Pharmacy Blames Cleaners in Meningitis Outbreak

Jan 4, 2013 11:41am

Credit: Minnesota Department of Health/AP Photo

The pharmacy at the heart of the fungal meningitis outbreak says a cleaning company it hired should share the blame for the tainted steroid injections that caused more than 600 illnesses in 19 states, killing 39 people.

Click here to read about the road to recovery for fungal meningitis victims.

The New England Compounding Pharmacy, which made the fungus-tainted drugs, sent a letter to UniFirst Corp., which provided once-a month cleaning services to the Framingham, Mass., lab, “demanding” it indemnify NECC for the meningitis outbreak, according to a UniFirst filing with the Securities and Exchange Commission.

“Based on its preliminary review of this matter, the company believes that NECC’s claims are without merit,” UniFirst wrote in its quarterly filing.

The New England Compounding Center recalled 17,000 vials of tainted steroid injections on Sept. 26 before recalling all drugs and shutting down on Oct. 6.

The Food and Drug Administration investigated NECC’s lab and found that a quarter of the steroid injections in one bin contained “greenish black foreign matter,” according to the report.  The FDA also identified several cleanrooms that had bacterial or mold overgrowths.

UniFirst’s UniClean business cleaned portions of the NECC cleanrooms to NECC’s specifications and using NECC’s cleansing solutions, UniFirst spokesman Adam Soreoff said in a statement. It provided two technicians once a month for about an hour and a half.

“UniClean was not in any way responsible for NECC’s day-to-day operations, its overall facility cleanliness, or the integrity of the products they produced,” Soreoff said. “Therefore, based on what we know, we believe any NECC claims against UniFirst or UniClean are unfounded and without merit. ”

Click here for our fungal meningitis outbreak timeline, “Anatomy of an Outbreak.”

NECC was not immediately available for comment.

The House of Representatives subpoenaed Barry Cadden, who owns NECC,  to a hearing in Washington, D.C. on Nov. 14. He declined to testify when members of Congress pressed him on his role in ensuring that the drugs his company produced were safe and sterile.

“On advice of counsel, I respectfully decline to answer on the basis of my constitutional rights and privileges including the Fifth Amendment of the Constitution of the United States,” he said at the hearing.

Members of Congress also questioned whether the FDA could have prevented the outbreak.

Compounding pharmacies, which are intended to tailor drugs to individuals with a single prescription from a single doctor, are typically overseen by state pharmacy boards rather than the FDA because they are so small. However, in 2006, the FDA issued a warning letter to NECC, accusing it of mass-producing a topical anesthetic cream, and jeopardizing another drug’s sterility by repackaging it.

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Syria rebels in push to capture air base

AZAZ, Syria (Reuters) - Rebels battled on Thursday to seize an air base in northern Syria, part of a campaign to fight back against the air power that has given President Bashar al-Assad's forces free rein to bomb rebel-held towns.

More than 60,000 people have been killed in the 21-month-old uprising and civil war, the United Nations said this week, sharply raising the death toll estimate in a conflict that shows no sign of ending.

After dramatic advances over the second half of 2012, the rebels now hold wide swathes of territory in the north and east, but are limited in exerting control because they cannot protect towns and villages from Assad's helicopters and jets.

Hundreds of fighters from rebel groups were attempting to storm the Taftanaz air base, near the northern highway that links Syria's two main cities, Aleppo and the capital Damascus.

Rebels have been besieging air bases across the north in recent weeks, in the hope this will reduce the government's power to carry out air strikes and resupply loyalist-held areas.

A rebel fighter speaking from near the Taftanaz base overnight said the base's main sections were still in loyalist hands but insurgents had managed to infiltrate and destroy a helicopter and a fighter jet on the ground.

The northern rebel Idlib Coordination Committee said the rebels had detonated a car bomb inside the base.

The government's SANA news agency said the base had not fallen and that the military had "strongly confronted an attempt by the terrorists to attack the airport from several axes, inflicting heavy losses among them and destroying their weapons and munitions".

Rami Abdulrahman, head of the opposition-aligned Syrian Observatory for Human Rights which monitors the conflict from Britain, said as many as 800 fighters were involved in the assault, including Islamists from Jabhat al-Nusra, a powerful group that Washington considers terrorists.

Taftanaz is mainly a helicopter base, used for missions to resupply army positions in the north, many of which are cut off by road because of rebel gains, as well as for dropping crude "barrel bombs" of explosives on rebel-controlled areas.

