Jeffrey A Brinker, M.D.
- Professor of Medicine
- Joint Appointment in Radiology and Radiological Science
Box 13-1 Words That Serve Double Duty Some words appear in more than one body fundus means the back part or base of an organ discount inspra online visa. The the uterus has a fundus buy cheap inspra 25mg online, the upper rounded medulla of the kidney is the inner portion of portion farthest from the cervix order inspra toronto, and so does the organ. The fundus of the eye, examined gland, ovary, and lymph nodes, may also be for signs of diabetes and glaucoma, is the individed into a central medulla and outer cornermost layer where the retina is located. There is a macula in the eye, term is also applied to the bone marrow, to the which is the point of sharpest vision. There is spinal cord, and to the part of the brain that also a macula in the ear, which contains recepconnects with the spinal cord, the medulla tors for equilibrium. There are ventrioften important to know the context in which a cles in the brain and in the heart. Use the appropriate root to write a word for each of the following deflnitions: 22. The infecting organisms are usually colon bacteria carried in feces, particularly Escherichia coli. Cystitis is more common in females than in males because the female urethra is shorter than the male urethra and the opening is closer to the anus. As in cystitis, signs of this condition include dysuria, painful or difflcult urination, and the presence of bacteria and pus in the urine, bacteriuria and pyuria, respectively. Urethritis is inflammation of the urethra, generally associated with sexually transmitted diseases such as gonorrhea and chlamydial infections (see Chapter 14). Glomerulonephritis Although the name simply means inflammation of the kidney and glomeruli, glomerulonephritis is a speciflc disorder that occurs after an immunologic reaction. It is usually a response to infection in another system, commonly a streptococcal infection of the respiratory tract or a skin infection. The symptoms are hypertension, edema, and oliguria, the passage of small amounts of urine. Because of damage to kidney tissue, blood and proteins escape into the nephrons, causing hematuria, blood in the urine, and proteinuria, protein in the urine. Blood cells may also form into small molds of the kidney tubule, called casts, which can be found in the urine. In such cases, urea and other nitrogen-containing compounds accumulate in the blood, a condition termed uremia. These compounds affect the central nervous system, causing irritability, loss of appetite, stupor, and other symptoms. There is rapid loss of kidney function with oliguria and accumulation of nitrogenous wastes in the blood. Failure of the kidneys to eliminate potassium leads to hyperkalemia, along with other electrolyte imbalances and acidosis. Renal failure may lead to a need for kidney dialysis or, ultimately, renal transplantation. Dialysis refers to the movement of substances across a semipermeable membrane; it is a method used for removing harmful or unnecessary substances from the body when the kidneys are impaired or have been removed (Fig. In hemodialysis, blood is cleansed by passage over a membrane surrounded by fluid (dialysate) that draws out unwanted substances. Urinary Stones Urinary lithiasis (condition of having stones) may be related to infection, irritation, diet, or hormone imbalances that lead to an increased level of calcium in the blood. Most urinary stones, or calculi, are formed of calcium salts, but they may be composed of other materials as well. Causes of stone formation include dehydration, infection, abnormal pH of urine, urinary stasis, and metabolic imbalances. This results in great pain, termed renal colic, and obstruction that can promote infection and cause hydronephrosis (collection of urine in the renal pelvis). Because they are radiopaque, stones can usually be seen on simple radiographs of the abdomen. A cellophane membrane separates the blood compartment and dialysis solution compartment. This membrane is porous enough to allow all of the constituents except the plasma proteins and blood cells to diffuse between the two compartments. A semipermeable membrane richly supplied with small blood vessels lines the peritoneal cavity. With dialysate dwelling in the peritoneal cavity, waste products diffuse from the network of blood vessels into the dialysate. External shock waves are used to crush stones in the urinary tract in a procedure called extracorporeal (outside the body) shock wave lithotripsy (crushing of stones). Cancer Carcinoma of the bladder has been linked to occupational exposure to chemicals, parasitic infections, and cigarette smoking. Often the cancer can be seen by viewing the lining of the bladder with a cystoscope (Fig. If treatment is not effective in permanently removing the tumor, a cystectomy (removal of the bladder) may be necessary. In this case, the ureters must be vented elsewhere, such as directly to the surface of the body through the ileum in an ileal conduit (Fig. Additional means for diagnosing cancer and other disorders of the urinary tract include ultrasound, computed tomography scans, and radiographic studies such as intravenous urography (Fig. It may also reveal disturbances in other systems when abnormal byproducts are eliminated in the urine. In a routine urinalysis, the urine is grossly examined for color and turbidity (a sign of bacteria); speciflc gravity (a measure of concentration) and pH are recorded; test are performed for chemical components such as glucose, ketones, and hemoglobin; and the urine is examined microscopically for cells, crystals, or casts.
