Sunday, March 18, 2007

Cardiac arrest: forget the kiss of life

GEORGE BUSH the elder received one from a golfing buddy. Pierce Brosnan as James Bond laid one on Halle Berry in Die Another Day. Now the famous kiss of life - a mainstay of resuscitation for 50 years - should be allowed to slip back into history, a large Japanese study suggests. It shows people who collapsed suddenly with cardiac arrest had a 50 per cent higher chance of surviving if someone gave them heart massage alone rather than alternating it with breathing into their lungs.

There were several reasons why chest compressions might work better than traditional cardiopulmonary resuscitation (CPR), said the study leader, Ken Nagao, from Tokyo's Surugadai Nihon University Hospital. Interrupting chest compression to perform mouth-to-mouth ventilation might do more harm than good if blood flow to the heart was not properly re-established, he said. As well, many people were too squeamish to lock lips with a stranger, whereas more might be prepared to attempt hands-only resuscitation. "This reluctance is partly caused by fear of transmission of infectious diseases," Dr Nagao wrote yesterday in the medical journal The Lancet. "Another barrier to bystanders attempting CPR is the complexity of the technique as presently taught."

Dr Nagao and colleagues studied the medical histories of 4068 people who collapsed with a heart attack while someone else was present. Nearly three-quarters received no resuscitation at all, but of the others, those who were given heart compressions alone were 50 per cent more likely to be alive without brain damage a month later. Nevertheless, only a small proportion survived - 6 per cent in the heart-only group versus 4 per cent of those who also received the kiss of life. The results apply only to cardiac arrest and not to drowning, the other main use of mouth-to-mouth resuscitation.

Dr Gordon Ewy, the chief of cardiology at the University of Arizona College of Medicine, wrote in the same journal that the results "should lead to a prompt interim revision of the guidelines for out-of-hospital cardiac arrest. Eliminating the need for mouth-to-mouth ventilation will dramatically increase the occurrence of bystander-initiated resuscitation efforts and will increase survival."

Carol Cunningham, the co-ordinator of a Heart Foundation campaign to improve early detection of heart attacks, said: "Most out-of-hospital cardiac arrests occur in the person's home. The person who's on hand is usually a relative or friend and anything that simplifies [resuscitation] is important because it saves lives." But Ms Cunningham said the foundation would follow the advice of the Australian Resuscitation Council, whose chairman, Ian Jacobs, said he was not convinced that recommendations needed further change.

In a revision adopted last year, the council recommends 30 chest compressions followed by two mouth-to-mouth ventilations "in order to increase the number of compressions and reduce the number of interruptions", in line with the Japanese findings, Associate Professor Jacobs said. This advice had superseded guidelines that varied according to whether the patient was a child or adult and how many bystanders were able to assist. Ventilation of the lungs was crucial in children, Associate Professor Jacobs said, emphasising: "Any resuscitation attempt is better than no attempt."



They have been a common sight in Brisbane suburban gardens over the years, but now the humble pomegranate is reaching celebrity status in the UK. And it's all because of their supposed health benefits. Demand for the fruit has grown by 76 per cent across stores over the past year, figures from market analysts TNS show. Dubbed a "superfood", the pomegranate has overtaken blueberries as Britain's fastest growing seller, according to supermarket chain Tesco which sold 3.8 million pomegranates in the past year - an increase of two million on the previous year. Other products dubbed "superfoods" because of their health benefits include spinach, broccoli, avocados and fish rich in omega 3 oils.

The pomegranate is a native fruit of the Middle East which grows well in Queensland's tropical conditions. Just one pomegranate provides around 40 per cent of the daily recommended vitamin C intake. They also contain high levels of antioxidants and anti-inflammatory agents and have been shown to help with the treatment of a range of illnesses including osteoarthritis and cardiovascular disease.

Research from the US also has revealed that eating pomegranates slows down the progress of prostate cancer. Last year, a team at the University of California, Los Angeles found drinking just one glass of pomegranate juice a day could allow a man aged 65-70 years who already has prostate cancer to complete his normal lifespan without harsh medical treatments. More than 2500 men die from prostate cancer in Australia each year.

