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Health News

  • The World Health Organization says the first-ever vaccine for dengue needs to be dealt with in 'a much safer way,' meaning that the shot should mostly be given to people who have previously been infected with the disease. In November, the vaccine's manufacturer, Sanofi Pasteur, said people who had never been sickened by dengue before were at risk of developing a more serious disease after getting the shot. After a two-day meeting this week, WHO's independent vaccines group said it now had proof the vaccine should only be used 'exclusively or almost exclusively in people who have already been infected with dengue.' The U.N. health agency said a test should be developed so doctors would be able to quickly tell if people had previously been sickened by dengue — but the group acknowledged doing that so isn't straightforward. 'We see significant obstacles in using the vaccine this way, but we are confident this also spurs the development of a rapid diagnostic test,' said Dr. Joachim Hombach, executive secretary of WHO's expert group, during a news conference Thursday. Sanofi said last year that doctors should consider whether people might have been previously infected with dengue before deciding whether they should risk getting immunized. The company said it expected to take a 100 million euro ($118 million) loss based on that news. People who catch dengue more than once can be at risk of a hemorrhagic version of the disease. The mosquito-spread virus is found in tropical and sub-tropical climates across Latin and South America, Asia, Africa and elsewhere. It causes a flu-like disease that can cause joint pain, nausea, vomiting and a rash. In severe cases, dengue can result in breathing problems, hemorrhaging and organ failure. About half the world's population is at risk of dengue; WHO estimates that about 96 million people are sickened by the viral infection every year. Following Sanofi's announcement last year, the Philippines halted its dengue immunization program, the world's first national vaccination program for dengue. The government also demanded a refund of more than 3 billion pesos ($59 million) from Sanofi and is considering further legal action. In February, the Philippines said the vaccine was potentially linked to the deaths of three people: all of them died of dengue despite having received the vaccine. The country imposed a symbolic fine of $2,000 on Sanofi and suspended the vaccine's approval, charging that the drugmaker broke rules on how the shot was registered and marketed. More than 730,000 children aged 9 and above in the Philippines have received at least one dose of the dengue vaccine, usually delivered in three doses. There is no specific treatment for dengue and there are no other licensed vaccines on the market.
  • The number of prescriptions for opioid painkillers filled in the U.S. fell dramatically last year, showing their biggest drop in 25 years and continuing a decline amid increasing legal restrictions and public awareness of the dangers of addiction, new data show. Health data firm IQVIA's Institute for Human Data Science released a report Thursday showing an 8.9 percent average drop nationwide in the number of prescriptions for opioids filled by retail and mail-order pharmacies. All 50 states and the District of Columbia had declines of more than 5 percent. Declines topped 10 percent in 18 states, including all of New England and other states hit hard by the opioid overdose epidemic, such as West Virginia and Pennsylvania. 'We're at a really critical moment in the country when everybody's paying attention to this issue,' said Michael Kleinrock, the institute's research director. 'People really don't want them if they can avoid them.' There was an even greater drop in total dosage of opioid prescriptions filled in 2017, down 12 percent from 2016. Reasons for that include more prescriptions being for a shorter duration, a 7.8 percent decline in new patients starting on opioid prescriptions and far fewer high-dose prescriptions. Opioid doses are measured in 'morphine milligram equivalents.' (A standard Vicodin pill has the equivalent of 5 milligrams of morphine.) Prescriptions for dosages of 90 morphine milligram equivalents per day or more, which carry the highest addiction risk, declined by 16 percent last year, according to the report. The U.S. is estimated to consume roughly 30 percent of all opioids used worldwide. Opioid prescriptions and daily doses rose steadily starting in the 1990s, fueled by factors including marketing of new opioid pills such as Oxycontin. Use peaked in 2011 at levels far above those in other wealthy countries where national health systems control narcotics more aggressively. The U.S. decline began after overdoses and deaths from prescription opioids and illicit narcotics soared, and multiple groups pushed back. The federal government and about half the states have enacted restrictions, such as limiting the dose or duration of opioids that can be prescribed. Insurers and drug stores began imposing similar limits on opioid use for acute pain, as opposed to cancer and chronic pain patients. The Drug Enforcement Administration increased prosecution of heavy prescribers. And numerous medical groups have issued guidelines urging prescribers to offer other pain-management options when possible and to limit doses and duration of opioid prescriptions. Despite those measures, deaths from drug overdoses have continued to increase in the U.S. and emergency rooms saw a big jump in overdoses from opioids last year, according to government data. Doctors have been heeding the messages from medical groups, and some worry they'll be arrested or lose their license if they provide too many opioids, said Bob Twillman, executive director of the Academy of Integrative Pain Management, which represents doctors and others who treat pain patients and gets some funding from opioid makers. 