Brain image study: Fructose may spur overeating

This is your brain on sugar — for real. Scientists have used imaging tests to show for the first time that fructose, a sugar that saturates the American diet, can trigger brain changes that may lead to overeating.

After drinking a fructose beverage, the brain doesn't register the feeling of being full as it does when simple glucose is consumed, researchers found.

It's a small study and does not prove that fructose or its relative, high-fructose corn syrup, can cause obesity, but experts say it adds evidence they may play a role. These sugars often are added to processed foods and beverages, and consumption has risen dramatically since the 1970s along with obesity. A third of U.S. children and teens and more than two-thirds of adults are obese or overweight.

All sugars are not equal — even though they contain the same amount of calories — because they are metabolized differently in the body. Table sugar is sucrose, which is half fructose, half glucose. High-fructose corn syrup is 55 percent fructose and 45 percent glucose. Some nutrition experts say this sweetener may pose special risks, but others and the industry reject that claim. And doctors say we eat too much sugar in all forms.

For the study, scientists used magnetic resonance imaging, or MRI, scans to track blood flow in the brain in 20 young, normal-weight people before and after they had drinks containing glucose or fructose in two sessions several weeks apart.

Scans showed that drinking glucose "turns off or suppresses the activity of areas of the brain that are critical for reward and desire for food," said one study leader, Yale University endocrinologist Dr. Robert Sherwin. With fructose, "we don't see those changes," he said. "As a result, the desire to eat continues — it isn't turned off."

What's convincing, said Dr. Jonathan Purnell, an endocrinologist at Oregon Health & Science University, is that the imaging results mirrored how hungry the people said they felt, as well as what earlier studies found in animals.

"It implies that fructose, at least with regards to promoting food intake and weight gain, is a bad actor compared to glucose," said Purnell. He wrote a commentary that appears with the federally funded study in Wednesday's Journal of the American Medical Association.

Researchers now are testing obese people to see if they react the same way to fructose and glucose as the normal-weight people in this study did.

What to do? Cook more at home and limit processed foods containing fructose and high-fructose corn syrup, Purnell suggested. "Try to avoid the sugar-sweetened beverages. It doesn't mean you can't ever have them," but control their size and how often they are consumed, he said.

A second study in the journal suggests that only severe obesity carries a high death risk — and that a few extra pounds might even provide a survival advantage. However, independent experts say the methods are too flawed to make those claims.

The study comes from a federal researcher who drew controversy in 2005 with a report that found thin and normal-weight people had a slightly higher risk of death than those who were overweight. Many experts criticized that work, saying the researcher — Katherine Flegal of the Centers for Disease Control and Prevention — painted a misleading picture by including smokers and people with health problems ranging from cancer to heart disease. Those people tend to weigh less and therefore make pudgy people look healthy by comparison.

Flegal's new analysis bolsters her original one, by assessing nearly 100 other studies covering almost 2.9 million people around the world. She again concludes that very obese people had the highest risk of death but that overweight people had a 6 percent lower mortality rate than thinner people. She also concludes that mildly obese people had a death risk similar to that of normal-weight people.

Critics again have focused on her methods. This time, she included people too thin to fit what some consider to be normal weight, which could have taken in people emaciated by cancer or other diseases, as well as smokers with elevated risks of heart disease and cancer.

"Some portion of those thin people are actually sick, and sick people tend to die sooner," said Donald Berry, a biostatistician at the University of Texas MD Anderson Cancer Center in Houston.

The problems created by the study's inclusion of smokers and people with pre-existing illness "cannot be ignored," said Susan Gapstur, vice president of epidemiology for the American Cancer Society.

A third critic, Dr. Walter Willett of the Harvard School of Public Health, was blunter: "This is an even greater pile of rubbish" than the 2005 study, he said. Willett and others have done research since the 2005 study that found higher death risks from being overweight or obese.

