Friday, July 24, 2009

News Clipping Archives

 

 

Maryland / Regional

Md Reports Its 4th Swine Flu Related Death (WBAL Radio Baltimore)

Eastern Shore adult dies from swine flu (USA Today)

O'Malley invites public to submit ideas for state savings (Baltimore Sun)

O'Malley wants advice on budget (Annapolis Capital)

State budget cuts felt in Carroll (Baltimore Sun)

Md. university system board to discuss budget cuts (Daily Record)

Hospice nurse charged with stealing medicine (USA Today)

Patient faces attempted murder charge (Cumberland Times-News)

Nutrition basics key to preventing obesity (The Gazette)

Keeping Clean to Help Prevent Spread of Disease (Washington Post)

Fair a good learning experience for young 4-Hers (Cumberland Times-News)

Preparing for Fall (Washington Post)

Black Presidents Lead Area Hospitals (Baltimore Afro-American)

Parents of disabled teen sue Md swim club (Daily Record)

Columbia man who killed mom to remain at state mental hospital (Baltimore Sun)

Kent pollution cleanup stalls (Baltimore Sun)

Water pumping station being built at APG  (The Aegis)

Youth's parents sue swim club for brain damage (Baltimore Sun)

St. Joseph reaches settlement with U.S. (Baltimore Sun)

FTC issues complaint against Carilion Clinic (USA Today)

Nearly 2,000 show up for free health care in Va. (USA Today)

 

National / International

Obama Visits Clinic Known for Quality Care, Controlling Costs (Washington Post)

Report: FEMA mishandled toxins in trailers (USA Today)

Radioactive Drug for Tests Is in Short Supply (New York Times)

Two Dietary Supplements Said to Contain Steroids (New York Times)

Getting Good Value in Health Care (New York Times)

Swine Flu May Cause Seizures in Children (New York Times)

H1N1 Flu Linked to Neurologic Complications in Children (Medscape News)

Comatose H1N1 Victim Gives Birth (CBS News)

H1N1 flu shots ready in months, winter a risk-WHO (Reuters)

EU Panel To Review H1N1 Vaccines Before Flu Season (Wall Street Journal)

AP Interview: WHO flu chief: World still 'relatively early' in swine flu Pandemic (Baltimore Sun)

Arab Health Ministers Impose Age Limits on Hajj to Limit Flu (Voice of America News)

Researchers: Zimbabwe's economic crisis driving HIV decline - fewer sugar Daddies (Baltimore Sun)

 

Opinion

Farms and Antibiotics (New York Times Editorial)

Too many crab licenses (Daily Record Editorial)

Faith program to save lives, ease stigma of HIV/AIDS (Baltimore Sun Commentary)

Viewpoint: Is 'Big Food' the next Big Tobacco? (Baltimore Sun Commentary)

Everyone Wins With Drug Patent Settlements (Washingto Post Letter to the Editor)

 

Maryland / Regional

Md Reports Its 4th Swine Flu Related Death

 

By Scott Wykoff

WBAL Radio Baltimore

Friday, July 24, 2009

 

The Maryland Department of Health and Mental Hygiene is reporting the state's fourth death associated with swine flu to the Centers for Disease Control and Prevention.

 

The latest report involves an adult from the Eastern Shore with no immediately apparent underlying medical condition or risk factors. Further investigation into the cause of death is underway. As before, personal details about the case, including age, gender and specific jurisdiction of residence, are not being released by the DHMH.

 

A department spokeswoman tells WBAL News this is the first death in Maryland, where the patient did not have any other underlying medical condition or risk factor.

 

The CDC reports as of July 17, 2009 that 263 people nationwide have died after contracting novel H1N1 influenza. In the Mid-Atlantic region, Virginia has reported two H1N1 flu-related deaths, Pennsylvania has reported eight and New Jersey has reported 14.

 

"We are saddened to report yet another death that has been associated with the novel H1N1 influenza," said John M. Colmers, DHMH Secretary. "The H1N1 flu death of someone without apparent underlying medical conditions reminds us of just how serious influenza can be, even in otherwise healthy unvaccinated individuals. More H1N1 flu-related deaths are expected, as we would normally see with seasonal flu. We continue to urge all Maryland families to take this H1N1 flu seriously. While we wait for the development and delivery of a vaccine, everyone should remain vigilant and take precautions to protect themselves and their loved ones."

 

WBAL Radio Baltimore http://wbal.com/ .

 

Eastern Shore adult dies from swine flu

 

Associated Press

USA Today

Friday, July 24, 2009

 

BALTIMORE (AP) — Maryland health officials say a fourth person has died from swine flu.

 

The Maryland Department of Health and Mental Hygiene announced the death Friday morning, saying the Eastern Shore resident didn't have any apparent illnesses or risk factors, unlike the first three cases.

 

Officials wouldn't release more details about the person but say a medical investigation into the cause of death was taking place.

 

Department Secretary John Colmers says the death of someone without apparent underlying medical conditions is a reminder of how serious swine flu can be even for healthy, unvaccinated adults.

 

Department officials say more deaths are expected with swine flu and seasonal flu. They say people should take swine flu seriously until a vaccine is developed.

 

Copyright 2009 The Associated Press. All rights reserved.

 

O'Malley invites public to submit ideas for state savings

 

By Laura Smitherman

Baltimore Sun

Friday, July 24, 2009

 

One visitor to Gov. Martin O'Malley's Web site suggested that all government offices close their doors for one day a month. Another suggested a contest among state employees for who can devise the best cost-cutting ideas.

 

And one person pointed out a relative for costing the state money by fraudulently receiving food stamps.

 

Those were some of the submissions to O'Malley's newly launched online suggestion box. As the Democratic governor works with his Cabinet to identify at least $420 million in budget cuts to balance this year's spending plan, he said he's open to ideas from people outside his inner circle in Annapolis about programs that could be axed or savings that could be achieved.

 

"We encourage all citizens to join in," O'Malley said when announcing the launch of the Web page Thursday. "Tradition is not a good enough excuse for continuing to do something in a suboptimal way."

 

O'Malley has undertaken several rounds of budget cuts as the economy tanked and proposed $280 million in trims this week that were approved by the Board of Public Works. The governor has to carve at least $700 million from this year's budget before tackling another shortfall of more than $1 billion in next year's budget when the General Assembly reconvenes in January.

 

While the governor has indicated the next round of budget cuts will be done by Labor Day and will target aid to local governments and state employee compensation, final decisions have not been made. The governor's aides said suggestions could be made anonymously, and that department heads plan to encourage state workers to participate.

 

O'Malley also hopes to recruit to the budget-cutting effort a consultant, David Osborne, who co-wrote the best-selling book Reinventing Government and helped run a task force on that topic for former Vice President Al Gore.

 

It's not clear how much Osborne's services would cost; details of an arrangement have not been worked out. But Shaun Adamec, a spokesman for the governor, said any efficiencies that Osborne identifies would far outweigh the expense of having him on board.

 

To make your suggestions about how to cut the state budget, go to: www.governor.maryland.gov/budgetcuts.asp

 

Copyright © 2009, The Baltimore Sun.

 

O'Malley wants advice on budget

Encourages suggestions on what should be cut next

 

By Liam Farrell

Annapolis Capital

Friday, July 24, 2009

 

Gov. Martin O'Malley wants your help. He isn't offering a contract or an appointment, but a chance to take part in the solution to Maryland's latest fiscal crisis.

Advertisement Learn to Live

 

Faced with a dwindling list of options, O'Malley announced during the public portion of a Cabinet meeting in Annapolis yesterday that Marylanders can submit comments or suggestions online as his administration struggles to find $700 million in cuts by Labor Day.

 

The Board of Public Works sliced more than $280 million from the budget on Wednesday, and the governor believes local aid to county governments and employee salaries will pop up in the next $420 million package.

 

All that is clear so far is what the governor doesn't want to do: cut education, release inmates early, or lay off large groups of state employees.

 

"We encourage all citizens … to join in the deliberation," O'Malley said.

 

Suggestions received so far include combining the trips for transporting files between correctional facilities and shutting down all state agencies one day a month, he said.

 

During the open part of the meeting, O'Malley also told his Cabinet the government needs to begin creating long-range budget reduction plans instead of finding quick ways to fill financial holes.

 

Wednesday's meeting was the fifth time during the governor's tenure the Board of Public Works has made emergency spending reductions.

 

"Typically it was a scenario where we all hoped it might be the last time," O'Malley said. "The time crunch … perhaps limited our range of options, the actions we might have taken if we had a year's time to plan for a transition."

 

The governor said the government has to develop strategies to match long-term economic forecasts and get "enterprisewide" goals. The administration is also bringing in David Osborne, a consultant and former aide to Vice President Al Gore who has authored several books on changing government budgeting and adapting to declining revenues.

 

"Tradition is not a good enough excuse for continuing to do something in a sub-optimal way," O'Malley said.

 

Some legislators are still waiting to see a comprehensive solution to the problem. Del. Steve Schuh, R-Gibson Island, one of the leading fiscal voices of the Republicans in the General Assembly, said the first rounds of cuts was a "positive but small first step."

 

Even the $1.6 billion deficit projected for fiscal 2011 could be understated if the state's assumptions on economic growth turn out to be optimistic, he said. Until the governor and legislature seriously consider eliminating mandated formulas driving budget growth, spending will continually outstrip revenues.

 

"The Maryland state budget will lurch from crisis to crisis perpetually until those formulas are eliminated," Schuh said. "It is really shortsighted thinking."

 

SOUND OFF

If you have ideas on how the state can close its budget gap, you can post them online at  www.governor.maryland.gov/budgetcuts.asp.

 

Copyright 2009 Annapolis Capital.

 

State budget cuts felt in Carroll

Springfield Hospital Center to see $317k reduction

 

Carroll Eagle.com

By Charles Schelle

Baltimore Sun

Thursday, July 23, 2009

 

Wednesday’s approval of $280 million cuts in the state’s fiscal 2010 budget is making its way to Carroll County.

 

The Maryland Board of Public Works unanimously approved the cuts Wednesday to help address a projected budget shortfall of more than $700 million. The governor, treasurer and comptroller compose the board.

 

One place affected is Springfield Hospital Center in Sykesville.

 

As part of cuts to various psychiatric hospitals, Springfield’s budget will be reduced by $317,208, making the hospital’s budget $74,483,647, said Karen Black, spokeswoman for the Department of Mental Health and Hygiene.

 

The move is to reduce the amount that is spent on per patient, said Valerie Roddy, chief-of-staff for the deputy secretary of behavioral health and disabilities.

 

“You're really reducing the cost of providing services,” she said.

 

Those costs include reducing overtime and operating more efficiently, Black said.

 

Another cut includes eliminating the Community Legacy grant from the state’s Department of Housing and Community Development.

 

The town of Sykesville had just approved two applications on July 13 for the $200,000 grant to improve a parking lot at the Warfield Commerce and Cultural Center and another for $135,000 to improve Main Street businesses’ façades.

 

It is unclear as of yet how much Carroll County Government will be affected by this round of cuts, said Ted Zaleski, Carroll County’s director of management and budget. It’s the next round he’s worried about.

 

“There’s not a whole lot,” he said. “In August, (the Board of Public Works) intend to cut another $470 million and will be looking toward the counties.”

 

From what Zaleski could tell, the latest cuts could affect funds for gypsy moth spraying, money to offset inflation given to community provider agencies such as the ARC of Carroll County and a possible cut to local management board administrations.

 

That final one might mean a service cut from what Zaleski said he read elsewhere, but the descriptions into what the cuts exactly mean need to be figured out.

 

“Some of this is hard to immediately know what it exactly means,” he said.

 

Copyright 2009 Baltimore Sun.

 

Md. university system board to discuss budget cuts

 

Associated Press

Daily Record

Friday, July 24, 2009

 

The Board of Regents for the University System of Maryland will discuss how the system will handle another $40 million in budget cuts.

 

Chancellor William Kirwan says he scheduled a conference call for board members on Thursday to talk about the cuts, but not tuition.

 

P.J. Hogan, associate vice chancellor for government relations, says the regents will likely cut back offices and support functions that students, faculty or parents would notice.

 

Hogan says the regents won't consider any tuition increase to affect the upcoming school year, but they may consider one for next school year.

 

Copyright 2009 Daily Record.

 

Hospice nurse charged with stealing medicine

 

Associated Press

USA Today

Friday, July 24, 2009

 

NEW CASTLE, Del. (AP) — New Castle County police have charged a 30-year-old hospice nurse with stealing prescription drugs from a dying woman.

 

Jennifer Williams of Delaware City is charged with stealing morphine and a marijuana derivative from the 81-year-old woman, who died early Wednesday.

 

Investigators said Williams was assigned to the woman's home Tuesday night and immediately began acting strangely, prompting family members to spend the night at the home.

 

After the woman died, a second nurse called in to pronounce her dead noticed that Williams was incoherent and unable to stand.

 

Police said Williams, who is seven months pregnant, had ingested the drugs. She was admitted to a Wilmington hospital.

