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A Seattle woman was listed in serious condition Sunday after she was struck on Highway 92 near Granite Falls while riding a bicycle. ...

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By Julie Rooney/Enterprise staff writer. After pedaling more than 2,000 miles, Doug Waterman is home. One wipe-out, several flat ...

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Accra, June 27, GNA - William Afful, 27, of Fire Bunch Cycling club in Nungua on Sunday, became the new wonder kid in the sport when he pulled the biggest ...

Sportinglife.com - UK
... In Scotland, Trick Cyclist looks the one to be on in the Hamilton Park Super Six Stakes after showing his first bit of decent form for a while last time out. ...

Don't worry, Old Glory can take the heat

Jewish World Review

Jewish World Review June 27, 2005 / 20 Sivan, 5765

By Mark Steyn

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http://www.JewishWorldReview.com | The House of Representatives passed a constitutional amendment on flag burning last week, in the course of which Rep. Randy ''Duke'' Cunningham (Republican of California) made the following argument:

''Ask the men and women who stood on top of the Trade Center. Ask them and they will tell you: Pass this amendment."

Unlike Congressman Cunningham, I wouldn't presume to speak for those who died atop the World Trade Center. For one thing, citizens of more than 50 foreign countries, from Argentina to Zimbabwe, were killed on 9/11. Of the remainder, maybe some would be in favor of a flag-burning amendment; and maybe some would think that criminalizing disrespect for national symbols is unworthy of a free society. And maybe others would roll their eyes and say that, granted it's been clear since about October 2001 that the federal legislature has nothing useful to contribute to the war on terror, and its hacks and poseurs prefer to busy themselves with a lot of irrelevant grandstanding with a side order of fries, but they could at least quit dragging us into it.

And maybe a few would feel as many of my correspondents did last week about the ridiculous complaints of ''desecration'' of the Quran by U.S. guards at Guantanamo — that, in the words of one reader, ''it's not possible to 'torture' an inanimate object.''

That alone is a perfectly good reason to object to a law forbidding the "desecration" of the flag. For my own part, I believe that, if someone wishes to burn a flag, he should be free to do so. In the same way, if Democrat senators want to make speeches comparing the U.S. military to Nazis and the Khmer Rouge, they should be free to do so. It's always useful to know what people really believe.

For example, two years ago, a young American lady, Rachel Corrie, was crushed by an Israeli bulldozer in Gaza. Her death immediately made her a martyr for the Palestinian cause, and her family and friends worked assiduously to promote the image of her as a youthful idealist passionately moved by despair and injustice. ''My Name Is Rachel Corrie,'' a play about her, was a huge hit in London. Well, OK, it wasn't so much a play as a piece of sentimental agitprop so in thrall to its subject's golden innocence that the picture of Rachel on the cover of the Playbill shows her playing in the backyard, age 7 or so, wind in her hair, in a cute, pink T-shirt.

There's another photograph of Rachel Corrie: at a Palestinian protest, headscarved, her face contorted with hate and rage, torching the Stars and Stripes. Which is the real Rachel Corrie? The "schoolgirl idealist" caught up in the cycle of violence? Or the grown woman burning the flag of her own country? Well, that's your call. But because that second photograph exists, we at least have a choice.

Have you seen that Rachel Corrie flag-burning photo? If you follow Charles Johnson's invaluable Little Green Footballs Web site and a few other Internet outposts, you will have. But you'll look for it in vain in the innumerable cooing profiles of the "passionate activist" that have appeared in the world's newspapers.

One of the big lessons of these last four years is that many, many beneficiaries of Western civilization loathe that civilization — and the media are generally inclined to blur the extent of that loathing. At last year's Democratic Convention, when the Oscar-winning crockumentarian Michael Moore was given the seat of honor in the presidential box next to Jimmy Carter, I wonder how many TV viewers knew that the terrorist ''insurgents'' — the guys who kidnap and murder aid workers, hack the heads off foreigners, load Down's syndrome youths up with explosives and send them off to detonate in shopping markets — are regarded by Moore as Iraq's Minutemen. I wonder how many viewers knew that on Sept. 11 itself Moore's only gripe was that the terrorists had targeted New York and Washington instead of Texas or Mississippi: ''They did not deserve to die. If someone did this to get back at Bush, then they did so by killing thousands of people who DID NOT VOTE for him! Boston, New York, D.C. and the plane's destination of California — these were places that voted AGAINST Bush!"

In other words, if the objection to flag desecration is that it's distasteful, tough. Like those apocryphal Victorian matrons who discreetly covered the curved legs of their pianos, the culture already goes to astonishing lengths to veil the excesses of those who are admirably straightforward in their hostility.

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If people feel that way, why protect them with a law that will make it harder for the rest of us to see them as they are? One thing I've learned in the last four years is that it's very difficult to talk honestly about the issues that confront us. A brave and outspoken journalist, Oriana Fallaci, is currently being prosecuted for ''vilification of religion,'' which is a crime in Italy; a Christian pastor has been ordered by an Australian court to apologize for his comments on Islam. In the European Union, ''xenophobia'' is against the law. A flag-burning amendment is the American equivalent of the rest of the West's ever more coercive constraints on free expression. The problem is not that some people burn flags; the problem is that the world view of which flag-burning is a mere ritual is so entrenched at the highest levels of Western culture.

