Most countries offer the Pill over-the-counter

NEW YORK (Reuters Health) – Unlike women in the U.S., Canada and much of Europe, most women in the world can access the birth control pill without a prescription, according to a new study.

As medical organizations and other groups push to ease the prescription requirements for the Pill in the U.S. and elsewhere, “we can start to use this information to… get a sense of the safety of women having access to this method where no prescription is required,” said Kari White, who studies birth control at the University of Alabama in Birmingham.

The Pill is generally considered safe, said White, who was not involved in the new work, and some studies have shown that, without a doctor’s input, women can accurately screen themselves for risk factors to steer away from using the Pill if it’s not appropriate for them.

Earlier this year, the American College of Obstetricians and Gynecologists, a leading group of women’s doctors, endorsed the idea of making the birth control pill available without a prescription (see Reuters Health report of November 20, 2012 here: http://reut.rs/UH0Zz9).

In a survey of government health officials, pharmaceutical companies, family planning groups, medical providers and other experts in 147 countries Dr. Daniel Grossman, of Ibis Reproductive Health in Oakland, California, and his colleagues found that women in the U.S. and 44 other countries need a prescription to get birth control pills.

The group reported in the medical journal Contraception that while another 56 countries had laws requiring prescriptions, in practice women could access the contraception over-the-counter.

Thirty-five countries legally allowed access to oral contraceptives over-the-counter, and 11 countries allowed over-the-counter access as long as the woman is screened to ensure that she is a good candidate.

“The patterns we saw were interesting,” said Grossman. “Higher income countries – western Europe, Australia, Japan and North America – generally require a prescription.”

Grossman told Reuters Health he couldn’t explain why these patterns have emerged.

“Perhaps in places like China and India that have pills available over-the-counter formally without a prescription might be consistent with strong national family planning programs,” he speculated.

Dr. Ward Cates, of FHI 360, a research organization in Durham, North Carolina, said the lack of a prescription requirement might also reflect a general approach to making health care more accessible in countries where it is less available.

In some countries, “healthcare tends to be more fragmented and healthcare oversight tends to be more fragmented. Therefore the availability of products tends to percolate to outlets that tend to be more accessible to the public,” said Cates, who was not part of the study.

Grossman said it will be useful for countries looking to ease restrictions on birth control access to look to the experiences of these countries.

“Will this information about the availability of pills being over-the-counter in other countries influence policy here? Probably not,” Grossman told Reuters Health.

“But I do think it helps to put it in perspective that this is not something revolutionary.”

SOURCE: http://bit.ly/S51BnH Contraception, online December 10, 2012.

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FDA Approves 39 New Drugs in 2012

Both pharmaceutical companies and officials at the U.S. Food and Drug Administration have been busy — the drug companies compiling statistics from clinical research trials and the FDA going through its vetting process to ensure the safety and efficacy of proposed new medications. The most recently approved medication, Sirturo, was developed for the treatment of multi-drug resistant tuberculosis, MDR-TB, an infection rarely seen in the United States but prevalent in China, Eastern Europe, Russia and India.

FDA 2012 Approval Numbers

In the last 20 years, the greatest number of new approvals occurred in 1996 when 53 new medications were added to the marketplace. In 1997, 39 new drugs met FDA approval. Approvals slowed for some years until 2004 when 36 approvals were awarded by the FDA, then slowed again until the 39 approvals in 2012.

Newest Tuberculosis-Fighting Drug Fast-Tracked by FDA for Approval

Johnson & Johnson’s drug Sirturo, or bedaquiline, intended for the treatment of drug-resistant strains of tuberculosis, received a speedy go-ahead to market, a process used by the FDA when preliminary clinical research demonstrates positive results.

Tuberculosis, caused by bacteria that most often affects the lungs, is rarely seen in the United States but is rampant in other areas of the world. As many as 1.4 million people die worldwide annually from the illness, with approximately 150,000 of those deaths from MDR-TB.

Sirturo, the first new anti-tuberculosis drug to market in more than 40 years, is not without its concerns. Designed to be used in conjunction with the older anti-tuberculosis medications, Sirturo carries a boxed warning on its label that it can interfere with the heart’s electrical system, something that could result in fatal arrhythmia .

Bedaquiline is not intended as a first line of defense against tuberculosis infection, but rather when all other available treatments have been ineffective. Left unabated, the tuberculosis could lead to death and at that point in the illness health care providers would need to weight the possible side effects of a medication that could save the person’s life by clearing the infection.

New Medications Approved by FDA in 2012

The FDA provides a listing of new and generic drugs the agency approved in 2012. Drugs in the listing include Eliquis, a blood thinner for people with atrial fibrillation not related to a heart valve problem; Juxtapid, an anti-cholesterol medication for people with an uncommon genetic disorder affecting LDL cholesterol levels; and Iclusig, another medication that received fast-track approval, for the treatment of two rare types of leukemia. Thirty-six other drugs also received approval.

Bottom Line

The discovery and clinical research that are behind each new drug is often long, arduous and expensive. MedCityNews.com reported that major pharmaceutical companies took a big financial hit in 2012 due to patents expiring on many large money-making medications, with cheaper generic drugs taking up the slack to the tune of $ 21 billion for U.S. drug makers and $ 10 billion for European drug makers.

As difficult as it can be to feel sympathy for the drug companies, the truth is manufacturing and distributing medications is a business. If profits fall too much, it is difficult to fund the discovery and research phases for potential new cures.

Everyone, from infants to baby boomers to centenarians, benefits from the continued science of pharmacy.

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Eleven Ways to Avoid Answering a Question: A Year in Review

When my grandfather was alive, each of his children and grandchildren was responsible for reporting to him about the world in which they worked. He loved knowledge; he always had. As the only scientist in the family, I was in charge of “science.” This never quite seemed fair and yet I did what I could until the day he asked me to explain dark matter. I am a broadly trained scientist. I have worked on bacteria, birds, plants, insects and a great deal else. But, when pressed, late in the evening, dark matter was beyond my comfort zone. I faltered. Sometimes with my grandfather, faltering could be propped up with grandstanding, but on this particular day there was no such doing. He knew I was guessing. His shoulders slumped and he announced softly, “I don’t think I am ever going to learn everything.” My ignorance was the BS that broke the camel’s back.