 

Copyright 2009 The Associated Press. All rights reserved.

 

Patient faces attempted murder charge

 

From Staff Reports

Cumberland Times-News

Thursday, July 23, 2009

 

CUMBERLAND — A Finan Center resident was choked into unconsciousness and taken to Memorial Hospital by ambulance following an alleged assault late Wednesday at the state-owned psychiatric hospital on Country Club Road.

 

Another resident was charged in the incident and also for alleged assault of a third resident that occurred there earlier in the day.

 

The 49-year-old victim was administered CPR by a staff member before she was taken to the hospital by a Cumberland Fire Department ambulance after the facility called the Allegany County 911 center at 10:35 p.m.

 

No further information was available concerning the victim’s injuries or medical condition.

 

After investigating the incident that occurred in Cottage 2 of the institution, Allegany County Bureau of Police arrested a 19-year-old resident of Cottage 2 on charges of attempted second-degree murder, first-degree assault, two counts of second-degree assault and reckless endangerment.

 

The defendant was initially detained on $100,000 bond Thursday before being taken to another state medical facility, police said.

 

Police said the accused resident allegedly placed a belt around the victim’s neck and strangled her to the point of unconsciousness. CPR was then used by a staff member to revive the victim before she was taken to the hospital.

 

The charges also related to another Cottage 2 resident, age 42, who was allegedly struck in the head with a fist sometime Wednesday prior to the Bureau of Police being notified.

 

The earlier victim apparently did not seek medical treatment.

 

Both incidents remain under investigation by the Bureau of Police, which withheld names of the residents.

 

Copyright © 1999-2008 cnhi, inc.

 

Nutrition basics key to preventing obesity

Library series looks at nutrition, obesity

 

By Katherine Mullen

The Gazette

Thursday, July 23, 2009

 

Compare a soda bottle's size in 2009 to a bottle made 20 years ago, and chances are that today's is three times as big and has an extra 165 calories.

 

That's the conclusion that Jennifer Mayer, a community health advocate for Priority Partners, presented July 14 during C. Burr Artz Library's workshop on nutrition basics and obesity prevention.

 

The workshop was the second in the three-part series, "Nutrition on a Nickel and Dime Budget," that aims to provide city residents with tips and tools to reduce grocery bills, watch portion sizes and make healthy choices. Priority Partners is a group that provides healthcare for Medicare and Maryland Children's Health Insurance recipients.

 

According to Mayer, portion sizes have increased dramatically in several decades partly because of a surplus of grains, the invention of less expensive means of food production and cultural shifts in attitudes toward food.

 

"It was a treat," Mayer said of soda decades ago. "It wasn't something you had every day."

 

She urged the group to make half of their diets whole grain, eating leafy, green vegetables and two cups of fruit a day. Meat portions should be no bigger than a deck of cards, Mayer said, and use products such as margarine, shortening, beef or chicken fat and butter sparingly.

 

In 2005, the United States Department of Agriculture released new dietary guidelines and revised its food pyramid for healthy eating. According to these dietary guidelines, a healthy diet is one rich in fruits and vegetables, whole grains, low-fat dairy and lean meats and limits saturated fats, cholesterol and sugars.

 

The refining process of grains into products such as white bread, flour and white rice, strips the grain of its fiber, B-vitamins and iron, Mayer said, and extends its shelf-life. Likewise, if food doesn't have an expiration date, "you might want to reconsider," she added.

 

E-mail Katherine Mullen at kmullen@gazette.net.

 

"Nutrition on a Nickel and Dime Budget" sessions are free and held at C. Burr Artz Library, 110 E. Patrick St., Frederick. Call 301-600-1630 or visit www.fcpl.org for more information.

 

-1 p.m., Aug. 22: "Living Vibrantly"

-Eat breakfast every day

-Choose more whole grains

-Take home half of your restaurant meal

-Share dessert

-Add flavor, not fat

 

Copyright 2009 The Gazette.

 

Keeping Clean to Help Prevent Spread of Disease

 

By Marilyn D'Angelo

Washington Post

Friday, July 24, 2009

 

Mother knew best when she told you to wash your hands before every meal and after you go to the bathroom. These days, following habits like those could be the deciding factor in maintaining your health. With the world still abuzz from the swine flu outbreak and E. coli-infected cookie dough, hand washing is an even more integral part in preventing the spread of many infectious diseases and viruses that can be passed on through a gesture as simple as a handshake.

 

Washing your hands properly with soap and water can drastically reduce germs that host diseases and viruses. "It's a good idea to sing 'row, row, row your boat' [while doing it] -- it really takes 15-20 seconds," said Marcia Patrick, a nurse and Director of Infection Prevention and Control for MultiCare Health System in Tacoma, Washington. "It's that mechanical removal and that's why you can't do it in 7 seconds."

 

Some colleges have also taken an initiative in spreading this message. James Welsh, Georgetown University's assistant vice president for student health services and chair of the Department of Family Medicine has done his best to keep the campus "sensitized to hand washing." Though Georgetown has had four students diagnosed with the H1N1 virus, their public health campaign has kept the spread of swine flu to a minimum. There are nearly 100 hand sanitizer dispensers on campus in many common areas, like the student center, cafeteria, and restrooms as well as some not so common places.

 

"We have some attached to trees and bus stop poles. It's a constant reminder that hand washing is extremely important," said Welsh. "Everyone is concerned in the fall and the early winter we may see possibly higher rates of influenza. I sure hope we get a [swine flu] vaccine, but until then these are the tools we have."

 

When soap and water are not available, Patrick supports the use of hand sanitizer instead. "Think about what we do every day. We go to the drive-thru and we don't have a sink in our car. I gel my hands before I start eating my lunch."

 

The FDA recommends an alcohol based sanitizer with a 60 to 95 percent ethanol or isopropanol concentration. Antimicrobial hand sanitizers are not effective in reducing bacterial counts on hands. According to a 2006 report from the Emerging Infectious Diseases Journal, "hand sanitizers were effective in reducing gastrointestinal illnesses in households, in curbing absentee rates in elementary schools and in reducing illnesses in university dormitories."

 

Domininon Virginia Power, based in Richmond, Va., like many other businesses, is responding to H1N1, by distributing posters and setting up a Web site for their employees to keep them updated on developments and provide tips, such as flu hygiene reminders, said Karl R. Neddenien, a spokesperson for Dominion Virginia Power.

 

"The tips include a specific suggestion for keeping alcohol-based hand cleanser nearby and using it often," he said. Washing hands often, coughing into the crook of your arm and even avoiding shaking hands. "Things we all know, but it pays to be reminded about."

 

They also have liquid hand sanitizer in all of their common work areas in each of their offices in Virginia, North Carolina, Connecticut, Pennsylvania and Ohio.

 

Washing and sanitizing hands may also prevent illnesses obtained from handling raw or uncooked food, or cooking with utensils that have touched contaminated food. Bacteria like E. coli has recently caused outbreaks associated with meat and spinach. The most recent contamination was found in Nestle raw cookie dough. E. coli is known to cause severe stomach cramps, diarrhea, and vomiting. It can be obtained by eating or handling food with the bacteria. Washing your hands is the first step in protecting yourself from contracting E. coli, or spreading it to other people and throughout your kitchen.

 

"There are several things people can do in their kitchens to protect themselves," said Patrick. "Assume that all chicken has salmonella, all ground beef has E. coli." Make sure you cut all the veggies first and wash all your surfaces after handling raw meats.

 

Patrick recommends using a plastic cutting board over the wooden ones for easy sanitization. "With steak, I never use a fork, only a spatula," said Patrick. "If there's surface contamination on the steak, poking it with a fork would drive it into the center of the steak that may not be quite as hot." Making sure to change utensils when switching between raw and cooked foods is also important in keeping the spread of disease down in the kitchen.

 

When cleaning up, Patrick recommends cleaning cutting boards with hot soapy water and using a bleach solution of one part bleach to nine parts water. "You can use that anywhere, but it's not a cleaner, it's a disinfectant. It's cheap, it's readily available, but it needs to be mixed fresh daily," she said.

 

There have also been efforts by the federal government to create new standards in food safety and awareness. The Food and Drug Administration is developing new industry guidelines to improve protections for leafy greens, melons, and tomatoes. The Department of Health and Human Services has also recently begun working with the Food Safety Working Group to implement these upgrades. These changes may not reach consumers for months, but people can be more diligent about washing their hands today.

 

Copyright 2009 Washington Post.

 

Fair a good learning experience for young 4-Hers

 

By Kristin Harty

Cumberland Times-News

Thursday, July 23, 2009

 

CUMBERLAND - The carnival rides hadn’t opened and the crowds hadn’t arrived when the hog got loose at the Allegany County Fair and Ag Expo.

 

Squealing and grunting and kicking up dust, he crashed into a table and squeezed past several gates, sending half a dozen humans in hot pursuit.

 

“Watch that hog!” said Katelin Lechliter, who, after a 2-minute chase finally corralled the 200-pound animal into a pen Thursday afternoon.

 

A 4-H veteran, Lechliter barely broke a sweat.

 

This sort of thing happens at the county fair, she said.

 

“It’s just really fun, and it’s a good learning experience,” said Lechliter, 17, of Rawlings, who has raised - and probably chased - lambs, rabbits, hogs, a horse and a steer during her four years in 4-H.

She’d been hosing off her two hogs, Lucy and Ricky, just before the Great Escape.

 

“You learn a lot of responsibility,” Lechliter said.

 

Elsewhere at the Allegany County Fairgrounds, things were quieter Thursday afternoon.

 

Most rabbits and hogs napped through the heat of midday, and small clusters of fairgoers wandered through the Exhibit Hall to see displays of the county’s finest cucumbers and cabbage, afghans and apple bread.

 

Entries for flower arrangements and other crafts were noticeably down this year, some volunteers said. The fair, which started Sunday, ends Sunday.

 

“They don’t have very many quilts at all, as you can see,” said Wanda Shipley, who with her husband, Robert, took charge of the ice cream stand operated by the Allegany Farm Bureau and the Mason Dixon Lions Club. “You can see what a small amount of canned goods we have. I mean, usually this is full, all the way across.”

 

The economy or a late growing season - or both - could be to blame, Shipley speculated. Neither, however, adversely affected ice cream sales, she said.

 

“Vanilla and chocolate, that’s mostly what the kids want,” said Shipley, who was running out of cones after about 200 children visited Thursday morning from area day cares. “Some of ‘em like moose track.”

 

Outside in the Ag Expo Pavilion, 10-year-old Kayla Kimmell led her two goats, named Gum and Ball, into a clean pen. Gum won two fourth-place prizes, said Kimmell, of Bean’s Cove, Pa., and Ball, won fifth place.

 

“It’s hard at first, but once you get to know your sheep, it gets easier,” said Kimmell, who was showing animals for the first time this year. “And I’ve learned you have to work with your sheep more, because if you just work with them closer to the fair, it doesn’t work out.”

 

Valerie Korns’ 8-year-old daughter, Danielle, didn’t win first place for her black rabbit, named Ricky Rex. But winning isn’t really the point, Korns said.

 

“It teaches them a lot,”  said Korns, who sat in a lawn chair near the rabbit pens to knit Thursday afternoon. “They have to handle all the financial records. If it’s a breeding rabbit they have to keep a pedigree on him. It teaches them about how to give certain medicines, how to handle the sanitation, things like that.”

 

Ricky Rex, who won several ribbons and was dressed as Darth Vader in Thursday morning’s costume contest (Danielle dressed as Princess Leah), was “spoiled rotten” during his year with the Korns.

 

“He has his own area he sleeps on, his own shelf,” Valerie Korns said, adding that the family is giving the rabbit away to make room for another pet. A puppy.

 

Contact Kristin Harty at kharty@times-news.com.

 

Copyright © 1999-2008 cnhi, inc.

 

Preparing for Fall

Swine flu vaccine trials are getting started.

 

Washington Post

Friday, July 24, 2009

 

THE HYSTERIA that ensued after the initial outbreak of the swine flu has dissipated. But the H1N1 virus continues its steady and rapid progression around the world. Just ask the 22 high school students from Maryland and the District who were quarantined after their arrival in Beijing last week when one of them was found to have a high temperature and flu-like symptoms. Their experience is a reminder that this pandemic demands vigilance and preparation. That's why the announcement of swine flu vaccine trials should hearten those who are girding themselves for the fall flu season.

 

At the direction of the National Institute of Allergy and Infectious Diseases, eight university research hospitals and medical groups across the country -- including the University of Maryland School of Medicine's Center for Vaccine Development -- will soon enroll 1,000 adults, seniors and children to test a potential vaccine. The trial will start with 200 healthy adults and 200 seniors. Two strengths of the vaccine will be tested to see which comes closest to triggering an immune response to protect against swine flu. If participants tolerate the vaccines, then researchers will test them on 600 children ages 6 months to 17 years old.

