FDA backs Vytorin for kidney disease patients (AP)

WASHINGTON � The Food and Drug Administration says Merck's cholesterol drug Vytorin helps reduce heart attack, stroke and related problems in patients with kidney disease, a potential new use for the blockbuster drug.

The agency's online review also found no new safety concerns with Vytorin, which came under scrutiny for potential cancer risks in 2008.

Merck has asked the FDA to approve the drug for a new use in reducing heart-related problems chronic kidney disease patients. The combination pill is already cleared to reduce bad cholesterol.

FDA says that Vytorin lowered kidney disease patients' heart-related problems by 16 percent compared with placebo. However results varied depending on whether patients were receiving dialysis, standard treatment for patients with late-stage kidney disease who can no longer remove waste from their blood. Patients on dialysis only saw a six percent drop in heart problems, compared with a 22 percent reduction for healthier patients not on dialysis.

On Wednesday, the FDA will ask non-government advisers to comment on the disparity and to vote on the overall safety and efficacy of the drug for kidney disease patients.

Vytorin, a $2 billion-a-year drug for Merck, combines two brand-name cholesterol pills Zocor and Zetia.

In July 2008, preliminary results from a four-year study indicated a possible increased risk of cancer in patients getting Vytorin. But FDA's latest review found no evidence of a link between Vytorin and cancer.

"We believe these data should help lay to rest investor concerns about Vytorin and Zetia's safety," Leerink Swann analyst Seamus Fernandez wrote in a research note Monday.

Shares of Merck & Co. Inc. fell 23 cents to $34.88 in morning trading Monday.

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Violence more common among kids of combat veterans (AP)

ATLANTA � A new study suggests that when parents are deployed in the military, their children are more than twice as likely to carry a weapon, join a gang or be involved in fights.

And that includes the daughters.

"This study raises serious concerns about an under-recognized consequence of war," said Sarah Reed, who led the research of military families in Washington state.

Last year, nearly 2 million U.S. children had at least one parent serving in the military. Deployment can hurt a family in a variety of ways. There's stress while that parent is overseas and in danger, as the remaining parent has to shoulder all responsibilities and family roles shift. There can also be challenges after deployed parents' return, especially if they were physically or psychologically damaged.

The effect of military deployment on kids is an emerging field of research. The new study is considered the first of its kind to focus on those affected by deployments to Afghanistan and Iraq. It's unique in that it looked at a statewide swath of the population in comparing the behavior of kids in military families to children in non-military families.

The study, to be presented Monday at a public health conference in Washington, D.C., was based on a 2008 questionnaire survey of about 10,000 students in the 8th, 10th and 12th grades in Washington. That state has the sixth largest active duty population in the country.

About 550 of surveyed children said they had a parent deployed to a combat zone in the previous six years.

The study tried to account for potential differences in educational background and other issues between military families and the general population that might skew the results.

Even after taking steps to account for such differences, the researchers found that high school-age daughters of deployed parents were nearly three times more likely than civilian girls to be in a gang or get into a fight. They were more than twice as likely to carry a weapon to school. There were similar increases among boys of deployed families when compared to civilians.

To be sure, such behavior in boys is more common � the rate of boys from deployed families involved in such violent behaviors was twice as high as for girls in deployed families. For example, 14 percent of girls from these military families said they had been in fights, compared to 28 percent of boys.

Nevertheless, experts say the findings contradict the traditional view that girls under stress exhibit "internalizing" behaviors, like becoming depressed or thinking about suicide, while boys are the ones who "externalize" through violent behavior

The new research may be something of a wake-up call for health professionals who deal with military families, one expert suggested.

"Maybe if we make assumptions about children, we may overlook other ways they may be suffering," said Dr. Gregory Gorman, an assistant professor of pediatrics at the Uniformed Services University of the Health Sciences in Bethesda, Md.

Additional research is needed to confirm the findings, said Reed, who has since left the University of Washington and is now a social worker with the Dana-Farber Cancer Institute in Boston. For example, the survey found that 10 to 20 percent of the adolescents in deployed families said they were in gangs. That's surprisingly high � more like something seen in New York City in the 1950s. Perhaps a larger, more national study would produce a lower number.

But it's not surprising that kids in deployed families would seek out other kids to help them deal with stress, said Gregory Leskin, a UCLA psychologist who is director of a military family program at the National Child Traumatic Stress Network.

"Adolescents may be able to get lost in social networks," he said.

___

Online:

American Public Health Association meeting:

http://www.apha.org/meetings/AnnualMeeting/

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Cain defends ad with smoking campaign manager (AP)

WASHINGTON � Republican presidential hopeful Herman Cain said Sunday that an Internet ad featuring his campaign manager smoking conveyed a message about letting "people be people" and was not intended to suggest that smoking is cool.

The video went viral this month with some 1 million clicks on Cain's campaign website. The ad shows Cain's top adviser, Mark Block, taking a deep drag from a cigarette and slowly exhaling into the camera.

"I'm not a smoker. But I don't have a problem if that's his choice," Cain said on CBS' "Face the Nation."

"So let Herman be Herman. Let Mark be Mark. Let people be people. This wasn't intended to send any subliminal signal whatsoever," the candidate said.

Cain, who was diagnosed with liver and colon cancer in 2006 and has said he's been cancer-free since 2007, was chided about the ad by his interviewer, Bob Schieffer, a bladder cancer survivor.

"Mark Block smokes. That's all that ad says," Cain said. "We weren't trying to say it's cool to smoke. You have a lot of people in this country that smoke. But what I respect about Mark as a smoker ... he never smokes around me or smokes around anyone else. He goes outside."

Cain said the video was meant "to be informative. If they listen to the message where he said America has never seen a candidate like Herman Cain, that was the main point of it. And the bit on the end, we didn't know whether it was going to be funny to some people or whether they were going to ignore it or whatever the case may be."

Cain said he understood the objection and that about 30 percent of the feedback the campaign had received to the video was similar to Schieffer's.

Schieffer pressed Cain to send an anti-smoking message on the show. Cain complied.

"Young people of America, all people, do not smoke. It is hazardous and it's dangerous to your health. Don't smoke. I've never smoked and I have encouraged people not to smoke," he said.

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Commonwealth leaders raise polio vaccine spending (AP)

PERTH, Australia � Commonwealth government leaders meeting in Australia have agreed to step up efforts to eradicate polio worldwide despite the Afghanistan war setting back vaccination efforts there and in neighboring Pakistan.

Leaders of Britain, Canada, Australia and Nigeria, as well as billionaire philanthropist Bill Gates, on Saturday committed tens of millions of dollars in additional funding toward eradication of the disabling disease from the four countries where it remains endemic � India, Afghanistan, Pakistan and Nigeria.

All the polio-endemic countries except for Afghanistan are represented at the three-day summit in the western Australian city of Perth. The summit comprises the leaders of 53 countries, most of them former British colonies.

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Halloween doesn't have to be gorge-fest to be fun (AP)

CHICAGO � Offer apples to trick-or-treaters and risk having your house get egged � maybe even by your own kids.

But dentists and dietitians say you can still make Halloween reasonably healthy for little devils and witches without resorting to dracul-onian tactics, like no candy.

"This is such a big adventure for them � let them have it, obviously with some caveats," said Dr. Rhea Haugseth, a dentist in Marietta, Ga., who's president of the American Academy of Pediatric Dentistry

There are tricks for keeping Halloween fun without risking cavities and extra pounds, like handing out dark chocolate instead of chewy candies or even bribing kids with a toy in exchange for the Halloween loot. Some studies have suggested dark chocolate is good for the heart, and chewy candies stick to the teeth.

Just don't go overboard on restrictions, says Cole Robbins, a Chicago 12-year-old and Halloween veteran.

"Halloween is the one day of the year where we kids just kind of break out and overload on candy," he said.

To help prevent that kind of gorging, try to give children a healthy, filling meal before trick-or-treating, says Bethany Thayer, a spokeswoman for the American Dietetic Association who works at the Henry Ford Health System in Detroit.

Procrastinators, take heart. Thayer also recommends waiting until Halloween day before buying candy, so no one is tempted to indulge beforehand.

"I know people who have to go back to the store because they've completely gone through their candy" before Halloween, she said.

