Increasing cardiac arrest survival
Each year in the U.S., about 395,000 people suffer cardiac arrest outside of a hospital setting, and fewer than 6 percent of them survive. According to a new report from the Institute of Medicine (IOM), educating the public on how to recognize and respond to cardiac arrest is one strategy that could improve that survival rate.
The IOM noted in a news release that a cardiac arrest is not the same thing as a heart attack. A heart attack happens when blood flow to the heart is blocked, resulting in damage to heart muscle. Symptoms can include pain, dizziness, shortness of breath and more, and the goal of treatment is to reopen blocked arteries and restore blood flow. A cardiac arrest results from a disturbance in the electrical activity of the heart that causes it to stop beating. Cardiac arrest symptoms include an almost instantaneous loss of consciousness, and the goal of treatment is to facilitate the return of circulation and restore electric rhythm.
The IOM committee found that more than 80 percent of cardiac arrests happen in a home setting, and another person witnesses nearly half (46 percent) of in-home cardiac arrests. According to the IOM report, effective treatment of cardiac arrest requires an individual to immediately recognize it, call 911, start CPR and use an automated external defibrillator (AED). The odds of surviving cardiac arrest decrease by 10 percent with every minute that passes between the patient’s collapse and the return of spontaneous circulation.
Despite the critical need for quick intervention, each year in the U.S., less than 3 percent of the population receives CPR training.
“Cardiac arrest survival rates are unacceptably low,” said Robert Graham, who chaired the committee that wrote the IOM report. “Cardiac arrest treatment is a community issue, requiring a wide range of people to be prepared to act, including bystanders, family members, first responders, emergency medical personnel, and health care providers.”
The study was sponsored by the American Heart Association, the American Red Cross, American College of Cardiology, U.S. Centers for Disease Control and Prevention, the National Institutes of Health, and the U.S. Department of Veterans Affairs.
High school soccer and concussions
Researchers at the Colorado School of Public Health collected and analyzed data on a large, nationally representative sample of high school soccer players from 2005-2014 to learn about trends in concussions in male and female soccer players.
Overall, researchers found that for girls, concussions occurred at a rate of 4.5 per 10,000 athlete exposures, while for boys, there were 2.78 concussions sustained per 10,000 athlete exposures. An “athlete exposure” was defined as one high school athlete participating in one school-sanctioned soccer practice or competition.
The study found also that:
• For both boys and girls, player-player contact was the most common way concussions were sustained.
• Heading was the soccer-specific activity during which nearly one-third of concussions among boys and about one-fourth of concussions among girls occurred.
• Contact with another player was the most common mechanism of heading-related concussions among players.
Despite previous suggestions from others, the study authors concluded that banning heading from soccer would do little to reduce concussions among high school players.
“Athlete-athlete contact was the most common mechanism of all concussions among boys (68.8 percent) and girls (51.3 percent) regardless of the soccer-specific activity during which the injury occurred,” the authors stated. “These trends are consistent with prior literature. Therefore, we postulate that banning heading from soccer will have limited effectiveness as a primary prevention mechanism (i.e., in preventing concussion injuries) unless such a ban is combined with concurrent efforts to reduce athlete-athlete contact throughout the game.”
Tommy John surgeries surge
Tommy John surgery to treat overuse elbow injuries is increasing among youth athletes, according to new research.
At Rush University Medical Center in Chicago, Brandon Erickson, M.D., authored a study that found 15-19-year-olds accounted for 56.7 percent of Tommy John surgery patients in the U.S. from 2007-2011, with most surgeries performed between April and June.
“This is a significant increase over time with an average increase of 9.12 percent per year,” Erickson said. “The research numbers suggest that more young athletes believe that having (Tommy John surgery) performed earlier in their career may lead to the big leagues or a scholarship, even though only one in 200 kids who play high school baseball will make it to the MLB. This paradigm shift needs to be evaluated further to help prevent overuse injuries in kids from the beginning of the season when most issues arise.”
Colon cancer survival
People with colorectal cancer discovered during a routine screening colonoscopy are likely to live longer than those whose cancer is found after reporting symptoms, a recent study found.
Researchers in Germany looked at data on more than 300 people diagnosed with colorectal cancer from 2003-2005. Sixty of the patients were diagnosed during a screening colonoscopy, and 252 were diagnosed during a diagnostic colonoscopy performed after a positive fecal occult blood test and/or symptoms such as abdominal pain, iron deficiency anemia, weight loss, changes in bowel habits or rectal bleeding.
The researchers kept track of patients for as long as 10 years following their diagnosis and found that those whose cancer was discovered during a screening colonoscopy lived an average of 20.2 months longer than the other patients, who tended to have more advanced stage tumors. More than half (55 percent) of patients with diagnostic colonoscopy and 77 percent of screening colonoscopy patients survived beyond the study’s time period.
