Critical Blood Shortage in Haiti, PAHO Says

By Martha Kerr

Medscape.com, January 20, 2010 — As of last night, Médicins sans Frontièrs (MSF, Doctors Without Borders) estimated that 3000 patients have been treated and 400 have undergone surgery, with a significant number of these being amputations.

Possibly the greatest medical need right now is for blood, but storage of blood donations is a problem, said the Pan American Health Organization (PAHO) Deputy Director Jon Kim Andrus, in a briefing today.

Haiti’s main blood center has been damaged, supply routes from the Port-au-Prince airport are compromised, and even when blood is delivered, refrigeration units are scarce and electricity is intermittent.

“Supplies are being deposited at the airport and left there,” Mr. Andrus said. Poor telecommunications are further hindering the delivery of blood donations and other supplies. In addition, tuberculosis and HIV are prevalent in Haiti, further compromising blood donation.

Mr. Andrus said that as of today, 50 units of blood have been carried in by relief organizations, and 200 units of blood and 600 units of plasma have been donated by PAHO and the World Health Organization (WHO). Blood donations are being managed through PROMESS, the PAHO/WHO-managed project that acts as Haiti’s pharmacy for essential medicines.

PAHO, in collaboration with WHO and the United Nations, has developed clusters dedicated to food, water and sanitation, shelter, healthcare, and logistics, with planned future clusters to aid in agriculture, telecommunications, and camp coordination, among other areas.

 
USNS Comfort crew members prepare for arrival in Haiti.

Four hospitals with surgical capabilities are in some degree of operation, but many surgeries are being performed out in the open.

 
Crew of USNS Comfort conduct mass casualty drill.

The International Health Commission, led by PAHO, is forming travelling brigades; performing triage and basic first aid; setting up fixed health posts, which are established in areas where people are congregating; and opening field hospitals with surgical capabilities in strategic areas around Port-au-Prince.

MSF’s inflatable 100-bed hospital with 2 operating theaters is being assembled now and should be up and running shortly.

The USNS Comfort, the military’s floating hospital, is due to arrive in port on Thursday.  According to the US Navy, the USNS Comfort “includes one of the largest trauma facilities in the U.S. and is able to provide a full spectrum of surgical and medical services.”

Crew members on board conducted a “patient flow drill” this morning, moving patients from helicopters into casualty receiving and then into the intensive care units in preparation for docking on Thursday.

Meanwhile, Israel reports that within 48 hours of the 7.0-magnitude earthquake on Tuesday, January 12, it had deployed several cargo planes with supplies, equipment, and staff to Haiti. An Israeli Defense Forces field hospital, with 40 physicians and 24 nurses, left Thursday evening. The hospital, capable of treating 500 patients, includes an intensive care unit, 2 operating rooms, a pharmacy, and an X-ray lab. It has been in operation since Saturday.

By Maggie Fox

GoogleNews.com, Medscape.com, January 20, 2010 – An earthquake killing up to 200,000 people would have been bad enough anywhere, but in Haiti, where AIDS, tuberculosis and malaria are rampant, children are malnourished and hygiene is already a challenge, it may create one of the worst medical disasters ever.

Medical teams pouring in to set up mobile hospitals say they are already overwhelmed by the casualties and fear the worst is yet to come as infection and disease take hold.

“The number one risk is always bacterial infections where they have open wounds,” said Josh Ruxin, a Columbia University public health expert living and working in Rwanda.

Haitian government officials said the death toll from Tuesday’s magnitude 7 quake was likely to be between 100,000 and 200,000, and no one has even begun to get a count of injuries, which include crushed or amputated limbs, compound fractures and lacerations.

Without quick treatment, these wounds will become infected. “Things are going to get much much worse before they are going to get better,” Ruxin said.

Water is at a premium and diarrhea is likely. Children, the weak and elderly will die unnecessarily from diarrheal disease that would be easily treated with water and rehydration salts under more normal conditions, doctors said.

Frustrated medical teams have flown in mobile hospitals and tons of supplies, but have been largely unable to get them set up because roads are destroyed and security lacking.

