Asperger’s dropped from revised diagnosis manual

CHICAGO (AP) — The now familiar term “Asperger‘s disorder” is being dropped. And abnormally bad and frequent temper tantrums will be given a scientific-sounding diagnosis called DMDD. But “dyslexia” and other learning disorders remain.

The revisions come in the first major rewrite in nearly 20 years of the diagnostic guide used by the nation’s psychiatrists. Changes were approved Saturday.

Full details of all the revisions will come next May when the American Psychiatric Association‘s new diagnostic manual is published, but the impact will be huge, affecting millions of children and adults worldwide. The manual also is important for the insurance industry in deciding what treatment to pay for, and it helps schools decide how to allot special education.

This diagnostic guide “defines what constellations of symptoms” doctors recognize as mental disorders, said Dr. Mark Olfson, a Columbia University psychiatry professor. More important, he said, it “shapes who will receive what treatment. Even seemingly subtle changes to the criteria can have substantial effects on patterns of care.”

Olfson was not involved in the revision process. The changes were approved Saturday in suburban Washington, D.C., by the psychiatric association’s board of trustees.

The aim is not to expand the number of people diagnosed with mental illness, but to ensure that affected children and adults are more accurately diagnosed so they can get the most appropriate treatment, said Dr. David Kupfer. He chaired the task force in charge of revising the manual and is a psychiatry professor at the University of Pittsburgh.

One of the most hotly argued changes was how to define the various ranges of autism. Some advocates opposed the idea of dropping the specific diagnosis for Asperger’s disorder. People with that disorder often have high intelligence and vast knowledge on narrow subjects but lack social skills. Some who have the condition embrace their quirkiness and vow to continue to use the label.

And some Asperger’s families opposed any change, fearing their kids would lose a diagnosis and no longer be eligible for special services.

But the revision will not affect their education services, experts say.

The new manual adds the term “autism spectrum disorder,” which already is used by many experts in the field. Asperger’s disorder will be dropped and incorporated under that umbrella diagnosis. The new category will include kids with severe autism, who often don’t talk or interact, as well as those with milder forms.

Kelli Gibson of Battle Creek, Mich., who has four sons with various forms of autism, said Saturday she welcomes the change. Her boys all had different labels in the old diagnostic manual, including a 14-year-old with Asperger’s.

“To give it separate names never made sense to me,” Gibson said. “To me, my children all had autism.”

Three of her boys receive special education services in public school; the fourth is enrolled in a school for disabled children. The new autism diagnosis won’t affect those services, Gibson said. She also has a 3-year-old daughter without autism.

People with dyslexia also were closely watching for the new updated doctors’ guide. Many with the reading disorder did not want their diagnosis to be dropped. And it won’t be. Instead, the new manual will have a broader learning disorder category to cover several conditions including dyslexia, which causes difficulty understanding letters and recognizing written words.

The trustees on Saturday made the final decision on what proposals made the cut; recommendations came from experts in several work groups assigned to evaluate different mental illnesses.

The revised guidebook “represents a significant step forward for the field. It will improve our ability to accurately diagnose psychiatric disorders,” Dr. David Fassler, the group’s treasurer and a University of Vermont psychiatry professor, said after the vote.

The shorthand name for the new edition, the organization’s fifth revision of the Diagnostic and Statistical Manual, is DSM-5. Group leaders said specifics won’t be disclosed until the manual is published but they confirmed some changes. A 2000 edition of the manual made minor changes but the last major edition was published in 1994.

Olfson said the manual “seeks to capture the current state of knowledge of psychiatric disorders. Since 2000 … there have been important advances in our understanding of the nature of psychiatric disorders.”

Catherine Lord, an autism expert at Weill Cornell Medical College in New York who was on the psychiatric group’s autism task force, said anyone who met criteria for Asperger’s in the old manual would be included in the new diagnosis.

One reason for the change is that some states and school systems don’t provide services for children and adults with Asperger’s, or provide fewer services than those given an autism diagnosis, she said.

Autism researcher Geraldine Dawson, chief science officer for the advocacy group Autism Speaks, said small studies have suggested the new criteria will be effective. But she said it will be crucial to monitor so that children don’t lose services.

Other changes include:

—A new diagnosis for severe recurrent temper tantrums — disruptive mood dysregulation disorder. Critics say it will medicalize kids’ who have normal tantrums. Supporters say it will address concerns about too many kids being misdiagnosed with bipolar disorder and treated with powerful psychiatric drugs. Bipolar disorder involves sharp mood swings and affected children are sometimes very irritable or have explosive tantrums.

—Eliminating the term “gender identity disorder.” It has been used for children or adults who strongly believe that they were born the wrong gender. But many activists believe the condition isn’t a disorder and say calling it one is stigmatizing. The term would be replaced with “gender dysphoria,” which means emotional distress over one’s gender. Supporters equated the change with removing homosexuality as a mental illness in the diagnostic manual, which happened decades ago.

