Sunday, September 30, 2007

More weekend stroke patients die - Heart Health




Weekend stroke patients have higher death risk

14 percent increase may be tied to lack of expertise, resources, experts say

DALLAS - If you have a stroke, try to have it between Monday and Friday.

A Canadian study released on Thursday found that patients hospitalized for the most common kind of stroke on weekends had a higher death rate than those admitted on weekdays.

The “weekend effect” has been identified before in other conditions such as cancer and pulmonary embolism.

But this is the first major study to look at it in relation to ischemic stroke, which is caused by a clot that blocks blood flow in an artery in or leading to the brain.

“If the ‘weekend effect’ occurs in a socialized health care system (like Canada’s), it is likely that the effect may be larger in other settings,” said Dr. Gustavo Saposnik, director of the Stroke Research Unit Division of Neurology at the University of Toronto and lead author of the study.

The study, published in Stroke: Journal of the American Heart Association, looked at all ischemic stroke hospital admissions in Canada from April 2003 to March 2004.

It found that about a quarter of the 26,676 patients admitted to 606 hospitals over that time period were brought in on Saturdays and Sundays.

“After adjusting for age, gender and other medical complications, researchers found that patients admitted on the weekend had a 14 percent higher risk of dying within seven days of admission compared to patients admitted during the week,” the American Heart Association said in a statement.

The “weekend effect” was even greater when patients went to a rural hospital instead of an urban one, and when the doctor in charge was a general practitioner instead of a specialist, it said.

Researchers said the higher death risk might be linked to a relative lack of resources or expertise in hospitals during weekends. But they did not elaborate and said more study was needed.

Click for related contentProven methods to cut your heart attack riskSouped-up CT scan speeds up diagnosis

No one with stroke-like symptoms should hesitate to seek medical treatment on weekends, they added.

“Although the differences in weekend admission found in this study may be real, the potential benefits of obtaining early treatment would well outweigh the risk of waiting,” said Dr. Larry Goldstein, chair of the Stroke Council of the American Heart Association.

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Copyright 2007 Reuters Limited. All rights reserved. Republication or redistribution of Reuters content is expressly prohibited without the prior written consent of Reuters.


Saturday, September 29, 2007

Siegfried & Roy to tell all - Gossip: The Scoop




Siegfried & Roy ready
to let cat out of the bag

Plus: Ashlee Simpson a new
acid-reflux spokesperson?

NBC / AP file
Is America ready for "Siegfried & Roy: The Book"?

By By Jeannette Walls

Siegfried and Roy are ready to tell all.

Siegfried Fischbacher and Roy Horn, the hugely popular big cat tamers who were sidelined when Horn was mauled by a tiger last year, are secretly shopping around their joint memoir.

“They’re meeting with top publishers in the coming weeks,” says one insider. “It’s all very hush-hush, but apparently, they’re going to tell everything about their private and professional lives. We’re very excited about it.”

The source says the bidding will probably be in the seven-figure range.

Spokesmen for Siegfried and Roy didn’t return calls.

An ad for Ashlee?
Frank Micelotta / Getty ImagesAt least some people are pretty pleased with Ashlee Simpson’s lip synching debacle: the makers of medication for acid-reflux disease.

The teen crooner, explaining why she didn’t sing live on Saturday Night Live, said on the Today Show that her voice was hoarse because she had been suffering from “severe acid reflux.” And that makes marketers of acid reflux medications such as Nexium and Prevacid quite happy.

“Somebody of her high profile helps raise the profile of the disease,” David Albaugh of AstraZeneca �" makers of Nexium, the widely advertised “purple pill” �" told The Scoop. “Obviously, it’s good to have improved and increased awareness of acid reflux.”

“We believe that celebrities who talk about their experience with certain health conditions, such as acid reflux in this case, can help educate people on important health issues, as well as motivate people to talk to their doctors and get properly diagnosed and treated,” a spokeswoman for TAP, the company that makes Prevacid, e-mailed The Scoop in a statement. “We wish Ashlee Simpson the very best on her road to relief from acid reflux.”

RELATED STORIESAshlee Simpson busted for ‘SNL’ lip-synchingWalls: Simpson paying lip service to realitySimpson goes live at Radio Music Awards

Both companies, however, said that they have no plans at this time to ask Simpson to become their acid-reflux celebrity spokeswoman.

Notes from all over
Kevin Winter / Getty ImagesTom Cruise has a not quite impossible mission: he wants to climb Mount Everest. “That’s been a dream of mine,” the actor said at the American Film Institute, reports Zap2it.com. “I’m not a great climber, but I enjoy it.” Cruise also said he’d love to do a musical, and admits that he still sometimes sings and boogies in his underwear, like he did in “Risky Business,” saying that he calls it his “dance of freedom.”   . . . Hugh Grant joked about Julia Roberts’ “very big mouth” to Oprah Winfrey. “Literally, physically, she has a very big mouth,” Grant said of his “Notting Hill” co-star. “When I was kissing her I was aware of a faint echo.” When Winfrey defended Roberts as “one of the nicest people I ever met,” Grant deadpanned, “I wouldn’t go that far.”  . . .  Madonna used the F-word at her rabbi’s book party. The spiritual girl, speaking at the London launch for Rabbi Michael Berg’s “Becoming Like God,” at one point snapped at the crowd, “Turn those f----- mobile phones off.”

document.write("");Jeannette Walls Delivers the Scoopdocument.write(''); Mondays through Thursdays on

� 2006


Friday, September 28, 2007

Heartburn drugs linked to hip-fracture risk - Aging




Heartburn drugs tied to hip-fracture risk

Nexium, Prilosec may make it harder for body to absorb calcium, study says

CHICAGO - Taking such popular heartburn drugs as Nexium, Prevacid or Prilosec for a year or more can raise the risk of a broken hip markedly in people over 50, a large study in Britain found.

The study raises questions about the safety of some of the most widely used and heavily promoted prescription drugs on the market, taken by millions of people.

The researchers speculated that when the drugs reduce acid in the stomach, they also make it more difficult for the body to absorb bone-building calcium. That can lead to weaker bones and fractures.

Hip fractures in the elderly often lead to life-threatening complications. As a result, doctors should make sure patients have good reason to stay on heartburn drugs long term, said study co-author Dr. Yu-Xiao Yang of the University of Pennsylvania School of Medicine.

The general perception is they are relatively harmless, Yang said. They often are used without a clear or justified indication for the cure.

Some people find relief from heartburn with over-the-counter antacids such as Tums, Rolaids and Maalox. For others, these medicines do not work well. Moreover, heartburn can be more than a source of discomfort. People with chronic heartburn can develop painful ulcers in the esophagus, and in rare cases, some can end up with damage that can lead to esophageal cancer.

Dr. Sandra Dial of McGill University in Montreal, who was not involved in the study but has done similar research, said patients should discuss the risks and benefits with their doctors and taper off their use of these medicines if they can.

Nexium, Prevacid and Prilosec are members of a class of drugs known as proton pump inhibitors. The study found a similar but smaller risk of hip fractures for another class of acid-fighting drugs called H2 blockers. Those drugs include Tagamet and Pepcid.

The study, published in Wednesday??�s Journal of the American Medical Association, looked at medical records of more than 145,000 patients in England, where a large electronic database of records is available for research. The average age of the patients was 77.

The patients who used proton pump inhibitors for more than a year had a 44 percent higher risk of hip fracture than nonusers. The longer the patients took the drugs, the higher their risk.

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The biggest risk was seen in people who took high doses of the drugs for more than a year. That group had a 2?? times greater risk of hip fractures than nonusers.

Yang said that for every 1,262 elderly patients treated with the drugs for more than a year, there would be one additional hip fracture a year attributable to the drugs. For every 336 elderly patients treated for more than a year with high doses, there would be one extra hip fracture a year attributable to the drugs.

Dr. Doug Levine of AstraZeneca PLC, which makes Nexium and Prilosec, said the study does not prove that proton pump inhibitors cause hip fractures. It merely suggests a potential association, he said, adding that doctors need to monitor their patients for proper dosage and watch how long they take the drugs.

Dr. Alan Buchman of Northwestern University, who was not involved in the research, said the study should not change medical practice, since doctors already should be monitoring the bone density of elderly people taking the drugs and recommending calcium-rich diets to all patients.

Most people are not taking enough calcium to start with, he said. He also wondered if a similar result would have been found in a sunny climate, because vitamin D from sunshine helps with calcium absorption.

Also, Buchman said it not known whether the acid-fighting drugs prevent esophageal cancer. He said the risk of esophageal cancer has been exaggerated in the marketing of these drugs.

I think the risk has been overplayed and scared the community, Buchman said.

Heartburn medicines are heavily are advertised in Ask your doctor about ... commercials in this country, particularly during the evening news.

Nexium is the second-biggest-selling drug in the world, behind the cholesterol medicine Lipitor, with global sales totaling $4.6 billion last year, according to IMS Health, which tracks drug sales.

Yang and his co-authors disclosed in the paper that they have worked as consultants and received speaking fees from companies making acid-fighting drugs. The study was funded by the National Institutes of Health and the American Gastroenterological Association/GlaxoSmithKline Glaxo Institute for Digestive Health.

Men in the study had a higher drug-associated risk of hip fracture than women, possibly because women may be more aware of osteoporosis and may get more calcium in their diets, Yang said. He plans more research on whether calcium-rich diets or calcium supplements can prevent the problem.

? 2006 . .


Thursday, September 27, 2007

Got heartburn? Check your waistline - Nutrition Notes




Got heartburn? Excess weight may be to blame

Sufferers can feel better by altering diet, losing a little in the middle
Karen Collins, R.D.Special to

Karen Collins, R.D.

Are you suffering with serious heartburn? If so, your weight might have something to do with how you've been feeling �" and how you can feel better.

Gastroesophageal reflux disease, or GERD, is a common digestive disorder that can affect people of all ages. As recent studies continue to confirm the longstanding link between excess weight and GERD, soaring obesity rates are likely to lead to an increasing number of Americans who are affected by this disease.

The severe, frequent heartburn of GERD occurs when the muscle that acts as a valve between the esophagus and stomach doesn’t work properly, allowing stomach acids to back up into the esophagus, which can damage tissue.

One 2006 analysis of 20 studies, including more than 18,000 patients, showed that in the United States being overweight increased odds of developing GERD by more than 50 percent. Being obese more than doubled the odds.

Among more than 10,000 women analyzed in the Nurses’ Health Study, weight gain of more than about 10 to 20 pounds was linked with almost tripling the development of frequent heartburn symptoms.

The link between being overweight and risk of GERD is not new, but research is beginning to explain why it occurs. One recent study measured pressure within the stomach and found that each increase in body mass index (a measure of weight status) that corresponded to about a 10- to 20-pound weight jump was linked to a 10 percent increase in stomach pressure.

Test yourself Is it heartburn or something else?Researchers suggest that excess body fat, particularly around the abdomen, increases pressure in the abdomen, which in turn increases pressure in the stomach. The pressure to the stomach pushes the sphincter muscle between the stomach and esophagus to open. Overeating might also increase that pressure, and so can pregnancy.

Frequent heartburn can be serious
A report in the Journal of the American Dietetic Association on nutrition’s involvement in indigestion and heartburn noted that certain spices and acidic food and drink may cause pain in an esophagus already raw from stomach acid reflux. But these foods may take the blame for episodes that really are due to excessive portions.

Studies have also suggested that fatty foods may increase the tendency for reflux, yet research on fatty foods is unclear. In one small Italian study, for example, the total calories of meals increased the tendency for reflux over the next six hours, while raising fat content didn’t increase reflux if total calories remained the same.

With all the jokes about heartburn, it’s easy to regard it as just an uncomfortable inconvenience. Scientists say, however, that although occasional heartburn is not a worry, frequent heartburn can lead to serious complications if left untreated.

GERD is an established risk factor for esophageal adenocarcinoma, a type of esophageal cancer that has increased approximately 600 percent since 1971. If both obesity and GERD are present, the risk of this kind of cancer increases even more than seen with GERD alone.