In part because of my grandfather I have always felt a responsibility to answer questions people ask about science. This year, I decided I would make this responsibility more conscious. I would try to focus much of my writing on answering questions that came up in my daily life, questions that I am responsible for because I am a scientist. It was a sort of New Year’s resolution. My other resolution was to write shorter articles.1–Sitting around enjoying a glass of wine with my family and our friends Ari Lit and Michelle Trautwein, Ari asked, Hey dude, why do we drink alcohol? Do monkeys drink alcohol? This led me to think about the big story of alcohol and, in as much, to write a whole series about our complex relationship with the yeasts that, as waste, produce our favorite drinks. It ended up becoming a forty thousand word online series, about alcohol, civilization and yeast. So much for the resolution to write short articles. Also, I forgot to check on the monkeys.2–My favorite questions tend to come from kids and earnest parents. This year at my daughter’s school, every third student and then every other students and then, jeez, almost every student seemed to have lice. Parents asked me, “what should we do about lice?” This was a follow-up to an article I had written years prior in response to a similar query. I was able to tell the story of how the louse problem (or success, depending on your perspective) came to be, over the last million years. But I failed to really answer what a parent should do if their kid gets lice. It turns out parents whose kids have lice don’t want to hear about ancient hominids and their lice. Go figure.Image 1. Picture of the louse species, Pthirus pubis, descended from an interaction between a human ancestor and a gorilla ancestor and that is all I am saying. Photo courtesy of the CDC. 3-In the last chapter of my book The Wild Life of Our Bodies I argue for a more serious gardening of nature in the places we live. Reading this, someone wondered about the ways in which we garden evolution itself. She emailed asking, Could we favor the evolution of good species in our houses? I wasn’t sure and am still not, but the question prompted me to reconsider the ways in which we have gardened evolution historically. I wrote the Garden of Our Neglect about this history. I then started to consider how we might favor the presence (if not evolution) of beneficial species on our bodies and in our homes. This led me to propose the Ecological Theory of Disease and to write Letting Biodiversity Get Under Our Skin, and How Clean Living is Bad for You. I also wrote an article about what our body might be doing to favor beneficial species in Your Appendix Could Save Your Life. None of these articles really told anyone which species to plant much less engender in their invisible gardens of indoor life.4-Another night with friends, we sat around talking about paleo diets. Ari asked who we should count as our ancestors, which ancestors should we consider if we were to eat ancestral diets? This debate inspired the piece Were Our Ancient Ancestors Vegetarians and then How to Eat Like a Chimpanzee. Later when Ari tried an essentially all nut and fruit super-fiber diet I found myself writing about the Hidden Truth about Calories. With these articles, I learned about diet, but I also learned that people can get very angry when it comes to discussing food. I never really answered Ari’s question.5-At one evening talk associated with the Museum of Life and Science in Durham, NC, someone asked me why her armpits smell sweet when she lives in the desert. She asked me that question in Durham, not in a desert, so I felt compelled to take her word for it rather than sniff around the story, but I did begin to wonder about what we do and don’t know about the microbial smells produced on our bodies and those of, for example, dogs, so I wrote Why Sick People Smell Bad. The article was fun, but I still don’t know why the woman had sweet pits; perhaps it is just her nature.6-My daughter (who sometimes seems to channel the pure inquisitivness of my grandfather) asked me “Why are our bodies warm and not cold?” This is the kind of question she asks so as to avoid going to bed. It led me to write the article How Killer Fungus May Have Made us Hot Blooded. The article offers a partial, possible, speculative answer to her question, which is her favorite kind of answer because it means she can stay up later as she asks follow-up questions.7–My son has started asking, “papa, who took your hair?” I told him, as I told my daughter when she was smaller, that the squirrels took it for their nest. This just seemed to make him afraid of squirrels so I decided to figure out the real answer, the result was a story in New Scientist (unfortunately pay-walled) about the mystery of baldness and its evolution. Balding, it turns out, is fascinating, but why we bald is still largely unresolved. Back to the squirrels.8–I sometimes introduce talks about social insects by mentioning the similarities between insect and human societies and the idea that insect societies can allow us to learn about our own. In response (and during election season), someone recently asked “who would the ants vote for?” The closest I could get to an answer was to discuss how other animals (mostly honey bees) choose their leaders. I figured out that we know far less about leaders in other societies, including those of ants, than I had thought.9–Piotr Naskrecki visited my house and found, in my basement, a species of camel cricket apparently native to Japan. He also found, to my wife’s dismay, two species of “interesting roaches.” This spurred me to ask other people about their camel crickets, which caused me to have to answer how a Japanese camel cricket has come to take over our basements? I don’t really have an answer yet, though if you check out the website there are ways for you to help me find one.10–For a number of years now, people have been offering me story ideas. “Man, you should totally write about…” Its often difficult to follow up on such ideas, but this year I tried. When my family and I were living in Parma, Italy Donato Grosso asked me if I knew about the species of crab living under Rome. “That,” he said, “would be a good story.” It was. It became “new species of crab living in Rome.” A visit to Girona, Spain where a friend had built a niche in his house for animals to colonize got me wondering about the niches in our cities that we have built for wild species. Pera said, “you should write about it.” I did, in the form of a story about the most common bird in the world, the house sparrow. There were no questions here, but even without a question to answer I seem to have written something slightly different from what Donato or Pera might have imagined.11-Finally, I have started to try to answer the question I have heard most often throughout my career, including from my grandfather, “what do I do about the ants in my kitchen?” Answering this question has required figuring out what the heck is going on with ants in kitchens and backyards and so I wrote one article about a backyard discovery made by English majors, another about a discovery made by an eight year old and another still about how little we seem to know about the most common ant species in eastern North America. I also recruited Eleanor Spicer to write Dr. Eleanor’s Book of Common Ants. None of these answered the question about what to do about the ants in your kitchen, though maybe the distraction bought me some time.Image 2. Camponotus pennsylvannicus, a common backyard (and occasionally kitchen) ant. Photo by Alex (the great) Wild.In short, although I’ve written something like 200,000 words this year, very few seem to have directly answered the questions I was asked. So much for my New Year’s resolution, though maybe part of the problem is that we still know so little about so many fields that it is nearly impossible to make it to the end of a story without encountering the unknown. Perhaps I can try to write shorter answers, answers short enough that I don’t get to what we don’t know. History is not on my side. I seem incapable of writing short articles (one of my shortest articles this year was repeatedly described as “long form”). Also, I come from a long history of “long form” people. My grandfather’s stories went long and, well, his father was apparently worse. When asked to comment on the history of the Episcopal church in his town, Greenville, Mississippi, my great grandfather wrote that he could not write about the history of the Episcopal church in Greenville without commenting on the history of the Episcopal church more generally. And he could not, he said, write about the Lutheran church in general without commenting upon the history of religion. And so he began. My people. It seems we start at the very beginning and answer a question similar too but not identical too the one we were asked. In this light, if my granddad were still around, I’d tell him now that, yes, I can explain dark matter now, but before I do I need to explain the big bang, which, ironically is what I do in my first article of 2013. So stay tuned and send me your questions. But don’t be surprised if, in commenting upon the history of your question, I need to comment on a broader church, the history of life or even the universe.Go ahead and post your science questions you think should be answered in 2013 here…   

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Omega-3s may not protect against faulty heart rhythm

NEW YORK (Reuters Health) – Sorry, Charlie, but fish oil supplements did not prevent atrial fibrillation in patients who had already experienced episodes of the heart rhythm malfunction, a new clinical trial has found.

The study, published in the Journal of the American College of Cardiology, adds to a growing pool of disappointing evidence regarding the protective effects of omega-3 fatty acids on heart health.

“The results for atrial fibrillation are important negative findings, answering key clinical and research questions,” said Dr. Dariush Mozaffarian, an omega-3 expert at the Harvard School of Public Health, who was not involved in the current study.

The new research, combined with other trials, “indicates that short-term fish oil use is unlikely to prevent recurrent atrial fibrillation,” he said.

But if the supplements don’t prevent heart rhythm problems, they don’t appear to be dangerous, either. “In all these studies, fish oil was safe and well-tolerated, with no evidence for increased bleeding,” Mozaffarian told Reuters Health.

Atrial fibrillation, in which the heart’s upper chambers beat out of step with those below, affects nearly one in 10 Americans in their 80s. The condition is linked to potentially life-threatening strokes and heart failure.

Although doctors prescribe certain medications to treat the condition, none to date has proven particularly effective. As a result, most drug treatment focuses on preventing strokes by administering blood thinners to dissolve clots caused by the fibrillation.

Some evidence suggests that omega-3 fatty acids, found in oily fish like sardines and tuna, might reduce the risk of atrial fibrillation, although exactly how they would produce their effect is not clear.

A study published earlier this year in Circulation, for example, found that people with the most omega-3s in their blood had a 30 percent lower chance of developing an irregular heart beat than those with the lowest concentrations of the substances (see Reuters Health story of February 1, 2012).

That 30 percent difference would work out to eight fewer cases of atrial fibrillation per 100 people – which would be a meaningful benefit if it could be enjoyed by those with fibrillation or at risk for it, just by consuming more omega 3s.

But the latest study suggests that it probably can’t. The trial included 586 men and women with a history of atrial fibrillation who were given a gram a day of fish oil or dummy capsules for a year. Participants also were allowed to take other drugs to control their heart rhythms, as prescribed by their doctors.

