Bird flu found at German poultry farm 2 hours, 42 minutes ago

Bird flu found at German poultry farm 2 hours, 42 minutes ago



BERLIN - Tests have found that birds at a poultry farm in southern Germany died of the H5N1 strain of bird flu, and some 160,000 birds were being slaughtered as a precaution, authorities said.

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The virus was detected in ducklings at the farm near Erlangen, in northern Bavaria. A federal lab confirmed that the birds died of the "highly pathogenic" H5N1 variant, the state consumer protection ministry said Saturday.

More than 400 birds had died over a short period of time at the farm, ministry spokeswoman Sandra Brandt said. Authorities planned to start Saturday evening with the slaughter of the 160,000 birds at the farm.

Several cases of the virus have surfaced among wild birds in Germany this year. Last month, it was detected in a domestic goose in the east of the country.

The H5N1 virus has killed more than 190 people worldwide, according to the World Health Organization.

It remains hard for humans to catch, but experts fear it could mutate into a form that spreads easily among people, potentially sparking a global pandemic. So far, most human cases have been traced to contact with infected birds.

Experts: U.S. childbirth deaths on rise By MIKE STOBBE, AP Medical Writer

Experts: U.S. childbirth deaths on rise By MIKE STOBBE, AP Medical Writer
53 minutes ago



ATLANTA - U.S. women are dying from childbirth at the highest rate in decades, new government figures show. Though the risk of death is very small, experts believe increasing maternal obesity and a jump in Caesarean sections are partly to blame.

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Some numbers crunchers note that a change in how such deaths are reported also may be a factor.

"Those of us who look at this a lot say it's probably a little bit of both," said Dr. Jeffrey King, an obstetrician who led a recent New York state review of maternal deaths.

The U.S. maternal mortality rate rose to 13 deaths per 100,000 live births in 2004, according to statistics released this week by the National Center for Health Statistics.

The rate was 12 per 100,000 live births in 2003 — the first time the maternal death rate rose above 10 since 1977.

To be sure, death from childbirth remains fairly rare in the United States. The death of infants is much more common — the nation's infant mortality rate was 679 per 100,000 live births in 2004.

Maternal deaths were a much more common tragedy long ago. Nearly one in every 100 live births resulted in a mother's death as recently as 90 years ago.

But the fact that maternal deaths are rising at all these days is shocking, said Tim Davis, a Virginia man whose wife Elizabeth died after childbirth in 2000.

"The hardest thing to understand is how in this day and age, in a modern hospital with doctors and nurses, that somebody can just die like that," he said.

Some health statisticians note the total number of maternal deaths — still fewer than 600 each year — is small. It's so small that 50 to 100 extra deaths could raise the rate, said Donna Hoyert, a health scientist with the National Center for Health Statistics. The rate is the number of deaths per 100,000 live births.

In 2003, there was a change in death certificate questions in the nation's most populous state, California, as well as Montana and Idaho. That may have resulted in more deaths being linked to childbirth — enough push up the 2003 rate, Hoyert said.

Some researchers point to the rising C-section rate, now 29 percent of all births — far higher than what public health experts say is appropriate. Like other surgeries, Caesareans come with risks related to anesthesia, infections and blood clots.

"There's an inherent risk to C-sections," said Dr. Elliott Main, who co-chairs a panel reviewing obstetrics care in California. "As you do thousands and thousands of them, there's going to be a price."

Excessive bleeding is one of the leading causes of pregnancy-related death, and women with several previous C-sections are at especially high risk, according to a review of maternal deaths in New York. Blood vessel blockages and infections are among the other leading causes.

Experts also say obesity may be a factor. Heavier women are more prone to diabetes and other complications, and they may have excess tissue and larger babies that make a vaginal delivery more problematic. That can lead to more C-sections. "It becomes this sort of snowball effect," said King, who is now medical director of maternal-fetal medicine at Riverside Methodist Hospital in Columbus, Ohio.

The age of mothers could be a factor, too. More women are giving birth in their late 30s and 40s, when complications risks are greater.

Other characteristics of the maternal mortality rate include:

_Race: Studies have found that the maternal death rate in black women is at least three times greater than is it is for whites. Black women are more susceptible to complications like high blood pressure and are more likely to get inadequate prenatal care.

_Quality of care: Three different studies indicate at least 40 percent of maternal deaths could have been prevented.

Sometimes, there is no clear explanation for a woman's death.

Valerie Scythes, a 35-year-old elementary schoolteacher, died in March at a hospital in New Jersey — the state with the highest Caesarean section rate. She had had a C-section, as did another teacher at the same school who died after giving birth at the same hospital two weeks later.

However, Scythes died of a blocked blood vessel and the other woman died from bleeding, said John Baldante, a Philadelphia attorney investigating the death for Scythes' family.

"I'm not sure there was any connection between the two deaths," Baldante said.

Also mysterious was the death of Tim Davis' 37-year-old wife, Elizabeth, who died a day after a vaginal delivery at a Danville, Va., hospital in September 2000.

She had a heart attack after a massive blood loss, Davis said. It's not clearly known what caused the heavy bleeding. There was no autopsy, he said, a decision he now regrets.

Two previous births had gone well.

"Nothing led us to believe anything was wrong with this pregnancy. She was like a picture of health," he continued, noting she had been a YMCA fitness instructor.

A lawsuit against the hospital ended in a settlement. Davis also sued the obstetrician, but a jury ruled in the doctor's favor.

The child born that day, Ethan, starts second grade next week. "He's a happy kid," Davis said. "He's just never had a mom."

___

On the Net:

National Center for Health Statistics 2004 deaths report:

http://www.cdc.gov/nchs/data/nvsr/nvsr55/nvsr55_19.pdf

Puffer fish sold as salmon kills 15 2 hours, 30 minutes ago

Puffer fish sold as salmon kills 15 2 hours, 30 minutes ago



BANGKOK, Thailand - Unscrupulous vendors in Thailand have been selling meat of the deadly puffer fish disguised as salmon, causing the deaths of more than 15 people over the past three years, a doctor said Thursday.

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Although banned since 2002, puffer fish continues to be sold in large quantities at local markets and restaurants, said Narin Hiransuthikul of Bangkok's Chulalonkorn University Hospital.

"Some sellers dye the meat of puffer fish and make it look like salmon which is very dangerous," Narin said.

Narin said over the past three years more than 15 people have died and about 115 were hospitalized from eating the fish.

The ovaries, liver and intestines of the puffer fish contain tetrodotoxin, a poison so potent that the U.S. Food and Drug Administration says it can "produce rapid and violent death."

The fish is called fugu in Japan, where it is consumed by thrill-seeking Japanese gourmets for whom the risk of poisoning adds piquancy.

Every year, there are reports of people dying or falling sick in Asia from eating puffer fish. Eating the fish can cause paralysis, vomiting, heart failure and death.

No prescription? No problem online By TOM BREEN, Associated Press Writer

No prescription? No problem online By TOM BREEN, Associated Press Writer
2 hours, 11 minutes ago



CHARLESTON, W.Va. - Drug shipments from illegal online pharmacies were once so frequent in Appalachia that delivery companies had to add trucks to their routes.

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Police have cracked down on such deliveries, but are still confronted by a booming global network of so-called rogue pharmacies operating online.

For people addicted to prescription medications like the painkiller hydrocodone — sold mostly as Vicodin — the days of "doctor shopping" are over, as long as they have Internet access. With the help of unscrupulous doctors and pharmacists, hundreds of Web sites dispense prescription narcotics to customers in exchange for nothing more than a credit card number.

Even as law enforcement agencies and state governments respond, rogue pharmacies continue to grow, filling hundreds of prescriptions a day, according to a recent study by the National Center on Addiction and Substance Abuse at Columbia University.

The Drug Enforcement Administration, which reported the additional parcel delivery trucks in southeastern Kentucky, says about 95 percent of products sold by online pharmacies are controlled substances. By comparison, controlled substances amount to roughly 11 percent of the dosages dispensed by legitimate pharmacies.

The DEA found that 34 rogue pharmacies dispensed more than 98.5 million dosage units of hydrocodone products last year — enough to give 410,000 patients a one-month supply.

Pharmacist Don Perdue has seen customers who run out of prescription refills turn to illegal online pharmacies.