Haugseth suggests avoiding cavity-promoting treats like caramels that stick to the teeth, or lollipops that bathe teeth in a long sugary bath.

Also, having kids brush their teeth before trick-or-treating helps reduce plaque and bacteria, which interact with sugar to produce tooth-decaying acid, Haugseth said. Kids should also brush right after eating candy, she said.

Ronni Litz Julien, a Miami nutritionist whose patients include overweight and obese kids, says another trick for parents is to ask kids not to dip into their loot bags until they bring it all home. That's for safety, so parents can toss any suspicious-looking candy, but it also can prevent an "eating frenzy."

She suggests parents help sort through the loot, have kids select their 10 favorite pieces, and give the rest away. Offer the choice of eating all 10 pieces at once, or over 10 days. That gives them a sense of control, without feeling shortchanged, she said.

"You can't deprive them. It's Halloween, for God's sake," she said.

President Barack Obama joked this week on "The Tonight Show" that he'd warned his health-promoting wife that the White House would get egged if she gave trick-or-treaters fresh fruit and raisins instead of candy. During festivities on Saturday, the Obamas will hand out White House M&Ms, cookies and dried fruit as they did the past two years.

Dr. Janet Silverstein, a Gainesville, Fla. pediatrician and member of the American Academy of Pediatrics' nutrition committee, says she doesn't give out candy, offering fruit or pencils instead; so far her house is unscathed.

When her own children were young, Silverstein would buy their candy for a nickel a piece. She recommends that to her patients' parents, too � though not necessarily her other solution � she used to eat her kids' candy.

In some places, kids willing to give up their candy can make more than a nickel. About 1,500 dentists across the country have agreed this year to participate in a Halloween candy buyback organized by Operation Gratitude. The California-based group periodically sends care packages to U.S. troops overseas. Some dentists pay kids $1 per pound of Halloween candy; last year, the program brought in 250,000 pounds of candy, said Carolyn Blashek, founder of the Van Nuys, Calif.-based group.

Blashek said troops overseas appreciate it as a token of gratitude, and Halloween candy brings back lots of fond childhood memories. Some have given their candy to Afghan children, she noted. Entering your ZIP code on the group's website, http://bit.ly/F1iSy will identify participating dentists.

Parents who plan to encourage giving up candy should be sure not to take it right away, says Brian Wansink, a Cornell University food behavior scientist and author of "Mindless Eating: Why We Eat More Than We Think."

That's because of a psychology principle called "the endowment effect." It refers to kids feeling a sense of ownership and putting a high value on candy they haul in.

If you let them eat several pieces first, that feeling can fade and they won't even feel hungry anymore. That's the time to offer a trade, Wansink said.

He's tried that trick with his own three daughters, aged 2, 4, and 6, and says "it works like a charm." His girls eagerly give up the rest of their Halloween candy in exchange for a new trinket or other toy that won't rot their teeth, he said.

Young kids aren't really aware of how much they brought home, and when "they sort of count their booty, that's probably the age where kids shouldn't be trick or treating anymore," he said.

___

American Academy of Pediatric Dentistry: http://www.aapd.org

American Dietetic Association: http://www.eatright.org___

AP Medical Writer Lindsey Tanner can be reached at http://www.twitter.com/LindseyTanner

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Program urges smokers switch to smokeless tobacco (AP)

In the smoker-heavy state of Kentucky, a cancer center is suggesting something that most health experts won't and the tobacco industry can't: If you really want to quit, switch to smoke-free tobacco.

The James Graham Brown Cancer Center and the University of Louisville are aiming their "Switch and Quit" campaign at the city of Owensboro. It uses print, radio, billboard and other advertising to urge smokers to swap their cigarettes for smokeless tobacco and other products that do not deliver nicotine by smoke.

Supporters say smokers who switch are more likely to give up cigarettes than those who use other methods such as nicotine patches, and that smokeless tobacco carries less risk of disease than cigarettes do.

"We need something that works better than what we have," said Dr. Donald Miller, an oncologist and director of the James Graham Brown Cancer Center, which supports the effort along with the University of Louisville. "This is as reasonable a scientific hypothesis as anybody has come up with and it needs to be tried."

The campaign runs counter to the prevailing opinion of the public health community, which holds that there is no safe way to use tobacco. Federal researchers, however, have begun to at least consider the idea that smokers might be better off going smokeless.

The National Cancer Institute at the National Institutes of Health says on its website that the use of all tobacco products "should be strongly discouraged," and that there is "no scientific evidence that using smokeless tobacco can help a person quit smoking." But this year it approved funding for a study that might provide some of that very evidence.

"Switch and Quit" is directed by Brad Rodu, a professor of medicine at the University of Louisville. He analyzed the 2000 National Health Interview Survey and found that male smokers who switched to smokeless tobacco were more likely to quit smoking than those who used nicotine patches or gum.

"Americans are largely misinformed about the relative risks. ... They think smokeless tobacco is just as dangerous," Rodu said. "This level of misinformation is an enormous barrier to actually accomplishing tobacco-harm reduction because if people believe that the products have equal risk, there's not a real incentive."

The program is funded through Rodu's research money, which includes grants from the tobacco industry. Grants through the University of Louisville are unrestricted, which the program says "ensures the scientific independence and integrity of research projects and activities."

"There's absolutely no influence whatsoever," Rodu said. "I decide, along with my colleagues, how we use the money, for what projects, and this is entirely the case. I would not have a situation where there was some control over the kind of projects I undertake."

Tobacco companies want to market more smokeless tobacco and other cigarette alternatives to make up for falling cigarette sales. Some have introduced "snus" � small pouches like tea bags that users stick between the cheek and gum � and dissolvable tobacco � finely milled tobacco shaped into orbs, sticks and strips.

But they're barred by federal law from explicitly marketing them as less risky than cigarettes � at least for now. That means the "Switch and Quit" program can do something the tobacco industry itself cannot: claim that smokeless tobacco has a health benefit when compared to smoking.

The program says smoking kills about 220 adults a year in and around Owensboro. The state of Kentucky, a leading tobacco grower, has the nation's highest smoking and lung cancer rates.

Owensboro and the surrounding area consume about 3 million cigarettes a week, according to the program. That amounts to well over a pack for every man, woman and child in the community of about 115,000 people.

Owensboro resident Vernon Goode had smoked for about 10 years before he recently traded his Marlboros for dissolvable tobacco tablets. The campaign didn't inspire him to quit, but he said he thought it was a good idea.

"I was just wanting to quit because, you know, I could feel it in my lungs," Goode said. "I'll smoke a cigarette every once in a while, but not very often. I want to quit altogether and I'm just using this right here as I guess what you'd call a stepping stone."

The Owensboro program has raised concerns among some in the public health community who say organizers are claiming smokeless tobacco is a healthier alternative to smoking without approval from the Food and Drug Administration.

A 2009 law gives the FDA authority to evaluate health risks of tobacco products and approve those that could be marketed as safer than what's currently for sale. None have been given the OK yet. The FDA also plans to regulate electronic cigarettes, battery-powered plastic and metal devices that heat a liquid nicotine solution in a disposable cartridge, creating vapor that users inhale.

Matthew Myers, president of the Campaign for Tobacco-Free Kids, called the program "a giant experiment with the people of Owensboro without rules or guidance designed to protect individuals from experimental medicine."

Smokeless tobacco isn't a safe alternative to cigarettes, according to the Centers for Disease Control and Prevention. Health warnings on the products required by the FDA state the same thing.

However, some studies, including a 2007 report from the Royal College of Physicians in London titled "Harm Reduction in Nicotine Addiction," suggest that some smokeless tobacco products are about 90 percent less harmful than cigarettes.

"The worst that you can say about smokeless tobacco is that it's the lesser of two evils," said Dr. Randall Thomas, an oncologist with the Owensboro Medical Health System. The health system, the community's largest employer, is going smoke-free in 2013 and is offering Rodu's program as one of a variety of quit-smoking tools for its employees.

"I don't think we have any problem in telling a person that drinks a six-pack a day that if they could cut it back to two beers a day or two drinks a day that their health risks are greatly reduced," Thomas said. "Finding a way to let people have their nicotine that carries less risk, it's the realistic solution."

