Intralesional measles, mumps, and rubella vaccine after failure of intralesional Candida antigen for the treatment of recalcitrant pediatric warts

Numerous studies have investigated the efficacy of intralesional immunotherapy for warts, but there are a lack of studies investigating the efficacy of alternative intralesional immunotherapies following failure of initial intralesional immunotherapy. In this retrospective study, we aimed to investigate the efficacy of intralesional measles, mumps, and rubella vaccine for the treatment of pediatric warts following failure of intralesional therapy with Candida antigen. Following intralesional measles, mumps, and rubella vaccine administration, 8/51 (15.5%) patients had complete resolution of their warts, 6/51 (12%) had near complete resolution, 19/51 (37%) had partial improvement, 12/51 (23.5%) had no change, and 6/51 (12%) had worsening. Although limited by retrospective nature and low sample size, our results demonstrate that intralesional immunotherapy with measles, mumps, and rubella vaccine provides an alternative therapeutic option for the treatment of recalcitrant pediatric warts in patients who fail to respond to intralesional Candida antigen.

Chinese medicinal herbs for mumps

BACKGROUND

Mumps is an infectious disease caused by the mumps virus. Chinese physicians generally believe that Chinese medicinal herbs are effective in alleviating symptoms and reducing the duration of mumps. Herbalists tend to develop a treatment plan according to the individual's symptoms.

OBJECTIVES

To evaluate the effectiveness and safety of Chinese medicinal herbs combined with routine treatments for mumps.

SEARCH METHODS

We searched CENTRAL (2015, Issue 1), MEDLINE (1948 to January week 4, 2015), EMBASE (1974 to February 2015), CINAHL (1981 to February 2015), AMED (1985 to April 2014), the Chinese Biomedical Database (CBM) (1980 to February 2015), China National Knowledge Infrastructure (CNKI) (1979 to February 2015), VIP Information (1989 to February 2015), and relevant databases of ongoing trials.

SELECTION CRITERIA

Randomised controlled trials (RCTs) of Chinese medicinal herbs for mumps (with or without complications).

DATA COLLECTION AND ANALYSIS

Two review authors independently evaluated trial quality and conducted data extraction. We contacted the trial authors for missing data regarding participant allocation. Some trials allocated participants according to the participants' admission sequence, making it a pseudo-random allocation. None of the trials concealed participants' allocation or used blinding.

MAIN RESULTS

We did not identify any eligible trials for inclusion. We identified 108 studies that claimed to use random allocation. We excluded 104 studies because the allocation methods the authors had used were not actually randomised. We were unable to contact the trial authors of the remaining four studies. These trials require further evaluation and have been allocated to the 'Studies awaiting classification' section.

AUTHORS' CONCLUSIONS

We did not find any RCTs for or against Chinese herbal medicine used in the treatment of mumps. We hope more high-quality RCTs will be conducted in the future.

Chinese medicinal herbs for mumps

BACKGROUND

Mumps is an infectious disease caused by the mumps virus. Chinese physicians generally believe that Chinese medicinal herbs are effective in alleviating symptoms and reducing the duration of mumps. Herbalists tend to develop a treatment plan according to the individual's symptoms.

OBJECTIVES

To evaluate the effectiveness and safety of Chinese medicinal herbs for mumps.

SEARCH METHODS

We searched CENTRAL Issue 4, 2012, MEDLINE (1948 to April week 3, 2012), EMBASE (1974 to April 2012), CINAHL (1981 to April 2012), AMED (1985 to April 2012), the Chinese Biomedical Database (CBM) (1980 to May 2012), China National Knowledge Infrastructure (CNKI) (1979 to May 2012), VIP Information (1989 to May 2012), and relevant databases of ongoing trials.

SELECTION CRITERIA

Randomised controlled trials (RCTs) of Chinese medicinal herbs for mumps (with or without complications).

DATA COLLECTION AND ANALYSIS

Two review authors (MS, ZL) independently evaluated trial quality and conducted data extraction. We contacted the trial authors for missing data regarding participant allocation. Some trials allocated participants according to the participants' admitting sequence, making it a pseudo-random allocation. None of the trials concealed participants allocation or used blinding.

