Central African Republic rebels halt advance, agree to peace talks


DAMARA, Central African Republic (Reuters) - Rebels in Central African Republic said they had halted their advance on the capital on Wednesday and agreed to start peace talks, averting a clash with regionally backed troops.


The Seleka rebels had pushed to within striking distance of Bangui after a three-week onslaught and threatened to oust President Francois Bozize, accusing him of reneging on a previous peace deal and cracking down on dissidents.


Their announcement on Wednesday gave the leader only a limited reprieve as the fighters told Reuters they might insist on his removal in the negotiations.


"I have asked our forces not to move their positions starting today because we want to enter talks in (Gabon's capital) Libreville for a political solution," said Seleka spokesman Eric Massi, speaking by telephone from Paris.


"I am in discussion with our partners to come up with proposals to end the crisis, but one solution could be a political transition that excludes Bozize," he said.


Bozize on Wednesday sacked his Army Chief of Staff and took over the defense minister's role from his son, Jean Francis Bozize, according to a decree read on national radio, a day after publicly criticizing the military for failing to repel the rebels.


The advance by Seleka, an alliance of mostly northeastern rebel groups, was the latest in a series of revolts in a country at the heart of one of Africa's most turbulent regions - and the most serious since the Chad-backed insurgency that swept Bozize to power in 2003.


Diplomatic sources have said talks organized by central African regional bloc ECCAS could start on January 10. The United States, the European Union and France have called on both sides to negotiate and spare civilians.


Central African Republic is one of the least developed countries in the world despite its deposits of gold, diamonds and other minerals. French nuclear energy group Areva mines the country's Bakouma uranium deposit - France's biggest commercial interest in its former colony.


RELIEF IN BANGUI


News of the rebel halt eased tension in Bangui, where residents had been stockpiling food and water and staying indoors after dark.


"They say they are no longer going to attack Bangui, and that's great news for us," said Jaqueline Loza in the crumbling riverside city.


ECCAS members Chad, Congo Republic, Gabon and Cameroon have sent hundreds of soldiers to reinforce CAR's army after a string of rebel victories since early December.


Gabonese General Jean Felix Akaga, commander of the regional force, said his troops were defending the town of Damara, 75 km (45 miles) north of Bangui and close to the rebel front.


"Damara is a red line not to be crossed ... Damara is in our control and Bangui is secure," he told Reuters. "If the rebellion decides to approach Damara, they know they will encounter a force that will react."


Soldiers armed with Kalashnikovs, rocket propelled grenade launchers and truck-mounted machineguns had taken up positions across the town, which was otherwise nearly-abandoned.


Some of the fighters wore turbans that covered their faces and had charms strung around their necks and arms meant to protect them against enemy bullets.


Chad's President Idriss Deby, one of Bozize's closest allies, had warned the rebels the regional force would confront them if they approached the town.


Chad provided training and equipment to the rebellion that brought Bozize to power by ousting then-president Ange Felix Patasse, who Chad accused of supporting Chadian dissidents.


Chad is also keen to keep a lid on instability in the territory close to its main oil export pipeline and has stepped in to defend Bozize against insurgents in the past.


A CAR government minister told Reuters the foreign troop presence strengthened Bozize's bargaining position ahead of the Libreville peace talks.


"The rebels are now in a position of weakness," the minister said, asking not to be named. "They should therefore stop imposing conditions like the departure of the president."


Central African Republic is one of a number of countries in the region where U.S. Special Forces are helping local soldiers track down the Lord's Resistance Army, a rebel group which has killed thousands of civilians across four nations.


France has a 600-strong force in CAR to defend about 1,200 of its citizens who live there.


Paris used air strikes to defend Bozize against a rebellion in 2006. But French President Francois Hollande turned down a request for more help, saying the days of intervening in other countries' affairs were over.


