scholarly journals Nonprescription Products of Internet Retailers for the Prevention and Management of Herpes Zoster and Postherpetic Neuralgia: Analysis of Consumer Reviews on Amazon

10.2196/24971 ◽  
2021 ◽  
Vol 4 (1) ◽  
pp. e24971
Author(s):  
Pengyi Zhu ◽  
Benjamin K P Woo
Keyword(s):  
Herpes Zoster ◽  
Postherpetic Neuralgia ◽  
Statistical Significance ◽  
Aloe Vera ◽  
Consumer Preference ◽  
The United States ◽  
The Internet ◽  
Lemon Balm ◽  
The Difference ◽  
Care Costs

Background Herpes zoster affects approximately 1 million people annually in the United States, with postherpetic neuralgia as the most common complication. The frequent prescription of opioids as the first-line medication for herpes zoster or postherpetic neuralgia contributes to the increasing health care costs of their treatment. Despite the advent of internet retailers providing alternative products for the prevention and management these conditions, there are limited studies on the availability, ingredients, and consumer preference for the products. Objective This study used the internet retailer Amazon to determine the availability of products for the management of herpes zoster and postherpetic neuralgia, and assessed consumer preference based on listed ingredients. Methods The internet retailer Amazon was used to perform a search for products related to “shingles” in September 2020. Top products sorted by reviews and ratings were determined to be either shingles-specific (including “shingles” in either the product title or description) or shingles-nonspecific. Analysis of price, rating, type of vehicle, and ingredients was performed. The types of vehicles, ingredients, and percentages of positive and negative reviews related to “shingles” of the product groups were analyzed with a two-tailed two-sample proportions Z-test to assess the difference between shingles-specific and shingles-nonspecific products. Statistical significance was judged at P<.05. Results The top 131 products among over 3000 products retrieved were determined based on a rating of 4 or more stars after searching for the term “shingles” on Amazon. Forty-six of the 131 products (35.1%) were shingles-specific. Shingles-nonspecific products were more likely to have positive reviews mentioning “shingles” (P=.005). Vehicles, balms (P=.02), and salves (P=.04) were more likely to be shingles-specific, whereas tablets or capsules (P=.002) were more likely to be shingles-nonspecific. Among the ingredients analyzed, aloe vera was the top-ranked ingredient, included in 29 of the 131 total products (22.1%). Aloe vera (P=.01), lemon balm (P<.001), vitamin E (P=.03), and peppermint oil (P=.008) were more likely to be included in the shingles-specific products, whereas magnesium (P=.01) was more likely to be included in shingles-nonspecific products. Conclusions There is an abundance of products and ingredients being used for the management and treatment of shingles with certain ingredients preferred by consumers. There is a discrepancy between approved ingredients and the ingredients preferred by consumers. Furthermore, there are insufficient studies on ingredients used by consumers on internet retailers such as Amazon, and future studies can focus on the effectiveness of popular ingredients to decrease misinformation on the internet.

scholarly journals Analysis of Non-prescription Products for the Prevention and Management of Herpes Zoster and Postherpetic Neuralgia (Preprint)

2020 ◽  
Author(s):  
Pengyi Zhu ◽  
Benjamin KP Woo
Keyword(s):  
Herpes Zoster ◽  
Postherpetic Neuralgia ◽  
Statistical Significance ◽  
Aloe Vera ◽  
Consumer Preference ◽  
The United States ◽  
First Line ◽  
Lemon Balm ◽  
Future Studies ◽  
Specific Analysis