 

The institute says these trials "are being conducted in a compressed time frame" to beat the onset of the fall flu season. Those who want to volunteer for the trials in Maryland can do so in Baltimore, Frederick and Annapolis. If you're thinking of volunteering, go to http://www.clinicaltrials.govor call (410) 706-6156.

 

Let's hope it works. While the flu is working its way through the Southern Hemisphere, where it is winter, it hasn't stopped spreading during summer here, and experts fear it might come back with a vengeance. The Centers for Disease Control and Prevention reports 263 deaths in the United States as of July 17. Because this is well below the average death rate for regular seasonal flu, there's no reason to panic. As long as people take common-sense precautions, U.S. exposure to this global menace can be minimized.

 

Copyright 2009 Washington Post.

 

Black Presidents Lead Area Hospitals

 

By Sean Yoes

Baltimore Afro-American

Thursday, July 16, 2009

 

Dr. Samuel Ross has served as CEO of Bon Secours Health System for three years. (Courtesy Photo)

 

(July 16, 2009) - When former CareFirst CEO William Jews became president of Lutheran Hospital in the 1980s he was Baltimore's first Black hospital head. But, when he left Lutheran it created a void of Black leadership at city hospitals for years.

 

But recently that void has been filled, with several relatively-young Black men now leading three area hospitals – Harbor Hospital, Union Memorial and Bon Secours.

 

Dennis Pullin is the most recent addition to that leadership group. He officially took the helm at Harbor Hospital in Southeast Baltimore on July 1, becoming the institution's first Black president. "My goal here is to make sure everybody here is treated in a special way – regardless of gender, race, age, socio-economic position," Pullen said. "We're about quality, we're about personalized care. And that is what I want my legacy to be about, is providing those things to a community that has a need."

 

Pullin was most recently senior vice-president and chief operating officer at the Washington Hospital Center in D.C., a sister hospital to Harbor. The Texas native has more than 25 years of executive experience with a variety of healthcare organizations including, St. Luke's Episcopal Health System, Baylor College of Medicine and Columbia/HCA Medical Center Hospital in Houston.

 

"Everybody knows there are many challenges in healthcare, well there are some challenges here in this community and we have challenges at the hospital," Pullen acknowledged. "But, I don't think any of them are insurmountable, and so there is truly an opportunity for me to sort of lead the way in making a difference in this community."

 

Dr. Samuel Ross is in his third year as CEO of Bon Secours Health System in West Baltimore. Bon Secours had been on the brink of closing its doors, but was saved by a $5 million cash infusion at the end of the 2009 state legislative session. "Because of where we are – the urban environment – because of our significant service to uninsured and underinsured patients, we really function like a public hospital in many ways," Ross said earlier this year. "So, our presence here is critical. This is a population that still needs to be served."

 

Dr. Shaw Wilgis is the chairman of the MedStar Health board of directors. The largest, not-for-profit community-based healthcare network in the Baltimore-Washington region, was formed in 1998 when Medlantic Healthcare Group of Washington, D.C., merged with Helix Health of Baltimore. Union Memorial and Harbor hospitals come under the MedStar Health umbrella.

 

According to a MedStar spokesperson, Wilgis is currently on vacation and unavailable for comment. Bradley Chambers, president of Union Memorial Hospital, declined to comment for this article.

 

Perhaps, the biggest challenge these leaders face is the country's massive health disparities between Blacks and Whites. "The proportion of Black doctors remains the same as it was in 1910 – about 2.5 percent," said Dr. Matthew Wynia, director of the American Medical Association's Institute of Ethics, last year.

 

The AMA – the nation's leading medical association – published a report last year indicating about 120,000 extra deaths occur each year in America among Blacks because of the disparities in health care between Blacks and Whites. The organization also issued an apology for decades of past discrimination against Black doctors, which many believe has contributed to these ongoing disparities.

 

"The complex history of race in the medical profession is rarely acknowledged and often misunderstood," the report states. "Yet, U.S. medicine's legacy of segregation and racism is linked to the current paucity of African-American physicians, distrust of professional associations by some physicians, and contemporary racial health disparities."

 

Those disparities are being cast in a new light within the context of this renewed debate – being led by President Obama – on the need for major healthcare reform in America. "There is some reform needed in healthcare, exactly what that is, is where the debate lies and how that's paid for his where the debate lies," Pullen said.

 

"But, there are still some huge disparities and I'm hoping the reform will focus on making healthcare accessible to all, but more importantly, affordable. And that's where it hits home in this particular community, is having affordable, available healthcare."

 

Copyright 2009 Baltimore Afro-American.

 

Parents of disabled teen sue Md swim club

 

Associated Press

Daily Record

Friday, July 24, 2009

 

The parents of a teenager who was left brain damaged after an apparent near-drowning is suing the Parkville swim club where the incident happened.

 

William and Mary Becker on Thursday filed a $40 million lawsuit in Baltimore County Circuit Court against the Woodcroft Swim Club and D.R.D. Pool Management Inc., which runs the club. The Beckers accuse both entities of failing to respond quickly to their son and properly resuscitating him after an apparent near-drowning.

 

The incident occurred in 2006, when their son James was 15. Today, his family says he uses a wheelchair and is barely able to speak.

 

The family's attorney says the boy's brain injury was caused by a heart attack he had in the pool, not by a near-drowning. William Carrier says James was pulled from the water less than a minute after he was seen struggling and given CPR.

 

Copyright 2009 Daily Record.

 

Columbia man who killed mom to remain at state mental hospital

Judge denies request for move to private facility

 

Howard County Times

By Mike Santa Rita

Baltimore Sun

Thursday, July 23, 2009

 

A Howard County Circuit Court judge ordered Thursday that a former Columbia man who killed his mother and a family friend in 2001 continue to be confined at a state mental hospital.

 

Judge Diane Leasure found that Benjamin Hawkes, 34, formerly of Columbia, still “presents some risk for violence to himself or others, as a result of his mental illness,” according to Wayne Kirwan a spokesman for Howard County State’s Attorney Dario Broccolino.

 

Hawkes’ attorney, Bradley Hersey, was not immediately available for comment.

 

Hawkes, 34, pleaded criminally not responsible in 2001 to the bludgeoning and stabbing deaths of his mother, Mary Jane Hawkes, 59, and Teena Wu, 18, a family friend who was living in her home at 4360 Wild Filly Court, in the Dorsey Hall neighborhood.

 

Diagnosed as paranoid schizophrenic, Hawkes has been housed at the Clifton T. Perkins Hospital Center in Jessup since the murders.

 

Earlier this month, prosecution and defense attorneys clashed over whether Hawkes should be released to a private facility that could ultimately lead to his freedom.

 

Deputy State’s Attorney Mary Murphy told Judge Leasure that Hawkes posed a real threat of recidivism and should not be moved to a new facility.

 

“You have to look at the past to see what the future might look like to Mr. Hawkes,” Murphy said.

 

But Hersey told Leasure that Administrative Law Judge Michael Wallace had already approved Hawkes for release from Clifton T. Perkins after the recommendation of three psychiatrists who had deemed him a low risk to the community. Hersey noted that Hawkes has already taken classes at Howard Community College and has had contact with the community.

 

Leasure, however, found insufficient evidence to show that Hawkes he did not pose a threat to himself or others.

 

According to a statement of facts submitted by Senior Assistant State’s Attorney Mary Murphy at the time of his sentencing, Hawkes said he killed the women because they followed a fascist ideology, and that he was trying to “act for all the people in America ... to make things better.”

 

Hawkes was living with a friend four miles from his parents’ home at the time of the murders.

 

Mary Jane Hawkes, who was a piano teacher, was boarding Wu in her home while the younger woman attended classes at Howard Community College, with plans to pursue a career in music education. The two met while attending the Church of Jesus Christ of Latter-day Saints in Ellicott City.

 

The Hawkes’ daughter Katie, who was 17 at the time of the killings, was at home Feb. 11 with her mother and Wu when Benjamin Hawkes walked into the home dressed in a robe and an American flag draped around his neck, according to the statement of facts.

 

He grabbed a kitchen knife and began stabbing his mother and later hit her with a sledgehammer while she was in the family room, according to court records.

 

The court records also detailed how Katie Hawkes called 911 from a locked bedroom upstairs. Benjamin Hawkes broke into the bedroom and told her to leave the house. When she did, the phone line to 911 was left open and recorded Wu’s screams as Benjamin Hawkes stabbed and bludgeoned her.

 

When police arrived, they found a calm and cooperative Benjamin Hawkes standing naked in the kitchen, covered in blood, while loud music played on a stereo in the family room.

 

Hawkes later told police he was fighting fascism by killing his mother, and that if he didn’t kill her he would be a bad example to the world.

 

“I felt sickened by the act of what I had to do,” he told police in a taped confession.

 

He explained to police he was told to spare his sister’s life by the “people who are helping me fight injustice. ... I hear voices and see signs.”

 

Copyright 2009 Baltimore Sun.

 

Kent pollution cleanup stalls

Genovique resists state demand for more soil, water tests

 

By Timothy B. Wheeler

Baltimore Sun

Thursday, July 23, 2009

 

A year after the state announced a legal settlement requiring cleanup of long-standing pollution problems at a chemical plant near Chestertown on the Eastern Shore, the work remains stalled by disputes with the plant's owner.

 

Genovique Specialties Corp. has balked at demands from the state Department of the Environment that it do more testing of soil and groundwater for toxic and potentially cancer-causing chemicals at its manufacturing facility, which sits beside an unnamed stream that ultimately flows to the Chesapeake Bay. The company, based in Rosemont, Ill., first submitted a plan last August for investigating contamination at its Kent County plant, which manufactures "plasticizers" -- substances that make plastics flexible. But the state found the original plan riddled with "data and information gaps" and has insisted on more sampling to ascertain how far contaminants may have spread.

 

"We've reviewed the cleanup plan, and we don't agree with it," said Dawn Stoltzfus, state environment agency spokeswoman. "We have requested revisions, and the party does not agree with us."

 

Stoltzfus said the problems at the plant pose no immediate threat to neighboring residents. But some environmental activists are not so sure, and they fault state regulators for not pressing harder to clean up a facility that has been the source of complaints for decades.

 

"I don't know the reason why it's taken so long," said Tom Leigh, the Chester Riverkeeper, who noted that groundwater contamination was first detected at the plant 20 years ago. While the facility's current and previous owners have taken some steps to remedy problems, he said, members of the community are frustrated by the apparent lack of progress since the consent decree was signed last July.

 

"They certainly deserve better from the state as well as the business owners that run the plant," said Leigh, who monitors the condition of the river for the Chester River Association.

 

The consent decree had settled a lawsuit filed by the state in 2007 that accused the plant of discharging polluted wastewater and of contaminating soil and groundwater beneath its facility. Under the decree filed in Kent County Circuit Court, the company, previously known as Velsicol Chemical Co., agreed to a timetable for investigating and cleaning up the problems within two years. The company also agreed to pay a $200,000 fine in 18 monthly installments. The settlement had been billed by state officials as the final resolution of chronic pollution problems at the plant, which has been in operation since the 1950s.

 

Over the years, the Chestertown plant has used a series of unlined ponds to store and treat its wastewater, and state officials say pollutants have leached into the soil and groundwater, including the solvents benzene and toluene and bis(2-ethylhexyl) phthalate, also known as BEHP. Benzene can cause cancer in humans, while toluene can damage the brain and nervous system, as well as other organs. BEHP has been classified as a probable carcinogen, and exposure to high levels has caused kidney damage and disrupted reproduction and sexual development in laboratory animals. Last year Congress banned the sale of children's toys containing some phthalates.

 

Marian Hwang, a lawyer for the Illinois-based corporation, declined to comment. But in a letter sent to the state earlier this month, she contends that it is being required to do more testing than is needed, because the levels of toxic pollution monitored in the ground water have declined and there is no evidence any has seeped beyond the fenceline. The company's lawyer asked that the court-approved timetable for completing the study and cleanup be put on hold while the state mulls its appeal, but pledged to begin work in the meantime on some of the cleanup the company had proposed to do.

 

Genovique submitted a plan for investigating the extent of contamination and pollution at the plant last September but it has never been approved by the state.

 

"We're not going to accept a substandard plan," said Stoltzfus, the MDE spokeswoman. "We're taking our time to make sure the cleanup is done right."

 

The Chester River Association agrees that more extensive soil and water testing is needed. But the environmental group also is concerned that storm water washing off the plant site contains BEHP, while wastewater released by the facility into a holding pond that overflows into a nearby stream contains phosphorus. Phosphorus is one of the pollutants chiefly responsible for the algae blooms that create a fish-suffocating "dead zone" on the bay bottom in summer. The state has never officially limited the amount of phosphorus the chemical plant can discharge, and since the consent decree was signed last July there have been 18 times that the phosphorus levels in the plant's wastewater exceeded the limit normally set on municipal sewage plants.

 

Meanwhile, Leigh said, ducks and geese frequent the pond collecting BEHP-tainted storm runoff.

 

"Those birds move on and may wind up on somebody's dinner plate one day," he said.

