emedinews Section
From the eMedinewS
Biomarker Predicts Colon Cancer Survival in Obese Patients A protein biomarker may predict better chances of survival for obese patients with colorectal cancer, but the biomarker held no prognostic value for nonobese patients, researchers found (April 27 issue of the Journal of the American Medical Association). Patients with a body mass index of 30 kg/m2 or more were 76% less likely to die from colorectal cancer when positive for cadherin-associated protein beta-1 (CTNNB1 or betacatenin, p < 0.001 for interaction) in analysis of nearly 1,000 prospectively-followed patients. Antifibrotic may Slow Diabetic Nephropathy Diabetic nephropathy may not just slow but may actually improve with the novel antifibrotic agent pirfenidone, researchers found in a preliminary study. Kidney function continued to drop in diabetic kidney disease patients without treatment, but rose significantly with a low-dose of pirfenidone over one year, Kumar Sharma, MD, of the University of California San Diego and VA Medical Center in La Jolla, Calif., and colleagues reported online in the Journal of the American Society of Nephrology. Some Benefit Seen for Ovary Removal at Hysterectomy Removing the ovaries at the same time as the uterus made a small risk of subsequent ovarian cancer even smaller without significantly increasing other risks, results of a large observational study showed. Breaking News: Person Revived after 96 Minutes of CPR A 54-year-old man with post-MI ventricular fibrillation regained spontaneous circulation after a dozen defibrillator shocks and continuous CPR for 96 minutes with full physical and neurological recovery reports Dr Roger D White at the Mayo Clinic in Rochester, Minn in a case report published online April 20 in the Mayo Clinic Proceedings. 680
The patient was resuscitated for initial 31 minutes by the emergency staff along with DC shocks. At the 31st minute a helicopter transport crew arrived and continued applying defibrillator shocks to the man who did not have a pulse, yet showed signs of systemic blood flow as measured by an end-tidal carbon dioxide sensor. The team administered a total of 12 defibrillator shocks and kept the patient’s blood flowing with continuous chest compressions. A key piece of technology on the scene was capnography, which measures how much blood is flowing through the lungs and subsequently to other organs. Capnography has been used to monitor patients in operating rooms but is not often used by ER when treating cardiac arrest. As the measurement remained sufficiently high, the rescuers were encouraged to continue resuscitation efforts. At the hospital, he was stabilized and taken to the cath lab and was stented for 100% occlusion in the mid-left anterior descending coronary artery. The persistent low blood pressure was stabilized with an intra-aortic balloon pump (IABP). The patient was discharged after 10 days with no neuro damage. Lessons Learned
It’s the only case where a person has been revived after 96 minutes of clinical death. We had a similar case where CPR was continued for 45 minutes. GB Pant reports a similar case with revival after an hour and with stenting (Dr Vijay Trehan) Medicolegal implications: Do not stop resuscitation for upto 100 minutes and make sure you measure E tube CO2 levels Transport the patient to nearest cardiac hospital for possible angiography and IABP, if required.
Too much Television may Increase Future Cardiovascular Risk for Children Young children who spend too much time watching TV or playing computer games have narrower eye Indian Journal of Clinical Practice, Vol. 21, No. 12, May 2011