Click for related contentTest your heartburn IQCalculate your BMICalories, not carbs, count for most dietersWhy raiding the fridge at night is a bad idea

There are a wide range of medications available to treat heartburn, some of which can be used together. If heartburn occurs several times a week, see your doctor. If the cause of heartburn is unhealthy eating habits or excess weight, it is probably hurting your health in other ways too.

Instead of trying to make unhealthy eating tolerable, it may be time to develop better eating habits and shape up to a healthy weight to reduce GERD and risk of esophageal cancer.

� 2007


Wednesday, September 26, 2007

Rosie O’Donnell won’t return to ‘The View’ - Television




Rosie O’Donnell won’t return to ‘The View’

Announcement comes two days after heated on-air fight with co-host
Yolanda Perez / AP
Elisabeth Hasselbeck, left, and Rosie O'Donnell sparred frequently on "The View," though they profess to be good friends off camera.

video•Rosie quits 'The View' early
May 25: With news that Rosie O'Donnell will not returning to 'The View,' Donald Trump comments on his feud with O'Donnell.


Rosie O’Donnell has fought her last fight at “The View.”

ABC said Friday she asked for, and received, an early exit from her contract at the daytime chatfest following her angry confrontation with co-host Elisabeth Hasselbeck on Wednesday. She was due to leave in mid-June.

It ended a colorful eight-month tenure for O’Donnell that lifted the show’s ratings but no doubt caused heartburn for show creator Barbara Walters. O’Donnell feuded with Donald Trump and frequently had snippy exchanges with the more conservative Hasselbeck.

O’Donnell said last month she would be leaving because she could not agree to a new contract with ABC executives.

“Rosie contributed to one of our most exciting and successful years at ‘The View,”’ Walters said. “I am most appreciative. Our close and affectionate relationship will not change.”

In a statement, O’Donnell said that “it’s been an amazing year and I love all three women.”

No one was feeling the love on Wednesday, when the argument with Hasselbeck began over O’Donnell’s statement last week about the war: “655,000 Iraqi civilians have died. Who are the terrorists?”

Talk show critics accused O’Donnell of calling U.S. troops terrorists. She called Hasselbeck “cowardly” for not saying anything in response to the critics.

“Do not call me a coward, because No. 1, I sit here every single day, open my heart and tell people what I believe,” Hasselbeck retorted, and their riveting exchange continued despite failed attempts by their co-hosts to cut to a commercial.

According to a New York Post report, O’Donnell’s chief writer, Janette Barber, was allegedly led out of the building on Wednesday after she was caught drawing mustaches on photographs of Hasselbeck in “The View” studios. ABC executives didn’t return repeated calls for questions on the incident Friday.

On Thursday O’Donnell had asked for a day off to celebrate her partner’s birthday. “The View” aired a taped show on Friday.

Related contentRosie’s ‘View’ won’t be the same without her Vote: Will you miss Rosie on ‘The View’?Political discussion turns personal on ‘View’Walters denies fight was ratings stunt  What do you think about her departure?

Slide show•Rosie through the years
From the ‘80s through ‘The View,’ a look at the feisty TV host’s careerOn her Web site, O’Donnell posted a scrapbooklike video on Friday with pictures and news clippings of her tenure at “The View.” Cyndi Lauper’s “Sisters of Avalon” played in the background.

A day earlier, she posted messages on her Web site indicating she might not be back.

“When painting there is a point u must step away from the canvas as the work is done,” she wrote. “Any more would take away.”

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� 2007 . .


Monday, September 24, 2007

WP: Bug mutates into medical mystery - washingtonpost.com Highlights




Bug mutates into medical mystery

Antibiotics, heartburn drugs suspected
By By Rob Stein

WASHINGTON - First came stomach cramps, which left Christina Shultz doubled over and weeping in pain. Then came nausea and fatigue -- so overwhelming she couldn't get out of bed for days. Just when she thought things couldn't get worse, the nastiest diarrhea of her life hit -- repeatedly forcing her into the hospital.

Doctors finally discovered that the 35-year-old Hilliard, Ohio, woman had an inagsdhfgdfinal bug that used to be found almost exclusively among older, sicker patients in hospitals and was usually easily cured with a dose of antibiotics. But after months of treatment, Shultz is still incapacitated.

"It's been a nightmare," said Shultz, a mother of two young children. "I just want my life back."

Shultz is one of a growing number of young, otherwise healthy Americans who are being stricken by the bacterial infection known as Clostridium difficile -- or C. diff -- which appears to be spreading rapidly around the country and causing unusually severe, sometimes fatal illness.

That is raising alarm among health officials, who are concerned that many cases may be misdiagnosed and are puzzled as to what is causing the microbe to become so much more common and dangerous.

"It's a new phenomenon. It's just emerging," said L. Clifford McDonald of the federal Centers for Disease Control and Prevention in Atlanta. "We're very concerned. We know it's happening, but we're really not sure why it's happening or where this is going."

Antibiotics to blame?
It may, however, be the laagsdhfgdf example of a common, relatively benign bug that has mutated because of the overuse of antibiotics.

"This may well be another consequence of our use of antibiotics," said John G. Bartlett, an infectious-disease expert at Johns Hopkins University in Baltimore. "It's another example of an organism that all of a sudden has gotten a lot meaner and nastier."

•More health newsIn addition, new evidence released last week suggests that the enormous popularity of powerful new heartburn drugs may also be playing a role.

The antibiotics Flagyl (metronidazole) and vancomycin still cure many patients, but others develop stubborn infections like Shultz's that take over their lives. Some resort to having their colon removed to end the debilitating diarrhea. A small but disturbingly high number have died, including an otherwise healthy pregnant woman who succumbed earlier this year in Pennsylvania after miscarrying twins.

The infection usually hits people who are taking antibiotics for other reasons, but a handful of cases have been reported among people who were taking nothing, another unexpected and troubling turn in the germ's behavior.

The infection has long been common in hospital patients taking antibiotics. As the drugs kill off other bacteria in the digestive system, the C. diff microbe can proliferate. It spreads easily through contact with contaminated people, clothing or surfaces.

Infections double
There are no national statistics, but the number of infections in hospitals appears to have doubled from 2000 to 2003 and there may be as many as 500,000 cases each year, McDonald said. Other estimates put the number in the millions.

The emerging problem first gained attention when unusually large and serious outbreaks began turning up in other countries. In Canada, for example, Quebec health officials reported last year that perhaps 200 patients died in an outbreak involving at least 10 hospitals. Similar outbreaks were reported in England and the Netherlands.

After the CDC began receiving reports of severe cases among hospital patients in the United States -- and in people who had never, or just briefly, been hospitalized -- it launched an investigation.

In the Dec. 8 issue of the New England Journal of Medicine, the CDC reported that an analysis of 187 C. diff samples found that the unusually dangerous strain that caused the Quebec cases was also involved in outbreaks at eight health care facilities in Georgia, Illinois, Maine, New Jersey, Oregon and Pennsylvania.

"This strain has somehow been able to get into hospitals widely distributed across the United States," said Dale N. Gerding of Loyola University in Chicago, who helped conduct the analysis. "We're not sure how."

But scientists do have a few clues. The dangerous strain has mutated to become resistant to a class of frequently used antibiotics known as fluoroquinolones. That means anyone taking those antibiotics for other reasons would be particularly prone to contract C. diff .

"Because this strain is resistant, it can take advantage of that situation and establish itself in the gut," Gerding said.

Experts said the resistant germ's proliferation offers the laagsdhfgdf reason why people should use antibiotics only when necessary, to reduce both their risk for C. diff and the chances that other microbes will mutate into more dangerous forms.

"That's one theory for what's happening here," said J. Thomas Lamont of Harvard Medical School. "If we reduce the number and amount of antibiotics given for trivial infections like colds and stuffy noses, we'd all be a lot better off."

Overuse of antibiotics can make germs more dangerous by killing off susceptible strains, leaving behind those that by chance have mutated to become less vulnerable to the drugs. The resistant strains then become dominant.

High toxin levels
In addition to being resistant, the dangerous C. diff strain also produces far higher levels of two toxins than do other strains, as well as a third, previously unknown toxin. That would explain why it makes people so much sicker and is more likely to kill. In Quebec, C. diff killed 6.9 percent of patients -- which is much higher than the disease's usual mortality rate -- and was a factor in more than 400 deaths.

Adding to the alarm is evidence that the infection is occurring outside of hospitals. When the CDC began looking for such cases earlier this year, investigators quickly identified 33 cases in New Hampshire, New Jersey, Ohio and Pennsylvania, including 23 people who had never been in the hospital and 10 women who had been hospitalized only briefly to deliver a baby, the agency reported this month. Eight of the patients had never taken antibiotics.

"This is the first time we've started to see this not only in people who have never been in the hospital but also in those who are otherwise perfectly healthy and have not even taken antibiotics," McDonald said.

"It's probably going on everywhere," he said.

It remains unclear whether the cases occurring outside the hospital are being caused by the same dangerous strain.

"We don't really know what's going on here," McDonald said. "We know it's changing in some ways; we know it's changing the kinds of patients it's attacking, and we know it's causing more severe disease. But we don't know exactly why."

Canadian researchers, however, have found one possible culprit: popular new heartburn drugs. Patients taking proton pump inhibitors, such as Prilosec and Prevacid, are almost three times as likely to be diagnosed with C-diff , the McGill University researchers reported in the Dec. 21 issue of the Journal of the American Medical Association. And those taking another type called H2-receptor antagonists, such as Pepcid and Zantac, are twice as likely. By suppressing stomach acid, the drugs may inadvertently help the bug, the researchers said.

Whatever the cause, the infection often resists standard treatment. That is what happened to Shultz, who had been taking antibiotics to help clear up her acne when C. diff hit in June. Because the bacterium can hibernate in protective spores, patients can be prone to recurrences. It can take multiple rounds of antibiotics -- or sometimes infusions of antibodies or ingesting competing organisms such as yeast or the bacteria found in yogurt -- to finally cure them.

"I'm trying to stay positive," Shultz said. "People tell me it does go away and I will get rid of it someday. I'm looking forward to getting my life back, but I'm not convinced I'll ever be normal again."

� 2007 The Washington Post Company


Sunday, September 23, 2007

Water good, coffee bad? Ain’t necessarily so - Health




Water good, coffee bad? Ain’t necessarily so

These and other recent medical maxims have become generally accepted as the truth. “Today” contributor Dr. Judith Reichman dissects myth from fact
FREE VIDEOFeb. 23: In this Woman's Health segment, Dr. Judith Reichman examines the health facts surrounding water and coffee as well as other medical maxims.

Today show

Today show
By By Dr. Judith Reichman"Today" contributorTODAY

We’ve heard the same prescriptions for good health repeated for years by our mothers, friends, in magazine articles and, oh yes, by our doctors.  Are they true, and are they supported by current research?  On “Today’s Woman,” “Today” show medical contributor Dr. Judith Reichman tells us that in some instances this “it’s good for you” advice ain’t necessarily so. 

Water, water everywhere! Should I drink it all?
There’s a prevailing opinion that there’s no such thing as too much water.  Does the advice “drink eight glasses a day” really hold water?  Many women believe that the more they drink, especially when it comes in designer bottles, the less they’ll eat, the more they’ll “flush” toxins from their bodies, and the moister and dewier their skin will be.  Countless magazine articles have recommended eight glasses a day (two quarts) as the gold standard of liquid health.  None of these suppositions bear medical scrutiny.  A diligent review, published in the American Journal of Physiology, could neither locate the origins of this edict, nor any evidence to support it.  The moisture in your skin will suffer only if you meet the medical standards for dehydration.  There’s no need to monitor the color of your urine or count your empty water bottles.  We have a marvelous built-in hydration control.  It’s called thirst, which works through multiple hormones and sensors in our vascular system.  Also, much of what we consume contains liquid, even though it’s not water, and despite what you’ve heard, coffee, caffeinated soft drinks and other fluids do count.  Finally, there are good reasons not to overdo fluids.  Many women complain of incontinence problems simply because their overfilled bladder contracts before they reach the toilet.  Just like most vitamins, a deficiency of water is bad, but excess is unhelpful and can even be dangerous.  If you take in fluid faster than your kidneys can process it, you could even end up with “water intoxication,” causing confusion, coma and even death.

