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CSI: Without A Clue - A New Report Forces Police and Judges to Rethink Forensic Science

From the New York Post:

Dust off the history of forensic science and you'll find Henry Faulds, a Scottish physician who in the late 19th century discovered that powder could make the perspiration from fingertips visible, and thus possible to study and match. In 1880, Faulds was the first to link the fingerprint from a crime scene to a perpetrator, and others who were thinking along the same lines implemented the method at Scotland Yard, developing a classification system and a large collection of fingerprints.

In 1903, fingerprint evidence got a boost in the United States when two convicts with the same name and same physical measurements were found in Fort Leavenworth prison. Only their fingerprints clearly distinguished them.

Eight years later, the Illinois Supreme Court became the first American court to evaluate the methodology. An intruder had shot and killed a man, Clarence Hiller, in his home. Thomas Jennings was apprehended, wearing bloodstained clothing and carrying a revolver that was matched to unused cartridges from Hiller's residence. In addition, four fingerprints were found in fresh paint on a fence near the window through which the intruder had entered, and four experts testified that Jennings was the source. The jury convicted Jennings, but his attorney appealed, challenging the admissibility of fingerprint evidence.

Since fingerprints had been admitted in Great Britain, and the method was commonly use by law enforcement, the Illinois Supreme Court ruled that there was a scientific basis. "Expert evidence is admissible," the court stated, "when the witnesses offered as experts have peculiar knowledge or experience not common to the world, which renders their opinions founded on such knowledge of experience, an aid to the court or jury in determining questions at issue." The sentence stood and Jennings was hanged.

Yet fans of "CSI" and other popular forensic science television programs today may be surprised to learn that the court never demanded, and the examiners had not produced, clear evidence of the reliability of fingerprints. Accepting them into court became a simple matter of "the experts know," but nothing was used to back up that expertise.

No one, moreover, decided how many points of comparisons were necessary to determine a conclusive fingerprint match. No one set standards or controls. In fact, more than 100 years after the first crime was solved with a fingerprint, no one completely has proved even the basic assumption: that everyone's fingerprint is unique.

Now such assumptions are being questioned - and with it may come a radical change in how forensic science is used by police departments and prosecutors.

For two years, a panel of experts brought together by the National Academy of Science's National Research Council examined the country's forensic science system. Their report, released two weeks ago, says it's in need of an overhaul - including mandatory accreditation, a national oversight committee and universal standards.

This call for "best practice" reform is nothing new; it just confirms earlier evaluations and has no binding effect. But certainly defense attorneys will be using the report to call into question even the most commonly used forensic tests.

Unfortunately, this expensive plan for a forensic makeover arrives just when there's little money to spare. While the need for reform is serious, the core component - a national institute - can hardly be mounted right away. Even if funding arrived tomorrow, an accrediting body requires years of planning and coordination.

Should we expect a wave of convicted criminals to be freed based on the NAS report? Certainly there will be more defense attorneys looking at appeals, but there's one thing to keep in mind: To say that a method has not proven itself to be a science is not the same as proving that it isn't. Suspects will still need to convince a judge or a jury that something went wrong.

The American Society of Crime Lab Directors advised its members last week to prepare for "an intense focus on the science of what we do" in the courtroom. But it added that changing the perception that science is lacking "can only be accomplished through engagement, collaboration, and healthy debate and not by defensive and dismissive postures or positions." In the big picture, the burden is squarely on education for a new generation. Dr. Michael Rieders, director for Arcadia University's master of forensic science program, is optimistic. "We are now graduating students into the forensic community who have been instilled with the standards of science in the pursuit of justice. They know what science is and what it isn't, so with respect to the future, we're off to a good start." The real issue is trust; people want to feel safe. That means correct decisions by investigators and attorneys - a process that depends on unbiased procedures, qualified experts, and proven facts. No more lip print mistakes, no more pronouncements of unerring certainty. If resources are forthcoming, the NAS report crystallizes changes that could make forensic science what its pioneers envisioned: a dependable beacon of justice.