At the end of the study period, about 24 percent of the people who took fish oil, and 20 percent of those who did not, had experienced a recurrence of atrial fibrillation – a difference so small, statistically, it was likely due to chance.

The supplements also did not appear to reduce the risk of other cardiovascular ailments – including stroke, heart attack, heart failure – or death from any cause.

The findings on atrial fibrillation echo results from a study led by Mozaffarian published in November, of patients recovering from heart surgery.

Even so, Dr. Alejandro Macchia, a cardiologist at the GESICA Foundation in Buenos Aires, who led the current study and collaborated with Mozaffarian on the previous one, said fish oil may still prove beneficial for heart health, at least in some patients.

“I am not sure the story is over,” Dr. Macchia told Reuters Health. “I think we have enough evidence to say that there is no role of (omega-3 fatty acids) for the prevention of atrial fibrillation” in patients with a history of the condition, he said. “However in the context of primary prevention – those people who had never had a previous episode of atrial fibrillation – there is a reasonable room for a well-designed and very large clinical trial.”

SOURCE: http://bit.ly/VrTKiY Journal of the American College of Cardiology, online December 19, 2012.

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Factbox: U.S. “fiscal cliff,” tax impact of no deal

WASHINGTON (Reuters) – Higher federal taxes for millions of businesses and individuals will become law on Tuesday unless Congress acts to stop them. These taxes, worth $ 500 billion, comprise the bulk of what is known as the “fiscal cliff” problem.

The following shows the probable impact on taxpayers if Congress does not act on Monday, or does not come back later and undo these tax increases, based on data from the nonpartisan Tax Policy Center.

INDIVIDUAL TAXES

If midnight passes with no deal, lower individual tax rates enacted in 2001 on a temporary basis under former President George W. Bush will expire on December 31.

The income tax brackets will rise to 15, 28, 31, 36, and 39.6 percent from the current 10, 15, 25, 28, 33 and 35 percent for nearly 160 million taxpayers.

The poorest fifth of taxpayers, about 40 million households, will see an average tax increase of about $ 412.

The most affluent fifth, about 23 million taxpayers, will typically pay about $ 14,173 more in income tax.

The wealthiest 1 percent, about 1.1 million taxpayers, will see an average tax hike of about $ 120,000.

PAYROLL TAX

About 160 million workers will pay higher Social Security payroll taxes. The rate goes up to 6.2 percent on January 31 when the current, temporary 4.2 percent rate expires. The lower rate was extended in 2012 to give workers a little extra in their paychecks as a way to boost the economy. Unlike some of the other tax measures, there appears to be little interest from Republicans or Democrats in continuing the lower rate.

INVESTMENT TAXES

The capital gains tax rate will rise to 20 percent from 15 percent for most taxpayers who have income from gains on their investments. The tax rate on dividends will rise to the top income tax rate, 39.6 percent, from the current 15 percent dividend tax rate.

ESTATE TAX

The estate tax will rise to 55 percent from 35 percent. The value of assets exempted also drops to $ 1 million per person from its current $ 5 million per person.

ALTERNATIVE MINIMUM TAX

About 27 million Americans could be required to pay the alternative minimum tax (AMT), a tax that initially was intended to make sure the wealthy paid some tax. The AMT fix that Congress has enacted annually had resulted in only 4 million Americans paying the AMT.

UNEMPLOYMENT BENEFITS

About 2.1 million long-term unemployed Americans will see their extended jobless benefits cut off as of January 1, according to the National Employment Law Project, an advocacy groups.

EXTENSIONS OF TAX BREAKS

A mix of tax breaks for individuals and businesses worth tens of billions of dollars annually, including the research and development tax credit for business, will lapse. These include deductions for payments of state and local taxes and tax benefits for college tuition.

MEDICARE PAYMENTS TO DOCTORS

Doctors treating elderly and disabled patients who make up the Medicare population will see a double-digit cut to in rates paid by the federal government health care program. Medicare patients could have a tougher time finding doctors who will treat them.

(Editing by Fred Barbash and Jackie Frank)

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Italian Nobel scientist Montalcini dies at 103

ROME (Reuters) – Rita Levi Montalcini, joint winner of the Nobel Prize for Medicine and an Italian Senator for Life, died on Sunday at the age of 103, her family said.

The first Nobel laureate to reach 100 years of age, she won the prize in 1986 with American Stanley Cohen for their discovery of nerve growth factor (NGF), a protein that makes developing cells grow by stimulating surrounding nerve tissue.

Her research helped in the treatment of spinal cord injuries and has increased understanding of cardiovascular diseases, Alzheimer’s and conditions such as dementia and autism.

One of twins born to a Jewish family in Turin in 1909, Montalcini was the oldest living recipient of the prize.

During World War Two, the Allies’ bombing of Turin forced her to flee to the countryside where she established a mini-laboratory. She fled to Florence after the German invasion of Italy and lived in hiding there for a while, later working as a doctor in a refugee camp.

After the war she moved to St. Louis in the United States to work at Washington University, where she went on to make her groundbreaking NGF discoveries.

She also set up a research unit in Rome and in 1975 became the first woman to be made a full member of the Vatican’s Pontifical Academy of Sciences in 1975. She won several other awards for her contributions to medical and scientific research.

Her face was instantly recognizable in Italy and she was well known as a dignified and respected intellectual, a counterbalance to the image of women succeeding through their looks and sexuality, exacerbated during the scandal-plagued era of former prime minister Silvio Berlusconi.

Two days after her birthday in April this year she posted a note on Facebook saying it was important never to give up on life or fall into mediocrity and passive resignation.

“I’ve lost a bit of sight, and a lot of hearing. At conferences I don’t see the projections and I don’t feel good. But I think more now than I did when I was 20. The body does what it wants. I am not the body, I am the mind,” she said.

Italian Prime Minister Mario Monti said in a statement that Montalcini’s Nobel prize had been an honor for Italy, and praised her efforts to encourage young people, especially women, to play a central role in scientific research.

(Editing by Louise Ireland)

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Year in Review: Meningitis Outbreak Still a Challenge

As part of the Year in Review series, MedPage Today reporters are revisiting major news stories and following up with an analysis of the impact of the original report, as well as subsequent news on the topic. Here’s what’s happened with the fungal meningitis outbreak since we published our first report.

The fungal meningitis outbreak that made headlines in the fall was “unprecedented,” in the words of the of the clinicians at the eye of the storm.

What’s more, “we’re not out of the woods yet,” said Tom Chiller, MD, deputy director of the CDC’s mycotic diseases branch.

The outbreak was unprecedented for its size, for the spectrum of disease, for the clinical challenges that faced doctors, and for the way the pattern of illness has changed since the outbreak began, Chiller told MedPage Today.

It also has enormous implications for patients, their families, hospitals, and insurers, said Carol Kauffman, MD, a fungal infections expert at the University of Michigan in Ann Arbor, Mich.

“The extent and repercussions of this outbreak, in comparison to other smaller outbreaks, are really amazing,” Kauffman told MedPage Today. “The huge morbidity and, for some, mortality, is enormous.”

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The outbreak, which has been linked to an injectable drug widely used to control chronic pain, has also seen the FDA under attack for not doing more to monitor so-called “compounding pharmacies.”

And the FDA has responded by saying it did not have clear authority to intervene, even though worries about the pharmacy in question, the New England Compounding Center (NECC) of Framingham, Mass., date back to at least 2002.

The agency is now asking for its authority to be clarified, although an organization representing compounding pharmacies has told lawmakers the FDA had all the power it needed, but just dropped the ball.

The bottom line from a public health standpoint is that as of Dec. 17, the CDC had recorded 620 cases of disease and 39 deaths. And more are likely, according to Chiller: “We’re still in the middle of this thing.”

