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Health & Fitness (233)
NEW YORK (AP) -- The government's latest report card on food poisoning shows a dip in salmonella cases but an increase in illnesses from bacteria in raw shellfish. The report counts cases in only 10 states for some of the most common causes of foodborne illness, but is believed to be a good indicator of national food poisoning trends. Highlights from Thursday's report from the Centers for Disease Control and Prevention:
WHAT'S MAKING US SICK?
Salmonella remains at the top of the chart, far ahead of most other foodborne germs. Only campylobacter (camp-ee-loh-bak-tur) - a bacteria commonly linked to raw milk and poultry - comes close. Other causes, listeria, shigella (shih-GEHL'-uh) and E. coli, trail behind.
IS FOOD POISONING GETTING WORSE?
Overall, no. Last year, there were no significant changes in most kinds of food poisoning, compared to the previous three years. The new report tallied about 20,000 illnesses and 80 deaths in the 10 states, similar to previous years. The CDC estimates that 1 in 6 Americans get sick from contaminated food each year, though most cases are not reported.
ANY GOOD NEWS?
Yes, for salmonella. The rate of new cases dropped 9 percent - the biggest drop in about a decade. But officials are cautious about making too much of it, since it was compared to a time period that included a big outbreak linked to eggs in 2010. Last year's rate is similar to what it was about five years ago. CDC officials hope new regulatory proposals, like one to prevent salmonella in chicken parts, will keep pushing rates down.
WHAT ABOUT BAD NEWS?
There was in increase in infections from vibrio (VIB'-ree-oh) bacteria found in raw shellfish, like oysters. Last year, cases were up 32 percent from the previous three years and 75 percent from about five years ago. But the numbers remain very small - only 242 of the 20,000 illnesses recorded in the 10 states. Climate change is warming coastal waters in some places, and that may be helping spread some vibrio strains to new locations, said Dr. Robert Tauxe, a CDC food-germ expert. "The warmer the water, the more vibrio," he said. A strain traditionally found in the Pacific Northwest, is now showing up along the East Coast. Tauxe said it might have been spread through water in ships' ballast tanks.
CAN YOU PREVENT FOOD POISONING?
Carefully wash and clean food, and cook meat, poultry and eggs thoroughly. Avoid raw milk and unpasteurized juices. Promptly refrigerate leftovers. A government report last year showed leafy greens like lettuce and spinach were the leading source of food poisoning, and produce in general accounted for nearly half of all illnesses. There were slightly more deaths attributed to poultry than to vegetables in the decade studied.
Food safety: HTTP://WWW.CDC.GOV/FOODSAFETY/
WASHINGTON (AP) -- A surge of eleventh-hour enrollments has improved the outlook for President Barack Obama's health care law, with more people signing up overall and a much-needed spark of interest among young adults.
Nonetheless, Obama's announcement Thursday that 8 million have signed up for subsidized private insurance, and that 35 percent of them are younger than 35, is just a peek at what might be going on with the nation's newest social program.
Still to be announced is what share of those enrolled were previously uninsured - the true test of Obama's Affordable Care Act - and how many actually secured coverage by paying their first month's premiums.
"This thing is working," a confident Obama said of his signature domestic achievement. The days of website woes and canceled policies seemed far behind.
State-by-state statistics, expected as early as next week, will provide a much fuller picture.
A key question is how many of those signed up were young adults, ages 18-34. They're the health care overhaul's most coveted demographic because they're healthier than older adults and their premiums can help cross-subsidize care for the sick. That would help hold down future premium increases.
According to the nonpartisan Kaiser Family Foundation, young adults 18-34 represent about 40 percent of the people eligible to buy coverage in the health care law's new insurance markets. The White House says that group now accounts for 28 percent of those who have picked a plan in states where the federal government is running the insurance exchanges.
Not perfect, but not bad either, said Larry Levitt, an insurance expert with Kaiser.
"Enrollment among young adults ended up lower than their share of the target population but sufficient to keep the market stable in the vast majority of the country," he said.
The nonpartisan Congressional Budget Office is forecasting only a slight average increase in premiums for 2015. Some private insurance experts expect big differences around the country, predicting that insurers will seek noticeably higher premiums, around 6 percent to 8 percent on average.