The U.S. Centers for Disease Control and Prevention sent a team of 267 medical experts, including surgeons, who arrived on Friday but had to wait until Sunday night for military escorts to take them through the chaos.

“Because of the amount of time that has gone by, they’ll probably have a lot of diabetes that is out of control,” Dr. Steven Harris, CDC’s senior medical director in Haiti, said in a telephone interview. “There will be kidney failure because of dehydration.”

The CDC is anticipating outbreaks of infectious diseases such as measles and malaria. “They are the typical kinds of diseases we have here anyway but they certainly would be worse following a disaster like this,” Dr. Harris said.

SMALLEST VICTIMS

“This could turn into a children’s disaster of unprecedented proportions,” said Dr. Irwin Redlener of Columbia University’s National Center for Disaster Preparedness.

He said 40 percent of Haiti’s population is made up of children under the age of 14, far more than in most countries.

“They are more susceptible to infections, dehydration and shock. And of course there is a tremendous emotional impact,” Dr. Redlener said.

Ruxin sees one spark of hope.

“While this is a terrible tragedy, there is an opportunity to do something which decades of aid hasn’t and that is build up a public health infrastructure that is stable,” Ruxin said.

A Commonwealth Fund report released on Friday found that in New Orleans, devastated by Hurricane Katrina in 2005, healthcare had improved.

It found that a program that set up a network of local clinics funded by federal and local government was providing care to more patients than were getting care before the disaster.

From Medscape Medical News

MSF Supply Planes Denied Landing in Port-au-Prince

January 20, 2010, BY Martha Kerr — Médicins sans Frontièrs (MSF, Doctors Without Borders) reports today that a cargo plane with 12 tons of medical equipment has been turned away from the Port-au-Prince airport for the third time since Sunday, despite being told repeatedly that it could land.

The plane is carrying drugs, surgical supplies, and 2 dialysis machines. The contents are from the cargo of an earlier plane carrying a total of 40 tons of supplies that was blocked from landing on Sunday morning, being diverted instead to the Dominican Republic.

Since January 14, MSF has had 5 planes diverted from the original destination of Port-au-Prince to the Dominican Republic. These planes carried a total of 85 tons of medical and relief supplies.

MSF has successfully landed 5 planes with a total of 135 tons of supplies into Port-au-Prince. Another 195 tons of supplies are needed immediately to continue MSF’s scale-up of its medical relief operation in Haiti, MSF officials say.

“We have had five patients in Martissant health center die for lack of the medical supplies that this plane was carrying,” said Loris de Filippi, emergency coordinator for MSF’s Choscal Hospital in Cite Soleil, in an MSF release.

“I have never seen anything like this…. We were forced to buy a saw in the market to continue amputations. We are running against time here,” Dr. de Filippi declared.

“We don’t have any more morphine to manage pain for our patients,” said Rosa Crestani, MSF medical coordinator for Choscal Hospital. “We cannot accept that planes carrying life-saving medical supplies and equipment continue to be turned away while our patients die. Priority must be given to medical supplies entering the country.” 

By Lisa Nainggolan

Medscape.com, January 20, 2010 (San Francisco, California) — A new study in patients with coronary artery disease (CAD) has uncovered an inverse association between baseline blood levels of fish oil and the rate of telomere shortening over five years, suggesting a possible explanation for the protective effects of omega-3 fatty acids [1].

Telomeres are the extreme ends of chromosomal DNA that shorten with age. Telomere shortening is seen as an indicator of biological aging, and telomere length has been shown to independently predict morbidity and mortality in patients with cardiovascular diseases, Dr Ramin Farzaneh-Far (San Francisco General Hospital, CA) and colleagues explain in their paper published in the January 20, 2010 issue of the Journal of the American Medical Association.

This is yet another reason for cardiologists to try to convince their patients to take either a fish-oil supplement or eat regular fatty-fish meals.

“This suggests the existence of a novel mechanism for why omega-3 fatty acids are effective in this patient population–an area that has not been well worked out previously; it suggests they could be acting through telomeres,” Farzaneh-Far told heartwire . “It’s also the first study that shows that a dietary factor may be able to slow down telomere shortening,” he observes.