Compounding Out of Bounds

The outbreak can be said to have started in the summer, when NECC made 17,675 vials of preservative-free methylprednisolone acetate, an injectable steroid, and shipped them to 76 healthcare facilities in 23 states.

That was problematic in itself: The company was licensed as a compounding pharmacy, meaning in principle it was allowed only to make up small quantities of specialized drugs, after getting a prescription from a doctor for an individual patient.

Instead, it was acting more like a large-scale drug manufacturer, and had been for some years, according to Massachusetts officials, which should have placed it under the FDA’s authority.

The manufacturing scale played a key role in what ensued: more than 13,000 people were exposed to the drug when they got injections – mainly into the spine – to control chronic pain.

They were also exposed to a fungal contaminant in the steroid vials, later found to be a black mold called Exserohilum rostratum, which only rarely causes human disease.

Oddly, the index case for the outbreak, reported to health authorities on Sept. 18, was a 56-year-old man in Nashville who had a case of meningitis apparently associated with the fungus Aspergillus fumigatus.

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Brazil president, cancer survivor, pronounced healthy

BRASILIA (Reuters) – Brazilian President Dilma Rousseff, who survived lymphoma cancer in 2009, was pronounced healthy by doctors after a routine exam on Friday.

Rousseff’s health was “within normal levels,” according to a statement released by her office following the check-up at the Sirio-Libanes Hospital in Sao Paulo, one of South America‘s leading cancer treatment centers.

Rousseff underwent chemotherapy in 2009 and briefly wore a wig, but the cancer went into remission and she appeared to be in good health by the time she staged her winning campaign for the presidency in 2010.

Concerns over her health have faded since then, although a bout with pneumonia and a lengthy recovery in 2011 have kept the issue on some investors’ radar screens.

(Reporting by Ana Flor, Writing by Brian Winter; Editing by Doina Chiacu)

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MSF warns Kenya not to send more refugees to stricken camp

LONDON (Reuters) – Conditions in a camp for Somali refugees in Kenya are deplorable and a government plan to send in thousands more would pose a major risk to health, medical charity Medecins Sans Frontieres (MSF) said on Friday.

Kenya has more than half a million refugees from Somalia, which has lacked an effective central government since the outbreak of civil war in 1991.

A series of bombings, shootings and hand-grenade attacks blamed on Somali militants prompted the government on December 18 to stop registering asylum seekers and refugees in urban areas.

A Kenyan official said more than 100,000 refugees must now head to the remote Dadaab camp in the country’s remote north. Amnesty International said the order breached international law.

Dadaab camp was set up 20 years ago and already houses four times the population it was built for. Hunger and disease outbreaks are common.

MSF says its inhabitants suffer from overcrowding and poor sanitation that recent floods had worsened.

“The assistance provided here in Dadaab is already completely overstretched and is not meeting the current needs,” said Elena Velilla, MSF’s head of mission in Kenya.

In the last month, the number of children admitted to Dadaab’s hospital for severe acute malnutrition has doubled to around 300, MSF said. Sixty-three of those were taken to intensive care this week after developing serious complications.

Most of the sick are also suffering from acute watery diarrhea or severe respiratory tract infections, MSF said.

(Reporting by Kate Kelland; Editing by Tom Pfeiffer)

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Kenya Hospital Imprisons New Moms Who Can’t Pay

The director of the Pumwani Maternity Hospital, located in a hardscrabble neighborhood of downtown Nairobi, freely acknowledges what he’s accused of: detaining mothers who can’t pay their bills. Lazarus Omondi says it’s the only way he can keep his medical center running.

Two mothers who live in a mud-wall and tin-roof slum a short walk from the maternity hospital, which is affiliated with the Nairobi City Council, told The Associated Press that Pumwani wouldn’t let them leave after delivering their babies. The bills the mothers couldn’t afford were $ 60 and $ 160. Guards would beat mothers with sticks who tried to leave without paying, one of the women said.

Now, a New York-based group has filed a lawsuit on the women’s behalf in hopes of forcing Pumwani to stop the practice, a practice Omondi is candid about.

“We hold you and squeeze you until we get what we can get. We must be self-sufficient,” Omondi said in an interview in his hospital office. “The hospital must get money to pay electricity, to pay water. We must pay our doctors and our workers.”

“They stay there until they pay. They must pay,” he said of the 350 mothers who give birth each week on average. “If you don’t pay the hospital will collapse.”

The Center for Reproductive Rights, which filed the suit this month in the High Court of Kenya, says detaining women for not paying is illegal. Pumwani is associated with the Nairobi City Council, one reason it might be able to get away with such practices, and the patients are among Nairobi’s poorest with hardly anyone to stand up for them.

Maimouna Awuor was an impoverished mother of four when she was to give birth to her fifth in October 2010. Like many who live in Nairobi’s slums, Awuor performs odd jobs in the hopes of earning enough money to feed her kids that day. Awuor, who is named in the lawsuit, says she had saved $ 12 and hoped to go to a lower-cost clinic but was turned away and sent to Pumwani. After giving birth, she couldn’t pay the $ 60 bill, and was held with what she believes was about 60 other women and their infants.

“We were sleeping three to a bed, sometimes four,” she said. “They abuse you, they call you names,” she said of the hospital staff.

She said saw some women tried to flee but they were beaten by the guards and turned back. While her husband worked at a faraway refugee camp, Awuor’s 9-year-old daughter took care of her siblings. A friend helped feed them, she said, while the children stayed in the family’s 50-square-foot shack, where rent is $ 18 a month. She says she was released after 20 days after Nairobi’s mayor paid her bill. Politicians in Kenya in general are expected to give out money and get a budget to do so.

A second mother named in the lawsuit, Margaret Anyoso, says she was locked up in Pumwani for six days in 2010 because she could not pay her $ 160 bill. Her pregnancy was complicated by a punctured bladder and heavy bleeding.

“I did not see my child until the sixth day after the surgery. The hospital staff were keeping her away from me and it was only when I caused a scene that they brought her to me,” said Anyoso, a vegetable seller and a single mother with five children who makes $ 5 on a good day.

Anyoso said she didn’t have clothes for her child so she wrapped her in a blood-stained blouse. She was released after relatives paid the bill.

One woman says she was detained for nine months and was released only after going on a hunger strike. The Center for Reproductive Rights says other hospitals also detain non-paying patients.

Judy Okal, the acting Africa director for the Center for Reproductive Rights, said her group filed the lawsuit so all Kenyan women, regardless of socio-economic status, are able to receive health care without fear of imprisonment. The hospital, the attorney general, the City Council of Nairobi and two government ministries are named in the suit.

———

Associated Press reporter Tom Odula contributed to this report.

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Film explores African-Americans’ unhealthy “soul food” habit

(Reuters) – After interviewing food historians, scholars, cooks, doctors, activists and consumers for his new film “Soul Food Junkies,” filmmaker Byron Hurt concluded that an addiction to soul food is killing African-Americans at an alarming rate.

The movie, which will premiere on January 14 on U.S. public broadcasting television, examines how black cultural identity is linked to high-calorie, high-fat food such as fried chicken and barbecued ribs and how eating habits may be changing.

In the deeply personal film, Hurt details his father’s fight and eventual death from pancreatic cancer. A high-fat diet is a risk factor for the illness, according to researchers at Duke University in North Carolina.

“I never questioned what we ate or how much,” 42-year-old New Jersey-based Hurt says in the film that travels from New Jersey and New York to Virginia, Georgia, Mississippi, Louisiana and Chicago.

“My father went from being young and fit to twice his size.”

Hurt, who also made “Hip-Hop: Beyond Beats and Rhymes,” decided to examine the link between calorie-loaded soul food and illnesses among blacks after his father was diagnosed in 2006.