Republicans were having none of Obama's celebration. A statement from the office of Senate GOP leader Mitch McConnell of Kentucky said he remains committed to repealing the law and replacing it.
The president appeared in the White House briefing room to trumpet the new figures, which beat initial projections by 1 million people
Following the disastrous rollout of the insurance exchanges in October, when HealthCare.gov was virtually unusable, Democrats have been hoping that higher-than-expected results could help their candidates reclaim the political high ground ahead of the midterm elections.
Seven months out from Election Day, they're seeking to turn the page on the law's flawed debut - a strategy underscored last week when Obama announced that Health and Human Services Secretary Kathleen Sebelius, who became the face of the rollout failure, was stepping down.
Polling shows the law remains unpopular in much of the country, yet most Americans say they don't expect it to be entirely repealed, but changed in some way.
With the insurance markets looking increasingly viable, Obama and Democrats were hoping to move the political debate away from repeal and toward efforts to fix lingering issues.
Republicans have been reluctant to pursue fixes for fear of tacitly embracing the overall law. Obama said that it's "absolutely possible" to make improvements but that it would require a change of attitude from Republicans.
AP Medical Writer Carla Johnson in Chicago contributed to this report.
NEW YORK (AP) -- In the midst of the diabetes epidemic, a glimmer of good news: Heart attacks, strokes and other complications from the disease are plummeting.
Over the last two decades, the rates of heart attacks and strokes among diabetics fell by more than 60 percent, a new federal study shows. The research also confirms earlier reports of drastic declines in diabetes-related kidney failure and amputations.
The drop is mainly attributed to better screening, medicines and care. The improvements came even as the number of U.S. adults with diabetes more than tripled in those 20 years.
"It is great news," said Dr. John Buse, a University of North Carolina diabetes specialist, of the drop in rates.
"The prognosis for folks with diabetes has improved dramatically over the last two decades, at least for those with good access to care," Buse said in an email. He was not involved in the study.
The Centers for Disease Control and Prevention research is reported in Thursday's New England Journal of Medicine.
Diabetes is a disease in which sugar builds up in the blood. The most common form is tied to obesity, and the number of diabetics has ballooned with the rise in obesity. Today, roughly 1 in 10 U.S. adults has the disease, and it is the nation's seventh leading cause of death, according to the CDC.
The obese are already at higher risk for heart attacks and strokes. But diabetics seem to have more narrowing of their blood vessels - a condition that can further foster those problems.
In the 1990s, key studies showed that diabetics could keep their blood sugar, blood pressure and cholesterol under control. The research suggested that vision and heart problems, leg and foot amputations and other diabetes complications were not necessarily inevitable.
Meanwhile, insurance programs expanded coverage of blood sugar monitors and diabetes treatment. Gradually, larger numbers of diabetics were diagnosed earlier and with milder disease.
For the new study, the CDC tallied complication rates from 1990 to 2010 for diabetics ages 20 or older.
During that time, the heart attack rate fell 68 percent, from 141 to 45.5 per 10,000 diabetics, according to hospital records.
The decline was so great that, despite the growing ranks of diabetics, the actual number hospitalized with heart attacks dropped from more than 140,000 to about 136,000.
The stroke rate fell less dramatically - but still declined by more than half, finishing at 53 per 10,000. The heart attack and stroke rates for diabetics are essentially even now, lead author Edward Gregg noted.
The researchers saw declines in hearts attack and stroke rates for non-diabetics as well, but those improvements weren't nearly as big as they were for diabetics.
Amputation rates also fell by more than half. However, like strokes, the actual number increased over the two decades.
The growth in the number of diabetics "wiped out most of the gains" from the declining rates, so the number who ended up in the hospital for strokes or amputations swelled, said Dr. Robert Gabbay, of Boston's Joslin Diabetes Center.
The study also found that the rate of kidney failure dropped by 28 percent. But that wasn't true for all ages - the rate in those 65 and older actually increased, for reasons that aren't clear. That could be a sign diabetics are living longer - long enough to get kidney disease, Gregg speculated.
The researchers also looked at a less common complication, death caused by dangerous levels of blood sugar. The rate of such deaths dropped by 64 percent; the numbers also declined by 18 percent. In 2010, those deaths totaled 2,361.
NEW YORK (AP) -- A small study of casual marijuana smokers has turned up evidence of changes in the brain, a possible sign of trouble ahead, researchers say.
