An expensive CT scan that uses multiple X- rays to produce spectacular 3- D images of the heart can' t replace tried- and- true coronary angiography for finding blocked blood vessels in chest- pain patients, according to a study in the New England Journal of Medicine. But doctors are using the newer test - - sometimes because patients ask for it - - despite a lack of evidence that it' s helpful, and a possibility that it might be harmful. & quot; I think it' s being used without clear data of any benefit for the patient, & quot; says Dr.

Rita Redberg, a professor at the University of California at San Francisco School of Medicine, who wrote an article accompanying the study. The gold standard for diagnosing heart disease is coronary angiography ( also known as an angiogram or cardiac catheterization) , in which doctors snake a tube through the femoral artery in the leg and up into heart vessels to release a dye that lights up blockages on an X- ray. CT scans of the heart, known as multi- detector computed tomographic ( CT) angiography, are less invasive than angiograms. But the CT scans use a contrast dye and multiple radiation- generating X- rays, which a computer assembles into a high- resolution, three- dimensional image of the heart. Health. com: How to Weigh Angiogram Benefits and Risks Supporters of the CT scans say they could be used in patients with chest pain who are at lower risk of having heart disease due to their age, sex, or type of pain.

If the test doesn' t find blockages, they say, these patients could skip traditional angiography altogether. However, in the new study, Dr.

Julie M. Miller of Johns Hopkins University School of Medicine in Baltimore, Maryland, and her colleagues looked at 291 patients who were scheduled for an angiogram but also had a 64- slice CT scan. They found the newer test was less accurate and yielded more false negatives than previous single- center studies had suggested. Dr.

Robert Bonow, chief of at Northwestern University' s Feinberg School of Medicine, notes that about 10 percent of study participants with a positive test had normal coronary arteries, and 17 percent of those with a normal test had coronary disease. Meanwhile, Medicare has covered the CT scans since 2006, and the tests are in widespread use, even though their usefulness for patients is unclear. The CT scans cost about $ 700 and angiograms cost about $ 1, 500, according to Johns Hopkins. However, people who have the CT scans often end up needing the angiogram anyway.

Bonow says he expects the new findings could & quot; put the brakes& quot; on current enthusiasm for the test. & quot; It is the way the world' s going to evolve in the future, but I just don' t think we' re there yet, & quot; he says. While traditional angiography is invasive, he adds, the risks are exceedingly low when performed by an experienced clinician. And if the test does identify blockages in the heart' s arteries, they can be treated with stents or angioplasty right away. ( Both require a catheter threaded through an artery into the heart. ) In the United States, 30 percent of angiograms find no blockages in the heart arteries, notes Dr. Kim Allan Williams, a professor of medicine and radiology at the University of Chicago. & quot; We' d like to fix it so we have no more normal angiograms, & quot; he says. According to Williams, CT angiography is useful for ruling out heart disease in patients with active chest pain and equivocal stress test results. ( In a stress test, patients' hearts are monitored while they exercise. ) Health. com: How Depression Hurts Your Heart & quot; It does help you select the patients who are going to need further management with revascularization and that' s really what you want the test to do, & quot; Williams says.

Revascularization is any procedure that restores blood flow to the heart, such as bypass surgery or angioplasty. But Redberg argues that the usefulness of a CT scan in patients with chest pain is debatable and the test has risks.

The scan exposes patients to considerably more radiation than an angiogram, she says, and these patients may wind up needing an angiogram anyway as well as other tests that could expose them to even more radiation, like those that use nuclear tracers. & quot; Importantly, but unfortunately, we don' t know what the radiation risks are, & quot; Redberg says. & quot; It' s been estimated that we' re going to see tens of thousands of additional cancers in the U.

S. population because of our increased use of CT scans. & quot; Radiation isn' t the only concern, she says: Technology is a major driver behind ballooning health care costs in the United States. & quot; It' s not always true that more tests are better, and it does drive up our health- care costs without a clear benefit to patients, & quot; she explains.