However he stresses that this was, “at its heart, an observational study” and that a randomized trial will be needed to prove causality. But in the meantime, the results “underscore and reinforce the American Heart Association guidelines that patients with CAD should be taking 1 g a day of omega-3 fatty acids for secondary prevention,” he says. “This is yet another reason for cardiologists to try to convince their patients to take either a fish-oil supplement or eat regular fatty-fish meals.”

Those With Lowest Levels of Fatty Acids Had Fastest Rate of Telomere Shortening

The researchers recruited 608 outpatients with stable CAD taking part in the Heart and Soul Study between 2000 and 2002 and measured telomere length at baseline in the blood and again after five years of follow-up, using a standard telomere-length assay. They also assessed baseline blood levels of the marine omega-3 fatty acids docosahexaenoic acid (DHA) and eicosapentaenoic acid (EPA), expressed as a percentage of total fatty-acid methyl esters, “a relatively new blood test,” Farzaneh-Far explains.

Patients were divided into quartiles on the basis of their marine omega-3 fatty-acid levels, with means of 2.3%, 3.3%, 4.3%, and 7.3% in the four groups, respectively. Farzaneh-Far says an important point to note is that omega-3 fatty acids “can be obtained only from the diet; there is no endogenous production.” The optimal level of omega-3 fatty acids is not firmly established but is thought to be around 7% to 8%, “with most people on Western diets likely having levels way below what is optimal,” he says.

Those in the lowest quartile of DHA+EPA experienced the fastest rate of telomere shortening, 0.13 telomere-to-single-copy-gene ratio [T/S] units over five years, whereas those in the highest quartile experienced the slowest rate, 0.05 T/S units over five years (p<0.001 for linear trend across the quartiles).

Novel Study, With Two Measures of Telomere Length

Farzaneh-Far says the research is “one of the few . . . that has two measurements of telomere length, so we were able to measure the actual rate of change, which gives us a sense of the rate at which biological aging is taking place. From a scientific point of view, that is one of the novel elements of this study.”

Also, “from the telomere point of view, this is the first study to show an effect of a dietary factor, that this may be able to slow down telomere shortening,” he notes.

Even after extensive statistical adjustments for confounding factors, “we found a dose-dependent decrease in the rate of telomere shortening according to the level of baseline omega-3 fatty acids,” he reiterates, “suggesting that the association is causal.”

However, he acknowledges, “To prove this, you would need a randomized trial. This would entail taking patients and measuring their telomere length at baseline, then randomizing half to omega-3 fatty acids and half to placebo and measuring the telomere length again to see whether the treatment group had less shortening of their telomeres: that would be the gold-standard way to prove causality.”

Could Omega-3 Fatty Acids Be a Risk Factor for CHD?

Farzaneh-Far says the research also highlights a possible new concept: that omega-3 fatty acids could be used as a marker for coronary artery disease, in much the same way as cholesterol, for example.

“The idea is that the omega-3 index, the percentage of fatty acids in the blood, could be measured and that low levels would predict worse outcomes. So the omega-3 index might be useful for risk stratification in the future.”

Coauthor Dr William S Harris (University of South Dakota, Sioux Falls) is an advisor and speaker for and has received research grants from companies with interests in omega-3 fatty acids, including GlaxoSmithKline and Monsanto. In addition, he has recently founded a company, OmegaQuant Analytics, to offer blood omega-3 fatty-acid testing. Farzaneh-Far and the other authors report no disclosures.

Jet propelled: These carbon nanotubes were laid down using an ink-jet printer. Researchers hope to use the technology to print sensors that detect levels of estrogen and other hormones in a drop of blood.   Credit: Aneeve Nanotechnologies

Novel device could aid the treatment of infertility

MIT Technology Review, January 20, 2010, by Lauren Gravitz  —  Just as glucose meters have revolutionized the treatment of diabetes, researchers at a startup called Aneeve Nanotechnologies believe they’re building hormone sensors that could revolutionize the understanding and treatment of infertility, menopause, and other conditions related to hormone fluctuation.

