I Was Misinformed: The Time She Tried Viagra

I have noticed, in the bragging-rights department, that “he doesn’t need Viagra” has become the female equivalent of the male “and, I swear, she’s a real blonde.” Personally, I do not care a bit. To me, anything that keeps you happy and in the game is a good thing.

But then, I am proud to say, I was among the early, and from what I gather, rare female users.

It happened when the drug was introduced around 1998. I was 50, but after chemotherapy for breast cancer — and later, advanced ovarian cancer — I was, hormonally speaking, pretty much running on fumes. Whether this had diminished my sex drive I did not yet know. One may have Zorba-esque impulses when a cancer diagnosis first comes in; but a treatment that leaves you bald, moon-faced and exhausted knocks that out of your system pretty fast.

But by 1998, the cancer was gone, my hair was back and I was ready to get back in the game. I was talking to an endocrinologist when I brought up Viagra. This was not to deal with the age-related physical changes I knew it would not address, it was more along the feminist lines of equal pay for equal work: if men have this new sex drug, I want this new sex drug.

“I know it’s supposed to work by increasing blood flow,” I told the doctor, “But if that’s true for men, shouldn’t it be true for women, too?”

“You’re the third woman who asked me that this week,” he said.

He wrote me a prescription. I was not seeing anyone, so I understood that I would have to do both parts myself, but that was fine. I have a low drug threshold and figured it might be best the first time to fly solo. My memory of the directions are hazy: I think there was a warning that one might have a facial flush or headaches or drop dead of a heart attack; that you were to take a pill at least an hour before you planned to get lucky, and, as zero hour approached, you were supposed to help things along by thinking beautiful thoughts, kind of like Peter Pan teaching Wendy and the boys how to fly.

But you know how it is: It’s hard to think beautiful thoughts when you’re wondering, “Is it happening? Do I feel anything? Woof, woof? Hello, sailor? Naaah.”

After about an hour, however, I was aware of a dramatic change. I had developed a red flush on my face; I was a hot tomato, though not the kind I had planned. I had also developed a horrible headache. The sex pill had turned into a bad joke: Not now, honey, I have a headache.

I put a cold cloth on my head and went to sleep. But here’s where it got good: When I slept, I dreamed; one of those extraordinary, sensual, swimming in silk sort of things. I woke up dazed and glowing with just one thought: I gotta get this baby out on the highway and see what it can do.

A few months later I am fixed up with a guy, and after a time he is, under the Seinfeldian definition of human relations (Saturday night date assumed) my official boyfriend. He is middle aged, in good health. How to describe our romantic life with the delicacy a family publication requires? Perhaps a line from “Veronika, der Lenz ist da” (“Veronica, Spring Is Here”), a song popularized by the German group the Comedian Harmonists: “Veronika, der Spargel Wächst” (“Veronica, the asparagus are blooming”). On the other hand, sometimes not. And so, one day, I put it out there in the manner of sport:

“Want to drop some Viagra?” I say.

Here we go again, falling into what I am beginning to think is an inevitable pattern: lying there like a lox, or two loxes, waiting for the train to pull into the station. (Yes, I know it’s a mixed metaphor, but at least I didn’t bring in the asparagus.) So there we are, waiting. And then, suddenly, spring comes to Suffolk County. It’s such a presence. I’m wondering if I should ask it if it hit traffic on the L.I.E. We sit there staring.

My reaction is less impressive. I don’t get a headache this time. And romantically, things are more so, but not so much that I feel compelled to try the little blue pills again.

Onward roll the years. I have a new man in my life, who is 63. He does have health problems, for which his doctor prescribes an E.D. drug. I no longer have any interest in them. My curiosity has been satisfied. Plus I am deeply in love, an aphrodisiac yet to be encapsulated in pharmaceuticals.

We take a vacation in mountain Mexico. We pop into a drugstore to pick up sunscreen and spot the whole gang, Cialis, Viagra, Levitra, on a shelf at the checkout counter. No prescription needed in Mexico, the clerk says. We buy all three drugs and return to the hotel. I try some, he tries some. In retrospect, given the altitude and his health, we are lucky we did not kill him. I came across an old photo the other day. He is on the bed, the drugs in their boxes lined up a in a semi-circle around him. He looks a bit dazed and his nose is red.

Looking at the picture, I wonder if he had a cold.

