Acupuncture therapies for postherpetic neuralgia: a protocol for a systematic review and Bayesian network meta-analysis.

INTRODUCTION: Postherpetic neuralgia (PHN) is the most common sequela of herpes zoster, and it is often refractory to guideline-recommended treatments. Acupuncture therapy, a wildly applied complementary-alternative treatment, may help in the management of PHN. Diverse types of acupuncture therapy for PHN have been proposed, however, their comparative efficacies remain unclear. This study protocol plans to compare the efficacy and safety of different acupuncture therapies for PHN. METHODS AND ANALYSIS: Databases including MEDLINE, Embase, Cochrane Library, Web of Science, Chinese Biomedical Database, China National Knowledge Infrastructure, VIP Database, Wanfang Database, WHO International Clinical Trials Registry Platform, ClinicalTrials.gov, Chinese Clinical Trial Register and OpenGrey will be searched from their inception to January 2022. Randomised controlled trials (RCTs) assessing the effectiveness of acupuncture therapy on the management of PHN will be selected. The primary outcome is pain intensity. Secondary outcomes include negative emotions, sleep condition, quality of life and adverse events. Reviewers will conduct study selection, data extraction and risk of bias assessment procedures. Then, standard pair-wised meta-analysis and Bayesian network meta-analysis will be performed (if applicable). The Confidence in Network Meta-Analysis application will be used to assess the confidence in the evidence for the primary outcome. ETHICS AND DISSEMINATION: All data used for this study will be extracted from published RCTs, thus, no ethical approval will be required. The results of this systematic review will be disseminated through peer-reviewed journal and conference presentation. PROSPERO REGISTRATION NUMBER: CRD42020219576.

COVID-19 pandemic as a risk factor for the reactivation of herpes viruses.

The appearance on the skin of herpes virus lesions, concomitantly with the coronavirus disease 2019 (COVID-19) pandemic, leads us to suspect an underlying infection with severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2). Diagnostic reverse transcriptase polymerase chain reaction tests and immunoglobulin M (IgM) and IgG seroconversion studies have therefore been carried out. We present three cases of herpes virus infections in immunocompetent patients: one of the infections was herpes simplex 1 in a 40-year-old woman, and the other two were herpes varicella-zoster infections in a 62-year-old man and a 25-year-old woman. The patients were in the care of the southern health district of Seville of the SAS (Andalusian Health Service) during the Spanish state of alarm over the COVID-19 pandemic. The SARS-CoV-2 infection was confirmed in only one of the three cases. In this study, we briefly review the etiopathogenic role of the COVID-19 pandemic situation, whereby immunodeficiencies are generated that favour the appearance of other viral infections, such as herpes virus infections.

The risk of herpes zoster in patients with ankylosing spondylitis: Analysis of the Korean National Health Insurance Service - Sample cohort database.

OBJECTIVES: The aims of our study were to determine whether the use of conventional disease-modifying antirheumatic drugs (cDMARDs) or tumor necrosis factor α (TNFα) inhibitors increase the risk of herpes zoster (HZ) in patients with ankylosing spondylitis (AS). METHODS: We searched the South Korean National Health Insurance Service - National Sample Cohort Database for relevant patient records between 2002 and 2013. We evaluated the incidence of HZ by categorizing patients into in three treatment groups: disease-modifying antirheumatic drug (DMARD) nonusers, cDMARD users and TNFα inhibitor users. RESULTS: Incidence rates of HZ was 11.0 per 1000 person-years in patients with AS. The adjusted hazard ratio of HZ was higher in cDMARD and TNFα inhibitor users than in DMARD nonusers. In subgroup analyses, current treatment with a TNFα inhibitor increased the risk of HZ significantly both in female patients and in patients aged 50 years or older, but not in patients taking steroids, compared to DMARD nonusers. CONCLUSIONS: Treatment with either TNFα inhibitors or cDMARDs is associated with a higher risk of HZ, especially in female patients and older patients, and these two patient groups could therefore benefit from HZ vaccination.

A Case of Shingles Following Auricular Acupuncture.

