We give you many useful information about health

Go to Blogger edit html and find these sentences.Now replace these sentences with your own descriptions.This theme is Bloggerized by Lasantha Bandara - Premiumbloggertemplates.com.

We give you many useful information about health

Go to Blogger edit html and find these sentences.Now replace these sentences with your own descriptions.This theme is Bloggerized by Lasantha Bandara - Premiumbloggertemplates.com.

We give you many useful information about health

Go to Blogger edit html and find these sentences.Now replace these sentences with your own descriptions.This theme is Bloggerized by Lasantha Bandara - Premiumbloggertemplates.com.

We give you many useful information about health

Go to Blogger edit html and find these sentences.Now replace these sentences with your own descriptions.This theme is Bloggerized by Lasantha Bandara - Premiumbloggertemplates.com.

We give you many useful information about health

Go to Blogger edit html and find these sentences.Now replace these sentences with your own descriptions.This theme is Bloggerized by Lasantha Bandara - Premiumbloggertemplates.com.

Sabtu, 21 Januari 2012

US proposes regulating face, hand transplants

AppId is over the quota
AppId is over the quota
FILE - These undated file photos provided Thursday, Aug. 11, 2011 by the Brigham and Women’s Hospital show chimpanzee attack victim Charla Nash after the attack, left, and post-face transplant surgery, right. The U.S. government wants to start regulating face and hand transplants just as kidneys, hearts and other organs are now. That means establishing waiting lists, a system to allocate body parts and donor testing to prevent deadly infections. Officials say this is a big step toward expanding access to these radical operations, especially for wounded troops returning home. The new rule is expected to take effect later in 2012 or early 2013. (AP Photo/Brigham and Women’s Hospital, Lightchaser Photography, File) FILE - These undated file photos provided Thursday, Aug. 11, 2011 by the Brigham and Women’s Hospital show chimpanzee attack victim Charla Nash after the attack, left, and post-face transplant surgery, right. The U.S. government wants to start regulating face and hand transplants just as kidneys, hearts and other organs are now. That means establishing waiting lists, a system to allocate body parts and donor testing to prevent deadly infections. Officials say this is a big step toward expanding access to these radical operations, especially for wounded troops returning home. The new rule is expected to take effect later in 2012 or early 2013. (AP Photo/Brigham and Women’s Hospital, Lightchaser Photography, File) Graphic shows procedure used in a facial tissue transplant surgeryeval("var currentItemd57851005a80479aaeeb90a12c70b9ff = 1;");eval("var nextd57851005a80479aaeeb90a12c70b9ff = 0;");eval("var previousd57851005a80479aaeeb90a12c70b9ff = 0;"); The government wants to start regulating face and hand transplants just as it does now with kidneys, hearts and other organs, with waiting lists, a nationwide system to match and distribute body parts and donor testing to prevent deadly infections.

It's a big step toward expanding access to these radical operations, especially for wounded troops returning home. A dozen U.S. hospitals already do face or hand transplants and more are preparing to offer the operations. More than 1,000 troops have lost an arm or leg in Afghanistan or Iraq, and the government estimates that 200 troops might be eligible for face transplants.

"These body parts are starting to become more mainstream, if you will, than they were five or 10 years ago when they were first pioneered in this country," said Dr. James Bowman, medical director of the Health Resources Services Administration, the government agency that regulates organ transplants.

The agency has proposed new rules that expand the regulation of transplants to include faces, hands and other body parts. Waiting lists for these body parts are informal and local now. The new rule would make such transplants part of the nationwide matching system run by the United Network for Organ Sharing, or UNOS.

The rules would regulate transplants of feet, ankles, legs, fingers, windpipes, voice boxes, the abdominal wall and possibly even a uterus or a penis — operations tried at least once in other countries.

"When you think about the human body, there is really nothing that could not be replaced by transplantation. Almost nothing," said Dr. Bohdan Pomahac, who has done four face transplants at Brigham and Women's Hospital in Boston.

At least 18 face transplants have been done around the world, starting in 2005 with a French woman mauled by her dog. The Cleveland Clinic did the first face transplant in the U.S. in 2008.

The U.S. Department of Defense is providing money for more of these surgeries in Cleveland and Boston in hopes of helping soldiers disfigured in battle. The University of Pittsburgh, the University of California, Los Angeles, and other medical centers plan to offer face or hand transplants soon.

The first successful hand transplant in the United States was performed in 1999, and more than three dozen have been done worldwide.

The proposal to treat these like organ transplants "is terrific" and is supported by leading transplant surgery groups, Pomahac said.

"It's a huge step forward in the right direction. It will make it easier for programs to get started," Pomahac said.

The federal agency will accept public comments on the rules until Feb. 14 before making a final decision. The rules are expected to take effect later this year or early next year.

The change would not affect regulation of heart valves, bone and other tissue implants or transplants, which are overseen by the Food and Drug Administration. Instead, it would cover transplants of complex tissues such as a combination of bone and muscle involving blood vessels — like a hand or face.

Many doctors and bioethicists long objected to face and hand transplants because patients must take drugs for the rest of their lives to prevent rejection, which can raise their risk of cancer and other problems. The risk wasn't considered worth the benefit for operations that are not life-saving as heart or liver transplants are.

But the objections have softened as face transplants have been so successful and greatly improved quality of life.

The most recent recipient is Charla Nash, a Connecticut woman mauled by a chimpanzee. She had a face transplant last May.

Now, "she's feeling a lot of the face. She can start to move on one side. She's able to talk better. Her spirits are great," said Pomahac, her surgeon.

Other face transplant recipients go out in public, enjoy eating normal food for the first time in years, and some have even become advocates for the procedure.

So far, only two face transplant-related deaths have been reported. One was a Chinese man who reportedly was not given or did not take medicines to prevent his body from rejecting his new face. The other was in Paris, a man who received a face and a double hand transplant. He suffered a heart attack during surgery for a complication.

___

Online:

Proposed rule: http://1.usa.gov/wsExRb

Chimp attack woman: http://bit.ly/kcxTfi

___

Follow Marilynn Marchione at http://twitter.com/MMarchioneAP

Associated Press

Technology



News

Chilean doctors separate conjoined twins

AppId is over the quota
AppId is over the quota
In this image taken from a video released by Luis Calvo Mackenna hospital, Roberto Paredes, right, kisses his daughter Maria Jose, one of two conjoined twins after she was separated from her sister Maria Paz at the Luis Calvo Mackenna hospital in Santiago, Chile, Wednesday, Dec. 14, 2011. The 10-months-old twins were joined at the chest, stomach and pelvis. (AP Photo/Luis Calvo Mackenna Hospital) In this image taken from a video released by Luis Calvo Mackenna hospital, Roberto Paredes, right, kisses his daughter Maria Jose, one of two conjoined twins after she was separated from her sister Maria Paz at the Luis Calvo Mackenna hospital in Santiago, Chile, Wednesday, Dec. 14, 2011. The 10-months-old twins were joined at the chest, stomach and pelvis. (AP Photo/Luis Calvo Mackenna Hospital) In this image taken from a video released by Luis Calvo Mackenna hospital, Roberto Paredes, right, caresses his daughter Maria Jose, one of two conjoined twins after she was separated from her sister Maria Paz at the Luis Calvo Mackenna hospital in Santiago, Chile, Wednesday, Dec. 14, 2011. The 10-months-old twins were joined at the chest, stomach and pelvis. (AP Photo/Luis Calvo Mackenna Hospital) In this image taken from a video released by Luis Calvo Mackenna hospital, medical personnel work around one of two conjoined twins after they underwent surgery to be separated at the Luis Calvo Mackenna hospital in Santiago, Chile, Wednesday, Dec. 14, 2011. The 10-months-old twins were joined at the chest, stomach and pelvis. (AP Photo/Luis Calvo Mackenna Hospital)eval("var currentItemd57851005a80479aaeeb90a12c70b9ff = 1;");eval("var nextd57851005a80479aaeeb90a12c70b9ff = 0;");eval("var previousd57851005a80479aaeeb90a12c70b9ff = 0;"); SANTIAGO, Chile (AP) — Chilean doctors successfully separated conjoined twin girls in a marathon 20-hour surgery, saying Wednesday that the operation went extremely well despite challenges.

The 10-month-old twins Maria Paz and Maria Jose were recovering in an intensive care unit, and doctors said the next two days would be critical as they watch for infections or other possible complications.

Parents Jessica Navarrete and Roberto Paredes kept an anxious vigil at Luis Calvo Mackenna Hospital in Santiago as doctors separated the twins at the thorax, abdomen and pelvis. It was the seventh and most complex operation yet for the twins.

Doctors successfully separated the twins late Tuesday night. Chief surgeon Francisco Ossandon described it as the moment "the girls finished the process of being born."

"Before, they had two souls and one body," Ossandon said.

Surgery on one of the twins was completed early Wednesday after a total of 19 hours, while for the other it took more than 20 hours.

"We had a number of difficulties during the surgery. There were some surprises, but we were able to fix, solve the problems," Ossandon said at a news conference.