Then I remember: the flush, the damn flush. If I had kids, I suppose I would have to lie about it.

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In BP Indictments, U.S. Shifts to Hold Individuals Accountable

HOUSTON — Donald J. Vidrine and Robert Kaluza were the two BP supervisors on board the Deepwater Horizon rig who made the last critical decisions before it exploded. David Rainey was a celebrated BP deepwater explorer who testified to members of Congress about how many barrels of oil were spewing daily in the offshore disaster.

Mr. Vidrine, 65, of Lafayette, La., and Mr. Kaluza, 62, of Henderson, Nev., were indicted on Thursday on manslaughter charges in the deaths of 11 fellow workers; Mr. Rainey, 58, of Houston, was accused of making false estimates and charged with obstruction of Congress. They are the faces of a renewed effort by the Justice Department to hold executives accountable for their actions. While their lawyers said the men were scapegoats, Attorney General Eric H. Holder Jr. said at a news conference, “I hope that this sends a clear message to those who would engage in this kind of reckless and wanton conduct.”

The defense lawyers were adamant that their clients would contest the charges, and prosecutors said that the federal investigations were continuing.

Legal scholars said that by charging individuals, the government was signaling a return to the practice of prosecuting officers and managers, and not just their companies, in industrial accidents, which was more common in the 1980s and 1990s.

“If senior managers cut corners, or if they make decisions that put people in harm’s way, then the criminal law is appropriate,” said Jane Barrett, a University of Maryland law professor and former federal prosecutor.

She noted that it was unusual for the Justice Department to prosecute individual corporate officers in recent years, including in the 2005 BP Texas City refinery explosion that killed 15 workers, where only the company was fined.

BP said on Thursday it would pay $4.5 billion in fines and other payments, and the corporation pleaded guilty to 14 criminal charges in connection with spill. The $1.26 billion in criminal fines was the highest since Pfizer in 2009 paid $1.3 billion for illegally marketing an arthritis medication.

The crew was drilling 5,000 feet under the sea floor 41 miles off the Louisiana coast in April 2010 when they lost control of the well during its completion. They tested the pressure of the well, but misinterpreted the test results and underestimated the pressure exerted by the flow of oil or gas up the well. Had the results been properly interpreted, operations would have ceased.

Mr. Vidrine and Mr. Kaluza were negligent in their reading of the kicks of gas popping up from the well that should have suggested that the Deepwater Horizon crew was fast losing control of the ill-fated Macondo well, according to their indictment, and they failed to act or even communicate with their superiors. “Despite these ongoing, glaring indications on the drill pipe that the well was not secure, defendants Kaluza and Vidrine again failed to phone engineers onshore to alert them to the problem, and failed to investigate any further,” the indictment said.

The indictment said they neglected to account for abnormal pressure test results on the well that indicated problems, accepting “illogical” explanations from members of the crew, which caused the “blowout of the well to later occur.”

In a statement, Mr. Kaluza’s lawyers said: “No one should take any satisfaction in this indictment of an innocent man. This is not justice.”

Bob Habans, a lawyer for Mr. Vidrine, called the charges “a miscarriage of justice.”

“We cannot begin to explain or understand the misguided effort of the United States attorney and the Department of Justice to blame Don Vidrine and Bob Kaluza, the other well site leader, for this terrible tragedy.”

Several government and independent reports over the last two years have pointed to sloppy cement jobs in completing the well or the poor design of the well itself as major reasons for the spill. But none of the three was indicted in connection with those problems.

Mr. Rainey was a far more senior executive, one who was known around Houston and the oil world as perhaps the most knowledgeable authority on Gulf oil and gas deposits. According to his indictment, Mr. Rainey obstructed Congressional inquiries and made false statements by underestimating the flow rate to 5,000 barrels a day even as millions were gushing into the Gulf.

Campbell Robertson contributed reporting.

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Jill Kelley, key figure in David Petraeus scandal, led lavish life

TAMPA, Fla. — When Jill Kelley believed a reporter was trespassing at her white-columned mansion in a wealthy neighborhood this week, the Tampa socialite called 911 and claimed diplomatic immunity.

"I'm an honorary consul general, so I have inviolability," an exasperated Kelley told the dispatcher in recordings released by police. "I don't know if you want to get diplomatic protection involved as well."