The process of performance measurement involves the selection and application of performance indicators quality 25mg inspra, which quantify the efficiency and effectiveness of service-delivery methods (Fine & Snyder inspra 50mg amex, 1999) purchase inspra without prescription. According to Matthews (2011), in a library setting, assessing organization effectiveness is a challenge, due to the lack of consensus about the goals and objectives of the library. Quality evaluation of library services involves various methodologies that provide quantitative and qualitative data to explore the extent to which they are satisfying the user’s expectations (Al Hijji & Cox, 2012, p. In 1973 (Orr apud Matthews, 2011) organized a set of performance measures that reflected the activities of transforming resources into information and/or services, which was the Input-Process-Output-Outcomes model. The purpose is to answer the following question: How are libraries using performance measurement in the literature To achieve the goal of this paper it is necessary to understand what bibliometric study is. It refers to statistics and mathematical analysis of standards from information that can be found on publications and documents. The citation analyses are based on the idea that the citations used by the authors are considered important for the research, and that the most often cited references have had more influence on the subject. Research methodology Bibliometric study is a method by which the state of science and technology can be observed through the overall production of scientific literature, at a given level of specialisation. The sources for bibliometrics nowadays are specialized databases, various of which are used to illustrate the results of science. The choice of a database hinges directly on the objectives pursed and the questions to be answered. Figure 1: Fields from Web of Science In the first result there was 2495 documents, which were refined using the Web of Science Categories, Information Science Library Science (370 results). One more search criteria was added: publication type (articles and proceedings of conferences), resulting in 296 documents. The bibliometric study was conducted with 138 results, the data analysis was done using the VantagePoint Software1 (Version 5. Results and discussion Figure 3 shows the distribution of the 138 papers by year of publication. Publications before 1990 were not selected to appear on the figure because of the low number of articles. From the 34 documents, 28 were published in the Proceedings from the 2nd Northumbria International Conference on Performance Measurement in Libraries and Information Services, which was indexed by Web of Science until the third. Number of publications per year 40 35 30 25 20 15 10 0 1990 1991 1992 1993 1994 1995 1996 1997 1998 1999 2000 2001 2002 2003 2004 2009 2010 2011 2012 Figure 3: Number of publications per year From the 138 papers, it was possible to analyse citation data, which is represented by Table 1, with the 10 articles most frequently cited. Evaluation of interactive query expansion in an online library catalog with a graphical user-interface. Beyond measuring service quality: Learning from the voices of the customers, the staff, the processes, and the organization. A gray code based ordering for documents on shelves: classification for browsing and retrieval. Higher-order factor analytic perspectives on users’ perceptions of library service quality. From measurement to management: Using data wisely for planning and decisionmaking, Library Trends, v. Service quality: an unobtrusive investigation of interlibrary loan in large public-libraries in Canada. Proceedings of the 2nd Northumbria Conference on Performance Measurement in Libraries and Information Service. Impact assessment of university libraries: a consideration of issues and research methodologies. Most references are about measuring service quality, focused in one dimension or indicator, such as user’s perception, interlibrary loan or acquisition. There are few papers focused on the performance assessment in a library as a whole. However the most cited paper was Hamburg, Bommer & Ramist (1972), which is on performance measures and their use in decision-making. The classic papers in performance measurement did not appear on the cited references, such as Neely, Bititci, Lynch and Cross, Keegan et al. Although the object of this paper is libraries, the classic authors should be considered, based on the evolution of performance measurement. The second phase started in the late 1980s as a result of changes in the world market, which became more competitive (Ghalayini & Noble, 1996). Publications on performance measurement and libraries were more common after the second phase. The concentration of publications on the Proceedings of the 2nd Northumbria International Conference on Performance Measurement in Libraries and Information Science was confirmed. The first two columns are the number of appearance of keywords defined by the authors. The analysis of keywords identifies a difference between the words authors register as keywords on the subject of their papers and the title of the published work. In fact, some libraries have the need to measure what is happening today, understand the past to plan the future. The decision making without this kind of information shows how library management is amateur. The aim of this paper is to demonstrate by bibliometric analysis how this issue is being discussed in literature. It is important to highlight that the paper is a preliminary work on bibliometric study, and that some important journals and conferences proceedings are not indexed on this database.