He delves into his family history, as well as slavery, the African diaspora and the black power movement in the film and provides photographs, drawings, historic film footage and maps.

In Jackson, Mississippi, Hurt joined football fans for ribs and corn cooked with pigs’ feet and turkey necks. He also visited Peaches Restaurant, founded in 1961, where freedom riders and civil rights activists including Martin Luther King Jr. ate.

Hurt, whose family came from Milledgeville, Georgia, grew up on a diet of fried chicken, pork chops, macaroni and cheese, potatoes and gravy, barbecued ribs, sweet potato pie, collard greens, ham hocks and black-eyed peas.

“The history of Southern food is complex,” he said. “In many ways, the term soul food is a reduction of our culinary foodways.”

The origins of the diet lie in the history of American slavery, according to food historian Jessica B. Harris, who appears in the film. Slaves ate a high-fat, high-calorie diet that would allow them to burn 3,000 calories a day working, she explained.

Southern food began to be called soul food during the civil rights and black power movements of the 1960s, according to Hurt.

“There’s an emotional connection and cultural pride in what they see as the food their population survived on in difficult times,” he said.

But Hurt said African-Americans are being devastated by nutrition-related diseases.

Black adults have the highest rates of obesity and a higher prevalence of diabetes than whites, and are twice as likely to die of stroke before age 75 than other population groups, according to the U.S. Centers for Disease Control and Prevention.

Besides tradition and habit, poverty and neighborhoods without good supermarkets also contribute to an unhealthy diet, Hurt said.

“Low-income communities of color lack access to vegetables and have an overabundance of fast food and highly processed foods that are high in calories and fats. I always know when I’m in a community of color because I see … very, very few supermarkets and health food stores,” he added.

In her book, “High on the Hog: A Culinary Journey from Africa to America,” Harris said the prevalence of overprocessed foods, low-quality meats, and second- or third-rate produce in minority neighborhoods amounts to “culinary apartheid.”

In the film, Marc Lamont Hill, an associate professor of English education at Columbia University in New York, described minority health problems related to poor diet as “21st-century genocide.”

Hurt says the government can help by increasing urban access to quality food and requiring calorie counts to be displayed on restaurant menus.

Nonprofit organizations such as Growing Power Inc., which runs urban farms in Chicago and Milwaukee, provide fresh vegetables to minority neighborhoods.

Brian Ellis, 21, said all he ate was fast food when he started working at one of Growing Power’s urban farms in Chicago when he was 14.

“Then I started eating food I’d never seen before like Swiss chard,” said Ellis, who appears in the film. “I never knew what beets were. I’d never seen sprouts before. I’m not that big of a beet fan, but I love sprouts. I could eat sprouts all day.”

(Editing by Patricia Reaney and Mohammad Zargham)

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Obama, Congress set for late push on “fiscal cliff”

WASHINGTON/HONOLULU (Reuters) – President Barack Obama is due back in Washington early Thursday for a final effort to negotiate a deal with Congress to avert or at least postpone the “fiscal cliff” of tax increases and government spending cuts set to begin next week.

No specific bill dealing with the cliff was on the schedule of either the U.S. Senate or House of Representatives, which are expected to return on Thursday after the holiday break. In Congress, the corridors were almost empty and the doors to members’ rooms were locked.

Investors are closely watching the talks, concerned that going over the cliff could throw the economy into recession. U.S. stocks slipped on Wednesday after retailers reported disappointing holiday sales as shoppers tightened belts possibly due to fiscal cliff worries.

Aides and members of Congress have said that a modest, last-minute measure to avoid the spending cuts and most of the tax hikes could pass the Democratic-controlled Senate if Republicans agree not use a procedural roadblock known as a filibuster, a commitment that Senate Republican leader Mitch McConnell has so far not made.

The legislative focus continues to shift from deficit reduction to averting the immediate shock of the December 31 cliff dive.

“This is the ‘Break Glass’ scenario that we have long believed would rise in probability the closer we go to December 31, which essentially calls for extending all the rates for those individuals making under $ 200K and households under $ 250K and does not address the debt ceiling or the deficit,” analyst Chris Krueger of Guggenheim Securities wrote in a research note.

But to win approval in the Republican-controlled House of any bill that raises taxes on anyone, a rare bipartisan vote would be required. All 191 Democrats would have to team with up with at least 26 Republicans to get a majority if the bill included tax hikes on the wealthiest Americans, as Obama is demanding.

Some of those votes could conceivably come from among the 34 Republican members who are either retiring or were defeated in the November elections and no longer have to worry about the political fallout.

JANUARY SCRAMBLE?

In the alternative, Congress could let income taxes go up on everyone as now scheduled and then during the first week of January, scramble and get a quick deal to cut them back except for the highest brackets, along with a measure putting off the $ 109 billion in automatic spending cuts that most lawmakers want to avoid.

Once the clock ticks past midnight on December 31, no member of Congress would have to vote for a tax increase on anyone – taxes would have risen automatically – and the only votes would be to decrease tax rates for most Americans back to their 2012 levels.

Americans’ optimism that Obama and congressional leaders will reach a budget agreement before January 1 has waned in recent days, according to a Gallup poll released on Wednesday. Fifty percent believe a deal will be reached – a drop of 7 percentage points from the previous week – and 48 percent are doubtful. The poll was taken just after talks ran into trouble last week.

Obama and congressional lawmakers left Washington on Friday for the Christmas holiday with negotiations to avert the fiscal cliff in limbo.

The president will cut short his vacation in Hawaii and leave for Washington later on Wednesday, arriving in the capital early on Thursday.

Obama is expected to turn to a trusted Democratic ally, Senate Majority Leader Harry Reid, to help craft a quick deal.

White House aides began discussing details of the year-end budget measure with Senate Democratic counterparts early this week.

Starbucks Chief Executive Howard Schultz is urging workers in the company’s roughly 120 Washington-area coffee shops to write “come together” on customers’ cups on Thursday and Friday to send a message to sharply divided politicians.

“We’re paying attention, we’re greatly disappointed in what’s going on and we deserve better,” Schultz told Reuters.

(Additional reporting by Thomas Ferraro and Richard Cowan in Washington and Lisa Baertlein in Los Angeles; Editing by Eric Beech)

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Light Therapy Helps Ease Winter Blues

Every October as the clocks are turned back, Jose Balido notices that his mood changes, almost as if his body were going into hibernation.

His limbs are heavy and he has trouble moving around. Simple household chores like loading the dishwasher seem “insurmountable,” he said. But when spring arrives, the lethargy lifts.

“It took me a while to realize what it was,” said Balido, owner of a travel social network site, Tripatini. “I was cranky, short-tempered, depressed, feeling hopeless and having difficulty concentrating.”

Balido, 51, was diagnosed a decade ago with seasonal affective disorder or SAD. The condition affects 62 million Americans, according to Michael Terman, director of the Center for Light Treatment and Biological Rhythms at Columbia University and a leader in the field.

About 5 percent of the population experiences the most severe symptoms of SAD — depression and hopelessness — while another 15 percent have the so-called “winter blues” or “winter doldrums.”

The vast majority never fall into full depression, according to Terman, but “plod through winters with slowness and gloominess that takes effort to hide from others.”

Two decades ago, SAD was identified as a legitimate disorder by the National Institute of Mental Health. Since then, the treatment of choice has been light therapy.

Balido, who lives in Miami, sought help from Terman and now undergoes light therapy. He sits in front of a daylight simulator for a half an hour each morning before 10 a.m.

“Within two or three days, the difference was mind-blowing,” he said.

The standard treatment for SAD is 30 minutes of 10,000-lux, diffused, white fluorescent light, used early in the morning. About half the patients are helped quickly — and when treatment is tailored to a person’s individual wake-sleep cycle, remission can climb to 80 percent, according to Terman.

