Sacramento officials Thursday night presented a plan to cap the number of marijuana dispensaries in the city at a dozen and impose strict requirements for their operations.

Faced with a packed room of pot shop owners and medical marijuana advocates, City Manager Gus Vina asked for measured input on "an emotional issue."

But representatives for marijuana patients and many of the city's 39 registered dispensaries threatened lawsuits. They charged the plan would shutter tax-producing businesses and deny care to hundreds of cannabis patients.

"This proposal would kill myself and other patients in similar situations," complained Ryan Landers, a Sacramento senior adviser for the Compassionate Coalition, a medical marijuana advocacy group. "You're going to close clubs where hundreds of patients get marijuana. This is a huge problem for the sick."

Landers, whose neck was bandaged on both sides from pain shots he takes for shingles, told city officials he was one of the architects of the 1996 Proposition 215 medical marijuana law.

He said the city plan amounted to Sacramento turning its back on people who should be protected under Proposition 215.

But Vina said Sacramento is trying to accommodate patients and communities. "There are a handful of cities that are trying to do something. And we're one of them," Vina said.

Robert Shantz, a lawyer for a dispensary association, the Sacramento Alliance of Collectives, said the city is offering "prohibition masquerading as authorization."

The plan includes a lottery to determine which pot shops could stay in business. It would require dispensaries to maintain security and would ban the hiring of workers with felony convictions.

It also would require pot shops to label their products with a disclaimer saying that the dispensary – not the city – assumes "risk of injury or harm" from any marijuana sold.

Sonny Kumar, co-founder of the El Camino Wellness Center, complained that the ordinance could force virtually every Sacramento pot shop to close.

He cited provisions that would restrict dispensaries to commercial and industrial zones and ban clubs within 300 feet of neighborhoods or 500 feet of churches, parks, schools, youth facilities or substance abuse centers.

"It would result in only three locations where clubs or dispensaries would be left in the total city," Kumar said.

Michelle Heppner, a special project manager working on the dispensary issue, said Sacramento officials studied Oakland, a city with a slightly larger population.

Oakland passed an ordinance allowing only four dispensaries but is considering expanding to 14, Heppner said.

Oakland also passed the nation's first special tax – on top of the state sales tax – for local medical marijuana sales. The Sacramento proposal doesn't include a local taxing plan.

City Councilwoman Lauren Hammond, who chairs a committee that will review the proposed ordinance, said she is concerned about dispensaries clustering disproportionately in a few city areas, including midtown.

She said Sacramento needs to get control of the issue to avoid a scenario similar to Los Angeles, where officials grappled over an ordinance as hundreds of dispensaries kept opening.

"We don't want to wind up like Los Angeles," she said. "We don't want to rush to do this, but we want to be timely."

WHAT'S NEXT?

The Sacramento City Council's Law and Legislation Committee is expected to work on the proposed dispensary ordinance in April and May. If approved by the City Council, the ordinance could go into effect in June or July.

Jason Sterling of Rio Linda stands at a sparsely attended rally at Cesar Chavez Plaza in support of medical marijuana prior to Thursday evening's meeting across the street in City Hall. Sacramento has 39 registered medical marijuana dispensaries.

A hub for regenerative medical research opens today in Sacramento, putting the University of California, Davis, in the forefront of stem cell research.

UC Davis already is testing dozens of therapies in the laboratory, such as HIV treatments and organ regeneration, and is even using stem cells to repair injuries in horses.

The new $62 million UC Davis Institute for Regenerative Cures will consolidate those efforts, which are scattered in various locations in the region. The center will bring 200 scientists and laboratory personnel together under one roof.

Experts say the new center reflects where medical advances are heading.

"Regenerative medicine will take us into a whole new era of medicine, especially personalized medicine, because we can make a cell line for each patient," said Jan Nolta, director of the UC Davis stem cell institute.

The red brick building a few blocks south of UC Davis Medical Center in Sacramento will be the first of a dozen major laboratories to open in California, funded in part by Proposition 71 of 2004. The initiative, the California Stem Cell Research and Cures Act, authorized $3 billion in bonds.