Flegal defended her work. She noted that she used standard categories for weight classes. She said statistical adjustments were made for smokers, who were included to give a more real-world sample. She also said study participants were not in hospitals or hospices, making it unlikely that large numbers of sick people skewed the results.

"We still have to learn about obesity, including how best to measure it," Flegal's boss, CDC Director Dr. Thomas Frieden, said in a written statement. "However, it's clear that being obese is not healthy - it increases the risk of diabetes, heart disease, cancer, and many other health problems. Small, sustainable increases in physical activity and improvements in nutrition can lead to significant health improvements."

___

Online:

Obesity info: http://www.cdc.gov/obesity/data/trends.html

___

Marilynn Marchione can be followed at http://twitter.com/MMarchioneAP

Mike Stobbe can be followed at http://twitter.com/MikeStobbe

Read More..

Greuel faults DWP for bypassing bids on lobbying contracts

The Los Angeles Department of Water and Power repeatedly bypassed its competitive bidding process when it awarded $480,000 in contracts to lobby Sacramento decision-makers, according to a report issued by City Controller Wendy Greuel.

DWP executives issued four no-bid contracts for state lobbying over the last two years, two of them to Mercury Public Affairs, a firm that includes former state Assembly Speaker Fabian Nuñez as one of its partners. No public debate or vote by the utility's five-member Board of Commissioners was required under DWP contracting rules because each agreement was $150,000 or less.

Greuel, who is running for mayor in the March 5 election, said the city utility had "lax controls" over the lobbying contracts and failed to require that two of the firms prepare reports showing what they had accomplished. Mercury also was paid $50,000 for a month of work to help secure passage of legislation on power plant upgrades that had been withdrawn on the first day of the firm's contract, the report found.

"DWP should have terminated" the contract, Greuel wrote.

The inquiry, which was conducted with help from the city Ethics Commission, was launched last year after Greuel's office received a tip alleging that the lobbying work was awarded in exchange for favors. But no evidence of "a 'pay to play' arrangement" was found, her report said.

Mercury received DWP lobbying contracts worth $50,000 in 2010 and $150,000 in 2011, both focused on state government. The firm also received a no-bid, nine-month contract worth $141,000 in 2010 for lobbying at the federal level, which was not examined in the controller's report.

The DWP said the no-bid contracts were reviewed and approved by the city's lawyers. The three lobbying firms helped shape costly state regulations dealing with greenhouse gas emissions and pollution of ocean plant life caused by coastal power plants, utility officials said.

"Their effective advocacy contributed to favorable outcomes that will save LADWP's customers in excess of a billion dollars," the DWP said in a statement.

Mercury Managing Director Roger Salazar said his firm provided strategy for dealing with water quality regulators, as well as state lawmakers. "The legislative process doesn't always end with the pulling of a bill," he added.

The DWP's hiring practices for outside lobbyists attracted scrutiny in 2009 after high-level officials proposed a contract worth up to $2.4 million with Conservation Strategy Group — a Sacramento-based firm that planned to use Mercury and a second company as subcontractors.

The deal would have included the involvement of Nuñez, author of the state's landmark 2006 climate change law. But it was scuttled after DWP commissioners raised questions about the cost. The agency already was paying $15,000 to its in-house lobbyist Cindy Montañez, a former Assembly member who is now a City Council candidate.

DWP officials subsequently began using simple purchase orders instead of competitive bidding procedures to hire lobbying firms. The utility awarded a one-year, $130,000 agreement to Weideman Group in 2010 and a one-year, $150,000 agreement with Conservation Strategy Group in 2011.

Mercury received its $150,000 contract in April 2011, during the same week that Nuñez contributed $3,000 to three of the mayor's legal defense funds and $1,000 to a separate officeholder account belonging to Mayor Antonio Villaraigosa. The defense funds were set up to pay nearly $42,000 in ethics fines levied against Villaraigosa for accepting free tickets to sports and cultural events.