Kelley isn't a diplomat; she holds the ceremonial title of "honorary consul" for South Korea, one of many informal ties to prestige and power that the energetic 37-year-old mother of three has brandished to climb to the top rungs of the social ladder in this conservative military community.

Kelley, the wife of a cancer surgeon, has a thin resume, a troubled family, shaky finances and a reputation for being, as one acquaintance here put it, "Tampa Kardashian." Now she is central to an unfolding scandal that has forced out David H. Petraeus as CIA director, threatens the career of Marine Gen. John Allen, commander of U.S. and international forces in Afghanistan, and cast previously unknown figures and a sex affair into international notoriety.

Kelley's complaint to the FBI last summer that she was being harassed by email triggered the investigation that uncovered Petraeus' extramarital affair with his biographer, Paula Broadwell, author of those emails. The inquiry also uncovered what the Pentagon has called 20,000 to 30,000 pages of possibly "inappropriate communication" between Kelley and Allen, whose nomination to a prestigious assignment overseeing all NATO military has been put on hold.

Allen "intends to fully cooperate with the inspector general investigators and directed his staff to do the same," his lawyer, Col. John Baker, the chief defense counsel of the Marine Corps, said in a statement Wednesday. "To the extent there are questions about certain communications by Gen. Allen, he shares in the desire to resolve those questions as completely and quickly as possible."

The Army suspended Broadwell's security clearance, which gave her access to classified information. She is a lieutenant colonel and intelligence officer in the Army Reserve.

President Obama said at a White House news conference that he had seen "no evidence at this point" that classified information had been compromised, but noted that the FBI investigation was continuing. He praised Petraeus, who resigned Friday, for his "extraordinary career" in the military and CIA. "We are safer because of the work Dave Petraeus has done," he said.

From 2008 to 2010, Petraeus headed Central Command, which runs U.S. military operations in the Middle East, including the wars in Iraq and Afghanistan. The command is based at MacDill Air Force Base, on a spit of land that juts into Tampa Bay. The base also is home to U.S. Special Operations Command and hosts representatives from 60 nations that joined together to fight terrorism after Sept. 11, 2001.

Balmy weather, a sparkling bay and a military-friendly population have made Tampa a welcome posting for officers and a favorite spot for retirees like Gen. Norman Schwarzkopf, who led the 1991 Persian Gulf War. The late New York Yankees owner George Steinbrenner had a booth at the Palm steakhouse, where his caricature adorns the wall — along with those of two other regulars, Scott and Jill Kelley.

Life here was a step up for Jill Kelley. Born in Beirut, she moved in the mid-1970s with her family to northeast Philadelphia, where they were the "oddballs" in a mostly Irish and German neighborhood, said Kelley's brother, David Khawam. The family opened restaurants in the area, he told reporters.

Scott and Jill Kelley moved to Tampa about a decade ago when Scott, who specializes in surgery for esophageal cancer, was hired by a local hospital. In June 2004, they purchased a 5,500-square-foot red-brick home on Bayshore Boulevard in the city's ritziest neighborhood.

With her dark tresses, high-wattage smile and gregarious personality, Kelley was a natural hostess. She became known for holding Champagne-and-caviar parties on a manicured front lawn, complete with billowing white tents and valet parking. Civic leaders rubbed shoulders with military brass from MacDill, a base so crucial to the local economy that generals were treated like rock stars.

In some cases, they acted that way too.

In February 2010, Petraeus and his wife, Holly, attended their first Gasparilla Pirate Festival, a local version of Mardi Gras. He arrived at the Kelley home with a 28-motorcycle police escort and wore a long string of beads around his neck.

"They became close friends with the general," said former Tampa Mayor Pam Iorio, who was a guest at multiple Kelley bashes. "The parties were purely social. It was a way, particularly with the coalition members, to just be a gracious hostess, to say, 'We're glad you're in Tampa.' There's nothing more to it than that."

Allen and Petraeus stayed in close touch with Kelley after they left Tampa. Although it might seem odd for a general running a war to stay in touch with a hostess back home, it's not unusual in the military world, where officers and their families frequently move and need to promote good relations with community leaders.

"She was part of that social connective tissue for generals and flag officers," said one officer.

Two years ago, Kelley strapped herself into a harness and made a tandem parachute jump with Special Operations troops, another official said. She was named an "honorary ambassador" by allied countries at Central Command and even secured a pass that allowed her to enter MacDill during daylight hours without an escort. That pass was revoked this week.