He added that the twins came out of the surgery in good condition. Ossandon, however, didn't rule out future complications involving the effects from anesthesia and possible infections.

"We're very happy because we think they've had the best evolution we could have hoped for," he said.

The girls' parents appeared in televised images as they kissed the twins before the operation. Then afterward, the mother and father gazed lovingly at the sleeping girls from beside their separate cribs in the intensive care unit.

Paredes softly placed a hand on one daughter's head.

Some Chilean television stations occasionally broke into their regular programming to broadcast updates from the doctors, both during and after the delicate surgery.

"The next 48 hours will be the most critical in terms of the ... risk they face of dying," said Dr. Carlos Acuna, chief of the intensive care unit. He said the girls faced risks of various organs ceasing to function, and also had kidney and lung problems.

The girls' mother said she was hoping for a miracle when the high-risk operation began Tuesday morning.

The Chilean twins presented a particularly difficult challenge because they were born sharing many of the same internal organs and even urinary system. About 100 people participated in the procedure, including 25 surgeons and anesthesiologists.

Perhaps providing some comfort to the parents was the hospital's history with conjoined twins. Staff there have separated three sets before. A fourth set, however, died during surgery due to cardiac complications.

According to the University of Maryland Medical Center, roughly one out of every 200,000 live births worldwide results in conjoined twins. The overall survival rate is between 5 percent to 25 percent, depending on various factors, including where they are joined.

While rare, such surgeries have become increasingly frequent over the years due to improvements in surgery, anesthesia and critical care, said Dr. Eric Strauch, a surgeon at the University of Maryland Medical Center.

"We've gotten better at dealing with them," Strauch said. "I think people are willing to undertake it more."

He said he has performed surgeries on two sets of twins. The first set, girls from Uganda, survived in 2002 and are now about 10 years old, he said.

"The second set survived for about six months after the separation, but they both succumbed to infection," said Strauch, adding that their intestines were unable to function.

He said he knew of another successful case in which two girls were separated and have reached adulthood.

"They're in their 20s and they're just graduated from college," Strauch said. "A lot of them don't do well, but a lot of them do."

Dr. Steven Fishman, a pediatric surgeon at Children's Hospital Boston, said that if twins make it out of the hospital without post-surgery complications, most tend to survive.

"If they're felt to be well enough to go home, in general they will make it long term," he said.

The Chilean twins were born in the Villarrica hospital about 470 miles (760 kilometers) south of Santiago and were kept under constant medical care, surviving with the aid of an artificial respirator.

Earlier this year, doctors separated the twins' legs, urinary tracts, pulmonary systems and other parts of their bodies. They now each have part of a leg that used to be fused together.

During the latest surgery, doctors managed to separate an intestine that had been shared by the two, giving each of them part of it, said Jaime Manalich, the government's health minister, who visited the family at the hospital.

Surgeons weren't able to completely close their abdominal cavities or their thoraxes, and therefore had to use meshing to cover them, Ossandon said. "These are foreign bodies that sometimes the body recognizes as foreign, and that can cause infections," he said.

Maria Jose was the first twin to reach the intensive care unit after the surgery. Her sister Maria Paz, whose operation was more complex due to difficulties in the area near her heart, arrived an hour and 15 minutes later.

They were born in February, and since then have been hospitalized and attached to machines including an artificial respirator.

The girls were still connected to a respirator on Wednesday.

They are to remain sedated for at least three days.

Ossandon said the twins will return to the operating room every two or three days so that doctors can clean their wounds. He called the surgery their "rebirth."

___

Associated Press writer Ian James in Caracas, Venezuela, contributed to this report.

Associated Press

Technology



News

Panel urges lower cutoff for child lead poisoning

AppId is over the quota
AppId is over the quota
In this Thursday, Feb. 23, 2006 photo, contractors Luis Benitez, foreground, and Jose Diaz, background, clean up lead paint in a contaminated building in Providence, R.I. A federal panel recommended Wednesday, Jan. 4, 2012 that the threshold for lead poisoning in children should be lowered. If adopted by government officials, hundreds of thousands of additional U.S. children could be classified as having lead poisoning. Recent research persuaded panel members that children could suffer harm from concentrations of lead lower than the old standard, Centers for Disease Control and Prevention officials said. (AP Photo/Chitose Suzuki) In this Thursday, Feb. 23, 2006 photo, contractors Luis Benitez, foreground, and Jose Diaz, background, clean up lead paint in a contaminated building in Providence, R.I. A federal panel recommended Wednesday, Jan. 4, 2012 that the threshold for lead poisoning in children should be lowered. If adopted by government officials, hundreds of thousands of additional U.S. children could be classified as having lead poisoning. Recent research persuaded panel members that children could suffer harm from concentrations of lead lower than the old standard, Centers for Disease Control and Prevention officials said. (AP Photo/Chitose Suzuki)eval("var currentItemd57851005a80479aaeeb90a12c70b9ff = 1;");eval("var nextd57851005a80479aaeeb90a12c70b9ff = 0;");eval("var previousd57851005a80479aaeeb90a12c70b9ff = 0;"); ATLANTA (AP) — For the first time in 20 years, a federal panel is urging the government to lower the threshold for lead poisoning in children.

If adopted, hundreds of thousands more children could be diagnosed with lead poisoning. Too much lead is harmful to developing brains and can mean a lower IQ.

Recent research persuaded panel members that children could be harmed from lead levels in their blood that are lower than the current standard, officials at the Centers for Disease Control and Prevention said.

While the number of cases has been falling, health officials think as many as 250,000 children have the problem, many of those undiagnosed. The proposed change could take it to 450,000 cases.

Wednesday's vote by the Advisory Committee on Childhood Lead Poisoning Prevention would lower the definition of lead poisoning for young children from 10 micrograms of lead per deciliter of blood to 5 micrograms. The CDC has accepted all of the panel's recommendations in the past.

Lead — a metal that for years was common in paint and gasoline — can harm a child's brain, kidneys and other organs. High levels in the blood can cause coma, convulsions and death. Lower levels can reduce intelligence, impair hearing and behavior and cause other problems.

Usually, the victims are children living in old homes that are dilapidated or under renovation, who pick up paint chips or dust and put it in their mouths. Lead has been banned in paint since 1978. Children have also picked up lead poisoning from soil contaminated by old leaded gasoline, and from dust tracked in from industrial worksites.

Lead poisoning is detected through a blood test, often when kids are toddlers. Most cases are handled by seeking out and removing the lead source, and monitoring the children to make sure lead levels stay down. A special treatment to remove lead and other heavy metals is used for very high levels.

But the problem has seemed to be diminishing, based on the old standard. In 2009, researchers reported that 1.4 percent of young children had elevated lead levels in their blood in 2004, the latest data available. That compares with almost 9 percent in 1988.

The lead poisoning threshold was last changed in 1991. The proposed level of 5 micrograms was calculated from the highest lead levels seen in a comprehensive annual U.S. health survey. The panel recommended that it be reassessed every four years.

"It's a moving target," said Perry Gottesfeld, co-chair of the group that came up with the advice.

Some groups celebrated the decision, saying medical evidence has been mounting that lower levels of lead poisoning can erode a child's ability to learn and cause behavior problems.

"This is long overdue," said Ruth Ann Norton, executive director of the Coalition to End Childhood Lead Poisoning, a Baltimore-based organization.

The recommendation might be difficult to implement. In many places, it's up to city and county health departments to provide many of the services for lead poisoned kids, and those departments have lost more than 34,000 jobs in the last three years because of budget cuts. Meanwhile, Congress just slashed the CDC's lead program from more than $30 million to $2 million.

"The CDC should accept the recommendation," said Robert Pestronk, executive director of the National Association of County and City Health Officials.

"(But) the grim reality is that local health departments and other community agencies don't have the person-power to identify and follow up on all these children," he said.

The panel's Gottesfeld acknowledged the challenge the new recommendations may pose.

"It's certainly going to put a great strain on local departments," he said.