This year, a utility company in the northern Swedish town of Umea installed ultraviolet lights at 30 bus stops to combat the effects of SAD.

“We wanted to celebrate the fact that all our electricity comes from green sources and we wanted to do this in a way that contributed to the citizens in one way or another,” said Umea Energi marketing chief Anna Norrgard in an email to ABCNews.com.

“As it is very dark where we live this time of year, a lot of us are longing for the daylight,” she said. “A lot of us are also a bit more tired this time of year and I would also say we sleep a little bit more. …We wanted to give the citizens of Umea a little energy boost, to be more alert.”

The town is located about 400 miles north of Stockholm. In December, the sun rises at about 10 a.m. and sets around 2:30 p.m. Some towns north of the Arctic Circle have no daylight for several weeks in the winter.

Geography has a strong influence on the prevalence of SAD symptoms, according to Terman.

“The common wisdom is that it’s worse the farther north you live, because winter days are so much shorter,” he said. “Not so simple.”

Columbia research shows that in North America, the incidence of SAD rises from the southern to the middle states, but levels off and stays bad from about 38 degrees North latitude (near such cities as San Francisco, St. Louis and Washington, D.C.) up through the northernmost states and Canada, according to Terman.

But the problem becomes “more severe” at the western edges of the northern states and provinces.

“This important finding reveals the underlying trigger for relapses into winter depression, since the sun rises an hour more later at the western edge of a zone,” said Terman, whose book, “Chronotherapy,” looks at the phenomenon.

Esther Kane, a clinical counselor from Vancouver, Canada, said her practice is filled with patients as the long days descend on British Columbia.

Seasonal Affective Disorder Hits Hard in Canada

“On the West Coast where we live it’s so rampant, I can’t even tell you how many people have it,” said Kane. “Everyone is feeling it with the gray skies and rain. It’s like nighttime all the time here.”

Doctors there routinely prescribe fish oil and vitamin D, as well as light therapy to balance out the sleep hormone melatonin and “boost” the feel-good hormone serotonin, according to Kane. Many are also on antidepressants.

“A lot of people depend on alcohol and drugs all of a sudden,” she said. “They are stuffing themselves with carbs and their food intake is up. They have depression symptoms — what’s the point of getting out of bed in the morning when they feel no energy and there is dark all over them?”

“Some suffer so bad, they can’t function,” said Kane. “Everyone here who can afford to get away for two weeks in the winter, go to Hawaii.”

Even those who live south of the Mason-Dixon Line in the United States can be affected.

Tina Saratsiotis, who works for a faith-based nonprofit group in Towson, Md., was surprised to develop SAD several years ago.

“I used to be a night person and like the dark. Then something changed,” she said. “By fall when it gets darker and the fatigue and sadness comes and by Christmas, it’s difficult to function.”

“It creeps in slowly — I eat more and have trouble concentrating,” she said. “I am more irritable and weeping, like a prolonged version of PMS. It makes it hard to get things done and to enjoy things.”

Columbia’s Terman said there may be genetic influences in who gets SAD — a vulnerability to depression and to insufficient light exposure.

SAD sufferers say it’s especially hard on their relationships when their winter moods kick in.

“Now, he’s very understanding,” said Saratsiotis, who uses both light therapy and antidepressants to deal with the condition. “But before, when I didn’t feel up to going out, I couldn’t explain not feeling great. People wonder, ‘Why doesn’t she like me?’ and, ‘She’s no fun.’”

But when spring rolls around, so does her old self.

“I love the solstice — thank you, Lord, for the solstice,” she said. “I really need [the medication] now, but I may not in the spring and summer.”

But now, in when the days are their shortest, SAD puts a crimp on the holidays.

“It kills Christmas,” said Saratsiotis. “I sit in the middle of the department store with that particular song about the sleigh bells ringing, and I am sobbing. I burst into tears and think, ‘Just kill that song.’”

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‘Bumping’ Your Way to Safer Sex With a Smartphone App

Reported by Dr. Lauren Browne:

Let’s face it.  Teens have sex.  Parents may choose to ignore it, and teens may choose to deny it, but almost 50 percent of American high school students are having sex, according to the U.S. Centers for Disease Control. And each year, millions of those sexually active teens contract sexually transmitted diseases such as chlamydia, gonorrhea, syphilis, herpes and HIV.

Now one doctor hopes to curb the spread of STDs in this tech savvy group with a smartphone app that lets users “bump” their STD status.

It’s called ‘safe bumping,’” said Dr. Michael Nusbaum, the New Jersey developer of MedXSafe, a feature of the new app called MedXCom.  “If you happen to be out at a bar or a fraternity house or wherever, and you meet someone, you can then bump phones and exchange contact information and STD status.”

The app’s special feature, according to Nussbaum, encourages dating singles to go to the doctor for regular STD checks.  Those who screen negative can ask their doctors to document their STD-free status on the app, allowing users to share the information with whomever they choose.

An alarming 19 million new sexually transmitted infections occur each year, and rates of chlamydia and gonorrhea are on the rise, according to a new report released this month by the CDC.  More than 1.4 million chlamydia infections were reported in 2011, up 8 percent from the previous year.  Cases of gonorrhea were up by 4 percent, marking the second consecutive year of increases.

Nearly half of all infections occur in young people, between the ages of 15 to 24, a group that can be particularly devastated by the associated health effects.

“[Some] undetected and untreated STDs can increase a person’s risk for HIV and cause other serious health consequences, such as infertility,” said Mary McFarlane, an acting chief in the Division of STD Prevention at the CDC.  Harnessing modern social networking technology to prevent these infections may appeal to a younger tech-savvy generation.

MedXSafe is just one of several Internet-based programs devoted to easing confidential STD-status sharing between sexual partners.  Services like Qpid.me, whose slogan is Spread the Love, Nothing Else and U Should Know, designed by a former college student and his girlfriend, also allow their users to check on a partner’s STD status.

But could these services offer a false sense of security to teens who believe that, with a simple phone bump, they have the green light to have unprotected sex?

“It can take months for HIV to show up on a test,” said Renee Williams, executive director of SAFE, a nonprofit organization dedicated to abstinence education.  “So you can test negative today, go out on Friday night and have sex, and then get retested later and find out that you had HIV all along.”

The app does nothing to prevent unplanned pregnancy, and may even encourage high-risk behaviors that young people might otherwise not have been tempted to try, said Williams.

Nor is the app likely to be completely reliable, said Dr. J. Joseph Speidel, director of communication at the Bixby Center for Global Reproductive Health.

“Does it come with a condom?” asked Dr. Richard Besser, ABC’s chief health and medical editor, who’s also a pediatrician and former acting director at the CDC.

But the app’s creator said it does promote regular STD testing and encourages potential partners to openly discuss safe sex practices.

“We’re recognizing that this behavior is going to take place no matter what we do or what we say,” said Nusbaum.  “I have friends that are nuns and I’ve run this by them, and they also agree that it’s promoting safer behaviors.”

Although each program promises to keep health information strictly confidential, none are immune from cyber attacks.

But such attacks would not expose any users who have an STD, according to Nusbaum.  MedXSafe does not allow doctors to upload information about any tests that come back positive, including HIV.  A user with an infection is simply treated for the STD and then retested.  And that user is only confirmed STD-free via the app once subsequent test results come back negative.

Still, it is too early to tell whether these services will become popular with teens.  Lingering social stigma surrounding STDs might make potential partners reluctant to mention such an app when out at a party.

“It’s a big personal step to bring up using such an app,” said Noah Bloom, creator of a smartphone app called Jiber, which uses the same “bump” technology to electronically connect new friends.  “Who really wants anything in the way of getting lucky?”