(Additional reporting by Paul-Marin Ngoupana in Bangui and Jon Herskovitz in Johannesburg; Writing by Richard Valdmanis; Editing by Andrew Heavens and Janet Lawrence)



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Motorcycle bomb kills four in Pakistan's Karachi






KARACHI: A motorcycle bomb exploded Tuesday near the venue of a major political rally in Pakistan's largest city Karachi, killing four people and injuring 42 others, officials said.

The bombing appeared to be targeted at buses carrying supporters of the city's dominant political party, the Muttahida Qaumi Movement (MQM), which organised the rally attended by thousands of people.

"The latest report we have collected from hospitals said that four people have been killed and 42 are injured," provincial health minister Saghir Ahmad told AFP, updating the earlier toll of two dead and 25 injured.

Another health official at Karachi's Abbasi Shaheed hospital confirmed the new toll.

"The bomb was planted in a motorcycle," said Asif Ijaz, a senior police official.

Imran Shokat, a police spokesman in the southern Sindh province of which Karachi is the capital, said the motorcycle was parked in a congested neighbourhood near the venue of the rally.

"Bomb disposal experts are investigating but preliminary reports said it was a remote-controlled bomb," Shokat told AFP.

Karachi, the commercial capital of Pakistan with an estimated population of 18 million, is in the grip of a long-running wave of political and sectarian violence.

Its Arabian Sea port is used by the United States and NATO to ship supplies to the war in neighbouring, landlocked Afghanistan.

- AFP/jc



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Tourism ministry to set up multi-lingual helpline

NEW DELHI: Tourism ministry will set up a multi-lingual helpline to provide tourism-related information and local assistance to foreign travelers.

Initially, the helpline will be in French, German, Spanish, Korean and Italian besides Hindi and English. The helpline will be a 1800 number that will be accessible from anywhere in India and should start functioning in the new calendar year.

The primary objective of the proposed helpline is to provide tourism-related information. The proposal was mooted at a meeting with the representatives of leading travel trade associations held in the ministry of tourism.

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Brain image study: Fructose may spur overeating


This is your brain on sugar — for real. Scientists have used imaging tests to show for the first time that fructose, a sugar that saturates the American diet, can trigger brain changes that may lead to overeating.


After drinking a fructose beverage, the brain doesn't register the feeling of being full as it does when simple glucose is consumed, researchers found.


It's a small study and does not prove that fructose or its relative, high-fructose corn syrup, can cause obesity, but experts say it adds evidence they may play a role. These sugars often are added to processed foods and beverages, and consumption has risen dramatically since the 1970s along with obesity. A third of U.S. children and teens and more than two-thirds of adults are obese or overweight.


All sugars are not equal — even though they contain the same amount of calories — because they are metabolized differently in the body. Table sugar is sucrose, which is half fructose, half glucose. High-fructose corn syrup is 55 percent fructose and 45 percent glucose. Some nutrition experts say this sweetener may pose special risks, but others and the industry reject that claim. And doctors say we eat too much sugar in all forms.


For the study, scientists used magnetic resonance imaging, or MRI, scans to track blood flow in the brain in 20 young, normal-weight people before and after they had drinks containing glucose or fructose in two sessions several weeks apart.


Scans showed that drinking glucose "turns off or suppresses the activity of areas of the brain that are critical for reward and desire for food," said one study leader, Yale University endocrinologist Dr. Robert Sherwin. With fructose, "we don't see those changes," he said. "As a result, the desire to eat continues — it isn't turned off."


What's convincing, said Dr. Jonathan Purnell, an endocrinologist at Oregon Health & Science University, is that the imaging results mirrored how hungry the people said they felt, as well as what earlier studies found in animals.


"It implies that fructose, at least with regards to promoting food intake and weight gain, is a bad actor compared to glucose," said Purnell. He wrote a commentary that appears with the federally funded study in Wednesday's Journal of the American Medical Association.


