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Among acutely ill patients who travel by emergency air transport, one in 20 experience a “critical event” — they die, suffer from dangerously low blood pressure or need to be resuscitated, Canadian researchers have found.

Women are at special risk, as are those with heart disease, traumatic injuries and other problems, according to the study by Dr. Jeff Singh, of the University Health Network in Toronto, and colleagues.

The observation that women are more at risk of adverse events “may be attributable to differences in disease presentations, differential treatment or differences in referral patterns and transport requests between men and women,” the study authors explained in a news release from CMAJ, the Canadian Medical Association Journal.

The study looked at 19,228 adults who were transported by air in Ontario, Canada. The researchers found that better preparation before the patients were transported could have prevented many of the problems.

“This data may provide insight for medical crew training regarding likely in-flight medical management scenarios, or markers for more robust stabilization of patients by hospital staff preparing patients for transport,” Dr. Alex Isakov, of the department of emergency medicine at Emory University in Atlanta, wrote in a commentary accompanying the study. “It may also help in the development of evidence-based criteria for dispatch.”

Hispanics in the United States are less likely to die from cancer than non-Hispanic whites, but they have higher rates of cancers linked to infections, including stomach, liver and cervix malignancies, a new report says.

At first glance, Hispanics’ lower death rate from cancer seems to be good news, but one explanation is that the Hispanic population skews younger than the general U.S. population. Cancer risk rises with age.

The new detailed look at cancer incidence is from Cancer Facts & Figures for Hispanics/Latinos 2009-2011, a report released Sept. 15 that’s published every three years by the American Cancer Society.

Hispanics are the largest, fastest-growing and youngest minority in the United States, according to the report. They also have a cancer risk profile that differs from whites and other ethnic groups.

Hispanics are less likely than non-Hispanic whites to die from the four most common cancers: breast, prostate, colorectal and lung.

But Hispanics have higher rates of stomach cancer, associated with Helicobacter pylori infection; liver cancer, associated with hepatitis B and C infection; and cervical cancer, linked to human papillomavirus infection.

Immunizations against human papillomavirus in teenage girls can prevent cervical cancer, and regular gynecological screenings for women can catch cervical cancer early, but Hispanic women are less likely to get either, said Vilma Cokkinides, the American Cancer Society’s director for risk factor surveillance.

And though Hispanics are less likely to smoke and drink alcohol, both risk factors for cancer, they are more likely to be poor, have fewer years of education and lack health insurance, barriers to getting recommended screenings, according to the report.

Hispanics are also more likely than whites to be diagnosed with breast and melanoma cancers at a later stage, when the cancers are more difficult to treat and have spread to other organs.

Cokkinides said that programs targeting Spanish-speakers about the importance of screening and risk factors for cancer could help, as could programs to increase access to medical insurance and medical care.

But one challenge in developing such programs, she said, is that the U.S. Hispanic population is diverse, with variations in country of origin, length of time in the United States, educational attainment and experience and knowledge of the health-care system.

“Things like mammograms and Pap smears aren’t necessarily routine where people are coming from,” Cokkinides said.

Yet certain lessons should be stressed across all cultures, she said.

“Avoidance of tobacco products, maintaining a healthy weight, eating a largely plant-based diet, minimizing alcohol consumption and exercising is good advice for everybody,” Cokkinides said.

Hilary Waldman, a spokeswoman for the Hispanic Health Council in Hartford, Conn., said that it’s not uncommon for Hispanic women to be diagnosed with later-stage cancers that could have been picked up sooner through proper screenings. The council runs a Spanish-language cancer support group for Hispanic women, in addition to its research and advocacy functions.

“There’s a real lack of support for culturally appropriate and linguistically appropriate services for them,” Waldman said.

And though many big-city hospitals have interpreters, smaller or suburban hospitals often don’t, she said, adding that the complexity of cancer and its often-complicated treatment plans and serious side effects make interpreters all the more important.

In the support groups, Waldman said, women often talk about their distress in not being able to understand their doctors — or having their doctors understand them.

