We present a set of female thoracoomphalopagus conjoined twins who were separated at ten months of age. Tissue expanders were used to expand the available soft tissue to cover the defect. The abdominal wall was closed by making a release incision on the outer aspect of the anterior sheath of the rectus muscle, detaching the anterior sheath of the muscle fibers, and flipping it over towards the midline. Meshes of decellularized collagen matrix were used to close the thorax. They had no major complications and were discharged from the hospital 60 days later. The girls are currently 5 years old and lead a normal life according to their age. We believe that the use of tissue expanders combined with the mobilization of aponeurotic flaps through discharge incisions adds a useful tool for the treatment of these patients

Introduction Primitive bone tumours of the pelvis represent a considerable challenge for carcinologic surgeons. Resections made in the acetabular zone could disrupt the continuity of the pelvic ring. The morbidity that comes after such a procedure requires a reconstruction surgery in order to improve the functional outcome. In this aim, multiple techniques have been reported. Case report We report the case of a 23-year-old male with no medical history diagnosed with a right pelvic bone osteosarcoma located in Enneking zones I and II. He first underwent neoadjuvant chemotherapy followed by a large resection of the whole bone. A reconstruction was then made using a vascularized fibular autologous graft and stabilized by a long customized lombo-femoral plate. Recovery of walking was possible using crutches. No recurrence was note at one year follow-up. Conclusion Malignant primitive tumours of the pelvis threaten the vital and functional prognoses of patients. It is now possible to perform conservative resections in more than 80% of case without compromising the survival of patients or their functional outcome.

Worldwide, one in eight deaths is due to cancer. Projections based on the GLOBOCAN 2012 estimates predict a substantive increase new cancer cases per year by 2035 in developing countries if preventive measures are not widely applied. According to the World Health Organization (WHO), millions of lives could be saved each year if countries made use of existing knowledge and the best cost-effective methods to prevent and treat cancer. Therefore, the aim of this study is to estimate a provisional budget against cancer in low and middle incomes countries, according the GNI-PPP, the cancer incidence and the number of population. Economically country classification is determining with the Gross national income (GNI), per capita, Purchasing power parity (PPP), according the administrations of the International Monetary Fund (IMF), the World Bank (WB) and the Central Intelligence Agency (CIA). Cancer incidence data presented are based on the most recent data available at IARC. However, population compares estimates from the US Bureau of the Census. The provisional budget is establishing among the guidelines developed by WHO for regional and national cancer control programs according to national economic development. Provisional budget against cancer is estimated to 12,782.535 (thousands of U.S $) for a population of 5,918,919 persons in Eritrea.

Remarkably, there is no place for inaccuracies and errors in modern era of value-based care medicine. The high stress clinical setting and the challenging demands within the medical field, to enhance improvement in patient safety culture. It is a difficult experience for health care practitioners to witness expected patient tragedies, and affect the most resilient health providers. Intended harm and negligence due to vindictiveness is extremely rare; yet, we treat our caregivers who are involved in human error and system failures with blame, shame, and, what may be most destructive and abandonment

In Belize, patients rely on nurses for nutritional guidance on non-communicable diseases in the Caribbean. The objectives of this study were to quantify the therapeutic nutritional knowledge of 198 Belizean nurses using the Al-Shwaiyat questionnaire. The mean correct response rate for the therapeutic nutritional knowledge was suboptimal (53.30%±17.20). Nurses in the West region of the country had the highest mean knowledge scores on nutrition and diabetes 75.41±20.10, p=0.003; on nutrition and cardiovascular diseases 57.23±10.90, p=0.000; and in overall knowledge 62.34±9.76 p=0.000. Nurses without a diagnosis of diabetes had higher mean knowledge scores on a) nutrition and diabetes 63.86±26.07, p=0.001; b) nutrition and obesity questions 49.55±20.80, p=0.004; c) nutrition and cardiovascular disease 53.30±15.70, p=0.007 and d), overall mean 55.24±16.67, p=0.000. There is a need to address the low levels of knowledge of Belizean nurses.