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

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Mexico’s Pena Nieto takes power vowing to end violence

MEXICO CITY (Reuters) – Enrique Pena Nieto took over as Mexico‘s president on Saturday, promising to end years of violence and sluggish economic growth, and giving the party that shaped modern Mexico a shot at redemption after 12 years out of office.

The 46-year-old Pena Nieto said the people had been let down since his centrist Institutional Revolutionary Party, or PRI, fell from power in 2000, and pledged a raft of changes to boost growth, create jobs and fight poverty.

“The state has lost ground in important areas. Lawlessness and violence have robbed various parts of the country of peace and freedom,” Pena Nieto said in his inaugural speech at a ceremonial palace in the old center of Mexico City. “My government’s first aim will be to bring peace to Mexico.”

Pena Nieto takes command of a country that was convulsed by the deaths of more than 60,000 people in violence between drug gangs and security forces during the six-year term of his conservative predecessor, Felipe Calderon.

Pena Nieto says he is committed to fighting organized crime, but has also stressed his main goal is to reduce the violence.

He paid tribute to Mexico’s armed forces early in his speech and then saluted them on the capital’s Field of Mars parade ground.

The torrent of gangland killings in Mexico has worried investors and tourists alike, and voters in the holiday resort of Cancun said they expected Pena Nieto to calm things down.

“I hope security improves, that there are no more decapitated bodies, that the drug gangs don’t continue shooting in the streets,” said Carlos Madrid, a tourism worker in the eastern city. “It’s no good for families, no good for business, no good for the population, it’s no good for anyone.”

PROTESTS

Calderon’s National Action Party, or PAN, took power in 2000 pledging to reinvigorate Mexico, but it never had a majority in Congress and struggled to push through legislation it wanted to create jobs in Latin America’s second-biggest economy.

Memories of the PRI’s unbroken 71-year rule are still vivid in Mexico, and the party was a byword for corruption, cronyism and vote-rigging by the time it left office.

“It’s like the Communist Party of the Soviet Union making a comeback,” said Lorenzo Meyer, a left-leaning political scientist and historian at the National Autonomous University of Mexico. “The PRI should be dead. Its time had passed.”

Demonstrators sought to take the shine off Pena Nieto’s swearing-in ceremony, and several thousand protesters, mainly from leftist groups that supported Pena Nieto’s main rival and oppose his reform plans, massed earlier outside Congress.

Police fired tear gas to disperse protesters, who rattled metal barriers in a bid to disrupt the upcoming ceremony. Elsewhere, small groups of protesters threw Molotov cocktails.

“They have imposed an illegitimate president. There’s lots of us here, this struggle is just beginning,” said a 16-year-old student who identified herself as Frida, her eyes stinging from the gas and wearing a T-shirt emblazoned with the image of a guerrilla leader.

Married to a popular actress, Pena Nieto, the telegenic former state of Mexico governor, won the July 1 election with about 38 percent of the vote, more than 6 points ahead of leftist Andres Manuel Lopez Obrador, who refused to accept the result.

Lopez Obrador also rejected the outcome of his narrow election loss in 2006 to Calderon, and the protests on Saturday were slight by comparison with the demonstrations then.

TWO-SPEED COUNTRY

Having helped shepherd a labor reform through Congress since his election victory, Pena Nieto now wants to pass legislation to strengthen Mexico’s tax base and allow more private investment in lumbering state oil giant Pemex.

“Mexico has not achieved the advances the people demand and deserve,” Pena Nieto said. “We are a country growing at two speeds. There’s a Mexico of progress and development. But there’s another one too that’s been left behind in poverty.”

If he is successful, the reforms could help spur stronger growth and create jobs, blunting the allure of organized crime.

Annual economic growth averaged less than 2 percent under the PAN over the past 12 years, far behind many other Latin American countries. That record and the drug war violence opened the door for a PRI comeback under Pena Nieto.

Still, inflation has been kept in check, debt levels are low and growth picked up toward the end of Calderon’s term, with the economy outperforming Brazil’s in the past two years.

Pena Nieto’s inner circle features several ambitious young economists and financial experts eager to prove the PRI can do a better job of managing the economy.

For much of the PRI’s rule, Mexico enjoyed stronger growth than the PAN mustered, but memories linger of default on the country’s debts in 1982 and a financial crash in 1994 and 1995.

“It’s very hard to believe in the PRI. They bankrupted Mexico,” said construction worker Jose Luis Mendoza.

Supporting a family of four on 1,300 pesos ($ 100) a week, Mendoza, 29, said he was worse off now than when Calderon took office, and doubted his life would improve under the PRI. “The cost of everything has gone up – but my wage hasn’t,” he said.

Pena Nieto has pledged to put more money in Mexicans’ pockets and shake up competition in a country where large swaths of the economy are concentrated in the hands of a few, like telecom billionaire Carlos Slim, the world’s richest man.

But Pena Nieto has been vague so far about how he plans to create a more level playing field, and pollster Jorge Buendia said it would be foolish to expect radical change.

“Pena Nieto’s not a reformist guy. He never has been,” Buendia said. “He’s an establishment guy and I don’t think he’s going to rock the establishment that much.”

