A randomized, controlled, multicenter trial assigned well-controlled hypertensive participants ≥55 years, with moderate hypercholesterolemia to receive pravastatin (n=5170) or usual care (n=5185) for 4-8 years, when trial therapy was discontinued. Passive surveillance using national databases to ascertain deaths and hospitalizations continued for total follow-up of 8-13 years to assess whether mortality and morbidity differences persisted or new differences developed. During the post-trial period, fatal and nonfatal outcomes were available for 98% and 64% of participants, respectively. Primary outcome was all-cause mortality; secondary outcomes included cardiovascular mortality, coronary heart disease (CHD), stroke, heart failure, cardiovascular disease, and end-stage renal disease. No significant differences appeared in mortality for pravastatin versus usual care (hazard ratio [HR], 0.96; 95% confidence interval [CI], 0.89-1.03), or other secondary outcomes. Similar to the previously reported in-trial result, there was a significant treatment effect for CHD in Blacks (HR, 0.79; 95% CI, 0.64-0.98). However, the in-trial result showing a significant treatment by race effect did not remain significant over the entire follow-up (P=.08). These findings are consistent with evidence from other large trials that show statins prevent CHD and add evidence that they are effective for CHD prevention in Blacks.

The chronic ingestion of .5% butylated hydroxyanisole (BHA) or butylated hydroxytoluene (BHT) by pregnant mice and their offspring resulted in a variety of behavioral changes. Compared to controls, BHA-treated offspring showed increased exploration, decreased sleeping, decreased self-grooming, slower learning, and a decreased orientation reflex. BHT-treated offspring showed decreased sleeping, increased social and isolation-induced aggression, and a severe deficit in learning.

A number of professions have a visual standard but there is no standard for surgeons, including surgeons such as ophthalmologists who operate with the aid of a microscope. We review which professions do have a visual standard, the evidence addressing the issue of a visual standard in medicine and surgery, and an international survey of what visual standards other countries apply to ophthalmologists, and performed a survey of the views of the member of the British Royal College of Ophthalmologists. A number of professions, where public safety is an issue, do have a visual standard without compelling supporting evidence. By contrast, all but two countries do not have a visual standard for their ophthalmic surgeons. The survey of members of the British Royal College of Ophthalmologists supported the adoption of such a standard, which would include minimum requirements for both visual acuity and stereoacuity. Good vision is clearly essential for ophthalmologists, as well as for other surgeons and practioners of some other branches of medicine. While there is no evidence to support a specific visual standard, we conclude that one should be adopted until there is definitive evidence to settle the issue on the basis of the precautionary principle as patient safety is involved.

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