Salazar said there was no link between the contracts and the donations from Nuñez. "Any insinuation that they are connected is absurd and irresponsible," he said.

Last month, the DWP's five-member board awarded a Sacramento lobbying contract worth $1 million annually to KP Public Affairs. That vote was taken after a competitive search process.

david.zahniser@latimes.com

Read More..

Used to Hardship, Latvia Accepts Austerity, and Its Pain Eases

RIGA, Latvia — When a credit-fueled economic boom turned to bust in this tiny Baltic nation in 2008, Didzis Krumins, who ran a small architectural company, fired his staff one by one and then shut down the business. He watched in dismay as Latvia’s misery deepened under a harsh austerity drive that scythed wages, jobs and state financing for schools and hospitals.

But instead of taking to the streets to protest the cuts, Mr. Krumins, whose newborn child, in the meantime, needed major surgery, bought a tractor and began hauling wood to heating plants that needed fuel. Then, as Latvia’s economy began to pull out of its nose-dive, he returned to architecture and today employs 15 people — five more than he had before. “We have a different mentality here,” he said.

Latvia, feted by fans of austerity as the country-that-can and an example for countries like Greece that can’t, has provided a rare boost to champions of the proposition that pain pays.

Hardship has long been common here — and still is. But in just four years, the country has gone from the European Union’s worst economic disaster zone to a model of what the International Monetary Fund hails as the healing properties of deep budget cuts. Latvia’s economy, after shriveling by more than 20 percent from its peak, grew by about 5 percent last year, making it the best performer in the 27-nation European Union. Its budget deficit is down sharply and exports are soaring.

“We are here to celebrate your achievements,” Christine Lagarde, the chief of the International Monetary Fund, told a conference in Riga, the capital, this past summer. The fund, which along with the European Union financed a $7.5 billion bailout for the country at the end of 2008, is “proud to have been part of Latvia’s success story,” she said.

When Latvia’s economy first crumbled, it wrestled with many of the same problems faced since by other troubled European nations: a growing hole in government finances, a banking crisis, falling competitiveness and big debts — though most of these were private rather than public as in Greece.

Now its abrupt turn for the better has put a spotlight on a ticklish question for those who look to orthodox economics for a solution to Europe’s wider economic woes: Instead of obeying any universal laws of economic gravity, do different people respond differently to the same forces?

Latvian businessmen applaud the government’s approach but doubt it would work elsewhere.

“Economics is not a science. Most of it is in people’s heads,” said Normunds Bergs, chief executive of SAF Tehnika, a manufacturer that cut management salaries by 30 percent. “Science says that water starts to boil at 100 degrees Celsius; there is no such predictability in economics.”

In Greece and Spain, cuts in salaries, jobs and state services have pushed tempers beyond the boiling point, with angry citizens staging frequent protests and strikes. Britain, Portugal, Italy and also Latvia’s neighbor Lithuania, meanwhile, have bubbled with discontent over austerity.

But in Latvia, where the government laid off a third of its civil servants, slashed wages for the rest and sharply reduced support for hospitals, people mostly accepted the bitter medicine. Prime Minister Valdis Dombrovskis, who presided over the austerity, was re-elected, not thrown out of office, as many of his counterparts elsewhere have been.

The cuts calmed fears on financial markets that the country was about to go bankrupt, and this meant that the government and private companies could again get the loans they needed to stay afloat. At the same time, private businesses followed the government in slashing wages, which made the country’s labor force more competitive by reducing the prices of its goods. As exports grew, companies began to rehire workers.

Economic gains have still left 30.9 percent of Latvia’s population “severely materially deprived,” according to 2011 data released in December by Eurostat, the European Union’s statistics agency, second only to Bulgaria. Unemployment has fallen from more than 20 percent in early 2010, but was still 14.2 percent in the third quarter of 2012, according to Eurostat, and closer to 17 percent if “discouraged workers” are included. This is far below the more than 25 percent jobless rate in Greece and Spain but a serious problem nonetheless.

