RESUMEN
The second part of this publication deals with varicella zoster virus (VZV) and presents an overview of new, rare, and atypical clinical manifestations, including photolocalized varicella, hemorrhagic bullae during varicella, the implication of VZV in immunoglobulin A vasculitis, VZV-related alopecia, ulcerative varicella skin lesions, childhood herpes zoster (HZ), prolonged prodromal pains, recurrent HZ, VZV implication in burning mouth syndrome, verruciform VZV lesions, the significance of satellite lesions during HZ, and late HZ complications, either neurological or internal. Furthermore, certain associations between the occurrence of HZ and subsequent internal pathologies, as well as risk factors for HZ and new developments in vaccination against HZ will be addressed.
Asunto(s)
Herpesvirus Humano 3/patogenicidad , Infección por el Virus de la Varicela-Zóster/virología , Adulto , Niño , Preescolar , Citosina/análogos & derivados , Citosina/uso terapéutico , Vacuna contra el Herpes Zóster/uso terapéutico , Humanos , Lactante , Terapia por Luz de Baja Intensidad , Persona de Mediana Edad , Organofosfonatos/uso terapéutico , Nucleósidos de Pirimidina/uso terapéutico , Recurrencia , Factores de Riesgo , Infección por el Virus de la Varicela-Zóster/diagnóstico , Infección por el Virus de la Varicela-Zóster/tratamiento farmacológico , VirulenciaRESUMEN
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.
Asunto(s)
Neoplasias Colorrectales/diagnóstico , Inmunosupresores/efectos adversos , Enfermedades Inflamatorias del Intestino/terapia , Medicina Preventiva/métodos , Vacunación/métodos , Conservadores de la Densidad Ósea/uso terapéutico , Varicela/etiología , Varicela/inmunología , Varicela/prevención & control , Vacuna contra la Varicela/uso terapéutico , Depresión/diagnóstico , Depresión/terapia , Manejo de la Enfermedad , Detección Precoz del Cáncer/métodos , Hepatitis Viral Humana/etiología , Hepatitis Viral Humana/inmunología , Hepatitis Viral Humana/prevención & control , Herpes Zóster/etiología , Herpes Zóster/inmunología , Herpes Zóster/prevención & control , Vacuna contra el Herpes Zóster/uso terapéutico , Humanos , Huésped Inmunocomprometido , Vacunas contra la Influenza/uso terapéutico , Gripe Humana/etiología , Gripe Humana/inmunología , Gripe Humana/prevención & control , Sarampión/etiología , Sarampión/inmunología , Sarampión/prevención & control , Vacuna contra el Sarampión-Parotiditis-Rubéola/uso terapéutico , Meningitis Meningocócica/etiología , Meningitis Meningocócica/inmunología , Meningitis Meningocócica/prevención & control , Vacunas Meningococicas/uso terapéutico , Paperas/etiología , Paperas/inmunología , Paperas/prevención & control , Osteoporosis/diagnóstico por imagen , Osteoporosis/tratamiento farmacológico , Infecciones por Papillomavirus/etiología , Infecciones por Papillomavirus/inmunología , Infecciones por Papillomavirus/prevención & control , Vacunas contra Papillomavirus/uso terapéutico , Vacunas Neumococicas/uso terapéutico , Neumonía Neumocócica/etiología , Neumonía Neumocócica/inmunología , Neumonía Neumocócica/prevención & control , Rubéola (Sarampión Alemán)/etiología , Rubéola (Sarampión Alemán)/inmunología , Rubéola (Sarampión Alemán)/prevención & control , Cese del Hábito de Fumar , Vacunas contra Hepatitis Viral/uso terapéutico , Vitamina D/uso terapéutico , Deficiencia de Vitamina D/diagnósticoRESUMEN
BACKGROUND: Incidence of shingles in different regions of the world ranged from 300 to 500/100,000 persons, and in the population older than 80 years of age reaches more than 1000/100,000. In the age group 50+ the incidence is enough high to be a serious medical and economic burden. Lack of details about the incidence and frequency of complications in Polish population let us too made an attempt to assess the scale of the problem, among others to the purpose of the evaluation of the legitimacy of implementing vaccination in the 50+ population. METHODS: First, based on coming data from the Swietokrzyskie Province Division of the National Health Fund we judged the incidence of shingles in this province in 2013 in individual ancient groups and depending on detailed diagnoses and with the division into the basic health, clinic and hospital care. Second, based on gathered data through NIZP-PZH, we judged hospital morbidity connected with shingles in Poland in 2008-2012 years, in individual ancient groups. RESULTS: Extrapolating the data from the Swietokrzyskie province we assess the incidence of shingles on average 338.8/100,000. She is tallest in the age group 50+ (614.3/100,000) and in this group also the most complications are being observed. Hospital morbidity in entire Poland showed in 2008-2012 years the frequency on average 4.93-5.42/100,000, in the group of 0-19 years; 0.10-1.50/100,000, in the group of 20-49 years; 4.9-5.42/100,000 and in the 50+ group--9.99-13.37/100,000. CONCLUSIONS: (1) Shingles, especially in the 50+ age group, constitutes a serious health problem in Poland, being a cause of numerous advices in basic health care and at clinics in Poland, as well of numerous hospitalizations and dangerous complications. (2) It seems, that active immunization against shingles, especially of 50+ persons, would be a favourable solution from the individual, as well as public perspective.
Asunto(s)
Costo de Enfermedad , Vacuna contra el Herpes Zóster/economía , Herpes Zóster/economía , Herpes Zóster/epidemiología , Neuralgia Posherpética/economía , Neuralgia Posherpética/epidemiología , Distribución por Edad , Anciano , Anciano de 80 o más Años , Análisis Costo-Beneficio , Femenino , Costos de la Atención en Salud , Herpes Zóster/prevención & control , Vacuna contra el Herpes Zóster/uso terapéutico , Humanos , Incidencia , Masculino , Persona de Mediana Edad , Programas Nacionales de Salud/economía , Neuralgia Posherpética/prevención & control , Polonia/epidemiología , Medición de RiesgoRESUMEN
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.