The Owensboro program doesn't suggest pharmaceutical nicotine replacement gum or patches. That's because they are regulated to provide very small doses of nicotine and are recommended for only a short period of time, while smokeless tobacco can be used as long as a smoker needs, Rodu said.

Myers, of the Campaign for Tobacco-Free Kids, said more research is needed before anyone should suggest that the nation's 46 million smokers would be better off using smokeless tobacco. In the meantime, he said, there are a host of FDA-approved products that can help people give up smoking.

"There's a right way and a wrong way to determine whether smokeless tobacco can and should be marketed as a way to help people quit," Myers said.

The National Cancer Institute approved funding earlier this year for a nationwide 1,250-person study to look at whether being given a snus product changes the habits of smokers who are not motivated to quit.

The tobacco industry sees smokeless tobacco as its future, said Matthew J. Carpenter, a psychology professor at the Medical University of South Carolina who is conducting the yearlong study.

Carpenter said the snus study will examine what smokers do when given smokeless tobacco. He won't look at the health effects, or advise smokers to use the snus to quit.

"They are probably safer than conventional cigarettes, if for no other reason than you're not burning anything, you're not smoking anything, you're not inhaling any smoke," he said.

"If you compare it to conventional cigarettes, they're probably a little bit better. If you compare it to quitting, they're absolutely worse."

___

Michael Felberbaum can be reached at http://www.twitter.com/MLFelberbaum.

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Gov't considers testing anthrax vaccine in kids (AP)

WASHINGTON � A government advisory panel is considering whether the anthrax vaccine should be tested in children.

Health experts worry that terrorists could one day use the potentially deadly bacteria in an attack on the United States.

There's plenty of vaccine stockpiled just in case, and it's been widely tested on adults.

But since it's never been tested on youngsters, the question is whether to do research now so doctors would know if and how well children respond to the shots � or just wait and, if there is an attack, offer the vaccine experimentally at that time.

That question is before the National Biodefense Science Board on Friday. The board gives advice to the Department of Health and Human Services on preparations for chemical, biological and nuclear emergencies.

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FDA ties newer birth control drugs to blood clots (AP)

WASHINGTON � Safety concerns with the popular birth control pill Yaz increased Thursday as federal health scientists reported that the Bayer drug and other newer birth control treatments appear to increase the risk of dangerous blood clots more than older medications.

A new study released by the Food and Drug Administration reviewed the medical history of more than 800,000 U.S. women taking different forms of birth control between 2001 and 2007. On average, woman taking Yaz had a 75 percent greater chance of experiencing a blood clot than women taking older birth control drugs.

Yaz contains estrogen along with a next-generation synthetic hormone called drospirenone, which is known to increase potassium levels in the blood. FDA compared medical records of women taking the drug with those taking the older drug levonorgestrel.

Yaz, Yasmin and related drospirenone-containing pills were Bayer's second-best-selling franchise last year at $1.6 billion in global sales.

In 2009, the FDA took the unusual step of ordering Bayer to run corrective TV advertisements on Yaz, saying the drugmaker's marketing campaign overstated the drugs' ability to prevent acne and premenstrual syndrome.

Bayer Healthcare, a division of the German conglomerate, said it "is currently evaluating this publication and cannot comment at this point in time."

The agency also reported higher complications in women using the Ortho Evra patch from Johnson & Johnson and the Nuvaring vaginal ring from Merck & Co. Inc. Those drugs combine estrogen, which is present in all birth control pills, with two other synthetic hormones launched in the last decade.

The FDA said it hasn't reached a final conclusion on the drugs' safety but will hold a meeting with scientific advisers Dec. 8.

Consumer safety advocates have criticized the agency for approving newer, more expensive birth control drugs when cheaper, generic drugs with established safety records are widely available.

"At a certain point we have to ask why the FDA continues to approve drugs that are less safe and have no benefit compared to drugs already on the market," said Dr. Diana Zuckerman, president of the National Center for Women and Families, a consumer group for women's health issues. "With all these different birth control options, why take the most expensive one that can also kill you?"

Recent studies have reached differing conclusions on the risks of newer birth control pills.

A study published earlier this week involving more than 1 million Danish women found that women taking Yaz and other newer medications had twice the risk of blood clots as women taking the older hormone levonorgestrel. The findings appeared Tuesday in the British Medical Journal.

However, two studies published in 2007, conducted as part of the postmarketing requirements of the FDA or European regulators, did not find any difference in blood clotting between the two comparable groups.

Birth-control pills that contain drospirenone include Bayer's Yaz, Yasmin, Beyaz, Safyral; Sandoz's Syeda and Loryna; as well as Barr Laboratories' Ocella, Watson Pharmaceuticals' Zarah and Teva Pharmaceuticals' Loryna.

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Pythons' big hearts hold clues for human health (AP)

WASHINGTON � You don't think of pythons as big-hearted toward their fellow creatures. They're better known for the bulge in their bodies after swallowing one of those critters whole.

But the snakes' hearts balloon in size, too, as they're digesting � and now scientists are studying them for clues about human heart health.

The expanded python heart appears remarkably similar to the larger-than-normal hearts of Olympic-caliber athletes. Colorado researchers report they've figured out how the snakes make it happen.

"It's this amazing biology," said Leslie Leinwand, a molecular biologist at the University of Colorado Boulder, whose team reports the findings in Friday's edition of the journal Science. "They're not swelling up. They're building (heart) muscle."

Reptile biologists have long studied the weird digestion of these snakes, especially the huge Burmese pythons that can go nearly a year between meals with no apparent ill effects. When they swallow that next rat or bird � or in some cases deer � something extraordinary happens. Their metabolism ratchets up more than 40-fold, and their organs immediately start growing in size to get the digesting done. The heart alone grows a startling 40 percent or more within three days.

Leinwand, who studies human heart disease, stumbled across that description and saw implications for people. An enlarged human heart usually is caused by chronic high blood pressure or other ailments that leave it flabby and unable to pump well. But months and years of vigorous exercise give some well-conditioned athletes larger, muscular hearts, similar to how python hearts are during digestion.

So Leinwand's team � led by a graduate student who initially was frightened of snakes � ordered a box of pythons and began testing what happens to their hearts.

The first surprise: A digesting python's blood gets so full of fat it looks milky. A type of fat called triglycerides increased 50-fold within a day. In people, high triglyceride levels are very dangerous. But the python heart was burning those fats so rapidly for fuel that they didn't have time to clog anything up, Leinwand said.

The second surprise: A key enzyme that protects the heart from damage increased in python blood right after it ate, while a heart-damaging compound was repressed.

Then the team found that a specific combination of three fatty acids in the blood helped promote the healthy heart growth. If they injected fasting pythons with that mixture, those snakes' hearts grew the same way that a fed python's does.

But did it only work for snakes? Lead researcher Cecilia Riquelme dropped some plasma from a fed python into a lab dish containing the heart cells of rats � and they grew bigger, too. Sure enough, injecting living mice made their hearts grow in an apparently healthy way as well.

Now the question is whether that kind of growth could be spurred in a mammal with heart disease, something Leinwand's team is starting to test in mice with human-like heart trouble. They also want to know how the python heart quickly shrinks back to its original size when digestion's done.

The experiments are "very, very cool indeed," said James Hicks, a biologist at the University of California, Irvine, who has long studied pythons' extreme metabolism and wants to see more such comparisons.

If the same underlying heart signals work in animals as divergent as snakes and mice, "this may reveal a common universal mechanism that can be used for improving cardiac function in all vertebrates, including humans," Hicks wrote in an email. "Only further studies and time will tell, but this paper is very exciting."

The study was funded by the National Institutes of Health and a Boulder biotechnology company that Leinwand co-founded, Hiberna Corp., that aims to develop drugs based on extreme animal biology.

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Keeping it clean: Protesters cope with sanitation (AP)

LOS ANGELES � With thousands of Occupy Wall Street demonstrators roughing it in parks for up to six weeks, garbage, human waste and hygiene are becoming a growing worry in public encampments nationwide.

Poor food storage exacerbated a rat infestation in Oakland. Inspectors found open human waste in Philadelphia. Hypothermia cases developed in Denver after a snowstorm hit.

Disease is the chief concern with so many people living in close proximity without proper sanitation.

"Any time you have a large number of people in an event like this, there's potential for illness to spread rapidly," said Angelo Bellomo, director of environmental health for Los Angeles County. "Conditions can change within an hour or two."