(Additional reporting by David Alire Garcia, Isela Serrano, Alexandra Alper, Miguel Gutierrez, Simon Gardner, Gabriel Stargardter and Noe Torres; Editing by Kieran Murray, Simon Gardner and Peter Cooney)

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Cargo plane crashes in Brazzaville, 3 dead

BRAZZAVILLE, Republic of Congo (AP) — A cargo plane owned by a private company crashed Friday near the airport in Brazzaville, the capital of the Republic of Congo, killing at least three people, officials said.

The Soviet-made Ilyushin-76 belonged to Trans Air Congo and appeared to be transporting merchandise, not people, said an aviation official who requested anonymity because he was not authorized to speak to the media.

The plane was coming from Congo‘s second-largest city, Pointe Noire, and tried to land during heavy rain, he said.

Ambulances rushed to the scene in the Makazou neighborhood, located near the airport, but emergency workers were hampered by the lack of light in this capital, which like so many in Africa has a chronic shortage of electricity.

“At the moment, my team is having a hard time searching for survivors in order to find the victims of the crash because there is no light and also because of the rain,” Congolese Red Cross head Albert Mberi said.

He said that realistically, they will only be able to launch a proper search Saturday, when the sun comes up.

Reporters at the scene fought through a wall of smoke. Despite the darkness, they could make out the smoldering remains of the plane, including what looked like the left wing of the aircraft. A little bit further on, emergency workers identified the body of the plane’s Ukrainian pilot, and covered the corpse in a blanket.

Firefighters were trying to extinguish the blaze of a part of the plane that had fallen into a ravine. They were using their truck lights to try to illuminate the scene of the crash. Although the plane was carrying merchandise, emergency workers fear that there could be more people on board.

Because of the state of the road connecting Pointe Noire to Brazzaville, many traders prefer to fly the roughly 400 kilometers (250 miles).

Africa has some of the worst air safety records in the world. In June, a commercial jetliner crashed in Lagos, Nigeria, killing 153 people, just a few days after a cargo plane clipped a bus in neighboring Ghana, killing 10.

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Putin aide denies Russian president has health problems

TOKYO/MOSCOW (Reuters) – Vladimir Putin is in good health, his chief of staff said on Friday after Japanese media said Prime Minister Yoshihiko Noda had postponed a visit to Moscow next month because the Russian president had a health problem.

A former KGB officer who enjoys vast authority in Russia, Putin has long cultivated a tough-guy image, and health issues could damage that. His condition though has been questioned in some media since he was seen limping at a summit in September.

Three Russian government sources told Reuters late in October that Putin, who began a six-year term in May and turned 60 last month, was suffering from back trouble, but the Kremlin has dismissed talk that he had a serious back problem.

Putin’s health troubles stem from a recent judo bout, Belarussian President Alexander Lukashenko said this week.

Then on Friday Japanese news agencies Kyodo and Jiji reported that Prime Minister Noda talked about the delay of a visit planned for December in a meeting with municipal officials on the northern island of Hokkaido.

“It’s about (President Putin’s) health problem. This is not something that can easily be made public,” Jiji cited one of the officials as quoting Noda as saying.

But Putin’s chief of staff Sergei Ivanov denied there was any problem.

“Please don’t worry, don’t be concerned. Everything is in order with his health,” Putin’s said in Vienna, according to state-run Russian news agency RIA.

In an interview published on Friday in the popular Russian tabloid Komsomolskaya Pravda, Putin’s spokesman Dmitry Peskov said rumors about a spine problem were “strongly exaggerated”.

“He is working as he has before and intends to continue working at the same pace,” Peskov said.

“He also does not plan to give up his sports activities and for this reason, like any athlete, his back, his arm, his leg might sometimes hurt a little – this has never gotten in the way of his ability to work.”

Putin had been expected to make several foreign trips in late October or November, but they did not take place.

Putin is however due to visit Turkey on Monday and Turkmenistan on Wednesday.

Putin’s foreign policy adviser, Yuri Ushakov, made amply clear the Kremlin was displeased by the public discussion of scheduling by Japanese officials and denied that Noda’s visit had been postponed, saying no date had been set.

“It is just unethical to name the dates that were discussed. There were several: at first it was October, November, December, January … then we even shifted to February,” Ushakov said, adding that the sides eventually agreed tentatively on January.

He said the diplomatic process of agreeing dates for the visit should have been “hermetically sealed”.

Putin’s image as a fit, healthy man helped bring him popularity when he rose to power 13 years ago because of the stark contrast with his predecessor Boris Yeltsin, who was sometimes drunk in public and had heart surgery when president.

He has used activities like scuba diving and horseback riding to maintain that image.

On Friday, Putin met leaders of parliamentary factions in his Novo-Ogaryovo residence outside Moscow. He appeared in good health and was walking without any sign of a limp.

Likely to be on the agenda in talks between Russian and Japanese officials are energy cooperation and a decades-old dispute over islands north of Hokkaido known as the Southern Kurils in Russia and the Northern Territories in Japan.

