Greek lawmakers back fresh cuts

11 November 2012 Last updated at 18:06 ET

Greek lawmakers have approved a 2013 budget involving fresh spending cuts, despite mass public street protests.

The budget was backed in by 167 votes to 128. The bill was a pre-condition for Athens to be granted a 31.5bn euro (£25bn; $ 40bn) EU/IMF loan necessary to stave off bankruptcy.

Another austerity package of tax rises and pension cuts was passed last week.

Ahead of the vote, more than 10,000 protesters rallied outside the parliament in the capital, Athens.

Prime Minister Antonis Samaras earlier warned that without the new loan, Greece would start running out of money on Friday.

Eurozone finance ministers are due to meet just hours after the vote in Athens, and Mr Samaras is now expected to travel to Brussels for a series of meetings.

The problem that he faces is that it could take some weeks before the EU backs the new instalment, BBC Athens correspondent Mark Lowen reports. The measure will have to be approved first by some parliaments, including Germany’s.

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BBC must reform or die, says Trust chairman

LONDON (Reuters) – The BBC could be doomed unless it makes radical changes, the head of its governing trust said on Sunday, after its director general quit to take the blame for the airing of false child sex abuse allegations against a former politician.

Chris Patten, chairman of the BBC Trust, said confidence had to be restored if the publicly funded corporation was to withstand pressure from rivals, especially Rupert Murdoch‘s media empire, which would try to take advantage of the turmoil.

“If you’re saying, ‘Does the BBC need a thorough structural radical overhaul?’, then absolutely it does, and that is what we will have to do,” Patten, a one-time senior figure in Prime Minister David Cameron‘s Conservative Party and the last British governor of Hong Kong, told BBC television.

“The basis for the BBC’s position in this country is the trust that people have in it,” Patten said. “If the BBC loses that, it’s over.”

George Entwistle resigned as director general on Saturday, just two months into the job, to take responsibility for the child sex allegation on the flagship news programme Newsnight.

The witness in the report, who says he suffered sexual abuse at a care home in the late 1970s, said on Friday he had misidentified the politician, Alistair McAlpine. Newsnight admitted it had not shown the witness a picture of McAlpine, or approached McAlpine for comment before going to air.

Already under pressure after revelations that a long-time star presenter, the late Jimmy Savile, was a paedophile, Entwistle conceded on the BBC morning news that he had not known – or asked – who the alleged abuser was until the name appeared in social media.

The BBC, celebrating its 90th anniversary, is affectionately known in Britain as “Auntie”, and respected around much of the world.

But with 22,000 staff working at eight national TV channels, 50 radio stations and an extensive Internet operation, critics say it is hampered by a complex and overly bureaucratic and hierarchical management structure.

THOMPSON’S LEGACY

Journalists said this had become worse under Entwistle’s predecessor Mark Thompson, who took over in the wake of the last major crisis to hit the corporation and is set to become chief executive of the New York Times Co on Monday.

In that instance, both director general and chairman were forced out after the BBC was castigated by a public inquiry over a report alleging government impropriety in the fevered build up to war in Iraq, leading to major organisational changes.

One of the BBC’s most prominent figures, Newsnight presenter Jeremy Paxman, said since the Iraq report furore, management had become bloated while cash had been cut from programme budgets.

“He (Entwistle) has been brought low by cowards and incompetents,” Paxman said in a statement, echoing a widely-held view that Entwistle was a good man who had been let down by his senior staff.

Prime Minister Cameron appeared ready to give the BBC the benefit of the doubt, believing that “one of the great institutions of this country” could reform and deal with its failings, according to sources in his office.

Patten, who must find a new director general to sort out the mess, agreed that management structures had proved inadequate.

“Apparently decisions about the programme went up through every damned layer of BBC management, bureaucracy, legal checks – and still emerged,” he said.

“One of the jokes I made, and actually it wasn’t all that funny, when I came to the BBC … was that there were more senior leaders in the BBC then there were in the Chinese Communist Party.”

Patten ruled out resigning himself but other senior jobs are expected to be on the line, while BBC supporters fear investigative journalism will be scaled back. He said he expected to name Entwistle’s successor in weeks, not months.