'We get a lot of phone calls from patients whose primary care doctors have said they won't prescribe opioids at all,' and want referrals to other doctors, Twillman said. The opioid data are part of IQVIA's annual report on U.S. drug-spending trends. It noted that last year the total spent on prescription drugs, after multiple discounts and rebates drugmakers give to middlemen, was $324 billion, up 0.6 percent. The report forecasts that after such discounts, drug spending will rise by 2 percent to 5 percent annually for the next five years. ___ Follow Linda A. Johnson at https://twitter.com/LindaJ_onPharma
  • Surgeons pack donated organs on ice while racing them to transplant patients but it may be time for a warmer approach. British researchers said Wednesday that keeping at least some livers at body temperature instead may work better. The livers keep functioning until they're transplanted thanks to a machine that pumps them full of blood and nutrients. It's a life-support system for the organs, and similar machines are being explored for lung and heart transplants, too. The transplant community isn't ditching affordable ice chests for the far pricier approach just yet. But proponents hope that storing organs in a way that mimics the body might eventually increase the number of transplants — by keeping precious donations usable for longer periods, and allowing use of some that today get thrown away. 'The biggest challenge in liver transplantation is the desperate shortage of organs,' said Dr. David Nasralla of the University of Oxford, who led the study in Britain and Europe. 'We found that livers that went on the machine were more likely to be transplanted.' Nearly 115,000 people are on the waiting list for an organ transplant in the United States alone, and last year there were just 34,770 transplants performed. Thousands die waiting. Partly, there are too few donations. Also, donated organs can't be stored for long — about four to six hours for a heart or lung, and about 12 hours for a liver. And sometimes surgeons discard organs they fear won't do well because of a donor's age or other health characteristics. Still, the vast majority of transplant recipients survive — showing the decidedly old-fashioned method of popping a donated organ into an ice chest with a cold preservation solution and rushing it to an operating room works pretty well. Organs essentially hibernate, not frozen but cold enough to slow cellular activity and thus their deterioration. Wednesday's study highlights 'the first radically different approach to organ preservation,' said Dr. David Klassen of the United Network for Organ Sharing, which oversees the U.S. transplant system. He isn't involved with studies of so-called 'normothermic' preservation but calls it 'really exciting technology' that might turn out to be appropriate for select organ donations rather than all of them. The new study involved 220 liver transplants performed in Britain, Belgium, Germany and Spain. Participating hospitals randomly assigned newly donated livers to be put into coolers as usual — or to be stored for up to 24 hours in a machine made by Britain's OrganOx Ltd. that keeps the organs functioning with warm fluids. The study wasn't big enough to detect any potential differences in patient survival. But the warmed livers were healthier when transplanted, the researchers reported in the journal Nature. They had less cellular damage during storage, a risk for transplant failure, than the livers kept on ice. More compelling, surgeons preserved the warmed livers several hours longer yet discarded fewer of them, ultimately transplanting 20 percent more of those organs than the cooled ones, the study found. Why? Instead of having to guess how well a liver would work based on its donor's characteristics, Nasralla said surgeons spent the extra time measuring how the organs functioned inside the warming machine. The study was funded by a European Commission grant. The results are promising but surgeons are watching for more evidence that such a big, and expensive, change in organ storage is worthwhile — and if so, when best to use it, said Dr. Devin Eckhoff, transplant division director at the University of Alabama at Birmingham. OrganOx's liver machine is approved abroad but experimental in the U.S., where a similar study is underway at 14 transplant centers including Eckhoff's. A competing company, Massachusetts-based TransMedics Inc., recently won U.S. Food and Drug Administration approval for warm preservation of donated lungs. 'It's clearly a lot more expensive than an ice box,' acknowledged Oxford professor Peter Friend, who co-invented the OrganOx machine. Friend couldn't provide exact costs. He said more study is needed to tell whether spending thousands more up-front on high-tech organ preservation might prove cost-effective if it lets doctors save organs that otherwise would be wasted or postpone middle-of-the-night transplants until morning. UNOS' Klassen says the bigger question is if scientists might use such machines to 'recondition' organs, by adding medications or other therapies to make them healthier before transplant. ___ The Associated Press Health & Science Department receives support from the Howard Hughes Medical Institute's Department of Science Education. The AP is solely responsible for all content.
