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Cureus Jul 2023Juvenile recurrent parotitis (JRP) is a rare recurrent non-obstructive inflammatory swelling of the parotid gland occurring most commonly in children aged three to six...
Juvenile recurrent parotitis (JRP) is a rare recurrent non-obstructive inflammatory swelling of the parotid gland occurring most commonly in children aged three to six years. JRP is usually idiopathic and presents as a painful swelling recurring on either side of the face at least twice within six months. We report the case of an eight-year-old Saudi boy with a painful acute right-sided parotid swelling and a history of similar occurrences bilaterally at least four times a year for two years. The routine laboratory investigations were unremarkable. Ultrasonography of the parotid glands suggested parotitis with cervical lymphadenopathy. He was treated conservatively and remained asymptomatic for a year. Although rare, an accurate diagnosis of JRP is possible with adequate history, physical examination, and lab investigations, supplemented with radiographic findings.
PubMed: 37644943
DOI: 10.7759/cureus.42632 -
Cureus Aug 2023Sjögren's syndrome is an autoimmune disease characterized by the destruction of exocrine glands. Clinically, this results in the loss of tear and saliva production....
Sjögren's syndrome is an autoimmune disease characterized by the destruction of exocrine glands. Clinically, this results in the loss of tear and saliva production. Although xerophthalmia and xerostomia, also known as sicca, is a common presentation among adults, paediatric patients more often present with recurrent parotitis and glandular enlargement. Overall, symptoms can vary, making initial diagnosis challenging. Approximately 80% of patients with Sjögren's syndrome experience parotid gland enlargement, however, salivary cysts are rare. Herein, we present a case of paediatric Sjögren's syndrome where a 12-year-old female presented with a two-month history of bilateral parotid masses. The patient denied any history of xerostomia, xerophthalmia, or constitutional symptoms. Imaging revealed bilateral complex cystic intraparotid masses. A right parotid gland biopsy was performed showing parotid gland parenchyma with dense lymphoplasmacytic infiltrate. Ultimately, the presumptive diagnosis of Sjögren's syndrome was made. This case illustrates the importance of a thorough workup to aid in diagnostic certainty. Parotid cysts associated with Sjögren's are rare but should be considered within the differential diagnosis for paediatric patients with parotid swelling/mass.
PubMed: 37674949
DOI: 10.7759/cureus.43033 -
Pediatric Rheumatology Online Journal Aug 2023Childhood Sjögren's Disease (cSjD) is an underdiagnosed phenomenon with clinical and pathophysiological nuances in contrast to Sjögren's Disease (SjD) in the adult...
BACKGROUND
Childhood Sjögren's Disease (cSjD) is an underdiagnosed phenomenon with clinical and pathophysiological nuances in contrast to Sjögren's Disease (SjD) in the adult population. While adults typically experience sicca symptoms, children with cSjD often present with recurrent parotitis, diverse autoantibody profiles, and renal and neurological manifestations. Diagnosis and classification in pediatric rheumatology remain controversial due to the reliance on adult-focused diagnostic criteria and the lack of standardized treatment and understanding of outcomes. The purpose of the paper is to propose a multimodal treatment plan and demonstrate the effectiveness of sialendoscopy in the management of cSjD.
CASE PRESENTATION
We present the case of a twelve-year-old female diagnosed with cSjD using the 2016 American College of Rheumatology (ACR) and the European League Against Rheumatism (EULAR) diagnostic criteria for SjD. In addition to medical management, she underwent sialendoscopy with triamcinolone irrigation under sedation and was monitored for progress via salivary gland ultrasonography (SGUS). Over the course of one year, she demonstrated significant improvement in symptoms, with serial SGUS scores gradually decreasing by five points.
CONCLUSIONS
This paper proposes a multimodal treatment plan involving sialendoscopy and medical management as a non-invasive and potentially more effective approach for cSjD. Standardized monitoring through SGUS scoring allows objective and quantifiable measurement of treatment progress, enabling better assessment of glandular tissue status. Recurrence is possible, and each cSjD patient may present differently. Nevertheless, our year-long observation of a patient with cSjD demonstrates that sialendoscopy, as seen in adults, can promote remission of recurrent parotitis in children as well.
Topics: Adult; Female; Child; Humans; Parotitis; Salivary Glands; Sjogren's Syndrome; Ultrasonography; Rheumatology; Chronic Disease
PubMed: 37574559
DOI: 10.1186/s12969-023-00870-3 -
European Journal of Public Health Dec 2023Routine childhood vaccination programs have had enormous positive public health impacts worldwide. However, in some areas, these benefits may be impeded by vaccine...