Aneeve is part of a new technology incubator program at the University of California at Los Angeles. The company is working to create low-cost sensors that can be made with off-the-shelf ink-jet printers and carbon-nanotube ink. The printers lay down nanotube circuits that, upon binding to the estrogen protein estradiol, undergo a change to their resistance and optical properties and transmit that change via radio waves to another device. The company’s chief operating officer, Kosmas Galatsis says he hopes the result will be a system as convenient as glucose meters.

Currently, there’s no easy and inexpensive method to regularly test fluctuations in a woman’s hormone levels. “There’s a glucose meter, but no hormone meter to help people keep their hormones at a desired level,” Galatsis says. Researchers conducting clinical trials, or physicians trying to determine fertility rhythms, for example, require blood samples to be collected at a lab on a daily or twice-daily basis. But with a simple, use-from-home monitor, a woman could keep close tabs on her hormone levels by pricking her finger and depositing a drop of blood on a disposable carbon-nanotube strip. “If a couple can’t get pregnant, they can monitor their hormone levels over several months and try to fertilize when their hormone levels are optimal,” he says.

The scientists at Aneeve also believe that such a device could help researchers better understand menopause and determine when hormone-replacement therapy might be beneficial. “Having a cheap, pennies-on-the-test type of monitoring that’s accurate and measures multiple parameters may open up more research in that area,” says Kumar Duraiswamy, a physician and MBA candidate involved with the project. Right now, he says, “It’s not easy or convenient or cheap for women to go into a testing center.”

Galatsis notes that this is just the first application to emerge from a technology platform they hope will have broad uses. The platform is based on research by UCLA nanotechnology researcher Kang Wang and colleague Chongwu Zhou at the University of Southern California. “Our novelty is low-cost, print-anywhere-anytime, off-the-shelf technology,” Galatsis says. “We can convert any ink-jet printer just by changing the cartridge [to carbon nanotube ink], so we can print any type of sensors, and make RF circuits, right here.”

With funding from DARPA the group decided to focus first on monitoring estrogen and other hormones because there appeared to be a gaping need. So far, they’ve shown that their sensors are capable of sensing estrogen, but are only accurate to the level of nanograms per milliliter. In order to be effective with a single finger prick, that sensitivity needs to be improved by an order of magnitude (to picograms per milliliter).

The combination of technologies being used by Aneeve is “quite compelling,” says Jerome Lynch, an engineer at the University of Michigan. He notes that the company’s innovation lies in integrating multiple technologies that others have explored individually. “And they’re exploiting technologies that are cost-effective. When others have tried it, they’ve looked more at the proof-of-concept level, whereas [Aneeve] is looking more at commercial viability and scalability in the marketplace.”

Nicholas Kotov, a nanotechnology and chemical engineer at the University of Michigan, agrees that it’s the combination of numerous technologies that makes the project important. “The use of ink-jet printing technology for sensing, and particularly hormones, is interesting,” he says.

Ultimately, the researchers hope to build a small device that can be plugged into a smart phone and can translate data from the carbon-nanotube sensor strips into a log that helps users, and their physicians, keep track of the information. At the moment, Aneeve’s “lab” consists of little more than a bare benchtop inside the UCLA incubator facility. But use of the incubator’s clean lab, printing, and other facilities has eliminated the need for the startup to purchase its own equipment. “Our next steps are to further optimize the sensing platform,” Galatsis says, adding that they aim to have a working prototype in 18 months. 

MIT Technology Review, January 20, 2010, by Emily Singer  —  A compound may repair a defective enzyme in people who metabolize alcohol poorly.

An estimated 40 percent of people of East Asian descent carry a defective copy of a gene involved in breaking down alcohol, making them more susceptible to the harmful effects of drinking, such as nausea, facial flushing and rapid heartbeat. The gene codes for an enzyme called aldehyde dehydrogenase 2 (ALDH2), which breaks down a toxic metabolite of alcohol, acetaldehyde, into non-toxic acetate.

