Stomach CT scans can be avoided in some kids – study

NEW YORK (Reuters Health) – Not all kids need a CT scan after a blunt trauma to the abdomen, according to a new study that identifies seven key signs to help doctors decide when a scan is unnecessary.

CT scans are becoming commonplace in emergency rooms, but they aren’t harmless. Each scan delivers a dose of radiation that slightly increases a person’s long-term risk of cancer – a risk that’s especially heightened for children.

The key, researchers said, is determining when a CT will help doctors make an important diagnosis – and is therefore worth the risk – and when it is unlikely to benefit a young patient’s care.

“An abdominal CT is the highest CT exposure for kids, and the younger the kid, the higher the exposure,” said Dr. James Holmes, who led the new study at the University of California, Davis School of Medicine.

“This is the big radiation risk, and (parents) need to be aware that if their child really needs the image, they should get it. But if there’s no good reason, they shouldn’t,” Holmes told Reuters Health.

His team’s study included just over 12,000 kids seen at one of 20 ERs after a car or bike crash, fall or other abdominal injury between 2007 and 2010.

Each doctor and hospital decided independently when to do an abdominal scan, and 45 percent of children ended up getting one while in the ER. Just over six percent of all kids had abdominal injuries spotted on a CT scan, and about one-quarter of those needed surgery, a blood transfusion or another intervention.

Based on kids’ symptoms and who ended up needing treatment, Holmes and his colleagues designed a seven-point checklist to determine when a CT scan is not warranted:

When children had no seat belt marks or other clear trauma, no stomach tenderness or pain and no thinking problems, breathing issues or vomiting, just one in 1,000 ended up with an acute injury requiring treatment.

Still, one-quarter of kids in the study who fit those criteria received a CT in the ER, the researchers reported in the Annals of Emergency Medicine.

A CT scan to the abdomen and pelvis delivers a radiation dose of eight millisieverts – equal to about three years’ worth of natural background radiation, or the combined radiation from 400 chest X-rays.

Holmes said that for an infant, the risk of developing cancer after a single abdominal and pelvic CT scan might be as high as 1 in 200. By adolescence, that risks drops to 1 in 1,000 or 1 in 1,500.

There are times when a CT scan is clearly warranted to help doctors find or rule out serious injuries such as a lacerated spleen or liver, Holmes said.

“You’re looking at those things that need to be identified because they need therapy, either an operation to repair their gastrointestinal injury, or perhaps an embolization to repair a bleeding artery,” he said.

In those cases, “You don’t want to send that patient home, because if they need that therapy, they’re not going to get it” – and waiting can make things worse.

But, Holmes said, parents should feel comfortable questioning a doctor’s decision to perform a stomach CT scan on their child, given the potential risks.

SOURCE: http://bit.ly/WD6wKF Annals of Emergency Medicine, online February 4, 2013.

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Wall Street ends lower on renewed euro zone fears

NEW YORK (Reuters) – Stocks declined on Thursday, taking a step back from their recent advance, prompted by comments by the ECB president on the euro and Europe’s outlook.

The euro currency dropped against the safe-haven dollar and yen, spurring a retreat from risky assets such as stocks, after European Central Bank President Mario Draghi said the exchange rate was important to growth and price stability. Investors took that as a sign the bank is concerned about the euro’s advance and its effect on the region’s economy.

Growth sectors were among the weakest performers on the S&P 500: the S&P 500 materials index <.splrcma> was down 0.6 percent while the S&P energy index <.spny> was down 0.5 percent. Housing stocks also declined, with a housing sector index <.hgx> off 1.4 percent.</.hgx></.spny></.splrcma>

Despite the day’s decline and weakness earlier this week, the stock market has been in an almost uninterrupted up trend for most of the year, with the S&P 500 up 5.8 percent so far for 2013.

Many analysts say some weakness at this point is no surprise.

“Given the amount the market moved in January, having a little bit of a pullback and some consolidation where the market goes sideways for a little while, we think would be a healthy sign,” said Eric Marshall, director of research at Hodges Capital Management in Dallas.

Top U.S. retailers reported strong January sales after offering compelling merchandise that drew in shoppers facing a hit to their take-home pay from higher payroll taxes.