Among the immediate challenges are threats of litigation.

McAlpine, a close ally of former prime minister Margaret Thatcher, has indicated he will sue for damages.

Claims for compensation are also likely from victims who say Savile, one of the most recognisable personalities on British television in the 1960s, 70s and 80s, sexually abused them as children, sometimes on BBC premises.

INQUIRIES

Two inquiries are already under way, looking at failures at Newsnight and allegations relating to Savile, both of which could make uncomfortable reading for senior figures.

Police have also launched a major inquiry into Savile’s crimes and victims’ allegations of a high-profile paedophile ring. Detectives said they had arrested their third suspect on Sunday, a man in his 70s from Cambridgeshire in central England.

Funded by an annual licence fee levied on all TV viewers, the BBC has long been resented by its commercial rivals, who argue it has an unfair advantage and distorts the market.

Murdoch’s Sun tabloid gleefully reported Entwistle’s departure with the headline “Bye Bye Chump” and Patten said News Corp and others would put the boot in, happy to deflect attention after a phone-hacking scandal put the newspaper industry under intense and painful scrutiny.

He said that “one or two newspapers, Mr. Murdoch’s papers” would love to see the BBC lose its national status, “but I think the great British public doesn’t want to see that happen”.

Murdoch himself was watching from afar.

“BBC getting into deeper mess. After Savile scandal, now prominent news program falsely names senior pol as paedophile,” he wrote on his Twitter website on Saturday.

It is not just the BBC and the likes of Entwistle and Patten who are in the spotlight.

Thompson, whom Entwistle succeeded in mid-September, has also faced questions from staff at the New York Times over whether he is still the right person to take one of the biggest jobs in American newspaper publishing.

Britain’s Murdoch-owned Sunday Times queried how Thompson could have been unaware of claims about Savile during his tenure at the BBC as he had told British lawmakers, saying his lawyers had written to the paper addressing the allegations in early September, while he was still director general.

(Editing by Kevin Liffey and Sophie Hares)

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Malaysian charged with Facebook insult of sultan; sister says he’ll file police complaint

KUALA LUMPUR, Malaysia – The sister of a Malaysian man who has been charged with insulting a state sultan on Facebook says he is innocent and plans to lodge a complaint over his detention.

Anisa Abdul Jalil, sister of Ahmad Abdul Jalil, says her brother was charged Thursday with making offensive postings on Facebook last month.

She says the charges are ridiculous because there is no evidence linking Ahmad to the posts in question, which were made by someone using the name “Zul Yahaya.”

Ahmad was freed on bail Thursday after six days of detention. Anisa says he will file a complaint with police for unlawful detention and intimidation.

Nine Malaysian states have sultans and other royal figures. Though their roles are largely ceremonial, acts provoking hatred against them are considered seditious.

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How Oscar entry “La Source” launched a campaign for clean water across Haiti

LOS ANGELES (TheWrap.com) – The documentary “La Source” was originally conceived to be the tale of a single project, the efforts by a Princeton University janitor to bring clean water to a single village in rural Haiti.

Now, the film’s exposure has spawned a soccer field, two schools and 20 more villages with sanitary water.

The Oscar-nominated film, which follows Haiti-born Josue Lajeunesse as he fulfills his dream of bringing bacteria-free water to his native village, launched a regional project by the nonprofit Generosity Water to improve the lives of rural Haitians.

“We’re hoping that we can really continue to build on what this film was about,” producer Jordan Wagner told TheWrap’s Steve Pond at Thursday night showing of “La Source,” which is part of TheWrap’s annual Award Screening Series.

Seated at Los Angeles‘ Landmark Theatre alongside director Patrick Shen, producer Brandon Vedder and Lajeunesse, Wagner, the nonprofit’s director, said his organization has already carved out a spot in the film’s namesake village for a school and soccer field.

“We’re putting a plan together to use the film at screenings to mobilize people,” Wagner said. “We figured out which plot of land we’d buy, we’re going to build a primary school and a secondary school.”