Poor food storage, along with public urination and defecation, led Oakland police to dislodge 200 protesters from a plaza outside City Hall before dawn Tuesday.

In Philadelphia, sanitary conditions have worsened at the 350-tent Occupy Philly camp, said city managing director Richard Negrin. The camp has four portable toilets that have not been cleaned or emptied regularly.

Health officials, who conduct daily inspections of Los Angeles' camp, have directed organizers to dispose of wastewater from portable showers into drains rather than the ground, and to increase the number of portable toilets, have them emptied twice a day and provide water jugs for hand-washing.

Close-quarters living can facilitate the spread of germs through airborne, foodborne or person-to-person contact. Norovirus has caused outbreaks of gastroenteritis on cruise ships, for example, while adenovirus has caused influenza and other respiratory illnesses in military barracks.

So far, no outbreaks of illness have been reported from the grassroots demonstrations that have sprouted nationwide to oppose policies viewed as promoting corporate greed. Medical tents in Los Angeles have only treated minor ailments such as scrapes and colds.

Protesters in Denver, however, said they took two demonstrators to a hospital with symptoms of hypothermia during an snowstorm that started Tuesday night.

Some demonstrators complain that the health issues have been exaggerated as a pretext to crack down on the camps. Authorities did not seem to be concerned about unhygienic conditions that existed before, they said.

"They never go and clean up Skid Row," said Juan Alcala, a camper in Los Angeles, where more than 350 tents are jammed on a lawn around City Hall.

The protesters are taking pains to keep the premises clean but acknowledge it's an ongoing battle to keep up as tents proliferate and attract the attention of public health officials.

Mayor Antonio Villaraigosa told the Los Angeles Times that county health inspectors have expressed concerns over the cleanliness of the camp. The mayor also said the city's lawn and trees are suffering.

"The lawn is dead, our sprinklers aren't working ... our trees are without water," Villaraigosa told the Times.

Although protesters formed a sanitation committee from the start, hygiene issues have gotten more complicated than Occupy LA organizers anticipated.

The camp is largely well kept, although numerous trash bins around the site were overflowing during recent visits. Organizers pay a private hauler $57 a week to collect the rubbish daily after being fined by the city for failing to remove trash.

As the scent of marijuana wafted in the air and drumbeats sounded in a steady rhythm, organizers roamed the camp, urging people to pick up their trash and not to walk barefoot. Most people complied and some pitched in. Alcala seized a large palm frond and swept concrete walkways.

Protesters said overall, people were careful about rubbish. "I smoke and I'm really conscious about not throwing my butts on the ground," said another camper, John Waiblinger.

Personal hygiene has been a more difficult issue.

Many people use showers at homeless shelters in Skid Row, while some have organized bathing trips to homes, said organizer Gia Trimble.

Others said they used the camp showers on site, filling up a plastic bag with solar-heated water or hot water from a City Hall faucet. The bag, which has a tube to spray the water, hangs from a cord.

"I use the solar-heated shower or even those moist towelettes," Alcala said. "We're clean here."

Campers said they weren't worried about illnesses. Nevertheless, some were taking commonsense precautions.

Tommy Schacht, who was brushing his teeth with bottled water on a recent morning, said he goes home to shower and change clothes, and mostly used bathrooms at nearby businesses or public facilities instead of the portable toilets on site.

"I don't worry about that at all, but I try to stay away from people that are dirty," he said.

Some campers' clothing was visibly grubby, although others said they went to friends' homes or Laundromats to do laundry.

Food handling has posed other problems.

The camp shut down its food tent, where volunteers made everything from sandwiches to a tabouli-type salad in blenders, after inspectors noted that it was not in compliance with food handling laws.

Now, donated prepared foods, ranging from cookies to packaged sandwiches, are distributed. Most campers make their own meals, heating up Ramen noodles, canned soup and refried beans on small gas-powered camp stoves.

Schacht, who's been camping out for more than a week, said he was cooking lots of pasta � "anything that can be made with hot water, that's easy."

Organizers said that although they continue to hammer out unforeseen logistical issues, they're trying to keep the political cause paramount.

"It's a very interesting time for us. We're dealing with trying to become self-sufficient," said Trimble. "We don't want the focus to be on their living conditions, we want it to be on the movement."

___

Associated Press writers Marcus Wohlsen in Oakland, Calif., Kristen Wyatt in Denver, and Kathy Matheson in Philadelphia contributed to this report.

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Report: Industry decides food ingredient safety (AP)

SAN FRANCISCO � Thousands of ingredients that go into food have been classified as safe by private industry alone, without any government oversight, according to a new report published Wednesday.

Since the early 1960's, private companies and industry trade associations have determined at least 3,000 ingredients are safe, with no federal scrutiny, the study found. The ingredients include everything from artificially synthesized chemicals used in chewing gum to grape seed extract used in cheese and instant coffee.

The peer-reviewed report published in the Comprehensive Reviews in Food Science and Food Safety journal draws on research funded by the Pew Health Group, the health and consumer safety arm of the nonprofit Pew Charitable Trusts.

The Grocery Manufacturers Association says the industry only classifies ingredients as safe after a battery of rigorous biological tests but agrees that more transparency in the vetting process would help build consumer confidence.

"The system is less transparent than it should be so we're looking to open that dialogue," said Leon Bruner, the association's chief science officer, who agreed the study's estimates were reasonable. "We are completely comfortable with increasingly the transparency or the visibility of ingredients that go through the process."

The Federal Food, Drug, and Cosmetic Act makes food manufacturers responsible for ensuring food ingredients are safe. Companies can classify an ingredient as "generally recognized as safe" for use in a specific product but aren't required to tell the Food and Drug Administration about what they find. Some do, through a voluntary notification program that gives the Food and Drug Administration a chance to review the findings.

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Secrets of long life sought in DNA of the elderly (AP)

NEW YORK � George Eberhardt turned 107 last month, and scientists would love to know how he and other older folks like him made it that far. So he's going to hand over some of his DNA.

He's one of 100 centenarians taking part in a project announced Wednesday that will examine some of the oldest citizens with one of the newest scientific tools: whole-genome sequencing, the deciphering of a person's complete collection of DNA.

Scientists think DNA from very old healthy people could offer clues to how they lived so long. And that could one day lead to medicines to help the rest of us stay disease-free longer.

By the time you reach, say, 105, "it's very hard to get there without some genetic advantages," says Dr. Thomas Perls, a geriatrics expert at Boston University.

Perls is helping find centenarians for the Archon Genomics X Prize competition. The X Prize Foundation, best known for a spaceflight competition, is offering $10 million in prize money to researchers who decipher the complete DNA code from 100 people older than 100. The contest will be judged on accuracy, completeness and the speed and cost of sequencing.

The contest is a relaunch of an older competition with a new focus on centenarians, and it's the second sequencing project involving the elderly to be announced this month.

Genome pioneer J. Craig Venter says the centenarian project is just a first step in revealing the genetic secrets of a long and healthy life.

"We need 10,000 genomes, not 100, to start to understand the link between genetics, disease and wellness," said Venter, who is co-chairing the X Prize contest.

The 107-year-old Eberhardt of Chester, N.J., played and taught tennis until he was 94. He said he's participating in the X Prize project because he's interested in science and technology. It's not clear his genes will reveal much. Nobody else in his extended family reached 100, and he thinks only a couple reached 90, he said in a telephone interview.

So why does he think he lived so long? He credits 70 years of marriage to his wife, Marie. She in turn cites his "intense interest in so many things" over a lifetime, from building radios as a child to pursuing a career in electronics research.

But scientists believe there's more to it, and they want to use genome sequencing to investigate. Dr. Richard Cawthon of the University of Utah, who is seeking longevity genes by other means, says it may turn up genetic features that protect against multiple diseases or that slow the process of aging in general.

Protective features of a centenarian's DNA can even overcome less-than-ideal lifestyles, says Dr. Nir Barzilai of the Albert Einstein College of Medicine in New York. His own study of how centenarians live found that "as a group, they haven't done the right things."

Many in the group he studied were obese or overweight. Many were smokers, and few exercised or followed a vegetarian diet. His oldest participant, who died this month just short of her 110th birthday, smoked for 95 years.