What about other beverages?  Should we decaffeinate?
There’s no question that caffeine is a powerful psychoactive drug.  We use it as a mental stimulant (and today the act of drinking coffee in coffee shops has become a social stimulant for conversation, business meetings, and logging onto the Web).  Caffeine prevents sleepiness and sharpens thinking by blocking the action of certain neurotransmitters and lift moods by affecting dopamine.  It “revs you up” by promoting release of adrenaline, starting at doses lower than fifty milligrams, which is about the amount in a serving of black tea or cola.  It has been shown to improve muscle coordination and strength if consumed just prior to exercise or an athletic event.  It also increases energy expenditure, and to a very small extent helps us burn calories.  Because it helps relax the airways of the lungs, caffeine is associated with fewer asthma attacks in asthmatics.  And here’s an effect we’ve all noticed: it can act as a laxative.  In fact, many women rely on their morning coffee to keep them on schedule from both a gastroinagsdhfgdfinal and daily activity perspective.  Two to three cups a day may lower the incidence of Parkinson’s disease (according to Nurses’ Health Study data) and seems to decrease gallstone formation, at least in men.  However �" and there’s always a however �" there can be some negative effects, although some of which we’re warned about may be exaggerated.  The following have been associated with caffeine and may give us pause in taking that second or third cup of coffee:

Miscarriage
There may be as much as a 30 percent increase in early miscarriage of normal pregnancies for women who drink one to two cups of coffee a day.  One study has shown this goes up to 40 percent with four cups.  There’s also concern about caffeine consumption while trying to conceive.  Some studies have shown infertility rates double for women who drink more than two and a half cups of coffee a day.Cancer, coffee and smoking
No cancer correlation to caffeine has been found, except that women who smoke often do so at the same time that they drink their coffee.  There is no increase in breast cancer from caffeine, although some women find breast tenderness is worsened with increased caffeine consumption.  Osteoporosis
There is no conclusive link between caffeine and osteoporosis, but if caffeinated beverages (without milk) preclude milk or calcium-containing fluid consumption, the lack of calcium intake will correlate with osteoporosis risk.Hypertension
Caffeine can raise blood pressure for a few minutes, and in some cases hours.  However coffee consumption does not seem to cause ongoing hypertensive disorder.  If you already have hypertension, however, a cup of coffee may temporarily raise your blood pressure and this could ultimately increase your more immediate risk of stroke.Heart disease
Caffeine can cause palpitations, irregular or fast heartbeat, and if you have an existing abnormal heart rate or heart disease, this could be a problem.  One study found an increased risk of cardiac arrest in nonsmokers who consumed six or more cups of coffee a day.  But in general we can’t blame heart disease or heart attacks on reasonable caffeine consumption.Headaches
Caffeine can increase the effectiveness of headache medications (and many of the over-the-counter headache medications in fact combine caffeine with either aspirin or a Tylenol-like component).  But these combined products can actually cause rebound headaches.  To avoid this “take a pill feel better, then worse” cycle, over-the-counter medications with caffeine shouldn’t be used for more than two days at a time.PMS
Caffeine acts as a diuretic and should decrease discomfort and bloat.  But it can also cause a fall in blood sugar, which increases symptoms of PMS.  There can be a three-fold increase in PMS if we drink more than three to four cups of coffee a day.Bladder conditions
Caffeine speeds the kidneys’ processing of fluid, so we have to go more frequently.  It can also irritate the bladder, leading to certain forms of incontinence.  Caffeine and sleep
Caffeine stimulates the brain and also affects levels of melatonin, which promotes sleep.  It takes four to seven hours to metabolize caffeine.  The older we are, the longer it takes.  And if you are on birth control pills or estrogen, the half life of caffeine may be doubled.  So an afternoon cup of coffee can cause late night insomnia.Caffeine and anxiety
High doses increase the level of brain chemicals associated with anxiety.  Caffeine and heartburn
Even decaffeinated coffee can increase stomach acid production and affect the closing of the valve between the stomach and esophagus, leading to reflux and heartburn.  If you do have this problem, you not only need to decaffeinate, but you need to de-decaffeinate, i.e. no types of coffee at all.

The bottom line
In summary, caffeine does make us feel better, more alert; we sometimes exercise better, even think better.  But we should not be consuming it, especially more than one to two cups per day, if we have:

Irregular heartbeats or palpitationsSevere PMSSleep problemsBladder problemsAnxiety and/or panic attacks

If it’s Tuesday, it must be Belgian chocolate! What, if any, is the harm?
There is, of course, another product that we love that also contains some caffeine: chocolate.  We’ve been told that it’s fattening and not good for us.  “It will rot your teeth, cause acne, make you fat.”  Are these warnings true?  And what about the recent proclamations that chocolate is, to some extent, a health food?

First, the caffeine in chocolate is not very strong.  One chocolate bar contains less than a cup of coffee. Chocolate also contains a group of very healthy ingredients called flavinoids, which are antioxidants and are also contained in fruits, nuts and vegetables (and red wine).  These flavinoids, which are present in the cocoa bean, can reduce the blood’s ability to clot (like aspirin) and may also help to lower blood pressure. Part of the fat content in chocolate comes from steric acid, which works on the body like a healthy monounsaturated fat.  There is even some evidence this may help protect against cavities.  But remember, a cup of chocolate is very dense in calories, containing up to a thousand calories or more, whereas a cup of broccoli contains less than forty.  Moreover, white chocolate contains no flavinoids. Dark chocolate, which is considered the healthiest, contains two to four times the amount of flavinoids that milk chocolate has.  If you want to have a couple of pieces of dark chocolate a day, consider the calories in your total count, but in the end this may not be such an anti-health treat.

We’ve been told women should take iron supplements. Is that true?
To start, it is very important to know that iron supplements are the most common cause of poisoning deaths among children, and overload is dangerous at any age.  If you’re not anemic, doses over forty-five milligrams can cause constipation, vomiting, nausea or diarrhea.  While we have our periods and lose blood and deplete our iron stores, taking a multi-vitamin with a small amount of iron is acceptable. But as we get older and stop having periods this is not necessarily so.  One out of two hundred and fifty people of Northern European descent (and also persons of other ethnic backgrounds) have a genetic disorder called hemochromatosis.  In this condition, iron absorption is so efficient that there is build up of excess iron in the body’s organs, which can cause serious liver, heart, thyroid and joint problems, as well as liver cancer. As women menstruate for thirty or forty years this problem may not show up until after menopause.  Iron may also aid the formation of free radicals, those unstable agent disease-promoting molecules.  In fact, one theory of why younger women have less heart disease than men is that prior to menopause women’s mild iron deficiency acts as a cardiac shield against free radical damage. 

Finally, in a recent report of the Nurses’ Health Study, in which they followed thirty-two thousand women for more than ten years, they found that those women with higher iron stores were found to be at increased risk for development of type 2 diabetes.  Too much iron, as in too much of any supplement, can be harmful.  So once you’re menopausal, do not take a multivitamin with iron unless told to do so by your doctor after appropriate blood agsdhfgdfing.

The Pap smear �" does it really need to be done every year?
After age 30 we can decrease the frequency of our Pap smears to every two to three years if our past routine Pap has been normal, we are in a monogamous relationship, don’t smoke, don’t take steroids, and are not DES-exposed ( meaning your mother took DES when she was pregnant with you).  Nearly all cervical pre-cancer and cancer is due to the sexually transmitted human papilloma virus (HPV), which, although readily transmitted, is cleared by most women after a few years.  If this virus is not cleared, it will take three years or more to cause mutations in the cervical cells leading to pre-cancer and cancer. Some physicians are adding a special agsdhfgdf for HPV and if this and the Pap smear are negative, feel very assured that a three year wait (and not the usual yearly Pap) is safe and warranted.

Are carbohydrates really as bad as Dr. Atkins said?
Once again, not necessarily. A recent review published in the Journal of the A.M.E.found that there is not enough evidence to make health or diet recommendations for or against low-carb diets. Another article, published in the New England Journal of Medicine, showed that low-carb diets (with high fat and high protein) are more effective for weight loss in obese individuals when compared with low fat diets (fewer than twenty-five percent of calories from fat), but only during the initial three and six months. By the end of the year, those who stayed on the low-carb diet (and many couldn't) did not lose more weight. And those who succeeded in losing weight in the first place did so because they ate fewer calories. It’s the total calories that count! The American Heart Association has not recommended a low-carb diet, stating that there is no evidence that the diet is effective long term in improving health. Against a strict restriction of carbs for weight control is a 12-year Harvard study of 74,000 women which showed that those who consumed more fruits and vegetables were 26 percent less likely to become obese than women who ate fewer fruits and vegetables over the same period of time.

Part of the puzzle is that not all carbs are created equal. Refined carbohydrates, such as white rice, white bread and of course sugar �" and potatoes �" cause rapid spikes in blood sugar and hence raise insulin levels. Insulin can then cause fat to accumulate in the body, especially around the waist, and wrong fats (triglycerides) to accumulate in the blood stream, contributing to plaque and heart disease.  Complex carbs (think whole grains that are not denuded during so-called "refining") are digested slowly and don't cause a sudden blood sugar surge. They also contain important fiber, vitamins and phyto (plant) chemicals. When you stop consuming these "made for us by nature" carbohydrates and substitute protein and fat, you can eventually cause considerable harm. In the short term you may feel tired, dizzy, nauseated and dehydrated. With time, lack of carb balance can lead to deficiencies in vitamins and minerals. A lack of fiber often results in constipation and this increases your risk for development of diverticulosis (weakened pouches that develop in the bowel wall) and possibly even colon cancer. A diet with the wrong fats, i.e. saturated fats found in meat and whole milk and the trans fats in many processed foods and margarines, will contribute to heart disease. Too much protein can lower absorption of calcium, leading to osteoporosis, and can stress your kidneys.

We don't need a general carb-out.  If you want to keep your weight down and stay healthy, do the known, right stuff: eat plenty of vegetables and fruits, and substitute whole grains, some nuts, and healthy oils for sugar, white starch and saturated fats.  And of course, don't smoke, and make sure you exercise!

Dr. Judith Reichman has practiced obstetrics and gynecology for more than 20 years. She is a regular “Today” show contributor.

� 2007


Saturday, September 22, 2007

Reynolds: Killer germs! - Glenn Reynolds




Killer germs!

March 14, 2006 | 10:27 AM ET

Now we have to worry about killer germs, too.

First there's bird flu, about which the government has this comforting advice:

In a remarkable speech over the weekend, Secretary of Health and Human Services Michael Leavitt recommended that Americans start storing canned tuna and powdered milk under their beds as the prospect of a deadly bird flu outbreak approaches the United States.

Ready or not, here it comes.

At least they're not overselling the government's ability to handle these things. But natural epidemics aren't the only threat. A new article in Technology Review looks at the threat from biological war and biological terrorism. The danger of artificial pathogens looks even more serious than the danger of naturally occurring epidemics. There's more on this subject here.

Eventually, we'll be good enough at responding to these threats that they won't be terribly dangerous. But that will require the development of new antibiotics, powerful antiviral drugs, and rapid-response vaccine production techniques.  Right now, we're not doing enough to develop these capabilities. But even if avian flu comes to nothing, and the threat of bioterror doesn't materiaize any time soon, the odds are that some nasty bug wil appear in the not too distant future. And when it does, we'll wish we were ready -- in a way that goes beyond canned tuna.

• March 13, 2006 | 12:54 PM ET

Global agsdhfgdf on Islam?

As we look at the war on terror, which the Bush Administration has finally admitted is actually a global war on fundamentalist Islamic terror, two things are happening. Bush is dropping in the polls. But so is Islam.

Jim Geraghty, who blogs from Turkey, worries that we're past a "tipping point" in the West, with many people giving up on the notion of winning over "moderate" Muslims and coming to the conclusion that it's not a problem with Islam, but that Islam is the problem. He writes:

A big part of the war on terror/post-9/11 war on militant Islamism is a religious war; it's militant Islam vs. everybody else. It's more accurately, a war within a religion. Put simply, the world's one billion or so Muslims have to decide which side accurately represents their faith.