If your doctor recommends the CT scan before a stress test, ask for more details, Redberg says: & quot; How is this going to help my health care; how is it going to help me to feel better? & quot; Bonow agrees: & quot; If the doctor is recommending this test, ask the right questions. Does this mean I will never need an invasive angiogram? What is this test going to do? & quot; What you need is an informed patient asking good questions. & quot; Try a FREE TRIAL issue of Health - ! Copyright All About & bull;

New York ( CNN) - - A collection of 46 never- before- seen photos from The Beatles' first concerts in the United States was auctioned off for more than $ 350, 000 at a New York auction house on Wednesday.

The evening' s biggest sellers included a close- up of John Lennon and Paul Mc. Cartney singing into a microphone, which sold for $ 30, 000 and an image of the four Beatles shot from behind, which went for $ 68, 500. The auction, held at Christie' s in Manhattan, was expected to bring in about $ 100, 000, but the grand total ended up being $ 361, 938. The Washington, D. C. - based photographer behind the show was 18 when he took the photos.

Mike Mitchell, who is now 65, said that the thought of someday auctioning off the photos for such a large sum had never crossed his mind as a rookie photographer vying for a press pass to see the Fab Four. & quot; Nobody knew where The Beatles would go, & quot; he said. & quot; They kind of marched and everybody fell in step behind them. & quot; When Mitchell heard The Beatles were making their first trip across the Atlantic, he managed to get a press pass from a magazine he worked for. & quot; I had realized that the camera was really a ticket to a lot of places one might not be able to go otherwise, & quot; he said. Some of the photos that were auctioned off were taken on Feb. 11, 1964, at the Washington Coliseum - - The Beatles' first concert in the United States.

The others were taken at the Baltimore Civic Center in September of that year.

Mitchell chose the 46 photos to be auctioned from about 450 negatives that had been collecting dust since the 1964 concerts. He chose group shots, close- ups and even photos without any faces.

One of his favorite photos is an image of Ringo Starr' s jeweled hands. Another is a photo of one of The Beatles' boots on a stage littered with jelly beans. Mitchell had to scan and restore the photos for the auction. & quot; I had to remove all the dust and scratches that had accumulated over that time, & quot; he said.

He decided to release the photos because & quot; it was time, & quot; he said. Cathy Elkies, director of iconic collections at Christie' s, said she was nervous going into the auction because Mitchell was a relatively unknown name, but that the photographs and their subjects spoke for themselves. & quot; They are beautiful, they are intimate, they are evocative, & quot; she said. & quot; And the fact that he was 18 just is really a very sobering idea. & quot; And the fact that the photos had never been seen added to the success of the auction, Elkies said. & quot; Beatles fans just think they' ve seen it all so to have the opportunity to bring something to market that was never seen before was great, & quot; she said.

( ) Many families and friends agonize over how to help a loved one struggling with alcoholism, drug problems, an eating disorder or other destructive behavior. One way to join forces and take action is through a formal intervention. Staging a well- planned intervention can be an effective way to help a loved one recognize the impact of his or her behaviors and accept treatment.

Here' s what you should know about an intervention, including what it is, who might benefit and how it works.

What is an intervention? An intervention is a carefully planned process in which family and friends, and sometimes colleagues, clergy or others, join together to confront someone about the consequences of alcoholism, addiction or another mental health problem, and ask him or her to accept treatment. The intervention: Who might benefit from an intervention? An intervention can help people who struggle with addictive behaviors but who are in denial about their situation or who have been unwilling to accept treatment.

Some examples of behaviors that may warrant an intervention include: People with addiction often don' t see the negative effects their behavior has on them and others. It' s important not to wait until they " want help. " Instead, think of an intervention as giving your loved one a clear opportunity to make changes before things get really bad. How does a typical intervention work?

Planning. A family member or friend proposes an intervention and forms a planning group. Gathering information. The group members find out about the extent of the loved one' s problem and research the condition and treatment programs.

