- Diverse clinical manifestations caused by varicella-zoster virus reactivation.
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Hosun Park
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Yeungnam Univ J Med. 2016;33(1):1-7. Published online June 30, 2016
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DOI: https://doi.org/10.12701/yujm.2016.33.1.1
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Abstract
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- The two distinctive clinical features of varicella-zoster virus (VZV) are varicella (chickenpox) by primary infection and zoster (singles) by the reactivation of latent infection. In addition to the two typical clinical symptoms mentioned above, diverse clinical manifestations have been reported as a result of VZV reactivation, including chronic radicular pain without rash, visual loss, facial palsy, dysphagia, sore throat, odynophagia, otalgia, hearing loss, dizziness, headache, hemiplegia, etc. Most of these symptoms are derived from neuropathy and vasculopathy of affected nerves and arteries. Diagnosis of VZV disease can be difficult if there is no appearance of a skin rash during development of atypical symptoms. In addition to natural infection, vaccination and anti-viral agent treatment have influenced the changes of epidemics and clinical presentations of varicella and zoster. In this article, diverse clinical manifestations caused by VZV reactivation, particular without skin rash, are reviewed.
- Efficacy of Pneumococcal Vaccines.
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Hosun Park
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Yeungnam Univ J Med. 2012;29(1):1-8. Published online June 30, 2012
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DOI: https://doi.org/10.12701/yujm.2012.29.1.1
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Abstract
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- Streptococcus pneumonia is a very important pathogen for children and elderly people. Two types of pneumococcal vaccines are available in the market: pneumococcal polysaccharide vaccine (PPSV) and pneumococcal conjugate vaccine (PCV). PPSVs have been used for more than 30 years, and PCVs for about 10 years. There have been many reports concerning the evaluation of the vaccines' efficacies in preventing pneumococcal diseases such as meningitis, pneumonia, and otitis media and bacteremia, but the clinical trials had been performed with different conditions, such as diverse vaccine valencies, age groups, races, target outcomes, immunological cut-off values, and follow-up periods. PPSV is recommended for elderly people and chronic disease patients such as asthma, diabetes mellitus, chronic renal failure, and hyposplenic patients. According to the data from several systemic reviews and population-based surveillances, PPSV is effective for pneumococcal pneumonia and vaccine-type bacteremia among healthy adults. Until now, however, there is insufficient evidence of the effectiveness of PPSV among high-risk adults. PCV is very effective in preventing vaccine-type invasive pneumococcal disease (IPD) among children, but its efficacy for pneumonia is very low among children. The incidence of vaccine-related or non-vaccine-type IPDs is increasing after the introduction of 7-valent PCV (PCV7) as a routine immunization for children. Recently, 10- and 13-valent PCVs have been used for children, instead of PCV7. Therefore, continuous surveillance for serotype change among pneumococcal diseases is necessary to evaluate the vaccines' efficacy.
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