SciTimes Update: Recent Developments in Health and Science News

Charles A. Nelson Lab, University of Minnesota

Studying the infant brain. From the book:  "Raising America: Experts, Parents and a Century of Advice About Children" by Ann Hulbert.

Wednesday in Science, babies who know what’s on your mind, a sinkhole in China, coral reefs in crisis and a soldier who can now talk with his hands. Check out these and other headlines from around the Web.

Baby Mind Readers: Even babies as young as 1 ½ can guess what other people are thinking, LiveScience.com reports. Previously, scientists thought this ability to understand other people’s perspectives emerged much later in children.

Time Wasters: An explosion in technology aimed at helping people manage their time and tasks may actually be making it harder, reports The Wall Street Journal. Many people choose something that doesn’t fit the way they think and work, or they jump from one tool to another, wasting time and energy.

More Housework, Less Sex: Married men who spend more time doing traditionally female chores, like cooking, cleaning and shopping, report having less sex than husbands who don’t do as much, reports The Houston Chronicle. Conversely, men who did more manly chores, such as yard work, paying bills and auto repairs, reported having more sex.

Roman Tag Artists: A facelift of the Colosseum in Rome that began last fall has revealed centuries of graffiti, National Geographic reports.

Sinkhole Swallows Building: An enormous sinkhole opened up under a building complex in China’s southern city of Guangzhou Tuesday, swallowing five shops and one building. Watch the video from The Christian Science Monitor.

Sandwiched Generation: More middle-aged adults are caring for both children and aging parents, reports USA Today. About 15 percent of American adults in their 40s and 50s provided financial support to both an aging parent and a child in 2012, according to a survey of 2,511 adults from the Pew Social and Demographic Trends Project.

Misleading Trials: A rare peek into drug company documents reveals troubling differences between publicly available information and materials the company holds close to its chest, reports ScienceNews.org. In comparing public and private descriptions of drug trials conducted by the pharmaceutical giant Pfizer, researchers discovered discrepancies,including changes in the number of study participants and inconsistent definitions of protocols and analyses.

Reuters

A diver swam past a healthy colony of Caribbean elkhorn coral near Molasses Reef, Florida, in 2009.

Coral in Crisis: Coral reefs are producing less calcium carbonate and growth rates have slowed dramatically, reports Science News.

Severe Flu Cases Among Chinese: A genetic variant commonly found in Chinese people may help explain why some got seriously ill with swine flu, reports The Boston Globe. The discovery could help pinpoint why flu viruses hit some populations particularly hard and change how they are treated.

Video by AssociatedPress

Double-Arm Transplant Recipient: Feels Amazing

Double-Arm Transplant Soldier Speaks: Brendan Marrocco, a soldier who lost all four limbs in Iraq and then received a double-arm transplant said he hated living without arms. “Not having arms takes so much away from you. Even your personality, you know. You talk with your hands. You do everything with your hands, and when you don’t have that, you’re kind of lost for a while,” the 26-year-old New Yorker told reporters Tuesday at Johns Hopkins Hospital, reports The Associated Press.

Read More..

Bits Blog: For Rent: The New Microsoft Office

Office is one of the great gushers of profits in the software industry, so it is noteworthy when Microsoft starts fiddling with how it charges for its suite of productivity applications.

On Tuesday, the company began what it called a reinvention of its Office product for consumers. Users will now subscribe to the software for a $100 annual fee, rather than buying it outright as they have for years. While Microsoft is still offering the more conventional option of buying a “perpetual” version of Office for the home — prices start at $140 — it’s clearly betting that it can get most of its customers to move to the new model over time.

“I would say in 10 years, the majority of customers, perhaps all customers, will be in a subscription relationship as opposed to a perpetual,” Kurt DelBene, president of Microsoft’s Office division, said in an interview.