___

CDC: http://www.cdc.gov/nceh/lead/

Associated Press

Technology



News

Stephen Hawking to turn 70, defying disease

AppId is over the quota
AppId is over the quota
FILE In this June 19, 2006 file photo Astrophysicist Stephen Hawking speaks at an international gathering of scientists on the origins of the universe at Beijing's Great Hall of the People in China. British scientist Stephen Hawking has decoded some of the most puzzling mysteries of the universe but he has left one mystery for others to explain: How he managed to survive so long with such a crippling disease. The physicist and cosmologist was diagnosed with Lou Gehrig's disease, or motor neuron disease, when he was a 21-year-old student at Cambridge University. Most people die within a few years of the disease being identified. On Sunday, Hawking will turn 70.(AP Photo/Elizabeth Dalziel-File) FILE In this June 19, 2006 file photo Astrophysicist Stephen Hawking speaks at an international gathering of scientists on the origins of the universe at Beijing's Great Hall of the People in China. British scientist Stephen Hawking has decoded some of the most puzzling mysteries of the universe but he has left one mystery for others to explain: How he managed to survive so long with such a crippling disease. The physicist and cosmologist was diagnosed with Lou Gehrig's disease, or motor neuron disease, when he was a 21-year-old student at Cambridge University. Most people die within a few years of the disease being identified. On Sunday, Hawking will turn 70.(AP Photo/Elizabeth Dalziel-File) FILE In this file photo of Monday, April 21, 2008 provided by NASA, Dr. Stephen Hawking, a professor of mathematics at the University of Cambridge, left, is praised by his daughter Lucy Hawking, as he delivers a speech entitled "Why we should go into space" during a lecture that is part of a series honoring NASA's 50th Anniversary, , at George Washington University's Morton Auditorium in Washington. British scientist Stephen Hawking has decoded some of the most puzzling mysteries of the universe but he has left one mystery for others to explain: How he managed to survive so long with such a crippling disease. The physicist and cosmologist was diagnosed with Lou Gehrig's disease, or motor neuron disease, when he was a 21-year-old student at Cambridge University. Most people die within a few years of the disease being identified. On Sunday, Hawking will turn 70.(AP Photo/NASA, Paul. E. Alers, file) FILE - In this Thursday, April 26, 2007 file photo physicist Stephen Hawking answers questions during an interview in Orlando, Fla. Famed mathematician Stephen Hawking has been rushed to a hospital and is seriously ill, Cambridge University said Monday April 20, 2009 .British scientist Stephen Hawking has decoded some of the most puzzling mysteries of the universe but he has left one mystery for others to explain: How he managed to survive so long with such a crippling disease. The physicist and cosmologist was diagnosed with Lou Gehrig's disease, or motor neuron disease, when he was a 21-year-old student at Cambridge University. Most people die within a few years of the disease being identified. On Sunday, Hawking will turn 70. (AP Photo/John Raoux. File ) FILE In this Thursday, April 26, 2007 file photo Astrophysicist Stephen Hawking is assisted off the tarmac at the Kennedy Space Center by his carer, Monica Guy, as he is applauded by members of the flight crew after completing a zero-gravity flight in Cape Canaveral, Fla. British scientist Stephen Hawking has decoded some of the most puzzling mysteries of the universe but he has left one mystery for others to explain: How he managed to survive so long with such a crippling disease. The physicist and cosmologist was diagnosed with Lou Gehrig's disease, or motor neuron disease, when he was a 21-year-old student at Cambridge University. Most people die within a few years of the disease being identified. On Sunday, Hawking will turn 70.(AP Photo/Peter Cosgrove, File )eval("var currentItemd57851005a80479aaeeb90a12c70b9ff = 1;");eval("var nextd57851005a80479aaeeb90a12c70b9ff = 0;");eval("var previousd57851005a80479aaeeb90a12c70b9ff = 0;"); CAMBRIDGE, England (AP) — British scientist Stephen Hawking has decoded some of the most puzzling mysteries of the universe but he has left one mystery unsolved: How he has managed to survive so long with such a crippling disease.

The physicist and cosmologist was diagnosed with Lou Gehrig's disease when he was a 21-year-old student at Cambridge University. Most people die within a few years of the diagnosis, called motor neurone disease in the U.K. On Sunday, Hawking will turn 70.

"I don't know of anyone who's survived this long," said Ammar Al-Chalabi, director of the Motor Neurone Disease Care and Research Centre at King's College London. He does not treat Hawking and described his longevity as "extraordinary."

"It is unusual for (motor neurone disease) patients to survive for decades, but not unheard of," said Dr. Rup Tandan, a neurology professor at the University of Vermont College of Medicine. Still, Tandan said many longtime survivors had ventilators to breathe for them — which Hawking does not.

Hawking first gained attention with his 1988 book "A Brief History of Time," a simplified overview of the universe. It sold more than 10 million copies worldwide. His subsequent theories have revolutionized modern understanding of concepts like black holes and the Big Bang theory of how the universe began.

To mark his birthday Sunday, Cambridge University is holding a public symposium on "The State of the Universe," featuring talks from 27 leading scientists, including Hawking himself. For 30 years, he held a mathematics post at the university previously held by Sir Isaac Newton. Hawking retired from that position in 2009 and is now director of research at the university's Centre for Theoretical Cosmology.

Hawking achieved all that despite being nearly entirely paralyzed and in a wheelchair since 1970. He now communicates only by twitching his right cheek. Since catching pneumonia in 1985, Hawking has needed around-the-clock care and relies on a computer and voice synthesizer to speak.

A tiny infrared sensor sits on his glasses, hooked up to a computer. The sensor detects Hawking's cheek pulses, which select words displayed on a computer screen. The chosen words are then spoken by the voice synthesizer. It can take up to 10 minutes for Hawking to formulate a single sentence.

"The only trouble is (the voice synthesizer) gives me an American accent," the Briton wrote on his website.

It took Hawking four years to write his last book, "The Grand Design," missing his publisher's original deadline.

Hawking declined requests from The Associated Press for an interview, but his personal assistant, Judith Croasdell, spoke to the AP. She described her boss as remarkably patient.

"The way he communicates can seem frustratingly slow to most people but he doesn't let that impede his thinking," she said.

After a brief hospital stay, Hawking told her that he spent the time thinking about black holes.

Hawking typically comes into the office after a big breakfast and reading the news, Croasdell said. "He's not an early morning person, but he does stay quite late," until about 7 or 8 in the evening, she said.

Hawking's rooftop university office is crammed full of memorabilia: family photos, a miniature NASA shuttle, and a signed picture of himself with President Barack Obama and his wife, Michelle. On top of physics books sits a disability access guide for the university.

Hawking's fame has led to guest appearances on some of his favorite television shows including "The Simpsons" and "Star Trek." His animated likeness from "The Simpsons" has even been turned into an action figure — one of which sits proudly on his office desk. There's also a Homer Simpson clock that Hawking is known to glare at when visitors are late for an appointment.

"He's a big ham, he loves the spotlight," said Kitty Ferguson, who's written two biographies of the physicist.

She said he has a wry sense of humor and has programmed his computer to respond to random encounters with people who ask if he's Stephen Hawking. "No, but I'm often mistaken for that man," his voice synthesizer deadpans.

Lou Gehrig's disease, also called amyotrophic lateral sclerosis, or ALS, attacks motor neurons, cells that control the muscles. Patients typically suffer muscle weakness and wasting, become paralyzed and have problems talking, swallowing and breathing. Only about 10 percent of patients live longer than a decade.

People who are stricken at a young age, as Hawking was, generally have a better chance of surviving longer. Most people are diagnosed between 50 and 70. Life expectancy generally ranges from two to five years after symptoms like slurred speech, difficulty swallowing and muscle weakness set in. Hawking's personal physicians don't discuss his condition with the press, Croasdell said.

For some reason, the disease has progressed more slowly in Hawking than in most. Al-Chalabi and colleagues are analyzing a DNA sample from Hawking, along with those of other patients, to see if there is something rare about his disease or any genetic mutations that could explain his long survival and if that information could be used to help others.

Some experts said the type of care Hawking has, including about a dozen health workers 24 hours a day, may have extended his life expectancy.

"The disease can sometimes stabilize and then the kind of care delivered may be a factor in survival," said Virginia Lee, a brain disease expert at the University of Pennsylvania School of Medicine. "Remaining mentally alert is also extremely important and he has clearly done that."

Hawking says he tries not to think about his limitations.

"I have had (Lou Gehrig's disease) for practically all my adult life," he says on his website. "Yet it has not prevented me from having a very attractive family and being successful in my work," he writes. "I try to lead as normal a life as possible and not think about my condition or regret the things it prevents me from doing, which are not that many."

From the office pictures documenting his achievements, that certainly seems to be the case. Framed photos show the physicist with several popes and on memorable trips to China and Easter Island.

He has even flown in a space simulator. In 2007, Hawking took a zero-gravity flight in Florida, the first time in 40 years he abandoned his wheelchair.

"That was the happiest I've ever seen Stephen," said Sam Blackburn, Hawking's graduate assistant, who accompanied him on the ride along with about a half-dozen others, including two doctors. "He just had the biggest grin on his face."

Hawking has also been married twice and has three children and three grandchildren. With his daughter Lucy, he has written several children's books on physics.

Al-Chalabi said most patients with Lou Gehrig's disease succumb after their breathing muscles stop working. He had no predictions for what the biggest health risks to Hawking's future might be.

"He is truly remarkable," Al-Chalabi said. "This is someone who's managed to find ways around every single problem the disease has thrown at him."

___

Online:

Hawking website: http://www.hawking.org.uk

Associated Press

Technology



News

Survey: 1 in 4 women attacked by intimate partner

AppId is over the quota
AppId is over the quota
ATLANTA (AP) — It's a startling number: 1 in 4 women surveyed by the government say they were violently attacked by their husbands or boyfriends.

Experts in domestic violence don't find it too surprising, although some aspects of the survey may have led to higher numbers than are sometimes reported.

Even so, a government official who oversaw the research called the results "astounding."

"It's the first time we've had this kind of estimate" on the prevalence of intimate partner violence, said Linda Degutis of the Centers for Disease Control and Prevention.