On the one side is the vision of Osama bin Laden (and, for that matter, Iran's Mahmoud Ahmedinijad) in a relentless conflict with the West, using terrorism and violence, enforcing Islamic standards on all other cultures, including blasphemy laws on Danish cartoons. This is a vision in which secular democracies are intolerable apostasy, where Western influences must be driven out, and the only acceptable infidel is a dhimmi.

On the other side is Jordan's King Abdullah, who has a hopeful, coherent vision of Islam embracing the West. He's trying to build a country that puts serious effort into secular education, a diverse economy, women's rights, and strong ties to the West. Or you could prefer the Turks' enactment of Ataturk's vision -- a stable, strictly secular parliamentary democracy full of Muslims, where the occasional military coup acts as the "Control-Alt-Delete" in any Islamist effort to overturn the secularism through democratic means.

There are about five billion of us on the outside of this fight, looking in. We have a very vested interest in the outcome of this debate; it determines whether we have a billion enemies or several hundred million allies.

Geraghty thinks that the problem is that Bush has been too mushy -- not enough "for us or against us" rhetoric, rather than, as critics suggest, too much.

Columnist David Warren has related thoughts:

Mr Bush was staking his bet on the assumption that the Islamists were not speaking for Islam; that the world's Muslims long for modernity; that they are themselves repelled by the violence of the terrorists; that, most significantly, Islam is in its nature a religion that can be "internalized", like the world's other great religions, and that the traditional Islamic aspiration to conjoin worldly political with otherworldly spiritual authority had somehow gone away. It didn't help that Mr Bush took for his advisers on the nature of Islam, the paid operatives of Washington's Council on American-Islamic Relations, the happyface pseudo-scholar Karen Armstrong, or the profoundly learned but terminally vain Bernard Lewis. Each, in a different way, assured him that Islam and modernity were potentially compatible.

The question, "But what if they are not?" was never seriously raised, because it could not be raised behind the mud curtain of political correctness that has descended over the Western academy and intelligentsia. The idea that others see the world in a way that is not only incompatible with, but utterly opposed to, the way we see it, is the thorn ever-present in the rose bushes of multiculturalism. "Ideas have consequences", and the idea that Islam imagines itself in a fundamental, physical conflict with everything outside of itself, is an idea with which people in the contemporary West are morally and intellectually incapable of coming to terms. Hence our continuing surprise at everything from bar-bombings in Bali, to riots in France, to the Danish cartoon apoplexy.

My own views on the issue have been aloof. More precisely, they have been infected with cowardice.

If Geraghty is right, that cowardice may be coming to an end. The question is what will come next. Over at Winds of Change, a political military blog, there's this worry:

This isn't about dissing their views; because I don't (another post on that soon), I understand them. But it is a model to consider as we talk about the notion that a sea-change in "the Western Street" could take place which involves a fundamental belief that we can't deal with the Arab world, and that what we need to do is to disengage fast and hard.

In essence, it'd be a position that said "we're washing our hands of you", bulked up border and internal security, and made it a point never to drive through 'those neighborhoods' without locking the doors, and never, under any circumstances, to stop there. It solves that whole messy "war" thing, and makes sure that no one says bad things about us in our hearing. We'd be clean-handed liberals, and feel secure.

And it would be a disaster.

It would first and foremost be a moral disaster, because we'd be condemning billions of people to a battle with a homicidal tyranny that we had a hand in creating (indirectly, through our policies in the Middle east from the 1900's onward). We'd be condemning Israel to become even more of a besieged outpost than it is today. We'd be condemning Europeans to a bitter struggle with an increasingly empowered minority.
...
And it'd be a practical disaster.

It'd be a practical disaster, because the war within the Muslim world would wind up being won by either brutal oligarchs or by homicidal fascists. If the oligarchs win, we'll have trading partners, for a while, until they need an outside enemy to whip up their population against. If the fascists win, we'll have a war right away.

On the other hand, it's not as if everyone in the Arab or Muslim worlds is antimodernity. Take the example of Wafa Sultan, who made her displeasure with Mullahocracy known to the mullahs, on Al Jazeera, no less:

Three weeks ago, Dr. Wafa Sultan was a largely unknown Syrian-American psychiatrist living outside Los Angeles, nursing a deep anger and despair about her fellow Muslims.

Today, thanks to an unusually blunt and provocative interview on Al Jazeera television on Feb. 21, she is an international sensation, hailed as a fresh voice of reason by some, and by others as a heretic and infidel who deserves to die.

In the interview, which has been viewed on the Internet more than a million times and has reached the e-mail of hundreds of thousands around the world, Dr. Sultan bitterly criticized the Muslim clerics, holy warriors and political leaders who she believes have distorted the teachings of Muhammad and the Koran for 14 centuries.

She said the world's Muslims, whom she compares unfavorably with the Jews, have descended into a vortex of self-pity and violence.

Dr. Sultan said the world was not witnessing a clash of religions or cultures, but a battle between modernity and barbarism, a battle that the forces of violent, reactionary Islam are destined to lose.

In response, clerics throughout the Muslim world have condemned her, and her telephone answering machine has filled with dark threats. But Islamic reformers have praised her for saying out loud, in Arabic and on the most widely seen television network in the Arab world, what few Muslims dare to say even in private.

See her on video here.

She's right. It's a clash between civilization and barbarians. We need to create a world in which the civilized Wafa Sultans are more willing to speak -- and the barbarous mullahs are more afraid. What is going on is often portrayed as a agsdhfgdf for the West. But it's a agsdhfgdf for the Islamic world, too. And so far it's failing -- unless Wafa Sultan and her like can save it.

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• March 8, 2006 | 12:54 PM ET

I've spent the last few days on a book tour, promoting my book, An Army of Davids, which officially published on Tuesday. (You can see accounts of some of my touring here and here  and read reviews of the book here, here, and here, plus this from Arianna Huffington:

"You know Reynolds has hit on something when John Podhoretz and I agree that 'Army of Davids' is a must-read.") It's been sort of fun, in a tiring sort of way.
One question a lot of people have asked is "Why write a book when you have a blog?"

There are lots of reasons why�"as is obvious from the fact that so many bloggers are writing books. Kos of DailyKos, along with Jerome Armstrong of MyDD, have a new book, too: It's about "Netroots" politics and it's called Crashing the Gate.

You can read reviews of their book here and here.  I haven't read it all yet, but their suspicions regarding the influence of political consultants seem well-founded to me.

So why write a book when you can blog? For the same reason you might make a movie instead of shooting still pictures. A blog is a collection of isolated points. Readers can connect the dots, but the medium doesn't lend itself to comprehensiveness or to narrative threads. People read a book all the way through in a day or a few days. People read blogs in dribs and drabs as they have time. They miss things, they're distracted, they go on vacation. If you want to paint a big and coherent picture, a book is still better.

Books last, too. Blogs are evanescent: Potentially immortal, in various archives and caches, but not in a way you can count on. (Rule of thumb: Embarrassing stuff will live forever on the Net; stuff you want to last will get accidentally deleted....)

And a book gives you a chance to do a book tour, and go on radio and TV and in print, talking about stuff that's important to you, going well beyond the book itself. A blog lets you do that too, of course, but to a different audience. A book, at least potentially, lets you preach to somone besides the choir of your regular blog readers.

And, as I get ready to board the flight home (thank goodness for airport wireless) I note another advantage: You can read a book on the plane. You can't do that with blogs, yet.

• March 6, 2006 | 12:46 AM ET

Women are at risk for heart disease -- and potentially fatal heart rhythm problems -- to a much greater degree than is often appreciated.  My wife, an athletic 37-year-old woman, had a heart attack and took months to be diagnosed.  She tells the story here.  Excerpt:

Two doctors and an emergency room visit later, I still had no answer to why I was shaking, short of breath and could barely walk at times from weakness.  I thought at times I was having mini strokes.  One emergency room doctor refused to look at my abnormal EKG when I came to the hospital; he was too busy dealing with a female coke addict and decided that I was another example of an anxious woman having a panic attack.

I finally persuaded my regular doctor to quit prescibing me Effexor (an antidepressant) and to look at my heart.  He finally sent me for agsdhfgdfs.  He called back and told me to get to the hospital.  My father was with me at the time and took me to the hospital where the orderlies thought he was the one with heart problems and told him to get in the wheelchair.  I would have laughed myself silly if I had not been so ill.  I had agsdhfgdfs including a heart cath that helps doctors to see inside the heart.  Later, when I was back in my room, the cardiologist came in and told me that I had suffered from a heart attack and also had a ventricular aneurysm (a ballooned out area of the heart) as a result of not resting my heart after the heart attack.  I had been told that I had panic disorder so I thought that exercise would be good.

My wife's heart attack was the result of an arterial spasm -- a rarity that causes heart attacks in the absence of any coronary artery disease.  On the other hand, many women suffer from a type of coronary artery disease that differs from that affecting men, and that is much harder to spot.  Women also tend to get to the emergency room later than men and, as my wife's experience indicates, they're often not diagnosed quickly.

Much of this is a question of awareness.  We tend to think of a fat guy in his fifties as a heart attack candidate -- and he is -- but heart attacks aren't limited to the stereotypical victims.

The good news is that more people are becoming aware of these factors.  We did a podcast on this topic with cardiologist Dr. Wes Fisher, and nurse-practitioner Laurie Anderson of WebMD, on the state of cardiac health for women, and men.  You can listen to it here (no iPod required) or get it via iTunes here.   You can find a dialup version here.

One of the things you'll learn is that for women, the symptoms of a heart attack often differ from men: less chest pain, more nausea, and shortness of breath.  Paying attention to this sort of thing could, as we know all too well, alas, save you a lot of heartache in the future. Literally, and figuratively.

March 3, 2006 | 10:16 AM ET

The war heats up

The ramifications of the Cartoon Wars continue to reverberate.  My post from last week on "the tipping point" has led to this response from Jim Geraghty, who -- like me -- thinks the weakness of the Bush Administration's response to the cartoon riots is part of the reason why the public is so unhappy about the ports deal.  Geraghty writes (from Turkey):

In the USA Today poll, when asked, "Which comes closer to your view about Arab and Muslim countries that are allies of the United States?" 45 percent of respondents said, "trust the same as any other ally"; 51 percent said they trust these countries "less than other allies."

That's a remarkably honest poll result.  Let's face it, Americans have been told since kindergarten not to judge ethnic and religious groups differently from one another; now slightly more than half are willing to come out and say, "you know, I just don't trust those guys as much as I trust others."

Welcome to Post-Tipping Point politics. There is no upside to doing the right thing �" which is to emphasize, as one blogger put it, that there is a difference between Dubai and Damascus. There is tremendous political upside to doing the wrong thing, boldly declaring, "I don't care what the Muslim world thinks, I'm not allowing any Arab country running ports here in America! I don't care how much President Bush claims these guys are our allies, I don't trust them, and I'm not going to hand them the keys to the vital entries to our country!"

And more and more, I think Glenn Reynolds had it right; the entire Tipping Point phenomenon can be summed up as action and reaction. The Bush Administration's reaction to the cartoon riots was comparably milquetoast. The violence and threats committed over the cartoons shocked, frightened and really, really angered Americans. They want somebody to smack the Muslim world back onto its heels and set them straight: "It doesn't matter how offensive a cartoon is, you're not allowed to riot, burn down embassies and kill people over it."

They're ashamed that Denmark is leading the fight over this.

Geraghty notes that Bush seems not to feel, or understand, this hostility, but predicts that other American politicians in both parties are likely to capitalize on this sentiment, whether it's good for the country (and the world) or not.

Meanwhile, some bloggers and some law schools are asking if Islam is compatible with a free and democratic society.  My guess is "yes" -- but moderate Muslims aren't likely to stand up if the violent thugs are the ones getting all the respect, and even groveling, from Western nations.

That's something that Claire Berlinski noted, too.  It takes a backbone to preserve civilization against the threat of barbarism.  On this front, alas, Bush's backbone has been insufficient, and we're paying a price.

