, one newborn had a skull fracture and a neonatal stroke. All infants were supplemented with oral cholecalciferol, resulting in the normalization of serum 25-hydroxyvitamin D levels and resolution of the skull softening. These cases highlight the critical role of maternal vitamin D levels in fetal bone development and the potential risks of its deficiency. Although craniotabes associated with maternal vitamin D deficiency is a known condition among neonatologists, these cases help to increase awareness of this diagnosis. We highlight the need for thorough clinical examination, along with complementary diagnostic tests, to identify any related complications.

Late-onset sepsis (LOS) is commonly associated with pathogens acquired in hospital or community settings and carries a significant risk of morbidity and mortality in neonates.We present a case of a late preterm neonate, born at 36 weeks and 2 days with low birth weight (1700 g), who was admitted to the neonatal intensive care unit (NICU) and developed LOS on the fourth day of life. LOS was diagnosed in the context of fever and lethargy, mild thrombocytopenia, leukopenia, and lymphopenia, and was caused by multidrug-resistant (MDR) Acinetobacter baumannii, confirmed through blood culture. Initial empirical treatment with vancomycin and gentamicin was adjusted to gentamicin and meropenem based on the antibiogram, resulting in a swift and favorable clinical and laboratory response.This case, a rare occurrence in our NICU, provides an opportunity to discuss the etiology, risk factors, and clinical presentation of LOS related to Acinetobacter baumannii, as well as to highlight the growing concern of MDR microorganisms in the NICU setting.

Monochorionic twin pregnancies carry a risk of perinatal complications due to shared placental anastomoses, which can cause uneven blood distribution and lead to conditions like selective fetal growth restriction (sFGR). This case describes a monochorionic pregnancy complicated by preeclampsia and late-onset sFGR of twin B. Labor was prematurely induced and a 45% weight discordance between the twins was confirmed. Twin A adapted well to extrauterine life, but a routine cerebral ultrasound on the second day revealed a periventricular venous infarction. Subsequent brain magnetic resonance imaging (MRI) confirmed deep medullary vein thrombosis and multiple small ischemic lesions secondary to hypoxia. Twin B, born with anhydramnios, experienced several perinatal complications including resuscitation at birth and acute kidney injury. By the fourth day, twin B developed inconsolable irritability, intermittent opisthotonus, and a cortical thumb. The brain MRI showed pachygyria, suggesting a cortical development malformation. sFGR can lead to severe cerebral injuries and adverse neurodevelopmental outcomes, often impacting the larger twin due to acute in-utero blood volume shifts between the twins through placental anastomoses, while also causing brain growth restriction in the smaller twin. Balancing the risks of prematurity against the potentially serious outcomes in twins poses a significant challenge in the management of sFGR cases.