Read More..

Jessica Simpson and Kendall & Kylie Jenner Make Readers Smile - and Frown

01/01/2013 at 07:00 PM EST

Splash News Online; Michael Simon/Startraks

What's on the minds of PEOPLE readers this week? We love getting your feedback, and as always, you weighed in – even while celebrating during the holidays – with plenty of reactions to all of our stories.

From Kelly Osbourne's dramatic weight loss to Jessica Simpson's happy baby news to the tragic death of hero surfer Dylan Smith in Puerto Rico, readers responded to what made them happy, what made them laugh out loud and what made them sad this week.

Check out the articles with the top reactions on the site this week, and keep clicking on the emoticons at the bottom of every story to tell us what you think!

Kelly Osbourne says loving herself was the key to her 60-lb. weight loss. She had to get to a place where she respected herself enough to take care of her health – and she emerged a fierce style star who is not afraid to rock a bikini.

Jessica Simpson became a new mom just 8 months ago – so the news that she's expecting baby No. 2 with fiancé Eric Johnson made readers say, "Wow!"

Reality stars Kendall and Kylie Jenner showed off expensive Christmas gifts on Instagram, and their pricey public display turned many readers off. From a pair of Louboutin spike heels to Balenciaga boots with a more than $1,000 price tag, the teens cleaned up with lavish presents that most could only dream about.

Dylan Smith captured our hearts with his heroic efforts during Superstorm Sandy, saving six people on his surfboard. But the Queens, N.Y., lifeguard, 23, who was named one of PEOPLE's Heroes of the Year, drowned on Dec. 24 in a surfing accident off Puerto Rico.

Does the idea of Tom Cruise dating a new woman make you laugh? Maybe. A story that falsely linked the actor romantically to a 26-year-old restaurant manager, had readers clicking LOL. Or maybe the funny part was this quote from a source, who told told PEOPLE: "He's single and will be talking to women – all of whom he won't be instantly dating."

Check back next week for another must-read roundup, and see what readers are reacting to every day here.

Read More..

Brain image study: Fructose may spur overeating

This is your brain on sugar — for real. Scientists have used imaging tests to show for the first time that fructose, a sugar that saturates the American diet, can trigger brain changes that may lead to overeating.

After drinking a fructose beverage, the brain doesn't register the feeling of being full as it does when simple glucose is consumed, researchers found.

It's a small study and does not prove that fructose or its relative, high-fructose corn syrup, can cause obesity, but experts say it adds evidence they may play a role. These sugars often are added to processed foods and beverages, and consumption has risen dramatically since the 1970s along with obesity. A third of U.S. children and teens and more than two-thirds of adults are obese or overweight.

All sugars are not equal — even though they contain the same amount of calories — because they are metabolized differently in the body. Table sugar is sucrose, which is half fructose, half glucose. High-fructose corn syrup is 55 percent fructose and 45 percent glucose. Some nutrition experts say this sweetener may pose special risks, but others and the industry reject that claim. And doctors say we eat too much sugar in all forms.

For the study, scientists used magnetic resonance imaging, or MRI, scans to track blood flow in the brain in 20 young, normal-weight people before and after they had drinks containing glucose or fructose in two sessions several weeks apart.

Scans showed that drinking glucose "turns off or suppresses the activity of areas of the brain that are critical for reward and desire for food," said one study leader, Yale University endocrinologist Dr. Robert Sherwin. With fructose, "we don't see those changes," he said. "As a result, the desire to eat continues — it isn't turned off."

What's convincing, said Dr. Jonathan Purnell, an endocrinologist at Oregon Health & Science University, is that the imaging results mirrored how hungry the people said they felt, as well as what earlier studies found in animals.

"It implies that fructose, at least with regards to promoting food intake and weight gain, is a bad actor compared to glucose," said Purnell. He wrote a commentary that appears with the federally funded study in Wednesday's Journal of the American Medical Association.

