Study: Pregnant women should get more vitamin D

(News Terupdate) - Pregnant women could -- and probably should -- consume 10 times more vitamin D than experts currently recommend, according to a new study.

Current guidelines for daily vitamin D intake during pregnancy range from 200 international units (IU) per day to 400 IU, the amount found in most prenatal vitamins. For decades, doctors have worried that too much vitamin D during pregnancy could cause birth defects, and under current guidelines anything over 2,000 IU per day is still considered potentially unsafe for anyone, not just pregnant women.

That much vitamin D is not only safe during pregnancy, the researchers say, but doubling it may actually reduce the risk of complications.

Pregnant women should not change their vitamin D intake without consulting their physicians, however. The study looked only at women in their second trimester and beyond, and it's not yet clear whether high doses of vitamin D are safe earlier in pregnancy, when organs are formed and the fetus is especially vulnerable to birth defects.

In the study, 500 women who were at least 12 weeks pregnant took either 400, 2,000, or 4,000 IU of vitamin D per day. The women who took 4,000 IU were least likely to go into labor early, give birth prematurely, or develop infections.

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"Pregnant women need to take 4,000 IU of vitamin D a day," says Bruce Hollis, Ph.D., the director of pediatric nutritional sciences at the Medical University of South Carolina, in Charleston, and one of the authors of the study. "We didn't see a single adverse effect. It was absolutely safe, and we saw a lot of improved outcomes. The risk of preterm labor was vastly decreased and so was the risk of other complications of pregnancy."

Hollis and his colleagues presented their research today at the annual meeting of the Pediatric Academic Societies in Vancouver, B.C.

Taking supplements is the only practical way to consume that much vitamin D. "You can't drink that much milk," Hollis says. "You take prenatal vitamins for other things, but the amount [of vitamin D] in a prenatal vitamin is useless."

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The findings are a sign that current vitamin D guidelines are far too low, says Elisa Ross, M.D., a staff physician at the Cleveland Clinic Institute of Women's Health, in Ohio. "In the olden days, we thought vitamin D could be associated with certain birth defects and may cause more calcium to build up in the women's blood. If this study is confirmed -- which I am hoping it will be -- it will increase the amount of vitamin D we recommend 10-fold."

Rasa Kazlauskaite, M.D., an endocrinologist at Rush University Medical Center, in Chicago, Illinois, cautions that more research is needed before firm recommendations can be made. "This study answers the question, 'Is vitamin D safe and beneficial for the average pregnant women?' but how it affects individual pregnant women needs to be answered," she says.

For instance, Kazlauskaite says, vitamin D intake during pregnancy should perhaps be pegged to a woman's blood levels of vitamin D. The American Academy of Pediatrics, which recommends that pregnant women take a prenatal vitamin containing at least 400 IU of the vitamin, also recommends that obstetricians measure the vitamin D in pregnant women's blood to ensure that the fetus is receiving enough to develop properly.

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Despite the medical community's long-standing fears, few women in the study were concerned about vitamin D--related birth defects, according to Hollis. "We got more resistance from physicians than from patients," he says. "One doctor wrote to the National Institutes of Health and said, 'Don't let this study go forward. You are going to injure fetuses.'" (The National Institutes of Health funded the research.)

"There are no risks," Hollis adds. The conventional wisdom about the dangers of too much vitamin D was "manufactured and based on flawed data," he says. "There was never any real harm, just misconceptions."

Known as the "sunshine vitamin" because the body produces it when exposed to sunlight, vitamin D has been the focus of intensive research in recent years. Studies in adults have linked vitamin D deficiency to a laundry list of serious health problems, including heart disease, certain cancers, osteoporosis, diabetes, Alzheimer's disease, schizophrenia, and some autoimmune disorders.

Even though vitamin D is added to food products such as milk, a deficiency of the vitamin is widespread in adults, children, and infants. A decrease in everyday sun exposure and the growing obesity epidemic are both likely to blame for this, according to Kazlauskaite. "At least half of Americans are overweight or obese, and fat traps vitamin D," she explains. "As a result, we are more predisposed to vitamin D deficiency."

