Report: Tracking system needed to fight fake drugs


WASHINGTON (AP) — Fighting the problem of fake drugs will require putting medications through a chain of custody like U.S. courts require for evidence in a trial, the Institute of Medicine reported Wednesday.


The call for a national drug tracking system comes a week after the Food and Drug Administration warned doctors, for the third time in about a year, that it discovered a counterfeit batch of the cancer drug Avastin that lacked the real tumor-killing ingredient.


Fake and substandard drugs have become an increasing concern as U.S. pharmaceutical companies move more of their manufacturing overseas. The risk made headlines in 2008 when U.S. patients died from a contaminated blood thinner imported from China.


The Institute of Medicine report made clear that this is a global problem that requires an international response, with developing countries especially at risk from phony medications. Drug-resistant tuberculosis, for example, is fueled in part by watered-down medications sold in many poor countries.


"There can be nothing worse than for a patient to take a medication that either doesn't work or poisons the patient," said Lawrence O. Gostin, a professor of health law at Georgetown University who led the IOM committee that studied how to combat the growing problem.


A mandatory drug-tracking system could use some form of barcodes or electronic tags to verify that a medication and the ingredients used to make it are authentic at every step, from the manufacturing of the active ingredient all the way to the pharmacy, he said. His committee examined fakes so sophisticated that health experts couldn't tell the difference between the packaging of the FDA-approved product and the look-alike.


"It's unreliable unless you know where it's been and can secure each point in the supply chain," Gostin said.


Patient safety advocates have pushed for that kind of tracking system for years, but attempts to include it in FDA drug-safety legislation last summer failed.


The report also concluded that:


—The World Health Organization should develop an international code of practice that sets guidelines for monitoring, regulation and law enforcement to crack down on fake drugs.


—States should beef up licensing requirements for the wholesalers and distributors who get a drug from its manufacturer to the pharmacy, hospital or doctor's office.


__Internet pharmacies are a particularly weak link, because fraudulent sites can mimic legitimate ones. The report urged wider promotion of the National Association of Boards of Pharmacy's online accreditation program as a tool to help consumers spot trustworthy sites.


The Institute of Medicine is an independent organization that advises the government on health matters.


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Wall Street rises, S&P hits highest since November '07

DEAR ABBY: My daughters are attractive young women, both doing well in their professional careers. "Melanie," who is 27, is married to "Sam," an extremely attractive and successful man.My 30-year-old daughter, "Alicia," has been divorced for a year. Her marriage failed two years ago because she and her husband had an appetite for sex outside their marriage. While I was disturbed about that, I was horrified to learn that Melanie allows her sister to occasionally have sex with Sam.Melanie's argument is that Sam is less likely to cheat given this situation. ...
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India Ink: In Kashmir, Clashes and Dwindling Supplies As Curfew Continues

The Kashmir Valley is on the fourth day of a government-imposed shutdown begun immediately after the hanging of the militant Muhammad Afzal, also known as Afzal Guru, who comes from the town of Sopore in Baramulla district.

Many residents are running out of food and milk in Srinagar, Kashmir’s summer capital. Meanwhile, dozens have been injured and at least one killed in protests against Mr. Afzal’s hanging, which happened secretly in Delhi on Saturday and was announced afterward.

Mr. Afzal, from the Jaish-e-Muhammad militant group, was convicted of conspiracy and sentenced to death by a special court in 2002 for his role in planning an attack on India’s Parliament in December 2001.

Schools, colleges and most shops in Kashmir are closed by government order, and people have been asked to stay inside their homes. Rows of shops and restaurants were shuttered.

Vehicles have been banned from the streets, cable news channels have gone dark, Internet service on cellphones has been blocked and newspapers were not being delivered. Hospitals, pharmacies and emergency services remain open.

In Srinagar, the only people in the deserted streets were security forces.