Posted: 3/13/2009 11:05:00 AM

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Anna Nicole Smith's boyfriend, doctors charged

From the Associated Press:

Anna Nicole Smith's lawyer-turned-boyfriend and a doctor surrendered to face charges that they conspired to provide the Playboy Playmate with thousands of prescription pills before her 2007 fatal overdose. A second doctor also is accused.

Howard K. Stern and Dr. Sandeep Kapoor were released late Thursday after posting $20,000 bond. Charges include conspiracy, unlawfully prescribing a controlled substance and prescribing, administering or dispensing a controlled substance to an addict, authorities said.

Dr. Khristine Eroshevich was expected to surrender Monday. Her attorney, Adam Braun, acknowledged she wrote some of the prescriptions using fictitious names for Smith, but it wasn't intended to commit fraud.

"It was done for privacy reasons," Braun told The Associated Press. "She did the best she could under difficult circumstances in the best interest of the patient."

Prosecutors see it differently.

"These individuals repeatedly and excessively furnished thousands of prescription pills to Anna Nicole Smith, often for no legitimate medical purpose," California Attorney General Jerry Brown said in a statement Thursday. His office was expected to release more details about the case at a news conference Friday.

Prosecutors said the doctors gave thousands of prescription drugs — including opiates and sedatives — to Stern, who then gave them to Smith.

The prescriptions were issued between June 2004 and January 2007, just weeks before her death on Feb. 8, 2007.

Medical examiners have said Eroshevich, a Los Angeles psychiatrist and friend of Smith's, authorized all 11 of the prescription medications found in the Hollywood, Fla., hotel room where the 39-year-old model was found unresponsive shortly before her death.

The criminal complaint also alleges Kapoor gave her excessive amounts of sleep aids, opiates, muscle relaxants and methadone-like drugs used to treat addiction, knowing she was an addict. Kapoor saw Smith in the spring of 2006 when she was treated at a Los Angeles County hospital for opiate withdrawal and prenatal care for the pregnancy of her daughter Dannielynn, according to the complaint.

Rumors swirled for weeks after Smith's death, but police cleared those around her of any wrongdoing and medical examiners ruled she died of an accidental overdose.

Documents obtained by the AP after her death showed most of the drugs found in her hotel room were prescribed in Stern's name and none were prescribed in Smith's own name.

The quantity was staggering. More than 600 pills — including about 450 muscle relaxants — were missing from prescriptions that were no more than 5 weeks old. Ultimately, it was a syrup — the powerful sleeping aid chloral hydrate — blamed with tipping the balance in the toxic mix of drugs and causing her death.

Posted: 3/13/2009 10:58:00 AM

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Antidepressants Linked to Sudden Cardiac Death in Women


A new study has concluded that women with no history of cardiac problems but who use antidepressants are at an increased risk for sudden cardiac death (SCD). HealthDay News reports that the reason for the link remains unknown, according to the researchers whose findings were published in the Journal of the American College of Cardiology.

“We suspect that their use is a marker for people with worse depression,” explained the study’s lead author Dr. William Whang, an assistant professor of clinical medicine at Columbia University Medical Center in Manhattan. “The elevated risk seems more specific for antidepressant use, but that use may well be a marker of more severe symptoms,” quoted HealthDay News. Whang noted that the link seemed to be physiological saying, “We found that women who had worse depressive symptoms had higher rates of risk factors such as hypertension, diabetes, and smoking.” As a matter-of-fact, the report indicated, said HealthDay News, women with clinical depression were at a two-fold risk of experiencing SCD.

The researchers looked at over 63,000 American women in the Nurses Health Study, said HealthDay, with no history of previous stroke or heart disease from 1992 to 2004, said Natural News, and found a link between depression and heart risk; however, the link between SCD and antidepressants was significantly more pronounced. Also, antidepressant use was not linked with an increased risk of cardiac arrest over fatal heart disease, only with the increased risk of SCD, reported HealthDay News.

Natural News pointed out that the study found women with the highest risk for SCD and fatal coronary heart disease (CHD) expressed the most severe depression symptoms or were on antidepressant therapy. “We can’t say antidepressant medications were the cause of higher risk of sudden cardiac death. It may well be that use of antidepressants is a marker for worse depression,” said Whang, reported Natural News.

