A large observational study of bystander CPR in adults reaches the conclusion that "Cardiac-only resuscitation by bystanders is the preferable approach to resuscitation for adult patients with witnessed out-of-hospital cardiac arrest, especially those with apnoea, shockable rhythm, or short periods of untreated arrest. " Reasons for the findings, based on previous studies and animal research, include reluctance of bystanders to do CPR at all if mouth-to-mouth ventilation is included, the compression time lost during ventilation, and possibly complications of ventilation.
"We enrolled 42 546 children aged 1–36 months, contributing a total of 56 507 child-years in a randomised, double-blind, placebo-controlled trial in Pemba, Zanzibar."
"Overall, there was a non-significant 7% (95% CI −6% to 19%; p=0·29) reduction in the relative risk of all-cause mortality associated with zinc supplementation.
"Interpretation
"We believe that a meta-analysis of all studies of mortality and morbidity, will help to make evidence-based recommendations for the role of zinc supplementation in public health policy to improve mortality, morbidity, growth, and development in young children. "
Effects of zinc supplementation on child mortality.
Reviews results of 6 randomized controlled trials of zinc supplementation. Points out the need to define the best dose (perhaps higher than in the current study) and to learn the mechanism by which zinc has positive effects.
"Screening blood donations for anti-HCV is only partially performed in many developing countries due to the relatively high costs of testing. The screening expenditures can be reduced by testing donations in pools. This study evaluates the accuracy and feasibility of pooled screening procedure for anti-HCV in blood banks in Israel and the Palestinian Authority."
"CONCLUSIONS: We recommend using manually created pools of up to 6 samples when testing for anti-HCV, but at the cost of 3% loss in sensitivity. Pooling can be considered, in countries which do not perform routine screening, due to their limited economic resources."
Methods: "Prospective observational study conducted in a paediatric teaching hospital in Cape Town, South Africa. All children admitted to the paediatric intensive care unit (PICU) with suspected HIV infection were screened."
Conclusions: "The majority of HIV-infected children survived to discharge from PICU, but only half survived to hospital discharge. LOI [limitation of intervention] decisions, usually made in PICU, directly influenced short-term survival and the opportunity to commence HAART. Although few critically ill HIV-infected children survived to become established on HAART, the long-term outcome of children on HAART is encouraging and warrants further investigation."
Despite the perhaps confusing title, the study does not look at the question of the acute use of antiretroviral therapy (i.e, during the illness requiring hospitalization), although it speculates that it might be helpful. It simply reports that children who survived their illness and were candidates for ART did get ART and often did well on it. No surprise here.
Journal Club 