Banning flag desecration flatters the desecrators and suggests that the flag of this great republic is a wee delicate bloom that has to be protected. It's not. It gets burned because it's strong. I'm a Canadian and one day, during the Kosovo war, I switched on the TV and there were some fellows jumping up and down in Belgrade burning the Stars and Stripes and the Union Jack. Big deal, seen it a million times. But then to my astonishment, some of those excitable Serbs produced a Maple Leaf from somewhere and started torching that. Don't ask me why — we had a small contribution to the Kosovo bombing campaign but evidently it was enough to arouse the ire of Slobo's boys. I've never been so proud to be Canadian in years. I turned the sound up to see if they were yelling ''Death to the Little Satan!'' But you can't have everything.

That's the point: A flag has to be worth torching. When a flag gets burned, that's not a sign of its weakness but of its strength. If you can't stand the heat of your burning flag, get out of the superpower business. It's the left that believes the state can regulate everyone into thought-compliance. The right should understand that the battle of ideas is won out in the open.

Every weekday JewishWorldReview.com publishes what many in in the media and Washington consider "must-reading". Sign up for the daily JWR update. It's free. Just click here.

JWR contributor Mark Steyn is North American Editor of The (London) Spectator. Comment by clicking here.

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"The Face of the Tiger and Other Tales from the New War."  

In this collection of essays, Mark Steyn considers the world since September 11th - war and peace, quagmires and root causes, new realities and indestructible myths. Incisive and witty as ever, Steyn takes on "the brutal Afghan winter", the "axels of evil", the death of Osama bin Laden and much more from the first phase of an extraordinary new war. Sales help fund JWR.

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... day chores, like stocking supplies and cleaning equipment. Being an EMT or a paramedic isn't just about going on ambulance calls.".

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Louisville -- On Monday, the public will get a sneek peek at what is in store for Louisville Metro EMS. The Mayor's office will ...

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The Gift of Singlehood

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The Gift of Singlehood In preparation for meeting your soul mate, now is the time to develop the burning desire to give.

When I was five, I wanted cookies. When I was 10, I wanted to go everywhere my big sister went. At age 16 I wanted a later curfew, an invitation to the prom, a driver's license and the keys to the car. The endless list of things I've desired over the years has included: a college degree, a tan, a job, a better job, a raise, a boyfriend, a better boyfriend, a husband, a baby, health, a better relationship with my parents, a better relationship with God, and world peace.

Currently, I'm finding myself wanting more time, more sleep, more storage space, and well... cookies.

Such is life. We graduate from one desire to the next. We live in a constant state of wanting.

We are creatures of want.

We graduate from one desire to the next, living in a constant state of wanting.

Soon after we get the object of our desire, we move on to the next desire. This is neither good nor bad in and of itself. Our desires can become the focus of our existence, or they can be a goal that we are moving toward, but not limited by.

Wanting, focusing on goals, is a positive thing. It can help us grow. A baby's desire for a toy that is out of reach motivates him to learn to crawl.

But wanting can also have a negative effect. Focusing on a future goal can take your focus away from the here and now. Being distracted from your current situation can rob you of the potential that the moment holds. It doesn't matter if what you want is noble, worthy, and provides positive benefit. If it causes you to ignore the present, it has this negative aspect.


If the object of your desire is marriage, you might be spending a lot of time concerned about the future. You may feel like real life is still waiting for you, out there, after you meet your soul mate. The life you are living now is a stopgap until your number is called and you get to walk down the aisle to your brand new life, the life you are focused on, the life you want.

The danger in this situation is that you could miss seeing the potential that lies in the current moment. This danger, of focusing on what we want to the detriment of recognizing the potential of our current situation, exists more for singles than for other individuals who don't have what they want. No want is equal to the desire of a significant other when it comes to how society views us, and how we view ourselves.

Welcome to singlehood.

Your current situation has a potential for growth that will never exist at any other time in life.

The word "single" in and of itself categorizes an entire group by what they are lacking, what they are seeking. It means alone, apart from the object of your desire. When you look at any other group that is without their object of desire, they are not called "alone." Would you ever describe someone who wanted a cookie as lonely?

And that's why it's so crucial to realize: The current situation, looking for your soul mate, has a certain potential for growth that will never exist again at any other time in life. Right now is an opportunity. Right now is a gift.

But if you are too focused on getting married, you may miss taking advantage of this precious time in your life.


The first step in realizing the potential of the moment is to appreciate that there are no accidents. You are not single by accident. There has to be a reason, a purpose. God can work things out. God is all good. He has decided that right now, this is the best thing for you. So if he isn't working things out the way you'd like, there must be meaning and potential in your current situation.

