Discontinuing Sedation during Mechanical Ventilation Critically ill patients receiving mechanical ventilation are often given continuous infusions of sedative and analgesic drugs. These infusions may make it difficult to evaluate mental status and to determine when mechanical ventilation can be discontinued. Among 128 patients receiving mechanical ventilation in the intensive care unit, those in whom sedative infusions were interrupted daily had a shorter duration of mechanical ventilation and earlier discharge from the intensive care unit than patients in whom infusions were not interrupted.

Coronary Calcification in Young Adults on Dialysis Older adults with end-stage renal disease treated by dialysis are at high risk for coronary artery disease, but whether children and young adults with end-stage renal disease are similarly affected is not known. A cardinal anatomical feature of coronary artery disease is coronary-artery calcification, which can be detected noninvasively by electron-beam computed tomography. The authors found that among 39 patients under the age of 30 with end-stage renal disease treated by dialysis, 36 percent had coronary-artery calcification, as compared with 5 percent of 60 normal subjects.

Levodopa or Ropinirole in Early Parkinson's Disease? Dyskinesia is a troublesome and common side effect of treatment with levodopa. In this double-blind trial, 268 patients with early Parkinson's disease were assigned to treatment with either levodopa or ropinirole, a dopamine agonist. By the end of five years, the rates of dyskinesia were 45 percent with levodopa and 20 percent with ropinirole. The authors conclude that early Parkinsonıs disease can be managed with a reduced risk of dyskinesia by initiating treatment with ropinirole alone and supplementing it with levodopa if necessary.