Docs Push for Over-the-Counter Pill

In an attempt to lower the alarmingly high rate of unplanned pregnancy — and the high cost associated with it — an expert panel of doctors recommended Tuesday that birth control pills be made available without a prescription.

Specifically, the committee said the potential benefits of over-the-counter birth control pills outweigh the danger, which includes a small risk of dangerous blood clots.

Nearly half of all pregnancies happen by accident, according to government data. These pregnancies cost taxpayers an estimated $ 11.1 billion each year, according to the American College of Obstetricians and Gynecologists’ Committee on Gynecologic Practice.

The birth control pill, commonly called “the pill,” is a formulation of hormones, usually progestin and estrogen, that helps prevent pregnancy mainly by keeping the ovaries from releasing eggs. Right now “the pill” is only available in the United States with a prescription, which the committee said poses a significant barrier.

“Access to and cost issues are common reasons why women do not use contraception or use it inconsistently,” said Dr. Kavita Nanda, one of the physicians on the committee.

A survey from 2004, cited by the committee, found that almost half of all uninsured women and 40 percent of low-income women who were not using birth control pills, the patch or the ring, said they would more likely use the pill if it were available over the counter.

This same survey also found that more than two out of three women at risk of an unintended pregnancy would use their pharmacy if more methods of birth control were available over the counter.

The committee said that birth control pills are good options for these women, with efficacy ranging from 92 to 99 percent depending on use.

Dr. Daniel Grossman, an American College of Obstetricians and Gynecologists fellow, who was not part of the committee, said oral contraceptives are also safe. “We have over 50 years of experience with this method,” he said.

There are still many steps that would have to occur for the American College of Obstetricians and Gynecologists recommendation to translate into the availability of birth control pills over the counter. And not all doctors support the idea that birth control pills are safely sold without a prescription.

“I think that the risks far outweigh the benefits,” said ABC News’ senior medical contributor Dr. Jennifer Ashton, who is also an obstetrician and gynecologist.

“Even though they’re hormones … they’re at much higher doses than our body makes, and as such there can be side effects ranging from minor to life threatening,” Ashton said. She went on to list some of the side effects associated with birth control pills, including low risks of blood clot, stroke and heart attack. “It’s a full spectrum of things that really needs a medical provider in the picture.”

Still, the committee noted in its recommendation that the risk of blood clots associated with birth control pills was low, with three to 10 women out of 10,000 taking the pill experiencing such a problem each year. By comparison, past research has found that the risk of blood clots associated with being pregnant is five to 20 women out of 10,000 each year, while the risk of clots associated with having just given birth is 40 to 65 per 10,000.

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Tel Aviv bus blast shakes Gaza diplomacy

TEL AVIV, Israel (AP) — A bomb struck an Israeli bus near the nation's military headquarters in Tel Aviv on Wednesday, wounding 10 people and complicating major diplomatic efforts to forge a truce between Israel and Gaza's militant Hamas rulers.

The attack came as U.S. Secretary of State Hillary Rodham Clinton shuttled between Jerusalem and the West Bank to help piece together a deal to end Israel's weeklong offensive against Palestinian militants in the Gaza Strip that has killed more than 130 Palestinians. Militant rocket fire into Israel has killed five Israelis. Clinton was due to travel later to Egypt, which is mediating in the crisis.

"What does it say about the future of the (truce) talks? I leave it to (the senior officials), but this doesn't add anything," Yitzhak Aharonovich, Israel's minister of internal security, told Army Radio.

The bus exploded around noon on one of the coastal city's busiest arteries, near the Tel Aviv museum, the district courthouse and across from an entrance to Israel's national defense headquarters.

The bus was completely charred, its side windows blown out and glass scattered on the asphalt. The wounded were evacuated and blood was splattered on the sidewalk.

"We suddenly heard a huge explosion and immediately knew it was a terror attack," said Nir Zano, 35. "I saw someone running in to carry out a woman who was injured."

Aharonovitch said the device was placed inside the bus by a man who then disembarked. The explosion took place while the bus was in movement, he said.

Police set up roadblocks across the city trying to apprehend the attacker.

"We strongly believe that this was a terror attack," said police spokesman Micky Rosenfeld. He said three of the 10 wounded were moderately to seriously hurt.

In Gaza, the Tel Aviv bombing was praised from mosque loudspeakers, while Hamas' television interviewed people praising the attack as a return of militants' trademark tactics.

No group claimed responsibility for the attack, but Hamas spokesman Fawzi Barhoum welcomed it.

"We consider it a natural response to the occupation crimes and the ongoing massacres against civilians in the Gaza Strip," he told The Associated Press.

