No abstract

Vaccination coverage in the so-called "developing countries" is still lower than expected. Such coverage is an important indicator of population health and the quality of care provided by the health care system. The current study describes the results of a household survey to estimate coverage of the basic immunization schedule in the first year of life in State capitals in Northeast Brazil, for the 2005 birth cohort. The methodology used was that recommended by the Pan American Health Organization for surveys on vaccination coverage. According to the data, vaccination coverage fell short of the goals set by the National Immunization Program for this age group, at high risk of acquiring vaccine-preventable diseases. The lowest coverage rates were found at the two extremes of socioeconomic strata. Assessment of vaccination coverage indicates whether the infant population is immunized and helps identify weak points in vaccination activities.

Summary:Purpose: To describe postoperative outcome in patients with familial mesial temporal lobe epilepsy (FMTLE).Methods: We studied FMTLE patients who underwent surgical treatment for refractory seizures. FMTLE was defined when at least two individuals in a family had a clinical EEG diagnosis of MTLE. Preoperative investigation included magnetic resonance imaging (MRI), interictal/ictal EEGs, and neuropsychological evaluation. We used Engel's classification for postoperative outcome.Results: To date, 20 FMTLE patients have been operated on, with 1.6 to 9.8 years of follow-up (mean, 5.5 years). Hippocampal atrophy (HA) and other signs of mesial temporal sclerosis (MTS) were present in 18 patients (15 unilateral). Seizures were recorded in 19 patients. Seventeen (85%) patients are in class I. Two patients had normal hippocampal volumes (HcV): one (5%) is in class II and the other (5%) in class IV (extratemporal seizures developed after surgery). One (5%) patient had bilateral HA and is in class III. Qualitative histopathology showed MTS with different degrees of severity.Conclusions: Refractory FMTLE patients have good surgical outcome when unilateral or clearly asymmetric HA is identified. Preoperative investigation should be the same as that in patients with sporadic refractory MTLE. Key Words: SurgeryHippocampal atrophy-Familial mesial temporal lobe epilepsy.Mesial temporal lobe epilepsy (MTLE) is the most common form of partial epilepsy in adults, and ≤50% of patients have refractory seizures. Surgical treatment has an excellent prognosis, particularly when unilateral hippocampal atrophy (HA) on magnetic resonance imaging (MRI) and ipsilateral ictal and interictal EEG abnormalities are present (1-5).The familial form of MTLE (FMTLE) has been recently established as a well-defined clinical syndrome, accounting for ∼7% of patients with TLE (6-8). Among the 22 families studied in our previous clinical MRI report, ≤23 affected individuals were found per family (mean, five). All possibly affected individuals underwent detailed clinical evaluation and EEG recordings whenever possible. Most families with MTLE have patients with different seizure severity; characteristically, few patients have refractory seizures, and the majority of affected individuals have benign MTLE (6-8). The presence of HA on MRI was observed in 57% of our series of 84 patients with

Pineal region tumors have no pathognomonic imaging pattern. MRI and CT are complementary in diagnosis and are important to determine localization, extension, and meningeal spread.

6. These findings show that the re-innervation oforiginal end-plates is ofimportance in facilitating the rapid return oftransmission to normal levels and limiting the extent of axonal growth.