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Federal regulators yesterday approved the use of an artificial heart, marking the first time a mechanical device has been made widely available to replace a failing human organ.

In contrast, with early hopes of permanently replacing an ailing heart with a manmade pump, the new device substitutes for the bottom half of the heart and can be used only to sustain critically ill patients in the hospital until they can get a heart transplant.

But the CardioWest Total Artificial Heart offers hope to the dozens of Americans who would otherwise die each year without it, and its approval by the Food and Drug Administration was hailed as an important, longsought moment.

However, critics questioned the value of the $100,000 device, saying it will only add expense to the nations already bloated healthcare bill without increasing the number of heart patients who survive.

The number of lives you save with heart transplants is limited by the number of hearts that are available. And this does nothing about that, said medical ethicist George Annas of Boston University. Dozens were injured, none critically.

The bus was en route from Chicago to Holly Springs, Miss., with 48 people Sunday night when it struck a guardrail on Interstate 57, slid nearly 70 feet down an embankment and landed on its side, said Robert Ventura, a state police official.

The driver, Albert Miller, 68, of Rossville, Tenn., was cited for improper lane usage.

Thirtyseven people, including the bus driver, were treated at hospitals and released, State Police Master Sgt. Barry Stricklin said yesterday. Stricklin said six other passengers, including two children, were hospitalized. The most seriously injured was a 6yearold girl who suffered a broken pelvis.

Escalades, Maximas seen as likely targets

The Cadillac Escalade EXT, a $53,000 chrometrimmed luxury pickup with leather bucket seats, a sevenspeaker stereo system with satellite radio and a global tracking system, is the vehicle most targeted by thieves, a study by the insurance industry has found.

Its the second year in a row that an Escalade has been at the top of the list, which was released today by the Insurance Institute for Highway Safety. The Escalade sportutility vehicle topped last years list; this year, that SUV is third.

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Salem abortion clinic had violations in three inspections

WinstonSalems only abortion clinic, operated by Planned Parenthood of WinstonSalem on Maplewood Avenue, has not faced closure. The clinic passed reinspections after correcting the problems that were discovered.

Some of the violations involve recordkeeping errors and similar mistakes. But during a 2010 inspection, a state inspector found that the clinic did not use proper procedures in performing a blood test for the Rh Rhesus factor a routine blood test for pregnant women.

The test involves mixing a patients blood with a substance that reveals the presence of the Rh factor, a type of protein found on red blood cells. According to the state inspection report, the method that the WinstonSalem clinic used didnt match the instructions listed by the manufacturer of the test.

The state inspector reported that the center manager said she was unaware that a difference existed between the procedures the lab was using and those outlined by the maker of the test. The lab agreed to update its procedures.

In another violation relating to Rhfactor testing, the 2010 inspection found that after the lab had allowed Rh testing supplies to get cooler than the acceptable level on eight days during December 2009, the lab failed to make sure that the problem was corrected. The state inspector said that the temperature log for the refrigerator showed that the temperature had been increased after being reduced incorrectly, but there was no documentation showing that the temperature had been returned to the correct level.

The Baker Clinic for Women in Durham that was shut down by the state this summer also incorrectly tested Rhfactor samples, The Associated Press reported. But Ricky Diaz, the communications director at the Department of Health and Human Services, said that the Baker clinic had other problems and that the inspections at the WinstonSalem clinic and in Durham cannot be compared.

Every inspection is different, Diaz said. At the Baker clinic, their violations rose to the level of presenting an immediate threat where the other in WinstonSalem did not. The Baker clinic failed to have qualified staff and failed to correct the problem.

Planned Parenthood did not return calls requesting comment on the WinstonSalem inspections.

In a typical pregnancy, according to the Mayor Clinic, the test is conducted to identify a womans Rh factor. If the woman is Rh negative and her baby is Rh positive, treatment is required to prevent complications.

But the Mayo Clinic goes on to say that if a woman is Rh negative she may need treatment in any situation where her blood may come in contact with Rh positive blood including miscarriage, abortion, bleeding during pregnancy and other situations.

Diaz said that any clinic that is shut down can reopen if it demonstrates it has corrected the problems that resulted in closure. For instance, the clinic in Charlotte that was closed in April has since reopened. General Assembly this year. Since those regulations are not yet in effect, all of the inspections including the ones that resulted in clinic closures were under the preexisting rules.

Abortion opponents have hailed the closures as proof that stronger regulations are needed. Supporters of abortion rights have said that the closures prove that the existing system was already working well.

The new rules, which could take some time to develop, were designed to regulate abortion clinics under the same standard as outpatient surgical centers. Although critics have said the changes will result in the closure of abortion clinics, Diaz said that he doesnt understand how the claim can be made since the rules have not been developed.

Diaz said that despite media reports to the contrary, it isnt true that the state has been stepping up its inspections as the General Assembly pondered new restrictions.

Department inspectors do their job by inspecting facilities according to the code and, at times, must act to protect North Carolinians from harm regardless of politics and what is in the news, Diaz said.