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The Medical Guide to Holiday Movies

Anna Karenina lies febrile on her post-partum bed, her husband, Karenin, and lover, Vronsky, flanking her in sorrow. She repents to each, anticipating her end, and just when the romance soars to its peak, you wonder aloud — why does she have a fever? And, could this really happen?

Luckily, we’ve got Hollywood’s holiday ailments covered. Our unofficial disease guide takes a shot at unraveling the medical mysteries you’ll see woven throughout the biggest hits of the season.

Medical Guide to Holiday Movies

Denzel Washington plays a drug-addicted, alcoholic airline pilot who executes a miracle crash landing but is later blamed for the incident.

ALCOHOLISM

It turns out that drinking and flying is relatively rare. But that wasn’t true in the 1960s. A landmark article on aviation and alcohol found that in 35 percent of all fatal airline accidents in 1963, the pilots had measurable levels of alcohol in their blood. A disproportionate amount of these accidents occurred at night and most occurred within the first half-hour of flight.

So how does alcohol affect flight performance? One scientific article reports that blood alcohol concentrations in the range of 0.03 to 0.05-percent can impair performance of tasks like tracking radio-frequency signals, airport traffic control vectoring, traffic observation and avoidance, and aircraft descent. That’s about the amount present after just one drink for an average size adult.

POST-TRAUMATIC STRESS SYNDROME (PTSD)

According to the book, Aviation Mental Health, pilots may be at risk for PTSD if they’ve ever experienced an aircraft mishap or near mishap. Because of this, the airline industry has a program in place called the Critical Incident Response Program that guides pilots through any potential PTSD inciting events. In addition to this, Federal law requires that all airline employees and their families have access to such counseling programs when faced with significant incidents like aircraft accidents.

When it comes to needing medication however, pilots face a double-edged sword. While counseling services for psychiatric conditions like PTSD are not reportable to the FAA, the use of certain medications is. Pilots are required to report use of any psychotropic medications beyond common antidepressants and refrain from flying until they are medication-free.

Medical Guide to Holiday Movies

Daniel Day-Lewis and Sally Field recreate the spirit of America’s first power couple and highlight the staggering height difference between Abe and Mary Todd.

MARFAN SYNDROME

At 6 feet, 4 inchesl, Abe Lincoln towered nearly 9 inches taller than the average 1860s man. Like a taupe, tailless Na’vi from the movie Avatar, his long legs and spidery fingers intimidated adversaries near and far. But his stately frame was more than just a normal variant. Historians have speculated that Lincoln was afflicted with a rare genetic disorder called Marfan syndrome. The disorder affects connective tissues in the body, causing skeletal abnormalities, and problems with the heart, eyes, and lungs. In addition to being extraordinarily tall, people with Marfan’s are often lanky, with long, slender limbs (dolichostenomelia) and fingers (arachnodactyly).

Some experts argue however that Lincoln instead had a condition called multiple endocrine neoplasia type 2, or MEN2. People with this disorder can also be unusually tall. Either way, his condition would have gone unnamed during his lifetime as Dr. Antoine Marfan, the French pediatrician who first described the condition, didn’t do so until 1896—well after President Lincoln’s untimely death.

Medical Guide to Holiday Movies

Keira Knightly stars in yet another period piece, this time portraying Leo Tolstoy’s beloved, Anna Karenina — a 19th century Russian aristocratic beauty caught in a nasty love triangle.

ENDOMETRITIS

Shortly after giving birth, Karenina experiences a high-grade fever that sends both her lovers to their knees, anticipating the worst. Puerperal fever, or endometritis as it’s now called, was known historically as “the doctor’s plague.” With no concept of germs, doctors often had no reason to wash their hands before attending to births. As such, they often precipitated such post-partum infections, giving thousands of women a simultaneous childbed and deathbed.

Other famous victims include Elizabeth of York, King Henry VIII’s mother, and his third wife, Jane Seymour. It is worth noting that, with the advent of antibiotics and modern-day hygiene, the chances of dying from a post-partum infection today are now incredibly rare.

Medical Guide to Holiday Movies

An all-star cast brings this classic tale of love and loss to the big screen this Christmas Day. And given its historical precedence, we’ll assume we’re not spoiling too much by first announcing Fantine’s death before diving into an explanation of the disease that kills her.

TUBERCULOSIS

Was there ever a more culturally documented medical affliction than consumption, or tuberculosis as it’s known medically? Perhaps not, and that’s why we see so many references to it in popular literature, music and film. Les Miserables is the latest creation to highlight the devastating effects of an infectious disease still commonly seen in third world countries.

TB is a contagious bacterial infection that attacks the lungs and less commonly, other organs. It causes fever, night sweats, weight loss, and sometimes hemetemesis—the coughing up of blood. It’s no wonder that folklore has often associated this disease with vampirism. An article in the American Journal of Physical Anthropology reports that prior to the Industrial Revolution, people interpreted the subsequent deaths of TB patients’ family members as proof that the initial victim was draining them of their lives. In other words, patient zero coughed up blood and therefore, was a vampire.

Today, some countries vaccinate against tuberculosis with a strain of the live, but weakened form of bacteria that infects cows. The vaccine works for only a limited amount of time and its efficacy is limited by geographic region. In the U.S., doctors screen only high risk populations like health care workers and recent immigrants.

Medical Guide to Holiday Movies

Bilbo Baggins returns in this prequel to Lord of the Rings, leading a group of dwarves on a riveting adventure through Middle Earth.

DWARFISM

Is it the hobbits that are really short or the elves that really tall? It’s all relative when it comes to height. If we assume however, that hobbits truly are little people, then it’s safe to say this is a generalized condition that’s associated with upwards of 200 different medical conditions. Either way, the National Institutes of Health defines a dwarf as someone of very short stature — usually under 4’10″ as an adult. Almost 70 percent of all dwarfism cases are due to a condition called achondroplasia, which is a genetic disorder affecting up to 1 in 15,000 people.

Dwarfism itself is not a disease and most little people go on to live healthy, long, and normal lives. Historical prejudice however, often led to their stigmatization as a different kind of being. During the Holocaust, the Nazis went so far as to conduct medical experiments on little people. A shocking example of this was German doctor Josef Mengele’s human zoo — a collection of different looking Jewish prisoners, including a family of dwarves called the Ovitzes.

OBSESSIVE COMPULSIVE DISORDER (OCD)

Greedy little Gollum exhibits the classic signs and symptoms of obsessive compulsive disorder. His obsession with the One Ring is concerning for an all-consuming, socially isolating disorder that nearly 1.5 percent of Americans experience. OCD is an anxiety disorder that causes repetitive, unwanted thoughts or behaviors, often plaguing its victims on a daily basis.

Luckily for patients with OCD, there are many treatment options available. Whether or not Gollum can access these in Middle Earth is an entirely different issue.

Medical Guide to Holiday Movies

Vampires are not real… or are they?

PORPHYRIA

In 1963, an article from the Proceedings of the Royal Society of Medicine entitled, “On Porphyria and the Aetiology of Werwolves” made the case for real life creatures of the night. The paper argued that these so-called beasts were, in fact, humans suffering from congenital prophyria. It references run-ins with these creatures by Pliny, Herodotus, and Virgil, and even offers photographic evidence of the scarring and mutilated human faces that could easily be mistaken for beast.

In 1985, biochemist David Dolphin furthered this association with his widely popularized scientific paper, “Porphyria, Vampires, and Werewolves: The Aetiology of European Metamorphosis Legends.” Not surprisingly, medical experts criticize this and other references for being both fake and promoting of an anti-porphyria stigma.

Porphyria itself is a disorder of the enzymes involved in red blood cell production. It causes neurologic complications and skin problems when affected people are exposed to light. Photosensitivity, blisters, itching, and swelling are just some of the symptoms that no doubt led to a corollary to vampirism. But if sun causes your skin to peel off, doesn’t it make sense that you’d avoid daylight?