“There’s a big problem getting medical interpretation for people who don’t speak English,” she said. “There is no mechanism to pay for it. If you’re lucky, they will bring in the housekeeper or somebody who happens to be around to translate.”

The inability to communicate, combined with financial issues, has led some women to skip appointments, Waldman said.

Nearly 99,000 Hispanics in the United States will be diagnosed with cancer in 2009, according to the American Cancer Society. Among men, prostate is the most common malignancy; among women, it’s breast cancer. Colorectal cancer is the second-most common cancer in both Hispanic men and women.

About 18,800 Hispanics will die from cancer in 2009, the society estimates. Among men, lung and colorectal cancer cause the most deaths, whereas breast and lung cancer are the top two killers of women.

There is no high-quality evidence that listening to music helps tiny babies born prematurely cope with pain, feed better and calm down, according to a review of studies.

While there are some “preliminary” indications that music could be helpful for specific purposes, such as easing pain during circumcision, “these findings need to be confirmed in methodologically rigorous trials,” Dr. Manoj Kumar of the University of Alberta in Edmonton, Canada and his colleagues conclude.

Premature infants must undergo a multitude of painful procedures, such as blood sampling with heel pricks, often without pain killing medication or other tactics, the researchers point out.

They reviewed the medical literature to determine if music, which has been promoted as helping preemies in many ways, could indeed reduce pain during such procedures and have other benefits.

The researchers identified nine studies: three of music for circumcision pain; three for pain during heel prick; and three looking at music’s impact on behavior like crying and other signs of stress, feeding rates and “physiological” measures.

Overall, Kumar and his colleagues found, the studies were of poor quality.

Two of the circumcision studies were of poor quality and found no benefit, but one high-quality study in 23 infants found that music did help reduce heart rate, boost oxygen levels in the blood, and ease pain.

The heel prick studies all found benefits of music for behavior and pain, but were all of low quality.

Of the remaining studies, one found music helped improve a few measures of behavior. The second, in 32 poorly feeding preemies, found feeding improved in babies given pacifiers that activated a lullaby when sucked, compared to babies who didn’t get the musical binkies.

The third study, in 22 preemies with lung disease, found no benefit of music on any physiological measures.

If pacifier-activated music could indeed help newborns feed better, it could have major benefits, the researchers note; however, the study in the review didn’t report on important factors such as how soon babies were able to begin feeding on their own.

Additional studies of higher-quality are needed on the potential benefits of music for newborns before any recommendations can be made on its use, Kumar and colleagues conclude.

Children — especially girls — are more likely to have psychiatric problems later in life if they’re bullied or victimized, a new Finnish study finds.

The study may be the first of its kind to examine what happens to bullied children of both genders years later.

Researchers at Turku University Hospital tried to find links between bullying and victimization at age 8 and later psychiatric problems between ages 13 and 24. The study examined more than 5,000 Finnish children who took part in a national survey.

The study found that about 6 percent of boys were frequent bullies and 6 percent were frequent victims; 3 percent fit into both categories.

Among girls, almost 4 percent were frequent victims, and less than 1 percent were frequent bullies or both.

“Frequent victim status at age 8 years among females independently predicted psychiatric hospital treatment” and use of psychiatric drugs, the authors write. The relationship is more complex among boys.

“It is important to inform policymakers, school professionals and the public about the potential short-term and long-term consequences of bullying and victimization,” the researchers write.

The study appears in the September issue of Archives of General Psychiatry.

Eye protection may be required on the job, but don’t forget to protect your eyes at home, too.

The U.S. National Safety Council says you should always wear protective eye gear when you:
Work on do-it-yourself projects around the house or on your car.
Cook with ingredients that could splash into the eye and cause burns or injury.
Work with chemicals such as pesticides, fertilizers, drain cleaners or cleaning sprays.
Play sports such as tennis, racquetball or baseball.
Do yard work, such as mowing the lawn, trimming plants or cutting weeds.