Surgeons are still searching for the ideal method for pharynx reconstruction after tumor ablation. The objective of this study was to prove the anatomic and clinical viability of an occipital galeal pedicle flap for hypopharynx reconstruction. We studied anatomic details in 50 fresh adult cadavers. The dissections were performed after posterior galea exposure, silicone injection in occipital vessels, and mobilization of the galeal flap with an 8 x 8 cm square of galea. We also used the proposed flap in three clinical cases after laryngopharyngectomy. The surgical technique and its problems are described. Some of the anatomic data obtained are as follows: occipital artery diameter, 2.69 mm (mean); occipital artery length, 134.25 mm; area of occipital vessels network on galea, 148.77 cm2; pedicle length, 116.63 mm; and success in rotation to pharynx region (100 percent). The flap showed good functional and cosmetic results when used in three patients. A partial necrosis occurred in one case. The pedicled galeal occipital flap has favorable anatomic characteristics for use in head and neck reconstruction. Additional studies are necessary to provide more substantial information about its clinical viability.

Conclusion These data suggest a high burden of TV and co-infection with CT. Public health surveillance focusing on CT infection may consider routine screening of other STIs, including TV, in local populations to reduce STI morbidity. Saúde do Distrito Federal, Brasília, Brazil This descriptive study set the profile of pregnant with positive VDRL followed at public maternity hospitals in Federal District, Brazil, of the newborns children of mothers with syphilis that showed clinic signs of congenital disease and verified approach according with the recommendations of the Ministry of Health. The study verified the percentage of pregnant women who had access to prenatal care and were inadequately treated and the percentage of newborns with inadequate clinical management in accordance with the recommendations of the MS. We interviewed 67 pregnant as postpartum women who reported to the National System of Disease Notification, users of five public hospitals of the DF and consulted information from medical records and from prenatal care charts, when available. The information relating to the clinical and laboratory received to the children were supplemented with data from medical records, compulsory notification forms of syphilis, from prenatal care charts and the child health card, when available. Data were collected on sociodemographic, obstetric, information related to diagnosis, treatment of pregnant and puerperal women their partners and treatment of newborns into delivery. Only 41.8% patients were adequately treatment and main reason for inadequacy was the lack of treatment (83.6%) or inadequate treatment of the partner (88.1%). The study demonstrated the need for new treatment of the mother at the hospital for lack of documentation of the treatment in prenatal care. There was disagreement with the recommendations of the MS to follow-up of newborns with congenital syphilis in relation to radiographic study only 48% children carried out and lumbar pucture was required only 42%. It was observed that 36% newborns not received any treatment. Our date demonstrates that the quality of prenatal care received by pregnant women is not sufficient to ensure control of congenital syphilis an reaching the goal of controlling the disease. In the years 1996-2012 all together 4966 pregnant women infected with syphilis were registered in Belarus (8.36% from the general number of the women with syphilis for this period -59426 cases). Primary syphilis was diagnosed in 13.2% of patients, secondary syphilis -30.5%, latent early syphilis -55.9%, latent late syphilis -0.4%. Disease has been revealed in I trimester of pregnancy in 56.7% of patients, II trimester -23.2%, III trimester -17.5%, after delivery -2.6%. 45.1% of women have made abortion after disease revealing. Maternal and Congenital SyPhiliS reMain a ChallengeThere are 127 children with congenital syphilis (CS) registered in 1994-2012 in Belarus in total, but last two years cases of CS have not been registered. Among women which have given birth to children with CS prim...