BACKGROUND
Routine childhood vaccination programs have had enormous positive public health impacts worldwide. However, in some areas, these benefits may be impeded by vaccine hesitancy and undervaccination. We estimated the number of reported cases of measles, pertussis, mumps and poliomyelitis averted in Sweden after the introduction of routine childhood vaccination programs.
METHODS
We used annual national data on population size and the number of reported cases of measles (1911-2019), pertussis (1911-2019), mumps (1914-2019) and poliomyelitis (1910-2019) for Sweden. For each disease, we calculated the median and 95% confidence interval of the annual pre-vaccination incidence to estimate the number of counterfactual cases; that is, the estimated number of cases that would have been observed in the post-vaccination period had no vaccine been introduced (median incidence × average annual population). For the post-vaccination periods, we calculated reported cases averted and assumed all decreases were due to vaccines.
RESULTS
In total, for all four diseases combined, over 2.1 million cases were reported over the respective surveillance periods. Since the introduction of vaccinations, we estimate that over 1.5 million reported cases of these four diseases combined have been averted: measles (633 091), pertussis (608 670), mumps (262 951) and poliomyelitis (58 240). However, due to underreporting, especially during pre-vaccination years, these are likely underestimates.
CONCLUSIONS
Since the introduction of these routine childhood vaccination programs in Sweden, a substantial number of reported cases of vaccine-preventable diseases have been averted. Vigilance against both failure to vaccinate and undervaccination is necessary to prevent future increases of these vaccine-preventable diseases.
Topics: Humans; Whooping Cough; Mumps; Sweden; Vaccine-Preventable Diseases; Vaccination; Vaccines; Measles; Poliomyelitis; Measles-Mumps-Rubella Vaccine
PubMed: 37883058
DOI: 10.1093/eurpub/ckad169 -
Vaccine Jan 2024We examined the association between socio-demographic determinants and uptake of childhood Measles, Mumps & Rubella (MMR) vaccines and the association between pregnant...
BACKGROUND
We examined the association between socio-demographic determinants and uptake of childhood Measles, Mumps & Rubella (MMR) vaccines and the association between pregnant women's pertussis vaccine uptake and their children's MMR vaccine uptake.
METHODS
We used nationally-representative linked mother-baby electronic records from the United Kingdom's Clinical-Practice-Research-Datalink. We created a birth cohort of children born between 01.01.2000 and 12.12.2020. We estimated the proportion vaccinated with first MMR vaccine by age 2 years and first and second MMR vaccines by age 5 years. We used survival-analysis and Cox proportional hazard models to examine the association between deprivation, ethnicity and maternal age and pertussis vaccination in pregnancy and children's MMR uptake.
RESULTS
Overall, 89.4 % (710,797/795,497) of children had first MMR by age 2 years and 92.6 % (736,495/795,497) by age 5 years. Among children still in the cohort when second MMR was due, 85.9 % (478,480/557,050) had two MMRs by age 5 years. Children from the most-deprived areas, children of Black ethnicity and children of mothers aged < 20 years had increased risk of being unvaccinated compared with children from the least-deprived areas, White children and children of mothers aged 31-40 years: first MMR by 5 years, adjusted Hazard Ratios (HR):0.86 (CI:0.85-0.87), HR:0.87 (CI:0.85-0.88) & HR:0.89 (CI:0.88-0.90) respectively. Deprivation was the determinant associated with the greatest risk of missed second MMR: adjusted HR:0.82 (CI:0.81-0.83). Children of mothers vaccinated in pregnancy were more likely than children of unvaccinated mothers to have MMR vaccines after adjusting for ethnicity, deprivation, and maternal age (First and Second MMRs adjusted HRs:1.43 (CI:1.41-1.45), 1.49 (CI:1.45-1.53).
CONCLUSION
Children from most-deprived areas are less likely to have MMR vaccines compared with children from least-deprived areas. Mothers who take up pregnancy vaccines are more likely to have their children vaccinated with MMR. Healthcare services should promote and facilitate access to both maternal and childhood vaccines during pregnancy.
Topics: Child; Female; Humans; Infant; Pregnancy; Cohort Studies; Demography; Measles; Measles-Mumps-Rubella Vaccine; Mumps; Rubella; United Kingdom; Vaccination
PubMed: 38072757
DOI: 10.1016/j.vaccine.2023.11.063 -
Skin Research and Technology : Official... Dec 2023Thread lifting is a common minimally invasive plastic surgery procedure. Parotid gland injury caused by thread lifting is a known complication; however, visual evidence...
