Bigger fights loom after “fiscal cliff” deal

WASHINGTON (Reuters) – President Barack Obama and congressional Republicans face even bigger budget battles in the next two months after a hard-fought “fiscal cliff” deal narrowly averted devastating tax increases and spending cuts.

The agreement, approved late on Tuesday by the Republican-led House of Representatives and signed by Obama on Wednesday, was a victory for the president, who had won re-election in November on a promise to address budget woes, partly by raising taxes on the wealthiest Americans.

But it set up potentially bruising showdowns over the next two months on spending cuts and an increase in the nation’s limit on borrowing. Republicans, angry the fiscal cliff deal did little to curb the federal deficit, promised to use the debt-ceiling debate to win deep spending cuts next time.

Republicans believe they will have greater leverage over Democrat Obama when they must consider raising the borrowing limit in February because failure to close a deal could mean a default on U.S. debt or another downgrade in the U.S. credit rating. A similar showdown in 2011 led to a credit downgrade.

“Our opportunity here is on the debt ceiling,” Republican Senator Pat Toomey of Pennsylvania said on MSNBC. “We Republicans need to be willing to tolerate a temporary, partial government shutdown, which is what that could mean.”

But Obama and congressional Democrats may be emboldened by winning the first round of fiscal fights when dozens of House Republicans buckled and voted for major tax hikes for the first time in two decades.

“We believe that passing this legislation greatly strengthens the president’s hand in negotiations that come next,” House Minority Leader Nancy Pelosi told NBC in an interview to air on Thursday.

Obama, who is vacationing in Hawaii, signed the legislation late on Wednesday, the White House said.

“We received the bill late this afternoon, and it was immediately processed. A copy was delivered to the president for review. He then directed the bill be signed by autopen,” a senior administration official said. An autopen is an automatic pen with the president’s signature.

Deteriorating relations between leaders in the two parties do not bode well for the more difficult fights ahead. Vice President Joe Biden and Republican Senate leader Mitch McConnell had to step in to work out the final deal as the relationship between House Speaker John Boehner and Obama unraveled.

Senate Majority Leader Harry Reid also drew the ire of Boehner, who told Reid in the White House to “Go fuck yourself” after a tense meeting last week, aides said. His remark came after the Democrat accused Boehner of running a “dictatorship” in the House.

Bemoaning the intensity of the fiscal cliff fight, Obama urged “a little less drama” when the Congress and White House next address budget issues like the government’s rapidly mounting $ 16 trillion debt load. He vowed to avoid another divisive debt-ceiling fight before the late-February deadline for raising the limit.

“While I will negotiate over many things, I will not have another debate with this Congress about whether or not they should pay the bills they have already racked up,” Obama said before he headed to Hawaii to resume an interrupted vacation.

NOT TIME TO CELEBRATE

Analysts warned that might not be so easy. “While the markets and most taxpayers may breathe a sigh of relief for a few days, excuse us for not celebrating,” said Greg Valliere, chief political strategist at Potomac Research Group.

“We have consistently warned that the next brawl represents a far greater threat to the markets – talk of default will grow by February, accompanied by concerns over a credit rating downgrade,” he said.

Rating agencies Moody’s Investors Service and Standard & Poor’s said the “fiscal cliff” measure did not put the budget on a more sustainable path. The International Monetary Fund said raising the debt ceiling would be a critical move.

“More remains to be done to put U.S. public finances back on a sustainable path without harming the still fragile recovery,” said Gerry Rice, a spokesman for the IMF.

Financial markets that had been worried about the fiscal cliff showdown welcomed the deal, with U.S. stocks recording their best day in more than a year. The S&P 500 achieved its biggest one-day gain since December 20, 2011, pushing the benchmark index to its highest close since September 14.

The debate over “entitlement” programs is also bound to be difficult. Republicans will be pushing for significant cuts in government healthcare programs like Medicare and Medicaid for retirees and the poor, which are the biggest drivers of federal debt. Democrats have opposed cuts in those popular programs.

“This is going to be much uglier to me than the tax issue … this is going to be about entitlement reform,” Republican Senator Bob Corker of Tennessee said on CNBC.

“Now that we have this other piece behind us – hopefully – we’ll deal in a real way with the kinds of things our nation needs to face,” he said.

The fiscal cliff crisis ended when dozens of Republicans in the House relented and backed a bill passed by the Democratic-controlled Senate that hiked taxes on household income above $ 450,000 a year. Spending cuts of $ 109 billion in military and domestic programs were delayed for two months.

Economists had warned that the fiscal cliff of across-the-board tax hikes and spending cuts would have punched a $ 600 billion hole in the economy this year and threatened to send the country back into recession.

Dozens of House Republicans reluctantly approved the Senate bill, which passed by a bipartisan vote of 257-167 and sent it to Obama to sign into law.

Peter Huntsman, chief executive of chemical producer Huntsman Corp, said the vote did little to reduce the U.S. budget deficit and would hinder growth.

“We haven’t even begun to address the basic issues behind this,” Huntsman told Reuters. “We haven’t fixed anything. All we’ve done is addressed the short-term pain.

The vote underlined the precarious position of Boehner, who will ask his Republicans to re-elect him as speaker on Thursday when a new Congress is sworn in. Boehner backed the bill, but most House Republicans, including his top lieutenants, voted against it.

The Ohio congressman also drew criticism on Wednesday from his fellow Republicans for failing to schedule a House vote on a bill passed by the Senate that would provide federal aid to Northeastern states hit by the storm Sandy.

(Additional reporting by Susan Heavey, Richard Cowan in Washington and Gabriel Debenedetti and Ernest Scheyder in New York, Editing by Alistair Bell, Peter Cooney and Mohammad Zargham)

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“Fiscal cliff” crisis heads to resolution in Congress

WASHINGTON (Reuters) – A months-long battle over the U.S. “fiscal cliff” headed to a close on Tuesday as the House of Representatives moved toward final approval of a bipartisan deal meant to prevent Washington from pushing the world’s biggest economy into recession.

The Republican-controlled House was expected to back a tax hike on the top U.S. earners shortly before midnight on Tuesday, ending weeks of high-stakes budget brinkmanship that threatened to spook consumers and throw financial markets into turmoil.

Approval of the bill would be a victory for President Barack Obama, who campaigned for re-election last November on a promise to raise taxes on the wealthiest but faced stiff opposition from congressional Republicans.

Republicans had earlier considered adding hundreds of billions of dollars in spending cuts after the bill had already passed the Senate with strong bipartisan support. That would have triggered further partisan warfare and pushed the crisis well past a self-imposed January 1 deadline.

But party leaders abandoned the effort after determining they lacked the votes.

“We’ve gone as far as we can go and I think people are ready to bring it to a conclusion,” Republican Representative Jack Kingston of Georgia said. “We fought the fight.”