SSRI antidepressants, such as Prozac, Lexapro, Zoloft, and Paxil have been described as safe for the heart; however, a number of cardiovascular side effects, such as irregular heart rhythms and potentially lethal arrhythmias, are known to occur in some taking these medications, said Natural News, noting that Prozac maker, Eli Lily, lists a variety of adverse cardiac symptoms on the official package insert for physicians.

Posted: 3/12/2009 10:52:00 AM

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Study: Ecstasy may help treat PTSD

From MarketWatch:

Ecstasy may help sufferers of post-traumatic stress disorder learn to deal with their memories more effectively, researchers in Norway suggest.

"A goal during exposure therapy for PTSD is to recall distressing experiences while at the same time remaining grounded in the present," study authors Pal-Orjan Johansen and Teri Krebs, based at the Norwegian University of Science and Technology said in a statement. "Emotional avoidance is the most common obstacle in exposure therapy for PTSD, and high within-session emotional engagement predicts better outcome."

Psychiatrists who have administered MDMA -- the pharmaceutical version of Ecstasy -- to anxiety patients have noted it promotes emotional engagement; strengthens the bond between the patient and doctor; decreases emotional avoidance and improves tolerance for recall and processing of painful memories.

Johansen and Krebs suggest there are three possible biological reasons for why ecstasy could help individuals with PSTD -- ecstasy is known to increase the release of the hormone oxytocin, which is involved in trust, empathy and social closeness. It also acts in two brain regions to inhibit the automatic fear response and increase emotional control and thirdly, ecstasy increases the release of two other hormones, noradrenaline and cortisol, essential to triggering emotional learning, including the process that leads to fear extinction, on which therapy for PTSD relies.

The findings are published in Journal of Psychopharmacology.
Posted: 3/10/2009 4:05:00 PM

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No BPA For Baby Bottles In U.S

From The Washington Post:

The six largest manufacturers of baby bottles will stop selling bottles in the United States made with bisphenol A, a controversial chemical widely used in plastics but increasingly linked to a range of health effects.

The manufacturers declared their intentions after Connecticut Attorney General Richard Blumenthal, joined by the attorneys general in Connecticut and New Jersey, wrote to the bottle makers and asked them to voluntarily stop using the chemical.

"The evidence seems too clear and emphatic and unequivocal to say we should simply permit this stuff to go into children on a massive scale," Blumenthal said yesterday. "And there's no reason for it, because there are substitutes available."

Bisphenol A, in commercial use since the 1950s, is found in a wide variety of everyday items, including plastic beverage containers, eyeglasses and compact discs. It is ubiquitous: One recent federal study estimated that the chemical is found in the urine of 93 percent of the U.S. population.

Commonly called BPA, the chemical mimics the hormone estrogen and may disrupt the body's endocrine system. Public health advocates say it poses a particular danger to fetuses, infants and children because BPA can interfere with cell function at a point when their bodies are still developing.

Over the past decade, more than 130 studies have linked BPA to breast cancer, obesity and other disorders. In September, the study of BPA in humans found adults with higher levels of bisphenol A had elevated rates of heart disease, diabetes and liver abnormalities. Last year, researchers at the Yale School of Medicine linked BPA to problems with brain function and mood disorders in monkeys.

Much of the new research suggests that BPA has an effect at very low doses -- lower than the current safety standard set by the Food and Drug Administration. The most prominent finding was by the National Toxicology Program, part of the National Institutes of Health, which reported last year that there is "some concern" BPA may affect the brain and behavioral development of fetuses, infants and young children.

The FDA has maintained that BPA is safe, relying largely on two studies that were funded by the chemical industry. In October, the agency was faulted by its own panel of independent science advisers, who said the FDA's position on BPA was scientifically flawed. As a result, the agency is revisiting its position on the chemical.

The American Chemistry Council, an industry group that represents companies that make BPA, yesterday repeated the FDA's position that BPA is safe at current levels in food bottles and containers.

Consumer concern about the chemical has placed increasing pressure on manufacturers and retailers. Late last year, Babies R Us and other major retailers told suppliers they would no longer stock baby bottles made with BPA.

