Police Detective in Pistorius Case Faces Attempted Murder Charges

PRETORIA, South Africa — In a remarkable twist in the case of Oscar Pistorius, the double amputee track star accused of murdering his girlfriend, the South African police said on Thursday that the officer leading the investigation against the athlete is himself facing attempted murder charges.

Stephane De Sakutin/Agence France-Presse — Getty Images

Police detective Hilton Botha arrived at court for the bail hearing of Oscar Pistorius on Wednesday.

The disclosure deepened questions surrounding the detective, Hilton Botha, who, under cross-examination at a bail hearing on Wednesday, was forced to concede that he could not rule out Mr. Pistorius’s own version of events based on the existing evidence.

While the prosecution has accused Mr. Pistorius, 26, of the premeditated murder of his girlfriend Reeva Steenkamp, 29, a week ago, the track star himself said he opened fire thinking there was an intruder in his home in a gated community and had no intention of killing her.

In a development that seemed as bewildering as it was sensational on Thursday, Police Brig. Neville Malila said that Mr. Botha is himself set to appear in court in May facing attempted murder charges relating to an incident in Oct. 2011, when Mr. Botha and two other police officers were accused of firing at a minivan carrying seven people.

The case had initially been dropped but was reinstated on Wednesday at the insistence of the state prosecutor, even as Mr. Botha was appearing as the lead police witness in the prosecution’s attempt to prevent Mr. Pistorius from securing bail.

“Botha and two other policemen allegedly tried to stop a mini bus taxi with seven people. They fired shots," Brigadier Malila told Reuters.

“We were informed yesterday that the charges will be reinstated," he said. “At this stage there are no plans to take him off the Pistorius case.”

Mr. Pistorius returned to court on Thursday for further arguments about whether he should be granted bail in a case that has riveted South Africa and fascinated a wider audience, reflecting Mr. Pistorius’s status as one of the world’s most renowned athletes, whose distinctive carbon-fiber running blades have given him the nickname Blade Runner.

On Wednesday, what was supposed to be a simple bail hearing took on the proportions of a full-blown trial, with sharp questions from the presiding magistrate, Desmond Nair, and a withering cross-examination that left Detective Botha grasping for answers that did not contradict his earlier testimony.

Initially, Detective Botha explained how preliminary ballistic evidence supported the prosecution’s assertion that Mr. Pistorius had been wearing prosthetic legs when he shot at a bathroom door early on Feb. 14. Ms. Steenkamp, a model and law school graduate, was hiding behind it at the time.

Mr. Pistorius said in an affidavit read to the court on Tuesday that he had hobbled over from his bed on his stumps and had felt extremely vulnerable to a possible intruder as a result.

But when questioned by Barry Roux, Mr. Pistorius’s lawyer, Detective Botha was forced to acknowledge sloppy police work, and he eventually conceded that he could not rule out Mr. Pistorius’s version of events based on the existing evidence. Mr. Roux accused the prosecution of selectively taking “every piece of evidence” and trying “to extract the most possibly negative connotation and present it to the court.”

Lydia Polgreen reported from Pretoria, South Africa, and Alan Cowell from London.

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American Idol: Women Face Sudden-Death Round

American Idol

By Jamie Bufalino

02/20/2013 at 11:00 PM EST

Mariah Carey

Mario Anzuoni/Reuters/Landov

American Idol threw yet another new twist at its 40 remaining contestants: a sudden-death round.

"One song, one chance, no mercy," Ryan Seacrest said as the first group of 10 female contestants gathered in Las Vegas to try to finally sing their way – in front of a boisterous studio audience – through to the "America votes" phase of the competition.

Five women moved on, five went home.

Kentucky high school junior Jenny Beth Willis, whose rendition of a Trisha Yearwood song earned mixed reviews from the judges, was the first up. Although Keith Urban appreciated her "effortless confidence," Nicki Minaj said her performance lacked excitement (a comment that elicited the first audience boos of the season). Final result: It was the end of the road for Willis.