Rules Committee Chairman David Dreier, a Republican, predicted the House would back the Senate bill, which also postpones for two months $ 109 billion in spending cuts on military and domestic programs set for 2013.

The bill easily cleared a procedural hurdle by a bipartisan vote of 408 to 10.

Lawmakers have struggled to find a way to head off across-the-board tax hikes and spending cuts that began to take effect at midnight, a legacy of earlier failed budget deals that is known as the fiscal cliff.

Strictly speaking, the United States went over the cliff in the first minutes of the New Year because Congress failed to produce legislation to halt $ 600 billion of tax hikes and spending cuts scheduled for this year.

TAX HIKES FOR WEALTHIEST

While many Republicans were uneasy with the tax hikes and wanted more spending cuts in the bill, they seemed to realize that the fiscal cliff would begin to damage the economy once financial markets and federal government offices returned to work on Wednesday. Opinion polls show the public would blame Republicans if a deal were to fall apart.

House Republicans had earlier considered adding $ 330 billion in spending cuts over 10 years to the Senate bill, which raises taxes on the wealthiest U.S. households by $ 620 billion over the same period.

But Senate Democrats refused to consider any changes to their bill, which passed 89 to 8 in a rare display of unity early Tuesday.

That measure, which passed the Senate at around 2 a.m., would raise income taxes on families earning more than $ 450,000 per year and limit the amount of deductions they can take to lower their tax bill.

Low temporary rates that have been in place for the past decade would be made permanent for less-affluent taxpayers, along with a range of targeted tax breaks put in place to fight the 2009 economic downturn.

However, workers would see up to $ 2,000 more taken out of their paychecks annually with the expiration of a temporary payroll tax cut.

The non-partisan Congressional Budget Office said the Senate bill would increase budget deficits by nearly $ 4 trillion over the coming 10 years, compared to the budget savings that would occur if the extreme measures of the cliff were to kick in.

But the bill would actually save $ 650 billion during that time period when measured against the tax and spending policies that were in effect on Monday, according to the Committee for a Responsible Federal Budget, an independent group that has pushed for more aggressive deficit savings.

(Additional reporting by Rachelle Younglai, Thomas Ferraro and David Lawder; Writing by Andy Sullivan; Editing by Alistair Bell and Eric Beech)

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FDA new drug approvals hit 16-year high in 2012

LONDON/NEW YORK (Reuters) – U.S. regulators approved 39 new drugs in 2012, the most in 16 years, suggesting that pharmaceutical makers are poised for growth after losing billions of dollars in recent years to generic drug makers because of patent expirations.

There were eight approvals in December alone, including a new treatment from Johnson & Johnson called Sirturo for drug-resistant tuberculosis approved on Monday, the first new TB drug in decades.

The pharmaceutical sector badly needs a pick-up in productivity as companies try to refill their medicine chests after heavy losses to generic manufacturers, which have benefited from a string of patent expirations that peaked in 2012. When generics go on the market at a lower cost, sales of name brand drugs plummet.

The tally of 39 new drugs and biological products approved by the Food and Drug Administration compares with 30 in 2011 and just 21 in 2010. At least 10 of the drugs had fast track status in 2012, which enabled them to be reviewed more quickly.

It is the highest number since 1996, when 53 so-called new molecular entities won a green light. For a graphic on new drugs approvals see: http://link.reuters.com/nuz84t

The FDA has met and exceeded its drug review goals under the Prescription Drug User Fee Act, in which drug companies help fund the drug approval process in return for an agreement by the Food and Drug Administration to meet regulatory deadlines, FDA spokeswoman Sandy Walsh said in an e-mailed statement.

She said the “pipeline of new drugs under development remains strong and is growing.”

Major U.S. drug companies have lost about $ 21 billion in revenue this year from lucrative medicines coming off patent, while the hit for European businesses is about $ 10 billion, according to ratings agency Standard & Poor’s.

This year’s expirations have included Plavix, a heart drug made by Sanofi and Bristol-Myers Squibb, and Seroquel, an antipsychotic made by AstraZeneca.

Winning approval from regulators, however, is only part of the battle for drugmakers.

Investors will also be watching closely to see how the new drugs perform commercially once they reach the market, since securing payment for innovative medicines is an increasingly tough fight.

“The patent exposure will be less going forward, but where there is still a little bit of uncertainty is how much better the pipelines have become and how strong the recently approved products are,” said Damien Conover, the director of pharmaceutical research at research firm Morningstar Inc.

The 2012 approvals included some medicines that are forecast by analysts to become multibillion-dollar sellers, such as Eliquis for reducing stroke risk in patients with irregular heartbeats from Bristol Myers-Squibb and Pfizer Inc.

But many others are for rare diseases, underscoring the drug industry’s increased focus on specialized, niche products.

They include treatments such as a Kalydeco from Vertex Pharmaceuticals Inc for a rare form of the lung disorder cystic fibrosis and Signifor from Novartis AG for Cushing’s disease, caused by over-production of the hormone cortisol.

The last drug approval of the year on Monday afternoon was for a drug to relieve symptoms of diarrhea in patients with HIV and AIDS made by Salix Pharmaceuticals Ltd.

There are also encouraging signs that the pick-up in new drug approvals could continue in 2013. The European Medicines Agency said on December 18 that it expected 54 new drug applications in 2013, up from 52 in 2012, 48 in 2011 and 34 in 2010.

(Editing by Jilian Mincer and Steve Orlofsky)

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Every school needs a doctor, pediatricians say

NEW YORK (Reuters Health) – Despite no federal or uniform state requirements to do so, all school districts should have a doctor to oversee school health services, according to a policy statement from a group of American pediatricians.

“Our hope is that a policy statement like this will start to get people talking,” said Dr. Cynthia Devore, a co-author of the statement from the American Academy of Pediatrics (AAP).

“New York – and the northeast in general – tends to spell out in legislation that school districts shall hire a medical director to oversee health services,” she told Reuters Health. “That’s ideal. It should be legislated, but not every state does that,” said Devore, a board-certified pediatrician in Rochester, New York.

The statement published in the journal Pediatrics on Monday encourages pediatricians to “advocate that all school districts should have a school physician” and their roles should be “well defined, fairly compensated and outlined in a written contract.”

Basically, Devore said, the group recommends having a doctor in every school district and a nurse in every school.

The American Medical Association also recommends that all schools have a nurse to provide healthcare and have a doctor available on a regular basis.

School doctors are not a new concept. In fact, the statement says, they have been around since the 1800s, and Devore said they are one of the oldest groups within the AAP.

But the roles of school doctors depend on the school district’s needs.

“Some physicians are hired by schools and have full-time jobs… Some physicians might be a consultant,” said Devore.

In addition to being full- or part-time employees and consultants, the statement says doctors can play a role as an independent contractor or a volunteer on a school health advisory group.

Ideally, the doctor should have an expertise in pediatrics or be a board-certified pediatrician, according to the statement.