BACKGROUND
Thread lifting is a common minimally invasive plastic surgery procedure. Parotid gland injury caused by thread lifting is a known complication; however, visual evidence of this complication is lacking.
OBJECTIVES
This study aimed to present cases of parotid gland injury by thread lifting shown using ultrasound and to discuss the importance of ultrasound detection of the location of the parotid gland before thread insertion.
METHODS
This study included eight patients diagnosed with parotid gland perforation and one with parotid duct injury due to threads from November 2020 to October 2022.
RESULTS
Six patients showed tenderness and swelling, three were asymptomatic, and one with duct injury showed severe swelling and pain. Although the severity and duration of symptoms have differed, we confirmed the progress of improvement with conservative treatment and confirmed ultrasound findings progressed.
CONCLUSIONS
Using ultrasound to detect the parotid gland's location before thread lifting might reduce the chance of parotid duct injury. Identifying immediate parotid duct or gland injury with ultrasound can help to act quickly for delayed pain or swelling and reduce the likelihood of additional complications.
Topics: Humans; Parotid Gland; Salivary Ducts; Ultrasonography; Pain; Ultrasonography, Interventional
PubMed: 38093502
DOI: 10.1111/srt.13535 -
Quantitative Imaging in Medicine and... Oct 2023Magnetic resonance sialography (MRS) can be used to clearly examine the main duct of the parotid and is widely applied in the diagnosis of chronic obstructive parotitis...
BACKGROUND
Magnetic resonance sialography (MRS) can be used to clearly examine the main duct of the parotid and is widely applied in the diagnosis of chronic obstructive parotitis (COP). However, there are few studies on the classification, treatment options and prognosis of COP using MRS.
METHODS
Clinical and imaging data were retrospectively collected from 41 patients with COP between January 2010 and December 2020 at the Ninth People's Hospital affiliated with Shanghai Jiao Tong University School of Medicine. All patients underwent MRS and were treated with intraductal irrigation. The patients were divided into 2 groups according to the presence or absence of symptomatic relapse during the 6-month follow-up period. The imaging features of parotid MRS included three parts: gland volume, stenosis classification and dilatation classification. The location/length of dilatation, the widest diameter of the dilated duct, and the condition of the branch ducts were also recorded and compared between the groups.
RESULTS
A mean of 14.8±12.3 irrigations were performed. There were 15 patients with recurrence and 26 without recurrence. There was no significant difference in the parotid volume (P=0.460), stenosis grade (P=0.738) or maximum diameter of dilatation of the branch duct (P=0.723) between the recurrence and non-recurrence groups. Statistically significant differences were found in dilatation classification (P=0.009), length of dilatation (P=0.043), condition of the branch ducts (P=0.017) and dexamethasone use (P=0.031).
CONCLUSIONS
MRS is an available diagnostic and grading modality for COP. The imaging features and classification of the parotid main duct in MRS could be helpful for treatment selection. Patients who accept irrigation could be less likely to experience recurrence with a low dilatation grade and no branch duct dilatation.
PubMed: 37869301
DOI: 10.21037/qims-22-1452 -
Vaccine Feb 2024In France, mumps surveillance is conducted in primary care by the Sentinelles network, the National Reference Centre for Measles, Mumps and Rubella and Santé publique...
What is the relevancy of a surveillance of mumps without a systematic laboratory confirmation in highly immunized populations? Epidemiology of suspected and biologically confirmed mumps cases seen in general practice in France between 2014 and 2020.
BACKGROUND
In France, mumps surveillance is conducted in primary care by the Sentinelles network, the National Reference Centre for Measles, Mumps and Rubella and Santé publique France.
AIM
The objective of this study was to estimate the incidence of suspected mumps in general practice, the proportion of laboratory confirmed cases and the factors associated with a virological confirmation.
METHODS
General practitioners (GPs) participating in the Sentinelles network should report all patients with suspected mumps according to a clinical definition in case of parotitis and a serological definition in case of clinical expression without parotitis. All suspected mumps cases reported between January 2014 and December 2020 were included. A sample of these cases were tested by real time reverse transcriptase polymerase chain reaction (RT-PCR) for mumps biological confirmation.
