Herpes Zoster Vaccine Reduces Zoster Risk
The results of a new community-based study published in the
January 12 issue of the Journal of the American Medical Association
show that vaccination of adults older than 60 years with
the herpes zoster vaccine (Zostavax, Merck & Co Inc.) reduced
subsequent herpes zoster cases by about 50 percent compared
with those not vaccinated, confirming the findings of clinical
trials. A related study from CDC, to be published in the February
issue of the American Journal of Preventive Medicine, shows
that as of 2008, less than 7 percent of United States (U.S.) seniors
had chosen to get the herpes zoster vaccine with particularly
low vaccination rates of minorities.
The community-based study is based on data from patients
enrolled in the Kaiser Permanente Southern California health
plan, which has recommended the vaccine’s use in adults 60
years and older in the Kaiser system since 2007.
The researchers conducted a retrospective cohort study comparing
the risk for herpes zoster among 75,761 plan members
60 years and older who received the vaccine with that of
227,283 unvaccinated age-matched members. Compared with
the unvaccinated cohort, vaccine recipients were more likely to
be white, to be women, and to have had more outpatient visits
and a lower prevalence of chronic diseases.
Here, the authors present an 80-year-old white male treated
with sorafenib for unresectable HCC who developed eight atypical
squamous proliferations.
There were 5,434 herpes zoster cases identified in the study, 6.4
cases per 1,000 person-years among those vaccinated versus
13.0 cases per 1,000 person-years among unvaccinated individuals.
In the fully adjusted analysis, vaccination was associated
with a 55 percent reduced risk for herpes zoster.
Long-term Efficacy and Potencies of Botulinum Toxin A and B
The results of a prospective randomized double-blind study to
compare short-term and long-term effects of Botox (BOT; Allergan
Inc., Irvine, CA, U.S.A.) and Neurobloc/Myobloc (NBC; Solstice
Neurosciences Inc., Malvern, PA, U.S.A.) in different doses
and dilutions in a human skin model were recently published in
the British Journal of Dermatology.
The study enrolled 18 volunteers (eight women and 10 men;
mean±SD age 28.4±5.7 years) who were injected intra-dermally
with pure saline, BOT and NBC at 10 points in the abdomen in
random order, using the BOT/NBC conversion ratio 1:75 and
different dilution schemes. The ninhydrin sweat test was used
to compare the anhidrotic areas. Ten measurements were then
taken over the course of 54 weeks.
Both preparations showed a peak effect at week 3, with significantly
larger anhidrotic areas for NBC. After week 3, the rate of
decline was lower in BOT, and after week 24, mean BOT areas
were larger. The effect of dilution was higher in NBC and the
mean dose equivalence conversion ratio (BOT/NBC) was 1:29
(area under the curve).
Management of Pain Associated With Debridement of Leg Ulcers
A recent randomized, multicenter, open-label study indicates
the advantage of the analgesic effect of lidocaine-prilocaine
cream (LPC) application over nitrous oxide oxygen mixture
(NOOM) inhalation during the mechanical repeated debridement
of chronic arterial and venous leg ulcers. The results appear
in the February 2011 edition of the Journal of the European
Academy of Dermatology & Venereology.
The study enrolled 41 patients who were randomized with 20
receiving NOOM and 21 LPC. The pain experienced by the patients
was evaluated before and after each care and debridement
session using a Visual Analog Scale (VAS) and a Verbal
Rating Scale (VRS), in the context of usual debridement and
wound care process. The quality of debridement and tolerability
of the treatments were also assessed.
The results of the study show that the pain experienced during
mechanical debridement of chronic leg ulcers assessed by
VAS and VRS was more intense in the NOOM group than in
the LPC group (5.29 versus 3.68 and 2.87 versus 1.71, P<0.001,
for the two scales respectively). No differences were found
concerning quality of debridement, safety or tolerability between
the two groups.