Israeli Deputy Prime Minister Silvan Shalom, who heard the explosion from his Tel Aviv office, called it "an escalation."

The cease-fire efforts come with thousands of Israeli ground troops massed on the Gaza border, awaiting a possible order to invade.

After meeting with Israeli Prime Minister Benjamin Netanyahu in Jerusalem Tuesday night, Clinton conferred with Palestinian President Mahmoud Abbas in the West Bank on Wednesday morning and was due to travel later to Cairo, which is mediating in the crisis.

The two sides had seemed on the brink of a deal Tuesday following a swirl of diplomatic activity also involving U.N. chief Ban Ki-moon and Egypt's President Mohammed Morsi. But sticking points could not be resolved as talks — and violence — stretched into the night.

Israeli aircraft pounded Gaza with at least 30 strikes overnight, hitting government ministries, smuggling tunnels, a banker's empty villa and a Hamas-linked media office.

Dozens of civilians are among the more than 130 Palestinians killed in a week of fighting. Four Israeli civilians and a soldier have been killed by rocket fire — a toll possibly kept down by a U.S.-funded rocket defense system that has shot down hundreds of Gaza projectiles.

The Tel Aviv bus bombed Wednesday was relatively empty during the explosion, which explains the relatively low number of casualties. The bombing was the first in the coastal city since April 2006, when a Palestinian suicide bomber killed 11 people at a sandwich stand near the city's old central bus station. A bomb left at a bus stand in Jerusalem last year killed one person.

More than 1,000 Israelis were killed during the violent Palestinian uprising in the last decade in bombings and shooting attacks. More than 5,000 Palestinians were killed as well.

___

Associated Press writer Ibrahim Barzak contributed to this report from Gaza City.

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Academy Sues Over “Deer Hunter” Oscar Statuette

LOS ANGELES (TheWrap.com) – A possibly counterfeit Oscars trophy for the 1978 film has sparked a very real lawsuit.

The Academy of Motion Picture Arts and Sciences has filed suit in U.S. District Court in Washington state over an Oscar statuette that “was either a genuine statuette or a very convincing counterfeit.”

If it’s real, the trophy was the one awarded to Aaron Rochin for his sound work on the 1978 film “The Deer Hunter.”

The Academy is suing Washington resident James Dunne, who sold the statue, and Edgard G. Francisco, who purchased it.

Dunne initially offered the statuette for sale on eBay in September but deleted the listing for fear that the Academy might discover it, according to the suit, which was filed last week. He later privately sold the statue of Florida resident Francisco for $ 25,000, the suit says.

The suit goes on to allege that after an appraisal, Francisco decided the statuette was fake and demanded a $ 15,000 refund. Dunne claims he provided a full refund. He also claims that he told Francisco that the trophy might not be authentic before he bought it.

Dunne told the Academy that he had either picked up the statuette at a moving sale or obtained it from a third party who got it at an estate sale.

After getting the refund, the suit says, Francisco threw the statuette away.

The Academy’s suit is two-fold: If the trophy was real, the Academy is seeking restitution for the loss of its property; if it was fake, the Academy claims that the pair infringed on the organization’s Oscars copyright.

The latter would seem to be the more probable scenario in this case. For one thing, the Academy says that the identification number for the statuette would place its manufacture in 1979, while the eBay auction billed it as a “Rare Pre-1950 Academy of Motion Picture Arts and Sciences OSCAR Statue Award!”

The Academy is asking for unspecified damages, plus suit costs and attorneys’ fees.

(Pamela Chelin contributed to this report)

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U.S. fiscal impact of great concern to Canada: Canada’s Harper

TORONTO (Reuters) – Any fiscal problems that would significantly slow the U.S. economy would be of great concern to Canada, Canadian Prime Minister Stephen Harper said on Monday.

The United States needed a credible medium-term fiscal plan, Harper said at a business forum in Ottawa, adding that he was following the U.S. fiscal debate with “great interest.”

(Reporting by Solarina Ho)

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Phillip Phillips looks at life beyond “American Idol”

LOS ANGELES (Reuters) – Like the 10 winners before him, Phillip Phillips faces the uneven road from “American Idol” victor to pop-chart mainstay.

After the success of his Top 10 hit, “Home,” the Georgia native is facing a new challenge – to replicate the mainstream successes of past “Idol” winners Carrie Underwood and Kelly Clarkson on his debut album, “The World from the Side of the Moon,” released on Monday by Interscope Records.

Phillips, 22, spoke to Reuters about making his first proper studio album, what he might do differently on a second one, and whether he could have won “Idol” with this season’s panel of judges.

Q: How do you plan to transition from “American Idol” winner to a mainstream music career?