This is a case report of an occurrence of shingles (herpes zoster [HZ]) following auricular acupuncture. The patient developed acute reactivation HZ in the V1 distribution of the right trigeminal nerve involving the forehead, scalp, and medial upper eyelid 13 days after being treated with auricular acupuncture for chronic low-back pain. The lesions were initially painless, but they clustered and became painful within 2 days. The patient was treated with oral valacyclovir 1000 mg, 3 times daily for 7 days, and ibuprofen as needed. The lesions resolved without sequelae.

Efectividad de la electro acupuntura y acupuntura en el tratamiento del herpes Zoster / Effectiveness of the electro acupuncture and acupuncture in the treatment of the herpes Zoster

Introducción: el herpes zoster es una enfermedad infecciosa aguda de etiología viral con vesículas localizadas en el dermatoma afectado. En su tratamiento pueden utilizarse técnicas de medicina tradicional como la acupuntura. Objetivos: evaluar la efectividad del tratamiento con electro acupuntura y acupuntura en pacientes con herpes zóster. Métodos: se realizó un estudio experimental en el Servicio de Rehabilitación Integral en el policlínico Flores Betancourt del municipio Artemisa, desde septiembre de 2014 hasta septiembre de 2015. Integraron la muestra 34 pacientes: un grupo estudio al que se le aplicó electro acupuntura y un grupo control que recibió acupuntura. Para determinar la confiabilidad del estudio se aplicó la prueba de diferencia de proporciones con un nivel de significación de 0,05. Resultados: el 52,94 po ciento de los pacientes presentó lesiones herpéticas en región torácica y lumbar. A las 20 sesiones terapéuticas, el 88,88 opr ciento de los pacientes del grupo estudio se presentaron asintomáticos, así como el 75,00 por ciento del grupo control, por lo que no existen diferencias estadísticas en cuanto a la efectividad del tratamiento en ambos grupos. Conclusiones: se consideró de buena efectividad el tratamiento con electro acupuntura y acupuntura en pacientes con herpes zóster, donde no existen diferencias significativas en cuanto a los resultados entre ambas técnicas de tratamiento(AU)

Introduction: the herpes zoster is a sharp infectious illness of viral etiología with vesicles located in the affected dermatoma. In their treatment it can be used technical of traditional medicine as the acupuncture. Objectives: to evaluate the effectiveness of the treatment with electro acupuncture and acupuncture in patient with herpes zóster. Methods: it was carried out an experimental study in the Service of Integral Rehabilitation in the policlínico Flores Betancourt of the municipality Artemisa, in the period of one year. They integrated the sample 34 patients: a study group to which was applied electro acupuncture, and a control group that they received acupuncture. To determine the dependability of the study the test diference of proportion it was applied squared with a level of significance of 0, 05. Results: to the region lumbar toraco it corresponded him 54, 92 percent of the lesions. To the 20 therapeutic sessions, 88, 88 percent the group study was presented asintomáticos and 75, 00 percent the group control too, without statisticians meaning as soon as both group. Conclusions: It was considered of good effectiveness the treatment with electro acupuncture and acupuncture in patient with herpes zóster, where not to exist meaning in the result between both treatments technical(AU)

Efectividad de la electro acupuntura y acupuntura en el tratamiento del herpes Zoster / Effectiveness of the electro acupuncture and acupuncture in the treatment of the herpes Zoster

Introducción: el herpes zoster es una enfermedad infecciosa aguda de etiología viral con vesículas localizadas en el dermatoma afectado. En su tratamiento pueden utilizarse técnicas de medicina tradicional como la acupuntura. Objetivos: evaluar la efectividad del tratamiento con electro acupuntura y acupuntura en pacientes con herpes zóster. Métodos: se realizó un estudio experimental en el Servicio de Rehabilitación Integral en el policlínico Flores Betancourt del municipio Artemisa, desde septiembre de 2014 hasta septiembre de 2015. Integraron la muestra 34 pacientes: un grupo estudio al que se le aplicó electro acupuntura y un grupo control que recibió acupuntura. Para determinar la confiabilidad del estudio se aplicó la prueba de diferencia de proporciones con un nivel de significación de 0,05. Resultados: el 52,94 po ciento de los pacientes presentó lesiones herpéticas en región torácica y lumbar. A las 20 sesiones terapéuticas, el 88,88 opr ciento de los pacientes del grupo estudio se presentaron asintomáticos, así como el 75,00 por ciento del grupo control, por lo que no existen diferencias estadísticas en cuanto a la efectividad del tratamiento en ambos grupos. Conclusiones: se consideró de buena efectividad el tratamiento con electro acupuntura y acupuntura en pacientes con herpes zóster, donde no existen diferencias significativas en cuanto a los resultados entre ambas técnicas de tratamiento(AU)

