Study Spotlights Helicopter Dangers

WASHINGTON -- Emergency medical helicopter pilots had the most dangerous jobs in the U.S., racking up fatalities at a faster clip than loggers and other historically risky professions, according to a new study presented to federal air-crash investigators.

In addition to sobering statistics about the hazards of such medical chopper flights for patients as well as pilots, testimony at a National Transportation Safety Board hearing Tuesday illustrated the drawbacks of relying on voluntary industry efforts to improve safety.

Comparing 13 medical helicopter crashes that claimed 29 lives in 2008 with federal fatality rates for many other accident-prone professions, Dr. Ira Blumen, of the University of Chicago Hospitals, concluded that statistically the pilots "far exceed any of the high-risk occupations."

At least 180 people have been killed or seriously injured in U.S. medical helicopter crashes over past decade, with 2008 ending up as the most deadly year ever. Against this backdrop, the safety board is prodding regulators to require helicopter operators to install devices that can warn pilots of impending collisions with the ground, as well as digital flight-data recorders that are better able to record what occurred in the event of a crash.

During the first of four days of hearings this week, the safety board also began examining how powerful economic forces -- ranging from consolidation to how much the government will reimburse operators -- affect safety margins.

Almost half of the world's roughly 26,000 choppers fly in the U.S. One industry representative testified that it's time for operators to become more aggressive in pursuing safety goals and embracing federal mandates.

"We have to, in essence, change the way we do business," said Matthew Zuccaro, president of Helicopter Association International. He said helicopter operators must pay more attention to flight planning, adverse weather hazards and ways to retrofit the existing fleet with advanced safety equipment.

At the same time, the Federal Aviation Administration released updated figures about the results of its years-long campaign to promote voluntary industry compliance.

An FAA spokesman told reporters that so far roughly 40% of U.S. helicopters have been voluntary outfitted with collision-avoidance systems, and only about 11% have recorders. Testimony by a Canadian helicopter official offered a stark contrast to the U.S. experience.

Sylvain Seguin, vice president of Canadian Helicopters, the largest medical chopper organization in Canada, described extensive safety programs that have allowed Canada to avoid a single fatality in this segment since the 1970s. Mr. Seguin emphasized that Canadian medical choppers have two-pilot crews as opposed to many single-pilot flights in the U.S. Funded and regulated strictly by government, the craft are equipped with the latest safety devices. They are required to adhere to strict instrument-flight rules and safeguards in all cases.

Write to Andy Pasztor at andy.pasztor@wsj.com

Putting A Face On The Stem Cell Argument

By MARY SWIFT
SOMETIME SOON, perhaps even this week, President Barack Obama is expected to lift federal regulations on the use of embryonic stem cells in medical research.

With recently awarded FDA approval, a California biotech firm sits poised to begin the world's first human trial that will involve injecting embryonic stem cells into the spinal cords of people who are paralyzed.

The subject spurs heated debate. Advocates believe it will throw open the door to medicine's future. Opponents say it destroys life.

At the heart of the debate, but on the sidelines of the fight, Jacob Coffron, soon to turn 18, sits in a wheelchair and breathes with the help of a ventilator.

His is the human face of the argument for embryonic stem cell research.

At 15, he fell while climbing over a fence outside his mother's Des Moines apartment.

He hasn't breathed on his own since. A month at Harborview was followed by four months at Seattle Children's, then he came home.

His mom, Amy Garnett, cares for him during the day. An aide comes in at night. Twice a week, he goes to Redmond's Pushing Boundaries, an organization that offers exercise therapy for victims of spinal cord injury.

Time has transformed him from a young teen into a near-man. He is husky and has the beginnings of a beard.

Dressed in dark sweat pants, and a black and gray T-shirt decorated with the image of a wizard and a dragon, he sat in a wheelchair in his bedroom one recent morning with a black watch cap pulled down close to his eyes. For a time he sat covered by a comforter he has to ask to have removed.

"I get so cold sometimes that I can't get warm," said Coffron, who by nature is quiet, understated -- and given to a dry sense of humor that surfaces in one-liners.

He wears metal studs in his lips and metal wires in his ears.

A poster from "Lord of the Rings" and one of the Three Stooges decorate the walls. A collection of miniature dragons sits on one shelf. Across the room, wire baskets holding an assortment of medical supplies hang on the wall next to his bed where his 12-year-old brother Cole sprawls companionably.