"This is a major problem," said Perdue, chairman of the West Virginia House of Delegates' Health and Human Resources Committee, who wants to see federal law changed to make it easier to shut down illicit pharmacies.

Congress is considering legislation that would clarify federal law on Internet pharmacies and increase penalties for selling pharmaceuticals to minors.

Testifying before the Senate Judiciary Committee in May, Joseph Rannazzisi, deputy assistant director of the DEA's Office of Diversion Control, described how rogue pharmacies commonly work.

The Web sites approach doctors, often those who are in debt or retired and are seeking extra income. The doctors write prescriptions after they review online questionnaires filled out by customers. They are usually paid between $10 and $25 for each prescription.

The sites approach small pharmacies and persuade them to fill the prescription and ship the pharmaceuticals to the customers. The Web sites target pharmacies struggling to make ends meet, and usually pay an additional fee on top of the cost of the medication.

Prescription drugs can legally be ordered online, but rogue pharmacies ignore the rules that legitimate pharmacies follow, like requiring a doctor-patient relationship and getting a certification from state boards. The difference between legitimate and rogue pharmacies can be confusing.

To make the distinction clearer, the National Association of Boards of Pharmacy has created a voluntary verification process for online pharmacies to establish that they comply with the law and only ship prescriptions to patients who have been examined by doctors.

So far, 13 sites have received verification, including those by Walgreen Co. and CVS Caremark Corp.

In May, the National Center on Addiction and Substance Abuse identified 581 Web sites that offer controlled prescription drugs, compared with 492 in 2004.

Both the center and the DEA say it's impossible to know exactly how many such sites there are, with estimates ranging from a few hundred to more than 1,400.

"These Web sites come and go very quickly," said Susan Foster, vice president of policy research and analysis at the center. "They could be up one day and operating under a different URL the next day."

Most of the sites identified by the center were so-called portal sites, which don't directly sell drugs. They lead browsers to anchor sites, where the drugs are sold.

The study identified 187 anchor sites. Of those, 157 did not require a prescription.

Experts warn that the sites are dangerous not only because they can be used to feed addictions, but because customers often don't know what they're getting. Ninety-one of the anchor sites identified by the center were located outside the United States, where there are often different safety standards for medicine.

"You have no idea what you're getting from these places," DEA spokeswoman Rogene Waite said. "It's just a very dangerous business."

Linda Surks of South Brunswick, N.J., knows better than most how dangerous rogue pharmacies can be.

She lost her 19-year-old son, Jason, three years ago when he overdosed on prescription medication he ordered from a Web pharmacy based in Mexico. His family had no idea he had been taking the drugs, since he didn't have prescriptions.

"One of the first questions they asked us in the emergency room was whether he was on any medications, and we said he wasn't," Surks said.

Some states have passed laws aimed at blocking the importation of pharmaceuticals from rogue Web sites.

All pharmacies shipping drugs to West Virginia and Kentucky have to be registered with those states' Board of Pharmacy. Some rogue pharmacies carry disclaimers saying they won't ship to those states.

Last year, West Virginia State Police intercepted hundreds of packages shipped to the cities of Huntington, Charleston, Beckley, Logan and Lewisburg, Cpl. M.T. Smith said.

But as more rogue pharmacies shift from a cash-on-delivery model to relying on credit cards, such seizures have become rare.

Since the passage of a 2005 law banning the importation of drugs from unlicensed online pharmacies, the Kentucky Bureau of Investigation has seized more than $1.5 million worth of controlled pharmaceuticals.

Other states passing laws to address online pharmacies include Idaho, Wisconsin, Arkansas and Texas, according to the National Conference of State Legislatures.

Study finds virus contributes to obesity By SETH BORENSTEIN, AP Science Writer

Study finds virus contributes to obesity By SETH BORENSTEIN, AP Science Writer
26 minutes ago



WASHINGTON - In the buffet of reasons for why Americans are getting fatter, researchers are piling more evidence on the plate for one still-controversial cause: a virus.

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New research announced Monday found that when human stem cells — the blank slate of the cell world — were exposed to a common virus they turned into fat cells. They didn't just change, they stored fat, too.

While this may be a guilt-free explanation for putting on pounds, it doesn't explain all or even most of America's growing obesity problem. But it adds to other recent evidence that blames expanding waistlines on more than just super-sized appetites and underused muscles.

For several years, researchers have looked at a possible link between obesity and this common virus, called adenovirus-36, from a family of viruses that cause colds and pinkeye in people. They had already found that a higher percentage of fat people had been infected with the virus than nonfat people. They had exposed animals to the virus and got them to fatten up and even found a a gene in the virus that causes animals to get obese.

But ethical restraints kept researchers from exposing people to the virus to see what happens. So they did what would be considered the next best thing, said Nikhil Dhurandhar, who headed the research at the Pennington Biomedical Research Center in the Louisiana State University system.

They took fat tissue from people who had liposuction, removed adult stem cells from the tissue and exposed the cells to the virus in the lab. Adult stem cells can regenerate and turn into different types of specialized cells to help the body heal itself.

More than half the stem cells exposed to the virus turned into fat cells and accumulated fats, while only a small percentage of the non-exposed stem cells did the same, said researcher Dr. Magdalena Pasarica, who presented the results Monday at the American Chemical Society's annual meeting in Boston.

"It's the first time we see an effect in human cells," Pasarica said in a phone interview.

If a viral cause of obesity can be confirmed, a vaccine could be developed, maybe within five to 10 years, to prevent the virus from making some people fat, Dhurandhar said. However, it wouldn't help people already obese, he said.

Outside experts are intrigued but worry about people blaming all obesity on viruses, when this may be just one of many causes. It doesn't mean it's OK to overeat, blame a bug or wait for some kind of antivirus medicine, they said.

"The cause for obesity in everyone is the same," said Dr. Samuel Klein, director of the Center for Human Nutrition at the Washington University School of Medicine in St. Louis. "You eat more calories than you burn up; You can't get away from that basic law of physics."

But there are many causes that trigger overeating and extra storage of fat in the body, including the virus, Klein said. However, he said he considers the virus only a small factor, easily outweighed by genetics and even childhood eating habits.

Dhurandhar said some of his earlier research found that 30 percent of obese Americans had developed antibodies to the virus, showing they had been exposed to it at some point. But for non-obese people, only 11 percent had antibodies, he said.

That means for some people it is not their fault they are fat, Dhurandhar said.

But Klein said that's not completely right.

"We don't want obese people to feel that it's all their fault because it is not all their fault ... but clearly the buck finally lies with the person," Klein said

Psychologists weigh interrogation ban By SUDHIN THANAWALA, Associated Press Writer

Psychologists weigh interrogation ban By SUDHIN THANAWALA, Associated Press Writer
42 minutes ago



SAN FRANCISCO - Stung by reports implicating mental health specialists in prisoner abuse scandals at Guantanamo Bay and Abu Ghraib, the nation's largest group of psychologists is considering banning its members from interrogations of terror suspects.

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The American Psychological Association, which is holding its annual meeting in San Francisco, is scheduled to vote Sunday on two competing measures concerning its 148,000 members' participation in military interrogations at Guantanamo Bay and other U.S. military detention centers.

One measure would bar members from any involvement in interrogations at U.S. detention facilities where foreigners are held. The moratorium would not be backed by sanctions, but it would carry the APA's "moral authority," said psychologist Neil Altman, who wrote the proposed resolution.

The other proposal, which is backed by APA's board of directors, would reaffirm the group's opposition to torture and prohibit members from taking part in more than a dozen specific practices, including forced nakedness, mock executions and simulated drowning.

An APA member who violates the torture resolution could be expelled from the Washington-based organization, which could lead to the loss of the professional's state license to practice, said spokeswoman Rhea Farberman.

The association's vote follows reports that mental health specialists were involved in prisoner abuse scandals at Guantanamo Bay and Abu Ghraib prison in Iraq. Among other things, psychiatrists and psychologists are accused of helping interrogators increase prisoners' stress levels by exploiting their fears.

A recently declassified Defense Department report said that since 2002, psychiatrists and psychologists have helped military interrogators develop new techniques to extract information from detainees.

Military interrogation has become a dominant issue at this year's meeting of the APA, which represents most of the nation's psychologists.