Introduction: the herpes zoster is a sharp infectious illness of viral etiología with vesicles located in the affected dermatoma. In their treatment it can be used technical of traditional medicine as the acupuncture. Objectives: to evaluate the effectiveness of the treatment with electro acupuncture and acupuncture in patient with herpes zóster. Methods: it was carried out an experimental study in the Service of Integral Rehabilitation in the policlínico Flores Betancourt of the municipality Artemisa, in the period of one year. They integrated the sample 34 patients: a study group to which was applied electro acupuncture, and a control group that they received acupuncture. To determine the dependability of the study the test diference of proportion it was applied squared with a level of significance of 0, 05. Results: to the region lumbar toraco it corresponded him 54, 92 percent of the lesions. To the 20 therapeutic sessions, 88, 88 percent the group study was presented asintomáticos and 75, 00 percent the group control too, without statisticians meaning as soon as both group. Conclusions: It was considered of good effectiveness the treatment with electro acupuncture and acupuncture in patient with herpes zóster, where not to exist meaning in the result between both treatments technical(AU)

Preventative Care in the Patient with Inflammatory Bowel Disease: What Is New?

Patients with inflammatory bowel disease (IBD) do not receive routine preventative care at the same rate as general medical patients. This patient population is at increased risk of vaccine preventable illness such as influenza and pneumococcal pneumonia. This review will discuss health maintenance needs and preventative care issues in patients with IBD.

Nutritional factors in herpes zoster, postherpetic neuralgia, and zoster vaccination.

Herpes zoster (HZ) results from a reactivation of latent varicella-zoster virus (VZV). HZ and its most common complication, termed postherpetic neuralgia (PHN), often cause long-term psychological distress and physical disabilities leading to profoundly negative impacts on the quality of patients' lives. The incidence and severity of HZ and PHN increase with advanced age as a consequence of declining cell-mediated immunity. Aging has been linked to progressive senescence of the immune system and also is associated with a greater susceptibility to nutritional deficiencies. Suppressing VZV reactivation depends on intact cell-mediated immunity, which requires adequate nutrients to maintain its efficient function. Contrarily, nutritional deficiencies may lead to dysfunction of the host immune responses. Recently, micronutrient deficiencies have been shown to increase the risk of HZ and PHN and to affect the immune response to vaccinations, whereas nutritional supplements effectively reduce herpetic pain and pain in patients with PHN. As the elderly population grows, the incidence and severity of HZ and PHN are expected to increase and cause a substantial financial burden on the health care system. Thus, enhancing knowledge of the risk factors of HZ and PHN and developing better interventions to treat and prevent HZ and PHN are important to public health. This article provides an overview of the present understanding of the association among nutritional deficiencies, diminished cell-mediated immunity, and the risk of HZ and PHN, and then illustrates the potential of nutritional intervention in the prevention, vaccination, and management of HZ and PHN.

[Ocular manifestations in HIV/AIDS patients undergoing highly active antiretroviral treatment (HAART) in Togo]. / Atteintes oculaires chez les personnes vivant avec le VIH/sida sous trithérapie au Togo.

AIM: The twofold purpose of this study in people living with human immunodeficiency virus (PLHIV/AIDS) and undergoing highly active antiretroviral treatment (HAART) was to determine the prevalence of ocular manifestations and its correlation with CD4 T-cell count. PATIENTS AND METHODS: All patients who attended 2 NGO care centers that manage PLHIV/AIDS in Lomé, Togo between August and October 2005 were recruited. CD4 T-cell counts and use of antiretroviral treatment was noted. A thorough eye examination was performed in all cases. RESULTS: A total of 422 PLHIV/SIDA were recruited including 281 who were undergoing HAART. The sex-ratio was 2 female/1 male. Mean age was 34 +/- 2294 years. Involvement of the anterior segment was observed in 36.3% of patients and involvement of the posterior segment in 54.1%. The second most common ocular manifestation was ophthalmic herpes zoster of the anterior segment (19.6%) secondary to conjunctivitis (57.8%). One case of palpebral and conjunctival Kaposi's sarcoma was noted. The most common type of posterior segment involvement was cotton-wool nodules (35.5%). Five cases of CMV retinitis were observed. CONCLUSION: A longitudinal study in PLHIV/AIDS will be needed to better evaluate the correlation between ocular manifestations and CD4 T-cell count.