 

Leigh said he is frustrated because state law prevents the citizens' group he works for from suing the company if the state has already taken action.

 

Michele Merkel, Chesapeake coordinator for the Waterkeeper Alliance, contended that the protracted Genovique cleanup is part of a pattern of flagging environmental enforcement in Maryland. State data show declines last year in both the number of sites inspected and actions taken, she noted.

 

"They either don't have the resources or the political will to adequately address violations of environmental laws," she said.

 

Stoltzfus said state officials are dedicated to cleaning up the plant, but acknowledged that "resources are limited." She said the agency staff is overseeing about 100 consent decrees requiring pollution cleanups.

 

Even though the state and company are at odds over the extent of testing still to be done, Stoltzfus said Genovique has begun treating its wastewater in recent months to remove phosphorus. And the contamination problems are limited for now to the plant site, she said.

 

"If there were public health risks, if drinking water were involved, it would be a different situation," the state spokeswoman said. "But we have to set priorities when resources are tight."

 

Copyright © 2009, The Baltimore Sun.

 

Water pumping station being built at APG

 

By L’Oreal Thompson

The Aegis

Friday, July 24, 2009

 

An amendment to the Harford County Spring 2009 Master Water and Sewer Plan Update will include an additional project at Aberdeen Proving Ground.

 

At its last legislative session July 14, the Harford County Council unanimously approved the amendment, which includes a capital project to build a pumping station at APG.

 

The pumping station will provide service for the nine buildings that are part of the U.S. Army’s Command, Control, Communications, Computers, Intelligence, Surveillance and Reconnaissance, or C4ISR, complex, according to Jackie Ludwig, chief of water and sewer administration and engineering.

 

According to Darryl Ivins, civil engineer for the county’s department of public works, division of water and sewer, the pumping station will be constructed and completed later this year.

 

“It’s required to be in the master plan for MDE [Maryland Department of the Environment] to issue the permit,” Ivins said.

 

Hank Selke, project manager for the APG privatization contract, said the project is “critical” for the city of Aberdeen and the Army.

 

Selke said he met with Aberdeen City Council members and asked them to approve the amendment.

 

“It needs to be approved tonight so MDE can issue the construction permit,” Selke told the county council during the public hearing.

 

Copyright 2009 The Aegis.

 

Youth's parents sue swim club for brain damage

Teen severely disabled after Parkville mishap

 

By Nick Madigan

Baltimore Sun

Friday, July 24, 2009

 

Three years ago, James Becker was doing what many vigorous 15-year-old boys do - playing baseball, basketball and soccer. He swam competitively and whacked forehands for his school's tennis team.

 

Now he is severely disabled, must use a wheelchair and is under the constant care of his mother. His speech is little more than a series of guttural noises.

 

The accident that reduced James to such circumstances occurred at the Woodcroft Swim Club in Parkville on July 29, 2006, when, his family's lawyer says, he almost drowned. His brain was apparently deprived of adequate oxygen for about 10 minutes.

 

On Thursday, his parents, William J. Becker III and Mary Becker, filed a $40 million lawsuit in Baltimore County Circuit Court against the swim club and the company that runs it, D.R.D. Pool Management Inc., accusing them of failing to both "timely recognize and respond" to the struggling boy and to properly perform resuscitation efforts.

 

Paramedics who arrived at the pool 13 minutes after the incident was reported found James without a pulse. They attempted to get his heart restarted, primarily by using a defibrillator. While in an ambulance headed toward Franklin Square Hospital Center, they found a pulse but, his lawyer says, the damage was done.

 

The lawyer, H. Briggs Bedigian, said the amount of damages sought for James "is not meant to shock the conscience," but represents the best estimate of what it will cost to care for him for the rest of his life. The suit accuses the defendants of negligence but does not seek punitive damages.

 

In the suit, the family is asking for $36 million for James, $3 million for his parents' expenses so far and $1 million for the boy's mother, who was at the pool with him and helped to pull him out of the water.

 

"Mary Becker was forced to bear eyewitness to her son James's horrifying near-drowning, [his] deteriorating condition in the minutes following his removal from the pool, and near death, which has resulted in real and severe emotional distress," the suit says.

 

At the time of the accident, James, an only child, was a sophomore at Archbishop Curley High School. Now, at 18, he attends the Chimes School, which serves children and young people who are developmentally disabled or have multiple handicaps, autism and other problems.

 

"He literally went from a normal, all-American boy who should have started college this year to basically the worst fate I can imagine," Bedigian said. "He can't eat, walk or talk. He's completely trapped, but he still has cognition - he recognizes people."

 

William W. Carrier, an attorney representing the swim club and the management company, said Thursday that the injury to James' brain was caused not by a near-drowning but by a heart attack he suffered in the pool. Carrier said James was pulled out of the water less than a minute after he showed signs of struggling, and never went to the bottom.

 

The boy was given CPR treatment by a Maryland Shock Trauma Center nurse who happened to be one of the 15 people swimming in the pool at the time, Carrier said, adding that three lifeguards were on duty and responded to the emergency.

 

The news that James had suffered a heart attack was common knowledge, Carrier said, and it was reported in the bulletin of the church the Becker family attended.

 

"We think there was no negligence and that we did everything properly in this case," Carrier said.

 

Woodcroft Swim Club is a private entity, owned by its members, who this year are paying dues of $550 and a bond of $325, according to its Web site.

 

Copyright © 2009, The Baltimore Sun.

 

St. Joseph reaches settlement with U.S.

Investigation involved hospital's dealings with MidAtlantic Cardiovascular

 

By Robert Little

Baltimore Sun

Friday, July 24, 2009

 

St. Joseph Medical Center in Towson has reached an "agreement in principle" with the federal government to settle any claims that might arise in a long-running investigation of the hospital's relationship with its dominant cardiology practice, hospital officials said yesterday.

 

Details of the agreement, which is expected to include a monetary penalty, were not disclosed. But interim CEO Robert Lovell began telling employees about the deal Thursday and released a statement later in the day saying that the agreement has been forwarded by U.S. Attorney Rod J. Rosenstein to the Justice Department and other federal agencies for final approval, which could take several months. A spokeswoman for Rosenstein's office declined to comment.

 

"We reached this agreement without admitting liability in order to avoid the expense and uncertainty of litigation and to allow the hospital to move forward," Lovell said in his message to employees. The agreement has also been approved by the hospital's board of directors and the leadership of Catholic Health Initiatives, its parent corporation.

 

St. Joseph's executives have said little about the scope and subject of the probe since subpoenas were issued in June 2008. Until Thursday, they had not acknowledged that the investigation involved the hospital's dealings with MidAtlantic Cardiovascular Associates, the dominant cardiology practice in the Baltimore suburbs.

 

The investigation has been handled by the U.S. Department of Health and Human Service's inspector general's office, which is responsible for investigating Medicare fraud and other health law violations.

 

St. Joseph's officials said they expect to begin discussions with the agency over whether it will impose a written agreement, usually lasting three to five years, designed to "help ensure that all conduct and activity going forward is unquestionable in its compliance with regulations governing health care."

 

In February, three of St. Joseph's top executives left their jobs because of the investigation, and all three subsequently resigned.

 

The relationship between the hospital and MidAtlantic has been a contentious one, spawning several lawsuits and allegations that decisions about patient care were sometimes guided by financial relationships between cardiologists and surgeons. As the dispute escalated, revenue from cardiac surgery at St. Joseph declined while revenue rose at rival Union Memorial Hospital, which was also issued a subpoena in the federal investigation.

 

A call to MidAtlantic's spokeswoman seeking comment Thursday was not returned.

 

Last year, St. Joseph hired away two of MidAtlantic's top doctors, derailing the physician group's $25 million deal to be acquired by Union Memorial's parent company, MedStar Health. In December, St. Joseph opened a new heart-catheterization suite under the direction of one of those physicians, Dr Mark G. Midei.

 

Yesterday, the hospital said Midei, a cardiologist who is among St. Joseph's most prominent clinicians, "is not available for scheduling procedures." He has been unavailable at the hospital for several weeks and could not be reached for comment yesterday. A spokeswoman for the hospital said she could not discuss Midei's status or say when or if he expects to return, calling it a personnel matter.

 

Copyright © 2009, The Baltimore Sun.

 

FTC issues complaint against Carilion Clinic

 

Associated Press

USA Today

Friday, July 24, 2009

 

ROANOKE, Va. (AP) — The Federal Trade Commission is accusing Carilion Clinic of violating federal antitrust laws in its acquisition last year of two health centers.

 

The administrative complaint says that the $20 million purchase of the Center for Advanced Imaging and the Center for Surgical Excellence will drive up health care costs in Roanoke by up to 900 percent. It also says it will reduce incentives to maintain and improve the quality of care for patients.

 

The FTC voted unanimously to issue the complain. It wants to force a sale of the two centers.

 

Carilion spokesman Eric Earnhart said there have been no changes in the prices at either center since their purchase and no changes are planned.

 

An evidentiary hearing in the case is set for March 23.

 

Copyright 2009 The Associated Press. All rights reserved.

 

Nearly 2,000 show up for free health care in Va.

 

Associated Press

By Sue Lindsey

USA Today

Friday, July 24, 2009

 

WISE, Va. — Nearly 2,000 people crowded onto a southwest Virginia fairgrounds and waited hours to receive free dental care, eyeglasses and medical procedures.

 

Stan Brock, head of the Remote Area Medical Expedition's three-day clinic in Wise County, said Friday that the daily limit of 1,600 patients was reached by 5:30 a.m. Friday.

 

He says another 200 people were admitted later in the morning, but several hundred more were turned away.

 

Brock says it's outrageous that hundreds of people must wait all day for treatment because they can't receive health care otherwise. He says his organization was founded to serve Third World nations, but now devotes 64 percent of its efforts to U.S. care because the need is so great.

 

Copyright 2009 The Associated Press. All rights reserved.

 

National / International

Obama Visits Clinic Known for Quality Care, Controlling Costs

 

By David Brown

Washington Post

Thursday, July 23, 2009

 

The Cleveland Clinic, the renowned medical center visited by President Obama on Thursday, embodies many features that experts believe are essential to both improving health care and controlling its cost.

 

Among the attributes that set it apart are a salaried staff, an engineered delivery system, electronic record-keeping, strong interest in the patient's experience, and a work culture committed self-improvement.

 

Once best known as the hospital where fabulously wealthy foreigners came for heart surgery and other high-risk procedures, the 88-year-old institution now includes eight community hospitals, as well as numerous outpatient offices, surgery centers, and urgent care sites all along the south shore of Lake Erie.

 

"It is a very well-established group practice that has over time become an integrated delivery system, both horizontally and vertically," said Eugene Nelson, a professor at Dartmouth Medical School who is an expert in measuring the quality of health care.

 

The clinic has been particularly successful in controlling the cost of state-of-the-art care, at least compared with its silk-stocking competitors.

 

In a study published in the British Medical Journal in 2004, Dartmouth researchers compared the health-care bills of Medicare patients treated at 13 institutions on the "Best Hospitals" list of U.S. News and World Report.

 

The average spending on a Medicare patient with severe chronic disease during the last two years of life was $35,455 at the Cleveland Clinic, which was the cheapest. Massachusetts General Hospital came in at $47,880, Johns Hopkins at $60,653, and UCLA Medical Center led the list at $72,793.

 

As with some other admired medical systems, such as the Mayo Clinic and Kaiser Permanente, the Cleveland Clinic has drawn on principles of engineering and industrial production to make sure that medical care is delivered in a predictable, reproducible way.

 

This consists largely of breaking complicated series of events into small units of activity that are monitored closely.

 

"It's a way of ensuring that what really should be done gets done," Nelson said.

 

For surgery patients, this includes at-home preparation, gathering of records and test results on the morning of operation, safety checks in the operating room, protocol-based post-op care, clear plans for follow-up visits, and a call to every patient within 48 hours of discharge from the hospital.

 

The clinic's electronic medical record was one of the first to allow patients to interact with physicians, contribute data (such as daily weights, kept by many patients with congestive heart failure) and make appointments.

 

"They have a fantastic health IT system, which is a necessary component of changing the game," said Ezekiel J. Emanuel, a doctor who is one of the chief architects of the Obama administration's health policies.

 

The record system is used to improve care by giving practitioners "clinical prompts" about what tests or therapies might be best in certain circumstances. It is also used to gather data on patient outcomes, which the clinic makes public.

 

A random sample of patients discharged from the hospital and treated in the clinics are interviewed in depth about their experience at all steps of clinical care.

 

"They have invested a good deal in trying to measure, understand and improve the patients' experience," Nelson said.

 

An important, if-hard-to-quantify, characteristic of successful medical systems is the shared commitment to self-improvement.

 

"It has a very strong physician culture -- people who believe in the organization and mission and are committed to excellence," said Donald M. Berwick, head of the Institute for Healthcare Improvement in Boston.

 

The Cleveland Clinic has 3.3 million patient visits and 50,465 admissions a year, for its main hospital, which is called The Cleveland Clinic.