Tenna Torres, 28, – who attended Mariah Carey's camp for kids as a youngster – took the stage next and impressed the judges with her take on the Natasha Bedingfield's "Soulmate." But she lost style points with Minaj, who didn't like one particular aspect of her look. "Lose the hair," said Minaj, who felt the contestant's coif aged her. Final result: She made it through to the Top 20.

The three most powerful performances of the night all made it to the next round: Nashville's Kree Harrison, who despite taking a decidedly plain-Jane approach to styling, wowed the judges with her version of Patty Griffin's "Up to the Mountain." "You sang the hell out of that song," said Carey.

Angela Miller, 18, of Massachusetts, belted out Jessie J's hit "Nobody's Perfect." But she pretty much was.

And Amber Holcomb, an assistant teacher from Texas, closed the show with a rousing (and well received) rendition of "My Funny Valentine."

For the final spot of the night, it came down to Anchorage, Alaska, resident Adriana Latonio, 17, who tackled Aretha Franklin's "Ain't No Way," and Shubha Vedula, a Michigan high school senior who sang Lady Gaga's "Born This Way."

Although the judges saw potential in both contestants, they ultimately picked Lantonio's powerhouse vocals in a final emotional moment.

Thursday will bring out the guys. The first round of 10 will take the stage to try to make the top 20 – but once again, five will go home.

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Doc groups issue list of overused tests, therapies

WASHINGTON (AP) — Don't be afraid to question your doctor and ask, "Do I really need that?"

That's the advice from leading medical groups who came up dozens of tests and treatments that physicians too often prescribe when they shouldn't.

No worrisome stroke signs? Then don't screen a healthy person for a clogged neck artery, the family physicians say. It could lead to risky surgery for a blockage too small to matter.

Don't routinely try heartburn medicine for infants with reflux, the pediatric hospitalists say. It hasn't been proven to work in babies, and could cause side effects.

Don't try feeding tubes in people with advanced dementia, say the hospice providers. Helping them eat is a better option.

These are examples of potentially needless care that not only can waste money and time, but sometimes can harm, says the warning being issued Thursday from medical specialty groups that represent more than 350,000 doctors.

Too many people "think that more is better, that more treatment, more testing somehow results in better health care," said Dr. Glen Stream, former president of the American Academy of Family Physicians, which contributed to the list. "That really is not true."

The recommendations are part of a coalition called Choosing Wisely, formed by the American Board of Internal Medicine Foundation. Participating medical societies were asked to identify five tests or treatments that are commonly overused in their specialty. The list is aimed at doctors and includes references to published studies. Consumers Reports and other consumer groups are publicizing the information in more patient-friendly terms.

Last year, the coalition listed 45 overused tests and treatments. It included some of the best known examples, such as too much imaging for back pain and repeating colonoscopies too frequently.

This year's list adds 90 more overused kinds of care. Some are the result of doctors' habits, hard to overcome despite new evidence, Stream said. Others come about because patients demand care they think they need.

Some other examples:

—Don't use opioid painkillers for migraines except as a last resort, say the neurologists. There are better, more migraine-specific drugs available without the addictive risk of narcotics. Plus, frequent use of opioids actually can worsen migraines, a concept known as rebound headache.

—Just because a pregnant woman misses her due date, don't race to induce labor if mom and baby are doing fine, say the obstetricians. Inducing before the cervix is ready often fails, leading to an unneeded C-section. "Just being due by the calendar doesn't mean your body says you're due," Stream notes.

—Don't automatically give a child a CT scan after a minor head injury, say the pediatricians. About half of children who go to the ER with head injuries get this radiation-heavy scan, and clinical observation first could help some who don't really need a CT avoid it.

—And don't leave an implanted heart-zapping defibrillator turned on when a patient is near death, say the hospice providers. This technology clearly saves lives by guarding against an irregular heartbeat. But if someone is dying of something else, or is in the terminal stages of heart disease, it can issue repeated painful shocks, to no avail. Yet fewer than 10 percent of hospices have formal policies on when to switch off the implants.

