Can Low-Dose Avandia for Diabetes Avoid Lethal Side Effects?

Testing a Low-Dose Avandia 'Cocktail' Shows Promise, but Some Doctors Say Pull Drug From Market.
Amid calls to pull the controversial diabetes drug Avandia from the market, new research suggests that a low dose of this GlaxoSmithKline drug may help prevent diabetes without undue risk. Though the study, published Wednesday in the Lancet, showed few adverse side effects for a low-dose treatment, diabetes experts say Avandia has a history of potentially lethal side effects, and that further testing and use of this dangerous drug is questionable.
"This is a desperate attempt to salvage a dangerous drug," Dr. Sidney Wolfe, director of Public Citizen's Health Research Group, says of the study. Wolfe urges that trials on Avandia, known clinically as rosiglitazone, be halted due to the mounting evidence that the drug brings with it significant risk of heart attack, weight gain, and other health risks. In the study, test subjects were given a half-dose of Avandia paired with another diabetes drug, metformin , over a four-year period. They saw "very little in the way of adverse side effects," says study author Dr. Bernard Zinman of the University of Toronto. The study was not designed to test cardiovascular safety however, and the results cannot speak to the controversy surrounding the drug, Zinman says. "I can't say that this is strong evidence that [Avandia] is safe, but it implies that at this dose it is much better," Zinman says. Given Avandia's troubled history, complete with thousands of patient law suits and FDA recognition of its added risks, however, diabetes experts question the motivation for continuing research on this drug. Avandia's competitor, pioglitazone (Actos), works just as well with fewer risks, and intensive lifestyle counseling has been shown to work as well with no side effects, so, Wolfe asks, why continue to play with fire?
A Safe Future for Avandia? The drug combination in the Lancet study reduced the relative risk of developing type 2 diabetes by 66 percent among those patients at risk when compared to placebo. Past studies have shown that intensive lifestyle counseling can reduce diabetes risk by nearly 60 percent, but Zinman says that this type of regular coaching is difficult to implement without society-wide changes in diet and exercise habits. While all participants in the study received one-on-one coaching on diet and exercise changes in the first year, nearly forty percent of those who received only this counseling and a placebo went on to develop diabetes while only 14 percent of those treated with drugs did. I have copy this news from ABC News Online.

Obama Scraps Asia Trip, Second Time This Year.

For the second time this year, President Obama has scrubbed a planned trip to Indonesia and Australia. White House Press Secretary Robert Gibbs announced the cancellation in a written statement released at midnight Eastern Time. Gibbs wrote that Obama spoke with the leaders of both countries Thursday night and that he “expressed his deep regret that he has to postpone his trip to Asia that was scheduled for later this month. The President looked forward to rescheduling so that he can visit both countries soon." Gibbs and other Administration officials have been asked several times in recent days about a possible postponement because of the BP oil spill fiasco that has devastated the Gulf of Mexico. Gibbs and his deputies had said repeatedly only that the trip was “still on the schedule.”
Until tonight.
The trip had previously been scheduled this past March. It was scrubbed then and rescheduled for June because of the heath care reform vote in Congress at the time. There is no word yet on when the trip will be rescheduled but Obama plans to meet with the leaders of both countries at the G-20 Summit later this month in Canada. I have copy this news from ABC News Online.

'World News' Political Insights: President Obama's Change Looking Like More of the Same.

President Battles Perceptions on Gulf Oil Spill, Sestak Job Offer.
For a president who promised change, the danger now is more of the same. The environmental calamity stemming from the BP oil spill is challenging President Obama's leadership in a fundamental way, threatening to undermine the sense of competence the president has sought to project. Meanwhile, the fallout from the White House's purported job offer to Rep. Joe Sestak , D-Pa., to keep him out of a Senate race is gnawing at Obama from another direction, depicting him as a business-as-usual politician who was slow to own up to an uncomfortable truth.
Oil Stains
The chorus of critics of the president's handling of the Gulf Coast crisis is only growing, with leading voices on the left leading the way -- and, increasingly, invoking comparisons to President Bush's handling of Hurricane Katrina. This is more than anger at Obama for not acting more quickly, or with more emotional power. It reflects a growing concern among the president's allies that a key attribute that fueled his political rise is leaking along with the oil spilling into the ocean. On the BP disaster, the president risks looking like part of the problem -- the head of an unfeeling and red-tape-wrapped federal government that has a cozy relationship with a tarnished oil company -- instead of the leader who promised "never again" to these same residents of the Gulf. His challenge will be to show both emotion and firm leadership in the weeks and months ahead, even with no end in sight to the leak and a clean-up that will last decades. It won't be enough to be seen as effectively marshaling the resources of the federal government, though that would be a start. With fingers pointing in every direction, the president will need to show that he's not just in charge but also on the side of the people of the Gulf. That's no easy task, given the growing frustrations of local officials in the region, and the hardening political storyline of a president who seemed not to grasp the urgency of the moment.
Toss in a president whose resting heart-rate is just different than your usual human being -- we're talking about "no-drama Obama" here -- and the political path is messy indeed. I have copy this news from ABC News Online.