 

Like the Mayo Clinic, the Cleveland Clinic has also built satellites far from the mother ship. In the Cleveland Clinic's case, they are in Florida, Toronto and the Persian Gulf emirate of Abu Dhabi.

 

Copyright 2009 Washington Post.

 

Report: FEMA mishandled toxins in trailers

 

By Rick Jervis

USA Today

Friday, July 24, 2009

 

NEW ORLEANS — The Federal Emergency Management Agency didn't react quickly enough to reports of toxins in trailers housing victims of Hurricane Katrina, endangering the health of thousands of victims across the Gulf Coast, according to a new report by the Department of Homeland Security's Office of Inspector General.

 

The 79-page report released Thursday is the first detailed accounting by Homeland Security, which oversees FEMA, of the way the emergency agency handled reports of formaldehyde in temporary trailers housing Katrina victims. Many of those victims reported bloody noses, blackouts, headaches and other more severe problems due to formaldehyde, a colorless, strong-smelling gas often produced in the manufacture of building materials and classified as a carcinogen.

 

"FEMA did not display a degree of urgency in reacting to the reported formaldehyde problem, a problem that could pose a significant health risk to people who were relying on FEMA's programs," the report read.

 

Other findings include:

 

• FEMA officials announced they had found hazardously high levels of formaldehyde in occupied trailers in February 2008, more than two years after the first storm victims were housed in them.

 

• FEMA caused a two-month delay in trailer testing in 2007 because it didn't have a public communications strategy in place for Congress, the media and trailer occupants.

 

• The emergency agency didn't do enough quality control to prevent obtaining the formaldehyde-affected trailers in the first place.

 

FEMA officials said Thursday they agreed with the OIG report's findings and have implemented policy changes such as improved air quality standards in temporary housing to avoid a repeat after future disasters.

 

"We recognize that there is still work to be done, and FEMA will take all appropriate and necessary steps," FEMA spokesman Clark Stevens said.

 

As of last month, nearly 3,000 trailers across the Gulf Coast still housed storm victims, down considerably from the 134,000 right after Katrina in 2005, according to FEMA. The agency has said it made it a priority to vacate the temporary trailers after formaldehyde and other toxins were found in the trailers.

 

The report vindicates many environmentalists who first raised alarms about the formaldehyde, said Oliver Bernstein, a spokesman for Sierra Club. But he said more needs to be done.

 

"There are still a lot of unanswered questions about hurricane preparedness and evacuee housing that hopefully this report calls some attention to," he said.

 

Copyright 2009 USA Today.

 

Radioactive Drug for Tests Is in Short Supply

 

By Matthew L. Wald

New York Times

Friday, July 24, 2009

 

WASHINGTON — A global shortage of a radioactive drug crucial to tests for cardiac disease, cancer and kidney function in children is emerging because two aging nuclear reactors that provide most of the world’s supply are shut for repairs.

 

The 51-year-old reactor in Ontario, Canada, that produces most of this drug, a radioisotope, has been shut since May 14 because of safety problems, and it will stay shut through the end of the year, at least.

 

Some experts fear it will never reopen. The isotope, technetium-99m, is used in more than 40,000 medical procedures a day in the United States.

 

Loss of the Ontario reactor created a shortage over the last few weeks. But last Saturday a Dutch reactor that is the other major supplier also closed for a month.

 

The last of the material it produced is now reaching hospitals and doctors’ offices. The Dutch reactor, at Petten, is 47 years old, and even if it reopens on schedule, it will have to be shut for several months in 2010 for repairs, its operators say.

 

“This is a huge hit,” said Dr. Michael M. Graham, president of the Society of Nuclear Medicine and a professor of radiology at the University of Iowa.

 

There are substitute techniques and materials for some procedures that use the isotope, Dr. Graham and others said, but they are generally less effective, more dangerous or more expensive. With the loss of diagnostic capability, “some people will be operated on that don’t need to be, and vice versa,” he said.

 

Dr. Andrew J. Einstein, an assistant professor of clinical medicine at the Columbia University College of Physicians and Surgeons, said the isotope was used to determine if a patient had a coronary blockage that required an angioplasty or stent. Without the test, Dr. Einstein said, those invasive procedures would be performed on some who did not need them. His hospital is already sometimes using smaller doses of the radioactive drug than guidelines specify, he said.

 

In patients with a known cancer, the drug pinpoints additional tumors in bone. At a tumor site, new bone will develop, and new bone growth absorbs the radioactive material.

 

In breast cancer surgery, the radioisotope is injected to find the lymph node nearest the tumor, so it can be biopsied for signs of cancer, to determine whether more extensive surgery is needed.

 

The alternative is to inject a dye, which sometimes does not let the surgeon find the node.

 

Without the tool, Dr. Graham said, the quality of medical care is “dropping back into the 1960s.”

 

On Tuesday, Representative Edward J. Markey, a Massachusetts Democrat who is one of the House’s fiercest critics of the nuclear industry, declared that the United States was facing “a crisis in nuclear medicine.”

 

Mr. Markey, chairman of the House Energy and Commerce subcommittee on energy, called for establishing new production facilities in the United States. He joined the ranking Republican on the subcommittee, Representative Fred Upton of Michigan, to introduce a bill to authorize $163 million over five years to assure new production.

 

The White House is coordinating an interagency effort to find new sources of supply, involving the Nuclear Regulatory Commission, the Food and Drug Administration and the Energy Department, but officials said the process would take months.

 

The reactors are typically small — sometimes no larger than a homeowner’s trash barrel — but a complete setup costs tens of millions of dollars.

 

Tech-99m, as it is abbreviated, emits a gamma ray that makes its presence obvious. It has a half-life of six hours, meaning that it loses half its strength in that period. Thus it does its job quickly, without lingering to give the patient a big dose. But it also means the isotope must be produced and used faster than most other drugs.

 

Tech-99m is the product of another isotope, molybdenum-99, which also has a short half-life, 66 hours. Thus a week after it is made, less than a quarter of the molybdenum-99 remains. Stockpiling is not practical.

 

“You lose about 1 percent an hour,” said another expert, Kevin D. Crowley, director of the Nuclear and Radiation Studies Board at the National Research Council. “So time is of the essence.”

 

Molybdenum-99 is made when uranium-235 is split, but only about 6 percent of the fission fragments are molybdenum. Purification has to be done in a heavily shielded “hot cell.”

 

The common method is to put a uranium target into the stream of neutrons produced in the reactor as uranium is split. But the preferred material is a high-purity uranium-235, which is also bomb fuel.

 

Mr. Markey and others are trying to have the industry switch to low-enriched — nonweapons-grade — uranium.

 

Dr. Crowley said that could be done, although the industry has resisted.

 

The reactors’ poor condition has been obvious for a while. In 2007, Canadian safety regulators said the Ontario reactor should not restart, but the Canadian Parliament overruled them.

 

In 1996, the company that purifies the molybdenum from the Ontario reactor, MDS Nordion, contracted with Atomic Energy of Canada Ltd., which owns the reactor, to build two new ones. MDS Nordion paid more than $350 million for them.

 

But when the new reactors were started up, both showed a problem: as the power level increased, the reactors had a tendency to run faster and faster, a condition called positive coefficient of reactivity. That is a highly undesirable characteristic in a reactor, one that contributed heavily to the Chernobyl disaster in 1986. So Atomic Energy of Canada Ltd., which is owned by the Canadian government, said it would not open them.

 

For all the years that the Ontario plant was running or the replacements were under construction, other potential manufacturers believed they could not compete, Dr. Klein said. And the business has always been small, he said, adding that a big pharmaceutical company “can make more on Viagra in two days than on tech-99m in a year.”

 

Several long-term alternatives are available. Babcock & Wilcox, a reactor manufacturer, has proposed a new kind of reactor that would manufacture molybdenum that could be siphoned off continuously.

 

In a few weeks, a company in Kennewick, Wash., Advanced Medical Isotopes, plans to test a new system, using a linear accelerator, a machine that shoots subatomic particles at high speeds.

 

Reactors in Belgium, France, South Africa and Argentina could also be used to make small amounts.

 

The High Flux Reactor at the Oak Ridge National Laboratory in Tennessee, owned by the federal government, and a research reactor at the University of Missouri, could do the work, but neither has the equipment in place to extract the molybdenum from the targets.

 

For the time being, said Dr. Crowley of the National Research Council, “we are in a triage situation.”

 

Copyright 2009 The New York Times Company.

 

Two Dietary Supplements Said to Contain Steroids

 

By Michael S. Schmidt and Natasha Singer

New York Times

Friday, July 24, 2009

 

Two over-the-counter dietary supplements that anti-doping officials say are popular among high school football players contain steroids, according to court papers filed by federal authorities on Thursday.

 

The supplements, Tren Xtreme and Mass Xtreme, are manufactured by American Cellular Labs and marketed as a “potent legal alternative to” steroids. But authorities alleged in search warrants executed on Thursday that the supplements contain illegal man-made steroids, also known as designer steroids. One of the substances is Madol, which was first identified six years ago during the investigation into the Bay Area Laboratory Co-operative.

 

The authorities said that Max Muscle, a walk-in supplement store with about 100 locations nation-wide, paid American Cellular Labs to be the exclusive retailer of these products, which could also be purchased on the Internet.

 

Maurice Sandoval, identified in the court documents as American Cellular’s chief executive, said in a telephone interview that he never personally sold steroids but declined to comment on whether the company had sold steroids. He said he sold the company last year but that a paperwork error kept his name on the company.

 

Someone who answered the phone Thursday at Max Muscle’s corporate office in Anaheim, Calif., said no one was available to comment on how many Max Muscle stores carried the American Cellular products. “This is not our product,” said the man, who would not give his name and hung up.

 

On Thursday, the Web site of a Max Muscle outlet in Des Moines was offering a promotion of Tren Xtreme for free, but a salesman who answered the phone there said the store no longer sold the brand.

 

Travis Tygart, the head of the United States Anti-Doping Agency, said the substance helped athletes quickly gain muscle mass and strength.

 

“This is the supplement of choice for high school football players, and we have heard that from more than one source,” Tygart said. “It’s one of the more popular dietary supplements for these athletes because it works.”

 

Tygart declined to estimate how many high school athletes had used the product.

 

The investigation into American Cellular Labs is led by Jeff Novitzky, an agent for the Food and Drug Administration, and prosecutors from the United States attorney’s office for the Northern District of California. Since 2002, Novitzky has become the face of the government’s investigations into the distribution of performance-enhancing drugs.

 

The F.D.A. did not return calls seeking comment on the investigation.

 

The search warrants were executed at a Muscle Max store in the Castro section of San Francisco and at Sandoval’s residence in Pacifica, Calif. Another search warrant was executed on the office of WVM Global Incorporated, in Lake Forest, Calif., which authorities believe is an associated business to American Cellular.

 

The F.D.A. has jurisdiction over dietary supplements, defined as products that can offer general health benefits but cannot claim to treat specific diseases or symptoms.

 

Manufacturers of dietary supplements are responsible for ensuring and documenting the safety and efficacy claims of their products. According to the law governing dietary supplements, the F.D.A. is empowered to act only in cases when it identifies a harmful or adulterated product that is already on sale.

 

But if federal authorities find a supplement to contain an undeclared active pharmaceutical ingredient like a steroid, the agency considers the product to be an illegal, unapproved drug.

 

Illegal steroids are of particular concern in preteen and teenage boys, doctors said, because artificially high levels of testosterone can stop their bones from growing.

 

Steroids are organic compounds, like hormones, naturally produced by the body. They are also used as legal drugs to treat conditions like testosterone deficiency. Athletes have also used illegal forms of steroids for performance enhancement.

 

Investigators grew concerned over sports products made by American Cellular Labs after the F.D.A. received reports of severe liver and kidney problems in people who had used the two products, according to court documents.

 

In one case, a liver transplant doctor reported that a 38-year-old male patient who had used these products was later hospitalized with severe liver dysfunction and acute kidney failure which needed to be treated with dialysis, the documents said.

 

Legal steroid drugs come with health risks. But unknowingly taking supplements that contain illegal compounded steroids is even riskier because such drugs entail unknown risks, said Dr. Pieter Cohen, an instructor at the Harvard Medical School who is studying the dangers of adulterated dietary supplements.

 

For example, when doctors prescribe testosterone for men who have a testosterone deficiency, physicians monitor the patients closely because such steroids can lead to higher-than-normal hormone levels, potentially putting patients at risk for prostate cancer.

 

But taking designer steroids in a sports supplement is even more dangerous for people, he said, because these compounds have not been studied for safety.

 

“It’s placing the consumer at very serious risk of harm because there is absolutely no research showing that this new compound is safe in humans,” said Cohen, a general internist at the Cambridge Health Alliance, a network of public hospitals in Massachusetts. “We do have evidence that, in the past, analogs of pharmaceutical compounds have led to unexpected life-threatening disease such as liver failure that required transplantation.”

 

Copyright 2009 The New York Times Company.

