Deans' stroke musings: Risk of Stroke Following Herpes Zoster(shingles): A Self-Controlled Case-Series Study

Changing stroke rehab and research worldwide now.Time is Brain! trillions and trillions of neurons that DIE each day because there are NO effective hyperacute therapies besides tPA(only 12% effective). I have 523 posts on hyperacute therapy, enough for researchers to spend decades proving them out. These are my personal ideas and blog on stroke rehabilitation and stroke research. Do not attempt any of these without checking with your medical provider. Unless you join me in agitating, when you need these therapies they won't be there.

What this blog is for:

My blog is not to help survivors recover, it is to have the 10 million yearly stroke survivors light fires underneath their doctors, stroke hospitals and stroke researchers to get stroke solved. 100% recovery. The stroke medical world is completely failing at that goal, they don't even have it as a goal. Shortly after getting out of the hospital and getting NO information on the process or protocols of stroke rehabilitation and recovery I started searching on the internet and found that no other survivor received useful information. This is an attempt to cover all stroke rehabilitation information that should be readily available to survivors so they can talk with informed knowledge to their medical staff. It lays out what needs to be done to get stroke survivors closer to 100% recovery. It's quite disgusting that this information is not available from every stroke association and doctors group.

Friday, May 16, 2014

Risk of Stroke Following Herpes Zoster(shingles): A Self-Controlled Case-Series Study

The shingles vaccine is on my list of things to do, including getting a doctor.
http://cid.oxfordjournals.org/content/early/2014/03/25/cid.ciu098.full?

+ Author Affiliations

Faculty of Epidemiology and Population Health, London School of Hygiene and Tropical Medicine, United Kingdom

Correspondence: Sinéad M. Langan, MB BCh BAO (Hons) MRCP MSc PhD, Faculty of Epidemiology & Population Health, London School of Hygiene & Tropical Medicine, Keppel St, London WC1E 7HT, UK (sinead.langan@lshtm.ac.uk).

↵a S. M. L. and C. M. contributed equally to this work.

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Abstract

Background. Herpes zoster is common and vaccine preventable. Stroke risk may be increased following zoster, but evidence is sparse and could be explained by differences between people with and without zoster. Our objective was to determine if stroke risk is increased following zoster.

Methods. Within-person comparisons were undertaken using the self-controlled case-series method and data from the UK Clinical Practice Research Datalink (1987–2012). Participants had a first-ever diagnosis of zoster and stroke within the study period. Stroke incidence in periods following zoster was compared with incidence in other time periods. Age-adjusted incidence ratios (IRs) and 95% confidence intervals (CIs) were calculated.

Results. A total of 6584 individuals were included. Stroke rate was increased following zoster compared with the baseline unexposed period, then gradually reduced over 6 months: weeks 1–4 (age-adjusted IR, 1.63; 95% CI, 1.32–2.02), weeks 5–12 (IR, 1.42; 95% CI, 1.21–1.68), and weeks 13–26 (IR, 1.23; 95% CI, 1.07–1.42), with no increase thereafter. A stronger effect was observed for individuals with zoster ophthalmicus, rising to a >3-fold rate 5–12 weeks after zoster. Oral antivirals were given to 55% of individuals: IRs for stroke were lower among those receiving antivirals compared with those not treated, suggesting a protective effect.

Conclusions. We have established an increased stroke rate within 6 months following zoster.Findings have implications for zoster vaccination programs, which may reduce stroke risk following zoster. The low antiviral prescribing rate needs to be improved; our data suggest that antiviral therapy may lead to a reduced stroke risk following zoster.