(Additional reporting by Darya Korsunskaya; Writing by Tomasz Janowski and Steve Gutterman; Editing by Nick Macfie and Jon Hemming)

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The Economy of Surgery

When I was twelve, my sister and I accompanied my grandparents to their annual yoga retreat in the hilly ranges of southern India. We had never been before, but the summer heat was particularly blistering that year, so we persuaded our grandparents to take us along. I envisioned a blissful two-week vacation in a photogenic little hamlet, nestled among tea plantations, in temperatures that were thirty degrees cooler than on the mainland. It was just that, and yet, it was even less complicated than that.The mean age of folk at the retreat was 67. Bells sounded every morning at 3:30am, and everyone filed out of their cabins and to a little gymnasium in the center of the dwelling, where we all meditated for two hours to the sounds of sitar music and transcendental humming. Meals were served at strict hours three times a day, and consisted of boiled vegetables and grains, with not a lick of salt or spice. The library in the middle of this utopian dwelling held only spiritual and philosophical texts, not the Nancy Drew or Hardy Boys I hoped for. In the afternoons, there were a variety of classes offered – cooking lessons, devotional classes, music and instrumental classes, and yoga. My sister and I stopped by the latter occasionally, and were always put to shame by octogenarians holding themselves up in impossible poses, such as balancing their entire habitus on the tips of their fingers. I journaled in the evenings, writing each day about a new facet of human life that I’d observed. In the absence of stimulus, my dreams grew vivid and exceedingly detailed.Over the course of the two weeks, my sister and I grew quiet and reflective. It was then that we began an important switch in our minds, something that has lasted to this day. We began to see value in living leanly, economically, functionally. We began to separate needs from wants, and to discard the ornamentation.*Third year of medical school has finally brought me around to my surgery rotation: three months of waking up at 4am, stuffing my white coat pockets to the brim with gauze and tape, retracting skin and fat during long abdominal surgeries, and practicing suturing techniques on pig’s feet procured at the local Stop&Shop grocery market. It’s fast and exhilarating, and deeply satisfying. I was skeptical when I first heard that my preceptor’s favorite procedure of all time was draining a deep-seated abscess. But when I saw it being done in clinic, how a single stab of the thing blade led to the gushing of what felt like liters of pus, I couldn’t help but agree. What a joy to just go in and fix a problem so dramatically, reconstruct a failing human body in a matter of hours!During orientation on the first day of the rotation, two residents sat down and gave my classmates and me some hard advice. Surgery is a demanding rotation, they said, and it reflects the demanding residency ahead that awaits the select few. We could expect to go in while it is still dark out, and leave after the sun had set, almost every day. Residents and attendings can be rough around the edges, and may be gruff with you, even kick you out of their operating room if they feel like it, but it’s not personal. Or even if it is, we’ve got to shrug it off and keep it moving. Gone are the days of noon conferences and luxurious afternoon didactics, with their promise of free lunches and coffee. We were to eat when we can, sit when we can, sleep when we can.After an hour of such grim prognostications, my classmates and I took a break and debriefed our feelings with each other outside the bathrooms. Some were giggling nervously with panicked eyes, but most looked inspired. I too felt like I had voluntarily signed up for a warrior training program, and was feeling pretty zen about it. I saw it as a character-building experience: surgery was the time to cut out the silly frills, and embrace a leaner, meaner way of living. It was time to lose the pretty business casual outfits and fancy footwear of internal medicine, and trade them in for utilitarian scrubs and clogs. It promised to be a time of talking less and getting things done.*During a recent health management class, my classmates and I discussed the case of a medical center based in Seattle that benefited from industry principles gleaned from, of all places, the Toyota car manufacturing company. Toyota’s revolution as a manufacturing miracle began in the supply-scarce post-WWII Japan, when management was confronted with the challenge of meeting customer needs in the face of little spare capital to hold inventory as a buffer to fluctuating demand. The company then developed a set of principles focused on cutting muda or waste, while pursuing kaizen, or continuous self -improvement by way of complete intolerance for redundancy. Toyota integrated these principles into every step of production and management.For instance, Toyota emphasizes innovation on the shop floor by frontline workers to solve problems in production in real time. If a problem is discovered that cannot be fixed within the production cycle time, workers pull a cord that halts the entire assembly line and brings a senior supervisor to the scene. The management aggressively seeks ideas for improvement from employees, resulting in an average yield of close to a million ideas annually, 90% of which go on to be implemented.Analysts attribute Toyota’s success to its emphatic optimization of flow – information flow, physical flow of parts, and overall production flow, via standardized processes and continuous improvement. Standardized processes are ones that are streamlined to eliminate aberrations and unplanned redundancies. Waste, measured even in the seconds, is simply not tolerated, forcing a redesign of processes, again and again, which any employee can take on.In 2004, Toyota surpassed Ford Motors to become the world’s second-largest manufacturer of cars and trucks, surpassing the latter consistently in quality, dependability and value assessments. In turn, Ford began to take cues from Toyota, transforming its assembly-line system to similarly cut out waste.*There are two kinds of people in the world: surgeons, and everyone else.Really, what does it mean to live leanly? I rediscovered it in this rotation. A life in surgery isn’t for everyone, but such an experience is something I truly feel everyone should have. These past 6 weeks have been teaching me to think fast, move fast. They’ve been teaching me to suffice with less, be it food, sleep, or words of appreciation. They’ve been teaching me to appreciate the vulnerabilities of the human body – for no matter how exhausted or sleep-deprived I may feel, actually laying hands on the more tangible deficits of another’s is always startling and humbling. The end result is a beautiful dance, for surgeons and their assistants, working with their hands, rediscovering the grace of human movement, bring art back into medicine.I never leave the OR thinking that more is better. I watch instruments fly, I watch the players push and pull, cut and stitch, wash and dry, and I think about things like symmetry, precision, and above all, the beauty of economy.