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Chagas disease American trypanosomiasis

Chagas disease is a zoonosis or an anthropozoonosis due to the flagellated protozoan parasite Trypanosoma cruzi. It is transmitted to man by infected faeces of a bloodsucking triatomine bug through the insect sting, another skin break or through mucous membranes, including conjunctiva or oral/digestive mucosa, occasionally causing outbreaks with contaminated food. Transmission through blood transfusion, pregnancy and delivery are also possible, and less frequently, through organ transplantation or laboratory accident.

The acute phase, with high parasitaemia, commonly lasts around two months. Most of the cases are a or oligosymptomatic, but depending on the inoculation site, the first sign can be a skin chancre chagoma or unilateral purplish orbital oedema Romaa sign with local lymphoadenopathies and fever over several weeks. That can be accompanied, among others, by headache, pallor, myalgia, dyspnoea, oedema in inferior limbs or face, abdominal pain, cough, hepatomegaly, rash, painful nodules, splenomegaly, generalized oedema, diarrhoea, multiple lymphoadenopathies, myocarditis chest pain, heart failure and more rarely meningoencephalitis seizures, paralysis. Morbidity can be higher in children under five, elderly, immunocompromised or in cases with possible high parasite inoculum, such as seen in oral outbreaks. In AIDS the meningoencephalitis is the more frequent manifestation differential diagnosis with toxoplasmosis.

The chronic phase, with parasites hidden in target tissues especially heart and digestive smooth muscle, has different possible clinical forms: a asymptomatic indeterminate form, more frequent, typically in the beginning of the chronic phase and lasting all life in most of the patients; b cardiac form, till 30% of the patients, with conduction disorders, arrhythmia, cardiomyopathy, heart failure and secondary thromboembolism; c digestive lesions megaoesophagus and megacolon or mixed forms cardiac plus digestive, till 10% of the patients, just seen south to the Amazon basin.

In the acute phase or in reactivation for immunosuppression a blood wet smear or a blood concentration technique such as microhaematocrit or Strout technique, must be used. Stained preparations, such as malaria films, detect parasites when parasitaemia is high acute phase. In the Amazon basin microscospy technicians of malaria have been trained to detect acute individual cases and through them possible oral outbreaks and areas of active transmission surveillance system. In the chronic phase serologic tests should be used: the detection of antiTrypanosoma cruzi antibodies through a conventional or recombinant enzymelinked immunosorbent assay ELISA, indirect hemagglutination assay, indirect immunofluorescence assay, western blot, rapid diagnostic test such as immunochromatography, among others. Especially for research purposes, haemoculture, xenodiagnosis faeces examination of uninfected triatomine bug fed with the patients blood and Polymerase Chain Reaction PCR are also used.

There is not any available vaccine. Depending on the region, key tools are vector control insecticide spraying, house improvement such as plastered walls, cement floors, corrugatediron roofs and personal preventive measures such as bed nets and good hygiene practices in food preparation, transportation, storage and consumption bed nets, together with the transmission control through blood transfusion and organ transplantation. Secondary prevention is important in: congenital transmission diagnosis of infected pregnant women and detection of possible newborn infection with parasitological or serological tests after eight months of age with no longer existing mother antibodies; laboratory accident prevention using safety standard protocols laboratory coat, gloves, face mask, cap, glasses, especially when dealing with trypomastigotes the human infective form of the parasite.

The etiological treatment is urgently indicated in the acute phase and reactivation immunosuppression. At that moment parasitological cure rates are almost 100% and they decrease with longer duration of the infection/disease. At younger age the prevalence of sideeffects is also lower. The etiological treatment is indicated, as well, in congenital infection and early chronic phase. In adults, especially those with indeterminated form, etiological treatment should be offered, but balancing potential benefits to prevent or delay the development of the Chagas disease against a long treatment schedule together with frequent sideeffects.

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Rochas News Updates and Coverage

Watching the spring runway collections, whether I was sitting at a runway show in the crumbling Beekman Palace in New York City or at a 13th century convent in Paris, I was dreaming of California.

It wasnt just homesickness, though after weeks on the road, that could have been part of it. I was thinking about how the clothes would play here, how they.

Nothing captures summers sunny joie de vivre like a devilmaycare hairstyle polished off with a pretty hair ornament. Headturning hair accessories were front and center in the spring runway collections. Satin bow headbands topped off 60sinspired beehives at Louis Vuitton, while silk faille hair bands decorated with oversized fabric flowers bloomed on aslowasyougo ponytails at Rochas. The nape of the neck became an alluring new focus, with large pearls adorning loose chignons at Chanel and.

PARIS This season of Paris Fashion Week, which runs through Wednesday, is shaping up to be about new beginnings as designers show their springsummer 2013 collections.

In the first of two main events, Belgian designer Raf Simons blew the dust off the mantel of Paris high fashion on Friday morning when he presented his first womens readytowear collection as creative director for Christian Dior, where he replaced the disgraced John Galliano after a lengthy search for a successor. Galliano, a.