South Korea takes battle over sunken warship to Twitter.

South Korea's defense ministry will show wreckage of a sunken ship to a group of Twitter users in an effort to dispel doubts among young skeptics about its investigation blaming North Korea for attacking the vessel, state media said Monday. Twenty users of the microblogging site will have a chance to review the evidence Friday after applying through the defense ministry's Twitter page, the Yonhap news agency reported. A group of college reporters and defense bloggers will also be invited to the presentation, which is part of a push to win over younger skeptics, Yonhap said. A South Korean report written by an international team of investigators accuses North Korea of firing a torpedo that sank the Cheonan warship in March, killing 46 sailors. North Korea has denied any involvement in the sinking and criticized the report's accuracy, claiming people who disagreed with the investigators' assertions were expelled from the investigation team, the state-run Korean Central News Agency reported. Questions about the report have also surfaced online, Yonhap said. Police are investigating online rumors about the ship's sinking, according to Yonhap, and have said they will reprimand those responsible for spreading unfounded allegations. On Friday, Twitter users will be briefed about the investigation's results and allowed to take photographs of the wreckage, Yonhap reported. The ship's sinking and ensuing report have escalated tensions throughout the region.
After the report's release, South Korean President Lee Myung-bak said that South Korea was suspending trade with North Korea, closing its waters to the North's ships and adopting a newly aggressive military posture toward its neighbor. North Korea reacted to a South Korean anti-submarine exercise Thursday by saying it would meet "confrontation with confrontation" and war with "all-out war," according to North Korean state-run media. Lee has said South Korea plans to bring the issue before the United Nations Security Council. I have copy this news from CNN News Online.

Agatha leaves 82 dead in Guatemala, El Salvador.

The remnants of Tropical Storm Agatha were headed into the Caribbean Sea late Sunday after leaving behind more than 80 dead in Guatemala and El Salvador, authorities in those countries reported. Most of the dead were in Guatemala, where heavy rains triggered mudslides that collapsed homes and forced thousands to evacuate. The country's preliminary death toll was 73 on Sunday, with 49 of those reported in the province of Chimaltenango, said David de Leon, Spokesperson for the National Commission for the Reduction of National Disasters. That toll was expected to rise, he said. And El Salvador reported nine deaths from the storm. The government issued a red alert, the highest warning level, which shut down schools and opened up shelters for families in the affected areas, President Mauricio Funes said. Agatha, an Eastern Pacific storm, struck land Saturday and was downgraded from a tropical depression to a remnant storm on Sunday. It was last reported moving toward the western Caribbean on Sunday afternoon, but was expected to keep producing heavy rains through Monday, according to the U.S. National Hurricane Center. In Guatemala, the storm damaged more than 3,500 homes and forced the evacuation of more than 61,000 people, the nation's emergency office said Sunday. And in Mexico, the government's National Meteorological Service predicted torrential rain for Chiapas state, intense downpours in Tabasco and strong showers in Quintana Roo.
Four other Mexican states were predicted to receive moderate rain. Strong winds also were forecast. Swollen rivers and mudslides were a concern. In Guatemala, four children were buried in a landslide outside Guatemala City, the nation's capital. Four adults were killed in the capital, disaster officials said. Another two children and two adults were killed when a boulder, dislodged by heavy rains, crushed a house in the department of Quetzaltenango, 125 miles (200 km) west of Guatemala City, officials said. Guatemala is already under a 15-day state of calamity because of Thursday's eruption of the Pacaya volcano, which killed at least three people. At least 1,800 people had already been evacuated to shelters. The volcano also shut down the capital's international airport. Ash from the volcano that covered city streets and other areas mixed with the heavy rain, forming a goo that caused many drainage systems to clog. Guatemalan President Alvaro Colom said damage from Agatha was probably worse than the destruction caused by Hurricanes Mitch in 1998 and Stan in 2005, both of which devastated the Central American country. "The country is suffering a great tragedy, this attack by nature," Colom said from the Guatemalan emergency agency center. Emergencies were reported in all of Guatemala's 22 states, called departments. The worst, Colom said, was the Pacific Ocean port of Champerico, which is isolated. "We have no way of getting there to help the public, which is in danger because of flooding," Colom said. The president said he has asked the international community for help. Agatha is the first named storm of the Pacific hurricane season. The Atlantic hurricane season starts June 1. I have copy this news from CNN News Online.