Wagner met Lajeunesse after he was filmed in Shen’s “The Philosopher Kings,” a movie about the stories behind college custodians.

He began raising money after hearing the janitor’s lifelong desire to pipe clean water down from a mountain spring and into his village. Students and faculty at Princeton, where Lajeunesse worked after coming to the United States in 1990, held benefit concerts and donated money to help fund the project.

For Lajeunesse, the plan was decades in the works.

“I was seven or eight years old, but I had in my mind that I have to go to school in order to do something to take the people and the town out of the situation,” Lajeunesse told Landmark Theatre audience. “Day by day, day by day, I save, I save, I save but we didn’t know how we were going to start it.”

Then, in January 2010, a 7.0 magnitude earthquake struck Haiti, killing more than 250,000 people and destroying the impoverished nation’s infrastructure.

“The first time we went was about a month after the earthquake,” Vedder said, adding that the humidity in the Caribbean country nearly destroyed the cinematographers’ cameras. “It was hard to be another camera sticking in these people’s faces, right in their lives.”

The troubles didn’t end there. After the pipeline was built and Lajeunesse and his brother installed the spigots, it was clear how the film would begin and finish, but the meat of the story was harder to pare down.

“We knew where it would end, but the whole kind of middle part of the narrative was what was tricky,” Shen said. “We had to have discussions every night about the strategy for the next day.”

And, with $ 30,000 going toward the actual water project, the filmmakers quickly ran out of cash to support themselves during the months of editing.

“The story was happening whether we decided to make this film or not,” Wagner said. “We were scrambling to make this happen. We have the money for the project and this is happening and now we don’t have money for the film.”

Still, the filmmakers raised enough to keep the film alive after its spring-to-fall shooting schedule in 2010, working through the footage for a year and creating a few different cuts of the film before finding its final shape.

The movie premiered at Washington’s Silverdocs festival – the same festival where Wagner first met Shen at a screening of “The Philosopher Kings,” beginning a relationship that led directly to “La Source.”

The film was also a selection in the International Documentary Association’s annual DocuWeeks showcase, which qualified it for the Academy Awards via week-long engagements in Los Angeles and New York in August.

And though Lajeunesse hasn’t been back to Haiti since July 2010 – his janitorial and taxi jobs, plus four kids, make travel difficult – he said he gets phone calls from his family frequently, updating him on how the town is improving.

“Everyone there is so happy,” he said, drawing applause from the audience. “They have water and they don’t know what to say. All the town, they say, ‘tell everyone thank you for me.’”

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Beer after work at the bar: a U.S. tradition is getting stale

MILWAUKEE (Reuters) – A tattooed man with a goatee shakes five dice in a black cup, slams it down on the bar and watches as they come to rest among half-full beer bottles and empty shot glasses.

“Nothin,” he says in disgust as he quickly slaps down a $ 20 bill to buy another round of drinks, in a U.S. ritual of beer drinking after work that is undergoing a gradual decline.

“I used to get the third-shift Allen Bradley guys in the morning, but they have cut and cut jobs,” said Terry Zadra, owner of the 177-year-old Zad’s Roadhouse on the south side of Milwaukee.

The bar is just blocks from an industrial plant owned by Rockwell Automation, which bought Allen Bradley, a factory equipment company, in 1985.

One result of the 2008-2009 recession that reduced manufacturing jobs in places such as Milwaukee has been slower traffic at some bars, and sluggish beer sales nationwide over the past four years, according to industry analysts.

“Contrary to the myth that people go out and drown their sorrows, the truth is that beer drinkers are pretty responsible people and when they have to cut back, they’re cutting back on their pleasures,” said Chris Thorne, vice president of communications at the Beer Institute, a Washington-based trade group.

According to the institute, beer drinkers last year in the United States drank 203.4 million barrels, about 5 percent less than in 2008.

More concern about healthy living, stiffer drunk-driving laws and measures that ban smoking in places such as taverns have hit beer sales during the last couple of decades in Milwaukee and throughout the country.