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India Ink: Irene Genovese, the Traveler from Italy

Why do millions of people, from entire Indian villages to urbane middle managers to foreign tourists, brave the crowds at the Kumbh Mela? During this year’s 55-day pilgrimage, to Allahabad, Uttar Pradesh, an estimated 100 million Hindus and others are expected to take a holy dip in the Ganges River to wash away their sins. India Ink interviewed some of them.

Irene Genovese, 55, a traveler from Tuscany, Italy,  was one among them. This is what she had to say.

Why did you come to the Kumbh Mela this year? Is it your first time?

Yes, it is my first time. I love the experience so far. My partner has been teaching yoga in Italy for about 40 years now, so he wanted to come down here and meet the sadhus who practice yoga regularly.

How have you found it so far?

I am overwhelmed by the number of people there are here! We knew there would be crowds, but didn’t expect this. These are unbelievable numbers. We have also liked the interactions with the sadhus. We live in the Hare Krishna tent so get to interact a lot more with the devotees.

Describe your journey to the Kumbh. Did you travel alone? How long did it take?

We took a stopover in Delhi before coming here. Our Kumbh trip is for only four days. Now we are wondering how we would get back to Delhi. They say there are no last-minute reservations on trains.

Do you consider yourself a religious person?

Yes, I am religious. But my partner is more religious than I. And I respect that.

Do you follow Indian politics? Who do you think is going to win the 2014 election?

I don’t follow Indian politics. I don’t follow politics at all.

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What's Next for Mindy McCready's Two Young Boys?

By Steve Helling

02/19/2013 at 07:00 PM EST

Mindy McCready's apparent suicide on Sunday has left her two young sons in custodial limbo.

The boys – Zander, 6, and Zayne, 10 months – had been in state custody since Feb. 7, when McCready called police to ask for help in making her father and stepmother leave her home. When police arrived, McCready appeared to be intoxicated, according to a Department of Human Services report.

In a subsequent petition, the singer's father, Tim McCready, asked the court to order her to undergo mental health and substance abuse evaluation and treatment, alleging that his daughter, who had recently lost her boyfriend, "hasn't had a bath in a week ... screams about everything ... [is] very verbally abusive to Zander."

After a judge granted the petition, the children were quickly removed and placed into foster care. Although McCready was released from treatment, the boys remained in state custody.

At the time, Zander's father, Billy McKnight, requested custody of his son. "My son needs me," he told PEOPLE on Feb. 8. "I'm married, working and successful. I'm on the right track and proud of it. I've been sober for years. I just want my son."

But McCready's mother and stepfather, Gayle and Michael Inge, also want custody of the children – and authorities seem to agree.

In a proposed order sent to Circuit Judge Lee Harrod, the Department of Human Services proposed that the Inges might be a better fit for the children, claiming that they have "a substantial relationship." The Inges had custody of Zander for much the past few years, during McCready’s rehab and jail stints.

With McCready's death, the judge will have to determine what is in the children's best interest. A custody hearing has been scheduled for April 5.

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Drug overdose deaths up for 11th consecutive year

CHICAGO (AP) — Drug overdose deaths rose for the 11th straight year, federal data show, and most of them were accidents involving addictive painkillers despite growing attention to risks from these medicines.

"The big picture is that this is a big problem that has gotten much worse quickly," said Dr. Thomas Frieden, head of the Centers for Disease Control and Prevention, which gathered and analyzed the data.

In 2010, the CDC reported, there were 38,329 drug overdose deaths nationwide. Medicines, mostly prescription drugs, were involved in nearly 60 percent of overdose deaths that year, overshadowing deaths from illicit narcotics.

The report appears in Tuesday's Journal of the American Medical Association.

It details which drugs were at play in most of the fatalities. As in previous recent years, opioid drugs — which include OxyContin and Vicodin — were the biggest problem, contributing to 3 out of 4 medication overdose deaths.

Frieden said many doctors and patients don't realize how addictive these drugs can be, and that they're too often prescribed for pain that can be managed with less risky drugs.

They're useful for cancer, "but if you've got terrible back pain or terrible migraines," using these addictive drugs can be dangerous, he said.

Medication-related deaths accounted for 22,134 of the drug overdose deaths in 2010.