  • Pollution has negative effects on our health, but scientists may be able to better combat the issue with a plastic-eating enzyme they discovered accidentally.  >> Read more trending news Researchers from the University of Portsmouth and the U.S. Department of Energy’s National Renewable Energy Laboratory recently conducted a study, published in the Proceedings of the National Academy of Sciences, to examine the natural molecules and chemicals found at a waste recycling center in Japan.  During their assessment, they discovered that the enzyme, Ideonella sakaiensis 201-F6, can “eat” polyethylene terephthalate (PET), the material used to make plastic bottles.  While they intended to better understand the structure of it, they actually engineered an enzyme that breaks down PET products.  >> Related: Soaps and paint pollute air as much as car emissions, study shows “This unanticipated discovery suggests that there is room to further improve these enzymes, moving us closer to a recycling solution for the ever-growing mountain of discarded plastics,” co-author John McGeehan said in a statement.  The scientists said PET can persist in the environment for hundreds of years. The chemicals can seep into the soil, affecting the groundwater and infecting drinking water. >> On AJC.com: Climate change will internally displace 143 million people by 2050, scientists warn While the analysts called their discovery a “modest” improvement, they hope to continue their investigations to improve the enzyme with the help of protein tools. They said they believe their work will be used to industrially break down plastics in a fraction of the time.  “We can all play a significant part in dealing with the plastic problem,” McGeehan said, “but the scientific community who ultimately created these ‘wonder-materials’ must now use all the technology at their disposal to develop real solutions.” 
  • There's an extra bonus to marriage for melanoma patients: They tend to be diagnosed in earlier more treatable stages than patients who are unmarried, widowed or divorced, a new study says. Spouses may be apt to notice suspicious moles on their partners that could signal melanoma, the most dangerous type skin cancer. More importantly, they may also be more inclined to nag their partners to get those moles checked out, the researchers said. The findings suggest that unmarried people should ask relatives or friends to do skin checks or seek frequent skin exams with dermatologists. Why marriage might a difference in diagnosis isn't clear since unmarried partners or observant friends might also notice skin changes. But maybe married people have more opportunities to notice or feel more of a responsibility to keep their partners healthy, said study co-authors Cimarron Sharon and Dr. Giorgos Karakousis of the University of Pennsylvania. Researchers analyzed 52,000 melanoma patients in a U.S. government cancer database who were diagnosed from 2010 to 2014. Melanoma is more likely than other skin cancers to spread beyond the initial tumor site to other organs, but all the patients had localized disease. Among married patients studied, almost 47 percent had the smallest, earliest-stage tumors compared with 43 percent of never-married patients, 39 percent of divorced patients and 32 percent of widowed patients. Just 3 percent of married participants had the most ominous tumors compared with almost 10 percent of widowed patients. Married patients also were more likely than the others to receive biopsies of nearby lymph nodes, usually recommended to guide treatment. The study , published Wednesday in JAMA Dermatology, echoes previous research that found advanced melanoma that has spread is less common in married patients. Melanoma often looks like a misshapen mole, with a diameter larger than a pencil eraser and can be a blend of black, brown, tan or even bluish pigment. It's linked with too much exposure to sun or tanning beds. It's also more common in fair-skinned people and those with lots of moles. The American Cancer Society estimates that about 90,000 U.S. cases will be diagnosed this year. Amanda Palmer, 37, was diagnosed with early-stage melanoma seven years ago after her husband noticed a suspicious mole on her right leg and kept pestering her about it. 'He wouldn't let up until I finally agreed to go to the doctor,' said Palmer, who is from the Washington D.C.-area. Palmer said surgery to remove her cancer and surrounding tissue left a 4-inch scar. She gets frequent skin exams, and she and her husband do mutual skin checks. He also reminds her to wear heavy-duty sunscreen every time she leaves the house. 'I nag him about plenty of things,' she said. 'I figure he can have one thing he nags me about.' ___ Follow AP Medical Writer Lindsey Tanner on Twitter at @LindseyTanner . Her work can be found here . ___ The Associated Press Health & Science Department receives support from the Howard Hughes Medical Institute's Department of Science Education. The AP is solely responsible for all content.
