Who is Who & Who am I?

Each of us is colonised, inside and out, by micro-organisms. More than three pounds of micro-organisms in our gut alone, and many more on our skin.In fact, we harbour 10 microbial cells for each one of our own cells.

If our microbial partners were merely fellow travellers with no effects on our health, their invisible presence would be of little interest. However, we have known for a long time that gut bacteria do affect our health.

Gut microbes produce molecules that travel through the gut-liver blood-circulation or breach natural gut barriers. These microbial molecules include anti-inflammatory factors, analgesic compounds, antioxidants and vitamins. In addition, toxins produced by gut bacteria can cause serious disease.
In recent years, surprising evidence has emerged that links gut bacteria even with obesity, diabetes and several cancers.

A huge international effort, the Human Microbiome Consortium, is under way to sequence the genes of all our microbial partners. This will be a tall order, as the microbes that colonise us have, taken together, 100 times more genes than we do. And on top of that, those genes appear to have more variants than our genes do.

So far, the genomes of 178 microbes, out of the roughly 1,000 that colonise us, have been sequenced (Nature 2010 Jun 17 & Science 2010 May 21).

So – we are a sort of Noah’s Ark; a vehicle for others, being used or abused – who knows. But we are also a community, a symbiotic constellation, where one needs the other and where one’s own benefit is to the benefit of everybody on that ship.

If Sigmund Freud postulated that where there is “It” must be “I,” one could revise this by saying that where there was “I” must be “We.”

Individual identity, as a modern Western concept, is on the way out. Social networks have replaced a chat in the weekly market place and even possibly the chat on the phone. Biological networks are on their way to redefine the Human Race – which turns out to be much less human than what we had thought before – surprised?

CPR revisited
To boost the human part of what we are, let me make another change to an ‘old,’ concept. Nearly everybody has, at one stage, been trained in CPR – cardio-pulmonary resuscitation: five chest compressions and then one resuscitation breath. The second part is normally the ‘yucky’ part of the business, unless it’s a longhaired brunette, no older than…? Or you happen to have a breathing mask in your pocket, which one puts over the others mouth and nose and blows through a nozzle.

Taking rescuers concerns about AIDS and other transmittable diseases seriously, investigators compared conventional CPR with chest compression alone.

Washington State and London were the places, where out-of-hospital cardiac arrest was treated either one way or the other. Children and victims of accidents, drowning or asphyxiation were not included into the trial.

Comparing data of more than 3,000 patients, there were no significant differences found. Survival at 24 hours, survival at 30 days and neurological status were similar in the two groups (N/Engl J Med 2010 Jul 29).

Rescue breathing to save somebody who is unconscious and not breathing is not improving survival compared with chest compression alone – another modern myth to be deleted.
Doing away with breathing is likely to increase the willingness of non-medic bystanders to perform CPR. No excuses anymore – particularly if it’s your Mother-in-Law!

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