The new institute, housed in a former California State Fair exhibit hall on Stockton Boulevard, received $20 million from the state's agency in charge of stem cell funding – the California Institute for Regenerative Medicine.

Outside, the 1940s structure has arches and Corinthian columns. Inside, it sports 90,000 square feet of hallways and pure-white state-of-the-art research facilities.

Giant tanks of liquid nitrogen store stem cells, and the researchers will work at rows and rows of laboratory benches.

Powerful filters hum and change the air every minute to discourage contamination. A normal cubic foot of air has 35 million dirt particles. This lab has fewer than 10,000.

"When we start working here in a month, we're going to have to wear all sorts of coverings and masks," said Nolta, one of America's top stem cell researchers with more than 20 years of research experience.

A year ago, President Barack Obama lifted a ban on embryonic stem cell research that was imposed by former President George W. Bush.

But UC Davis now is moving away from using embryonic stem cells, Nolta said. Instead, researchers have found that skin cells have the ability to function much like embryonic stem cells.

Lab designer Gerhard Bauer said skin cells can produce a more favorable outcome.

"With skin cells we can make a personalized stem cell line, so there is no chance the patient would reject the stem cells," he said.

Bauer hopes to get the skin cell technique to clinical trials within five years.

The opening of California's first major center comes as national policy and public acceptance of stem cell research has shifted, observers said Tuesday.

Robert Klein, who conceived, wrote and led the campaign for Prop. 71, said the change has been sweeping. He cited three examples:

• First, the scientific community has identified new therapies it believes will be successful in treating a number of chronic diseases. The therapies are expected to reach human trials within 48 months.

• Second, $270 million in bond funds combined with another $880 million of donor, institutional and matching funds are financing the new stem cell centers, most attached to the UC system.

• Third, he said, there has been a "broad-based global validation" of California's leadership in the field, with more than a half dozen nations seeking collaboration and bilateral funding of some projects.

Judy Roberson, president of the Northern California chapter of the Huntington's Disease Society of America, said stem cell research is more accepted. Her husband died from Huntington's in 2003 at age 51.

"Before, people used to think of stem cells only as embryonic," she said. "Now there are a lot more types of cells. And people are starting to listen."

Acceptance grew, too, with the personal stories of well-known public figures who sought the benefits that stem cell research could bring.

The late Christopher Reeve, who became a quadriplegic after he was thrown from a horse, was perhaps the best known advocate for research to treat spinal injuries.

Actor Michael J. Fox has promoted stem cell research to aid those with Parkinson's disease, a degenerative disorder of the central nervous system.

Lisa Hughes, president of the Coalition for the Advancement of Medical Research in Washington, D.C., said both have been powerful persuaders of public opinion.

She said Obama's decision to reverse Bush's policy on embryonic stem cell research was pivotal.

"Just lifting that policy alone has breathed new life into the research community, and there is a sense they can move forward now, supported by the federal government," Hughes said.

California isn't the only state paying for stem cell research. New York is spending $600 million, said John Robson of the California Institute for Regenerative Medicine.

The California institute reports that it has funded more than 425 discoveries being published in scientific journals, each discovery moving closer to new therapies.

At UC Davis, dozens of therapies are being tested. Nolta, the stem cell institute director, described the process of using bone marrow cells for damaged hearts with a bit of awe.

"We put the stem cells into the bloodstream through an IV bag, and the stem cells find the injured area and repair it," she said. "It's really amazing."

Don Cross climbs up to secure a banner welcoming visitors to today's grand opening of the UC Davis Institute for Regenerative Cures in Sacramento. The facility boasts 90,000 square feet of hallways and state-of-the-art research facilities.

Jose Nunez, of Classic Party Rentals, aligns one of 400 chairs being set up for today's grand opening of the $62 million laboratory for stem cell research, funded in part by 2004's Proposition 71.