MAIN RESULTS

We did not identify any eligible trials for inclusion. We identified 102 studies which claimed to use random allocation. Ninety-nine studies were excluded because the allocation methods the authors had used were not actually randomised. We were unable to contact the trial authors of the remaining three studies. These trials require further evaluation and have been allocated to the 'Studies awaiting classification' section.

AUTHORS' CONCLUSIONS

We did not find any RCTs for or against Chinese herbal medicine used in the treatment of mumps. We hope more high-quality RCTs will be conducted in the future.

Mumps in prison: description of an outbreak in Manitoba, Canada

OBJECTIVE

There is a lack of published information on the management of mumps in a prison setting. We describe an outbreak of mumps that occurred in a medium-security correctional centre (Milner Ridge) in Manitoba, Canada.

METHODS

A case definition of mumps consistent with that in the document "Guidelines for the Prevention and Control of Mumps Outbreaks in Canada" was adopted. Cell culture, polymerase chain reaction, and serology were used for case confirmation.

RESULTS

Five confirmed cases of mumps infection were identified at the Milner Ridge Correctional Centre between January 12 and February 5, 2009. One additional confirmed case and 3 additional probable cases were identified at a second correctional centre. Outbreak control at Milner Ridge was accomplished by cohorting the affected units of the centre, providing education on mumps, deferring transfers, and monitoring for further cases. Vaccination was offered to inmates and staff on the assumption, based on average inmate age, that the majority of inmates would have previously received, at most, a single dose of mumps-containing vaccine.

CONCLUSION

An outbreak of mumps in a correctional setting was successfully contained via implementation and tailoring of basic infection control measures, and vaccination of inmates and staff. Given the relatively young age of many inmates and the parallels between prisons and dormitories, it could be argued that inmates may represent another group of individuals for whom a second dose of mumps vaccine (if not received in childhood) would be beneficial as primary prophylaxis.

Mumps in prison: description of an outbreak in Manitoba, Canada

OBJECTIVE

There is a lack of published information on the management of mumps in a prison setting. We describe an outbreak of mumps that occurred in a medium-security correctional centre (Milner Ridge) in Manitoba, Canada.

METHODS

A case definition of mumps consistent with that in the document "Guidelines for the Prevention and Control of Mumps Outbreaks in Canada" was adopted. Cell culture, polymerase chain reaction, and serology were used for case confirmation.

RESULTS

Five confirmed cases of mumps infection were identified at the Milner Ridge Correctional Centre between January 12 and February 5, 2009. One additional confirmed case and 3 additional probable cases were identified at a second correctional centre. Outbreak control at Milner Ridge was accomplished by cohorting the affected units of the centre, providing education on mumps, deferring transfers, and monitoring for further cases. Vaccination was offered to inmates and staff on the assumption, based on average inmate age, that the majority of inmates would have previously received, at most, a single dose of mumps-containing vaccine.

CONCLUSION

An outbreak of mumps in a correctional setting was successfully contained via implementation and tailoring of basic infection control measures, and vaccination of inmates and staff. Given the relatively young age of many inmates and the parallels between prisons and dormitories, it could be argued that inmates may represent another group of individuals for whom a second dose of mumps vaccine (if not received in childhood) would be beneficial as primary prophylaxis.

[Study on in vitro release and transdermal behaviors of mumps cataplasm of complex prescription]

OBJECTIVE

To investigate the in vitro release and transdermal behaviors of mumps cataplasm of complex prescription.

METHODS

The improved Franz difficusion was used and the concentration of drugs was detected. DCS was determined by HPLC and flavanoid contents were determined by UV.

RESULTS

The accumulation skin permeation percentage of DCS and flavanoid was 32% and 21%, respectively, the in vitro release percentage of DCS and flavanoid was 47% and 42%, respectively.

CONCLUSION

The transdermal behavior of mumps cataplasm of complex prescription is an zero-order kinetics progress. The in vitro release behavior is in accordance with the Higuchi equation.