 

Getting Good Value in Health Care

 

Doctor and Patient

 

By Pauline W. Chen, MD

New York Times

Thursday, July 23, 2009

 

Like most doctors I know, every time I see a patient in clinic, questions scroll down my mind’s eye like credits at the end of a movie. Over the years, I have whittled down the number of questions, from the exhausting repertoire I memorized as a medical student to the streamlined clinical checklist I use today.

 

Some of the questions I ask are generic: What brings you here today? What medications are you taking? Some are specialized: Was your liver transplant done “piggy back”? Have you had any episodes of rejection? But a few of the questions have nothing to do with the work I do or the care I am trained to offer. Rather, they are questions about being well and preventing disease: Are you exercising? Do you smoke? Have you had a mammogram?

 

For years I believed that this last group of questions was a clinician’s equivalent of performing a good deed. After all, discussing such topics could help a patient avoid the kind of potentially preventable diseases I had seen other patients suffer from. And since I knew that countless health care resources had been depleted while caring for those patients, I also couldn’t help but feel as if bringing up these questions with patients, however briefly, was like contributing to some greater public good. Any kind of preventive care that I could offer as a doctor, I believed, had to save money.

 

But it turns out that at least one of my assumptions — that I could help to save money — was erroneous. Sort of.

 

In the enormous pie that makes up health care expenditures, only 1 to 3 percent can be attributed to preventive interventions. The miniscule size of this share is due in part to the fact that very few clinical preventive services actually result in savings. In fact, the data for savings is so lackluster that some economists have argued that it is less cost-effective to prevent illness than it is to simply let people get sick. Other economists have taken that argument even further, contending that preventive care adds to societal costs by extending lives and thus the time we must care for people (though one would hope that costly treatments might result in the same “problem”).

 

But according to Dr. Steven H. Woolf, a professor of family medicine at the Virginia Commonwealth University in Richmond and a leading expert on preventive care, all of these assertions are premised on the wrong question. In a commentary published earlier this year in The Journal of the American Medical Association, Dr. Woolf maintains that the economic argument for disease prevention rests not on how much people save but on how much value they gain for each dollar spent.

 

“Health is a good, like food or gas,” Dr. Woolf said. “When you go to a grocery store or gas up a car, you don’t ask whether it will produce a net savings. You don’t expect the cashier to give you money back. The more appropriate question is whether we are getting good value for the money we’re spending.”

 

To help determine value, Dr. Woolf utilizes a unit of measurement — the Quality Adjusted Life Year, or QALY. QALY has been used historically in studies to assess the relative value of different interventions, with each intervention carrying a “price tag” or a rough estimate of the cost to save a comparable year of life.

 

Viewed in terms of QALY value then, there are indeed some clinical preventive services that confer few health benefits for the amount of money spent. But several preventive interventions turn out to be downright bargains. Childhood immunizations and smoking cessation cost so little per QALY (less than $5,000 per QALY gained) that they may actually end up yielding net savings. Other preventive services, like taking aspirin daily if you are at high risk for cardiovascular disease, cost roughly a third to a fifth of more expensive disease interventions that are now routinely paid for, like angioplasty, the procedure that widens or “roto-rooters” narrowed heart vessels.

 

There is also value added beyond these cost efficiency calculations. Last fall, the National Commission on Prevention Priorities found that by increasing just five preventive services, clinicians could save more than 100,000 lives per year. These services include breast cancer screening in women 40 and older, flu immunizations in adults 50 and over, colorectal cancer screening in adults 50 and over, smoking cessation counseling, and a daily aspirin in high risk cardiovascular patients.

 

Much of the responsibility of these preventive services currently rests on clinicians’ shoulders. This focus has contributed in part to the poor data regarding preventive medicine’s results, since relying on clinical settings alone is a relatively inefficient way of changing health behaviors and preventing illness. “Putting it all on doctors and the clinical setting is not a powerful formula,” Dr. Woolf noted. “What is unique about prevention is that so much is happening outside of the clinical setting. Good preventive care requires breaking down the boundaries and getting beyond the constraints of a doctor’s appointment. It requires thinking more broadly in terms of a community-based approach.”

 

It is in this way that preventive medicine offers an additional public good: the potential to strengthen and broaden how we define the patient-doctor relationship.

 

To that end, Dr. Woolf and his colleagues recently spearheaded a program using electronic medical records to link nine physician practices to several community services that offered telephone and group counseling services. “If their patients who smoked were interested,” Dr. Woolf said, “doctors could click a button and auto-enroll the patient with the state’s quit smoking line. Two days later, those patients would receive a call to enroll.” Dr. Woolf’s group created similar electronic links to Weight Watchers and to Alcoholics Anonymous.

 

These quick and reliable connections between physicians and community-based programs resulted in significant improvements for patients and a higher rate of referrals from doctors. “It’s not feasible for doctors to offer intensive smoking cessation counseling in 15 minutes and to be there through the whole process,” Dr. Woolf said. “The barriers to change are at home, work, school, the store. That’s where people need help with behavior change. The last physician or emergency room visit only goes so far.” Such connections are even more critical for patients with chronic diseases, since these individuals often have complicated care plans and can benefit tremendously from increased coordination with preventive and caregiving resources in the community.

 

All of these links, however, require additional outside support, at least initially. “What is needed is a third party,” Dr. Woolf said, “individuals apart from the busy physicians or busy community organizations who can work out the logistical details. Once you have done that, it takes literally seconds to connect the dots for patients.”

 

But as long as the focus is on savings and not on value, such support is not likely to be forthcoming, and preventive care stands to remain a nearly negligible part of our health care expenditures.

 

“Community health and wellness have been pushed aside in the health care reform debate partly because we have been focused on net savings, not value,” Dr. Woolf observed. “That analysis has not been favorable with preventive medicine, so people continue to get highly expensive studies and procedures that are ineffective, even though we have cost-effective public health interventions at our fingertips.”

 

“It’s as if our house is going up in flames,” Dr. Woolf continued. “There is one room, filled with explosives, that hasn’t yet caught on fire. But people are hesitating to put out the fire because they believe they don’t have the data.”

 

Join the discussion on the Well blog, “The Value of Prevention.”

 

Copyright 2009 The New York Times Company.

 

Swine Flu May Cause Seizures in Children

 

By Sarah Arnquist

New York Times

Friday, July 24, 2009

 

The nation’s top public health officials are alerting doctors that swine flu may cause seizures, after four children were hospitalized in Texas for neurological complications.

 

All four children fully recovered without complications after being treated at a Dallas hospital, according to a report released Thursday by the Centers for Disease Control and Prevention.

 

The announcement does not surprise doctors accustomed to seeing complications in the brain caused by the seasonal flu viruses that circulate every year.

 

“It’s completely to be expected given that so far this novel H1N1 flu is behaving like the seasonal flu that we are familiar with,” said Dr. Anne Moscona, a professor of pediatrics and microbiology at the Weill Cornell Medical Center .

 

Because flu-related brain complications are more common in children than adults and swine flu seems to infect children more often than adults, public health experts expect to see more cases of children who develop swine-flu-related neurological complications as the pandemic continues.

 

Parents should not be alarmed, Dr. Moscona said, but if they notice a change in their child’s personality or behavior, like increased irritability or memory problems, soon after the onset of a respiratory illness, it might be swine-flu related and parents should alert their child’s doctor as early as possible.

 

In the four children described in the disease centers’ report, neurological problems, including seizures, confusion and delirium, followed the onset of respiratory symptoms within one to four days. The complications were less severe than those previously described in the medical literature as associated with seasonal flu, according to the report.

 

Neurological complications in children are among the most serious side effects of influenza, said Dr. Andrew T. Pavia, chief of pediatric infectious diseases at the University of Utah. Milder complications like seizures or brain swelling are moderately common, whereas death occurs in only a couple of cases each year, Dr. Pavia said.

 

Some flu strains are worse than others when it comes to causing brain-related complications, and scientists do not yet know how bad H1N1 will be, he said.

 

Most swine flu cases so far have been fairly mild, but many questions remain about the severe cases, like what complications are most likely and who is most likely to develop them, he said.

 

“The usefulness of this case report is that many doctors who deal with outpatient flu only may never have seen a case with neurological complications,” Dr. Pavia said. “It’s an important reminder that flu can present as seizures or as encephalitis.”

 

Copyright 2009 The New York Times Company.

 

H1N1 Flu Linked to Neurologic Complications in Children

 

By Allison Gandey

Medscape News

Friday, July 24, 2009

 

Children with flulike symptoms and unexplained seizures or mental changes should be tested for H1N1 influenza, says a Centers for Disease Control and Prevention (CDC) report, published in the July 24 issue of the Morbidity and Mortality Weekly Report . It suggests that patients may benefit from prompt treatment with antivirals.

 

Concern was first sparked in May, when the Dallas County Department of Health and Human Services reported 4 children with neurologic complications associated with H1N1 flu.

 

Patients were aged 7 to 17 years and were admitted with flulike symptoms and seizures or altered mental status. In all 4 patients, clinicians detected H1N1 viral RNA in nasopharyngeal specimens, but not in cerebrospinal fluid. Three patients had abnormal electroencephalograms.

 

All patients received the antiviral oseltamivir and 3 received rimantadine. The patients fully recovered and had no neurologic sequelae at discharge.

 

Patients Fully Recovered

According to the CDC, just like with the seasonal flu, neurologic complications can occur after respiratory-tract infection with H1N1. Considering that clusters of influenza-associated encephalopathy in children have been reported during previous community outbreaks of seasonal flu and that children appear to be infected with H1N1 more frequently than adults, officials anticipate that additional neurologic complications are likely to be reported as the pandemic continues.

 

The CDC recommends that healthcare providers also consider a diagnosis of Reye's syndrome in patients with viral illness and altered mental status. Clinicians should not administer salicylates or salicylate-containing products to children with influenza or other viral infections because this may also increase the risk for Reye's syndrome.

 

The CDC recommends that all children at least 6 months of age receive annual seasonal influenza vaccinations to prevent illness and complications from infection. No vaccination against H1N1 influenza is currently available.

 

MMWR Morb Mortal Wkly Rep. 2009;58;773-778.

 

Comatose H1N1 Victim Gives Birth

Husband Warns The Bug Shouldn't Be Taken for Granted

 

CBS News

Thursday, July 23, 2009

 

(CBS)  Three weeks ago, Katie Flyte, then six months pregnant, developed a cough and fever. She had the H1N1 virus, commonly known as swine flu, but three different tests missed it. She is now in a drug-induced coma, unaware she's given birth.

 

Kenny Flyte, Katie's husband, said on "The Early Show" Thursday the virus would have been caught if doctors had used a more expensive test to detect it. He told CBS News an X-ray taken six days after her fever began was completely white, showing the flu's spread throughout her body.

 

Since the premature birth of their daughter, Abbey, the newborn has rallied, and is now doing "excellent," Kenny said. And although still in a coma, Kenny said Katie is doing well.

 

Kenny said he just wants people to become aware of H1N1, and protect themselves and others from spreading the virus.

 

"They don't know enough about this H1N1 to really understand how to fight it," he said. "It's been 23 days, and (Katie's) still being treated for the H1N1. ... This isn't something to take for granted.”

 

Web link for video news story:

http://www.cbsnews.com/stories/2009/07/23/earlyshow/main5182331.shtml

 

Copyright 2009 CBS News.

 

H1N1 flu shots ready in months, winter a risk-WHO

 

By Laura MacInnis and Stephanie Nebehay

Reuters

Friday, July 24, 2009

 

GENEVA, July 24 (Reuters) - Vaccines should be ready within months for H1N1 flu, which could mutate and become more severe in winter, the World Health Organisation said on Friday.

 

WHO spokesman Gregory Hartl said about 800 people have died from the newly-discovered "swine flu" virus that has spread to some 160 countries worldwide. So far, the pandemic strain is causing mainly mild symptoms, he told a news briefing.

 

"For the moment we haven't seen any changes in the behaviour of the virus. What we are seeing still is a geographic expansion across countries," Hartl said, while warning that the flu could mutate with the onset of colder temperatures.

 

"We do have to be aware that there could be changes and we have to be prepared for those."

 

At least 50 governments worldwide have placed orders or are negotiating with pharmaceutical companies to secure supplies of vaccines against the H1N1 strain, which are still being developed and tested.

 

"We expect the first doses to be available for human use in early autumn of the northern hemisphere," Hartl said.

 

The WHO is trying to ensure that health workers in the world's poorest countries can be vaccinated against the strain so that their hospitals and medical clinics can stay open.

 

Two manufacturers have promised to donate 150 million doses and the Geneva-based United Nations agency is negotiating with other producers for further doses which would be earmarked for the least developed countries, he said.

 

Hartl did not name the donor companies. Leading vaccines makers include Sanofi-Aventis, Novartis, Baxter, GlaxoSmithKline and Solvay.

 

It is still unclear if one or two jabs will be required for protection against the virus -- a never-before-seen combination of swine, bird and human flu strains. Its emergence and international transmission caused the WHO to declare in June that a full pandemic is under way.