In order to learn what being single is about, let's look at the first single who ever existed, Adam:

Classified Ad: Single man, very spiritual, down to earth, likes gardening, dislikes snakes. Seeks life partner who can be my equal, to challenge me, help me grow, and keep me on the straight and narrow.

Humanity was created in two stages. The first being (Adam) was androgynous. All that was female and all that was male existed as one. One body, one soul. Then God makes a very interesting statement: "It is not good for man to be alone" (Genesis 2:18).

Up until now in the creation story, God's running commentary is that everything is good, meaning that everything has all that it needs to do what it was created to do. Not so of man. Man's aloneness will keep him from fulfilling his potential.

There was a purpose for Adam's creation as a bachelor.

The second stage of human creation is the division of male and female. All that is female, physically and spiritually, is separated from this first being (Adam) and placed in its own vessel (Eve). Now man is not alone. He has a wife.

Why didn't God create Adam and Eve as separate beings in the first place? God doesn't make mistakes; therefore, there must have been a purpose for Adam's creation as a bachelor.

During singlehood, Adam went through an exercise, as per God's request, of naming all the animals. By naming each of the animals, he understood the essence of each creature and realized his uniqueness among them. Adam was created B'tzelem Elokim -- in the image of God. Since God has no form, "image" cannot be taken literally. Rather it refers to our ability to relate to other human beings, our capacity to care and to give. This is the meaning of the image of God.


This ability to give could not be expressed when there was just Adam. As a bachelor, he had no one to give to. Man needed an equal in order to express this level of giving. The creation of Eve was the creation of society (not just the creation of women) and the creation of the ability to give meaningfully.

God did not just create the ability to give, He created the desire, the wanting to give, which preceded this ability. "It is not good for man to be alone." During this stage of singlehood we discover our need to give. And this is the time for developing our desire to give.

Singlehood is the time to develop the craving, the absolute burning desire to give.

This is the "now" of being single. Singlehood is the time to develop the craving, the absolute burning desire to give. This is where the pain of being single comes from. Developing an awareness of this need to give, and not having the fullest opportunity to express it.

Real giving means to look at what the other person needs. Learning to understand a person's real needs is the primary skill required for a successful marriage. Giving is only meaningful when it takes into consideration what the receiver needs, not what you want or are able to give. When you focus on the needs of others you are developing sensitivity toward them. You grow into the other person's world and begin to understand them on a very deep level.

Singlehood is the time to practice becoming a giver. Look around you for opportunities to develop as a giver. Are there poor people? Sick? An elderly neighbor? A lonely relative? Get out of your mindset and see how the other person thinks. This is the first step towards meaningful giving, to becoming the greatest "you" -- in preparation for your soul mate.

Now is the time.

based on a lecture by Rabbi Yitzchak Berkowitz

Published: Sunday, April 21, 2002

Updates & Comments on Defib Death

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Heart attack treatment: Better late than never

Science News Online

Week of June 25, 2005; Vol. 167, No. 26 , p. 413

Ben Harder

Results from a new study contradict the prevailing notion that heart attacks run their course in less than a day and suggest that even delayed treatment can preserve heart tissue that otherwise would die.

Widely used guidelines for treating heart attacks recommend deploying procedures for clearing blocked heart arteries only if the patient can be treated within 12 hours of the attack's onset (see "A Matter of Time," in this week's issue). In Europe and North America, up to 40 percent of people who have severe heart attacks don't get to the hospital within that period, says cardiologist Albert Schömig of the German Heart Center at Munich Technical University. Those latecomers traditionally receive only supportive care for their hearts, which are presumed to have been irreparably damaged.

The new study enlisted 365 patients who arrived at any of 16 hospitals in Germany, Italy, and Austria between 12 and 48 hours after their heart attacks began. Schömig's team treated about half of these patients the traditional way. In the rest, the team performed such procedures as propping open the obstructed artery with a stent.

Diagnostic images made about a week after each attack showed that the latter group had less dead heart tissue than did the group that got standard care, Schömig and his colleagues report in the June 15 Journal of the American Medical Association .

If you have a comment on this article that you would like considered for publication in Science News, send it to editors@sciencenews.org . Please include your name and location.


Gibbons, R.J., and C.L. Grines. 2005. Acute PCI for ST-segment elevation myocardial infarction: Is later better than never? Journal of the American Medical Association 293(June 15):2930-2932. Extract available at http://jama.ama-assn.org/cgi/content/extract/293/23/2930.

Schömig, A. . . . and A. Kastrati; for the Beyond 12 hours Reperfusion AlternatiVe Evaluation (BRAVE-2) Trial Investigators. 2005. Mechanical reperfusion in patients with acute myocardial infarction presenting more than 12 hours from symptom onset. Journal of the American Medical Association 293(June 15):2865-2872. Abstract available at http://jama.ama-assn.org/cgi/content/abstract/293/23/2865 .

Further Readings:

Harder, B. 2005. A matter of time. Science News 167(June 25):408-409. Available to subscribers at http://www.sciencenews.org/articles/20050625/bob8.asp .


