scholarly journals Pain and its Assessment in Herpes Zoster

1997 ◽  
Vol 8 (6_suppl) ◽  
pp. 31-36
Author(s):  
RH Dworkin
Keyword(s):  
Risk Factors ◽  
Herpes Zoster ◽  
Antiviral Treatment ◽  
Antiviral Agents ◽  
Future Research ◽  
Post Herpetic Neuralgia ◽  
Substantial Evidence ◽  
Acute Herpes Zoster ◽  
Prolonged Pain ◽  
Definition Of

Pain typically accompanies acute herpes zoster. In a proportion of patients, herpes zoster pain persists well beyond rash healing. This persisting pain is termed post-herpetic neuralgia (PHN). Because of the substantial personal and economic burdens caused by PHN, studies of the pathophysiology of herpes zoster pain and of the efficacy of antiviral treatment in reducing prolonged pain are of great importance. Different methods have been used to examine pain in research on herpes zoster and in clinical trials, making it difficult to compare across studies. There is substantial evidence, however, that demonstrates the importance of distinguishing acute pain from PHN. Several differences have been found between acute herpes zoster pain and PHN, including pathophysiological findings, risk factors and pain quality. Recommendations for the design and analysis of future trials of antiviral agents in herpes zoster have been recently proposed. These include a definition of PHN and recommended secondary end points for future trials. Adopting these recommendations in future research on herpes zoster pain, and in the design and analysis of future trials, will facilitate comparisons across studies of the pathophysiology and prevention of PHN.

Acupuncture in the Management of Herpes Zoster

1996 ◽  
Vol 14 (2) ◽  
pp. 80-83 ◽  
Author(s):  
Janet Boaler
Keyword(s):  
Herpes Zoster ◽  
Substantial Reduction ◽  
Ageing Population ◽  
Post Herpetic Neuralgia ◽  
Controlled Clinical Trials ◽  
Care Level ◽  
Primary Health ◽  
Acute Herpes Zoster ◽  
Pain Clinics ◽  
Distressing Condition

Although it has been demonstrated conclusively that anti-viral medication reduces the duration and intensity of the manifestations of acute herpes zoster, controversy remains concerning its effectiveness in preventing post herpetic neuralgia and patients with this distressing condition are often referred to Pain Clinics. The problem is likely to become more prevalent in the future due to the ageing population, particularly in those over 80 years of age. Research, most of it uncontrolled so far, suggests that simple acupuncture starting in the acute phase, within 24–72 hours of the appearance of the skin eruption, could, if combined with anti-viral medication, produce a substantial reduction in the incidence and severity of post herpetic neuralgia. Further controlled clinical trials conducted at primary health care level are urgently needed.

scholarly journals Prevention of Post-herpetic Neuralgia from Dream to Reality: A Ten-step Model

2017 ◽  
Vol 2 (20;2) ◽  
pp. E209-E220 ◽  
Author(s):  
Mohamed Younis Makharita
Keyword(s):  
Herpes Zoster ◽  
Dorsal Root ◽  
Risk Groups ◽  
Substantial Effect ◽  
Viral Reactivation ◽  
Post Herpetic Neuralgia ◽  
Suggested Approach ◽  
Varicella Zoster ◽  
Acute Herpes Zoster ◽  
Step Model

Herpes zoster (HZ) is a painful, blistering skin eruption in a dermatomal distribution caused by reactivation of a latent varicella zoster virus in the dorsal root ganglia (DRG). Post-herpetic neuralgia (PHN) is the most common complication of acute herpes zoster (AHZ). Severe prodrome, greater acute pain and dermatomal injury, and the density of the eruption are the risk factors and predictors for developing PHN. PHN has a substantial effect on the quality of life; many patients develop severe physical, occupational, social, and psychosocial disabilities as a result of the unceasing pain. The long-term suffering and the limited efficacy of the currently available medications can lead to drug dependency, hopelessness, depression, and even suicide. Family and society are also affected regarding cost and lost productivity. The pathophysiology of PHN remains unclear. Viral reactivation in the dorsal root ganglion and its spread through the affected nerve result in severe ganglionitis and neuritis, which induce a profound sympathetic stimulation and vasoconstriction of the endoneural arterioles, which decreases the blood flow in the intraneural capillary bed resulting in nerve ischemia. Our rationale is based on previous studies which have postulated that the early interventions could reduce repetitive painful stimuli and prevent vasospasm of the endoneural arterioles during the acute phase of HZ. Hence, they might attenuate the central sensitization, prevent the ischemic nerve damage, and finally account for PHN prevention. The author introduces a new Ten-step Model for the prevention of PHN. The idea of this newly suggested approach is to increase the awareness of the health care team and the community about the nature of HZ and its complications, especially in the high-risk groups. Besides, it emphasizes the importance of the prompt antiviral therapy and the early sympathetic blockades for preventing PHN. Key words: Acute herpes zoster, prevention, post-herpetic neuralgia, sympathetic blockade, tenstep model

Invisible Borders

2021 ◽  
pp. 85-108
Author(s):  
Kendra Larrisha Blakely ◽  
Chiquita Long Holmes ◽  
Eugenie Joan Looby ◽  
Kevin Merideth ◽  
Alexis M. Jackson ◽  
...  
Keyword(s):  
Risk Factors ◽  
School Counselors ◽  
Demographic Data ◽  
Future Research ◽  
Psychological Risk Factors ◽  
Definition Of ◽  
Psychological Risk ◽  
Mixed Status Families ◽  
Mixed Status