The group says it’s critical the doctors know about, among other things, disease outbreak control, risk management, immunizations and sports medicine.

Previous studies have found that having a school doctor is linked to better attendance for some students, especially those with chronic health conditions like asthma.

“Because states fund schools on a basis of student attendance, a school physician can potentially save schools money by decreasing absenteeism through advocacy and education,” the statement says.

It also suggests doctors can save school districts money by preventing costly litigation through better health services and protocols.

“Unfortunately when budgets are tight, money is short and education jobs are at risk, some people view health services as an expendable cut, and we don’t see it that way,” Devore said.

SOURCE: http://bit.ly/HjQ8dI Pediatrics, online December 31, 2012.

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Dan Ariely Talks Creativity And Dishonesty

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India gang rape victim dies in Singapore hospital

SINGAPORE/NEW DELHI (Reuters) – An Indian woman whose gang rape in New Delhi triggered violent protests died of her injuries on Saturday in a Singapore hospital, bringing a security lockdown in Delhi and recognition from India‘s prime minister that social change is needed.

The Indian capital braced for a new wave of protests, closing metro stations and banning vehicles from the city centre district where young activists had converged to demand improved women’s rights. The news came in the early hours of the morning in India and there were no signs of protests as morning broke.

The 23-year-old medical student, severely beaten, raped and thrown out of a moving bus in New Delhi two weeks ago, had been flown to Singapore in a critical condition by the Indian government on Thursday for specialist treatment.

“We are very sad to report that the patient passed away peacefully at 4:45 a.m. on Dec 29, 2012 (2045 GMT Friday). Her family and officials from the High Commission (embassy) of India were by her side,” Mount Elizabeth Hospital Chief Executive Officer Kelvin Loh said in a statement.

Indian Prime Minister Manmohan Singh said in a statement he was deeply saddened by the death and described the emotions associated with her case as “perfectly understandable reactions from a young India and an India that genuinely desires change.

“It would be a true homage to her memory if we are able to channelize these emotions and energies into a constructive course of action.”

Delhi‘s Chief Minister, Sheila Dikshit, expressed revulsion.

“It is a shameful moment for me not just as a chief minister but also as a citizen of this country,” she said.

The woman, who has not been identified, and a male friend were returning home from the cinema by bus on the evening of December 16 when, media reports say, six men on the bus beat them with metal rods and repeatedly raped the woman. The reports say a rod was used in the rape, causing internal injuries. Both were thrown from the bus. The male friend survived the attack.

Singh’s government has been battling criticism that it was tone-deaf to the outcry that followed the attack and was heavy handed in its response to the protests in the Indian capital.

Most rapes and other sex crimes in India go unreported and offenders are rarely punished, women’s rights activists say. But the brutality of the December 16 assault sparked public outrage and calls for better policing and harsher punishment for rapists.

VEHICLES BARRED FROM DELHI CITY CENTRE

T.C.A. Raghavan, the Indian High Commissioner to Singapore, told reporters hours after the woman’s death that a chartered aircraft would fly her body back to India on Saturday, along with members of her family. The woman’s body had earlier been loaded into a van at the hospital and driven away.

In New Delhi, the Joint Commissioner of Traffic Police, Satyendra Garg, told NDTV news channel that residents and commuters were advised to avoid the city centre.

The case has received blanket coverage on cable television news channels. Some Indian media have called the woman “Amanat”, an Urdu word meaning “treasure”.

Talking to reporters earlier on Saturday, Raghavan declined to comment on Indian media reports accusing the government of sending her to Singapore to minimize the possible backlash in the event of her death.

Some Indian medical experts had questioned the decision to airlift the woman to Singapore, calling it a risky maneuver given the seriousness of her injuries. They had said she was already receiving the best possible care in India.

But Dr B.D. Athani, medical superintendent of the New Delhi hospital where she had initially been treated, told Indian television the intention was to give the victim the best chance of surviving in what he described as “an extreme case”.

“Her condition was very critical from day one. We had managed what best we could do at our end … she had to be shifted to a centre with much better facilities.”

On Friday, the Singapore hospital had said the woman’s condition had taken a turn for the worse. It said she had suffered “significant brain injury”. She had already undergone three abdominal operations before arriving in Singapore.

The suspects in the rape – five men aged between 20 and 40, and a juvenile – were arrested within hours of the attack and are in custody. Media reports say they are likely to be formally charged with murder next week.

Commentators and sociologists say the rape tapped into a deep well of frustration many Indians feel over what they see as weak governance and poor leadership on social and economic issues.

Many protesters have complained that Singh’s government has done little to curb the abuse of women in the country of 1.2 billion. A global poll by the Thomson Reuters Foundation in June found that India was the worst place to be a woman because of high rates of infanticide, child marriage and slavery.

New Delhi has the highest number of sex crimes among India’s major cities, with a rape reported on average every 18 hours, according to police figures. Government data show the number of reported rape cases in the country rose by nearly 17 percent between 2007 and 2011.

(Additional reporting by Ross Colvin and Devidutta Tripathy in New Delhi; Saeed Azhar, Edgar Su and Sanjeev Miglani in Singapore; Editing by Michael Roddy, Ron Popeski and Mark Bendeich)

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Study links milk-producing protein to aggressive breast cancer

HONG KONG (Reuters) – The discovery that a protein which triggers milk production in women may also be responsible for making breast cancers aggressive could open up new opportunities for treatment of the most common and deadliest form of cancer among women.

Found in all breast cells, the protein ELF5 tries to activate milk production even in breast cancer cells, which does not work and then makes the cancer more aggressive, according to scientists in Australia and Britain.

“The discovery opens up new avenues for therapy and for designing new markers that can predict response to therapy,” said lead author Professor Chris Ormandy from the Garvan Institute of Medical Research in Sydney.

In 2008, Ormandy‘s work linked ELF5 to milk production.

The latest research by Ormandy and his team, published in the journal PLOS Biology on Friday, went a step further to find the link between ELF5 and breast cancer.

“Cancer cells can’t respond properly (to ELF5), so they … acquire some characteristics … that make the disease more aggressive and more refractory (resistant) to treatment with existing therapies,” Ormandy said by telephone.

Ormandy and his team grew human breast cancer tissues, genetically manipulated to contain high amounts of ELF5, in petri dishes and saw how the protein proliferated aggressively.

FINDINGS MAY HELP TARGETED THERAPY

Breast cancer is the most commonly diagnosed cancer and the top cause of cancer death among women, accounting for 23 percent of total cancer cases and 14 percent of cancer deaths in women.

To decide on treatment, doctors normally need to find out if the cancer has receptors for the hormones estrogen and progesterone, which, in the case of breast cancer patients, promote growth in their tumors.

Two-thirds of breast cancers are usually positive for estrogen receptors, which then require anti-hormonal therapies that lower estrogen levels in the patient or block estrogen from supporting the growth of the cancer.

