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Heart Rescue, Skin Cancer, Fat, Diabetes, Sex Drive

Sunday, 23 April 2006 12:00 AM

A new kind of cardiopulmonary resuscitation substantially improves the survival rate for most patients who have out-of-hospital heart attacks, according to a study at the University of Arizona.

Called cardiocerebral resuscitation (CCR), the new technique involves starting fast, powerful chest compressions as quickly as possible.

The rescuers skip the first steps of the standard protocol: Intubating the patient for ventilation and delivering a shock using a defibrillator. While still attaching the victim to a defibrillator, they do not wait for the device to analyze the patient's heart rhythm, but start fast, forceful chest compressions.

Dr. Michael J. Kellum and his colleagues at the University of Arizona College of Medicine found that CCR nearly tripled survival rates during a one-year study.

The Arizona researchers also joined with the Wisconsin Emergency Medical Services Bureau teamed to test CCR in two Wisconsin counties during 2004 and 2005. That study also showed many more patients survived and many more who survived were completely free of brain damage.

"Intubating the patient and waiting for the defibrillator to do its analysis takes time -- time a cardiac arrest victim doesn't have," said Dr. Gordon A. Ewy, director of the University of Arizona Sarver Heart Center and senior author of the study.

Previous laboratory experiments showed that the most important factor for survival of cardiac arrest patients was to maintain blood flow through the body by continuous chest compressions, said Dr. Ewy.

"Stopping chest compressions for ventilations was far more harmful than helpful," he said. "Excessive ventilations during chest compression turned out to be harmful, too."

"I am convinced that cardiocerebral resuscitation will have a worldwide impact," Dr. Ewy said.

The Arizona study appears in The American Journal of Medicine.

The United States is in the midst of a of skin cancer epidemic, according to a report in from the Mayo Clinic.

One in five Americans will develop skin cancer, and a person's risk of the disease doubles if that person has had five or more sunburns, according to the Mayo statistics.

Basal and squamous cell carcinomas, the most common and treatable types of skin cancers, had long been considered a problem only for people over 50, according to the report. But Mayo researchers report that percentage of women under 40 with the more common type, basal cell, tripled between 1976 and 2003, while the rate of squamous cell cancers increased 400 percent.

The researchers found that just 60 percent of the cancers they identified occurred on skin frequently exposed to the sun, such as the head and neck, rather than the normal 90 percent. Most of the remaining cancers were seen on the torso, possible due to the widespread use of tanning beds.

The Mayo report offers the following tips for effective sun protection:

The study appears in the April issue of the Mayo Clinic Health Letter.

Shockwave treatment for kidney stones increases the risk of diabetes almost four-fold, according to a 19-year follow-up study at the Mayo Clinic.

The study also found that use of the noninvasive technique which uses magnified sound waves to break up the stones, raises the risk of hypertension.

Dr. Amy Kranbeck and her colleagues followed up on nearly 600 patients 19 years after they had kidney stone treatment. They found that those who had the shockwave treatment were 3.75 as likely as others to have developed diabetes. Further, the risk of diabetes was related to the number of shocks and total intensity of treatment.

The researchers believe the increase in diabetes could be a result of damage from shock waves to pancreatic islet cells. The pancreas is in the blast path of the lithotriptor, the shockwave device, the researchers said.

Co-author Dr. Joseph Segura said Mayo urologists will continue to use the shockwave treatment, among other alternative treatments. About a million people in the United States have had shockwave therapy, he said.

The study appears in the Journal of Urology.

Diabetes makes stomach ulcers far more dangerous, according to a disturbing new Danish study that should give patients another big reason to carefully manage their diabetes.

Dr. Reimar W. Thomsen and his colleagues at Aarhus University Hospital assessed the outcomes of 7,323 patients hospitalized for bleeding ulcers and 2,061 patients with perforated ulcers. Roughly 10 percent of the first group and 7 percent of the second had diabetes.

