Enhancing access to immunization services and exploiting the benefits of recent innovations in the African region.

The African Regional Office of the World Health Organization (WHO AFRO) organized the annual regional conference on immunization (ARCI) from 10 to 12 December 2012 in Dar es Salaam, Tanzania, under the theme, "Innovations, access and the right of all to vaccines". The meeting reviewed the status of immunization in the region and identified all innovations, strategies and technologies available and how these could be fully utilized to enhance the access and the rights of all to vaccines. Over 50 oral presentations were made in plenary and parallel sessions of the conference which was attended by over 200 participants drawn from national immunization programs, academia, public health experts and immunization partners.

Mutations in KLHL40 are a frequent cause of severe autosomal-recessive nemaline myopathy.

Nemaline myopathy (NEM) is a common congenital myopathy. At the very severe end of the NEM clinical spectrum are genetically unresolved cases of autosomal-recessive fetal akinesia sequence. We studied a multinational cohort of 143 severe-NEM-affected families lacking genetic diagnosis.

Urinary profile of catecholamines and metabolites in Parkinson patients with deep brain stimulation.

Background And Purpose: Deep brain stimulation of the subthalamic nucleus (DBS-STN) is thought to continuously alter the activity of STN neurons in Parkinson's disease (PD). A chronic decrease in the levodopa dose with continuous STN stimulation may induce plastic neuronal changes.

Objective: The objective of this work was to study urinary excretion of catecholamines in patients with PD before and after DBS-STN.

Trans-lamina terminalis approach for third ventricle and suprasellar tumours.

Background: The trans-lamina terminalis (TLT) approach to the suprasellar region and third ventricle is complex, with risks of visual and hormonal deficits. However, the postoperative deficits might not be directly related to opening of the lamina terminalis but to the close relationship of tumours with vital neural and vascular structures. The analysis of results using this approach was the objective of this study.

One-step tunneling of DBS extensions--a technical note.

Background: Infection constitutes a serious adverse event in deep brain stimulation (DBS) surgery, being responsible for difficult therapeutic decisions that may ultimately involve the removal of implanted material. Some cases begin with skin erosion and wound dehiscence of the retroauricular incision, which is one of the most fragile points. Several techniques of rotation flaps and skin reconstruction, as well as prolonged antibiotic regimens, have been proposed as therapeutic options.

Zoonotic potential of multidrug-resistant extraintestinal pathogenic Escherichia coli obtained from healthy poultry carcasses in Salvador, Brazil.

The zoonotic potential to cause human and/or animal infections among multidrug-resistant extraintestinal pathogenic Escherichia coli from avian origin was investigated. Twenty-seven extraintestinal pathogenic E. coli isolates containing the increased survival gene (iss) were obtained from the livers of healthy and diseased poultry carcasses at two slaughterhouses in Salvador, northeastern Brazil.

Regional variations in brain oxygenation during temporary clipping in aneurysm surgery.

Objectives: Brain tissue oxygen concentration (PbtO(2)) monitoring has been used in aneurysm surgery to detect decreased brain oxygenation during temporary clipping. The effects of circulatory interruption according to different aneurysm locations have not been established. In this work, variations in PbtO(2) during temporary clipping were studied in anterior communicating (AcomA), posterior communicating (PcomA) origin, and middle cerebral artery (MCA) aneurysm surgery.

Intracerebral abscess: a rare complication of Deep Brain Stimulation.

Introduction: Deep Brain Stimulation (DBS) is a therapeutic option for some forms of Parkinson's disease (PD). The main adverse effects of this surgery are: infection (2-9%), haemorrhage (1-4%) and seizures (1-3%). We report a rare complication of DBS: an intracranial abscess.

[Anemia in Chronic Kidney Disease: from facts to clinical practice].

Anemia in Chronic Kidney Disease (CKD) is present in approximately 90% of patients with glomerular filtration rate below 25-30 mL/min. It's impact in the quality of life makes it one of the major problems in CKD patients. Although the etiology is multifactorial the suboptimal production of erithropoietin caused by renal mass loss appears to be of major importance.

Revisiting Vibrational Circular Dichroism Spectra of (S)-(+)-Carvone and (1S,2R,5S)-(+)-Menthol Using SimIR/VCD Method.

The VCD spectra of (S)-(+)-carvone and (1S,2R,5S)-(+)-menthol are recalculated using the DFT method with extended conformation and configuration spaces. The calculated individual and averaged spectra are compared against observed ones using the previously reported similarity index, SV. It is found that the SV population forms approximately two normal distributions, depending on whether a spectrum matches the observed one or not.

[Spontaneous spinal subdural hematoma].

Spontaneous spinal subdural hematomas are rare and may be caused by vascular malformations or bleeding disorders. The diagnosis is based on the conjunction of clinical examination with imaging studies, being MRI the gold standard in detection and surgical planning. The authors report the case of a patient on anticoagulant therapy in the context of atrial fibrillation and mechanical prosthetic mitral and tricuspid valves, presenting with sudden onset of dorsal pain radiated to both lower limbs, paresthesias and progressive paraparesis.

Fibronectin promotes migration, alignment and fusion in an in vitro myoblast cell model.

Myogenesis is a complex process in which committed myogenic cells differentiate and fuse into myotubes that mature into the muscle fibres of adult organisms. This process is initiated by a cascade of myogenic regulatory factors expressed upon entry of the cells into the myogenic differentiation programme. However, external signals such as those provided by the extracellular matrix (ECM) are also important in regulating muscle differentiation and morphogenesis.

Intraoperative brain oxygenation monitoring and vasospasm in aneurysmal subarachnoid hemorrhage.

