cut 66.cut.0002 Louis J. Sheehan, Esquire

A chemical in some air fresheners and pest-control products may slightly impair lung function in millions of people, a nationwide study suggests.

The compound, para-dichlorobenzene, is used to make mothballs, urinal deodorizers, and air-freshening blocks for household use. At room temperature, the strong-smelling chemical gradually changes from a solid to a gas.

Para-dichlorobenzene was previously detected in the blood of more than 95 percent of the participants tested in a U.S. study called NHANES III.

Scientists at the National Institute of Environmental Health Sciences in Research Triangle Park, N.C., looked for effects of the chemical and 10 other volatile organic compounds commonly detected in U.S. residents. Led by internist and epidemiologist Stephanie J. London, the team analyzed NHANES III data from 953 adult volunteers.

The researchers compared the recorded blood concentrations of each of the 11 chemicals to several measures of lung function, including forced expiratory volume in 1 second (FEV1). They also considered related factors, such as exposure to cigarette smoke.

The tenth of the study's participants who had the most para-dichlorobenzene in their blood—more than 4.4 micrograms per liter—had about 4 percent lower FEV1 values than did the tenth of participants with the lowest blood concentrations—averaging 0.1 µg/l. That difference in FEV1 amounted to an average of 0.15 l. The average FEV1 of people in the study was 3.44 l, the researchers report in the August Environmental Health Perspectives.

While "it's not some huge effect," London says, "at the borderline [of healthy lung function], losing 4 percent of your FEV1 could be a problem." http://www.soulcast.com/Louis3J3Sheehan

FEV1 is low in people who have chronic obstructive pulmonary disease or who are regularly exposed to cigarette smoke. The FEV1 deficit associated with para-dichlorobenzene exposure is on par with that linked to secondhand smoke, London says. One-quarter of the volunteers were smokers, and others had been exposed to secondhand smoke in various amounts. The link between para-dichlorobenzene and reduced lung function persisted even when the researchers took those factors into account.

"This is an interesting new finding that will need to be replicated," comments Ralph J. Delfino of the University of California, Irvine. http://www.soulcast.com/Louis3J3Sheehan/

Delfino and London agree that para-dichlorobenzene may not be the culprit behind the reduced lung function that London's team reports. Rather, there may be other environmental hazards that are common in homes and workplaces that have products emitting para-dichlorobenzene, London says. Louis J. Sheehan, Esquire

pygmy 33.pyg.23 Louis J. Sheehan, Esquire

Furbies, those annoying furry robots that were all the rage in the late nineties, are back. But this time they’re alive. In the past few months, scientists have captured three live Furby lookalikes—called pygmy tarsiers (Tarsius pumilus)—in Indonesian forests. Pygmy tarsiers are tiny nocturnal primates, less than four inches long, with giant eyes and long thin fingers tipped with claws. http://sheehan.myblogsite.com

Until now, the gremlin-like creatures were almost mystical. The last time a pygmy tarsier was found alive was in 1930. Many scientists were convinced that the species was extinct until Indonesian scientists found one dead in a mouse trap in 2000. Determined to track down the mysterious species, a team of primatologists set up 276 mist nets in the mountains of Indonesia. They captured three, two males and one female, and fitted them with radio collars.http://sheehan.myblogsite.com/

So little is known about the creatures that the researchers are literally learning first-hand. For example, Sharon Gursky-Doyen, leader of the team, learned that the little guys can turn their heads 180 degrees after one pulled the maneuver and bit her finger while she was attaching the radio collar. Unlike the gibberish-speaking Furbies, pygmy tarsiers are quiet. The researchers believe they may call in frequencies outside the range of the human ear.http://sheehan.myblogsite.com/

With the radio collars, the researchers were able to track the movements of the three pygmy tarsiers for several weeks. They feed on insects and scamper around in the tops of trees. So far no word on whether it’s safe to feed them after midnight. Louis J. Sheehan, Esquire

rise http://Louis2J2Sheehan2Esquire.US

Virginia, a state perhaps best known for its links to colonial America, contains some of the earliest known remains of prehistoric Americans, according to data presented in Philadelphia last week at the annual meeting of the Society for American Archaeology.

Analyses of soil, plant, and animal remains and stone artifacts that researchers found in layers of a sand dune known as Cactus Hill suggest that people lived there at least 15,000 years ago. That's well before the appearance of the Clovis culture, long regarded as the first in the New World.http://Louis2J2Sheehan2Esquire.US

Sites from Florida to Alaska have yielded distinctive Clovis stone points. Such finds date at earliest to 11,500 years ago.