"WHAT IS THE FAULT OF THE CHILDREN?"

Near Minakh, another northern air base that rebels have surrounded, government forces have retaliated by regularly shelling and bombing nearby towns.

In the town of Azaz, where the bombardment has become a near nightly occurrence, shells hit a family house overnight. Zeinab Hammadi said her two wounded daughters, aged 10 and 12, had been rushed across the border to Turkey, one with her brain exposed.

"We were sleeping and it just landed on us in the blink of an eye," she said, weeping as she surveyed the damage.

Family members tried to salvage possessions from the wreckage, men lifting out furniture and children carrying out their belongings in tubs.

"He (Assad) wants revenge against the people," said Abu Hassan, 33, working at a garage near the destroyed house. "What is the fault of the children? Are they the ones fighting?"

Opposition activists said warplanes struck a residential building in another rebel-held northern town, Hayyan, killing at least eight civilians.

Video footage showed men carrying dismembered bodies of children and dozens of people searching for victims in the rubble of the destroyed building, shouting "God is greatest". The provenance of the video could not be independently confirmed.

In addition to their tenuous grip on the north, the rebels also hold a crescent of suburbs on the edge of Damascus, which have come under bombardment by government forces that control the center of the capital.

On Wednesday, according to opposition activists, dozens of people were incinerated in an inferno caused by an air strike on a petrol station in a Damascus suburb where residents were lining up for precious fuel.

The civil war in Syria has become the longest and bloodiest of the conflicts that rose out of uprisings across the Arab world in the past two years.

Assad's family has ruled for 42 years since his father seized power in a coup. The war pits rebels, mainly from the Sunni Muslim majority, against a government supported by members of Assad's Shi'ite-derived Alawite minority sect and some members of other minorities who fear revenge if he falls.

The West, most Sunni-ruled Arab states and Turkey have called for Assad to leave power. He is supported by Russia and Shi'ite Iran.

(Additional reporting by Khaled Yacoub Oweis in Amman and Dominic Evans in Beirut; Writing by Peter Graff; Editing by Ruth Pitchford)

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Fiat says to boost stake in Chrysler to 65.17%

ROME: Italian auto giant Fiat on Thursday said it was exercising its option to increase by 3.3 percentage points its stake in US automaker Chrysler to 65.17 per cent for US$198 million.

Fiat said the value of the purchase from a trust run by the US auto union UAW to pay health care benefits for Chrysler retirees was its estimate, which still had to be determined by a US court.

In July, the Italian company said it was exercising its option to purchase another 3.3-percent tranche from the Voluntary Employee Beneficiary Association (VEBA) trust.

"Following the consummation of both purchases, Fiat will hold 65.17 per cent of the outstanding equity in Chrysler," the company said in a statement.

Fiat took over operational command of the ailing US automaker in June 2009, when Chrysler emerged from a government-supported bankruptcy following a collapse in sales amid the financial crisis.

In June 2011, Fiat took a majority stake of the company and Fiat boss Sergio Marchionne is now also chief executive of the Chrysler Group, though the two groups still operate independently.

Marchionne does not foresee a full merger before 2015.

- AFP/jc

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Gulf flight cites low fuel, lands in Mumbai

NEW DELHI: Is jet fuel becoming so expensive that airlines are no longer able to afford tanking up their aircraft with the required amount for a journey? An aircraft that recently took off from Hyderabad for an over three-hour flight to the Gulf found itself running low on fuel barely after reaching Mumbai—less than a third of the total distance it was supposed to travel nonstop. It then made an unscheduled refuelling stop there.

This unprecedented situation was witnessed on Thursday, December 27, with Oman Air's flight WY232 that was winging its way from Hyderabad to Muscat and was supposed to reach there in three hours and thirty five minutes. But it ended up taking a refuelling stop in Mumbai—which is about 45 minutes flying time from Hyderabad!

Top ATC officials, who say the Oman Air aircraft had flown about 180km out of Mumbai and was over the Arabian Sea when it decided to land at the megacity, are baffled at what they term is possibly the first of its kind fuel emergency ever reported in India. The Directorate General of Civil Aviation (DGCA) is examining this incident because of its serious implications.

According to global norms, aircraft are supposed to carry fuel to meet these requirements: make it from origin to destination; divert from destination to an alternate airport in case of a problem at the former and hover at both destination and alternate airport for up to 30 minutes.

Oman Air admitted that the pilots of its nonstop Hyderabad-Muscat flight (WY 232) on December 27 had requested to land in Mumbai for refuelling. But it said the pilot did so as the flight's alternate airport Sharjah was not available to it.