Researchers now are testing obese people to see if they react the same way to fructose and glucose as the normal-weight people in this study did.

What to do? Cook more at home and limit processed foods containing fructose and high-fructose corn syrup, Purnell suggested. "Try to avoid the sugar-sweetened beverages. It doesn't mean you can't ever have them," but control their size and how often they are consumed, he said.

A second study in the journal suggests that only severe obesity carries a high death risk — and that a few extra pounds might even provide a survival advantage. However, independent experts say the methods are too flawed to make those claims.

The study comes from a federal researcher who drew controversy in 2005 with a report that found thin and normal-weight people had a slightly higher risk of death than those who were overweight. Many experts criticized that work, saying the researcher — Katherine Flegal of the Centers for Disease Control and Prevention — painted a misleading picture by including smokers and people with health problems ranging from cancer to heart disease. Those people tend to weigh less and therefore make pudgy people look healthy by comparison.

Flegal's new analysis bolsters her original one, by assessing nearly 100 other studies covering almost 2.9 million people around the world. She again concludes that very obese people had the highest risk of death but that overweight people had a 6 percent lower mortality rate than thinner people. She also concludes that mildly obese people had a death risk similar to that of normal-weight people.

Critics again have focused on her methods. This time, she included people too thin to fit what some consider to be normal weight, which could have taken in people emaciated by cancer or other diseases, as well as smokers with elevated risks of heart disease and cancer.

"Some portion of those thin people are actually sick, and sick people tend to die sooner," said Donald Berry, a biostatistician at the University of Texas MD Anderson Cancer Center in Houston.

The problems created by the study's inclusion of smokers and people with pre-existing illness "cannot be ignored," said Susan Gapstur, vice president of epidemiology for the American Cancer Society.

A third critic, Dr. Walter Willett of the Harvard School of Public Health, was blunter: "This is an even greater pile of rubbish" than the 2005 study, he said. Willett and others have done research since the 2005 study that found higher death risks from being overweight or obese.

Flegal defended her work. She noted that she used standard categories for weight classes. She said statistical adjustments were made for smokers, who were included to give a more real-world sample. She also said study participants were not in hospitals or hospices, making it unlikely that large numbers of sick people skewed the results.

"We still have to learn about obesity, including how best to measure it," Flegal's boss, CDC Director Dr. Thomas Frieden, said in a written statement. "However, it's clear that being obese is not healthy - it increases the risk of diabetes, heart disease, cancer, and many other health problems. Small, sustainable increases in physical activity and improvements in nutrition can lead to significant health improvements."

___

Online:

Obesity info: http://www.cdc.gov/obesity/data/trends.html

___

Marilynn Marchione can be followed at http://twitter.com/MMarchioneAP

Mike Stobbe can be followed at http://twitter.com/MikeStobbe

Read More..

Brown plans extensive changes for school funding in 2013

SACRAMENTO — Gov. Jerry Brown will push this year to upend the way schools are funded in California, hoping to shift more money to poorer districts and end requirements that billions of dollars be spent on particular programs.

Brown said he wants more of the state's dollars to benefit low-income and non-English-speaking students, who typically are more expensive to educate.

"The reality is, in some places students don't enjoy the same opportunities that people have in other places," the governor said in an interview. "This is a way to balance some of life's chances."

He would also scale back — and possibly eliminate — dozens of rules that districts must abide by to receive billions in state dollars. Some of those requirements, such as a mandate to limit class size, have been suspended amid Sacramento's recurrent budget problems but are set to resume by 2015.

Brown and his aides are keeping most details under wraps. But advisers say his proposals, part of the budget blueprint to be unveiled early this month, will amount to the most extensive changes in decades in the relationship between school districts and state government.

His intentions are already raising concerns among school administrators, district officials and labor unions. The governor postponed earlier plans to push for the changes when the discord threatened to distract from his campaign for higher taxes. Voters approved the tax hikes in November, averting billions of dollars in education cuts.

