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Query: UMLS:C0033774 (pruritus)
 14,546 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

A double-blind placebo controlled trial of oral acyclovir in otherwise healthy immune competent young adults with chickenpox was conducted. One hundred males were recruited into the trial, fifty were randomised to receive acyclovir at a dose of 800 mg five times daily for 5 days and fifty to receive matching placebo. Acyclovir recipients experienced itching and required anti-pruritic therapy for a significantly shorter period of time (p less than 0.05); no significant effects of acyclovir therapy on overall rash progression were observed. In patients with a mild rash on entry the maximum daily temperature recorded was significantly lower in the acyclovir group as compared with placebo recipients on day 1 of therapy (p less than 0.01). Acyclovir was extremely well tolerated and no adverse events were reported. Studies with early oral acyclovir therapy in otherwise healthy children with chickenpox has demonstrated significant benefits, particularly in rash progression. It is postulated that the partial benefits shown in this study in adults reflect the high proportion of patients with mild disease and enrollment of the majority of patients more than 24 hours after the rash onset.
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PMID:A double blind, placebo controlled trial of efficacy and safety of oral acyclovir (Zovirax) in the treatment of chickenpox in adults. 152 49

The efficacy of oral acyclovir 400 mg twice daily in suppressing frequently relapsing genital herpes simplex was evaluated in an open multicenter study. Seventy-one patients were treated for 12 months. During treatment, 73% of the patients were completely free of symptoms when taking the tablets continuously, and another 14% had mild symptoms such as erythema and/or itching at single occasions. An accidental treatment interruption for 2-4 days led to mild but definite herpes episodes within a few days in 5 otherwise symptom free patients. Definite herpes episodes despite acyclovir medication occurred in 3 cases (4%). No noteworthy side effects were recorded during the acyclovir treatment. After withdrawal of acyclovir, herpes relapsed within 1-4 weeks in 69% of the patients. The frequency of relapses during the following months was reported to be equal to that before the treatment period in most of the patients. Acyclovir susceptibility of the isolated herpes simplex virus (HSV) strains did not change during treatment. The mean titres of antibodies against HSV type-common glycoprotein antigen, HSV-2 type-specific antigen and varicella zoster virus antigens decreased significantly during treatment with acyclovir.
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PMID:One year acyclovir suppression of frequently recurring genital herpes: a study of efficacy, safety, virus sensitivity and antibody response. 166 44

Diphenhydramine hydrochloride is an antihistamine with anticholinergic properties that is frequently used both orally and topically for the temporary relief of pruritus. Significant systemic absorption may occur following topical administration of diphenhydramine in patients with varicella-zoster lesions. We describe three children with varicella-zoster infection (VZI) who developed bizarre behavior as well as visual and auditory hallucinations following topical applications of large amounts of diphenhydramine to the majority of skin surfaces. In two cases, oral diphenhydramine was also administered. Serum diphenhydramine concentrations approximated or exceeded those previously reported. In each case, a complete resolution of mental status abnormalities occurred within 24 hours after discontinuation of all diphenhydramine-containing products. Pharmacists and other health professionals should be aware of the potential toxicity of topical diphenhydramine in patients with VZI.
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PMID:Diphenhydramine toxicity in three children with varicella-zoster infection. 205 84

An open multicenter study has been carried out to evaluate efficacy and tolerability of oral acyclovir in the treatment of varicella in immunocompetent patients in the first two years of life. Fifty-three children aged 3-24 months received acyclovir at 80 mg/Kg/day in four divided doses for 4 to 6 days; 24 of them were treated in the first 24 hours following disease onset, while the remaining 29 patients were enrolled within 48 hours. The assessment of evolution of disease signs and symptoms showed a rapid resolution of fever, itching and other constitutional symptoms, with interruption of vesicle formation and acceleration of cutaneous healing processes. No statistically significant differences have been demonstrated as to disease progression between patients treated in the first 24 hours, when compared with subjects receiving acyclovir in the following 24 hours. Acyclovir confirmed its excellent clinical and laboratory safety profile. By acting favorably on both the duration and severity of disease signs and symptoms, acyclovir treatment should be recommended in young children and infants with varicella, since a higher incidence of severe and complicated disease has been observed in these patient groups.
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PMID:Varicella in immunocompetent children in the first two years of life: role of treatment with oral acyclovir. Italian Acyclovir-Chickenpox Study Group. 762 63

An open study was conducted to evaluate the efficacy of oral acyclovir in a group of 295 Singapore Armed Forces male servicemen. The 148 patients who were willing to take acyclovir were given 800 mg orally five times per day for seven days. The other 147 who refused to take acyclovir were monitored as a control group. Each of these groups was further classified into two groups. Group A patients presented with rash within 24 hours of rash onset and Group B presented between 24 and 72 hours. Daily lesion counts, temperature, pruritus scores and laboratory tests were used to monitor disease progression. Early acyclovir intervention (Group A) reduced the time to 100% crusting from 7.19 to 5.71 days (P = 0.0001), decreased the maximum number of all lesions by 26% (P = 0.03) and the maximum number of vesicular lesions by 45% (P = 0.0004). Late therapy (Group B) was effective in reducing the maximum number of vesicular lesions by 38% (P = 0.003). The number of patients requiring antibiotics for suspected secondary skin infection, the duration of fever and paracetamol consumption were significantly reduced in both the early and late intervention groups. However, there were no effects in minimizing pruritus in either group. Serious complications such as pneumonia, encephalitis or death were not observed in this study. The most common adverse effect of acyclovir was mild diarrhoea occurring in 35% of patients treated with the drug. We conclude that early treatment with acyclovir was beneficial whereas late therapy had limited effect in reducing the severity of cutaneous lesions in patients with varicella.
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PMID:Oral acyclovir in the treatment of adult varicella. 765 78