  • So you want to have a baby. Would you like a dark-haired girl with a high risk of someday getting colon cancer, but a good chance of above-average music ability? Or would you prefer a girl with a good prospect for high SAT scores and a good shot at being athletic, but who also is likely to run an above-average risk of bipolar disorder and lupus as an adult? How about a boy with a good shot at having musical ability and dodging asthma, but who also would be predisposed to cataracts and type 2 diabetes? Confused? You're just getting started. There are dozens more choices for which of your embryos should be placed in the womb to become your child. That's the future a biomedical ethics expert envisions for 20 to 40 years from now — soon enough that today's children may face it when they start their own families. 'The majority of babies of people who have good health coverage will be conceived this way,' predicts Henry Greely, a Stanford University law professor who works in bioethics. You've probably read about concerns over 'designer babies,' whose DNA is shaped by gene editing. Greely is focused on a different technology that has gotten much less attention: In a startling bit of biological alchemy, scientists have shown that in mice, they can turn ordinary cells into sperm and eggs. It's too soon to know if it could be done in people. But if it can, it could become a powerful infertility treatment, permitting genetic parenthood for people who can't make their own sperm or eggs. It also would mean that a woman who wants to get pregnant could produce dozens more eggs per attempt than with the current procedure of harvesting some from her ovaries. And that means a lot of choices. ___ AN ARRAY OF EMBRYOS Here's what Greely envisions: A man and woman walk into a fertility clinic. The man drops off some sperm. The woman leaves some skin cells, which are turned into eggs and fertilized with the man's sperm. Unlike in vitro fertilization today, which typically yields around eight eggs per try, the new method could result in 100 embryos. The embryos' complete library of DNA would be decoded and analyzed to reveal genetic predispositions, both for disease and personal traits. The man and woman would get dossiers on the embryos that pass minimum tests for suitability. Out of, say, 80 suitable embryos, the couple would then choose one or two to implant. The possibilities don't stop there. The technology might also help open the door to same-sex couples having children genetically related to both of them, though the additional twist of making eggs from men or sperm from women would be a huge biological challenge. More worrisome is the so-called Brad Pitt scenario: We all shed a bit of sloughed-off DNA every day, like on the lip of a coffee cup. Such discarded material could be secretly snatched up to turn an unwitting celebrity into a genetic parent. It is a long way in the future, but real life is already creeping toward it. Some scientists are trying to make human eggs and sperm in the lab. They are working with 'iPS cells,' which are ordinary body cells that have been morphed into a malleable state. Amander Clark of the University of California, Los Angeles, says her goal is to aid basic research into why some people are infertile. She acknowledges the technique might itself be used to treat some infertility, particularly in young people made sterile by cancer treatments. As for decoding the complete DNA library of embryos, Dr. Louanne Hudgins, who studies prenatal genetic screening and diagnosis at Stanford, says some pregnant patients there say they've already had fertility clinics do that. They didn't reveal why, Hudgins said. Hudgins, who's president of the American College of Medical Genetics and Genomics, said no national medical association has endorsed decoding all the DNA of an embryo, which is called its genome. So she believes no insurance company would pay for that now. ___ 'EASY' PRENATAL DIAGNOSIS Greely, who lays out his ideas in a book called 'The End of Sex and the Future of Human Reproduction,' calls his vision 'easy PGD,' or prenatal genetic diagnosis. Ordinary PGD has been done for decades. When a couple is known to be at risk for having a child with a specific genetic disorder, such as cystic fibrosis or sickle cell anemia, the woman undergoes a procedure to remove some eggs. After fertilization, some cells are plucked from the embryos and examined to identify those without carry the disease-causing abnormality. That procedure looks for a specific problem in a few embryos, not entire genomes from dozens of them. If a couple wants to select a 'super baby,' says Dr. Richard Scott Jr., a founding partner of Reproductive Medicine Associates of New Jersey, 'we tell them we can't do it.' In fact, Scott and others say, even wide-ranging analysis would not provide a precise forecast of how a child will turn out. If DNA is the hardware, there's also the software: chemical modifications that determine when and where particular genes turn on and off. Much of this 'epigenome' would develop after an embryo's genes are sampled, Scott said. 