Periodontal herpesvirus morbidity and treatment

Four billion individuals worldwide have a history of periodontitis, with the poorest people in society most affected. Periodontitis can lead to unsightly drifting of teeth and tooth loss that may interfere with the wellbeing of daily living and has also been linked to at least 57 medical diseases and disabilities. The etiology of severe periodontitis includes active herpesviruses, specific bacterial pathogens, and destructive immune responses, but herpesviruses seem to be the major pathogenic determinant. Periodontal herpesviruses that disseminate via the systemic circulation to nonoral sites may represent a major link between periodontitis and systemic diseases. Current treatment of periodontitis focuses almost exclusively on bacterial biofilm and will require revision. Periodontal therapy that targets both herpesviruses and bacterial pathogens can provide long‐term clinical improvement and potentially reduces the risk of systemic diseases. Molecular diagnostic tests for periodontal pathogens may enable early microbial identification and preemptive therapy. This review details an efficient and reliable anti‐infective treatment of severe periodontitis that can be carried out in minimal time with minimal cost.     

单纯疱疹病毒性角膜炎治疗方法研究进展

单纯疱疹病毒1型（herpes simplex virus 1, HSV-1）是一种普遍存在的病原体，感染角膜可引起单纯疱疹病毒性角膜炎（herpes simplex keratitis, HSK）。HSV-1可潜伏于三叉神经胞体，易形成复发感染。多次反复恶化可造成角膜免疫-炎症反应损伤，促进新生血管形成，进一步导致角膜浑浊、视力障碍甚至失明，是导致角膜盲的首要病因之一。目前，临床使用的抗病毒药物不能根除HSV-1，本文将汇总有关HSK的最新治疗进展，主要从抑制HSV-1入侵、增殖以及减少新血管生成两方面进行综述，以期为临床研究提供理论依据。     

Impact of a multi-component immunization intervention on pneumococcal and herpes zoster vaccinations: A randomized controlled trial of community pharmacies in 2 states

BackgroundThe purpose of this study was to assess the impact of the We Immunize Program on structures, processes, and outcomes of pneumococcal and herpes zoster pharmacy-based immunization services.MethodsPharmacy-technician pairs from 62 Alabama and California community pharmacies participated in a 6-month randomized controlled trial (intervention = 30/control = 32). All received immunization update training; intervention participants also received practical strategies training and monthly telephonic expert feedback. Completion of immunization service structure and process activities were analyzed using Fisher's Exact and one-way Mann-Whitney U tests. The primary outcome, change in number of pneumococcal, herpes zoster, and total vaccine doses administered, was assessed using one-way Wilcoxon signed rank and Mann-Whitney U tests. Associations between program and vaccine doses across time were explored using generalized estimating equations (GEE).ResultsIntervention pharmacies completed more structure (median 12.00 versus 9.00, p = 0.200) and process activities (median 8.00 versus 7.00, p = 0.048) compared to control. Statistically significant increases in the median number of pneumococcal vaccine doses (7.50–12.00 doses, p = 0.007), and total vaccine doses (12.50–28.00 doses, p = 0.014) were seen from baseline to post-intervention within the intervention group. However, these changes were not statistically significant when compared to the control group (pneumococcal p = 0.136, total p = 0.202). Changes in median herpes zoster vaccine doses did not reach significance among intervention (8.50–9.00, p = 0.307) or control (9.00–13.00, p = 0.127) pharmacies.ConclusionsPractical strategies training combined with tailored expert feedback enhanced existing pneumococcal immunization services in community pharmacies.Clinical trial registrationClinicalTrials.gov identifier: NCT02615470.     

A case of congenital herpes simplex virus infection diagnosed at 8 months of age

We present the case of an 8-month-old boy with the repeated recurrence of vesicles from the time of birth and who subsequently manifested psychomotor developmental delay. We retrospectively diagnosed the patient with congenital herpes simplex virus (HSV) infection. Computed tomography showed multiple calcifications in the periventricular white matter and thalami. The bilateral deep white matter showed an abnormally high signal intensity on T2-weighted magnetic resonance imaging. The patient required consecutive, suppressive therapy with valacyclovir to prevent the repeated recurrence of vesicles. This case presented a milder phenotype of congenital HSV infection in comparison to previous reports, and highlights the importance of the careful examination for this disease when neonates present with skin lesions.     

强化护理干预在带状疱疹患者中的应用效果

目的探讨强化护理干预在带状疱疹患者中的应用效果。方法选取2010年1月-2013年1月在本站就诊的126例带状疱疹患者作为研究对象，根据随机原则将患者分为观察组、对照组，每组各63例。两组都常规使用阿昔洛韦、甲氰咪胍、尼美舒利分散片、维生素Bm维生素B1、复方甘草酸苷片、肌苷等药物治疗，对照组接受常规护理，观察组在常规护理的基础上接受强化护理。结果观察组患者的止痛时间、水泡结痂时间和疱疹愈合时间明显短于照组（P〈0．05）；观察组患者的总有效率为96．82％，明显高于对照组的84．13％（P〈0．05）。结论强化护理干预用于带状疱疹患者可明显提高治愈率，有利于减轻患者的疼痛，缩短水泡结痂及疱疹愈合时间，其对带状疱疹的治疗有较好的应用效果，值得临床推广。