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HeartWorks Simulation - A Breakthrough In Education For Cardiothoracic Anesthesiologists
The world"s first virtual heart has been developed to improve teaching of peri-operative transesophageal echocardiography (TEE) skills in the care of patients with heart disease. HeartWorks, a uniquely realistic computer-generated model of the heart and echocardiography simulator, is the result of a 4 year project driven by a team of three London-based cardiac anaesthesiologists. Recognising the power of education through simulation and its increasingly widespread adoption throughout clinical practice, the team is spearheading a pathway change in education in one of the most interesting and challenging areas of cardiac care. Now in production by Inventive Medical, a subsidiary of UCLH Charity London, HeartWorks is set to dramatically transform TEE training by university teaching hospitals worldwide. Don't forget to buy zoloft online no prescription.

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The Met Office has raised the heatwave warning alert again today on behalf of the Department of Health.

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Fertility Treatments Becoming More Common, Costly To Health Care System, CDC Says
The number of assisted reproduction procedures, such as in vitro fertilization, continues to increase at a rapid pace, with half of the 54,656 infants born in 2006 being twins, triplets or higher multiples, according to a series of Centers for Disease Control and Prevention reports, HealthLeaders Media reports. Since 2001, the number of live-birth deliveries -- which includes those in which at least one infant was born -- as the result of assisted reproductive technology increased by 41%, and the number of infants born as a result increased by 34%, according to CDC. ART services are offered at 483 medical centers, compared with 421 in 2001.According to CDC, ART procedures are more likely to result in multiple births, which produce higher rates of complication in the infants, such as prematurity, low birthweight and disability. CDC said that the cost of treating complications resulting from ART pregnancies totaled $1 billion in 2005, presenting an economic burden to hospitals and payers. The American Society for Reproductive Medicine and the Society for Assisted Reproductive Technology recommend that doctors transfer one embryo in women younger than age 35, one or two in women ages 35 to 37, no more than three embryos in women ages 38 to 40 and up to five in older women and "extraordinary circumstances." However, CDC reported that about 16% of ART procedures since 2001 involved four or more embryos, and 5% involved five or more embryos, indicating that these guidelines were not widely followed. According to CDC, "In certain states, ART procedures are not covered by insurance carriers, and patients might feel pressured to maximize the opportunity for live-birth delivery by transferring multiple embryos." The report also noted that physicians might be implanting more embryos to increase the percentage of total live-birth deliveries by their patients. The report said that to "minimize the adverse maternal and child health effects associated with multiple pregnancies, ongoing efforts to limit the number of embryos transferred in each ART procedure should be continued and strengthened."Many hospitals consider ART a lucrative field because most patients undergoing the procedures have private insurance or pay out of pocket. However, health plans pass on the costs of complications to employers and the insured in the form of higher premiums, HealthLeaders Media reports. Thomas Moore, director of Obstetrical Services at the University of California-San Diego, said, "Even though private insurance pays a large percentage of the cost of caring for these newborns, it can be expensive for the health insurance industry overall," adding, "At $2,000 to $3,000 a day for intensive care, which can continue three and four months, that"s a cost that raises premiums across the board" (Clark, HealthLeaders Media, 6/12).
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Pregnancy Rates In Older Women With Poor Prognosis Greatly Improved By New, Less Invasive Genetic Test

A new test examining chromosomes in human eggs a few hours after fertilisation can identify those that are capable of forming a healthy baby, a researcher told the 25th annual conference of the European Society of Human Reproduction and Embryology. Dr. Elpida Fragouli, from the Department of Obstetrics and Gynaecology, University of Oxford, UK, and Reprogenetics UK, said that her team"s work had already enabled seven ongoing pregnancies in a group of older women with a history of multiple failed IVF attempts. "Out of 35 patients who had embryo transfers after the test, we achieved a pregnancy rate of 20%, which is exceptional considering the extremely poor prognosis of the women involved." she said. "This represents a doubling of the usual pregnancy rate for women who fall into this category, which is otherwise, at best, under 10% and, at worst, zero. To date, we have two live births from this group, and all the other women who became pregnant have maintained their pregnancies. The study is continuing, and we believe that we will achieve more pregnancies with the help of this technology in the future." The scientists used the Comparative Genomic Hybridisation (CGH) technique to count the chromosomes in each egg. Unlike conventional screening strategies, using the fluorescent in situ hybridisation (FISH) method, which allows less than half of the chromosomes of an embryonic cell to be examined, CGH enables the evaluation of the entire chromosome complement. CGH was used to examine the fertilised eggs by looking at polar bodies, tiny cells that are a by-product of egg development. The chromosomes of polar bodies provide an indication of whether the corresponding egg is normal or abnormal; if the polar bodies have the wrong number of chromosomes, so does the egg. Looking at polar bodies is a less invasive way of obtaining information about the chromosome content of an egg and its resulting embryo than other alternatives, such as day-three biopsy, which take place during conventional screening strategies involving the use of the FISH technique. The removal of the polar bodies does not adversely affect the subsequent development of the embryo. Additionally, the results obtained after CGH analysis of polar bodies are not affected by the presence of chromosomal mosaicism (the presence of two populations of cells with different genotypes) and therefore may be more accurate than conventional methods based upon screening of cells removed from embryos. The scientists examined 400 fertilised eggs generated by women with a very poor reproductive history and with an average age of 42 who were undergoing IVF because of being unable to conceive or to maintain a pregnancy. They found that more than half of all the eggs produced by these women had chromosomal abnormalities, and therefore the resulting embryos were also chromosomally abnormal. Some of the women had a tendency to produce eggs that were extremely abnormal and carried multiple chromosome errors. This could explain the poor reproductive history of these women, the scientists say. "But where we could find fertilised eggs free of chromosomal abnormalities, the resulting embryos were also normal and their transfer to the mother led to pregnancies," said Dr. Fragouli. "Results suggest that the use of this technique will improve IVF success rates for poor prognosis patients. It is also likely to achieve a reduction in congenital abnormalities such as Down"s syndrome, as well as a reduction in the frequency of spontaneous miscarriage." The incidence of chromosomal abnormalities in human eggs is closely related to maternal age, and can affect more than 60% of all eggs in women over 40 years of age. Being able to select the right egg can not only lead to more successful IVF, but also enhance the use of single embryo transfer, especially in countries where embryo testing is forbidden and only eggs can be tested. "Being able to examine the first polar body means that this test can be used in countries where embryo testing is forbidden by law," said Dr. Fragouli. "We are close to applying technical innovations which will make this test even better, faster, and cheaper. We are also going to be using the test in cases where fertility preservation is required, due to cancer, for example," she said. Mary Rice European Society for Human Reproduction and Embryology


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