Meds a good “first step” for treating alcoholism

NEW YORK (Reuters Health) – Two drugs commonly used to treat alcoholism may be appropriate for people in different stages of recovery, a new analysis confirms – likely because they work differently in the brain.

The drugs, acamprosate (marketed as Campral) and naltrexone (ReVia), are both non-addictive themselves and don’t make users sick when mixed with alcohol. So they’re a good first option for people struggling with alcohol dependence who are motivated to stop drinking but would like to avoid an inpatient program, researchers said.

In a new analysis of 64 trials evaluating the two medications, researchers from California found acamprosate was more effective at helping people who were not currently drinking stay sober. Naltrexone had the advantage when it came to cutting back on heavy drinking and helping recovering alcoholics avoid cravings.

All of the trials randomly assigned participants to take one of the drugs or a placebo pill, with drinkers typically also attending therapy sessions. They included about 11,000 people in total.

Both acamprosate and naltrexone tended to work better when study subjects had stayed away from alcohol for at least a few days before starting the drug trials, or had been through a detox program.

Natalya Maisel from the VA Palo Alto Health Care System in Menlo Park, California, and her colleagues calculated that eight people dependent on alcohol would need to be treated with acamprosate for one additional person to quit drinking. Nine would need to take naltrexone to keep one from returning to heavy drinking, the researchers reported in the journal Addiction.

The findings make sense to addiction specialists given how each drug acts on the brain, according to Dr. Raymond Anton, head of the Center for Drug & Alcohol Programs at the Medical University of South Carolina in Charleston.

Acamprosate is known to calm brain activity in general, so it can stabilize a brain that gets out of sorts when an alcoholic stops drinking. But if people start drinking again while on acamprosate, it probably won’t help keep their cravings down, he added.

Naltrexone, Anton said, works on the brain’s reward and reinforcement system – so if people were to drink while on the drug, it would block some of the positive feelings produced by alcohol and keep them from overdoing it.

“It stops a slip from becoming a relapse,” he said. Naltrexone can also help alcoholics in recovery avoid giving in to cues, like when they drive past a liquor store, according to Anton, who wasn’t involved in the new study.

Maisel’s team noted that most of the trials of both acamprosate and naltrexone used in the analysis were only a few months long – and there is “a paucity of information in the literature regarding how long the benefits of these medications last after treatment,” the researchers said.

Anton said both drugs could be a useful “first step” in addressing problem drinking when paired with therapy – especially for people who are hesitant to seek care because of the time and money involved in intensive treatment. They should talk with their doctors about medication options, he said.

Generic acamprosate costs $ 40 to $ 90 for a one-month supply. Naltrexone runs closer to $ 100 per month.

“People should realize that there are alternative treatments that are useful for them while they continue in their normal work and family, that they don’t necessarily have to go into a 30-day treatment center to get treatment for alcohol,” Anton told Reuters Health.

“If it doesn’t work, you can always think about rehab or inpatient treatment later on.”

SOURCE: http://bitly.com/TiGITG Addition, online October 17, 2012.

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Amnesty Int: Ivory Coast torturing detainees

ABIDJAN, Ivory Coast (AP) — Ivory Coast security officials are torturing dozens of detainees by administering electric shocks and other forms of abuse, Amnesty International alleged Friday.

The victims include people charged with endangering state security in the wake of a recent spate of attacks targeting military installations. Since early August, unknown gunmen have carried out roughly 10 attacks at checkpoints, military bases and other installations throughout the country, including in the commercial capital of Abidjan.

United Nations officials have said that more than 200 people have been detained on suspicion of involvement in the attacks, and that torture has been documented at multiple detention facilities.

Gaetan Mootoo, West Africa researcher for Amnesty, said an investigation team received reports of a range of abuses during a recent month-long visit.

“We were able to meet dozens of detainees who told us how they have been tortured by electricity or had molten plastic poured on their bodies,” Mootoo said. “Two of them have been sexually abused. Some have been held for many months denied contact with their families and access to lawyers.”

Army spokesman Cherif Moussa denied the torture allegations Friday. “Our camps are not concentration camps,” he said.

However, he acknowledged the possibility that individual soldiers may occasionally “go beyond what they are allowed to do” when dealing with inmates.

He added that the government tried to ensure that inmates’ rights were respected. “We want to prove that we are not abusing people’s rights,” he said. “We’re working for the state’s security. We’re working for the people’s security.”

Earlier this month, the Associated Press interviewed former detainees at a military camp in the southwestern port town of San Pedro who described widespread beatings as well as the use of electric shocks. A guard at the camp corroborated most of the claims, though camp commanders denied them.

In its statement Friday, Amnesty described how one detainee, a police officer, had died as a result of the torture he endured at the San Pedro camp.

