PITTSBURGH (AP) — The first lady of Ukraine says she wants to develop cooperation between hospitals in her country and the University of Pittsburgh Medical Center.
Kateryna Yushchenko toured the medical center's Children's Hospital on Saturday.
The wife of Ukrainian President Viktor Yushchenko says she says she wants to use the development of the medical center's planned new Children's Hospital as a model for hospitals in her country.
She was given a tour of the hospital's intensive care unit and emergency departments by Dr. Andrew Urbach, the center's medical director of clinical excellence and service.
Cancer is a major concern in Ukraine since the disaster at the Chernobyl nuclear power plant 22 years ago.
Information from: Pittsburgh Tribune-Review,
(This version CORRECTS last name to Yushchenko sted Yuschenko, CORRECTS president's first name to Viktor sted Victor.)

BANGKOK, Thailand — An emergency official says an explosion inside the Thai prime minister's besieged office compound has wounded 33 people.
A spokesman from the Narentorn Medical Center said early Sunday morning that five had been hospitalized.
Police have not yet responded to the compound that protesters have held since August.
An Associated Press photographer says the device was hurled from outside the compound. It was not clear what was thrown.
Protesters have also seized Bangkok's two airports — stranding about 100,000 travelers — in their campaign to topple the government.

Googling for what ails you? You might want to think again.
According to a new study, human nature prevails when it comes to searching for health-related information, with users often jumping to conclusions and assuming the worst.
Microsoft researchers Ryen White and Eric Horvitz said their investigation of online medical search behavior found that it can often lead to "cyberchondria," an eight-year-old term describing the online equivalent of hypochondria, a psychological ailment in which people view minor medical symptoms as evidence of a serious illness.
"We use the term 'cyberchondria' to refer to the unfounded escalation of concerns about common symptoms based on the review of search results," the researchers wrote. "The Web has the potential to increase the anxieties of people who have little or no medical training, especially when Web search is employed as a diagnostic procedure."
With the Internet already a daily tool used at home and at work, both on PCs and on mobile smartphone devices, it's not surprising that consumers are relying on it for their even most private research needs. A recent study
of mobile workers surveyed said it would be easier to go without a car for a week than relinquish Internet access.
In their report, White and Horvitz said the Web is "fertile ground" for those suffering from hypochondria, since it enables surfers to conduct detailed investigations into perceived conditions.
As a result, hypochondria-prone users' concerns about common health symptoms -- think "headache" and "heartburn" -- quickly ramp up to Web queries on serious illnesses -- think "brain tumor" and "heart attack".
"We found that escalation is potentially related to the amount and distribution of medical content viewed by users, the presence of escalatory terminology in pages visited and a user’s predisposition to escalate or seek more reasonable explanations for ailments," White and Eric Horvitz wrote.
According to the report, information gleamed in healthcare-related searches can also affect a person's decision on when to reach out to a medical expert, as well as a person's approach to maintaining health.
"Information drawn from the Web can influence how people reflect and make decisions about their health and wellbeing, including the attention they seek from healthcare professionals, and behaviors with regard to diet, exercise, and preventative, proactive health activities," the authors wrote.
The study was conducted as part of an ongoing project to enhance Microsoft's search engine, the company said.
Despite the findings, searchers shouldn't dismiss using the Internet at all for their medical questions, the researchers said.
"Our findings suggest that there is inappropriate escalatory risk associated with using general Web search to support differential diagnosis, and that more valuable information may come via search within expert medical sites," White and Eric Horvitz wrote.

DALLAS (AP) — Twin girls born joined at the head have overcome long odds, but the doctor who brought them to the United States to be evaluated for surgery now says there's no longer any chance they will ever lead separate lives.
Anastasia and Tatiana Dogaru, who will be 5 in January, were born in Rome to Romanian parents. The top of Tatiana's head is attached to the back of Anastasia's, meaning the girls have never been able to look each other in the eye.
Tatiana has had to undergo heart surgery. Anastasia has no kidney function and relies on Tatiana's kidneys.
