Bush discourages expulsion of Arafat


The Bush administration has notified Israel it is opposed to the expulsion of Yasser Arafat even though “he is part of the problem and not part of the solution” in the tense standoff with the Palestinians.

“We think that it would not be helpful to expel him because it would just give him another stage to play on,” spokesman Richard Boucher said as Prime Minister Ariel Sharon’s government threatened to oust Arafat from the West Bank.

“The Israeli government is very clear on what our views are on these things and I think understands clearly our position,” Boucher said.

While the administration tried to restrain Israel, Secretary of State Colin Powell said there must be a freeze on Jewish settlements and the removal of unauthorized outposts on the West Bank.

In an interview with Al-Jazeera, the satellite network that blankets the Arab world, Powell also said “there are problems” with the security fence Israel is constructing to separate itself from Palestinian-held territories.

Still, Powell said in an interview Wednesday that was released yesterday, “it is very difficult to get these obligations met or dealt with in the presence of continuing acts of terror on the part of Hamas and other organizations.”

More than 4,000 Italians die in heatwave


At least 4,175 more elderly Italians died this summer compared with the same period last year, Italy said yesterday, in its first official report on the number of deaths related to the blistering heat wave that swept through Europe.

The toll was the second-highest after France, where the government reported a startling 11,435 deaths. The Italian Health Ministry warned the figure could go as high as 5,000 once all data are in.

While stopping short of blaming the deaths entirely on the heat, officials stressed the scorching temperatures played a key role.

“The relationship between heat and mortality can certainly be established,” said Enrico Garaci, president of the ministry’s Superior Health Institute, which compiled a report based on mortality data from Italy’s 21 largest cities that was expanded to a national estimate.

Garaci said the heat may have directly caused some deaths and worsened existing illnesses and conditions. Health officials were still studying the data.

The institute estimated 34,071 people over 65 died nationwide from July 16 to Aug. 15, compared to 29,896 in 2002 – a 14 percent increase.

Looking at people of all ages in the 21 cities, the report said 2,244 more people died compared with last year, up 36 percent. It did not estimate the total national death toll for people of all ages.

Health Minister Girolamo Sirchia said the typical victim was old and already ill, lived alone in a small home with no air conditioning, and had a low income. He placed part of the blame on lack of assistance for the aged during Italy’s vacation period, when residents flood out of cities by the millions and doctors can be hard to find.

Sirchia acknowledged social services were unprepared to cope with the emergency. “We need to create…a system of active surveillance for the elderly,” he said.

Social workers must regularly visit old people when they are alone and assess their needs, he added.

Italian media had widely reported the death toll rose dramatically this summer, when temperatures soared into the 100s in many parts of the country. But health officials initially refused to release data on deaths, saying it was impossible to determine if heat was the cause.

The Italian report said the north of the country suffered most from the heat wave, because people there are less used to extreme heat. It singled out Turin as the city with the worst record, with an 87 percent increase in elderly deaths compared with last year. Some 824 died there as opposed to 441 in the same period in 2002.

Deaths by smoking deemed global crisis


About as many people are now dying from smoking in the developing world as in industrialized nations, according to the most thorough estimate to date of global deaths caused by tobacco.

The research, published this week in The Lancet medical journal, concludes that 4.84 million people died from smoking worldwide in 2000 – 2.41 million in developing countries and 2.43 million in rich nations.

“This study is the first to quantify that the 21st century’s ‘brown plague’ is striking the world’s middle- and low-income countries with an intensity equal to that which has already been felt in the world’s high-income nations and is, in fact, on the verge of surpassing it,” said John Seffrin, chief executive officer of the American Cancer Society.

Experts say the study will likely spur governments – especially those in developing countries – to pursue anti-smoking health policies.

Experts have previously estimated tobacco death trends in the industrialized world, where smoking first became prevalent, but evidence from poorer countries has been thin.

The World Health Organization estimated in 1990 that about 3 million people die every year from smoking worldwide, but that was a crude extrapolation of trends in the Western world. Much more has been learned since then about how smoking affects different populations.

A major study in 2001 of smoking patterns in China showed that, unlike in the West, tobacco causes many more deaths there from chronic lung disease than from lung cancer.

A study last month found that in India, smoking mainly kills through tuberculosis rather than lung cancer as in the West.

“Smoking kills people in different ways in different countries, but what is common is this very high toll from smoking, wherever it becomes prevalent,” said Dr. Michael Thun, head of epidemiology for the American Cancer Society, who was not involved in the study.

The new estimates, researched by Alan Lopez at the University of Queensland in Brisbane, Australia, and Majid Ezzati of the Harvard School of Public Health, used findings from recent studies to build a global picture.

“Tobacco, which we have traditionally thought of as a Western risk, is really in developing countries now,” said Ezzati. “This is the first time, according to these estimates, that there are literally identical numbers of deaths in developing and industrialized countries.”

“Much of the increase in smoking in the last few decades has been in developing countries, so we really have shifted tobacco from a Western risk to a global risk, and, more so, a developing country risk. That’s where a lot of tobacco control should be moving,” Ezzati said.

New loan procedure deters home buyers


Manufactured homes are a popular choice for low-income families, but new regulations from mortgage giant Fannie Mae could price some of those would-be homeowners out of the market.

