Herpes zoster (HZ, shingles) is a frequent medical condition which may severely impact the quality of life of affected patients. Different therapeutic approaches to treat acute HZ are available. The aim of this European project was the elaboration of a consensus-based guideline on the management of patients who present with HZ, considering different patient populations and different localizations. This interdisciplinary guideline aims at an improvement of the outcomes of the acute HZ management concerning disease duration, acute pain and quality of life of the affected patients and at a reduction in the incidence of postherpetic neuralgia (PHN) and other complications. The guideline development followed a structured and pre-defined process, considering the quality criteria for guidelines development as suggested by the AGREE II instrument. The steering group was responsible for the planning and the organization of the guideline development process (Division of Evidence-Based Medicine, dEBM). The expert panel was nominated by virtue of clinical expertise and/or scientific experience and included experts from the fields of dermatology, virology/infectiology, ophthalmology, otolaryngology, neurology and anaesthesiology. Recommendations for clinical practice were formally consented during the consensus conference, explicitly considering different relevant aspects. The guideline was approved by the commissioning societies after an extensive internal and external review process. In this second part of the guideline, therapeutic interventions have been evaluated. The expert panel formally consented recommendations for the treatment of patients with HZ (antiviral medication, pain management, local therapy), considering various clinical situations. Users of the guideline must carefully check whether the recommendations are appropriate for the context of intended application. In the setting of an international guideline, it is generally important to consider different national approaches
Herpes zoster (HZ, shingles) is a frequent medical condition which may severely impact the quality of life of affected patients. Different therapeutic approaches to treat acute HZ are available. The aim of this European project was the elaboration of a consensus-based guideline on the management of patients who present with HZ, considering different patient populations and different localizations. This interdisciplinary guideline aims at an improvement of the outcomes of the acute HZ management concerning disease duration, acute pain and quality of life of the affected patients and at a reduction of the incidence of postherpetic neuralgia and other complications. The guideline development followed a structured and predefined process, considering the quality criteria for guidelines development as suggested by the AGREE II instrument. The steering group was responsible for the planning and the organization of the guideline development process (Division of Evidence based Medicine, dEBM). The expert panel was nominated by virtue of clinical expertise and/or scientific experience and included experts from the fields of dermatology, virology/infectiology, ophthalmology, otolaryngology, neurology and anaesthesiology. Recommendations for clinical practice were formally consented during the consensus conference, explicitly considering different relevant aspects. The guideline was approved by the commissioning societies after an extensive internal and external review process. In this first part of the guideline, diagnostic means have been evaluated. The expert panel formally consented recommendations for the management of patients with (suspected) HZ, referring to the assessment of HZ patients, considering various specific clinical situations. Users of the guideline must carefully check whether the recommendations are appropriate for the context of intended application. In the setting of an international guideline, it is generally important to consider different national
During the last decade, global interest in the multiple benefits of formal peer teaching has increased. This study aimed to explore the perceptions of first-year medical students towards the use of peer teaching to learn anatomy using cadaveric specimens. A descriptive, cross-sectional, retrospective survey was carried out. Data were collected using an online questionnaire which was administered to all medical students who were in their second year of their medical school curriculum and who had participated in sessions taught by their peers during their first year. Peer teaching was perceived as an effective method of learning anatomy by more than half of the participants. Analysis of mean responses revealed that the peer teachers created a positive, non-intimidating learning environment. Overall, participants gave positive feedback on their peer teachers. Six categories emerged from the responses given by participants as to why they would or would not recommend peer teaching. Ways of improvement as suggested by the respondents were also reported. Variables found to be significantly associated with the perceived benefits of the peer teaching program included sex differences, educational level and recommendations for peer teaching. This study brings to light the merits and demerits of peer teaching as viewed through the eyes of the peer learners. Peer teaching provides a sound platform for teaching and learning anatomy. Further discussions at higher levels are encouraged in order to explore the feasibility of introducing formal peer teaching in the medical curriculum. Anat Sci Educ 11: 346-357. © 2017 American Association of Anatomists.
A prospective study of otitis externa in the district of South Bedfordshire was undertaken between October 1990 and January 1991. Patients were referred untreated by general practitioners; self-referred patients with external otitis were also included. A detailed history was taken, the severity of the condition assessed, aural toilet performed, bacteriology swabs taken and the patient treated according to department protocol. 48 patients were included in the study; a similar number of age and sex-matched controls without otitis externa were randomly selected from the ENT outpatient clinics for comparison. Regular swimming emerged as a significant factor in the aetiology of otitis externa. The commonest organism cultured was Pseudomonas aeruginosa and this accounted for the most severe cases seen.
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