Localized cold urticaria to the face in a pediatric patient: a case report and literature review.

We present a curious case of localized cold urticaria restricted to the face in a 10-year-old girl. Testing for the condition using an ice cube was positive only in the facial area. After 2 years, the patient continues to experience localized urticaria only on her face on cold exposure. A review of the available published medical literature on cold urticaria was performed using Ovid and PubMed databases. The literature search was not limited to the English language. Only three other cases of cold urticaria localized to the face were identified. Upon review of the published reports on cold urticaria and discussion of classification and diagnostic testing, we conclude that cold urticaria clearly is a rare and poorly understood entity.

Pleural fibrosis mediates shrinking lungs syndrome in children.

The etiology of restrictive lung physiology in SLS is not well-defined, and has been hypothesized to be due to defects in lung recoil, phrenic nerve function and diaphragmatic strength. We present a case of SLS in an adolescent in whom imaging and electrophysiology studies demonstrate pleural fibrosis as the fundamental defect accounting for the restrictive lung physiology.

Seroprevalence of antibody to varicella among Somali refugees.

OBJECTIVES: To determine the seroprevalence of varicella antibody among recent Somali refugees living in Olmsted County, Minnesota, and to estimate the risk of varicella-zoster virus (VZV) infection in this group. SUBJECTS AND METHODS: We obtained blood samples from the study subjects, along with demographic information, immunization records, and vaccine-preventable disease history. Serum samples were tested using a whole-virus IgG VZV-specific commercial enzyme-linked immunosorbent assay kit. This study was completed in 1998. RESULTS: Overall, 200 Somali refugees, comprising 33 extended families, were interviewed, with 193 providing adequate blood samples. Thirty-five subjects (18%) were seronegative for varicelia. Males had a significantly higher seronegativity rate (25% [n = 23]) compared with females (12% [n = 12]; P = .02); however, this association disappeared after adjustment for age and varicella infection history. Five percent (5/92) of adults were seronegative compared with 30% (30/101) of all children (P < .001). Eight percent (5/61) of the adult females were seronegative, whereas none (0/31) of the adult males were seronegative. Conversely, 38% (23/60) of male children were seronegative compared with 17% (7/41) of female children (P < .001). CONCLUSION: These results demonstrate a high prevalence of varicella seronegativity among Somali refugees who have immigrated to an endemic area. We recommend instituting improved education regarding varicella among Somali communities and increasing vaccine uptake or routine testing for serum varicella antibody to prevent VZV-related morbidity and mortality, particularly in adolescents, adult refugees, and women of childbearing age.

Medical students speak: a two-voice comment on learning professionalism in medicine.

We are two medical students. For one of us, medical school is just beginning; for the other, it is coming to an end. Our experiences are different, but our message is the same. Professionalism is a vital component in the field of medicine. Characteristics such as trustworthiness, compassion, integrity, honesty, leadership, and social responsibility must be embraced by the next generation of doctors so the future healthcare system will be one that patients and physicians admire and respect. To reach this goal, it is important to understand how medical students today view professionalism and how such a construct is integrated into medical education. We hope to provide insight into this area by reflecting on the lessons we have learned regarding professionalism in medical school. Professionalism, like the medical field itself, is a life-long learning process. By encouraging this process early in medical training, future doctors will be able to provide their patients with highest quality care.