Kicking up a storm: From Henry VIII to Cristiano Ronaldo.

From the original celebrity endorser King Henry VIII to modern-day superstars such as Cristiano Ronaldo and Lionel Messi, the humble football boot has come a long way.
Britain's notorious wife-beheading royal paid four shillings -- the equivalent of $1,350 in today's money -- for his custom-made leather pair that were in an inventory of his wardrobe when he died in 1547. By comparison, Nike's new Mercurial Vapor Superfly II is the most expensive boot on the modern retail market, coming in at around $400. Henry VIII's boots would have been sturdy models made from tough leather to cope with the violent, no-rules, all-in-brawl approach to the game of the 16th century, a far cry from the streamlined and lightweight shoes designed for today's game. "We have a revolutionary technology which has a stud that adapts to different pitch conditions," Nike design director Andy Caine told CNN. "This will make the fastest player even faster whatever the pitch conditions might be. For a modern footballer who's really fast, this is really going to change his game." The birth of boot-making giants from workers knocking about in brutal steel-caps, the evolution of boots really kicked off in the late 1880s when nailed-in leather studs helped with traction in muddy fields. In 1948, a falling-out between the two German siblings behind the Dassler Brothers Shoe Factory led to the creation of Adidas and Puma -- the two most influential boot makers until the emergence of Nike in the 1980s. Both companies laid claim to the invention of the screw-in synthetic stud. are trying hard to sign the world's best football players to endorse their products--Consultant Stephanus Tekle
South Africa
Adolf ("Adi") Dassler's company said his firm's innovation helped Germany win the 1954 World Cup when treacherously wet weather struck before the final against Hungary, but brother Rudolph insisted Puma's Super Atom boot featured interchangeable studs years previously.
Two decades later, Puma struck an important blow by signing up the world's greatest player, Pele, for $125,000, according to a book by Dutch author Barbara Smit. At the opening game of the 1970 World Cup, the Brazil legend asked the referee to delay starting the match so he could tie up his laces -- meaning valuable exposure for Puma as the world's television cameras focused in on the player's feet, Smit wrote in "Three Stripes Versus Puma." Pele's Puma King range was also worn in the 1980s by Argentina superstar Diego Maradona, giving the company an association with two of the best players to have graced the sport, says Alan Spurgeon of specialist Web site www.Footy-Boots.com.
Enter the Predator
But Adidas consolidated their position at the top of the boot market thanks to a much lesser-known player. Craig Johnston, born in South Africa and raised in Australia, made his name with English club Liverpool in the 1980s. After retiring at the relatively young age of 27 to look after his ill sister, Johnston came up with the novel idea of adding rubber patches to the outside of boots, which boosted control of the ball and gave added swerve when kicking it. "I was coaching kids in Australia and I was telling them that they had to grip and bite into the ball like a table tennis bat to swerve it. 'That's fine Mr Johnston,' they said, 'but our boots are made of leather and not rubber, it's raining and they are slippery,' " he told Britain's Design Museum Web site. "I went home and took the rubber off a table tennis bat and stuck it on my boots with super glue. Immediately I went outside again and kicked the ball, I could hear a squeak when the rubber engaged with the polyurethane of the ball." The result, after years of development, was the Predator. Launched in 1994, it has been worn by superstar names such as Zinedine Zidane and David Beckham -- both of whom had customized versions. Johnston, ironically, has recently been a critic of modern boots, saying they contribute to injuries suffered by players. "People say that the boots don't provide enough protection. In fact, the opposite is true," he told FootyBoots in 2009. "The problem is that the boots are so well made there is no give at all in the materials -- especially the cheaper synthetics. "The pitches are now so well-maintained and even woven with synthetic materials that the players' studs engage like they should do, but they don't release enough, causing injury. Also, the studs are far too long and give far too much grip."
A new major player in the market
The next most significant boot was Nike's Mercurial Vapor, Spurgeon said, launched in 1998 with the endorsement of Brazilian World Cup winner Ronaldo. That range's popularity is expected to continue with the Superfly II, worn by Portugal's Real Madrid superstar Cristiano Ronaldo -- the planet's most expensive player at $130 million -- at the World Cup in South Africa. Caine said the design took a painstaking three years. "We really started from scratch on this boot," he said. "It's a long process. Every change you make, you have to make a sample then you have to test it on the pitch, test it in a lab, and make sure it provides a benefit."
The process starts with a small core team who focus on what needs improving from the previous boot, Caine said, gathering input from players and seeking out the latest technical innovations.
"Once you get onto the manufacturing side there's obviously larger development teams that come into it," he said. "A lot of people touch it through its life cycle, but there's quite a small core team who work on the real essence of the design and what it's about." While Caine is proud of the Superfly's new adaptable retraction system, which can change and extend automatically, Adidas have also unleashed an innovative new product before the World Cup -- even daring to revamp the traditional three-stripe design in a boot that changes color in different light.
The AdiZero is the lightest football boot on the market, Spurgeon says, with 2009 world player of the year Lionel Messi's F50 spearheading the range. "It's the fastest and lightest football shoe that we've ever created," Adidas senior product manager for footwear Aubry Dolan told CNN. "We've talked to the players, professionals and amateurs, and their message was very simple: make me faster. "The goal was simple, the challenge was very difficult. Never before have so many players felt, touched, tested, seen and thought about the product."
Who rules the roost?
The leading companies are coy about releasing boot market figures, but Spurgeon believes Adidas is a clear leader from Nike -- last year the firm claimed it had a 50 percent share in North America and Germany. United States-based Nike, however, is regarded the No. 1 sportswear company, he said. And it may be team shirts and balls, rather than boots, which prove to be the biggest money-earner at the World Cup, according to Germany-based marketing consultancy SPORT+MARKT. "As the sale of boots is still the core business, both companies are trying hard to sign the world's best football players to endorse their products," consultant Stephanus Tekle told CNN. "However, although boots are the right tool to promote the reliability and the technology of the brands, in terms of sales the World Cup shows a different trend. "During the event, fans tend to show commitment to their own national teams by purchasing the official jersey and the official ball rather than the boots of their favorite football players. This is probably the most profitable line of business during the World Cup for both Adidas and Nike."
New avenues: The Internet
Adidas has guaranteed maximum exposure in South Africa by buying up exclusive sponsorship rights, forcing Nike to continue the more innovative tactics it started with 2006's "Joga Bonito" social networking-style Web site. "Now Nike is trying to pursue a long-term strategy: no more single campaigns but the activation of more comprehensive marketing, especially via the Internet," Tekle said. "For instance, Nike is deeply involved in CSR (Corporate Social Responsibility) activities with the latest campaign, "Lace Up, Save Lives," endorsed by important athletes. The aim is to lend more credibility and reliability to the brand. "The Internet is soon going to be a major resource for the kit suppliers more and more, and new innovative campaigns should be expected on the web." I have copy this news from CNN News Online.