Concerned about rising loan delinquencies and foreclosures, Fannie Mae has begun requiring a 10 percent down payment for 30-year mortgages on such homes, plus a fee of one-half of 1 percent of the loan amount. Previously, people could put no money down and paid no fee.

For those who cannot afford 10 percent, Fannie Mae has introduced a 20-year loan requiring a 5 percent down payment. However, monthly payments are higher.

Manufactured homes are built in factories and assembled on building sites. They include mobile homes, though many manufactured dwellings have characteristics found on traditional single-family homes – pitched roofs, decks and porches.

The Department of Housing and Urban Development says mobile or manufactured homes account for one-third of all new single-family homes. There are about 7.2 million such homes, many in rural areas and the South.

The average sale price is roughly $49,000, compared to about $164,000 for a traditional single-family home, according to the Manufactured Housing Institute, an industry trade group.

Rep. Barney Frank, (D-Mass.) has sent numerous letters to Fannie Mae chief executive officer Franklin Raines asking him to withdraw the down payment guidelines, which went into effect Aug. 24.

“To make it harder for people to buy homes in this way is a great mistake,” said Frank, ranking member of the House Financial Services Committee.

According to Fannie Mae’s Deborah Tretler, the changes were prompted by a spike in delinquencies and foreclosures on manufactured home loans. That came after many home sellers and lenders in the late 1990s extended loans to buyers with poor credit histories or not enough income to pay their mortgages, industry experts say.

“We don’t serve borrowers well when it is easy for a borrower to get into a home under very flexible terms, only to have them lose their home, their credit ruined and their homeownership dreams turned into a nightmare,” said Tretler, vice president of single-family homes.

Lance George, research associate for the private Housing Assistance Council, said of the changes: “In some remote rural areas, that will knock people out” of the housing market.

But he also said, “It’s not all Fannie Mae’s fault. It’s the industry. They let a lot of the retailers go wild and give loans to everyone.”

Researchers find way to keep blood longer


A little dab of sugar may double the shelf life of blood platelets, a lifesaving clotting component that is in chronic short supply because of spoilage.

Harvard University researchers report this week in the journal Science that laboratory tests show that putting a small amount of galactose, a type of sugar, into isolated platelets allows the blood components to be refrigerated and usefully preserved for at least 12 days.

That more than doubles the shelf life of the current routine, which is to store the platelets at room temperature for only five days. Because of spoilage, more than 25 percent of all platelets taken from donated blood must be discarded. Extending the shelf life of platelets would significantly improve the supply, experts say.

“If this proves out in clinical trials, this would be an important advance in transfusion medicine,” said Dr. Louis Katz, medical director of the Mississippi Valley Regional Blood Center in Davenport, Iowa. Katz is president of America’s Blood Centers, an organization that collects about half the blood donated in the United States.

Platelets play a central role in forming blood clots, an essential action to prevent uncontrolled bleeding in the body. Platelets are made in the bone marrow and typically live 10 to 12 days in the bloodstream, so the body has to constantly make more platelets to replace those that die.

Many cancer and leukemia patients are unable to naturally replace their platelets. Aggressive chemotherapy used to treat many cancers can cause the bone marrow to shut down, leaving these patients, at least temporarily, without natural platelet replacement.

As a result, about 2 million patients a year require platelet transfusions to avoid possibly lethal, uncontrolled bleeding.

To get enough platelets for a single treatment, blood centers have to process four to six pints of donated blood.

Once they are separated, platelets are very fragile. If they are refrigerated, as whole blood is, the platelets undergo a chemical change that makes them the target of macrophages, one of the body’s immune cells. When chilled platelets are transfused, they are engulfed and killed by the macrophages. For this reason, platelets are stored at room temperature and become useless after five days.

Room temperature storage also causes bacteria to grow in warm platelets. Refrigeration, if it were possible, would prevent this.

A team of researchers at Harvard and Brigham and Women’s Hospital in Boston have found that platelets can be refrigerated and remain useful for about 12 days if they add a small amount of galactose.

Dr. Karin Hoffmeister, first author of the Science study, said macrophages attack chilled platelets because the immune cell targets another type of sugar on the surface of the transfused cell. Adding galactose covers up that other sugar and protects the platelets from the macrophages.

“It is kind of a trick that prevents the removal of platelet cells by the macrophages,” Hoffmeister said.

The technique was tested in mice and the researchers found that the chilled, sugarcoated platelets lasted longer and performed better than platelets that had been kept at room temperature.

In test tube studies, said Hoffmeister, human platelets also lasted longer.

“The same action that we found in mouse platelets seems to happen in human specimens,” she said. “Human platelets (mixed with galactose) can be stored up to 12 days in a tube at (39 degrees) and they still function.”

Hoffmeister said the next step is to test the viability of sugarcoated, chilled platelets in laboratory primates, such as monkeys or apes. If the technique proves successful there, she said, the research team will apply to the Food and Drug Administration to test the system on humans. That could take two to three years, she said.

Katz said that to completely process a dose of platelets from donated blood takes 24 hours to 48 hours. Since the platelets are only good for five days, this leaves only three days to distribute the dose, sometimes across the country, and to get it to a patient who needs it. As a result, he said, about one-fourth of all platelet doses are wasted.

Extending viability to 12 days, he said, means, “The problem of platelets outdating before they are transfused will become a tiny problem in comparison to what it is now. This could be very, very important.”

— Compiled from Daily wire reports.

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