"In this case, the destination airport was Muscat, Oman, and alternative airport was Sharjah, UAE. However, whilst following the flight plan on route to Muscat, the captain identified that Sharjah was no longer legal as an alternative airport even though he had adequate fuel for the flight to land at the destination. In line with Oman Air's policies of always operating above safety standards, the captain rightfully decided to divert to Mumbai... it was done to ensure rigorous safety compliance even if the chances of dependence on the additional safety measure were remote," said Usama Karim Al Haremi, Oman Air's head of corporate communications and media.

However, top ATC officials here are sceptical of the explanation given by Oman Air and blame the airline for this mid-air fuel shortage. "If Sharjah was not available as the alternate airport, why did Oman Air file for there in the first place? Airlines can have second alternates also. Most importantly, if the aircraft had fuel to fly till Muscat, it could have gone there and then declared a fuel emergency to land at any of the numerous airports dotting the region. Dubai and Abu Dhabi are not too far either. We suspect some other reason for this fuel shortage," said a top ATC official, seeking an inquiry by the DGCA so that the aviation regulator of Oman could then be contacted with the right reasons.

The official added that either miscalculation in fuel required for the journey and then tanking up the aircraft or a technical snag seem more likely to have caused this situation.

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CDC: 1 in 24 admit nodding off while driving

NEW YORK (AP) — This could give you nightmares: 1 in 24 U.S. adults say they recently fell asleep while driving.

And health officials behind the study think the number is probably higher. That's because some people don't realize it when they nod off for a second or two behind the wheel.

"If I'm on the road, I'd be a little worried about the other drivers," said the study's lead author, Anne Wheaton of the Centers for Disease Control and Prevention.

In the CDC study released Thursday, about 4 percent of U.S. adults said they nodded off or fell asleep at least once while driving in the previous month. Some earlier studies reached a similar conclusion, but the CDC telephone survey of 147,000 adults was far larger. It was conducted in 19 states and the District of Columbia in 2009 and 2010.

CDC researchers found drowsy driving was more common in men, people ages 25 to 34, those who averaged less than six hours of sleep each night, and — for some unexplained reason — Texans.

Wheaton said it's possible the Texas survey sample included larger numbers of sleep-deprived young adults or apnea-suffering overweight people.

Most of the CDC findings are not surprising to those who study this problem.

"A lot of people are getting insufficient sleep," said Dr. Gregory Belenky, director of Washington State University's Sleep and Performance Research Center in Spokane.

The government estimates that about 3 percent of fatal traffic crashes involve drowsy drivers, but other estimates have put that number as high as 33 percent.

Warning signs of drowsy driving: Feeling very tired, not remembering the last mile or two, or drifting onto rumble strips on the side of the road. That signals a driver should get off the road and rest, Wheaton said.

Even a brief moment nodding off can be extremely dangerous, she noted. At 60 mph, a single second translates to speeding along for 88 feet — the length of two school buses.

To prevent drowsy driving, health officials recommend getting 7 to 9 hours of sleep each night, treating any sleep disorders and not drinking alcohol before getting behind the wheel.

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Online:

CDC report: http://www.cdc.gov/mmwr

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Sandy Hook Parents Cope With Students' Return

Sandy Hook parents put their children on school buses this morning and waved goodbye as the yellow bus rolled away, but this first day back since the pre-Christmas massacre is anything but normal for the families of Sandy Hook Elementary School.

Erin Milgram, the mother of a first grader and a fourth grader at Sandy Hook, told "Good Morning America" that she was going to drive behind the bus and stay with her 7-year-old Lauren for the entire school day.

"I haven't gotten that far yet, about not being with them," Milgram said. "I just need to stay with them for a while."

Today is "Opening Day" for Sandy Hook Elementary School, which is re-opening about six miles away in the former Chalk Hill school in Monroe, Conn.

Lauren was in teacher Kaitlin Roig's first grade class on Dec. 14 when gunman Adam Lanza forced his way into the school and killed 20 students and six staffers.

Roig has been hailed a hero for barricading her students in a classroom bathroom and refusing to open the door until authorities could find a key to open the door.

The 20 students killed were first-graders and the Milgrams have struggled to explain to Lauren why so many of her friends will never return to school.

Sandy Hook Elementary School: Ready to Return Watch Video

Newtown, Conn. Students Return to New Sandy Hook Watch Video

"She knows her friends and she'll also see on the bus... there will be some missing on the bus," Milgram said. "We look at yearbook pictures. We try to focus on the happy times because we really don't know what we're doing."