Adnan Kastrati
Deutsches Herzzentrum
Technische Universität München
Lazarettstrasse 36
80636 Munich

Albert Schömig
Deutsches Herzzentrum
Technische Universität München
Lazarettstrasse 36
80636 Munich

From Science NewsVol. 167, No. 26, June 25, 2005, p. 413.

A Matter of Time

Science News Online

Week of June 25, 2005; Vol. 167, No. 26 , p. 408

Should most hospitals send away heart attack patients?

Ben Harder

When a heart attack strikes, cardiologist William O'Neill wants to see the patient quickly. But it doesn't always work out that way. Once, for instance, a man whom O'Neill had previously treated was transported to a hospital in a different suburb of Detroit, even though the patient's wife pleaded with the ambulance company to take him straight to Beaumont Hospital in Royal Oak, Mich., where O'Neill works. At the first facility, doctors evaluated the man and decided that he needed more care than they could provide. So, they sent him back on the road. All told, it took 3 hours for the patient to reach O'Neill's cardiac catheterization unit. Yet it was just 30 minutes from the man's home.


GETTING AROUND. If transferring patients between hospitals didn't take so long, more people might receive the most-effective treatment for severe heart attacks.
Getty Images

Once the man reached Beaumont, the cardiac team used a catheter to insert a balloonlike device into his blocked heart artery and inflate it. That procedure, known as angioplasty, prized open the vessel and restored blood flow to the suffocating heart muscle downstream of the congestion. Although the man survived the ordeal, his heart suffered.

"There was lots of damage to the heart muscle that could have been avoided if he had gotten to our place sooner," O'Neill says.

Emergency angioplasty is more effective in treating the most serious kind of heart attack than is its main alternative, which relies on intravenous drugs called thrombolytics to break up arterial clots. Angioplasty is particularly effective when it's followed by the insertion of a mesh support tube, or stent, into the artery. "This is the preferred therapy," says Alice K. Jacobs, president of the American Heart Association.

Most studies haven't found a benefit to using a combination of clot-busting drugs and angioplasty.

Perhaps a fifth of U.S. hospitals offer angioplasty on an emergency basis. Most hospitals either don't have the facilities or staff to perform the procedure or find it impractical to have them available 24 hours a day, says cardiologist Ellen C. Keeley of the University of Texas Southwestern Medical Center in Dallas.

As a result, in the United States, the majority of severe heart attacks—those known as ST-segment-elevated myocardial infarctions—get treated only with clot-busting agents.

For patients found to need angioplasty, a few U.S. cities have local agreements among hospitals and ambulance companies that facilitate immediate transfer from a hospital not offering it to one that does. Furthermore, in Boston, medics riding in ambulances have the tools to identify patients with severe heart attacks and take those patients only to hospitals that perform angioplasty.

But shuttling a patient from place to place in the midst of a heart attack is risky. "Heart muscle is dying as the clock is ticking," says cardiologist Elliott M. Antman of Brigham and Women's Hospital in Boston.

Over the past few years, data accumulated in several carefully orchestrated clinical trials have revealed that systematically redirecting patients to angioplasty-ready hospitals can improve health outcomes—at least when the associated delays are brief. Evidence gathered outside of such trials, however, suggests that transfer-related delays are significant in much of the United States.

Dane to consider

Cardiologist Henning Rud Andersen lives and works in Aarhus, a Danish city with about 400,000 residents and two hospitals. A decade ago, his center, Skejby Hospital, was the only one in Denmark to offer emergency angioplasty. The hospital across town, like others in the nation, used thrombolytic drugs instead. Which hospital the ambulance went to determined which treatment a patient got for a heart attack. That generated a discussion among local cardiologists, Andersen says.

"It was an unethical strategy within one city to have two different treatments," he says. "So, we agreed within this city that we would have only one strategy. If a patient came into the other hospital in our city, we transferred that patient."

But that resolution only confronted the physicians with a broader geographic dilemma, Andersen recalls. The next question to arise regarded a hospital 30 kilometers to the north of Aarhus. Should that facility administer drugs or transfer patients to Skejby Hospital? "The argument was, 'It's unethical to have two different treatments within the same county,'" says Andersen. In the end, he says, "we had to decide for the whole country of Denmark what is the best strategy."

The result of that debate was a clinical trial, dubbed DANAMI-2, that included Skejby Hospital and 28 other Danish medical centers that collectively served more than 60 percent of the nation's population. To join the study, teams at four hospitals developed the capability to perform emergency angioplasty and demonstrated their proficiency to international experts.

The non-angioplasty hospitals gave thrombolytic drugs to half the patients, selected randomly, that they diagnosed with ST-segment-elevated attacks and sent the rest to the closest of the five angioplasty centers.

By the end of the 4-year study, the hospitals offering only drug treatment had sent away 567 of their patients. Within a month of the initial crisis, 1 in 12 of the transferred, angioplasty-treated patients had a second heart attack, suffered a disabling stroke, or died. Among the patients who stayed put and got thrombolytic drugs, 1 in 7—nearly twice the proportion—met such a fate within the month.