For the remaining one-third of patients, their cancers do not have receptors, which means they won’t benefit from hormonal therapies. Such patients are usually given other treatments, such as chemotherapy.

Ormandy’s team found that cancers with these receptors had low levels of ELF5, while those without receptors had significantly higher levels of the protein.

“What we have shown in this paper is high ELF5 tumors are dependent on ELF5 for their proliferation and if we block ELF5 in high ELF5 tumors, we will block proliferation and that will treat the tumor,” Ormandy said.

“If we can develop a drug that targets ELF5, it will be very useful for that group of women,” he said.

(Reporting by Tan Ee Lyn; Editing by Paul Tait)

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S.Africa’s Mandela ‘not yet fully recovered’: spokesman

JOHANNESBURG (Reuters) – Former South African President Nelson Mandela is doing well after being discharged from hospital, although he is still not fully recovered, a government spokesman said on Thursday.

“He is not yet fully recovered, but he has sufficiently moved forward so that he can be discharged,” Mac Maharaj told local broadcaster eNCA.

“He is sufficiently well to be home.”

The 94-year-old anti-apartheid leader and Nobel Peace Prize laureate was discharged from the hospital on Wednesday, ending a nearly three-week stay during which he was treated for a lung infection and had surgery to remove gallstones.

Mandela, who has been in frail health for several years, is now receiving care at his suburban Johannesburg home.

Mandela has a history of lung problems dating back to when he contracted tuberculosis while in jail as a political prisoner. He spent 27 years in prison, including 18 years on the windswept Robben Island off Cape Town.

The former president was admitted to a Pretoria hospital on December 8 and this was his longest stay in a hospital since he was released from prison in 1990.

Current President Jacob Zuma visited Mandela on Christmas Day and said the former South African leader was doing much better, making progress and in good spirits.

Mandela was also admitted to a hospital in February because of abdominal pain but released the following day after a keyhole examination showed there was nothing seriously wrong with him.

He has spent most of his time since then in another home in Qunu, his ancestral village in the impoverished Eastern Cape province.

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Early Childhood Obesity Rates Might Be Slowing Nation-Wide

About one in three children in the U.S. are now overweight, and since the 1980s the number of children who are obese has more than tripled. But a new study of 26.7 million young children from low-income families shows that in this group of kids, the tidal wave of obesity might finally be receding.Being obese as a child not only increases the risk of early-life health problems, such as joint problems, pre-diabetes and social stigmatization, but it also dramatically increases the likelihood of being obese later in life, which can lead to chronic diseases, including cancer, type 2 diabetes and heart disease. Children as young as 2 years of age can be obese–and even extremely obese. Early childhood obesity rates, which bring higher health care costs throughout a kid’s life, have been especially high among lower-income families.”This is the first national study to show that the prevalence of obesity and extreme obesity among young U.S. children may have begun to decline,” the researchers noted in a brief report published online December 25 in JAMA, The Journal of the American Medical Association. (Reports earlier this year suggested that childhood obesity rates were dropping in several U.S. cities.)The study examined rates of obesity (body mass index calculated by age and gender to be in the 95th percentile or higher–for example, a BMI above 20 for a 2-year-old male–compared with reference growth charts) and extreme obesity (BMI of more than 120 percent above that of the 95th percentile of the reference populations) in children ages 2 to 4 in 30 states and the District of Columbia. The researchers, led by Liping Pan, of the Division of Nutrition, Physical Activity and Obesity at the U.S. Centers for Disease Control and Prevention, combed through 12 years of data (1998 to 2010) from the Pediatric Nutritional Surveillance System, which includes information on roughly half of all children on the U.S. who are eligible for federal health care and nutrition assistance.A subtle but important shift in early childhood obesity rates in this low-income population seems to have begun in 2003. Obesity rates increased from 13.05 percent in 1998 to 15.21 percent in 2003. Soon, however, obesity rates began decreasing, reaching 14.94 percent by 2010. Extreme obesity followed a similar pattern, increasing from 1.75 percent to 2.22 percent from 1998 to 2003, but declining to 2.07 percent by 2010.Although these changes might seem small, the number of children involved makes for huge health implications. For example, each drop of just one tenth of a percentage point represents some 26,700 children in the study population alone who are no longer obese or extremely obese. And if these trends are occurring in the rest of the population, the long-term health and cost implications are massive.Public health agencies and the Obama Administration have made battling childhood obesity a priority, although these findings suggest that early childhood obesity rates, at least, were already beginning to decline nearly a decade ago. Some popular prevention strategies include encouraging healthier eating (by reducing intake of highly processed and high-sugar foods and increasing fruit and vegetable consumption) and increased physical activity (both at school and at home).The newly revealed trends “indicate modest recent progress of obesity prevention among young children,” the authors noted. “These finding may have important health implications because of the lifelong health risks of obesity and extreme obesity in early childhood.”

Follow Scientific American on Twitter @SciAm and @SciamBlogs.Visit ScientificAmerican.com for the latest in science, health and technology news.
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Venezuela’s Chavez improving after surgery: officials

CARACAS (Reuters) – Venezuelan President Hugo Chavez is improving after a cancer operation in Cuba and has started exercising, officials said on Monday, amid doubts over whether the former soldier is in good enough health to continue governing.

Vice President Nicolas Maduro said he had spoken by phone with Chavez, who was walking and doing exercises as part of his treatment.

“We’ve gotten the best present we could get this Christmas: a phone call from our commander president,” Maduro said on state television.

Information Minister Ernesto Villegas said earlier in the day that Chavez had “shown a slight improvement in his condition,” without providing details.

Chavez has not been heard from in two weeks following a fourth operation for an unspecified type of cancer in the pelvic region. The government has said he suffered post-operatory complications including unexpected bleeding and a lung infection, but offered few details about his actual condition.

His death, or even his resignation for health reasons, would upend the politics of the South American OPEC nation where his personalized brand of oil-financed socialism has made him a hero to the poor but a pariah to critics who call him a dictator.

His allies are now openly discussing the possibility that he may not be back in time to be sworn in for his third six-year term on the constitutionally mandated date of January 10.

Opposition leaders say a delay to his taking power would be another signal that Chavez is not in condition to govern and that fresh elections should be called to choose his replacement.

They believe they have a better shot against Maduro, Chavez’s anointed successor, than against the charismatic president who for 14 years has been nearly invincible at the ballot box.

But a constitutional dispute over succession could lead to a messy transition toward a post-Chavez era.

Maduro has become the government’s main figurehead in the president’s absence. His speeches have mimicked Chavez’s bombastic style that mixes historical references with acid insults of adversaries.

Opposition leader Henrique Capriles, who lost to Chavez in the October presidential vote, slammed Maduro in an interview published on Sunday for failing to seek dialogue with the opposition at a time of political uncertainty.

“Maduro is not the one that won the elections, nor is he the leader,” Capriles told the local El Universal newspaper. “Because Chavez is absent, this is precisely the time that (Maduro) needs help from people (in the opposition camp).”