BACKGROUND Herpes zoster affects a million people annually in the United States, while postherpetic neuralgia is the most common complication. Opioids is most prescribed as the first line medication for herpes zoster or postherpetic neuralgia, however it contributes to the increasing healthcare cost of treating herpes zoster and postherpetic neuralgia. With the advent of internet retailers providing alternative products for prevention and management these conditions, there are limited studies on the availability of products, the ingredients in the products, and consumer preference for the products. OBJECTIVE This study seeks to determine the availability of products for management of herpes zoster and postherpetic neuralgia and consumer preference based off ingredients. METHODS Internet retailer Amazon was used in September 2020 to conduct a search for products related to “shingles.” Top products sorted by reviews and ratings were determined to be either shingle specific (including “shingles” in either product title or description) or shingle non-specific. Analysis of price, rating, type of vehicle, and ingredients was performed. The types of vehicles, ingredients, and percentage of positive and negative reviews related to “shingles” of the product groups was analyzed with two-tailed two-sample proportions Z-test to assess a difference between shingles specific and shingles non-specific products. P<.05 showed statistical significance. RESULTS The top 131 products out of over 3,000 products was determined by having a rating of 4 or more after searching “shingles” on Amazon. 46 out of 131 products (35.1%) were shingles specific. Shingles non-specific products were more likely to have positive reviews mentioning “shingles” (P=0.005). As vehicles, balms (P=0.02) and salves (P=0.04) were more likely to be shingles specific and tablets or capsules (P=0.002) more likely to be shingles non-specific. Of ingredients analyzed, aloe vera was the top ranked ingredient, comprising 29 out of 131 total products (22.1%). Aloe vera (P=0.01), lemon balm (P=0.0009), vitamin E (P=0.03), and peppermint oil (P=0.008) were more likely included in shingles specific products, while magnesium (P=0.0096) was more likely included in shingles non-specific products. CONCLUSIONS There is an abundant amount of products and ingredients being used for management and treatment of shingles with certain ingredients preferred by customers. There is a discrepancy between approved ingredients and the ingredients preferred by customers. Furthermore, there are not enough studies on ingredients used by consumers on internet retailers, such as Amazon, and future studies can focus on the effectiveness of popular ingredients to decrease misinformation on the internet.

Postherpetic Neuralgia: A Patient’s and a Physician’s Perspective

2016 ◽  
Author(s):  
James H. Diaz
Keyword(s):  
Neuropathic Pain ◽  
Herpes Zoster ◽  
Postherpetic Neuralgia ◽  
Clinical Manifestations ◽  
The United States ◽  
Evidence Based ◽  
Pain Medicine ◽  
High Prevalence ◽  
Antiviral Medications ◽  
Physician’S Perspective

Herpes zoster can plague anyone who has had varicella or has received the varicella or chickenpox vaccine. The incidence of herpes zoster increases with age and rises exponentially after 60 years of age. Postherpetic neuralgia (PHN) may occur after herpes zoster at any age but typically occurs after 50 years of age, with over 40% of persons over 60 years of age suffering from PHN after a shingles attack. Up to 1 million new cases of herpes zoster and 200,000 new cases of PHN may now be anticipated in the United States every year, with the incidence rate increasing as the population grows and ages with prolonged life expectancies. Although new antiviral medications will improve and shorten the course of herpes zoster, they do not guarantee the prevention of PHN. Given the high prevalence of PHN in an aging population and the availability of primary prevention by vaccination, the objectives of this review are to describe the epidemiology, pathophysiology, and clinical manifestations of zoster and PHN and to recommend a combination of strategies for the clinical management and prevention of PHN. This review contains 6 figures, 4 tables and 13 references Key words: evidence-based pain medicine, herpes zoster, neuropathic pain, postherpetic neuralgia

Assessment of The Digestive System Malignancy Information in Wikipedia and Baidu Encyclopedia: Longitudinal Study (Preprint)

2021 ◽  
Author(s):  
Jianchen Luo ◽  
Jing Ma ◽  
Liangliang Xu ◽  
Lian Li ◽  
Ming Zhang ◽  
...  
Keyword(s):  
Digestive System ◽  
Medical Information ◽  
Statistical Significance ◽  
Relevant Information ◽  
Medical Professional ◽  
The Internet ◽  
Treatment Information ◽  
International Statistical Classification ◽  
The Difference ◽  
Search For Information

