Fiberoptic bronchoscopy before bronchial artery embolization is unnecessary in patients with hemoptysis of known causation if the site of bleeding can be determined from radiographs and no bronchoscopic airways management is needed.
Zhou et al state that "recent evidence-based recommendations for the management of patients with herpes zoster recommend using antiviral therapy to decrease the incidence of PHN," citing an article for which I am a coauthor. 4 This article stated that antiviral therapy should be used to treat patients with herpes zoster and that it had an impact on acute neuritis. Although the guidelines concluded that the use of antiviral therapy may have an effect on "chronic pain," this therapy was not sufficient to uniformly prevent PHN. As noted here, the FDA reached a similar conclusion.The goal of management of herpes zoster is to accelerate healing, prevent complications, and decrease pain-both acute pain and PHN. With the evidence available from existing antiviral studies, these end points have been achieved with the exception of prevention of PHN. The management of PHN is of critical importance for individuals who have herpes zoster. Consideration of combination therapy at the onset of disease, particularly in patients with severe acute pain, needs to be further evaluated. 4 Future treatment strategies may prevent or provide more significant relief for this potentially devastating complication.
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