Psychologists for an Ethical APA, which supports the moratorium, rallied Friday outside the Moscone Center, where the conference is being held. Supporters wore buttons that read "Do No Harm" and carried signs condemning torture. A person in an orange jumpsuit and black hood stood in the middle of the crowd.

Moratorium backers say psychologists should not assist with interrogations where foreigners are held indefinitely and could be tortured because their involvement discredits the profession.

"We will not be satisfied until we get a resolution that says psychologists cannot be part of interrogations at sites where detainees' human rights are being violated," said New York psychologist Steven Reisner.

Supporters of the moratorium say they want the APA to follow the examples of the American Medical Association and American Psychiatric Association, which have said their members have no legitimate role in interrogations at detention centers like Guantanamo. The U.S. military has indicated it would favor using psychologists, who are not affected by the other groups' policies.

Critics of the moratorium say the presence of psychologists helps ensure interrogations are not abusive.

APA spokeswoman Farberman said psychologists help interrogators build rapport with detainees, so they don't have to resort to abusive behavior.

"We want to stay engaged in the discussion about appropriate and effective interrogation techniques," Farberman said.

___

On the Net:

American Psychological Association:http://www.apa.org/

Psychologists for an Ethical APA:http://www.ethicalapa.com/

More smoothies cutting the calories By ELIZABETH M. GILLESPIE, AP Business Writer

More smoothies cutting the calories By ELIZABETH M. GILLESPIE, AP Business Writer
1 hour, 30 minutes ago



SEATTLE - Concerned about losing the calorie-conscious, smoothie makers are whipping up no-sugar and faux-sugar blends.

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That Orange Twister will saddle you with just 140 calories.

Smoothie companies are increasingly focusing much of their marketing muscle on winning over the ultra-health-conscious consumer — especially those trying to eat less sugar.

"There are a lot of folks that aren't hindered by high sugar, but we do know that there's a significant percentage that are, and we think that number's growing all the time," said Jim Baskett, an executive with the Seattle-area chain Emerald City Smoothie.

Many makers are turning to Splenda, the zero-calorie artificial sweetener. Some have drinks that are only fruit and juice. Executives at several smoothie companies say the low-sugar offerings have fared impressively — right alongside popular higher-cal versions.

The smoothie industry has been on an upward climb in recent years, with many chains big and small expanding their reach with new stores.

In 1997, there were just under 1,000 juice and smoothie bars in the U.S., pulling in an estimated $340 million in revenue. Today, there are roughly 5,000 of them, with 2007 sales projected at $2.5 billion, according to Juice Gallery Multimedia, a publishing and consulting firm that provides support services for the businesses.

In the beginning, many customers were health nuts. But the appeal now is much more mainstream and many of the offerings defy a healthy label by calorie count alone.

Take The Blender, a 1,270-calorie whopper made with chocolate or vanilla protein, peanut butter, banana, milk and ice cream, made by Emerald City. And there's Anne Kessler's favorite, the Mocha Bliss, another of the chain's more indulgent offerings.

"It just tastes good," she said, sipping down a tall one recently in her neighborhood smoothie shop.

But for her 2-year-old daughter, Kessler only orders from the low-sugar menu. Usually it's a banana-strawberry-papaya concoction with less than half the calories of her chocolatey choice.

Emerald City, which is gearing up to expand beyond a handful of Western states into Hawaii and New York, is among the Splenda users. So is Jamba Juice, a company based in the San Francisco area that last year also introduced a line with no added sweeteners.

Smoothie King, headquartered in the New Orleans area, sweetens many of its drinks with honey and raw cane sugar. But it allows customers to "Make It Skinny" by skipping the sugar, with a Splenda option.

Freshens Smoothie Company, a unit of Atlanta-based Freshens Quality Brands, offers some Splenda-sweetened drinks and prominently posts on its menu boards that 21-ounce servings of each contain less than 155 calories.

Along with the trend toward Splenda are other new ingredients — unrelated to calorie counts — that smoothie makers are hoping will entice. There's acai (pronounced AH-sigh-ee), a Brazilian berry touted as an antioxidant. There are plant sterols, soy and something called conjugated linoleic acid. Freshens is considering tweaking its yogurt base to add probiotics, a trendy food additive that some claim boost the immune system.

In general, consumer health advocates applaud efforts to make smoothies healthier. But serving sizes remain a frustration for the experts.

"When I was growing up, we had 6-ounce servings of orange juice. ... People don't drink 6 ounces of anything anymore," said Marion Nestle, a nutrition expert and professor at New York University.

The standard size of smoothies in many stores is 24 ounces.

Bonnie Liebman, director of nutrition for the Center for Science in the Public Interest, a health advocacy group, questions why people seem so eager to gulp their fruits in giant single servings rather than eating them whole — an apple here, an orange there.

"The idea is to fill up on fruit and vegetables so you have less room for calorie-dense food," she said.

Smoothie companies say most of their customers use smoothies as meal replacements.

___

On the Net:

Emerald City Smoothie: http://www.emeraldcitysmoothie.com

Jamba Juice: http://www.jambajuice.com

Smoothie King: http://www.smoothieking.com

Freshens: http://freshens.com

Center for Science in the Public Interest: http://www.cspinet.org

Juice Gallery Multimedia: http://www.juicegallery.com

US slipping in life expectancy rankings By STEPHEN OHLEMACHER, Associated Press Writer

US slipping in life expectancy rankings By STEPHEN OHLEMACHER, Associated Press Writer
25 minutes ago



WASHINGTON - Americans are living longer than ever, but not as long as people in 41 other countries.

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For decades, the United States has been slipping in international rankings of life expectancy, as other countries improve health care, nutrition and lifestyles.

Countries that surpass the U.S. include Japan and most of Europe, as well as Jordan, Guam and the Cayman Islands.

"Something's wrong here when one of the richest countries in the world, the one that spends the most on health care, is not able to keep up with other countries," said Dr. Christopher Murray, head of the Institute for Health Metrics and Evaluation at the University of Washington.

A baby born in the United States in 2004 will live an average of 77.9 years. That life expectancy ranks 42nd, down from 11th two decades earlier, according to international numbers provided by the Census Bureau and domestic numbers from the National Center for Health Statistics.

Andorra, a tiny country in the Pyrenees mountains between France and Spain, had the longest life expectancy, at 83.5 years, according to the Census Bureau. It was followed by Japan, Macau, San Marino and Singapore.

The shortest life expectancies were clustered in Sub-Saharan Africa, a region that has been hit hard by an epidemic of HIV and AIDS, as well as famine and civil strife. Swaziland has the shortest, at 34.1 years, followed by Zambia, Angola, Liberia and Zimbabwe.

Researchers said several factors have contributed to the United States falling behind other industrialized nations. A major one is that 45 million Americans lack health insurance, while Canada and many European countries have universal health care, they say.

But "it's not as simple as saying we don't have national health insurance," said Sam Harper, an epidemiologist at McGill University in Montreal. "It's not that easy."

Among the other factors:

• Adults in the United States have one of the highest obesity rates in the world. Nearly a third of U.S. adults 20 years and older are obese, while about two-thirds are overweight, according to the National Center for Health Statistics.

"The U.S. has the resources that allow people to get fat and lazy," said Paul Terry, an assistant professor of epidemiology at Emory University in Atlanta. "We have the luxury of choosing a bad lifestyle as opposed to having one imposed on us by hard times."

• Racial disparities. Black Americans have an average life expectancy of 73.3 years, five years shorter than white Americans.

Black American males have a life expectancy of 69.8 years, slightly longer than the averages for Iran and Syria and slightly shorter than in Nicaragua and Morocco.

• A relatively high percentage of babies born in the U.S. die before their first birthday, compared with other industrialized nations.

Forty countries, including Cuba, Taiwan and most of Europe had lower infant mortality rates than the U.S. in 2004. The U.S. rate was 6.8 deaths for every 1,000 live births. It was 13.7 for Black Americans, the same as Saudi Arabia.

"It really reflects the social conditions in which African American women grow up and have children," said Dr. Marie C. McCormick, professor of maternal and child health at the Harvard School of Public Health. "We haven't done anything to eliminate those disparities."