Now, the transformation of school funding is at the top of his agenda. He says his goal is more local control.

"What the state has done for 40 years is develop one new program after another to compensate for underperforming" schools, he said. "What we have now is command and control issuing from headquarters in Sacramento."

Scores of programs set up by state mandate — for smaller classes, bilingual education and summer school, for example — have their own pots of money sent from Sacramento to pay for them. ¿The Public Policy Institute of California found that nearly 40% of every dollar sent to schools from both the state and federal governments is earmarked for such a purpose.

The programs vary in size and scope: $4.5 million to meet the needs of Native American students, $10 million to improve school Internet access, more than $618 million set aside for school buses, etc.

According to Brown's Department of Finance, 56 such programs received a total of $11.8 billion in state funds last year. ¿The result, the governor says, is a bloated school bureaucracy that takes money away from core instruction.

"You have to have administrators at the state level, district level and at the school level who are engaged in making sure this money is used for what it's supposed to be used for," Brown said. "This constant articulation of rules is a world unto itself that is not directly supporting the teacher in the classroom."

But many of the programs are popular with parents and various interest groups and have staunch defenders in the Capitol. They say lifting restrictions on how schools spend their money could hurt struggling students.

In recent years, state lawmakers have offered districts some flexibility to cope with rounds of budget cuts. The results, some say, have not always been good, leading to larger classes and sharp reductions in programs for adults trying to earn a high school degree.

Since 2008, the average class size in kindergarten through third grade has grown from 20 to 23, among the largest in the nation, according to a study from the Public Policy Institute of California. During the same period, the average class size elsewhere in the country remained at around 15 students.

In addition, "since schools have been given greater flexibility, adult education ... has been decimated throughout the state," said Jeff Freitas, secretary-treasurer of the California Federation of Teachers. "You can't just give the locals carte blanche with the money."

Shifting money to poorer schools at the expense of wealthier ones is also certain to stir protest.

Under a similar proposal the governor floated last year, the Department of Finance estimated that Compton Unified schools would see an uptick of more than $4,700 per pupil by the 2017-18 school year. Manhattan Beach Unified would get a per-student increase of just $681.

Those who have met with Brown's top education aides expect the governor to propose a similar formula in January, asking districts to account for the expenditures to make sure the funds serve higher-needs students.

Adonai Smith, a lobbyist for the Assn. of California School Administrators, said his members would not support a plan that amounts to a "redistribution of resources."

The governor says that even if funding is tweaked to favor more poor students and English learners, all schools will receive more money now that state revenue is on the uptick.

"I want to align more closely the money schools receive with the problems that teachers encounter," Brown said. "When somebody's teaching in Compton, it's a much bigger challenge than teaching in Beverly Hills."

anthony.york@latimes.com

Read More..

Movers roundup: Facebook, Best Buy

Among the stock activity stories for Monday, Dec. 31, from AP Business News:

— Shares of Facebook Inc. rose after an analyst said advertising spending was picking up on the Internet social network and raised his rating on its stock.

— Shares of Best Buy Co. rose on light volume as the struggling electronics retailer closed out a rocky year.

— Shares of Duff & Phelps Corp. rose on news that the company had agreed to be acquired.

Social Media News Headlines – Yahoo! News

Title Post: Movers roundup: Facebook, Best Buy
Rating:
100%

based on 99998 ratings.
5 user reviews.
Author: Fluser SeoLink
Thanks for visiting the blog, If any criticism and suggestions please leave a comment

Read More..

Eric Prydz Picks a New Year's Eve Playlist

By Dahvi Shira

12/31/2012 at 06:50 PM EST

Unfortunately not everyone can be in Las Vegas when the ball drops this year, but Eric Prydz is bringing the party to PEOPLE.com readers in advance.

The DJ and producer, 36 – best known for his 2004 hit single, "Call on Me" – is playing a three-hour extended set at Surrender Nightclub on Monday, and he's sharing the tracks he's most excited to spin, including songs from his album, Eric Prydz Presents Pryda.