Researchers have now identified a molecule, called Alda-1, that appears to restore activity of the defective form of the enzyme. According to a release from the National Institute on Alcohol Abuse and Alcoholism, which funded the research:

The normal, active form of ALDH2 creates a catalytic tunnel, a space within the enzyme in which acetaldehyde is metabolized. In the defective enzyme, the tunnel does not function properly. Alda-1 binds to the defective enzyme in a way that effectively reopens the catalytic tunnel and thus allows the enzyme to metabolize acetaldehyde. Alda-1 binds to the defective enzyme in a way that effectively reopens the catalytic tunnel and thus allows the enzyme to metabolize acetaldehyde.

Research has shown that people with two defective copies of the gene are less susceptible to alcoholism.

 So why would you need a drug that helped them drink?

 Because the enzyme is also responsible for breaking down other toxic aldehydes that can accumulate in the body. The defective variation has been linked to an increased risk of cancer, and lack of response to nitroglycerin, a drug used to treat chest pain. According to Thomas Hurley, a biologist at Indiana University School of Medicine in Indianapolis who led the research, it “opens up the possibility of designing new analogs that can selectively affect the metabolism of other molecules that are detoxified by aldehyde dehydrogenase.”

From Medscape Medical News

UPDATED January 20, 2010, by Robert Lowes  — When Massachusetts voters elected Republican Scott Brown to the US Senate,  they threw a wild card into the poker game called healthcare reform.

Brown, a state senator, ran as an opponent of Democratic reform plans, and the Senate race in heavily Democratic Massachusetts was seen as a referendum on the Obama administration itself. Once he takes office — and when that will happen isn’t clear — Senate Republicans will command 41 votes, thus depriving Democrats of a 60-vote bloc (which includes 2 independents) that could prevent Republicans from filibustering healthcare reform legislation to death.

Both chambers of Congress passed separate healthcare reform bills late last year, largely similar but with a few salient differences. Usually, a conference committee consisting of House and Senate members would blend such dual bills into a single one that would come before both chambers for a final vote. Congressional Democrats chose instead to bypass the conference committee and merely amend the Senate bill behind closed doors to incorporate some House provisions.

That was the strategy before Brown upset Democratic contender and state Attorney General Martha Coakley in the race to fill the seat vacated by the late Edward “Ted” Kennedy, the Democratic lion of the Senate and the strongest Congressional advocate of healthcare reform during the past 40 years. The seat had been temporarily occupied by Paul Kirk. If Congressional Democrats can’t come up with a unified bill by the time Brown takes office, they won’t have the 60 votes needed to end a Republican filibuster.

Possible Strategy

To avoid that fate, Congressional Democrats have contemplated a hurry-up offense. They’ve considered the possibility of asking the House, for example, to quickly approve the Senate bill passed last year as-is — no dickering with House Democrats about their preferences. That way, they’d avoid a showdown vote in the Senate. And filibustering isn’t allowed in the House either.

Taking an unamended Senate bill to the floor of the House promises to leave a lot of parties disgruntled. For one thing, the House would be voting on legislation that lacks critical compromises reached earlier this month on taxing “Cadillac” health plans, all for the sake of preserving the support of labor unions. The Senate bill originally called for health insurers to pay a 40% tax beginning in 2013 on annual premiums above $8500 for individual health plans and $23,000 for family plans, but organized labor protested that the tax would be too hard on its members.

To placate the unions, Congressional Democrats upped the health-plan thresholds to $8900 for individual plans and $24,000 for family plans and indexed these thresholds to changes in the Consumer Price Index plus 1%. In addition, Democrats agreed to raise thresholds even further for plans for several groups, such as workers in high-risk professions; exempt dental and vision costs beginning in 2015, and delay imposing the tax on plans negotiated by organized labor until 2018. Such compromises would go by the wayside if the House votes on the Senate bill passed in December.

For their part, House Democrats with their own reform agenda are bound to dislike being forced to vote the Senate bill up or down. In several respects, the House plan is a bolder one. It extends insurance coverage to more nonelderly, legal residents (96% of this group vs 94% in the Senate plan), expand Medicaid eligibility further, and create a government-sponsored health plan to compete with private ones.