The main symptoms of zoster, a disease caused by the reactivation of the varicella zoster virus (that causes chicken-pox) are: rash, associated with pain, burning, or itching, and pain that outlasts the rash sometimes by months or years. The uncomfortable and long-lasting symptoms of herpes zoster are likely to compromise the patient's quality of life. However, the impact of zoster on health-related quality of life has not previously been measured directly. Recent papers have demonstrated the ability of generic measures to discriminate among patients with different clinical symptoms. In this paper, we demonstrate the convergent validity for zoster of a generic measure, the Nottingham Health Profile (NHP), by measuring its correlation with rash progression, pain levels, and pain medications. The discriminant validity of the NHP was demonstrated by its ability to distinguish between different levels of pain severity. The NHP dimensions most highly correlated with the pain measures, were pain (0.42-0.50), energy (0.34-0.38) and sleep (0.32-0.38). The NHP scores in all six dimensions show large differences at different levels of pain severity that are statistically significant. These results demonstrate the NHP's validity as a measure of health-related quality of life in zoster patients.
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PMID:The Nottingham Health Profile as a measure of quality of life in zoster patients: convergent and discriminant validity. 786 61

The efficacy and safety of aciclovir granules (containing 40% w/w aciclovir) were evaluated in the treatment of chickenpox in otherwise healthy children. Patients presenting with chickenpox received aciclovir granules at a dose of 20 mg/kg four times daily for five to seven days. Overall 51 children received treatment with aciclovir. A further 53 patients receiving conventional symptomatic therapy acted as a control. In the aciclovir group the overall efficacy rate was 92.2%. There were reductions in the numbers of lesions, fever, itching and the duration of symptoms. No adverse experiences were reported. Overall this formulation of aciclovir appears to be a safe and effective treatment for chickenpox in this patient population. However the need for anti-viral therapy in otherwise healthy children is still the subject of debate and it might be appropriate to identify sub-groups for whom such therapy is justified.
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PMID:[Clinical evaluation of aciclovir granules in the treatment of chickenpox in otherwise healthy children]. 815 Nov 50

The Meeting "An Update on Chickenpox" (Florence, 19-3-1993) has contributed to verify, in the light of the most recent acquisitions, the new guidelines for a correct rationale in the diagnosis and therapy of chickenpox. The present availability of an effective specific antiviral therapy for chickenpox (acyclovir) leads to a careful selection of patients to be treated. The high incidence of chickenpox morbidity keeps long unaltered and, beyond the usually benign onset of the primary infection in the child, the severity of this pathology in particular subjects and situations at risk is to be certainly underlined. Treatment is suggested for cases of chickenpox contracted inside the family. Generally, boys are at higher risk. Adolescents and adults, usually with a lower incidence, report a much higher severity of the acute onset and complications. Another category to be certainly treated is the one--in constant increase--of immunocompromised subjects. In any case, acyclovir treatment improves the symptomatologic evolution (pruritus and fever) and duration of clinical course. Among the progenitors of acyclovir, Valacyclovir seems to have the best prospects of success for the immediate future of antiviral therapy.
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PMID:[Varicella: how and when to start antiviral treatment]. 834 Dec 23

Oka/Merck varicella vaccine has been studied in this institution since 1981. Persistence of antibody for 6 to 8 years has been demonstrated; however, cases of chickenpox have been seen in immunized children. The severity of chickenpox in healthy children who have received Oka/Merck varicella vaccine since 1981 is described. All vaccinees who developed chickenpox-like rashes more than 6 weeks postimmunization were examined. Of 2163 vaccinees, 164 were examined, of whom 114 had rashes consistent with chickenpox. When sera were available (46%), antibody studies uniformly confirmed varicella-zoster virus infection. Chickenpox occurred 2 to 96 months (median of 44 months) postimmunization. The range for the number of skin lesions was 1 to 285 (median 18) in seroconverters. Symptoms included itching in 39%, fever in 9%, headaches in 7%, lymphadenopathy in 3%, and malaise in 2%; 54% were asymptomatic, except for the rash. The median time to total healing was 5 days. The median time lost from school was 2 days. Thirteen of the children in whom infections developed had failed to seroconvert after immunization. Their infections were similar in severity to those of children who had seroconverted originally. When varicella was introduced into families as a result of chickenpox in an immunized family member (index case), the rate of secondary chickenpox among immunized siblings was 12.2%. Eleven such secondary cases were similar in severity to the 9 index cases. It is concluded that chickenpox is generally mild in previously immunized children.
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PMID:Modified chickenpox in children immunized with the Oka/Merck varicella vaccine. 841 99

Three cost-consequence models were developed for treatment of infections due to varicella-zoster virus (VZV) with acyclovir in immunocompetent patients--adult- and childhood-onset chickenpox, and herpes zoster (shingles) in adults. For chickenpox, separate models allow examination of differences in severity and impact of the disease for children and adults, as well as in the management of civilians and adults in military service. Each model includes direct medical costs, indirect costs and health-related productivity loss, symptom and quality of life impact, and model assumptions and conclusions. Alternatives of treatment and no treatment are addressed. Quality of life impact is conceptualized in terms of a quality-adjusted life-days decrement due to VZV symptoms of importance to the patient, such as pain, rash, and itching. As experience and data become available, alternative agents such as valacyclovir and famciclovir for the treatment of patients with herpes zoster should be included in the modeling process.
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PMID:Cost-consequence models for varicella-zoster virus infections. 857 31


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