Herpes Zoster Pain,Postherpetic Neuralgia,and Quality of Life in the Elderly

Herpes zoster pain and postherpetic neuralgia (PHN) particularly affect older persons. This literature review presents how quality of life is evaluated and the consequences of shingles and PHN on the quality of life of older persons. Although more than 150 articles have been published on herpes zoster and its consequences, specific studies focusing on the older population are needed, in several domains like epidemiology, preventive medicine, neuropsychology, and pharmacology.     

Transdermal Opioid Patches for Pain Treatment in Ancient Greece

Abstract: Pain treatment in ancient Greece, and through the middle ages in Europe, was to a great extent based on the expertise of the Greek physician Galen (c. 129–200 A.D.). Galen makes particular reference to “Olympic Victor’s Dark Ointment” (OVDO), which is listed with a number of collyria. Galen states that OVDO can be useful for treating extreme pain and swellings, forming one of the best eye salves. Olympic Victor’s Dark Ointment, an opium‐based treatment, forms a “patch” when applied externally as an ointment, because it quickly dries to cover a localized region but still retains its elastic properties. This study has recreated OVDO and applied the ointment to abdominal mouse skin, in vitro. To assess the efficacy of OVDO, the transdermal transfer of morphine was measured when given as OVDO and compared to morphine administered in the form of a solution of Opium + PBS (ringer). Olympic Victor’s Dark Ointment showed a transdermal transfer of morphine over time comparable to 25% of the most efficient modern transdermal opioid patches, while hardly any morphine was able to penetrate the skin when applied mixed in PBS. We conclude that OVDO is very efficient in its composition and may carry some forgotten abilities in terms of drug delivery, which could be transferred to modern medicine. Indeed, this may lead to a better choice of morphine use and controlled management in individual patient cases, taking both pain relief and anti‐inflammatory aspects into account.     

Chronic vocal fold scar restoration with hepatocyte growth factor hydrogel

Objectives/Hypothesis:

Therapeutic challenges exist in the management of vocal fold scarring. We have previously demonstrated the therapeutic potential of hepatocyte growth factor (HGF) in the management of acute phase vocal fold scarring using a novel hydrogel‐based HGF drug delivery system (DDS). However, the effect of HGF on matured vocal fold scarring remains unclear. The current study aims to investigate the effect of HGF‐DDS on chronic vocal fold scarring using a canine model.

Study Design:

Animal model.

Methods:

Vocal folds from eight beagles were unilaterally scarred by stripping the entire layer of the lamina propria; contralateral vocal folds were kept intact as normal controls. Six months after the procedures, hydrogels (0.5 mL) containing 1 μg of HGF were injected into the scarred vocal folds of four dogs (HGF‐treated group). Hydrogels containing saline solution were injected into the other four dogs (sham group). Histological and vibratory examinations on excised larynges were completed for each group 9 months after the initial surgery.

Results:

Experiments conducted on excised larynges demonstrated significantly better vibrations in the HGF‐treated group in terms of mucosal wave amplitude. Although phonation threshold pressure was significantly lower in the HGF‐treated group compared with the sham group, no significant differences were observed in the normalized glottal gap between HGF‐treated and sham groups. Histological examinations of the HGF‐treated vocal folds showed reduced collagen deposition and less tissue contraction with favorable restoration of hyaluronic acid.

Conclusions:

Results suggest that administration of HGF may have therapeutic potential in the treatment of chronic vocal fold scarring. Laryngoscope, 2010