While Israel was long thought to be nearly without drunk drivers, new statistics present serious concerns. A study by the National Center for Trauma and Emergency Medicine Research at the Gertner Institute and the L. Greenberg Institute for Forensic Medicine has found a tripling in drunk-driver fatalities between 2000 and 2004. In 2004, 14.7% of drivers killed on the road were found to be "under the influence," compared to only 5% four years earlier. Nearly 70% of drunk drivers who die in accidents are killed on the weekends, when pubs and restaurants serving alcohol are busiest. The legal limit for alcohol in the blood of drivers is 50 milligrams per 100 cubic centimeters, but most of the dead drivers had a level of over 80 mgs. This is significant, as a recent study in Holland showed that the risk of being involved in an accident is 5.5 times higher when drivers' alcohol levels are between 50 and 79 mgs. than below 50, and 15.5 times higher when it is over 80 mgs. Center director Dr. Kobi Peleg says the continual rise in road accidents involving drunken drivers is very worrisome, and results from a change in Israel's culture. The authorities, he said, must act quickly to fight this trend. The statistics do not reflect the whole picture, because there are accidents in which the drunk driver is not killed or injured but kills other passengers or pedestrians, he said. His center is currently studying alcohol levels in drivers involved in accidents, along with local hospitals and with funding by the National Road Safety Authority. GLOBAL MED STUDENTS IN BEERSHEBA The current security crisis has not deterred 46 foreign medical students who are beginning their studies at the Ben-Gurion University of the Negev Faculty of Health Sciences' Medical School for International Health, in collaboration with Columbia University Medical Center (BGUCU MSIH). The MSIH's class of 2010, who have begun their classes on the Beersheba campus, includes men and women from the US, Canada, Poland, Germany, Israel, Belarus, Brazil, Russia, Malawi, Austria, India, South Korea, the Fiji Islands, Venezuela and Nigeria. They will spend their first three years studying global health issues. During the fourth year, students may take up to five months of clinical electives at Columbia's affiliated hospitals in New York, and must complete a two-month hands-on clinical clerkship in locations such as Kenya, Ethiopia, India, Nepal, Peru and Vietnam. In addition to its four-year American-style curriculum, the MSIH integrates subjects such as infectious diseases, nutrition and disease prevention, humanitarian emergencies, cross-cultural competencies and community health. Students receive the training essential to practice medicine in varied cultural settings and clinical conditions; skills that will help them pursue careers in global health and population-based medicine. The MSIH is a unique medical school that prepares physicians to work with populations throughout the globe. Now in its ninth year, the program has enrolled more than 100 students from around the world, and counts two Palestinian-Americans among its alumni. Graduates are now doing residency training and fellowships at over 70 leading medical centers in the US. After completing residency training, alumni are expected to make significant contributions to global health through clinical work, policy development and medical education. SENSIBLE EXERCISE GOOD FOR MILDLY HYPERTENSIVE ELDERLY A Johns Hopkins study should ease the concerns held by many older adults with mild high blood pressure about the harm exercise could cause their hearts. Results of the research on 104 men and women age 55 to 75 showed that a moderate program of physical exertion had no ill effects on the heart's ability to pump blood, nor does it produce a harmful increase in heart size. In this study, "moderate" translated to sustained exercise for about an hour, three times a week. Researchers say that people's concerns stem from the fact that during each workout, blood pressure can rise from 40 millimeters to 60 millimeters of mercury. The Hopkins study is believed to be the first to evaluate the effects of exercise on the heart's ability to function, to pump and to fill up with blood. "While having high blood pressure at rest is a well-established risk factor for heart problems, older people should not fear the effects of moderate exercise, despite short-term rises in blood pressure," says lead study investigator Prof. Kerry Stewart, director of clinical and research exercise physiology at Johns Hopkins University's School of Medicine. "Exercise is a highly effective means of increasing the heart's efficiency and reducing body fat - factors that may ward off health problems such as heart disease and diabetes." A report on the Hopkins study, published in the July issue of Heart, showed that after six months of aerobic exercise on a treadmill, bicycle or stepper, plus weightlifting, participants showed no overall ill effects in 11 measures of diastolic heart function, when the organ's main chamber fills with blood between beats. They also found that exercise produced no increase in eight measures of heart size, including left ventricular mass and wall thickness. In contrast, a long-term effect of hypertension, even when the body is relaxed, is an enlargement of the heart that eventually stiffens and weakens the muscle. Not only were there no ill effects despite periodic increases in blood pressure during the workouts, Stewart reported, but results also suggest that exercise benefited the hearts of those who made the most gains in physical fitness and lost the most abdominal fat. Unlike the increased heart size that results from high blood pressure, any increase in heart size observed in the active group was similar to what athletes experience when their hearts get bigger and stronger, not stiff.