Another reason for the U.S. drop in the ranking is that the Census Bureau now tracks life expectancy for a lot more countries — 222 in 2004 — than it did in the 1980s. However, that does not explain why so many countries entered the rankings with longer life expectancies than the United States.

Murray, from the University of Washington, said improved access to health insurance could increase life expectancy. But, he predicted, the U.S. won't move up in the world rankings as long as the health care debate is limited to insurance.

Policymakers also should focus on ways to reduce cancer, heart disease and lung disease, said Murray. He advocates stepped-up efforts to reduce tobacco use, control blood pressure, reduce cholesterol and regulate blood sugar.

"Even if we focused only on those four things, we would go along way toward improving health care in the United States," Murray said. "The starting point is the recognition that the U.S. does not have the best health care system. There are still an awful lot of people who think it does."

__

On The Net:

Census Bureau: http://www.census.gov/ipc/www/idb/

National Center for Health Statistics: http://www.cdc.gov/nchs/fastats/lifexpec.htm

FDA: Heartburn drugs seem OK for heart 1 minute ago

FDA: Heartburn drugs seem OK for heart 1 minute ago



WASHINGTON - The popular heartburn drugs Prilosec and Nexium don't appear to spur heart problems, say preliminary U.S. and Canadian probes announced Thursday.

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The Food and Drug Administration and its Canadian counterpart began reviewing the drugs, used by tens of millions of people, back in May, when manufacturer AstraZeneca provided them an early analysis of two small studies that suggested the possibility of a risk.

Those studies compared treating the chronic heartburn known as gastroesophageal reflux disease, or GERD, with either of the two drugs or with surgery, and tracked patients for five to 14 years. The company's initial analysis counted more patients treated with drugs who had had heart attacks, heart failure or heart-related sudden death.

The FDA followed up on those studies, and found that they seemed skewed: Patients who underwent surgery were younger and healthier than those treated by drugs, suggesting the heart link was a coincidence.

While the studies' designs make safety assessments difficult, many of the participants who developed heart problems had risk factors before starting the drugs, Health Canada said Thursday.

The FDA then looked at 14 additional studies of the drugs, and found no evidence of heart risks. In fact, in a few studies where patients received either medication or a dummy pill, those who took the heartburn drugs actually had a lower incidence of heart problems.

The FDA plans to complete its probe within three months, but issued a public notice Thursday that it "does not believe that health care providers or patients should change either their prescribing practices or their use of these products at this time."

Health Canada reached the same initial conclusion. It also urged doctors and patients to make no changes until its own probe is finished by year's end, noting that untreated GERD can lead to serious complications.

The drugs are among a family of acid-reducers known as proton pump inhibitors. FDA's Dr. Paul Seligman said Thursday that while the agency's focus is on Nexium and Prilosec, it is "interested in the data from all similar products" as it looks for all available evidence to settle the heart question.

Nexium is the world's No. 2 selling drug, with 2006 sales of $6.7 billion, according to health care research firm IMS Health.

FDA investigates import seafood claims By JUSTIN PRITCHARD, Associated Press Writer

FDA investigates import seafood claims By JUSTIN PRITCHARD, Associated Press Writer
2 hours, 40 minutes ago



LOS ANGELES - The Food and Drug Administration said Wednesday it is checking whether shipments of Chinese seafood on an agency watch list were properly cleared for public consumption without being tested for banned drugs or chemicals.

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Agency officials said that while they believe the shipments were screened correctly, they wanted more details. That review comes in response to findings The Associated Press published Tuesday that at least 1 million pounds of frozen shrimp, catfish or eel raised in Chinese ponds were on an agency watch list but were not diverted to a lab.

The 28 shipments the AP identified arrived under an FDA "import alert," which is supposed to trigger the tough screening requirement.

The seafood, equal to the amount 66,000 Americans eat in a year, did not pose an immediate public health risk; the FDA has worried that long-term exposure to substances fed to some Chinese seafood could increase the risk of cancer or make antibiotics less potent.

A leading Democrat in the House of Representatives said the AP's report raises serious questions about FDA's inspection system and his committee's investigators want the FDA to explain what percentage of all import alert shipments from China — not just seafood — are being stopped and tested.

"The discovery that suspect seafood from China has reached dining room tables in America without being tested is disturbing," said Rep. John Dingell, D-Mich., whose Energy and Commerce Committee has been investigating the FDA's imported-food safety record. "Apparently, the 'import alert' system used by the FDA to test high risk foods cannot be trusted."

The agency said it has about 450 budgeted positions for screening all the imports it oversees — approximately 20 million shipments of everything from fish to vegetables to pharmaceuticals. Funding for inspectors has not kept pace with the surge in imports over the past decade and FDA employees have told Dingell's committee they're too stretched to guarantee food safety.

For its investigation, the AP reviewed 4,300 seafood shipments from China and found 211 that arrived under import alert between October and May. It was during that period the FDA was putting specific Chinese companies with seafood that had flunked lab tests on its watch list, leading up to a June announcement that all farm-raised shrimp, catfish and eel had to be inspected.

The AP was able to reach importers that brought in 112 of the shipments. They said that 28 of the 112 shipments had not been detained and tested.

The FDA did not verify the AP's numbers.

Agency officials said their initial research showed that from an AP-provided list of more than 200 shipments that arrived under an import alert, 19 were flagged by FDA's computer system and reviewed by a person who determined they didn't need to be tested. Agency officials said they needed to talk to local offices that processed the cargo to find out why those shipments, as well as four others, were allowed through.

The AP gave the FDA its list weeks before publication; the agency did not comment on the specific shipments until after Tuesday's story ran.

"What we're saying is that based on the electronic 30,000-foot view, we can't determine why they were released and we're going to look into those further," said Michael Chappell, the official responsible for field inspections and labs.

"There is no evidence to say they were released ... incorrectly," said Domenic Veneziano, who oversees FDA's import operations.

The agency would not provide details on the total 23 shipments without a Freedom of Information Act request.

IBM launches system to track medications By BARBARA ORTUTAY, AP Business Writer

IBM launches system to track medications By BARBARA ORTUTAY, AP Business Writer
2 hours, 57 minutes ago



NEW YORK - To help the pharmaceutical industry combat drug counterfeiting, IBM is launching an electronic pedigree system Thursday that tracks medications through the supply chain until they reach consumers.

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The system employs radio-frequency identification, or RFID tags, which are already used to track packages of drugs, especially ones popular with counterfeiters. Pfizer, for example, uses RFID chips to track packs of its erectile dysfunction drug Viagra, and Purdue Pharma LP has been using them since 2004 to track its pain reliever OxyContin.

IBM's ePedigree system helps drug companies create electronic certificates of authenticity for medications — down to the individual bottle — as they move from manufacturers and distributors to pharmacies and hospitals.

"The whole time, the system is watching what's happening, it records (the drug's) life history," said Chris Clauss, director of sensor information management at IBM Software.

While there is no guarantee that RFID tags will get rid of all counterfeits, he added, "what we can do is raise the bar," and make it substantially more difficult.

Drug companies' prior attempts at fighting fakes — such as holograms, watermarks and the like — were often reproduced within months, to the point where even their brand managers could not tell the difference between the counterfeit and the real thing.

IBM, which first worked with RFID more than 10 years ago, said its ePedigree system will help companies comply with a slew of new regulations, such as ones going into effect in California in 2009.

California's ePedigree law will require that any medication distributed in the state have its life history attached to it — starting at the drug manufacturer until it ends up in the pharmacy.

In recent years, much of the market has focused on the hardware of RFID — how the data is scanned and collected in the chips — said Michael Liard, research director of RFID and Contactless at ABI Research. IBM's ePedigree system, however, focuses on how that information is distributed along the supply chain.

The ePedigree system is useful not just for battling fakes, Clauss said, but for keeping track of expiration dates, batch numbers in case a drug is recalled, and so on.

International Business Machines Corp. is based in Armonk, N.Y.

FDA investigates import seafood claims By JUSTIN PRITCHARD, Associated Press Writer

FDA investigates import seafood claims By JUSTIN PRITCHARD, Associated Press Writer
39 minutes ago



LOS ANGELES - The Food and Drug Administration said Wednesday it is checking whether shipments of Chinese seafood on an agency watch list were properly cleared for public consumption without being tested for banned drugs or chemicals.

