Isolated Pulmonary Langerhans Cell Histiocytosis

Isolated pulmonary involvement in Langerhans Cell Histiocytosis (LCH) is rare in childhood. The authors report a 6-y- old boy presenting with recurrent pneumothorax, whose CT thorax showed diffuse pulmonary cystic lucencies bilaterally. Biopsy of the lesions confirmed pulmonary LCH with Cd1a and S 100 positivity.     

The Personality Assessment Inventory as a tool for diagnosing psychogenic nonepileptic seizures

Using 184 subjects with valid personality assessment interview (PAI) profiles and video–electroencephalography (VEEG)–confirmed diagnoses of epileptic seizures (ES; n = 109) or psychogenic nonepileptic seizures (PNES; n = 75), we present the diagnostic test performance of the PAI PNES Indicator and other PAI scales when used to differentiate PNES from ES. Subjects with PNES reported significantly higher somatic, conversion, depressed, anxious, and suicidal symptoms. As a diagnostic tool, the PNES Indicator does not add additional accuracy beyond the conversion subscale (SOM-C). The somatization (SOM-S) and physiological depression (DEP-P) subscales perform as well as the SOM-C subscale. The SOM-C scale (cut point ≥70) was 58.7% sensitive and 83.5% specific at diagnosing PNES. Assuming a 30% prevalence of PNES, the SOM-C scale has a positive predictive value (PPV) of 60.4% and negative predictive value (NPV) of 82.5%. Overall, the PAI SOM-C subscale does not appear more accurate than other psychometric tests used to differentiate PNES from ES.     

Trend in proportions of missed children during polio supplementary immunization activities in the African Region: Evidence from independent monitoring data 2010–2012

This is a comparative analysis of independent monitoring data collected between 2010 and 2012, following the implementation of supplementary immunization activities (SIAs) in countries in the three sub regional blocs of World Health Organization in the African Region. The sub regional blocs are Central Africa, West Africa, East and Southern Africa. In addition to the support for SIAs, the Central and West African blocs, threatened with importation and re-establishment of polio transmission received intensive coordination through weekly teleconferences. The later, East and Southern African bloc with low polio threats was not engaged in the intensive coordination through teleconferences. The key indicator of the success of SIAs is the proportion of children missed during SIAs. The results showed that generally there was a decrease in the proportion of children missed during SIAs in the region, from 7.94% in 2010 to 5.95% in 2012. However, the decrease was mainly in the Central and West African blocs. The East and Southern African bloc had countries with as much as 25% missed children. In West Africa and Central Africa, where more coordinated SIAs were conducted, there were progressive and consistent drops, from close to 20–10% at the maximum. At the country and local levels, steps were undertaken to ameliorate situation of low immunization uptake. Wherever an area is observed to have low coverage, local investigations were conducted to understand reasons for low coverage, plans to improve coverage are made and implemented in a coordinated manner. Lessons learned from close monitoring of polio eradication SIAs are will be applied to other campaigns being conducted in the African Region to accelerate control of other vaccine preventable diseases including cerebrospinal meningitis A, measles and yellow fever.