Thursday, February 4, 2010

360 News Briefs

Obama's Words Fail To Bridge Health Care Divide

President Obama exhorted Democrats to "finish the job" on a health care overhaul Wednesday, but his comments failed to bridge deep divisions within his party.

Addressing a gathering of Senate Democrats, Obama insisted that lawmakers have an opportunity to remake the nation's system of medical care.

"Here we are with a chance to change it," he said. "And all of you put extraordinary work last year into making serious changes that would not only reform the insurance industry, not only cover 30 million Americans, but would also bend the cost curve and save a trillion dollars on our deficits."

That wasn't enough for Louisiana Sen. Mary Landrieu to upgrade her assessment of the health legislation's condition.

"Just declaring that he's still for it doesn't mean that it comes off life support. ... But I agree with the president that giving up is not an option," Landrieu said.

Congressional leaders are working to see whether they can move comprehensive legislation forward under complex procedures requiring a simple majority in the Senate rather than the 60-vote supermajority that Democrats lost after last month's special election in Massachusetts. The House and Senate each passed separate bills last year, but a deal to merge those measures was upended by Republican Scott Brown's win in Massachusetts.

The legislation remains stuck in limbo, and there were fresh signs Wednesday of greater skepticism among some rank-and-file Democrats.

California Reps. Dennis Cardoza and Jim Costa, both moderates who voted for the House-passed health bill, burst out laughing when asked about the issue's fate.

Democrats are "having great difficulty trying to figure out what the art of the possible is," Costa said, adding, "some of our colleagues want their wish list to be the art of the possible."

Progressive Democrats in the House are fighting to revive a proposal for the government to sell health insurance in competition with private industry. That proposal was left for dead months ago when it became clear it could not pass the Senate. The Progressive Caucus in the House renewed its appeal for the so-called public option, and Rep. Jared Polis, D-Colo., circulated a letter in support of the idea that has attracted signatures from about 120 House Democrats.

Cardoza and Costa scoffed at that.

"Those people are delusional," Cardoza said.

Dismissing the delusional quip, Rep. Raul Grijalva, D-Ariz., said: "Don't write the obituary yet."

House Speaker Nancy Pelosi, D-Calif., insisted that progress was being made.

"We are on track to have comprehensive health care reform for our country ... and there are several paths to that goal," Pelosi said.

SALMONELLA UPDATE: Tests Confirm Salmonella In Salami Pepper

More details on the salmonella outbreak we reported to you this week. Tests have shown that the same strain of salmonella that sickened more than 200 people in at least 42 states has been found in black pepper, but it's not clear if it's the only source of the outbreak, the state health department announced Wednesday.

The tests traced the salmonella to closed containers of ground black pepper that would have been used to coat salami at Daniele Inc., a meat company in Burrillville, health department spokeswoman Annemarie Beardsworth said.

Daniele recalled more than 1 million pounds of salami last month after many of those who got sick reported they ate it. Beardsworth said about half the people sickened didn't eat any salami.

"That maybe tells you that we're not done looking for a source of the outbreak yet," she said.

Daniele had two suppliers for the pepper, and the U.S. Department of Agriculture and the U.S. Food and Drug Administration are working to trace its origin and determine if it was distributed anywhere else, Beardsworth said.

"It was imported, and any pepper that is now coming into the country is going to be subject to additional testing," she said.

She said it was not yet known which country the pepper came from and whether it was sold directly to consumers or used in prepared foods. The federal Centers for Disease Control reported this week that at least 203 people had been infected with the same strain of salmonella since July 1, and at least 40 were hospitalized.

It was reported in 42 states and the District of Columbia, including Alaska, Alabama, Arizona, California, Colorado, Connecticut, Delaware, Florida, Georgia, Iowa, Idaho, Illinois, Indiana, Kansas, Louisiana, Massachusetts, Maryland, Maine, Michigan, Minnesota, Missouri, North Carolina, North Dakota, Nebraska, New Hampshire, New Jersey, New Mexico, New York, Ohio, Oklahoma, Oregon, Pennsylvania, Rhode Island, South Carolina, South Dakota, Tennessee, Texas, Utah, Virginia, Washington, West Virginia and Wyoming.

Study: Vegetative Brains Show Signs Of Awareness

Scientists have detected glimmers of awareness in some vegetative brain-injury patients and have even communicated with one of them -- findings that push the boundaries of how to assess and care for such people.