However, the twins have become smart, active girls, said Dr. Kenneth Salyer, chairman and founder of the Dallas-based nonprofit World Craniofacial Foundation. Still, their long-term prognosis is uncertain.
"They're troupers and they may be with us a long time, God willing," Salyer said.
Physicians at Rainbow Babies & Children's Hospital in Cleveland had hoped to separate the girls, but that surgery was deemed too dangerous and was called off in August 2007.
Still, Salyer, whose foundation brought the girls to Dallas when they were babies, had kept up hope that separation might still be possible.
But no longer.
"We have finally decided that it's in these girls' best interest that they remain like they are and that's really hard for me to say because I've been optimistic about separation," Salyer told The Associated Press earlier this month.
He said attempts to find other medical centers to take the case were unsuccessful after the Ohio operation was called off.
In addition, other complications arose as the twins grew older. One girl's brain is growing into the other's, making surgery impossible. Also, their brains' ability to recover from a separation surgery has diminished.
"As they've gotten older and they've grown and developed — it's now too dangerous to separate the children," Salyer said.
Twins born joined at the head — known as craniopagus twins — occur about once every 2.5 million births.
After Anastasia and Tatiana were born in 2004, doctors in Italy told the girls' parents, Claudia and Alin Dogaru, that nothing could be done for them.
However, the parents had heard about the successful separation in Dallas the year earlier of Egyptian twins joined at the head. Through his foundation, Salyer had brought Ahmed and Mohamed Ibrahim to Dallas and was part of the team of surgeons who performed the 34-hour surgery.
The Dogarus contacted Salyer and the girls came to Dallas in October 2004. Not long after arriving, Tatiana underwent heart surgery to fix a constriction of the main vessel of her heart — a defect that would have been deadly.
After more than a year, Salyer said a plan was developed for a separation surgery. "I had nothing that told me at that time that we couldn't do it," he said.
The next issue was finding a hospital for the surgery and the foundation hoped to find an institution that could donate the majority of the costs, said Sue Blackwood, foundation vice president.
Children's Medical Center Dallas, where the Ibrahim twins were separated, turned them down. It said that as a not-for-profit, it couldn't absorb the cost of every complex surgery and still serve its community.
Finally, Rainbow Babies hospital agreed to do the surgery, Salyer said. The plan was for Anastasia to undergo dialysis after the separation and then get a kidney transplant, likely from one of her parents.
After the surgery was called off at Rainbow Babies, Salyer consulted three more centers but all three decided against taking on the surgery.
He said he told the girls' parents a couple of months ago that separation would be impossible. The family now lives in the Chicago area, where Alin Dogaru, a Byzantine Rite Catholic priest, has accepted an assignment at a parish. The parents declined to comment.
While they are doing well now, the girls' future is uncertain because of their complicated connection. Besides their joined brains, they also share blood vessels and don't have enough venous drainage, Salyer said. "They don't have normal systems," Salyer said.
"All of the medical issues in total, you can't say how these children are going to do," he said.
He said that based on today's medical capabilities, the girls cannot be separated.
"Nobody is going to go in there unless we get some new magical methods," Salyer said.

CLAREMONT, Calif.
— Until last year, Alan Felzer was an energetic engineering professor who took the stairs to his classes two steps at a time. Now the 64-year-old grandfather sits strapped to a wheelchair, able to move little but his left hand, his voice a near-whisper.
Felzer suffers from ALS, also known as Lou Gehrig’s disease. The fatal neurological disorder steals the body’s ability to move, speak and ultimately to breathe. But rather than succumb to despair along with his illness, Felzer turned to the Web to become his own medical researcher — and his own guinea pig.
Dozens of ALS patients are testing treatments on their own without waiting on the slow pace of medical research. They are part of an emerging group of patients willing to share intimate health details on the Web in hopes of making their own medical discoveries.
Some doctors caution that such patient-led research lacks rigor and may lead to unreliable results, false hopes and harm to patients.
“The Internet is a wonderful tool, but you know, it’s buyer beware,” said Dr. Edward Langston, immediate past chairman of the American Medical Association’s board.