'Your child may not turn out to be the three-sport All-American at Stanford,' because 'the epigenome didn't work out,' Scott said. Greely agrees that predictions about behavioral traits like intelligence and athletic ability will be imprecise, because of epigenetics and because of basic uncertainties about what genes are involved and how they interact. And a person's upbringing and life experiences have a big effect. ___ WHAT WOULD COUPLES DO? Even if the predictions aren't perfect, would couples want to take steps to control their child's genetics? Many experts doubt it. Only a 'very small minority' seek a perfect baby, says Stanford's Hudgins. In her practice, she said she often finds women pass up all screening because they figure the baby's fate is 'in God's hands.' Dr. James Grifo of the New York University Fertility Center also questions how popular the idea would be. 'No patient has ever came to me and said, 'I want a designer baby,'' said Grifo, who's performed in vitro fertilization since 1988. Greely doubts that influencing brainpower or athleticism would be a major draw for parents. Instead, he thinks they would care most about avoiding awful diseases that strike in infancy or childhood. They'll probably be less concerned about illnesses that might show up later in life, such as Alzheimer's or Parkinson's. For one thing, he says, parents-to-be may see them as becoming treatable by the time a child becomes vulnerable. He thinks easy PGD is coming, and it would be better if properly handled. He says it should be proven safe, subsidized, monitored for long-term effects, and regulated so that parents can choose whether to use it and decide what embryonic traits to focus on. And he'd outlaw stealing somebody's DNA and unwittingly making them a parent. ___ OTHERS SEE PITFALLS Once the genetic profile is done, could it come back to haunt a child if, say, a life insurer or nursing home demanded to see it to assess disease risk? How would the large number of rejected embryos be handled ethically and politically? Perhaps future regulation could limit the number of embryos created, as well as what traits a couple could select for, said I. Glenn Cohen, a Harvard law professor. Lori B. Andrews, a professor at the Chicago-Kent College of Law, summed up her views in a review of Greely's book. 'The idea of easy PGD,' she wrote, 'should make us uneasy indeed.' Still, even some who doubt the idea's feasibility say Greely is right to raise the issue. 'It's certainly something we have to take seriously and think through now,' said Marcy Darnovsky, who writes on the politics of human biotechnology as executive director of the Center for Genetics and Society in Berkeley, California. 'This is not just a technical or science question.' ___ Follow Malcolm Ritter at @MalcolmRitter . His recent work can be found here . ___ This Associated Press series was produced in partnership with the Howard Hughes Medical Institute's Department of Science Education. The AP is solely responsible for all content.

Health Reporter Sabrina Cupit

  • A new Centers for Disease Control and Prevention study finds work-related injuries play a major role in the current opioid epidemic.
  • Tuesday, April 17th is tax day ! The typical tax deadline of April 15th fell on a Sunday, the day would have normally been moved to Monday, April 16th but this year, April 16 is Emancipation Day, a holiday observed in Washington, D.C. Emancipation Day is a holiday set aside to commemorate the 1862 signing of the Emancipation Act by President Abraham Lincoln. Emancipation Day is a legal holiday in D.C. with city workers off the job. So that's why tax day is today!!
  • The body of 35-year-old Timothy Cunningham, has been found in the Chattahoochee River, according to the Atlanta Police Department. The body was discovered by two fishermen Tuesday night who called 911.