Anti-anxiety drugs including Valium were among common causes of medication-related deaths, involved in almost 30 percent of them. Among the medication-related deaths, 17 percent were suicides.

The report's data came from death certificates, which aren't always clear on whether a death was a suicide or a tragic attempt at getting high. But it does seem like most serious painkiller overdoses were accidental, said Dr. Rich Zane, chair of emergency medicine at the University of Colorado School of Medicine.

The study's findings are no surprise, he added. "The results are consistent with what we experience" in ERs, he said, adding that the statistics no doubt have gotten worse since 2010.

Some experts believe these deaths will level off. "Right now, there's a general belief that because these are pharmaceutical drugs, they're safer than street drugs like heroin," said Don Des Jarlais, director of the chemical dependency institute at New York City's Beth Israel Medical Center.

"But at some point, people using these drugs are going to become more aware of the dangers," he said.

Frieden said the data show a need for more prescription drug monitoring programs at the state level, and more laws shutting down "pill mills" — doctor offices and pharmacies that over-prescribe addictive medicines.

Last month, a federal panel of drug safety specialists recommended that Vicodin and dozens of other medicines be subjected to the same restrictions as other narcotic drugs like oxycodone and morphine. Meanwhile, more and more hospitals have been establishing tougher restrictions on painkiller prescriptions and refills.

One example: The University of Colorado Hospital in Aurora is considering a rule that would ban emergency doctors from prescribing more medicine for patients who say they lost their pain meds, Zane said.

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Stobbe reported from Atlanta.

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Online:

JAMA: http://www.jama.ama-assn.org

CDC: http://www.cdc.gov

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AP Medical Writer Lindsey Tanner can be reached at http://www.twitter.com

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Asian shares hit 18-month high on growth hopes

TOKYO (Reuters) - Asian shares scaled their highest levels since August 2011 on Wednesday after an improving global economic outlook whetted investor appetite for risk, while the yen firmed amid doubts over Japan's commitment to drastic reflation.

Asian shares have been on an uptrend as risks from the euro zone debt crisis and the U.S. fiscal impasse abated and signs of recovery emerged in major economies including China. Corporate earnings have also been generally positive.

"The tide continued to push higher for equity markets across Asia today, with solid leads from Europe and the U.S. enough to keep traders in a buying frame of mind," said Tim Waterer, senior trader at CMC Markets.

News of new possible mergers boosted U.S. stocks on Tuesday, pinning the benchmark Standard & Poor's 500 Index <.spx> near a five-year high, while European shares rose after the German ZEW investor sentiment index rose to a three-year high.

European markets will likely consolidate, with financial spreadbetters predicting London's FTSE 100 <.ftse>, Paris's CAC-40 <.fchi> and Frankfurt's DAX <.gdaxi> would open down 0.1 percent. U.S. stock futures were flat to suggest a subdued start for Wall Street. <.l><.eu><.n/>

The MSCI's broadest index of Asia-Pacific shares outside Japan <.miapj0000pus> added 0.8 percent, up for a third day in a row, led by a 1.9 percent gain in its technology sector <.miapjit00pus>. The index has risen 4.3 percent year to date.

South Korean shares <.ks11> outperformed their peers with a 1.8 percent jump to a one-month high, as foreigners stepped up buying and a pause in the yen's falling trend soothed sentiment.

Australian shares <.axjo> rose 0.3 percent, extending their bull run at 4-1/2-year highs on improving sentiment overseas and a better-than-expected domestic earnings season. The Australian market has risen nearly 10 percent this year.

Positive growth in Southeast Asia has drawn foreign investors, keeping regional stocks robust. The Philippines stock market <.psi> extended gains to a record high while Bangkok's SET index <.seti> hit a fresh 18-year high.

Rallying stocks weighed on assets perceived as safe-haven, with spot gold inching up 0.2 percent to $1,606.84 an ounce but stuck near a six-month low.

Asian credit markets took their cues from stocks, tightening the spread on the iTraxx Asia ex-Japan investment-grade index by two basis points.

London copper edged up 0.2 percent to $8,067.75 a metric ton, off Tuesday's three-week lows.