Officials in the area said they were taking preventive measures. During the past decade, many Kashmiris have opposed the death sentence for Mr. Afzal, saying he was being unfairly accused of the crime. His wife had requested a pardon from the Indian government, but her plea was denied.

Many Kashmiris were also outraged that the government letter carrying the news of execution reached Mr. Afzal’s widow in Sopore only after he died. The central government said Tuesday that Mr. Afzal’s family could visit his grave at te Tihar Jail in Delhi, but a date has yet to be decided, according to the Press Trust of India.

The ban on the movement of people and vehicles was imposed under Section 144 of India’s criminal procedure code, the same section invoked after protests over the recent Delhi gang rape, which prohibits the assembly of more than four people.

It was invoked by a district magistrate to prevent “a law and order problem,” Suresh Kumar, principal secretary in Jammu and Kashmir’s Department of Home Affairs, said in a telephone interview Tuesday. 

Mr. Afzal’s death was mourned across the valley through organized street protests that involved stone pelting, in defiance of the ban.

Three civilians have died and many have been injured over the last four days, officials said. Some news reports attributed all three deaths to protest-related activities, but Mr. Kumar said only one man died of injuries caused by the police. The other two drowned when their boat capsized, an incident unrelated to the violence, he said.

Obair Mushtaq, from the Baramulla district, died after he was shot, his relatives said. Farooq Ahmed, his uncle, said Obair was 13.

Mr. Ahmed said that on Sunday evening, a handful of children, including his nephew, were throwing stones at a passing military convoy. “It was not aggressive. We were laughing at them,” he said, crying over the phone. “We can’t understand why there is so much fighting. Why are our children dying?”

A Kashmir police official told India Ink that 60 people have been injured since Saturday in clashes between police and civilians. Forty of those were security officials and 20 were civilians, he said. He spoke on the condition of anonymity, saying that he feared for his life.

Additionally, there were about 60 incidents of stone pelting across the valley. “Most of the violence erupted in Sopore and Baramulla,” he said.

“People are not allowed to step out of their homes,” he added.Many residents described the past four days as the longest curfew since 2010, when the valley was shaken by mass pro-independence demonstrations. 

Manzoor Ahmed, who drives an auto-rickshaw, said that he hasn’t earned any money since the curfew was imposed on Saturday. “I haven’t stepped out of the house so I cannot even make the little money I do,” he said during a telephone interview. “The children cannot go to school.”

Mr. Ahmed said that his family was surviving on dal, a stew made of lentils, because there are no fresh vegetables available. “We have a backup supply of dal because we know things like this can happen,” he said.

In some areas, for a few hours in the evening, residents said they were allowed out of their homes to shop. Vegetables and milk are generally shipped into Srinagar, which is nestled in the mountains, from villages and other states during the winter months.

Mr. Mohammed, a hotel manager near the Dal Lake, who requested his first name not be used to avoid any retaliatory action, said that his hotel was running out of vegetables like peas and cauliflower, and guests were only being served beans and potatoes from storage. “The situation is quite bad,” he said.

For around two hours in the evening, a few stores selling basic groceries were open. But these shops have limited resources because the supply chain had been disrupted because of the ban on vehicles.

One businessman, who requested not be named to avoid possible retaliatory action by the police, said he hasn’t opened his crockery shop in downtown Srinagar in the past four days. “What choice do I have? They won’t let us step out,” he said. He estimated he has lost 60,000 rupees ($1,000) since Saturday.

The hanging of Mr. Afzal came as Kashmiris were planning protests to mark the death of Maqbool Bhatt, a pro-Kashmir independence leader who was hanged on Feb. 11, 1984. His death is considered the spark for two decades of unrest. Both men are buried at Tihar Jail in Delhi.

“Maqbool Bhatt inspired the insurgency while Afzal Guru was the product of it,” said Sheikh Showkat Hussain, a law professor at Kashmir University. 

He warned that Mr. Afazal’s hanging and the subsequent curfew would make the Kashmiri people’s “alienation with the government more deep rooted.”