Why fork over $100 for Office each year, rather than make one payment of $140? Perhaps more pointedly, why pay anything at all when Google offers online alternatives to Word, Excel and PowerPoint that are free for basic versions and cost only $50 a year for versions with extra features?

Microsoft justifies the price for the subscription version of Office, called Office 365 Home Premium, by adding some flexibility for households with multiple computers. A subscription comes with the rights to install the software on up to five Windows and Mac computers. If you’re using a computer outside the home that doesn’t have Office on it, you can download a version of the software from Microsoft’s site that deletes itself from the computer when you’re finished.

Office subscribers also get extra online storage through Microsoft’s SkyDrive service and 60 minutes of free Skype phone calls. Microsoft also says it will update the subscription version of software with new features before it updates the version that people buy the old-fashioned way.

There is one glaring omission in the new Office offering: support for the iPad. Although Microsoft has a hush-hush development effort to bring its major Office apps to Apple’s tablet, the company hasn’t done so yet. The company has released one Office app, OneNote, for the iPad and says people can do light editing of Office documents through versions of the Office apps that run through the iPad’s Web browser.

Still, there are undoubtedly many users who would love to have an authentic version of Office on their devices, given how popular the iPad is becoming in the workplace.

Mr. DelBene said Microsoft had “nothing to announce at this point” when asked when the company will bring the complete version of Office to the iPad.

As for Google, Mr. DelBene said it has not “in any way diminished demand” for Office because Microsoft’s applications are “just so far beyond the capabilities that are in those alternative products.” As an example, he cited a feature in Excel that analyzes a batch of numbers selected by a user and automatically recommends the best way to represent the data in a chart.

Despite Google, Mr. DelBene said, “we think that we’re on track for Office 365 to be one of the fastest-growing businesses in the history of Microsoft.”

Read More..

Syrian Opposition Leader Softens Position on Talks with Assad

BEIRUT, Lebanon — Syria’s top political opposition leader expressed willingness for the first time on Wednesday to talk with representatives of President Bashar al-Assad, softening what had been an absolute stand of refusing to negotiate with the government in an increasingly chaotic civil war.

The opposition leader, Sheik Ahmad Moaz al-Khatib, coupled his offer with two demands: the release of what he described as 160,000 prisoners held by Mr. Assad’s government, and the renewal of all expired passports held by Syrians abroad — a gesture apparently aimed at disaffected expatriates and exiled opposition figures who could not return home even if they wanted to.

Sheik Khatib’s offer quickly provoked sharp criticism from others in the Syrian opposition coalition, with some distancing themselves and complaining that the leader had not consulted with colleagues in advance. Nonetheless, the offer still represented a potential opening for dialogue in a nearly two-year-old conflict that has threatened to destabilize the Middle East.

He made the offer as the United Nations was scrambling to raise money to manage the humanitarian crisis caused by the conflict, which has sent at least 700,000 Syrians into neighboring countries and left more than one million displaced inside Syria. A donor conference under way in Kuwait has produced commitments for about $1 billion of the $1.5 billion that the United Nations is seeking.

“I announce that I am willing to sit down with representatives of the Syrian regime in Cairo or Tunisia or Istanbul,” Sheik Khatib said in the offer, published in Arabic on his Facebook page. His motivation to make such an offer, he said, was “to search for a political resolution to the crisis, and to arrange matters for the transitional phase that could prevent more blood.”

There was no immediate Syrian government response to the offer by Sheik Khatib, a respected Sunni Muslim cleric who once had been the imam of the historic Umayyad mosque in Damascus. His unified Syrian opposition coalition, created at a meeting in Qatar two months ago, has been formally recognized by the Arab League, the European Union and the United States.

Sheik Khatib’s offer was made less than a day after the peace envoy for Syria from the United Nations and Arab League, Lakhdar Brahimi, gave the United Nations Security Council a pessimistic prognosis for negotiations.