A silver-colored basketball -- a gift from a friend -- serves as a bittersweet reminder of a former passion."What I miss most is basketball, just playing for fun," Coffron said.

He's planning on a tattoo when he turns 18 next month, dreams about someday living in his own apartment and smiles wryly when he's asked about his "good" days.

"A good day is when they're not yelling," he said, mounting a lighthearted jab at his mother and grandmother, Jane Coffron of Kent. They laughed.

He drew more laughter when asked what he liked to eat.

"A lot," he deadpanned, flashing a fleeting smile.

After his accident, Coffron went back to Mount Rainier High briefly but eventually dropped out. At his mother's urging, he's now talking about getting a tutor and working on his GED.

His father, Terry Hornbeck, lives nearby and has a knack for treating his son like a buddy, a gift not lost on his son, who calls him "more like a friend than a dad."

Struggling to understand why an act as innocent as climbing over a fence ended so badly, he said, "I still haven't found the answer."

Behind him, Jane Coffron dabbed at her eyes. That question -- and its unfathomable answer -- is still emotional for her.

But she is steadfast in her belief that embryonic stem cell research is the key to her grandson's future.

"With it, there's hope," she said. "This is the first time that someone with his type of injury can look forward and have real hope."

As discussion swirled around him, he listened without speaking, his expression set.

Coffron's not about to kiss off hope. But right now he's busy coping with the present -- not politics.

"I don't know," he said softly when he spoke again. "I just take one day at a time."

P-I columnist Mary Swift can be reached at 206-909-9612 or swiftyk@netscape.com.
source: seattlepi.nwsource.com

Have A Heart For Women's Health

Many women who need to hear this message the most aren't getting it: Heart disease is the No. 1 killer of women.

Nationally, only 28 percent of African-American women and 24 percent of Hispanic women understand this reality, said Elizabeth Cisco, a member of the board of the American Heart Association's Midwest Affiliate. The comparable figure for all women is 57 percent, according to association data.

Cisco hopes the association's annual Go Red for Women campaign (www.goredforwomen.org) during February will increase awareness.

"I lose sleep thinking about the fact that the audience we need to be communicating to has a higher rate of heart disease. We have a lot of work to do to educate all women," said Cisco, system marketing executive at St. Vincent Health.

On National Wear Red Day on Friday, everyone is encouraged to wear red -- symbolizing the fight against heart disease. During the Love Your Heart Casting Call from 11 a.m. to 2 p.m. at the Indianapolis Artsgarden, above the intersection of Washington and Illinois streets, women who have improved their health can apply to star in local, possibly national, promotions to inspire other women.

Another event is the annual Go Red for Women Luncheon Feb. 20 at the Downtown Marriott, presented by St. Vincent Heart Center of Indiana. For information, call (317) 873-3640.

While one in 30 women will die of breast cancer, one in three will die of heart disease, said Cisco. "Women are taught to think a lot about the outside of our chest, with respect to breast cancer, but we also need to be thinking about the inside of our chests."

U.S. Study: Insulin Possible New Treatment For Alzheimer's Disease

WASHINGTON, Feb. 2 (Xinhua) -- A Northwestern University-led research team reports that insulin, by shielding memory-forming synapses from harm, may slow or prevent the damage and memory loss caused by toxic proteins in Alzheimer's disease.

The findings, which provide additional new evidence that Alzheimer's could be due to a novel third form of diabetes, was published Monday in the online edition of the Proceedings of the National Academy of Sciences.

In a study of neurons taken from the hippocampus, one of the brain's crucial memory centers, the scientists treated cells with insulin and the insulin-sensitizing drug rosiglitazone, which has been used to treat type 2 diabetes. (Isolated hippocampal cells are used by scientists to study memory chemistry; the cells are susceptible to damage caused by ADDLs, toxic proteins that build up in persons with Alzheimer's disease.)

The researchers discovered that damage to neurons exposed to ADDLs was blocked by insulin, which kept ADDLs from attaching to the cells. They also found that protection by low levels of insulin was enhanced by rosiglitazone.

ADDLs, short for "amyloid beta-derived diffusible ligands," are known to attack memory-forming synapses. After ADDL binding, synapses lose their capacity to respond to incoming information, resulting in memory loss.

