Characteristics of facial nerve palsy during childhood in Japan: frequency of varicella–zoster virus association

BACKGROUND: The aim of this study was to clarify the clinical characteristics of facial nerve palsy and the frequency of varicella-zoster virus association in Japanese children, retrospectively. METHODS: The subjects were 30 facial nerve palsy patients less than 15 years old, treated in the Department of Pediatrics, Kawasaki Medical School Hospital, Okayama, Japan, during the last 10 years. RESULTS: The male/female and right/left ratios were 16/14 and 16/13, respectively. The patients included 21 cases (70%) of Bell's palsy, four cases (13%) due to otitis media, three cases (10%) of Ramsay Hunt syndrome and two cases (7%) due to birth trauma. There were six cases of zoster sine herpete among the Bell's palsy cases. CONCLUSION: Varicella-zoster virus-associated facial palsy was found in nine (36%) of the 25 patients examined. Zoster sine herpete was more frequently encountered in children than adults. Ramsay Hunt syndrome was found in school-age children and zoster sine herpete was often found in preschool children. The period of recovery was fast for facial nerve palsy due to acute otitis media, which occurred within 23 months of age, after myringotomy and administration of antibiotics.     

Clinical observations on the treatment of Ramsay Hunt syndrome by blood-letting puncture and cupping as main therapy

目的:观察穴位刺络拔罐疗法配合针灸等治疗Ramsay Hunt综合征的临床疗效.方法:治疗组32例患者取大椎、完骨等穴运用梅花针刺络拔罐的方法配合针灸治疗;对照组32例患者以针灸、阿昔洛韦等治疗.结果与结论:4个疗程后治疗组愈显率为81.2%,对照组为56.2%,治疗组优于对照纽(P<0.05).且治疗组中、短期耳痛缓解率也均明显优于对照组(P<0.01).     

43例海洛因依赖者并发带状疱疹和HIV感染分析

目的 :了解海洛因依赖者中并发带状疱疹和感染HIV之间的关系。方法 :对收治的戒毒人员中并发带状疱疹的患者进行抗 -HIV抗体检测。结果 :海洛因依赖者中并发带状疱疹的 4 3例患者抗 -HIV抗体均为阳性。结论 :在今后的戒毒治疗中 ,如遇感染带状疱疹的患者 ,应高度怀疑为HIV感染者或进入艾滋病发病期的病人 ,在诊断治疗、护理、隔离和防护工作中应予以高度重视。     

带状疱疹的发生与脊柱损伤的关系探讨

目的探讨带状疱疹（Hz）的发生与脊柱损伤之间的关系。方法首先明确脊柱损伤的四项标准：即脊柱损伤史，与Hz相对应的脊柱部位的疼痛和压痛，相应的X线或cT检查诊断。然后将16例确诊为脊柱损伤的Hz病例与同期的56例Hz依其就诊时间和地点自然形成的6个组别进行检验。结果显示了脊柱损伤是Hz发生的重要原因之一。结合现代脊柱病学观点，一元化的解释了Hz的发病机制、临床体征，特别是呈单侧性的带状分布现象的原因。结论Hz的发生是脊柱损伤和类水痘病毒感染二者共同作用的结果，前者为先决条件，后者是继发感染的病原因素。     

Insurance reimbursements for recombinant zoster vaccine in the private sector

A two-dose series of the recombinant zoster vaccine (RZV, Shingrix) was licensed by the Food and Drug Administration in 2017 and recommended by the Advisory Committee on Immunization Practices in 2018 for adults in the United States age 50 years and older. Despite the health benefits of shingles vaccination, coverage has remained low, with financial barriers among healthcare providers identified as one potential factor. This study estimates the reimbursement levels for RZV among a large sample of privately insured individuals in the US from the 2018 IBM® MarketScan® Commercial Claims and Encounters database. Of 198,534 claims for an RZV dose, the mean reimbursement was $149. Most claims (83%) exceeded $140, which was the private sector vaccine price reported on the CDC vaccine price list in April 2018. These results can be useful for providers considering procuring RZV and for state immunization programs considering ways to improve vaccination coverage.     

害羞生产力

创业过程里,帅也是一种生产力.我亲弟弟是“木知道”古典家具创始人,很帅,他最初是与朋友合伙创业,分管角色是销售经理,非常成功……我笑问：你卖的是色？他说,不是,是老实.怎么看你老实？他说：“我的普通话口音重,有一些害羞.”小缺点,往往是让人亲近信任的“心”武器. 据说,传统藏人做大笔生意谈价钱时,会说“拉特”（交手）,就是要你伸出手来!要你开个价,然后无论买方还是卖方,其中一方会主动把手伸到对方的长袖里面,买方会握住卖方的五指,卖方则用比手指的方式来暗示卖价.     

Successful differentiation of herpes zoster‐associated erythema multiforme from generalized extension of herpes by rapid polymerase chain reaction analysis

The polymerase chain reaction (PCR) assay for varicella zoster virus (VZV), herpes simplex virus (HSV)‐1 and HSV‐2 is available for use. Sometimes the differential diagnosis of the generalized herpes zoster (HZ), HSV1/2, and drug eruption is difficult. We report a case of HZ followed by the vesicular erythema multiforme (EM)‐like lesion. In this case the use of PCR was of great assistance. A 78‐year‐old Japanese man without any significant previous history of disease was admitted to our hospital complaining of zosteriform vesicle on an erythematous base from his right shoulder to the upper arm. We diagnosed him with HZ at the level of right Th2. In spite of the prompt start of antiviral therapy, a secondary new vesiculous erythema developed on his trunk. Clinically, it was quite difficult to differentiate the lesion from the generalized HZ. Rapid PCR assay of effusion and crust for VZV was performed. A PCR assay of VZV was positive for the crust taken from the primary lesion, while it was negative for the effusion and crust of the secondary widespread lesion. We diagnosed the secondary widespread lesion as an EM‐type drug eruption induced by acyclovir, or an EM associated with herpes zoster. We then stopped the use of acyclovir and applied steroid ointment of a very strong class for the secondary lesions, which improved after a few days. A PCR assay for VZV was useful for ruling out the generalized HZ in our case with secondary developed vesiculous lesions.