States’ use of tobacco money questioned

NEW YORK

The American Lung Association is criticizing states for using tobacco settlement money to cover budget deficits instead of anti-smoking programs.

A report released yesterday found that most states spend only a fraction of what federal health officials have recommended on measures like anti-tobacco programs at schools and counseling to help people quit smoking.

In many cases, the association found, states have used money from the tobacco settlement to plug budget gaps. The sluggish economy and new anti-terrorism spending have opened huge deficits for many states.

In 1998, tobacco companies agreed to pay $206 billion over 25 years to 46 states to settle lawsuits. Four states later settled separately for a total of $40 billion.

The association gave 32 states and the District of Columbia a grade of “F” for weak spending on anti-tobacco programs. Only six states earned an “A.”

“They are raiding tobacco funds to cover budget shortfalls and denying themselves a sound investment in their citizens’ health,” said John Kirkwood, the association’s chief executive.

Joan Henneberry, director of health policy for the National Governors Association, pointed out states are under unprecedented fiscal pressure, much of it brought about by skyrocketing Medicaid costs.

“States are in such a bad financial position now, if they don’t tap into other sources, they’re going to have to cut benefits and eligibility in Medicaid,” she said. “That doesn’t help with anti-smoking efforts either.”

The report painted a brighter picture of states’ use of cigarette taxes. Many states have raised taxes on cigarettes as a way of generating quick money, and the association said the move is discouraging smoking.

Eight states more than doubled their tobacco tax in 2002, the report said, and 14 now have a per-pack tax of $1 or more. Massachusetts taxes cigarettes at $1.51 per pack, highest in the nation.

GOP picks New York for 2004 convention

NEW YORK

The Republican Party yesterday chose the city that suffered the heaviest blow on Sept. 11 to host the 2004 GOP national convention.

After an intensive monthslong courtship of GOP leaders that included a Broadway show and breakfast at Tiffany’s, New York City beat out New Orleans and Tampa, Fla.

Party strategists said the decision to come to New York City – where Democrats outnumber Republicans 5-1 – is a clear sign President Bush and the party believe the GOP can carry the state in 2004 and wrest its 31 electoral votes from the Democrats.

No Republican presidential candidate has won the state since Ronald Reagan in 1984. And while New York City has hosted the Democrats several times, as recently as 1992, it has never been the site of a Republican convention.

“If the Republican Party wants to make the case that they can represent everybody, this is the place to go and do it,” Republican Mayor Michael Bloomberg said.

Republican Gov. George Pataki said the selection also demonstrates New York has recovered from the terrorist attacks that killed 2,800 people. It is “yet another sign of the confidence people have in New York and sends a message to America and the world that New York is back,” Pataki said.

The convention is expected to draw nearly 50,000 people and generate more than $150 million in economic activity for the city, according to the mayor’s office. New York has agreed to set aside 22,000 hotel rooms for those attending the convention at Madison Square Garden.

Magnet used in new brain surgery method

WASHINGTON

Demetrius Lopes snaked a thin wire with a tiny magnet on its tip into an artery in Paul Kelsey’s groin and threaded it all the way up into his brain.

Aided by a helmet-shaped magnet hung over Kelsey’s head, Lopes guided the wire through twists and turns deep in the brain, finally reaching swollen blood vessels that were giving the Chicago man double vision. A few squirts of glue to seal off the excess blood flow, and Lopes pulled the wires back out – surgery done.

Normally, curing Kelsey’s disorder would require operating through a hole drilled in his skull. But doctors now are creating ways to fix brains from the inside, no drilling required. And using magnets as a guide, while still highly experimental, could let them go into deeper, trickier areas than ever imagined to treat aneurysms, strokes and other serious brain ailments.

Indeed, neurology may be poised for a shift as important as cardiology underwent years ago when heart specialists began using balloons instead of bypass surgery to unclog heart arteries.

The field is called endovascular surgery, operating by snaking through blood vessels. It’s not as easy in the brain as in the heart. Brain blood vessels are smaller and more twisted. Plus, they float in brain fluid that makes pushing wires through them like operating inside a bowl of gelatin.

Bend the wire the wrong way and miss the brain target, and the doctor must pull out the wire – it can stretch more than six feet – and start over. (They start from the groin, not closer to the head, because it provides a wide, easy-to-thread artery.)

There are only 300 endovascular brain specialists in the country, compared with about 6,000 traditional brain surgeons.

“The reason there are so few doing what we do is it’s hard and dangerous,” says one endovascular specialist, Christopher Moran of Washington University in St. Louis, which pioneered research on the magnet guide. “If this (magnet) makes it easier, therefore it becomes safer and therefore it makes it easier for patients to gain access” to drill-free brain surgery.

Experiments to prove if the magnet, Stereotaxis Inc.’s Telstar system, works in the brain are under way at Washington University and Rush-Presbyterian-St. Luke’s Medical Center in Chicago. While the experiments will take several years, there’s optimism because the Food and Drug Administration recently approved the Telstar’s use by heart specialists to map the source of irregular heartbeats. In the heart, the system seems to speed up those doctors’ work.