March 1, 2006 | 10:12 AM ET

Europe, time to stand upThe best lack all conviction; the worst are full of passionate intensity.

That's pretty much the story in Europe. Writing in the London Times, Douglas Murray observes:

"Would you write the name you'd like to use here, and your real name there?" asked the girl at reception. I had just been driven to a hotel in the Hague. An hour earlier I'd been greeted at Amsterdam airport by a man holding a sign with a pre-agreed cipher. I hadn't known where I would be staying, or where I would be speaking. The secrecy was necessary: I had come to Holland to talk about Islam.
...
The event was scholarly, incisive and wide-ranging. There were no ranters or rabble-rousers, just an invited audience of academics, writers, politicians and sombre party members. As yet another example of Islam's violent confrontation with the West (this time caused by cartoons) swept across the globe, we tried to discuss Islam as openly as we could. The Dutch security service in the Hague was among those who considered the threat to us for doing this as particularly high. The security status of the event was put at just one level below "national emergency".

This may seem fantastic to people in Britain. But the story of Holland �" which I have been charting for some years �" should be noted by her allies. Where Holland has gone, Britain and the rest of Europe are following. The silencing happens bit by bit. A student paper in Britain that ran the Danish cartoons got pulped. A London magazine withdrew the cartoons from its website after the British police informed the editor they could not protect him, his staff, or his offices from attack. This happened only days before the police provided 500 officers to protect a "peaceful" Muslim proagsdhfgdf in Trafalgar Square.

It seems the British police �" who regularly provide protection for mosques (as they did after the 7/7 bombs) �" were unable to send even one policeman to protect an organ of free speech. At the notorious London proagsdhfgdfs, Islamists were allowed to incite murder and bloodshed on the streets, but a passer-by objecting to these displays was threatened with detention for making trouble.

It seems to me that the European authorities are afraid to stand up for the principles of tolerance on which their societies are, allegedly, based.

It also seems that way to Claire Berlinski, whose new book Menace in Europe: Why the Continent's Crisis is America's Too examines Europe's intellectual and moral anomie, its inability to either assimilate or deal with a swelling immigrant population, and its resentment of America.

We interviewed Berlinski for a podcast and her take was, if anything, even less positive than that presented in her book.  (You can listen here or, via iTunes, here.)

I hope that Europe will get its act together before it's too late, and there are a few signs of awakening.  But the last time we saw a European nation whose elites lacked the strength or conviction to stand up to rampaging mobs of ignorant thugs, it was Weimar Germany.  That turned out very badly, and I'm afraid that today's Europe -- in which many nations seem to suffer from that problem -- may well turn out badly, too.

� 2007


Friday, September 21, 2007

Fixing America's Hospitals - Health For Life




Fixing America's Hospitals

No institution is doing everything right. But we found 10 that are using innovation, hard work and imagination to improve care, reduce errors and save money. Fresh fruit and digital record-keeping, anyone?
Photo illustration by Fredrik Broden for Newsweek
By By Claudia KalbNewsweek

Oct. 16, 2006 issue - Every day, hospitals across the country care for Americans in need. Babies are born, heart-attack victims are saved, broken bones are healed. But today, as the population ages, medical demands surge and costs rise, America's hospitals are being agsdhfgdfed like never before. Solving the crisis is a formidable task, but innovative hospitals are rising to the challenge??"they're reforming nursing practices, digitizing medical records, transforming end-of-life care.

The most urgent hurdle of all: improving patient safety. In 1999, the Institute of Medicine declared that close to 100,000 Americans die annually from medical errors. This year, more dire news: medication errors harm at least 1.5 million people and cost some $3.5 billion per year. What goes wrong? Missed diagnoses, incorrect drug dosing, failure to treat promptly. Experts agree that doctors, nurses, pharmacists and technicians will always make mistakes??"it's the safety net around them that needs to be fixed. "No matter how good people are, they suffer from being human and they're going to screw up," says Jim Conway, senior vice president at Boston's Institute for Healthcare Improvement. "We have to put systems in place that stop that error from causing harm."

Those systems may be simple or high tech. In 2005, Good Samaritan Hospital in Suffern, N.Y., launched Rapid Response Teams??"on-call experts to tend to patients in distress. Since then, "codes" for cardiac and respiratory arrests have dropped 22 percent. "This is one of the best interventions I've seen in my entire career," says Kathleen Lynam, chief nurse officer. At Intermountain Healthcare in Salt Lake City, which owns or operates 22 hospitals, the timely use of antibiotics has slashed postoperative infections. And controlling blood sugar levels during open-heart surgery has reduced the death rate from 2.49 percent to 0.18 percent.

Patient tragedies often trigger change. When Southwestern Vermont Medical Center execs heard Dale Micalizzi talk about the death of her 11-year-old son, Justin, after surgery for a swollen ankle at another hospital??"and that hospital's lack of response??"they reached out to her. Now, with Micalizzi's help, Southwestern is adopting a culture of openness after mistakes. "This is an injustice I experienced," she says, "and I can't let another mother go through it." A worthy goal for all.

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CONTINUED: Facing Up To Mistakes1 | 2 | 3 | 4 | 5 | 6 | 7 | 8 | 9 | 10 | 11 | Next >




Doctors discourage use of cough syrup - Cold & Flu




Doctors discourage use of cough medicine

Over-the-counter versions do little to relieve symptoms, experts say
Scott Olson / Getty Images file
Non-prescription cough syrups generally contain drugs in too low a dose to be effective, a group of chest physicians say.

CHICAGO - Despite the billions of dollars spent every year in this country on over-the-counter cough syrups, most such medicines do little if anything to relieve coughs, the nation’s chest physicians say.

Over-the-counter cough syrups generally contain drugs in too low a dose to be effective, or contain combinations of drugs that have never been proven to treat coughs, said Dr. Richard Irwin, chairman of a cough guidelines committee for the American College of Chest Physicians.

Drugstore shelves are crowded with cough syrups promising speedy, often non-drowsy relief without a prescription.

But “the best studies that we have to date would suggest there’s not a lot of justification for using these medications because they haven’t been shown to work,” said Irwin, a professor of medicine at the University of Massachusetts Medical School in Worcester, Mass.

The group’s new cough cure guidelines discourage use of over-the-counter cough medicines. Irwin said that not only are such medicines ineffective at treating coughs due to colds �" the most common cause of coughs �" they can also can lead patients to delay seeking cure for more serious coughs, including whooping cough.

The guidelines strongly recommend that adults receive a new adult vaccine for whooping cough, approved last year.

Guidelines disputed
The Consumer Healthcare Products Association, a trade group for makers of over-the-counter medications, disputed the guidelines and said over-the-counter cough medicines provide relief to millions of people each year.

The guidelines were published in the January issue of Chest, the American College of Chest Physicians’ journal, released Monday. The recommendations have been endorsed by the college, the American Thoracic Society and the Canadian Thoracic Society.

Many popular over-the-counter cough medicines proudly advertise that they don’t cause drowsiness, but Irwin said that is because they do not contain older antihistamine drugs that do help relieve coughs that are due to colds.

These antihistamines, including diphenhydramine �" an active ingredient in Benadryl �" are also available over the counter but are not marketed as cough medicines, he said.

Some over-the-counter cough syrups contain two drugs that have been shown to help relieve coughs caused by colds �" codeine and dextromethorphan �" but generally the doses are too small to be effective, Irwin said.

Vote

Do you think over-the-counter cough syrups work?

Dextromethorphan is in Robitussin, a top-selling over-the-counter cough syrup. It is among Robitussin ingredients that the Food and Drug Administration has found to be safe and effective, said Francis Sullivan, a spokesman for Wyeth Consumer Healthcare, which makes Robitussin.

Sullivan said Robitussin “wouldn’t be a top brand if people didn’t feel it was efficacious.”

Coughs can have numerous underlying causes, including asthma, allergies, severe heartburn, postnasal drip and bronchitis.

Dr. Edward Schulman, an American Thoracic Society representative on the guidelines panel, said patients should see their doctors for coughs that linger longer than three weeks or are accompanied by shortness of breath, which could indicate pneumonia or other serious conditions.

Coughs due to colds usually last less than three weeks. Drinking lots of fluids can help relieve these coughs, and so can chicken soup, Schulman said.

� 2007 . .


Thursday, September 20, 2007

'Scarborough Country' for Feb. 7 - Transcripts




'Scarborough Country' for Feb. 7

Read the transcript to the 10 p.m. ET show

Guest: Harvey Levin, Karen Hanretty, Paul Levinson, Ann Coulter, Peter Brookes, Bob Kerrigan, Gloria Luttig, John Luttig

JOE SCARBOROUGH, HOST:  Tonight‘s top headline: Christian missionaries murdered by a CIA operation.  Now comes the cover-up. 

Welcome to SCARBOROUGH COUNTRY.  No passport is required, and only common sense allowed. 

American missionaries shot down over Peru with working with the CIA.  After a three-year investigation, the DOJ drops the case.  Was there cover-up?  We are going to be talking to the parents of the murdered missionary. 

And then, the Colorado professor who compared 9/11 victims to Nazis apologizes for his anti-American rhetoric.  Oh, wait.  No, he didn‘t.  In fact, he says he is not sorry and he is not going to apologize and he doesn‘t want anybody else to apologize for him.  And, oh, yes, he also says that more 9/11s are necessary.  We‘re going to be asking author Ann Coulter what she thinks of that.

Later, America loves comedian Bill Cosby.  But now allegations that he drugged and groped a woman are reportedly backed up by taped phone calls. 

And John Kerry defends himself on “Imus,” but Imus doesn‘t think he defended himself very well.  

ANNOUNCER:  From the press room, to the courtroom, to the halls of Congress, Joe Scarborough has seen it all.  Welcome to SCARBOROUGH COUNTRY.

SCARBOROUGH:  Welcome to the show.

You know what, I haven‘t seen it all, because I haven‘t seen what‘s happened in this case that I am about to tell you about. 

An American missionary and her 7-month-old baby are shot to death in a CIA operation, and now they are having to deal with a cover-up from the feds.  It‘s time for tonight‘s “Real Deal.” 

Now, in 2001, on clear day in Peru, Veronica Bowers, a Christian missionary and mother of two, was killed while she and her family were flying from one camp to another.  Somehow, the CIA mistook the missionaries inside their small, slow Cessna plane for drug runners.  Bullets ripped through the small plane, killing Ms. Bowers and her 7-month-old baby, Charity.  After the plane crashed-landed in the river, Veronica‘s 6-year-old son, Cory, and her husband managed to swim to safety. 

After the incident, CIA agents became the subject of what “The New York Times” called the most serious investigation involving the CIA since the Iran Contra scandal.  Agents were accused of lying to Congress about their activities, and the Justice Department launched a criminal inquiry.  But according to “The Times” and other sources, outraged CIA leaders pressured the Congress to drop the investigation. 

Apparently, the intimidation tactic worked.  This week, the Justice Department announced it had dropped the investigation.  And a Bush administration official was quoted as saying�"quote�"“A criminal investigation such as this breeds a risk-adverse culture in the CIA.”

Oh, really?  Well, even if you were to assume that George W. Bush is unaware of the details of this case, ask yourself this question.  How would the president respond if one of his two daughters decided to become a missionary and then that daughter and her baby girl were shot to death in a CIA operation gone terribly wrong, and then the federal government covered up possible criminal conduct by dismissing top secret investigation because of pressure put on it by the same offending agency? 

Now, I know that, under those circumstances, George Bush and any father would feel angry and betrayed by his government, and for good reason.  Terrible accidents occur.  We all know that.  But, when they do, there has to be accountability from the top down.  That‘s why President Bush must immediately investigate this incident, release the Justice Department findings to the family and the public, and make sure those responsible are held accountable for their terrible, terrible mistakes. 

If these agents are innocent, fine.  But no one is being served by a federal cover-up that does nothing but bring more pain to a family that‘s already suffered enough.  Justice must be done.  And that‘s tonight‘s “Real Deal.” 

Now, with me to talk about this story are Roni Bower‘s parents.  We have Gloria and John Luttig. 

It‘s so good to see you all tonight.  I feel so terribly for you. 

Gloria, I want to start with you. 