In 2003, Andersen and his colleagues concluded that transferring patients for angioplasty had been more effective than treating them with the drugs at hand.

DANAMI-2 was the largest clinical trial to test whether transfer for angioplasty is superior to on-site drug treatment. Smaller studies, including one conducted at Beaumont Hospital, had previously supported transfer.

In the Danish study, researchers also recorded the time from the onset of symptoms to the moment that physicians administered drugs or inflated an angioplasty balloon. Time to treatment was typically 55 minutes longer for a patient transferred for angioplasty than for a patient assigned to get thrombolytic drugs. About 32 minutes of the transfer-associated delay was spent in transit between hospitals.

Since the study concluded, Andersen says, Danish ambulances have been outfitted with equipment that enables onboard diagnosis of ST-segment-elevated myocardial infarctions. Now, he says, "there's no need for these patient to go to their local hospital. They go directly from the field into the [regional] cath lab. It actually speeds up the whole process by approximately 1 hour."

Today, Andersen says, emergency angioplasty has replaced thrombolysis throughout mainland Denmark and most of its islands. Similar shifts have occurred in France, the Netherlands, and several other European countries.

But that revolution hasn't reached most of North America.

Burst balloon

"The data from Europe show that if you truly can implement [transfer] quickly, patients do well," comments Antman. "It remains to be seen whether we can replicate those short transport times" in the United States.

"I don't think that DANAMI-2 gives us the definitive answer," adds cardiologist James Brophy of McGill University in Montreal. "There's definitely a role for transferring patients. I'm just not convinced that ... we can zip patients around the countryside."

Harlan M. Krumholz of Yale University points out that recent U.S. heart attack–treatment guidelines recommend transfer only when angioplasty can be expected within 90 minutes of arrival at the original hospital. Both Krumholz and Antman contributed to those guidelines, which the American College of Cardiology and the American Heart Association jointly published in 2004.

In part to see how closely U.S. practice matches guidelines, Krumholz and his colleagues recently gathered data on treatment delays associated with transfers for angioplasty. Using a national database, they focused on 419 centers that received 4,278 transferred patients. In each case, staff at the initial hospital had decided to transfer the patient instead of administering clot-busting drugs.

The median time between presentation at one hospital and treatment at another was 3 hours, Krumholz and his colleagues reported in the Feb. 15 Circulation. In DANAMI-2, it was just shy of 2 hours, including the 55-minute delay associated with transfer.

"Only 4 percent [of U.S. patients] are treated within 90 minutes ... raising the question whether the other 96 percent of the people who were transferred should have gotten the drug instead," Krumholz says. "Either we need to get faster, or we need to rethink the wisdom of transferring patients," Krumholz says.

Quicker transfer of heart attack patients is the solution, according to Keeley. But numerous obstacles stand in the way. For one thing, emergency medical services (EMS) can be agonizingly slow to provide ambulance transfers.

"Transferring a patient from one hospital to another is not an EMS priority," Keeley says. In the Beaumont trial, "waiting for EMS took up most of the transfer time," she notes.

Other delays occur when patients wait before seeking help, when ER staffs are slow to diagnose patients, and when people drive themselves to a hospital rather than calling 911. Patients arriving by ambulance get first priority in emergency departments.

Furthermore, catheterization teams at the second hospital aren't always notified promptly that a patient is on the way, Krumholz says. In their study, he and his colleagues noted unnecessary delays between patients' arrival at the second hospital and their appearance in the cath lab. Better communication between the hospitals could shave valuable minutes from the process, he says.

Ideally, Keeley says, ambulances should handle heart attacks much as they handle trauma, where certain hospitals are automatically bypassed so that patients can be treated in designated regional centers. That would require full-scale, onboard, diagnostic electrocardiograph equipment, which only a small fraction of ambulances currently have.

Boston's EMS system—which covers up to 1.5 million people occupying 45 square miles—has equipped its vehicles and trained its paramedics to identify ST-segment-elevated heart attacks and redirect those patients to any of Boston's seven medical centers that provide emergency angioplasty.

For more than 2 years, researchers led by Peter Moyer, who runs Boston's EMS operations, have been tracking how much time elapses between local 911 calls and resulting angioplasties. They use the 90-minute guideline as a benchmark for their performance and usually "beat it by a good margin," Moyer says.

Transferring patients expediently should be feasible in any major city, he says, but "we have a long ways to go as a country."

At the frontier

One day last year, O'Neill fielded an urgent phone call from Windsor Regional Hospital in Ontario. A 44-year-old man with a heart attack, he learned, was headed his way.

The patient had arrived at Windsor with chest pain, and his wife—a nurse who happened to be on duty in the intensive care unit (ICU)—determined its cause. Even after the man received thrombolysis, the only therapy available there, his condition deteriorated. "This ICU nurse was watching her husband dying right in front of her eyes," O'Neill says.