Researchers now are testing obese people to see if they react the same way to fructose and glucose as the normal-weight people in this study did.


What to do? Cook more at home and limit processed foods containing fructose and high-fructose corn syrup, Purnell suggested. "Try to avoid the sugar-sweetened beverages. It doesn't mean you can't ever have them," but control their size and how often they are consumed, he said.


A second study in the journal suggests that only severe obesity carries a high death risk — and that a few extra pounds might even provide a survival advantage. However, independent experts say the methods are too flawed to make those claims.


The study comes from a federal researcher who drew controversy in 2005 with a report that found thin and normal-weight people had a slightly higher risk of death than those who were overweight. Many experts criticized that work, saying the researcher — Katherine Flegal of the Centers for Disease Control and Prevention — painted a misleading picture by including smokers and people with health problems ranging from cancer to heart disease. Those people tend to weigh less and therefore make pudgy people look healthy by comparison.


Flegal's new analysis bolsters her original one, by assessing nearly 100 other studies covering almost 2.9 million people around the world. She again concludes that very obese people had the highest risk of death but that overweight people had a 6 percent lower mortality rate than thinner people. She also concludes that mildly obese people had a death risk similar to that of normal-weight people.


Critics again have focused on her methods. This time, she included people too thin to fit what some consider to be normal weight, which could have taken in people emaciated by cancer or other diseases, as well as smokers with elevated risks of heart disease and cancer.


"Some portion of those thin people are actually sick, and sick people tend to die sooner," said Donald Berry, a biostatistician at the University of Texas MD Anderson Cancer Center in Houston.


The problems created by the study's inclusion of smokers and people with pre-existing illness "cannot be ignored," said Susan Gapstur, vice president of epidemiology for the American Cancer Society.


A third critic, Dr. Walter Willett of the Harvard School of Public Health, was blunter: "This is an even greater pile of rubbish" than the 2005 study, he said. Willett and others have done research since the 2005 study that found higher death risks from being overweight or obese.


Flegal defended her work. She noted that she used standard categories for weight classes. She said statistical adjustments were made for smokers, who were included to give a more real-world sample. She also said study participants were not in hospitals or hospices, making it unlikely that large numbers of sick people skewed the results.


"We still have to learn about obesity, including how best to measure it," Flegal's boss, CDC Director Dr. Thomas Frieden, said in a written statement. "However, it's clear that being obese is not healthy - it increases the risk of diabetes, heart disease, cancer, and many other health problems. Small, sustainable increases in physical activity and improvements in nutrition can lead to significant health improvements."


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Online:


Obesity info: http://www.cdc.gov/obesity/data/trends.html


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Marilynn Marchione can be followed at http://twitter.com/MMarchioneAP


Mike Stobbe can be followed at http://twitter.com/MikeStobbe


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House Hesitates, Fears Cliff Deal Could Bloat Deficit













Top House Republicans today opposed a bipartisan compromise that passed the Senate in the wee hours of New Year's Day to avert the "fiscal cliff," as new studies conclude that the compromise on taxes and spending would add trillions to the U.S. deficit.


If House Republicans tweak the legislation, as they seem likely to do, there's no clear path for its return to the Senate before a new Congress is sworn in Thursday.


GOP leaders emerged from a morning conference meeting disenchanted by the legislative package devised by Senate Minority Leader Mitch McConnell and Vice President Biden early this morning, with several insisting they cannot vote on it as it now stands.


"I do not support the bill," House Majority Leader Eric Cantor, R-Va., said as he left the meeting. "We're looking for the best path forward. No decisions have been made yet."


It's almost certain that Republicans will attempt to amend the bill in order to win over the support of more conservatives.


House Speaker John Boehner refused to comment on the meeting, but his spokesman said "the lack of spending cuts in the Senate bill was a universal concern amongst members in today's meeting."


"Conversations with members will continue throughout the afternoon on the path forward," Brendan Buck said in a statement.