In the brain, even smaller Telstar wires “may extend our reach to treat lesions considered untreatable today,” says Joel MacDonald of the University of Utah, who is monitoring the technology for the Congress of Neurological Surgeons.

Take Kelsey, a roofer who suddenly developed double vision whenever he looked down. Brain scans spotted a fistula, a mass of malformed blood vessels that were swelling and putting pressure on crucial vision nerves. Last spring, Lopes, a Rush neurosurgeon, snaked a catheter with repair glue to the spot. But the fistula was too deep and twisted for Lopes to manually push the catheter to its origin, and the swelling returned.

Last month, Lopes tried again with the Telstar. Following his route on an X-ray, Lopes used the magnets like a steering wheel: To navigate twists and turns, the doctor increased or decreased current flowing from superconducting magnets hung over Kelsey’s head to the magnet-tipped guidewire in his artery.

This time, the wire successfully pulled a catheter to the fistula’s core, giving Lopes a tunnel through which to squirt healing glue. If the three-hour procedure worked, Kelsey’s vision should return to normal in six months; he claims a small improvement already.

The magnet’s use may not just be for inside blood vessels. Even drilling through the skull doesn’t always allow neurosurgeons to reach just the brain tissue they want without damaging nearby spots. Researchers also are studying whether the magnet guide could provide more precision in those cases, possibly helpful in treatment of Parkinson’s disease or brain tumors.

As for no-drill treatment, it is a controversial field, not around long enough yet for endovascular fixes to have proven as durable as open-brain methods.

But more patients each year seek no-drill treatments. If the magnet system ultimately is proved to fix deeper, more complicated problems, “what’s going to drive it is the public,” says Moran. “Most people would rather have us work through the vessel than have their head opened.”

German plane theft causes safety review

FRANKFURT, Germany

Officials urged a security review for small airports yesterday after a man stole a plane and threatened to crash it into Frankfurt’s financial center, sowing fear of a terror attack.

Police said the man was a 31-year-old German who is apparently mentally disturbed.

The man circled the city’s skyscrapers Sunday for about two hours before landing safely at Frankfurt’s international airport.

He said he wanted to draw attention to Judith Resnik, a U.S. astronaut killed in the explosion of the space shuttle Challenger. The pilot was persuaded to land after air traffic controllers arranged a phone conversation with the astronaut’s brother, Charles Resnik, in Baltimore.

During his flight and attack threat, military jets shadowed him and authorities ordered thousands of people to leave Frankfurt’s main rail station, two opera houses and several skyscrapers – the latter mostly empty on a Sunday afternoon at the end of the Christmas season.

The incident also forced the brief closure of runways at the Frankfurt airport, continental Europe’s busiest.

German media identified the man as Franz-Stephan Strambach. He made a partial confession to investigators yesterday, but his questioning was interrupted after several hours when his lawyer said Strambach was exhausted, said Job Tilmann, a spokesman for Frankfurt prosecutors.

A state court judge in Frankfurt ordered that he be transferred to a mental institution pending a decision by authorities on whether he is fit to be charged. “This was not a terrorist attack, but the act of an apparently disturbed person,” Axel Raab, a spokesman for German air traffic control, said yesterday.

In a rambling dialogue with air traffic controllers during the drama, officials said, the man threatened to crash into the European Central Bank headquarters unless he was allowed a TV interview as well as a call to Resnik’s family.

Amtrak reduces fares, hopes to gain users

WASHINGTON

Citing a slight dip in the number of its passengers last year, Amtrak said yesterday it will cut coach fares as much as 25 percent on many of its routes nationwide in an effort to boost revenue.

“With this rollback in fares, we hope to not only stimulate interest in rail travel, but also to provide a draw for the travel industry as a whole,” said Barbara Richardson, Amtrak’s vice president of marketing and sales.

Ridership was down last year – 23.4 million passengers traveled aboard Amtrak trains in fiscal year 2002 compared to 23.5 million the year before, according to Amtrak spokeswoman Karina Van Veen.

“Everyone in the travel industry has experienced a decline,” Van Veen said. “That’s due to the economy, people losing jobs, which makes leisure travel something they aren’t doing.”

The Senate has voted to give Amtrak $1.2 billion for the current budget year, but the House Appropriations Committee approved only $762 million. With no resolution imminent, the railroad’s board of directors approved a $3.4 billion budget that assumes the $1.2 billion in federal support.

Amtrak also launched its winter promotion yesterday, allowing companions to travel for free and a 25 percent discount for those traveling alone. The promotion may be combined with the new fare rollback.

The deals are available for sale Jan. 7 through Feb. 15 for travel Jan. 10 through Aug. 28.

The fare reduction is available for coach travel on most of Amtrak’s long distance routes but does not apply to travel between cities in the Northeast corridor.

For example, the fare for those traveling between Seattle and St. Paul usually is $134. The new rollback fare is $101. The solo traveler fare is $75.75, and the free companion fare is $50.50 per person based on two passengers traveling together.

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