Even before the scandal broke, she had begun to wear out her welcome, flooding senior officers' inboxes with emails and requests for help organizing her social functions. Her constant presence caused some officers' aides to worry about the appearance of an attractive, outgoing woman cozying up to senior military leaders.

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BAFTA Shifts Corporate Sponsors for Film Awards

LOS ANGELES (TheWrap.com) – You can’t buy awards, but when it comes to the BAFTAs you can certainly sponsor them.

The British Academy of Film and Television is switching up its corporate partners for its annual film awards ceremony. That means it’s out with telecom company Orange, and in with broadband network EE.

The overhaul will require some rechristening of BAFTA‘s hardware. After 15 years with Orange in the title, the ceremony will now be known as the EE British Academy Film Awards. Moreover, its award for best newcomer will now be named the EE Rising Star Award.

The BAFTAs are the U.K. equivalent of the Oscars. EE is a sister company of Orange, so the shakeup is not seismic.

The EE British Academy Film Awards will be broadcast on the BBC on February 10, 2013 and will be hosted by satirist Stephen Fry.

TV News Headlines – Yahoo! News

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Alzheimer’s Tied to Mutation Harming Immune Response

Alzheimer’s researchers and drug companies have for years concentrated on one hallmark of Alzheimer’s disease: the production of toxic shards of a protein that accumulate in plaques on the brain.

But now, in a surprising coincidence, two groups of researchers working from entirely different starting points have converged on a mutated gene involved in another aspect of Alzheimer’s disease: the immune system’s role in protecting against the disease. The mutation is suspected of interfering with the brain’s ability to prevent the buildup of plaque.

The discovery, researchers say, provides clues to how and why the disease progresses. The gene, known as TREM2, is only the second found to increase Alzheimer’s risk substantially in older people.

“It points very specifically to a potential metabolic pathway that you could intervene in to change the course of Alzheimer’s disease,” said William Thies, chief medical and scientific officer of the Alzheimer’s Association.

Much work remains to be done before scientists understand precisely how the newly discovered gene mutation leads to Alzheimer’s, but already there are some indications from studies in mice. When the gene is not mutated, white blood cells in the brain spring into action, gobbling up and eliminating the plaque-forming toxic protein, beta amyloid. As a result, Alzheimer’s can be staved off or averted.

But when the gene is mutated, the brain’s white blood cells are hobbled, making them less effective in their attack on beta amyloid.

People with the mutated gene have a threefold to fivefold increase in the likelihood of developing Alzheimer’s disease in old age.

The intact gene, says John Hardy of University College London, “is a safety net.” And those with the mutation, he adds, “are living life without a safety net.” Dr. Hardy is lead author of one of the papers.

The discovery also suggests that a new type of drug could be developed to enhance the gene’s activity, perhaps allowing the brain’s white blood cells to do their work.

“The field is in desperate need of new therapeutic agents,” said Alison Goate, an Alzheimer’s researcher at Washington University in St. Louis who contributed data to Dr. Hardy’s study. “This will give us an alternative approach.”

The fact that two research groups converged on the same gene gives experts confidence in the findings. Both studies were published online Wednesday in The New England Journal of Medicine. “Together they make a good case that this really is an Alzheimer’s gene,” said Gerard Schellenberg, an Alzheimer’s researcher at the University of Pennsylvania who was not involved with the work.

The other gene found to raise the odds that a person will get Alzheimer’s, ApoE4, is much more common and confers about the same risk as the mutated version of TREM2. But it is still not clear why ApoE4, discovered in 1993, makes Alzheimer’s more likely.

Because the mutations in the newly discovered gene are rare, occurring in no more than 2 percent of Alzheimer’s patients, it makes no sense to start screening people for them, Dr. Thies said. Instead, the discovery provides new clues to the workings of Alzheimer’s disease.

To find the gene, a research group led by Dr. Kari Stefansson of deCODE Genetics of Iceland started with a simple question.

“We asked, ‘Can we find anything in the genome that separates those who are admitted to nursing homes before the age of 75 and those who are still living at home at 85?’ ” he said.

Scientists searched the genomes of 2,261 Icelanders and zeroed in on TREM2. Mutations in that gene were more common among people with Alzheimer’s, as well as those who did not have an Alzheimer’s diagnosis but who had memory problems and might be on their way to developing Alzheimer’s.