In a test of how much marijuana reasonably can be carried for personal medical needs, a Sacramento jury Tuesday convicted a man of felony transportation for attempting to take 3 pounds of pot through Sacramento International Airport.

The case of Matthew Zugsberger, 34, a deep sea diver injured in an oil rig accident, left jurors saying they were confused by California's hazy medical marijuana laws and troubled by the case they had to decide.

Earlier in the day, jurors had told Sacramento Superior Court Judge Roland Candee that they were "hopelessly deadlocked" on a felony charge of possessing marijuana for sale.

The judge ordered them back into deliberations. A few hours later, they found Zugsberger innocent of possession of marijuana for sale but guilty of simple possession, a misdemeanor.

They also convicted him of illegally transporting marijuana, a felony that could land him in prison for four years.

Zugsberger, who has been free in lieu of $100,000 bail, was taken into custody. Candee scheduled sentencing for April 8.

Zugsberger, 34, had a Mendocino County physician's recommendation saying he could possess up to 5 pounds of pot and 25 plants.

He testified that he packed his luggage and clothing with marijuana for a flight to New Orleans so that his ex-wife and another master chef could meld it into food products for his personal use.

He said he was hoping his case would be bolstered by a Jan. 21 California Supreme Court decision which found that the state cannot impose limits on how much pot medical marijuana users can grow or possess.

In that case, the high court voided the conviction of cannabis patient Patrick Kelly of Long Beach, finding that the Legislature improperly amended Proposition 215 – the 1996 ballot measure that legalized medical pot use in California – by restricting medical users to 8 ounces of dried pot and six mature or immature plants.

The 2003 legislation, Senate Bill 420, also allowed local governments to approve standards exceeding the state possession limits.

The attorney for Zugsberger, who looked crushed as the verdict was read, said his client will appeal.

"Obviously, this was the first case to interpret the Kelly decision," said defense lawyer Grant Pegg. "So it is going to be heavily monitored."

Prosecutor Satnam Rattu argued that the amount of pot Zugsberger had – and its packaging – suggested possession for sale.

Before Tuesday's verdict, Zugsberger said outside court that he considered himself a test "for all our medical rights and freedoms."

His trial took only a day and a half. But the jury – which requested the text of Proposition 215 – took more than three days to render a verdict.

"His (physician's) recommendation said he was allowed to carry 5 pounds," said juror Laura Pope of Sacramento. "But the law says it (medical marijuana use) is for current medical needs.

"The way the laws were written, we really had to struggle."

She said the jurors had particular difficulty deciding whether the amount of marijuana Zugsberger was carrying constituted possession for sale or simple possession. She said the panel more readily agreed that he was illegally transporting pot.

"That was easiest for us – because he checked his bags. And he was going," she said.

Zugsberger was preparing to board his flight when airport security officers found marijuana in a metal dominoes container – and also wrapped in a scuba suit – in his checked baggage.

He presented a copy of his marijuana recommendation from Dr. Milan Hopkins, a former general practitioner who runs a Mendocino County "alternative medi-spa" featuring herbal treatments and laser hair removal.

Hopkins' standard medical pot recommendation reads: "Any one of my patients may need to grow 25 mature plants and possess 5 pounds of cannabis for their yearly medical needs."

Prosecutors argued that the recommendation didn't spare Zugsberger from charges of illegally possessing and transporting pot.

"I struggled with that," said juror Vera Nichols of Sacramento. She was unwilling to convict Zugsberger on the felony count of possession for sale.

"There needs to be changes in the marijuana laws," she said, "because it's not clear."

Today, an Assembly watchdog committee is expected to question officials from the Department of Insurance and the Managed Health Care Department.

Both agencies have boasted of their record in going after insurance companies for so-called rescission practices.

But some elected officials say the state agencies have done a poor job in helping subscribers regain coverage or recoup expenses for medical care that should have been paid for by their insurance companies – had their policies not been rescinded.

"There has been no follow-through," said Assemblyman Hector De La Torre, D-South Gate, who chairs the Assembly Committee on Accountability and Administrative Review, which is holding today's hearing.