The young adults who volunteered for the study were not dependent on pot, nor did they show any marijuana-related problems.
"What we think we are seeing here is a very early indication of what becomes a problem later on with prolonged use," things like lack of focus and impaired judgment, said Dr. Hans Breiter, a study author.
Longer-term studies will be needed to see if such brain changes cause any symptoms over time, said Breiter, of the Northwestern University Feinberg School of Medicine and Massachusetts General Hospital.
Previous studies have shown mixed results in looking for brain changes from marijuana use, perhaps because of differences in the techniques used, he and others noted in Wednesday's issue of the Journal of Neurosciences.
The study is among the first to focus on possible brain effects in recreational pot smokers, said Dr. Nora Volkow, director of the National Institute on Drug Abuse. The federal agency helped pay for the work. She called the work important but preliminary.
The 20 pot users in the study, ages 18 to 25, said they smoked marijuana an average of about four days a week, for an average total of about 11 joints. Half of them smoked fewer than six joints a week. Researchers scanned their brains and compared the results to those of 20 non-users who were matched for age, sex and other traits.
The results showed differences in two brain areas associated with emotion and motivation - the amygdala and the nucleus accumbens. Users showed higher density than non-users, as well as differences in shape of those areas. Both differences were more pronounced in those who reported smoking more marijuana.
Volkow said larger studies are needed to explore whether casual to moderate marijuana use really does cause anatomical brain changes, and if so, whether that leads to any impairment.
The current work doesn't determine whether casual to moderate marijuana use is harmful to the brain, she said.
Murat Yucel of Monash University in Australia, who has studied the brains of marijuana users but didn't participate in the new study, said in an email that the new results suggest "the effects of marijuana can occur much earlier than previously thought." Some of the effect may depend on a person's age when marijuana use starts, he said.
Another brain researcher, Krista Lisdahl of the University of Wisconsin-Milwaukee, said her own work has found similar results. "I think the clear message is we see brain alterations before you develop dependence," she said.
AP Medical Writer Lindsey Tanner in Chicago contributed to this report.
MIAMI (AP) -- Tied to an unpopular president and his signature health care law, Democrats in the nation's largest swing state see medical marijuana as a potential antidote to political malaise in this year's midterm elections.
Party operatives are pushing a constitutional amendment that would make Florida the first state in the South to legalize some pot use. Polls show the measure has widespread public support, and it's particularly popular among young voters - a critical part of the Democratic coalition with historically weak turnout in non-presidential election years.
"I wish that it didn't take medical marijuana on the ballot to motivate our young voters," said Ana Cruz, former executive director of the Florida Democratic Party. "But listen, we'll take it any way we can get it."
Activists are also gathering signatures for medical marijuana initiatives in Arkansas, where Democrats are fighting to retain the governorship and a U.S. Senate seat, and Ohio, where the party is trying to oust GOP Gov. John Kasich. But those petition drives face significant organizational hurdles.
The political world likely will be focused on Florida in November for clues about the turnout potential among young voters of pot on the ballot. At stake is the governor's office, as well as a handful of competitive House seats.
In 2012, both Washington and Colorado saw spikes in youth turnout when marijuana initiatives were on the ballot. This year, Florida could be a critical test case for whether those increases were an anomaly or the start of a trend in advance of the presidential election in 2016, when activists plan to launch legalization campaigns in at least six states, including battleground Nevada.
"It's a smart move on the Democrats' part," said David Flaherty, a Colorado-based GOP pollster. "It's going to help them, no doubt about it."
Florida Republicans argue that Democrats do not have a clear-cut advantage on medical pot, with public polls showing an overwhelming majority of GOP voters supporting it. They also say it's unlikely to excite young voters in the way that legalization campaigns did in Colorado and Washington, where pot was sanctioned for recreational use along the lines of alcohol, or become part of a divisive culture war that could drive turnout.
Nevertheless, the marijuana initiative may be one bright spot for Democrats in an election year that could be grim for the party. President Barack Obama remains unpopular, and Republicans are trying to make the elections a referendum on his health care law. Gov. Rick Scott is making the health care overhaul a central issue in the governor's race and outside conservative groups, such as Americans for Prosperity, are funding a barrage of negative ads against Democrats in a handful of swing-voting House districts.