The group may make arrangements to enroll the loved one in a specific treatment program. Forming the intervention team. The planning group forms a team that will personally participate in the intervention. Team members set a date and location and work together to present a consistent message, treatment plan and changes each person will make if the addicted person doesn' t seek treatment. Keep the plan confidential until the day of the intervention.

Deciding on specific consequences. If your loved one doesn' t accept treatment, each person on the team needs to decide what action he or she will take. Examples include asking your loved one to move out or taking away contact with children.

Writing down what to say. Each member of the intervention team should detail specific incidents where the addiction has resulted in problems, such as emotional or financial issues. Discuss the toll of your loved one' s behavior while still expressing care and the expectation that your loved one can change.

The intervention meeting. Without revealing the reason, the loved one is asked to the intervention site. Members of the core team then take turns expressing their concerns and feelings. The loved one is presented with a treatment option and asked to accept that option on the spot. Each team member will say what specific changes they will make if the addicted person doesn' t seek care.

Follow- up. Involvement of a spouse and family members is critical in helping someone with an addiction stay in treatment and avoid relapsing into old patterns. This can include changing patterns of everyday living to make it easier to abstain from the destructive behavior, offering to participate in counseling with your loved one, seeking your own therapist and recovery support, and knowing what to do if relapse occurs.

Should you consult a professional for an intervention? Consulting an intervention professional ( interventionist) , an addiction specialist, psychologist or mental health counselor can help you organize an effective intervention. It' s a good idea to get professional help if your loved one: Is in denial, likely to become angry or tends to minimize his or her situation Who should be on the intervention team? An intervention team usually includes four to six people who are important in the life of your loved one.

They should be people your family member or friend loves, respects, admires, depends on and likes, and may include relatives, friends, and community leaders such as clergy members or teachers. Don' t include anyone who your loved one dislikes, anyone who has an unmanaged mental health issue or substance abuse problem, or anyone who might sabotage the intervention. If you think it' s important to have someone involved but worry that it may create a problem during the intervention, consider having that person write a short letter that someone else can read at the intervention.

How do you find a treatment program to offer at the intervention? Depending on the severity of your loved one' s behavior or condition, it may be appropriate to ask them to seek support from a group such as Alcoholics Anonymous. A more severe problem may require admittance into a structured program or hospital.

If a treatment program is necessary, it may help to make arrangements in advance for admittance. Do some research, keeping these considerations in mind: Ask a trusted addiction specialist, doctor or mental health provider about the best treatment approach for your loved one and recommendations about programs. Contact national organizations, online support groups or local clinics for treatment programs or advice.

Find out if insurance will cover the treatment program you' re considering. Find out what steps are required for admission, such as an evaluation appointment, insurance pre- certification and whether there' s a waiting list.

Be wary of treatment centers promising quick fixes or using uncommon methods or treatment that seem like they could be harmful.

If the program requires travel, make arrangements ahead of time. Consider having a packed suitcase ready for your loved one.

How can you help ensure a successful intervention? Keep in mind, your loved one' s problem involves intense emotions.

The process of organizing the intervention and the intervention itself can cause conflict, anger and resentment even among family and friends who know a loved one needs their help. To help run a successful intervention: Don' t hold an intervention on the spur of the moment. It can take several weeks to plan an effective intervention. However, don' t make it too elaborate, either, or it may be difficult to get everyone to follow through. Plan the time of the intervention.

Make sure you choose a date and time when the addicted person is least likely to be under the influence of alcohol or drugs. Do your homework. Research your loved one' s addiction, substance abuse issue or other mental illness so that you have a good understanding about what' s going on. Appoint a single person to act as a liaison.

Having one point of contact for all team members will help you communicate and stay on track.

Share information. Make sure each team member has the same information about your loved one' s addiction and the intervention so that everyone is on the same page. Hold meetings or conference calls to share updates. Stage a rehearsal intervention. Here, you can decide who will speak when, sitting arrangements and other details so that there' s no fumbling during the real intervention with your loved one.