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General Principles of Auscultation Boundaries of Traube’s space Right side Left lobe of the liver a cheap inspra 25 mg mastercard. As most normal lung sounds are low pitched discount inspra 50 mg on-line, the Left side Spleen bell is normally preferred over the diaphragm order inspra with a mastercard. Above Left lung resonance Stretching of the skin under the diaphragm during Below Left costal margin breathing is apt to produce scratching sound similar Content Fundus of stomach to a pleural rub. In order to avoid time consumption and practical difficulty, diaphragm is used Traube’s space is obliterated in: b. If the chest is hairy, moisten the chest wall with water Traube’s space is shifted upwards in: and apply the chest piece tightly to avoid sounds 1. Percussion Tenderness Posterior: Above the level of the spine of the scapula It is present in empyema and inflammation of parietal down to the 11th rib. When abnormal breath sounds are heard, the extent It is present in hydropneumothorax. It Tubular helps differentiate coarse crepitation and low pithced rhonchi from pleural rub. Coughing does not alter They are high pitched and present in: pleural rub, but may alter the character of rhonchi a. Above the level of pleural effusion (in a partially Importance of Auscultation collapsed lung with a patent bronchus). Character of vocal resonance (voice sounds and whisThey are low pitched and heard in the presence of thickpering sounds) walled cavity with a communicating bronchus. Amphoric Breath Sounds They are low pitched, with a high tone and a metallic quality and present in: Breath sounds are produced by vibrations of the vocal a. Vesicular Breath Sound It is low pitched, rustling in nature and is produced by Absent Breath Sounds attenuating and filtering effect of the lung parenchyma. Pleural effusion (massive) Duration of the inspiratory phase is longer than the b. Collapsed lung or lobe when bronchus is occluded There is no pause between the end of inspiration d. Near fatal asthma (silent chest) Conditions with diminished vesicular breath sounds f. Collapsed lung with occluded bronchus They are non-musical, interrupted added sounds of f. Bronchial Breath Sound Types It is produced by passage of air through the trachea and 1. Fine—They are less loud, short in duration and arise large bronchi, heard over an area of diseased, airless or from the alveoli consolidated lung interposed between the bronchi and 2. Character: It is loud and high pitched, with an aspirate Crackles may be: or guttural quality. Early inspiratory as in chronic bronchitis shortened whereas that of expiration is prolonged and b. Mid inspiratory as in bronchiectasis sometimes the duration of inspiration and expiration c. There is a pause between inspiration and sis, pneumonitis, interstitial lung disease, pulmonary expiration. Mechanism of Crackles They may be low pitched (sonorous), arising from large airways or high pitched (sibilant), arising from a. Fixed monophonic wheeze: It is a single note of constant Crackles without sputum production indicates interpitch, timing and site. Sequential inspiratory wheeze: It is due to the opening of Post-tussive suction: It is a sucking sound, heard over the distal airways which has become abnormally opposed chest wall during inspiration, following a bout of cough, during previous expiration. Voice Sounds Succussion splash: Splashing sound heard over the chest Vocal Resonance either with the stethoscope or unaided ear applied to the chest wall when the patient is shaken suddenly by It is a voice sound heard with the chest piece of the the examiner (Fig. This is done by asking the patient to lie down laterally Types with the healthy side in the dependent position. Bronchophony: Voice sounds appear to be heard near and determine the air-fluid level in the paraspinal region the earpiece of stethoscope and words are unclear, and keep the stethoscope over that region. It is when a sound like that of splashing water can be heard normally heard in proximity to the trachea. Whispering pectoriloquy: the patient is asked to whisper words at the end of expiration, and this whispered voice is transmitted without distortion so that the individual syllables are recognised clearly. Miscellaneous Sounds Pleural rub: It is a superficial, localised squeaking or grating sound best heard with firm pressure of stethoscope. It is due to roughened pleural surface adjacent to the pericardium being moved across one another by cardiac pulsation. It is heard in tension pneumothorax and at the air fluid level of hydropneumothorax. DeEspine’s sign: It is the presence of high pitched tubular breathing and whispering pectoriloquy over the thoracic spine below T3 in adults and T4 in children and infants. It is due to transmission of bronchial breath sound through a mass or central pneumonia in the middle or posterior mediastinum. Bronchial breath sounds may be heard normally over the midline in the back up to T3 in adults and T4 in children. Succussion splash can be heard in hydropneumoLaryngeal stridor: It is a high pitched, crowing sound thorax (Fig. Signs in Common Respiratory Disorders Pathology Mediastinal shift Percussion note Breath sounds Vocal resonance Added sounds 1. Consolidation Midline Dull Tubular Increased Indux fine crackles Redux coarse crackles 2.