Follow Scientific American on Twitter @SciAm and @SciamBlogs.Visit ScientificAmerican.com for the latest in science, health and technology news.
© 2012 ScientificAmerican.com. All rights reserved.
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China Nov official factory PMI hits seven-month high

BEIJING (Reuters) – China‘s official manufacturing purchasing managers’ index rose to a seven-month high of 50.6 in November from 50.2 in October, the National Bureau of Statistics said on Saturday.

The headline figure is in line with an economist poll by Reuters this week, and confirms a trend toward recovering growth in the world’s second-largest economy.

A PMI reading below 50 suggests growth slowed, while a number above 50 indicates accelerating growth.

While growth accelerated for large firms for the third month in a row, medium and smaller companies saw a retrenchment, with the decline more pronounced for the smaller firms, the NBS said in an accompanying statement.

“The improving numbers are mostly because of government investment. From the second quarter the government has unleashed a lot of projects, and that has started to be felt in the economy, but it’s not a very healthy recovery yet,” said Dong Xian’an, economist with Peking First Advisory.

The HSBC China flash PMI – which gathers more data from smaller, privately-held firms that have a strong export focus – signaled that November growth in the manufacturing sector had quickened for the first time in 13 months with a reading of 50.4 when it was published last week, reflecting a steady uptick in the economy.

China’s economic health has improved since September, with an array of indicators from factory output to retail sales and investment showing Beijing’s pro-growth policies are starting to gain traction.

Analysts said the end of a destocking cycle and a greater pace of investment would keep driving up domestic demand, and extend the recovery trend into the final quarter of this year.

Smaller and private firms are still pleading for greater access to credit and investment incentives, which have gone disproportionately to the state sector, particularly since the financial crisis of 2008-2009.

China’s annual economic growth dipped to 7.4 percent in the third quarter, slowing for seven quarters in a row and leaving the economy on course for its weakest showing since 1999.

Given the recent signs of recovery, many analysts expect the economy to snap out of its longest downward cycle since the global financial crisis, and start to trend upwards in the fourth quarter.

But economists also warn of downside risks from still cloudy external markets. The European debt crisis and listless U.S. economy continue to crimp demand from China’s two largest trade partners.

China’s central bank has moved cautiously in easing monetary policy to underpin economic growth, wary of reigniting inflation and fanning property prices which are still high.

It cut interest rates twice in June and July and lowered banks’ reserve requirement ratio by 150 basis points in three stages since last November, but has refrained from further cuts since July. The authorities have opted to inject liquidity via open market operations to pump short-term cash into money markets.

The official PMI generally paints a rosier picture of the factory sector than the HSBC PMI because the official survey focuses on big, state-owned firms, while the HSBC PMI targets smaller, private companies. There are also differing approaches to seasonal adjustment between the two surveys.

This year’s final HSBC PMI reading is due to be published at 0145 GMT on Monday.

(Reporting By Lucy Hornby; Editing by Daniel Magnowski)

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African Union asks UN for immediate action on Mali

DAKAR, Senegal (AP) — In an open letter Thursday to U.N. Secretary-General Ban Ki-moon, the president of the African Union urged the U.N. to take immediate military action in northern Mali, which was seized by al-Qaida-linked rebels earlier this year.

Yayi Boni, the president of Benin who is also head of the African Union, said any reticence on the part of the U.N. will be interpreted as a sign of weakness by the terrorists now operating in Mali. The AU is waiting for the U.N. to sign off on a military plan to take back the occupied territory, and the Security Council is expected to discuss it in coming days.

In a report to the Security Council late Wednesday, Ban said the AU plan “needs to be developed further” because fundamental questions on how the force will be led, trained and equipped. Ban acknowledged that with each day, al-Qaida-linked fighters were becoming further entrenched in northern Mali, but he cautioned that a botched military operation could result in human rights abuses.

The sprawling African nation of Mali, once an example of a stable democracy, fell apart in March following a coup by junior officers. In the uncertainty that ensued, rebels including at least three groups with ties to al-Qaida, grabbed control of the nation’s distant north. The Islamists now control an area the size of France or Texas, an enormous triangle of land that includes borders with Mauritania, Algeria and Niger.

Two weeks ago, the African Union asked the U.N. to endorse a military intervention to free northern Mali, calling for 3,300 African soldiers to be deployed for one year. A U.S.-based counterterrorism official who saw the military plan said it was “amateurish” and had “huge, gaping holes.” The official insisted on anonymity because he was not authorized to speak on the matter.