May Use Budget Reconciliation to Make Changes Later

However, any bill passed by Congress and signed into law by President Barack Obama could be revised afterward more to the House’s liking in a process called budget reconciliation. In the Senate, budget reconciliation measures can’t be filibustered, which means Senate Democrats need only a simple, 51-vote majority to get their way.

However, budget reconciliation does not allow legislators to freely revise enacted legislation. They’re essentially limited to tweaking congressional budget resolutions regarding spending, revenue, and debt levels. So budget reconciliation probably would not allow Democrats, for example, to make the Senate bill as hawkish as the House bill is about not funding abortions with taxpayer money.

In any event, it’s not clear how much of the House bill will make it into the Senate bill in the reconciliation process, whether it’s related to the budget or not. At risk, for example, is the House provision to increase Medicaid reimbursement to physicians to Medicare rates — a $57 billion boost to physician revenue over 10 years. Organized medicine also prefers the House’s nonpunitive approach to the Physician Quality Reporting Initiative in Medicare. While the Senate bill imposes penalties on physicians who fail to participate, the House bill does not.

Command control: The company that makes most laptop touch pads has developed

software that lets users accomplish complicated tasks with the touch pad alone, as shown

above.            Credit: Synaptics

A company says sophisticated gestures will reduce dependence on keyboards

MIT Technology Review, January 20, 2010, by Erica Naone  —  New software promises to let laptop users accomplish complicated tasks without lifting their fingers from the touch pad. The software, called Scrybe, is made by Synaptics, a Santa Clara, CA, company that already provides touch pads for 70 percent of notebooks on the market and 90 percent of their smaller netbook cousins. The software is currently available to a limited number of beta users.

With Scrybe, users can perform tasks, such as performing a search on Wikipedia, by tracing one of a number of predetermined shapes on a touch pad. They can also create custom gestures for specific custom tasks.

Ted Theocheung, head of the Scrybe program and Synaptics’s PC and digital home business unit, says the software is built around the idea of “gestural workflows,” which accomplish fairly complex tasks, such as conducting online research, shopping, or using multimedia, with the touch pad alone. Theocheung says that gestures can eliminate the need to type and shorten the number of steps needed to complete a task. Some laptops already feature simpler multifinger gestural controls, such as two-finger scrolling.

A user initiates Scrybe by tapping three fingers against the touch pad. This activates a mode in which the user can draw commands with a single finger that set off strings of actions. For example, a “W” opens Wikipedia and searches for a phrase the user highlighted previously. When the user is ready to go back to using a single finger, another three-fingered tap exits Scrybe’s command mode.

“I think there’s definitely value in being able to maintain focus on the track pad,” says Gabriel White, interaction design director at Punchcut, a user-interaction design firm based in San Francisco. White notes that the Synaptics software includes multitouch gestures, but suggests that many aspects of Scrybe’s gestural workflows are similar to keyboard shortcuts–useful and appealing to an advanced user, but likely to overwhelm a more casual user.

More complex gestural interactions are possible because of the underlying technology of touch pads, says Theocheung. Newer touch pads use “image sensors” that gather “pixels” of touch data from the pad and use that to build up an image of how the user is in contact with the device. “Some of the Scrybe technology has been in our labs a long time, but we needed these new sensors to make it a reality,” Theocheung says.

Those who own older devices can use a simpler version of Scrybe that lacks multitouch but still supports command symbols drawn with a single finger. Synaptics will soon include Scrybe in the software packages it delivers to manufacturers, which then sell the software along with new laptops.

However, White says the success of gestural interfaces may depend on developing a vocabulary that can be transferred from one product to another. “If you give someone a touchscreen phone, they immediately start doing the gestures they have learned from However, White says the success of gestural interfaces may depend on developing a vocabulary that can be transferred from one product to another. “If you give someone a touchscreen phone, they immediately start doing the gestures they have learned from iPhone,” he says. 

Spotlight on 3-D: Specialized cameras will be required to provide content for 3-D televisions.
Credit: ESPN 

Glasses-free 3-D television is still a long way from the market; but…
Mitsubishi currently sells its 3-D televisions for between $1,500 and $4,200
MIT Technology Review, January 20, 2010, by Erica Naone  —  Television manufacturers and content producers started out the year pushing 3-D television hard, hoping to ride the wave of success enjoyed by the 3-D movie Avatar. Though glasses-free 3-D is still some ways away, manufacturers hope to entice consumers with a flurry of products that make the best of the difficulties with bringing 3-D content to the small screen.