"When you're a regulatory agency and you claim to have fixed the problem, and yet a year and a half later, pretty close to nothing has happened, it deserves scrutiny," he said.

According to a report prepared for today's hearing, about 6,000 Californians had their policies rescinded by the state's five largest health insurers between 2004 and 2008.

The Managed Health Care Department attempted to inform 3,366 affected subscribers of the settlements via letter, but only 177 of those letters resulted in new coverage and only 92 subscribers recovered out-of-pocket medical expenses, totaling $870,000.

Lynn Randolph, spokeswoman for the Managed Health Care Department, took issue with the criticism.

She said the low participation rate is not unusual.

Randolph said the agency should be lauded for its crackdown on rescission practices, which has reduced the number of cases from about 1,500 in 2005 to less than a dozen.

Randolph said her agency sent out letters, aired public service announcements and did what it could to get consumers to participate in the settlements.

WASHINGTON – Thousands of liberal public-option backers and conservative tea partiers launched last-chance campaigns Tuesday in the nation's capital to persuade Congress to pass – or reject – sweeping health care legislation.

Democratic congressional leaders conceded that they may not have the votes for final passage of the overhaul by March 26, when Congress is to break for spring recess. They're trying to persuade party moderates and abortion foes to go along. President Barack Obama wants final votes even earlier, before his March 18 departure on an overseas trip. That appears unlikely.

Republicans launched an all-out effort to derail the bill, urging congressional candidates to hold town hall meetings, organize voters over the Internet and denounce any special deals that may be cut to grease Democrats' votes.

"A vote for this bill opens an entirely new line of attack on House Democrats," wrote Johnny DeStefano, deputy director of the National Republican Congressional Committee, in a memo to candidates.

The U.S. Chamber of Commerce said it will spend as much as $10 million on a television ad claiming that Obama's plan will only worsen the bad economy and job market.

And Obama senior adviser David Axelrod, on a conference call Tuesday, told advocates of the legislation, "What happens in the next 10 days will be critical."

Despite their divergent goals, what these camps share is an acute understanding of what happened last year after Democrats failed to pass the health care overhaul before the monthlong congressional August recess. In the boisterous town hall meetings and small-government tea party protests that followed, all sides learned that delaying a big vote until after a recess buys the opposition time, and that public demonstrations can have an impact on the political process.

"Our intent and our hope is to have no vote take place before recess," said Mark Skoda, founder of the Memphis Tea Party and a spokesman for the "Take the Town Halls to Washington" campaign that began Tuesday.

The group's Web site asked volunteers to travel to Washington before the two-week spring recess to lean on 66 Democratic lawmakers in the House of Representatives that they consider to be wavering on Obama's plan: "We want to let them know there is only one vote their constituents will support: No on Obamacare."

Organizers plan to videotape the meetings and release them to constituents.

In the pro-legislation camp, thousands of supporters of Obama's plan – many organized by unions and some dressed in hospital gowns with tubes taped to their faces – protested outside a Washington hotel where a meeting was being held by America's Health Insurance Plans, the trade group of health insurers.

Ten protesters crossed a police line saying they were there to make citizens' arrests of insurance officials. Police hauled the 10 away.

At an earlier rally nearby, Howard Dean, the physician, former Vermont governor and 2004 Democratic presidential candidate, declared that Republicans are in the bag for insurance companies. He said the question for wavering Democrats is: "Are you for the insurance companies or the American people?"

Sen. Barbara Boxer, D-Calif., a supporter of the overhaul, said demonstrations do sway congressional votes.

"The more people rally, the more it shows people here they care," she said. "It adds to the excitement. It tells you people are engaged."

But Sen. Ben Nelson, D-Neb., a moderate, added that "you have to remember that there are those who are quiet who merit consideration."

Republicans remain united against the legislation.

Sen. John Thune, R-S.D., said lawmakers who support Obama's plan will be casting a vote for "higher taxes, Medicare cuts and higher premiums for most Americans. Those core elements and core features of that bill have not changed."

