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Does “I Know CPR” Mean You Can Do CPR?

While I was browsing the produce section of my grocery store the other day, the sound of a panicked voice coming over the store’s loudspeaker made me jump. “Does anyone in the store know CPR? Anyone? CPR? We need you in baked goods!”

I froze. In theory, I know how to perform CPR — cardiopulmonary resuscitation. I took a two-hour course on it nearly 25 years ago. But I hadn’t given it much thought since then and I certainly hadn’t practiced what I learned.

My mind started whirling as I tried to remember the sequence of steps. They’d changed the rules a few years back — I knew that much — so I wouldn’t have to do mouth-to-mouth resuscitation. But where exactly on the chest was I supposed to push? Should I form a fist and push down with my knuckles, or use the ball of my hand?

Suddenly, sirens wailed outside the store. The rescue squad had arrived. Too late, as I learned afterward, for this man, who was a victim of a sudden cardiac arrest. This type of heart attack strikes so fast that there usually aren’t any warning signs. You might see someone grasp his or her chest, collapse, twitch and gasp a few times, and then lie deathly still.

At that point, every minute counts. Enough oxygen remains in the person’s bloodstream to nourish the brain for several minutes — but a bystander has to circulate oxygenated blood to the brain and other organs by pushing down on the chest hard and fast, mimicking the heartbeat.

I’m a health writer. I knew this intellectually. But until those agonizing moments in the grocery store, I never really understood on a gut level just how important every minute is. Read more »

*This blog post was originally published at Harvard Health Blog*

Coffee And Stroke: Another Study The Media Got Wrong

Here we go again. Headlines across America blaring lines like, “Coffee may reduce stroke risk.”

It was a big study, but an observational study. Not a trial. Not an experiment. And, as we say so many times on this website that you could almost join along with the chorus, observational studies have inherent limitations that should always be mentioned in stories. They can’t prove cause and effect. They can show a strong statistical association, but they can’t prove cause and effect. So you can’t prove benefit or risk reduction. And stories should say that.

USA Today, for example, did not explain that in its story. Nor did it include any of the limitations that were included in, for example, a HealthDay story, which stated:

“The problem with this type of study is that there are too many factors unaccounted for and association does not prove causality, said Dr. Larry B. Goldstein, director of the Duke Stroke Center at Duke University Medical Center.

“Subjects were asked about their past coffee consumption in a questionnaire and then followed over time. There is no way to know if they changed their behavior,” Goldstein said.

And, he noted, there was no control for medication use or other potential but unmeasured factors.

“The study is restricted to a Scandinavian population, and it is not clear, even if there is a relationship, that it would be present in more diverse populations. I think that it can be concluded, at least in this population, that there was not an increased risk of stroke among coffee drinkers,” he said.”

When you don’t explain the limitations of observational studies — and/or when you imply that cause and effect has been established — you lose credibility with some readers. And you should. Read more »

*This blog post was originally published at Gary Schwitzer's HealthNewsReview Blog*

Nearly 12 Million Cancer Survivors In The U.S.

The number of cancer survivors in the United States increased to 11.7 million in 2007, according to a report released by the Centers for Disease Control and Prevention (CDC) and the National Cancer Institute (NCI), part of the National Institutes of Health (NIH). Women survive more often, and survive longer, according to the report.

There were 3 million cancer survivors in 1971 and 9.8 million in 2001. Researchers attributed longer survival to a growing aging population, early detection, improved diagnostic methods, more effective treatment and improved clinical follow-up after treatment.

The study, “Cancer Survivors in the United States, 2007,” is published today in the CDC’s Morbidity and Mortality Weekly Report.