Chavez has vastly expanded presidential powers and built a near-cult following among millions of poor Venezuelans, who love his feisty language and social welfare projects.

The opposition is smarting from this month’s governors elections in which Chavez allies won 20 of 23 states. They are trying to keep attention focused on day-to-day problems from rampant crime to power outages.

(Reporting by Brian Ellsworth; Editing by Sandra Maler)

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Few tests done at toxic sites after superstorm

OLD BRIDGE, N.J. (AP) — For more than a month, the U.S. Environmental Protection Agency has said that the recent superstorm didn’t cause significant problems at any of the 247 Superfund toxic waste sites it’s monitoring in New York and New Jersey.

But in many cases, no actual tests of soil or water are being conducted, just visual inspections.

The EPA conducted a handful of tests right after the storm, but couldn’t provide details or locations of any recent testing when asked last week. New Jersey officials point out that federally designated Superfund sites are EPA’s responsibility.

The 1980 Superfund law gave EPA the power to order cleanups of abandoned, spilled and illegally dumped hazardous wastes that threaten human health or the environment. The sites can involve long-term or short-term cleanups.

Jeff Tittel, executive director of the Sierra Club in New Jersey, says officials haven’t done enough to ensure there is no contamination from Superfund sites. He’s worried toxins could leach into groundwater and the ocean.

“It’s really serious and I think the EPA and the state of New Jersey have not done due diligence to make sure these sites have not created problems,” Tittel said.

The EPA said last month that none of the Superfund sites it monitors in New York or New Jersey sustained significant damage, but that it has done follow-up sampling at the Gowanus Canal site in Brooklyn, the Newtown Creek site on the border of Queens and Brooklyn, and the Raritan Bay Slag site, all of which flooded during the storm.

But last week, EPA spokeswoman Stacy Kika didn’t respond to questions about whether any soil or water tests have been done at the other 243 Superfund sites. The agency hasn’t said exactly how many of the sites flooded.

“Currently, we do not believe that any sites were impacted in ways that would pose a threat to nearby communities,” EPA said in a statement.

Politicians have been asking similar questions, too. On Nov. 29, U.S. Sen. Frank Lautenberg, D-N.J., wrote to the EPA to ask for “an additional assessment” of Sandy’s impact on Superfund sites in the state.

Elevated levels of lead, antimony, arsenic and copper have been found at the Raritan Bay Slag site, a Superfund site since 2009. Blast furnaces dumped lead at the site in the late 1960s and early 1970s, and lead slag was also used there to construct a seawall and jetty.

The EPA found lead levels as high as 142,000 parts per million were found at Raritan Bay in 2007. Natural soil levels for lead range from 50 to 400 parts per million.

The EPA took four samples from the site after Superstorm Sandy: two from a fenced-off beach area and two from a nearby public playground. One of the beach samples tested above the recreational limit for lead. In early November, the EPA said it was taking additional samples “to get a more detailed picture of how the material might have shifted” and will “take appropriate steps to prevent public exposure” at the site, according to a bulletin posted on its website. But six weeks later, the agency couldn’t provide more details of what has been found.

The Newtown Creek site, with pesticides, metals, PCBs and volatile organic compounds, and the Gowanus Canal site, heavily contaminated with PCBs, heavy metals, volatile organics and coal tar wastes, were added to the Superfund list in 2010.

Some say the lead at the Raritan Bay site can disperse easily.

Gabriel Fillippeli, director of the Center for Urban Health at Indiana University-Purdue University Indianapolis, said lead tends to stay in the soil once it is deposited but can be moved around by stormwaters or winds. Arsenic, which has been found in the surface water at the site, can leach into the water table, Fillippeli said.

“My concern is twofold. One is, a storm like that surely moved some of that material physically to other places, I would think,” Fillippeli said. “If they don’t cap that or seal it or clean it up, arsenic will continue to make its way slowly into groundwater and lead will be distributed around the neighborhood.”

The lack of testing has left some residents with lingering worries.

The Raritan Bay Slag site sits on the beach overlooking a placid harbor with a view of Staten Island. On a recent foggy morning, workers were hauling out debris, and some nearby residents wondered whether the superstorm increased or spread the amount of pollution at the site.

“I think it brought a lot of crud in from what’s out there,” said Elise Pelletier, whose small bungalow sits on a hill overlooking the Raritan Bay Slag site. “You don’t know what came in from the water.” Her street did not flood because it is up high, but she worries about a park below where people go fishing and walk their dogs. She would like to see more testing done.

Thomas Burke, an associate dean at the Johns Hopkins School of Public Health, says both federal and state officials generally have a good handle on the major Superfund sites, which often use caps and walls to contain pollution.

“They are designed to hold up,” Burke said of such structures, but added that “you always have to be concerned that an unusual event can spread things around in the environment.” Burke noted that the storm brought in a “tremendous amount” of water, raising the possibility that groundwater plumes could have changed.

“There really have to be evaluations” of communities near the Superfund sites, he said. “It’s important to take a look.”

Officials in both New York and New Jersey note they’ve also been monitoring less toxic sites known as brownfields and haven’t found major problems. The New York DEC said in a statement that brownfields in that state “were not significantly impacted” and that they don’t plan further tests for storm impacts.

Larry Ragonese, a spokesman for the New Jersey Department of Environmental Protection, said the agency has done visual inspections of major brownfield sites and also alerted towns and cities to be on the lookout for problems. Ragonese said they just aren’t getting calls voicing such concerns.

Back at the Raritan Bay slag site, some residents want more information. And they want the toxic soil, which has sat here for years, out.

Pat Churchill, who was walking her dog in the park along the water, said she’s still worried.

“There are unanswered questions. You can’t tell me this is all contained. It has to move around,” Churchill said.

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‘Smart-Tattoos’: How They Could End Up Saving Your Life

So they’re not exactly cute, but if you came of age during the 90s, chances are you have at least regrettable tattoo anyway. (Raise your hand if that same tattoo is in the shape of a butterfly!)   But the latest temporary tattoos do much more than serve as a symbol of misspent youth; they can read a body’s internal processes and alert the user of potential dangers like a dip in blood sugar or a drop in kidney function− all without having to draw any blood.

A recent collaboration between researchers at the University of California San Diego and the University of Toronto created a lightweight and stick-on “smart tattoo.” Embedded in its fibers are a set of “ion-selective electrodes” which is a cooler way of saying “sensors that detect the pH or salt levels of the skin, as well minerals like potassium, and even blood oxidation.”

In other words, it can monitor athletic performance at a granular level, but without any of the bulk or wiring of older sensors. It also means that for the first time, detailed athletic response testing would no longer be limited to the walls of a sports clinic, but could be done daily by the athlete herself. And because the stick-ons are both quick and cheap to produce, it seems a natural fit with a mass market roll-out. Researchers are hoping they’ve designed the next big thing in sports training and expect it to hit shelves within the next twelve months.