Until 1980 order 50 mg inspra mastercard, most accreditation standards for libraries centred around the number of volumes discount 50mg inspra otc, staff cheap inspra 25 mg line, expenditures and facilities. However, the professional associations took the lead in moving away from an input/output based assessment to evaluating student learning outcomes. Regional accreditation followed in the late 1990s, although there was usually a separate set of library standards. By 2010, there was no longer a separate library standard but libraries were integrated with other academic programmes. The Northwest Commission on Colleges and Universities had four substandards for libraries: l the institution holds or provides access to library and information resources that support the institution’s mission, wherever offered and however delivered. In this context of wider demand for accountability and the emphasis on outcomes assessment in higher education, librarians could no longer take the link between library resources and outcomes for granted, or assume those they served would see the link: ‘in the last two decades, the implicit relationship among inputs, outputs, and student learning has been under fire by external stakeholders such as regional accreditors and other governmental bodies’ (Ackermann, 2007, 2). In tandem with the demand for accountability, parents and students concerned by rapidly rising tuition rates also began asking questions about whether institutions provide ‘value for money’. While libraries (and higher education institutions more generally) may have previously been able to rely on being seen as a good in and of themselves, the post-1990s period saw increasing pressures to demonstrate that libraries were being responsible stewards of resources. In addition to trends in higher education related to accountability and affordability, the availability of information in the networked environment also meant that libraries were required to think about how they provided and demonstrated their value to users. With increasing amounts of information being available online, faculty and students no longer needed to come into the library to access information: ‘ the most notable feature of user behaviour in these [networked] environments is that the tools and resources they use are those which are embedded in their workflows Information usage is integrated into the workflow. The question for libraries became not how users fit into our work, but how we fit into their work and lives. This required libraries to understand how users worked, what their information needs were in this networked environment, and how the library could best integrate into workflows in order to meet user needs. It is worth pausing to note, however, that while we are arguing that the trend toward user-centred assessment and an interest in the value and impact of the library certainly reached a critical mass from the last decade of the twentieth century onwards (largely because of some of the pressures we have just outlined), the ideas at the core of these trends emerged earlier. He stresses the importance of the library’s capability ‘as perceived by its users’ (326). In terms of value, Orr emphasizes the importance of trying ‘to assess the beneficial effects attributable to a particular service of the library (or to all of its services collectively) in terms of how much the service contributes toward achieving [these] organizational objectives’ (327). Orr’s work is recognised as a foundational moment for library assessment because it represents an early signal of the move towards the key trends that would emerge in the 1990s – the focus on the user perspective, the call to expand beyond purely quantitative measures of library effectiveness, and the gesture towards the wider organisational context in which the library operates. The first of the trends we see emerging in the midto late 1990s is the turn to the customer (or user) centred library, which meant that library services and activities were increasingly viewed from the perspective of the user. Rather than emphasising ‘what counts for the library’ (eg, collection size, number of checkouts), the concern became more about ‘what counts for the user’ (eg, the services that are important to users, and their satisfaction with these services). Much of this work to identify user needs and understand if those needs were being met took the form of satisfaction surveys. In the 1990s, a number of academic libraries (such as our own institution, the University of Washington) began conducting large-scale user surveys to gauge satisfaction and the importance of services and resources to library customers. These surveys have provided (and continue to provide) valuable information that can be used for improvement, as well as some sense of what users value and what the library enables them to do. However, there is a limit to what surveys can do for us in terms of understanding the depth and nature of the impact on users’ lives and work. In the absence of other measures, user satisfaction was often used as a surrogate for value and impact. With the recent development of alternative ways to assess the value and impact of library services, satisfaction measures can be used to complement, rather than substitute for, an understanding of value. In addition to surveys, assessment approaches that emerged from the shift to a user-focused perspective