Twins' Health and Adult Socioeconomic Status
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چکیده
July 2005 | Volume 2 | Issue 7 | e238 | e242 Postherpetic neuralgia (PHN) is a chronically painful condition that is a complication of shingles (acute herpes zoster), a recurrence of the varicellazoster virus, which initially causes chickenpox. Although shingles usually resolves within a month, some people continue to feel the pain of PHN long after the rash and blisters heal, because of nerve damage (neuropathic pain) caused by the shingles. Not everyone who has had shingles develops PHN, although it is a common complication of shingles in older adults. Despite advances in antiviral therapy during acute herpes zoster and the more recent introduction of vaccination against varicella zoster, PHN continues to be a signifi cant clinical problem, with 10–20% of patients developing persistent neuropathic pain after acute herpes zoster reactivation. The nature of PHN pain is variable, which implies that a variety of mechanisms might be operating. This variability has led to the hypothesis that treatment plans could be optimised for individual patients on the basis of the individual pattern of their symptoms or the underlying mechanism of the pain. However, the current evidence base for therapies in PHN is based on clinical trials of analgesics, which have examined PHN as a single disease entity. Furthermore, there is little evidence for the effi cacy of drugs for specifi c sets of symptoms and no simple way to determine which pain mechanisms might be operating in an individual patient. In this month’s PLoS Medicine, Andrew Rice and colleagues reassessed the evidence base by doing a systematic review and meta-analysis of analgesic therapy for PHN, which has fundamentally changed in the wake of several major new trials. The authors searched the literature for trials of PHN and retrieved 62 articles, of which 35 were kept for fi nal analysis. Their analysis confi rmed several previous research fi ndings, although they cautioned that the meta-analytic study design of collecting data from a range of trials had several inherent pitfalls, and it is diffi cult to directly compare treatments across different trials. However, they found evidence for analgesic effi cacy in established PHN for Which Treatment for Postherpetic Neuralgia?
منابع مشابه
Lifetime Socioeconomic Position and Twins' Health: An Analysis of 308 Pairs of United States Women Twins
BACKGROUND Important controversies exist about the extent to which people's health status as adults is shaped by their living conditions in early life compared to adulthood. These debates have important policy implications, and one obstacle to resolving them is the relative lack of sufficient high-quality data on childhood and adult socioeconomic position and adult health status. We accordingly...
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To assess recall of childhood socioeconomic position for public health research, the authors conducted a cross-sectional study of 352 adult women twin pairs enrolled in Examination II of the Kaiser Permanente Women Twins Study carried out in 1989-1990 in Oakland, California. Among twin pairs, 91% (95% confidence interval (CI) 89-94%) agreed on their father's educational level and 81% (95% CI 77...
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BACKGROUND The association between socioeconomic circumstances and health in adulthood could come about through processes that may be divided into factors experienced early in life and those experienced in later adulthood. In order to disentangle the influences on health of the early genetic, prenatal and rearing environmental factors from environmental factor later in life, we compared the hea...
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BACKGROUND Low socioeconomic status (SES), indicated by low income and education, has consistently been found to be a strong predictor of sick leave. Several possible pathways from SES to sick leave have been described in previous literature, but there are also evidence indicating that the association can be confounded by common underlying factors. This study utilizes a population-based sample ...
متن کاملCo-twin study of the effect of environment and dietary elements on acquisition of Helicobacter pylori infection.
The rate of Helicobacter pylori infection is inversely related to socioeconomic status, and childhood is thought to be the major acquisition period. The authors investigated the importance of childhood environment in the acquisition of H. pylori infection. A cross-sectional study was conducted of monozygotic and dizygotic twins who were reared apart or reared together. Three hundred twins from ...
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ورودعنوان ژورنال:
- PLoS Medicine
دوره 2 شماره
صفحات -
تاریخ انتشار 2005