PIP: By mid-1995, a total of 308 HIV cases had been reported in Papua New Guinea. The majority (74%) of these cases were diagnosed in Port Moresby. This article describes the clinical characteristics of HIV infection in 67 adults who presented to Port Moresby General Hospital in 1990-95. The median age at presentation was 27 years in men and 28 years in women, with an equal distribution of cases by sex. The major presenting symptoms were wasting and weight loss exceeding 10% of body weight (94%), chronic diarrhea (47%), prolonged fever (77%), and oropharyngeal candidiasis (66%). Pulmonary tuberculosis was diagnosed on the basis of chest X-ray and history in 37 patients (56%), but only 3 had sputum positive for acid-fast bacilli. Anemia was present in 75%. 65 patients (97%) fulfilled the World Health Organization criteria for AIDS. The inpatient mortality rate in this series was 43%, and 13 of these 29 patients died within a month of their first presentation.
Acquired Immunodeficiency Syndrome - diagnosis ; Acquired Immunodeficiency Syndrome - epidemiology ; HIV Infections - diagnosis ; HIV Infections - epidemiology ; Humans ; Papua New Guinea - epidemiology ; Risk Factors

Stereoelectroencephalography (SEEG) is an invasive technique used during the surgical management of medically refractory epilepsy. The utility of SEEG rests in its ability to survey the three-dimensional organization of the epileptogenic zone as well as nearby eloquent cortices. Once concentrated to specialized centers in Europe and Canada, the SEEG methodology has gained worldwide popularity due to its favorable morbidity profile, superior coverage of deep structures, and ability to perform multilobar explorations without the need for craniotomy. This rapid shift in practice represents both a challenge and an opportunity for pediatric neurosurgeons familiar with the subdural grid approach. The purpose of this review is to discuss the indications, technique, and safety of long-term SEEG monitoring in children. In addition to reviewing the conceptual and technical points of the diagnostic evaluation, attention will also be given to SEEG-based interventions (e.g., radiofrequency thermo-coagulation).
Canada ; Child ; Craniotomy ; Epilepsy ; Europe ; Humans ; Neurosurgeons ; Pediatrics

BACKGROUND AND PURPOSE: The purpose of this study was to estimate the incidence and prevalence of epilepsy among an elderly and poor population in the United States. METHODS: Arizona Medicaid claims data from January 1, 2008 to December 31, 2010 were used for this analysis. Subjects who were aged > or =65 years and were continuously enrolled in any Arizona Medicaid health plans (eligible to patients with low income) for > or =12 months between January 1, 2008 and December 31, 2009 were considered eligible for inclusion in the study cohort. In addition to meeting the aforementioned criteria, incident and prevalent cases must have had epilepsy-related healthcare claims. Furthermore, incident cases were required to have a 1-year "clean" period immediately preceding the index date. Negative binomial and logistic regression models were used to assess the factors associated with epilepsy incidence and prevalence. RESULTS: The estimated epilepsy incidence and prevalence for this population in 2009 were 7.9 and 19.3 per 1,000 person-years, respectively. The incidence and prevalence rates were significantly higher for patients with comorbid conditions that were potential risk factors for epilepsy and were of younger age than for their non-comorbid and older counterparts (p<0.05). The prevalence rates were significantly higher for non-Hispanic Blacks and male beneficiaries than for non-Hispanic Whites and female beneficiaries, respectively (p<0.05). CONCLUSIONS: This patient population had higher epilepsy incidence and prevalence compared with the general US population. These differences may be at least in part attributable to their low socioeconomic status.
African Continental Ancestry Group ; Aged* ; Arizona ; Cohort Studies ; Delivery of Health Care ; Epilepsy* ; Female ; Humans ; Incidence* ; Logistic Models ; Male ; Medicaid ; Poverty* ; Prevalence* ; Risk Factors ; Social Class ; United States*