“Serge Herve Kribie was arrested in San Pedro on August 21 by the national army and interrogated about recent attacks,” Amnesty said. “He was stripped naked, tied to a pole, had water poured on his body, and was then subjected to electric shocks. He died a few hours later.”

Amnesty said that some detainees were only released after ransoms were paid. One detainee told the rights group: “My parents first paid 50,000 CFA (a little under US $ 100) and then after my release, my jailers went at my house and demanded a higher sum. I told them that I couldn’t pay such an amount and they agreed to receive 20,000 CFA more (about US$ 40).”

The government has blamed the attacks on allies of former President Laurent Gbagbo, who was arrested in April 2011. Gbagbo’s refusal to cede office after losing the November 2010 election to now-President Alassane Ouattara sparked six months of violence in which at least 3,000 were killed.

Amnesty researchers also met with some of the more than 100 Gbagbo allies – including his wife, Simone – who are being detained on charges stemming from the post-election violence.

“Some of them told us that despite the fact that they have been held since April 2011, they only saw an investigating judge twice for less than a few hours,” Mootoo said.

Despite widespread evidence that forces loyal to Ouattara also committed atrocities during the violence, none have been arrested or credibly investigated, sparking allegations of victor’s justice.

Also Friday, in Amsterdam, judges at the International Criminal Court rejected a request for release by former president Gbagbo, who is being detained on suspicion of crimes against humanity.

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Star Silicon Valley analyst felled by Facebook IPO fallout

SAN FRANCISCO (Reuters) - The firing of Citigroup stock analyst Mark Mahaney on Friday in the regulatory fallout from Facebook Inc's initial public offering was greeted with shock and dismay in Silicon Valley, where Mahaney was a well-known and well-liked figure.

"Pretty shocked," was the reaction of Jacob Funds Chief Executive Ryan Jacob, who described Mahaney as one of the most respected financial analysts covering the Internet industry.

"I'd put him at the top. If not at the top, then near the top," said Jacob. "He really knew what to look for."

In addition to firing Mahaney, Citigroup paid a $2 million fine to Massachusetts regulators to settle charges that the bank improperly disclosed research on Facebook ahead of its $16 billion IPO in May.

The settlement agreement said Mahaney failed to supervise a junior analyst who improperly shared Facebook research with the TechCrunch news website. (Settlement agreement: http://r.reuters.com/pyj63t)

The settlement agreement also outlined an incident in which Mahaney failed to get approval before responding to a journalist's questions about Google Inc -- and told a Citigroup compliance staffer that the conversation had not occurred -- even after being warned about unauthorized conversations with the media.

Mahaney declined to comment.

Mahaney got his start in the late 1990s, during the first dot-com boom where he worked at Morgan Stanley for Mary Meeker, one of the star analysts of the time. He went on to work at hedge fund Galleon Group before moving to Citigroup in 2005. Unlike most of his New York-based peers in the analyst world, Mahaney worked in San Francisco's financial district, close to the companies and personalities at the heart of the tech industry.

Earlier this month, Mahaney was named the top Internet analyst for the fifth straight year by Institutional Investor. The review cited fans of Mahaney who praised a "systematic" investment approach that allows him to avoid the "waffling" often evidenced by other analysts.

Mahaney's Buy rating on IAC/InteractiveCorp in April 2011, when the stock traded at $33.32, allowed investors to lock in a 51 percent gain before he downgraded the stock to a Hold at $50.31 a few months later, according to Institutional Investor.

But it wasn't only his stock picks that put him in good stead. He earned kudos for simply being a nice guy.

"He's a kind and thoughtful person and that's evident in the way he deals with people," said Jason Jones of Internet investment firm HighStep Capital. "He's very well liked on Wall Street because of that."

A CAUTIOUS VIEW ON FACEBOOK

Mahaney was only indirectly involved in the incident involving the Facebook research, according to the settlement agreement by Massachusetts regulators released on Friday. But the actions of the junior analyst who worked for him provide an unusual glimpse into the type of behind-the-scenes information trading that regulators are attempting to rein in.

While the Massachusetts regulators did not identify any of the individuals by name, Reuters has learned that the incident involved TechCrunch reporters Josh Constine and Kim-Mai Cutler as well as Citi junior analyst Eric Jacobs.

Jacobs, Constine and Cutler all did not respond to requests for comments.

In early May, shortly before Facebook's IPO, Jacobs sent an email to Cutler and Constine. Constine attended Stanford University at the same time as Jacobs.

Constine, who studied social networks such as Facebook and Twitter for his 2009 Master's degree in cybersociology at Stanford, had a close friendship with Jacobs, according to the settlement agreement.

"I am ramping up coverage on FB and thought you guys might like to see how the street is thinking about it (and our estimates)," Jacobs wrote in the email. The email included an "outline" that Jacobs said would eventually become the firm's 30-40 page initiation report on Facebook.