Anticipate your loved one' s objections. Have calm, rational responses prepared for each reason the addicted person may give to avoid treatment or responsibility for his or her behavior. Offer support to your loved one that makes it easier to engage in treatment, such as arranging child care or attending counseling sessions with him or her.

Avoid confrontation. Be honest, but don' t use the intervention as a forum for hostile attacks. Avoid name- calling and angry or accusing statements. Ask for an immediate decision. Don' t give your loved one time to think about whether to accept the treatment offer, even if he or she asks for a few days to think it over.

Doing so just allows your loved one to continue denying a problem, go into hiding or go on a dangerous binge. Be prepared to get your loved one into an evaluation to start the treatment immediately if he or she agrees to the plan.

What if your loved one refuses help despite an intervention? Unfortunately, not all interventions achieve their goal.

In some cases, a loved one may refuse the treatment plan. The addicted person may erupt in anger or insist that he or she doesn' t need help, or may be resentful and accuse you of betrayal or being a hypocrite.

Emotionally prepare yourself for these situations, while remaining hopeful for positive change. If your loved one doesn' t accept treatment, be prepared to follow through with the changes you presented. Oftentimes, children, partners, siblings and parents are subjected to abuse, violence, threats and emotional upheaval because of alcohol and drug problems.

You don' t have control over an addicted person' s behavior. However, you do have the ability to remove yourself & mdash; and any children & mdash; from a destructive situation. Even if an intervention doesn' t work, you and others involved in your loved one' s life can make changes that may help.

Ask other people involved to avoid enabling the destructive cycle of behavior and take active steps to encourage positive change.

( CNN) - - Planning a trip to the United States? Tuesday is the last day for citizens of some countries to dodge a new travel fee. Starting Wednesday, travelers from 36 nations will be required to pay $ 14 to register through the Electronic System for Travel Authorization, or ESTA, required for travelers using the Visa Waiver Program.

Four of the $ 14 will cover ESTA operating costs, and $ 10 will go toward promoting the United States as a tourist destination. Charging tourists to promote tourism doesn' t make sense, critics say. & quot; It' s like inviting a friend over for dinner and then charging them a fee at the door, & quot; said Steve Lott, a spokesman for the International Air Transport Association, which represents airlines around the world. & quot; If the idea is to make the United States more welcoming and to increase tourism, raising the entry fee seems to be counterintuitive to what you' re trying to do, & quot; Lott said. Instead, more effort should be made to improve the cumbersome entry process, he said.

IATA voiced opposition to the fee to members of Congress before it was established by the Travel Promotion Act, which was signed by President Obama in March.

The legislation created a nonprofit public/ private Corporation for Travel Promotion that will be funded in part by the $ 10 fee collected from visitors who are not required to apply and pay for visas. Up to $ 100 million in matching private sector contributions will provide the rest of the corporation' s funding. The U. Travel Association, an industry trade group, is pleased with the establishment of the country' s first national travel promotion program, which will address a need to bolster international visitation to the United States. In some countries, national tourism organizations have been spending more than $ 100 million annually on tourism promotion for years, according to the association.

The United States welcomed 633, 000 fewer overseas visitors in 2008 than in 2000, despite strong global growth in long- haul international travel during that period, according to figures from the U. Department of Commerce.

The U. Travel Association doesn' t expect the fee to have a negative effect on visitation.

Economic consulting firm Oxford Economics estimates a well- executed promotional program would draw 1. 6 million new international visitors annually. In addition to promoting tourism, the Corporation for Travel Promotion will be tasked with communicating U.

S. travel and security policies to international visitors.

The $ 14 fee covers travel to the United States for two years.

It' s too soon to say how the fee will affect tourism, either positively or negatively, IATA' s Lott said, but his organization will be watching closely to see how the promotional funds are spent and whether other countries respond with fees for U. S. visitors. & quot; The minute the U. K. or France or Brazil start charging a similar fee, [ Americans] are going to get angry, & quot; Lott said.