 

While influenza viruses typically spread fastest in winter, when cold and dry conditions help the virus survive outside of the body, Hartl said people have been catching H1N1 flu even in warm climates because they have no natural immunity against it.

 

Last week, the WHO described H1N1 as the fastest-moving pandemic ever seen and said it was pointless to count every case. Most of the people infected recover fully without drugs, though pregnant women and those with other health problems have been vulnerable to more serious effects.

 

Public health officials fear the H1N1 strain could mix with other viruses such as the deadly H5N1 bird flu or become widely resistant to the antivirals Tamiflu, made by Roche and Gilead Sciences, and Relenza, made by GlaxoSmithKline under license from Biota.

 

Hartl said that five patients have been identified with infections with Tamiflu-resistant H1N1, but said those were isolated and did not require a change to the WHO's guidance on how infections should be treated.

 

WHO Director-General Margaret Chan has said patients with mild symptoms should avoid seeking medical care unless they have key warning signs.

 

These include long-lasting high fever in adults and a lack of alertness in children.

 

 (Additional reporting by Jonathan Lynn; editing by Robin Pomeroy)

 

Copyright 2009 Reuters.

 

EU Panel To Review H1N1 Vaccines Before Flu Season

 

Wall Street Journal

Friday, July 24, 2009

 

European Medicines Agency said Friday it has started to receive data on H1N1 pandemic vaccines follwoing the review begining in July, with the commitment from the Committee for Medicinal Products for Human Use, to fast-track the review of data as vaccine manufacturers make them available.

 

MAIN FACTS:

 -Given the public health threat posed by the current pandemic, the Agency's goal is to ensure data submitted to support marketing authorisations for vaccines are reviewed as early as possible, before the beginning of the Northern hemisphere flu season, expected in September.

 

-At present the Committee, or CHMP, is reviewing data relating to manufacture of vaccines.

 

-Additional clinical trials in adults and children are currently being initiated by the vaccine manufacturers and the results will be reviewed in the coming months as they become available.

 

-Four 'mock-up' vaccines developed by Baxter, GlaxoSmithKline and Novartis have already been approved in the European Union based on earlier data generated with the H5N1 virus strain, which is similar to H1N1. These vaccines were developed in the knowledge that the virus strain would be changed in the event of a declared pandemic, to include the strain causing the pandemic. Altogether, they have been tested in more than 8,000 subjects.

 

-Decades of experience with seasonal influenza vaccines indicate that insertion of a new strain in a vaccine, as will apply with the change from H5N1 to H1N1 in the mock-up vaccines, should not substantially affect the safety or level of protection offered.

 

-Data relating to the change in strain are currently being reviewed by the CHMP on a rolling basis as soon as they become available.

 

-Approval of the H1N1 vaccine is expected to be given after satisfactory review of these data. Clinical trials with the H1N1 strain are currently being initiated or are ongoing.

 

-Initial results on the efficacy, immunogenicity and safety of the vaccine from these trials are expected from September onwards, and will also be reviewed as soon as they become available. As with all medicines, rare adverse reactions can only be detected during the wider use of the vaccine.

 

-Regulatory authorities and vaccine manufacturers will implement plans to actively investigate and monitor the safety of these vaccines and take swift action if safety issues emerge.

 

-In addition to the mock-up vaccines, a number of other pandemic influenza vaccines are currently under development, and preliminary data from GlaxoSmithKline (GSK.LN) and Sanofi Pasteur are also being assessed by the Committee on an accelerated basis. For each of these vaccines, the Committee will make a recommendation to the European Commission for final authorisation.

 

-Following this, the use of the vaccines in each Member State will depend on national recommendations and the availability of the vaccines in each country.

 

-The Agency has undertaken to provide regular updates on its influenza pandemic preparedness through its website and the issuing of press releases as appropriate.

 

-By London Bureau, Dow Jones Newswires; Contact Ian Walker; +44 (0)20 7842 9296; ian.walker@dowjones.com

 

Copyright 2009 Wall Street Journal.

 

AP Interview: WHO flu chief: World still 'relatively early' in swine flu pandemic

 

Associated Press

By Frank Jordans

Baltimore Sun

Friday, July 24, 2009

 

GENEVA (AP) — The global swine flu epidemic is still in its early stages, even though reports of over 100,000 infections in England alone last week are plausible, the World Health Organization's flu chief said Friday,

 

Keiji Fukuda, WHO's Assistant Director-General for Health Security and Environment, told The Associated Press that given the size of the world's population, the new H1N1 virus is likely to spread for some time.

 

WHO earlier estimated that as many as 2 billion people could become infected over the next two years.

 

"Even if we have hundreds of thousands of cases or a few millions of cases ... we're relatively early in the pandemic," Fukuda said in an interview at WHO's headquarters in Geneva.

 

The global health agency stopped asking governments to report new cases last week, saying the effort was too great now that the disease has become so widespread in some countries.

 

Authorities in Britain say there were over 100,000 infections in England alone last week, while U.S. health officials estimate the United States has passed the 1 million case mark. Those figures dwarf WHO's tally of 130,000 confirmed cases worldwide since the start of the outbreak last spring.

 

"We know that the total number of laboratory-confirmed cases is really only a subset of the total number of cases," Fukuda said.

 

Fukuda, the former chief of epidemiology at the U.S. Centers for Disease Control and Prevention, or CDC, also said there must be no doubt over the safety of swine flu vaccines before they are given to the public.

 

Health officials and drug makers are looking into ways of speeding up the production of the vaccine before the northern hemisphere enters its flu season in the fall.

 

The first vaccines are expected in September and October, said Fukuda. Other vaccines will take until December or January before they are released onto the market — well into flu season when a further dramatic rise in swine flu cases is predicted.

 

"Everybody involved with the vaccine work, from manufacturers up to the regulatory agencies, are looking at what steps can be taken to make the process as streamlined as possible," Fukuda said. "One of the things which cannot be compromised is the safety of vaccines."

 

The search for an effective inoculation has taken on a new urgency as WHO announced that almost 800 people have died from the disease in the past four months. This is more than the H5N1 bird flu strain has killed in six years.

 

The CDC said Friday that — based on the experience of the 1957 flu pandemic — the number of Americans dying from swine flu over the next two years could range from 90,000 to several hundred thousand. That projection would drop if the vaccine campaign and other measures are successful, U.S. health officials said.

 

One question that scientists and health officials disagree on is whether pregnant women should be among the first to receive a vaccine — after health workers, who make up about 1-2 percent of the world population and are considered indispensable.

 

A report by WHO experts found that pregnant women appear to be "at increased risk for severe disease, potentially resulting in spontaneous abortion and/or death, especially during the second and third trimesters of pregnancy."

 

Several women and their children have died in recent weeks, though obesity may have played a role in some of the deaths, the report says.

 

"Pregnant women have emerged as one of the groups that we are concerned about as being at higher risk than other people in terms of having the possibility of developing severe illness," said Fukuda.

 

But right now, WHO is holding back on recommending that pregnant women receive priority vaccinations. And the agency is not commenting on the contentious suggestion by British and Swiss health officials that women should consider delaying pregnancy if they can.

 

"WHO certainly has no recommendations on whether women should try to have children" now, Fukuda said.

 

The agency has been working hard to ensure that poor countries receive vaccines too, despite rich nations having pre-ordered most of the available stock. A WHO spokesman said Friday that two drug makers have pledged to donate 150 million doses of vaccine to poorer countries by the end of October.

 

"We're working with a range of partners to secure more vaccine for developing countries," WHO's Gregory Hartl said.

 

Fukuda, who is effectively in charge of WHO's pandemic response until mid-August while the agency's Hong Kong-born Director-General Margaret Chan is on home leave, also addressed the possibility that the virus might mutate and become resistant to anti-viral drugs such as Tamiflu.

 

Four separate Tamiflu-resistant cases have been reported recently from Denmark, Japan, Hong Kong and Canada.

 

"We haven't seen widespread emergence of resistance to the drug right now," Fukuda said, but added "this is something we're watching very carefully."

 

It is inevitable that over a long enough period of time the swine flu virus will mutate, he said.

 

"Unfortunately we can't predict in what direction," he said.

 

Associated Press Writer Bradley S. Klapper in Geneva and Mike Stobbe in Atlanta contributed to this report.

 

Copyright 2009 Associated Press. All rights reserved.

 

Arab Health Ministers Impose Age Limits on Hajj to Limit Flu

 

By Edward Yeranian

Voice of America News

Thursday, July 23, 2009

 

Arab health ministers, meeting in Cairo, have agreed to impose restrictions on this year's Muslim pilgrimage to Mecca in a bid to control the spread of the H1N1 swine flu virus. The ministers are forbidding those under age 12 and over age 65 from participating.

 

Growing fears of a flu epidemic across the Arab world is prompting Arab health ministers to restrict participation in this year's annual Hajj.

 

After an urgent meeting in Cairo, more than a dozen Arab health ministers agreed to prevent young and elderly Hajj candidates, as well as those with health problems, from traveling to Saudi Arabia for the annual event.

 

Saudi Arabia, which hosts the Hajj and grants visas to participants, first recommended restricting participation last month.  The kingdom has had a number of H1N1 flu cases, and fears of a health crisis during the Hajj were behind the move.

 

Saudi Health Minister Abdullah al-Rabeeah speaks during press conference in Cairo, 22 Jul 2009

Saudi Health Minister Abdullah al-Rabeeah urged the Arab press to inform the public about the decision to limit Hajj participation and noted that his country was increasing the number of flu shots on hand to control an eventual outbreak.

 

The Saudi Kingdom, he argues, is working to protect the health of pilgrims.

 

He says the recommendations on restricting Hajj participants have been approved and will be put into action, and hopefully, they will guarantee the safety of all those who want to perform their pilgrimage.

 

The Eastern Mediterranean regional director of the World Health Organization, Hussein Gezairi pointed out the recommendations of the health ministers would be enforced and that no visas would be granted unless Hajj candidates met all requirements.

 

He says organizational procedures were devised based on the categories that have been determined by the Saudi health minister. Centers to approve visa candidates will be set up, registered, and equipped under the Health Ministry to prevent anyone from obtaining visa documents that are not correctly approved.

 

Yemeni Health Minister Abdul Karim Rasae, who chaired the conference, said the decision to prevent vulnerable people from attending this year's Hajj was debated long and hard before being approved.

 

He says all the ministers profited from their discussions and the decisions that were arrived at stemmed from their debate and had not been cooked up in advance.

 

The Saudi government has the power to grant or deny visas according to its own discretion, and the Saudis indicated last month that participation in this year's Hajj should be restricted.

 

Copyright 2009 Voice of America News.

 

Researchers: Zimbabwe's economic crisis driving HIV decline - fewer sugar daddies

 

Associated Press

By Michelle Faul

Baltimore sun

Friday, July 24, 2009

 

CAPE TOWN, South Africa (AP) — Fewer Zimbabweans are getting infected with AIDS, and researchers speculate it's due in part to a battered economy that's leaving men short of money to be sugar daddies and keep mistresses.

 

Presenting a study of the infection rate among pregnant women at a major international AIDS conference in South Africa this week, Dr. Michael Silverman said the prevalence of the virus that causes AIDS fell from 23 percent in 2001 to 11 percent at the end of 2008. His study was based on tests of 18,746 women at a prenatal clinic in rural Zimbabwe over that period.

 

Silverman, a Canadian infectious disease expert, works at Howard Hospital in Zimbabwe, where the women were tested.

 

Silverman said he concluded that "a lot of the effect (of the decline in HIV infections) is from the collapsing economy." AIDS experts have long noted that the richest countries in Africa are also those with the highest infection rates.

 

"You can't pay the sex worker if you have no currency," he said. "It's hard to have a concurrent relationship if you're always in earshot of your spouse, because you can't afford to travel. Because of the economic collapse, people are forced to stay home, like being in quarantine."

 

Getting accurate AIDS numbers in Africa, however, has been notoriously difficult since researchers are often forced to guess from imperfect indicators like HIV incidence in pregnant women, instead of counting actual numbers of HIV patients.

 

Researchers long have speculated how much they could drive down incidence of AIDS if people were constricted to having sex with partners in their age group. Now, in Zimbabwe, said David Katzenstein, a professor of infectious diseases at California's Stanford University who has worked in Zimbabwe for 25 years, "everybody's hungry, there aren't as many sugar daddies (older men who attract young girlfriends with gifts and money) and those that are around don't have as much sugar."

 

"The good news from Zimbabwe is that, apparently without any intervention whatsoever, there does seem to be a declining incidence in young women and maybe young men," said Katzenstein, who was not involved with Silverman's study.

 

"Lack of transport, lack of money, lack of food, all decrease the amount of sex that you can have and the number of partners," Katzenstein said.

 

Katzenstein noted there is no evidence of a decline in infection rates in other places which had incidences as high as Zimbabwe — Swaziland, Botswana and South Africa's KwaZulu-Natal province. AIDS infections in many African countries are tending toward a plateau.