To determine the number of survivors, the authors analyzed the number of new cases and follow-up data from NCI’s Surveillance, Epidemiology and End Results Program between 1971 and 2007. Population data from the 2006 and 2007 Census were also included. The researchers estimated the number of persons ever diagnosed with cancer (other than non-melanoma skin cancer) who were alive on Jan. 1, 2007. Read more »

*This blog post was originally published at ACP Internist*

Pregnant Women And Exposure To Paint

I came across an article the other day about paint and pregnancy. Yes, that paint — the kind that you put on a canvas or slap on your walls. Did you know that paint is made of pigment particles in a liquid base called a medium? Oil paints are thinned or cleaned with paint thinners. Latex paints are thinned or cleaned with water. Most paint that’s used in the home is latex.

Can environmental forces affected pregnancy? The short answer is “yes,” according to the Organization of Teratology Information Specialists (OTIS), whose mission is to study malformations of the unborn.

Regarding paint and pregnancy, the amount of exposure is important. A one-time household exposure causes fewer problems than ongoing exposure through a work setting. And there have been medical studies documenting babies being born with problems if their mothers abused toluene-containing paint in order to “get high.” Toluene is a paint thinner that can cause low birth weight, premature labor, small head size, and developmental delays. Again, these problems only occur if pregnant women have been exposed to very high levels of toluene — much higher levels than exposure based on a hobby or a professional painter.

According to OTIS, working as a painter doesn’t pose concrete risks to the pregnancy. However, any reduction in chemical exposure is always a good thing. Read more »

*This blog post was originally published at Dr. Linda Burke-Galloway*

What I Want Her To Know About Diabetes

After a tough low this morning:

I want her to know that she was wanted so much, well before she arrived, and that her parents went to great lengths to make sure her arrival was as safe as they could manage.

I want her to know that those moments when she has to wait while I test, or while I bolus, or the times when I have to set her in her crib and gulp down grape juice while she stands there with her big, brown eyes staring at me while her mouth tugs into an impatient smile, that I love her and I just need to deal with diabetes for a few seconds so I can be the best mommy I can.

I want her to know that if my eyes don’t get better, it’s not her fault. It’s not my fault, either. The fault lies with diabetes.

I want her to know that the reason I’ll sometimes frown at a soggy diaper or a voracious pull from the bottle isn’t because she’s being “bad” or doing something wrong, but because I’m worrying.

I want her to know that just because I have it, and because some of her best buddies have it, doesn’t mean that she will have it. But I also want her to know that if a diagnosis of any kind ever touches her life, we’ll manage just fine and take the best care of one another that we can.

I want her to know that when she smiles at me, it’s like a thousand online communities inspiring me all at once. That the hope of her was once the biggest incentive to improve my health, only to be superseded by her arrival in my arms.

I want her to know that regardless of what she may hear about this “diabetes,” her mommy is going to be just fine. Just fine.

*This blog post was originally published at Six Until Me.*

Latest Interviews

IDEA Labs: Medical Students Take The Lead In Healthcare Innovation

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How To Be A Successful Patient: Young Doctors Offer Some Advice

I am proud to be a part of the American Resident Project an initiative that promotes the writing of medical students residents and new physicians as they explore ideas for transforming American health care delivery. I recently had the opportunity to interview three of the writing fellows about how to…

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Latest Book Reviews

Book Review: Is Empathy Learned By Faking It Till It’s Real?

I m often asked to do book reviews on my blog and I rarely agree to them. This is because it takes me a long time to read a book and then if I don t enjoy it I figure the author would rather me remain silent than publish my…

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The Spirit Of The Place: Samuel Shem’s New Book May Depress You

When I was in medical school I read Samuel Shem s House Of God as a right of passage. At the time I found it to be a cynical yet eerily accurate portrayal of the underbelly of academic medicine. I gained comfort from its gallows humor and it made me…

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Eat To Save Your Life: Another Half-True Diet Book

I am hesitant to review diet books because they are so often a tangled mess of fact and fiction. Teasing out their truth from falsehood is about as exhausting as delousing a long-haired elementary school student. However after being approached by the authors’ PR agency with the promise of a…

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