“We know that screening colonoscopy can prevent cancer by detecting and removing precancerous polyps,” said Kilian Friedrich, M.D., lead author of the study. “Independent of that, this study shows that screening colonoscopy also can contribute to reduced mortality from colorectal cancer by catching tumors at earlier and more treatable stages.”
Another year to comply
The U.S. Food and Drug Administration (FDA) is giving restaurant chains another year to publicly display food calorie counts.
Late in 2014, the FDA ruled that restaurants belonging to a chain of 20 or more locations had until December 2015 to clearly display calorie information for standard offerings on their menus and menu boards, but earlier this month, the FDA said it would extend that deadline to Dec. 1, 2016.
In announcing the extension, the FDA said additional time is necessary for the agency to “provide further clarifying guidance” to help restaurants come into compliance with the rule.
New NSAID warning
The U.S. Food and Drug Administration (FDA) is strengthening its existing labels of non-aspirin, non-steroidal anti-inflammatory drugs (NSAIDs) warning consumers that use of the products increases the risk of heart attack and stroke.
In an announcement issued July 9, FDA officials said prescription NSAID labels will be revised to inform people that:
• The risk of heart attack or stroke can occur as early as the first weeks of taking NSAIDs. Longer use of the NSAID may increase risk.
• The risk appears to be greater at higher doses.
• NSAIDs can increase heart attack or stroke risk in people with or without heart disease or risk factors for heart disease. A large number of studies supported that finding, with varying estimates of how much the risk is increased, depending on the drugs and the doses studied.
• In general, individuals with heart disease or risk factors for it have a greater likelihood of suffering a heart attack or stroke following NSAID use than people without risk factors.
• Patients who were treated with NSAIDs following a first heart attack were more likely to die in the first year after the heart attack than patients not treated with NSAIDs after a first heart attack.
• There is an increased risk of heart failure with NSAID use.
FDA officials said the agency would ask for similar updates to existing heart attack and stroke risk information included on the Drug Facts labels of over-the-counter non-aspirin NSAIDs.
Prescription NSAIDs are used for treating symptoms of many conditions, including osteoarthritis, rheumatoid arthritis, gout and more. Over-the-counter NSAIDs are used to reduce fever and relieve minor aches and pains and include ibuprofen (Motrin and Advil) and naproxen (Aleve). Some multi-symptom cold products also contain NSAIDs.
“Patients and health care professionals should remain alert for heart-related side effects the entire time that NSAIDs are being taken,” the FDA said. “Stop taking NSAIDs and seek medical help if you experience symptoms that might signal heart problems or stroke, such as chest pain, trouble breathing, sudden weakness in one part or side of the body, or sudden slurred speech.”
The FDA noted also that while aspirin is an NSAID, the revised warning does not apply to aspirin.
On the calendar
“Knee Replacement: Is it Right for Me?” is from 6-7 p.m. on Thursday, July 23 at the Desloge Outpatient Center, 121 St. Luke’s Center Drive in Chesterfield. An orthopedic physician presents a straightforward discussion about minimally invasive knee replacement surgery and other treatment options for arthritic knees. Admission is free; registration is required. Call (314) 542-4848, or visit stlukes-stl.com.
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Cholesterol and glucose wellness screenings are offered from 8-9:30 a.m. on Friday, July 24 at St. Luke’s Women’s Center, 6 McBride & Son Corp. Center Drive in Chesterfield. A one-on-one consultation also includes blood pressure and body composition measurement. A 10-12-hour fast and appointment are required. The fee is $20. Call (314) 542-4848.
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Missouri Baptist Medical Center offers free cholesterol and glucose screenings from 1:30-5 p.m. on Wednesday, July 29 in the pharmacy area at Dierbergs, 8 Four Seasons Center in Chesterfield. The screening measures glucose, total cholesterol and HDL and does not require fasting. Appointments are recommended. For more information, call (314) 996-5000.
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“I have Hip Pain: What are my Options?” is from 6-7 p.m. on Thursday, July 30 at the St. Luke’s Hospital Desloge Outpatient Center, 121 St. Luke’s Center Drive in Chesterfield. An orthopedic physician discusses the many causes of hip pain and answers participants’ questions. Admission is free; registration is required. Call (314) 542-4848, or visit stlukes-stl.com.
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“Balancing Your Life” is from 6:30-8 p.m. on Wednesday, Aug. 12 at St. Luke’s Hospital, 232 S. Woods Mill Road in Chesterfield. A certified holistic stress management instructor offers techniques to help participants better balance their lives and deal with common, everyday stressors. Admission is free. To register, call (314) 542-4848, or visit stlukes-stl.com.