herpes zoster

带状疱疹
  • 文章类型: Journal Article
    背景:带状疱疹(HZ),俗称“带状疱疹”,“可能通过神经炎症或直接神经元损伤等机制导致认知下降。然而,关于HZ与认知减退之间的纵向关联的证据是相互矛盾的,并且尚未研究APOEε4携带者状态的风险是否不同;也缺乏关于HZ疫苗接种与认知减退之间关联的前瞻性队列研究.
    方法:我们包括来自三个大型队列的149,327名参与者-护士健康研究(NHS),NHSII,和健康专业人员随访研究(HPFS)-前瞻性检查HZ与随后的主观认知能力下降(SCD)之间的关系。使用泊松回归来估计自HZ以来与没有HZ病史的参与者相比,SCD评分增加3个单位的多变量调整相对风险(MVRR)。
    结果:与没有HZ病史的个体相比,在有HZ病史的个体中,SCD评分增加3个单位的MVRR(95%CI)显著且独立地更高,但是自HZ以来SCD风险升高的持续时间在队列中具有统计学意义。在NHS中,HZ与SCD的长期风险较高相关;与没有HZ病史的个体相比,自HZ以来≥13年,SCD评分增加3个单位的MVRR(95%CI)为1.14(1.01,1.32).在NHSII中,HZ在短期[MVRR1.34(1.18,1.53)持续1-4年]和长期[MVRR1.20(1.08,1.34)持续≥13年]均与较高的SCD风险相关。在HPFS中,所有时间点均提示SCD风险升高.在具有APOEε4信息的参与者子集中,有一个建议是,该关联因APOEε4携带者身份而异,但结果男女不一致.在有HZ疫苗接种信息的女性中,有一项研究表明,在未接种HZ疫苗的女性中,SCD的长期风险可能更大.
    结论:来自三个独立的女性和男性大型队列的数据表明,HZ与SCD的长期风险较高有关,并且风险可能因APOEε4承运人状态而异。
    BACKGROUND: Herpes zoster (HZ), commonly known as \"shingles,\" may contribute to cognitive decline through mechanisms such as neuroinflammation or direct neuronal injury. However, evidence on the longitudinal association between HZ and cognitive decline is conflicting and whether the risk differs by APOE ε4-carrier status has not been studied; prospective cohort studies on the association between HZ vaccination and cognitive decline are also lacking.
    METHODS: We included 149,327 participants from three large cohorts-the Nurses\' Health Study (NHS), NHSII, and Health Professionals Follow-Up Study (HPFS)-to prospectively examine the association between HZ and subsequent subjective cognitive decline (SCD). Poisson regression was used to estimate the multivariable-adjusted relative risk (MVRR) of a 3-unit increment in SCD score according to years since HZ compared with participants with no history of HZ.
    RESULTS: Compared with individuals with no history of HZ, the MVRR (95% CI) of a 3-unit increment in SCD score was significantly and independently higher among individuals with a history of HZ, but the duration of time since HZ when the elevated risk of SCD was statistically significant differed among the cohorts. In NHS, HZ was associated with higher long-term risk of SCD; compared with individuals with no history of HZ, the MVRR (95% CI) of a 3-unit increment in SCD score was 1.14 (1.01, 1.32) for ≥ 13 years since HZ. In NHS II, HZ was associated with higher risk of SCD in both the short-term [MVRR 1.34 (1.18, 1.53) for 1-4 years] and long-term [MVRR 1.20 (1.08, 1.34) for ≥ 13 years since HZ]. In HPFS, an elevated risk of SCD was suggested across all time points. Among the subset of participants with information on APOE ε4, there was a suggestion that the association differed by APOE ε4 carrier status, but the results were not consistent between women and men. Among the subset of women with information on HZ vaccination, there was a suggestion that the long-term risk of SCD may be greater among women who were not vaccinated against HZ.
    CONCLUSIONS: Data from three large independent cohorts of women and men showed that HZ was associated with higher long-term risk of SCD, and the risk may differ by APOE ε4-carrier status.