How do you feel about the federal government just sweeping this under the rug and closing down the investigation? 

GLORIA LUTTIG, MOTHER OF KILLED MISSIONARY:  Thank you, brother Joe, for having us on. 

I want some answers.  I want to know why that, at this point, that the Justice Department did a criminal investigation, why has it taken all this time, and why�"we knew absolutely nothing about this, nothing.  There‘s just so many questions.  What is this deal about them lying, lying to the Justice Department? 

(CROSSTALK)

SCARBOROUGH:  Well, Ms. Luttig, that‘s the thing that‘s so troubling.  They hold this investigation.  These four CIA agents go before the United States Senate.  Apparently, the senators believe they are lying to them.  They conduct an investigation, and then they just dismiss it because the CIA is angry. 

I want to ask�"John, let me ask you a question. 

JOHN LUTTIG, FATHER OF KILLED MISSIONARY:  Yes, sir. 

SCARBOROUGH:  What would you like to say, father to father, to George W. Bush tonight? 

J. LUTTIG:  I would just like to ask him to sit down with me for just a few minutes and answer some questions that I have.  Nobody has ever notified us of anything.  We had one phone call right after the incident that President Bush called us and told us he was sorry, that he just can‘t understand how we hurt, because he has two daughters. 

SCARBOROUGH:  And yet, John, tonight, again, we are talking about a case where your daughter, and your 7-month-old granddaughter were murdered, shot down. 

J. LUTTIG:  Yes, sir, they were. 

SCARBOROUGH:  Shot down while serving God. 

Four CIA agents reportedly lied to the Senate.  The CIA pressures the Justice Department to drop this investigation, according to reports out of “The New York Times,” and you are still here.  You haven‘t heard from the Justice Department, the CIA, anybody investigating this.  The missionary board hasn‘t heard.  How do you conduct an investigation without talking to the principals? 

J. LUTTIG:  Good question.  You tell me. 

SCARBOROUGH:  And that‘s the question that you want George Bush to answer.

J. LUTTIG:  Yes, sir.  I would like to ask him that. 

G. LUTTIG:  And I would like to know why some of the CIA agents, some of the top agents are still serving.  And one is in CIA headquarters in Langley, Virginia. 

SCARBOROUGH:  All right.  Thanks so much, Gloria and John.  We are going to stay on this story.  We appreciate you being with us.  And we are going to ask you back. 

I want to show you some footage taken, remarkable footage of the day that the plane was shot down, and Roni and her beautiful 7-month-old baby daughter were murdered.  This�"it was a landing on a river deep in the jungles of Peru.  Take a look. 

(BEGIN VIDEO CLIP)

UNIDENTIFIED MALE:  The plane is talking to Iquitos tower on VHF.

(CROSSTALK)

UNIDENTIFIED MALE:  OK.  OK.

UNIDENTIFIED MALE:  (SPEAKING SPANISH)

UNIDENTIFIED MALE:  Tell them to terminate.

UNIDENTIFIED MALE:  Don‘t.  Don‘t shoot. 

UNIDENTIFIED MALE:  Tell them to terminate.

UNIDENTIFIED MALE:  (SPEAKING SPANISH)

UNIDENTIFIED MALE:  (SPEAKING SPANISH) 

UNIDENTIFIED MALE:  God.

UNIDENTIFIED MALE: ... land back here. 

UNIDENTIFIED MALE:  OK.  There.  You got (INAUDIBLE)

UNIDENTIFIED MALE:  Where? 

UNIDENTIFIED MALE:  Right there. 

UNIDENTIFIED MALE:  (SPEAKING SPANISH) 

UNIDENTIFIED MALE:  OK, OK, OK. 

UNIDENTIFIED MALE:  Now, let‘s just circle over�"hang on.  Just hang on. 

UNIDENTIFIED MALE:  They‘re smoking. 

UNIDENTIFIED MALE:  (SPEAKING SPANISH) 

UNIDENTIFIED MALE:  He‘s smoking.  Oh, yes.

UNIDENTIFIED MALE:  Yes.  He‘s smoking. 

(END VIDEOTAPE)

SCARBOROUGH:  With us now to talk about why the Justice Department dropped the case are renowned Florida attorney Bob Kerrigan, who also follows human rights closely, and also Peter Brookes from the Heritage Foundation. 

Bob, a mother and baby are gunned down in the middle of a CIA operation.  Apparently, the agents lie to Congress.  Pressure is put on an agency, the Justice Department, to drop it, and they drop it.  Is that justice? 

BOB KERRIGAN, HUMAN RIGHTS ATTORNEY:  It‘s not justice.  However, there‘s an obscure provision in the Defense Authorization Act of 1995 that actually grants prosecutorial immunity to anybody involved in shooting down one of these planes. 

The real gravamen of the wrong, I think, is lying to Congress, and Congress needs to do something about it. 

SCARBOROUGH:  But they are�"the CIA, according to “The New York Times,” the CIA was offended by this investigation, where you have a young mother and her daughter basically blown out of the sky, bleed to death in front of a 6-year-old boy, and yet we have the Justice Department saying, you know what, we are just going to drop it.  What can be done? 

KERRIGAN:  Well, something can be done, and something is odd.  Within six months of this event, the United States Senate found culpable negligence by United States officials. 

And then Colin Powell within a matter of two or three months said they are going to resume the shootdown.  And then two and a half years later, nothing has happened until we get this announcement other than resuming these shootdowns in Colombia just a few months ago. 

SCARBOROUGH:  Robert Brookes, what‘s wrong with this picture?  A young American mother and her 7-month-old baby girl are shot out of the sky.  The CIA reportedly lied to Congress.  The CIA got offended by it, and the Justice Department dropped the investigation.  Something is terribly wrong here. 

PETER BROOKES, HERITAGE FOUNDATION:  Joe, it‘s a terrible tragedy. 

There‘s no doubt about that. 

But I think�"I am curious to know all the facts.  I don‘t think we have all the facts yet.  This was a very short article in “The New York Times” today.  I think we need a full airing of what happened.  I agree with you that, if there were, people need to be held accountable.  This is very important in our intelligence business.  We know this.  We know this from Iraq.  We know this other issues.  But I think we need to know more. 

All I saw is the same article you saw in “The New York Times” today, and I don‘t know that anybody was successful in getting this dropped.  I think we need a full public airing of what‘s been going on with this case, other than just a very short article in “The New York Times” this morning. 

SCARBOROUGH:  Robert, I agree with you.

And, Bob Kerrigan, you are from the area where this missionary‘s family is from, where she is from originally.  Could it be that the reason why we don‘t know what‘s going on there is because the four-year investigation has been top secret? 

KERRIGAN:  Well, they ought to bring the family into this top secret involvement. 

Joe, the families of the church women killed in El Salvador 25 years ago still have no answers from the United States government on the death of those women serving their church in El Salvador.  This is going to get stalled and covered up indefinitely from now on, no question about it. 

SCARBOROUGH:  Well, gentlemen, we need to blow the lid off the cover-up, if it is going on. 

Bob Kerrigan, Peter Brookes, thanks for being with us tonight.  We look forward to having you back to talk about this issue.  We are going to stay on it until we get answers from the federal government. 

Coming up next, Ward Churchill‘s laagsdhfgdf outrageous statement.  You are not going to believe it.

That‘s when SCARBOROUGH COUNTRY returns.

(COMMERCIAL BREAK)

SCARBOROUGH:  More shocking comments from Colorado Professor Ward Churchill, who attacks America and says�"what does he say on the taxpayers‘ dime?  That we need more 9/11s. 

That story next.

(COMMERCIAL BREAK)

(NEWS BREAK)

SCARBOROUGH:  Now, as we told you last week, University of Colorado Professor Ward Churchill faces possible firing for comparing 9/11 victims to Nazis and for praising al Qaeda terrorists who killed 3,000 Americans.  He called them heroes.  The university has 30 days to read everything that Churchill has written.  And they may want to read this interview from 2004. 

He said�"quote�"“One of the things I suggested is that it may be that more 9/11s are necessary.  This seems like such a no-brainer that I hate to frame it in terms of actual transformation of consciousness.”

Now, Denver radio talk show host Peter Boyles spoke to Churchill and the father of a 9/11 victim last week.  Let‘s listen to that exchange. 

(BEGIN AUDIO CLIP)

FATHER OF 9/11 VICTIM:  My son was an assistant trader at Cantor Fitzgerald.  He was 23, his first job out of college. 

(CROSSTALK)

WARD CHURCHILL, PROFESSOR, UNIVERSITY OF COLORADO:  Well, I would like to do something here.  I would like to engage you. 

PETER BOYLES, RADIO TALK SHOW HOST:  Let me ask him, if I could, before it gets away, Ward, would his son have qualified as one of the little Eichmanns? 

CHURCHILL:  Yes, he would have. 

(END AUDIO CLIP) 

SCARBOROUGH:  That is unbelievable.  That is just unbelievable that this guy, after this controversy breaks, this guy is telling the father of a dead 23-year-old son that he would qualify as an Eichmann, again, Adolf Eichmann, the Nazi that was the architect of the Holocaust, six million Jews killed.  The guy seems like a beast. 

Well, author and now DVD star Ann Coulter is with us.  It‘s a great honor to have her back in SCARBOROUGH COUNTRY.  We also have Fordham University media Professor Paul Levinson.

Ann, let‘s begin with you.  And I just got to ask you�"again, here‘s the quote.  This guy says in 2004: “More 9/11s are necessary.”  We hear time and time again that this is about free speech, but I say, if it‘s public university, it‘s about taxpayer-funded speech.  What is your take? 

ANN COULTER, AUTHOR, “HOW TO TALK TO A LIBERAL (IF YOU MUST)”:  Right. 

Well, more than that, don‘t call yourself a radical if you have tenure.  Everyone else in the world suffers consequences for the things they say, if they said something as outrageous as this.  These guys want to go around acting like big radicals, getting laid by coeds with hairy armpits, who probably don‘t like men, by going to conferences and saying, oh, yes, I‘m the one who said that.

And they can say more and more outrageous things because they are never at risk of losing a job, unlike everyone else in the universe.  Whatever you say about any of the crazy things professors say, maybe they are right.  Maybe they have a very good point.  Maybe it‘s worth listening to them.  But the one thing you can‘t say about them is they are courageous.  Other people are putting their jobs on the lines.  So, if you want to be called a radical, then give up the tenure before you start going around shooting off your mouth like this. 

SCARBOROUGH:  Ann, I have been asking this question of conservatives and of moderates and even some liberals who are offended by this type of talk on campus.  Why is it that everybody can be held accountable, but our Republican president, our Republican Senate, our Republican House, our Republican governors, our Republican state legislators all say the same thing, which is we can‘t do anything about it, academic freedom, when, again, we are not talking about free speech?  We are talking about speech, that, just like an NEA so-called art display where you put a crucifix in urine, that is subsidized. 

It‘s not art, and this is not free speech. 

COULTER:  No, and it‘s especially preposterous coming from probably the least tolerant of free speech institutions in America, college campuses, where they have speech codes on hate speech and people�"students at risk of being expelled for jokes or inappropriate laughing. 

I mean, of all places in the world where�"and Larry Summers, look over that the furor over that a few weeks ago, when he opined that there might�"we might want to have some scientific research into whether there are innate differences between men and women.  He was nearly driven out of town, fainting, whining, screeching. 

So of all places to be talking about academy freedom.  But as many people who engage in free speech for a living know, there are consequences and you could lose your job.  You could lose your show.  People could not buy your books.  You could lose a radio show.  This is the one industry where you can‘t be fired for what you say.

And they have the audacity to walk around with the long hair and the shades acting like he‘s a radical.  I mean, I really find that more offensive than anything else.  This is a little craven chicken who can‘t lose his job squealing about the fact that his tenure is even being considered for revocation right now, show that he knew he had absolute job security, and he would just shoot off his mouth.  And it‘s like farting in a church.  It‘s just, what‘s the most outrageous thing I can say?

SCARBOROUGH:  Yes.  And the most interesting thing is, again, for these people at these college campuses to talk about free speech, they have obviously never been a conservative trying to give a speech at a campus, where you are booed and hissed and not allowed to continue.