The researchers confirmed their results by looking for the gene in people with and without Alzheimer’s in populations studied at Emory University, as well as in Norway, the Netherlands and Germany.

The TREM2 connection surprised Dr. Stefansson. Although researchers have long noticed that the brain is inflamed in Alzheimer’s patients, he had dismissed inflammation as a major factor in the disease.

“I was of the opinion that the immune system would play a fairly small role, if any, in Alzheimer’s disease,” Dr. Stefansson said. “This discovery cured me of that bias.”

Meanwhile, Dr. Hardy and Rita Guerreiro at University College London, along with Andrew Singleton at the National Institute on Aging, were intrigued by a strange, rare disease. Only a few patients had been identified, but their symptoms were striking. They had crumbling bones and an unusual dementia, sclerosing leukoencephalopathy.

“It’s a weird disease,” Dr. Hardy said.

He saw one patient in her 30s whose brain disease manifested in sexually inappropriate behavior. Also, her bones kept breaking. The disease was caused by mutations that disabled both the copy of TREM2 that she had inherited from her mother and the one from her father.

Eventually the researchers searched for people who had a mutation in just one copy of TREM2. To their surprise, it turned out that these people were likely to have Alzheimer’s disease.

They then asked researchers around the world who had genetic data from people with and without Alzheimer’s to look for TREM2 mutations.

“Sure enough, they had good evidence,” Dr. Hardy said. The mutations occurred in one-half of 1 percent of the general population but in 1 to 2 percent of patients with Alzheimer’s disease.

“That is a big effect,” Dr. Hardy said.

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GOP senators cool to idea of Susan Rice as secretary of State

WASHINGTON — Senate Republicans signaled stiffening resistance Tuesday to the Obama administration's possible nomination of U.N. Ambassador Susan Rice to replace Hillary Rodham Clinton as secretary of State.

GOP strategists said lawmakers would use such a nomination as an opening for an extended examination of how the administration handled the Sept. 11 militant attack on the U.S. mission in Benghazi, Libya, that killed four Americans, including the U.S. ambassador. Although the Senate rarely rejects a president's Cabinet picks, the strategists said, the process could be so painful and lengthy that Obama might come to regret his choice.

A senior Republican aide said he couldn't predict whether the nomination would be voted down, but "the question is, is this worth spending political capital and taking punches on a subject they'd like to distance themselves from?"

"Whether it's fair to her or not, she's become a poster child for perceptions that there's been a coverup by the administration," he said, speaking anonymously because he was not authorized to address the topic publicly.

Some Senate Republicans have already begun discussing how they would question Rice, he said, and plan to gather information from House Republican colleagues to bore in on questions they say the administration has not yet satisfactorily answered.

Sen. Jon Kyl (R-Ariz.), the No. 2 Senate Republican, told reporters he considered Rice "tainted" by her role in the administration's handling of Benghazi, and recommended that the White House instead choose Sen. John F. Kerry (D-Mass.), chairman of the Senate Foreign Relations Committee, whom administration officials have also been considering for the diplomatic post.

Administration officials said that Rice, a pillar of Obama's foreign policy team since the 2008 election campaign, was a leading candidate for the post, and that they would not be deterred by Republican warnings. Officials and some others familiar with the process predicted that the GOP would eventually end its resistance to Rice because it would become clear that her disputed comments after the attack were prepared by other U.S. officials for her appearances on Sept. 16 talk shows.

Rice said in those TV appearances that the attack was motivated by anger at a U.S.-made film trailer that denounced the prophet Muhammad, and that it was not a planned assault.

Sen. Bob Corker (R-Tenn.), who is expected to become the ranking minority member of the Senate Foreign Relations Committee, found it "beyond belief" that Rice could have described the attack as motivated by anger over the film, when U.S. officials in Benghazi had told officials in Washington during the attack that it was a terrorist assault.

"I still don't know how anybody of that capacity could have been on television five days later saying the things that were said," Corker said. "I don't know how that could happen."

On Sunday, Sen. Lindsey Graham of South Carolina, an influential Republican on foreign policy issues, predicted that Rice's nomination would have a difficult time making it through the Senate. He said he would not vote for Rice unless she provided more satisfactory explanations of her actions.