Port-au-Prince appeared as heaps of rubble growing ever distant as the plane carrying Dr. Hernando Garzon flew home from Haiti.

"It's hard to appreciate the devastation without a bird's-eye view," said Garzon, an emergency room doctor at Kaiser's Sacramento Medical Center who led a team from Relief International during two recent trips to the country.

He was one of dozens of capital area doctors and nurses who descended on Haiti in the days and weeks following the massive Jan. 12 earthquake.

"I felt I left too early. There is still so much work to do," Garzon said.

With the rainy season approaching, there is heightened concern that Haiti's people will be ravaged anew – this time by infectious diseases, malaria and other mosquito-borne ailments. Mudslides could add to the misery, making it more difficult for doctors to treat the injured and producing unsanitary conditions that could cause wounds to become infected.

"We're all worried that there's a second wave of suffering that is coming, with so many people living out there in tents, in rainy conditions. There's the increased possibility of disease," said David Harbin, who is coordinating the Haiti response for Relief International.

Other calamities, such as Monday's quake in Turkey and the recent quake in Chile, could divert global attention from Haiti at the worst time, Harbin said.

"The level of suffering in Haiti is magnitudes greater – just by sheer numbers of people who died," he said. "Haiti will continue to need our help for some time."

Haiti's government estimates 200,000 people were killed by the 7.0 earthquake and a half-million survivors left homeless and threatened by disease in the teeming tent cities that have risen amid tons of rubble.

Already, there have been at least 11 reported cases of malaria, according to the U.S. Centers for Disease Control and Prevention, which dispatched a team of nearly 400 staffers to aid and monitor relief efforts. Other communicable diseases, such as typhoid and dysentery, have afflicted segments of the population.

Scores of doctors and nurses from the across the United States – it's unclear how many – have flown to Haiti to lend their expertise.

Dr. George Lian, an orthopedic surgeon aligned with Sutter Health and Mercy's Sacramento hospitals, spent a week in Haiti, returning home to the capital on Saturday – on the same day that one of his colleagues, another orthopedic surgeon, flew to Haiti.

"The big problem right now is with infections," said Lian. Downpours are already adding to the challenges. "When it rains, it's awful hard for people to get to your facility," which he described as makeshift clinics housed in tents.

"Just trying to keep things clean is much more difficult with mud everywhere," Lian said.

"When I arrived, it was a little disorienting," he said. "Initially, I didn't quite understand the depth of it. … The devastation is amazing, just how many buildings had collapsed and the thousands of people who now end up sleeping outside at night."

The global community has poured more than $2 billion into Haiti for relief efforts, but the needs are still great.

Even before the quake, the country was among the world's poorest. Concerned with the lack of access to health care, Doctors Without Borders already had thousands of volunteers in Haiti when the quake hit.

"The Haitian health care system was already weak prior to the earthquake, and it is not in a position to provide the required care," Christopher Stokes, the group's general director in Brussels, said in an interview posted on the organization's Web site.

Doctors Without Borders has more than 3,000 personnel in the country and has treated more than 40,000 people since the quake, according to the medical relief organization. It has distributed about 7,000 tents.

Much of the country's health care infrastructure was demolished when the temblor struck. Entire neighborhoods were flattened, and most hospitals in the capital of Port-au-Prince were rendered nonfunctional.

Garzon, the Kaiser emergency room doctor, made two trips to the country. His first, just days after the quake, lasted 12 days. On his second trip, which lasted 17 days, he took his 18-year-old daughter along.

As he flew away from the city on Feb. 16, the magnitude of the job ahead was readily apparent.

"None of the cleanup and rebuilding seems to have begun," he said.

On a blog hosted by Kaiser Permanente, he could only marvel, he said, "at how quickly I adapted to the utter chaos and destruction around me."

Garzon gazed out the airplane window at the collapsed neighborhoods that were now the color of dust and earth. "I could identify the streets that I had been through."

Up close, the sorrow and misery were more evident. Garzon spoke of a 15-year-old girl whose arm was amputated to free her from the rubble of her collapsed school.