He also included a "Facebook One Pager" document, which contained confidential, non-public information that Citigroup obtained in order to help begin covering Facebook after the IPO.

Asked by Constine if the information could be published and attributed to an anonymous source, Jacobs responded that "my boss would eat me alive," the agreement said.

A spokeswoman for AOL Inc, which owns TechCrunch, declined to answer questions on the matter, saying only that "We are looking into the matter and have no comment at this time."

Ironically, Mahaney was one of a small group of analysts at the many banks underwriting Facebook's IPO who had cautious views of the richly valued offering. Mahaney initiated coverage of the company with a neutral rating.

Analysts at the top three underwriters on Facebook's IPO - Morgan Stanley, Goldman Sachs and J.P. Morgan - started the stock with overweight or buy recommendations.

Earlier this year, Reuters reported that Facebook had pre-briefed analysts for its underwriters ahead of its IPO, advising them to reduce their profit and revenue forecasts.

Facebook, whose stock was priced at $38 a share in the IPO, closed Friday's regular session at $21.94 and has traded as low as $17.55.

"There were tens of billions of dollars in losses based on hyping the name, a lack of skeptical information and misunderstanding the company," said Max Wolff, chief economist and senior analyst at research firm GreenCrest Capital.

"It's highly unfortunate and darkly ironic that one of the signature regulatory actions from this IPO so far involves punishing analysts for disseminating cautious information about Facebook," he added.

(Editing by Jonathan Weber, Mary Milliken and Lisa Shumaker)

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Amid dire forecast, Sandy a hurricane again

SHIP BOTTOM, N.J. (AP) — With much of the Eastern Seaboard in the path of a rare behemoth storm, residents of the nation's most densely populated corridor contemplated whether to heed dire warnings of torrential rain, high winds and up to 2 feet of snow.

"You know how many times they tell you, 'This is it, it's really coming and it's really the big one,' and then it turns out not to be?" said Alice Stockton-Rossini as she packed up to leave her home a few hundred yards from the ocean in Ship Bottom, N.J.

"I'm afraid people will tune it out because of all the false alarms before, and the one time you need to take it seriously, you won't. This one might be the one."

Hurricane Sandy — upgraded again Saturday just hours after forecasters said it had weakened to a tropical storm — was barreling north from the Caribbean and was expected to make landfall early Tuesday near the Delaware coast, then hit two winter weather systems as it moves inland, creating a hybrid monster storm.

Even if Sandy loses strength and makes landfall as something less than a hurricane, the combined storm was expected to bring misery to a huge section of the East. An 800-mile wide swath of the country could see 50 mph winds regardless of Sandy's strength.

Experts said the storm could be wider and stronger than Irene, which caused more than $15 billion in damage, and could rival the worst East Coast storm on record. On Saturday morning, forecasters said hurricane-force winds of 75 mph could be felt 100 miles away from the storm's center.

Up and down the coast, people were cautioned to be prepared for days without electricity. Jersey Shore beach towns began issuing voluntary evacuations and protecting boardwalks. Atlantic City casinos made contingency plans to close, and officials advised residents of flood-prone areas to stay with family or be ready to leave. Several governors declared states of emergency. Airlines said to expect cancellations and waived change fees for passengers who want to reschedule.

In North Carolina's Outer Banks, light rain was falling Saturday and winds were building up to a predicted 30 to 50 mph. A steady stream of campers and other vehicles hauling boats were leaving the low-lying islands for the mainland. Residents feared a temporary bridge built after Irene last year poked a new inlet through the island could be washed out again, severing the only road off Hatteras Island.

In Ship Bottom, N.J., Russ Linke was taking no chances Saturday. He and his wife secured the patio furniture, packed the bicycles into the pickup truck and headed off the island.

"I've been here since 1997, and I never even put my barbecue grill away during a storm, but I am taking this one seriously," he said. "They say it might hit here; that's about as serious as it can get."

After Irene left millions without power, utilities were taking no chances and were lining up extra crews and tree-trimmers. Wind threatened to topple power lines, and trees that still have leaves could be weighed down by snow and fall over if the weight becomes too much.

New York City began precautions for an ominous but still uncertain forecast. No decision had been made on whether any of the city's public transportation outlets would be shut, despite predictions that a sudden shift of the storm's path could cause a surge of 3 to 6 feet in the subways.

The subway system was completely shuttered during Irene, the first such shutdown ever for weather-related reasons. Irene largely missed the city, but struck other areas hard.

The storm loomed a little more than a week before Election Day, while several states were heavily involved in campaigning, canvassing and get-out-the-vote efforts. Republican presidential nominee Mitt Romney and Vice President Joe Biden both canceled weekend campaign events in coastal Virginia Beach, Va., though their events in other parts of the states were going on as planned. In Rhode Island, politicians asked supporters to take down yard signs for fear they might turn into projectiles in the storm.