"She had genes that protected her against the environment," Barzilai said. One of her sisters died at 102, and one of her brothers is 105 and still manages a hedge fund.

Earlier this month, Scripps Health of San Diego announced a different genome project involving the elderly. The Scripps Wellderly Study will receive the complete genomes of 1,000 people age 80 and older from a sequencing company.

A complete genome reveals not only genes but also other DNA that's responsible for regulating genes. It's "the full monty," showing DNA elements that are key for illness and health, says Dr. Eric Topol, who heads the Wellderly Study.

Participants in that study have an average age of 87 and range up to 108, and they've never had diabetes, heart disease or cancer, or any neurological disease.

"Why are these people Teflon-coated?" Topol asked. "Why don't they get disease?"

The ability to turn out lots of complete genomes is "the new-new thing" in trying to find out, he said.

"There's been too much emphasis on disorders per se and not enough on the people who are exceptionally healthy," to learn from their genomes, Topol said. "Now we have the powerful tools to do that."

___

Online:

X Prize competition: http://genomics.xprize.org/

Wellderly Study: http://bit.ly/pHFHDj

___

Malcolm Ritter can be followed at http://twitter.com/MalcolmRitter

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Panel: Boys should get HPV vaccine given to girls (AP)

ATLANTA � A vaccine against cervical cancer hasn't been all that popular for girls. It may be even a harder sell for boys now that it's been recommended for them too.

A government advisory panel on Tuesday decided that the vaccine should also be given to boys, in part to help prevent the cancer-causing virus through sex.

Public health officials have tried since 2006 to get parents to have their daughters vaccinated against the human papillomavirus, or HPV, which causes most of the cervical cancer in women.

They have had limited success, hitting a number of hurdles. Some parents distrust the safety of vaccines, especially newer products. Others don't want to think about their daughters having sex one day, or worry that the vaccine essentially promotes promiscuous behavior.

Tuesday's vote by the Advisory Committee on Immunization Practices' was the first to strongly recommend routine vaccination for boys since the vaccine was first approved for them two years ago. Officials acknowledged the low rate in girls encouraged them to take a new, hard look.

Experts say a key benefit of routinely vaccinating boys could be preventing the spread of the virus to others through sex � making up somewhat for the disappointing vaccination rate in girls. But the recommendation is being framed as an important new measure against cancer in males.

"Today is another milestone in the nation's battle against cancer," said Dr. Anne Schuchat, a U.S. Centers for Disease Control and Prevention administrator who oversees the agency's immunization programs.

Federal health officials usually adopt the panel's recommendations and ask doctors and patients to follow them.

The vaccine has been advised for girls since 2006. Just 49 percent of adolescent girls have gotten at least the first of the three HPV shots. Only a third had gotten all three doses by last year.

"Pretty terrible," Schuchat said.

Schuchat attributed the low rates for girls to confusion or misunderstanding by parents that they can wait until their daughter becomes sexually active. It works best if the shots are given before a girl or boy begins having sex.

Some conservatives argue the vaccine could promote promiscuous behavior. It has come up in the GOP presidential campaign. Texas Gov. Rick Perry came under attack for a 2007 executive order requiring adolescent girls to get the vaccine (with an opt-out clause). When conservative lawmakers rebelled, he backed down.

An estimated 75 to 80 percent of men and women are infected with HPV during their life, but most don't develop symptoms or get sick, according to the CDC. Some infections lead to genital warts, cervical cancer and other cancers, including of the head and neck.

The HPV vaccine is approved for use in males and females ages 9 to 26; it is usually given to 11- and 12-year olds when they get other vaccines. The committee also recommended that males 13 to 21 years get vaccinated.

Tuesday's vote follows recent studies that show the vaccine prevents anal cancer in males, and may work against a type of throat cancer. A study that focused on gay men found it to be 75 percent effective against anal cancer.

While anal cancer has been increasing, it's still fairly rare. Only about 7,000 U.S. cases in men each year are tied to the strains targeted in the HPV vaccine. In contrast, about 15,000 vaccine-preventable cervical cancers in women occur annually.

Preventing a cancer that's primarily associated with gay men may not be much of a selling point, said Dr. Ranit Mishori, a family practice doctor in Washington, D.C. and an assistant professor at the Georgetown University School of Medicine.

Some parents may say "`Why are you vaccinating my son against anal cancer? He's not gay! He's not ever going to be gay!' I can see that will come up," said Mishori, who supports the panel's recommendation.

Schuchat indicated the CDC is ready for that kind of argument: "There's no data suggesting that offering a vaccine against HPV will change people's subsequent sexual behavior," she said.

So far, the threat of genital warts hasn't been persuasive: Some data suggest that less than 1.5 percent of adolescent males have gotten the vaccine over the past two years.

Meanwhile, some feel it's unlikely that most parents will agree to get their sons vaccinated primarily to protect girls. A survey of 600 pediatricians last year found that nearly 70 percent of doctors thought families would deem vaccination of their boys as unnecessary.

Experts at the committee meeting noted an earlier analysis that showed vaccinating boys would not be cost-effective if the female vaccination were high.

"If you do reach high coverage of females, will you stop vaccinating males?" asked Dr. David Salisbury, director immunization for the United Kingdom's Department of Health.

There are two vaccines against HPV, but Tuesday's vote applies only to Merck & Co.'s Gardasil, which costs $130 a dose. The other vaccine wasn't tested for males.

The committee's recommendation � and the greater insurance coverage of the vaccine that is expected to follow � will make it easier for more boys to get the shots, said Dr. Mark Feinberg, chief public health and science officer for Merck Vaccines.

Merck officials bristled at the idea that males would see the vaccine as mainly meant for gay men, noting that HPV-caused anal cancers can occur in heterosexual men.

Maura Robbins of Chicago said she's likely to have her 12-year-old son, Cole, vaccinated against HPV � but probably not until he's a little older. "I would just like to see some long-term testing and long-term results," she said.

___

AP Medical Writer Lindsey Tanner in Chicago contributed to this report.

___

Online:

HPV info: http://www.cdc.gov/hpv/

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Boys should get HPV vaccine too, panel says (AP)

ATLANTA � A government panel is recommending that young boys also get the controversial HPV shot. That's the vaccine now given to girls to prevent cervical cancer.

Doctors argue that it could protect boys against genital warts and some kinds of cancers. But they also say vaccinating 11- and 12-year old boys could also help prevent the spread of the sexually transmitted virus to girls.

The HPV vaccine has been controversial since it was recommended for girls five years ago. And only about a third of adolescent girls have been fully vaccinated against the virus.

The Advisory Committee on Immunization Practices made the recommendation Tuesday. Federal health officials usually adopt what the panel says and asks doctors and patients to follow the recommendations.

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Divide over when to use in-depth cholesterol tests (AP)

WASHINGTON � For heart health, you're supposed to know your numbers: Total cholesterol, the bad LDL kind and the good HDL kind. But your next checkup might add a new number to the mix.

More doctors are going beyond standard cholesterol counts, using another test to take a closer look at the bad fats � a count of particles that carry LDL through the blood.

Cardiologists are divided over the usefulness of that approach. Proponents contend it might help them spot at-risk patients that regular checks might miss, or get more information about how aggressively to treat them.

But so far, guidelines from major heart organizations don't recommend these extra tests. They're pricier than regular cholesterol exams, although Medicare and many other insurers pay for them. And it's not always clear what the results mean.

"I see a lot of people being confused," says Dr. Nieca Goldberg of New York University Langone Medical Center and the American Heart Association. Especially when they're used on lower-risk people, "you don't know how to make sense of the information."

Yet up to half of patients diagnosed with heart disease apparently had normal levels of LDL cholesterol, and some doctors say particle testing might help find some of them sooner.

"For most people, the standard lipid profile is fine," says Dr. Michael Davidson of the University of Chicago. But "I get referred people who said, `My cholesterol was fine, why do I have heart disease?' We're showing them, well, because your particle number's sky high and they were not aware that was a problem."

Davidson chaired a committee of the National Lipid Association which this month called the extra tests reasonable to assess which at-risk patients might need to start or intensify cholesterol treatment. That committee's meeting was paid for by a grant from eight pharmaceutical companies, including some makers of particle tests.