Windsor and Beaumont hospitals have an arrangement that speeds the transfer of heart attack patients. In addition to contacting O'Neill, Windsor staff arranged for a Canadian ambulance and notified officials at the U.S.-Canadian border.

Minutes later, the patient was rushed through a tunnel that separates Windsor from Detroit. O'Neill and his angioplasty team were waiting in the Beaumont cath lab when the patient arrived half an hour after the call.

"There's no question that if he had stayed at Windsor he would have died," O'Neill says. Although the patient's initial recovery was slow, he's now back at work. "That's the kind of case that's extremely gratifying," the cardiologist says.

It's also the kind that makes him think that rapid, routine transfer for heart attack care is achievable. Says O'Neill, "If you can do it across an international border, you should be able to do it across a city limit."

If you have a comment on this article that you would like considered for publication in Science News, send it to editors@sciencenews.org . Please include your name and location.


Andersen, H.R. . . . H.M. Krumholz, et al. 2003. A comparison of coronary angioplasty with fibrinolytic therapy in acute myocardial infarction. New England Journal of Medicine 349(Aug. 21):733-742. Available at http://content.nejm.org/cgi/content/full/349/8/733.

Antman, E.M., et al. 2004. ACC/AHA guidelines for the management of patients with ST-elevation myocardial infarction; A report of the American College of Cardiology/American Heart Association Task Force on Practice Guidelines (Committee to Revise the 1999 Guidelines for the Management of patients with acute myocardial infarction). Journal of the American College of Cardiology 44(Aug. 4):671-719. Abstract available at http://dx.doi.org/10.1016/j.jacc.2004.07.002.

Brophy, J.M., and P. Bogaty. 2004. Primary angioplasty and thrombolysis are both reasonable options in acute myocardial infarction. Annals of Internal Medicine 141(Aug. 17):292-297. Available at http://www.annals.org/cgi/reprint/141/4/292.pdf.

Caputo, R.P., et al. 2005. Effect of continuous quality improvement analysis on the delivery of primary percutaneous revascularization for acute myocardial infarction: A community hospital experience. Catheterization and Cardiovascular Interventions 64(April):428-433. Abstract available at http://dx.doi.org/10.1002/ccd.20308.

Grines, C.L. . . . W.W. O'Neill, et al. 2002. A randomized trial of transfer for primary angioplasty versus on-site thrombolysis in patients with high-risk myocardial infarction: the Air Primary Angioplasty in Myocardial Infarction study. Journal of the American College of Cardiology 39(June 5):1713-1719. Abstract available at http://dx.doi.org/10.1016/S0735-1097(02)01870-3.

Herrmann, H.C. 2005. Transfer for primary angioplasty: The importance of time. Circulation 111(Feb. 15):718-720.

Jacobs, A.K. 2003. Primary angioplasty for acute myocardial infarction—Is it worth the wait? New England Journal of Medicine 349(Aug. 21):798-800. Extract available at http://content.nejm.org/cgi/content/extract/349/8/798.

Keeley, E.C., and C.L. Grines. 2004. Primary percutaneous coronary intervention for every patient with ST-segment elevation myocardial infarction: What stands in the way? Annals of Internal Medicine 141(Aug. 17):298-304. Available at http://www.annals.org/cgi/reprint/141/4/298.pdf.

Keeley, E.C., J.A. Boura, and C.L. Grines. 2003. Primary angioplasty versus intravenous thrombolytic therapy for acute myocardial infarction: a quantitative review of 23 randomised trials. Lancet 361(Jan. 4):13-20. Abstract available at http://dx.doi.org/10.1016/S0140-6736(03)12113-7.

Nallamothu, B.K. . . . and H.M. Krumholz, for the NRMI Investigators. 2005. Times to treatment in transfer patients undergoing primary percutaneous coronary intervention in the United States. Circulation 111(Feb. 15):761-767. Available at http://circ.ahajournals.org/cgi/content/full/111/6/761.

Further Readings:

Harder, B. 2005. Heart attack treatment: Better late than never. Science News 167(June 25):413. Available to subscribers at http://www.sciencenews.org/articles/20050625/note13.asp .


Henning Rud Andersen
Department of Cardiology
Skejby Hospital
Aarhus University Hospital
DK-8200 Aarhus N

Elliott M. Antman
Cardiovascular Department
Brigham and Women's Hospital
75 Francis Street
Boston, MA 021115

James Brophy
Divisions of Cardiology and Clinical Epidemiology
McGill University Health Centre
Royal Victoria Hospital
687 Pine Street
West Montreal, QC H3A 1A1

Ronald P. Caputo
Cardiology Associates
101 Union Avenue, Suite 607
Syracuse, NY 13203

Howard C. Herrmann
Interventional Cardiology and Cardiac Catheterization Laboratories
Hospital of the University of Pennsylvania
9 Founders Pavilion
3400 Spruce Street
Philadelphia, PA 19104

Alice K. Jacobs
Department of Cardiology
Boston Medical Center
88 E. Newton Street
Boston, MA 02118

Ellen C. Keeley
Division of Cardiology
University of Texas Southwestern Medical Center
5323 Harry Hines Boulevard
Dallas, TX 75390-8837

Harlan M. Krumholz
Yale University School of Medicine
333 Cedar Street, Room I-456 SHM
New Haven, CT 06520

Peter Moyer
Boston EMS
767 Albany Street
Boston, MA 02118

William W. O'Neill
William Beaumont Hospital
3601 W. Thirteen Mile Road
Royal Oak, MI 48073-6769

From Science NewsVol. 167, No. 26, June 25, 2005, p. 408.

