Herpes simplex virus infection in pregnancy and its management.

Neonatal herpes simplex virus (HSV) infection is considered to be rare in the UK, affecting less than 3 per 100,000 live births, but the true incidence is probably higher due to under-reporting. In contrast, neonatal HSV infection is more common in the USA affecting 1 per 7500 live births overall. Infection in neonates is frequently serious and may be fatal.

Effects of qigong on late-stage complex regional pain syndrome.

CONTEXT: Despite the growing popularity of qigong in the West, few well-controlled studies using a sham master to assess the clinical efficacy of qigong have been conducted. OBJECTIVE: To study the effect of qigong on treatment-resistant patients with late-stage complex regional pain syndrome type I. DESIGN: Block-random placebo-controlled clinical trial. SETTING: Pain Management Center at New Jersey Medical School. PATIENTS: 26 adult patients (aged 18 to 65 years) with complex regional pain syndrome type I. INTERVENTIONS: The experimental group received qi emission and qigong instruction (including home exercise) by a qigong master. The control group received a similar set of instructions by a sham master. The experimental protocol included 6 forty-minute qigong sessions over 3 weeks, with reevaluation at 6 and 10 weeks. Assessment included comprehensive medical history, physical exam, psychological evaluation, necessary diagnostic testing. Symptom Check List 90, and the Carleton University Responsiveness to Suggestion Scale. MAIN OUTCOME MEASURES: Thermography, swelling, discoloration, muscle wasting, range of motion, pain intensity rating, medication usage, behavior assessment (activity level and domestic disability), frequency of pain awakening, mood assessment, and anxiety assessment. RESULTS: 22 subjects completed the protocol. Among the genuine qigong group, 82% reported less pain by the end of the first training session compared to 45% of control patients. By the last training session, 91% of qigong patients reported analgesia compared to 36% of control patients. Anxiety was reduced in both groups over time, but the reduction was significantly greater in the experimental group than in the control group. CONCLUSIONS: Using a credible placebo to control for nonspecific treatment effects, qigong training was found to result in transient pain reduction and long-term anxiety reduction. The positive findings were not related to preexperimental differences between groups in hypnotizability. Future studies of qigong should control for possible confounding influences and perhaps use clinical disorders more responsive to psychological intervention.