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South Africa’s Mandela to remain in hospital for Christmas

JOHANNESBURG (Reuters) – Former South African President Nelson Mandela continues to respond to treatment more than two weeks after being taken to hospital in Pretoria and will remain there for Christmas Day, the presidency said on Monday.

The 94-year-old anti-apartheid hero and Nobel Peace laureate has been treated for a lung infection and gallstones after being hospitalized on December 8.

President Jacob Zuma said in a statement that Mandela “will recover from this episode with all our support… We also humbly invite all freedom loving people around the world to pray for him.”

It will be the first Christmas that Mandela has spent away from home since 1989, when he was still in prison. He was jailed for almost three decades for his role in the struggle against white minority rule.

He was released in 1990 and went on to use his prestige to push for reconciliation between whites and blacks as the bedrock of the post-apartheid “Rainbow Nation”.

Mandela was elected South Africa‘s first black president in 1994. He stepped down five years later after one term in office and has been largely removed from public life for the last decade.

(Reporting and writing by Ed Stoddard; Editing by Stella Mapenzauswa and Tom Pfeiffer)

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Former President George H.W. Bush remains hospitalized

(Reuters) – Former President George H.W. Bush, who has been hospitalized for a month undergoing treatment for bronchitis, may not be released from a Houston hospital in time to celebrate Christmas at home as doctors had hoped.

Bush, 88, remained in stable condition and doctors were optimistic he would make a full recovery, George Kovacik, a spokesman at Methodist Hospital, said in an emailed statement on Sunday.

But doctors were being “extra cautious” with his care and no discharge date had been set, the statement said. Earlier this month, Kovacik said doctors expected Bush would be able to spend Christmas at home with his family.

“His doctors feel he should build up his energy before going home,” the statement said.

Bush, the 41st president and a Republican, took office in 1989 and served one term in the White House. The father of former President George W. Bush, he also is a former congressman, U.N. ambassador, CIA director and vice president for two terms under Ronald Reagan.

(Reporting by Kevin Gray; Editing by Daniel Trotta and Vicki Allen)

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Former President George H.W. Bush remains hospitalized

(Reuters) – Former President George H.W. Bush, who has been hospitalized for a month undergoing treatment for bronchitis, may not be released from a Houston hospital in time to celebrate Christmas at home as doctors had hoped.

Bush, 88, remained in stable condition and doctors were optimistic he would make a full recovery, George Kovacik, a spokesman at Methodist Hospital, said in an emailed statement on Sunday.

But doctors were being “extra cautious” with his care and no discharge date had been set, the statement said. Earlier this month, Kovacik said doctors expected Bush would be able to spend Christmas at home with his family.

“His doctors feel he should build up his energy before going home,” the statement said.

Bush, the 41st president and a Republican, took office in 1989 and served one term in the White House. The father of former President George W. Bush, he also is a former congressman, U.N. ambassador, CIA director and vice president for two terms under Ronald Reagan.

(Reporting by Kevin Gray; Editing by Daniel Trotta and Vicki Allen)

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China probes Yum Brands’ KFC over safety of chicken products

SHANGHAI (Reuters) – Yum Brands Inc‘s fast-food chain KFC was supplied with chicken in China that contained excessive amounts of antibiotics, said food safety authorities investigating allegations of tainted KFC products.

The finding by the Shanghai Food and Drug Administration (SFDA) deals a blow to KFC’s reputation in China, where it is facing fierce competition from the likes of Taiwanese-owned fried chicken chain Dico and Japanese-style noodle chain Ajisen (China) Holdings Ltd. Yum Brands has forecast a drop in same store China sales in the fourth quarter.

Eight of the 19 batches of chicken samples Yum Brands sent to a testing laboratory in 2010 and 2011 contained overly high levels of antibiotics, the SFDA said in a statement on its Website late on Thursday.

An investigation is underway to determine whether Yum Brands had taken corrective measures at that time, and the Louisville, Kentucky-based company may face harsh penalties if the probe showed laws had been violated, the SFDA said.

Shares in Yum Brands have slumped 4 percent since December 18 when China’s state television CCTV reported that some poultry suppliers in eastern Shandong province had fed chickens with anti-viral drugs and hormones to accelerate their growth.

The SFDA is looking into the CCTV report and has not released its findings yet, but authorities in Shandong have already shut two chicken farms in eastern China, including one that supplied KFC and McDonald’s Corp, the official Shanghai Daily newspaper reported on Thursday.

Officials at Yum Brands in China could not be immediately reached for comment.

KFC’s subsidiary in China has pledged to cooperate with the authorities, while McDonald’s wrote on its official microblog that its chicken and raw materials pass through independent, third-party laboratory tests.

Shares in Yum Brands, which also owns Pizza Hut and Taco Bell, closed 1 percent lower at $ 69.49 in New York on Thursday.

China has been trying to stamp out health violations that have dogged the country’s food sector amid reports of fake cooking oil, tainted milk and even exploding watermelons. In 2008, milk laced with the industrial chemical melamine killed at least six children and sickened nearly 300,000.

(Reporting by Samuel Shen and Kazunori Takada; Editing by Ryan Woo)

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Long-lived bats offer clues on diseases, aging

HONG KONG (Reuters) – The bat, a reservoir for viruses like Ebola, SARS and Nipah, has for decades stumped scientists trying to figure out how it is immune to many deadly bugs but a recent study into its genes may finally shed some light, scientists said on Friday.

Studying the DNA of two distant bat species, the scientists discovered how genes dealing with the bats’ immune system had undergone the most rapid change.

This may explain why they are relatively free of disease and live exceptionally long lives compared with other mammals of similar size, such as the rat, said Professor Lin-Fa Wang, an infectious disease expert at the Duke-NUS Graduate Medical School in Singapore who led the multi-centre study.

“We are not saying bats never get sick or never get infections. What we are saying is they handle infections a lot better,” Wang said in a telephone interview.

What was missing from both species of bats was a gene segment known to trigger extreme, and potentially fatal, immune reactions to infections, called the cytokine storm.

Cytokine storms end up killing not only offending viruses in the body, but the host’s own cells and tissues too.

“Viruses rarely kill the host. The killing comes from the host’s immune response. So it looks like what bats are doing is depress the inflammation (cytokine storm). If we can learn that, we can design drugs to minimize the inflammation damage and control viral infection,” Wang said.

The study, which saw the participation of researchers from China, Denmark, Australia and the United States, was published on Friday in the journal Science.

Compared with other mammals of similar size, bats live a long time, with lifespans of between 20 and 40 years. Rats live between 2 and 3 years, on average.

IMMUNE GENES LINKED TO FLIGHT

Interestingly, Wang and his colleagues found that the highly evolved genes that give bats their superior immune system also enable them to fly.

Out of more than 5,000 types of mammals on the planet, bats are the only one capable of sustained flight and some species can fly more than 1,000 km in a single night.

Such intense physical exertion is known to produce toxic “free radicals” that cause tissue damage and it is these same genes that give the bat the ability to repair itself, Wang said.

“What we found was the genes that evolved fastest were genes involved in repairing DNA damage. That makes sense … because when you fly, metabolism goes up and it generates free radicals that are toxic to cells,” Wang said.

“Because bats fly, they (would have had) to evolve and adapt … to get genes that can repair DNA damage.”

Wang said we have much to learn from the bat, which has evolved to avoid disease and live exceptionally long lives.

“Cancer, ageing and infectious disease, these are the three major areas of concern for people,” he said.

“We have studied rats for 150 years to understand how to do better in these three areas. Now we have a system, the bat, that has done very well in evolution. We can learn from the bat. With modern techniques, we can design new drugs to slow down the ageing process, treat cancer, fight infections.”

(Editing by Robert Birsel)

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