Sandy killed more than 40 people in the Caribbean, wrecked homes and knocked down trees and power lines.

Early Saturday, the storm was about 355 miles (571 kilometers) southeast of Charleston, S.C. Its sustained wind speed was about 75 mph (121 kph).

Sandy was projected to hit the Atlantic Coast early Tuesday. As it turns back to the north and northwest and merges with colder air from a winter system, West Virginia and further west into eastern Ohio and southern Pennsylvania are expected to get snow. Forecasters were looking at the Delaware shore as the spot the storm will turn inland, bringing 10 inches of rain and extreme storm surges, said Louis Uccellini, environmental prediction director for the National Oceanic and Atmospheric Administration.

Up to 2 feet of snow was predicted to fall on West Virginia, with lighter snow in parts of Ohio and Pennsylvania.

Jeff Masters, meteorology director of the forecasting service Weather Underground, said this could be as big, perhaps bigger, than the worst East Coast storm on record, a 1938 New England hurricane that is sometimes known as the Long Island Express, which killed nearly 800 people.

While rains were light Saturday in North Carolina's Outer Banks, winds were building up to a predicted 30 to 50 mph and a steady stream of campers and other vehicles hauling boats or with kayaks strapped to the roof were headed off the low-lying islands to the mainland. Local residents were preparing for power outages lasting days and fearing a temporary bridge built after Hurricane Irene poked a new inlet through the island last year could be washed out again, cutting off the only road out of Hatteras Island.

Retirees Larry and Jean Collier, of Brantford, Ontario, were leaving their beachfront hotel in Kill Devil Hills, N.C., early Saturday and trying to plot their route home knowing they risked driving into a mess.

"I'll try to split (the trip) right down the middle, not too close to Washington, not too far west," Larry Collier said. "The storm has kind of put a wrench in it."

Others were shrugging off dire predictions. Warren Ellis and his 10-foot-long camper were stuck on an uninhabited Outer Banks island on his annual fishing pilgrimage, the conditions too rough Saturday for the ferry to carry him to safer ground.

"We might not get off here until Tuesday or Wednesday, which doesn't hurt my feelings that much because the fishing's going to be really good after this storm. It's always good after a storm," said Ellis, 44, of Ammissville, Va.

___

Dalesio reported from Kill Devil Hills, N.C. Associated Press writers Brock Vergakis in Duck, N.C., Frank Eltman in Freeport, N.Y., George Walsh in Albany, N.Y., Joe Mandak in Pittsburgh, Kathy Matheson in Philadelphia, Seth Borenstein in Washington and Christine Armario in Miami contributed to this report.

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German composer Hans Werner Henze dies at 86

BERLIN (AP) — German composer Hans Werner Henze, whose prolific and wide-ranging work included a wealth of operas and 10 symphonies, died Saturday, his publisher said. He was 86.

Henze died in the eastern German city of Dresden, longstanding publisher Schott Music said in a statement, calling him “one of the most important and influential composers of our time.” It didn’t disclose the cause of death.

Henze’s work over the decades straddled musical genres. He composed stage works, symphonies, concertos, chamber works and a requiem, and once said that “many things wander from the concert hall to the stage and vice versa.”

His operas ranged from the 1950s “Ein Landarzt” (“A Country Doctor”), based on a story by Franz Kafka, to “L’Upupa,” written in 2002 and the only opera for which Henze wrote his own libretto. Other works included the musical dramas “Elegy for Young Lovers” and “The Bassarids,” and the oratorio “The Raft of the Medusa” — dedicated to the Cuban revolutionary Che Guevara.

The Semperoper opera house in Dresden recently kicked off a tribute to Henze with a performance of his antiwar drama “We come to the River,” produced in collaboration with writer Edward Bond and first performed in London in 1976.

Henze was born July 1, 1926 in Guetersloh in western Germany and grew up as the Nazis tightened their grip on the country. After studying and starting his career in music and theater in West Germany, he left the country in 1953 and went to live in Italy.

Alongside his operas, Henze was known for his symphonies, among them “Sinfonia N. 9,” finished in 1997 — a choral symphony based on Anna Seghers’ novel “The Seventh Cross” that reflected his anti-fascist convictions.

His final symphony, “Sinfonia No. 10,” completed in 2000, was premiered by Sir Simon Rattle with the City of Birmingham Symphony Orchestra.

As well as composing, Henze took teaching assignments in Austria, the U.S., Cuba and Germany. He served as composer-in-residence at the Berkshire Music Center in Tanglewood, Massachusetts, and at the Berlin Philharmonic, Schott Music said.

Henze founded the Cantiere Internazionale d’Arte festival and summer school in Montepulciano, Italy, in 1976.

Information on survivors and funeral arrangements was not immediately available.

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