Cholesterol isn't the only factor behind heart disease. High blood pressure, smoking, obesity, diabetes or a strong family history of the disease can put someone in the high-risk category even if their cholesterol isn't a red flag. Some doctors also are testing for inflammation in arteries that may play a role, too.

On the cholesterol front, doctors have long focused on three key numbers:

_Total cholesterol should be below 200.

_An LDL or "bad" cholesterol level below 130 is good for healthy people, but someone with heart disease or diabetes should aim for under 100.

_For HDL, the "good" cholesterol that helps control the bad kind, higher numbers are better � 60 is protective while below 40 is a risk.

Where do particles come in? Scientists have long known that small, dense LDL particles sneak into the artery wall to build up and narrow blood vessels more easily than larger, fluffier particles. While overall LDL levels usually correlate with the amount of particles in blood, they don't always, just as a beach bucket of sand may weigh the same as a bucket of pebbles but contain more particles.

Only in recent years have commercial tests made particle checks more feasible � although there's no standard method, and different tests measure in different ways. The tests add another $100 to $150 to regular cholesterol checks.

But is knowing about your particles really useful, and if so when? That's where doctors are split.

A study published last spring used one particle test, from Raleigh, N.C.-based LipoScience, to analyze a database of more than 5,000 middle-aged people whose heart health was tracked for five years. Most people's overall LDL and particle counts correlated pretty well. But people had a higher risk of heart disease when their particle count was much higher than their LDL predicted � and, conversely, a lower risk if their particle count was lower than expected, says lead researcher Dr. David Goff Jr. of Wake Forest University.

"We could be treating some people who don't need to be treated ... and we may be missing some people who should be treated," Goff says. "But I'd also say that we haven't done all the research that needs to be done to prove that this will lead to better patient outcomes."

Many of those higher-risk patients could be caught by a closer look at standard tests "for no additional charge," says Dr. Roger Blumenthal of Johns Hopkins University and the American College of Cardiology.

Triglycerides, another harmful fat, are a good indicator, Blumenthal says. You're at risk despite a low LDL if your triglycerides are over 130, not to mention a low HDL, he said. People who are obese, diabetic of borderline diabetic also are at greater risk, because they often have higher LDL particle counts.

Another way to measure without an added test: Just subtract HDL from your total cholesterol number. The resulting bad-fat total should be no higher than 30 points above your recommended LDL level � and if they are, it's time for serious diet and exercise, adds Dr. Allen Taylor of Washington Hospital Center.

Still, even some doctors who don't think particle testing is for the masses say they use it sometimes to tip the scales on a borderline patient.

Others use it to guide therapy. Consider Denny Fongheiser of Santa Monica, Calif. At 52, his usual 3-mile-a-day walk suddenly left him panting, but his insurer wouldn't pay for a stress test because his cholesterol was normal.

A month later, chest pain sent Fongheiser to the hospital where he needed a stent to unclog an artery. It turned out he had high particle levels, which his cardiologist now aims to get below the LipoScience-recommended level of 1,000 with cholesterol-lowering drugs.

"I was basically a time bomb," Fongheiser says. He welcomes "being able to test this and know what's going on."

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Demise of Obama long-term care plan leaves gap (AP)

WASHINGTON � It's the one major health expense for which nearly all Americans are uninsured. The dilemma of paying for long-term care is likely to worsen now that the Obama administration pulled the plug on a program seen as a first step.

The Community Living Assistance Services and Supports program, or CLASS, was included in the health overhaul law to provide basic long-term care insurance at an affordable cost. But financial problems dogged it from the outset.

Those concerns prompted the administration to announce that CLASS would not go forward. Yet it could take a decade or longer for lawmakers to tackle the issue again, and by then the retirement of the Baby Boomers will be in full swing.

Most families don't plan for long-term care. Often the need comes unexpectedly: an elder takes a bad fall, a teen is calamitously injured in a car crash or a middle-aged worker suffers a debilitating stroke.

Nursing home charges can run more than $200 a day and a home health aide averages $450 a week, usually part-time. Yet Medicare doesn't cover long-term care, and only about 3 percent of adults have a private policy.

"Long-term care is a critical issue, and people are in total denial about it," said Bill Novelli, former CEO of AARP. "I am very sorry the administration did what they finally did, although I understand it. It is going to take a long time to get this back � and fixed."

The irony, experts say, is that paying for long-term care is the kind of problem insurance should be able to solve. It has to do with the mathematics of risk.

Most drivers will have some kind of accident during their years behind the wheel, but few will be involved in a catastrophic wreck. And some very careful drivers will not experience any accidents. The risks of long-term care are not all that different, says economist Harriet Komisar of the Georgetown University Public Policy Institute.

"A small percentage of people are going to need a year, two years, five years or more in a nursing home, but for those who do, it's huge," Komisar said. "Insurance makes sense when the odds are small but the financial risk is potentially high and unaffordable."

Komisar and her colleagues estimate that nearly 7 in 10 people will need some level of long-term care after turning 65. That's defined as help with personal tasks such as getting dressed, going to the toilet, eating, or taking a bath.

Many of those who need help will get it from a family member. Only 5 percent will need five years or more in a nursing home. And 3 in 10 will not need any long-term care assistance at all.

For those who do need extended nursing home care, Medicaid has become the default provider, since Medicare only covers short-term stays for rehab. But Medicaid is for low-income people, so the disabled literally have to impoverish themselves to qualify, a wrenching experience for families.

Liberals say the answer is government-sponsored insurance, like the CLASS plan the Obama administration included in the health overhaul law, only to find it wouldn't work financially.

The administration was unable to reconcile twin goals of CLASS: financial solvency and affordable coverage easily accessible to all working adults, regardless of health.

Conservatives have called for private coverage, perhaps with tax credits to make it more affordable.

Some experts say it will take a combination of both approaches.

"It almost has to be," said Robert Yee, a financial actuary hired by the Obama administration to try to make CLASS work.

Lower-income workers probably would never be able to afford private insurance, Yee explained. And a lavish public plan is out of the question.

"Anytime people talk about a social program, you are talking about a basic layer," he said.

Indeed, Yee had proposed to keep CLASS afloat by using some of the techniques of private insurers to attract the healthy and discourage the frail. The administration rejected that hybrid approach as incompatible with the law's intent to cover all regardless of health.

"Despite our best analytical efforts, I do not see a viable path forward for CLASS implementation at this time," Health and Human Services Secretary Kathleen Sebelius told congressional leaders.

Although CLASS would have come too late to help his disabled mother, Jacob Bockser of Walnut Creek, Calif., says he is disappointed.

Bockser, 29, is a former emergency medical technician studying to become a respiratory therapist. His mother Elizabeth, 58, is struggling with an aggressive form of multiple sclerosis.

She had moved to lower-cost Washington state to save money, but as her condition worsens her son is trying to find a way to bring her back to California. She can still live in her own home, with help to keep safe.

"She did a lot of good saving. But because she did good, it disqualifies her from some kinds of public assistance," said the son. "When you are only 58 and looking at hopefully living another 20 or 25 years, it's scary to think the money just won't last."

Bockser says he doesn't expect the government to solve everything, but "even if there is the opportunity to try to piece together a couple of different programs that would be a start."

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BPA in pregnant women might affect kids' behavior (AP)

CHICAGO � Exposure to BPA before birth could affect girls' behavior at age 3, according to the latest study on potential health effects of the widespread chemical.

Preschool-aged girls whose mothers had relatively high urine levels of bisphenol-A during pregnancy scored worse but still within a normal range on behavior measures including anxiety and hyperactivity than other young girls.

The results are not conclusive and experts not involved in the study said factors other than BPA might explain the results. The researchers acknowledge that "considerable debate" remains about whether BPA is harmful, but say their findings should prompt additional research.

The researchers measured BPA in 244 Cincinnati-area mothers' urine twice during pregnancy and at childbirth. The women evaluated their children at age 3 using standard behavior questionnaires.

Nearly all women had measurable BPA levels, like most Americans. But increasingly high urine levels during pregnancy were linked with increasingly worse behavior in their daughters. Boys' behavior did not seem to be affected.

The researchers said if BPA can cause behavior changes that could pose academic and social problems for girls already at risk for those difficulties.

