This statement summarizes the recommendation of the third U.S. Preventive Services Task Force (USPSTF) for aspirin for the primary prevention of cardiovascular events, as well as the supporting ...scientific evidence. The complete information on which this statement is based, including evidence tables and references, can be found in a companion article in this issue. Copies of this document, the summary of the evidence, and the systematic evidence review can be obtained through the USPSTF Web site (http://www.ahrq.gov/clinic/uspstfix.htm) and in print through the Agency for Healthcare Research and Quality Publications Clearinghouse (800-358-9295).
Abstract Objective While the efficacy of antipsychotic medications for the treatment of psychosis is generally established, the speed of onset of antipsychotic action remains controversial. The ...objective of this study was to evaluate the early response (within the first 24 h) in psychosis with ziprasidone IM treatment, and to determine whether this early effect is distinct from a reduction in agitation symptoms. Methods In a 24-h, double-blind study, hospitalized patients with psychotic disorder and acute agitation were randomized to treatment with fixed doses of IM ziprasidone: 2 mg ( N = 38) or 20 mg ( N = 41). Efficacy assessments were based on the PANSS positive subscale and PANSS early psychosis factor score (conceptual disorganization, hallucinatory behavior, and unusual thought content) at 4 and 24 h. Results Ziprasidone IM demonstrated a significant dose-related effect (20 mg vs. 2 mg) on both the PANSS early psychosis factor score and the PANSS positive subscale at the first post-baseline time point (4 h), and at 24 h (all p < 0.05). There was a significant direct effect of ziprasidone IM on early psychosis at 24 h ( p < 0.05), distinct from improvement in agitation symptoms. Conclusions These findings suggest, in addition to an early reduction in acute agitation, ziprasidone IM may be associated with a more rapid improvement in psychotic symptoms than previously reported, thus lending further support to the emergent hypothesis of early psychosis improvement in antipsychotic treatment.
This article reports on a prevalence study of dementia and Alzheimer's disease among two groups of subjects with the same ethnic background but widely differing environments.
The study was conducted ...among residents aged 65 years and older in two communities: Yorubas (N = 2,494) living in Ibadan, Nigeria, and African Americans (N = 2,212 in the community and N = 106 in nursing homes) living in Indianapolis, Indiana. The study design consisted of a screening stage followed by a clinical assessment stage for selected subjects on the basis of their performance on the screening tests.
The age-adjusted prevalence rates of dementia (2.29%) and Alzheimer's disease (1.41%) in the Ibadan sample were significantly lower than those in the Indianapolis sample, both in the community-dwelling subjects alone (4.82% and 3.69%, respectively) and in the combined nursing home and community samples (8.24% and 6.24%, respectively). The prevalence rates of dementia and Alzheimer's disease increased consistently with advancing age in both study groups.
To the authors' knowledge, this is the first study, using the same research method at the two sites, to report significant differences in rates of dementia and Alzheimer's disease in two different communities with similar ethnic origins.
The lungs and intrathoracic cardiovascular structures compete for space within the thorax, interacting through their adjacent surfaces via the pleural space. Theoretical analysis and in vitro model ...studies (detailed here) established that when a vessel indents the lung surface, the increase in intravascular pressure with positive pressure lung inflation can be greater than the change in the pleural surface pressure measured outside of the interaction area. We define this phenomenon as intravessel pressure augmentation. We determined the average intravessel pressure gain as the slope of the linear regression of the pressure in a vascular structure or balloon indenting the lung on the pleural surface pressure measured by a flat disk-shaped device (disk). The analysis showed that the disk pressure overestimates the pleural pressure. Therefore, the derived pressure gain underestimated the pressure augmentation. In five dogs, the disk and a 2-ml balloon were placed in the lateral pleural space, and a segment of IVC was ligated at both ends and filled with saline. The dogs were ventilated with fixed tidal volumes, while the positive end-expiratory pressure was changed. The pressures were compared at the end of expiration. For the IVC segment, the pressure gains under four different tidal volumes were significantly greater than one 95% confidence interval of mean value (CIM) = 1.57 +/- 0.16, P less than 10(-4), and for the small balloon, this was the case for three of four tidal volumes (95% CIM for all four volumes 1.13 +/- 0.04, P less than 10(-4)). We conclude that the surface interaction of the lungs with adjacent cardiovascular structures causes appreciable pressure augmentation in those structures during ventilation with the positive end-expiratory pressure.
A summary of the third US Preventive Services Task Force (USPSTF) recommendations on newborn hearing screening and the supporting scientific evidence is presented. The USPSTF concludes the evidence ...is insufficient to recommend for or against routine screening of newborns for hearing loss during the postpartum hospitalization.
A summary of the current US Preventive Services Task Force recommendations on screening for colorectal cancer is presented with the supporting scientific evidence. It is strongly recommended that ...clinicians screen men and women 50 years of age or older for colorectal cancer.