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Michael F. Holick, M.D., a professor of medicine, physiology, and biophysics at the Boston University School of Medicine, has maintained for years that getting too little vitamin D is worse than getting too much. Although doctors have been taught that vitamin D is toxic in large amounts, he says, vitamin D intoxication is extremely rare and easy to treat.

The levels of vitamin D recommended in the new study are sensible, Holick says. Previous research suggests that pregnant women who get too little vitamin D are more likely to develop life-threatening high blood pressure (preeclampsia) and are also more likely to require a Cesarean section, he says.

"Giving 4,000 IU a day to pregnant women not only doesn't cause toxicity, but may improve birth outcomes," Holick says. "The risks of vitamin D during pregnancy are overblown and the benefits are understated."

Prompted by the recent flood of research on vitamin D deficiency, the Institute of Medicine, an independent organization that advises the U.S. government on health matters, is now considering whether to raise its guidelines for vitamin D intake, including those for pregnant women (200 IU per day) and the maximum safe daily dose (2,000 IU). The new guidelines are expected to be announced this summer.

Hollis predicts that the institute will take a conservative approach. But he hopes that at the very least, "the upper limit is raised from 2,000 IU to something much higher, so it is not an impediment to doing research."

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Children's cold, allergy medicine recalled

(News Terupdate) - A voluntary recall has been issued for more than 40 over-the-counter drugs for children, including Tylenol and Motrin, because they don't meet quality standards.

"This recall is not being undertaken on the basis of adverse medical events," McNeil Consumer Healthcare said in a statement Friday. "However, as a precautionary measure, parents and caregivers should not administer these products to their children."

FDA commissioner Margaret Hamburg gave a similar recommendation in a statement Saturday, saying, "we want to be certain that consumers discontinue using these products," though she called the chance for serious health problems "remote."

"Some products in the recall may have a higher concentration of active ingredient than specified while others may have inactive ingredients that don't meet testing requirements, the company said.

The company said it issued the recall after consulting with the Food and Drug Administration. The affected brands include: Tylenol Infants' Drops, Children's Tylenol Suspensions, Children's Tylenol Plus Suspensions, Motrin Infant Drops, Children's Motrin Suspensions, Children's Zyrtec Liquids in Bottles and Children's Benadryl Allergy Liquids in Bottles.

The drugs were made in the United States and distributed to Canada, the Dominican Republic, Dubai, Fiji, Guam, Guatemala, Jamaica, Puerto Rico, Panama, Trinidad & Tobago and Kuwait.

"There are a number of other products on the market, including generic versions of the recalled products, which are intended for use in infants and children and are not affected by the recall," the FDA said Saturday in issuing guidance to parents.

More details are available by calling 1-888-222-6036 or visiting McNeil's website.

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Historic Manhattan hospital shuts doors

(News Terupdate) - After 161 years of treating survivors of major catastrophes, from the sinking of the Titanic to the attacks of September 11, and leading early HIV treatments, New York's St. Vincent's Hospital closed Friday.

Faced with financial troubles and mounting debts, the historic hospital was forced to shutter its operations. By Friday, no patients were left, and about 3,500 employees were laid off.

There were a few community rallies to keep the private nonprofit hospital open, but the efforts did not succeed. There were no protests outside the hospital Friday, according to police.

Saddled by financial woes, the Saint Vincent Catholic Medical Centers board of directors voted to close the hospital this month.

"It is a combination of a large legacy debt that we had, the worst recession since the Great Depression and a very challenging health care environment," said Michael Fagan, Saint Vincent Catholic Medical Centers' vice president for public affairs.

The debt was a result of reorganization efforts in 2005-07, he added. There were other factors, too.

"In New York state, there have been eight rounds of cuts to Medicaid," Fagan said. "And we were a standalone hospital, and so we didn't have the leverage with managed care companies. Therefore we had lower managed care rates than you would when you're aligned with larger academic medical centers."

Saint Vincent Catholic Medical Centers filed a Chapter 11 petition for bankruptcy this week.

The hospital had been sponsored by the Sisters of Charity, a Catholic order whose ministry seeks to help the needy, and the Catholic Diocese of Brooklyn, Fagan said.

Located in Greenwich Village, St. Vincent's Hospital provided charity cases and care to the uninsured, handling about $40 million worth of uncompensated care last year.