Among patients with bleeding ulcers, the 30-day death rate was 17 percent in the diabetic group versus just 10 percent in the non-diabetic group. This translates into a 40 percent increased risk of death for the diabetic group.

The mortality difference in the perforated ulcer group was even more pronounced. Diabetic patients had a 30-day death rate of 43 percent compared with 24 percent for nondiabetic patients -- an increased risk of 51 percent.

The researchers speculate that diabetic patients with complicated ulcer disease may face a higher short-term death risk because of diabetic blood vessel problems, blurring of symptoms, and an increased risk of overwhelming bacterial infection.

"Our findings suggest that efforts to improve outcomes from these medical emergencies in diabetic persons should be directed to reducing preventable diabetes complications," they conclude.

Their report appears in the journal Diabetes Care.

A Mediterranean-style diet that appears to cut the risk of heart disease also may help protect against Alzheimer's disease, a new study suggests.

People who followed the diet were up to 40 percent less likely than those who largely avoided it to develop Alzheimer's during the course of the research, scientists reported.

Still, more research must be done before the diet can be recommended to ward off Alzheimer's, said Dr. Nikolaos Scarmeas of the Columbia University Medical Center in New York, lead author of the research. The work was recently published online by the Annals of Neurology.

The diet he tested includes eating lots of vegetables, legumes, fruits, cereals and fish, while limiting intake of meat and dairy products, drinking moderate amounts of alcohol and emphasizing monounsaturated fats, such as in olive oil, over saturated fats. Previous research has suggested that such an approach can reduce the risk of heart disease.

Prior research has also suggested that certain components of the Mediterranean diet can reduce the risk of developing Alzheimer's, Scarmeas said. But he said the previous work has tended to focus on individual nutrients like vitamin C or foods like fish. By studying a comprehensive diet instead, the new research could take possible interactions between specific foods and nutrients into account, he said.

The idea that a heart-healthy diet could also help fight Alzheimer's fits in with growing evidence that "the kinds of things we associate with being bad for our heart turn out to be bad for our brain," said Dr. Marilyn Albert, a Johns Hopkins neurology professor and spokeswoman for the Alzheimer's Association. The list includes high cholesterol, high blood pressure, obesity, smoking and uncontrolled diabetes, she said.

So it makes sense that a diet low in saturated fats and cholesterol would reduce the risk of Alzheimer's, said Albert, who was not involved in the new study.

The new work is among the most convincing so far to show an effect of diet on Alzheimer's risk, she said. Such large studies are important, she said, "to add to the body of evidence to help persuade people they really can do something in their daily lives to reduce risk."

Scarmeas and colleagues followed 2,258 elderly residents of northern Manhattan for an average of four years. The participants were asked in detail about their dietary habits and evaluated every 18 months or so for signs of dementia. None showed any dementia at the start of the study, but by the end, 262 had developed Alzheimer's.

To look for an effect of diet, the researchers gave each participant a score of 0 to 9 on a scale that measured how closely they followed the Mediterranean diet. Compared to those showing the lowest adherence, those who scored 4 or 5 showed 15 percent to 25 percent less risk of developing Alzheimer's during the study, while those with higher scores had about 40 percent less risk.

Middle aged and older men tend to be more satisfied with their sex lives than women in the same age group, according to the results of a global sex survey done by researchers at the University of Chicago.

The survey of 27,500 people aged 40 to 80 in 29 countries found that there was a substantial difference between men and women throughout the world, according to study head Edward Laumann.

"There's a systematic disparity between men and women, where men are on the average substantially -- or about 10 points -- higher in their levels of satisfaction as women in that country," he said.

The survey looked at how people viewed their sex lives, their health, and their happiness. Most of those surveyed were married.

Here are some other results of the survey:

The report appears in the Archives of Sexual Behavior.

Moderate, gentle exercise may actually be more effective for weight loss than strenuous aerobics, according to a new study from Greece.

