Particularly older children and adolescents are often not fully v

Particularly older children and adolescents are often not fully vaccinated or are even unvaccinated. A high pro-portion is missing the recommended booster doses against diphtheria, tetanus, pertussis and polio. Vaccination compliance especially regarding completeness and timeliness is lower in western than eastern Germany, as well as in children

of vaccine sceptics and foreign-born children, More comprehensive surveillance of vaccination coverage and adverse events following immunization as well as the implementation of a national 3-MA in vitro immunization plan focussing on closure of immunization gaps could lead to improved vaccination coverage.”
“Study Design. This is a retrospective comparative cohort study. Objective. To compare the outcomes of patients with symptomatic selleck compound cervical intervertebral disc

herniation (CIVDH) treated with full-endoscopic cervical discectomy (FECD) using the anterior approach with those treated with the posterior approach. Summary of Background Data. The optimal FECD surgical approach for CIVDH remains controversial. Methods. From March 2010 to July 2012, a total of 84 consecutive patients with symptomatic single-level CIVDH who underwent FECD using the anterior approach (42 patients) or the posterior approach (42 patients) were enrolled. Patients were assessed neurologically before surgery and followed up at regular outpatient visits. The clinical outcomes were evaluated using the visual analogue scale and the modified MacNab criteria. Radiographical follow-up included the static and dynamic cervical plain radiographs, computed tomographic scans, and magnetic

resonance images. Results. In both selleck chemicals groups, shorter mean operative time (63.5 min vs. 78.5 min), increased mean volume of disc removal (0.6 g vs. 0.3 g), larger mean decrease in the final postoperative mean intervertebral vertical height (1.0 mm vs. 0.5 mm), and longer mean hospital stay (4.9 d vs. 4.5 d) were observed in the anterior full-endoscopic cervical discectomy group. Postoperatively, the clinical outcomes of the 2 approaches were significantly improved, but the differences between the 2 approaches were not significant (P = 0.211 and P = 0.257, respectively). Four surgery-related complications were observed among all enrolled patients (complications in each group were 2; overall 4 of 84, 4.8%). Conclusion. In our study, the clinical outcomes between the 2 approaches did not differ significantly. Nevertheless, posterior full-endoscopic cervical discectomy may be preferable when considering the volume of disc removal, length of hospital stay, and the postoperative radiographical changes. As an efficacious supplement to traditional open surgery, FECD is a reliable alternative treatment of CIVDH and its optimal approach remains open to discussion.

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