A single senator can hold up a nomination if he or she is determined to do so. But a more likely avenue to blocking confirmation would be with a filibuster, aides said. Sixty votes are required to end a filibuster — more than the number of senators in the Democratic caucus.

Senate aides said the Republican caucus, which is regrouping after the election defeat, might decide that shooting down Obama's choice would be a way of underscoring its unhappiness with the administration's treatment of the Benghazi issue. But historically, the Senate has deferred to presidents on Cabinet picks, and Republicans would run the risk of looking unreasonable.

Clinton's intention to leave the post has been public for more than a year, and the candidacies of Rice and Kerry have been discussed for months. Both are interested in the job.

The Washington Post reported Tuesday that Rice was the leading candidate for the diplomatic post and Kerry, a Vietnam veteran, was under consideration as secretary of Defense. If Kerry took either post, Republicans would have a chance to win his Senate seat in a special election — further narrowing the Democrats' majority.

Sources who have been familiar with past nominations say that Obama confers with only a small circle on his top choices, and sometimes emerges with surprise selections. Jim Yong Kim, Obama's choice to head the World Bank, was one such case.

As a second-term president, Obama has wide latitude to pick the candidate he believes will best serve his interests. He is under less pressure to satisfy political constituencies, some Democrats pointed out.

Jay Carney, the White House press secretary, declined to comment on the nomination, but said Obama believed Rice had done an "excellent job" at the United Nations.

paul.richter@latimes.com

Michael Memoli and Christi Parsons in the Washington bureau contributed to this report.

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Petraeus enlisted for cameo in ‘Call of Duty’ game

LOS ANGELES (AP) — David Petraeus has landed on his feet with a new gig in “Call of Duty: Black Ops II.”

The retired Army general who stepped down as CIA director last week amid a scandal surrounding his extramarital affair pops up in the highly anticipated Activision Blizzard Inc. first-person shooter game released Tuesday.

A character with Petraeus’ name and likeness voiced by Jim Meskimen briefly appears as the Secretary of Defense in the year 2025.

The cameo was first reported by the gaming site Kotaku.com.

“Call of Duty” games have often employed virtual renditions of political figures.

“Black Ops II” also features an encounter with Manuel Noriega, a female president resembling current Secretary of State Hillary Rodham Clinton, an aircraft carrier named the USS Barack Obama and an appearance by retired Lt. Col. Oliver North.

Entertainment News Headlines – Yahoo! News

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Kidney Donors Given Mandatory Safeguards

ST. LOUIS — Addressing long-held concerns about whether organ donors have adequate protections, the country’s transplant regulators acted late Monday to require that hospitals thoroughly inform living kidney donors of the risks they face, fully evaluate their medical and psychological suitability, and then track their health for two years after donation.

Enactment of the policies by the United Network for Organ Sharing, which manages the transplant system under a federal contract, followed six years of halting development and debate.

Meeting at a St. Louis hotel, the group’s board voted to establish uniform minimum standards for a field long regarded as a medical and ethical Wild West. The organ network, whose initial purpose was to oversee donation from people who had just died, has struggled at times to keep pace with rapid developments in donations from the living.

“There is no question that this is a major development in living donor protection,” said Dr. Christie P. Thomas, a nephrologist at the University of Iowa and the chairman of the network’s living donor committee.

Yet some donor advocates complained that the measures did not go far enough, and argued that the organ network, in its mission to encourage transplants, has a conflict of interest when it comes to safeguarding donors.

Three years ago, the network issued some of the same policies as voluntary guidelines, only to have the Department of Health and Human Services insist they be made mandatory.

Although long-term data on the subject is scarce, few living kidney donors are thought to suffer lasting physical or psychological effects. Kidney donations, known as nephrectomies, are typically done laparoscopically these days through a series of small incisions. The typical patient may spend only a few nights in a hospital and feel largely recovered after several months.

Kidneys are by far the most transplanted organs, and there have been nearly as many living donors as deceased ones over the last decade. What data is available suggests that those with one kidney typically live as long as those with two, and that the risk of a donor dying during the procedure is roughly 3 in 10,000.

But kidney transplants, like all surgery, can sometimes end in catastrophe.

In May at Montefiore Medical Center in the Bronx, a 41-year-old mother of three died when her aorta was accidentally cut during surgery to donate a kidney to her brother. In other recent isolated cases, patients have received donor kidneys infected with undetected H.I.V. or hepatitis C.