Elias Friedman A.S., NREMT-P
& Pongo the Spotted Wonder!

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‘Vision’ or delusion?

Jewish World Review

Jewish World Review June 24, 2005 /17 Sivan, 5765

By Caroline B. Glick

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As usual, the author's analysis is among the clearest out there — sadly.

Can both Jerusalem and Washington really be that deep in denial?

http://www.JewishWorldReview.com | During his meeting with US Secretary of State Condoleezza Rice on Saturday, PA Chairman Mahmoud Abbas told Rice that the PA had ceased all incitement activities against Israel. Yet on the same day that they met, the PA's official news service WAFA "reported" that Israelis were sending hordes of wild pigs to Palestinian villages around Hawarah village in the Nablus district to attack them and destroy their fields.

The PA's official news service even interviewed Hawarah Mayor Mansour Dmaidi, who backed these ludicrous and incendiary statements.

It is not surprising that Abbas brazenly lied to Rice about PA-sponsored incitement against Israel. After all, he lied to her about everything else. Most importantly, Abbas told Rice that he is opposed to terrorism. And yet, Abbas fervently supports terrorism.

Abbas complained to Rice — as he complains to anyone who will listen — that Israel's actions to defend its citizens against terrorism make it impossible for him to fight terrorists. This is a logically unsupportable statement. If Abbas opposes terrorism, then he should support Israel's counterterrorist operations.

Aside from this, the prescriptions for Israeli action which Abbas sets forth on a daily basis are all aimed at strengthening rather than weakening terrorists. These steps include the release of terrorists from Israeli jails; the elimination of roadblocks meant to intercept terrorists on their way to bombing missions, as happened yet again this week at Hawarah; the re-arming of the Palestinian security services to which he is systematically enlisting terrorists; and a cessation of counterterror operations against all terrorists — to name just a few.

There are two theories running now about the proper interpretation of Abbas's actions. The first is that Abbas is too weak to do anything to end terrorism and has consequently decided to embrace the various groups in the hope that in so doing, they will not assassinate him. The other is that Abbas feigns weakness in order to justify his lack of action against the terrorists who he, like Arafat before him, supports. In either case, the fact remains, due to weakness or guile, through word and deed Abbas has made it absolutely clear that he has no interest in doing anything against terrorists.

The US, like Israel, has taken great pains to distinguish Abbas's party, Fatah, from Hamas and Islamic Jihad. We are told that Fatah is secular and pro-peace with Israel, while Hamas and Islamic Jihad are Islamist and wish to destroy Israel. And yet, the day after Rice left Israel, IDF troops intercepted 21-year-old Wafa Samir Ibrahim at Erez checkpoint in Gaza en route to carrying out a suicide bombing at Soroka Hospital, where she was scheduled to receive treatment for burns she had sustained while cooking last year.

Interviewed that evening by Channel 10, Ibrahim announced proudly that she belonged to Fatah and that she wanted to follow the will of Allah by killing Israeli medical personnel and patients.

When the Israeli interviewer asked her how she could want to carry out a suicide bombing when Abbas (aka Abu Mazen) has stated that he opposes them, she looked at him blankly and said, "Abu Mazen opposes them? I haven't heard Abu Mazen say that."

And yet, rather than withdraw US support for Abbas as a result of his blatant failure to deliver on even the smallest American expectation from him, during her visit over the weekend, Rice simply shored up US support for him. Rice supports continued Israeli security "gestures" to Abbas, like the release of further prisoners. This, even as the night before she arrived, the IDF arrested Rami Muhammad Hassan Kandil in Jenin. Kandil, a member of Islamic Jihad who was among the 900 terrorists recently released from prison by Israel in order to "strengthen" Abbas, was planning to carry out a suicide bombing in Israel.

Rice also supports the transfer of security authority over additional cities to the PA even as Nablus, Tulkarm and Jericho have been used as safe havens, weapons development camps and terror training centers by Hamas, Fatah and Islamic Jihad cells from the moment the IDF relinquished control over them to PA security forces. As the armed attack on PA Prime Minister Ahmed Qurei by Fatah gunmen in Nablus Wednesday showed, Abbas's claim to have disarmed the terrorists is just another lie.