MORE: One in Ten Adults Will Be Diabetic in 20 Years

But this athletic testing sensor is only the latest iteration of a variety of body-reading tattoos set to hit the market in the coming year.

Sano Intelligence is in the testing phase of a smart tattoo that reads a wearer’s blood markers. The application would be particularly useful for diabetics, who need to keep strict control over their blood sugar levels and often have to resort to finger-prick tests to determine if those levels are within normal range. The Sano patch would not only allow them to forgo the pain of finger-pricks, but the constant hassle of dragging around testing devices and interrupting daily activities to draw their own blood.

And Boston-based MC10 announced earlier this year that it would soon release its own “stretchable electronics” patch, that can be applied internally to human organs, or externally to human skin, or clothing, depending on what needed to be monitored.  The stick-on’s ability to remain flexible while reading vital signs means that it could effectively gauge the function of specific organs, track brain processes, and monitor more mainstream functions like heart rate, blood oxidation and body hydration. 

What’s going to make the biggest difference in our daily lives as a result of this technology isn’t even the technology itself- it’s that for the first time, we as patients will be able to maintain our mobility and independence as we’re being monitored. This presumably could mean it would be easier to catch oncoming deficiencies before they manifest any symptoms, and the distance between the patient and her specialist would no longer be a hinderance to treatment.

Do you think this kind of technology would be useful in your own life, or do you think that a sensor monitoring your vital signs is just too “sci-fi” for your taste?

Related Stories on TakePart:

• Five Years Out of Juvenile Detention, Depression, Addiction Linger

• Researchers Are Closing In On Method to Predict Flu Outbreaks

• The Most Vulnerable Pay a High Price for Flu Infection

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A Bay Area native, Andri Antoniades previously worked as a fashion industry journalist and medical writer.  In addition to reporting the weekend news on TakePart, she volunteers as a webeditor for locally-based nonprofits and works as a freelance feature writer for TimeOutLA.com. Email Andri | @andritweets | TakePart.com

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Perennial Flu Vaccine Gets Closer

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First Condom/Contraceptive Sales for DKT International in Pakistan

WASHINGTON–(BUSINESS WIRE)–

DKT International has just launched a new birth control and safe sex project in Pakistan. DKT is one of the world’s largest private providers of contraceptives in developing countries and brings 23 years of social marketing experience to the Pakistan effort. Early work has included hiring key staff, registering with the Government of Pakistan, and building partnerships with the Ministry of Health and with the Maternal, Neonatal and Child Health Program in the province of Sindh. In November 2012 DKT Pakistan made its first sales of nearly 700,000 condoms and 1,000 IUDs to eight distributors in three Pakistani administrative districts.

Pakistan is the world’s sixth most populous country and its population could double by 2050, if the current rate of growth continues. Although its birth rate has been falling, Pakistan’s total fertility rate is still 4.1 children per woman and has remained even higher for women living in rural areas. Maternal mortality remains very high at approximately 276 deaths per 100,000 live births.

DKT Pakistan and its local partners are working together to reach Pakistani couples and more than 6 million women with unmet needs for contraception. The goal is to provide customers and health providers with more contraceptive choices, combined with regular access to family planning training and education.

DKT Pakistan’s program, called JANNAT (heaven), offers high quality, affordable contraceptives for Pakistani women and families, and training for reproductive health service providers. It addresses problems of supply and demand that have kept Pakistan’s contraceptive prevalence rate lower than its neighbors, with a focus on underserved populations. Supply-side barriers, especially in rural areas, include such challenges as the limited number of providers and outlets for family planning products, and the lack of trained mid-level providers of reproductive health services, such as community midwives, lady health workers and lady health visitors.

DKT Pakistan will overcome these barriers by using social marketing to drive contraception demand through mass media and non-traditional communication and by improving reproductive health service availability via regular contact with the country’s primary providers of family planning and OBGYN health services.

DKT International promotes family planning and HIV/AIDS prevention through 21 social marketing programs in 19 countries.

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Obama calls Army secretary over day care scandal

WASHINGTON (AP) — President Barack Obama called the Army secretary to express concerns over arrests and the discovery of problems with background checks at an Army day care center and to urge a speedy investigation, U.S. officials said Wednesday.

The call at 10 p.m. Tuesday to Army Secretary John McHugh came against the backdrop of last week’s massacre of young children in a shooting at an elementary school in Newtown, Conn.

A White House official said the president relayed his concern about reports of abuse at the Fort Myer, Va., day care center and made clear that there must be a zero tolerance policy when it comes to protecting the children of service members.

The official said Obama urged McHugh to conduct the investigation into its hiring practices quickly and thoroughly.

Obama has been outspoken in his demands for a quick government reaction to the Newtown shooting that left 20 children and six adults dead, and he visited the Connecticut town Sunday to offer condolences to parents and the community.

The Army had no immediate comment on the president’s call.

The Pentagon is reviewing hiring procedures at military day care centers, schools, youth centers and other facilities where children are present, after revelations that some employees at the day care center had criminal records. Pentagon leaders were angry that it took months for the Army to disclose the problems to top officials and the public.

Defense Secretary Leon Panetta ordered the military-wide review Tuesday shortly after the Army disclosed problems with security background checks of workers at Fort Myer. Pentagon press secretary George Little said department leaders were surprised to hear of the problems and that “clearly this information did not get reported up the chain of command as quickly as we think it should have.”

Little said Wednesday that officials also are questioning why it took three months for the Army to inform Panetta about arrests and problems with background checks at the day care center. Two people were arrested in September on multiple charges of assault against children at the center.

Little also said reports that parents of children at the center weren’t told about the problems indicate there may have been a serious breakdown in communications.

“We need to do everything we can wherever our children are entrusted to the care of DOD-employed personnel to insure we have the right personnel with the right background taking care of them,” said Little. “We want to insure that there’s consistency in the standards and policies and practices in hiring wherever military youth are involved.”

The actions stem from the Sept. 26 arrests of two Army employees. One was charged with five counts of assault and the second was charged with four counts of assault.

But the problems at Fort Myer apparently went much deeper. Indications are that at least 30 workers at the facility have histories that call into question their suitability to care for children, according to two officials, speaking on condition of anonymity because the investigation into worker backgrounds at Fort Myer has not been completed.

After the Fort Myer arrests, the Army replaced the day care center’s management team and found what the Army called “derogatory information” in the background of an unspecified number of other employees there. Army officials did not reveal the information, and officials said it’s not clear if the background checks were not done, were not sufficient or simply were not used appropriately in screening personnel.

Col. Fern Sumpter, the Fort Myer commander, said the day care center was closed “out of an abundance of caution” and the children moved to a separate day care center at Fort Myer. A Fort Myer spokeswoman, Mary Ann Hodges, said the center was closed on Dec. 13.

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Associated Press writer Jim Kuhnhenn contributed to this report.

