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  1. Atif Latif,
  2. Jonathan Wyatt

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Bad news for shift workers

Sophia is sure that many readers of the journal will be interested in a paper published in the BMJ 2012;345:e4800). A systematic review and meta-analysis investigated some of the potential risks associated with shift work and discovered a rather worrying answer. Shift work is associated with myocardial infarction, coronary events and ischaemic stroke and although the relative risks are modest, the population attributable risks are not insignificant. It is possible that disruption of circadian rhythms may be responsible for predisposing shift workers to vascular events.

Out of hospital cardiac arrest

In 2005, the American Heart Association published their ‘chain of survival’ concept for resuscitation of patients with out of hospital cardiac arrest. The chain will be familiar to many practitioners, comprising four links: early access to emergency medical care, early cardiopulmonary resuscitation, early defibrillation and early advanced cardiac life support. A recent paper in Circulation (2012;126:589–97) recommends the implementation of a fifth link: transfer to a tertiary hospital where patients may receive intensive post-resuscitation care, appropriate circulatory and respiratory support, therapeutic …

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