Less clear are any longer-term effects on donors. Research conducted by the United Network for Organ Sharing shows that of roughly 70,000 people who donated kidneys between late 1999 and early 2011, 27 died within two years of medical causes that may — or may not — have been related to donation. For a small number of donors, their remaining kidney failed, and they required dialysis or a transplant.

The number of living donors — 5,770 in 2011 — has dropped 10 percent over the last two years, possibly because the struggling economy has made it difficult for prospective donors to take time off from work to recuperate. With the national kidney waiting list now stretching past 94,000 people, and thousands on the list dying each year, transplant officials have said they must improve confidence in the system so more people will donate.

The average age of donors has been rising, posing additional medical risks. And new ethical questions have been raised by the emergence of paired kidney exchanges and transplant chains started by good Samaritans who give an organ to a stranger.

Brad Kornfeld, who donated a kidney to his father in 2004, told the board that it had been impossible to find good information about what to expect, leaving him to search for answers on unreliable Internet chat rooms. He said he had almost backed out.

“If information is power,” said Mr. Kornfeld, a Coloradan who serves on the living donor committee, “the lack of information is crippling.”

Under the policies approved this week, the organ network will require hospitals to collect medical data, including laboratory test results, on most living donors to study lasting effects. Results must be reported at six months, one year and two years.

Similar regulations have been in place since 2000, but they did not require blood and urine testing, and hospitals were allowed to report donors who could not be found as simply lost.

That happened often. In recent years, hospitals have submitted basic clinical information — like whether donors were alive or dead — for only 65 percent of donors and lab data for fewer than 40 percent, according to the organ network. Although the network holds the authority, no hospital has ever been seriously sanctioned for noncompliance.

“It’s time we put some teeth into our policy,” said Jill McMaster, a board member from Tennessee.

By 2015, transplant programs will have to report thorough clinical information on at least 80 percent of donors and lab results on at least 70 percent. The requirements phase in at lower levels for the next two years.

Dr. Stuart M. Flechner of the Cleveland Clinic, the chairman of a coalition of medical societies that made recommendations to the organ network, said 9 of 10 hospitals would currently not meet the new requirement.

Donna Luebke, a kidney donor from Ohio who once served on the organ network’s board, said the new standards would matter only if enforcement were more rigorous. She noted that the organization was dominated by transplant doctors: “UNOS is nothing but the foxes watching the henhouse,” she said.

Another of the new regulations prescribes in detail the medical and psychological screenings that hospitals must conduct for potential donors. It requires automatic exclusion if the potential donor has diabetes, uncontrolled hypertension or H.I.V., among other conditions.

The new policies also require that hospitals appoint an independent advocate to counsel and represent donors, and that donors receive detailed information in advance about medical, psychological and financial risks.

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At Microsoft, Sinofsky Seen as Smart but Abrasive

On a warm night in late October, Steven Sinofsky stood on a platform in New York’s Times Square, smiling as a huge crowd roared at the unveiling of a Microsoft retail store, where Windows 8 and the company’s new Surface tablet were about to go on sale.

Less than three weeks later, Mr. Sinofsky — who, as the head of Windows, was arguably the second-most important leader at Microsoft — suddenly left the company. His abrasive style was a source of discord within Microsoft, and he and Steven A. Ballmer, Microsoft’s chief executive, agreed that it was time for him to leave, according to a person briefed on the situation who was not authorized to speak publicly about it.

Mr. Sinofsky was widely admired for his effectiveness in running one of the biggest and most important software development organizations on the planet. But his departure, which Microsoft announced late on Monday, parallels in many respects that of Scott Forstall, the headstrong former head of Apple’s mobile software development, who was fired by Apple’s chief executive, Timothy D. Cook, in late October.

Both cases underscore a quandary that chief executives sometimes face: when do the costs of keeping brilliant leaders who cannot seem to get along with others outweigh the benefits?

The tipping point that led to Mr. Sinofsky’s departure came after an accumulation of run-ins with Mr. Ballmer and other company leaders, rather than a single incident, according to interviews with several current and former Microsoft executives who declined to be named discussing internal matters.

One example of the kind of behavior that hurt Mr. Sinofsky’s standing at the company occurred this year at a two-day retreat for Microsoft’s senior executives at the Semiahmoo resort on the coast just below the Canadian border in Washington State. At the meeting, Microsoft’s various division heads were expected to make presentations on their businesses, answer questions and remain to hear their peers repeat the exercise.

