Increased seroprevalence of Toxoplasma gondii in a population of patients with Bell's palsy: a sceptical interpretation of the results regarding the pathogenesis of facial nerve palsy

Effectiveness of multiwave locked system laser on the treatment of patients with idiopathic Bell's palsy: a randomized double-blind placebo controlled trial

The objective of this study is to investigate the effect of scanning and point application of multiwave locked system (MLS) laser therapy on the recovery of patients with idiopathic Bell's palsy (IBP). A randomized double-blind placebo-controlled trial was carried out on 60 patients with subacute BP. Patients were randomly assigned into three groups of 20 patients each. Facial massage and facial exercises were applied to all patients. Group one received MLS laser as a manual scanning technique (10 J/cm², area 50cm², total energy 500 J). Group two received MLS laser using point application technique (10 J/point, 8 points, total 80 J). Group three received placebo laser. House-Brackmann scale (HBS) and facial disability index (FDI) were used to evaluate the facial recovery. Assessment was performed at baseline and after 3 and 6 weeks of treatment. Comparison within and between groups was performed statistically with significance level p < 0.05. Results showed significant improvement in the FDI and HBS after treatment in all groups. Both scanning and point application significantly improved the score of FDI and HBS more than placebo group. Scanning technique combined with facial massage and exercises had a more significant effect than the point application group or the placebo group in improving FDI and HBS scores after 3 and 6 weeks of treatment. The MLS laser is an effective physiotherapy method used for the treatment of patients with IBP. MLS laser in scanning or point application techniques was more effective than exercise alone with greater effect of scanning technique than point application technique.

Revisión sistemática sobre la prevalencia de la serología infecciosa en la parálisis facial periférica

Introducción y objetivos. La parálisis facial periférica es una afección del Nervio Facial que suele cursar con dolor retroauricular, pródromos vitales y parálisis facial. Ante la falta de bibliografía sobre la etiología de dicha parálisis se propuso realizar una revisión sistemática orientada a conocer la prevalencia serológica de la parálisis facial periférica en los diferentes estudios publicados incluyendo el realizado en esta facultad el curso anterior. Materiales y métodos. Revisión sistemática y metanálisis de los estudios publicados sobre la confirmación de una parálisis facial periférica por serología positiva. Resultados. Un total de 628 pacientes fueron analizados, de los cuáles 76 tenían serología positiva (12,10%). El metanálisis muestra heterogeneidad entre los resultados y sesgo de publicación. Conclusiones. No se evidencia que haya una relación significativa entre una parálisis facial periférica y una serología positiva reciente por lo que no se obtendría beneficio con un tratamiento antiviral.

Considerations and complications after Bells' palsy

We present a retrospective, observational study of all patients diagnosed with Bells' palsy (BP) at the Central District of Clalit Health Services from 2003 through to 2012. BP is associated with several complications. We evaluated clinical characteristics including the number of patient visits to general physicians (GP), otolaryngologists, ophthalmologists and neurologists, medications prescribed in the acute phase of BP (steroids and antiviral agents), and the ophthalmic diagnoses. A total of 4463 patients with the diagnosis of BP were included. The incidence per 100,000/year was 87.0, and it increased with age. Patients had significantly more visits to all specialists at 6 months after the BP event. Steroid treatment was prescribed to 50.4% of the patients and antiviral agents to 65.5%. Both treatments were associated with older patient age and female sex. The rate of post BP lagophthalmos and keratitis was 3.45% and 0.63% at 1-3 months, respectively, and both were more likely to develop in older patients. Steroid and/or antiviral treatments were not associated with a decrease in ophthalmic complications. BP may cause ophthalmic complications at a low rate, which are associated with older age. Steroids and antiviral agents appeared to have no effect on ophthalmic complications.

Toxoplasmosis--a global threat. Correlation of latent toxoplasmosis with specific disease burden in a set of 88 countries

BACKGROUND

Toxoplasmosis is becoming a global health hazard as it infects 30-50% of the world human population. Clinically, the life-long presence of the parasite in tissues of a majority of infected individuals is usually considered asymptomatic. However, a number of studies show that this 'asymptomatic infection' may also lead to development of other human pathologies.

AIMS OF THE STUDY

The purpose of the study was to collect available geoepidemiological data on seroprevalence of toxoplasmosis and search for its relationship with mortality and disability rates in different countries.

METHODS AND FINDINGS

Prevalence data published between 1995-2008 for women in child-bearing age were collected for 88 countries (29 European). The association between prevalence of toxoplasmosis and specific disease burden estimated with age-standardized Disability Adjusted Life Year (DALY) or with mortality, was calculated using General Linear Method with Gross Domestic Product per capita (GDP), geolatitude and humidity as covariates, and also using nonparametric partial Kendall correlation test with GDP as a covariate. The prevalence of toxoplasmosis correlated with specific disease burden in particular countries explaining 23% of variability in disease burden in Europe. The analyses revealed that for example, DALY of 23 of 128 analyzed diseases and disease categories on the WHO list showed correlations (18 positive, 5 negative) with prevalence of toxoplasmosis and another 12 diseases showed positive trends (p<0.1). For several obtained significant correlations between the seroprevalence of toxoplasmosis and specific diseases/clinical entities, possible pathophysiological, biochemical and molecular explanations are presented.

CONCLUSIONS

The seroprevalence of toxoplasmosis correlated with various disease burden. Statistical associations does not necessarily mean causality. The precautionary principle suggests however that possible role of toxoplasmosis as a triggering factor responsible for development of several clinical entities deserves much more attention and financial support both in everyday medical practice and future clinical research.