The hospital's closure brought an eerie silence in Julio Ortiz-Teissonniere's neighborhood.

View Ortiz-Teissonniere's iReport

"We don't hear ambulances any more," said the Chelsea resident, who lives four blocks from the hospital. "They started rerouting them or something. It's kind of weird. You grow used to the sound of the ambulance, even though it's noisy. It's security."

Ortiz-Teissonniere, 53, an iReport contributor, said the hospital saved his life twice: in 2001 after a heart attack and in January after he became unconscious from low blood sugar.

"It keeps me wondering, " he said, "if they wouldn't have been that close, it could've been a different ending."

The hospital was rooted in the community, he said.

One nurse who was born at the hospital lamented the closure.

"St. Vincent's is my home, and the people I work with are my family, and it's been taken away from me now," Nancy McGuire, an emergency room nurse for 39 years, told CNN affiliate WABC-TV New York.

A private Mass and lunch were held for the employees in the afternoon.

"It's a very sad, difficult day for our employees," Fagan said. "They're really dedicated."

The Sisters of Charity started the hospital in 1849 in a small rental house with 30 beds, in response to a cholera epidemic.

It served the poor, immigrants and victims in major disasters such as the Triangle Shirtwaist Factory fire of 1911, in which 146 garment workers died, and epidemics including HIV/AIDS.

Four days after the Titanic sank in April 1912, the ship's only survivors arrived in New York aboard another liner, the Carpathia. The injured were taken to St. Vincent's, The New York Times reported.

In the early 1980s, when uncertainty about the disease fueled fear and panic, the hospital treated HIV patients even though they had been turned away from other clinics. Its Comprehensive HIV Center opened in 1988; that clinic is expected to operate as usual.

"Outpatient services are still open, but we are seeking to transfer them to new sponsors," Fagan said. These include St. Vincent's nursing home and long-term care program.

The hospital referred patients to a number of neighboring hospitals.

St. Vincent's is to be turned into an urgent care facility run by Lenox Hill Hospital, according to WABC.

The hospital held a lot of personal meaning for people in the neighborhood, Ortiz-Teissonniere said.

He recalled seeing rows of stretchers outside on September 11, 2001.

"Right in front of St. Vincent's, doctors and nurses were waiting outside the hospital. I remember them waiting," he recalled.

People also posted photos of their missing relatives and loved ones on a wall outside the hospital.

"That's an example of how important to the city's history [the hospital] was," Ortiz-Teissonniere said.

"The only thing I can think of is, how come there is a bailout for financial companies, but no one can come up with a plan to save this hospital? That's what I thought about. How come?"

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Doctors: Sleep drug likely not cause of plane suspect's odd behavior

(News Terupdate) - A man accused of disrupting a trans-Atlantic flight by claiming he was carrying explosives also told the federal marshal onboard that he had taken the popular sleep aid Ambien, according to court documents.

Ambien, also known as zolpidem, can cause extreme side effects such as e-mailing, cooking and driving while asleep, according to the Food and Drug Administration and published medical research. However, sleep experts say the behavior exhibited by the suspect, Derek Stansberry, 27, is inconsistent with the known side effects of the sleep medication.

Ambien is a prescription drug used to treat insomnia. It belongs to a class of medication called sedative-hypnotics, which slow activity in the brain to allow sleep.

There have been reports of individuals making and eating food, talking on the phone and having sex while not fully awake after taking Ambien with alcohol or other medications, according to the FDA.

Doctors and Sanofi-aventis, the maker of Ambien, say it's imperative the medication be taken as prescribed, which includes not mixing Ambien with alcohol or other drugs.

Ambien can increase the likelihood for confusional arousal, a state when the brain is half asleep and half awake, say sleep doctors. Usually the person will speak in garble that doesn't fit the context of his or her environment, said Dr. Michel Cramer Bornemann, a lead investigator of Sleep Forensics Associates.

For example, a 30-year-old man might wake up saying "I don't want to go to school," although he was a student 10 years ago.

"The behaviors this individual described are not consistent with Ambien's side effects," Cramer Bornemann said regarding Stansberry's case.