Varicella zoster meningoencephalitis following treatment for dermatomal zoster in an alloBMT patient.

Herpes zoster infections are frequently observed after allogeneic bone marrow transplantation (alloBMT). In the majority of cases, the infection is restricted to specific dermatomes and responds to oral acyclovir, without visceral dissemination. We report the case of a 40-year-old male who developed dermatomal herpetic infection 8 months post alloBMT. The herpetic rash responded well to treatment with high-dose oral acyclovir. However, within a week of cessation of therapy, the patient re-presented with dermatomal zoster and meningoencephalitis. Although the cutaneous lesions resolved with intravenous acyclovir, clinical features of meningoencephalitis persisted, along with evidence of varicella zoster virus (VZV) DNA in cerebrospinal fluid (CSF). A satisfactory response to treatment was observed only after the addition of intravenous foscarnet to acyclovir. Based on our experience with this patient, we suggest that in a subset of alloBMT recipients, late dermatomal herpes zoster infections may respond only partially to treatment with standard oral acyclovir. The use of oral acyclovir preparations with higher bioavailability (valacyclovir) or intravenous acyclovir early on may prevent the considerable morbidity associated with disseminated zoster infection. Bone Marrow Transplantation (2000) 26, 795-796.

Incidence, risk factors and outcome of varicella-zoster virus infection in children after haematopoietic stem cell transplantation.

We report a retrospective analysis of VZV infection after haematopoietic stem cell transplantation (HSCT) in children. Thirty-three (30%) of the total 109 children who were transplanted during a 7 year period developed post-transplant VZV infection. Twenty-four of these 33 (73%) children had VZV infection within 1 year following HSCT. The cumulative incidences of post-transplant VZV infection at 1 and 5 years were 26% and 45%, respectively. The positive and negative predictive values of pretransplant VZV serology in recipients on the development of HZ following HSCT were 39% and 88%, respectively. Pretransplant VZV seropositivity in recipients was the only risk factor for post-transplant herpes zoster (HZ) infection on multivariate analysis. All patients responded to acyclovir. The median duration of VZV infection was 5 days. Three (11%) and one (3%) children with HZ developed visceral dissemination and post-herpetic neuralgia, respectively. No mortality was directly attributed to VZV infection. VZV infection remains a major cause of morbidity in children after HSCT. Further studies are warranted to evaluate the potential use of VZV vaccine in these children. Bone Marrow Transplantation (2000) 25, 167-172.

Neuralgia postherpetica / Postherpetic neuralgia

Realizamos una actualización de la neuralgia postherpética,en especial en sus aspectos terápeuticos.Se pone énfasis en la fisiopatología de este proceso,con el objeto de lograr una comprensión acabada de las propuestas terapéuticas actuales. Dada la incidencia de esta complicación del herpes zozter (20 porciento de la población general) y su tendencia a la cronicidad con refractariedad al tratamiento,consideramos de suma utilidad profundizar en el conocimento del tema

Neuralgia postherpetica / Postherpetic neuralgia

Realizamos una actualización de la neuralgia postherpética,en especial en sus aspectos terápeuticos.Se pone énfasis en la fisiopatología de este proceso,con el objeto de lograr una comprensión acabada de las propuestas terapéuticas actuales. Dada la incidencia de esta complicación del herpes zozter (20 porciento de la población general) y su tendencia a la cronicidad con refractariedad al tratamiento,consideramos de suma utilidad profundizar en el conocimento del tema(AU)

Presumed ophthalmic herpes zoster after contralateral cataract extraction.

Herpes zoster ophthalmicus (HZO) may occur spontaneously, but can be precipitated by stress, trauma, debility or systemic illness. A case is here reported of Herpes zoster involving the contralateral eye, associated with a midline skin rash, following cataract extraction under local anaesthesia.