It also followed a grisly massacre discovered on Tuesday in the contested northern city of Aleppo, from which anti-Assad activists posted videos online of scores of bound victims who had been shot in the head and dumped in a river. Some insurgents said the death toll exceeded 100, mostly abducted men in their 20s and 30s.

Both sides in the conflict blamed the other for those killings, just as they have traded accusations for other atrocities, including two major explosions a few weeks ago that killed more than 80 people at the University of Aleppo. Outside assessments based on video of the university blasts have suggested that a Syrian military missile was responsible.

Sheik Khatib did not hide his contempt for Mr. Assad’s government in his statement, saying, “One can’t trust a regime that kills children and attacks bakeries and shells universities and destroys Syria’s infrastructure and commits massacres against innocents, the last of which won’t be the Aleppo massacre, which is unprecedented in its savagery.”

But he decided to reach out, he wrote, partly because the Syrian government had publicly invited political opposition leaders this week to return to Damascus for what it called a dialogue.

Three weeks ago, Mr. Assad said in a speech that he was open to reconciliation talks but not with political opponents he described as terrorists, the government’s generic term for armed insurgents. At the time, most members of the political opposition dismissed Mr. Assad’s speech as meaningless.

The opposition’s longstanding position has been that Mr. Assad must resign as a precondition for any talks and that he cannot be part of any transitional government. Mr. Assad and his aides have said he has no intention of resigning and may even run for another term in elections next year.

Hania Mourtada reported from Beirut, and Rick Gladstone from New York. Anne Barnard and Hwaida Saad contributed reporting from Beirut.

Read More..

DealBook: Gleacher to Leave His Investment Bank

9:32 a.m. | Updated with interview with Mr. Gleacher

Eric J. Gleacher, a veteran deal maker who participated in the fight over RJR Nabisco, said on Tuesday that he would leave the investment bank he founded about 23 years ago.

The departure of Mr. Gleacher as chairman comes months after his struggling firm hired Credit Suisse to explore a sale.

Gleacher & Company disclosed last month that the Nasdaq stock market had initiated a move to delist the investment bank, after its stock price lingered below $1 for months. The firm is appealing the decision.

Mr. Gleacher, 72, told DealBook in an interview on Tuesday that his decision was prompted in part by finishing work on the sale of Archstone, a massive real estate company once owned by Lehman Brothers. Since the deal was announced in late November, he has been approached by a number of companies seeking advice, and he is weighing opportunities to essentially become a freelance adviser.

“As the business model on Wall Street changes, I’m looking forward to working with C.E.O.’s and investors in helping them realize their goals,” he said. “I’m looking forward to doing so in an independent manner.”

(He has been contemplating a move for some time, having put up his Manhattan town house for sale earlier this month.)

Mr. Gleacher, a former Marine and long one of Wall Street’s top golfers, founded his company after having become one of the top deals bankers on Wall Street during the 1980s. He founded the mergers department at Lehman Brothers in 1978, and then led Morgan Stanley‘s deal team from 1985 to 1990.

He then founded his firm, maintaining it for years as an independent merger advisory shop. He sold it to the British bank Natwest in 1995, but bought it back four years later.

Mr. Gleacher and his partners decided in 2009 to sell their business to Broadpoint Securities, a small brokerage, giving rise to the current Gleacher & Company. But the firm struggled, burdened with rising regulatory constraints and tepid deal activity.

Under Thomas Hughes, Gleacher & Company’s chief executive, the investment bank has sold off businesses in an attempt to revive its flagging fortunes. In the fall, the firm explored a potential sale to a larger concern, Stifel Financial, but the talks fell apart over price, according to people briefed on the matter.

It is unclear whether the investment bank is still pursuing a sale. Mr. Hughes suggested in a statement that the firm continued to weigh its options.

“We will continue to grow our M.&A. and capital-raising capabilities in line with the vision we have described previously, a vision that Eric helped author,” Mr. Hughes said. “On behalf of the company, I want to wish Eric the best in his future endeavors.”