The Dow Jones industrial average <.dji> was down 42.47 points, or 0.30 percent, at 13,944.05. The Standard & Poor’s 500 Index <.spx> was down 2.73 points, or 0.18 percent, at 1,509.39. The Nasdaq Composite Index <.ixic> was down 3.34 points, or 0.11 percent, at 3,165.13.</.ixic></.spx></.dji>

Shares of Apple helped to limit losses on the Nasdaq, the stock ending up 3 percent at $ 468.22. Fund manager David Einhorn’s Greenlight Capital said it has sued Apple Inc and said the company needs to do more to unlock value for shareholders.

Though the earnings season is winding down, results continue to boost growth estimates for the fourth quarter. According to Thomson Reuters data through Thursday morning, of 317 companies in the S&P 500 that have reported earnings, 69 percent have exceeded analysts’ expectations, above a 62 percent average since 1994 and 65 percent over the past four quarters.

Fourth-quarter earnings for S&P 500 companies rose 5 percent, according to the data, above a 1.9 percent forecast at the start of the earnings season.

Akamai Technologies Inc lost 15.2 percent to $ 35.26 as the worst percentage performer on the S&P 500 after the Internet content delivery company forecast current-quarter revenue below analysts’ expectations.

Among retailers, Macy’s Inc rose 2 percent to $ 40.27 after reporting January same store sales rose 11.7 percent.

But Ann Inc dropped 8 percent to $ 30.20 after forecasting fourth-quarter sales below analysts’ expectations.

Economic data was mixed. Initial jobless claims dipped last week, with the four-week moving average falling to its lowest level since March 2008, signaling the economy continues to recover slowly.

A separate report said fourth-quarter productivity registered its biggest drop in nearly two years, while unit labor costs jumped 4.5 percent, more than economists expected.

Roughly 6.6 billion shares traded on the New York Stock Exchange, the Nasdaq and the NYSE MKT, compared with the 2012 average daily closing volume of about 6.45 billion.

Decliners outpaced advancers on the NYSE by nearly 4 to 3 and on the Nasdaq by about 5 to 3.

(Additional reporting by Angela Moon; Editing by Kenneth Barry and Nick Zieminski)

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Holidays, politics may give NKorea nuke test clues

SEOUL, South Korea (AP) — So when will it be?

North Korea vowed last month to carry out its third nuclear test but has said nothing about timing. As a result, the building suspense in Seoul has prompted many to look at the dates Pyongyang has chosen for past atomic tests, as well as rocket and missile launches.

Dates and numbers have great symbolic importance to North Korea’s government. So Pyongyang often schedules what Washington calls “provocative acts” around U.S. holidays and important South Korean political events, an effort to send none-too-subtle messages to its main enemies — Washington and Seoul. Pyongyang also uses the tests to give a nationalistic boost to its citizens, often favoring significant milestones of the state, party and ruling Kim family.

Here’s a look at the “meaningful dates” North Korea has selected for past tests and launches, as well as future key dates on which Pyongyang might choose to stage its third nuclear test:

U.S. HOLIDAYS AND POLITICAL EVENTS:

Both previous nuclear tests were conducted as Americans celebrated U.S. holidays: Oct. 9, 2006, was Columbus Day; May 25, 2009, was Memorial Day.

North Korea also conducted missile tests on America’s Independence Day in 2006. It launched a long-range rocket just a few months after Obama’s first inauguration in 2009.

Some speculate that Pyongyang might make good on its atomic threat on the upcoming Feb. 18 federal holiday. That day is Washington’s Birthday, also known as Presidents Day. South Korea’s foreign minister has also suggested President Barack Obama‘s State of the Union address on Feb. 12.

SOUTH KOREAN POLITICAL EVENTS:

North Korea also has used inaugurations and elections in archrival South Korea to test its missiles and to launch rockets. South Korean President-elect Park Geun-hye will be inaugurated Feb. 25.

Last year’s successful Dec. 12 long-range rocket launch, which was condemned by the U.N. as a cover for a banned missile test, came just a week before South Koreans went to the polls to choose a new president.

North Korea fired a short-range missile on the eve of former liberal President Roh Moo-hyun’s 2003 inauguration. Days before that, a North Korean jet also intruded into South Korean airspace over the Yellow Sea, turning back as warplanes in South Korea scrambled.