"I would rather have it on the ballot than not," said Steve Schale, a Democratic consultant who managed Obama's Florida campaign in 2008. "It could have a marginal impact, and a marginal impact in Florida could be the difference between winning and losing."
A Republican victory in a special House election last month in Florida underscored the Democrats' turnout problem. The St. Petersburg-area district has 2.4 percent more registered Republicans than Democrats, but GOP voters outnumbered Democrats by 8 percentage points among those who cast ballots.
Some Republicans paint the medical marijuana initiative as a ploy by Democrats to help former Gov. Charlie Crist, a Republican turned Democrat, reclaim the governorship. Crist supports the measure, saying it's "an issue of compassion." Scott opposes it, citing his brother's struggles with substance abuse.
The marijuana campaign's chief financier is John Morgan, an Orlando trial lawyer and major Democratic donor whose firm employs Crist. Morgan insists the effort is personal, not political; he says marijuana eased the suffering of his father, who died of esophageal cancer, and his brother, who is a quadriplegic.
Democrats say the medical pot measure could help counter Republican energy by motivating young and independent voters. According to a national survey sponsored by George Washington University last month, nearly 40 percent of likely voters said they would be "much more likely" to vote if a legalization measure was on the ballot, with another 30 percent saying they would be "somewhat" more likely to vote.
Organizers of the medical marijuana effort plan to raise and spend $10 million on their campaign, with much of the money devoted to a turnout operation aimed at registering voters to cast absentee ballots.
"We want to be able to have our stereotypical, lazy pothead voters to be able to vote from their couch," said Ben Pollara, a Democratic fundraiser and campaign manager for the United for Care group, which also plans to get voters to the polls on Election Day.
Associated Press news researcher Judy Ausuebel contributed to this report.
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KAMPALA, Uganda (AP) -- Goaded by journalists who wanted a clear view of her face, the Ugandan nurse looked dazed and on the verge of tears. The Ugandan press had dubbed her "the killer nurse," after the HIV-infected medical worker was accused of deliberately injecting her blood into a two-year-old patient.
The 64-year-old nurse, Rosemary Namubiru, was charged with attempted murder, denied bail and sent to jail in an unusual case that many here saw as a horrifying example of the lax hospital standards believed to be prevalent in this East African country.
But in the course of her trial - on the revised charge of criminal negligence - the nurse is attracting sympathy and emerging as the apparent victim of rampant stigma in a country that until recently was being praised as a global leader in fighting AIDS and promoting an open attitude toward the disease.
The nurse, while attempting to give an injection to a distraught child on Jan. 7, accidentally pricked her finger with a needle, according to AIDS-Free World, an international advocacy group that has been monitoring the ongoing trial. After bandaging her finger she returned to administer the injection, apparently using the contaminated needle. Uncertain about whether the same needle was used, the child's mother "became concerned about the possibility that her child had been exposed to HIV," the group said. After a test showed the nurse was HIV positive, she was arrested and prosecutors argued against giving her bail on the grounds that she posed a grave danger to the public.
If convicted, the nurse faces seven years in jail and would be the first Ugandan medical worker to be sentenced under a colonial-era law against negligent acts likely to lead to the spread of an infectious disease.
The child who may have been exposed to HIV was given post-exposure treatment and will be tested again for HIV in coming days, according to lawyers and activists familiar with the case.
Namubiru's trial has consequences for the rights of people with HIV and AIDS, say AIDS activists in Uganda and abroad. Uganda, which achieved global attention in the 1990s for its efforts to stem the spread of the disease, has about 1.5 million people living with HIV out of a total population of 36 million. Activists note that it's virtually impossible to find a Ugandan family that hasn't been affected by the disease since it was first reported here in the 1980s. Yet stigma toward people suffering from AIDS persists, shocking activists.
The nurse's case illustrates "the failure of both the media and the prosecutor's office to act responsibly" and could set "a dangerous precedent and could have grave consequences for the fundamental rights of people living with HIV and AIDS in Uganda and beyond," said AIDS-Free World, in a statement.
Namubiru shouldn't be on trial and her case should simply have been referred to the Uganda Nurses and Midwives Council, a statutory body charged with protecting the public from unsafe nursing practices, said Dorah Kiconco, a Ugandan lawyer who runs a watchdog group called the Uganda Network on Law, Ethics and HIV/AIDS.