No new rules for U. S. travelers have been announced, but some countries are not happy with the new fee. Cecilia Malmstr& ouml; m, European commissioner for home affairs, called the fee & quot; inconsistent with the commitment of the U. S. to facilitate transatlantic mobility, & quot; saying it will be & quot; an additional onus for European citizens traveling to the U.

S. & quot; Maureen Dugan, an executive director with Customs and Border Protection, said during a briefing last week that many countries impose fees that are rolled into airline ticket prices. & quot; There are 56 plus countries that impose entry- exit fees and they are in - - within the ticket or within some other tax. . . . We don' t see that this is inconsistent with the Visa Waiver Program. & quot; The United Kingdom, France, Sweden, Australia and Japan are among the 36 nations that participate in the , which allows visitors to travel to the United States for stays of 90 days or less without obtaining a visa.

( CNN) - - The American Cancer Society said Thursday that keeping weight under control is the most important thing non- smokers can do to prevent the disease. In revised guidelines, the society put top priority on diet and fitness, saying that eating a nutritious diet, staying active and limiting alcohol are the top things that people who don' t smoke should do to fight cancer. The guidelines are published Thursday in CA: A Cancer Journal for Clinicians. ( One- third of the more than 500, 000 cancer deaths each year are attributable to poor diet and inadequate physical activity, including overweight and obesity, the cancer society said.

That' s about the same number of cancer cases caused by smoking. Avoiding tobacco products continues to be the most important avoidable risk factor in reducing cancer risk. But about 80 percent of Americans don' t smoke, and for those people, diet and exercise are paramount. & quot; No doubt about it - if you smoke, the most important thing for you to do is quit. If you don' t use tobacco products, your best shot at reducing your cancer risk is to watch your weight, be more active and eat well, & quot; said Colleen Doyle, director of nutrition and physical activity for the American Cancer Society and co- author of the report.

Research has long shown that colon, rectal, stomach, breast , prostate and pancreas cancers are related to diet. New studies indicate that for most nonsmokers, weight control can cut other cancer risks. & quot; There is evidence that losing weight can reduce the risk for postmenopausal breast cancer, and because of hormonal changes that occur with weight loss, there' s reason to believe it' s beneficial for other cancers as well, & quot; said Ms. Doyle. The guidelines also say that the standard recommendation - - 30 minutes of moderate exercise five days a week - - is still good, but it works better with with more strenuous activities such as biking, running or power walking.

Doyle said it' s time people understand they have a say in the future of their health. & quot; Unfortunately, there' s no guarantee. You can do all those things and still get cancer.

But the good news is that a lot of people think they don' t have any control over their risk of cancer and we' re here to tell people that absolutely you do have some control. & quot;

WASHINGTON ( CNN) - - A handwritten message in a notebook found in the car of the man accused of fatally shooting a Holocaust museum security guard boasted, & quot; You want my weapons - - this is how you' ll get them, & quot; an FBI criminal complaint says. The purpose of the complaint is to establish probable cause for bringing charges against white supremacist James von Brunn, 88, in the shooting death Wednesday of a security guard at the U. Holocaust Memorial Museum. Von Brunn is charged with a federal count of murder, according to court documents. If convicted, said acting U.

Attorney Channing Phillips, he would face a mandatory sentence of life in prison without parole and, if certain criteria are met, could face the death penalty. Von Brunn also is charged with killing while in possession of a firearm in a federal facility. He remained hospitalized in critical condition Thursday from shots fired by other security guards.

The complaint says he was shot in the face and fell backward outside the museum' s front door. Stephen Tyrone Johns, the security guard who was shot to death, had opened the door for the gunman, who then raised a rifle and killed him, authorities told reporters Thursday.

Johns, 39, & quot; was kind enough to open the door, allowing him to enter, & quot; Lanier said. & quot; As he entered, he raised the rifle and shot special police Officer Johns. & quot; According to the complaint, Johns was shot in the left upper chest area. He died at a hospital. The notebook discovered by police also contained other messages from the man who flaunted his anti- Jewish, anti- black beliefs. & quot; The Holocaust is a lie. Obama was created by Jews. Obama does what Jew owners tell him to do.