And in 1998, six months after liberal South Korean President Kim Dae-jung took office, North Korea launched what it said was a rocket carrying a satellite.

NORTH KOREAN MILESTONES:

A failed North Korean rocket test last year fell on April 12, days before the April 15 celebration of the centennial of the birth of national founder Kim Il Sung.

The 2006 nuclear test also came a day before the 61st anniversary of the founding of the ruling Workers’ Party.

North Korea has repeatedly sought to link the legacy of late leader Kim Jong Il — Kim Il Sung’s son and the father of current leader Kim Jong Un — to the development of its nuclear program. His birthday falls on Feb. 16. Two days before that, Feb. 14, is the anniversary of Kim Jong Il being posthumously named Generalissimo.

__

Associated Press writers Hyung-jin Kim and Sam Kim in Seoul contributed to this report.

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Segregationist U.S. Senator Thurmond’s biracial daughter dies

CHARLESTON, South Carolina (Reuters) – Essie Mae Washington-Williams, who in 2003 revealed she was the biracial daughter of segregationist U.S. Senator Strom Thurmond, died on Monday at age 87, her attorney said.

Washington-Williams, who had been in declining health in recent years, died of natural causes at a care home in Columbia, South Carolina, said lawyer Frank Wheaton.

Washington-Williams was born in 1925 to a black teenage girl who worked as a maid in Thurmond’s parents’ home when Thurmond was 22. She announced she was Thurmond’s daughter in 2003 after his death at age 100 that year, and the late senator’s family confirmed her claim.

Washington-Williams was a teacher in Los Angeles for three decades and was the mother of four. She moved to South Carolina about five years ago to be closer to a daughter who lived there, Wheaton said.

Her 2006 memoir, “Dear Senator,” detailed her decades-long relationship with her father, the letters they wrote each other and the kindness he showed her personally, which she struggled to reconcile with his opposition to civil rights and his defense of racial segregation.

“She was very low-key and never wanted to rock the boat, I think that’s why she kept her secret until he died,” said William Stadiem, who co-wrote “Dear Senator.”

Stadiem said Thurmond had great affection for Washington-Williams‘ mother, Carrie Butler.

“The fact he stayed close to Essie for all those years, it would be so easy for him to say ‘get out of my life, you don’t exist,’ and he didn’t do that,” Stadiem said. “I think she reminded him of her mother.”

Washington-Williams as a young child went to live with her mother’s sister and her husband in Pennsylvania, and it was from him that she took the surname Washington. She adopted the name Williams from her marriage to attorney Julius Williams.

Thurmond began his career as a Democrat but switched to the Republican Party in 1964. In his lifetime, Thurmond said he was not racist but opposed what he saw as excessive federal intervention.

He staged the longest filibuster in U.S. history when he spoke for more than 24 hours against a 1957 civil rights bill that sought to fight the disenfranchisement of blacks in the South by giving new powers to federal prosecutors.

In 2004 a statue of Thurmond outside the South Carolina State House was altered to engrave the name Essie Mae with those of his other four children on the foundation stone.

(Reporting by Harriet McLeod; Writing by Alex Dobuzinskis; Editing by Xavier Briand)

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Mariel Hemingway hopes new film will end her family’s curse

LONDON (Reuters) – Actress Mariel Hemingway hopes going public in a documentary about the curse that has plagued her family will finally dispel any mystery around their battles with addiction and raise awareness about mental illness.

For years, Hemingway ignored the drinking, addiction and mental illness that coursed through her family, leading several relatives to take their own lives.

Her grandfather Ernest Hemingway, the Nobel Prize-winning writer, killed himself in 1961 just months before she born. Mirroring his own father’s suicide, he shot himself.

One of her sisters, Margaux, died of an overdose in 1996 at the age of 42, and her youngest sister, Joan, has been in and out of institutions for a decade.

Mariel Hemingway, 51, who soared to fame in her Oscar-nominated role in the Woody Allen film “Manhattan”, has faced her own demons, battling depression.

But she hopes that talking opening about the so-called Hemingway curse in a new documentary, “Running from Crazy”, will help others confront mental illness in their own families.