"I love to play on New Year's Eve because it has that special tension in the air," Prydz says. "People are so excited about the new year coming, leaving the old behind and starting fresh. It's also the perfect excuse to blow off some steam after that long Christmas with family. Let's make New Year's Eve 2013 one to remember!"

Recently scoring a Grammy nomination for his remix of M83's "Midnight City," Prydz, who is relocating to Los Angeles, already predicts 2013 "is going to be an amazing year."

As for his evening playlist, he plans to "blend a lot of the highlights from the past year with classics and brand new music set to blow up in 2013."

Check out part of his planned set below:

• Jeremy Olander – "Let Me Feel"
"This tune has spring/summer of 2013 written all over it. It's such a feel good track!"
Listen here

• Fehrplay – "I Can't Stop It"
"Fehrplay had a great year in 2012 and is set to blow up in 2013. This is his forthcoming single on my Pryda Friends imprint. The first time I heard this record, it took me somewhere really nice."
Listen here

• Rone – "Parade (Dominik Eulberg Remix)"
"Every now and then there is a track that comes along and blows your mind. This is one of those tracks. Nine minutes of pure emotion."
Listen here

• Eric Prydz – "Every Day"
"This one has been huge for me this summer and fall. Enough said."
Listen here

• Pachanga Boys – "Time"
"This was the soundtrack of my summer 2012. And I'm sure I'm not alone on that one."
Listen here

• Para One – "When the Night (Breakbot Remix)"
"I've been a fan of Para One's music for many years and this one is no exception. This song has a great retro vibe with a modern touch from Breakbot on this remix."
Listen here

• Pig & Dan – "Savage"
"This is a real club stomper. I can't wait to play this one out."
Listen here

• Pryda – "The End"
"I had to throw this one in. It's one of the biggest releases on Pryda to date."
Listen here

• Green Velvet & Harvard Bass – "Lazer Beams"
"Hit me with those laser beams!"
Listen here.

• Deetron feat. Hercules & Love Affair – "Crave (Deetron cRAVE Dub)"
"This song is a dark, big room destroyer."
Listen here

Read More..

Clinton's blood clot an uncommon complication

The kind of blood clot in the skull that doctors say Hillary Rodham Clinton has is relatively uncommon but can occur after an injury like the fall and concussion the secretary of state was diagnosed with earlier this month.

Doctors said Monday that an MRI scan revealed a clot in a vein in the space between the brain and the skull behind Clinton's right ear.

The clot did not lead to a stroke or neurological damage and is being treated with blood thinners, and she will be released once the proper dose is worked out, her doctors said in a statement.

Clinton has been at New York-Presbyterian Hospital since Sunday, when the clot was diagnosed during what the doctors called a routine follow-up exam. At the time, her spokesman would not say where the clot was located, leading to speculation it was another leg clot like the one she suffered behind her right knee in 1998.

Clinton had been diagnosed with a concussion Dec. 13 after a fall in her home that was blamed on a stomach virus that left her weak and dehydrated.

The type of clot she developed, a sinus venous thrombosis, "certainly isn't the most common thing to happen after a concussion" and is one of the few types of blood clots in the skull or head that are treated with blood thinners, said neurologist Dr. Larry Goldstein. He is director of Duke University's stroke center and has no role in Clinton's care or personal knowledge of it.

The area where Clinton's clot developed is "a drainage channel, the equivalent of a big vein inside the skull — it's how the blood gets back to the heart," Goldstein explained.

It should have no long-term consequences if her doctors are saying she has suffered no neurological damage from it, he said.

Dr. Joseph Broderick, chairman of neurology at the University of Cincinnati College of Medicine, also called Clinton's problem "relatively uncommon" after a concussion.

He and Goldstein said the problem often is overdiagnosed. They said scans often show these large "draining pipes" on either side of the head are different sizes, which can mean blood has pooled or can be merely an anatomical difference.