The survey, released by the CDC Wednesday, marks the beginning of a new annual project to look at how many women say they've been abused.

One expert called the new report's estimate on rape and attempted rape "extremely high" — with 1 in 5 women saying they were victims. About half of those cases involved intimate partners. No documentation was sought to verify the women's claims, which were made anonymously.

But advocates say the new rape numbers are plausible.

"It's a major problem that often is underestimated and overlooked," said Linda James, director of health for Futures Without Violence, a San Francisco-based organization that advocates against domestic abuse.

The CDC report is based on a randomized telephone survey of about 9,000 women and 7,400 men.

Among the findings:

— As many as 29 million women say they have suffered severe and frightening physical violence from a boyfriend, spouse or other intimate partner. That includes being choked, beaten, stabbed, shot, punched, slammed against something or hurt by hair-pulling.

— That number grows to 36 million if slapping, pushing and shoving are counted.

— Almost half of the women who reported rape or attempted rape said it happened when they were 17 or younger.

—As many as 1 in 3 women have experienced rape, physical violence or stalking by an intimate partner in their lifetimes, compared to about 1 in 10 men.

—Both men and women who had been menaced or attacked in these ways reported more health problems. Female victims, in particular, had significantly higher rates of irritable bowel syndrome, asthma, frequent headaches and difficulty sleeping.

—Certain states seemed to have higher reports of sexual violence than others. Alaska, Oregon and Nevada were among the highest in rapes and attempted rapes of women, and Virginia and Tennessee were among the lowest.

Several of the CDC numbers are higher than those of other sources. For example, the CDC study suggests that 1.3 million women have suffered rape, attempted rape or had sex forced on them in the previous year. That statistic is more than seven times greater than what was reported by a Department of Justice household survey conducted last year.

The CDC rape numbers seem "extremely high," but there may be several reasons for the differences, including how the surveys were done, who chose to participate and how "rape" and other types of assault were defined or interpreted, said Shannan Catalano, a statistician with the Bureau of Justice Statistics.

"It is an evolving field, and everyone is striving to get a handle on what's the best estimate," Catalano said.

The CDC's numbers don't seem surprising to people who work with abused women.

"I think that the awareness is growing," said Kim Frndak, community educator for the Women's Rescue Center to End Domestic Violence, which operates a shelter on the outskirts of Atlanta.

"More and more people are really saying, 'Oh, this is something that we need to pay attention to as well,' because it's your sister, it's your mother, it's your daughter, it's your son, it's your brother. Someone in your own circle is being affected by domestic violence, and the effects can be devastating," she said.

____

Associated Press Writer Kate Brumback in Atlanta contributed to this report.

___

Online:

CDC report: http://www.cdc.gov/violenceprevention/nisvs/

Associated Press

Technology



News

Survey: Teen marijuana use rises, alcohol use down

AppId is over the quota
AppId is over the quota
LANSING, Michigan (AP) — More U.S. teens are using marijuana and see it as less of a risk, while their alcohol use has dipped to historic lows, according to an annual national survey of drug use released Wednesday.

The findings are based on an annual survey of 47,000 teens conducted by the University of Michigan for the National Institute on Drug Abuse.

One of every 15 high school seniors reported smoking marijuana on a daily or near daily basis, the highest rate since 1981.

"One thing we've learned over the years is that when young people come to see a drug as dangerous, they're less likely to use it," Lloyd Johnston, the study's principal investigator, said in a telephone interview with The Associated Press. "That helps to explain why marijuana right now is rising, because the proportion of kids who see it as dangerous has been declining."

The study said marijuana use among teens rose in 2011 for the fourth straight year after considerable decline in the preceding decade.

One of every nine students in their last year of school before college reported using synthetic marijuana within the previous 12 months.

The synthetic drug survey question was asked for the first time this year. Fake marijuana, sometimes sold in drug paraphernalia shops and on the Internet as incense, contains organic leaves coated with chemicals that provide a marijuana-like high when smoked.

A Drug Enforcement Administration emergency order banning the sale of five chemicals used in herbal blends to make synthetic marijuana took effect March 1. Many states also have their own laws banning the sale of synthetic marijuana.

White House drug czar Gil Kerlikowske called on parents to get involved to help stop the use of synthetic marijuana.

"It's not in the vocabulary of parents, and they need to be aware of it so that when they have that conversation about substance abuse that they are knowledgeable and they talk about this," he told the AP.

Alcohol use continued a trend of decline dating to the 1980s and hit a historic low for the survey, which began in the 1970s.

Other drugs showing some evidence of decline in use this year include cocaine, crack cocaine and inhalants.

___

Online:

The survey can be found at http://www.monitoringthefuture.org

Associated Press

Technology



News

Obama admin: 2.5M young adults gain coverage

AppId is over the quota
AppId is over the quota
FILE - In this Nov. 30, 2011, file photo, U.S. Health and Human Services Secretary Kathleen Sebelius participates in an roundtable discussion on health information technology and job creation at Cuyahoga Community College in Cleveland. The Obama administration says the number of young adults going without medical coverage has shrunk by 2.5 million since the new health care law took effect. A new analysis to be released Wednesday, Dec. 14, 2011, finds the drop is two-and-half times larger than indicated by government and private estimates from earlier this year. The health care overhaul allows young adults to stay on a parent’s plan until they turn 26. (AP Photo/Tony Dejak, File) FILE - In this Nov. 30, 2011, file photo, U.S. Health and Human Services Secretary Kathleen Sebelius participates in an roundtable discussion on health information technology and job creation at Cuyahoga Community College in Cleveland. The Obama administration says the number of young adults going without medical coverage has shrunk by 2.5 million since the new health care law took effect. A new analysis to be released Wednesday, Dec. 14, 2011, finds the drop is two-and-half times larger than indicated by government and private estimates from earlier this year. The health care overhaul allows young adults to stay on a parent’s plan until they turn 26. (AP Photo/Tony Dejak, File)eval("var currentItemd57851005a80479aaeeb90a12c70b9ff = 1;");eval("var nextd57851005a80479aaeeb90a12c70b9ff = 0;");eval("var previousd57851005a80479aaeeb90a12c70b9ff = 0;"); WASHINGTON (AP) — Young adults trying to get traction in a tough economy are getting a welcome assist: the new federal health care law has markedly improved their access to health insurance.

The number of young Americans ages 19-25 lacking health insurance has shrunk by 2.5 million since President Barack Obama's health care overhaul took effect, the administration announced in an analysis released Wednesday.

That drop is 2½ times as large as the decline indicated by previous government and private estimates from earlier this year, which showed about 1 million had gained coverage.

The improvement comes even as the uninsured rate stayed basically stuck for those a little older, ages 26-35.

Under the health care overhaul, adult children can stay on a parent's plan until they turn 26, a provision that has proven popular in an otherwise divisive law.

Health and Human Services Secretary Kathleen Sebelius said the numbers show the law is making a big difference for families with adult children.

"Many of them gained coverage earlier this spring, meaning the law was there for young people as they graduated from college or high school and began their careers," she said.

Administration officials said there are a couple of reasons for the better-than-expected result.

First, there is more data available now than earlier this year. Secondly, analysts are slicing the numbers more precisely than the government usually does.

The health care law's main push to cover the uninsured doesn't come until 2014. But the young adults' provision took effect last fall, and most workplace health plans started carrying it out Jan. 1. Since then, families have flocked to sign up adult children making the transition to work in a challenging environment.

The overall fate of Obama's law remains uncertain, with the Supreme Court scheduled to hear a constitutional challenge next year, and Republican presidential candidates vowing to repeal it. But this provision seems to have gotten a seal of approval from consumers.

"The increase in coverage among 19- to 25-year-olds can be directly attributed to the Affordable Care Act's new dependent coverage provision," said the HHS analysis.

Using unpublished quarterly statistics from the government's ongoing National Health Interview Survey, analysts in Sebelius' policy office determined that nearly 36 percent of those age 19-25 were uninsured in the third calendar quarter of 2010, before the law's provision took effect.

That translates to more than 10.5 million people.

By the second calendar quarter of 2011, the proportion of uninsured young adults had dropped to a little over 27 percent, or about 8 million people.

The difference — nearly 2.5 million getting coverage — can only be the result of the health care law, administration officials said, because the number covered by public programs like Medicaid went down slightly.

Overall, nearly 30 million Americans are ages 19 to 25.

"From September 2010 to June 2011, coverage rose only among those adults affect by the policy," said the HHS report.

The National Center for Health Statistics has documented a broadly similar trend in its official publications, only it's not nearly as dramatic.

Administration officials said those statistics did not focus on the change from calendar quarter to calendar quarter, as does the new HHS report. Instead, they pool data over longer time periods, and that has the effect of diluting the perceived impact of the law, officials said.

Traditionally, young adults have been more likely to be uninsured than any other age group.

Some are making the switch from school to work. Others are holding down low-wage jobs that don't usually come with health care. And some — termed the "invincibles" — pass up job-based health insurance because they don't think they'll use it and would rather get extra money in their paychecks.