While striking off on his own will allow him more personal time, Mr. Gleacher added that he intended to keep busy.

“To me, retirement is just time allocation,” he said. “I’ve always just enjoyed what I’ve done.”

Read More..

Well: Ask Well: Long-Term Use of Nicotine Gum

In small doses, like those contained in the gum, nicotine is generally considered safe. But it does have stimulant properties that can raise blood pressure, increase heart rate and constrict blood vessels. One large report from 2010 found that compared to people given a placebo, those who used nicotine replacement therapies had a higher risk of heart palpitations and chest pains.

That’s one reason that nicotine gum should, ideally, be used for no more than four to six months, said Lauren Indorf, a nurse practitioner with the Cleveland Clinic’s Tobacco Treatment Center. Yet up to 10 percent of people use it for longer periods, in some cases for a decade or more she said.

Some research has raised speculation that long-term use of nicotine might also raise the risk of cancer, though it has mostly involved laboratory and animal research, and there have not been any long-term randomized studies specifically addressing this question in people. One recent report that reviewed the evidence on nicotine replacement therapy and cancer concluded that, “the risk, if any, seems small compared with continued smoking.”

Ultimately, the biggest problem with using nicotine gum for long periods is that the longer you stay on it, the longer you remain dependent on nicotine, and thus the greater your odds of a smoking relapse, said Ms. Indorf. “What if the gum is not available one day?” she said. “Your body is still relying on nicotine.”

If you find yourself using it for longer than six months, it may be time to consider switching to sugar-free gum or even another replacement therapy, like the patch or nasal spray.

“Getting people on a different regimen helps them break the gum habit and can help taper them off nicotine,” Ms. Indorf said.

Read More..

Well: Ask Well: Long-Term Use of Nicotine Gum

In small doses, like those contained in the gum, nicotine is generally considered safe. But it does have stimulant properties that can raise blood pressure, increase heart rate and constrict blood vessels. One large report from 2010 found that compared to people given a placebo, those who used nicotine replacement therapies had a higher risk of heart palpitations and chest pains.

That’s one reason that nicotine gum should, ideally, be used for no more than four to six months, said Lauren Indorf, a nurse practitioner with the Cleveland Clinic’s Tobacco Treatment Center. Yet up to 10 percent of people use it for longer periods, in some cases for a decade or more she said.

Some research has raised speculation that long-term use of nicotine might also raise the risk of cancer, though it has mostly involved laboratory and animal research, and there have not been any long-term randomized studies specifically addressing this question in people. One recent report that reviewed the evidence on nicotine replacement therapy and cancer concluded that, “the risk, if any, seems small compared with continued smoking.”

Ultimately, the biggest problem with using nicotine gum for long periods is that the longer you stay on it, the longer you remain dependent on nicotine, and thus the greater your odds of a smoking relapse, said Ms. Indorf. “What if the gum is not available one day?” she said. “Your body is still relying on nicotine.”

If you find yourself using it for longer than six months, it may be time to consider switching to sugar-free gum or even another replacement therapy, like the patch or nasal spray.

“Getting people on a different regimen helps them break the gum habit and can help taper them off nicotine,” Ms. Indorf said.

Read More..

Streaming Shakes Up Music Industry’s Model for Royalties

Jim Wilson/The New York Times

Zoe Keating published on her blog the details of what she made in royalties from the Web streaming of her music. It wasn’t a lot.

Like plenty of music fans, Sam Broe jumped at the chance to join Spotify two summers ago, and he hasn’t looked back.

Spotify, which began streaming music in Sweden in 2008, lets users choose from millions of songs over the Internet free or by subscription, and is increasingly seen as representing the future of music consumption. Mr. Broe, a 26-year-old from Brooklyn, said that having all that music at his fingertips helped him trim his monthly music budget from $30 to the $10 fee he pays for Spotify’s premium service.