As lawmakers wrestled with the legislation, the Joint Committee on Taxation and the Congressional Budget Office, two bipartisan groups that evaluate the cost of bills, said the measure would add roughly $4 trillion to the federal deficit in the next 10 years.






Bill Clark/Roll Call/Getty Images











Fiscal Cliff Countdown: Missing the Deadline Watch Video











Obama on Fiscal Cliff: 'Agreement Within Sight' Watch Video





The impasse once again raised the specter of sweeping tax hikes on all Americans and deep spending cuts' taking effect later this week.


"This is all about time, and it's about time that we brought this to the floor," House Minority Leader Nancy Pelosi said after emerging from a meeting with Democrats.


"It was a bill that was passed in the U.S. senate 89-8. Tell me when you've had that on a measure as controversial as this?" she said of the overwhelming vote.


Pelosi could not say, however, whether the measure had the backing of most House Democrats. "Our members are making their decisions now," she said.


Biden, who brokered the deal with McConnell, joined Democrats for a midday meeting on Capitol Hill seeking to shore up support for the plan.


While Congress technically missed the midnight Dec. 31 deadline to avert the so-called cliff, both sides have expressed eagerness to enact a post-facto fix before Americans go back to work and the stock market opens Wednesday.


"This may take a little while but, honestly, I would argue we should vote on it today," said Rep. Tom Cole, R-Okla., who sits on the Budget Committee. "We know the essential details and I think putting this thing to bed before the markets is important.


"We ought to take this deal right now and we'll live to fight another day, and it is coming very soon on the spending front."


The Senate passed legislation shortly after 2 a.m. that would extend current tax rates on 98 percent of Americans, raise taxes on the wealthiest earners and delay by two months the pending automatic spending cuts to defense and domestic programs, known as the "sequester."


The measure passed by an overwhelming majority vote of 89-8, boosting the prospects that enough House members would follow suit to make it law.


If the House amends the bill, however, the fragile compromise could get shattered. The Senate would need to reconvene to consider the changes.


A Senate Democratic leadership aide told ABC News, "we did our work, and McConnell's office said they were confident of House passage. All bets are off if they amend our bill."


Meanwhile, most Senators have already returned home, dismissed early this morning by Majority Leader Sen. Harry Reid.


"I've said all along our most important priority is protecting middle-class Americans, this legislation does that," Senate Majority Leader Harry Reid, D-Nev., said early this morning prior to the vote.






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At least 61 crushed to death in Ivory Coast stampede


ABIDJAN (Reuters) - At least 61 people were crushed to death in a stampede after a New Year's Eve fireworks display at a stadium in Ivory Coast's main city Abidjan early on Tuesday, officials said.


Witnesses said police had tried to control crowds around the Felix Houphouet-Boigny Stadium following the celebrations, triggering a panic in which scores were trampled.


"The estimate we can give right now is 49 people hospitalized ... and 61 people dead," said the chief of staff of Abidjan's fire department Issa Sacko.


Crying women searched for missing family members outside the stadium on Tuesday morning. The area was covered in patches of dried blood and abandoned shoes.


"My two children came here yesterday. I told them not to come but they didn't listen. They came when I was sleeping. What will I do?" said Assetou Toure, a cleaner.


Sanata Zoure, a market vendor injured in the incident, said New Year's revelers going home after watching the fireworks had been stopped by police near the stadium.


"We were walking with our children and we came upon barricades, and people started falling into each other. We were trampled with our children," she said.


Another witness said police arrived to control the crowd after a mob began chasing a pickpocket.


President Alassane Ouattara called the deaths a national tragedy and said an investigation was under way to find out what happened.


"I hope that we can determine what caused this drama so that we can ensure it never happens again," he said after visiting the injured in hospital.


The country, once a stable economic hub for West Africa, is struggling to recover from a 2011 civil war in which more than 3,000 people were killed.