When Mr. Sinofsky stood on the first day to speak about the Windows division, he told the group he had not prepared a presentation, and if they wanted to catch up on the progress of Windows 8, they could read his company blog, where he publicly chronicled the software’s development. He answered questions from the audience and then left the resort, while his colleagues remained until the next day, according to multiple people who were present.

Mr. Sinofsky’s early exit and halfhearted presentation were widely noted by his colleagues, irking even his admirers in the company. “He lost a lot of support,” one attendee said.

It wasn’t until this Monday, though, that Mr. Sinofsky and Mr. Ballmer both decided it would be best if Mr. Sinofsky left. Bill Gates, Microsoft’s chairman, supported the move, a person briefed on the matter said. Mr. Sinofsky served as a technical assistant to Mr. Gates in the 1990s.

In an e-mail to Microsoft employees, Mr. Sinofsky said the decision to leave “was a personal and private choice.” Many surprised Microsoft insiders noted that Mr. Sinofsky’s departure was immediate, an unusual arrangement for someone with a 23-year track record at the company. A Microsoft spokesman, Frank Shaw, said Mr. Sinofsky was not available to comment.

Although Mr. Ballmer grew increasingly impatient with Mr. Sinofsky throughout the year, he held back from taking any action earlier to avoid disrupting the release of Windows 8, the most important product Microsoft has unveiled in years, a person with knowledge of his thinking said.

The final decision could not have come lightly. Although many people at Microsoft viewed him as a ruthless corporate schemer, Mr. Sinofsky ran the highly complex organization responsible for Windows as a disciplined army that met deadlines, and he was respected by people on his team.

He achieved hero status within Microsoft several years ago by taking over the leadership of Windows after the debacle that was Windows Vista, a much-delayed operating system whose sluggish performance and technical problems worsened Microsoft’s reputation for mediocre software. Mr. Sinfosky led the development of a new version of the operating system, Windows 7, which was positively reviewed and sold well.

“He did great things with Windows,” said Michael Cusumano, a professor at the Sloan School of Management at the Massachusetts Institute of Technology. “That’s still the core of the company.”

But while Mr. Sinofsky was effective, Mr. Cusumano said, he could be secretive and difficult to get along with, as he learned while dealing with Mr. Sinofsky while Mr. Cusumano was writing a book on Microsoft in the early 1990s. “I could imagine that he burned a lot of bridges and created a bunch of enemies,” he said.

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Prescription deaths: Lawmaker wants cases reported to Medical Board

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The chairman of a state Senate committee that oversees the Medical Board said Monday he would introduce a bill requiring coroners to report all prescription drug deaths to the agency — a move aimed at helping authorities identify doctors whose prescribing practices may be harming patients.

Sen. Curren D. Price Jr., responding to a Times' report that authorities have failed to recognize how often people overdose on medications prescribed by their doctors, said the medical board needed coroners reports to improve oversight of potentially dangerous practices.

“There appears to be a disconnect between coroners and the Medical Board,” Price (D-Los Angeles), said in an interview. “Hopefully legislation will tighten that up and provide the kind of accountability we all expect.”

FULL COVERAGE: Legal drugs, deadly outcomes

The Times investigation published Sunday found that in nearly half of the accidental deaths from prescription drugs in four Southern California counties, the deceased had a doctor's prescription for at least one drug that caused or contributed to the death.

The investigation identified 3,733 deaths that involved prescription drugs in Los Angeles, Orange, San Diego and Ventura counties from 2006 through 2011. In 1,762 of those cases — 47% — drugs for which the deceased had a prescription were the sole cause or a contributing cause of death.

The Times found that prescription drug deaths often involved multiple drugs, sometimes prescribed by more than one doctor. In some cases, the deceased also mixed prescribed drugs with illegal drugs, alcohol or both.

The paper identified 71 Southern California physicians who prescribed drugs to three or more patients who later fatally overdosed. The doctors were primarily pain specialists, general practitioners and psychiatrists.

Price said that although there may be legitimate reasons for a doctor's prescriptions being linked to a death, “it’s cause for some further review.”

“I think a red flag goes up any time you have one [doctor] involved in several deaths,” he said. “And I think an investigation is not only warranted but called upon by the public.”

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