RESULTS
A total of 252 individuals with suspected mumps were included in the study. The average annual incidence rate of suspected mumps in general practice in France between 2014 and 2020 was estimated at 11 cases per 100,000 population [CI95%: 6-17]. A mumps confirmation RT-PCR test was performed on 146 cases amongst which 17 (11.5 %) were positive. Age (between 20 and 29 years old), the presence of a clinical complication and an exposure to a suspected mumps case within the 21 days prior the current episode were associated with a mumps biological confirmation.
CONCLUSION
If these results confirm the circulation of mumps virus in France, they highlight the limits of a surveillance without a systematic laboratory confirmation in highly immunized populations.
Topics: Humans; Young Adult; Adult; Mumps; Parotitis; Mumps virus; General Practice; France; Measles-Mumps-Rubella Vaccine
PubMed: 38092609
DOI: 10.1016/j.vaccine.2023.12.017 -
Vaccine Feb 2024Students in medicine and other health professions are exposed to numerous occupational hazards, primarily biological hazards, during their academic careers at...
BACKGROUND
Students in medicine and other health professions are exposed to numerous occupational hazards, primarily biological hazards, during their academic careers at university. The aim of the present study was to investigate the seroprevalence characteristics of anti-HBsAg, anti-Measles, anti-Mumps, anti-Rubella and anti-Varicella IgG antibodies in healthcare students of a large teaching hospital in Rome.
METHODS
To accomplish the study's aims, antibody serology data were gathered from students of Medicine and Surgery, Dentistry, and Health Professions at the Catholic University of the Sacred Heart (Rome Campus) during their first Health Surveillance visit, that took place from 2013 to 2023.
RESULTS
Our study sample included 2523 students, 44.4 % were protected against Hepatitis B, 87.3 % against measles, 85.5 % against mumps, 94.6 % rubella and 95.2 % against varicella. Differences in antibody coverage between age groups were statistically significant (p < 0.001), except for mumps. It found a lower probability of having seronegative anti-HBVs with an older date since the presumed primary vaccination.
CONCLUSION
In our sample, seropositivity rate against vaccine-preventable diseases, especially for Hepatitis B, was often inadequate to prevent possible biological risks connected with the activities carried out on the ward.
Topics: Humans; Mumps; Seroepidemiologic Studies; Vaccine-Preventable Diseases; Measles; Rubella; Chickenpox; Students; Hepatitis B; Measles-Mumps-Rubella Vaccine; Antibodies, Viral; Immunity; Delivery of Health Care; Vaccination
PubMed: 38246845
DOI: 10.1016/j.vaccine.2024.01.038 -
Human Vaccines & Immunotherapeutics Dec 2023Mumps reemergence has been reported in developed countries with high levels of two-dose mumps-containing vaccine (MuCV) coverage. The effectiveness of the two-dose MuCV...
Mumps-specific antibody persistence in children aged 3-7 years immunized with two doses of mumps-containing vaccines: A prospective cohort study in Jiangsu Province, China.
Mumps reemergence has been reported in developed countries with high levels of two-dose mumps-containing vaccine (MuCV) coverage. The effectiveness of the two-dose MuCV may be compromised by limitations in the persistence of immunity. This prospective cohort study evaluated the persistence of immunity of a two-dose MuCV in children aged 3-7 years from 2015 to 2020. Persistence of antibody to mumps, determined as the geometric mean antibody concentration (GMC), and seropositivity were analyzed for both repeated measurements from three follow-ups and on each cross-section, respectively. A total of 105 eligible subjects were recruited. Their overall seropositivity rate was relatively high and stable (92.4%-84.8%), while the overall GMC decreased from 547.6 U/ml to 333.3 U/ml. Analysis of waning immunity in 91 participants showed a significant and consistent downward trend for GMC, which differed significantly in boys and girls. The overall seropositivity rate decreased slightly from 2015 (95.6%) to 2016 (92.3%) but both were significantly higher than in 2018 (84.6%). The rates in girls remained stable, while those in boys declined to 75% in 2018. The seropositivity rate of the cross-section level decreased from 95.4% to 86.4% in 4 years. Although two-dose MuCV may result in a high level of immunity, antibody concentrations decay over 2 years after the second dose. Children with waning immunity after receiving two doses, especially boys, require further surveillance at 4 years and later to avoid future mumps epidemics. NCT02901990.
Topics: Male; Female; Humans; Child; Mumps; Prospective Studies; Mumps Vaccine; Antibodies, Viral; China; Measles-Mumps-Rubella Vaccine; Measles
PubMed: 36653029
DOI: 10.1080/21645515.2023.2166758