“There has been a definite shift from the on-premise to the off-premise consumption,” said Pete Madland, executive director of the Tavern League of Wisconsin. “The smoker, for instance, is going to the liquor store, buying a 12-pack of beer and going home.”

Over the past few decades, it has become much less acceptable in the business community to have a drink during lunch or tip a few after work with colleagues.

“Society looks at that person that has a glass of beer with his burger like he has a drinking problem,” Madland said.

HIGH-END HOPES

A glimmer of hope for the industry is the high-end craft beer segment, which has seen sales increase by 14 percent during the first half of 2012 compared with the same period last year, according to the Beer Institute.

These regional and local brews are more expensive and tend to be more recession-proof than mass-consumption brands like Miller Lite and Bud Light.

“Those occupations that weathered the storm of the Great Recession and then a very weak recovery … they were always able to afford a high-end beer,” Thorne said. “We would still like to see that American pilsner part of the brewing market get back its share.”

Despite the cultural and economic pressures, beer remains synonymous with Milwaukee, where brewers such as Fred Miller, Joseph Schlitz, Val Blatz and Frederick Pabst built their empires more than a century ago.

Even after heavy manufacturing of farm equipment, marine diesels and cranes became the dominant force in Milwaukee’s economy, MillerCoors remains an institution, brewing about 10 million barrels of beer each year on the city’s west side.

The love affair the city has for beer remains strong, evident in its Major League baseball team – the Milwaukee Brewers – paying homage to the city’s beer makers while playing in Miller Park, sponsored by MillerCoors.

While beer consumption nationwide may be down, in Wisconsin it has increased a bit. In the first eight months of 2012, about 2 percent more beer was sold than the same period of 2011, the state revenue department said.

Milwaukee also remains a blue-collar town with a fair number of neighborhood taverns such as Zad’s Roadhouse still serving a shot and a beer to the working class from early morning until late into the night, according to Milwaukee historian John Gurda.

“The scene is far from gone. I’m talking about saloons and bars being the communal living rooms of Milwaukee, and in many neighborhoods, that’s still very much the case,” Gurda said.

(Editing by Greg McCune and Eric Walsh)

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‘Star Wars’: Disney’s Latest Empire

“Attacking that battle station ain’t my idea of courage. It’s more like suicide,” Han Solo warns Luke Skywalker in the first Star Wars film. As we know, the rebels’ wild risk-taking pays off, and they manage to bring down the Empire over the course of George Lucas’s holy trilogy. The movies may be an affirmation of chancy interstellar battle tactics, but Walt Disney’s (DIS) $ 4.05 billion purchase of Lucasfilm is best understood as an effort to make film production as risk-free as possible. On the analysts’ conference call following the announcement, Disney Chief Executive Officer Bob Iger was asked, “What do Star Wars films come in lieu of, creatively?” The answer: non–Star Wars films. Iger explained: “We actually determined that we’d be better off as a company releasing a sequel to Star Wars than probably most other, I’ll call them not-yet-determined, films.”

It’s no wonder Iger hopes to remove the risk from blockbuster moviemaking. This year, Walt Disney Studios released the disastrous John Carter and, in 2011, Mars Needs Moms, reported to be the biggest money loser in film history. (The company’s Marvel, Pixar, and Disney Animation output has performed much better.) Up next are a series of pricey hedged bets, new prospective franchises based on old material: the prequel Oz: The Great and Powerful (opening March 8); Johnny Depp in The Lone Ranger (July 3); and Maleficent (March 14, 2014), starring Angelina Jolie as the villainess from Sleeping Beauty. Iger noted, “One of the things that we were very mindful of is the value of brands and the value of properties that are both known and loved.” That describes Star Wars to a T but may not apply to a title like Maleficent, whose value is, let’s say, not yet determined.