The protective mechanism of insulin works through a series of steps by ultimately reducing the actual number of ADDL binding sites, which in turn results in a marked reduction of ADDL attachment to synapses, the researchers report.

"Therapeutics designed to increase insulin sensitivity in the brain could provide new avenues for treating Alzheimer's disease," said senior author William L. Klein, a researcher in North western's Cognitive Neurology and Alzheimer's Disease Center." Sensitivity to insulin can decline with aging, which presents a novel risk factor for Alzheimer's disease. Our results demonstrate that bolstering insulin signaling can protect neurons from harm."

Kids Most In Need Least Likely To Take Vitamins

By Megan Rauscher
NEW YORK (Reuters Health) - Children and teenagers who face the greatest risk of nutritional deficiencies tend to use vitamin and mineral supplements the least, researchers reported Monday.

Among 10,828 US children ages 2 to 17 years old who participated in the 1999 to 2004 United States National Health and Nutrition Examination Survey, roughly 34 percent had used vitamin and mineral supplements in the past month.

"We hypothesized," Dr. Ulfat Shaikh told Reuters Health, "that children who had poor diets (low vegetable intake, low milk intake, high fat intake, low fiber intake), faced food insecurity, had less physical activity and poor access to health care, would use such supplements more."

"What we found was for the most part the opposite of what we expected," said Shaikh from University of California Davis School of Medicine, Sacramento.

"Other than children who were underweight (we did expect these children to use more vitamin and mineral supplements and found this to be true from the data), children who used vitamin and mineral supplements were for the most part healthier, had more nutritious diets, greater physical activity, lower sedentary activity, lower obesity, lower food insecurity and better health care access," Shaikh noted.

"Their parents additionally reported them to be in better health than children who did not use such supplements."

The American Academy of Pediatrics does not recommend vitamin and mineral supplements for healthy children older than 1 year who consume a varied diet, Shaikh and colleagues note in a report in the Archives of Pediatrics and Adolescent Medicine.

"Our data," Shaikh warned, "indicate that families with children who may benefit from these supplements appear to have limited resources and competing financial demands that prevent them from using them."

SOURCE: Archives of Pediatrics and Adolescent Medicine, February 2009.

PostPartum Depression Often Revealed in Blood Test

Many a new mother suffers the ravages of postpartum depression just when her new baby demands the most attention. Until recently, there’s been little physical evidence to determine which mothers are most at risk of developing this debilitating condition but doctors at the University of California, Irvine, have just reported their finding that a simple blood test, taken during pregnancy, does indeed provide clinical evidence of impending depression and it does so in time to begin intervention strategies before symptoms begin.

Assistant psychology professor Ilona S. Yim led a research team through a study of placental corticotropin-releasing hormone (pCRH) and any potential link with postpartum pregnancy. Their success rate in identifying new mothers who would later develop postpartum depression was 75%.

Yim’s team worked with 100 women at various stages of pregnancy. They tested the study participants’ blood for pCRH and each woman was assessed for symptoms of depression. The psychological evaluations were conducted during pregnancy and again about eight weeks after delivery, a time when postpartum depression typically begins.

Sixteen of the study participants did develop postpartum depression and each one had high levels of pCRH in her bloodstream at the 25th week of pregnancy. Using blood testing for pCRH alone revealed a 75% accuracy rate but adding the psychological evaluations to the blood testing proved even more accurate.

About 13% of all new mothers develop postpartum depression. The condition makes it difficult for the woman to cope with everyday issues but her new baby and all other family members suffer as well. Children can develop problems with cognition, behavior, and social issues when a parent is depressed.

A lingering complication of postpartum depression is that the disorder is likely to return in the future. When mothers are at particular risk, intervention can begin before symptoms start appearing and, in many cases, they can ward off the condition before it develops.

Yim suggests stress reduction measures, such as yoga, for mothers at risk. She says women who already have a history of depression are at greater risk of postpartum depression, as are women who’ve experienced stressful events in life, have a weak social support system, and who suffer from low self-esteem. When a woman experiences anxiety, depression, or stress during pregnancy, her risk of postpartum depression increases.

The February issue of the journal, ‘Archives of General Psychiatry,’ carries Yim’s full report.