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Diabetes remission possible with diet, exercise

NEW YORK (Reuters Health) – One in nine people with diabetes saw their blood sugar levels dip back to a normal or “pre-diabetes” level after a year on an intensive diet and exercise program, in a new study.

Complete remission of type 2 diabetes is still very rare, researchers said. But they added that the new study can give people with the disease hope that through lifestyle changes, they could end up getting off medication and likely lowering their risk of diabetes-related complications.

“Kind of a long-term assumption really is that once you have diabetes there’s no turning back on it, and there’s no remission or cure,” said Edward Gregg, the lead author on the report from the Centers for Disease Control and Prevention.

The research, he told Reuters Health, “is a reminder that adopting a healthy diet, physically-active lifestyle and reducing and maintaining a healthy weight is going to help manage people’s diabetes better.”

His team’s study can’t prove the experimental program – which included weekly group and individual counseling for six months, followed by less frequent visits – was directly responsible for blood sugar improvements.

The original goal of the research was to look at whether that intervention lowered participants’ risk of heart disease (so far, it hasn’t).

But the diabetes improvements are in line with better weight loss and fitness among people in the program versus those in a comparison group who only went to a few annual counseling sessions, Gregg’s team reported Tuesday in the Journal of the American Medical Association.

IS IT COST-EFFECTIVE?

About eight percent of people in the United States have diabetes, according to the American Diabetes Association. The new study included 4,503 of them who were also overweight or obese.

People randomly assigned to the intensive program had diet and exercise counseling with a goal of cutting eating and drinking back to 1200 to 1800 calories per day and increasing physical activity to just under three hours per week.

After one year, 11.5 percent of them had at least partial diabetes remission, meaning that without medication their blood sugar levels were no longer above the diabetes threshold. That compared to just two percent of participants in the non-intervention group who saw their diabetes improve significantly.

People who’d had diabetes for fewer years were more likely to have blood sugar improvements, as were those who lost more weight or had stronger fitness gains during the study.

However, less than one-third of people whose diabetes went into remission during the program managed to keep their blood sugar levels down for at least four years, the researchers found.

“Clearly lifestyle intervention is good for people with diabetes,” said Dr. John Buse, a diabetes researcher from the University of North Carolina at Chapel Hill School of Medicine.

“The question is how cost-effective is it, what are the long-term consequences (and) how would it really compare with alternative approaches like bariatric surgery and drug therapy?” Buse, who wasn’t involved in the new study, told Reuters Health.

Dr. David Arterburn, from Group Health Research Institute in Seattle, said some studies of weight-loss surgery, for instance, have found two-thirds of people who start out with diabetes have complete remission.

Arterburn, who co-wrote an editorial published with the new study, said anyone with diabetes – or at high risk – should consider either lifestyle interventions or surgery, if they’re eligible, to reduce future health risks.

Gregg said his team was working on a cost-analysis of the current program, but that it was fairly “resource-intensive.”

“If people have access to the support to make these sorts of changes, they may have the benefits that we’ve seen here,” he said. But, “What we should remember is that more modest changes in lifestyle are also effective.”

SOURCE: http://bit.ly/JjFzqx Journal of the American Medical Association, online December 18, 2012.

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Amgen to plead guilty in criminal case Tuesday: prosecutors

NEW YORK (Reuters) – Biotech company Amgen Inc is scheduled to plead guilty on Tuesday in a criminal case in federal court in Brooklyn, New York, prosecutors said.

A brief statement from the U.S. Attorney‘s office gave no details of the charges Amgen would plead guilty to.

Representatives of Amgen could not immediately be reached to comment.

(Reporting by Jessica Dye)

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Keep thimerosal in vaccines: pediatricians

NEW YORK (Reuters Health) – A mercury-containing preservative should not be banned as an ingredient in vaccines, U.S. pediatricians said Monday, in a move that may be controversial.

In its statement, the American Academy of Pediatrics (AAP) endorsed calls from a World Health Organization (WHO) committee that the preservative, thimerosal, not be considered a hazardous source of mercury that could be banned by the United Nations.

Back in 1999, a concern that kids receiving multiple shots containing thimerosal might get too much mercury – and develop autism or other neurodevelopmental problems as a result – led the AAP to call for its removal, despite the lack of hard evidence at the time.

“It was absolutely a matter of precaution because of the absence of more information,” said Dr. Louis Cooper, from Columbia University in New York, who was on the organization’s board of directors at the time.

“Subsequently an awful lot of effort has been put into trying to sort out whether thimerosal causes any harm to kids, and the bottom line is basically, it doesn’t look as if it does,” Cooper, who wrote a commentary published with the AAP’s statement, told Reuters Health.

In a 2004 safety review, for example, the independent U.S. Institute of Medicine concluded there was no evidence thimerosal-containing vaccines could cause autism. A study from the Centers for Disease Control and Prevention came to the same conclusion in 2010.

With the exception of some types of flu shots, the compound is not used in vaccines in the United States, which are distributed in single-dose vials.

And nobody is arguing that should change, according to Dr. Walter Orenstein, a member of the AAP Committee on Infectious Diseases and a researcher at the Emory Vaccine Center in Atlanta.

But in countries with fewer resources – where many children still die of vaccine-preventable diseases – it’s cheaper and easier to use multi-dose vials of vaccines against diphtheria and tetanus, for example.

Thimerosal prevents the rest of a multi-dose vial from getting contaminated with bacteria or fungi each time a dose is used.

Researchers estimated it could cost anywhere from two to five times as much to manufacture vaccines for developing countries without thimerosal, and both transporting vaccines and keeping them refrigerated would be much harder as well.

“If we had to take the thimerosal out of those multi-dose vials, we’re having a hard time completing the task of getting every kid immunized now, that would add a tremendous burden,” Cooper said – and more children would probably die as a result.

“Children who can now be protected from these life-threatening diseases could become vulnerable,” Orenstein told Reuters Health.

The new statement is published in the AAP’s journal Pediatrics.

Thimerosal contains a type of mercury called ethyl mercury. Toxic effects have been tied to its cousin, methyl mercury, which stays in the body for much longer.

Earlier this year, the WHO said replacing thimerosal with an alternative preservative could affect vaccine safety and might cause some vaccines to become unavailable.

Mercury, however, is still on the list of global health hazards to be banned in a draft treaty from the United Nations Environment Program – which would mean a ban on thimerosal.

Reducing mercury exposure “is a wonderful thing,” Orenstein said.

However, “We need this exception because thimerosal is so vital for protecting children.”

He said keeping thimerosal in vaccines is essential mostly for humanitarian reasons – although preventing childhood diseases in the developing world could also help the U.S. because other countries can serve as reservoirs for illness.

“For American parents, this is more looking at the world and our role and responsibility in protecting the children of the world than it is a direct impact,” Orenstein said.

SOURCE: http://bit.ly/cxXOG Pediatrics, online December 17, 2012.