Paul Levinson, let me bring in here.  And I want to ask you to explain to Americans why somebody that speaks, a professor that is paid by the government, by taxpayers, why that person can‘t be held accountable for hate speech, whereas, if somebody works at a private institution, like Fordham, such as yourself, you know, it seems to me that institution should be isolated from taxpayer revolt. 

PAUL LEVINSON, DIRECTOR OF MEDIA STUDIES, FORDHAM UNIVERSITY:  Well, I think you and Ann don‘t understand how tenure works.  No one is saying that this obnoxious, disgusting person has some kind of immunity from being fired.  And, as a matter of fact, the last I heard, his university is looking over his record, and will make a decision. 

(CROSSTALK)

SCARBOROUGH:  How many tenured professors have been fired at Fordham in the past five years?

LEVINSON:  I don‘t know.  I have no idea.

SCARBOROUGH:  Because they... 

(CROSSTALK)

LEVINSON:  But that‘s not the point.  Tenure is not an absolute immunity. 

(LAUGHTER)

(CROSSTALK)

SCARBOROUGH:  It‘s about as damn close as you can get. 

LEVINSON:  As a matter of fact, one reason why tenured professors have been fired over the years is there aren‘t enough students in their courses.  And for an economic reason, they can‘t be continued at the university. 

So there‘s a sort of public myth that university professors with tenure can do anything they want and they can‘t be fired.  That‘s just flatly not true. 

(CROSSTALK)

SCARBOROUGH:  I will ask you again, when is the last time that a tenured professor got fired at any institution where you worked? 

LEVINSON:  The last time a tenured professor got fired at an institution where I worked, I can‘t give you an answer, because I am not an expert on when people get fired.

But I can flatly guarantee you that, if you look over the last, say, 50 years of American history, you will find that there are any number of tenured professors who have been fired, for a variety of reasons. 

SCARBOROUGH:  Ann Coulter...

LEVINSON:  So this is a myth, which it may make you and Ann Coulter happy to imagine it‘s the case, but it‘s not the case.  And furthermore...

SCARBOROUGH:  Wow. 

LEVINSON:  To show you that you are wrong, why, then, is the University of Colorado considering whether or not to continue... 

(CROSSTALK)

SCARBOROUGH:  I will tell you why, because for the first time...

LEVINSON:  Because tenure is not an absolute guarantee.

SCARBOROUGH:  For the first time in 30 years, since radicals have taken over campus, it‘s taken a clown like Ward Churchill to wake Americans up and say enough is enough. 

(CROSSTALK)

LEVINSON:  It‘s nonsense to say that radicals have taken over campuses. 

SCARBOROUGH:  Oh, good God.  What are they, conservatives? 

(CROSSTALK)

LEVINSON:  There‘s a very vibrant Republican Party.  One of my students by the name of Lara Hanson organized a debate between Democrats and Republicans.

(CROSSTALK)

SCARBOROUGH:  I‘m not talking about Fordham specifically. 

LEVINSON:  Then don‘t say radicals have taken over campuses.  That‘s just not true. 

SCARBOROUGH:  Are you suggesting that there‘s an equal conservative presence on campus? 

LEVINSON:  Yes, I am suggesting that if you look at the last election...

SCARBOROUGH:  You are suggesting that? 

LEVINSON:  Yes.  I think that there are conservatives.  There are radicals.

SCARBOROUGH:  Among professors? 

LEVINSON:  It‘s a continuum.  Conservatives like to put up as sort of a boogeyman...

(CROSSTALK)

SCARBOROUGH:  College professors?  Are you saying there‘s an equality among college professors in America between liberals and conservatives?  Because if so, and I fat Fordham..

LEVINSON:  Have you done a survey?  Do you know that there isn‘t?

(CROSSTALK)

SCARBOROUGH:  Well, actually, there was a survey out six months ago that said seven out of eight�"it was reported in “The New York Times” that seven out of eight, tenured professors, interviewed said they leaned to the left.  But I‘ll tell you what.

LEVINSON:  Nobody asked me in that survey. 

SCARBOROUGH:  Well, I will tell you what, though.  You know what?  My son wants to go to school in New York.  And he‘s looking at Fordham.  If it‘s that split down the middle, I am going to order him to go. 

(LAUGHTER)

SCARBOROUGH:  Ann Coulter, am I�"listen, I respect Paul Levinson, but there‘s a part of me that says he is kind of like Dan Rather when Dan Rather said, “The New York Times” biased?  Wait a second.  “The New York Times” is in the mainstream of American politics. 

(LAUGHTER)

COULTER:  No.  In fact, I think I can tell you the last time a professor in the United States of America had his tenure revoked.  My law firm defended him here in New York, Professor Levin�"I think it was at CCNY�"for academic articles he had written on ethics that were not P.C. 

SCARBOROUGH:  I was going to say, he must have been a conservative.

(CROSSTALK)

COULTER:  Yes.  It was a major investigation into�"it was directly on free speech. 

And I think the point that Professor Levinson doesn‘t understand is that in industries other than teaching with tenure, it doesn‘t take 17 TV shows featuring your comments every night for you to have your job at risk.  You can be fired a lot faster. 

(CROSSTALK)

SCARBOROUGH:  We are going to have to leave it there.

But, Ann Coulter and Paul Levinson, thank you so much.  I have always loved Jesuit institutions.  I think my son is going to be going to one in a year and a half, whether he likes it or not. 

Joey, return the card to Fordham University. 

Still ahead on SCARBOROUGH COUNTRY, female soldiers just having fun in the mud find themselves in military quicksand.  Now, that‘s a tease.  We will talk about and much more with my political roundtable coming up next. 

(COMMERCIAL BREAK)

SCARBOROUGH:  Coming up next, from Bill Cosby to the Super Bowl to Britney Spears, plus, female soldiers mud wrestling.  Well, let‘s just say you would be wise to stick around.  That‘s coming up.

But, first, let‘s get the laagsdhfgdf news that your family needs to know. 

(NEWS BREAK)

ANNOUNCER:  From the press room, to the courtroom, to the halls of Congress, Joe Scarborough has seen it all.  Welcome back to SCARBOROUGH COUNTRY.

SCARBOROUGH:  Hey, we are back here with Ann Coulter.  She‘s got a new DVD coming out.  And “The New York Post” today calls it a behind-the-scenes look at Ann‘s life.

And sort of�"they were a bit snide, Ann.  Tell me about it.

COULTER:  Well, I didn‘t see the “Post” item.  Apparently, they claim I am behind this and, actually, you just implied by saying I have a DVD coming out. 

It wasn‘t my idea.  I didn‘t do any of the editing, the participation in the content, the merchandising, the packaging.  In fact, I haven‘t even seen it.  It was someone else‘s project.  I merely cooperated. 

SCARBOROUGH:  Yes, so “The Post” wrote that. 

COULTER:  And I thank you for asking me.  Usually, when nasty, untrue things are said about me, you get the bust.  You never get the counterbust.  This is not my DVD.  It‘s a DVD about me.  I haven‘t seen it.  Maybe they have, so, apparently it‘s a good DVD, but I think I still want to watch it. 

(LAUGHTER)

SCARBOROUGH:  OK.  Let‘s talk. 

I want to bring in Karen Hanretty right now.

But, Ann, I want to talk about the president‘s budget today.  The media‘s take on the budget has been mixed.  “The New York Times” said that it cuts veterans‘ benefits and cuts benefits to grandmas and kids and furry barnyard animals.  “USA Today” and others say it doesn‘t cut enough.  We have talked about how this president and this Republican Congress have spent money irresponsibly. 

Do you think George Bush and the Republicans in Washington have backed themselves into a corner it‘s going to be hard to get out of now that we‘ve got the largest deficit, the largest debt ever, and Republicans acting like big spenders? 

COULTER:  I hope so. 

There is a good complaint, that we are supposed to be the party of smaller government.  Well, we have the House and Senate now.  It is Congress that is responsible for the purse.  So, I think they will have something to answer for if they don‘t cut the budget. 

Most of all, I want to see if liberals are as concerned about the deficit as they were when we were cutting taxes. 

SCARBOROUGH:  Karen Hanretty, you‘re a Republican strategist also.  How could the Republicans have acted so irresponsibly over the past four years and led Americans to the largest deficit and the largest debt ever? 

KAREN HANRETTY, REPUBLICAN STRATEGIST:  Well, you know, Joe, there was an interesting report that came out today that says that, with regard to education spending, $66 billion went unspent by states across the country. 

So, while Democrats are out there complaining about spending cuts to education and all of their pet projects, I think it‘s important that finally this president is stepping up, looking at how money is being spent.  And is there wasteful spending?  And I think, if you ask just about any voter, certainly in California, but throughout the country, if they think that there is waste and abuse in government, they will unanimously agree, regardless of blue state, red state.

So I think that the spending is certainly long overdue.  And I think it‘s a positive signal for Republicans. 

SCARBOROUGH:  It could be positive if they do it. 

OK.  So let‘s say that all voters say that there is waste, fraud, and abuse in the federal government.  Well, the Republicans have controlled the White House.  They have controlled the Senate.  They have controlled the House of Representatives since 2001.  And now John McCain is even saying he is afraid that members of Congress won‘t even go along with the president on these budget cuts.  What is the difference between Republicans and Democrats when it comes to spending? 

HANRETTY:  Well, I think that John McCain is right to raise this issue. 

I think that there are a lot of Republicans across the country who have been very concerned about how fiscally conservative this administration is, although granted, the spending in this administration has gone up due to homeland security and the military. 

SCARBOROUGH:  Well, everything, farm subsidies.  You name it. 

HANRETTY:  Well, and I think it‘s...

SCARBOROUGH:  If you want money from the federal government, this president has given it. 

HANRETTY:  Well, and I think that he is in an interesting position right now, and we‘ll see if the Republicans�"I hope the Republicans have the courage to stand up and support this president, who is saying, you know, maybe we need to cut back on some of our farm subsidies and Amtrak and some other pet projects that, whether you are a Republican or a Democrat, and you are looking to get reelected, these are the issues you run on.

And I am hoping that the Republicans have the courage to stand up, support this president and say, moving forward, we have got to get spending under control. 

SCARBOROUGH:  Let‘s hope so.

HANRETTY:  We know what happens when that doesn‘t happen.  We have seen what happens here in California when spending is out of control. 

SCARBOROUGH:  Yes.  Let‘s hope so, because spending is out of control everywhere. 

Now, Ann, today, the French said they want to make nice with America.  The French foreign minister said his country wants a fresh start in relations with the United States.  And his comments come one day before Secretary of State Condoleezza Rice visits Paris.  But it‘s a little late, isn‘t it?  They obviously read the headlines from the Sunday elections.  And they don‘t mean it. 

COULTER:  No, but it‘s interesting that the French are ready to start being nice about America.  Liberals aren‘t yet.  Maybe Chirac should run the Democratic National Committee, instead of Howard Dean.  They are sounding a little warmer toward Bush than liberals are. 

(CROSSTALK)

SCARBOROUGH:  Well, Bush is also, though, sounding warmer to what Rumsfeld called old Europe than he did in the first term.  Obviously, he and Condoleezza Rice have been stressing that they need to reach out to Europe.  They need to bring this alliance back together.  Do you think that‘s going to work or you think... 

COULTER:  It must be the influence of that magnificent new secretary of state we have, Condoleezza Rice, whom the Democrats opposed. 

SCARBOROUGH:  Yes. 

Karen Hanretty, what is your response?  Should we reach out to France or should we tell them, too late? 

HANRETTY:  Well, you know, this has got to be a very difficult day for France.  And I am sure that it was not without a little bit of trepidation that they made that statement.

And the thought of France surrendering to America has a bit of a nice ring.  But I am sure that people like Condoleezza Rice would be much more gracious than perhaps myself or Ann Coulter.  But we‘ll see what France does and what their true motives are.  And I think a lot of us suspect that they have ulterior motives.  So I guess, in the coming months, we will see if they actually cooperate with the United States or not. 

SCARBOROUGH:  All right, women, ladies, I want to ask you a question. 