Other early coverage expansions in the health care law have not worked as well, including a special program for people with health problems turned away by private insurers. Many applicants found the premiums unaffordable.

Young adults are less expensive to cover than people who are middle-aged, and many companies have spread the extra premiums among their workers. Benefits consultant Delloite LLP has projected additional health plan costs in the range of 1 percent to 2 percent for covering young adults.

Before the health care overhaul, families with adult children faced a hodgepodge of policies. Some health plans only covered older children while they were full-time students. Others applied an age cutoff.

Associated Press

Technology



News

Palm-sized baby among the world's smallest

AppId is over the quota
AppId is over the quota
14-week-old Melinda Star Guido holds her mother's little finger while lying in an incubator at the Los Angeles County-USC Medical Center in Los Angeles, Wednesday, Dec. 14, 2011. At birth, Melinda Star Guido tipped the scales at only 9 1/2 ounces, a tad less than the weight of two iPhone 4S. Melinda is believed to be the second smallest baby to survive in the United States and the third smallest in the world. (AP Photo/Jae C. Hong) 14-week-old Melinda Star Guido holds her mother's little finger while lying in an incubator at the Los Angeles County-USC Medical Center in Los Angeles, Wednesday, Dec. 14, 2011. At birth, Melinda Star Guido tipped the scales at only 9 1/2 ounces, a tad less than the weight of two iPhone 4S. Melinda is believed to be the second smallest baby to survive in the United States and the third smallest in the world. (AP Photo/Jae C. Hong) Haydee Ibarra, looks at her 14-week-old daughter, Melinda Star Guido, at the Los Angeles County-USC Medical Center in Los Angeles, Wednesday, Dec. 14, 2011. At birth, Melinda Star Guido tipped the scales at only 9 1/2 ounces, a tad less than the weight of two iPhone 4S. Most babies her size don’t survive, but doctors are preparing to send her home as soon as the end of the month. Melinda is believed to be the second smallest baby to survive in the United States and the third smallest in the world. (AP Photo/Jae C. Hong) This undated photo provided by Los Angeles County-USC Medical Center shows shows Melinda Guido shortly after her birth in late August with the hand of Dr. Rangasamy Ramanathan as a comparison. Melinda was born premature at 24 weeks weighing only 9.5 ounces. She's believed to be the second smallest baby to survive in the United States and third in the world. (AP Photo/Los Angeles County-USC Medical Center ) This undated photo provided by Melinda Guido’s family shows Melinda, with her mother's fingers in the scene, in the neonatal intensive care unit at the Los Angeles County-USC Medical Center. Melinda was born premature at 24 weeks weighing 9.5 ounces. She’s believed to be the second smallest surviving baby in the United States and third smallest in the world. (AP Photo/Haydee Ibarra) This undated photo provided by Melinda Guido’s family shows Melinda in the neonatal intensive care unit at the Los Angeles County-USC Medical Center. Melinda was born premature at 24 weeks weighing 9.5 ounces. She’s believed to be the second smallest surviving baby in the United States and third smallest in the world. (AP Photo/Haydee Ibarra)eval("var currentItemd57851005a80479aaeeb90a12c70b9ff = 1;");eval("var nextd57851005a80479aaeeb90a12c70b9ff = 0;");eval("var previousd57851005a80479aaeeb90a12c70b9ff = 0;"); LOS ANGELES (AP) — At birth, Melinda Star Guido was so tiny she could fit into the palm of her doctor's hand. Weighing just 9 1/2 ounces — less than a can of soda — she is among the smallest babies ever born in the world.

Most infants her size don't survive, but doctors are preparing to send her home by New Year's.

Melinda was born premature at 24 weeks in late August and is believed to be the second-smallest baby to survive in the U.S. and third smallest in the world. She spent the early months cocooned in an incubator in the neonatal intensive care unit in Los Angeles.

Despite hurdles, Melinda lived to her original Thursday due date. Doctors say it is too early to say how she will fare developmentally and physically when she grows up.

For now, her 22-year-old mother sits at her bedside almost every day and stays overnight whenever she can.

On Wednesday, Haydee Ibarra caressed Melinda through the portholes of the incubator where nurses pinned up a homemade sign bearing her name. Now 3 ½ months old and weighing 4 pounds, Melinda gripped Ibarra's pinky finger and yawned.

"Melinda, Melinda," she cooed at her daughter dressed in a polka dot onesie. "You're awake today."

During her pregnancy, Ibarra suffered from high blood pressure, which can be dangerous for mother and fetus. She was transferred from a hospital near her San Fernando Valley home to the county's flagship hospital, which was better equipped to handle high-risk pregnancies.

There was a problem with the placenta, the organ that nourishes the developing fetus. The fetus, however, was not getting proper nutrition, blood and oxygen. Doctors knew Melinda would weigh less than a pound, but they were surprised at how small and fragile she was.

"The first few weeks, it was touch and go. None of us thought the baby was going to make it," said Dr. Rangasamy Ramanathan, who oversees premature infants at the Los Angeles County-USC Medical Center.

Even if she survived, doctors told Ibarra and her husband Yovani Guido, children born this extremely premature can have developmental delays and impairments such as blindness, deafness or cerebral palsy.

Ibarra, who previously had a stillborn, told doctors to do whatever necessary to help her baby.

"They said, 'We'll take the chance. Please try.' So we said. 'OK we'll try,'" Ramanathan recalled.

Melinda was delivered by cesarean section at 24 weeks and was immediately transferred to the NICU where a team of doctors and nurses kept watch around the clock. Infants born before 37 weeks are considered premature.

Melinda was kept insulated in an incubator and was hooked up to a machine to aid her breathing. She got nutrition through a feeding tube. Her mother said her skin felt like plastic because it was so thin.

"It takes a lot of good care and a lot of good luck. Most of them don't survive," said pediatrician Dr. Edward Bell of the University of Iowa who keeps an online database of the world's smallest surviving babies who were less than a pound at birth.

The list currently contains 126 babies dating back to 1936. Since submission is voluntary, it does not represent all survivors.

Ten babies weighing less than a pound were born last year and survived. Melinda joins three other tiny survivors delivered this year in Berkeley; Seoul, South Korea; and Iowa City, Iowa. All are bigger than Melinda, who is not eligible to be listed until she gets discharged.

Most tiny babies who survive tend to be female. That's because female fetuses mature faster than males of the same gestational age. Having more developed lungs and other vital organs increases odds of survival.

Bell published a study last year that found many survivors struggle with health and learning problems. For those for whom growth data are available, many are short and underweight for their age.

There are some success stories.

The smallest surviving baby born weighing 9.2 ounces is now a healthy 7-year-old and another who weighed 9.9 ounces at birth is an honors college student studying psychology. Their progress was detailed in a study published this week in the journal Pediatrics by doctors at Loyola University Medical Center in Illinois where the girls were born.

In the past three years, Los Angeles County-USC Medical Center cared for two other babies with extremely low birth weight who survived, but Melinda holds the record at the hospital.

Prematurity comes with high costs. Ramanathan estimates it costs $3,000 to $5,000 a day to care for a premature infant.

A month after birth, Melinda was treated for an eye disorder that's common in premature babies. She faced her biggest test last month when she underwent surgery to close an artery that usually seals after birth.

Ybarra held her daughter for the first time after the surgery. Before that, she could only touch her through the incubator.

The next challenge is learning to bottle feed before discharge. Ramanathan predicted at least another two-week stay, dashing her parents' hopes of taking her home by Christmas.

Ramanathan said doctors don't know how Melinda will fare when she's older. Since she did not have major complications such as bleeding in the brain, he held out hope.

Melinda can breathe by herself, but still uses an oxygen tube as a precaution. On Wednesday, an ophthalmologist checked out her eyes and said everything looked good.

After the checkup, Ibarra lifted Melinda out of the incubator and sat in a rocking chair, cradling her.

___

Follow Alicia Chang's coverage at http://www.twitter.com/SciWriAlicia

___

Online:

Tiniest Babies Registry: http://bit.ly/rvglZQ

Associated Press

Technology



News

Jumat, 20 Januari 2012

2 more dead birds in HK test positive for H5N1

AppId is over the quota
AppId is over the quota
HONG KONG (AP) — Hong Kong authorities say two more dead birds have tested positive for a dangerous strain of bird flu, adding to health worries in the city.

Agriculture officials said Friday that two black-headed gulls found separately about a week ago in rural areas had H5N1 avian influenza. The birds are common visitors in winter.

Last month, a Chinese bus driver who tested positive for H5N1 died in a city bordering Hong Kong. Also, workers in Hong Kong slaughtered nearly 20,000 birds at a market after two dead birds, one a chicken, were found to have the dangerous strain.

H5N1 rarely infects humans and usually only those who come into close contact with diseased poultry. The World Health Organization says globally there have been 336 human deaths from 573 confirmed bird flu cases since 2003.

