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Most travelers survive in-flight medical emergencies, study shows

Is there a doctor on board? Surprisingly often, there is - in half of in-flight medical emergencies - and sick airline passengers almost always survive, a new study finds. The research is the largest look yet at what happens to people who develop a medical problem on a commercial flight - about 44,000 of the 2.75 billion passengers worldwide each year, researchers estimate. Most cases don't require diverting a plane as the study's leader, Dr. Christian Martin-Gill, advised a pilot to do two years. He works for MD-STAT, a service at the University of Pittsburgh Medical Center that advises about 20 major airlines on how to handle in-flight emergencies. Another large service is based in Phoenix. Martin-Gill handled a call when a passenger seemed to be having a heart attack on a flight from Europe to the U.S. The man's implanted defibrillator had shocked his heart five times to try to restore normal rhythm. “The aircraft was in the middle of its destination, flying over the Atlantic,” so he recommended landing at Newfoundland off the Canadian coast to get the man to the nearest hospital, Martin-Gill said. The federally funded study reviewed about 12,000 cases handled by the Pittsburgh center over nearly three years. Results are in Thursday's New England Journal of Medicine. Researchers found: -The odds of a medical emergency are 1 per 604 flights, or 16 per 1 million passengers. -Planes had to be diverted for emergency help in only 7 percent of cases. -Doctors were on board and volunteered to help in 48 percent of cases; nurses and other health workers were available in another 28 percent. Only one-third of cases had to be handled by flight attendants alone. -The most common problems: Dizziness or passing out (37 percent of cases); trouble breathing (12 percent) and nausea or vomiting (10 percent). -About one-fourth of passengers were evaluated at a hospital after landing and 9 percent were admitted, usually with stroke, respiratory or cardiac symptoms. -Out of nearly 12,000 cases, a defibrillator was applied 137 times, including in 24 cases of cardiac arrest, where the heart had stopped. (Sometimes defibrillators are used to analyze an irregular heart rhythm to help doctors figure out what to do, not necessarily to deliver a shock.) -Of the cases in this study, only 36 deaths occurred, 30 of them during the flight and the others after landing. -Pregnancy-related problems were generally rare - 61 cases, in this study - and two-thirds of them involved women less than 24 weeks along with possible miscarriages. Air travel is considered safe up to the 36th week, or the last month, of pregnancy. Only three cases of women in labor beyond 24 weeks of pregnancy led to a plane being diverted. Dr. Lisa Rosenbaum, a University of Pennsylvania cardiologist, helped in a case like that in 2007, on a flight from Boston to Portland, Ore. The passenger was three months from her due date but was having contractions every minute - something that can often be stopped with drugs and treatment at a hospital but not in midair. “It was clear to me that labor was imminent and that we needed to land the plane,” so, on her advice, the pilot diverted to upstate New York, Rosenbaum said. “It was one of the scariest experiences of my life. It's not like taking care of a patient in the hospital.” Dr. David Rogers, a pediatric surgeon at the University of Alabama at Birmingham School of Medicine, felt that fear five years ago when an elderly woman had trouble breathing during a flight to Atlanta from Toledo, Ohio. Being a specialist at treating children rather than adults, “my first reaction was to look around and hope there would be somebody else” more qualified to help, he said. Luckily, a flight attendant had already given the woman an oxygen mask and she seemed to be improving, so he felt the plane could continue to Atlanta, the woman's home. Trying to determine whether to divert a plane was a tough call, he said. “I'm making a decision that's going to affect a plane full of people,” not just the patient, Rogers said. Some passengers may fear liability if they help in such situations, but a Good Samaritan law protects those who do so, the study notes. And although health workers are not legally obliged to help, they have a moral obligation to do so, the authors write. And you never know what kind of help will be requested. Martin-Gill said a partner once was consulted when a dog suffered a cardiac arrest during a flight. He didn't know how things turned out.source : http://www.foxnews.com/health/2013/05/30/most-travelers-survive-in-flight-medical-emergencies-study-shows/

Experts devise new embryo selection method to boost IVF success

British fertility experts have devised a new IVF technique that takes thousands of snapshots of a developing embryo that they say can help doctors pick those most likely to implant successfully and develop into healthy babies. At a briefing in London before publishing their results, the researchers said they are already using the technique to select “low risk” embryos that are the least likely to have chromosomal abnormalities that could hamper their development. In their study, published in the journal Reproductive BioMedicine Online, the team's chances of producing a successful live birth after in-vitro fertilization (IVF) were increased by 56 percent using the new technique compared to the standard method of selecting embryos that look best through a microscope. “In the 35 years I have been in this field, this is probably the most exciting and significant development that can be of value to all patients seeking IVF,” said Simon Fishel, a leading fertility doctor and director at the IVF clinic operator CARE Fertility where the technique is being developed. Independent scientists not involved in the work welcomed it as a significant advance but said full randomized controlled trials - the gold standard in medicine - should be conducted before it is adopted as mainstream practice. “This paper is interesting because we really do need to make advances in selecting the best embryos created during IVF,” said Allan Pacey of Sheffield University, chair of the British Fertility Society. “The idea of monitoring embryo development more closely is being used increasingly in clinics around the world and so it is good to see the science involved submitted to peer review and publication,” he added. “All too often, developments in IVF are trumpeted as advances when they remain unproven.” Experts say that today, as many as 1 to 2 percent of babies in the Western world are conceived through IVF. The standard methods of selecting embryos are based largely on what they look like through a microscope, and many IVF cycles fail because the embryo chosen and transferred to the womb fails to develop. The scientists who led this study said that using time-lapse images, they had found that developmental delays in the embryo at crucial stages are good indicators of likely chromosomal abnormalities that could result in a failed pregnancy. Viewing far more images “In conventional IVF laboratories, embryo development will be checked up to six times over a 5-day period,” said Alison Campbell, Care Fertility's embryology director and the lead researcher on the study being published. “With time-lapse we have the ability to view more than 5,000 images over the same time period to observe and measure more closely each stage of division and growth.” Using this new knowledge, the team developed what they call morphokinetic algorithms to predict success (MAPS). By applying these MAPS to the selection of embryos, they predict they could reach a live birth rate for patients undergoing IVF of 78 percent - about three times the national average. Fishel, whose CARE Fertility clinics are Britain's largest independent provider of assisted conception cycles, with around 3,500 a year, said he is charging around 750 pounds ($1,100) for IVF using the MAPS technique - compared to several thousand pounds for a standard IVF cycle. But Sue Avery, head of the Women's Fertility Centre in Birmingham, said it was too soon for all clinics to adopt it. “Until the new technique is compared to current practice we cannot know whether different embryos are being chosen,” she said. “The IVF community needs a prospective randomized controlled trial to prove that the new approach delivers better results before it can be recommended to patients.”source : http://www.foxnews.com/health/2013/05/17/experts-devise-new-embryo-selection-method-to-boost-ivf-success/

Possible new acute leukemia marker, treatment target identified

The study was led by researchers at the Ohio State University Comprehensive Cancer Center — Arthur G. James Cancer Hospital and Richard J. Solove Research Institute (OSUCCC — James). The researchers found that when microRNA-155 (miR-155) is present at abnormally high levels in CN-AML cells, patients are less likely to have a complete remission, and they experience a shorter disease-free period and shorter overall survival…