"In a person experiencing confusional arousal because of Ambien, you wouldn't expect to hear comments from that person that seem to fit into the context of the environment that they are in," he said. "In this case, a man on board a plane is talking about false passports, bombs, dynamite and blowing up a plane. This seems really at first glance, inconsistent with what we know of Ambien's side effects."

This is because the suspect's comments were "oriented to time, location and place," Cramer Bornemann said.

Dr. Michael Breus agreed. Breus is the clinical director of the sleep division at Southwest Spine and Sports in Scottsdale, Arizona.

"If you took eight Ambien pills, you'd be slurring your speech. You'd sound like you're drunk. You wouldn't be coherent to say, 'There's a bomb in my backpack and I have a pressure switch,' " he said.

Breus expressed skepticism that Ambien alone could have triggered such a behavior.

"There had to be an interaction effect or he drank alcohol or there was some other drug," he said. "We also don't know his mental health history. If he had significant history of mental health problems, he could have had a psychotic break."

Stansberry, of Riverview, Florida, has been charged with two felony counts of interfering with flight crew members and knowingly giving false information about possession of an explosive device. Stansberry told authorities he was carrying dynamite and a detonation device.

On a Delta flight from Paris, France, to Atlanta, Georgia, on Tuesday, Stansberry allegedly made threats of a bomb and told the air marshal he had taken eight tablets of Ambien. After the plane landed, he told FBI investigators he had taken one Ambien pill, a change from his earlier comment, according to court documents.

Stansberry, a former Air Force intelligence specialist, was ordered Wednesday to undergo a competency evaluation.

Competency tests ordered for suspect in airline flight diversion

Like other sedative-hypnotic sleep aids, including Lunesta and Sonata, Ambien mimics neurotransmitters and binds to a specific brain chemical receptor, promoting sleep.

Sleep doctors do not recommend taking sleep aids like Ambien before a flight, although it is a common practice. Breus recommended taking the pill in a predictable environment, such as one's bedroom, rather than an airplane.

"Ambien and all the medications like it are serious medications," he said. "You're supposed to take them and turn out the lights."

Sanofi-aventis, in a statement e-mailed to CNN.com, said:

"Sanofi-aventis is committed to patient health and safety [and] treats these matters with the highest degree of importance. It is important to note that Ambien or Ambien CR is not appropriate for every individual.

"Patients should fully disclose alcohol and drug use with their health care professional, and not consume alcohol while they are taking a prescription sleep medication."

Since the introduction of Ambien in 1992, more than 230 million prescriptions have been filled.

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Police: Bad blood led to doctor's slaying

New York (News Terupdate) - A former colleague accused of murdering a Yale University doctor carried a grudge -- along with a wig, handguns and approximately 1,000 rounds of ammunition when he was arrested, police said.

In addition, investigators said they found printouts in the suspect's car with information about two people who may have been potential targets.

Lishan Wang, 44, was charged this week with the murder of Dr. Vajinder Toor and the attempted murder of Toor's wife. Toor, who worked in the infectious disease branch of Yale New Haven Hospital, was gunned down Monday morning outside his home in Branford, Connecticut.

Toor was the second person in the Yale medical community to be slain in less than a year. Annie Le, a graduate student at the medical school, was strangled to death inside a research building in September, police said. A lab technician has been charged with killing Le and is awaiting trial.

Yale was not the connection between Wang and Toor, however. They previously worked together at Kingsbrook Jewish Medical Center in New York City.

The Brooklyn hospital fired Wang in 2008 after a confrontation with Toor, according to a police report and civil court records. Wang then sued the medical center, alleging discrimination against him.

In his federal lawsuit, Wang said supervisors and other doctors humiliated and harassed him because he is Chinese.

He also said that a hospital committee unfairly labeled him as "excitable, emotional, and unable to control his anger," and that the human resources department falsely characterized him as "mentally impaired and suffering from anger issues."

Wang alleged in his lawsuit that Toor, who was the chief resident for the Department of Medicine, had accused him of ignoring pages and calls from hospital staff. The two men then "engaged in a heated discussion," with Toor accusing Wang of "threatening his safety by using hostile body language," according to the suit.