Ivory Coast's security forces once were among the best trained in the region, but a decade of political turmoil and the 2011 war has left them in disarray.


At least 18 people were killed in another stampede during a football match in an Abidjan stadium in 2009.


(Reporting by Loucoumane Coulibaly and Alain Amontchi; Writing by Richard Valdmanis; Editing by Michael Roddy)



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'Fiscal cliff' deal talk, Apple lift US stocks at year-end






WASHINGTON: US markets closed out the year on Monday with a sharp jump on news that Congress was close to a deal to avert the fiscal cliff - but also on a 4.4 percent gain by market giant Apple.

The Dow Jones Industrial Average finished up 166.03 points (1.28 percent) at 13,104.14.

The broad-market S&P 500 gained 23.79 points (1.69 percent) at 1,426.19, while the tech-rich Nasdaq Composite surged 59.20 points (2.00 percent) to 3,019.51.

The gains reversed losses of the previous week when cliff worries were strong, and left the main indices with respectable gains for the year: 7.3 percent for the Dow, 13.4 percent for the S&P 500, and 15.9 percent for the Nasdaq.

With a midnight deadline looming to avert the sharp tax hikes and spending cuts aimed at slashing the fiscal deficit - but which could force a recession - the White House and congressional leaders said a deal was nigh that would mitigate the worst effects.

Nothing was certain: while the Senate was expected to pass the compromise legislation after it is finalised, possibly before the midnight Monday deadline, in the Republican-controlled House of Representatives, where resistance could be tougher, the vote would not be before Tuesday.

But the markets pushed higher in expectation that the immediate threat of more than $400 billion in tax increases would mostly be avoided.

"A compromise over taxes and spending would be an important step that supports economic growth in the year ahead," said Gary Thayer, strategist at Wells Fargo Advisors.

Major shares were nearly all in the green, led by Apple's surge.

The world's most valuable company by market capitalisation - an even $500 billion at the end of trade on Monday - was a major driver of the markets ruing the year. Even though its price at Monday's close, $532.17, was well below the year's high of $705.07, Apple shares still racked up a 25.8 percent gain for 2012.

Other major gainers on Monday included ExxonMobil, up 1.8 percent; General Electric (2.6 percent); and Caterpillar (2.8 percent).

Bond prices fell. The 10-year US Treasury yield rose to 1.76 percent from 1.71 percent Friday, while the 30-year moved to 2.95 percent from 2.88 percent. Bond prices and yields move inversely.

- AFP/de



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Delhi gang-rape: Nirbhaya case rarest of rare, Krishna Tirath says

NEW DELHI: Favouring imprisonment till death for the six accused in the Nirbhaya gang rape, Union minister Krishna Tirath on Monday said that the case was an exceptional one and should be treated as "rarest of rare".

Following hectic consultations last week with over 40 NGOs, social and women's rights activists, the ministry plans to consult with the ministries of home and law to recommend life term without parole till the natural death of all accused, including the juvenile offender.

Speaking on the issue, Tirath, who holds the charge for the ministry of women and child development, said, "I am of the opinion that an exception should be made in this case keeping in view the sheer brutality of the crime. My view is that the accused should be subjected to harshest punishment possible. This could be life imprisonment without parole till the natural death of the accused. The juvenile offender in this case should also be treated as an adult."

Tirath will meet home minister Sushilkumar Shinde and law minister Ashwani Kumar on January 4 to finalize the government's recommendations before they are submitted to the Justice Verma Committee. Incidentally, when a court awards life imprisonment to a convict in a heinous crime, it means the guilty is to spend the rest of his life behind bars.

But given the reformative sentence system operational in India, the state has been vested with the discretion of commuting the sentence if the prisoner exhibits good conduct for a prolonged period erasing any perception of being a threat to society. A prisoner can apply for release from jail on grounds of good conduct after completion of 14 years in prison.