include usability testing of websites and online tutorials, as well as user-centred design of spaces. This shift in perspective to the user also gives rise to outcomes-based metrics, which attempt to assess the difference library services and resources make for users, and how user behaviour is changed as a result of using the library. A second key trend in assessment and performance measurement post-1990 is the turn outward from the library towards wider organisational contexts, both within and beyond individual institutions. We are calling this ‘collaboration’, and thinking of this as the move towards assessment activity that is connected to broader institutional and higher education priorities, as well as to the development of assessment work among libraries at the regional, national, or international level. This shift to a wider institutional lens means that libraries became increasingly concerned with measures that were meaningful to their parent organisations and with framing their work in terms of its contributions to institutional mission and values. As Sarah Pritchard notes in a 1996 article, ‘the major objective for academic libraries, especially in an environment of increasing economic pressure, structural change, and technological innovation, must be to align themselves with the structures of higher education and the criteria by which those institutions are judged’ (573). Collaborative assessment activity also meant that libraries began to look for partners in other programmes and units at their colleges and universities to identify shared goals, outcomes and measures of success. A key element of this collaborative activity involves the alignment of assessment activities with strategic planning, both at the library and institutional level. When there is a meaningful association between assessment and strategic planning, assessment data can inform strategic directions (what’s important to users/communities we serve, and what do we need to be doing to provide them with what they need in the next 2-3 years From the 1990s, libraries also began to develop a shared community concerned with assessment and performance measurement. The case of instruction in libraries is a useful illustration of this move towards a focus on the user and collaboration, and the trajectory from inputs/output measures to outcomes, value, and impact. During the 1970s and 1980s, a great deal of library instruction concentrated on ‘how to use the library’ (in other words, the library was the focus, not the needs of users). There was some focus on outcomes and some collaborative efforts, but assessment tended to focus on surveys and preand post-tests or on satisfaction/opinion surveys. The United States in the mid-1990s, however, witnessed a paradigm shift in higher education that placed an ‘emphasis on moving from teaching to learning’ (Gilchrist, 2009, 71). In this new ‘learning-centered framework’ (Gilchrist, 2009, 71), the student, rather than the teacher, was at the centre of the educational experience. This shift in pedagogical approach converged with demands from accreditors for the assessment of outcomes and helped to bring about changes in how we think about, and assess, library instruction. The report called on libraries to establish and assess outcomes, and to align library assessment with institutional outcomes and priorities: the purpose of outcomes assessment of academic libraries is to measure their quality and effectiveness, focusing on an organizational analysis of the library as a whole, and of its constituent activities and services, and the contributions they make to accomplishing the purposes of the university or college of which it is a part. It follows from this purpose that outcomes assessment must begin with an analysis of the parent organization’s mission, goals, and objectives, and an identification of the elements of them that the library supports.
Two well-designed clinical trials demtaneous buy 50mg inspra amex, motor discount inspra 25 mg line, neurologic buy inspra overnight, or ocular complications. However, the addition of the corticosteroid did have In patients who still have new vesicles forming or who have benecial effects on acute pain and some cutaneous end points cutaneous, motor, neurologic, or ocular complications after 7 days of antiviral therapy, close monitoring is recommended to in both of these trials; in one of the trials, the times to uninassess the need for further evaluation. Because the potential terrupted sleep, return to normal daily activity, and cessation benets are unknown but may be meaningful, and given the of analgesic therapy were all signicantly accelerated in patients minimal risks of treatment, it is also recommended that conwho received combination therapy . Individuals with consideration be given to extending the duration of antiviral thertraindications to the use of corticosteroids, including hyperapy for 17 days for these patients. In patients who have been tension, diabetes, and peptic ulcer disease, were excluded from given an incorrect diagnosis or who develop toxicity, antiviral these studies. Nevertheless, adverse effects of corticosteroids therapy should be discontinued immediately. No randomized placebo-controlled an infectious diseases specialist is recommended. However, until the efcacy of these antidepressants beyond that achieved with antiviral therapy administered alone. One of the most