Children have been particularly traumatized.

"There's a lot of psychological trauma. The kids were very, very traumatized, and that hasn't been addressed," said Dr. Douglas Gross, a UC Davis pediatrician who embarked on a two-week stint for Haiti on Jan. 22.

"I've struggled significantly since I've been back with the degree of the devastation and thinking about what the future holds for the Haitian people," Gross said.

"My concern is that this is going to fade from people's memories," he said, "even though the aftermath is going to be here for a long, long time."

Only the UC Davis researchers who created Nutributter have a lofty goal: preventing childhood malnutrition across the world.

Each ketchup-packet-size dose of Nutributter is 4 teaspoons stuffed with 120 calories and all 40 essential vitamins and minerals.

The goal is to get children in developing nations to consume one packet a day, starting in infancy.

"Kids love it," said Steve Vosti, part of the UC Davis team that helped develop Nutributter. "And if we are successful in introducing it, we will have a relatively cheap way of keeping kids on their mental and physical growth paths."

The UC Davis team leads the International Lipid-based Nutrient Supplements (iLiNS) Project, an international collaboration that is currently testing Nutributter in three African countries. Last year, the project won a $16 million Bill and Melinda Gates Foundation grant.

The idea of ready-to-eat food packets originates from Plumpy'nut, a similar paste of oil, milk powder and sugar used to combat severe childhood malnutrition. Each packet has 500 calories, and children can gain 1 to 2 pounds a week by eating it twice daily. In 2004, Plumpy'nut was credited with saving some 30,000 lives in the Darfur region of Sudan.

Nutributter is different because it's not an emergency measure, the researchers said.

Plumpy'nut was designed as a sole food source for severely malnourished children, whereas Nutributter complements - rather than replaces - home-prepared food, said UC Davis nutrition professor Kathryn Dewey. Parents can mix the paste into the foods they feed their children, usually some kind of porridge. Ideally, it will prevent childhood malnutrition and ensure proper cognitive and physical development.

"Many households simply don't have access to highly nutritious foods," Dewey said. "Because infants don't need a lot of calories, we've designed a supplement that is low in calories but has all the essential nutrients."

The iLiNS team is conducting field trials in three African nations: Malawi, Ghana and Burkina Faso. They will enroll about 7,000 infants and pregnant and lactating women, who receive free Nutributter packets in exchange for participating in weekly checkups and surveys.

A 2004-06 Nutributter trial in Ghana reduced childhood anemia and growth stunting and doubled the number of children who could walk independently at age 1.

But Nutributter's positive health effects are just one component of making it a successful venture. The 10-cent packets should be self-sustaining, so that if they were sold in grocery stores, parents would choose to buy them, said Vosti, an economics professor.

"There are plenty of examples of things we know would work, but people simply aren't adopting them," he said. "We need to have a game plan for what can be done to make sure these supplements get into the mouths of youngsters who need them."

One way of doing this is to satiate palates around the world. The team says kids like and ask for the sweet paste, but creating versions using local flavors might make Nutributter more appealing. For example, they are working on a cinnamon-flavored version to be evaluated in Guatemala, and cumin and cardamom versions for Bangladesh, Dewey said.

A new study tracking 20,000 American women through middle age found those who had two or more drinks a day gained less weight than their non-drinking counterparts.

The study is published in the March 8 issue of Archives of Internal Medicine.

Researchers at Brigham and Women's Hospital in Boston asked normal-weight women 39 years and older to report their weight and drinking habits. Normal weight for women is defined as a body mass index between 18.5 and 25.

Through the nearly 13 years of follow-up, the women steadily gained weight.

However, women who drank more than 30 grams of alcohol a day – about 2 normal-sized drinks – gained the least weight. They gained on average 3.4 pounds, with the amount of weight gained increasing with decreased alcohol consumption. The non-drinkers gained an average of 8 pounds.

When looking at the risk of becoming obese, any woman who imbibed 15 or more grams of alcohol a day – or 1 or more drinks – would be at lowest risk.

