VACCINATION TO PREVENT HERPES ZOSTER

Herpes zoster and postherpetic neuralgia occur more often with increasing age. In this controlled trial among 38,546 adults 60 years of age or older, vaccination with a live attenuated varicella-zoster vaccine reduced the incidence of postherpetic neuralgia by 66.5 per cent (as compared with placebo) and the incidence of herpes zoster by 51.3 per cent.
Vaccination with the highly immunogenic varicella - zoster vaccine was associated with frequent local symptoms but not severe adverse reactions. Boosting immunity to varicella can reduce the incidence and severity of herpes zoster.

N Engl J Med, 2005; 2271, 2266, 2344, 2365.

TIMING OF SUDDEN DEATH AFTER MYOCARDIAL INFARCTION

After myocardial infarction, the risk of sudden death is greatest in the first month and declines thereafter. Patients with an ejection fraction of 30 per cent or less are at especially high risk for sudden death, though patients with a higher ejection fraction are still at increased risk.

N Engl J Med, 2005; 352 : 2569.

NURSE LED PROGRAMMES DON'T IMPROVE COPD

Nurse led interventions for management of chronic obstructive pulmonary disease (COPD) don't have a detectable effect on mortality, disability, or health related quality of life and psychological wellbeing. In a systematic review of nine randomised controlled trials, Taylor and colleagues found no evidence that nurse led interventions improve management of this chronic disease. The evidence on hospital readmissions was equivocal, and the evidence on some important outcomes such as patients' adherence to treatment was extremely weak or absent.

BMJ, 2005; 331 : 485.