In Felzer’s case, the experiment’s results illustrate the obstacles that stand between patients and self-discovered breakthroughs. The drug he tried did no good. But he and his family felt they had little time and little to lose in trying.
“ALS is such a short illness,” said Felzer’s wife, Laura. She helps her husband communicate using sign language with his one good hand when his slow, halting words become difficult to understand. “You want to do what you can as fast as you can.”
The U.S. Food and Drug Administration has approved only one drug to treat ALS symptoms. It only works for some patients, and its effects are limited. As a result, Internet forums for ALS patients brim with links to the latest research offering any hint of promise. After Alan Felzer was diagnosed last year, his 33-year-old daughter, Karen, dived into the forums and found new hope.
In a recent small study, Italian scientists reported that every ALS patient given the drug lithium, commonly used to treat bipolar disorder, saw the disease’s progress slow substantially.
Many ALS patients began trying lithium on their own. They persuaded their doctors to prescribe it “off-label” — a use not approved by federal drug regulators. Off-label prescribing is a common practice, researchers say, when patients are facing a terminal illness.
Despite the risks, Langston of the AMA pointed out that doctors often stumble upon treatments, and patients could possibly do the same. “If patients are willing to share their experiences, that may in fact occur,” he said.
Felzer began taking lithium in January, and his scientifically minded family reached out to other ALS patients. “All those people are taking it anyway,” said Alan Felzer, whose smile remains bright and his gaze sharp even as the rest of his body fails him. “So it only made sense to keep track of what was happening.”
The task of leading the ALS-lithium project fell to Felzer’s daughter, Karen, a U.S. Geological Survey earthquake researcher. Her partner in the effort was Humberto Macedo, a 42-year-old computer systems analyst, father of six and ALS patient in Brasilia, Brazil.
The study grew naturally out of the strong reliance of ALS patients on one another for information, Macedo said.
Working online, Karen Felzer and Macedo recruited nearly 200 patients worldwide to take a specific lithium dosage and answer standard surveys to gauge their symptoms. They began running their study through a Web site called PatientsLikeMe.com, using it to attract volunteers and track their progress.
On the site, patients share detailed information about their symptoms and the drugs they are taking. The site focuses on conditions that have stubbornly resisted medical science, such as ALS, Parkinson’s and multiple sclerosis.
The site’s founders hope professional and amateur researchers alike will dip into the resulting pool of data and emerge with insights that lead to better treatments.
“My ultimate frustration that drove this site into existence was an overall feeling that there was a lack of transparency and speed or urgency” by the medical system, said Jamie Heywood, who co-founded PatientsLikeMe months before his own brother died of ALS.
Heywood too hoped that lithium was the breakthrough he and others had been seeking.
But after six months, none of the 87 people who stuck with the study showed any letup in the disease’s progress, said Karen Felzer. She now doubts the Italian study’s results.
“It’s obvious to everyone it’s not the miracle drug we thought at first,” she said. She also thinks other tests of lithium for ALS should be halted to spare patients the drug’s possible side effects, such as tremors, weakness and difficulty breathing. Her father stopped taking the drug, though Macedo is continuing.
However, other reseachers say professional lithium studies should go forward. Dr. Merit Cudkowicz, a Harvard Medical School professor, is set to begin one in December with 84 patients. Her study will stick to the so-called gold standard of research, in which each patient will be randomly chosen to take the drug in question or a placebo. Neither patients or researchers will know who got the drug to avoid introducing bias.
Because the patient-led lithium study lacked those tight controls, it is unreliable as a measure of safety and effectiveness, Cudkowicz said. With an incurable disease, she said, “You don’t want to be throwing something away that works because of a bad study.”

Medical history is dotted with stories of cancers vanishing without a trace and without any treatment, either.  Once considered medical oddities, a new study suggests more cancers go away without treatment than would be expected.  The theory, however, is quite difficult to prove conclusively because almost every cancer detected is treated aggressively, leaving no opportunity to explore spontaneous regressions.
Leading the study were Dr. Jan Maehlen, of the Ulleval University Hospital, Oslo, Norway; Dr. H. Gilbert Welch, of the Dartmouth Medical School in Vermont; and Dr. Per-Henrik Zahl, of Norway’s Institute of Public Health.  The research team compared mammogram records of women, all between 50 and 64 years old, for the six-year period from 1992 till 1997 and from 1996 till 2001.  Norway first started using mammography in 1996.