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Westminster's Most Paw-some Moments - So Far!















02/12/2013 at 11:00 AM EST







You snooze, you lose? Not when you're as adorable as this Bichon Frise


Frank Franklin II/AP


It may be Fat Tuesday, but as any dog lover knows, the real action is at the Westminster Kennel Club Dog Show.

Dogs of every shape, size and color – including two new breeds who were admitted into competition this year – have taken over several New York City locations, including Madison Square Garden, and the contest is starting to get fur-rocious.

We know you'd rather be at home watching these pooches strut their stuff, but since you're probably otherwise occupied, here's a taste of all the canine pageantry taking place:

Westminster's Most Paw-some Moments – So Far!| Dogs, Westminster Kennel Club Dog Show

This Afghan Hound is 'hair' to stay

Monika Graff / Landov


Westminster's Most Paw-some Moments – So Far!| Dogs, Westminster Kennel Club Dog Show

Don't they know I need my beauty sleep? This Dogue de Bordeux, named Azlo, is ready to retire to his room at the Hotel Pennsylvania

Carlo Allegri / Landov


Westminster's Most Paw-some Moments – So Far!| Dogs, Westminster Kennel Club Dog Show

A kiss for good luck! There's no ill will between Boston terriers Gaga (left) and Spitzer

Keith Bedford / Landov


Westminster's Most Paw-some Moments – So Far!| Dogs, Westminster Kennel Club Dog Show

Last year's winner, Malachy, returns to the limelight to turn the Empire State Building purple and gold (with a little help from a furry friend) in honor of Westminster's kickoff

Bryan Smith / ZUMA

Check back tonight to see who takes home top prize!

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Pope shows lifetime jobs aren't always for life


The world seems surprised that an 85-year-old globe-trotting pope who just started tweeting wants to resign, but should it be? Maybe what should be surprising is that more leaders his age do not, considering the toll aging takes on bodies and minds amid a culture of constant communication and change.


There may be more behind the story of why Pope Benedict XVI decided to leave a job normally held for life. But the pontiff made it about age. He said the job called for "both strength of mind and body" and said his was deteriorating. He spoke of "today's world, subject to so many rapid changes," implying a difficulty keeping up despite his recent debut on Twitter.


"This seemed to me a very brave, courageous decision," especially because older people often don't recognize their own decline, said Dr. Seth Landefeld, an expert on aging and chairman of medicine at the University of Alabama at Birmingham.


Age has driven many leaders from jobs that used to be for life — Supreme Court justices, monarchs and other heads of state. As lifetimes expand, the woes of old age are catching up with more in seats of power. Some are choosing to step down rather than suffer long declines and disabilities as the pope's last predecessor did.


Since 1955, only one U.S. Supreme Court justice — Chief Justice William Rehnquist — has died in office. Twenty-one others chose to retire, the most recent being John Paul Stevens, who stepped down in 2010 at age 90.


When Thurgood Marshall stepped down in 1991 at the age of 82, citing health reasons, the Supreme Court justice's answer was blunt: "What's wrong with me? I'm old. I'm getting old and falling apart."


One in 5 U.S. senators is 70 or older, and some have retired rather than seek new terms, such as Hawaii's Daniel Akaka, who left office in January at age 88.


The Netherlands' Queen Beatrix, who just turned 75, recently said she will pass the crown to a son and put the country "in the hands of a new generation."


In Germany, where the pope was born, Chancellor Angela Merkel, who is 58, said the pope's decision that he was no longer fit for the job "earns my very highest respect."


"In our time of ever-lengthening life, many people will be able to understand how the pope as well has to deal with the burdens of aging," she told reporters in Berlin.


Experts on aging agreed.


"People's mental capacities in their 80s and 90s aren't what they were in their 40s and 50s. Their short-term memory is often not as good, their ability to think quickly on their feet, to execute decisions is often not as good," Landefeld said. Change is tougher to handle with age, and leaders like popes and presidents face "extraordinary demands that would tax anybody's physical and mental stamina."