"How could someone be so angry?" Lauren's father Eric Milgram wondered before a long pause. "We don't know."

The school has a lecture room available for parents to stay as long as they wish and they are also allowed to accompany their children to the classroom to help them adjust. Counselors will be available throughout the day for parents, staff and students, according to the school's website.

The first few days will be a delicate balancing act between assessing the children's needs and trying to get them back to a normal routine.

"We don't want to avoid memories of a trauma," Dr. Jamie Howard told "Good Morning America." "And so by getting back to school and by engaging in your routines, we're helping kids to do that, we're helping them to have a natural, healthy recovery to a trauma."

Security is paramount in everyone's mind. There is a police presence on campus and drivers of every vehicle that comes onto campus are being interviewed.

"Our goal is to make it a safe and secure learning environment for these kids to return to, and the teachers also," Monroe police Lt. Keith White said at a news conference on Wednesday.

A "state-of-the-art" security system is in place, but authorities will not go into detail about the system saying only that the school will probably be "the safest school in America."

White said at a news conference today that the security presence would be evaluated on a day-by-day and week-by-week basis moving forward.

"We are trying to keep a balance," he said. "We don't want them [the students] to think that this is a police state. This is a school and a school first."

Every adult in the school who is not immediately recognizable will be required to wear a badge as identification, parent and school volunteer Karen Dryer told ABCNews.com.

"They want to know exactly who you are at sight, whether or not you should be there," Dryer said.

Despite the precautions and preparations, parents will still be coping with the anxiety of parting with their children.

"Rationally, something like this is a very improbable event, but that still doesn't change the emotional side of the way you feel," Eric Milgram said.

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Central African Republic rebels halt advance, agree to peace talks

DAMARA, Central African Republic (Reuters) - Rebels in Central African Republic said they had halted their advance on the capital on Wednesday and agreed to start peace talks, averting a clash with regionally backed troops.

The Seleka rebels had pushed to within striking distance of Bangui after a three-week onslaught and threatened to oust President Francois Bozize, accusing him of reneging on a previous peace deal and cracking down on dissidents.

Their announcement on Wednesday gave the leader only a limited reprieve as the fighters told Reuters they might insist on his removal in the negotiations.

"I have asked our forces not to move their positions starting today because we want to enter talks in (Gabon's capital) Libreville for a political solution," said Seleka spokesman Eric Massi, speaking by telephone from Paris.

"I am in discussion with our partners to come up with proposals to end the crisis, but one solution could be a political transition that excludes Bozize," he said.

Bozize on Wednesday sacked his Army Chief of Staff and took over the defense minister's role from his son, Jean Francis Bozize, according to a decree read on national radio, a day after publicly criticizing the military for failing to repel the rebels.

The advance by Seleka, an alliance of mostly northeastern rebel groups, was the latest in a series of revolts in a country at the heart of one of Africa's most turbulent regions - and the most serious since the Chad-backed insurgency that swept Bozize to power in 2003.

Diplomatic sources have said talks organized by central African regional bloc ECCAS could start on January 10. The United States, the European Union and France have called on both sides to negotiate and spare civilians.

Central African Republic is one of the least developed countries in the world despite its deposits of gold, diamonds and other minerals. French nuclear energy group Areva mines the country's Bakouma uranium deposit - France's biggest commercial interest in its former colony.

RELIEF IN BANGUI

News of the rebel halt eased tension in Bangui, where residents had been stockpiling food and water and staying indoors after dark.

"They say they are no longer going to attack Bangui, and that's great news for us," said Jaqueline Loza in the crumbling riverside city.

ECCAS members Chad, Congo Republic, Gabon and Cameroon have sent hundreds of soldiers to reinforce CAR's army after a string of rebel victories since early December.

Gabonese General Jean Felix Akaga, commander of the regional force, said his troops were defending the town of Damara, 75 km (45 miles) north of Bangui and close to the rebel front.

"Damara is a red line not to be crossed ... Damara is in our control and Bangui is secure," he told Reuters. "If the rebellion decides to approach Damara, they know they will encounter a force that will react."

Soldiers armed with Kalashnikovs, rocket propelled grenade launchers and truck-mounted machineguns had taken up positions across the town, which was otherwise nearly-abandoned.

Some of the fighters wore turbans that covered their faces and had charms strung around their necks and arms meant to protect them against enemy bullets.

