JAMA : the journal of the American Medical Association
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No national data exist to examine use of bone-morphogenetic proteins (BMPs) in spinal fusion surgery. ⋯ Bone-morphogenetic protein was used in approximately 25% of all spinal fusions nationally in 2006, with use associated with more frequent complications for anterior cervical fusions and with greater hospital charges for all categories of fusions.
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The current prevailing view is that participation in biomedical research is above and beyond the call of duty. While some commentators have offered reasons against this, we propose a novel public goods argument for an obligation to participate in biomedical research. Biomedical knowledge is a public good, available to any individual even if that individual does not contribute to it. ⋯ The current social norm is that individuals participate only if they have a good reason to do so. The public goods argument implies that individuals should participate unless they have a good reason not to. Such a shift would be of great aid to the progress of biomedical research, eventually making society significantly healthier and longer lived.
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Herpes zoster is a common late complication of varicella-zoster virus exposure and can be further complicated by postherpetic neuralgia. Ms A is a 70-year-old woman with shingles and Ramsay-Hunt syndrome who presented to the emergency department with a few days of earache followed by pain in the back of her head. Using her case as a springboard, the diagnosis, natural history, and treatment of herpes zoster and postherpetic neuralgia in immunocompetent older adults are reviewed, in addition to the effectiveness of the herpes zoster vaccine.
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Plasma levels of C-reactive protein (CRP) are independently associated with risk of coronary heart disease, but whether CRP is causally associated with coronary heart disease or merely a marker of underlying atherosclerosis is uncertain. ⋯ The lack of concordance between the effect on coronary heart disease risk of CRP genotypes and CRP levels argues against a causal association of CRP with coronary heart disease.