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OCTOBER 2010 World Neurology 01_10wfn10_10.qxp 9/24/2010 10:55 AM Page 1 VOL. 25 • NO. 5 • OCTOBER 2010 World Neurology THE OFFICIAL NEWSLETTER OF THE WORLD FEDERATION OF NEUROLOGY Neurological Care Under Scrutiny in Africa INSIDE Ukraine BY SUSAN W. MARINO, suance of the United Nations The WFN’s Parkinsonism PH.D. Millennium Development Goals and Related Disorders in 2000, the establishment of the isorders of the nervous President’s Emergency Plan for Research Group holds a EWS system produce a chal- AIDS Relief (PEPFAR) program N movement disorders lenging and largely un- by George W. Bush in 2003, and course in Lviv, marking D EDICAL mitigated disease burden in growing support from nonprof- M the Federation’s first many countries in the sub- it organizations such as the meeting in Ukraine. Gates Foundation. The organiz- LOBAL Saharan region, yet there is a se- G PAGE 8 vere shortage of people who ers of the Kampala meeting are trained in the treatment of hoped to emulate that effort for LSEVIER United States psychiatric and neurological MNS disorders. /E conditions, and appropriate Researchers studying ARRELL human embryonic stem medications and equipment are Numbers Count H in short supply, if available at all. Good epidemiological data are cells are trapped in a Last year, the Uganda Na- needed for two purposes – to de- legal quagmire over the ATHERINE tional Academy of Sciences’ Fo- vise a strategy for improving C federal government’s rum on Health and Nutrition quality of care and to convince Sound data on the nature and extent of mental, neurological, and policy on funding for government policy makers, who substance-use disorders are needed, says Dr. Susan W. Marino. and the US-based Institute of research using the cells. Medicine’s Forum on Neuro- need to see evidence to act. science and Neurological Dis- For the latter, data on the ef- ly an extreme underreporting of ment needs related to HIV/ PAGE 10 orders hosted a workshop in fectiveness of treatment and the burden of MNS disease in AIDS, malaria, tuberculosis, and Kampala, Uganda, at which rep- treatment delivery systems are sub-Saharan Africa. Affected pa- other infectious diseases are so Ethiopia resentatives from the medical, needed in addition to accurate tients often are hidden by their great that MNS disorders are Tetanus continues to academic, and governmental baseline information. The World families because of the stigma often misdiagnosed, over- contribute to a communities of 16 countries Health Organization anticipates and superstition associated with looked, and underreported. significant neurological met to address the quality of that the prevalence of MNS dis- mental disease and epilepsy, and This is exacerbated by the short- burden and a high care for mental, neurological, orders will rise over the next 15 are therefore not treated or their ages of trained personnel and mortality rate even and substance-use disorders years, with changing contribu- cases not reported. Those who diagnostic equipment. (MNS) disorders in the region. tory factors. It will be necessary are treated by traditional healers Analyzing epidemiological though it is a vaccine- Much attention has been fo- to track these changes. will not be reported. Even at data is also complicated. For preventable disease. cused on infectious disease in de- There was a consensus at the clinics, the number of deaths, PAGE 14 veloping countries since the is- meeting that there is most like- disabilities, and associated treat- See MNS Disorders • page 8 Alternate Cut-Off Might Boost Ultrasound Diagnostic Accuracy BY KERRI WACHTER ported at the annual meeting of (Radiology 2003;229:340-6). curacy, none was more accurate ent carotid velocity threshold Elsevier Global Medical News the Society for Vascular Surgery. The criteria’s peak systolic ve- than the consensus criteria for numbers to define the severity The conclusions are based on locity (PSV) cut-off (more than this level of stenosis, said Dr. of carotid stenosis. However, BOSTON – Consensus criteria an analysis of the accuracy of 230 cm/sec) for detecting steno- Aburahma, professor of surgery there had been no standardiza- for the use of duplex ultrasound the consensus criteria for carotid sis of 70% and greater showed at West Virginia University in tion until the consensus criteria can be used accurately for the di- duplex ultrasound (CDUS), good sensitivity (99%) and speci- Charleston. However, the NPV in 2002. The consensus panel agnosis of stenosis of the inter- compared with angiography, of ficity (86%). Positive predictive of the consensus criteria for recommended that PSV should nal carotid artery that is 70% or 376 arteries in 197 patients. The value (PPV) was 93%, the nega- 50%-69% stenosis (PSV, 125-230 be the primary parameter. greater, but diagnostic accuracy consensus criteria were devel- tive predictive value (NPV) was cm/sec) was disappointing at In the study by Dr. Aburahma can be improved for 50%-69% oped by a multidisciplinary pan- 98%, and the overall accuracy 81%, he