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  • 文章类型: Journal Article
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  • 文章类型: Case Reports
    腹部假疝是一种特征在于腹部内脏通过腹壁的弱化区域突出而没有疝囊的病症。各种原因,包括脊柱疾病和外伤,可能导致这种情况;然而,据报道,最常见的原因是带状疱疹。我们介绍了肺癌手术后腹部假疝自发消退的罕见病例。一名71岁男性,表现为左上腹部隆起和疼痛。当时进行的CT扫描偶然发现右下叶有结节性病变,怀疑是肺癌.进行了单孔胸腔镜手术,最终诊断为右下叶肺鳞状细胞癌。肺癌手术后,左上腹部隆起在一周内自发缓解。在这种情况下,我们假设由肺癌引起的免疫失调增加了带状疱疹病毒的活性,导致了假疝的发展.假疝的自发消退被认为是由于手术后免疫失调的改善。
    Abdominal pseudohernia is a condition characterized by the protrusion of abdominal viscera through a weakened area of the abdominal wall without a hernia sac. Various causes, including spinal disorders and trauma, can lead to this condition; however, the most common cause is reported to be herpes zoster. We present a rare case of spontaneous resolution of abdominal pseudohernia following lung cancer surgery. A 71-year-old male presented with left upper abdominal bulging and pain. A CT scan performed at the time incidentally revealed a nodular lesion in the right lower lobe, suspicious for lung cancer. Single-port thoracoscopic surgery was performed, and the final diagnosis was right lower lobe lung squamous cell carcinoma. Following the lung cancer surgery, the left upper abdominal bulging spontaneously resolved within one week. In this case, we hypothesize that the immune dysregulation caused by lung cancer increased the activity of the herpes zoster virus, leading to the development of pseudohernia. The spontaneous resolution of the pseudohernia is thought to be due to the improvement of immune dysregulation after surgery.
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  • 文章类型: Journal Article
    冠状动脉疾病(CAD)和带状疱疹代表了巨大的健康负担,它们潜在的相互关系仍未得到充分研究。这项队列研究旨在通过系统地探索CAD患者是否有增加的患带状疱疹的风险来解决现有的知识差距。
    使用台湾国民健康保险计划的2006-2015年索赔数据,我们将新诊断为CAD的年龄≥20岁的参与者确定为CAD组.我们选择没有CAD的性别和年龄匹配的参与者作为非CAD组。计算随访结束时带状疱疹的发生率。使用多变量Cox比例风险回归模型来测量与协变量相关的带状疱疹的风险比和95%CI。
    与非CAD组相比,CAD组带状疱疹的总发病率高1.14倍(6.52vs5.74/1000人年;95%CI,1.08-1.20)。在控制了协变量之后,与非CAD组相比,CAD组带状疱疹的校正风险比为1.21(95%CI,1.14~1.27).
    这项队列研究为CAD与带状疱疹发病风险之间的潜在关联提供了有价值的见解。这些发现可能对CAD患者带状疱疹的预防策略有影响。与不同团体的进一步研究和合作对于验证和扩展我们的发现至关重要。
    UNASSIGNED: Coronary artery disease (CAD) and herpes zoster represent significant health burdens, and their potential interrelationships remain understudied. This cohort study aimed to address the existing knowledge gap by systematically exploring whether people with CAD are at increased risk for developing herpes zoster.
    UNASSIGNED: Using the 2006-2015 claims data of the National Health Insurance Program in Taiwan, we identified participants aged ≥20 years with a new diagnosis of CAD as the CAD group. We selected sex- and age-matched participants without CAD as the non-CAD group. The incidence rate of herpes zoster at the end of follow-up was calculated. A multivariable Cox proportional hazards regression model was used to measure the hazard ratio and 95% CI for herpes zoster associated with covariables.
    UNASSIGNED: The overall incidence rate of herpes zoster was 1.14-fold greater in the CAD group as compared with the non-CAD group (6.52 vs 5.74 per 1000 person-years; 95% CI, 1.08-1.20). After controlling for covariables, the adjusted hazard ratio of herpes zoster was 1.21 (95% CI, 1.14-1.27) for the CAD group as compared with the non-CAD group.
    UNASSIGNED: This cohort study provides valuable insights into the potential association between CAD and the risk of developing herpes zoster. The findings may have implications for preventive strategies of herpes zoster in people with CAD. Further research and collaboration with diverse groups will be critical to validate and extend our findings.