“The only time I download anything on iTunes is in the rare case that I can’t find it on Spotify,” he said.

A decade after Apple revolutionized the music world with its iTunes store, the music industry is undergoing another, even more radical, digital transformation as listeners begin to move from CDs and downloads to streaming services like Spotify, Pandora and YouTube.

As purveyors of legally licensed music, they have been largely welcomed by an industry still buffeted by piracy. But as the companies behind these digital services swell into multibillion-dollar enterprises, the relative trickle of money that has made its way to artists is causing anxiety at every level of the business.

Late last year, Zoe Keating, an independent musician from Northern California, provided an unusually detailed case in point. In voluminous spreadsheets posted to her Tumblr blog, she revealed the royalties she gets from various services, down to the ten-thousandth of a cent.

Even for an under-the-radar artist like Ms. Keating, who describes her style as “avant cello,” the numbers painted a stark picture of what it is like to be a working musician these days. After her songs had been played more than 1.5 million times on Pandora over six months, she earned $1,652.74. On Spotify, 131,000 plays last year netted just $547.71, or an average of 0.42 cent a play.

“In certain types of music, like classical or jazz, we are condemning them to poverty if this is going to be the only way people consume music,” Ms. Keating said.

The way streaming services pay royalties represents a major shift in the economic gears that have been underlying the industry for decades.

From 78 r.p.m. records to the age of iTunes, artists’ record royalties have been counted as a percentage of a sale price. On a 99-cent download, a typical artist may earn 7 to 10 cents after deductions for the retailer, the record company and the songwriter, music executives say. One industry joke calls the flow of these royalties a “river of nickels.”

In the new economics of streaming music, however, the river of nickels looks more like a torrent of micropennies.

Spotify, Pandora and others like them pay fractions of a cent to record companies and publishers each time a song is played, some portion of which goes to performers and songwriters as royalties. Unlike the royalties from a sale, these payments accrue every time a listener clicks on a song, year after year.

The question dogging the music industry is whether these micropayments can add up to anything substantial.

“No artist will be able to survive to be professionals except those who have a significant live business, and that’s very few,” said Hartwig Masuch, chief executive of BMG Rights Management.

Spotify has 20 million users in 17 countries, with five million of them paying $5 to $10 a month to eliminate the ads seen by freeloaders.

In a recent interview, Sean Parker, a board member, said he believed Spotify would eventually attract enough subscribers to help return the music industry to its former glory — that is, to the days before Mr. Parker’s first major enterprise, Napster, came along.

“I believe that Spotify is the company that will make it succeed,” said Mr. Parker, who is also a former president of Facebook. “It’s the right model if you want to build the pot of money back up to where it was in the late ’90s, when the industry was at its peak. This is the only model that’s going to get you there.”

Read More..

Ukrainian General Given Life Sentence in Killing of Journalist

Sergey Dolzhenko/European Pressphoto Agency

Gen. Oleksei Pukach listened to his sentence from the defendant's cage during a court session of the Pechersk district court on charges of murder of the journalist Georgy Gongadze in Kiev, Ukraine, on Tuesday.

MOSCOW — A Ukrainian court sentenced a former security official to life in prison on Tuesday for the death of Georgy Gongadze, a journalist whose mysterious death in 2000 provoked an international outcry and helped set off protests against the president at the time, Leonid D. Kuchma.

The former security official, Gen. Oleksei Pukach, who once headed a surveillance department for Ukraine’s Interior Ministry, testified that he had not intended to kill Mr. Gongadze, but strangled him with a belt accidentally in the course of an interrogation. He is the highest-ranking official to be convicted in Mr. Gongadze’s death.

Mr. Gongadze went missing in September 2000 and his body was found two months later, beheaded, in a forest 75 miles from Kiev, the capital. He had infuriated the president, Mr. Kuchma, with muckraking publications in Ukrainskaya Pravda, an Internet newspaper he had founded.