Over the past several years, the discretionary power has been utilized to grant relief to everyone across the board even in cases where a person is sentenced to life after being found guilty of heinous crime.

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AP IMPACT: Big Pharma cashes in on HGH abuse


A federal crackdown on illicit foreign supplies of human growth hormone has failed to stop rampant misuse, and instead has driven record sales of the drug by some of the world's biggest pharmaceutical companies, an Associated Press investigation shows.


The crackdown, which began in 2006, reduced the illegal flow of unregulated supplies from China, India and Mexico.


But since then, Big Pharma has been satisfying the steady desires of U.S. users and abusers, including many who take the drug in the false hope of delaying the effects of aging.


From 2005 to 2011, inflation-adjusted sales of HGH were up 69 percent, according to an AP analysis of pharmaceutical company data collected by the research firm IMS Health. Sales of the average prescription drug rose just 12 percent in that same period.


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EDITOR'S NOTE — Whether for athletics or age, Americans from teenagers to baby boomers are trying to get an edge by illegally using anabolic steroids and human growth hormone, despite well-documented risks. This is the second of a two-part series.


___


Unlike other prescription drugs, HGH may be prescribed only for specific uses. U.S. sales are limited by law to treat a rare growth defect in children and a handful of uncommon conditions like short bowel syndrome or Prader-Willi syndrome, a congenital disease that causes reduced muscle tone and a lack of hormones in sex glands.


The AP analysis, supplemented by interviews with experts, shows too many sales and too many prescriptions for the number of people known to be suffering from those ailments. At least half of last year's sales likely went to patients not legally allowed to get the drug. And U.S. pharmacies processed nearly double the expected number of prescriptions.


Peddled as an elixir of life capable of turning middle-aged bodies into lean machines, HGH — a synthesized form of the growth hormone made naturally by the human pituitary gland — winds up in the eager hands of affluent, aging users who hope to slow or even reverse the aging process.


Experts say these folks don't need the drug, and may be harmed by it. The supposed fountain-of-youth medicine can cause enlargement of breast tissue, carpal tunnel syndrome and swelling of hands and feet. Ironically, it also can contribute to aging ailments like heart disease and Type 2 diabetes.


Others in the medical establishment also are taking a fat piece of the profits — doctors who fudge prescriptions, as well as pharmacists and distributors who are content to look the other way. HGH also is sold directly without prescriptions, as new-age snake oil, to patients at anti-aging clinics that operate more like automated drug mills.


Years of raids, sports scandals and media attention haven't stopped major drugmakers from selling a whopping $1.4 billion worth of HGH in the U.S. last year. That's more than industry-wide annual gross sales for penicillin or prescription allergy medicine. Anti-aging HGH regimens vary greatly, with a yearly cost typically ranging from $6,000 to $12,000 for three to six self-injections per week.


Across the U.S., the medication is often dispensed through prescriptions based on improper diagnoses, carefully crafted to exploit wiggle room in the law restricting use of HGH, the AP found.


HGH is often promoted on the Internet with the same kind of before-and-after photos found in miracle diet ads, along with wildly hyped claims of rapid muscle growth, loss of fat, greater vigor, and other exaggerated benefits to adults far beyond their physical prime. Sales also are driven by the personal endorsement of celebrities such as actress Suzanne Somers.


Pharmacies that once risked prosecution for using unauthorized, foreign HGH — improperly labeled as raw pharmaceutical ingredients and smuggled across the border — now simply dispense name brands, often for the same banned uses. And usually with impunity.


Eight companies have been granted permission to market HGH by the U.S. Food and Drug Administration, which reviews the benefits and risks of new drug products. By contrast, three companies are approved for the diabetes drug insulin.


The No. 1 maker, Roche subsidiary Genentech, had nearly $400 million in HGH sales in the U.S. last year, up an inflation-adjusted two-thirds from 2005. Pfizer and Eli Lilly were second and third with $300 million and $220 million in sales, respectively, according to IMS Health. Pfizer now gets more revenue from its HGH brand, Genotropin, than from Zoloft, its well-known depression medicine that lost patent protection.