With the Lucasfilm acquisition, one 2015 tent-pole slot goes to a Star Wars film, as sure a bet as exists in the film industry. The irony is that Star Wars itself is Hollywood’s greatest example of the virtue of risk-taking. After being rejected by Universal Studios (CMCSA) and United Artists, Lucas’s odd sci-fi scenario was picked up by Twentieth Century Fox (NWSA). As Lucas remembers in Tom Shone’s book Blockbuster, “Alan [Ladd Jr., president of Fox] …  said, ‘I don’t understand this movie, I don’t get it at all, but I think you’re a talented guy, and I want you to make this.’ ” Dumped into theaters inauspiciously in late May, when its presumed audience of children would still be in school, Star Wars drew massive crowds. The flocks of fans have kept the franchise minting money ever since (an estimated $ 33 billion so far, combining worldwide box office, DVD sales, and merchandise).

Granted, with its comparatively modest budget—$ 40 million in today’s dollars—Star Wars wasn’t as big a swing as recent big-budget gambits. And even Hollywood isn’t immune from surprises: Who’d have thought Liam Neeson would win fanboy love not from his roles in the Star Wars or Batman series, but from Taken, a $ 25 million revenge flick?

Oddly, the very particular set of skills that Lucas demonstrated with Star Wars—creating an original film franchise—are ones that contemporary studios refuse to nurture even with their favorite filmmakers. Today’s nerd-God auteurs came to prominence introducing original concepts in television (J.J. Abrams and Joss Whedon), independent film (Christopher Nolan), or animation (Brad Bird), but their marquee live-action Hollywood credits have come on preexisting properties such as Star Trek, The Avengers, Batman, and Mission: Impossible. James Cameron’s Avatar is the exception that proves the rule: These days, if you want to make an event movie based on an original screenplay set in a galaxy far, far away, you’d better have written and directed the highest-grossing movie of all time first. It’s a sign of the times that the Lucas-worshiping Abrams, Whedon, and Cameron all have their next films lined up: sequels to Star Trek, The Avengers, and Avatar.

George Lucas’s sale to Disney will give a new generation of writers and directors the opportunity to make Star Wars movies. But it diminishes their chances of creating the next Star Wars.

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Twin explosions strike southern Syrian city

BEIRUT (AP) — Syria‘s state-run news agency says two large explosions have struck the southern city of Daraa, causing multiple casualties and heavy material damage.

SANA did not immediately give further information or say what the target of Saturday’s explosions was.

The Britain-based Syrian Observatory for Human Rights says the blasts went off near a branch of the country’s Military Intelligence in Daraa.

The Observatory, which relies on a network of activists on the ground, says the explosions were followed by clashes between regime forces and rebels fighting to topple President Bashar Assad.

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Review: iPad Mini charms, but screen is a letdown

NEW YORK (AP) — I bet the iPad Mini is going to be on a lot of wish lists this holiday season. I also bet that for a lot of people, it’s not going to be the best choice. It’s beautiful and light, but Apple made a big compromise in the design, one that means that buyers should look closely at the competition before deciding.

Starting at $ 329, the iPad Mini is the cheapest iPad. The screen is a third smaller than the regular iPads, and it sits in an exquisitely machined aluminum body. It weighs just 11 ounces — half as much as a full-size iPad — making it easier to hold in one hand. It’s just under 8 inches long and less than a third of an inch thick, so it fits easily into a handbag.

The issue is the screen quality. Apple has been on the forefront of a move toward sharper, more colorful screens. It calls them “Retina” displays because the pixels — the little light-emitting squares that make up the screen — are so small that they blend together almost seamlessly in our eyes, removing the impression that we’re watching a grid of discrete elements.

The iPad Mini doesn’t have a Retina screen. By the standards of last year, it’s a good screen, with the same number of pixels as the first iPad and the iPad 2. The latest full-size iPad has four times as many pixels, and it really shows. By comparison, the iPad Mini’s screen looks coarse. It looks dull, too, because it doesn’t have the same color-boosting technology that the full-size model has.

This is not an entirely fair comparison, as the full-size iPad starts at $ 499 and weighs twice as much. The real issue is that this year, there are other tablets that are cheaper than the iPad Mini, weigh only slightly more and still have better screens.

Amazon.com Inc.’s Kindle Fire HD costs $ 199 and has about the same overall size as the Mini. While the Kindle’s screen is somewhat smaller (leaving a bigger frame around the edges), it is also sharper, with 30 percent more pixels than the Mini. Colors are slightly brighter, too.