Suspicions of official involvement grew with the release of covert recordings made by one of Mr. Kuchma’s bodyguards, in which the a man who sounded like the president spoke of Mr. Gongadze, telling a subordinate to “throw him out, give him to the Chechens.”

The killing came to epitomize the role that crime had come to play in Ukrainian politics and provoked a wave of demonstrations that some describe as the first manifestation of the 2004 Orange Revolution.

Three former police officers who stood trial over Mr. Gongadze’s death said that he had climbed into what he believed to be a taxi and was taken to a location outside Kiev, where he was beaten and strangled, doused with gasoline and burned.

General Pukach said he had been trying to force Mr. Gongadze to confess to espionage, something Mr. Gongadze refused to do, though he did admit accepting $400,000 from Western diplomats for passing on information.

Volodymyr Shilov, a prosecutor, said that General Pukach had testified that he was carrying out an order, but would not say what the order was or who issued it, according to the Interfax news agency. But just before guards took him away on Tuesday, General Pukach gave a revealing response to journalists who asked him to comment on the verdict, telling them to direct their questions to Mr. Kuchma and his chief of staff, Volodymyr Lytvyn.

“Ask Kuchma and Lytvyn, they’ll tell you everything,” he said, shaking his finger angrily, according to television coverage of the trial. “I told everything during the investigation and trial. So ask Lytvyn and Kuchma about their motives and intentions.”

The trial was mostly closed to journalists, who were allowed to be present only for the verdict and sentencing. But a lawyer representing Mr. Gongadze’s widow complained that the investigation and trial were flawed and inconsistent, overlooking evidence that General Pukach had intended to kill Mr. Gongadze.

“He spoke clearly about receiving an order to kill burn and bury him, and he was prepared for this,” said the lawyer, Valentyna Telychenko, in comments broadcast on television. “He brought a shovel and a canister of gasoline, meaning his actions were directed toward murder, and nothing else.”

General Pukach testified that he had been ordered to conduct surveillance by Ukraine’s interior minister — a man who was found dead in 2005, hours before he was to be questioned by prosecutors in the matter. Officials called it a suicide, though Ukrainian news agencies said he had suffered two gunshot wounds.

This article has been revised to reflect the following correction:

Correction: January 29, 2013

An earlier version of this article misstated, on first reference, the year of Georgy Gongadze’s death. It was in 2000, not 2002.

Read More..

DealBook: Iceland Wins Major Case Over Failed Bank

BRUSSELS — Iceland won a landmark case at a European court, ending an acrimonious legacy from the collapse of its banking system more than four years ago.

On Monday, the court upheld the country’s refusal to promptly cover the losses of British and Dutch depositors who had put more than $10 billion in Icesave, the bankrupt online offshoot of a failed Icelandic bank.

In a judgment issued in Luxembourg, the court of the European Free Trade Association, or EFTA, cleared Iceland of complaints that it violated rules governing the protection of depositors drawn up by the European Union. While Iceland is not a member of the Union, it is bound by most of its rules, as a member of EFTA.

The case has attracted widespread attention because it touches on issues of cross-border banking that have been at the center of the European Union’s efforts to ensure the future stability of the region’s financial system. The Iceland banking collapse in 2008 — and the mayhem it caused far beyond the country’s borders — raised issues directly relevant to the 27-nation Union.

Monday’s court ruling in Luxembourg was a significant victory for Iceland. Unlike Ireland, Iceland declined to use taxpayer money to bail out foreign bondholders and depositors. This caused a bitter dispute with Britain, which used antiterrorism rules to take control of assets held in Britain by Icesave’s parent, Landsbanki.

In a recent interview with British television, Iceland’s president, Olafur Ragnar Grimsson, denounced Britain for its legal justification for seizing Icelandic assets. “We were there together with al Qaeda and the Taliban on that list,” he said. “We have not forgotten that in Iceland.” He referred to the maneuver as Britain’s “eternal shame.”

