Relief From Pain of Shingles
Chickenpox in children is a relatively harmless infection that causes a rash and fever for a few days, then disappears. But Herpes zoster, the virus that causes chickenpox, doesn’t leave when the chickenpox ends. Instead, it hides in the nervous system, often emerging decades later to cause a much more painful disorder called shingles.
More than 1 million Americans develop shingles each year, and although 85% recover shortly, the rest are left with a severe, debilitating pain called post-herpetic neuralgia. Patients describe the pain as tearing, burning, piercing or like an electric shock.
The pain can be partially controlled with the so-called tricyclic antidepressants, but they have many side effects--including low blood pressure, grogginess, dry mouth, constipation, confusion and urinary retention--that are dangerous in some elderly patients and intolerable to others.
New evidence, however, indicates that a drug developed to control epileptic seizures also controls post-herpetic neuralgia and has fewer side effects. The drug is gabapentin, trade-named Neurontin.
Dr. Michael Rowbotham of UC San Francisco and his colleagues studied 229 patients with the disorder. One hundred thirteen received gabapentin; 116, a placebo. The researchers reported in Wednesday’s Journal of the American Medical Assn. that the patients who received gabapentin had one-third less pain--about the same improvement offered by tricyclics--with only minor side effects, such as sleepiness and dizziness. Twice as many patients who received the drug were pain-free.
In a separate study in the same journal, Dr. Miroslav Backonja and his colleagues at the University of Wisconsin in Madison studied 165 patients with painful diabetic neuropathy, another debilitating form of pain that is caused by uncontrolled type 2 diabetes. Half of the 16 million Americans with this form of diabetes suffer from painful neuropathy, which affects primarily the lower limbs.
Diabetic patients who received gabapentin had significantly less pain than those who received a placebo, were able to sleep better and had few side effects, Backonja’s team reported.
Propane Clouds Air at Indoor Ice Rinks
The Zamboni machines that keep the ice smooth at indoor skating rinks may be endangering the health of people who skate at those rinks by emitting high levels of the pollutant nitrogen dioxide.
Dr. Jonathan I. Levy and his colleagues at the Harvard School of Public Health studied 19 indoor rinks over three winters and found that levels of nitrogen dioxide were, on average, five times higher in rinks using propane-fueled resurfacers than in those using electric-powered resurfacers.
They reported in Tuesday’s American Journal of Public Health that hockey players in the rinks with higher pollutant levels suffered chest tightness, cough and shortness of breath. One team had difficulty breathing after 30 minutes of exposure to 35 to 40 parts per million of nitrogen dioxide. Pollutant levels could be decreased by tuning the resurfacers and by increasing ventilation, the team found.
Better Detection May Explain STD Rates
New data released Wednesday indicate that there were 15.3 million new cases of sexually transmitted diseases (STDs) in 1996, far more than the 12 million a year estimated by the Centers for Disease Control and Prevention in the mid-1980s. But the panel that produced the figures at the behest of the American Social Health Assn. and the Kaiser Family Foundation cautioned that the apparent increase resulted primarily from better methods of disease detection, and that the actual incidence of STDs may have dropped slightly.
More than two-thirds of the new cases in 1996 were the result of two infections: human papillomavirus and trichomoniasis. The incidences of the three STDs for which there are formal surveillance programs--chlamydia, gonorrhea and syphilis--dropped, due in large part to national control programs.
Study Disputes Link Between Dyes, Cancer
Contradicting the conclusions of previous investigators, a large new UC San Francisco study concludes that hair dyes do not cause lymphoma, a form of blood cancer. Epidemiologist Elizabeth Holly and her colleagues studied 4,108 participants--twice as many women and four times as many men as were included in an earlier study that showed a 50% increase in risk.
Holly’s group reported in Tuesday’s American Journal of Public Health that they found no link between the use of hair coloring products and non-Hodgkin’s lymphoma, the fifth most common form of cancer in the United States among men and women.
Post-Angioplasty Procedure Questioned
Anyone who has undergone angiography or angioplasty knows the pain of lying motionless in a bed for six hours afterward with a 10-pound sandbag or a tightly wrapped pressure bandage on the groin to prevent bleeding from the artery into which a catheter was inserted.
A new study from Australia suggests that this procedure is unnecessary and may even be counterproductive.
The researchers studied more than 1,000 angiography patients at three university hospitals in Melbourne. A little more than half (556) had a pressure bandage applied to the groin, while the rest (519) had no bandage.
The team reported in the November/December issue of Heart & Lung that 6.6% of those with no bandage developed bleeding from the puncture site, compared to 3.5% of those with the pressure bandage. But those who received the bandage experienced a higher incidence of back, groin and leg pain, nausea and urinary difficulties. They concluded that pressure bandages should not be used routinely following angiographic procedures.