Jews captured America' s money. Jews control the mass media. The First Amendment is abrogated - - henceforth, & quot; an excerpt said.

At the end of the writings was the signature: James W. von Brunn. The Holocaust museum, which is near the Washington Monument and other popular tourist attractions, remained closed Thursday, its flags lowered to half- staff in tribute to Johns. A six- year veteran of the museum' s security staff, Johns was hailed as a hero by Washington Mayor Adrian Fenty and other officials.

Johns was a resident of Temple Hills, Maryland, according to a statement issued by Wackenhut Services Inc. , which provided security services at the museum since 2002. Johns & quot; died heroically in the line of duty, & quot; said Sara Bloomfield, director of the museum. & quot; Obviously there are no words to express our grief and shock over the horrific event that took place at this museum today, & quot; Bloomfield said.

Von Brunn is a Holocaust denier, well- known to human rights groups for decades, who created an anti- Semitic Web site called & quot; The Holy Western Empire. & quot; The Southern Poverty Law Center, which focuses on human rights, said von Brunn has & quot; an extremely long history with neo- Nazis and white supremacists. & quot; He has repeatedly claimed & quot; The Diary of Anne Frank, & quot; an iconic diary written by a teenage girl who was hiding from Nazis with her family, was a hoax. Johns was killed on the day the museum was to stage a play based on Anne Frank and two days before what would have been her 80th birthday. Joseph Persichini Jr. , assistant director in charge of the FBI' s Washington Field Office, said at a news conference that police were investigating whether the killing of Johns, who was black, might be considered a hate crime.

Von Brunn served six years in prison for trying in 1981 to kidnap Federal Reserve Board members because of high interest rates. He blamed his prison term on a & quot; Negro jury, Jew/ Negro attorneys& quot; and & quot; a Jew judge, & quot; he said on his Web site. One of many questions is whether von Brunn, as a convicted felon, should have been barred from owning weapons.

Witnesses to the shooting described blood on the floor and chaos within the museum' s halls. Visitor Maria Hernandez told CNN she heard five shots and saw the wounded security guard. & quot; It was definitely a security guard; he was down bleeding on the floor, & quot; said Hernandez, 19. & quot; He was face down.

His back . . . blood was coming out. & quot; Sirens blared as emergency vehicles converged on the area.

The museum was full at the time, with a & quot; couple of thousand& quot; people inside, said William Parsons, chief of staff at the museum. & quot; Never take your guard force and security people for granted, & quot; he said. & quot; They did exactly what they were supposed to do to protect people in the museum. & quot; The shooting sent shock waves throughout the nation' s capital and elsewhere. & quot; I am shocked and saddened by today' s shooting at the U.

Holocaust Memorial Museum, & quot; said President Obama, who just days earlier had spoken emotionally about the Holocaust when he visited Buchenwald, a former Nazi concentration camp with Holocaust survivor and Nobel Peace Prize laureate Elie Wiesel. & quot; This outrageous act reminds us that we must remain vigilant against anti- Semitism and prejudice in all its forms, & quot; Obama said Wednesday. Israel issued a statement through its embassy, expressing sadness and condemning the attack. The Anti- Defamation League said the shooting & quot; reminds us in the starkest way where the spread of hatred can lead. & quot; The Council on American- Islamic Relations condemned & quot; this apparent bias- motivated attack& quot; and said it stands & quot; with the Jewish community and with Americans of all faiths in repudiating the kind of hatred and intolerance that can lead to such disturbing incidents. & quot; The museum canceled a performance scheduled for Wednesday night of a play about racism and anti- Semitism, based on a fictional meeting between Anne Frank and Emmett Till, the teenage victim of a racist killing in the United States. Attorney General Eric Holder and Rep.

Steve Cohen, D- Tennessee, were among those planning to attend the play, which was written by Janet Langhart Cohen, the wife of former Defense Secretary and U.

Sen.

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