The new research suggests that standard tests may overlook patients who have some consciousness, and that someday some kind of communication may be possible.

In the strongest example, a 29-year-old patient was able to answer yes-or-no questions by visualizing specific scenes the doctors asked him to imagine. The two visualizations sparked different brain activity viewed through a scanning machine.

"We were stunned when this happened," said one study author, Martin Monti of Medical Research Council Cognitive and Brain Sciences Unit in Cambridge, England. "I find it literally amazing. This was a patient who was believed to be vegetative for five years."

Ever since a research paper four years ago showed apparent signs of awareness in a vegetative patient -- one who was included in the new study -- families of patients have been clamoring for brain scans, said Dr. James Bernat of Dartmouth Medical School, a spokesman for the American Academy of Neurology.

In fact, a spokeswoman for a patient advocacy group said the organization will urge families to ask about the type of brain imaging used by the researchers.

But experts said more study is needed before the specialized brain scans could be used routinely. "It's still a research tool," Bernat said.

Experts also emphasized that only a few tested patients showed evidence of awareness. And they said it is not clear what degree of consciousness and mental abilities the signs imply.

They also noted that the positive signals appeared only in people with traumatic brain injury -- not in patients whose brains had been deprived of oxygen, as can happen when the heart stops. Terri Schiavo, the vegetative woman at the center of a national controversy before her feeding tube was removed and she was allowed to die in 2005, suffered oxygen deprivation.

The new work, published online Wednesday by the New England Journal of Medicine, came from researchers in Britain and Belgium. One author is Dr. Steven Laureys at the University of Liege in Belgium. He made headlines in November by showing awareness in Rom Houben, a 46-year-old man who had been diagnosed as being vegetative for 23 years. (Houben was excluded from the new study because he could not keep his head still enough in the brain scanner to produce a usable scan; his awareness was revealed by bedside behavioral tests).

The new study used brain scanning called functional MRI, or fMRI, for 23 patients in a vegetative state and 31 diagnosed as minimally conscious.

Patients are diagnosed as being in a vegetative state if they are tested and found unable to do such things as move on command or follow a moving object with their eyes. (Their eyes are open; in contrast, comatose people's eyes are closed.) Minimally conscious patients show signs of awareness, but they are minimal and intermittent.

While in the fMRI scanner, the patients were asked to imagine two situations. One was that they were standing on a tennis court, hitting a ball to an instructor; the other was that they were navigating familiar streets or walking from room to room in their homes. The two tasks produce different patterns of brain activity in healthy people.

The study found those patterns appeared in five patients when they were asked to imagine the scenes. Four of those patients had been diagnosed as vegetative.

"It just says how much we can learn from looking directly at somebody's brain," Monti said.

But he said the results cannot be taken to indicate how commonly a vegetative brain holds hidden signs of awareness. And the findings certainly don't mean all vegetative patients have that capacity, he said.

The 29-year-old, who had been injured in a traffic accident, was asked simple questions about his life, such as "Is your father's name Alexander?" He was told to answer "yes" or "no" by thinking about one or the other of the imagined scenes about playing tennis or navigating streets or his home. For five of the six questions, his brain activity matched the correct answer.

Monti and Laureys said it is not clear whether such patients have the mental capacity to answer more important but complicated questions, such as whether they wish to go on living.

"I'm trying to figure out what is the best way to tackle this," Laureys said.

Laureys also said fMRI technology isn't practical for routine assessments of vegetative patients or for enabling communication. So he is working to develop a more portable and less expensive approach based on sampling brain waves.

Oregon Man Sues Over Tree That Fell And Hurt Him

An Oregon man has filed a lawsuit against the U.S. Forest Service and a logging company on allegations that they failed to cut down a tree before it fell and injured him.

The suit filed Monday in U.S. District Court in Medford says Bert Fernandez of Prospect was driving through the Rogue River National Forest on Feb. 3, 2008, when a 32-foot-tree fell on his truck, seriously injuring him.

He contends the Forest Service had marked the tree for removal and that the logging company was supposed to have cut it down before the accident.

The lawsuit, which names the U.S. government and Dodenhoff Logging Co. as defendants, seeks $900,000 in medical bills, lost wages and pain and suffering.

Taken from - Associated Press; Food and Drug Administration; USDA; Centers for Disease Control; New England Journal of Medicine; The Oregonian, .

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