Chad's President Idriss Deby, one of Bozize's closest allies, had warned the rebels the regional force would confront them if they approached the town.

Chad provided training and equipment to the rebellion that brought Bozize to power by ousting then-president Ange Felix Patasse, who Chad accused of supporting Chadian dissidents.

Chad is also keen to keep a lid on instability in the territory close to its main oil export pipeline and has stepped in to defend Bozize against insurgents in the past.

A CAR government minister told Reuters the foreign troop presence strengthened Bozize's bargaining position ahead of the Libreville peace talks.

"The rebels are now in a position of weakness," the minister said, asking not to be named. "They should therefore stop imposing conditions like the departure of the president."

Central African Republic is one of a number of countries in the region where U.S. Special Forces are helping local soldiers track down the Lord's Resistance Army, a rebel group which has killed thousands of civilians across four nations.

France has a 600-strong force in CAR to defend about 1,200 of its citizens who live there.

Paris used air strikes to defend Bozize against a rebellion in 2006. But French President Francois Hollande turned down a request for more help, saying the days of intervening in other countries' affairs were over.

(Additional reporting by Paul-Marin Ngoupana in Bangui and Jon Herskovitz in Johannesburg; Writing by Richard Valdmanis; Editing by Andrew Heavens and Janet Lawrence)

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US shooting relatives blast theatre offer

LOS ANGELES: Relatives of victims massacred by a gunman in a Colorado movie theatre criticised Wednesday an invitation to its re-opening as a "ridiculously offensive" publicity ploy.

Family members of nine of the 12 people who died in Aurora, outside Denver in July said the invitation's timing was particularly painful over the Christmas holiday, and called for others to boycott the "special evening of remembrance."

"During the holiday we didn't think anyone or anything could make our grief worse," they wrote in a letter to movie theatre chain Cinemark.

"But you, Cinemark, have managed to do just that by sending us an invitation two days after Christmas inviting us to attend the re-opening of your theatre in Aurora where our loved ones were massacred.

"Thanks for making what is a very difficult holiday season that much more difficult. Timing is everything and yours is awful."

As well as those killed, 58 people were wounded at a midnight premiere of the Batman movie "The Dark Knight Rises." Alleged gunman James Holmes, 24, reportedly wore body armour and threw smoke bombs before opening fire.

The massacre revived the perennial debate about US gun control laws, triggered again by the killing of 26 people including 20 young children at a Connecticut elementary school last month.

Wednesday's letter by Aurora victims' relatives said Cinemark -- which is facing a number of lawsuits from relatives and survivors alleging lax security -- had never reached out to the families to offer condolences.

"This disgusting offer that you'd 'like to invite you and a guest to a special evening of remembrance on Thursday, January 17 at 5 PM' followed by the showing of a movie and then telling us to be sure 'to reserve our tickets' is wholly offensive to the memory of our loved ones.

"Our family members will never be on this earth with us again and a movie ticket and some token words from people who didn't care enough to reach out to us, nor respond when we reached out to them to talk, is appalling."

They added: "We, the families, recognise your thinly veiled publicity ploy for what it is: a great opportunity for you to distance yourselves and divert public scrutiny from your culpability in this massacre.

"After reading our response to your ridiculously offensive invitation, you now know why we will not be attending your re-opening celebration and will be using every social media tool at our disposal to ask the other victims to ask their friends and family to honour us by boycotting the killing field of our children."

There was no immediate response from the theatre chain.

- AFP/jc

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CJI ensures speedy trial in rape case

NEW DELHI: Ensuring a speedy trial in the Nirbhaya case, Chief Justice of India Altamas Kabir on Wednesday inaugurated a fast track court to try sexual offence cases against women.

The CJI, who justified the public reaction against the ghastly incident, said that had the Supreme Court guidelines on removal of tinted glasses from the vehicles been followed, such incidents could be averted.

"It's good to know that after the tragic incident, people have started raising their voice on crime against women," he said while expressing hope that the fast track court at Saket district courts complex would be operational immediately. He said blame game should be avoided and the case, which is in the "public eye", should be decided on fast track."

He also cautioned about the people's reaction against sending the accused for trial and calling for handing them over to the public to be dealt with by saying that it is a "dangerous reaction".

"People's reaction has been that do not send the accused to trial. Hand them over to us, we will deal with them. Hang them. But let us not get carried away. Let us deal with the matter in a manner in which we are able to do justice as early as possible. Let us show that the judiciary is behind the common man," he said.

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Brain image study: Fructose may spur overeating

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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Online:

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

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

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

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