BACKGROUND The Internet has gradually become the most important way for people to search for information. Increasing number of people searched for relevant information or even treatment plans on the Internet when they get health problem. The reliability of the medical information provided online remains to be proved. Wikipedia and Baidu Encyclopedia are the most widely used search engines in English and Chinese, respectively. The quality of the medical information they provide needs to be assessed. OBJECTIVE This study aimed to evaluate the quality and timeliness of medical information related with digestive system malignancy retrieved from Wikipedia and Baidu Encyclopedia. Comparison was made between the 2 encyclopedias. We conducted a 3-year follow-up to find out if the quality and timeliness of articles improved. METHODS We conducted a search based on International Statistical Classification of Diseases and Related Health Problems 10th Revision Version 2016 codes in Wikipedia and Baidu Encyclopedia, and evaluated articles related to digestive system malignancy by using the DISCERN instrument. We calculated the update interval of the webpages to evaluate the update timeliness of these websites. RESULTS In 2017 and 2020, we searched out a total of 50 and 52 articles from Baidu Encyclopedia, with 2 articles increased and no article missed. 30 and 32 articles were found in Wikipedia, with 1 article increased and no article missed. According to the scores evaluated by DISCERN instrument. In both 2017 and 2020, Wikipedia scored higher than Baidu Encyclopedia in section1 and section2, and it's statistically significant. Wikipedia scored higher than Baidu Encyclopedia in Section3, but it's not statistically significant. The total score of Wikipedia was higher than Baidu Encyclopedia, and the difference was statistically significant. The update interval of Wikipedia is shorter than that of Baidu Encyclopedia, with better timeliness and statistical significance. CONCLUSIONS The quality and timeliness of digestive system malignancy relative articles on Wikipedia are better than those on Baidu Encyclopedia. Both Baidu Encyclopedia and Wikipedia articles have improved in quality over the past three years. However, the treatment information obtained from the Internet still can’t guarantee its comprehensiveness or reliability. Patients should consult a medical professional directly.

scholarly journals Corticosteroid therapy of zoster-associated pain

2004 ◽  
Vol 57 (1-2) ◽  
pp. 18-21
Author(s):  
Dejan Cvjetkovic ◽  
Jovana Jovanovic ◽  
Ivana Hrnjakovic-Cvjetkovic ◽  
Mirjana Djordjevic-Aleksic ◽  
Aleksandra Radojcic ◽  
...  
Keyword(s):  
Herpes Zoster ◽  
Postherpetic Neuralgia ◽  
Skin Lesions ◽  
Control Group ◽  
Statistical Data Analysis ◽  
Statistical Validation ◽  
Chi Square ◽  
Daily Dose ◽  
Chi Square Test ◽  
The Difference

Introduction Lack of exact clinical studies on effects of corticosteroids in therapy and prevention of herpes zoster-related pain, elicited many controversies in the past. The aim of our study was to estimate effects of prednisone on frequency, intensity and duration of postherpetic neuralgia. Material and methods 68 immunocompetent herpes zoster patients, 8-90 years of age (37 females and 31 males, mean age 55,7 years) were enrolled for study; 30 patients were treated with acyclovir (5x800 mg daily for a 7-day period) and prednisone (initial daily dose 60 mg, tapering over 14 days), and the control group of 38 patients with acyclovir only. Patients were clinically followed up for 3 months after complete resolution of skin lesions. Chi-square test was used in statistical data analysis. Results The difference regarding incidence of postherpetic neuralgia in acyclovir/prednisone group and acyclovir group (although slightly less in the former one) was not significant. Duration of postherpetic neuralgia over 3 months was similar in both groups. Mild postherpetic pain was more common in the acyclovir/prednisone group (44.4%) than in the acyclovir group (28.6%); however, statistical validation requires more patients to be studied. Discussion Results of our study didn?t confirm efficiency of prednisone regarding occurrence and characteristics of postherpetic neuralgia. Failure of prednisone therapy may be partly contributed to advanced age of patients and delayed onset of therapy. Conclusion Use of corticosteroids in zoster patients gives neither reliable protection from appearance of postherpetic neuralgia, nor shortens its duration. Further investigations are necessary to estimate their effects on postherpetic pain.