"She was working and she got into a bad accident and it should have been treated as such," Kiconco said. "She's on trial because of her HIV status."
Jane Kajuga, a spokeswoman for Uganda's public prosecutor, defended the decision to press charges, saying there's evidence a crime was committed.
The Global Commission on HIV and the Law said the nurse's "life has been ruined. No matter the outcome of the trial, the panorama of ferociously intemperate accusation will haunt her and her family forever."
Uganda's HIV rate has been rising in recent times, confounding officials who succeeded in reducing the prevalence from 18 percent in 1992 to 6.4 percent in 2005. Now the rate stands at 7.3 percent, according to the most recent survey by Uganda's Ministry of Health. Ugandan health officials say more married couples are getting infected, in part because of what campaigners have dubbed a "sexual network" in which married people keep secret lovers. Billboards in Kampala, the Ugandan capital, urge couples to "put your love to the test" by testing for HIV.
Ugandan President Yoweri Museveni last year publicly tested for HIV in a bid to spark similar action among reluctant Ugandans. Although being HIV positive no longer spells a death sentence, even for poor Ugandans, public knowledge of one's HIV-positive status can destroy a life. A Ugandan man who worked in the presidential palace as a gardener recently accused his bosses of firing him after they discovered that he was infected with HIV.
Ugandan Maj. Rubaramira Ruranga, one of few officials who have publicly revealed they have HIV in a bid to discourage stigma, said the case against the nurse proves that "stigma still rages on" in Uganda.
"If I were her I would be very angry, I would feel isolated and I would feel dejected," he said. "She was brutalized."
LONDON (AP) -- Two new studies describe the latest achievements in growing body parts in a lab and transplanting them into people, this time with nostrils and vaginas.
Windpipes, bladders, blood vessels and other structures have previously been created in part from a patient's own cells and then implanted. Eventually, scientists hope to tackle more complicated things like lungs and kidneys with this strategy, which is aimed at avoiding rejection of transplanted organs.
The latest experiments were published online Friday in the journal Lancet.
"They both show that by using fairly simple tissue engineering techniques, you can get real tissue forming where it's supposed to," said Dr. Martin Birchall, of The Ear Institute at University College London, who co-authored an accompanying commentary. He said the simple methods could be useful for making other body parts, including joint cartilage, bowels and the esophagus.
One experiment involved four teenage girls in Mexico who were born without vaginas because of a rare disorder. Currently, surgeons use tissue grafts to create vaginas for such patients, but that method carries a risk of complications.
The experimental results were reported by Dr. Anthony Atala of the Wake Forest University School of Medicine in Winston-Salem, North Carolina, with researchers there and at the Metropolitan Autonomous University in Mexico City. Atala said the procedure might also prove useful for replacing vaginas removed because of cancer, and repairing or replacing the organ after an injury.
For the experiment, researchers took a tissue sample less than half the size of a postage stamp from the patients' genitals. They multiplied cells from this tissue in the lab, seeded them onto a biodegradable scaffold and molded it into the right size and shape for each patient before implantation.
The first surgery was done in 2005, and the Lancet report provides a follow-up of the patients for an average of nearly seven years. The women report normal levels of sexual functioning, without any long-term complications. It is not known whether the women could get pregnant; only two have wombs, Atala said.
One of the women, in a video provided by the Mexican university, said she felt fortunate "because I have a normal life." The university didn't identify the woman.
In the other experiment, Swiss scientists built new outer nostrils for five patients who had skin cancer on their noses. When surgeons removed the tumor, they also took a tiny bit of nose cartilage. They grew the cells for four weeks in the lab to make a small flap. That was then implanted onto their nose and covered with skin from their foreheads. Normally, cartilage is taken from the patient's ear or ribs to recreate the nostril.
Ivan Martin of University Hospital Basel, the study's senior author, said none of the patients reported any side effects by one year after surgery, and all were satisfied with their new nostrils.
"Now that we have demonstrated this is safe and feasible, we can use (this technique) for more complicated clinical needs," he said, adding that the same approach is being tested in people to supply knee cartilage. He said scientists were slowly gaining more expertise in making body parts, but predicted it could take another couple of decades before the process becomes mainstream.
"It's not a trivial thing to engineer a functional tissue," he said.
Malcolm Ritter reported from New York.