"We think people went to Cactus Hill, on and off, beginning at least 15,000 years ago," says Joseph M. McAvoy of Nottoway River Survey-Archaeological Research in Sandstone, Va., who directs research at the site.

Clovis culture may have flourished first in the southeastern United States and then spread westward, McAvoy proposes. However, many archaeologists have assumed that Clovis people crossed into North America from Siberia about 12,000 years ago and then moved eastward.

Excavations at Cactus Hill, which lies along the Nottoway River 45 miles south of Richmond, began in 1993. Wind has carved out this dune and others in the area over the past 25,000 years, McAvoy says. The dune contains enough silt and clay to hold its deposits together.

McAvoy's team identified two sediment layers containing signs of human occupation. The upper level, radiocarbon dated to 10,920 years ago, contained Clovis-style spear points. The lower level, radiocarbon dated to 15,070 years ago, yielded stone points and other implements without Clovis features.

These stone points and blades exhibit microscopic wear marks typical of butchery and hide scraping, reports Larry R. Kimball of Appalachian State University in Boone, N.C. He calls the points "logical precursors" of Clovis points.

Charcoal from the dune's lowest level dates to as early as 19,700 years ago, says McAvoy. That material may have resulted from either human activity or forest fires.

Several lines of evidence lend credence to these dates, McAvoy says. Optically stimulated luminescence dating, a technique for estimating the last exposure of buried soil to sunlight, confirms the site's radiocarbon dates, holds James K. Feathers of the University of Washington in Seattle.

Soil samples from Cactus Hill indicate that no major geological disturbances affected the two archaeological deposits, according to analyses by James C. Baker of Virginia Polytechnic Institute and State University in Blacksburg.

Moreover, artifact-bearing soil at the site contains high concentrations of microscopic plant remains, another sign that the human-occupation levels have remained undisturbed, says Lucinda J. McWeeney of Yale University.http://Louis2J2Sheehan2Esquire.US

Microscopic studies of soil structure at Cactus Hill, however, suggest that geological forces may have affected the artifact layers, assert Carole A. Mandryk and J. Taylor Perron of Harvard University. "I don't think it's been proved that these artifacts come from undisturbed locations," Mandryk says.

Vance Haynes of the University of Arizona in Tucson also views Cactus Hill cautiously. He awaits further radiocarbon tests before accepting the site's age estimates. Haynes says that it's "most unusual" that only 6 inches of soil separate the two occupation levels and so must cover a span of about 5,000 years.

Still, "Cactus Hill is the best candidate for a pre-Clovis site in a long time," Haynes remarks.

Dennis Stanford of the Smithsonian Institution in Washington, D.C., argues that pre-Clovis artifacts at Cactus Hill resemble western European specimens from about the same time. He raises the controversial possibility that seagoing Europeans settled eastern North America and founded the pre-Clovis culture.http://Louis2J2Sheehan2Esquire.US

Whatever the case, the existence of pre-Clovis folk at Cactus Hill looks convincing, says Michael Johnson, an archaeologist at Fairfax County Park Authority in Falls Church, Va., who's conducting a separate excavation at Cactus Hill.

tb Louis J. Sheehan, Esquire

To properly treat tuberculosis (TB), you must take up to four antibiotics every day for six months under careful supervision. If you are one of the 17 stricken individuals in this small farming community, you can get that care either at the clinic–hospital in the town center or one of the newly opened satellite clinics in outlying neighborhoods.

But none of those were accessible to 85-year-old Lubov Potaskaeva, who lives in a rundown apartment complex for agricultural laborers far from town. The Kyrgyzstani native has no idea how she caught the disease. She only knows that when she was screened for TB as part of her application to enter the area's retirement home—she wanted in because she was always short of breath and could no longer climb the stairs to her second-floor apartment—her test came back positive.

Over the past 10 years, local health authorities in Siberia's Tomsk Oblast (a Poland-size province with about one million people) have built a wide-ranging network for ensuring that people like Potaskaeva get the World Health Organization–recommended treatment for TB, known as DOTS (for directly observed therapy, short course). If they are among the 15 percent diagnosed with multidrug-resistant, or MDR-TB, they get a two-year long treatment with up to six or eight drugs known as DOTS-Plus.

The key to the program lies in reaching out to people who can't or won't go to a hospital or clinic to be "directly observed." Every day, someone comes to them. In this apartment bloc, at the end of a dirt road that had turned to mud from a summer rain on the day I visited, the task fell to one of Potaskaeva's neighbors, who gets paid to watch her take her drugs and then doles out the special food packages that bolster her strength and immune system.