 

But Mike Chirenje, an AIDS researcher in charge of obstetrics and gynecology at the University of Zimbabwe, said: "You're also talking about a period of time when a lot of people were not accessing ARV (anti-retroviral) therapy. So you cannot rule out cases of people dying for lack of access to ARVs" and therefore not being around to be studied.

 

Another consideration: Women infected with the virus are less likely to fall pregnant.

 

Many ask how anyone can really know what is going on in Zimbabwe, where President Robert Mugabe's yearslong fight to remain in political power triggered economic and social crises that caused as much as a third of the population to flee, collapsed government health and education and left more than 80 percent jobless. The collapse of piped water services brought on a cholera epidemic that killed 2,000 people.

 

But Howard Hospital, run by the Canadian branch of the Salvation Army, remained open throughout the crises.

 

The decline registered by Silverman at Howard is "in keeping with national data that shows from research 10 years ago a decrease from 30 percent (prevalence) to 15 percent today," said Chirenje, whose work is funded in part by the U.S. National Institutes for Health and who has done clinical trials, especially in HIV prevention through microbicides and risk reduction through condom use.

 

Simon Gregson, a professor at Imperial College London and a demographer and epidemiologist who has worked half time in Zimbabwe since 1998, said he also sees a sharp decline in Zimbabwe. He was not involved with Silverman's study.

 

Through studies following the same 10,000 to 12,000 people every couple of years, Gregson said: "We have found that it is not just that more people are dying than are becoming newly infected; it's not just because the death rate is very high; but the rate of new infections have been coming down and that is because people have been changing their behavior and adopting safe practices."

 

The studies show people, particularly men, are having fewer partners, and condom use is quite high, Gregson said in an interview from his office in Zimbabwe.

 

"What's not so clear is what caused them to change their behavior and why there is more of a change in Zimbabwe than in other neighboring countries."

 

Chirenje also said that behavior change appeared to be mainly among men. Studies from his research unit at primary health care centers have women reporting no changes in the frequency of their sexual activity of three or four times a week, he said.

 

Chirenje estimated that between 30 and 40 percent of Zimbabweans eligible for ARV therapy are receiving it. Katzenstein said only about 100,000 are receiving therapy — one-tenth of those believed infected and much fewer than the 250,000 who should be getting treatment. He said an estimated 50,000 Zimbabweans are dying of AIDS each year.

 

Copyright 2009 Associated Press. All rights reserved.

 

Opinion

Farms and Antibiotics

 

New York Times Editorial

Friday, July 24, 2009

 

The Union of Concerned Scientists estimates that 70 percent of the antibiotics used in this country are fed to farm animals. These animals do not receive these drugs the way humans do — as discrete short-term doses. Agricultural antibiotics are a regular feed supplement intended to increase growth and lessen the chance of infection in crowded, industrial farms.

 

These practices are putting both humans and animals increasingly at risk. In an environment where antibiotics are omnipresent, as they are in industrial agriculture, antibiotic-resistant strains of diseases quickly develop, reducing the effectiveness of common drugs like penicillin and tetracycline.

 

Despite that danger, the Food and Drug Administration had been reluctant to restrict routine agricultural use of antibiotics. The F.D.A.’s principal deputy commissioner, Dr. Joshua Sharfstein, signaled a welcome change in direction recently, testifying on behalf of a new bill, the Preservation of Antibiotics for Medical Treatment Act. It would allow veterinarians to prescribe antibiotics to treat individual animals or prevent disease, but it would sharply restrict the routine feeding of antibiotics to farm animals — the practice most closely associated with the development of drug-resistant pathogens.

 

The legislation is drawing strong opposition from the farm lobby since the restrictions would make it much harder for industrial farms to crowd thousands of animals together in confined, inhumane and unhealthy quarters. But the current practice is dangerously self-defeating: treating more and more animals with less and less effective drugs and in turn creating resistant strains of disease that persist in the soil and water. Congress should stop this now before an entire class of drugs becomes useless.

 

Copyright 2009 The New York Times Company.

 

Too many crab licenses

 

Daily Record Editorial

Friday, July 24, 2009

 

The Department of Natural Resources has adopted a new tactic in its ongoing battle to protect one of Maryland’s most precious and delicious natural resources — the Chesapeake Bay blue crab.

 

The department is offering to buy back 3,676, or more than half, of the commercial limited crab catcher licenses. Under this voluntary program, license holders may submit a bid for the value of their licenses by July 31 so the department can decide if it will pay that amount by Aug. 15.

 

About 6,000 commercial crabbing licenses have been issued by the state, but officials say that only about 1,800 are in use. But the remaining licenses could be used at any time, which could have a serious impact on the state’s efforts to maintain an acceptable level of crabs in the bay.

 

“Our concern is if even a fraction of these individuals decide to re-enter the fishery in a given year, our regulations will not be sufficient to maintain the harvest target,” said DNR Secretary John Griffin.

 

So if people are willing to sell them, DNR is willing to buy back as many licenses as it can afford.

 

Obviously, for this program to work, Maryland cannot go it alone.

 

“Our counterparts in Virginia are also pursuing a license buy-back program this summer using Federal Blue Crab Disaster Funds, and the Potomac River Fisheries Commission is discussing this as well,” said Fisheries Director Tom O’Connell. “Working in close coordination with them, we can continue to do our job of maintaining the bay’s iconic blue crab fishery so that it will prosper for many generations to come.”

 

If inactive license holders do not submit bids for their licenses or if DNR does not accept the bids, the licenses will be subject to new restrictions on their use, which will be proposed this fall.

 

Chesapeake Bay crabs have been under siege from the ravages of overfishing and pollution for decades. Last year, Maryland, Virginia and the Potomac River Fisheries Commission adopted measures to reduce the crab harvest, and there are signs that the crab population has bounced back somewhat.

 

More needs to be done to stabilize the situation, much less provide for a steady increase in the number of crustaceans.

 

But the voluntary auction program is a step worth taking to help get us where we need to be.

 

Copyright 2009 Daily Record.

 

Faith program to save lives, ease stigma of HIV/AIDS

 

By Nancy Johnston

Baltimore Sun Commentary

Friday, July 24, 2009

 

Since California's Proposition 8 was passed last year, the narrative has largely been that religious and black communities shun homosexuals ( http://www.nytimes.com/2009/07/11/us/11gay.html ) and actively challenge their rights. That's why today's story detailing Project SHALEM, a partnership with the Maryland AIDS Administration, the JACQUES Initiative* and various religious and community institutions is so heartening ( http://www.baltimoresun.com/health/bal-md.jacques22jul22,0,5391216.story ). As the story explained:

 

"'The ultimate goal is to make churches, mosques and synagogues a safe place where people can receive HIV support,' said Derek Spencer, the executive director of the JACQUES Initiative.

 

'We are no longer going to wait for people to come into our academic centers for help,' he said."

 

Baltimore churches have long been the rallying points for communities to band together against poverty, violence and other urban ills. It is only right that they now focus on educating their parishioners and community members about the often-fatal virus and how to remain HIV-negative.

 

The goal of the event was to test 1,000 people. Those with a negative test result were taught how best to remain healthy. For those who received a positive test result, they were in a loving environment, surrounded by volunteers trained to aid them both medically and spiritually. In such surroundings, I can only hope that the decades-old stigma attached to HIV/AIDS (and -- though wrong -- by extension, homosexuality) will lose much of its sting.

 

Educating the community and supporting the sick and marginalized should always trump fearful ignorance and moral grandstanding. The Baltimore faith communities and the University of Maryland School of Medicine partnership is a wonderful tribute to the best ideals of both institutions.

 

*Clarification: Project SHALEM is led by the JACQUES Initiative, which is a program of the Institute of Virology at the University of Maryland School of Medicine. 

 

Copyright 2009 Baltimore Sun.

 

Viewpoint: Is 'Big Food' the next Big Tobacco?

 

By Ellen Goodman

Baltimore Sun Commentary

Friday, July 24, 2009

 

BOSTON - What caught my eye was not just the ashtray sitting forlornly on the yard-sale table. It was the sign that marked it "vintage," as if we needed to label this relic of midcentury America.

 

Ashtrays that once graced every airline armrest, coffee table and office have gone the way of spittoons. Today the car's cigarette lighter is used to juice up the cell phone. Ask most restaurants for the smoking section, and you'll be shown the doorway.

 

If I had to pick the year attitudes changed, it would 1994, when seven CEOs of Big Tobacco came before Congress and swore that nicotine wasn't addictive. A lobby too big to fail and too powerful to oppose began to lose clout. Smokers are no longer seen as sexy and glamorous but as the addicted dupes.

 

I don't know that we will ever have such a dramatic moment in the annals of Big Food. But I have begun to wonder whether this is the summer when the (groaning) tables have turned on the obesity industry.

 

Now that two-thirds of Americans are overweight, the lethal effects of fat are catching up to those of smoke. We regularly hear the cha-ching of obesity costs in the health care debate. And we are beginning to see that Overweight America is not some collective collapse of national willpower, but a business plan.

 

A measure of the moment is Food Inc., a documentary chronicling the costs to the land, worker and customer of a food industry that's more grim factory than sylvan farm. A system that makes it cheaper to buy fast food than fresh food.

 

A more personal measure is David Kessler's best-seller, The End of Overeating, which is both a thinking person's diet book and an investigation into an industry that wants us to eat more. The former head of the FDA had crusaded against smoking but found himself helpless before a chocolate-chip cookie. So this yo-yo dieter set out to discover what, exactly, we're up against.

 

Dr. Kessler is a scientist, not a conspiracy theorist. But he writes about how the food industry has learned to produce "hyperpalatable combinations of sugar, fat and salt" that not only appeal to us but "have the capacity to rewire our brains, driving us to seek out more and more of those products."

 

And if words that Dr. Kessler uses, like "craveability" and "conditioned hypereating," sound exaggerated, he takes you to an industry meeting where a food scientist on a panel called "Simply Irresistible" offers tips on "spiking" the food to make people keep eating.

 

We eat more when more is on the plate. We eat more when snacks are ubiquitous, when flavors are layered on and marketed as "eatertainment." As one food executive admitted to Dr. Kessler, "Everything that has made us successful as a company is the problem."

 

Sometimes it seems that our consumer society sets up the same conflict again and again. Sophisticated marketing campaigns hard-sell everything from sex and cigarettes to the 1,010-calorie Oreo Chocolate Sundae Shake at Burger King. And we're told to stay abstinent or tobacco-free or skinny by resisting them. We are even promised "Guiltless Grill" entrees at Chili's that can weigh in at almost 750 calories and are only guilt-free when compared to an order of Texas cheese fries that tip the scales at 1,920 calories.

 

The analogy between Big Tobacco and Big Food is imperfect. You can't quit eating or wear a food patch. We are also quite torn between "size acceptance" - a fight against the fat bias that has even been aimed at the new surgeon general nominee's waistline - and criticizing fat as a health risk.

 

But if the campaign against smoking provides a model, it's in the effort to label restaurant foods and expose the tactics of Big Food. It's also in recasting the folks who bring us bigger food, drinks and snacks as obesity dealers. As Dr. Kessler writes, "The greatest power rests in our ability to change the definition of reasonable behavior. That's what happened with tobacco - the attitudes that created the social acceptability of smoking shifted." Are we the addicted dupes of the Frappuccino?

 

The honchos at McDonald's may never confess how the Big Mac made us bigger, and the food scientists at Frito-Lay may not explain why we "can't eat just one" potato chip. But maybe this will be the year when an entree of chicken quesadillas with bacon, mixed cheese, ranch dressing and sour cream - 1,750 calories - begins to look just a little bit more like an ashtray.

 

Ellen Goodman is a columnist for The Boston Globe. Her e-mail is ellengoodman1@me.com.

 

Copyright © 2009, The Baltimore Sun.

 

Everyone Wins With Drug Patent Settlements

 

Washington Post Letter to the Editor

Friday, July 24, 2009

 

The July 16 editorial ["Dangerous Side Effects"] seriously mischaracterized out-of-court patent settlements between innovator and generic pharmaceutical companies on exclusive marketing periods. These settlements do not have the "effect of delaying competition."

 

Quite the opposite: For the most part, the settlements permit generic products to reach America's patients before patent expiration, promoting competition and allowing generics companies to challenge innovators' patents without the daunting prospect of litigating each case to judgment.

 

The current system, whereby settlements are evaluated on a case-by-case basis by federal regulatory agencies, ensures that anticompetitive agreements are thrown out, while pro-patient agreements are allowed to proceed. Unfortunately, a blanket ban would ensure that settlements that are in the public interest will never see the light of day.

 

Across the legal system, settlements are favored because they save time, preserve resources and allow the parties to find a reasonable compromise. They should not be banned for one particular business sector, in this case pharmaceuticals, in which historical opponents agree that these settlements benefit the industry and, most important, patients.

 

KEN JOHNSON

Senior Vice President

Pharmaceutical Research

and Manufacturers of America

Washington

 

Copyright 2009 Washington Post.

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