Boni, in his letter, said Africa was counting on the U.N. to take decisive action.

“I need to tell you with how much impatience the African continent is awaiting a strong message from the international community regarding the resolution of the crisis in Mali. … What we need to avoid is the impression that we are lacking in resolve in the face of these determined terrorists,” he said.

The most feared group in northern Mali is al-Qaida in the Islamic Maghreb, or AQIM, al-Qaida’s North African branch, which is holding at least seven French hostages, including a 61-year-old man kidnapped last week.

On Thursday, SITE Intelligence published a transcript of a recently released interview with AQIM leader, Abu Musab Abdul Wadud, in which he urges Malians to reject any foreign intervention in their country. He warned French President Francois Hollande that he was “digging the graves” of the French hostages by pushing for an intervention.

Also on Thursday, Islamists meted out the latest Shariah punishment in northern city of Timbuktu. Six young men and women were each given 100 lashes for having talked to each other on city streets, witnesses said.

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Associated Press writer Virgile Ahissou in Cotonou, Benin and Baba Ahmed in Bamako, Mali contributed to this report.

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Stephen King and Steven Spielberg’s “Under the Dome” gets series order from CBS

LOS ANGELES (TheWrap.com) – “Under the Dome” has landed under the wing of CBS.

The network has given a 13-episode, straight-to-series order for the project, an adaptation of the Stephen King novel of the same name.

The series will premiere in summer 2013.

King will executive-produce, along with Steven Spielberg, whose Amblin Television will produce the series in association with CBS Television Studios. Neal Baer, Justin Falvey, Darryl Frank, Stacey Snider and Brian K. Vaughan are also executive-producing. Niels Arden Oplev (“The Girl With the Dragon Tattoo”) will direct the first episode.

The series will revolve around a small New England town that is suddenly and inexplicably sealed off from the rest of the world by an enormous transparent dome. The town’s inhabitants must deal with surviving the post-apocalyptic conditions while searching for answers to what this barrier is, where it came from and if and when it will go away.

“This is a great novel coming to the television screen with outstanding auspices and in-season production values to create a summer programming event,” CBS Entertainment president Nina Tassler said. “We’re excited to transport audiences ‘Under the Dome’ and into the extraordinary world that Stephen King has imagined.”

Showtime, which is owned by CBS, had previously been developing the project.

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Human stool treatment upends race to treat colon germ

(Reuters) – Drugmakers racing to develop medicines and vaccines to combat a germ that ravages the gut and kills thousands have a new challenger: the human stool.

For patients hit hardest by the bacterium Clostridium difficile, getting a “stool transplant” could become a standard treatment within just a few years. Just as blood banks and sperm banks are now commonplace, stool banks may soon dot the landscape.

About 3 million Americans are infected annually with the bacterium – also known as C. diff – which spreads mainly through hospitals, nursing homes and doctors’ offices.

Most people have no symptoms, but 500,000 – more than half of them 65 and older – develop abdominal cramps, fever, diarrhea and inflamed colons. As many as 30,000 Americans die each year from the bacterium, usually after recurrences of infection.

The infections are typically the result of taking antibiotics, which wipe out friendly bacteria in the colon that normally keep C. diff under control. Transplants of stool from screened donors – given by enema, colonoscopy or a tube down the throat – restore these bacteria.

Although the vast majority of C. diff infections occur in healthcare settings, more and more cases are occurring in younger adults and children who have not recently taken antibiotics or been hospitalized. They include people who take proton pump inhibitors – a leading class of heartburn drugs.

Costly treatments from Merck & Co and other drugmakers, and a vaccine from Sanofi, are on the horizon. But growing numbers of gastroenterologists are more excited about the use of human stool transplants, which in experimental settings have consistently cured 85 percent to 90 percent of patients who have had multiple episodes of C. diff.

“Until recently, fecal transplants have been on the fringes of mainstream medicine,” said Dr. Cliff McDonald, an epidemiologist with the U.S. Centers for Disease Control and Prevention (CDC). “It could become the primary mode of therapy within a year or two for patients with multiple recurrences.”

Francie Williamson, a 32-year-old editor for the Cedar Rapids Gazette in Iowa, has been battling C. diff since giving birth in May and considers herself a prime candidate.

After several recurrences, she still suffers from cramping and diarrhea and is making another appointment with her doctor to see if she still has the germ.

“He’s done fecal transplants, like 10 of them. So I definitely want to have (that option) in my back pocket.”

WHEEL OF MISFORTUNE

The first recorded stool transplants were given in 1958 to four patients with inflamed colons. The procedures won more attention in the mid-1980s, when Australian gastroenterologist Thomas Borody began using them to treat his C. diff. patients.

Dr. Moshe Rubin, head of gastroenterology at New York Hospital Queens, said most patients prefer the simplicity of a pill or injection, but for those with multiple bouts the fecal transplants could become a mainstay treatment.

“This has to be tested in large numbers of people before you unleash it for such a widespread disease,” Rubin said.