News

  • Authorities have declined to press criminal charges against anyone in the 2016 overdose death of musical icon Prince, saying Thursday that investigators were unable to determine where the artist got the fentanyl that killed him. >> Read more trending news >> READ MORE: Charges could be announced in Prince opioid investigation two years after his death | Prince died of fentanyl overdose, autopsy report released | Search warrants unsealed in Prince death investigation | Photos: Prince through the years | MORE
  • Atlanta police are working to identify a woman found dead near Interstate 75/85 and Langford Parkway in southeast Atlanta. Channel 2 Action News there as police tried to figure out how the woman got there. We're talking to investigators as they try to figure out what happened for Channel 2 Action News starting at 4 p.m. A family will receive some tough news today when the medical examiner finally identifies a woman found dead on the side of an interstate at 2am. I'll have the lates at Noon on Ch2 pic.twitter.com/JY3wgM4ZIi — Tyisha Fernandes (@TyishaWSB) April 19, 2018 Atlanta police said officers responded to a report of a person down call just before 2 a.m. Thursday.  When officers got there, they met with two drivers who said they had seen someone having trouble walking in the road and pulled over to help them. They said the woman then collapsed. Police said Grady EMS arrived and said she was dead. TRENDING STORIES: Guilty or Not? Tex McIver jury deliberations continue Man charged with arson in stable fire that killed 24 horses 'Armed and dangerous man' on the loose after killing wife, sheriff says Her injuries were consistent with being struck by a vehicle, Atlanta police Capt. Andrew Senzer said. Police said they believe the woman is between the ages of 25 and 35 years old. Police on scene said they noticed that there are no apartments or homes nearby, so they said they do not know why she was in the road. “You have 75/85 that splits with Langford Parkway and that loops around, it’s a lot of twists and turns over here, very dark, but we don’t know why the pedestrian was on the roadway,” Senzer said. If the woman was hit by a car, police will then start searching for the hit-and-run driver.
  • The Latest on fired FBI deputy director Andrew McCabe (all times local): 4:55 p.m. A lawyer for fired FBI Deputy Director Andrew McCabe says a criminal referral to prosecutors about his client is 'unjustified.' Attorney Michael Bromwich confirmed the referral to the U.S. Attorney's Office in Washington in a statement Thursday. It comes amid an inspector general report that concluded that McCabe misled investigators about his role in a news media disclosure. The referral doesn't mean he will be charged, but it does mean he could face a criminal investigation. In his statement, Bromwich says the standard for an inspector general referral 'is very low.' He says he's already met with representatives from the U.S. Attorney's office and is confident that, 'unless there is inappropriate pressure from high levels of the Administration, the US Attorney's Office will conclude that it should decline to prosecute.' __ 4:25 p.m. The Justice Department's inspector general has sent a criminal referral about fired FBI deputy director Andrew McCabe to federal prosecutors in Washington, a person familiar with the matter said Thursday. The referral to the U.S. Attorney's office for the District of Columbia does not mean McCabe will ever be charged, but it does raise the possibility that the longtime law enforcement official could face a criminal investigation into whether he illegally misled officials about a news media disclosure. Prosecutors could move to charge him if they conclude that he intentionally lied. The person who described the referral was not authorized to discuss a confidential process publicly and spoke on condition of anonymity to The Associated Press.