"A shift to cyclicals from defensives has come full circle and investors are now looking at sector-specific factors within an asset class, selecting those with a tight supply/demand outlook," said Naohiro Niimura, a partner at research and consulting firm Market Risk Advisory.

He said industrial metals and oil are favored by investors. Within base metals, copper will likely rise further as economic activity increases, as will Brent crude oil, while U.S. crude was seen weighed by ample supply.

U.S. crude steadied around $96.72 a barrel but Brent eased 0.2 percent to $117.31.

Platinum and palladium also have further upside scope due to supply concerns.

The rise in equities weighed on assets perceived as safe-haven, such U.S. Treasuries and gold on Tuesday. Spot gold inched up 0.2 percent to $1,607.94 an ounce, but hovered near a six-month low hit the day before.

YEN INSTABILITY RISES

Tokyo's Nikkei stock average <.n225> closed 0.8 percent higher at its highest close since late September 2008. <.t/>

The yen remained jittery, swinging in narrow ranges on concerns Japan may not be able to pursue as strong a reflationary policy mix as previously perceived.

The government delayed nominating a new Bank of Japan governor, fuelling talk of friction between the prime minister and the finance minister over who is best suited to implement the bold steps needed to reignite the economy.

The G20 meeting last weekend gave tacit approval to a weak currency as long as it was as a result of domestic monetary easing, but maintained its traditional opposition to currency manipulation aimed at fostering exports and growth of one country at others' expense.

"In light of the G20 statement to avoid competitive devaluation, it will be difficult to talk down the yen specifically. I think the onus now is on policy to do the work," said Sim Moh Siong, FX strategist for Bank of Singapore.

The dollar fell 0.4 percent to 93.15 yen, off its highest since May 2010 of 94.465 hit on February 11. The euro eased 0.3 percent to 124.91 yen. It touched a peak since April 2010 of 127.71 yen on February 6.

Japan logged its biggest monthly trade deficit on record in January, underscoring the country's deteriorating trade balances and accenting the yen's weak fundamental trend.

Sterling was under pressure on growing speculation the UK could soon lose its prized triple-A credit rating. Sterling traded at $1.5444, having plumbed a seven-month low at $1.5414 in New York.

Investors remained wary of possible U.S. federal spending cuts and outcome of the upcoming Italian election. They also awaited the release later in the session of the minutes of the Federal Reserve's January policy meeting for clues to its future bond-buying plans.

The ZEW report was a positive sign ahead of the more important euro zone flash PMIs on Thursday and Germany's IFO business sentiment on Friday, said Vassili Serebriakov, a strategist at BNP Paribas.

The euro extended its gains, rising 0.2 percent to $1.3413.

(Additional reporting by Masayuki Kitano in Singapore and Thuy Ong in Sydney; Edting by Eric Meijer)

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Japan Finds Swelling in Second Boeing 787 Battery

TOKYO (Reuters) - Cells in a second lithium-ion battery on a Boeing Co 787 Dreamliner forced to make an emergency landing in Japan last month showed slight swelling, a Japan Transport Safety Board (JTSB) official said on Tuesday.

The jet, flown by All Nippon Airways Co, was forced to make the landing after its main battery failed.

"I do not know the exact discussion taken by the research group on the ground, but I heard that it is a slight swelling (in the auxiliary power unit battery cells). I have so far not heard that there was internal damage," Masahiro Kudo, a senior accident investigator at the JTSB said in a briefing in Tokyo.

Kudo said that two out of eight cells in the second battery unit showed some bumps and the JTSB would continue to investigate to determine whether this was irregular or not.

The plane's auxiliary power unit (APU) powers the aircraft's systems when it is on the ground. National Transportation Safety Board investigators in the United States are probing the APU from a Japan Airlines plane that caught fire at Boston's Logan airport when the plane was parked.

The U.S. Federal Aviation Authority grounded all 50 Boeing Dreamliners in commercial service on January 16 after the incidents with the two Japanese owned 787 jets.

The groundings have cost airlines tens of millions of dollars, with no solution yet in sight.

Boeing rival Airbus said last week it had abandoned plans to use lithium-ion batteries in its next passenger jet, the A350, in favor of traditional nickel-cadmium batteries.