Mumps orchitis in the post-vaccine era (1967-2009): a single-center series of 67 patients and review of clinical outcome and trends

Since the introduction of the mumps vaccine, the age of appearance of mumps infection has shifted from children to adolescents and young adults, groups with a higher incidence of disease complications and sequelae. During the years 2000-2001, the Gran Canaria Island was part of an epidemic of mumps. In that period, our institution attended 67 cases of serologically confirmed acute mumps orchitis, the most serious complication of mumps infection in young postpubertal males. We conducted a descriptive and prospective study of this cohort and extensively reviewed the literature from 1967 (the year the first mumps vaccine was introduced) to 2009. Fifty-six patients were admitted because of general impairment and were treated with alpha-interferon. Sixty-six patients presented parotitis previous to orchitis (interval from parotitis to orchitis, 4.9 d). Orchitis was unilateral in 89.5% and bilateral in 10.4% of cases. More than 98% of patients had orchitis-associated fever. Nine patients had clinical and biochemical data showing acute mumps meningitis, and 11 had subclinical pancreatitis. The mean duration of symptoms was 4.6 days (range, 1-9). During the acute phase, more than 41% of the evaluated testes had a volume >25 mL. Acute hormonal disturbances were highly prevalent. These included decreased levels of testosterone and inhibin B with low or normal levels of gonadotropins in 35% of subjects, and, to our knowledge not previously reported, an atypical hormonal pattern consisting of low levels of free testosterone and inhibin B, along with increased measures of luteinizing hormone but low or normal follicle-stimulating hormone levels (11% of cases). During the follow-up period (mean, 331 d) a high incidence of sperm disturbance was found.

Therapy of other viral infections: herpes to hepatitis

Over the past several years, there has been an increase in knowledge pertaining to the diagnosis and management strategies for the herpes family (Types 1-8), the pox viruses, mumps, measles, rubella, and parvovirus B19 as well as the viral etiologies of hepatitis. Various antiviral treatments, such as nucleoside analogs and interferon therapy, have been available to reduce the signs and symptoms of these common viral infections. This article summarizes the preferred treatment strategies to be employed for each of the viruses for reducing severity, duration, recurrences (notably in the herpes family), transmission rates, as well as preventive alternatives. The majority of the therapeutic options attenuate the course of disease. Treatment decisions are driven by knowledge of the natural history and often are tailored to incorporate clinical circumstances for individual patients. Promotion of community awareness and the development of vaccines should be emphasized in the battle against these common viruses, particularly the herpes simplex viruses, the pox viruses, and hepatitis B.

[Clinical studies on the short-course and efficient treatment of mumps meningitis]

OBJECTIVE

To investigate the short-course and efficient way to treat mumps meningitis.

METHODS

Totally 155 cases of mumps meningitis treated by intrathecal injection with dexamethasone only once were enrolled as experimental group and 55 similar cases treated with the common therapy as control.

RESULTS

The time for recoveries of temperature, headache, the pathologic reflexes and the total time of treatment were 32 hours, 15 hours, 12 hours and 3.1 days, respectively, while those of the control group were 58 hours, 24 hours, 32 hours, 6.5 days respectively. There was statistical difference between the two groups (P<0.01 or 0.05).

CONCLUSIONS

Intrathecal injection with dexamethasone only once is efficient and safe in the treatment of mumps meningitis.

[Experience gained with the drug amizon in the treatment of patients with mumps, with special reference to its effects on some biochemical markers]

Effectiveness was studied of a new drug amyzonum in a complex therapy of mumps in 149 patients versus the group of 177 patients having been treated with conventional methods only. A positive effect was shown of the drug on clinical indices, with the incidence of complications having gotten lower, biochemical indices having returned to normal.

[The case of mumps complicated by one-sided hearing loss]

We presented the case of mumps complicated by left ear's hearing loss in 32-year-old man. Audiological examinations performed after one, two and three months since the date of discharge from hospital showed the maintenance of hearing loss.

[Neurologic manifestation in mumps virus infection]

OBJECTIVE

To study the incidence, clinical manifestations and treatment of mumps virus meningitis.

MATERIAL AND METHOD

Study of 64 patients with mumps virus meningitis, admitted to the Clinic of Infectious Diseases of Iaşi during 1996-1999.