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Agency officials said that while they believe the shipments were screened correctly, they wanted more details. That review comes in response to findings The Associated Press published Tuesday that at least 1 million pounds of frozen shrimp, catfish or eel raised in Chinese ponds were on an agency watch list but were not diverted to a lab.

The 28 shipments the AP identified arrived under an FDA "import alert," which is supposed to trigger the tough screening requirement.

The seafood, equal to the amount 66,000 Americans eat in a year, did not pose an immediate public health risk; the FDA has worried that long-term exposure to substances fed to some Chinese seafood could increase the risk of cancer or make antibiotics less potent.

A leading Democrat in the House of Representatives said the AP's report raises serious questions about FDA's inspection system and his committee's investigators want the FDA to explain what percentage of all import alert shipments from China — not just seafood — are being stopped and tested.

"The discovery that suspect seafood from China has reached dining room tables in America without being tested is disturbing," said Rep. John Dingell, D-Mich., whose Energy and Commerce Committee has been investigating the FDA's imported-food safety record. "Apparently, the 'import alert' system used by the FDA to test high risk foods cannot be trusted."

The agency said it has about 450 budgeted positions for screening all the imports it oversees — approximately 20 million shipments of everything from fish to vegetables to pharmaceuticals. Funding for inspectors has not kept pace with the surge in imports over the past decade and FDA employees have told Dingell's committee they're too stretched to guarantee food safety.

For its investigation, the AP reviewed 4,300 seafood shipments from China and found 211 that arrived under import alert between October and May. It was during that period the FDA was putting specific Chinese companies with seafood that had flunked lab tests on its watch list, leading up to a June announcement that all farm-raised shrimp, catfish and eel had to be inspected.

The AP was able to reach importers that brought in 112 of the shipments. They said that 28 of the 112 shipments had not been detained and tested.

The FDA did not verify the AP's numbers.

Agency officials said their initial research showed 19 shipments from a list the AP provided weeks before publication were flagged by FDA's computer system and reviewed by a person who determined they didn't need to be tested. The officials said further research may add as many as four more shipments to the 19 they've identified.

The officials said they needed to talk to local offices that processed the cargo to find out why each of the shipments was allowed through.

"What we're saying is that based on the electronic 30,000-foot view, we can't determine why they were released and we're going to look into those further," said Michael Chappell, the official responsible for field inspections and labs.

"There is no evidence to say they were released ... incorrectly," said Domenic Veneziano, who oversees FDA's import operations.

The agency would not provide details on the total 23 shipments without a Freedom of Information Act request.

Some children shut out from vaccines By CARLA K. JOHNSON, Associated Press Writer

Some children shut out from vaccines By CARLA K. JOHNSON, Associated Press Writer
1 hour, 9 minutes ago



CHICAGO - For children whose health insurance doesn't cover newly recommended shots, it's better to have no insurance at all, a new study suggests.

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Free vaccines are available to children who are uninsured or qualify for public insurance.

But many states can't afford to help children with inadequate private insurance that doesn't cover new, expensive shots and even some older shots, the study found. That puts more than a million children at risk, researchers said.

Illinois, for example, doesn't provide vaccines against chickenpox, pneumonia, hepatitis A, human papillomavirus and rotavirus to children with insufficient private insurance. Parents would have to pay $400 out of pocket for those vaccines.

"Health insurance plans are not necessarily keeping up with the new vaccines, posing significant ethical dilemmas to public health clinics," said the study's lead author Dr. Grace Lee of Harvard Medical School.

The study of the nation's patchwork system of paying for immunizations appears in Wednesday's Journal of the American Medical Association.

Childhood shots have become a $1 billion-a-year endeavor for government since the discovery of polio vaccine 55 years ago. The per-child cost grew more than sevenfold from $155 in 1995 to $900 for boys and $1,200 for girls this year. Costs in the private sector are higher.

Lee and her colleagues surveyed states to find out which shots they provide and to whom. Program managers from 48 states responded. Lee wouldn't say which states participated because researchers promised anonymity.

Sixteen of the states require health insurers to cover all recommended vaccines.

About 55 million employees and their dependents get coverage through self-insured companies that are exempt from state mandates. Those people are the most likely to be underinsured for vaccines, said vaccine policy expert Dr. Matthew Davis of the University of Michigan.

According to the research, 17 states reported they were unable to give a vaccine for meningitis to children with inadequate private insurance, even if they were seen in public health clinics. And eight states don't give pneumococcal shots to underinsured infants and toddlers.

A handful of states don't provide shots for chickenpox and hepatitis A to the underinsured. Two states don't provide Tdap, the combined booster shot for tetanus, diphtheria and pertussis (whooping cough) for 11- to 12-year-olds.

More than 1 million insured children are unable to get the meningococcal vaccine leaving them vulnerable to potentially deadly infection, the researchers estimated.

The survey did not ask about two vaccines recommended last year: an oral vaccine for infants against rotavirus, a common cause of childhood diarrhea and vomiting, and a vaccine for girls against human papillomavirus, which can cause cervical cancer.

Workers covered by plans marketed by Aetna and other insurance companies generally are covered for childhood vaccines, although they may have to pay co-payments or satisfy deductibles, said Mohit Ghose, a spokesman for America's Health Insurance Plans.

As costs rise, it may be necessary to decide at a national level which vaccines are most important, Davis said. He was not involved in the new study, but wrote an accompanying editorial in the journal.

Officials at the U.S. Centers for Disease Control and Prevention oppose prioritizing vaccines and instead favor better coverage by insurers and more government funding as a safety net, said CDC immunizations director Dr. Lance Rodewald.

AP: Seafood from China wasn't screened By JUSTIN PRITCHARD and ADAM GOLDMAN, Associated Press Writers

AP: Seafood from China wasn't screened By JUSTIN PRITCHARD and ADAM GOLDMAN, Associated Press Writers
Tue Aug 7, 4:33 PM ET



At least 1 million pounds of suspect Chinese seafood landed on American store shelves and dinner plates despite a Food and Drug Administration order that the shipments first be screened for banned drugs or chemicals, an Associated Press investigation found.

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The frozen shrimp, catfish and eel arrived at U.S. ports under an "import alert," which meant the FDA was supposed to hold every shipment until it had passed a laboratory test.

But that was not what happened, according to an AP check of shipments since last fall. One of every four shipments the AP reviewed got through without being stopped and tested. The seafood, valued at $2.5 million, was equal to the amount 66,000 Americans eat in a year.

FDA officials stuck the pond-raised seafood on their watch list because of worries it contained suspected carcinogens or antibiotics not approved for seafood.

No illnesses have been reported, but the episode raises serious questions about the FDA's ability to police the safety of America's food imports.

"The system is outdated and it doesn't work well. They pretend it does, but it doesn't," said Carl R. Nielsen, who oversaw import inspections at the agency until he left in 2005 to start a consulting firm. "You can't make the assumption that these would be isolated instances."

If the system cannot stop known risks, Nielsen said, how can it protect against hidden dangers, such as the ingredients from China that made toothpaste potentially poisonous and killed dozens of pets earlier this year?

China is America's biggest foreign source of seafood, the 1.06 billion pounds it supplied in 2006 accounting for 16 percent of all seafood Americans buy.

President Bush has asked a Cabinet-level panel to recommend better imported food safety safeguards. Chinese officials have promised to inspect fish farms closely for the use of drugs and chemicals, even as they called the FDA's testing mandate illegal under world trade rules.

FDA officials acknowledged that some shipments slip through import alerts, but said overall they work.

"Any time you introduce a human element into something, I don't think you can necessarily guarantee 100 percent," said Michael Chappell, the official responsible for field inspections and labs.

Normally, the FDA inspects just 1 percent of the cargo it oversees. When goods land under an import alert, however, they are considered guilty until proven innocent: All shipments are supposed to be held until private tests that cost importers thousands of dollars show the seafood is clean. Sometimes, the FDA double-checks those tests in its own labs. Products can be detained for months, irking importers.

However, a shipment can escape inspection if, for example, a company uses a name or address not on an import alert, Chappell said. That appears to be what happened in one case AP found.

Also, FDA workers who must review hundreds of shipments that flash across a computer screen each day may miss some tagged for testing.