Several bottle makers contacted by Blumenthal said they were already ridding their product lines of the chemical.

"We made a business decision to move out of BPA," said Shannon Jenest of Philips Avent, which is number one in U.S. dollar sales of baby bottles.

Philips Avent stopped selling baby products with BPA on Dec. 31 in North America but continues to market them overseas, she said. "We felt like we had hit a tipping point with our consumers and with our retailers," Jenest said. "Babies R Us was banning it, Target was going to, CVS was going to, and so the distribution channels were lessening and lessening."

Blumenthal said he is gathering support from other attorneys general to demand that manufacturers take BPA out of infant formula cans and all food and beverage containers.

Richard Wiles, executive director of the Environmental Working Group, an advocacy organization, said the states are acting because the federal government has refused to do so.

Posted: 3/10/2009 8:37:00 AM

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Antidepressant, Sleeping-Pill Sales Get No Rest in Recession

From Advertising Age:

You snooze, you lose? Not for some pharmaceutical companies seeing big sales jumps for sleep aids and antidepressants, despite lower marketing spending in both categories.

According to IMS Health, prescriptions for major sleeping-pill brands rose 7% last year, while antidepressant-brand prescriptions jumped 15%.

The economy, it appears, is keeping us up at night, according to a new "Sleep In America" poll out this week from the Washington-based National Sleep Foundation. Some 31% of respondents said they are losing sleep over the dismal economy and their own financial situation.

Even more surprising, prescriptions are up despite a dramatic decrease in marketing -- in the case of sleeping aids, by hundreds of millions of dollars.

Dr. Robert Aronson, a sleep specialist at Cardinal Sleep Center in Joliet, Ill., said there is a correlation between the falling economy, a lack of sleep and the uptick in prescriptions and purchase of sleep aids -- and he doesn't see it ending soon. "The economic problems are likely to be protracted," he said. But, he added, continual use of sleep aids or antidepressants are "not good because sedative hypnotics are best used for short-term insomnias due to transient stressors."

Sales of antidepressants in 2008 were up 2% compared to 2007. While prescriptions were up, dollar sales of prescription sleep aids were down 30% in '08 vs. '07 because the patent expired on Ambien (which was succeeded by Ambien CR). Sales were also hurt by the introduction of the cheaper generic Zolpidem, not to mention the emergence of more wallet-friendly over-the-counter sleep medications such as Unisom.

The total over-the-counter market for sleep aids reached $604 million in 2008, an increase of 9% over 2007 according to Packaged Facts, a division of Rockville, Md.-based Market Research Group.

Posted: 3/6/2009 9:48:00 AM

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AstraZeneca Warned Japanese Doctors of Diabetes Link


AstraZeneca Plc pushed salespeople to tell U.S. doctors its antipsychotic drug Seroquel didn’t cause diabetes more than two years after warning physicians in Japan of possible links to the disease, internal documents show.

The London-based drugmaker issued a letter to Japanese physicians in November 2002 that said AstraZeneca had received 12 reports that Seroquel users were diagnosed with high blood-sugar levels over a 21-month period, according to company documents unsealed last week in connection with litigation over the drug.

“Since February 2001 when Seroquel started to be marketed, 12 serious cases (including 1 death) of hyperglycaemia, diabetic ketoacidosis and diabetic coma where causality with the drug could not be ruled out have been reported,” AstraZeneca officials said in the letter.

Almost three years later, AstraZeneca sales managers were instructing company representatives to tell U.S. physicians that “the available data has not established a causal link between diabetes and Seroquel,” according to a transcript of an August 2005 voice-mail unsealed last week.

More than 15,000 patients have sued AstraZeneca, claiming the company withheld information about links between diabetes and Seroquel use from doctors and patients. Many of the lawsuits also claim AstraZeneca promoted Seroquel, approved by the U.S. Food and Drug Administration for schizophrenia and bipolar disorder, for unapproved uses.

AstraZeneca has denied wrongdoing in its handling of the drug and is vowing to fight the lawsuits in court.