Dr. Vassilis Mougios and his colleagues at Aristotle University of Thessaloniki randomly assigned 14 normal-weight and overweight women to one of two groups: One that exercised on a treadmill at a moderate pace, four times a week; and one that worked out at a more vigorous clip, also four times per week.

The researchers set the duration of the workouts so that women in both groups would burn 370 calories each time.

After three months, exercisers in both groups were slimmer, but the lower-intensity group lost more weight -- about 7 pounds on average, compared with 4 pounds in the high-intensity group.

It's possible, according to Mougios, that women in the high-intensity group shed fewer pounds because they ended up eating more, or were so drained by their regimen that they relaxed more in their leisure time.

Dr. Mougios says he's not suggesting that people who enjoy strenuous exercise quit. The most important thing, he says, is to stay active with various forms of exercise.

The study appears in the International Journal of Sports Medicine.

The following is an excerpt from

Over an extended period, no diet will work without exercise.

It's all about energy balance. If you are taking in more calories than you burn, the excess is stored as fat. To realign the balance, you need to increase the amount of energy you burn.

The beauty of exercise is that not only are you burning calories while you exercise - you continue to burn them hours later. But not all exercise is the same.

Muscle is the main engine burning fats and consuming calories. The more your muscles work, the easier it is to lose weight.

Starvation diets lower your thyroid function, making you tired. As a result, you tend not to exercise, and then weight loss becomes progressively more difficult. If you are having a lot of difficulty losing weight, I suggest you have your doctor perform a thyroid function test on you.

I caution readers to avoid aerobic exercise, as it leads to injuries and increased free radical generation. You are best served doing moderate exercise employing weights or other resistance exercises. This builds muscle and is also the best way to increase insulin function, which will help you avoid diabetes.

To start, exercise about 30 minutes a day. As you begin to feel better and get back into shape, increase this to an hour a day. Add to the resistance load accordingly. Exercise is an excellent way to reduce depression and reduce binge eating. Exercise also promotes the release of growth hormones and this reduces body fat.

Providing forearm support helps prevent the upper body pain associated with computer work, according to a study in The British Journal of Occupational and Environmental Medicine.

The study, done at the University of California, San Francisco, shows that use of large arm boards cuts neck and shoulder pain as well as hand, wrist and forearm pain.

"Based on these outcomes, employers should consider providing employees who use computers with appropriate forearm support," said lead author Dr. David Rempel, MD, MPH, director of the ergonomics program at San Francisco General Hospital.

The study also found that arm boards and ergonomics training provide the most protective effect, with a statistically significant reduction in both neck and shoulder pain and right hand/wrist/forearm pain.

The boards reduced the risk of incidence of neck and shoulder disorders by nearly half.

The one year, randomized study evaluated the effects of two workstation interventions on the musculoskeletal health of call center employees -- a padded forearm support and a trackball. The forearm support is commonly called an arm board and attaches to the top front edge of the work surface. The trackball replaces a computer mouse and uses a large ball for cursor motion.

For one year, 182 participants filled out a weekly questionnaire to assess pain level in their hands, wrists, arms, upper backs and shoulders.

The trackball intervention had no effect on right upper extremity disorders.

"The trackball was difficult for some participants to use," said Rempel. "Employees with hand pain may want to try them, but they should stop if it is difficult to use."

"Based on this study, it is in the best interest of the company and the employees to provide forearm supports and training," Rempel concluded.

The researchers also suggested several simple things computer users can do to reduce problems, including taking regular breaks, maintaining erect posture, adjusting chair height so thighs are parallel to the floor, working with forearms parallel to the floor, minimizing reach to mouse and keyboard, and keeping the center of the monitor approximately 15 degrees below the visual horizon.


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A new kind of cardiopulmonary resuscitation substantially improves the survival rate for most patients who have out-of-hospital heart attacks, according to a study at the University of Arizona. Called cardiocerebral resuscitation (CCR), the new technique involves starting...
Sunday, 23 April 2006 12:00 AM
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