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Shingles Recurrence: Can The Vaccine Help?

This month’s Harvard Health Letter has an article about getting shingles a second or even a third time. (Click here to read the full article.) The bottom line is that recurrence is a) certainly possible and b) if some recent research is correct, much more common than previously thought and about as likely as getting shingles in the first place if you’re age 60 or older.

I talked to Barbara Yawn, M.D., director of research at the Olmsted Medical Center in Rochester, Minn., for the article and mentioned results that she and her colleagues first presented at a conference several years ago.

Yawn reported a more complete version of those results in last month’s issue of the Mayo Clinic Proceedings (a favorite journal of mine). Full text of the study isn’t available unless you have a subscription to the journal, but here’s a summary (in medical publishing, such summaries are called abstracts.)

Melinda Beck, a health columnist for the Wall Street Journal,  had a column about shingles last week and this how she neatly summed up Yawn’s research:

For the new study on shingles recurrence, researchers at the Olmsted Medical Center in Rochester, Minn., examined medical records of nearly 1,700 patients who had a documented case of shingles between 1996 and 2001. They found that more than 5% of them were treated for a second episode within an average of eight years—about the same rate as would typically experience a first case.

And here is a link to the Journal Watch item of the study and a short comment by the Journal Watch editor. Journal Watch is a monthly newsletter published by the Massachusetts Medical Society that summarizes and comments on recently published research.

In the Mayo Clinic Proceedings paper, Yawn and her colleagues report that 95 of the 1,669 people with an “index” case of shingles got shingles again over the course of a follow-up period that averaged 7.3 years, which works out to about 5.6 percent of the shingles sufferers. Six people had two recurrences and two had three! The timing of recurrence varied from 96 days to 10 years after the initial episode. In 45 percent of those who got shingles again, the site of the recurrence was in a different region of the body than the site of the first case. They also noted that the single biggest risk factor for having a second case of shingles was having pain that lasted 30 days or longer during the first case. Read more »

*This blog post was originally published at Harvard Health Blog*

Healthcare Improvement Via An Imperfect Solution

My professional organization recently asked me to participate in an interesting meeting at the state capitol talking about healthcare payment reform and how to improve the healthcare delivery system. This was sponsored by the state of Ohio and their Health Care Coverage and Quality Council.

It was the first meeting that I’ve been to where there were physicians, hospitals, insurance companies, and patients — all trying to put our heads together — present our points of view and try to come to consensus. Did we come to consensus on solutions? Not really, only that we will continue the conversation. There is no perfect solution that will make everyone happy, but we will strive to try to get to that best imperfect solution.

When is comes to healthcare delivery and healthcare payment, there was a lot of discussion on physicians and hospitals — meaning healthcare providers. The motivating factor in these cases uses terms like payment, lack of payment, incentives, bonuses, and penalties. Read more »

*This blog post was originally published at Doctor Anonymous*

Latest Interviews

IDEA Labs: Medical Students Take The Lead In Healthcare Innovation

It’s no secret that doctors are disappointed with the way that the U.S. healthcare system is evolving. Most feel helpless about improving their work conditions or solving technical problems in patient care. Fortunately one young medical student was undeterred by the mountain of disappointment carried by his senior clinician mentors…

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How To Be A Successful Patient: Young Doctors Offer Some Advice

I am proud to be a part of the American Resident Project an initiative that promotes the writing of medical students residents and new physicians as they explore ideas for transforming American health care delivery. I recently had the opportunity to interview three of the writing fellows about how to…

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Latest Book Reviews

Book Review: Is Empathy Learned By Faking It Till It’s Real?

I m often asked to do book reviews on my blog and I rarely agree to them. This is because it takes me a long time to read a book and then if I don t enjoy it I figure the author would rather me remain silent than publish my…

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The Spirit Of The Place: Samuel Shem’s New Book May Depress You

When I was in medical school I read Samuel Shem s House Of God as a right of passage. At the time I found it to be a cynical yet eerily accurate portrayal of the underbelly of academic medicine. I gained comfort from its gallows humor and it made me…

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Eat To Save Your Life: Another Half-True Diet Book

I am hesitant to review diet books because they are so often a tangled mess of fact and fiction. Teasing out their truth from falsehood is about as exhausting as delousing a long-haired elementary school student. However after being approached by the authors’ PR agency with the promise of a…

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