The Journal of the American Osteopathic Association
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J Am Osteopath Assoc · Mar 2007
ReviewManagement strategies for herpes zoster and postherpetic neuralgia.
Evidence-based strategies for the management of herpes zoster and postherpetic neuralgia (PHN) include the use of antiviral agents in acute zoster and specific analgesics in PHN. Antiviral agents are effective in reducing the severity and duration of acute herpes zoster when given within 72 hours of rash onset, but they do not prevent PHN. ⋯ Therefore, prevention of herpes zoster and PHN with prophylactic vaccination using the zoster virus vaccine is an effective strategy to reduce the morbidity of these conditions. Treatment modalities are available, however, that may shorten the duration of acute herpes zoster and alleviate the pain of PHN.
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J Am Osteopath Assoc · Mar 2007
ReviewThe burden of herpes zoster and postherpetic neuralgia in the United States.
Herpes zoster (shingles), a painful and disabling disease, affects an estimated 1 million individuals in the United States annually and results in significant morbidity, lost productivity, and diminished quality of life. Herpes zoster constitutes the reactivation of varicella-zoster virus (VZV), the same virus that causes chickenpox. After resolution of chickenpox, VZV remains dormant in dorsal root ganglia. ⋯ Herpes zoster is associated with significant morbidity, especially in the elderly. Herpes zoster is both more common and more severe among older adults. In both acute herpes zoster and postherpetic neuralgia, pain is the primary cause of morbidity.
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The current continuing medical education (CME) cycle began on January 1, 2007, and will end on December 31, 2009. Statistics for the 2004-2006 CME cycle will not be available until May 31, 2008. The author provides an update on trends in osteopathic CME programs and details minor changes to CME requirements for state licensure. In addition, this article explains changes to several policies of the American Osteopathic Association with regard to the Association's awarding and recording of CME credits for physicians who hold specialty board certification.
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J Am Osteopath Assoc · Jan 2007
The value of internship in graduate medical education: survey of emergency medicine residents and program directors.
To assess the opinions of emergency medicine (EM) residents and program directors about the value of completing a nonrequired 1-year internship before entering an EM residency program accredited by the Accreditation Council for Graduate Medical Education (ACGME). ⋯ Completing a 1-year internship before entering an EM residency program may better prepare physicians for their first year of residency in terms of basic clinical competancy, but further study is needed in this area.
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J Am Osteopath Assoc · Dec 2006
Randomized Controlled TrialHemodynamic stability during labor and delivery with continuous epidural infusion.
Epidural anesthesia for labor pain is frequently complicated by maternal hypotension. ⋯ Continuous epidural infusion of 0.2% ropivacaine hydrochloride without bolus administration reduces the incidence of hypotension by 67% and is safer than traditional bolus dosing for routine labor. This method requires further study in high-risk patients, including those with preeclampsia and cardiovascular disease.