A: “It’s pretty funny that you mention that because the majority of the people I meet don’t even know that I was on ‘Idol.’ It’s really cool to hear that. When I go home, people ask, ‘What’ve you been doing? I’ve heard your song,’ but they don’t even know that I’ve been on ‘Idol.’”

Q: Your first single “Home” has gone twice platinum. You’ve said that it isn’t a song you would have written yourself. What’s your relationship now with your first hit?

A: “It’s amazing how well it has done, and I look at all the stories that I hear like how it has helped families out with their situation, or something’s happened with their kid, mom or dad, or if their child’s overseas in the war. Something like that’s pretty amazing how many different stories come out of it.”

Q: Did you have any ideas on how you wanted to develop your sound finally getting into a big-time studio?

A: “I already had the songs written, and it was just a matter of throwing in ideas and then just trimming it down to what felt right, because we only had three weeks to do this album. So it was kind of pressured, but that kind of helped out as well. It didn’t make us overthink anything.”

Q: Was there anything in particular you wanted to achieve?

A: “I wanted to make it similar to what I did on the show – a horn section and some rock. I tried to be a little artistic. I just wrote what came from my heart and what felt right.”

Q: Unlike many of the other contestants, you went into “Idol” as a songwriter, how many of the album’s songs did you write?

A: “I think five. Some of the co-writes, (the writers) really just kind of pushed me, so I kind of wrote most of those myself. But it was a lot of fun; it was a great experience.”

Q: Would you do anything differently next time?

A: “It’s still early, but I’d definitely want a little more time to do it. But that’s really about it, because three weeks is just really quick, and also I have just so many other things going on. … It was very kind of stressful and hopefully for the next record I’ll have a little more time.”

Q: What would that time allow you to do in the studio?

A: “Just being able to listen to it a little more. We all knew that it sounded really good but also having to listen to, like 17 songs in a row. You say, ‘Yeah that sounds great’ but you listen to it more and more and (say) ‘Maybe I would’ve brought this instrument down a little bit or brought it up a little bit more.’”

Q: Would you have fared any differently on ‘Idol’ with the current judges Nicky Minaj and Mariah Carey?

A: “I don’t know. I’m curious to see how they’re going to judge. It’s a completely different panel this year. … I don’t really know how I would’ve turned out. Maybe I’ll have to go out and audition again (laughs).”

Q: Would you have had to change your roots-y style?

A: “Naw, I would’ve still been the same dude. If they wouldn’t have sent me through, they wouldn’t have sent me through. And if they did, that’d be awesome.”

(Reporting By Eric Kelsey, editing by Jill Serjeant and Gunna Dickson)

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Women With Breast Cancer Wait Weeks Before Surgery

FIRST PERSON | New research shows that Medicare patients with breast cancer wait as long as 32 days before surgery. This wait is typical in the United States. It is not only older women that have a long wait. I first found a lump in my breast in September 2011. My first surgery was not until November 2011. The wait was not on my end — in northwest Arkansas, it takes at least three weeks to get an appointment with anyone.

The study

MedicalXpress reports that the Fox Chase Cancer Center published its findings in the Nov. 19, 2012 edition of The Journal of Clinical Oncology. The study evaluated data from over 72,000 Medicare patients with non-metastatic breast cancer and found that in 2005, at least half of the breast cancer patients waited a minimum of 32 days before having surgery. This data shows a marked increase from 21 days back in 1992.

Breast cancer diagnosis

It is interesting that they looked only at non-metastatic breast cancer. When you first go to see your doctor about a breast problem, like a lump, you have no idea if it is even cancer, much less if it has spread to other parts of the body. Diagnostic mammography, breast MRIs, and ultrasound cannot tell you if the area of concern is cancer. Only surgery can determine breast cancer — that means either a needle biopsy or other invasive procedures.

The waiting can kill you

Medicare had nothing to do with my time delays, as I have private insurance. I have non-metastatic breast cancer. It took 3 weeks to see my OBGYN, then it was another week before I had the imaging done. From there, it took three weeks to schedule a wire-guided surgical biopsy. I had the biopsy in mid-November 2011. It was then I received a cancer diagnosis and was told that it was a high-grade tumor — meaning it was very aggressive. At the same time of my diagnosis, my surgeon ordered more tests. We waited until late December 2011 to discuss a mastectomy. The wait was due to him wanting to see the results of genetic testing. Personally, I was uncomfortable with the long wait time.

Long waits are not just for Medicare recipients and for people in large metropolitan areas. Here in rural Arkansas, wait times are long because there is a shortage of physicians. The area is growing but the medical community is not keeping up with the growth. Patients like me who have serious medical conditions are traveling to other areas in order to get better care.

