Gene/Protein Disease Symptom Drug Enzyme Compound
Pivot Concepts:   Target Concepts:
Query: UMLS:C0030193 (pain)
 261,466 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Intravenous acyclovir was evaluated in the treatment of 97 immunocompromised patients with mucocutaneous herpes simplex virus infection in a randomized, double-blind, placebo-controlled trial. Acyclovir recipients had significantly shorter periods of virus shedding (p less than 0.0002) and lesion pain (p less than 0.01), and more rapid lesion scabbing (p less than 0.004) and lesion healing (p less than 0.04). The most common adverse reaction was a low incidence of peripheral vein irritation; no serious toxicity could be definitely attributed to acyclovir treatment even in these seriously ill patients. Intravenous acyclovir offers both safe and effective treatment for mucocutaneous herpes simplex virus infection in the immunocompromised host.
 ...
PMID:Multicenter collaborative trial of intravenous acyclovir for treatment of mucocutaneous herpes simplex virus infection in the immunocompromised host. 704 14

Forty-three immunocompromised patients with progressive cutaneous herpes simplex virus infections were studied in a double-blind, placebo-controlled evaluation of topically applied acyclovir. Patients were randomized and 22 received acyclovir and 21 placebo; medications were applied four times daily for 10 days. Both study populations were balanced for all demographic characteristics. Acyclovir therapy resulted in no median differences in time to total healing compared with placebo responses, p = 0.13. However, those patients who received the acyclovir ceased shedding virus more rapidly, p less than 0.001, and lost pain more readily, p = 0.04, than placebo counterparts. Neither group experienced adverse effects. Because of the protracted nature of mucocutaneous herpes simplex infections in these patients, the immunocompromised host provides a good model for evaluation of topical antiviral therapy.
 ...
PMID:Mucocutaneous herpes simplex virus infections in immunocompromised patients. A model for evaluation of topical antiviral agents. 704 15

A case of relentlessly recurrent, violently inflammatory, and extremely painful Sweet's syndrome of twenty-three years' duration is presented. For many years lesions were often solitary, and frequently localized to the left adductor thigh. This led to the misdiagnosis of the condition as recurrent herpes simplex. For twenty-three years the disease was localized to the left lower extremity. Recurrences became more protracted during the past two years. The most prominent symptom was lesional pain, and recently this could not be relieved with narcotic analgesics. Lesions were asymmetric, bright red, raised, painful and had sharp borders. The largest lesion measured 18 cm in diameter. Response to systemic steroids was prompt and dramatic, and healing occurred without scarring.
 ...
PMID:Sweet's syndrome. Report of a case. 728 27

Aciclovir (acyclovir) is a nucleoside analogue with antiviral activity in vitro against the herpes simplex viruses (HSV), varicella zoster virus (VZV), Epstein-Barr virus (EBV), cytomegalovirus (CMV) and human herpesvirus 6 (HHV-6). Topical, oral or intravenous aciclovir is well established in the treatment of ophthalmic, mucocutaneous and other HSV infections, with intravenous aciclovir the accepted treatment of choice in herpes simplex encephalitis. The efficacy of aciclovir is increased with early (preferably during the prodromal period) initiation of treatment but, despite significant clinical benefit, viral latency is not eradicated, and pretreatment frequencies of recurrence usually continue after episodic acute treatment is completed. Intravenous administration has also shown benefit in the treatment of severe complications of HSV infection in pregnancy, and neonatal HSV infections. Recurrence of HSV has been completely prevented or significantly reduced during suppressive therapy with oral aciclovir in immunocompetent patients. Use of oral aciclovir is effective but controversial in the treatment of otherwise healthy individuals with varicella (chickenpox), and in some countries it has been recommended for use only in cases which may be potentially severe. The development of rash and pain associated with herpes zoster (shingles) is attenuated with oral or intravenous aciclovir therapy, ocular involvement is prevented, and post-herpetic neuralgia appears to be decreased. Similarly, in a few patients with zoster ophthalmicus, oral aciclovir has reduced the frequency and severity of long term ocular complications and post-herpetic neuralgia, and herpes zoster oticus is improved with intravenous aciclovir. Oral aciclovir has prevented recurrence of HSV genital or orofacial infections during suppressive therapy in > 70% of immunocompetent patients in most clinical trials. Suppression of latent HSV, VZV and CMV infections has been achieved in many immunocompromised patients receiving the oral or intravenous formulations. Aciclovir also appears to offer partial protection from invasive CMV disease in CMV-seropositive bone marrow transplant recipients. The few comparative trials published have shown aciclovir to be at least as effective as other investigated antivirals in the treatment of HSV infections in immunocompetent patients, and more effective than inosine pranobex in the prophylaxis of genital herpes. Similarly, in isolated clinical trials, oral aciclovir appears as effective as topical idoxuridine and oral brivudine in some parameters in immunocompetent patients with VZV infections, and the intravenous formulation appears at least as effective as oral brivudine and intravenous vidarabine in treating these infections in immunocompromised patients.(ABSTRACT TRUNCATED AT 400 WORDS)
 ...
PMID:Aciclovir. A reappraisal of its antiviral activity, pharmacokinetic properties and therapeutic efficacy. 751 Jun 19