Sex Differences in Birth Order of Alcoholics

1971 ◽  
Vol 119 (553) ◽  
pp. 657-661 ◽  
Author(s):  
Howard T. Blane ◽  
Herbert Barry ◽  
Herbert Barry
Keyword(s):  
United States ◽  
Sex Differences ◽  
Birth Order ◽  
Statistical Significance ◽  
The United States ◽  
Small Samples ◽  
Male And Female ◽  
Large Sample ◽  
The Difference

Studies of birth order of male alcoholics, reviewed by Chen and Cobb (1960), Sampson (1965), and Barry, Barry, and Blane (1969), generally showed more last-born than first-born cases. This difference was found in samples of more than 500 cases hospitalized in Denmark (Martensen-Larsen, 1957); Austria (Navratil, 1959); Canada (de Lint, 1964b), and Norway (Steén, 1966). Most samples in the United States have shown the same trend but with smaller numbers of cases, so that the difference was short of statistical significance. Ambiguous results have been obtained from the few studies of birth order of female alcoholics, generally based on small samples. The present paper reports on the birth-order distributions of a relatively large sample of male and female out-patient alcoholics in the United States.

scholarly journals Analysis of real-world health care costs among immunocompetent patients aged 50 years or older with herpes zoster in the United States

2017 ◽  
Vol 13 (8) ◽  
pp. 1861-1872 ◽  
Author(s):  
Juliana L. Meyers ◽  
Shweta Madhwani ◽  
Debora Rausch ◽  
Sean D. Candrilli ◽  
Girishanthy Krishnarajah ◽  
...  
Keyword(s):  
United States ◽  
Health Care ◽  
Herpes Zoster ◽  
Health Care Costs ◽  
Real World ◽  
The United States ◽  
World Health ◽  
Care Costs ◽  
Immunocompetent Patients

What Happened in Hazelwood: Statistics, Employment Discrimination, and the 80% Rule

1984 ◽  
Vol 9 (1) ◽  
pp. 139-186 ◽  
Author(s):  
Paul Meier ◽  
Jerome Sacks ◽  
Sandy L. Zabell
Keyword(s):  
Employment Discrimination ◽  
Equal Employment Opportunity Commission ◽  
Statistical Significance ◽  
United States Supreme Court ◽  
The United States ◽  
Significance Test ◽  
Black Teachers ◽  
Prima Facie ◽  
Statistical Significance Test ◽  
The Difference

Tests of statistical significance have increasingly been used in employment discrimination cases since the Supreme Court's decision in Hazelwood. In that case, the United States Supreme Court ruled that “in a proper case” statistical evidence can suffice for a prima facie showing of employment discrimination. The Court also discussed the use of a binomial significance test to assess whether the difference between the proportion of black teachers employed by the Hazelwood School District and the proportion of black teachers in the relevant labor market was substantial enough to indicate discrimination. The Equal Employment Opportunity Commission has proposed a somewhat stricter standard for evaluating how substantial a difference must be to constitute evidence of discrimination. Under the so-called 80% rule promulgated by the EEOC, the difference must not only be statistically significant, but the hire rate for the allegedly discriminated group must also be less than 80% of the rate for the favored group. This article argues that a binomial statistical significance test standing alone is unsatisfactory for evaluating allegations of discrimination because many of the assumptions on which such tests are based are inapplicable to employment settings; the 80% rule is a more appropriate standard for evaluating whether a difference in hire rates should be treated as a prima facie showing of discrimination.