This chapter focuses on children in mixed-status families. The authors provide demographic data and the definition of a mixed-status family, then outline the challenges experienced by these families. The authors delineate developmental, educational, and psychological risk factors for these children. Intervention and advocacy initiatives in which school counselors can engage are examined. Authors provide practical solutions, suggestions for future research, a glossary of terms, and further readings. Finally, each topic discussed includes application strategies for school counselors.

scholarly journals FV-100 versus valacyclovir for the prevention of post-herpetic neuralgia and the treatment of acute herpes zoster-associated pain: A randomized-controlled trial

2016 ◽  
Vol 89 (7) ◽  
pp. 1255-1264 ◽  
Author(s):  
Stephen K. Tyring ◽  
Patricia Lee ◽  
Gordon T. Hill ◽  
Joel C. Silverfield ◽  
Angela Yen Moore ◽  
...  
Keyword(s):  
Randomized Controlled Trial ◽  
Herpes Zoster ◽  
Controlled Trial ◽  
Post Herpetic Neuralgia ◽  
Randomized Controlled ◽  
Acute Herpes Zoster

scholarly journals Secondary use of clinical data in data-gathering, non-interventional research or learning activities: definition, types, and a framework for risk assessment (Preprint)

2020 ◽  
Author(s):  
Martin Jungkunz ◽  
Anja Köngeter ◽  
Katja Mehlis ◽  
Eva C. Winkler ◽  
Christoph Schickhardt
Keyword(s):  
Risk Factors ◽  
Risk Assessment ◽  
Clinical Data ◽  
Data Gathering ◽  
Scientific Progress ◽  
Learning Activities ◽  
Research Quality ◽  
Future Research ◽  
Secondary Use ◽  
Definition Of

UNSTRUCTURED Background: The secondary use of clinical data in data-gathering, non-interventional research or learning activities (SeConts) bears great potential for scientific progress and health care improvement. At the same time, it poses relevant risks for privacy and informational self-determination of the patients whose data are used. A tailored framework for risk assessment in SeConts is still lacking and so does a clarification of the concept and practical scope of SeConts. Methods: (1) We analyze each element of the concept of SeConts to provide a synthetic definition. (2) We investigate the practical relevance and scope of SeConts through a literature review. (3) We operationalize the widespread definition of risk (as a harmful event of a certain magnitude that occurs with a certain probability) in order to conduct a tailored analysis of privacy risk factors typically implied in SeConts. Results: (1) We offer a conceptual clarification and a definition of SeConts. (2) We provide a list of types of research and learning activities that can be subsumed under the definition of SeConts. We also offer a proposal for the classification of SeConts types into the categories “non-interventional (observational) clinical research”, “quality control and improvement”, or “public health research”. (3) We provide a list of risk factors that determine either probability or magnitude of harm implied in SeConts. Discussion: The risk factors mentioned above provide a framework for assessing the privacy-related risks for patients implied in SeConts. We illustrate the usage of the risk assessment by applying it to a concrete example. Conclusion: In the future, research ethics committees and data use and access committees will be able to rely on and apply the framework offered here when reviewing projects of secondary use of clinical data for learning and research purposes.

scholarly journals The prevalence of pediatric metabolic syndrome—a critical look on the discrepancies between definitions and its clinical importance

2020 ◽  
Vol 45 (1) ◽  
pp. 12-24
Author(s):  
Carolin Reisinger ◽  
Benedicta N. Nkeh-Chungag ◽  
Per Morten Fredriksen ◽  
Nandu Goswami
Keyword(s):  
Risk Factors ◽  
Insulin Resistance ◽  
Metabolic Syndrome ◽  
Abdominal Obesity ◽  
International Diabetes Federation ◽  
Clinical Importance ◽  
High Density Lipoproteins ◽  
Future Research ◽  
The Metabolic Syndrome ◽  
Definition Of

Abstract Introduction The Metabolic Syndrome (MetS) describes the clustering of cardio-metabolic risk factors—including abdominal obesity, insulin resistance, elevated blood pressure, high levels of triglycerides, and low levels of high-density lipoproteins—that increase the risk for developing cardiovascular diseases and type 2 diabetes mellitus. However, a generally accepted definition of MetS in pediatric patients is still lacking. Objectives The aim was to summarize current prevalence data of childhood MetS as well as to discuss the continuing disagreement between different pediatric definitions and the clinical importance of such diagnosis. Methodology A systematic literature search on the prevalence of pediatric MetS was conducted. Articles that were published during the past 5 years (2014–2019), using at least one of four predetermined classifications (International Diabetes Federation, Cook et al., Ford et al., and de Ferranti et al.), were included. Results The search resulted in 1167 articles, of which 31 publications met all inclusion criteria. Discussion The prevalence of MetS ranged between 0.3 and 26.4%, whereby the rising number of children and adolescents with MetS partly depended on the definition used. The IDF definition generally provided the lowest prevalences (0.3–9.5%), whereas the classification of de Ferranti et al. yielded the highest (4.0–26.4%). In order to develop a more valid definition, further research on long-term consequences of childhood risk factors such as abdominal obesity, insulin resistance, hypertension, and dyslipidemia is needed. There is also a temptation to suggest one valid, globally accepted definition of metabolic syndrome for pediatric populations but we believe that it is more appropriate to suggest definitions of MetS that are specific to males vs. females, as well as being specific to race/ethnicity or geographic region. Finally, while this notion of definitions of MetS specific to certain subgroups is important, it still needs to be tested in future research.

Sign in / Sign up

Export Citation Format

Share Document