Associated Press

Technology



News

Smoggy Beijing to reveal more pollution data

AppId is over the quota
AppId is over the quota
FILE - In this Saturday, Dec. 3, 2011 file photo, Tan Liang carries a PM2.5 detector while walking towards a garbage-burning facility located near his apartment to check levels of fine particles in the air in Beijing, China. A bureau in charge of monitoring China's frequently smog-choked capital will release more detailed reports, state media said Friday, Jan. 6, 2012, following a public outcry over the hazards of fine particle pollution. (AP Photo/Andy Wong, File) FILE - In this Saturday, Dec. 3, 2011 file photo, Tan Liang carries a PM2.5 detector while walking towards a garbage-burning facility located near his apartment to check levels of fine particles in the air in Beijing, China. A bureau in charge of monitoring China's frequently smog-choked capital will release more detailed reports, state media said Friday, Jan. 6, 2012, following a public outcry over the hazards of fine particle pollution. (AP Photo/Andy Wong, File)eval("var currentItemd57851005a80479aaeeb90a12c70b9ff = 1;");eval("var nextd57851005a80479aaeeb90a12c70b9ff = 0;");eval("var previousd57851005a80479aaeeb90a12c70b9ff = 0;"); BEIJING (AP) — A bureau in charge of monitoring China's frequently smog-choked capital will release more detailed reports, state media said Friday, following a public outcry over the hazards of fine particle pollution.

Beijing's decision to publish the data appeared aimed at appeasing residents' anger over the pollution and a lack of government transparency.

Frustration over the issue has been fueled by a Twitter feed set up by the U.S. Embassy in Beijing that reports air quality as measured by a monitor on the embassy roof and publishes it online every hour. Those readings include levels of fine particulate matter, or PM2.5 — a type of pollution that Beijing authorities also measure but keep secret from the public.

China's environmental ministry has said it will factor PM2.5 into national air quality standards, but not until 2016.

The official Xinhua News Agency said Beijing's environmental protection bureau will also now post hourly online readings for PM2.5 before Chinese New Year, which begins later this month. The city already has six monitoring stations measuring PM2.5 and will add more before the end of the year, Xinhua said.

Beijing is frequently cloaked in yellow haze. Buildings a couple of blocks away are barely visible. Still, Beijing's official air quality index records the pollution as "light" — a reading at odds with what many people experience.

Sometimes seen as soot or smoke, PM2.5 is tiny particulate matter — less than 2.5 micrometers in diameter, or approximately 1/30th the average width of a human hair — that can result from the burning of fuels in vehicles, power plants and agriculture. Breathing such fine particles causes respiratory problems and can lead to death.

Associated Press

Technology



News

More US women having twins; rate at 1 in 30 babies

AppId is over the quota
AppId is over the quota
ATLANTA (AP) — The number of twins born in the U.S. soared over the last three decades, mostly the result of test-tube babies and women waiting to have children until their 30s, when the chances of twins increase.

In 2009, 1 in every 30 babies born in the U.S. was a twin, an astounding increase over the 1 in 53 rate in 1980, according to a government report issued Wednesday.

"When people say it seems like you see more twins nowadays, they're right," said Joyce Martin, an epidemiologist who co-authored the Centers for Disease Control and Prevention report.

Some increase was expected as more women are delaying starting a family until they are over 30. For some unknown reason, mothers in their 30s are more likely to have twins than younger or older women. As much as a third of the increase can be attributed to that, Martin said.

The rest of the rise is due to fertility drugs and treatments.

"You have a double whammy going on. There are more older moms and more widespread use of fertility-enhancing therapies," Martin said.

Starting in the early 1980s, couples who had trouble conceiving began to benefit from medical advances like fertility drugs and in vitro fertilization and other procedures. These treatments became fairly widespread in the 1990s but are expensive, and availability and insurance coverage varies.

The twin birth rate rose by more than 2 percent a year, on average, from 1980 through 2004. It leveled off to less than 1 percent annually although the rise from 2008 to 2009 was nearly 2 percent.

In 2009, twin rates increased in all 50 states, though the jumps were highest in lower New England, New Jersey and Hawaii. In Connecticut, twins now account for nearly 5 percent of births.

That's high. Nationally, 3.3 percent of all births were twins in 2009, up from 2 percent in 1980.

Over the last three decades, rates rose for white, black and Hispanic women, but the increases were not uniform. Rates doubled for whites, rose by half for blacks and by about a third for Hispanics. Historically, black moms have twins most often, but white moms have almost caught up.

"That's changed with infertility treatments," said Barbara Luke, a Michigan State University expert on twin births.

The greatest increase in twin rates was for women 40 and older. They are more likely to use fertility treatments and to have two embryos implanted during in vitro fertilization, whereas younger women are more likely to get just one.

About 7 percent of all births for women 40 and older were twins, compared to 5 percent of women in their late 30s and 2 percent of women age 24 or younger.

While a lot of attention is focused on the impact of fertility treatments, that's not the only factor. Before fertility treatments existed, about 2.5 percent of the babies born to women in their late 30s were twins, compared to under 2 percent for younger and older women. Some research has suggested women in that age group are more likely to produce multiple eggs in a cycle, increasing their chances of twins.

Clearly, there are more older moms. In recent years, more than a third of all births have been to women 30 and older, up from just one-fifth in 1980.

Take Victoria Jacobson. At 31, she gave birth to twin girls last April — her first children. With no history of twins in her family, and no fertility drugs, it was a big surprise when she found out at six months pregnant.

"I cried, because I'm more of a realist. My husband laughed," said Jacobson, of Glen Ellyn, Ill. "They were not tears of joy. Maybe shock, more than anything."

Still, Jacobson doesn't find the new report on twin births surprising. A good friend had twins four months after Jacobson's girls were born. "I'm stopped at every corner and in every store" by mothers who also have twins, or who know of other twins, she says.

"I never knew how many twins were around until I got twins."

Are more twins good news? Some experts say the trend is worrisome, noting that multiple births are more dangerous for the mother and their babies. The infants tend to be born earlier, smaller and weaker, and require much more care.

Jacobsons' twins arrived a month early and were tiny, about 3 pounds each. They had to be cared for in a hospital intensive care unit, and one needed a ventilator at first to help her breathe.

At 8 months, they are still small, but healthy and doing fine. Still, they don't sleep through the night, and breastfeeding two and getting them on the same schedule hasn't been easy, she said.

Despite the challenges, she has this advice to other moms of twins: Don't "think about it as double trouble. It's still a double blessing."

___

AP Medical Writer Lindsey Tanner in Chicago contributed to this report.

____

Online:

CDC report: http://www.cdc.gov/nchs/

Associated Press

Technology



News

New England Journal: 200 years of medical history

AppId is over the quota
AppId is over the quota
EMBARGOED FOR RELEASE AT WEDNESDAY, JAN. 4, 2012 AT 5 P.M. EST - This illustration made available by the New England Journal of Medicine shows a diagram of a human heart in the article "Cases of Organic Diseases of the Heart and Lungs" by John C. Warren in the April 1, 1812, Issue of the journal. Unhappy with today's health care? Think of what it was like to be sick 200 years ago. No stethoscopes, antibiotics, X-rays or vaccines. Bloodletting was a common treatment. If you had a heart attack or a stroke, doctors put you in bed and hoped for the best. Into this medical dark age, two Boston doctors brought a beacon of light. Two centuries ago, they started what is now the New England Journal of Medicine with the idea that science should guide care medical treatment. (AP Photo/New England Journal of Medicine) EMBARGOED FOR RELEASE AT WEDNESDAY, JAN. 4, 2012 AT 5 P.M. EST - This illustration made available by the New England Journal of Medicine shows a diagram of a human heart in the article "Cases of Organic Diseases of the Heart and Lungs" by John C. Warren in the April 1, 1812, Issue of the journal. Unhappy with today's health care? Think of what it was like to be sick 200 years ago. No stethoscopes, antibiotics, X-rays or vaccines. Bloodletting was a common treatment. If you had a heart attack or a stroke, doctors put you in bed and hoped for the best. Into this medical dark age, two Boston doctors brought a beacon of light. Two centuries ago, they started what is now the New England Journal of Medicine with the idea that science should guide care medical treatment. (AP Photo/New England Journal of Medicine)eval("var currentItemd57851005a80479aaeeb90a12c70b9ff = 1;");eval("var nextd57851005a80479aaeeb90a12c70b9ff = 0;");eval("var previousd57851005a80479aaeeb90a12c70b9ff = 0;"); Unhappy with today's health care? Think of what it was like to be sick 200 years ago.

No stethoscopes, antibiotics, X-rays or vaccines. Bloodletting was a common treatment. If you had a heart attack or a stroke, doctors put you in bed and hoped for the best. If you needed surgery, you got a few shots of whiskey and a bullet to bite.

Into this medical dark age, two Boston doctors brought a beacon of light. They started what is now the New England Journal of Medicine with the idea that science should guide care — not whoever argued loudest or had the most persuasive theory.

The first 100 copies in January 1812 were delivered by horseback. Today, 2 million people read the journal online every month. It is the oldest continuously publishing medical journal in the world, and it has touched lives in more ways than you may know. Some examples:

—Stroke victims now get clot-busting medicine, not dark rooms to ride out their brain trauma, because a 1995 study in the journal proved its benefit.