Wang was suspended without pay pending an investigation. He said in his court papers that the hospital would fire him if he did not seek "disability leave for mental impairment." Wang said he refused to "feign impairment for the sake of saving his job." He was terminated in July 2008.

Wang's civil attorney, Christine A. Fernandez, said in a statement that she was "deeply saddened" by the shooting. "My heartfelt condolences go out to Dr. Toor's family and to Dr. Wang's wife and three children," she said.

Attempts to reach Wang's lawyer in the criminal case were not successful, but the New York Times reported that he's being represented by two public defenders. He has not yet entered a plea.

Police say Wang allegedly sought revenge against his former medical colleague and harbored a grudge against him.

The Branford Police Department report provides chilling details of the violence that intruded on Blueberry Lane on Monday morning:

Toor kissed his wife and headed out to his driveway, on his way to work. Wang greeted him with gunfire, the report says.

Toor's wife, who was inside the couple's condo, told police "she heard a loud and rapid noise which sounded like gunshots and ran out of the house," according to the report. She saw her husband lying on the grass in the front yard and spotted a man later identified as Wang standing next to a minivan.

"What are you doing to my husband?" she shouted, according to the police report.

The man turned his handgun toward her and fired several shots, she told police. She ducked behind a car, and he missed.

Neighbors heard the shots as well. One told police she saw the man firing at Toor's wife. Another said she heard a woman screaming and saw a man lying on the grass. The woman kept Toor's son, 3, inside so he would not see his fatally wounded father, the police report said.

Toor, who was shot five times, was pronounced dead at the scene, police said.

Wang was stopped a short time later, driving a red Dodge Caravan, police said. He was carrying two ammunition magazines in his right front jacket pocket, according to the police report.

Inside the minivan, police said they found three handguns and approximately 1,000 rounds of ammunition. According to the report, "also discovered in the vehicle were clothing, and a wig along with numerous other weapons such as a hammer, and a knife."

Authorities said a picture of the victim was found in the vehicle along with printout information on two other people.

Wang is being held on $2 million bail.

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'Oklahoma, what have you done?'

New York (News Terupdate) - As a reproductive rights advocate and a proud mother of two, my blood ran cold as I read about Oklahoma's new abortion legislation (HB 2656). The state of Oklahoma just decided, and by an appallingly high margin I might add, that a doctor is protected from being sued if he or she chooses not to tell a woman that the baby she is carrying has a birth defect.

State legislators made this decision Tuesday, voting 36-12 in the Senate and 84-12 in the House to override Gov. Brad Henry's veto of this law. (The Legislature also overrode the governor's veto of a second egregious law, HB 2780, which forces women to view an ultrasound before having an abortion.)

Oklahoma, what have you done?

Under this new law, a doctor may withhold information, mislead or even blatantly lie to a pregnant woman and her partner about the health of their baby if the doctor so much as thinks that fetal test results would cause a woman to consider abortion.

As expected, the anti-abortion movement is claiming victory. But this bill isn't "anti-abortion." It is devastating because it is anti-motherhood and anti-medicine.

When I found out I was pregnant with each of my children, like every woman who has ever undergone fetal testing, I held my breath at each doctor's appointment. I didn't let it go until the doctor or the tech said, "Everything looks great." I seized up when they took out the blood work results and I didn't relax until I heard, "It all came back negative."

But a woman in Oklahoma no longer gets to exhale. Because now, when a doctor says, "Everything looks fine," she has to wonder; does it really? Oklahoma politicians have now said that she can no longer count on the sacred trust that always existed between her and her doctor. A doctor may now lie to her face and, in doing so, deny a woman what is quite possibly the most important piece of information she will ever receive in her life.

The very thought makes my breath catch even now. The information you get on those visits matters to every woman getting prenatal care, regardless of what she decides to do based upon the results. The legislators have decided that a woman, when she becomes pregnant, loses the right to full, honest information from her doctor.

It is her right to know this information. It is how she and her family determine what to do next, not only to decide if they want to continue a pregnancy, but also to consider how they will prepare to care for a special needs child.

What specialist will they turn to? What support will they require? Who will hold their hand in the delivery room if a child is born who will only live an hour, or a day? Does she want to call her own mom in from across the country or does she want to grieve silently with her partner? What will they tell the children they already have?

