Herpes zoster manifests as a characteristic painful rash that resolves within 2 months of initial presentation in 90% of patients. As pain is a hallmark of the disease, the severity of an episode can be described by the magnitude and duration of pain. The Brief Pain Inventory (BPI) was used to follow the daily and weekly amount of pain reported by 50 patients with herpes zoster. Results demonstrate that the BPI is a reproducible, responsive and valid measure of pain due to herpes zoster. From the individual responses on the BPI, the area under the curve (AUC) for each patient was derived from the pain reported on sequential administrations of the BPI. This metric was simple to calculate, easy to explain and captured two dimensions of this episodic disease (magnitude and duration of pain) in a single continuous measure. AUC could prove useful in the application of patient response data to intervention trials in diseases that are of an episodic nature.
A multiple logistic regression analysis of 12,914 pregnancies and 10,523 live births, based on a mail survey of professional women in medicine, was carried out to determine the relationship between maternal cigarette smoking, and spontaneous abortion and congenital abnormality. After controlling for interfering variables (age, exposure to trace anesthetic gases, pregnancy history, and mailing response), a statistically significant increase in risk associated with maternal cigarette smoking was found for spontaneous abortions and congenital abnormalities. The risk of spontaneous abortion for the heavy smoker is estimated to be as much as 1.7 times that of the nonsmoker in certain risk groups. The risk for congenital abnormality for babies born of smoking mothers is estimated to be as much as 2.3 times that of the nonsmoker, depending on age, pregnancy history, and other factors.
Naloxone tests for opiate dependence were given to 296 applicants for treatment with the surrogate opiate levomethadyl acetate (LAAM, levo-alpha-acetylmethadol) and to 103 applicants for treatment with the opiate antagonist naltrexone. Thirty-five of the 296 LAAM applicants applied first for LAAM, then following detoxification, for naltrexone. There was a dramatic decrease in withdrawal signs and symptoms when the subject went from opiate-dependent to a nondependent state. From our experience, we devised a scoring guide and testing procedure based on objective signs. We propose a 2-step test, with an initial intramuscular dose, then (if necessary) an intravenous dose, to determine an applicant's eligibility for surrogate opiate or narcotic antagonist treatment.
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