Background: Psoriasis is a chronic, autoimmune disorder that affects the skin and joints with an approximate global prevalence of 2–3%. Mild to moderate psoriasis is highly prevalent in about 80% of the global psoriatic population (2-3%). Currently available treatment options for mild to moderate psoriasis are topical dosage forms. Though a variety of topical formulations available, they are associated with different side effects. There is an unmet need for a product that can be used for a prolonged period with minimal side effects. Hence, Apremilast gel was developed and clinical proof of concept study (POC) was performed to investigate the efficacy and safety in mild to moderate psoriasis patients. Methods: A single-center randomized, double-blind, placebo-controlled study was conducted to evaluate the efficacy and safety of apremilast topical gels 2% & 4% w/w, in adult mild to moderate psoriatic patients for 12 weeks. Patients were examined at weeks 0, 2, 4, 8, and 12 weeks to assess the efficacy and safety. At 0 and 8 weeks, blood samples were collected to investigate the pharmacokinetics. The significance in % recovery was calculated statistically. Results: Both gels exhibited a significant reduction in PASI values when compared with baseline PASI scores. The average percentage inhibition of PASI with test products i.e. 2% and 4% w/w Apremilast topical gels is about 46.8% and 34.6% respectively after 12 weeks of treatment. Both the test products have not shown any adverse effects, hematological & biochemical changes and have exhibited Cmax less than 20ng/ml after 6 hours of application. Conclusion: Results have shown that topically applied apremilast could be an effective and safe option for the management of mild to moderate psoriasis.

Worldwide, one in eight deaths is due to cancer. Projections based on the GLOBOCAN 2012 estimates predict a substantive increase new cancer cases per year by 2035 in developing countries if preventive measures are not widely applied. According to the World Health Organization (WHO), millions of lives could be saved each year if countries made use of existing knowledge and the best cost-effective methods to prevent and treat cancer. Therefore, the aim of this study is to estimate a provisional budget against cancer in low and middle incomes countries, according the GNI-PPP, the cancer incidence and the number of population. Economically country classification is determining with the Gross national income (GNI), per capita, Purchasing power parity (PPP), according the administrations of the International Monetary Fund (IMF), the World Bank (WB) and the Central Intelligence Agency (CIA). Cancer incidence data presented are based on the most recent data available at IARC. However, population compares estimates from the US Bureau of the Census. The provisional budget is establishing among the guidelines developed by WHO for regional and national cancer control programs according to national economic development. Provisional budget against cancer is estimated to 177,825.819 (thousands of U.S $) for a population of 6,172,011 persons in El Salvador.

Myomas represent the most common benign type of female genital track. Therapeutic mapping is strongly associated with age of the patient, number and location of the myomas and patient’s reproductive capacity. Among the future operative and postoperative complications consist communication of vaginal wall with local organs, formation of a fistula. Adjunction and further anatomic penetration between vaginal wall and urine bladder epithelium, can depict a vesicovaginal fistula. After proper diagnosis, therapeutic mapping depends on the type of the fistula and surgical intervention in order to ensure patient’s quality of life. Aim of our study, consists proper diagnosis and conservative management of vesicovaginal fistula. Cystoscopy therapeutic strategy with proper follow up represents an alternative treatment of choice, avoiding compound surgical interventions.

Worldwide, one in eight deaths is due to cancer. Projections based on the GLOBOCAN 2012 estimates predict a substantive increase new cancer cases per year by 2035 in developing countries if preventive measures are not widely applied. According to the World Health Organization (WHO), millions of lives could be saved each year if countries made use of existing knowledge and the best cost-effective methods to prevent and treat cancer. Therefore, the aim of this study is to estimate a provisional budget against cancer in low and middle incomes countries, according the GNI-PPP, the cancer incidence and the number of population. Economically country classification is determining with the Gross national income (GNI), per capita, Purchasing power parity (PPP), according the administrations of the International Monetary Fund (IMF), the World Bank (WB) and the Central Intelligence Agency (CIA). Cancer incidence data presented are based on the most recent data available at IARC. However, population compares estimates from the US Bureau of the Census. The provisional budget is establishing among the guidelines developed by WHO for regional and national cancer control programs according to national economic development. Provisional budget against cancer is estimated to 24,127.516 (thousands of U.S $) for a population of 920,938 persons in Fidji.