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Research studies for the treatment of the putative prodromal phase of
psychotic disorders have begun to appear
To obtain preliminary evidence of the short-term efficacy and safety of
aripiprazole treatment in people with the psychosis prodrome
Fifteen participants meeting prodrome criteria (mean age 17.1 years,
s.d.=5.5) enrolled in an open-label, single-site trial with
fixed-flexible dosing of aripiprazole (5–30 mg/day) for 8 weeks
In the mixed-effects repeated-measures analysis, improvement from
baseline on the Scale of Prodromal Symptoms total score was statistically
significant by the first week. No participant converted to psychosis and
13 completed treatment. Neuropsychological measures showed no consistent
improvement; mean weight gain was 1.2 kg. Akathisia emerged in 8
participants, but the mean Barnes Akathisia Scale score fell to baseline
levels by the final visit. Adverse events were otherwise minimal
Aripiprazole shows a promising efficacy and safety profile for the
psychosis prodrome. Placebo-controlled studies are indicated
Awareness of the risk of spinal-cord damage in moving an unconscious person with a suspected neck injury into the “lateral recovery position,” coupled with the even greater risk of inadequate airway management if the person is not moved, has resulted in a suggested modification to the lateral recovery position for use in this circumstance.
It is proposed that the modification to the lateral recovery position reduces movement of the neck. In this modification, one of the patient's arms is raised above the head (in full abduction) to support the head and neck. The position is called the “HAINES modified recovery position.” HAINES is an acronym for High Arm IN Endangered Spine.
Neck movements in two healthy volunteers were measured by the use of video-image analysis and radiographic studies when the volunteers were rolled from the supine position to both the lateral recovery position and the HAINES modified recovery position.
For both subjects, the total degree of lateral flexion of the cervical spine in the HAINES modified recovery position was less than half of that measured during use of the lateral recovery position (while an open airway was maintained in each).
An unconscious person with a suspected neck injury should be positioned in the HAINES modified recovery position. There is less neck movement (and less degree of lateral angulation) than when the lateral recovery position is used, and, therefore, HAINES use carries less risk of spinal-cord damage.
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