Shingles on the forearm
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Shingles

Herpes zoster, colloquially known as shingles, is the reactivation of varicella zoster virus, leading to a crop of painful blisters over the area of a dermatome. It occurs very rarely in children and adults, but its incidence is high in the elderly (over 60), as well as in any age group of immunocompromised patients. It affects some 500,000 people per year in the United States. Treatment is generally with antiviral drugs such as acyclovir. Many patients develop a painful condition called postherpetic neuralgia which is often difficult to manage. more...

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In some patients, herpes zoster can reactivate subclinically with pain in a dermatomal distribution without rash. This condition is known as zoster sine herpete and may be more complicated, affecting multiple levels of the nervous system and causing multiple cranial neuropathies, polyneuritis, myelitis, or aseptic meningitis.

The word herpes came from Greek, which is cognate with serpent and, as can be expected, herpetology. Interestingly, the skin disease is also commonly known as "snake" in Chinese.

Signs and symptoms

Often, pain is the first symptom. This pain can be characterized as stinging, tingling, numbing, or throbbing, and can be pronounced with quick stabs of intensity. Then 2-3 crops of red lesions develop, which gradually turn into small blisters filled with serous fluid. A general feeling of unwellness often occurs.

As long as the blisters have not dried out, HZ patients may transmit the virus to others. This could lead to chickenpox in people (mainly young children) who are not yet immune to this virus.

Shingles blisters are unusual in that they only appear on one side of the body. That is because the chickenpox virus can remain dormant for decades, and does so inside the spinal column or a nerve fiber. If it reactivates as shingles, it affects only a single nerve fiber, or ganglion, which can radiate to only one side of the body. The blisters therefore only affect one area of the body and do not cross the midline. They are most common on the torso, but can also appear on the face (where they are potentially hazardous to vision) or other parts of the body.

Diagnosis

The diagnosis is visual — very few other diseases mimic herpes zoster. In case of doubt, fluid from a blister may be analysed in a medical laboratory.

Pathophysiology

The causative agent for herpes zoster is varicella zoster virus (VZV). Most people are infected with this virus as a child, as it causes chickenpox. The body eliminates the virus from the system, but it remains dormant in the ganglia adjacent to the spinal cord or the ganglion semilunare (ganglion Gasseri) in the cranial base.

Generally, the immune system suppresses reactivation of the virus. In the elderly, whose immune response generally tends to deteriorate, as well as in those patients whose immune system is being suppressed, this process fails. (Some researchers speculate that sunburn and other, unrelated stresses that can affect the immune system may also lead to viral reactivation.) The virus starts replicating in the nerve cells, and newly formed viruses are carried down the axons to the area of skin served by that ganglion (a dermatome). Here, the virus causes local inflammation in the skin, with the formation of blisters.

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Shingles look to shake asbestos reputation - Industry News - recycling of shingles
From C&D Recycler, 5/1/03

Among the topics at the Second Asphalt Shingles Recycling Forum, which took place April 13-14 in Minneapolis, was a discussion of removing regulatory barriers to shingle recycling.

Because a few brands of shingles contained small amounts of asbestos when they were manufactured decades ago, traces of asbestos sometimes show up when tests of old shingles are conducted. As a percentage of the overall materials mix, recyclers contend, asbestos is insignificant.

Paul Ruesch, of Chicago-based U.S. EPA Region 5, explained the current federal regulations regarding asbestos-containing materials. Because of that small number of shingles many years ago that had asbestos in them, the perception that shingles have asbestos remains a barrier to more asphalt shingle recycling. This is despite that fact that testing of incoming loads of shingles to recycling yards shows the presence of asbestos to be virtually non-existent.

Also speaking was Dan Krivit, of Dan Krivit and Associates, St. Paul, Minn., one of the organizers of the event, who told of Minnesota's results from testing incoming tear-offs for asbestos. Virtually none was found except where expected in built-up roofing. He also outlined a plan to develop a sampling protocol for tear-offs.

James "Buzz" Surwilo, from the Vermont Agency of Natural Resources, reported on his state's project, done in cooperation with the Federal Highway Administration, using tear-off shingles in roadwork. The shingles were processed and given to local municipalities to be used on local gravel roads for dust control. There were positive responses from municipalities, although the results were mixed, as some roads became too stiff as time passed.

Two speakers on specifications for the use of recycled shingles also addressed attendees. Roger Olson of the Minnesota Department of Transportation (MnDOT) presented new specifications in his state that can allow more recycled materials to be used in roadwork. Henry Justus, of Chesner Engineering, Commack, N.Y., presented the first draft of a proposed guideline specification for recycled shingles use in hot-mix asphalt.

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COPYRIGHT 2003 Gale Group

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