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What's Wrong With CSI? Forensic evidence doesn't always tell the truth.

From Forbes:

Forensic evidence is foolproof, right? It's how those clever cops on CSI always catch the killer. DNA evidence springs innocent men from prison. Fingerprints nab the bad guys.

If only forensics were that reliable. Instead, to judge by the most comprehensive study on the reliability of forensic evidence to date, the error rate is more than 10% in five categories of analysis, including fiber, paint and body fluids. (Meaning: When the expert says specimen X matches source Y, there's a 10% probability he's wrong.) DNA and fingerprints are more reliable but still not foolproof.

Though a 2005 study in the Journal of Criminal Law & Criminology suggests a fingerprint false-positive rate a bit below 1%, a widely read 2006 experiment shows an alarming 4% false-positive rate.

Yet the public sees errors as gross anomalies. Like the time the FBI wrongly linked an Oregon attorney named Brandon Mayfield to the 2004 Madrid commuter train bombing that killed 200 people. The FBI had claimed a 100% match between fingerprints found at the scene and Mayfield, who was held for two weeks in federal custody. When the Spanish National Police got the real perpetrator, an Algerian named Ouhnane Daoud, the FBI had to admit its mistake. Mayfield accepted a $2 million settlement from the government.

How can we preserve the usefulness of forensic evidence while protecting the public when it breaks down? The core problem with the forensic system is monopoly. Once evidence goes to one lab, it is rarely examined by any other. That needs to change. Each jurisdiction should include several competing labs. Occasionally the same DNA evidence, for instance, could be sent to three different labs for analysis.

Other reforms should include making labs independent of law enforcement and a requirement for blind testing. When crime labs are part of the police department, some forensic experts make mistakes out of an unconscious desire to help their "clients," the police and prosecution. Independence and blind testing prevent that. Creating the right to a forensic expert for the defense would help restore the imbalance in scientific firepower that too often exists between prosecution and defense. Private labs are subject to civil liability claims and administrative fines, giving them financial incentives to get it right. 

Posted: 5/28/2008 8:50:00 AM

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Study suggests antidepressants for stroke victims

From the Associated Press:

Doctors may want to give stroke victims antidepressants right away instead of waiting until they develop depression, a common complication, new research suggests.

The findings may lead to an expanded use for antidepressants. Someday high-risk people like stroke patients might take the drugs before suffering depression — just as people now take cholesterol drugs to prevent heart attacks, the lead author said.

The researchers gave low doses of the antidepressant Lexapro to stroke patients. The patients on the drug were 4.5 times less likely to develop depression than patients taking a dummy pill.

More than 700,000 Americans suffer strokes each year and more than one-third will develop depression in the next two years. Stroke patients with depression recover more slowly and are more likely to die, according to previous research.

Experts say strokes may damage parts of the brain affecting mood. Add to that the stress of relearning simple tasks and adjusting to stroke-caused impairments and you've got a recipe for depression.

Lexapro may work by making the chemical serotonin more available in the brain and by promoting brain repair, said Dr. George Bartzokis of the University of California, Los Angeles, who was not involved in the new study.

"Treating the depression may actually help treat the stroke and vice versa," Bartzokis said.
Posted: 5/28/2008 8:45:00 AM

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Patients battle perception of fibromyalgia

From Lubbock Online:

Imagine being in pain most of the time, over most of your body. You go to your doctor, who gives you medicine that doesn't help. You go back to your doctor several times, but the pain never gets better. You begin to feel discouraged, you stop going to the doctor and you start to live with the pain.

"That is the picture of unrecognized fibromyalgia," said Dr. Anne C. Epstein, an internal medicine specialist who has a special interest in fibromyalgia.

Four percent of the population has fibromyalgia, said Dr. Naga Bushan, a rheumatologist. It is more common among women, he said.

Fibromyalgia, as Epstein explained, is a condition in which a person is in pain nearly all the time, and the pain is all over the body. But, she said, it's not a normal pain. It doesn't get better or worse with exercise.

Epstein said there is nothing wrong with the parts of the body that hurt. Instead the disorder is in the chemical messages that the nerves use to send pain sensation to the brain.

It is unclear what causes fibromyalgia, but there are a number of causes that seem to trigger it, Epstein said. Injury, such as from an automobile accident, or stress can bring on fibromyalgia, she said.

But pain isn't the only aspect of fibromyalgia, both doctors said.

Chronic headaches, memory problems, tingling in hands and feet, irritable bowel syndrome and depression may accompany the pain in people with fibromyalgia, Bushan said.

Fibromyalgia is a treatable condition.

Pain unrelated to the fibromyalgia, such as localized pain and muscle and joint pains, must be managed in someone with fibromyalgia. Fatigue must be managed as well.

Several medications have been shown to help people with fibromyalgia, she said. Some antidepressants, anticonvulsants and a new medication, pregabalin (Lyrica) , have been shown to help people with fibromyalgia.

In addition to medication, Epstein said a regular sleep, eating and exercise program can help. Even gentle physical therapy can be beneficial for someone with fibromyalgia, she said.

Bushan said education about available medications and their side effects is a very important part of treatment. He also said a psychologist can help someone with fibromyalgia learn to cope with the condition, as well as help the person to learn relaxation techniques.

Posted: 5/23/2008 9:00:00 AM

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Vitamin D may benefit breast cancer patients

From the Associated Press:

Breast cancer patients with low levels of vitamin D were much more likely to die of the disease or have it spread than patients getting enough of the nutrient, a study found — adding to evidence the "sunshine vitamin'' has anti-cancer benefits.

The results are sure to renew arguments about whether a little more sunshine is a good thing.

The skin makes vitamin D from ultraviolet light. Too much sunlight can raise the risk of skin cancer, but small amounts — 15 minutes or so a few times a week without sunscreen — may be beneficial, many doctors believe.

While the vitamin is found in certain foods and supplements, most don't contain the best form, D-3, and have only a modest on blood levels of the nutrient. That's what matters, the Canadian study found.

Only 24 percent of women in the study had sufficient blood levels of D at the time they were first diagnosed with breast cancer. Those who were deficient were nearly twice as likely to have their cancer recur or spread over the next 10 years, and 73 percent more likely to die of the disease.

"These are pretty big differences,'' said study leader Dr. Pamela Goodwin of Mount Sinai Hospital in Toronto. "It's the first time that vitamin D has been linked to breast cancer progression.''

But people shouldn't start downing supplements, she warned. Experts don't agree on how much vitamin D people need or the best way to get it, and too much can be harmful. They also don't know whether getting more vitamin D can help when someone already has cancer.

The study was released Thursday by the American Society of Clinical Oncology and will be presented at the group's annual meeting later this month.

Also from the Associated Press, Q&A: All about vitamin D.

Posted: 5/16/2008 8:49:00 AM

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