Peanut Product Recall Took Company Approval

WASHINGTON — Even though federal health officials have begun a criminal investigation into whether the Peanut Corporation of America deliberately sold contaminated products, the government still needed the company’s permission last week before announcing a huge recall of its products.

The wording of the recall statement had to be approved by the company before the Food and Drug Administration could publish it under current rules. The agency relies on cooperation from food makers to ensure the safety of the food supply even when those makers are suspected of crimes.

Some Democrats in Congress have vowed to change this by giving the F.D.A. more authority, and the agency’s critics say it is too timid with the power it has.

On Monday, President Obama promised a “complete review of F.D.A. operations.”

“I think that the F.D.A. has not been able to catch some of these things as quickly as I expect them to catch,” Mr. Obama said in an interview on the “Today” show.

The president said Americans should be able to count on the government to keep children, including his daughter, Sasha, 7, safe when they eat peanut butter.

“That’s what Sasha eats for lunch probably three times a week,” Mr. Obama said. “And, you know, I don’t want to have to worry about whether she’s going to get sick as a consequence to having her lunch.”

The White House press secretary, Robert Gibbs, said Friday that Mr. Obama would soon announce a new F.D.A. commissioner and other officials. Mr. Gibbs said they would put in place a “stricter regulatory structure” to prevent breakdowns in food-safety inspections.

Part of the review is sure to examine whether the requirement for the peanut company’s approval caused delays in warnings about its products once public health officials became aware of significant problems at its plant in Blakely, Ga. The warning also covered products from the company’s customers that manufacture food, including Kellogg.

A representative for the peanut company would not comment. Kris Charles, a Kellogg spokeswoman, said “Kellogg acted quickly and recalled potentially impacted products within hours” of the peanut company’s second recall announcement.

Judy Leon, an F.D.A. spokeswoman, refused to comment.

More than 500 people have been sick in the outbreak of salmonella poisoning, and 8 have died. More than 430 product brands have been recalled.

The delays meant Sarah Kirchner of Belle Plaine, Minn., whose two young children became ill from the outbreak, for weeks had no idea how to prevent a recurrence. Her 3-year-old son, Michael, was hospitalized for four days with intense pain in his head, neck and shoulders, she said.

“He had a spinal tap, bone scan, M.R.I. and a CT scan,” Ms. Kirchner said. “I’m still so worried about him.”

Representative Rosa DeLauro, Democrat of Connecticut, said she had been asking top food and drug officials for years if they needed authority for ordering mandatory recalls.

But the officials said companies cooperated when recalls were needed.

“They can’t even get a press release out on this stuff without industry approval. It’s just unbelievable,” said Ms. DeLauro, who promised to offer legislation on Wednesday that would split the agency’s food oversight into a separate entity with mandatory recall authority and other powers.

Public health officials pinpointed the Blakely plant as the source of the salmonella outbreak on Jan. 9. The peanut company announced a limited recall on Jan. 13 and expanded it on Jan. 16. The company waited until Jan. 28 before recalling all products made at the plant in 2007 and 2008, even though it had known since 2007 that tests of products showed contamination with salmonella.

Food buyers and some top public health officials say they knew before any public announcement that the company’s products and those of its customers were the likeliest source of the outbreak.

Craig Wilson, an assistant vice president at Costco, said he pulled Kellogg’s Keebler and Austin peanut butter crackers off shelves a day before Kellogg’s first announcement and nearly a week before the Peanut company and Kellogg issued a nationwide recall that covered those cookies.

Mr. Wilson said he could not wait for the F.D.A. to make announcements about food problems that are widely known among food safety officials.

“I don’t want to say that you can’t rely on the F.D.A.,” Mr. Wilson said, “but we certainly can move quicker than they do.”

The F.D.A. can seize a product that it suspects is contaminated, and it can ask a federal judge for authority to recall products if a maker refuses to do so. The agency can also announce that it suspects problems with a product before the company agrees to a recall. But it rarely does any of these.

Bill Marler, a food safety lawyer in Seattle, said the agency had neither the authority nor the courage it needed to keep the food supply safe.

Michael R. Taylor, a former top official at the food agency, said change was needed.

“F.D.A. negotiates communications about recalls with companies,” Mr. Taylor said, “and that sometimes leads to delays. Changing that dynamic when people are getting seriously ill and dying is something that ought to happen.”