C. diff medicines and vaccines could eventually claim total annual sales of $ 2 billion, according to Morningstar analyst David Krempa, or 10 times current sales.

Fecal transplants might initially be appropriate for patients who have had a third recurrence – or about 25,000 Americans each year, according to Dr. Sahil Khanna, a Mayo Clinic gastroenterologist. That number could rise as the procedure becomes more widely accepted, and pose perhaps the biggest threat to sales of Merck’s experimental drug, which is expected to target a similar patient group.

About 90 percent of C. diff patients initially treated with vancomycin, and 60 percent of those treated with another standard oral drug called metronidazole, recover within weeks. But 20 percent suffer recurrences, as surviving bacteria spores become activated or as patients become re-infected with spores that cling to clothing and furniture and can survive for months.

With each recurrence, risk of another rises, with more weight loss, diarrhea and fatigue. After a third recurrence, the risk of suffering a fourth is 60 percent to 70 percent.

“It’s a constant wheel of misfortune,” said Eric Kimble, a senior executive for Cubist Pharmaceuticals Inc, which is developing a C. diff treatment called CB-315.

GETTING OVER THE ‘ICK’ FACTOR

Fecal transplants have proved a godsend to such patients. They are given to those who have not benefited from metronidazole or vancomycin – or who have suffered repeat recurrences of C. Diff after being temporarily helped by the treatments.

In more than 100 of the experimental procedures performed by Dr. Christine Lee, the transplants cured the infections and prevented recurrences in 90 percent of patients, said the infectious disease physician at St. Joseph’s Healthcare (hospital) at McMaster University in Hamilton, Ontario.

“Their energy level and appetite bounce back within a week, sometimes within 48 hours,” Lee said. “They can’t believe how simple and effective the procedure is.”

In a five-minute bedside procedure, Lee introduces about 50 grams (1.75 ounces) of donated fecal matter into the rectum, using an inexpensive plastic plunger. A single procedure re-establishes the balance of bacteria.

Friends and family of patients, as well as doctors and nurses, provide without pay the stool used in Lee’s procedures. They are screened to ensure they do not have viruses, such as HIV or hepatitis C, or other pathogens that can be transmitted to patients. She said some donate stool on a regular basis, which can be used for a great number of patients.

Once transplants are approved by health regulators, Lee predicted, enema procedures will be less costly than two other delivery methods now used for stool transplants. They include colonoscopy, in which doctors sedate the patient and insert stool into the colon, or through a different procedure in which a plastic feeding tube is passed through the nose, down the throat and into the stomach.

In the meantime, gastroenterologists say doctors and hospitals can help prevent C. diff by being more restrained in the use of antibiotics and ensuring that hospital rooms are diligently cleaned with bleach wipes to kill C. diff spores.

MERCK, SANOFI TAKE AIM AT TOXINS

One of the best hopes for stopping C. diff, aside from fecal transplants, could be Merck’s injectable monoclonal antibody. In a mid-stage trial, 7 percent of patients had recurrences when taking the Merck product in combination with metronidazole or vancomycin. That compared with 25 percent of those receiving only standard therapy.

Merck’s drug works by disabling two toxins released by C. difficile that wreak havoc in the colon, and is meant to be taken alongside the standard treatments.

“Other drugs go after the bacteria, but there is nothing out there now that targets the toxins directly,” said Dalya Guris, Merck’s project leader for the medicine.

French drugmaker Sanofi is working on a vaccine that is not expected to become available for at least five years. It will be tested among high-risk individuals who expect to be hospitalized for elective surgeries or who plan to enter nursing homes.

“The intent of the vaccination is to prevent the first occurrence of symptoms of the disease” among those at highest risk, said Patricia Pietrobon, Sanofi’s project leader.

Merck and Sanofi declined to say how much they will spend to test their products, but costs of developing antibodies and vaccines can top $ 1 billion and $ 500 million, respectively, according to drugmakers.

The most effective approved drug against the first recurrence of C. diff is Dificid, from Optimer Pharmaceuticals Inc, introduced in May 2011. It is as effective as vancomycin in curing initial C. diff infections, and almost 50 percent better at preventing a first recurrence.

But Dificid has had modest sales because it costs about $ 3,000 for a 10-day course of treatment. That’s twice the cost of vancomycin and 300 times the cost of metronidazole.

Dificid could peak in 2016 with annual sales of $ 210 million, according to Cowen and Co.

Cubist, which co-markets Dificid in the United States, is testing its own drug CB-315 and expects it to be approved in 2016. Like Dificid, it is a narrow-spectrum antibiotic meant to attack C. difficile while sparing normal bowel bacteria.

Dr. Mark Pochapin, director of gastroenterology at NYU Langone Medical Center, said Merck’s anti-toxin approach might eliminate symptoms the same day of treatment. But he said fecal transplants have more appeal.

“They appear effective, balance the normal intestinal flora, are inexpensive and are safe when done with appropriate testing,” he said. “They will far and away revolutionize how we treat this disease.”