Thai prime minister says state of emergency may be lifted.

Thai Prime Minister Abhisit Vejjajiva said the country was calm Sunday morning after the first night without a government-imposed curfew in 10 days, state media said. In his weekly television address, Abhisit said the state of emergency could be lifted, but did not say when a relaxation or removal of emergency regulations would take place, the Thai News Agency reported. Officials implemented the state of emergency on April 7 in Bangkok and nearby provinces, when thousands of anti-government protesters had amassed in the capital's central shopping district. They imposed a curfew in Bangkok and 23 provinces May 19. Violent clashes between the demonstrators and government troops broke out earlier this month, killing at least 50 people and injuring nearly 400, government officials said.
Thai PM lifts curfew
More than 30 buildings -- including a bank, a police station, a local television station and Thailand's biggest shopping mall -- were set ablaze. Abhisit said an independent committee would be established this week to examine the political unrest. Thai investigators claim former Prime Minister Thaksin Shinawatra, who was ousted in a bloodless military coup in 2006, helped mastermind and fund the Red Shirt anti-government protests, Thailand's state news agency said this week. A Thai court issued an arrest warrant for Thaksin this week on terrorism charges connected to the clashes, the news agency said. Thaksin has denied he was a leader of the Red Shirt demonstrations and said the charges in the arrest warrant show the government lacks legitimacy. I have copy this news from CNN News Online.