Potaskaeva, appearing spry and in good health, was nearing the end of the grueling regimen. Pointing to Sergei Ilyin, the young physician overseeing her care who had just brought a carload of inquisitive foreigners to her home, she said, "When he told me I had TB, I said, 'You're a liar.'" Then she reached up and pinched his cheeks with both hands. "I can run now. I must thank you."

The jury is still out on the outreach program's effectiveness. Local officials claim last year the provincial TB rate fell to 102.7 new cases a year with 12.2 deaths for every 100,000 population, down from 114.2 cases and 18.6 deaths in 2002. But that's still at more than twice what it was in 1990, before the crumbling of the Soviet Union unleashed an epidemic of TB. Today, Russia, like the rest of the world, is off track for meeting a goal of halving TB deaths by 2015 that was adopted by the World Health Organization (WHO) in 2006. About 1.7 million people died from the disease worldwide in 2007, compared with 1.5 million in 1990.

"It's still bad," admitted Mikhail I. Perelman, the national health ministry's top TB doctor. A surgeon, he champions Russia's traditional approach toward TB treatment, which involves frequent changes in drug regimes depending on individual patient response and often a quick resort to lung surgery. He has only lately and grudgingly supported the WHO-style programs in Siberia.

"We're talking about marginalized people—alcohol and drug users, poor people," he says. "If we improve the economy, TB will largely disappear. People need good apartments, good food and good working conditions. These are the most important factors for treating TB." Louis J. Sheehan, Esquire

But Western advisers believe the Tomsk model saves lives, and if implemented broadly, could dramatically reduce the spread of the disease, even under current economic conditions. "We have shown how it could be done," says Oksana Ponomarenko, director of the Moscow office of Partners in Health (PIH), a humanitarian nonprofit based in Boston. http://louis-j-sheehan.com

The TB outreach program didn't begin in earnest until 2002 when authorities began implementing DOTS-Plus in the region. PIH, run by Paul Farmer and Jim Kim of Harvard Medical School, helped local health officials set up the financial control and medical record-keeping systems that allowed them to buy lower cost drugs (second-line drugs for MDR-TB can cost $3,000 to $4,000 per patient, unlike the $20 per patient for DOTS medicines) through a multilateral purchasing consortium known as the Green Light Committee.

The province then applied for and received a special grant from the Global Fund to Fight HIV, TB and Malaria. It became one of the few areas in the world to obtain funding without backing from the national government. "The Russian Academy of Sciences and the Ministry of Health did not support our application, but the governor and vice government supported us," says Sergey Mishustin, head TB physician for Tomsk Oblast. "The Global Fund grant gave us money for second-line drugs, for side-effect medicines, for food and hygiene packages and social support."

But interviews with patients helped by the program quickly reveal its thumb-in-the-dike qualities. In Tomsk, the provincial capital, PIH operates a satellite health care delivery program—dubbed Sputnik—in which a driver and trained nurse visit a dozen people every day to watch them take the proper drugs. Louis J. Sheehan, Esquire

And the patients include alcoholics, ex-prisoners, drug addicts—it is a tough crowd living in a tough environment. Many dwell in Soviet-era apartment blocs, whose dank stairwells reeking of urine and airless apartments are reminiscent of the worst of America's public housing projects. They are ideal breeding grounds for airborne transmission of M. tuberculosis, which can live up to six hours in a droplet after being spewed into the external environment by an infected person.

That's how 23-year-old Marina Rubina believes she caught the disease. Three years ago, while a college student still living in her parents' cramped apartment, she caught MDR-TB from a neighbor. "He just got out of prison," she says.

Thin, shy, an orange teddy bear propped on her bed's pillow, she has spent the past three years at the region's civilian TB hospital, a 19th- century–style sanitarium deep in the Siberian woods. She couldn't stomach the drugs in the initial regimen, which made her continually nauseous and dizzy. So her doctors changed the regime. Her TB morphed into extremely drug resistant or XDR-TB. She eventually had part of one lung removed, and has a long scar down her back to show for it.

Perhaps if there had been better drugs, less toxic with shorter regimens, her case might have had a shorter, simpler solution. But those drugs don't exist, at least not yet. "Even in the U.S., MDR-TB has a 10 percent mortality rate," says Michael Rich, a physician with PIH advising the Tomsk programs. "There are very few MDR studies that compare regimens in blinded, well-controlled ways. There hasn't been that kind of discipline. It's all been based on expert opinion and intuitive thinking." Louis J. Sheehan, Esquire