That US research team found pomegranate juice dramatically slowed prostate cancer in mice. "Our study, while early, adds to growing evidence that pomegranates contain very powerful agents against cancer, particularly prostate cancer," said Professor Hasan Mukhtar who led the study. "There is good reason now to test this fruit in humans, both for cancer prevention and treatment."


Journal abstract follows. Note that the research showed effects only in the test tube and in specially prepared mice. It is a big leap from that to an effect on human lifespan

Pomegranate fruit juice for chemoprevention and chemotherapy of prostate cancer

Arshi Malik et al

Prostate cancer is the most common invasive malignancy and the second leading cause of cancer-related deaths among U.S. males, with a similar trend in many Western countries. One approach to control this malignancy is its prevention through the use of agents present in diet consumed by humans. Pomegranate from the tree Punica granatum possesses strong antioxidant and antiinflammatory properties. We recently showed that pomegranate fruit extract (PFE) possesses remarkable antitumor-promoting effects in mouse skin. In this study, employing human prostate cancer cells, we evaluated the antiproliferative and proapoptotic properties of PFE. PFE (10-100 æg/ml; 48 h) treatment of highly aggressive human prostate cancer PC3 cells resulted in a dose-dependent inhibition of cell growth/cell viability and induction of apoptosis. Immunoblot analysis revealed that PFE treatment of PC3 cells resulted in (i) induction of Bax and Bak (proapoptotic); (ii) down-regulation of Bcl-XL and Bcl-2 (antiapoptotic); (iii) induction of WAF1/p21 and KIP1/p27; (iv) a decrease in cyclins D1, D2, and E; and (v) a decrease in cyclin-dependent kinase (cdk) 2, cdk4, and cdk6 expression. These data establish the involvement of the cyclin kinase inhibitor-cyclin-cdk network during the antiproliferative effects of PFE. Oral administration of PFE (0.1% and 0.2%, wt/vol) to athymic nude mice implanted with androgen-sensitive CWR22Rnu1 cells resulted in a significant inhibition in tumor growth concomitant with a significant decrease in serum prostate-specific antigen levels. We suggest that pomegranate juice may have cancer-chemopreventive as well as cancer-chemotherapeutic effects against prostate cancer in humans.


Just some problems with the "Obesity" war:

1). It tries to impose behavior change on everybody -- when most of those targeted are not obese and hence have no reason to change their behaviour. It is a form of punishing the innocent and the guilty alike. (It is also typical of Leftist thinking: Scorning the individual and capable of dealing with large groups only).

2). The longevity research all leads to the conclusion that it is people of MIDDLING weight who live longest -- not slim people. So the "epidemic" of obesity is in fact largely an "epidemic" of living longer.

3). It is total calorie intake that makes you fat -- not where you get your calories. Policies that attack only the source of the calories (e.g. "junk food") without addressing total calorie intake are hence pissing into the wind. People involuntarily deprived of their preferred calorie intake from one source are highly likely to seek and find their calories elsewhere.

4). So-called junk food is perfectly nutritious. A big Mac meal comprises meat, bread, salad and potatoes -- which is a mainstream Western diet. If that is bad then we are all in big trouble.

5). Food warriors demonize salt and fat. But we need a daily salt intake to counter salt-loss through perspiration and the research shows that people on salt-restricted diets die SOONER. And Eskimos eat huge amounts of fat with no apparent ill-effects. And the average home-cooked roast dinner has LOTS of fat. Will we ban roast dinners?

6). The foods restricted are often no more calorific than those permitted -- such as milk and fruit-juice drinks.

7). Tendency to weight is mostly genetic and is therefore not readily susceptible to voluntary behaviour change.

8). And when are we going to ban cheese? Cheese is a concentrated calorie bomb and has lots of that wicked animal fat in it too. Wouldn't we all be better off without it? And what about butter and margarine? They are just about pure fat. Surely they should be treated as contraband in kids' lunchboxes! [/sarcasm].

Trans fats:

For one summary of the weak science behind the "trans-fat" hysteria, see here. Trans fats have only a temporary effect on blood chemistry and the evidence of lasting harm from them is dubious. By taking extreme groups in trans fats intake, some weak association with coronary heart disease has at times been shown in some sub-populations but extreme group studies are inherently at risk of confounding with other factors and are intrinsically of little interest to the average person.