  • A serious accident between a vehicle and tractor trailer has lanes blocked on I-285 in East Point, police say.  The crash happened near Washington Road in the southbound lanes Thursday afternoon.  Police said several people were injured, including a child. The child was taken to a local hospital. We’re working to learn more details about the accident, for Channel 2 Action News. [DOWNLOAD: WSB-TV's news app for breaking news alerts] TRAVEL ADVISORY: Tractor Trailer Crash: I-285/sb (outer loop) past Camp Creek Pkwy; (exit 2); only a left lane is open; delays; use I-75/85; https://t.co/kTgeaYu0Zi; #ATLTraffic pic.twitter.com/YVpHvQvaC8 — Triple Team Traffic (@WSBTraffic) April 19, 2018 TRENDING STORIES: Authorities believe they have found body of teacher missing for 3 years Hundreds of bus drivers call out sick; more 'sickout' days planned Waffle House is selling this for the first time ever
  • An inmate convicted in the mail-bomb death of a federal judge killed during a wave of Southern terror in 1989 was scheduled to be executed Thursday as the oldest prisoner put to death in the United States in modern times. Walter Leroy Moody Jr., 83, is scheduled to receive a lethal injection Thursday evening. At his 1996 trial, prosecutors described Moody as a meticulous coward who committed murder by mail because of his obsession with getting revenge on the legal system, and then committed more package bombings to make it look like the Ku Klux Klan was behind the judge's murder. If his execution is carried out, Moody will be the oldest inmate put to death since executions resumed in the U.S. in the 1970s, according to the non-profit Death Penalty Information Center. His attorneys have not raised his age in legal filings, but have argued in a clemency petition to Alabama's governor that his age and health would complicate the lethal injection procedure. Judge Robert S. Vance, a member of the Atlanta-based 11th U.S. Circuit Court of Appeals, was at his kitchen table in Mountain Brook, Alabama, on Dec. 16, 1989, when he opened a package after a morning of errands and yard work. The explosion ripped through the home near Birmingham, killing Vance instantly and severely injuring his wife, Helen. Prosecutors said Moody, who had attended law school, had a grudge against the legal system because the 11th Circuit refused to overturn a 1972 pipe-bomb possession conviction that prevented him from practicing law. Authorities said Moody mailed out a total of four package bombs in December 1989. A device linked to Moody killed Robert E. Robinson, a black civil rights attorney from Savannah, Georgia. Two other mail bombs were later intercepted and defused, including one at an NAACP office in Jacksonville, Florida. Authorities said those bombs were meant to make investigators think the crimes were racially motivated. Moody was first convicted in 1991 in federal court and sentenced to seven life terms plus 400 years. He was later convicted in state court in 1996 and sentenced to death for Vance's murder. Moody's attorneys asked the U.S. Supreme Court to stay his execution in order to review whether his federal sentence, which was handed down first, can be interrupted. They also argued that the aggravating factors used to impose a death sentence were improper. Separately, Moody's lawyer asked the Alabama Supreme Court to block the lethal injection arguing that an emergency medical technician who assessed Moody on Wednesday told the inmate he had 'spider veins' and seemed concerned. Alabama halted an execution last month after workers couldn't find a usable vein on a 61-year-old inmate. Vance's son, Robert Vance Jr., now a circuit judge in Jefferson County and Democratic candidate for chief justice in Alabama, said it's important that people remember how his father lived, not just how he died. 'He was a great judge, a great lawyer before that, and a great father,' he said. Friends said the senior Vance quietly fought for the rights of underprivileged as both a jurist and a politician. As chairman of the Alabama Democratic Party in the 1960s and early 1970s, Vance worked to bring African-Americans into the party and fought then-Gov. George C. Wallace's and other segregationists effort to control the party machinery, said Al LaPierre, who worked for Vance in the 1970s. 'He believed the Democratic Party should be open and not be the party of George Wallace and the Dixiecrats,' LaPierre said. Moody had sent a letter from death row to the younger Vance claiming he was the innocent victim of a government conspiracy. 'Had my Dad been murdered, I would want to know who had done it,' Moody wrote. Vance said he tossed the letter in the trash. The younger Vance, who does not plan to witness the execution, said he had to make peace with his father's death, but said he has no doubt that Moody is guilty. Moody, he said, fits the definition of a psychopath. In the effort to spare his life, Moody's attorneys have raised his victim's personal opposition to the death penalty in their request for clemency from Gov. Kay Ivey. 'The murder of Judge Vance was unprovoked and inexcusable. Judge Vance was, by all accounts, a devoted husband, caring father, and remarkable jurist. He was also, by all accounts, an opponent of capital punishment,' a lawyer for Moody wrote. The younger Vance said his father also upheld death sentences because he believed in following the law. 'The point to emphasize is my Dad was personally opposed to the death penalty but always made clear that his personal feelings had to give way to the law,' Vance said. ___ Associated Press writer Jay Reeves in Birmingham contributed to this report.