Doesn't every family have the right to the information that may help them decide the course of their future or the future of their child? According to the Oklahoma State Legislature, they no longer do.

These politicians have decided they know best what women need. They are wrong.

I ask each politician in Oklahoma who voted yes on this bill: How dare you? How dare you deny a woman the peace of mind that her baby is healthy? How dare you not give her and her family time to prepare if, God forbid, her baby is not? How is this bill "pro-life"? How is this mockery of medical care and paternalistic devaluing of women, "pro-life"?

This bill is anti-mom, it's anti-doctor and it is anti-family. And all women, regardless of how they feel about abortion, should be appalled. I hope the courts stand up for the women and families whom politicians have turned their backs on and find this law unconstitutional and flat-out wrong.

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Michaels' type of hemorrhage has wide range of outcomes

(News Terupdate) - The feeling of blood hitting the brain's sensitive covering can give a person the worst headache of his life, doctors say.

That's what happens in a subarachnoid hemorrhage, and that's what singer and reality star Bret Michaels, 47, might have felt before he was taken to the emergency room Thursday. A source close to the situation said Michael described it as "like [getting] hit in the head with a baseball bat over and over again," according to People magazine.

In a subarachnoid hemorrhage, an individual bleeds into the space between the brain and its transparent, web-like tissue covering. This is also the place where spinal fluid is located.

Doctors are still searching for the cause of Michaels' hemorrhage, his road manager posted on his website Monday.

"As of now, Bret remains in ICU under 24 hour surveillance," she wrote. "Further testing this week will help locate the source of the bleeding."

About 65,000 of these hemorrhages occur in the United States every year, said Dr. M. Sean Grady, chairman of neurosurgery at the Hospital of the University of Pennsylvania. Grady was not involved with treating Michaels.

Michaels' type of hemorrhage has a wide range of outcomes: Some patients die almost instantly, some will have difficulty speaking and other neurological dysfunction and some will walk away without long-term complications.

"Sometimes the patients will experience the onset of [the] absolute worst headache of their life, and can be wide awake and alert," said Dr. Daniel Barrow, chief of neurosurgery service at Emory University Hospital, who did not treat the singer. These are often called thunderclap headaches.

In about 10 to 15 percent of cases, the cause is never found. This scenario often has the most promising survival outcome, as these patients often make good recoveries and don't tend to have a recurrence, Barrow said.

The most common cause is physical injury, Barrow said. Car crashes can lead to a subarachnoid hemorrhage in young people, according to the National Institutes of Health. In the elderly, people who fall and hit their head may experience this kind of bleeding.

For spontaneous subarachnoid hemorrhages, an aneurysm is the likely cause, experts say. An aneurysm is a bulging of a blood vessel in the brain. About half of patients with a ruptured aneurysm die from the burst itself, Grady said.

Patients with hemorrhages undergo a procedure called an angiogram, a test used to visualize blood vessels. Sometimes the initial angiogram does not pick up an aneurysm because when the bleeding stops, the clotting fills the aneurysm. That is one possibility for Michaels' case, Barrow said, but he could also fall into the category of unknown cause.

Blood thinners and blood disorders can cause this type of bleed, Barrow said, as can cocaine.

Michaels had undergone an emergency appendectomy on April 12, less than two weeks before suffering the hemorrhage Thursday. The events are likely unrelated, Grady and Barrow said.

The singer's type I diabetes also does not put him at any greater risk of a subarachnoid hemorrhage, Grady said.

The brain's covering is pain-sensitive, and blood coming into contact with it hurts, resulting in a severe headache, Barrow said.

Other symptoms may include sudden loss of consciousness or diminished consciousness, nausea and vomiting, seizure, stiff neck, vision problems and mood changes, according to the National Institutes of Health.

If there is one, it's important to identify the aneurysm and treat it because it will bleed again, Barrow said. One treatment is to surgically clip the aneurysm, excluding it from the normal circulation. An alternative is to put tiny coils of soft platinum metal in the aneurysm.

Someone in Michaels' position would most likely have his blood pressure and neurological function monitored carefully, Grady said. Doctors would watch the arterial blood flow into the brain to make sure the vessels are working as they should, he said.