—Heart attack patients have arteries unclogged without surgery, then go home on medicines that studies in the journal showed could prevent future attacks.

—Women with early stage breast cancer can have just the lump removed followed by radiation instead of losing the whole breast, thanks to a 1985 study that found the lesser surgery just as good.

—Bone marrow and organ transplants — radical ideas when first tried half a century ago — are now routine. Even face transplants are becoming more common: three were described in last week's issue.

—Rehydration is now recognized as the main treatment for many diarrheal diseases. A journal article warned against bloodletting in 1832 as cholera ravaged New York City.

—People no longer suffer surgery without anesthesia, a field that grew from Henry Jacob Bigelow's 1846 report on the first successful use of inhaled ether.

—Medicine is more ethical, and study participants have more protections, because of a 1966 report in the journal about researchers failing to get informed consent. Another top journal had rejected the article as too controversial.

The New England Journal started decades before the American Medical Association was founded in 1847 and is widely credited with promoting evidence-based care.

"It has been very good for society," said Pat Thibodeau, head librarian and associate dean for the Medical Center Library at Duke University. "When I go in, I'm hoping my doctor has read the New England Journal of Medicine or something similar and is following that information."

"It's the cream of the crop," said Dr. Barron Lerner, a Columbia University physician and medical historian.

"They get the best research submitted to them, and they do an extremely good job of peer reviewing" to make sure it is solid, he said.

That's what Boston surgeon John Collins Warren and James Jackson, who helped found Massachusetts General Hospital, hoped for the journal, which is now published weekly. It got its current name in 1928, seven years after it was bought by the Massachusetts Medical Society.

Warren's father, John Warren, surgeon to George Washington's troops, wrote the first article, on chest pain. Doctors had been debating whether it was caused by plaque — "the cement that builds up in arteries" — or blood clots, said Dr. Jeffrey Drazen, the journal's editor-in-chief since 2000. Both proved correct — the "cement" fractures and allows a clot to form that blocks an artery, he said.

Heart care has been a journal specialty, and two prominent doctors — Elizabeth Nabel and Eugene Braunwald of Brigham and Women's Hospital — trace its evolution in this week's issue. Nabel is former director of the National Heart, Lung and Blood Institute and now is president of the Boston hospital.

They describe the first human cardiac catheterization — now a common diagnostic procedure — that Werner Forssman performed on himself in 1929. Under local anesthesia, he put a catheter into his arm and maneuvered it into his own heart.

For a heart attack, "it used to be that all we did was put people to bed for five weeks," but studies in the journal showed "that that was the worst thing you could do," said Dr. Jerome Kassirer, its top editor from 1991 to 1999.

The journal also helped prove "germ theory" and the nature of infectious diseases.

"People didn't realize you could infect people when you were using your dirty gloves or not using gloves. People didn't realize tuberculosis was communicable. They thought it emanated from clouds they called miasma, clouds of dirty smoke in cities," said Lerner, the Columbia historian.

Not all was grand in the journal's history, though, as Allan Brandt, a Harvard University medical historian writes in this week's issue.

When Harvard Medical School debated admitting female students in 1878, the journal expressed concern about men and women mingling during surgeries normally witnessed only by one sex. The school didn't admit women until 1945, when World War II caused a shortage of men.

The journal also agreed with mandatory sterilization of "mental defectives" in the early 20th century. "Most alarming," Brandt writes, was its declaration in 1934 that "Germany is perhaps the most progressive nation in restricting fecundity among its unfit." The journal later condemned Nazi medicine.

In recent years, it has tracked health policy, from the Clinton health care plan and the advent of managed care to current debates about Medicare.

There were oddball reports along the way, like the 2007 account of a cat named Oscar that had a knack for predicting when patients at a Providence, R.I., nursing home were close to death by curling up to them in their final hours.

The journal has printed few studies on alternative medicine because so little good research has been done on it, Drazen said. Unlike some other journals that like controversial research, the New England Journal tries to avoid it.

"People think the cutting edge is sharp. The cutting edge is very dull. It's very foggy and you don't know what the right answer is," so editors try to pick studies that are definitive enough to affect care, Drazen said.

That's why it publishes very few observational studies, the kind that in the 1990s led to pronouncements like "margarine is better than butter" only to be reversed by the next such study.

"Some of those are papers that we've seen and turned back," Drazen said. "I'm looking for a higher evidence standard."

___

Online:

Journal and medical timeline: http://nejm200.nejm.org

___

Marilynn Marchione can be followed at http://twitter.com/MMarchioneAP

Associated Press

Technology



News

Your home's age important for child lead exposure

AppId is over the quota
AppId is over the quota
FILE - In this Thursday, Feb. 23, 2006 file photo, contractors clean up lead paint at a contaminated building in Providence, R.I. The risk of lead-based paint from older homes is back in the news, as the U.S. government considers tightening the definition of lead poisoning in babies, toddlers and preschoolers. Lower levels than previously thought may harm their developing brains. (AP Photo/Chitose Suzuki, File) FILE - In this Thursday, Feb. 23, 2006 file photo, contractors clean up lead paint at a contaminated building in Providence, R.I. The risk of lead-based paint from older homes is back in the news, as the U.S. government considers tightening the definition of lead poisoning in babies, toddlers and preschoolers. Lower levels than previously thought may harm their developing brains. (AP Photo/Chitose Suzuki, File)eval("var currentItemd57851005a80479aaeeb90a12c70b9ff = 1;");eval("var nextd57851005a80479aaeeb90a12c70b9ff = 0;");eval("var previousd57851005a80479aaeeb90a12c70b9ff = 0;"); WASHINGTON (AP) — If you've been putting off repairing a peeling windowsill, or you're thinking of knocking out a wall, listen up: Check how old your house is. You may need to take steps to protect your kids from dangerous lead.

The risk of lead-based paint from older homes is back in the news, as the government considers tightening the definition of lead poisoning in babies, toddlers and preschoolers. Lower levels than previously thought may harm their developing brains.

That's a scary-sounding message. But from a practical standpoint, it's not clear how much would change if the government follows that advice. Already there's been a big drop in childhood lead poisoning in the U.S. over the past few decades. Public health programs have targeted the youngsters most at risk — poor children living in crumbling housing, mostly in cities — to try to get them tested and their homes cleaned up.

But specialists say it can be a risk in more affluent areas, too, as do-it-yourselfers embark on fix-ups without knowing anything about an environmental hazard that long ago faded from the headlines.

The main value of the proposed change may be in increasing awareness of how to avoid lead in everyday life.

"What we need to do is prevent the exposure in the first place," said Dr. Nicholas Newman, who directs the environmental health and lead clinic at Cincinnati Children's Hospital.

There are lots of ways people can be exposed to lead: Soil polluted from the leaded gasoline of yesteryear. Old plumbing with lead solder. Improperly using lead-glazed pottery or leaded crystal with food. Certain jobs that expose workers to the metal. Hobbies like refinishing old painted furniture.

Sometimes even imported toys or children's jewelry can have illegal lead levels, prompting recalls if they're caught on the U.S. market.

But the main way that U.S. children are exposed is from layers of old paint in buildings built before 1978, when lead was banned from residential paint.

Sure, the walls might have been painted over recently, and there may be no obvious paint chips to attract a tot crawling around on the floor. But friction from opening and closing windows and doors allows tiny leaded particles to make their way into household dust — and youngsters then get it on their hands that go into their mouths, explained Dr. John Rosen, a lead poisoning specialist at the Children's Hospital at Montefiore in New York City.

Very high lead levels can cause coma, convulsions, even death, fortunately a rarity today. But lower levels, especially in children under 6, can harm a child's brain, can reduce IQ and cause other learning, attention and behavioral problems — without any obvious symptoms to alert the parent.

How much is too much? Until now, the definition of lead poisoning in young children was 10 micrograms of lead per deciliter of blood. But in a draft report last fall, the National Toxicology Program analyzed recent scientific research to conclude there's good evidence that levels lower than 10 are a risk. Now advisers to the Centers for Disease Control and Prevention are urging that agency to lower the definition to 5 micrograms for now, periodically reassessing.

If the CDC agrees, its advisers estimated that could classify about 450,000 children with lead poisoning, up from roughly 250,000 today.

At these levels, there's no treatment for the child other than to end the ongoing exposure — clean up the house, Newman stressed. That's why prevention is so important. And while the youngest children are the most vulnerable, lead's not good for anyone's brain, so he advises taking common-sense precautions before potential exposures like renovating an old home.

What should families do? Here's advice from the Environmental Protection Agency and public health agencies:

—Check the age of your house. At checkups for babies through age 5, pediatricians are supposed to ask if you live in a home built before 1960, or one built before 1978 that's recently undergone renovation. The answers help guide who may need a blood test to check lead levels. Some states require testing of toddlers on Medicaid.

—Wash kids' hands before they eat, good advice no matter where you live or how old your house.

—Clean up paint chips immediately, and regularly wash toys that tots put in their mouths.

