Gene/Protein Disease Symptom Drug Enzyme Compound
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Query: UMLS:C0184567 (acute pain)
 3,962 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Eighty-seven immunosuppressed patients (53 with localized and 34 with disseminated herpes zoster) from 10 institutions were enrolled in a controlled therapeutic trial of adenine arabinoside. A crossover design was employed; thus, 47 patients received drug for five days and then received placebo, and 40 were given the two substances in the opposite order. Resolution of acute pain and the cutaneous lesions were graded during a 10-day observation period. During the initial five-day period, treated patients showed a statistically significant resolution of pain and cutaneous lesions. Surprisingly, in many untreated patients, natural resolution occurred during this period so that crossover data could not be adequately assessed. Effects on visceral disease also could not be judged, because such disease was uncommon. Ratings of late complications such as postherpetic neuralgia were confused by the crossover design. Toxicity posed no problem. The data further emphasized the potential usefulness of adenine arabinoside as an antiviral chemotherapeutic agent, but also clearly indicated the need for a double-blind study to define this usefulness and to determine how it can most practically be used, if the risk-benefit factor remains favorable.
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PMID:Adenine arabinoside for therapy of herpes zoster in immunosuppressed patients: preliminary results of a collaborative study. 18 Jan 98

We tested the effect of human leukocyte interferon on early localized herpes zoster infections in three placebo-controlled, randomized double-blind trials involving 90 patients with cancer. There were no significant differences in pretreatment severity of infection or nature of underlying disease in the groups. Higher dosages of more purified interferon in the second and third trials produced a significant (P less than or equal to 0.01) decrease in cutaneous dissemination. No dissemination occurred in those receiving the highest dosage (5.1 x 10(5) U per kilogram per day) (P less than or equal to 0.025). The number of days of new-vesicle formation in the primary dermatome decreased (mean, 2.3 days, P less than or equal to 0.05) in this group. Treated patients had a trend toward less acute pain, and significantly (P less than or equal to 0.05) diminished severity of post-herpetic neuralgia, at the two highest dosage levels. Visceral complications were six times less frequent in interferon recipients. High-dosage interferon appeared effective in limiting cutaneous dissemination, visceral complications and progression within the primary dermatome.
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PMID:Human leukocyte interferon for the treatment of herpes zoster in patients with cancer. 34 94

Pain is frequently the most distressing symptom of herpes zoster. Pain occurs in most patients during the acute phase and sometimes continues as postherpetic neuralgia (PHN) for months or years after the rash has healed. Both the acute pain and the incidence and duration of postherpetic pain are influenced by the age of the patient and the distribution of the rash. The acute pain is probably related to neuronal inflammation induced by the replicating varicella-zoster virus and can be helped by antiviral agents and by steroids. As yet, the pathophysiology of PHN is poorly understood and may well be multifactorial, perhaps accounting for the two clearly different types of PHN described. Prevention of PHN is not possible but there are some data suggesting the use of antiviral agents during the acute phase may be helpful. Once PHN has become established conventional analgesics are ineffective and tricyclic antidepressants seem to be the optimal therapy.
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PMID:Herpes zoster and pain. 180

A highly specialized experimental treatment was used in the therapy of Herpes zoster, which was aimed at inducing good control over acute pain and the prevention of post herpic neuritis using poly-pharmacologic al infiltration of ganglia and of relevant roots.
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PMID:[Therapeutic approach in the treatment of acute cervico-brachial Herpes zoster]. 205 85

Herpes zoster is an acute nervous system infection that commonly affects the elderly. Because the causative agent is a virus, herpes zoster is often treated symptomatically in the primary care setting. While this approach is acceptable for immunocompetent patients less than 50 years of age, it can leave older patients at greater risk of developing painful and debilitating complications such as postherpetic neuralgia. There is evidence that appropriate treatment initiated within 48 to 72 hours after the onset of the zoster eruption can decrease healing time, reduce acute pain, decrease ocular complications and may prevent the development of postherpetic neuralgia in this age group. The health care practitioner in a primary care setting is ideally placed to identify elderly clients with herpes zoster in the early stages; to consult with physicians about therapies such as steroids, antiviral agents and sympathetic nerve blocks; to monitor treatment effects; and to provide supportive therapy to those who develop postherpetic neuralgia.
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PMID:Herpes zoster and postherpetic neuralgia: the need for early intervention in the elderly. 264 8