Dr. Barbara Messinger-Rapport, geriatrics chief at the Cleveland Clinic, noted that half of people 85 and older in developed countries have some dementia, usually Alzheimer's. Even without such a disease, "it takes longer to make decisions, it takes longer to learn new things," she said.


But that's far from universal, said Dr. Thomas Perls, an expert on aging at Boston University and director of the New England Centenarians Study.


"Usually a man who is entirely healthy in his early 80s has demonstrated his survival prowess" and can live much longer, he said. People of privilege have better odds because they have access to good food and health care, and tend to lead clean lives.


"Even in the 1500s and 1600s there were popes in their 80s. It's remarkable. That would be today's centenarians," Perls said.


Arizona Sen. John McCain turned 71 while running for president in 2007. Had he won, he would have been the oldest person elected to a first term as president. Ronald Reagan was days away from turning 70 when he started his first term as president in 1981; he won re-election in 1984. Vice President Joe Biden just turned 70.


In the U.S. Senate, where seniority is rewarded and revered, South Carolina's Strom Thurmond didn't retire until age 100 in 2002. Sen. Robert Byrd of West Virginia was the longest-serving senator when he died in office at 92 in 2010.


Now the oldest U.S. senator is 89-year-old Frank Lautenberg of New Jersey. The oldest congressman is Ralph Hall of Texas who turns 90 in May.


The legendary Alan Greenspan was about to turn 80 when he retired as chairman of the Federal Reserve in 2006; he still works as a consultant.


Elsewhere around the world, Cuba's Fidel Castro — one of the world's longest serving heads of state — stepped down in 2006 at age 79 due to an intestinal illness that nearly killed him, handing power to his younger brother Raul. But the island is an example of aged leaders pushing on well into their dotage. Raul Castro now is 81 and his two top lieutenants are also octogenarians. Later this month, he is expected to be named to a new, five-year term as president.


Other leaders who are still working:


—England's Queen Elizabeth, 86.


—Abdullah bin Abd al-Aziz al-Saud, king of Saudi Arabia, 88.


—Sabah al-Ahmad al-Jaber al-Sabah, emir of Kuwait, 83.


—Ruth Bader Ginsburg, U.S. Supreme Court associate justice, 79.


__


Associated Press writers Paul Haven in Havana, Cuba; David Rising in Berlin; Seth Borenstein, Mark Sherman and Matt Yancey in Washington, and researcher Judy Ausuebel in New York contributed to this report.


___


Marilynn Marchione can be followed at http://twitter.com/MMarchioneAP


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Wall Street flat ahead of Obama speech

NEW YORK (Reuters) - Stocks were little changed on Tuesday, hovering near multi-year highs as traders awaited President Barack Obama's State of the Union address.


The economy will be one of the main topics of Obama's speech at 9 p.m. (0200 GMT Wednesday). Investors will listen for any clues on a deal with Republicans in Congress to avert automatic spending cuts due to take effect March 1.


The S&P 500 has risen in the past six weeks and is up more than 6 percent so far this year. Despite a dip in volume Monday and the sideways move this week the market is showing technical strength as it digests the recent gains.


"It's positive we haven't seen an urge to take profits after the run-up we had recently," said Peter Jankovskis, co-chief investment officer at OakBrook Investments in Lisle, Illinois.


He said it was natural for the market to be pausing amid a lack of major economic data points and with earnings season winding down, and markets will be attentively watching Obama's speech in Washington.


The Dow Jones industrial average <.dji> rose 7.6 points or 0.05 percent, to 13,978.84, the S&P 500 <.spx> lost 0.27 points or 0.02 percent, to 1,516.74 and the Nasdaq Composite <.ixic> dropped 1.41 points or 0.04 percent, to 3,190.59.


Coca-Cola Co shares fell 1.5 percent to $38.04 after the world's largest soft drink maker reported quarterly earnings that were slightly better than expected as strength in emerging markets offset a decline in European business.