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  • 文章类型: Journal Article
    目的:本研究旨在评估接受Janus激酶抑制剂(JAKi)治疗的类风湿关节炎(RA)患者带状疱疹(HZ)的发生率,并预测HZ发展的潜在风险因素。方法:我们回顾性分析了我们风湿病科的RA患者的病历,这些患者符合2010ACR/EULARRA标准,并正在接受JAKI治疗。通过图表审查和补充电话访谈评估了HZ的发生率和病程。结果:对198例接受JAKI治疗的患者进行了平均18.5个月的监测。九名受试者经历过HZ,导致每100名患者年2.95的发病率。在发展HZ的患者和未发展HZ的患者中没有发现人口统计学或治疗相关的差异。疾病持续时间(OR:1.06,95%CI:1.01-1.12),JAKI治疗时间(OR:1.04,95%CI:1.009-1.073),JAKI开始时疾病活动较高(OR:4.16,95%CI:1.07-16.17),在3个月的随访中(OR:6.0,95%CI:1.35-26.60)被确定为HZ发生的预测因子。36名患者接受了HZ疫苗接种,在平均9.6个月的随访中,没有报告不良反应或突发。结论:HZ的发病率与已发表的数据一致,表明疾病和治疗持续时间,以及疾病活动,是JAKI治疗的RA患者中HZ的重要预测因子。接种HZ疫苗被证明是安全有效的,强调其在该患者人群中的潜在保护价值。
    Objectives: This study aimed to evaluate the incidence of Herpes Zoster (HZ) in patients with rheumatoid arthritis (RA) treated with Janus kinase inhibitors (JAKi), and to predict potential risk factors for HZ development. Methods: We retrospectively analysed medical records from RA patients at our rheumatology unit who met the 2010 ACR/EULAR criteria for RA and were receiving JAKi. The incidence and course of HZ were assessed through chart review and supplementary phone interviews. Results: A total of 198 JAKi-treated patients were monitored for an average of 18.5 months. Nine subjects experienced HZ, resulting in an incidence of 2.95 per 100 patient-years. No demographic or treatment-related differences were found among patients who developed HZ and those who did not. Disease duration (OR: 1.06, 95% CI: 1.01-1.12), time on JAKi treatment (OR: 1.04, 95% CI: 1.009-1.073), higher disease activity at JAKi initiation (OR: 4.16, 95% CI: 1.07-16.17), and at 3-month follow-up (OR: 6.0, 95% CI: 1.35-26.60) were identified as predictors of HZ occurrence. Thirty-six patients received vaccination against HZ, and none reported adverse reactions or flare-ups during a mean follow-up of 9.6 months. Conclusions: The incidence of HZ aligns with published data, suggesting that disease and treatment duration, as well as disease activity, are significant predictors of HZ in RA patients on JAKi therapy. Vaccination against HZ proved to be safe and effective, underscoring its potential protective value in this patient population.
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  • 文章类型: Journal Article
    背景:带状疱疹(HZ)的发病率正在迅速增加,在中国造成临床和经济负担。关于中国居民对每种疫苗接种属性的疫苗偏好和支付意愿(WTP)知之甚少。
    目的:本研究旨在了解中国城市成年人(25岁或以上)对HZ疫苗接种计划的偏好,并计算每个疫苗接种属性的WTP。
    方法:在本研究中,我们采访了中国9个城市的2864名居民。进行了离散选择实验,以调查居民对HZ疫苗接种的偏好,并预测不同疫苗方案的摄取率。使用混合logit模型来估计每个属性的偏好和WTP。实验中包含了七个不同级别的属性,我们将其他属性的系数除以价格系数来衡量WTP。
    结果:疫苗有效性,保护持续时间,副作用的风险,原产地,事实证明,成本会影响中国成年人对HZ疫苗接种的偏好。HZ疫苗的有效性是对居民偏好产生最主要影响的属性,其次是保护期限。居民愿意支付974元人民币(145美元),将疫苗的有效性从45%提高到90%,他们几乎不会支付将疫苗接种时间表从2剂换成1剂。建议将保护率从45%增加到90%,可以最大程度地促进预期的吸收(20.84%)。
    结论:中国城市成年人在疫苗有效性之间进行了权衡,保护持续时间,原产地,副作用,和HZ疫苗接种的费用。疫苗的有效性是最重要的特征。居民的WTP最高(974元人民币;145美元),以提高疫苗的有效性。为了最大限度地吸收HZ疫苗,卫生当局应提高疫苗的有效性。
    BACKGROUND: The incidence of herpes zoster (HZ) is rapidly increasing, causing both clinical and economic burdens in China. Very little is known about Chinese residents\' HZ vaccine preferences and willingness to pay (WTP) for each vaccination attribute.
    OBJECTIVE: This study aims to elicit the preferences of Chinese urban adults (aged 25 years or older) regarding HZ vaccination programs and to calculate WTP for each vaccination attribute.
    METHODS: In this study, we interviewed 2864 residents in 9 cities in China. A discrete choice experiment was conducted to investigate the residents\' preferences for HZ vaccination and to predict the uptake rate for different vaccine scenarios. A mixed logit model was used to estimate the preferences and WTP for each attribute. Seven attributes with different levels were included in the experiment, and we divided the coefficients of other attributes by the coefficient of price to measure WTP.
    RESULTS: Vaccine effectiveness, protection duration, risk of side effects, place of origin, and cost were proven to influence Chinese adults\' preferences for HZ vaccination. The effectiveness of the HZ vaccine was the attribute that had the most predominant impact on residents\' preferences, followed by protection duration. The residents were willing to pay CN ¥974 (US $145) to increase the vaccine effectiveness from 45% to 90%, and they would barely pay to exchange the vaccination schedule from 2 doses to 1 dose. It is suggested that the expected uptake could be promoted the most (by 20.84%) with an increase in the protection rate from 45% to 90%.