common rash onset; however, the effect of treatment on chronic pain adverse effects of opioid analgesics is constipation, which can could not be determined because of the short follow-up dube managed with preemptive laxative and stool-softener therration . The principles of state-of-thebedtime and subsequent dosage increases administered 3 times art pain management, such as the use of standardized pain daily for gabapentin and twice daily for pregabalin. The rst 2 measures, scheduled analgesia, and consistent and frequent folweeks after rash onset can be expected to be associated with low-up to adjust dosing to the needs of the patient, should be the greatest benet of treatment. In addition, any diagnosis for patients with at least moderately severe pain and transplant recipient with suspected visceral dissemination. The recommended dose is 10 mg/kg (or 500 mg/m2) cranial polyneuritis to improve motor outcomes, peripheral every 8 h. The presence of atypical lesions or a failed clinical reocular pressure–lowering drugs given as needed for glaucoma sponse should prompt evaluation for drug susceptibility to de. Systemic steroids are insistance occurs, treatment with alternative medications. Startingdosthetic blocks can be used for pain that is refractory to rstages of medications should be lower than those recommended line therapy, although there are no controlled studies of these for younger individuals, and the dosage should be titrated more treatments [223–225]. These individuals experience siggressive herpetic retinal necrosis in immunocompromised panicant ageand disease-related declines in glomerular ltratients remains undened. Responses to intravenous acyclovir tion rate, so the dosages of renally excreted medications. Several case reports have reported improved presviduals are at high risk for adverse drug effects because of ervation of vision in patients treated with a combination of multiple comorbidities, age-related changes in pharmacokiintravenous ganciclovir plus foscarnet, with or without intranetics and dynamics, use of multiple medications, and frequent vitreal antivirals [227–232]. The optimal should take into account the patient’s diseases, medication regduration of induction therapy and options for long-term mainimen, and adverse event experiences. For nonpharmacotherapeuvirulent disease and responds better to antiviral therapy. For tic approaches, it is critically important for the practitioner to such patients, acyclovir is clearly benecial for preserving useful recognize that these treatments are just as important as the use vision . Nonpharmacologic approaches include mainnecrosis in the otherwise healthy host is intravenous acyclovir taining physical activity, enhancing nutrition, maintaining or (10–15 mg/kg every 8 h for 10–14 days) followed by oral valincreasing social contact, and providing assistance for problems acyclovir (1 g 3 times daily for 4–6 weeks), although this treatwith basic and instrumental activities of daily living during the ment approach has not been studied in a controlled fashion. These interventions usually require a multidisVulnerable and frail elderly patients. The health status of ciplinary approach that involves nursing, social work, physical older adults varies widely, from well elderly individuals who therapy, occupational therapy, and the family. Pharperiod, as dened by older age, poor self-rated health, and macotherapeutic and nonpharmacologic approaches require pardecreased functional status . Cutaneous dissemination and, posin assessing patients with advanced dementia . Finally, sibly, visceral dissemination seem to be more common in elwhen frail elderly individuals are residents of nursing homes, derly individuals. Both of the latter 2 objectives should be a priority antiviral therapy outweigh any potential risks . Dosages should be adjusted if renal insufWe anticipate that ongoing and planned research will address ciency is present when acyclovir (creatinine clearance,! Dosages of gabapentin and pregabalin should be reduced We dedicate these recommendations to the memory of Richard T. This article was published as part of a suplication by epidermal cell interferon-a. Latent and lytic ter,” sponsored by the International Association for the Study of Pain infection of isolated guinea pig enteric ganglia by varicella zostervirus. Neuropathic Pain Special Interest Group, the Neuropathic Pain Institute, J Med Virol 2003;70(Suppl 1):S71–8. Intracellular transport of newly synthesised varicella-zoster viparticipation in the consensus meeting from the University of Rochester rus: nal envelopment in the trans-Golgi network. Membrane fusion mediated by herpesvirus glyPharma, Cephalon, Dov Pharmaceuticals, Eli Lilly, Endo Pharmaceuticals, coproteins: the paradigm of varicella-zoster virus. Rev Med Virol EpiCept Corporation, Fralex Therapeutics, Johnson & Johnson, Merck, 2003;13:207–22. M has served on an advisory board varicella-zoster virus in human dorsal root ganglia. Varicella-zoster virusgeneexpression months from Alnylam, Biogen, Eli Lilly, Hind Health Care, Metaphore, in latently infected and explanted human ganglia. T has received research Varicella-zoster virus gene 66 transcription and translation in latently support, consulting fees, or honoraria from Astellas Pharma, Catalyst, infected human ganglia. J Virol 2005;79: report of the Quality Standards Subcommittee of the American Acad14079–87.