“I never felt it was a curse but I definitely wanted a normal life,” Hemingway told Reuters in London on Wednesday where she attended the opening night of “Fiesta”, a play based on Ernest Hemingway’s first novel, “The Sun Also Rises”.

“There are lifestyle choices you can make which can change the course of your life. I have been able to do that through the food I eat, what I drink, what I do on a day-to-day basis. I have managed to find a balance.”

The documentary, which made its premiere at last month’s Sundance Film Festival and is due to be released in Britain this spring, explores her parents’ tumultuous marriage and her troubled relationships with her siblings.

It includes footage of her sister Margaux, a model and actress, whose death she refused to say was suicide until 2003.

“Making this documentary ended up being very therapeutic,” she said. “It was not until recently that I realized I had been depressed for so long and I am finally happy.”

Hemingway said her family and her own battles had made her passionate about advocating awareness about suicide and mental illness with her own two daughters as well as other people.

“Mental illness especially in the United States is still taboo. Hopefully seeing what my family has gone through will help people talk about these issues,” she said.

Hemingway said she was currently working on turning her grandfather’s posthumous memoir “A Moveable Feast” into a film and was acutely aware how difficult it was to adapt his prose, which was so often dependent on what was not said.

“You have to have a very delicate hand to adapt his work,” she said, praising “Fiesta”, which was adapted from “The Sun Also Rises” and directed by Alex Helfrecht.

Helfrecht received approval from the Hemingway estate to adapt the novel, which follows a group of hard-drinking expatriates from Paris to Pamplona’s bull-running festival in the 1920s, for the stage. “Fiesta” runs at the Trafalgar Studios 2 until March 2.

(Reporting by Belinda Goldsmith; Editing by Angus MacSwan)

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Senate panel to vet Lew for Treasury secretary next week

WASHINGTON (Reuters) – The Senate Finance Committee will hold a hearing on February 13 to consider the nomination of Jacob “Jack” Lew for Treasury secretary, the committee said on Wednesday.

Committee chairman Max Baucus, a Montana Democrat, will question Lew “about his experience, his views on fiscal policy and ideas for spurring economic growth” at the 10 a.m. hearing, the committee said.

“We have a tremendous amount of work to do over the next couple months to get our fiscal house in order. It is my hope that — after a thorough vetting process – Jack Lew will be quickly confirmed so he can help tackle our country’s pressing economic issues,” Baucus said in the committee statement.

Lew was recently Obama’s chief of staff and a former White House budget director.

(Reporting by Rachelle Younglai; Editing by Jackie Frank)

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Iran’s Ahmadinejad kissed and scolded in Egypt

CAIRO (Reuters) – Mahmoud Ahmadinejad was both kissed and scolded on Tuesday when he began the first visit to Egypt by an Iranian president since Tehran’s 1979 Islamic revolution.

The trip was meant to underline a thaw in relations since Egyptians elected an Islamist head of state, President Mohamed Mursi, last June. But it also highlighted deep theological and geopolitical differences.

Mursi, a member of the Sunni Muslim Brotherhood, kissed Ahmadinejad after he landed at Cairo airport and gave him a red carpet reception with military honors. Ahmadinejad beamed as he shook hands with waiting dignitaries.

But the Shi’ite Iranian leader received a stiff rebuke when he met Egypt’s leading Sunni Muslim scholar later at Cairo’s historic al-Azhar mosque and university.

Sheikh Ahmed al-Tayeb, head of the 1,000-year-old seat of religious learning, urged Iran to refrain from interfering in Gulf Arab states, to recognize Bahrain as a “sisterly Arab nation” and rejected the extension of Shi’ite Muslim influence in Sunni countries, a statement from al-Azhar said.

Visiting Cairo to attend an Islamic summit that begins on Wednesday, Ahmadinejad told a news conference he hoped his trip would be “a new starting point in relations between us”.

However, a senior cleric from the Egyptian seminary, Hassan al-Shafai, who appeared alongside him, said the meeting had degenerated into an exchange of theological differences.

“There ensued some misunderstandings on certain issues that could have an effect on the cultural, political and social climate of both countries,” Shafai said.

“The issues were such that the grand sheikh saw that the meeting … did not serve the desired purpose.”