The agency has about 450 budgeted positions for screening approximately 20 million shipments annually of such things as fish, fruit and medical devices. At a congressional hearing last month, FDA employees doubted whether they have the resources to do the job.

Last summer, FDA labs began accumulating evidence that 15 percent of farm-raised shrimp, eel and catfish contained dangerous or unapproved substances. The agency started throwing individual companies on its watch list, and ultimately issued a sweeping mandate that all shrimp, eel and catfish raised on Chinese farms be stopped and tested.

Federal food safety officials said that while the seafood poses no immediate danger, long-term exposure could increase the risk of cancer or undermine the effectiveness of drugs used to fight outbreaks of disease.

The FDA did not tell shoppers to throw away what they had bought; agency officials said they simply had to get control over what China was sending.

Seafood that clears the ports enters a vast distribution system that includes restaurants, wholesalers and brand-name packagers.

The Chinese government and U.S. importers say the FDA overreacted. It would be impossible, importers say, for a person to eat enough seafood to be affected by the trace levels that FDA found of substances such as the antifungal chemical malachite green and the antibiotic Cipro.

The AP reviewed 4,300 manifests of seafood shipments from China compiled by Piers Reports, a company that tracks import-export data, and found 211 shipments that arrived under import alert since last fall.

FDA officials refused to identify exactly which shipments were tested, saying they were too busy to do so.

So the AP contacted importers directly, talking to 15 companies responsible for 112 of the 211 shipments. Eleven said their products were tested; four said the FDA did not bother to stop a total of 28 shipments weighing 1.1 million pounds. Virtually all the shipments entered through ports in the Southeast, including Tampa, Fla., Miami and Savannah, Ga.

The importer with the most cases was Florida-based Tampa Bay Fisheries.

Chief executive Robbie Paterson said 23 shipments of breaded or dusted frozen shrimp delivered between October and May were not inspected. In rare cases, the FDA removes from its watch list companies that have passed five straight tests. Paterson said he assumed that was why Tampa Bay's shipments went through.

Not so: Tampa Bay's shrimp supplier — the Fuqing City Dongyi Trading Co. — was on the watch list.

Three other companies said a total of five shipments of catfish, eel or shrimp were not stopped and tested.

Like many others in the importing business interviewed for this story, Paterson said he believed that import alerts were completely effective and that Chinese seafood poses no health risk.

FDA officials "are diligently doing the inspections as they see fit," Paterson said.

The expanded testing mandate has rattled China. U.S. importers said they are being told that the government is holding back shipments until tests show they will pass U.S. muster. The disruption has yet to result in any substantial price increases in the United States.

"I don't really know why they conducted the special test on our products," said a woman who identified herself as Miss Lin, a spokeswoman for Shantou Red Garden Foodstuff, which the FDA placed on its watch list in April after finding its dusted shrimp contained nitrofurans, an antibiotic that may cause cancer. "We've been exporting products to the U.S. for many years and we respect their standards and we meet their standards."

___

Associated Press Writer Christopher Bodeen in Shanghai, China, contributed to this report.

Court rules out terminally ill for tests By MATT APUZZO, Associated Press Writer

Court rules out terminally ill for tests By MATT APUZZO, Associated Press Writer
Tue Aug 7, 4:44 PM ET



WASHINGTON - Terminally ill patients do not have a constitutional right to be treated with experimental drugs, even if they likely will be dead before the medicine is approved, a federal appeals court said Tuesday.

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The ruling by the U.S. Court of Appeals for the District of Columbia Circuit overturned last year's decision by a smaller panel of the same court, which held that terminally ill patients may not be denied access to potentially lifesaving drugs.

The full court disagreed, saying in an 8-2 ruling that it would not create a constitutional right for patients to assume "any level of risk" without regard to medical testing.

"Terminally ill patients desperately need curative treatments," Judge Thomas B. Griffith wrote for the majority. But "their deaths can certainly be hastened by the use of a potentially toxic drug with no proven therapeutic benefit."

Food and Drug Administration approval of drugs generally requires extensive testing that can involve years of trials and thousands of patients.

The Abigail Alliance for Better Access to Developmental Drugs and the Washington Legal Foundation sued the FDA in 2003, seeking access for terminally ill patients to drugs that have undergone preliminary safety testing in as few as 20 people but have yet to be approved.

FDA spokeswoman Susan Cruzan said the agency was pleased with the decision, which she said considered the public's safety and the need for access to experimental drugs.

Abigail Alliance founder Frank Burroughs pledged an appeal to the Supreme Court. Burroughs' daughter, Abigail, was denied access to experimental cancer drugs and died in 2001. The drug she was seeking was approved years later.

"What the opinion by Judge Griffith is saying is, 'We don't want to risk one life or a few lives, even at the expense of the lives of hundreds or thousands of people,'" Burroughs said. "The logic of that escapes me."

In a sharply worded dissent, Judge Judith W. Rogers called the ruling "startling." She said courts have established the right "to marry, to fornicate, to have children, to control the education and upbringing of children, to perform varied sexual acts in private, and to control one's own body even if it results in one's own death or the death of a fetus."

"But the right to try to save one's life is left out in the cold despite its textual anchor in the right to life," Rogers wrote.

Rogers was joined by Chief Judge Douglas H. Ginsburg. The case cut across party lines, with conservative and liberal judges taking both sides of the dispute.

The court noted that there are government programs that provide access to experimental drugs in certain situations. It said the matter is not closed and said Congress might be a better venue than the courts to address the issue.

Burroughs said he expects such legislation to be introduced this session. Both the Senate and House have considered such legislation but it languished in committee.

Hospitals are shutting down burn centers By BILL POOVEY, Associated Press Writer

Hospitals are shutting down burn centers By BILL POOVEY, Associated Press Writer
Tue Aug 7, 4:29 PM ET



U.S. hospitals are increasingly shutting down their burn centers in a trend experts say could leave the nation unable to handle widespread burn casualties from a fiery terrorist attack or other major disaster.

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Associated Press interviews and an examination of official figures found that the shrinking number of beds is a growing cause for concern in this post-Sept. 11 world.

Experts say burn centers are expensive to maintain and often lose money because they are staffed with highly specialized surgeons and nurses and stocked with sophisticated equipment designed to ease patients' excruciating pain, fend off deadly complications and promote healing.

The number of burn centers in the U.S. has dropped from 132 in 2004 to 127, and burn beds have fallen from 1,897 to 1,820, according to American Burn Association records compiled from voluntary reporting by hospitals.

The U.S. Department of Health and Human Services puts the number of burn beds even lower, at just 1,500. And most of those are already filled, with the number available on any given day variously estimated at just 300 to 500.

"If something happens and we need the beds for burn patients, it is going to be a real catastrophe," said Dr. Alan R. Dimick, past president of the American Burn Association and founder of the burn center at the University of Alabama at Birmingham.

Some states — Mississippi, North Dakota, Montana, Wyoming, Idaho and New Hampshire among them — have no burn centers at all. South Carolina has only a children's burn center, and there are just a few dedicated burn beds in Maine, Alaska and Hawaii.

"People ought to be pretty frightened by this," said Dr. Barbara Latenser, burn center director at the University of Iowa Hospitals. "Some people who live out West, they are 800 miles from a burn center."

Many hospitals contend their general trauma units can handle burn victims adequately. But many authorities say burn units are far superior because of the equipment and expertise they offer.

"You need a burn team to take care of folks, not just docs and nurses," Dimick said.

HHS oversees the Homeland Security Department's efforts to prepare the nation's medical system for a disaster. HHS preparedness spokesman Marc Wolfson acknowledged that a disaster such as nuclear blast in a large urban area could produce thousands of burn victims, and that there would not be enough burn facilities to treat everyone.

"The number of total beds available in hospitals, we don't have direct control over that," he said.

But he said he hopes some of the money the government has been dispensing to hospitals since 9-11 for disaster readiness goes toward preparing for a surge of burn victims, even if does not lead to an increase in burn beds.

Wolfson said that if burn beds are full, patients can be taken to trauma units. Also, he said some veterans hospitals have beds that could be used in a fiery catastrophe. And he said burn centers can be expanded in an emergency.

Some burn experts are not reassured.