Due to its predominantly nociceptive innervation, viral tracing from the tooth pulp provides a potential means for tracing central pain pathways. The neural pathways from the tooth pulp to cortex were determined using in situ hybridization to detect the anterograde transneuronal spread of herpes simplex virus type 1 strain H129 following inoculation into the murine mandibular incisor pulp. Virus first appeared in the brain at day 3 in the dorsomedial region of all three subnuclei of the spinal trigeminal nucleus and the principal sensory nucleus. By days 5-6 virus had spread to the contralateral medial nucleus of the medial geniculate complex, posterior thalamus, and ventroposteromedial thalamus. At days 7-8 virus was detected in laminae IV and Va of the primary somatosensory cortex and lamina IV of the secondary somatosensory cortex in regions previously shown to receive input from the lower jaw. Several mice also showed infection of laminae II/III of the ipsilateral dysgranular insular cortex, along with labeling for virus in the ipsilateral external lateral parabrachial nucleus, posterior thalamus, and posterior basolateral amygdala. Our results are highly consistent with previous tracing and electrophysiological studies utilizing the tooth pulp and with studies implicating the infected structures in nociception. Viral spread appeared to define two separate afferent systems with infection of structures which have been implicated in the sensory-discriminative aspects of pain, such as the ventroposteromedial thalamus and somatosensory cortex, as well as in the dysgranular insular cortex and related subcortical nuclei which may have a role in the affective-motivational aspects of pain.
 ...
PMID:Anterograde tracing of trigeminal afferent pathways from the murine tooth pulp to cortex using herpes simplex virus type 1. 753 24

The naturally occurring polyphenolic biopolymer SP-303 has in vitro activity against both HSV-1 and HSV-2, including strains that are resistant to acyclovir. Nine AIDS patients with acyclovir-unresponsive mucocutaneous herpes simplex virus infection were treated with thrice daily topical SP-303T ointment in an open-label pilot study. Although a transient decrease in lesion size was observed in 4 patients during study drug therapy, and 3 patients sustained a quantitative decrease in virus burden, neither complete healing nor cessation of virus shedding occurred in any patient. Seven patients complained of pain or burning upon application of the study ointment, causing 1 patient to terminate the study. In summary, application of SP-303T ointment effected no significant improvement in the clinical course of 9 AIDS patients with acyclovir-unresponsive HSV infection.
 ...
PMID:Treatment of acyclovir-unresponsive cutaneous herpes simplex virus infection with topically applied SP-303. 771 Feb 68

The incidence of Acanthamoeba keratitis has decreased significantly, and it is no longer a reportable condition in the United States. Corneal abrasion and contact lenses play an important role in the development of Acanthamoeba keratitis. One of the most important features of the disease is severe pain, which is atypical for herpes simplex. The pathognomonic sign for Acanthamoeba is radial neuritis or inflammation around the corneal nerve caused by the parasites. The most important step in prevention of Acanthamoeba keratitis is effective education of patients about the care of contact lenses. A combination of Brolene and Neomycin is the best approach in treating Acanthamoeba keratitis. However, if treatment with these drugs fails, clotrimazole is recommended.
 ...
PMID:Acanthamoeba keratitis. 771 13

A retrospective review for bullous keratopathy in our hospital from 1985 to 1992 was studies. Among the cases with bullous keratopathy, 14 were performed with antiglaucoma operation and cataract extraction, 12 that experienced a contusion or penetrating trauma history underwent cataract operation. IOL implantation seen in 3 patients, 4 cases were associated with vitreous contact to cornea after cataract extraction, the other 4 cases had advanced glaucoma. Besides, there were 1 case of Fuch's endothelium dystrophy, ICE syndrome and severe herpes simplex keratitis, respectively. The preoperation visual acuity of them was all less than finger count. The follow-up was 3 months to 5 years. The results showed the grafts of 28 cases (70%) were clear, 7 cases (17.5%) semi-clear, 5 cases (12.5%) opaque. Postoperatively, all of the patients escaped from the pain and 22 cases achieved a visual acuity of 0.02-0.7. Some good advice in treatment of bullous keratopathy were proposed.
 ...
PMID:[Penetrating keratoplasty for bullous keratopathy]. 777 1

We treated six eyes of five patients with linear endotheliitis. This entity appears clinically as a line of keratic precipitates on the corneal endothelium that progresses centrally and is accompanied by peripheral stromal and epithelial edema. All five patients had ocular pain, redness, and photophobia. One eye had an episode of a dendritic lesion typical of herpes simplex. Two eyes had a history of cataract extraction before developing linear endotheliitis. We treated all patients aggressively with a combination of corticosteroids and antiviral agents. Complete resolution of inflammation and edema occurred in all cases. Four patients required the use of oral acyclovir to control the inflammation and prevent recurrence of the disease. Linear endothelitis is a distinct form of endotheliitis that may be associated with herpes simplex virus, and treatment included corticosteroid and antiviral therapy.
 ...
PMID:Linear endotheliitis. 815 28

Two otherwise healthy immunocompetent men, ages 62 and 66 years, experienced years of radicular pain without zoster rash. An extensive search for systemic disease and malignancy was negative. Varicella-zoster virus DNA, but not herpes simplex virus DNA, was found in the cerebrospinal fluid of the first patient 5 months after the onset of pain, and in the second patient 8 months after the onset of pain. Prolonged radicular pain without zoster rash combined with the presence of varicella-zoster virus in the cerebrospinal fluid indicates that both men had zoster sine herpete, and strongly supports this syndrome as a clinical variant.
 ...
PMID:Zoster sine herpete, a clinical variant. 817 98


<< Previous 1 2 3 4 5 6 7 8 9 10 Next >>