The visit would have been unthinkable during the rule of Hosni Mubarak, the military-backed autocrat who preserved Egypt’s peace treaty with Israel during his 30 years in power and deepened ties between Cairo and the West.

“The political geography of the region will change if Iran and Egypt take a unified position on the Palestinian question,” Ahmadinejad said in an interview with Al Mayadeen, a Beirut-based TV station, on the eve of his trip.

He said he wanted to visit the Gaza Strip, the Palestinian territory which neighbors Egypt to the east and is run by the Islamist movement Hamas. “If they allow it, I would go to Gaza to visit the people,” Ahmadinejad said.

Analysts doubt that the historic changes that brought Mursi to power will result in a full restoration of diplomatic ties between states whose relations were broken off after the conclusion of Egypt’s peace treaty with Israel in 1979.

OBSTACLES TO FULL TIES

At the airport the two leaders discussed ways of improving relations and resolving the Syrian crisis “without resorting to military intervention”, Egyptian state media reported.

Egypt is concerned by Iran’s support for Syrian President Bashar al-Assad, who is trying to crush an uprising inspired by the revolt that swept Mubarak from power two years ago. Egypt’s overwhelmingly Sunni Muslim population is broadly supportive of the uprising against Assad’s Alawite-led administration.

Egyptian Foreign Minister Mohamed Kamel Amr sought to reassure Gulf Arab allies – that are supporting Cairo’s battered state finances and are deeply suspicious of Iran – that Egypt would not jeopardize their security.

“The security of the Gulf states is the security of Egypt,” he said in remarks reported by the official MENA news agency.

Mursi wants to preserve ties with the United States, the source of $ 1.3 billion in aid each year to the influential Egyptian military.

“The restoration of full relations with Iran in this period is difficult, despite the warmth in ties … because of many problems including the Syrian crisis and Cairo’s links with the Gulf states, Israel and the United States,” said one former Egyptian diplomat.

Iranian Foreign Minister Ali Akbar Salehi said he was optimistic that ties could grow closer.

“We are gradually improving. We have to be a little bit patient. I’m very hopeful about the expansion of the bilateral relationship,” he told Reuters. Asked where he saw room for closer ties, he said: “Trade and economics.”

Egypt and Iran have taken opposite courses since the late 1970s. Egypt, under Mubarak’s predecessor Anwar Sadat, concluded a peace treaty with Israel in 1979 and became a close ally of the United States and Europe. Iran from 1979 turned into a center of opposition to Western influence in the Middle East.

Symbolically, Iran named a street in Tehran after the Islamist who led the 1981 assassination of Sadat.

Egypt gave asylum and a state funeral to Iran’s exiled Shah Reza Pahlavi, who was overthrown in the 1979 Iranian revolution. He is buried in a mosque beside Cairo’s mediaeval Citadel alongside his ex-brother-in-law, Egypt’s last king, Farouk.

(Additional reporting by Ayman Samir, Marwa Awad and Alexander Diadosz; Writing by Paul Taylor and Tom Perry; Editing by Andrew Roche and Robin Pomeroy)

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Smooth-singing Josh Groban offers edgier sound on new album

LOS ANGELES (Reuters) – After selling more than 22 million albums in the United States and becoming a staple in the classical music field, singer Josh Groban is embracing an edgier sound for his latest record, “All That Echoes,” out on Tuesday.

Groban, 31, put together a collection of covers and original songs for the album, including a rendition of one of his personal favorites, “Falling Slowly” from the movie and stage musical “Once.”

Under the guidance of veteran producer Rob Cavallo, the Warner Bros. Records chairman who has worked with rockers like Green Day, Goo Goo Dolls and Paramore, Groban showcases his usual smooth vocals against a more energetic, live-concert sound.

“It’s not about walking out of your lane and scaring people. It’s about slightly expanding what your lane is and allowing all of that to be part of your world,” Groban said in an interview with Reuters.

Along with covers including a rendition of Stevie Wonder’s “I Believe (When I Fall in Love It Will Be Forever),” Groban also wrote original songs, which he said emerged from frustration.

“It was the frustration of hearing songs that were maybe written for me after a little bit of success, going ‘Ahh, is that really what you think I do?’ Yes, I know the other thing was kind of cheesy, but that’s really cheesy,’” the singer said.