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Source: Bret Michaels was in excruciating pain

(News Terupdate) - As Bret Michaels continues to be watched closely by his doctors, a source reveals the rocker's excruciating moments before he was taken to the emergency room.

According to the source, Michaels, 47, said the headache that prompted him to call for an ambulance felt "like [getting] hit in the head with a baseball bat over and over again."

Often referred to by doctors as a "thunderclap headache" because of the intensity and suddenness of the pain, such headaches are a tell-tale symptom of the kind of brain hemorrhage that Michaels suffered.

The source close to the situation adds, "Bret is still in ICU. He still has the headache and is heavily sedated."

A statement on his fan site noted that doctors are still searching for the source of the bleeding.

"In some patients, doctors never find the source," says Dr. Keith Siller of New York University's Comprehensive Stroke Care Center. The bleeding could be very small, or the rupture itself can "cure" the source of the problem, says Dr. Siller.

If no source of an aneurysm or an abnormal vein-artery connection known as an AVM is found, "you basically just wait for the symptoms to go away," says Dr. Siller. The patient typically remains under close observation, as Michaels is, so doctors can monitor for possible complications.

But if the patient is able to speak, "they're on the better end of things," says Dr. Siller, noting that physical therapy and speech therapy are often required to make a full recovery.

On TV's "Celebrity Apprentice," on which Michaels is a participant, Sunday night's episode carried a post-script.

Accompanying slow-motion footage of Bret carrying luggage across a tarmac, a voiceover said, "Everyone here at NBC wishes Bret Michaels a speedy recovery."

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Despite widespread claims, little proof for brain supplements

(News Terupdate) - In the fight against memory loss, nothing is certain, doctors say.

A seemingly steady stream of new research purports to show supplements' and vitamins' promise in preventing or slowing cognitive decline, but in reality no hard evidence supports taking any of them. At the same time, such supplements have been proved safe, barring drug interactions and other complications, so some doctors recommend trying them anyway.

With millions of aging Americans experiencing a decrease in cognitive function, the need for a natural prevention method is obvious.

As many as 2.4 million to 4.5 million Americans have Alzheimer's disease, according to the National Institute on Aging. Between 1 and 4 percent of people over the age of 65 have vascular dementia, according to the Mayo Clinic.

Fish oil

At the forefront of the supplement claims to improve brain function has been fish oil. Several observational studies -- which did not involve the scientific rigor of control groups -- have found benefits in cognition, or a lower risk of dementia, among older people who ate a lot of fish, although results overall have been mixed.

A study from Britain, to be published in the June issue of the American Journal of Clinical Nutrition, has found no benefit in taking fish oil supplements in cognitively healthy older adults. Researchers looked at more than 800 people ages 70 to 79, comparing the effects of fish oil to a placebo of olive oil.

On average, there was no difference in cognitive decline during the two years of study. Still, the authors caution that this may not have been long enough to see the real consequences of taking fish oil.

The theory is that fish oil could help because it's rich in omega-3 fatty acids, which control inflammation and protect cells. Omega-3s have been suggested to lower the risk of chronic diseases, such as cancer and heart disease.

The authors of the new study conclude that although they found no benefit on cognition, they also found no harm, and they acknowledge the benefits that have been found for other conditions. They recommend further study on fish oil and cognitive decline.

Gingko biloba

Gingko biloba is a popular botanical supplement that comes from one of the oldest living tree species. Its leaves are thought to have antioxidant properties. Research has suggested that this herbal medicine improves blood flow to the brain and protects nerve cells, and thus may be used to boost memory in people with dementia.

But a study of more than 3,000 people, followed for six years, could not find any effect of delaying or preventing Alzheimer's disease or improving memory. The latest published results were in the Journal of the American Medical Association in December.

"I do not believe that data suggest it has a role to play in prevention," senior author Dr. Steven DeKosky, dean of the University of Virginia School of Medicine, said in an e-mail.

The research did show, however, that the supplement is safe. It is also relatively inexpensive, "so if people insist on taking it, I do not object," DeKosky said.

The prevention trial has ended, but the group is still working on the mounds of data collected from participants, ages 72 to 96, DeKosky said.

