Copy
BROUGHT TO YOU BY        


 

Apr 12, 2019

Mouth off

The story

Mouth-to-mouth resuscitation doesn't seem so icky compared to the sights of smells of your last night shift, but experts worry it turns bystanders away. How does compression-only CPR (CO-CPR) affect resuscitation rates?

The background

You don't blink when called to lead a code in the middle of the night, but your typical CPR bystander doesn't have that kind of training. Fortunately, there's not a lot of subtlety to chest compressions. Randomized trials have found that during dispatch-assisted CPR, in which bystanders perform CPR under the instructions of emergency medicine personnel over the phone, CO-CPR was similarly effective as standard (rescue-breath) CPR with a trend towards possible benefit. In 2010, European resuscitation guidelines were changed to recommended CO-CPR during dispatch-assisted CPR.

The study

A retrospective analysis of OHCA events in Sweden through 3 different guideline periods covering 2000 - 2017 found that CPR rates increased with the gradual introduction of CO-CPR. The proportion of OHCA patients receiving CPR changed from 41% from 2000 - 2005 (no CO-CPR) to 68% from 2011 - 2017, when CO-CPR was formally recommended for dispatch-assisted CPR. While standard CPR produced a small survival advantage compared to CO-CPR, OHCA patients who received any form of CPR were about twice as likely to survive at 30 days compared to those who didn't.
Circulation

The takeaway

While there's plenty of room for confounding variables in this time-period based retrospective study, the message is clear: any form of CPR is better than none. Strategies that increase bystander participation help save lives.

Say it on rounds

When you wonder if Jon and Dany are a thing

Season 8 is on the way with answers. And if you wonder if your patient with non-small-cell lung cancer (NSCLC) will respond to immunotherapy, look to PD-L1 expression: a phase 3 study of pembrolizumab vs. chemotherapy in 1,200 patients with advanced NSCLC found a median survival advantage favoring pembro for patients with PD-L1 expression as low as ≥ 1% (17 vs. 12 months). Previously, pembro had only shown a survival advantage for patients with PD-L1 ≥ 50%. The FDA chose to expand the approval of single-agent pembro in NSCLC in line with these results.
Lancet

When you can't get a wet read

Sometimes radiologists have fancier stuff to do than checking line placement. Using PET imaging designed to detect tau deposition in the brain, researchers compared the brains of 26 former NFL players with cognitive symptoms to 31 healthy controls. For the NFL players, tau deposition – as measured by PET uptake – matched chronic traumatic encephalopathy (CTE) patterns previously only seen on autopsies. Many are hopeful the imaging technique can monitor CTE changes in living patients.   
NEJM

When your research is way behind schedule

If only there were a quick fix. CABANA randomized 2,200 patients with atrial fibrillation (AF) to catheter ablation or conventional medical therapy. After median follow-up of 4 years, catheter ablation failed to improve a primary endpoint of death, stroke, bleeding or arrest compared to medical therapy. Ablation did improve a secondary endpoint of death and CV hospitalization (52% vs. 58% with medical therapy), and a secondary analysis found that ablation improved quality-of-life scores at 12 months.
JAMA
SPONSORED
TOGETHER WITH LAUREL ROAD
Now that you’ve learned about how you could be saving on student loans and common misconceptions about refinancing, it’s time to take the next step and get your application started!

How does it work?
  • Get Your Preliminary Rate¹ – fill out our 5-minute² application and get preliminary rates instantly if you are eligible

  • Upload Your Documents – upload files that verify your information and identify to finalize your rate offer

  • Choose Your Loan – select your rate, sign your final documents online, and start saving
As a Scope reader, you’ll receive a $300 bonus³ when you refinance with Laurel Road. Click here to check your rate.

Brush up

Crohn's disease

Abdominal pain, diarrhea, failure to thrive, and extraintestinal manifestations like uveitis and ankylosing spondylitis are prominent symptoms of Crohn's disease (CD). Relative to its IBD partner-in-crime ulcerative colitis, CD can affect any part of the GI tract and can cause transmural inflammation of the gut mucosa that can lead to fistulae and strictures. Treatment generally starts with mesalamine, though several immune-modulating biologics have proven effective for refractory or persistent disease.

Get meta

With fecal calprotectin and IBD. While your friends are sure they need an endoscopy for their strange bowel habits, a 2010 analysis of 1,000 patients across 13 studies found that fecal calprotectin had a pooled sensitivity of 93% and pooled specificity of 96% in adults and 92% and 76% in children when measured alongside gold standard endoscopy for detection of IBD. The researchers estimated that use of fecal calprotectin as a screening test for IBD could reduce IBD-related endoscopies by 67% in adults.

What your space medicine friends are talking about

Ever wonder what your twin would look like after a year of golden weekends and waking up at 9 AM? Scientists answered that question for astronauts, measuring how Scott Kelly's body changed in space compared to his earthbound brother Mark.

Spread the word

Send your interns something to look forward to

  

We're off next week and will return on April 26th

Sign up at medicinescope.com

¹Preliminary rates mean a delivery of personalized rates for those individuals who provide sufficient information to return a rate. For preliminary rates a soft credit pull will be conducted, which will not affect your credit score. To proceed with an application, a hard credit pull will be required, which may affect your credit score.
²5-minutes indicates typical time it takes to complete application with applicant information readily available. It does not include time taken to provide underwriting decision or funding of the loan.
³The Scope reader $300 cash bonus is offered for applications from active The Scope readers. The loan application must close in order to qualify for the bonus. Offer cannot be combined with other Laurel Road offers, including the Referral Program. Existing customers are not eligible.

Loans provided by KeyBank N.A

Copyright © 2019 Scope Media, LLC. All rights reserved.