“All That Echoes” features original songs such as “Below the Line,” which draws in Latin jazz beats and sweeping ballads such as “Brave” and “False Alarms,” where Groban showcases his powerful voice.

ACTING CHOPS

Groban first found the spotlight in 1999, when he was asked to fill in for ailing Italian tenor Andrea Bocelli at a rehearsal with Canadian singer Celine Dion.

Groban went on to land a short role on TV show “Ally McBeal” in 2001 and released his debut self-titled solo album later that year.

Five studio albums later, Groban has cemented himself at the top of the list of pop-vocal performers. His 2007 holiday record “Noel” became the best-selling U.S. album of the year.

Los Angeles native Groban has also taken small acting roles in TV comedy “The Office, movie “Crazy Stupid Love” and will make a cameo appearance on an upcoming episode of “CSI: NY.”

If he had his dream gig, Groban said he would be fronting rock band Queen for a day. But in the more foreseeable future, he hoped to become a regular face in theater.

“There are only so many albums I’m going to want to make before I decide to go and follow that dream for a minute or longer than a minute,” the singer said.

“I think that there will come a time very soon, hopefully in the next two or three years, where I’ll take out a big chunk of time and dedicate it to theater and do some of that.”

For now, the singer will hit the road in support of his new album, heading to Australia in April before returning to Los Angeles to perform three dates at the Hollywood Bowl in July.

(Reporting By Lindsay Claiborn, writing by Piya Sinha-Roy; Editing by Cynthia Osterman)

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Steroid shots for tennis elbow may hurt, not help

NEW YORK (Reuters Health) – Getting a cortisone injection won’t cure tennis elbow any better than a drug-free saline shot, according to a new study – and it might actually slow recovery.

Researchers found that a few weeks after receiving the steroid shots, people reported less pain and disability than those who’d been given placebo injections. But a year later, the same patients lagged behind the placebo group in their likelihood of complete recovery.

“This absolutely confirms that steroid injections are not a good idea,” said Dr. Allan Mishra, an orthopedic surgeon at Stanford University in Menlo Park, California.

“This is important, because people think that it’s okay to get a cortisone injection (for tennis elbow), and it’s not okay. It puts you at a disadvantage long term in terms of getting better,” Mishra, who has studied tennis elbow treatment but wasn’t involved in the new study, told Reuters Health.

The condition is caused by overuse of tendons in the elbow and typically treated with non-steroidal anti-inflammatory drugs, physical therapy and steroid shots.

Last month, a study from Denmark found neither steroid nor platelet injections improved pain and functioning among people with tennis elbow any better than saline shots, over a period of three months (see Reuters Health story of January 22, 2013 here: http://reut.rs/Wl9Ckw).

Researchers at the time cautioned that the study’s follow-up period was short and the results might look different at six months or a year post-injections.

By following patients longer, the new report shines a light on the possible long-term tendon damage that can be caused by cortisone shots, Mishra said.

‘DOES NOT SUPPORT’ STEROID SHOTS

Bill Vicenzino from the University of Queensland in Australia and his colleagues randomly assigned 165 adults with tennis elbow to one of four treatment groups: cortisone shots with physical therapy, placebo shots with physical therapy, cortisone shots without physical therapy and placebo shots without physical therapy.

After one year, there was no difference in people’s improvement in pain or functioning based on whether they’d had the eight sessions of prescribed therapy.

Among those who’d received a cortisone shot, 83 percent reported they had completely recovered from tennis elbow by one year. That compared to 96 percent of those who’d received a placebo injection, according to findings published Tuesday in the Journal of the American Medical Association.

Symptoms were also more likely to come back after a cortisone injection. The research team calculated that one more person would have a recurrence for every two or three treated with steroids instead of a saline shot.

“This evidence does not support the clinical practice of using corticosteroid injection to facilitate active rehabilitation,” the study team wrote.

Cortisone injections typically start at about $ 100.

Mishra said researchers are looking for better treatments to address what is causing tendon pain in the first place, such as weakening of collagen in the tendon. One possible option being studied by himself and others is so-called platelet-rich plasma injections, but “we’re not quite there yet,” he said.

Many cases of tennis elbow also go away on their own with time and basic stretching, Mishra added.