All the 109,784 women in the earlier study period were offered mammograms in 1996 and 1997 and almost all of them accepted the offer as did almost all the 119,472 women in the later group.
While the researchers expected to find a similar prevalence of breast cancer in both groups of women, they were surprised to find the later group had 22% more cancers (1,909 cases of invasive breast cancer) than the earlier group (1,564 cases).
The research group suggests other explanations for the cancer rate discrepancy but none is more likely than the possibility that the women in the earlier group, without access to mammography, actually developed cancer at a rate similar to the women of the later group but, without detection, many of these cancers disappeared of their own accord, before they were ever detected.
The study’s findings do not implicate mammograms as a cause for the later group’s higher incidence of cancer nor does it suggest women should forego mammogram screenings.  There is no doubt mammograms save lives but undisputed knowledge about how cancer progresses is in short supply, making it impossible at this time to determine which cancers require medical intervention and which do not.
The research team describes their study’s design as not perfect but establishing a perfectly designed study of this nature is unrealistic.  To conduct such a study, some women with breast cancer would need to be treated while others would be required to refrain from treatment.
Postmenopausal women who use hormone-replacement therapies (HRT) are more likely to be screened for breast cancer than those who do not but this possibility accounts for less than 3% of the outcome.
Improved mammography technologies emerging during the later study period but the sensitivity rate of the technology remained relatively stable throughout the study period.
The later group of women may have had a higher likelihood of developing cancer but cancer risk factors were thought to be strikingly similar in both groups of women.
Women in the first group, when mammography was new to Norway, received only one screening while the later group had mammography available for repeated screenings over the course of the study.  Analysis, however, revealed no increased likelihood of detection with repeated screenings.
Medical science has documented similar spontaneous regressions of cancer but Dr. Barnett Kramer, director of the National Institutes of Health’s Office of Disease Prevention, says the frequency of such events, as suggested by the Norwegian study, is “shocking.”  Speaking with the understanding that the research does not completely rule out other possibilities, he says the research indicates other explanations are not very likely.
The study has piqued the interest of Dr. Robert M. Kaplan, who is interested in replicating the study.  Saying the “implications are potentially enormous,” Kaplan, who serves as department chairman of health services at the University of California, Los Angeles, School of Public Health, is considering a similar study based in Mexico, where mammography screenings are just now becoming available.
The chairman of Houston’s MD Anderson Cancer Center, Donald A. Berry, expressed concerns about the ability of screening tests to detect cancers at an increasingly early rate.  He fears such early detection, and the aggressive treatment that follows such a diagnosis, may be causing people to treat cancers that might otherwise go away on their own.  He would like to see more study done on the natural history of cancer with the hope of learning which cancers are dangerous, requiring treatment, and which are not.
Dr. Laura Esserman, surgery and radiology professor at the University of California in San Francisco, looks forward to the day she can tell her patients not to worry because their cancer isn’t real and will go away on its own.
A report of the study has been published in the November 25 issue of the ‘Archives of Internal Medicine.’

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Foreign Ministry considers dispatching team of doctors from New Delhi to Mumbai to aid victims of Wednesday's attacks, orders diplomats from across Asia to travel to India to help Israelis. Magen David Adom also preparing to send medical aid to scene

is preparing to send rescue teams to Mumbai, India following Wednesday's
that left 101 people dead and hundreds injured.
In the attack terrorists seized a Chabad office in the city and have been holding Rabbi Gavriel Holtzberg and his wife hostage.
The Foreign Ministry ordered Israeli diplomats stationed in representatives around Asia to travel to Mumbai immediately to help treat Israelis in the city.
The ministry is also examining the possibility of sending a team of Israeli doctors stationed in New Delhi to Mumbai to assist the local authorities in treating the injured.
Thursday morning, the Foreign Ministry began initial preparations for sending aid to Mumbai from Israel, but the final decision to transfer aid to India has not yet been made, since India is not in need of such aid at this point.