Many patients might benefit most from transplantation of their own stool, rather than relying on donors. They would include those undergoing chemotherapy or hip or knee replacements, all of which involve use of antibiotics, said the CDC’s McDonald.

People, he said, would set aside stools for processing into capsules that would be frozen and stored until needed.

Such “bacterial treatment” after antibiotics might eventually also lower the risk of developing asthma, allergy, obesity or other conditions that may be partly linked to loss of helpful bacteria, McDonald said.

“Look at it as a way to put people’s bacterial population back together again after antibiotics, like restoring Humpty Dumpty,” said McDonald.

(Reporting By Ransdell Pierson; Editing by Jilian Mincer, Edward Tobin, Martin Howell and Steve Orlofsky)

Medications/Drugs News Headlines – Yahoo! News

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Argentina’s 11-Year War With Hedge Funds

Since it defaulted on its debt more than a decade ago, Argentina’s economy has engaged in a Cold War of sorts with international investors. Buenos Aires stuck bondholders with a take-it-or-leave-it exchange offer of 30¢ on the dollar, the harshest sovereign debt haircut in at least half a century.

Companies delisted. Foreign investors bolted. Argentina, meanwhile, was demoted from the league of “emerging markets” to that of less-developed “frontier” economies, alongside Bangladesh and Kenya—among which the South American nation has been struggling to remain. To inflict injury on these insults, late President Néstor Kirchner and the wife who succeeded him, Cristina Fernández de Kirchner, have nationalized $ 24 billion in private pensions and assumed control of the country’s top energy company, which was majority owned by Spain’s Repsol (REP:SM). The government also instituted bizarre regulations, such as one that requires car importers to match their imports with exports of equal value.

However, a hardy group of “holdout” creditors, including U.S. institutional investors and a handful of elderly Argentinian pensioners, refused to participate in the nation’s 2005 and 2010 debt restructurings, wagering that they could band together to get better terms out of Buenos Aires. Last month’s scorched-earth volley: A court in Ghana, of all places, detained an Argentine frigate at the request of a hedge fund that says Buenos Aires owes it $ 300 million on old debt. Argentina just escalated the affair to the United Nations. All this at a time when the defiant Kirchner has rekindled nationalism over the Falkland Islands, over which Argentina went to war with the U.K. more than 30 years ago.

Now, the battle for the economic soul of the nation of 41 million—amid a raging international debate about the limits of creditor rights (Greece, anyone?)—is taking place in, of all places, New York. In courtrooms there, the aforementioned aggrieved hedgie, Paul Singer, is spearheading a campaign to wrest better payment on the debt he owns. Last week, U.S. District Judge Thomas Griesa ordered Argentina to deposit $ 1.33 billion to pay the Singer-led holdouts. On Wednesday, an appeals court gave Argentina more time to fight the ruling.

The nervously awaited outcome could either sink Argentina’s economy or make it ever more hostile to the global capital markets. Or neither. Or both. Probably some titration therein. Fitch Ratings was sufficiently spooked by the standoff to say an Argentine default is now “probable.” It’s not just a matter of Argentina facing off with its creditors: Bondholders who agreed to the haircut don’t necessarily want to see the renegades made whole, especially if it threatens their own payments. Accordingly, Bush v Gore super lawyer David Boise has entered the crowded fray. It gets better: Theodore Olson, Boies’s Supreme Court opponent in Election 2000, could well end up arguing opposite Boies again. (At least they agree on something.) The boom in Argentina-related billable hours is an international incident unto itself. According to law firm White & Case, since Argentina’s default, jilted bondholders have filed at least 180 civil lawsuits against the country in the Empire State.

Confused? So is everyone else. This explainer, by Ohio State international financial law professor Steven Davidoff, is a must-read.

How, you ask, can Argentina possibly still wield any financial suasion abroad? Well, 1) Look at it on a map. 2) Try its steak. The geographically blessed nation has undeniable breadbasket appeal, with its abundance of soybeans, livestock, and minerals in a China-dominated world that wants ever more of those things.

Witness how very well Brazil, Colombia, and Peru have done during Argentina’s pariah decade. For all its faults, Argentina remains the continent’s No.2 economy. (Columbia is disputing that.) So even as its Merval stock index has been whittled to near-irrelevance by the delistings and falling international interest, it has more than quintupled since the nation’s financial meltdown.

“My view is that Argentina will stand more defiant than ever but at the same time, it will do whatever it can to make sure to keep servicing their debt and show the world community that they are the victims and that the ‘vulture funds’ are the bad guys,” says Santiago Maggi, managing partner with Latmark Asset Management in Miami.

“Without accessing capital markets, we have been punctually paying since 2005 with our own resources and we are going to continue to do so because we are going to honor our obligations as corresponds to a country that has recovered its self-esteem,” Kirchner said in a speech earlier this week.

Can she hang on long enough to be kept to her word? On top of legal and frigate-forfeiture problems, Argentina is mired in a deep recession marked by growing labor unrest, high inflation, and declining infrastructure.

Which, depending on Kirchner’s read, could call for more sticking it to los capitalistas.

Businessweek.com — Top News

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