Background: Vasospasm is a frequent complication of subarachnoid hemorrhage (SAH), implicated in poor outcome, and prediction of its occurrence might be important on the therapeutic approach of this condition. Brain oxygenation in aneurysmal SAH was prospectively monitored during surgery in 28 patients, using brain tissue oxygen pressure (PbtO(2)), studying its association with the occurrence of post-operative vasospasm, detected by transcranial Doppler.

Methods: PbtO(2) monitoring was performed during surgery of 28 patients with aneurysmal SAH, using a polarographic microcatheter (Licox; GMS, Kiel, Germany), inserted into the cerebral tissue.

Extracellular matrix remodeling accompanies axial muscle development and morphogenesis in the mouse.

Background: Skeletal myogenesis is extensively influenced by the surrounding environment. However, how the extracellular matrix (ECM) affects morphogenesis of muscles is not well understood.

Results: We mapped the three-dimensional (3D) organization of fibronectin, tenascin, and laminin by immunofluorescence during early epaxial myogenesis in mouse embryos.

Deep Brain Stimulation of the Subthalamic Nucleus for Parkinson's Disease in a Patient with HIV Infection: Dual Clinical Benefit.

As a result of the efficacy of highly active antiretroviral therapy (HAART), patients with human immunodeficiency virus (HIV) can survive longer and are thus naturally prone to ageing-related degenerative disorders such as Parkinson's disease (PD). Managing PD and HIV in the same patient may be challenging, as HAART and levodopa interact and may cause intolerable side effects. Concerns about the increased risk of hardware infection in immunocompromised patients submitted to deep brain stimulation of the subthalamic nucleus (STN-DBS) still persist.

Surgical removal of giant acoustic neuromas.

Objective: The authors present the outcome of radical surgical removal of giant acoustic neuromas.

Methods: Twenty-nine patients with acoustic neuroma with maximum diameter greater than 40 mm, submitted to surgery between the years 2005 and 2010, were reviewed by a retrospective study. The extension of tumor removal, surgical morbidity, facial nerve function, hearing, and evolution after surgery of preoperative neurologic conditions were the studied parameters.

Bond strength and interfacial micromorphology of etch-and-rinse and self-adhesive resin cements to dentin.

Purpose: To evaluate the microtensile bond strength and interfacial micromorphology of indirect composite restorations to dentin using three commercial resin cements after 24 hours and 30 days of water storage.

Materials And Methods: The medium dentin of third human molars was exposed (N = 30, n = 10 per group). Three commercial resin cements were used to cement indirect resin composite restorations to dentin: the auto-cured C&B Cement/All Bond 2, the dual-cured RelyX ARC/Adper Single Bond 2, and the self-adhesive dual-cured RelyX Unicem.

Role of Tc-Sulesomab Immunoscintigraphy in the Management of Infection following Deep Brain Stimulation Surgery.

Infection constitutes a serious adverse event in patients submitted to deep brain stimulation, often leading to removal of the device. We set to evaluate the potential role of immunoscintigraphy with (99m)Tc-labelled antigranulocyte antibody fragments ((99m)Tc-sulesomab) in the management of infection following DBS. (99m)Tc-sulesomab immunoscintigraphy seems to correlate well with the presence and extent of infection, thus contributing to differentiate between patients who should remove the hardware entirely at presentation and those who could undergo a more conservative approach.

Impact of EGFR genetic variants on glioma risk and patient outcome.

Background: The epidermal growth factor receptor (EGFR) regulates important cellular processes and is frequently implicated in human tumors. Three EGFR polymorphisms have been described as having a transcriptional regulatory function: two single-nucleotide polymorphisms in the essential promoter region, -216G/T and -191C/A, and a polymorphic (CA)(n) microsatellite sequence in intron 1. We aimed to elucidate the roles of these EGFR polymorphisms in glioma susceptibility and prognosis.

Juvenile psammomatoid ossifying fibroma of the orbit and paranasal sinuses. A case report.

Juvenile psammomatoid ossifying fibroma (JPOF) is an uncommon benign fibro-osseous lesion predominantly arising in the paranasal sinuses and orbits of children and young adults. We report a case of JPOF involving the paranasal sinuses and orbit in a 15-year-old boy that presented due to progressive proptosis and downward displacement of the left eye. The lesion, first described as fibrous dysplasia (FD), was totally removed surgically, and then proved to be a JPOF, by histopathology.

Monitoring of brain oxygenation in surgery of ruptured middle cerebral artery aneurysms.

Background: The occurrence of brain ischemic lesions, due to temporary arterial occlusion or incorrect placement of the definitive clip, is a major complication of aneurysm surgery. Temporary clipping is a current technique during surgery and there is no reliable method of predicting the possibility of ischemia due to extended regional circulatory interruption. Even with careful inspection, misplacement of the definitive clip can be difficult to detect.

Monitoring of brain tissue oxygenation in surgery of middle cerebral artery incidental aneurysms.

Introduction: The management of incidental unruptured aneurysms remains a matter of controversy; middle-sized or large anterior circulation incidental aneurysms, in young or middle age patients, should be considered for treatment. Surgical clipping is an accepted treatment for middle cerebral artery unruptured aneurysms. Ischemic events can occur even in cases of incidental aneurysm surgery.

[Lumbar tuberculous spondylodiscitis: a minimally invasive surgical approach].

Introduction: Tuberculous spondylodiscitis is the most frequent and severe manifestation of extra-pulmonary tuberculosis, accounting for 40 to 50 percent of the cases with osteoarticular involvement. Although antituberculous drugs remain the cornerstone of therapy, surgical treatment still has an important role in the management of some situations. Classical approaches of radical debridement have been gradually replaced by minimally invasive surgical procedures.