Not all alcohol is equally kind to the waistline. While drinking any kind of alcohol decreased the risk of becoming obese, red wine drinkers were least likely to become obese. Beer and liquor came in second, with white wine having the weakest correlation with declining obesity risk.

The findings oppose the conventional wisdom that alcohol is misspent calories.

"I'm really puzzled by the findings," said UC Davis nutrition professor Judith Stern. "I would think that when people drink something at a cocktail party, their inhibitions are lowered and they get the munchies and eat more."

The study's authors think it's because women might forgo dessert if they have the extra glass of chardonnay.

Additionally, "other studies have shown alcohol consumption in women can induce increased energy expenditure," said author Lu Wang, an epidemiologist with the division of preventive medicine at Brigham and Women's Hospital.

It's not likely men exhibit the same self-control. Wang cited past studies showing men who drank tended to put on pounds.

Physique aside, research on alcohol and its health implications is mixed.

Experts agree that moderate drinking may reduce the risk of heart disease and strokes, said Valentina Medici, a gastroenterologist at UC Davis Medical Center.

But she said heavy drinking damages the liver and increases risks of certain cancers.

Furthermore, it's more dangerous for a woman to drink heavily.

"High amounts of alcohol are more toxic for women than men," she said. "Women can get sicker and their liver can be more affected at a younger age."

As a registered nurse, Rosey Ramsey knew there was something wrong as soon as she woke up that night. Her right side was tingly and numb. She made it into the bathroom without difficulty, and then she lost her balance, tearing at the shower curtain as she fell.

It was Aug. 15, 2002. She was 52 years old, and she was having a stroke.

"I was determined from the get-go," said Ramsey, now 59, a stroke activist who lives in West Sacramento. "This wasn't going to hold me down. At 52, you've got a bunch of living left to do. You'd better learn to live your best life ever after having a stroke."

Years earlier than medical experts expected, stroke may be becoming a baby boomer disease. Several recent studies show the incidence of stroke in people in their 50s and younger has increased so much in some regions of the country that the average age of first stroke has dropped from 71 to 68.

Stroke – the interruption of blood flow to the brain, which can lead to loss of brain function – is America's leading cause of disability and the third most common cause of death. And it is no longer your grandparents' disease.

"Not at all," said Dr. Richard Atkinson, a Sutter Medical Center neurologist and stroke specialist. "In women, it's more common than heart attack until age 40."

The American Stroke Association says 3 percent of women and 1 percent of men in their 40s and 50s suffer strokes.

But in what some experts fear could indicate a disturbing new trend, half the patients treated for stroke in a recent Washington University School of Medicine study were younger than 65, and a quarter were younger than 55.

Ramsey's risk factor was genetic: Strokes were such a medical issue in her father's family that few relatives lived beyond their 50s.

For Nancy Briggs – a Sierra College music professor who suffered an aneurysm leading to stroke at age 58 – the risk factor was gender, said her Kaiser Permanente Sacramento Medical Center neurologist, Dr. Paul Akins.

Ethnicity can be another factor, with people of Asian or African American descent at statistically greater risk of having strokes earlier in life. But for many other stroke patients in their 50s and younger, lifestyle choices are to blame.

"We see more stroke in Sacramento in younger people because of methamphetamine use," said Atkinson. "I see middle-class secretaries who come in with cerebral hemorrhage and test positive for methamphetamine.

"They say they're using it for weight loss. People always say that. No one ever says they're using it recreationally."

The top cause of stroke is high blood pressure. Smoking, another stroke cause, may be on the wane, but obesity – which many times can lead to hypertension, diabetes and other conditions that increase stroke risk – is on the rise.

"One of the biggest factors is obesity," said Akins. "That leads to diabetes. We're seeing young people having strokes from diabetes and renal (kidney) failure."

An accomplished pianist, Briggs was playing in a recital on Nov. 8, 2008, when she suddenly developed a pounding headache. Sounds faded momentarily, and she started seeing lights. She thought she was having a migraine – not that she'd had one before – so she continued with the concert.