RESULTS

The mumps virus meningitis had a high prevalence în 1998 (39%) most patients being males (62.5%) from the urban areas. 39.06% of cases were on the age group of 5-6 years old, 25% were in the age group 10-14 years old and 18.75% were adults patients. The clinical manifestation were dominated by headache (100%), fever (100%), vomiting (89%), photophobia (43.75%) and meningeal syndrome of contracture. The laboratory diagnosis was established by the cerebro-spinal fluid exam, together with the peripheric blood exam. The treatment was in all the cases with pathogenic (corticotherapy) and symptomatics with a very good evolution.

CONCLUSIONS

All the cases with diagnosis mumps virus meningitis were well going, having good evolution and complete healing under symptomatic and pathogenic therapy.

An adult case of mumps brainstem encephalitis

We present an adult case of mumps brainstem encephalitis. He was successfully treated with steroid pulse therapy and recovered completely except for persistent dysuria. He had not been vaccinated and had no history of acute mumps infection. We consider that encephalitis in this case was caused by a reversible autoimmune process triggered by mumps infection. We emphasize the usefulness of pulse therapy for the treatment of some cases of mumps brainstem encephalitis in addition to the importance of mumps vaccination to prevent such a severe complication as encephalitis.

The preventive effect of systemic treatment with interferon-alpha2B for infertility from mumps orchitis

OBJECTIVE

To evaluate the effect of interferon-alpha2B on mumps orchitis, often caused by postpubertal mumps and which can result in permanent testicular atrophy.

PATIENTS AND METHODS

The study included 21 patients with mumps orchitis, treated between May 1990 and June 1997. Patients were randomly assigned into two groups: in group 1, 13 patients received therapy with interferon-alpha2B (3 x 10(6) IU per day) and group 2 did not, acting as controls. All were evaluated by measurements of testis size, mumps virus titre, hormone level and semen analysis.

RESULTS

In group 1, the patients' symptoms resolved within 2-3 days and the volume of the testes returned to normal within 11 days; there was no testicular atrophy in any patient during the follow-up. However, asthenospermia continued to be detected in four patients (unilateral in two, bilateral in two). In group 2, the patients' symptoms resolved within 5-6 days and the volume of the testes returned to normal within 10 days; testes atrophied in three patients (unilateral in two, bilateral in one) during the follow-up. Asthenospermia continued in four patients (unilateral in two, bilateral in two).

CONCLUSION

These results suggest that treatment with systemic interferon-alpha2B is effective in preventing testicular atrophy when combined with standard symptomatic treatment.

[The efficacy of amizon in the combined treatment of patients with epidemic parotitis]

Efficacy was studied of a new anti-inflammatory interferon-inducing drug preparation amizon in a combined therapy of epidemic parotiditis in 118 patients versus the group of comparison consisting of 147 patients. A positive effect was ascertained of the drug on clinical parameters, decrease in the incidence rate and in severity of complications (orchitis, pancreatitis), immune indices.

Acute viral and bacterial infections of the salivary glands

Acute infection can involve any salivary gland, but it predominately affects the major salivary glands, especially the parotid gland. The anatomic and physiologic factors accounting for the parotid gland's predilection for infection are reviewed. Numerous conditions that are predisposed to acute bacterial sialadenitis and differ from risk factors associated with viral infection are also reviewed. The pathogenesis, diagnostic evaluation, treatment, complications, and prognosis of bacterial infections are discussed and contrasted with those of viral infections.

Augmentation of verotoxin-induced cytotoxicity/apoptosis by interferon is repressed in cells persistently infected with mumps virus

Verotoxin type 2 (VT2) produced by enterohemorrhagic Escherichia coli (EHEC) has been shown to have high cytotoxic potency toward several human B lymphoid cell lines with and without Epstein-Barr virus (EBV). Cell death, apoptosis induced by VT2, is closely correlated with the expression of receptor molecule Gb3/CD77, recognized by the toxin, but not with the infection or presence of EBV. Pretreatment of cells with interferon-alpha (IFN-alpha) for 24 h resulted in augmentation of apoptosis by VT2. Pretreatment within 8 h, however, was not effective. It has been reported that IFN-alpha-induced apoptosis is correlated with the induction of the 2',5'-OAS/RNase L system or dsRNA-activated protein kinase (PKR) or both. We have established persistent infection in both Akata and P3HR-1 cells with mumps virus. The persistently infected cell lines, P3HR-MP2 and Akata-MP2, showed poor induction of 2',5'-OAS and PKR in response to IFN-alpha. Augmentation of VT2-induced apoptosis by IFN-alpha was not found in the cell lines P3HR-MP2 and Akata-MP2. Therefore, these findings were interpreted to indicate that augmentation of VT2-induced apoptosis by IFN-alpha may be mediated by PKR and the 2',5'-OAS/RNaseL system. It is also suggested that mumps virus can suppress apoptosis and establish persistent infection.