Lighter and more powerful than conventional batteries, lithium-ion power packs have been in consumer products such as phones and laptops for years but are relatively new in industrial applications, including back-up batteries for electrical systems in jets.

(Reporting by Mari Saito; Editing by Richard Pullin)

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Mindy McCready: Under Police Scrutiny at Time of Suicide?

By Steve Helling and Mike Fleeman

02/18/2013 at 06:00 PM EST

Mindy McCready and David Wilson

Courtesy Mindy McCready

When Mindy McCready talked to police in recent weeks, her account of how her boyfriend came to be found with a fatal gunshot wound to the head concerned police, a law enforcement source tells PEOPLE.

"At first, she said she hadn't heard the gunshot because the TV was too loud. Then she said she had heard the gunshot," the source says. "So obviously there were a lot of questions, and the Sheriff was asking for clarification."

But before investigators could re-interview her, the long-troubled country singer also would die under eerily similar circumstances, her body discovered at the same Heber Springs, Ark., house just feet away from where David Wilson died.

McCready's death was blamed on what "appears to be a single self-inflicted gunshot wound," the Cleburne County Sheriff's Office said in a statement.

This differed from how the sheriff characterized Wilson's case. His cause and manner of death still have not been established by the coroner. It was McCready's publicist, and not a law enforcement official, who announced that Wilson had died of a self-inflicted gunshot wound.

After Wilson's death, McCready, 37, spoke to investigators three times, but they didn't feel as if they were through with her.

"At no point did [police] tell her she was a suspect, and she wasn't officially one," says the source. "But she knew that some of her answers didn't stand up to questioning. She was very cooperative, but she just wasn't making a lot of sense."

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Hip implants a bit more likely to fail in women

CHICAGO (AP) — Hip replacements are slightly more likely to fail in women than in men, according to one of the largest studies of its kind in U.S. patients. The risk of the implants failing is low, but women were 29 percent more likely than men to need a repeat surgery within the first three years.

The message for women considering hip replacement surgery remains unclear. It's not known which models of hip implants perform best in women, even though women make up the majority of the more than 400,000 Americans who have full or partial hip replacements each year to ease the pain and loss of mobility caused by arthritis or injuries.

"This is the first step in what has to be a much longer-term research strategy to figure out why women have worse experiences," said Diana Zuckerman, president of the nonprofit National Research Center for Women & Families. "Research in this area could save billions of dollars" and prevent patients from experiencing the pain and inconvenience of surgeries to fix hip implants that go wrong.

Researchers looked at more than 35,000 surgeries at 46 hospitals in the Kaiser Permanente health system. The research, published Monday in JAMA Internal Medicine, was funded by the U.S. Food and Drug Administration.

After an average of three years, 2.3 percent of the women and 1.9 percent of the men had undergone revision surgery to fix a problem with the original hip replacement. Problems included instability, infection, broken bones and loosening.

"There is an increased risk of failure in women compared to men," said lead author Maria Inacio, an epidemiologist at Southern California Permanente Medical Group in San Diego. "This is still a very small number of failures."

Women tend to have smaller joints and bones than men, and so they tend to need smaller artificial hips. Devices with smaller femoral heads — the ball-shaped part of the ball-and-socket joint in an artificial hip — are more likely to dislocate and require a surgical repair.

That explained some, but not all, of the difference between women and men in the study. It's not clear what else may have contributed to the gap. Co-author Dr. Monti Khatod, an orthopedic surgeon in Los Angeles, speculated that one factor may be a greater loss of bone density in women.

The failure of metal-on-metal hips was almost twice as high for women than in men. The once-popular models were promoted by manufacturers as being more durable than standard plastic or ceramic joints, but several high-profile recalls have led to a decrease in their use in recent years.

"Don't be fooled by hype about a new hip product," said Zuckerman, who wrote an accompanying commentary in the medical journal. "I would not choose the latest, greatest hip implant if I were a woman patient. ... At least if it's been for sale for a few years, there's more evidence for how well it's working."

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Online:

Journal: http://www.jamainternalmed.com

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