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Experts: No link between Asperger’s, violence

NEW YORK (AP) — While an official has said that the 20-year-old gunman in the Connecticut school shooting had Asperger’s syndrome, experts say there is no connection between the disorder and violence.

Asperger‘s is a mild form of autism often characterized by social awkwardness.

“There really is no clear association between Asperger’s and violent behavior,” said psychologist Elizabeth Laugeson, an assistant clinical professor at the University of California, Los Angeles.

Little is known about Adam Lanza, identified by police as the shooter in the Friday massacre at a Newtown, Conn., elementary school. He fatally shot his mother before going to the school and killing 20 young children, six adults and himself, authorities said.

A law enforcement official, speaking on condition of anonymity because the person was not authorized to discuss the unfolding investigation, said Lanza had been diagnosed with Asperger’s.

High school classmates and others have described him as bright but painfully shy, anxious and a loner. Those kinds of symptoms are consistent with Asperger’s, said psychologist Eric Butter of Nationwide Children’s Hospital in Columbus, Ohio, who treats autism, including Asperger’s, but has no knowledge of Lanza’s case.

Research suggests people with autism do have a higher rate of aggressive behavior — outbursts, shoving or pushing or angry shouting — than the general population, he said.

“But we are not talking about the kind of planned and intentional type of violence we have seen at Newtown,” he said in an email.

“These types of tragedies have occurred at the hands of individuals with many different types of personalities and psychological profiles,” he added.

Autism is a developmental disorder that can range from mild to severe. Asperger’s generally is thought of as a mild form. Both autism and Asperger’s can be characterized by poor social skills, repetitive behavior or interests and problems communicating. Unlike classic autism, Asperger’s does not typically involve delays in mental development or speech.

Experts say those with autism and related disorders are sometimes diagnosed with other mental health problems, such as depression, anxiety, bipolar disorder or obsessive-compulsive disorder.

“I think it’s far more likely that what happened may have more to do with some other kind of mental health condition like depression or anxiety rather than Asperger’s,” Laugeson said.

She said those with Asperger’s tend to focus on rules and be very law-abiding.

“There’s something more to this,” she said. “We just don’t know what that is yet.”

After much debate, the term Asperger’s is being dropped from the diagnostic manual used by the nation’s psychiatrists. In changes approved earlier this month, Asperger’s will be incorporated under the umbrella term “autism spectrum disorder” for all the ranges of autism.

__

AP Writer Matt Apuzzo contributed to this report.

___

Online:

Asperger’s information: http://1.usa.gov/3tGSp5

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Venezuela furious at Obama’s comments on ailing Chavez

CARACAS (Reuters) – Venezuela‘s government reacted with fury on Friday to U.S. President Barack Obama‘s criticism of ailing Hugo Chavez‘s “authoritarian” government at a time of national anxiety over his battle to recover from cancer surgery.

In an interview with U.S. network Univision, Obama declined to speculate on the 58-year-old socialist president’s health in Cuba, where he is in a delicate state after his fourth operation since mid-2011 for cancer in his pelvic region.

But he did say U.S. policy was aimed at ensuring “freedom” in Venezuela. “The most important thing is to remember that the future of Venezuela should be in the hands of the Venezuelan people. We’ve seen from Chavez in the past authoritarian policies, suppression of dissent,” Obama said.

Those remarks went down badly with officials in Caracas where emotions are running high over the future of Chavez and his self-styled revolution in the South American OPEC nation.

In power since 1999, Chavez is due to start a new six-year term on January 10 after winning re-election just weeks before Obama did. His health crisis has thrown that into doubt, and Chavez has named a successor in case he is incapacitated.

“With these despicable comments at such a delicate moment for Venezuela, the U.S. president is responsible for a major deterioration in bilateral relations, proving the continuity of his policy of aggression and disrespect towards our country,” the Venezuelan government said in a statement.

‘SLOW’ RECOVERY, BUT SPEAKING

During his tumultuous rule, Chavez has gleefully assumed former Cuban leader Fidel Castro’s mantle as Washington’s main irritant in the region – though oil has continued to flow freely north to the benefit of both nations’ economies.

Adored by poor supporters for his charismatic style and channeling of oil revenue into a wide array of welfare projects, Chavez is regarded as a dictator by opponents who point to his often harsh treatment of political foes.

Officials said doctors had to use “corrective measures” on Chavez to stop unexpected bleeding caused during Tuesday’s six-hour operation, but that his condition had since improved.

“The patient is fulfilling his post-operation protocol satisfactorily, given the complexity of the surgery,” the latest Venezuelan government statement on his condition said. “Recovery has been slow but progressive,” it added, saying Chavez had communicated with relatives and sent greetings to Venezuelans.

Amid rumors Chavez had been unconscious since his operation, presidential press officer Teresa Maniglia indicated he had spoken for the first time on Friday. “‘How are my people?’ was the first thing Chavez said today when he spoke with his family for the first time,” she said via Twitter.

Chavez’s situation is being closely tracked around the region, especially among fellow leftist-run nations from Cuba to Bolivia which depend on his generous oil subsidies and other aid for their fragile economies.

“The president is battling hard – this time for his life, before it was for the Latin American fatherland,” said President Evo Morales of Bolivia, a Chavez friend and ally who announced he was flying to Havana overnight for an “emergency” visit.

“This is very painful for us.”

SPECULATION

Venezuela’s leader has not divulged details of the cancer that was first diagnosed in June 2011, sparking endless speculation among the country’s 29 million people and criticism from opposition leaders for lack of transparency.

“They’re hiding something, I think,” said 57-year-old housewife Alicia Marquina. “I’m not convinced by the announcements they’re making. I’m not a ‘chavista’, but neither am I cruel. I hope he does not suffer much and finds peace.”

If Chavez has to leave office, new elections must be held within 30 days. Chavez has named his vice president, Nicolas Maduro, a 50-year-old former bus driver and union leader, as his heir apparent.

Opposition flagbearer Henrique Capriles, who lost the presidential race against Chavez in October, is the favorite to face Maduro should a new vote be held, though first the governor of Miranda state must retain his post in local elections on Sunday.

“The regime change is already occurring,” Jefferies’ & Co. managing director Siobhan Morden said in one of numerous Wall Street analyses of events in Venezuela. “The question is whether the alternative is Chavista-light or the opposition.”

Even if he dies, Chavez is likely to cast a long shadow over Venezuela’s political landscape for years – not unlike Argentine leader Juan Peron, whose 1950s populism is still the ideological foundation of the country’s dominant political party.

There are parallels with the situation in Cuba too, where Chavez’s close friend and mentor, Fidel Castro, suffered a health downturn, underwent various operations in secret, then eventually handed over power to his brother Raul Castro.

(Additional reporting by Mario Naranjo and Eyanir Chinea in Caracas, Carlos Quiroga in La Paz; Editing by Paul Simao)

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