Barnes & Noble Inc.’s Nook HD costs $ 229 for a comparable model with 16 gigabytes of storage and has a screen that’s even sharper than the Kindle HD’s. It’s got 65 percent more pixels than the iPad Mini. (There’s a $ 199 model with half the memory, and the storage space can be expanded with inexpensive memory cards.)

Why do tablets from two companies chiefly known as book stores beat Apple’s latest for screen quality?

Sharper screens are darker, requiring a more powerful backlight to appear bright. That, in turn, would have forced an increase in the battery size. That’s the reason the first iPad with a Retina display was thicker and heavier than the iPad 2. So to keep the iPad Mini thin while matching the 10-hour battery life of the bigger iPads, Apple had to compromise on the display.

This can’t last, though. By next year, it will likely be even more obvious that Apple is seriously behind in screen quality on its small tablet, and it will have to upgrade to a Retina display somehow. That means this first-generation iPad Mini will look old pretty fast.

The display causes a few other problems, too. One is that when you run iPhone apps on the Mini, it uses the coarsest version of the graphics for that app — the version designed for iPhones up to the 2009 model, the 3GS. You can blow the app up to fill more of the screen, but it looks pretty ugly. The full-size iPad uses the higher-quality Retina graphics when running iPhone apps, and it looks much better.

Some apps adapted for the iPad screen don’t display that well on the Mini screen, either, because of the smaller size. Buttons can be too small to hit accurately, bringing to mind Steve Jobs’ 2010 comments about smaller tablets. The late Apple founder was of the vociferous opinion that the regular iPad was the smallest size that was also friendly to use.

In some apps, text on the Mini is too small to be comfortably read — the section fronts in The New York Times and The Wall Street Journal apps are examples of this.

Of course, in some other respects, the iPad Mini outdoes the Fire and the Nook, so it isn’t just the tablet for the buyer who needs the prettiest and the thinnest. In particular, the Mini is a $ 329 entry ticket to the wonderful world of iPad and iPhone apps. For quality and quantity, it beats all the other app stores. (Oddly, there’s an inverse relationship between screen quality and app availability in this category — the Nook HD has the best screen and the fewest apps, while the second-best Kindle Fire HD has middling access to apps.)

The Mini also has front- and back-facing cameras, for taking still photos and video and for videoconferencing. The Kindle Fire HD only has a front-facing camera for videoconferencing. The Nook HD doesn’t have a camera at all.

In short, the iPad Mini is more versatile than the competition, and I’m sure it will please a lot of people. But take a look at the competition first, and figure that by next year, we’ll see something from Apple that looks a lot better.

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Peter Svensson can be reached at http://twitter.com/petersvensson

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About the iPad Mini:

The base model of the iPad Mini costs $ 329 and comes with 16 gigabytes of storage. A 32 GB model goes for $ 429 and 64 GB for $ 529. Soon, you’ll be able to get versions that can connect through cellular networks, not just Wi-Fi. Add $ 130 to the price.

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Stradivarius dealer gets six years for embezzlement

VIENNA (Reuters) – A dealer in rare Stradivarius violins coveted by the world’s top violinists was sentenced on Friday to six years in prison for embezzlement after his glittering global empire crumbled.

Dietmar Machold, 63, built his Bremen-based family business into a juggernaut with branches in Zurich, Vienna, New York and Chicago to serve elite musicians and collectors of the instruments that can command prices of several million dollars.

But the business collapsed in 2010, triggering claims against him worth tens of millions of euros (dollars) from creditors and clients who say they were bilked.

“I am a failure. I have lost everything,” Machold said in a Vienna court as he was sentenced after being convicted of embezzling client funds and hiding assets from creditors.

“You played for high stakes and you lost a lot, but you understand you have to take the responsibility for this,” Judge Claudia Moravec-Loidolt told him.

Prosecutor Herbert Harammer had traced the career of the fifth-generation violin expert who became one of the world’s most influential dealers in instruments crafted by 18th-century masters like Antonio Stradivari, whose workshop in Cremona, Italy produced some of the finest violins and cellos ever made.