Severely burned patients suffer extreme pain, their bodies lose the ability to regulate temperature and fluid levels, and they are highly vulnerable to infections because their skin has been stripped away.

Burn centers are staffed by medical professionals specially trained in treating people with severe burns.

They also have special features such as individually temperature-controlled rooms, mattresses with circulating air to support a burn victim, and beds that automatically turn immobile patients to prevent further skin damage.

In addition, there are warming devices for beds since burn patients get cold easily, and tubs in which patients can be immersed to clean their wounds and promote drainage.

Other burn center features include synthetic material that serves as a temporary skin substitute, and a device that uses ultrasound to determine the severity of burns without having to touch a seriously burned patient.

The exact number of burn beds in the U.S. is a matter of dispute, and may well be overstated, because hospitals do not always distinguish between specialized burn beds and beds that are used for various traumatic injuries, including burns.

Wolfson said one recent report to the federal government showed that only 520 beds were actually available for use. Dr. William B. Hughes, director of the Temple University Hospital Burn Center in Philadelphia, said that more commonly, only about 300 beds are available at any one time.

Hughes said the United States had easily more than 3,000 dedicated burn beds in the early 1970s. But there has been a steady decline since then.

"We keep hearing we are ready for a terrorist attack," said Dr. Jeffrey Guy, director of the 29-bed Vanderbilt University Burn Center in Nashville. But even now, "our space is full almost all the time."

Guy said it is not uncommon for regional burn centers to be full and for patients to be transported long distances. "There are days we are taking burn calls for Chicago," he said.

Burn center directors say more beds are likely to disappear. Most burn centers are losing money because Medicare and Medicaid reimbursements have not kept up with the cost of providing care, experts say. Private insurers often follow Medicare's lead.

Since it costs about $10,000 a day to treat a patient with severe burns, and such patients typically require 50 days of intensive care, a single uninsured patient can wreck the finances of a small burn program.

Some burn centers around the country have lost a lot of money treating uninsured adults and children who were severely burned in explosions of clandestine methamphetamine labs.

"Burn units are money-losers," Hughes said.

Some health industry officials say that it is unreasonable to expect the nation's hospitals to be prepared for a worst-case burn scenario at all times.

"You don't want to have so much capacity you lose your shirt on it," said Jim Bentley, the American Hospital Association's senior vice president for strategic policy planning.

Dr. David Mozingo, director of the Shands Burn Center at the University of Florida in Gainesville, said state officials there have, in fact, begun committing some terrorism and disaster-preparedness money to burn care.

"They have been buying equipment and training. A lot of supplies and equipment have been distributed that are burn-care specific," he said.

Some burn-care experts warn that in an all-out disaster, health professionals would have to conduct a pitiless form of triage and decide which patients get sent to burn centers and which ones do not.

"The person on scene is going to look at people who have the best chance of surviving," Iowa's Latenser said. "We will not have the resources."

Burn care professionals "spend a lot of time talking about, `How do we get the government to listen to this?'" Latenser said. "You can't have the disasters and then say, `Oh golly, we should have had the centers.'"

___

On the Net:

Health and Human Services: http://www.hhs.gov/disasters

Vanderbilt Burn Center: http://www.vuburncenter.com

University of Iowa Burn Center: http://www.uihealthcare.com/depts/burntreatmentcenter

UK farmers pray outbreak is contained By JANE WARDELL, AP Business Writer

UK farmers pray outbreak is contained By JANE WARDELL, AP Business Writer
Mon Aug 6, 6:02 PM ET



LONDON - Michael Fordham remembers all too well the ravages of the foot-and-mouth epidemic that swept Britain in 2001 — millions of cattle destroyed and a personal financial burden almost impossible to bear.

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Six years later, government measures to contain a new outbreak of the highly contagious disease are threatening Fordham's farm of 90 head of cattle near the town of Uckfield in southern England.

"I couldn't believe it, it was absolutely staggering to think it could happen again," he said Monday. "And on top of all the flooding and bad weather."

Severe floods in June and July had already proved costly for farmers, and authorities were looking into the possibility that the flooding helped spread the virus.

On Monday night, authorities began slaughtering a new group of about 50 cattle suspected of being infected, Britain's Chief Veterinary Officer Debby Reynolds said. The cows were within the initial 2-mile radius protection zone officials set up Friday around the Surrey farm. About 120 cows were destroyed after the virus was first detected last week.

Test results from the new group were expected Tuesday, but the precautionary slaughter had already begun, Reynolds told Sky News.

The investigation was focusing on a research laboratory near the Surrey farm where two cattle were discovered with the disease last week. The strain of the disease found in the infected cattle is the same one used at the laboratory.

Fordham heard news of the outbreak when he switched on the TV after a day in the fields doing long overdue work prevented by the rising waters, such as haymaking.

Now, a swift ban imposed by the government on all movement of cattle, sheep, goats and pigs nationwide threatens the viability of Fordham's small store at Bradford Farm. He was unable to send selected cattle to the slaughterhouse this week, and a longer ban would eventually drain his supply of goods for sale.

At the national level, the Farmers Union said the government's voluntary ban on exports of livestock, meat and milk has already cost millions of dollars. The ban was imposed Saturday, a day after the discovery of the disease at the Surrey farm.

The European Commission endorsed Britain's ban Monday. Each week it lasts is expected to cost Britain millions more, and a long-term ban is also likely to cause the domestic price of British meat to plummet.

"We know from long and bitter experience that a ban on exports leads to very low prices," said National Farmers' Union director of communications Anthony Gibson. "Further price cuts could be the last straw for an awful lot of people."

The EU, which was accused of retaining its 2001 ban longer than necessary, tried to ease some of the economic impact this time. It said it would allow imports of animal products produced before July 15, which were treated in a way to inactivate the virus, and those manufactured in Britain but derived from animals reared outside the country.

Imports of British pigs and pork products have been banned by the United States, Japan, Russia and South Korea in response to the outbreak. The United States and Japan already have bans in place on British beef imports.

Britain's Meat and Livestock Commission said cattle and beef exports in 2006 were worth more than $200 million. Sheep and sheepmeat exports were valued at almost $510 million, while pig and pork exports accounted for nearly $360 million.

Exports of British beef only resumed in May 2006, reversing a 10-year ban that followed the discovery of a link between bovine spongiform encephalopathy, or mad cow disease, and the variant Creutzfeldt Jakob Disease in humans.

Many farmers are still recovering from the outbreak of foot-and-mouth in 2001, when 7 million animals were slaughtered, costing the economy around $17 billion.

"By its nature, farming is a long term business, with sheep flocks just coming out of the aftereffects of 2001," said Malcolm Corbett, the head of the National Farmers Union. "This is a real body blow to the livestock industry."

Along with domestic sales and exports, tourism could be hit.

Former Prime Minister Tony Blair's decision to shut down large swaths of the countryside and appeal for people to stay in the cities to avoid spreading the disease was blamed for worsening the 2001 outbreak's effect on tourism.

This time around, while keeping a tight reign on livestock movements, Prime Minister Gordon Brown has stressed that the countryside remains open to tourists.

Foot-and-mouth can be fatal among young hogs, sheep and cattle, while infection in older animals causes blistering on the mouth and tongue, reducing milk and meat production. Foot-and-mouth can be carried by wind and on the vehicles and clothes of people who come into contact with infected animals.

Whether the latest scare reaches the proportions of the 2001 epidemic depends on containment, and farmers have so far welcomed the government's efforts.

Brown visited an emergency response center in Reigate on Monday and promised "no resources will be spared to get to the bottom of this because we know the future of farming depends on it."

Meanwhile, Merial Animal Health, the private company that shares the research laboratory with the government's Institute for Animal Health, said it was temporarily resuming production of its foot-and-mouth vaccine to meet a government order for 300,000 doses of a strain-specific vaccine.

All Fordham can do is keep a close eye on his cattle — it can take 10 days for symptoms to show in infected animals — and hope the virus does not spread.

"You just pray when you see something resembling the symptoms, that it's not foot-and-mouth," he said. "We just hope this is an isolated incident."