Producing a 3-D television that doesn’t require glasses is “impractical for the foreseeable future,” says Peter Fannon, vice president of corporate and government affairs for Panasonic.

Demos featuring glasses-free 3-D television technology have yet to pan out into real products. Two years ago, Mitsubishi attracted attention by showing off glasses-free 3-D research technology, but the company has no products based on the work.

Fannon says that a key trouble with glasses-free 3-D is that it would significantly raise production costs. Most glasses-free TV displays use a lenticular lens, which gives off light at different angles–so that a different image reaches each eye. Such a display requires images of the same object to be captured from many different angles, forcing content producers to film and process the same scene from a dozen or more angles at a once. “That’s a production cost no one can bear,” he says. Lenticular lenses can also distort a picture, and viewers often have to watch from a specific angle.

Instead, 3-D technologies in use today employ glasses to control the images. The most common technology, used in movie theaters, is made by RealD, a company based in Beverly Hills, CA. This technology uses a special screen to reflect polarized light to the audience when images are projected onto it. The glasses then filter the light so that images are directed correctly to each eye.

RealD has made deals with many of the major manufacturers, including Sony, JVC, Samsung, Toshiba, Panasonic, and DirecTV, to use its format to deliver 3-D content to televisions. However, the majority of 3-D televisions use “active eyewear” to process 3-D content for each eye, unlike the passive glasses used in movie theaters.

Active glasses for 3-D are battery-operated, and they have lenses that rapidly shutter open and closed. The television display–often an LCD or plasma screen–works double-time, cramming in twice as many pictures so that a each eye sees a continuous, high-quality image.

A RealD spokesman explained that the special screen technology used in movie theaters, where the display does most of the work, would be too expensive if translated to 3-D TVs for consumers. Active glasses, on the other hand, are too expensive for movie theaters to hand out in volume, but work well for home users.

Panasonic’s Fannon adds that polarized glasses work best in a dark environment, where a large screen fills the audience’s entire field of vision. Active shutters are better suited to the home environment, he says.

The challenges brought by 3-D aren’t just in the display technology, either. Sports network ESPN recently announced that it would offer a special 3-D channel, which will start out in June showing World Cup events. As part of offering this content, the network has to change some of its filming practices, explains Anthony Bailey, vice president of emerging technology at ESPN.

“The biggest change is the camera placement,” Bailey says. Shooting in 3-D works best if the cameras are positioned closer and lower than normal, Bailey says. He notes that in tests the network has done, changing from one camera to another can introduce changes in perspective that can alter the perceived size of players on the field. Heavy movement also tends to blur, and placing graphics on-screen can be challenging.

Bailey says ESPN will start out showing soccer partly because the network’s tests have helped it determine some of the best ways to present the sport in 3-D. ESPN is still looking into the best ways to shoot golf tournaments and other sports.

Besides simply making sure that content is available, part of the industry’s strategy is to offer lots of 3-D-enabled products. In addition to televisions, companies are releasing 3-D-enabled Blu-ray players and camcorders. Consumers who want 3-D content from satellite TV service DirecTV will need to download new software for their set-top boxes, but they won’t need any new hardware.

Panasonic’s Fannon believes that this approach will make 3-D television mainstream in a much shorter time than it took to gain widespread adoption of HDTV. With that earlier technology, he says, there was a “chicken and egg” problem–content and hardware weren’t released in step with each other. The hope now, he says, is that consumers will upgrade to 3-D when they buy new televisions, since there is content available and they won’t need additional hardware. In contrast, consumers who wanted HD content from DirecTV, for example, had to buy a set-top box and new dish in addition to a new television.

Fannon says Panasonic plans to offer its plasma screen 3-D televisions for a few hundred dollars more than the baseline price for a standard full-featured television. Mitsubishi currently sells its 3-D televisions for between $1,500 and $4,200