"These subtle shifts can actually have very dramatic implications at the population level," said Joe Braun, the lead author and a research fellow at Harvard's School of Public Health.

For every 10-fold increase in mothers' BPA levels, girls scored at least six points worse on the questionnaires.

The study was released online Monday in Pediatrics.

Linda Birnbaum, director of the National Institute of Environmental Health Sciences and the National Toxicology Program, said the study contributes important new evidence to "a growing database which suggests that BPA exposure can be associated with effects on human health."

Grants from that federal agency helped pay for the study.

The Food and Drug Administration has said that low-level BPA exposure appears to be safe. But the agency also says that because of recent scientific evidence, it has some concern about potential effects of BPA on the brain and behavior in fetuses, infants and small children. The FDA is continuing to study BPA exposure and supports efforts to minimize use in food containers.

BPA has many uses, and is found in some plastic bottles and coatings in metal food cans. It was widely used in plastic baby bottles and sippy cups but industry phased out that use.

Braun said it's possible that exposure to BPA during pregnancy interferes with fetal brain development, a theory suggested in other studies, and that could explain the behavior differences in his study. Why boys' behavior wasn't affected isn't clear. But BPA is thought to mimic the effects of estrogen, a female hormone.

The researchers evaluated other possible influences on children's behavior, including family income, education level and whether mothers were married, and still found an apparent link to BPA.

But Dr. Charles McKay, a BPA researcher and toxicologist with the Connecticut Poison Control Center, said the researchers failed to adequately measure factors other than BPA that could explain the results.

For example, there's no information on mothers' eating habits. That matters because mothers' higher BPA levels could have come from eating lots of canned foods instead of healthier less processed foods, which might have affected fetal brain development.

The American Chemistry Council, a trade group whose members include companies that use BPA, said the research "has significant shortcomings ... and the conclusions are of unknown relevance to public health."

___

Online:

FDA: http://tinyurl.com/ya4d4ku

Info for parents: http://www.hhs.gov/safety/bpa/

___

AP Medical Writer Lindsey Tanner can be reached at http://www.twitter.com/LindseyTanner

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Russia parliament adopts law restricting abortions (AP)

MOSCOW � Russia's parliament adopted a law Friday limiting abortions but rejected even tougher restrictions backed by the country's conservative Orthodox Church.

Health officials say Russia's abortion rates are among the world's highest, contributing to a fertility rate of only 1.4 children per woman � far below the 2.1 needed to maintain the existing population. The country's birth rate has become a serious concern for Russia as it fights to stem a steep population decline.

The Health Ministry says more than a million pregnancies are terminated in Russia annually, although abortion critics say the statistics don't include private clinics and the real number amounts to six million a year.

The law passed Friday limits abortions to 12 weeks of pregnancy, except for women who say they can't afford a child, who may have an abortion up to 22 weeks. The law also stipulates a mandatory waiting period of two to seven days before the procedure to allow a woman to reconsider her decision.

The law does not include restrictions proposed by the Russian Orthodox Church, such as a requiring a husband's consent for married women, parents' consent for teenage girls or for a doctor's right to refuse an abortion.

During the Soviet era, abortion laws were liberal and unrestricted abortions became virtually the only effective method of family planning, as condoms were unreliable and seldom used.

The abortion debate in Russia has not become as divisive and heated as the abortion debate in the United States, but the effort to restrict them has strong backing from the Russian Orthodox Church, which has sought a more muscular role in society.

Russia's population, now at 143 million, has shrunk by 5.7 million since the 1991 fall of the Soviet Union, a plunge blamed on rampant alcoholism, bad diets and lack of exercise.

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Largest study on cellphones, cancer finds no link (AP)

LONDON � Danish researchers can offer some reassurance if you're concerned about your cellphone: Don't worry. Your device is probably safe.

The biggest study ever to examine the possible connection between cellphones and cancer found no evidence of any link, suggesting that billions of people who are rarely more than a few inches from their phones have no special health concerns.

The Danish study of more than 350,000 people concluded there was no difference in cancer rates between people who had used a cellphone for about a decade and those who did not.

Last year, a separate large study found no clear connection between cellphones and cancer. But it showed a hint of a possible association between very heavy phone use and glioma, a rare but often deadly form of brain tumor. However, the numbers of heavy users was not sufficient to make the case.

That study of more than 14,000 people in multiple countries, in addition to animal experiments, led the International Agency for Research on Cancer to classify electromagnetic energy from cellphones as "possibly carcinogenic," adding it to a list that also includes things such as coffee and gasoline engine exhaust.

But that designation does not mean the phones necessarily pose a risk. Cellphones do not emit the same kind of radiation as that used in some medical tests or found in other sources such as radon in soil.

Two U.S. agencies � the Food and Drug Administration and the Federal Communications Commission � have found no evidence that cellphones are linked to cancer.

Yet fears of a link persist, despite the fact that cancer rates have not risen since cellphones were introduced.

In the latest research, published online Thursday in the journal BMJ, researchers updated a previous study examining 358,403 cellphone users aged 30 and over in Denmark from 1990 to 2007. They found cellphone users did not have a higher cancer risk compared with those without cellphones.

Cancer rates in people who used cellphones for about 10 years were similar to rates in people without a cellphone. Cellphone users were also no more likely to get a tumor in the part of the brain closest to where phones are usually held against the head. The study was paid for by the government's Danish Strategic Research Council.

"Our study provides little evidence for a causal association, but we cannot rule out a small to moderate increase in risk for subgroups of heavy users," said Patrizia Frei, of the Institute of Cancer Epidemiology in Copenhagen, Denmark, one of the paper's authors.

"This is encouraging news, but it doesn't mean we're at the end of the road," said Hazel Nunn, head of Health Evidence and Information at Cancer Research U.K., which was not linked to the study.

About three-quarters of the world's population, more than 5 billion people, use a cellphone. That makes it difficult for scientists to compare cancer incidence in people who use the devices versus those who do not.

Others disputed the Danish study's findings. The advocacy group MobileWise, which believes cellphones pose a health risk, said the study wasn't long enough to consider the long-term risk, since brain tumors can take decades to develop.

In an accompanying editorial in BMJ, Anders Ahlbom and Maria Feychting of Sweden's Karolinska Institute wrote that one of the study's strengths was its use of objective data from cellphone records. Previous studies have been criticized for relying on people to recall their cellphone habits from decades earlier.

In about 30 other studies done in Europe, New Zealand and the U.S., patients with brain tumors have not reported using their cellphones more often than unaffected people.

The editorial writers pointed out that research on cellphones and cancer was not sparked by any evidence of a connection, but from concerns that something about the relationship between radio frequency fields and human physiology had been "overlooked or misunderstood." Research into the safety of cellphones is now "extensive," they wrote.

Nunn said studies with longer-term data were still needed and that there was little information on children's exposure to cellphones.

There was no biological evidence for how cellphones might cause cancer, unlike, for example, the proof that tobacco is carcinogenic, she added.

Cellphones send signals to nearby towers via radio waves, a form of energy similar to microwaves. But the radiation produced by cellphones cannot directly damage DNA and is different from stronger types of radiation like X-rays or ultraviolet light. At very high levels, radio frequency waves from cellphones can heat up body tissue, but that is not believed to damage human cells.

Nunn said people should not change their cellphone habits based on the current evidence, except perhaps for limiting their kids' use of the devices.

"There are a lot more worrying things in the world than mobile phones," she said.

___

Online:

Journal: http://www.bmj.com

IARC: http://www.iarc.fr/en/media-centre/pr/2011/pdfs/pr208(underscore)e.pdf

FDA advice: http://tinyurl.com/29e8qzr

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Talk of treaty ban on mercury concerns scientists (AP)

LONDON � Scientists are warning officials negotiating a global treaty on mercury that banning the deadly chemical completely would be dangerous for public health because of the chemical's use in vaccines.

The ban option is one of several proposals on the table for a meeting later this month in Nairobi, but a final treaty isn't expected until 2013.

According to the World Health Organization, mercury is one of the top 10 chemicals of public health concern and is highly toxic. Most of the worry is centered on mercury emissions from burning coal, gold mining and people eating mercury-tainted fish.

Mercury in small amounts is also found in many products including light bulbs, batteries and thermometers. WHO advises such products to be phased out, suggesting for example, that health systems switch to digital thermometers instead.