“This ascent was built on sand,” Harammer had told the court, accusing Machold of leading a lifestyle that was a facade for a business that had actually been insolvent since mid-2006.

FIXTURE OF HIGH SOCIETY

A fixture of high society, Machold lived in an Austrian castle, had a fleet of expensive cars and collected watches and cameras. His global network of rare instrument dealerships let him move in the highest circles of music, fame and money.

His former wife and her mother got one-year suspended sentences for helping him hide precious musical instruments and a valuable watch collection as his business imploded.

Machold admitted from the start that he embezzled money made from the sale of instruments entrusted to him by his customers, but denied fraud charges that are being handled separately.

“I did what I did and I am to be punished for it. That is the way it has to be,” the German native told the court before sentencing, his voice calm before he teared up and had to pause.

Machold, who told the court he did not deserve a mild sentence given the magnitude of his misdeeds, had faced a sentence of up to 10 years. His lawyer did not say if he would file an appeal.

Machold said he acted in desperation after losing a lawsuit brought by a construction company which meant his Eichbuechl castle was at risk.

The high-profile dealer had at times given contradictory testimony, at one stage saying he built personal relationships with the instruments in his care that he called “my children”.

But later he said he “simply forgot” one expensive violin that he failed to report to administrators.

($ 1 = 0.7857 euros)

(Editing by Michael Roddy)

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Smokers may fare worse after colorectal surgery

NEW YORK (Reuters Health) – Smoking has long been linked with slower recovery in general from injuries and surgeries, and now a new study finds that smokers face more complications and higher chances of death following major surgery for colorectal cancers and other diseases.

“We wanted to see if smoking has a specific effect on these patients… and really wanted to know if patients who stopped smoking had better results,” said lead author Dr. Abhiram Sharma, who was at the University of Rochester in New York during the study.

Smoking constricts the flow of blood throughout the body and is thought to prevent oxygen from getting to tissues that are trying to heal, according to the authors.

In September, a review of surgeries to repair knee ligaments found that smokers tended to have worse outcomes, including not being able to get back full knee function. (See Reuters Health article of September 26, 2012: http://reut.rs/Xqf6is)

For the new report, published in the Annals of Surgery, Sharma and his colleagues studied patients included in a nationally representative database of U.S. surgeries between 2005 and 2010.

Overall, 47,574 patients were included in the analysis. All had part of their colon or rectum removed, a surgery known as a colorectal resection, either because of cancer, diverticular disease or inflammatory bowel disease.

About 60 percent of the patients had never smoked, 19 percent were former smokers and 20 percent were current smokers.

The researchers looked at the 30 days after surgery to see how many patients in each group suffered either a major complication – such as severe infection, heart or breathing problems or death – or a minor complication, such as an infection at the surgical site or in the urinary tract.

Sharma’s team found that current smokers had a 30 percent greater risk of having a major complication compared to patients who never smoked, and an 11 percent greater risk than ex-smokers.

Among 9,700 current smokers, for example, there were 1,497 major complications and 1,448 minor ones, whereas the 9,136 ex-smokers had 1,374 major and 1,386 minor complications. Never smokers, the largest group numbering 28,738, had 3,316 major complications and 3,462 minor ones.

Current smokers were also 1.5 times as likely to die within 30 days of surgery as never smokers.

In addition, the longer someone had smoked – that is, the greater their number of “pack years” – the stronger their chances of complications, the researchers note.

“We were not completely surprised (by the results). We know smoking is not good and there have been other studies that show smoking is a problem,” Sharma said.

There were, Sharma’s team acknowledges, some limitations in the study.

For example, ex-smokers were defined as patients who had not smoked in at least one year, therefore some more recent ex-smokers may have been included with current smokers, leading the benefits of quitting to be underestimated.

Nonetheless, Sharma told Reuters Health, the results show it’s never too late to stop smoking.

“The sooner the better,” he said.

SOURCE: http://bit.ly/XqnA9h Annals of Surgery, online October 10, 2012.

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