Odd treadmill may help stroke survivors By LAURAN NEERGAARD, AP Medical Writer

Odd treadmill may help stroke survivors By LAURAN NEERGAARD, AP Medical Writer
2 hours, 34 minutes ago



WASHINGTON - A weird treadmill is pushing people at a Baltimore research hospital into sloppy versions of Michael Jackson's moonwalk, in hopes of training stroke survivors and others with brain injuries to walk normally again.

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The custom-built treadmill hides a split belt — one side can move one foot backward while the other moves forward, and at different speeds.

It can be a wild ride: Your brain must automatically adjust how you walk so you won't fall down.

Scientists at the Kennedy Krieger Institute are tapping into that unconscious adjustment, using a brief workout to jolt patients who usually limp and lurch back into a normal stride, one they retain for a few minutes after the treadmill stops.

The discovery: Separate nerve networks control how each leg moves, networks that can be retrained to change someone's innate walking patterns, at least temporarily.

Now the challenge is to make the better walking permanent. This fall, Kennedy Krieger's Dr. Amy Bastian will begin a government-funded study putting at least 40 stroke survivors through longer sessions with the wacky treadmill, to see if practice helps the improvement stick.

Because Kennedy Krieger is a pediatric research institute, she hopes eventually to begin a similar study with children recovering from major brain surgery.

The findings offer a glimpse into the newest frontier in rehabilitation research: How to spur brain and spinal cord circuitry to rewire itself for normal leg control after a stroke or other brain injury.

"The amazing thing about walking control (is) when you try to consciously override things, it doesn't work so well," says Bastian, who has personally tested the treadmill.

"The belts start moving and if you think about it, you start to screw it up. If you just let your system take over, it's these lower, less conscious control networks that can do this, no sweat," she explains. "Those are the ones we want to train."

A healthy brain continually adapts and reorganizes itself, a condition called plasticity. It's easiest for younger brains, but it is possible to spur this process even in older people. For example, tying down a stroke victim's good arm while repeatedly exercising the weak one strengthens arm circuitry in the stroke-damaged brain region while improving movement.

Far less research has been done on ways to improve rehab for the legs, however.

The split-belt treadmill is "a fascinating concept," says Dr. Milton Thomas of the Baylor Institute for Rehabilitation, who was amazed that Bastian's experiments didn't have people falling down. The research "showed both legs are taught to function almost independent of each other — or can be."

First, Bastian tested the funky walking on 40 healthy people. Sometimes, the treadmill moved their legs in opposite directions. Sometimes it moved one leg up to four times faster than the other.

With a 15-minute session, she essentially retrained them to walk with a lurch. No matter how hard they tried to walk normally when the session ended, they couldn't for 10 minutes or so — until automatic nerve systems recalibrated themselves again.

Tracking that adjustment, Bastian reported in the journal Nature Neuroscience last month that there are separate neural networks to control forward walking and backward walking, and each leg, too. That means researchers might target just the bad leg.

What about people with brain injuries? Thirteen stroke survivors who had limped for months saw that same brief improvement from the treadmill test, Bastian and University of Delaware physical therapist Darcy Reisman reported in the journal Brain.

That suggests the right circuitry for good walking is lying dormant in these patients, if doctors can learn to tap it.

Then Bastian tried the technique with a few children relearning to walk after surgery removed half of the brain to stop seizures. Video shows Beth Nielsen, then 4 1/2, pointing her right foot outward and dragging it. After a treadmill session, she strides correctly for a few minutes.

"One of the highlights of her day was to get to do that," says her mother, Sharon Nielsen, of Woodbury, Minn.

Beth went on to regular physical therapy, and six months later Nielsen says she walks fairly well unless she's tired.

A split-belt treadmill isn't the only approach under study. The Baylor Institute for Rehabilitation in Dallas is having success training brand-new stroke victims to walk normally by giving them specially supervised sessions on a regular treadmill as soon as they can stand but before they've tried walking on their own.

"We're extraordinarily excited about this," Thomas says.

But this is key: Wait until six months after the stroke and the Baylor method is too late. Patients who try walking on their own immediately compensate for the weak leg with a limping gait that the body soon adopts as its new normal, he explains.

So Thomas was impressed that the Baltimore team is tackling long-term limpers.

"The fact that these guys were able to disrupt the (ingrained) pattern is, I think, groundbreaking," he said. "It's going to be really interesting to see what comes of this."

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EDITOR'S NOTE — Lauran Neergaard covers health and medical issues for The Associated Press in Washington.

FDA approves novel drug AIDS patients By LAURAN NEERGAARD, AP Medical Writer

FDA approves novel drug AIDS patients By LAURAN NEERGAARD, AP Medical Writer
Mon Aug 6, 5:58 PM ET



WASHINGTON - The government approved a novel drug Monday to help patients with the AIDS virus who are running out of options, while acknowledging lingering questions about the pills' long-term effects.

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Pfizer Inc.'s Selzentry is the first anti-AIDS drug that works by blocking a crucial doorway, called the CCR5 receptor, that the HIV virus often uses to enter white blood cells.

New York-based Pfizer said the pill, known chemically as maraviroc, would be available next month. A spokeswoman said it would cost about the same as other HIV medicines, roughly $900 a month wholesale.

It marks the first in a new class of HIV medicines since 2003, when the FDA approved an injectible "fusion inhibitor" that blocks a slightly later stage of infection.

Researchers have long known that people who naturally lack a working version of the CCR5 doorway are somewhat resistant to HIV infection, and slow to develop AIDS if they do become infected. But the race to develop CCR5 receptor blockers slowed with concerns that this family of drugs might cause serious side effects, including liver or heart damage, and an increased risk of other infections or cancer.

The Food and Drug Administration approved Selzentry after concluding that certain hard-to-treat patients need the new option — but is requiring Pfizer to conduct further research to assess long-term side effects, said Dr. Debra Birnkrant, the agency's HIV drugs chief.

For that select group, Selzentry's "benefits clearly outweigh the risks," Birnkrant said. "That doesn't mean there aren't any risks."

The drug is not for the newly diagnosed, but only for patients whose virus is fast becoming resistant to today's HIV drugs, she stressed.

Those patients also must get a blood test to ensure the HIV strain they have uses the CCR5 pathway. Doctors would send a frozen blood sample to a San Francisco testing company, Monogram Biosciences.

Patients determined to have so-called "R5 virus" would take the twice-a-day pill in addition to their usual HIV drugs.

In a six-month study where patients added either Selzentry or a dummy pill to their regular medicine, Selzentry users were twice as likely to have their virus levels become almost unmeasurable, she said.

Topping the side-effect list is a stern warning that the drug may damage the liver, with symptoms that may at first mimic an allergic reaction. People who develop signs of hepatitis or an allergic reaction should see a doctor immediately.

Pfizer also warned that studies counted more cardiovascular problems, including heart attacks, in Selzentry users. Other side effects include dizziness, upper respiratory infections and fever.

Pfizer said it planned to use the brand name Celsentri outside the U.S. The FDA forced a spelling change for fear of mixups with similar-sounding drugs here, Birnkrant said.

Illinois flu vaccine donation destroyed 36 minutes ago

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Illinois flu vaccine donation destroyed 36 minutes ago



CHICAGO - Millions of dollars worth of flu vaccine that Illinois donated to Pakistan after federal regulators refused to allow it into the U.S. never helped anyone, according to a published report.

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Pakistani health officials destroyed the quarter-million doses of vaccine, worth $2.6 million, because the expiration date had passed, The Chicago Tribune reported Sunday.

"After all, human beings are equal. They are not guinea pigs. And vaccines, if they are not good in one country, they should not be usable in another country," said Pakistan's retired Lt. Gen. Farooq Ahmad Khan, who coordinated relief for the Oct. 8, 2005, earthquake that killed 80,000 people.

Gov. Rod Blagojevich's administration ordered the medication from European suppliers in 2004 during a nationwide shortage of flu vaccine, but the U.S. government said it wasn't approved and refused to let it into the country. Illinois Auditor General William Holland later determined the Democratic governor's move was an unlawful attempt to bypass regulators.

The vaccine was refrigerated for months before Pakistan destroyed it in November 2006, according to documents Pakistani officials released to the newspaper.

The Blagojevich administration told the newspaper the governor's office did not track the vaccine once it reached Pakistan and had believed the Pakistanis were happy with the donation.

The Pakistanis said they didn't know the vaccine had expired when they agreed to accept it.