scholarly journals Moral Rights Laws and Income Disparity Between Artists in High and Low GDP States

2021 ◽  
Vol 10 (2) ◽  
Author(s):  
Victoria Avanesov ◽  
Robert Hodgson
Keyword(s):  
United States ◽  
Statistical Significance ◽  
Well Being ◽  
The United States ◽  
T Test ◽  
Data Availability ◽  
Moral Rights ◽  
Difference In Differences ◽  
The Difference ◽  
The Impact

The United States' laissez-faire approach to moral rights legislation has left many academics questioning the impact that these laws have on artists' welfare. In using artists' income as one component of measuring overall well-being, states with additional statewide moral rights legislation have been shown to contribute to more significant artist losses, in contrast to states with only federal legislation. At the same time, moral rights laws have been shown to have no impact on artists' choice of residency, leaving some artists possibly disadvantaged regarding their choice of residency. Utilizing a difference in differences framework, this paper explores the impact of moral rights legislation on artists' weekly incomes between moral rights states of varying outputs of GDP. Although results suggested that artists would lose approximately $0.18 per one billion dollar increase in GDP at the statewide level, after conducting an additional t-test, these findings were shown to have no statistical significance. Several limitations, most prominently a lack of data availability in the pre-law values required for the difference in differences framework, may have contributed to these findings. These indeterminate results leave the question of whether some artists remain economically disadvantaged as a result of moral rights legislation uncertain.  

Abstract WP105: A Practical Wake up Tpa Protocol at a United States Based Comprehensive Stroke Center Hub and Its Telestroke Spokes

Stroke ◽  
2020 ◽  
Vol 51 (Suppl_1) ◽  
Author(s):  
Navdeep S Sangha ◽  
Duy Le ◽  
Raeesa Dhanji ◽  
Denise Gaffney ◽  
David McCartney ◽  
...  
Keyword(s):  
United States ◽  
Small Sample Size ◽  
Statistical Significance ◽  
The United States ◽  
Small Sample ◽  
The Difference ◽  
Waking Up ◽  
Comprehensive Stroke Center ◽  
Stroke Center ◽  
Main Barrier

Background: IV tPA is established as an effective treatment for acute ischemic stroke. Currently it is endorsed up to 4.5 hours of last known well time by major guidelines. A randomized trial, WAKE-UP, displayed its safety and efficacy in patients who presented within 4.5 hours of waking up with their symptoms. Objective: To establish a practical tPA protocol for patients who wake up or are found with stroke symptoms at a large Comprehensive Stroke Center (CSC) and its 13 telestroke spokes (TS) based on the WAKE-UP trial. Methods: A wake up tPA protocol was created and given to all teleneurologists. Door to needle times (DTN) and reasons for no tPA were collected for 12 months post implementation and evaluated for differences between wake up (WU) and non-wake up (NW) patients. Results: 93 WU patients were identified; 23 at CSC and 70 at TS. 11 (47.8%) vs. 4 (5.7%) patients received tPA at CSC and TS, respectively. Median DTN was not significantly different for WU patients at CSC vs. TS (64 vs. 89 mins, p=0.54). Median DTN at CSC was shorter for NW vs. WU (37 vs. 64 mins; p=0.003). Similarly, median DTN at TS trended toward being shorter for NW vs. WU (44 vs. 89 mins; p=0.062). The reasons for no tPA at CSC were no mismatch found in 6 (50%), and MRI unavailability in 6 (50%); at TS were no mismatch found in 11 (16.6%), MRI unavailability in 54 (81,1%) and MRI was contraindicated in 1 (1.5%). Conclusion: Treating WU patients using a CSC Hub and TS model is feasible. DTN are longer for WU vs. NW. In the United States, MRI availability is the main barrier to WU tPA at both CSC and community hospitals. The difference between median DTN for WU between CSC and TS did not reach statistical significance, likely due to the small sample size.

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