“I think home-based exercises are probably sufficient for treating this,” he said. “You’d be better off with that than with a cortisone injection. That’s what you should start with, because you might not even need physical therapy.”

SOURCE: http://bit.ly/JjFzqx Journal of the American Medical Association, online February 5, 2013.

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Harvard Flunks Investing, Taps Accel’s Jim Breyer

(Updates 9th paragraph with comments from a Harvard spokesman on Breyer’s role.)

When the Ivy League’s fiscal year ended in June, Harvard University finished in an unfamiliar spot: last. The school’s endowment was the only one in the hallowed group to lose money on its investments, with a return of negative 0.05 percent—below the average gain of 2.3 percent and well behind Dartmouth’s leading return of 5.8 percent. Harvard’s fund is still the Ivy League’s biggest by far, at $ 30.7 billion, but in Cambridge, ranking eighth in anything simply will not do.

And so on Feb. 4, the university announced that prominent venture capitalist Jim Breyer of Accel Partners had joined Harvard’s board.

In Breyer, Harvard is getting one of Silicon Valley’s most successful venture capitalists, best known for an early bet on Facebook (FB) that helped make him a billionaire. In Harvard, Breyer gets to add perhaps the most prestigious name in board memberships to his ever-growing list of affiliations.

Breyer, a graduate of Harvard Business School, collects directorships like baseball cards. At this point, it might be faster to list the places where he’s not a director, but here’s a start: Breyer is on the boards of Facebook, Wal-Mart Stores (WMT), Dell (DELL), News Corp. (NWS), Etsy, Prosper Marketplace, Booyah, Ubermedia, and Bbnt Solutions, according to a Bloomberg database. Accel’s website adds that Breyer “serves on the board of Stanford Technology Ventures Program, Epicenter, the National Center for Engineering Pathways to Innovation, Technet and is a trustee of the San Francisco Museum of Modern Art (SFMOMA), and of The Menlo School.”

Plus, Accel says, Breyer is chairman of the Stanford Engineering Venture Fund and an honorary professor at Hunan University’s Yuelu Academy in China. Previous memberships, chairmanships, and other roles came at the National Venture Capital Association and the Western Association of Venture Capitalists; Harvard’s Global Advisory Council and Harvard Business School; Brightcove (BCOV); Marvel Entertainment; RealNetworks (RNWK); Lightspan; Mpath Interactive; Actuate (BIRT); Thestreet.co.uk (TST); Legendary Entertainment; Model N; and more.

At some point Breyer even finds the time to work at Accel.

In May 2012, New York Times columnist Gretchen Morgenson faulted Breyer for board promiscuity, noting that four of his five directorships at public companies were tainted by scandal or mismanagement. That included News Corp., which had already become engulfed in a phone hacking scandal before Breyer joined the board; Wal-Mart, accused of bribery in Mexico; and Dell, the struggling computer maker that agreed to take the humbling step of going private. Morgenson also criticized Breyer for favoring companies with dual-class stock structures, which tend to have weak board oversight because voting power is concentrated in the hands of a few shareholders. Breyer did not respond to an e-mailed request for comment.

Joining the Harvard Corporation, as the board is known, must be extra sweet for Breyer. In 2004, Forbes reported, the university dropped its investment in Accel Partners. This came just as the firm’s performance was about take off, thanks largely to its stake in Facebook—which was started in a Harvard dorm room.

Harvard’s endowment is run by the Harvard Management Company, led by Jane L. Mendillo. Kevin Galvin, a university spokesman, emphasized in an emailed statement that Breyer had joined the school’s top board, and not that of the investment company. “The University Board is not involved in setting the investment policy for the University,” he wrote. “Mr. Breyer’s close involvement with leading technology and media companies will no doubt make him an invaluable counselor for the University on a range of issues.”

While Harvard trailed the rest of the Ivy League last year, its investment performance was in line with colleges nationwide. Endowments declined 0.3 percent on average, according to the National Association of College & University Officers. The whole point of Harvard, though, is that it is not average. The university’s operations and ability to compete for academic talent depend on strong financial performance.

As Harvard students know, when your grades start to fall behind the curve, it’s smart to bring on a tutor. Breyer’s expertise can’t hurt—if he can truly find the time to lend it.

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