On their face, the numbers make no sense to the recognized hormone doctors known as endocrinologists who provide legitimate HGH treatment to a small number of patients.


Endocrinologists estimate there are fewer than 45,000 U.S. patients who might legitimately take HGH. They would be expected to use roughly 180,000 prescriptions or refills each year, given that typical patients get three months' worth of HGH at a time, according to doctors and distributors.


Yet U.S. pharmacies last year supplied almost twice that much HGH — 340,000 orders — according to AP's analysis of IMS Health data.


While doctors say more than 90 percent of legitimate patients are children with stunted growth, 40 percent of 442 U.S. side-effect cases tied to HGH over the last year involved people age 18 or older, according to an AP analysis of FDA data. The average adult's age in those cases was 53, far beyond the prime age for sports. The oldest patients were in their 80s.


Some of these medical records even give explicit hints of use to combat aging, justifying treatment with reasons like fatigue, bone thinning and "off-label," which means treatment of an unapproved condition


Even Medicare, the government health program for older Americans, allowed 22,169 HGH prescriptions in 2010, a five-year increase of 78 percent, according to data released by the Centers for Medicare and Medicaid Services in response to an AP public records request.


"There's no question: a lot gets out," said hormone specialist Dr. Mark Molitch of Northwestern University, who helped write medical standards meant to limit HGH treatment to legitimate patients.


And those figures don't include HGH sold directly by doctors without prescriptions at scores of anti-aging medical practices and clinics around the country. Those numbers could only be tallied by drug makers, who have declined to say how many patients they supply and for what conditions.


First marketed in 1985 for children with stunted growth, HGH was soon misappropriated by adults intent on exploiting its modest muscle- and bone-building qualities. Congress limited HGH distribution to the handful of rare conditions in an extraordinary 1990 law, overriding the generally unrestricted right of doctors to prescribe medicines as they see fit.


Despite the law, illicit HGH spread around the sports world in the 1990s, making deep inroads into bodybuilding, college athletics, and professional leagues from baseball to cycling. The even larger banned market among older adults has flourished more recently.


FDA regulations ban the sale of HGH as an anti-aging drug. In fact, since 1990, prescribing it for things like weight loss and strength conditioning has been punishable by 5 to 10 years in prison.


Steve Kleppe, of Scottsdale, Ariz., a restaurant entrepreneur who has taken HGH for almost 15 years to keep feeling young, said he noticed a price jump of about 25 percent after the block on imports. He now buys HGH directly from a doctor at an annual cost of about $8,000 for himself and the same amount for his wife.


Many older patients go for HGH treatment to scores of anti-aging practices and clinics heavily concentrated in retirement states like Florida, Nevada, Arizona and California.


These sites are affiliated with hundreds of doctors who are rarely endocrinologists. Instead, many tout certification by the American Board of Anti-Aging and Regenerative Medicine, though the medical establishment does not recognize the group's bona fides.


The clinics offer personalized programs of "age management" to business executives, affluent retirees, and other patients of means, sometimes coupled with the amenities of a vacation resort. The operations insist there are few, if any, side effects from HGH. Mainstream medical authorities say otherwise.


A 2007 review of 31 medical studies showed swelling in half of HGH patients, with joint pain or diabetes in more than a fifth. A French study of about 7,000 people who took HGH as children found a 30 percent higher risk of death from causes like bone tumors and stroke, stirring a health advisory from U.S. authorities.


For proof that the drug works, marketers turn to images like the memorable one of pot-bellied septuagenarian Dr. Jeffry Life, supposedly transformed into a ripped hulk of himself by his own program available at the upscale Las Vegas-based Cenegenics Elite Health. (He declined to be interviewed.)