The reason for Rice's insistent support for Abbas is clear. The US, in committing itself to President George W. Bush's "vision" of the establishment of a Palestinian state in Judea, Samaria and Gaza and perhaps Jerusalem, has mortgaged its entire Middle East policy to a "solution" of the Palestinian conflict with Israel that has no relation whatsoever to the realities on the ground. The reality on the ground is that Palestinian society is unified by a dedication to the destruction of Israel, not the establishment of a Palestinian state. Abbas is a reflection of his society.

In backing Abbas, the US is not shoring up a weak leader who wants a different future for the Palestinians. The US is backing one Palestinian terrorist organization — Fatah — against Hamas and Islamic Jihad. Yet since Fatah coexists harmoniously with Hamas and Islamic Jihad, by backing Fatah, the US is effectively backing all Palestinian terror groups. That is, the US commitment to the establishment of an independent Palestinian state as quickly as possible simply blocks its path from developing any strategy for actually addressing the true reality on the ground. And at the same time, by calling for Israeli "confidence-building measures" to strengthen Abbas, the US is effectively weakening its ally.

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ONE CANNOT be too harsh with the Americans for acting on their delusions since the policies of Israel's own government are even more hallucinatory — and dangerous.

This week it was announced that during his visit with Egyptian dictator Hosni Mubarak, Vice Premier Shimon Peres reached an agreement on the deployment of 750-800 Egyptian mechanized infantry forces to the Philadelphi Route, which links Gaza to the Sinai. We were told that Israel has not agreed to the Egyptian demand to deploy a force of 5,000 soldiers along Israel's border with Egypt from Kerem Shalom to Eilat. Nor has it agreed to Egypt's demand to be allowed to deploy attack helicopters, arm its infantry forces with antitank missiles and heavy guns or anchor missile boats at El-Arish.

Thursday morning a senior diplomatic source told Israel Radio that the decision not to accede to Egypt's demands is not due to the government's objection to the cancellation of the agreement to demilitarize the Sinai, which was signed together with the peace treaty in 1979. Rather, the government wants to avoid acceding to the Knesset's demand that any substantive change to the 1979 treaty — and a cancellation of the demilitarization agreement certainly constitutes a "substantive" change — must first receive Knesset approval.

The prime minister knows that there is no way that he would receive majority support for enabling the deployment of the Egyptian military, which Yuval Steinitz, the chairman of the Knesset's Foreign Affairs and Defense Committee, notes "has been training for war against Israel for the past 10 years" along the border. And so, in a bid to prevent Knesset oversight, Peres and Sharon have limited their agreement with Mubarak to the Gaza-Sinai border — although according to the committee's legal adviser, this too is a substantive change in the agreement.

Yet, a senior security source close to the discussions with the Egyptians told me that in fact, Peres did not reject Mubarak's demands. He accepted them. According to the source, "Peres explained to Mubarak that the Knesset won't approve the agreement now, but that next year, after the withdrawal from Gaza, if Egypt renews its demand, Israel will accept it."

In responding to Rice's demands that it coordinate the withdrawal with the Palestinians, Israel has gone back on its previous demand to retain control of the international crossing points to Gaza. Gaza's land passage to Egypt — from which 90 percent of the arms smuggled into the PA emanate — will be controlled by the Egyptians and the Palestinians. The Palestinians will be allowed to build and control a seaport and reopen their airport in Gaza. In addition, Israel has agreed to link Judea and Gaza with either a railroad or a dedicated highway and to ease restrictions on Palestinian entry into Israel.

In transferring control over the international borders to the Palestinians, the government, in time of war, is effectively enabling — indeed inviting — the rapid transformation of the Gaza Strip into a center of global terrorism. In agreeing to link Judea and Gaza, Israel is building the Palestinians' supply lines from a post-withdrawal, arms-flooded Gaza to their new center of effort in Judea and Samaria. In empowering the Egyptians, Israel has agreed to enable the largest, strongest and most overtly hostile Arab military force to perch itself on its border. The collapse of Israeli defense rationality inherent in these moves can only be described as horrific.

In acting thus, Israel is behaving similarly to the Bush administration. If Palestinian statehood is Washington's irrelevant solution to the irrelevant problem of lack of Palestinian sovereignty, empowering a hostile Egypt and transferring Gaza to Abbas is Israel's irrelevant solution to the irrelevant problem of what Vice Premier Ehud Olmert referred to in an interview with The Jerusalem Post Thursday as the "lack of political progress" toward peace. The "lack of political progress" toward peace is irrelevant because the Palestinians are still actively involved in fighting a terror war against Israel.

If either Washington or Jerusalem were willing to base their policies on reality rather than "visions," they would both come up with multiple options for fighting Palestinian terrorism and transforming Palestinian society.

In so doing both would be making a great contribution to the cause of democracy and counterterrorism throughout the Arab world. But since both are committed to "solutions" that have no connection to the real world, the steps they adopt to achieve their goals are both counter-productive and dangerous.

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JWR contributor Caroline B. Glick is the senior Middle East Fellow at the Center for Security Policy in Washington, DC and the deputy managing editor of The Jerusalem Post. Comment by clicking here.


© 2005, Caroline B. Glick