When Akins saw her later in intensive care, she was paralyzed on the left side, with major stroke symptoms, the result of a ruptured aneurysm and severe arterial spasms.

After extensive treatment, three weeks in an intensive-care unit and two more weeks in rehab, she returned to the piano.

"I started a regimen of practicing as if I was a beginner," said Briggs, now 59, who lives in Rocklin. "I really improved. I got it back."

A year ago, with Akins in the audience, she played her first post-stroke concert. This weekend, she participated in another. She returned to teaching at Sierra College last July.

For Ramsey, despite extensive rehabilitation, the outcome was somewhat different.

She walks with a slight limp and has limited use of her right arm. But she also has a sunny personality and a bright smile that she worked hard in physical therapy to get back.

Stroke changed her life. She leads support groups, helped compile a directory of local stroke resources and works one-on-one with new stroke patients.

"It's become my new career," she said. "It's not making lemonade from lemons at all. It's finding a way to be better than you were before."

Nancy Briggs chats with neurologist Paul Akins after her piano performance in Sierra College's faculty recital Sunday. After Briggs suffered a stroke, she worked hard to regain her piano skills. "I got it back," she said.

Also on Thursday, Sen. Dianne Feinstein, D-Calif., introduced legislation that would give the federal government authority to reject rate increases that insurance companies cannot justify.

The developments come as President Barack Obama intensifies his push for legislation to overhaul the country's health care system, with escalating premiums his central talking point.

Posting rate increases online would "shine a bright light" on how premiums are set, said Health and Human Services Secretary Kathleen Sebelius.

She met Thursday with the top executives of the country's largest health insurance firms, including the CEO of WellPoint, whose California subsidiary, Anthem Blue Cross, recently triggered a political firestorm when it raised rates by as much as 39 percent for thousands of customers.

"I'm hoping that the CEOs respond to the call for putting their information up in public," Sebelius said. "At the very least, they owe it to consumers to justify why the rates are sky high," Sebelius told reporters after her meeting with insurers and insurance commissioners from four states.

Insurers didn't outright dismiss the idea, "but there were no commitments of any kind," said UnitedHealth's chief executive officer, Stephen Hemsley.

Angela Braly, president and CEO of WellPoint, also took part in the White House meeting, as did Aetna and Cigna executives.

The president made an appearance at the meeting, delivering a letter from an Ohio woman who says her premiums have skyrocketed.

Anthem Blue Cross recently sent letters in the mail notifying its subscribers that it planned to raise rates by as much as 39 percent.

On Thursday, The Bee contacted the office of state Insurance Commissioner and GOP gubernatorial candidate Steve Poizner to ask whether he thinks rate increases should be posted online. Poizner spokesman Darrel Ng responded with an e-mail saying public access to that information already exists in California, albeit not online.

In California, the only venues for the public to view rate filings are in San Francisco and Los Angeles, where the state Department of Insurance allows inspection of the documents.

"The fact that you have to schlep to San Francisco to see these filings is not very transparent," said Anthony Wright, executive director of Health Access California, among those who have joined the call for greater transparency in how health insurance rates are set.

"Putting them online is a good step in California, where we have very few regulations regarding health insurance rates," Wright said.

"I think people want to know why" rates are increasing, he said. "It informs consumers as well as policymakers and others who watch the industry. How can they raise rates without justification or even without explanation?"

The rate hikes have spurred public outcry. Politicians in California and Washington have seized on them as an argument for overhaul legislation and wider regulation of the health insurance industry.

Sebelius acknowledged that the federal government and many states, including California, have little authority to bring relief to consumers.

Sebelius called consumers "absolute sitting ducks," who "don't have any bargaining power" against insurance companies.

Feinstein's legislation would give the Health and Human Services Department authority to reject or modify rate increases, according to her office. It would also establish a national Health Insurance Rate Authority.

California's insurance commissioner, unlike commissioners in at least 25 states, does not have authority to regulate premiums.