Avon Products shares jumped 13.4 percent to $19.59 after the beauty products company reported a better-than-expected quarterly profit.


Goodyear Tire & Rubber shares fell 4.6 percent to $13.27 after it posted a stronger-than-expected quarterly profit but cut its 2013 forecast due to weakness in the European automotive market.


Michael Kors Holdings shares soared 12 percent to $63.82 after the fashion company handily beat Wall Street's estimates and raised its full-year outlook.


(Reporting by Rodrigo Campos; Editing by Chizu Nomiyama, Kenneth Barry and Nick Zieminski)



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The Lede: Latest Updates on the Pope’s Resignation

The Lede is providing updates on Pope Benedict XVI’s announcement on Monday that he intends to resign on Feb. 28, less than eight years after he took office, the first pope to do so in six centuries.
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Record $1 Million Bounty Offered for Fugitive Cop















02/11/2013 at 09:15 AM EST







Undated photo of Christopher Dorner


LAPD/AP


Authorities in Los Angeles upped the ante Sunday on a bounty for Christopher Dorner, the fugitive former Los Angeles police officer who remains at large after killing another officer and targeting police and their families over his 2008 firing from the force.

Police announced a record $1 million reward for information leading to the capture of Dorner, 33, who has eluded capture for five days and whose angry 15,000-word "manifesto" threatened the lives of at least 50 former colleagues and their relatives.

The record bounty, described by police as the largest for a criminal investigation in Southern California, was posted Sunday and comes from donations from police unions, businesses and private investors who want Dorner captured and off the streets.

Security was tightened at the Staples Center in downtown for Sunday's 55th annual Grammy Awards, as police continued the largest manhunt ever for the Los Angeles area. The search focused on the San Bernandino mountains where Dorner's burned out truck was found abandoned near Big Bear Lake, as police offered security to lawe enforcement families mentioned in Dorner's rambling writings.

Dorner, a former U.S. Navy reservist, engaged in a shooting with two officers on Thursday, grazing one, before ambushing two other police while they were sitting in their patrol car at a stoplight. One was killed and the other was seriously wounded. The revenge killings came after Dorner had posted rants on his Facebook page last week over what he claimed was his wrongful firing from the LAPD.

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How Should Doctors Treat Childhood Trauma?





Feb 11, 2013 7:30am


ht newton bee school shooting nt 121214 wblog How Should Doctors Treat Childhood Trauma?

Credit: Shannon Hicks/The Newton Bee via AP


After tragic events involving children including the Sandy Hook Elementary School shooting the kidnapping of 5-year-old Ethan by Jimmy Lee Dykes’ in Alabama, researchers are focusing more attention on how to treat children who’ve experienced trauma to avoid post traumatic stress disorder and other psychological repercussions. But they have few answers on what course of treatment is best.


Researchers Valerie Forman-Hoffman, Dr. Adam Zolotor and the rest of their team set out in 2010 to pull together data from hundreds of studies to determine which medicines and behavioral therapy produced the best results in traumatized children and adolescents. But they were surprised to find that only 25 studies fit the criteria of being large, randomized and controlled.


“We’re seeing more and more of these [traumas] every day, but we don’t have good evidence for how to make decisions for these kids,” said Forman-Hoffman, a psychiatric epidemiologist at RTI International, a research institute in North Carolina.  ”This topic is so hard to study when you consider the kids involved and what they’re exposed to. The last thing we want to do when kids are involved in a terrible tragedy and traumatic event is come in with clipboards.”


The review, which was published today in the journal of the American Academy of Pediatrics, says in its background that two thirds of children experience a traumatic event before they’re 16 years old. (This comes from a 2007 study that followed 1,420 children for up to seven years.) A traumatic event could include seeing or being the victim of domestic abuse, experiencing a natural disaster or witnessing a violent act involving strangers.