Ann, I will start with you.  It‘s a tough question.  OK.  So you decide you want to serve the United States military.  You are in Iraq for, I don‘t know, a year or so.  People are shooting at you.  Your life is on the line.  Right before you are about to come home, you and your company go out.  You have a little fight in mud.  And after dodging bullets, after risking your life, because you are in a mud wrestling conagsdhfgdf, you get demoted.  And the American media seems to be making it an international incident. 

Do you think that‘s fair cure of these women that have been demoted? 

COULTER:  I think you got the wrong girl here.  You lost me the moment you said, I am in the military. 

(LAUGHTER)

COULTER:  I would like a United States military capable of winning wars, which will not involve sending girls to do fighting.  No, from the moment you start sending women in to do the fighting, you have lost me. 

SCARBOROUGH:  All right, Karen, Hanretty, I will ask you the same question. 

HANRETTY:  I am not going to argue the military‘s criteria for demoting soldiers.

But I think that, once again, the media has proven that, on a slow news day, they can turn women mud wrestlers into a major international incident.  All the while, they ignore stories of schools being built and all of the improvements in Iraq.  They don‘t want to tell those stories.  They want to sink to reality TV, but, increasingly, that‘s what the media does. 

(CROSSTALK)

COULTER:  Well, apparently, it‘s also what these girls did. 

(LAUGHTER)

HANRETTY:  Well, you know what?  If men were mud wrestling, would this be a story all over the Drudge Report and the Internet and television? 

(CROSSTALK)

COULTER:  No.  No, it would not.

HANRETTY:  No, it wouldn‘t. 

COULTER:  And I think you can check with Larry Summers on whether there could be an innate difference between men and women.  And, yes, I think it‘s appalling that these women are mud wrestling, but I think it‘s appalling that they are in the military. 

SCARBOROUGH:  Let me bring in Jim Warren right now with “The Chicago Tribune.”

HANRETTY:  Well, I would not agree with that. 

SCARBOROUGH:  Jim, I want to ask you a question that I asked Ann and Karen before regarding the president‘s budget.  I know you have been fighting traffic.  Thanks for being with us. 

(CROSSTALK)

SCARBOROUGH:  Do you think George Bush, who is now getting attacked from both sides for his new budget, do you think he has backed himself into a corner with the largest deficit and debt ever that he is not going to be able to get out easily? 

JIM WARREN, DEPUTY MANAGING EDITOR, “THE CHICAGO TRIBUNE”:  No, although I have to first put aside this discussion of mud wrestling. 

SCARBOROUGH:  Well, no, but, well, please...

WARREN:  I just had this image of Lawrence Summers, president of Harvard...

SCARBOROUGH:  Mud wrestling.

WARREN:  ... being involved in mud wrestling in Iraq. 

I think, if you put aside the facile and certainly the easy criticisms, this�"what he presented today does not take note of the cost of Iraq, of Afghanistan, of whatever his Social Security plan is.  I still think you can argue that it is quite notable.  He is taking, attempting to take a whack, as you know, former Congressman, at some truly politically sensitive matters, which include agricultural subsidies.

It also includes something like medicines for vets.  So I have got to hand it to him for having the nerve to try to do that and also in taking a whack at discretionary spending.  For those whose eyes glaze over, that‘s the stuff that folks like Joe Scarborough‘s old colleagues in Congress actually have a chance to take a shot at. 

SCARBOROUGH:  That you can actually control, right.

(CROSSTALK)

WARREN:  That you can actually control. 

SCARBOROUGH:  Outside of Social Security, outside of Medicare, outside of the mandatory spending. 

Well, Jim, what...

(CROSSTALK)

WARREN:  The real question...

SCARBOROUGH:  Are Republicans going to follow him, for instance, let‘s say Republicans in red states, on farm subsidies? 

WARREN:  Well, you know, you tell me. 

Tell me about some Republicans in Florida who might be very sensitive to sugar subsidies.  Tell me about some folks in other parts of the South who might be very sensitive to cotton subsidies.  I think the devil is in the details.  And the devil is who is going to be lobbying for the most powerful force, as you know, in that town, which is the status quo.  They are going to get a lot of Republicans on the Hill who are going to say, no way, don‘t want you to go after those veteran benefits, no way, don‘t want you to go after those ag subsidies. 

SCARBOROUGH:  And, of course, as a representative of Florida, I saw people voting for the peanut subsidies, voting for the sugar subsidies.  I voted against them, but I am not in Washington anymore. 

(LAUGHTER)

(CROSSTALK)

WARREN:  On the surface, this does hint at being quite serious about the deficit.  Now, it‘s not in the same ballpark as one of those Clinton budgets, which you well remember, which, by and large, was DOA, dead on arrival, when it got to at least the Republican-controlled House. 

It‘s a little different here.  It will be a little bit more interesting here. 

SCARBOROUGH:  All right, Jim, Ann and Karen, thanks so much for being with us.  We greatly appreciate it. 

And I have got to tell you, I am going to be watching the House and Senate Republicans, who got elected to Congress talking about how conservative they were on fiscal issues.  And the second they got up there, the second Republicans got in control of everything, they decided they wanted to stay in control, so they started spending money at a rate that even Democrats never spent.

Now, that makes a lot of my Republican friends angry, but you know what?  It‘s the facts.  Don‘t be mad at me.  Be mad at your Republican so-called conservative Republican senator.  You write them a letter and tell them it‘s time to get the deficit and the debt under control, or else you and your children and your grandchildren are going to pay for it. 

Now, coming up next, I have got issues with John Kerry.  He tried to defend himself today on “Imus,” but Imus doesn‘t think he did such a great job. 

I‘ll tell you about that coming up next.

(COMMERCIAL BREAK)

(NEWS BREAK) 

SCARBOROUGH:  Just another manic Monday, and I‘ve got issues. 

First of all, I‘ve got issues with Senator John Kerry.  This morning on the “Imus” show, the senator responded to the Cheney family‘s complaints at Kerry‘s mention of Mary Cheney being a lesbian during the third and most important presidential debate. 

Take a listen. 

(BEGIN AUDIO CLIP, “IMUS IN THE MORNING”)

SEN. JOHN KERRY (D), MASSACHUSETTS:  They had talked a number of times themselves publicly about their daughter with considerable pride.  And I thought I was doing it in a constructive, decent, gentle way.  It was intended, and we made it very, very clear, as nothing more than affirmation of their own family‘s love for her. 

(END AUDIO CLIP)

SCARBOROUGH:  An affirmation of love.  I feel like getting with the senator and singing “We Are the World.”

Senator, are you serious?  In the most important debate of your life, you bring up the fact that the vice president‘s daughter is lesbian, and you want to pretend that you were doing the vice president and his family a favor?  You know what?  If they had wanted that out there publicly in that forum, you know, you should have let the president say it.  Or John Edwards, when he brought it up also, should have let the vice president say it.  Not good. 

And I have got issues with last night‘s Super Bowl ads.  Now, I thought the funniest ads of the night belonged to CareerBuilder.com�"or .net�"which featured a man surrounded by monkeys in the workplace.  I just love monkeys.  I don‘t know what there is about them. 

But a more controversial ad mocked last year‘s wardrobe malfunction.  So, did I find that ad offensive?  Well, absolutely not.  At least not as offensive as I found the ad for Cialis. 

(BEGIN VIDEO CLIP, CIALIS AD)

NARRATOR:  Cialis is the only erectile dysfunctional tablet clinically proven to not only work fast, but also work up to 36 hours.  Side effects may include headache, upset stomach, delayed backup for muscle ache.  Erections lasting longer than four hours, though rare, require immediate medical help. 

(END VIDEO CLIP)

SCARBOROUGH:  I don‘t want to see it.  I just�"I don‘t want to see it.  Thank you, Cialis, for ruining that song for me forever.  I‘ll no longer be able to hear the Ronettes without hearing a voice-over speaking of glory of overwhelming erectile dysfunction

Again, thank you, Cialis.  Now, leave.  Go home.  No mas.

And, finally, I have got issues with forgetful pop stars.  Britney Spears is suing eight insurance companies for $10 million for failing to pay up after a knee injury forced the diva to cancel last year‘s summer tour.  The insurance companies say they are not paying, and for good reason, because Britney told them she had no previous injuries, when in fact she already had knee surgery once. 

But Britney claims she forgot about the surgery and the injury because it healed up.  Hey, Britney, you are 22 years old, and this ain‘t like marriage.  You should be able to remember having a knee surgery four years ago, when you were 18 years old.  I think you‘re out of luck.  The insurance companies win on this one. 

And now one from “Celebrity Justice.”  Two weeks ago, a female acquaintance of Bill Cosby claimed the sitcom dad drugged and fondled her in January of 2004.  Mr. Cosby‘s publicist has called the charges categorically false. 

And with me now to talk about it more, from “Celebrity Justice” is Harvey Levin. 

Harvey, give us the very laagsdhfgdf on what you know. 

HARVEY LEVIN, EXECUTIVE PRODUCER, “CELEBRITY JUSTICE”:  Well, we know that there‘s an ongoing police investigation.

We also know that Bill Cosby has told the cops in Philadelphia he did have a sexual encounter with this woman.  The difference is, he says it was purely consensual.  And here‘s what‘s really interesting about the case.  This woman maintained a cordial relationship with Bill Cosby all last year.  And, in fact, seven months after this incident, we know that she actually called Bill Cosby and said, look, I would love to go to your concert near Toronto, your performance.  Can you get me tickets for myself and my parents?

And Cosby actually got them tickets.  It wasn‘t this woman who complained.  Last month, it was her mother that contacted Cosby and got really upset.  And we are told from sources connected with Cosby that the mother made overtures about getting some kind of money from Cosby. 

SCARBOROUGH:  I was going to ask, is there any proof out there that this mother, again, not the daughter who was involved in the incident, but this mother actually saw an opportunity to shake down a public figure like Bill Cosby and thought, hey, I am going to milk this for all it‘s worth?

LEVIN:  Well, Joe, that‘s exactly what Cosby‘s people are saying happened.  We are told that she didn‘t make a specific money demand.  She merely talked around it and said it would be nice if you would help with my daughter‘s education.  It would be nice if you would help her out.  They never really talked about a specific amount.

But we know that Cosby actually called her at one point, called the mother and basically said, look, what can we do to work it out?  Not that he was worried about any kind of criminal allegation, because he had no idea at the time.  He just didn‘t want the embarrassment of this happening.  So, before she went to the cops, we are told these conversations occurred where there were these overtures about dough. 

SCARBOROUGH:  All right, Harvey, thanks for being with us.  We are going to ask you to come back as we follow this story.  Again, it sounds like a pure shakedown operation to me.  Thanks for being with us. 

And we will be back with some amazing footage of a multimillion-dollar home being ruined by rain.  That‘s coming up next.

(COMMERCIAL BREAK)

SCARBOROUGH:  My blog today talks about media bias in covering the president‘s new budget.  You can read that and much more on my Web site at Joe. . 

(COMMERCIAL BREAK)

SCARBOROUGH:  You know, there‘s some very unhappy homeowners in Southern California, as several multimillion-dollar homes are sliding off their foundations and down hills. 

After last month‘s torrential rain, this home in Anaheim Hills, California, has been one that‘s been declared unlivable and is literally sliding away.  Witnesses say they can hear windows popping and the house slowly ripping apart.  Ugly scene out there. 

Now, if you can, send us an e-mail.  Tell us what you think about the show and what you want to see.  You can do that by e-mailing me at Joe. .  We will be reading your e-mails as we move forward on a lot of these stories we have been talking about, whether it‘s eradicating radicalism on college campuses or whether it‘s about the CIA cover-up of these Christian missionaries being killed.  Whatever it is, e-mail us at Joe. . 

Hey, we appreciate you being with us tonight.  Thanks so much. 

And you can catch Senator Joe Lieberman tomorrow morning on “Imus in the Morning.”  And, of course, that‘s “Imus in the Morning” live from world headquarters. 

See you tomorrow. 

THIS IS A RUSH TRANSCRIPT. THIS COPY MAY NOT BE IN ITS FINAL FORM AND MAY BE UPDATED.

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