The problem is that a proposed ban might include thiomersal, a mercury compound used to prevent contamination and extend the shelf life of vaccines, many scientists say. It is used in about 300 million shots worldwide, against diseases including flu, tetanus, hepatitis B, diptheria and meningitis.

"Not being able to use mercury is not a viable option," said David Wood, a WHO vaccines expert.

Wood said there isn't a viable alternative to thiomersal at the moment. If banned, pharmaceuticals would likely have to switch to preservative-free vaccines, which would complicate the supply chain and vaccination campaigns in poor countries, since the injections would have a much shorter shelf life. Costs would also spike since manufacturers would need to reconfigure their factories.

In 2009, the United Nations Environment Programme, or UNEP, began working on a legally binding global treaty on mercury. At the end of October, the third of five meetings to hammer out a treaty will take place in Nairobi.

"The document is a draft at the moment, so some of these proposals have to be taken with a grain of salt," said Tim Kasten, head of the chemicals branch at UNEP. Kasten said the amount of mercury in vaccines is so minute it doesn't threaten the environment. He said there could be provisions to allow mercury for certain uses, such as in dental fillings and vaccines.

But according to an annex in the draft document, there is currently no "allowable use exemption" for mercury products in pharmaceutical products, putting vaccines in the same category as banned mercury-containing paints and pesticides.

"That would be a terrible idea," said Paul Offit, an infectious diseases expert at the University of Pennsylvania. "It would be another tragic example of us not being able to explain to the public where the real risk lies."

Thiomersal has mostly been removed from childhood vaccines in the U.S. and Canada. In some European countries, including Norway and Sweden, manufacturers have been encouraged to make thiomersal-free vaccines � and no other uses of mercury as a medical preservative are allowed.

Fears about thiomersal in vaccines were first raised after a flawed medical study in 1998 linked a common childhood injection to autism. But numerous studies since have found no sign the mercury compound is risky.

Experts hope countries won't go overboard in their attempts to control the substance.

"Provided you know the risks and it's handled properly, there isn't a problem," said Andrew Nelson, a toxicology expert at the University of Leeds. "The health of so many millions of children benefit from vaccines containing mercury that an absolute ban is ridiculous."

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Online:

http://www.unep.org

http://www.who.int

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Docs facing questions about 'Michael Jackson drug' (AP)

LOS ANGELES � Doctors sometimes call the anesthesia drug by its nickname � milk of amnesia. Patients are calling it the "Michael Jackson drug."

Ever since propofol was blamed in the singer's death, patients who seldom asked or cared about what kind of sedation they were getting were suddenly peppering their doctors with questions about the potent drug.

"You won't believe how many people with their eyes wide open ask me: `Are you going to give me the Michael Jackson drug?' They're scared to death," said Dr. H.A. Tillmann Hein, president of the Texas Society of Anesthesiologists.

While some initially balk at going under, fearing they will end up like Jackson, they come around after Hein explains that propofol, widely used for surgeries and other procedures for more than 20 years, is safe when used by a trained professional in a hospital or clinic.

Propofol gained notoriety in 2009 after an autopsy found Jackson died of an overdose. Prosecutors have accused his personal physician, Dr. Conrad Murray, of giving the 50-year-old pop icon a lethal dose at the singer's rented Los Angeles mansion.

Murray has pleaded not guilty to involuntary manslaughter. His lawyers contend the amount of propofol Murray gave him to battle insomnia while prepping for his comeback tour was too small to cause the singer's death.

While Jackson's death thrust propofol into the spotlight, the circumstances of the case are rare.

Since the drug is hard to get (it's usually kept in medical settings) and hard to use (it's injected through an IV), there's little abuse in the general public. Almost all cases of recreational propofol use and deaths involve medical professionals.

Even before Jackson died, the federal government had considered adding the drug to its roster of controlled substances amid concerns about growing abuse in the medical community.

For the past two years, anesthesiologists have tried to counter the bad rap that propofol has gotten in the Jackson case.

Before Jackson's death, less than 10 percent of patients that Dr. John Dombrowski saw asked about propofol. Now more than half do, mostly about what monitoring safeguards are in place in case problems occur.

"It's important to have this conversation so people aren't fearful," said Dombrowski, who runs the private Washington Pain Center.

While doctors are seeing more patients with questions, they say no one has refused care after they are reassured that their situations are different than those of Jackson.

About 40 million Americans undergo anesthesia each year, with the vast majority receiving propofol. Because it is fast-acting and clears quickly from the body, people can return to normal activities sooner than older anesthetics.

During the past two weeks, prosecution witnesses said Murray flouted the standard of care by giving propofol in Jackson's home to help the superstar sleep and by leaving the room while he was sedated. Propofol is not approved to treat sleep disorders.

Propofol expert Dr. Steven Shafer of Columbia University testified Wednesday for the prosecution without a fee, saying he wanted to restore public confidence in doctors who use propofol, which he called "an outstanding drug" when properly administered.

Like many anesthesiologists, Shafer said he has received questions from many patients in the operating room about whether they will receive "the drug that killed Michael Jackson."

"I get that question daily. This is a fear that patients do not need to have," said Shafer, who wrote the package insert that guides doctors in the use of the anesthetic and demonstrated to jurors the appropriate way to administer the drug.

Within the medical profession, there have been growing concerns in recent years about abuse by health care workers. Published studies have uncovered several overdose deaths and cases of medical professionals who self-administer propofol to get high.

"It takes away anxiety, fear and pain," said anesthesiologist Dr. Paul Wischmeyer of the University of Colorado, Denver, who has studied propofol abuse. "That's the draw of the drug."

The U.S. Drug Enforcement Administration's proposal to make propofol a controlled substance is pending.

At UAB Hospital in Birmingham, Ala., officials are already treating propofol like other controlled drugs such as morphine and Valium by requiring stricter accounting of how it is disposed of.

Before that change went into effect eight months ago, doctors would dump leftover propofol bottles and used syringes in a biohazard container after an operation. Now the hospital requires another witness to be present to document the disposal.

Hospital officials first considered that change several years ago after reports of abuse by health care workers around the country. The Jackson case heightened awareness, chief pharmacy officer Mark Todd said.

"It got some momentum" after Jackson's death, Todd said. "It helped move it along."

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Online:

American Society of Anesthesiologists: http://www.asahq.org

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Follow Alicia Chang's coverage at http://twitter.com/SciWriAlicia

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Report: Food labels need Energy Star-like ratings (AP)

WASHINGTON � Just like that Energy Star tag helps you choose your appliances, a new report says a rating symbol on the front of every soup can, cereal box and yogurt container could help hurried shoppers go home with the healthiest foods.

Thursday's report urges the Food and Drug Administration to adopt new food labeling that clears the confusing clutter off today's packages and gives consumers a fast way to compare their choices.

It wouldn't replace the in-depth Nutrition Facts panel that's now on the back or side of food packages. But few shoppers stop to read or heed that fine print in the middle of the grocery aisle.

The Institute of Medicine says it's time to put right upfront the most important information for health: how many calories per serving � and just how big that serving is � along with stars or some other symbol to show at a glance how the food rates for certain fats, sodium and added sugars.

"American shoppers are busy shoppers," said Ellen Wartella, a psychology professor at Northwestern University who chaired the IOM committee that studied the issue at the government's request.

"We want a really simple system that says if you have three marks, that product is healthier than one with two marks."

How to get Americans to eat more wisely is a huge problem as obesity and diet-related diseases are skyrocketing. The FDA already was working to change the food-labeling system to make it more user-friendly. The agency didn't say if it would adopt a ratings approach but called Thursday's report a thoughtful analysis that would help it decide next steps.

"FDA agrees consumers can benefit from a front-of-pack labeling system that conveys nutrition information in a manner that is simple and consistent with the Nutrition Facts panel," said spokeswoman Siobhan DeLancey.

But the IOM's recommendation would face an uphill battle with food manufacturers who are pushing their own version of on-the-front food labels and don't like the idea of ranking one food as healthier than a competitor's.

"We believe the most effective programs are those that trust consumers and not ones that tell consumers what they should and should not eat," said Scott Faber, a lobbyist for the Grocery Manufacturers Association.

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Associated Press writer Mary Clare Jalonick contributed to this report.

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