Ovarian cancer: Symptom screening may advance early detection
[black small square]According to a study recently published in CANCER, a symptom survey may provide a quick, cost- effective screening tool to detect early stages of ovarian cancer.
Ovarian cancer is considered to be a "silent killer" because it develops asymptomatically or with symptoms easily attributable to benign causes, and it's often not diagnosed until late in the disease, after a cure is likely. Currently, there is no effective screening test to detect early-stage ovarian cancer.
The CANCER study suggests that early-stage symptoms may be identifiable and could be used to develop a symptom index for early disease. Researchers compared the clinical history of women at high risk for developing ovarian cancer and women already diagnosed with the disease to develop a basic symptom index. They found that a fairly simple evaluation of symptoms of recent onset and significant frequency could be of use as a potential screening tool. According to the study, any complaint of pelvic/abdominal pain, increased abdominal size/bloating, or difficulty eating/feeling full that is present more than 12 days per month and for less than a year was 57% sensitive for early disease and 80% sensitive for advanced cancer; these symptoms were 90% specific for women age 50 or older and 86.7% for women under age 50.
Because the development of a screening blood test for ovarian cancer is years away, the symptom index could be used in combination with other methods to help with early detection.
Source: Goff B, et al. Development of an ovarian cancer symptom index: Possibilities for earlier detection. CANCER, January 15, 2007.
Cardiac care: New resuscitation guidelines may improve survival
[black small square]The American Heart Association's (AHA) latest resuscitation guidelines, which put greater emphasis on cardiopulmonary resuscitation (CPR), may improve survival after out-of-hospital cardiac arrest, according to a recent study.
The AHA guidelines, published in December 2005, call for a single shock from a defibrillator followed immediately by 2 minutes of CPR, beginning with chest compressions. The old guidelines, published in 2000, called for repeated shocks and a pulse check before starting CPR.
For the study, researchers trained a group of emergency medical technicians to follow the new protocol and reprogrammed defibrillators to support the new guidelines. They then compared survival (defined as surviving at least through hospital discharge) for the year after implementing the new guidelines with 3 years prior, when the old guidelines were in place. They found that from 2002 through 2004, survival rate after cardiac arrest averaged 33%. The survival rate of patients under the new guidelines increased to an average 46%.
While it's not a definitive study, the findings suggest that emergency medical teams should consider changing to the new 2005 guidelines to increase their patients' chances for survival.
Anger: Shocking facts about dysrhythmias
Acute anger may cause potentially fatal dysrhythmias, according to a recent study funded by the National Heart, Lung, and Blood Institute and the Guidant Foundation, Guidant Cardiac Rhythm Management. Researchers enrolled 1,188 patients with implantable cardioverter defibrillators (ICDs) in a 2-year study at more than 30 medical centers around the United States. Patients were asked how often they felt four levels of anger: mildly angry, moderately angry, very angry, and furious. They were told to call and report their experience when their ICD delivered a shock and to fill out a questionnaire about their emotions before the shock.
Researchers gathered interview data from patients after 271 events. In 199 of them, shocks were delivered in response to ventricular fibrillation (VF) or ventricular tachycardia (VT), and of those 199 shocks, 15 (17.5%) were preceded by at least moderate levels of anger within the hour before ICD discharge. The researchers found that it was 3.2 times more likely for VF or VT to develop after the patient became at least moderately angry; if the patient was very angry or furious, there was a 16.7-fold increased risk of having the ICD shock.
The results suggest that emotions, particularly anger, can trigger dangerous dysrhythmias.