    CONCLUSIONS: Chinese urban adults made trade-offs between vaccine effectiveness, protection duration, place of origin, side effects, and cost of HZ vaccination. Vaccine effectiveness was the most important characteristic. The residents have the highest WTP (CN ¥974; US $145) for enhancing the effectiveness of vaccines. To maximize HZ vaccine uptake, health authorities should promote vaccine effectiveness.
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  • 文章类型: Case Reports
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  • 文章类型: Journal Article
    带状疱疹疫苗接种对于预防带状疱疹病毒感染及其相关后果至关重要。尽管它的相关性,全球带状疱疹免疫接种覆盖率仍然低得惊人。了解导致疫苗怀疑和接受的因素对于提高免疫接种率和改善公共卫生结果至关重要。
    此范围审查,按照乔安娜·布里格斯研究所的指导方针,包括18项研究检查疫苗犹豫,接受,和相关因素。细致的数据分析揭示了犹豫在国家和人口统计学中的复杂动态。
    研究显示了广泛的接受率(2.8%-89.02%),展示了对疫苗接种的态度和行为的复杂相互作用。在这种情况下,拒绝疫苗的原因被反复发现,包括对潜在不利影响的担忧,疫苗必要性的观点,和疫苗供应限制。值得注意的是,各国个人对疫苗的接受和犹豫模式不同,疫苗,和疫苗接种相关因素。
    通过提高可访问性解决接受障碍,提供准确的信息,加强医疗保健建议至关重要。了解影响犹豫的多方面因素,可以进行有针对性的干预,提高免疫接种率,增强全球公共卫生。
    UNASSIGNED: Herpes zoster vaccination is critical in preventing herpes zoster virus infection and its associated consequences. Despite its relevance, global herpes zoster immunisation coverage remains alarmingly low. Understanding the factors that drive vaccine scepticism and acceptance is crucial for increasing immunisation rates and improving public health outcomes.
    UNASSIGNED: This scoping review, following Joanna Briggs Institute guidelines, included 18 studies examining vaccine hesitancy, acceptance, and associated factors. Meticulous data analysis revealed hesitancy\'s intricate dynamics across countries and demographics.
    UNASSIGNED: Studies displayed a wide range of acceptance rates (2.8%-89.02%), showcasing the complex interplay of attitudes and behaviors towards vaccination. Reasons for vaccine refusal were repeatedly identified in this setting, including worries about potential adverse effects, views of vaccine necessity, and vaccine supply constraints. Notably, individuals\' patterns of vaccine acceptance and hesitancy differed among countries, vaccines, and vaccination-related factors.
    UNASSIGNED: Addressing acceptance hurdles by improving accessibility, providing accurate information, and strengthening healthcare recommendations is crucial. Understanding the multifaceted factors influencing hesitancy allows for targeted interventions, elevating immunization rates and enhancing public health globally.
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  • 文章类型: Journal Article
    粘膜相关的不变T(MAIT)细胞是非常规的T细胞,通过TCR依赖性和非依赖性途径对核黄素生物合成和细胞因子做出反应。分别。MAIT细胞活化对几种病原体具有免疫保护作用,然而,MAIT细胞在直接感染或暴露于感染因子后的功能能力仍不明确.我们调查了水痘带状疱疹病毒(VZV)对血液来源的MAIT细胞的影响,并报告了病毒介导的活化损伤,细胞因子产生,VZV感染的(抗原+)和VZV暴露的(抗原-)MAIT细胞响应TCR依赖性和非依赖性刺激而改变转录因子表达。此外,我们揭示了VZV暴露(抗原)MAIT细胞的抑制不是由邻近VZV感染(抗原)MAIT细胞的可溶性因子介导的。最后,我们证明VZV损害MAIT细胞响应核黄素合成细菌的细胞溶解潜力。总之,我们报道了一种病毒介导的免疫逃避策略,可以解除MAIT细胞的应答.
    Mucosal-associated invariant T (MAIT) cells are unconventional T cells that respond to riboflavin biosynthesis and cytokines through TCR-dependent and -independent pathways, respectively. MAIT cell activation plays an immunoprotective role against several pathogens, however the functional capacity of MAIT cells following direct infection or exposure to infectious agents remains poorly defined. We investigated the impact of Varicella Zoster Virus (VZV) on blood-derived MAIT cells and report virus-mediated impairment of activation, cytokine production, and altered transcription factor expression by VZV infected (antigen+) and VZV exposed (antigen-) MAIT cells in response to TCR-dependent and -independent stimulation. Furthermore, we reveal that suppression of VZV exposed (antigen-) MAIT cells is not mediated by a soluble factor from neighbouring VZV infected (antigen+) MAIT cells. Finally, we demonstrate that VZV impairs the cytolytic potential of MAIT cells in response to riboflavin synthesising bacteria. In summary, we report a virus-mediated immune-evasion strategy that disarms MAIT cell responses.
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