After the 2008 crash, the government tried twice to settle the Icesave debts. But the country’s voters, asked to approve settlement plans in two separate referendums, rejected the proposals. Foreign holders of bonds issued by Icesave’s corporate parent, Landsbanki, and two other failed Icelandic banks lost some $85 billion. Those losses were not at issue in the Luxembourg case, which involved only customers with bank deposits.

Iceland’s government, in a statement by its foreign ministry after Monday’s verdict, said Landsbanki had already paid out some $4.5 billion to Icesave depositors, covering nearly half of all initial claims by individuals, charities and others in Britain and the Netherlands. The ministry said the bank would eventually reimburse the rest.

“It is a considerable satisfaction that Iceland’s defense has won the day in the Icesave case,” the government said in its statement. The Luxembourg ruling, it added, “brings to a close an important stage in a long saga,” and “Icesave is now no longer a stumbling block to Iceland economic recovery.”

Iceland’s economy, which went into a nosedive after the banking crash, is now growing again. The credit-rating agency Fitch recently raised its rating of the country’s debt, noting that its ‘‘unorthodox crisis policy response has succeeded in preserving sovereign creditworthiness.’’

But the Icesave saga has clouded the recovery.

Icesave collapsed in October 2008 along with its parent, Landsbanki, and the rest of Iceland’s banking sector. Caught in the wreckage were some 350,000 people in Britain and the Netherlands who, lured by unusually high interest rates, had put their money in Icesave accounts.

The government protected the deposits of Icelanders who had money in failed banks by moving them into new, solvent versions of the banks. But it declined to cover the losses of foreigners with online accounts operated by Icesave, a move that prompted complaints of illegal discrimination to the court in Luxembourg.

The case against Iceland was bought by the Surveillance Authority of the European Free Trade Association and revolved around interpretation of a European Union directive requiring that deposits in European banks be covered equally by deposit guarantee systems. Britain and the Netherlands supported the case.

But the court, according to a statement summarizing the verdict, ruled that the directive on guaranteeing bank deposits did not oblige Icelandic authorities to ensure immediate payment to depositors in Britain and the Netherlands “in a systemic crisis of the magnitude experienced in Iceland.”

Iceland argued that all Icesave depositors would eventually get their money back, but that the government, confronted in 2008 with a total breakdown of the financial system, did not have the means to offer immediate payment of all claims. The court also cleared Iceland of complaints that it violated nondiscrimination rules when it protected domestic depositors by moving their accounts to solvent new banks but reneged on protecting foreign depositors in Icesave.

Read More..

Well: Keeping Blood Pressure in Check

Since the start of the 21st century, Americans have made great progress in controlling high blood pressure, though it remains a leading cause of heart attacks, strokes, congestive heart failure and kidney disease.

Now 48 percent of the more than 76 million adults with hypertension have it under control, up from 29 percent in 2000.

But that means more than half, including many receiving treatment, have blood pressure that remains too high to be healthy. (A normal blood pressure is lower than 120 over 80.) With a plethora of drugs available to normalize blood pressure, why are so many people still at increased risk of disease, disability and premature death? Hypertension experts offer a few common, and correctable, reasons:

¶ About 20 percent of affected adults don’t know they have high blood pressure, perhaps because they never or rarely see a doctor who checks their pressure.

¶ Of the 80 percent who are aware of their condition, some don’t appreciate how serious it can be and fail to get treated, even when their doctors say they should.

¶ Some who have been treated develop bothersome side effects, causing them to abandon therapy or to use it haphazardly.

¶ Many others do little to change lifestyle factors, like obesity, lack of exercise and a high-salt diet, that can make hypertension harder to control.