Transverse myelitis following mumps in an adult -- a case report with MRI correlation

This is a case report of the 2nd oldest patient reported in the literature with transverse myelitis after mumps, and the 1st with magnetic resonance imaging (MRI) correlation. He is a 38-year-old Chinese man presenting with bilateral lower limb weakness and numbness, and urinary retention starting 3 weeks after an attack of mumps parotitis. Clinically, there was mild lower limb paresis, absent plantar responses and reduced pain sensation below the umbilicus. MRI revealed cord swelling and increased T2 signal from T7 to T11. Cerebrospinal fluid showed 23 cells/mm3 and 55 mg protein/dl. He received a 5-day course of intravenous methylprednisolone 0.5 g/d. The sensory and motor deficits improved over 2 weeks; urinary symptoms improved over the next year. Transverse myelitis following mumps is recognizable clinically and radiologically, and potentially responsive to methylprednisolone.

[Edema in acute diffuse glomerulonephritis, rheumatic peliosis and epidemic parotitis]

The Authors present a substantial series of infant APING in which the venous blood gas analysis shows poor use of oxygen, due to a probably reduced cellular combustion associated with low pCO2, high pH, which are characteristic of arterial blood travelling through anastomotic paths and preferential channels at the microcirculation level. They emphasize the contemporaneous increase in volemia, even with oedema present, and the poor permeation of the capillary wall found with the Landis test, contrary to what happens in glomerulonephrosis with minimal changes which features increased systematic capillary permeation with hypovolemia. The look of the oedema, together with the hypervolemia, led to the suspicion that the nephritic oedema was a sign of mainly intracellular oedema. In the opinion of the Authors these nephritic forms would seem to show systemic cellular respiratory suffering sensitive to the action of chlorpromazine, which has also dealt swiftly and cleanly with the oligoanuresis. The Authors consider 52 cases of Schöenlein-Henoch vasculitis which showed very rapid detumescence of periarticular swelling and those on the back of the hands and feet, as well as the disappearance of skin petechias and melena following treatment with chlorpromazine. They also mention two cases of Kawasaki's disease which seemed to react favorably to the combination of the action of chlorprmazine with acetylsalicylic acid. The effects obtained with chlorpromazine in 27 cases of epidemic parotitis with periscialoadenitis elastic tumescence are reported, with the focus on the reduction of the perisalivary tumescence. It is important to point out the very rapid disappearance of epigastrial pain, probably pancreatic in origin.(ABSTRACT TRUNCATED AT 250 WORDS)

[Pharmacokinetics and clinical studies of a new cephalosporin: cefamandole nafate]

The results of a pharmacokinetic and clinical study of cephamandol naphate indicated that the drug quickly reaches high plasma concentration after both i.m. and i.v. bolus administration. Urinary excretion of the biologically active form is as much as 84--90% of the total dose and mostly takes place in the first 6 hr. The therapeutic response was good: clinical cure in 90%, marked improvement in 6.6%, no change in 3.3%.

[Course of the liquor cytology in central nervous system mumps manifestations under various therapeutic regimens]

A total of 156 children with mumps meningitis and mumps encephalitis were, under 5 different regimes of therapy, subjected to continuous liquor cytology. It has been found that the "aminophenazone" group showed the best results so far as both the time required for normalization of the total number of cells and the differential evaluation of the liquor cytogram was concerned. Administration of plasma, corticosteroids, or chloramphenical gave less satisfactory results from the point of view of liquor cytology, the possible causes of which are discussed in detail.