—Regularly wash windowsills and floors where paint dust can collect.

—If you're planning repairs or renovation in an old building, use lead-certified contractors who must follow EPA rules to minimize exposure from the work and can perform quality tests to see if your old paint really contains lead.

—If you rent and have peeling paint, notify your landlord. Many cities and states have lead-abatement rules, and programs to contact for help.

—Aside from paint, take off shoes at the door, to minimize tracking in lead-tainted soil.

—Use only cold water for drinking, cooking and making baby formula, and run it for 15 to 30 seconds. Hot tap water can pick up more lead from older plumbing than cold water.

___

Online:

EPA lead information: http://www.epa.gov/lead/pubs/leadinfo.htm#hazard

Associated Press

Technology



News

Full ban on driver calls could be tough to enforce

AppId is over the quota
AppId is over the quota
FILE - In a Wednesday, Dec. 14, 2011 file photo, Dan Johnson uses a hands-free device to talk on a cellphone while driving, in San Diego. The National Transportation Safety Board declared Tuesday, Dec. 13, that texting, emailing or chatting while driving is simply too dangerous to be allowed anywhere in the United States. But if lawmakers follow the advice of the federal board, police officers could be faced with decoding whether someone is using their cell phone or simply singing along to the radio, pleading with backseat children to stop fighting or reciting an important sales pitch. (AP Photo/Gregory Bull, File) FILE - In a Wednesday, Dec. 14, 2011 file photo, Dan Johnson uses a hands-free device to talk on a cellphone while driving, in San Diego. The National Transportation Safety Board declared Tuesday, Dec. 13, that texting, emailing or chatting while driving is simply too dangerous to be allowed anywhere in the United States. But if lawmakers follow the advice of the federal board, police officers could be faced with decoding whether someone is using their cell phone or simply singing along to the radio, pleading with backseat children to stop fighting or reciting an important sales pitch. (AP Photo/Gregory Bull, File) FILE - In a Tuesday, June 24, 2008 file photo, a sign warning drivers that hands-free technology will be required starting July 1, displays its message over a highway in San Francisco. While most states have banned texting among drivers and a number have also prohibited hand-held phones, the Tuesday, Dec. 13, 2011 recommendation from the National Transportation Safety Board is to outlaw all behind-the-wheel cell phone use, wireless or not. (AP Photo/Jeff Chiu, File) A driver uses a cellphone while driving Wednesday, Dec. 14, 2011, in Los Angeles. The National Transportation Safety Board declared Tuesday that texting, emailing or chatting on a cellphone while driving is just too dangerous to be allowed anywhere in the United States and is urging all states to impose total bans except for emergencies. (AP Photo/Damian Dovarganes) A motorist uses a cellphone while holding the steering wheel and a cigarette in her other hand while passing through an intersection Wednesday, Dec. 14, 2011, in Houston. The National Transportation Safety Board declared Tuesday that texting, emailing or chatting on a cellphone while driving is just too dangerous to be allowed anywhere in the United States and is urging all states to impose total bans except for emergencies. (AP Photo/David J. Phillip) Dan Johnson uses a hands-free device to talk on a cellphone while driving Wednesday, Dec. 14, 2011, in San Diego. Johnson, an operations manager, uses his cellphone while driving frequently for business. The National Transportation Safety Board declared Tuesday that texting, emailing or chatting while driving is simply too dangerous to be allowed anywhere in the United States. (AP Photo/Gregory Bull)eval("var currentItemd57851005a80479aaeeb90a12c70b9ff = 1;");eval("var nextd57851005a80479aaeeb90a12c70b9ff = 0;");eval("var previousd57851005a80479aaeeb90a12c70b9ff = 0;"); WEST PALM BEACH, Fla. (AP) — A driver in the next lane is moving his lips. Is he on a hands-free cellphone? Talking to someone in the car? To himself? Singing along to the radio?

If lawmakers follow the advice of a federal board, police officers will have to start figuring that out — somehow.

The National Transportation Safety Board said this week that drivers should not only be barred from using hand-held cellphones, as they are in several states, but also from using hands-free devices. No more "Sorry, I'm stuck in traffic" calls, or virtually any other cellphone chatter behind the wheel.

Though no state has yet implemented such restrictive rules, the NTSB's recommendations carry weight that could place such language into future laws, or motivate the federal government to cut funding to states that don't follow suit.

Many of the men and women patrolling the nation's streets and highways wonder how they would sort the criminally chatty from the legally chatty.

"It would be almost impossible to determine if someone was talking on a phone or exercising their vocal cords," said Capt. Donald Melanson of the West Hartford, Conn., police department, which took part in a national pilot program aimed at cracking down on drivers' cellphone use. "That would be much more difficult to enforce, almost to the point where it would be impossible."

Officer Tom Nichols of the Port St. Lucie, Fla., police said a law written like the NTSB suggests would be difficult to enforce because so many variables would be at play.

"If you identify someone who has a hands-free set hooked up to their ear that doesn't mean they are talking on the phone," he said. "They could be talking to a passenger. They could be talking to a child in the back. They could be singing."

Police could end up turning to technology for help. They might even end up with the cellphone equivalent of a radar speed gun.

Fred Mannering, a Purdue University civil engineering professor who is associate director of the Center for Road Safety, said that since all cellphones emit signals, a simple Bluetooth detection device could spot them.

Computers are already common in patrol cars, and Mannering said a relatively cheap add-on could fit them to track cellphone signals.

"It would be really easy for police to have a computer on board and pick up those signals," Mannering said, "but it is sort of Big Brother."

The NTSB's proposal, announced Tuesday as a unanimous recommendation of its five-member board, urges all states to impose total bans except for emergencies. It cited deadly crashes caused by distracted drivers across the country, and noted that many studies have shown that hands-free cellphones are often as unsafe as hand-held devices.

The recommendation poses an astounding number of questions. What about chauffeurs and traveling salesmen who spend their entire day on the road? And roadside Amber Alert and Silver Alert notifications that implore drivers to call in if they spot a specific vehicle? What comes of phone lines dedicated to those "How's My Driving?" signs on trucks? How will you let someone know you're stuck in traffic?

Joe Schwieterman, a DePaul University professor who studies people's use of technology while traveling, said he can't envision a law so restrictive ever hitting the books because phone use has become commonplace for drivers. He called such an approach "draconian" and said that if such a law were passed, the public would despise it as "imperial overreach," then ignore it.

"It's a little like speeding laws where it will become just culturally acceptable to violate," he said. He said a no-call law would be followed only if violations carried stiff penalties like those for drunken driving.

Lewis Katz, a law professor at Case Western Reserve University, said a nationwide ban on using cellphones while driving would be wildly unpopular, and likely the target of legal challenges. But he believed such a law, and the methods police might use to enforce it, ultimately would be deemed as constitutional as seatbelt enforcement.

"I'm sure that it would be challenged on all sorts of constitutional grounds, including free speech," he said in a phone call from his car. "But it seems to me that it doesn't in any way infringe on any constitutional rights. It's a simple safety issue."

Whether the NTSB's recommendations will motivate decision-makers remains to be seen, but they have certainly caught their attention.

Transportation Secretary Ray LaHood, who has made combating distracted driving the signature issue of his tenure, stopped short of an endorsement. His department is separate from the NTSB.

"My focus is going to be on preaching to people: Take personal responsibility. Put your cellphone and your texting device in the glove compartment when you get behind the wheel of a car," LaHood told reporters at a news conference in Chicago. "You can't drive safely when you have your hand on a cellphone and are trying to drive a 4,000- 5,000 pound vehicle."

Florida House Speaker Dean Cannon, a Republican, said he was wary. His state is among those that have resisted passing laws restricting drivers' cellphone use.

Cannon said future technological advances may prove more effective than legislation at addressing driver distraction issues. As an example, he cited his new iPhone, which can make phone calls and send text messages via voice command.

"In these attempts to try and prevent every bad thing from happening," he said, "it's all too easy to overly restrict personal freedoms and individual rights and responsibilities."

Sheriff Ric Bradshaw, the top law enforcement official in Palm Beach County, Fla., said that if lawmakers take the NTSB's suggestions to heart, they should address all manner of distracted driving.

"I see women putting makeup on. I see a guy with an electric shaver. I see one woman with a newspaper. I see a guy with a dog in his hands. All of those are worse than texting," he said.

Monique Bond, a spokeswoman for the Illinois State Police, said training would be key to enforcing any ban. Officers are already looking for unbuckled seat belts and swerving drivers; they'd have to add to their mental checklists.

"It's something that is not insurmountable," Bond said. "How you're going to spot it, or how you're going to look for it — you have to acclimate the troops and acclimate the operations as to how to do this."

Chief Walter McNeil of Quincy, Fla., president of the International Association of Chiefs of Police, said enforcement of a total ban would be difficult, but that distracted driving needs to be addressed.

"We certainly need to deal with the overall problem with distracted drivers, and getting some level of uniformity in how we enforce that would be helpful," he said.

___

Associated Press writer Dave Collins in Hartford, Conn., contributed to this report.

Associated Press

Technology



News