Dr. Samuel J. Mann, a hypertension specialist and professor of clinical medicine at Weill-Cornell Medical College, adds another factor that may be the most important. Of the 71 percent of people with hypertension who are currently being treated, too many are taking the wrong drugs or the wrong dosages of the right ones.

Dr. Mann, author of “Hypertension and You: Old Drugs, New Drugs, and the Right Drugs for Your High Blood Pressure,” says that doctors should take into account the underlying causes of each patient’s blood pressure problem and the side effects that may prompt patients to abandon therapy. He has found that when treatment is tailored to the individual, nearly all cases of high blood pressure can be brought and kept under control with available drugs.

Plus, he said in an interview, it can be done with minimal, if any, side effects and at a reasonable cost.

“For most people, no new drugs need to be developed,” Dr. Mann said. “What we need, in terms of medication, is already out there. We just need to use it better.”

But many doctors who are generalists do not understand the “intricacies and nuances” of the dozens of available medications to determine which is appropriate to a certain patient.

“Prescribing the same medication to patient after patient just does not cut it,” Dr. Mann wrote in his book.

The trick to prescribing the best treatment for each patient is to first determine which of three mechanisms, or combination of mechanisms, is responsible for a patient’s hypertension, he said.

¶ Salt-sensitive hypertension, more common in older people and African-Americans, responds well to diuretics and calcium channel blockers.

¶ Hypertension driven by the kidney hormone renin responds best to ACE inhibitors and angiotensin receptor blockers, as well as direct renin inhibitors and beta-blockers.

¶ Neurogenic hypertension is a product of the sympathetic nervous system and is best treated with beta-blockers, alpha-blockers and drugs like clonidine.

According to Dr. Mann, neurogenic hypertension results from repressed emotions. He has found that many patients with it suffered trauma early in life or abuse. They seem calm and content on the surface but continually suppress their distress, he said.

One of Dr. Mann’s patients had had high blood pressure since her late 20s that remained well-controlled by the three drugs her family doctor prescribed. Then in her 40s, periodic checks showed it was often too high. When taking more of the prescribed medication did not result in lasting control, she sought Dr. Mann’s help.

After a thorough work-up, he said she had a textbook case of neurogenic hypertension, was taking too much medication and needed different drugs. Her condition soon became far better managed, with side effects she could easily tolerate, and she no longer feared she would die young of a heart attack or stroke.

But most patients should not have to consult a specialist. They can be well-treated by an internist or family physician who approaches the condition systematically, Dr. Mann said. Patients should be started on low doses of one or more drugs, including a diuretic; the dosage or number of drugs can be slowly increased as needed to achieve a normal pressure.

Specialists, he said, are most useful for treating the 10 percent to 15 percent of patients with so-called resistant hypertension that remains uncontrolled despite treatment with three drugs, including a diuretic, and for those whose treatment is effective but causing distressing side effects.

Hypertension sometimes fails to respond to routine care, he noted, because it results from an underlying medical problem that needs to be addressed.

“Some patients are on a lot of blood pressure drugs — four or five — who probably don’t need so many, and if they do, the question is why,” Dr. Mann said.

---

How to Measure Your Blood Pressure

Mistaken readings, which can occur in doctors’ offices as well as at home, can result in misdiagnosis of hypertension and improper treatment. Dr. Samuel J. Mann, of Weill Cornell Medical College, suggests these guidelines to reduce the risk of errors:

¶ Use an automatic monitor rather than a manual one, and check the accuracy of your home monitor at the doctor’s office.

¶ Use a monitor with an arm cuff, not a wrist or finger cuff, and use a large cuff if you have a large arm.

¶ Sit quietly for a few minutes, without talking, after putting on the cuff and before checking your pressure.

¶ Check your pressure in one arm only, and take three readings (not more) one or two minutes apart.

¶ Measure your blood pressure no more than twice a week unless you have severe hypertension or are changing medications.

¶ Check your pressure at random, ordinary times of the day, not just when you think it is high.

Read More..