Oral acyclovir therapy for herpes zoster has been studied in double-blind, placebo-controlled trials of two dosages, 400 mg and 800 mg five times per day for 10 days. Compared with placebo recipients, recipients of the high-dosage acyclovir experienced a significantly shortened period of viral shedding, significantly accelerated time to 50 percent scabbing, significantly accelerated time to 50 percent healing, and after two days of therapy, significantly less frequent formation of new lesions. The duration and severity of acute pain were less in acyclovir recipients, with differences in pain severity achieving statistical significance (p = 0.03) between Days 3 and 10 and correlating with the treatment differences in new lesion formation. In studies of the 400 mg five times per day dose schedule, differences between acyclovir and placebo recipients were not significant. In a six-month follow-up of recipients in the higher dosage study, the acyclovir recipients experienced less post-zoster pain than placebo recipients; differences in the prevalence of pain were most significant for the presence of a persistent pain in the first three months of follow-up. Oral acyclovir at these dosages appears to be free of adverse reactions. In summary, oral acyclovir at a dosage of 800 mg five times per day for 10 days for treatment of acute herpes zoster is superior to 400 mg five times per day and favorably alters the course of the disease.
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PMID:Therapy of herpes zoster with oral acyclovir. 304 99

Sixty-four patients with herpes zoster were entered into a randomised double-masked, placebo-controlled trial of 5% acyclovir cream applied five times daily for 5 days. Of these patients, 56 were included in the final analysis (26 acyclovir, 30 placebo). Significant and objective differences in either progression of the rash, severity of acute pain or incidence of post-herpetic neuralgia were not observed. Although significantly more rashes involuted in the acyclovir group, this isolated finding cannot be explained. Twenty-two patients (12 acyclovir, 10 placebo) experienced erythema or desquamation or both during treatment with the cream. The similar incidence of skin reactions in both groups suggests that they were related to the cream base rather than the acyclovir.
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PMID:A double-masked, placebo-controlled trial of acyclovir cream in immunocompetent patients with herpes zoster. 306 May 42

Previous studies have shown that intravenous acyclovir does modify rash development, reduce viral shedding and alleviate acute pain in herpes zoster. To assess the clinical efficacy of an oral dosage regimen with 800 mg acyclovir five times daily, double-blind, placebo-controlled studies were carried out at three centres within the U.K., using a common protocol. According to inclusion criteria (immune competent patients over 60 years of age with a clinical diagnosis of herpes zoster with rash of no more than 72 h duration, no previous systemic antiviral treatment, no history of renal insufficiency) 205 patients were recruited after they had given their informed consent. Patients were randomly assigned to receive either two 400 mg tablets acyclovir (41 men, 59 women) or matching placebo (46 men, 59 women) five times daily for seven days. Treatment was predominantly domiciliary based. According to clinical assessment and pain score acyclovir recipients showed a significant benefit in terms of reduction in rash progression if treatment was started within 48 h of the onset of rash, and alleviation of pain during the acute phase of herpes zoster. Overall, the number of patients developing extradermal lesions was significantly lower in the acyclovir group than in the placebo group (p = 0.02). However, there were no significant differences in rash progression and pain response in patients with herpes zoster affecting the ophthalmic division of the trigeminal nerve in patients who received acyclovir (n = 21) compared to those who received placebo (n = 32). 12 acyclovir and 13 placebo recipients reported symptoms, predominantly gastrointestinal in nature, possibly or probably related to therapy.(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:Oral acyclovir for acute herpes zoster infections in immune-competent adults. 329 71

Intravenous acyclovir is effective for varicella in adults and immunocompromised children, causing more rapid resolution of the illness and fewer complications. Intravenous acyclovir in immunocompromised patients with herpes zoster decreases new lesion formation, decreases acute pain, halts dissemination of the virus, and lessens visceral complications. Intravenous acyclovir may also be effective in zoster encephalitis. Intravenous vidarabine also has a favorable affect on chickenpox and herpes zoster. Topical acyclovir may benefit herpes zoster in immunosuppressed patients by accelerating cutaneous healing. Oral acyclovir appears to be effective in varicella and zoster in immunocompromised patients. It is also effective in otherwise normal patients, but its effect seems less dramatic and the drug must be given early. Neither acyclovir nor vidarabine has been proven clearly to prevent postherpetic neuralgia. Because varicella zoster virus is less sensitive to acyclovir than is herpes simplex, intravenous doses of 500 mg/m2 or 10 mg/kg every 8 hours or oral doses of 800 mg five times a day are recommended. At these doses adequate hydration and urine flow must be maintained, the mental status of the patient must be monitored, and impaired renal function requires regulation of dosage downward.
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PMID:Antiviral treatment in chickenpox and herpes zoster. 333 43

Cimetidine was administered to two patients for herpes zoster infection. An acute pain-relieving effect was observed. The patients were followed for 11 and 14 months without developing postherpetic neuralgia. Possible mechanisms for prevention of postherpetic neuralgia by cimetidine are discussed.
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PMID:Effect of cimetidine on herpes zoster infection. 342 39


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