added. and his colleagues, arteries were stenosis by using other cut-off el to simplify the ultrasound di- was 95%. Although other cut-off Several classification systems values, Dr. Ali F. Aburahma re- agnosis of carotid artery disease values offered comparable ac- have been used, offering differ- See Ultrasound • page 4 Also in this issue of WORLD NEUROLOGY ... Efforts to contain the spread of Chagas disease in South and Central Amercia have paid off, but the disease is now an emerging problem in nonendemic countries because of migrations, writes Dr. Marco Oliveira Py. See Page 12 01_10wfn10_10.qxp 9/27/2010 12:01 PM Page 2 2 • WORLD NEUROLOGY WWW.WFNEUROLOGY.ORG • OCTOBER 2010 EDITOR IN CHIEF’S COLUMN Calendar of The Burden of International Events 2010 Neurological Disease Symposium on Neuroinflammation 63rd Annual Meeting of the and Neuroinfection American Academy of Neurology n the World Health Organization cine’s Forum on Neuroscience and Nov. 2 April 9-16 (WHO), Neurology is a footnote in Neurological Disorders about the Glasgow, Scotland Honolulu, Hawaii, USA Ithe Noncommunicable Diseases quality of care for mental, neurologi- www.rcpsg.ac.uk/Education/Events/ www.aan.com/go/am11 and Mental Health Divi- cal, and substance use Physicians/Pages/ed_spMedical sion. To a certain extent, (MNS) disorders in sub-Sa- Symposia.aspx 21st Meeting of the European the attention of the WHO haran Africa. The report Neurological Society is driven by consideration makes it clear that there 7th International Congress on May 28-31 of the DALY, the Disability are important needs in that Mental Dysfunctions and Other Non- Lisbon, Portugal Adjusted Life Year. Disor- region for dealing with Motor Features in Parkinson’s www.congrex.ch/ens2011 ders become important many noncommunicable Disease and Related Disorders based on premature loss of neurological disorders. Dec. 9-12 European Neuro-Ophthalmology life and disability. Epilepsy is one example of Barcelona, Spain Society Meeting In the grand scheme of a substantial problem www2.kenes.com/mdpd2010/ June 18-21 things, infectious disease is where more education as pages/home.aspx Barcelona, Spain still the biggest health BY MARK HALLETT, M.D. well as more therapy www.eunos2011barcelona.com/ problem worldwide. Low- would be valuable. 2011 er respiratory infections are number 1, Although neurological disorders are 4th European Neurological World Congress on Huntington diarrheal diseases are number 2, pegged as noncommunicable, there are Conference on Clinical Practices Disease HIV/AIDS is number 5, and neonatal many that are communicable. Two oth- Jan. 28-30 Sep. 11-14 infection, tuberculosis, and malaria er articles in the current issue illustrate Lisbon, Portugal Melbourne, Australia are 10, 11, and 12, respectively. this point. Chagas disease (p. 12) is en- www.paragon-conventions.net/enc- www.worldcongress-hd2011.org Noncommunicable disease is of less- demic in South America and should be cp2011/ er importance. Cerebrovascular dis- suspected in patients with autonomic 7th International Congress on ease at number 6 is the only neuro- nervous system abnormalities or stroke. 10th International Conference on Vascular Dementia logical condition in the top 20. It is Tetanus is still common in many de- Alzheimer’s & Parkinson’s Diseases Oct. 20-23 anticipated, however, that in the com- veloping countries, and this includes March 9-13 Riga, Latvia ing years, infections will be better con- Ethiopia (p. 15). The acute onset of se- Barcelona, Spain www2.kenes.com/vascular2011/ trolled, and noncommunicable dis- vere spasms and autonomic dysfunc- www.kenes.com/adpd pages/home.aspx eases will become more important. tion is dramatic. As described in the ar- Unipolar depression is predicted to be ticles, treatment for both these 3rd Asian and Oceanian Parkinson's 20th World Congress of Neurology number 1 by 2030. conditions is difficult, and the best ap- Disease and Movement Disorders Nov. 12-17 On page 1 of this issue of WORLD proach is prevention. It is good to hear Congress Marrakesh, Morocco NEUROLOGY, there is a report from the that progress is being made in public March 25-27 www2.kenes.com/wcn/Pages/ Uganda National Academy of Sci- heath for Chagas disease and in vacci- Taipei, Taiwan Home.aspx ences’ Forum on Health and Nutrition nation for tetanus, though there is still www.aopmc2011taiwan.com and the US-based Institute of Medi- a way to go. ■ GLOBAL MEDICAL RESEARCH ORLD Publisher Peter F. Bakker, W ELSEVIER GLOBAL MEDICAL NEWS A Division of International Medical News Group NEUROLOGY President IMNG Alan J. Imhoff Editor in Chief Mary Jo M. Dales WORLD FEDERATION OF NEUROLOGY WORLD NEUROLOGY, an official publication of the World Federation Executive Editors Denise Fulton, Kathy Scarbeck Editor in Chief Dr. Mark Hallett (USA) of Neurology, provides reports from the leadership of the WFN, its Managing Editor Renée Matthews EDITORIAL ADVISORY BOARD member societies, neurologists around the globe, and news from Clinical News Editor Jeff Evans Dr.
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