These promoters of HGH say there is a connection between the drop-off in growth hormone levels through adulthood and the physical decline that begins in late middle age. Replace the hormone, they say, and the aging process slows.


"It's an easy ruse. People equate hormones with youth," said Dr. Tom Perls, a leading industry critic who does aging research at Boston University. "It's a marketing dream come true."


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Associated Press Writer David B. Caruso reported from New York and AP National Writer Jeff Donn reported from Plymouth, Mass. AP Writer Troy Thibodeaux provided data analysis assistance from New Orleans.


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AP's interactive on the HGH investigation: http://hosted.ap.org/interactives/2012/hgh


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The AP National Investigative Team can be reached at investigate(at)ap.org


EDITOR'S NOTE _ Whether for athletics or age, Americans from teenagers to baby boomers are trying to get an edge by illegally using anabolic steroids and human growth hormone, despite well-documented risks. This is the second of a two-part series.


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Fiscal Cliffhanger: Tax Deal 'Within Sight,' Not Done













President Obama said an 11th-hour agreement to avert year-end tax hikes on 98 percent of Americans is "within sight" but not yet complete with just hours to go before the nation reaches the so-called fiscal cliff.


"There are still issues left to resolve but we're hopeful Congress can get it done," Obama said at a midday White House news conference. "But it's not done."


Congressional and White House negotiators have forged the contours of an agreement that would extend current tax rates for households making $450,000 or less; raise the estate tax from 35 to 40 percent for estates larger than $5 million; and prevent the Alternative Minimum Tax from hammering millions of middle-class workers, sources said.


The deal would also extend for one year unemployment insurance benefits set to expire Tuesday, and avert a steep cut to Medicare payments for doctors.


"I can report that we've reached an agreement on the all the tax issues," Senate Minority Leader Mitch McConnell said in an afternoon speech on the Senate floor.


But Sen. John McCain, R-Ariz., was among the less conciliatory Republicans.
Rather than staging a "cheerleading rally," he said, the president should have been negotiating the finishing touches of the deal.






Chip Somodevilla/Getty Images











'Fiscal Cliff': Lawmakers Scramble for Last-Minute Deal Watch Video









"What did the president of the United States just do? Well, he kind of made fun, he made a couple of jokes, laughed about how people are going to be here for New Year's, sent a message of confrontation to the Republicans," McCain said. "I guess I have to wonder, and I think the American people have to wonder whether the president really wants this issue resolved or is it to his short-term political benefit for us to go over the cliff?"


McCain said the president's speech today "clearly will antagonize members of the House," and "that's not the way presidents should lead."


Both sides remained at odds on what to do about the other significant piece of the "fiscal cliff" -- the more than $1 trillion of automatic cuts to defense and domestic programs set to begin tomorrow.


The White House has proposed a three-month delay of the cuts to allow more time to hash out details for deficit reduction, while many Senate Democrats want a flat one-year delay. Republicans insist that some spending cuts should be implemented now as part of any deal.


"In order to get the sequester moved, you're going to have to have real, concrete spending cuts," Rep. Mike Rogers, R-Mich., said. "[Without that], I don't know how it passes the House."


Vice President Joe Biden and McConnell, R-Ky., have been locked in behind-the-scenes negotiations for much of the day, sources said, following several "good" conversations that stretched late into Sunday night.


"We are very, very close," McConnell said today. "We can do this. We must do this."


If a deal is reached between Biden and McConnell, members in both chambers would still need to review it and vote on it later today. Passage is far from guaranteed.


"This is one Democrat that doesn't agree with that at all," Iowa Democratic Sen. Tom Harkin said of the tentative deal. "No deal is better than a bad deal, and this looks like a very bad deal the way this is shaping up."


"I don't see how you get something voted on today," Rogers said. "Even if they get a handshake deal today, you have to put the whole thing together and that's probably not going to happen before midnight. So it would make sense to roll into tomorrow to do that."






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