Lynda Altman was diagnosed with breast cancer in November 2011. She writes a series for Yahoo! Shine called “My Battle With Breast Cancer.”

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Hamas says Gaza truce agreed, Israel says no deal yet

Robert Pattinson and Kristen Stewart are coming to the end of their whirlwind international promotional tour for "The Twilight Saga: Breaking Dawn - Part 2," and while the on-screen couple have yet to confirm they've reunited off-screen, they appear to be enjoying each other's company. Following the final "Twilight" film's Germany premiere in Berlin on Friday, Robert, 26, and Kristen, 22, were photographed heading to the Berolina Bowling Lounge to relax after their completing their red carpet duties.

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U.S. fiscal impact of great concern to Canada: Canada’s Harper

TORONTO (Reuters) – Any fiscal problems that would significantly slow the U.S. economy would be of great concern to Canada, Canadian Prime Minister Stephen Harper said on Monday.

The United States needed a credible medium-term fiscal plan, Harper said at a business forum in Ottawa, adding that he was following the U.S. fiscal debate with “great interest.”

(Reporting by Solarina Ho)

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Kopp: Impostor filed motion in NY Facebook case

BUFFALO, N.Y. (AP) — Lawyers fighting a New York man’s ownership claim against Facebook Inc. say a bizarre motion bearing the name of convicted abortion doctor killer James Charles Kopp earlier this month was apparently filed by an impostor.

In court papers, Facebook lawyers say they received a sworn statement from the imprisoned Kopp Monday denying he’s filed any motion in Paul Ceglia‘s lawsuit. An accompanying letter from Kopp to the federal judge handling the case says someone is impersonating him.

The motion signed with Kopp’s name had sought permission to intervene in Ceglia’s lawsuit while accusing Ceglia of a litany of personal slights, threats and crimes. Kopp’s serving life in prison for the 1998 killing of Dr. Barnett Slepian in suburban Buffalo.

Facebook says the Kopp motion, even if it’s real, should be denied.

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Task Force Backs HIV Screening

In an effort to curb HIV transmission and get treatment to those already infected, the U.S. Preventive Services Task Force has recommended that every American between the ages of 15 and 65 be tested for HIV.

Experts hope that the new recommendations will encourage more Americans to get tested and, if necessary, get treated.

“HIV screening is an important way to help people who have HIV, and also to prevent transmission,” said Dr. Doug Owens, a leader of the task force and professor of medicine at Stanford University and the Veterans Affairs Palo Alto Health Care System. Owens said that HIV treatment “decreases the amount of circulating virus,” making it less likely for it to spread from person to person.

Roughly 1.2 million Americans are currently living with HIV, a number that has been increasing steadily over the past five years, according to the U.S. Centers for Disease Control and Prevention. There continue to be about 48,000 new cases per year in the United States, but new treatments are allowing people to live long lives after they’re diagnosed.

“Hopefully, more people with HIV will be identified and treated earlier,” said Dr. Roger Chou of the Pacific Northwest Evidence Based Practice Center, whose study on the evidence supporting the new recommendation was published today in the Annals of Internal Medicine.

HIV-positive patients who start treatment while their immune systems are relatively intact live longer and are less likely to spread the virus to other people. But 20 percent of patients are unaware they have the virus, said Dr. Carlos Del Rio, co-director of the Emory Center for AIDS research in Atlanta.

“This news about screening is very exciting,” Del Rio said.

Previous task force recommendations on HIV testing, published in 2005, called for adults to get tested only if they’d had unprotected sex with multiple partners or used intravenous drugs — in other words, were at high risk. But up to a quarter of patients who test positive for HIV report no risk factors, according to the new Preventive Services Task Force statement.

“People are terrible at knowing their own risk,” said Del Rio, adding that people may be unaware of the HIV status of their sexual partners. “And doctors are terrible at asking them about risk. It can be difficult to discuss sex and drugs with our patients.”

The task force recommendations are used by Medicare and other insurance companies to determine what laboratory tests should be covered. Other important task force recommendations included screening for breast and colon cancer, as well as high cholesterol.

“I don’t have to ask my patients if they eat hamburgers before ordering a cholesterol test,” said Del Rio. “Now I can do a routine HIV test when patients come to clinic.”

In order for the U.S. Preventive Services Task Force to make a testing recommendation, the test has to be accurate, treatment for the disease must be available and the benefits of the treatment outweigh the harms.

“HIV testing is one of the most accurate tests that we have for any condition,” said Chou.

Coupled with the fact that the benefits of HIV treatment are now known to outweigh the risks, screening now makes sense, according to the experts on the task force.

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