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.

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.

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.

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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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.

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.

Herpes zoster (HZ), a common disease in older adults, affects their quality of life. Therefore, this study aimed to examine the blog posts of HZ-related information on social media platforms to analyze the attitudes and behaviors of residents toward the dissemination of health information. This research used content analysis to focus on Weibo, a representative social media in China, to analyze the content of 1866 blog posts related to herpes zoster (HZ) and herpes zoster vaccine (HZV). According to the consistency test by Cohen\'s Kappa, four themes were identified: (a) sources, (b) tones, (c) epidemiological information, and (d) extended parallel process model elements. The findings showed that most information on Weibo came from non-professionals, with a neutral tone, and showed the invisible pain of HZ and the effectiveness of HZV through the two largest aspects of prevention and aged protection in epidemiological information. However, current blog posts treat the older adult as invisible individuals, failing to acknowledge them as recipients of the information. Additionally, the cost of the vaccine acts as an invisible economic barrier, contributing to the dissemination of incorrect information about folk remedies. This impacts the older adult\'s acceptance of health information related to HZV. Thus, the way to share health information with the older adult needs to be improved in the future, and attention should be paid to the transmission of incorrect information to improve their vaccination rates and awareness of health management.

BACKGROUND: Facial herpes is a common form of the herpes simplex virus-1 infection and usually presents as vesicles near the mouth, nose, and periocular sites. In contrast, we observed a new facial symptom of herpes on the entire face without vesicles.
METHODS: A 33-year-old woman with a history of varicella infection and shingles since an early age presented with sarcoidosis of the entire face and neuralgia without oral lesions. The patient was prescribed antiviral treatment with valacyclovir and acyclovir cream. One day after drug administration, facial skin lesions and neurological pain improved. Herpes simplex without oral blisters can easily be misdiagnosed as pimples upon visual examination in an outpatient clinic.
CONCLUSIONS: As acute herpes simplex is accompanied by neuralgia, prompt diagnosis and prescription are necessary, considering the pathological history and health conditions.

UNASSIGNED: Solid organ transplant recipients are at high risk for developing severe zoster-associated neuralgia, and the pharmaceutic therapies of pain management for these patients with limited organ function are challenging. Intravenous lidocaine infusion showed positive analgesic effects and is used for the management of neuropathic pain. This case series reports the safety and effectiveness of intravenous lidocaine infusion in the treatment of intractable zoster-associated neuralgia in solid organ transplant recipients.
UNASSIGNED: Five solid organ transplant recipients suffering from refractory zoster-associated neuralgia (numeric rating scale 8-10, despite using high doses of antiepileptic drugs or combined with opioids) were enrolled. Intravenous lidocaine (5 mg/kg ideal bodyweight) was administered over 1.5 h with the monitoring of vital signs. Pain intensity, patient satisfaction, adverse events, typical liver, and kidney function were evaluated. All subjects reported high satisfaction with their treatment and effective pain relief at the 6-month follow-up. One patient experienced short and mild numbness in the mouth and dizziness after the therapy, but no major adverse reactions were reported.
UNASSIGNED: This case series provides evidence that intravenous lidocaine infusion provided effective pain relief as an analgesic treatment option for transplant patients with intractable zoster-associated neuralgia.