News

Here's some good news for people who would like to have the ability to save a life with cardiopulmonary resuscitation, but feel they don't have time to acquire the skills.

New research, published in the medical journal Resuscitation, found that people learn as much in a 30-minute CPR course as in a traditional four-hour class.

The study, conducted by emergency doctors at the University of Texas Southwestern Medical Center at Dallas, showed that the ability to perform CPR and use an automated external defibrillator was as good or better in those who took the shorter course, even six months after training.

The key, they found, was in the method of teaching. The shorter courses involved more hands-on learning.

In the traditional four-hour course, there is one instructor and mannequin for every six to eight people, allowing little time for individuals to practise CPR.

In the 30-minute course, participants watched a DVD while practising CPR on their own mannequin. There was one facilitator for a group of 30. The short course included only five minutes of defibrillator training, but follow-up research showed that was all people needed.

The short course was not only less time-consuming, but less costly.

The research is important, the American Heart Association said in a statement, because the number one reason people cite for not learning CPR is the time required, followed by the cost.

Abortion pill safety

Performing abortions using prescription medicine is just as safe and effective as doing so using common surgical methods, according to a new study.

The research, published in The New England Journal of Medicine, seems to lay to rest concerns that abortion pills such as RU-486 can interfere with fertility and subsequent pregnancies.

"We found no evidence that a previous medical abortion, as compared with a previous surgical abortion, increases the risk of spontaneous abortion [miscarriage], ectopic pregnancy, preterm birth or low birth weight," said Jun Zhang, an epidemiologist at the U.S. National Institutes of Health and co-author of the study.

Abortion is legal in Canada, but the so-called abortion pill, mifepristone (formerly RU-486) is not available in this country. The drug is prescribed in the United States and commonly used in Europe.

In medical abortion, a woman takes one tablet of mifepristone - which destabilizes the connecting tissue between an embryo and the uterus - followed by about four misoprostol pills, which cause the uterus to expel the embryo. Surgical abortions are done by vacuuming out an embryo or fetus with a syringe or electric pump.

The study was conducted in Denmark, the only country to have an abortion registry. There, researchers could track the outcomes of pregnancies of women who had previously had abortions.

Heartburn and cancer

People with persistent heartburn (gastroesophageal reflux disease) have a dramatically higher risk of developing cancer of the esophagus, and now scientists think they've figured out why.

Heartburn occurs when acid splashes up from the stomach into the esophagus, the long tube that connects the stomach and the throat, causing a burning sensation.

Over time, the persistent acid bath can cause normal skin-like cells in the esophagus to change into tougher, more acid-resistant cells of the type found in the stomach and intestine, a condition called Barrett's esophagus.

"Unfortunately, those acid-resistant cells are also more prone to cancer," said Stuart Spechler, chief of gastroenterology at Dallas Veterans Affairs Medical Center and senior author of the paper published in the American Journal of Physiology - Gastrointestinal and Liver Physiology.

Researchers found that the altered cells in the esophagus contain shortened telomeres (the ending sequences in DNA strands), and these shortened sequences allow other cells more prone to cancer to take over.

The take-home message from the study is that it is important to prevent acid reflux, because the more heartburn you have and the longer you have it, the greater your risk of cancer.

A number of medications are used to treat GERD, including over-the-counter antacids such as Tums and prescription histamine blockers such as Zantac. The first line of defence, however, is a change in diet to avoid acidic, spicy and fatty foods, and losing weight.

Adenocarcinoma of the esophagus, the cancer associated with Barrett's esophagus, is currently the most rapidly rising cancer in the United States, with a sixfold increase in cases during the past 30 years, according to the U.S. National Cancer Institute.

More lung testing needed

Not nearly enough people are being tested properly for chronic obstructive pulmonary disease, scientists have found.

The research, published in the medical journal Chest, shows that only one-third of patients with a COPD diagnosis received spirometry testing.

Spirometry testing is an inexpensive, quick and painless procedure: The patient blows into a device that measures the amount of air expelled. The American Lung Association recommends that all current and former smokers over the age of 45 undergo the test, as well as anyone who suffers persistent wheezing or shortness of breath after mild exertion.

"Without proper testing, both underdiagnosis and misdiagnosis may occur, which can lead to improper therapies being prescribed," said MeiLan Han, a pulmonologist at the University of Michigan and lead author of the research.

"This study shows that we have a lot of work ahead of us in terms of raising awareness among both patients and physicians."

The study, which involved 5,039 patients diagnosed with COPD, found that only 32 per cent had undergone spirometry testing.

Dr. Han said the test is essential to distinguish COPD from other common respiratory ailments such as asthma.

At least 750,000 Canadians are living with COPD, a condition characterized by shortness of breath, wheezing and coughing; the symptoms grow progressively worse over time, and there is no cure. More than 10,000 Canadians a year die of COPD, making it the country's fourth leading killer.

apicard@globeandmail.com