Click here to read about other abductions, starting with Katie Beers in 1991.


Although the Pediatrics review revealed that children taking medications for their trauma didn’t experience fewer signs of trauma than than those who didn’t; and that children undergoing cognitive behavioral therapy showed some benefit; it’s hard to determine how heavily to weigh the findings, Forman-Hoffman said. There were also no studies that examined treatment-outcome differences between genders, ages or types of trauma.


“It was very, very surprising to me,” she said. “This is a really important topic. Nobody seems to be talking about how to get these children who are witnesses to these things treatment.”


Forman-Hoffman and Zolotor only examined studies about non-relational trauma, meaning the the person (or thing) afflicting the trauma was not a friend or family member of the child. For instance, a non-relational trauma would be a shooting by a stranger or a national disaster, but not a domestic abuse situation.


Zolotor, a family physician and professor at the University of North Carolina School of Medicine, said he embarked on the study because he often treats patients – children and adults — who experienced trauma during their childhood. He’s not sure of the best early treatment, and added that many children don’t fit neatly into the post traumatic stress disorder diagnosis as adults do. Sometimes, they experience other symptoms of mental illness.


He, too, expected more studies and studies of better quality during the Pediatrics review. He said he hopes his findings prompt more studies to determine how to treat these children in the future.


“The science is quite immature,” he said. “With the recent experience in Newtown, I think we see this over and over again….  School of public health officials and practices feel the need to do something, and we don’t have a lot of good guidance on what’s the best thing to do.”



SHOWS: 20/20







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Wall Street dips from multiyear highs, Fed's Yellen on tap

NEW YORK (Reuters) - Stocks slipped at the open on Monday, with the S&P and Nasdaq dipping from multiyear highs, as Google shares weighed on the market on plans by its former chief executive to sell a large chunk of his stake in the Internet company.


Trading volume was relatively low, which could make the market volatile and exaggerate moves.


Google fell 0.9 percent at $777.94 after the company said in a filing former chief executive Eric Schmidt is selling roughly 42 percent of his Google stake, a move that could potentially net him $2.51 billion.


The decline was partly offset by gains in Apple , up 1.2 percent at $480.78 after a New York Times report that the iPhone maker is experimenting with the design of a device similar to a wristwatch.


No economic data or major earnings reports are scheduled for Monday, but Federal Reserve Vice Chair Janet Yellen is due to speak about the economic recovery at 1 p.m.


Upbeat U.S. and Chinese data last week helped the S&P 500 extend its weekly winning streak to six. The benchmark is up more than 6 percent so far this year after a steep rally in January that has stalled as the S&P and Dow industrials near record highs.


The large market rally so far this year has created space for hesitation in the absence of clear catalysts, according to Steve Goldman, principal at Goldman Management in Short Hills, New Jersey.


"Some positives behind the market rally are still there, and the path of least resistance is likely to be higher," he said.


The Dow Jones industrial average <.dji> fell 35.39 points or 0.25 percent, to 13,957.58, the S&P 500 <.spx> lost 1.94 points or 0.13 percent, to 1,515.99 and the Nasdaq Composite <.ixic> dropped 5.75 points or 0.18 percent, to 3,188.12.


US Airways shares edged up as people familiar with the matter said an $11 billion merger with AMR Corp appeared closer. The deal would create the world's largest airline by passenger traffic.


Opposition grew to the $24.4 billion buyout of Dell Inc , the No. 3 personal computer maker, as three of the largest investors joined Southeastern Asset Management on Friday in raising objections. Dell said in a regulatory filing it had considered many strategic options before opting to go private in a buyout led by Chief Executive Michael Dell.


Dell shares hovered near $13.65, the buyout offer price.


Regeneron Pharmaceuticals Inc shares jumped 8 percent to $179.11 after Sanofi said it plans to buy Regeneron's common stock.


(Reporting by Rodrigo Campos; Editing by Chizu Nomiyama and Kenneth Barry)



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