Nonetheless, Jerusalem did not rule out the possibility that an Israeli airplane carrying medical and other equipment be sent to India at a later stage, and possibly be used to bring Israelis staying in India back home.
Magen David Adom Director-General Eli Bin instructed the organization to prepare for the deployment of a team of paramedics and medical assistants to help locate and treat missing people in Mumbai.
The organization said it would cooperate with the International Red Cross and the Foreign Ministry and give any aid that is necessary.
Magen David Adom Spokesman Zaki Heller, who is in charge of sending the aid envoy, said, "We are preparing to send a team of doctors, paramedics, medical assistants and professionals and are preparing for the possibility that we may be called to treat victims in hospitals or locate families and friends.
"We have already made contact with the joint organization's envoys in the area to help us understand what is needed."
The defense establishment did not make any decision regarding the deployment of a terror combating intervention team to help the Indian security forces.
Defense establishment officials are in constant contact with the Indian authorities and the Israeli representatives in India.
A defense establishment source told Ynet Jerusalem is closely following the Indian commando units' operations to have the hostages released from the hotels and the Chabad office in Mumbai.

About 20% to 30% of those tests give patients a clean bill of health -- and that means hundreds of thousands of people are exposed to needless risk, Miller said.
Many cardiologists see CT scans as a safer alternative because the scans are powerful enough to create a high-resolution image even though the contrast dye is administered by a simple intravenous line and thus more dilute.
Miller and her colleagues at nine hospitals in the U.S., Canada, Germany, Japan, Brazil, Singapore and the Netherlands identified 291 patients with symptoms of coronary artery disease who were candidates for traditional angiograms. Their median age was 59, and 74% of them were men.
Before the patients underwent conventional angiograms, their hearts were imaged in 8.5 seconds with a 64-slice CT scanner made by Toshiba Medical Systems, which funded the study along with the National Institutes of Health and private foundations.
Two physicians examined each image and graded the degree of narrowing in 19 places in the main coronary arteries. Then the researchers compared the results from both procedures.
In 163 patients with the highest degree of coronary artery disease -- a narrowing of at least 50% in at least one artery -- the CT angiograms were 93% as good as the traditional angiograms, according to the study.
Overall, the CT scans accurately identified 85% of the patients who had the biggest blockages and 90% of the patients who did not.
The researchers also found that 91% of patients who were identified by the CT scans as having the most severe disease were correctly diagnosed, as were 83% of patients whose scans did not reveal large blockages.
Two patients in the study had a reaction to the contrast dye used to perform the CT angiogram, and one patient died as a result of the conventional angiogram.
Dr. Matthew Budoff, director of cardiac CT at Harbor-UCLA Medical Center, said the study confirmed results from his own research using a similar scanner made by General Electric Co.
His study, which was funded by GE, was published this month in the Journal of the American College of Cardiology.
"It's not quite but almost as good as an invasive angiogram," said Budoff, who also receives speaking fees from GE.
The CT test is faster and costs thousands of dollars less, and patients leave "with a Band-Aid and a bottle of water," he said.
"The benefits for many patients outweigh the risk of missing 1% of disease," he said.
But other doctors say more data are needed to prove that coronary CT angiograms are worthwhile, especially as a screening tool.
"What we really need is a study that compares cardiac CT to traditional ways of working up chest pain, like stress testing, and look at patient outcomes in both groups," said Dr. Rita Redberg, director of women's cardiovascular services at UC San Francisco Medical Center, who co-wrote a perspective article accompanying the study.
"Without actual outcome data, we don't know that this is going to help patients at all," Redberg said.
Until their benefits are proven, Medicare should not be paying for the tests, which typically cost $700 to $1,000, Redberg wrote with her UCSF colleague, Dr. Judith Walsh. An attempt by the Centers for Medicare and Medicaid Services to cut off funding for such procedures was met with resistance by physicians and ultimately scuttled in March, they wrote.
An official from the federal agency responded that "additional studies are needed to clearly delineate the appropriate use of this technology in the Medicare population."
Kaplan is a Times staff writer.