They are also going to look at whether the presence or absence of amyloid plaques, a marker of Alzheimer's in the brain, predicts participants' cognitive status over the next five years. A smaller portion of people in the study will take part in a brain imaging study to examine what portion of normal 85-year-olds have these amyloid plaques.

Vitamin E

Dr. Alireza Atri, neurologist at Massachusetts General Hospital, gives vitamin E to his patients with Alzheimer's who wouldn't have side effects because of other medications but admits that it's not clear why this nutrient would help or what dose would be ideal.

Atri's group's findings, presented last year at the annual meeting of the American Geriatrics Society, suggested some potential in vitamin E slowing cognitive decline. They found a modest effect that increased with time.

The study has not been published in a peer-reviewed journal and has not been updated since it was presented, said Atri, also at the VA Bedford Medical Center.

Research on this subject over the past decade has been mixed. Some studies have found a decreased risk of developing Alzheimer's in people who take vitamin E, but others have not found this effect. In terms of slowing the progression of symptomatic patients, a controlled study found no effect, DeKosky said.

Large doses of vitamin E have been shown to cause serious toxic side effects, but low doses may be beneficial, Atri said.

"There's no evidence-based medicine for this," he said. "I think evidence-based opinion would say probably 150 to 100 units a day is fine."

People with bleeding problems should not take vitamin E because of interactions, Atri said.

What to do

Always consult your doctor to find out what supplements are right for you, as even natural remedies can have serious side effects in combination with other drugs or underlying conditions.

"I tell people to take a multivitamin because we know that as we get older, we have an increased risk of not absorbing all the nutrients we need," said Dr. Gary Small, director of the Center on Aging at the University of California, Los Angeles. "Beyond that, there's no hard, fast recommendation."

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Taliban suspected of sickening female Afghan students

(News Terupdate) - Afghan authorities will investigate the sudden illness of students and staff at three schools in the past week in northern Afghanistan, the Afghan Human Independent Rights Commission said on Sunday. Local doctors suggested the Taliban may be the perpetrators of possible poison attacks.

"During the last seven days three cases of poisoning [have] occurred in Kunduz Province," said Syed Karim Talash, the director of the commission office in the province.

At least 88 girls and teachers became ill in separate cases at three girls' schools.

The cause of the illnesses was not known, but Talash said poison gas was suspected.

"It is really big concern for us, and big concern for the family of the girls," Talash said.

Dr. Mohammad Qasam Khamoosh, who treated girls from two schools, said "unknown gases" were responsible for the mass illnesses.

These are "terrorist activities against education in the country," he said.

Girls were not allowed to attend school during the Taliban's rule. Girls' schools have been open in the region since 2001.

Khamoosh said authorities were able to gather a sample of the gas, which has been sent off for testing.

Kunduz province has seen a drastic influx in terrorist activity, particularly by the group known as Hizb-e-Islami, led by the notorious leader Gulbudeen Hekmatyar. It's an independent group that has increasingly worked under the Taliban umbrella in recent years.

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Spanish doctors conduct full face transplant

(News Terupdate) - Doctors in Spain say they have carried out the world's first full face transplant on a man who severely damaged his face in an accident.

Doctors at Barcelona's Vall d'Hebron University Hospital say they were able to give the man a new nose, lips, teeth and cheekbones during 24 hours of surgery.

Thirty doctors were part of the surgery that occurred in late March.

The patient had undergone nine failed operations before being considered for the transplant.

The medical team's leader, Joan Pere Barret, told reporters that the patient was satisfied when he saw his new appearance. He has scars on his forehead and neck, but they will be concealed in the future, Barret said.

"'The patient asked to see himself one week after the surgery, and he reacted very calmly and with satisfaction, and when we asked him -- in writing, because we communicate with writing and gestures -- he said he was very grateful and satisfied," Barret said.

Although this is the first total face transplant, there have been partial face transplants in France, the United States, China and Spain.

The first was when doctors operated on Isabelle Dinoire in Amiens, France, in 2005. She had been mauled by her dog.

In 2008, the United States had its first-ever near-total face transplant.

Connie Culp, injured by a bullet in 2004, received the nose, upper lip and cheekbones of a donor in a 22-hour operation at the Cleveland Clinic in Ohio.

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