AstraZeneca officials said today they sent the letter to Japanese doctors at the request of that nation’s regulators.

“Every country has a different regulatory administration with different regulatory standards and requirements,” Tony Jewell, an AstraZeneca spokesman, said in an e-mailed statement. “AstraZeneca marketing companies are required to comply with the rules and regulations of the regulatory authorities in the country in which they operate.”

Sidney Wolfe, director of Washington-based Public Citizen’s health-research group and a member of the FDA’s drug safety committee, called AstraZeneca’s failure to make a similar disclosure to American doctors “irresponsible.”

Jewell noted that under U.S. law, drug company salespeople are required to use information from “the label approved by the FDA.” AstraZeneca officials contend that Seroquel’s warning label provided “adequate and appropriate information” about possible diabetes-related side effects.

“When first approved, the Seroquel labeling alerted physicians that diabetes mellitus, hyperglycemia, and weight gain had been observed in clinical trials,” Jewell said in his e- mail. “We have continued to update the label on these topics as the science has developed.”

AstraZeneca agreed to release more than 100 files with information about the drug last week after Bloomberg News filed a motion in federal court in Orlando, Florida, to unseal records in the case. All federal-court suits over the drug have been consolidated in Orlando. The letter to Japanese doctors became publicly available when it appeared on the court’s electronic docket on Feb. 27.

In the letter, AstraZeneca officials noted that the 12 diabetes-related cases emerged from 130,000 patients who had taken Seroquel through the end of September 2002. That means only 0.009 percent of those who had taken the drug reported any diabetes-related problems.

The company advised Japanese doctors not to prescribe the drug for diabetic patients and to ensure that users monitor their blood-sugar levels, according to the letter. Seroquel’s label didn’t advise U.S. doctors to monitor blood-glucose levels until January 2004, Jewell said.

In the 2005 voice-mail, AstraZeneca manager Christine Ney offered the company’s U.S. sales reps information that they could use to “neutralize customer objections to Seroquel’s weight and diabetes profile.”

Ney noted that while “hyperglycemia-related adverse events have been reported in patients taking atypical antipsychotics, including Seroquel, to date the available data has not established a causal link between Seroquel and diabetes,” according to the transcript.

Ney also suggested that salespeople “refocus” doctors away from questions about Seroquel’s links to diabetes to its “Trusted Tolerability profile,” according to the transcript.

Posted: 3/3/2009 1:50:00 PM

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Fewer kids have high lead levels than 20 years ago

From the Associated Press:

In a stunning improvement in children's health, far fewer kids have high lead levels than 20 years ago, new government research reports — a testament to aggressive efforts to get lead out of paint, water and soil.

Lead can interfere with the developing nervous system and cause permanent problems with learning, memory and behavior. Children in poor neighborhoods have generally been more at risk because they tend to live in older housing and in industrial areas.

Federal researchers found that just 1.4 percent of young children had elevated lead levels in their blood in 2004, the latest data available. That compares with almost 9 percent in 1988.

"It has been a remarkable decline," said study co-author Mary Jean Brown of the Centers for Disease Control and Prevention. "It's a public health success story."

The 84 percent drop extends a trend that began in the 1970s when efforts began to remove lead from gasoline. The researchers credited continuing steps to reduce children's exposure to lead in old house paint, soil, water and other sources.

The study was being released Monday in the March edition of the journal Pediatrics. It is based on nearly 5,000 children, ages 1 to 5, who were part of a periodic government health survey.

The government considers levels of at least 10 micrograms of lead per deciliter of blood to be elevated, although research has shown that levels less than that can still cause problems including attention and reading difficulties. There is no known "safe" level, the study authors noted.

Dr. Bruce Lanphear, a lead specialist at Cincinnati Children's Hospital Medical Center who wasn't involved in the government study, said lead levels have probably continued to decline since 2004. But the findings show "we need to still continue to be aggressive" with prevention efforts, he said.

Lead-based paint in old housing, which can contaminate house dust and soil, is the main source. Children also can be exposed to lead in water, mostly from old plumbing pipes, as well as toys and certain folk medicines.

Posted: 3/2/2009 9:50:00 AM

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