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Thursday, October 27, 2011

One Man at a Time — Resolving the PSA Controversy — NEJM

One Man at a Time — Resolving the PSA Controversy — NEJM

Excerpt (follow link above for article):

"Our perspective is that this evidence of a possible small but finite benefit from the largest trial would best support a grade C recommendation for men 55 to 69 years of age. With a grade C recommendation, the task force would be recommending “against routinely providing the service” while indicating that “there may be considerations that support providing the service in an individual patient” and stipulating that “there would need to be at least moderate certainty that the net benefit is small.” The task force's suggestions for practice in the case of a grade C recommendation include the suggestion that they “offer/provide this service only if other considerations support offering or providing the service in an individual patient.”

A grade C recommendation would allow the patient to be involved in the decision to skip or choose a PSA screening test, after a discussion with a primary care provider about the magnitude of the known harms and the potential for some benefit. The patient could then provide his perspective on how he views the trade-off. Weighing the pros and cons to make a decision about PSA screening is an individual process, and different well-informed men will make different decisions."

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Pharmacy History

"The earliest known compilation of medicinal substances was ARIANA the Sushruta Samhita, an Indian Ayurvedic treatise attributed to Sushruta in the 6th century BC. However, the earliest text as preserved dates to the 3rd or 4th century AD.
Many Sumerian (late 6th millennium BC - early 2nd millennium BC) cuneiform clay tablets record prescriptions for medicine.[3]

Ancient Egyptian pharmacological knowledge was recorded in various papyri such as the Ebers Papyrus of 1550 BC, and the Edwin Smith Papyrus of the 16th century BC.

The earliest known Chinese manual on materia medica is the Shennong Bencao Jing (The Divine Farmer's Herb-Root Classic), dating back to the 1st century AD. It was compiled during the Han dynasty and was attributed to the mythical Shennong. Earlier literature included lists of prescriptions for specific ailments, exemplified by a manuscript "Recipes for 52 Ailments", found in the Mawangdui tomb, sealed in 168 BC. Further details on Chinese pharmacy can be found in the Pharmacy in China article."

From Wikipedia: http://en.wikipedia.org/wiki/Pharmacy#History_of_pharmacy

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