"I'm sure she's got the best doctors in the world looking at her," and if they are saying she has no neurological damage, "I would think it would be a pretty optimistic long-term outcome," Broderick said.

A review article in the New England Journal of Medicine in 2005 describes the condition, which more often occurs in newborns or young people but can occur after a head injury. With modern treatment, more than 80 percent have a good neurologic outcome, the report says.

In the statement, Clinton's doctors said she "is making excellent progress and we are confident she will make a full recovery. She is in good spirits, engaging with her doctors, her family, and her staff."

___

Online:

Medical journal: http://dura.stanford.edu/Articles/Stam_NEJM05.pdf

Read More..

Ruling over bumper-car injury supports amusement park

SAN FRANCISCO — The California Supreme Court, protecting providers of risky recreational activities from lawsuits, decided Monday that bumper car riders may not sue amusement parks over injuries stemming from the inherent nature of the attraction.

The 6-1 decision may be cited to curb liability for a wide variety of activities — such as jet skiing, ice skating and even participating in a fitness class, lawyers in the case said.

"This is a victory for anyone who likes fun and risk activities," said Jeffrey M. Lenkov, an attorney for Great America, which won the case.

But Mark D. Rosenberg, who represented a woman injured in a bumper car at the Bay Area amusement park, said the decision was bad for consumers.

"Patrons are less safe today than they were yesterday," Rosenberg said.

The ruling came in a lawsuit by Smriti Nalwa, who fractured her wrist in 2005 while riding in a bumper car with her 9-year-old son and being involved in a head-on collision. Rosenberg said Great America had told ride operators not to allow head-on collisions, but failed to ask patrons to avoid them.

The court said Nalwa's injury was caused by a collision with another bumper car, a normal part of the ride. To reduce all risk of injury, the ride would have to be scrapped or completely reconfigured, the court said.

"A small degree of risk inevitably accompanies the thrill of speeding through curves and loops, defying gravity or, in bumper cars, engaging in the mock violence of low-speed collisions," Justice Kathryn Mickle Werdegar wrote for the majority. "Those who voluntarily join in these activities also voluntarily take on their minor inherent risks."

Monday's decision extended a legal doctrine that has limited liability for risky sports, such as football, to now include recreational activities.

"Where the doctrine applies to a recreational activity," Werdegar wrote, "operators, instructors and participants …owe other participants only the duty not to act so as to increase the risk of injury over that inherent in the activity."

Amusement parks will continue to be required to use the utmost care on thrill rides such as roller coasters, where riders surrender control to the operator. But on attractions where riders have some control, the parks can be held liable only if their conduct unreasonably raised the dangers.

"Low-speed collisions between the padded, independently operated cars are inherent in — are the whole point of — a bumper car ride," Werdegar wrote.

Parks that fail to provide routine safety measures such as seat belts, adequate bumpers and speed controls might be held liable for an injury, but operators should not be expected to restrict where a bumper car is bumped, the court said.

The justices noted that the state inspected the Great America rides annually, and the maintenance and safety staff checked on the bumper cars the day Nalwa broke her wrist. The ride was functioning normally.

Reports showed that bumper car riders at the park suffered 55 injuries — including bruises, cuts, scrapes and strains — in 2004 and 2005, but Nalwa's injury was the only fracture. Nalwa said her wrist snapped when she tried to brace herself by putting her hand on the dashboard.

Rosenberg said the injury stemmed from the head-on collision. He said the company had configured bumper rides in other parks to avoid such collisions and made the Santa Clara ride uni-directional after the lawsuit was filed.

Justice Joyce L. Kennard dissented, complaining that the decision would saddle trial judges "with the unenviable task of determining the risks of harm that are inherent in a particular recreational activity."

"Whether the plaintiff knowingly assumed the risk of injury no longer matters," Kennard said.

maura.dolan@latimes.com

Read More..