Healthcare News and Research

[*Anya*]

Antidepressants taken during pregnancy increase risk of autism by 87 percent

14th December 2015

Researchers came to their conclusion after reviewing data from the outcomes of 145,456 pregnancies.

The study published today in JAMA Pediatrics used data from the Quebec Pregnancy Cohort and studied 145,456 children between the time of their conception up to age ten. The study accounted for a number of other factors that have known links to autism, including genetic predisposition to autism (i.e., a family history of it), maternal age, depression itself, and certain socio-economic factors such as being exposed to poverty. Exposure to antidepressants was defined as the mother having had one or more prescription for antidepressants filled during the second or third trimester of the pregnancy.

Researchers suspect that because serotonin is involved in numerous pre- and postnatal developmental processes, antidepressants that inhibit serotonin (particularly selective serotonin reuptake inhibitors known as SSRIs) will have a negative impact on the ability of the brain to fully develop in-utero.

We spoke with study senior author Professor Anick Bérard, Université de Montréal and the CHU Sainte-Justine Research Centre about the study. The full research team includes: Odile Sheehy, CHU Sainte-Justine, Laurent Mottron, Hôpital Rivière-des-Prairies, and Takoua Boukhris, Université de Montréal.
The study published today in JAMA Pediatrics used data from the Quebec Pregnancy Cohort and studied 145,456 children between the time of their conception up to age ten. The study accounted for a number of other factors that have known links to autism, including genetic predisposition to autism (i.e., a family history of it), maternal age, depression itself, and certain socio-economic factors such as being exposed to poverty. Exposure to antidepressants was defined as the mother having had one or more prescription for antidepressants filled during the second or third trimester of the pregnancy.

Researchers suspect that because serotonin is involved in numerous pre- and postnatal developmental processes, antidepressants that inhibit serotonin (particularly selective serotonin reuptake inhibitors known as SSRIs) will have a negative impact on the ability of the brain to fully develop in-utero.

We spoke with study senior author Professor Anick Bérard, Université de Montréal and the CHU Sainte-Justine Research Centre about the study. The full research team includes: Odile Sheehy, CHU Sainte-Justine, Laurent Mottron, Hôpital Rivière-des-Prairies, and Takoua Boukhris, Université de Montréal.

ResearchGate: What were your results?

Anick Bérard: Using antidepressants, especially selective serotonin reuptake inhibitors (SSRI), during the 2nd/3rd trimesters of pregnancy increases the risk of having a child with autism (87 percent increased risk of autism with any antidepressants; more than doubling the risk with SSRI use specifically) – this risk is above and beyond the risk associated with maternal depression alone (maternal depression was associated with a 20 percent increased risk of autism in our study). Given the mounting evidence showing increased risk of adverse pregnancy outcome with antidepressant use during pregnancy, our study shows that depression should be treated with other options (other than antidepressants) during this critical period.

Indeed, 80-85 percent of depressed pregnant women are mildly to moderately depressed; exercise and psychotherapy have been shown to be efficacious to treat depression in this sub-group. Therefore, we acknowledge that depression is a serious condition but that antidepressants are not always the best solution.

RG: We normally think of the first trimester as being the riskiest time for the fetus, but this study was actually in the second and third trimesters. Why is the risk greater later in pregnancy?

AB: 1st trimester exposure is problematic for embryogenesis; 2nd/3rd trimesters are critical for brain development. Hence, the critical time-window for our study was the later part of the pregnancy.

NOTE: Rest of this important article at research gate, link below:

https://www.researchgate.net/blog/po...-by-87-percent

[*Anya*]

8th December 2015

Long-work hours and stress have potentially dangerous consequences – for doctors and patients.

Researchers analyzed 50+ studies that looked for symptoms of depression in more than 17,500 medical residents. They found that 29 percent of physicians in training had signs of depression. The results of the study published in the Journal of the American Medical Association (JAMA) are worrying for both doctors themselves and their patients.

We speak with the study’s senior author, Srijan Sen, Associate Professor of Psychiatry, University of Michigan who worked with lead author Douglas Mata, of Harvard University to analyze the studies.

ResearchGate: What made you want to study depression among doctors?

Srijan Sen: Going through the experience of physician training ourselves, we noted how stressful the experience was and how many of our colleagues seemed to be suffering from depression.

RG: What were your results?

Sen: In our meta-analysis across 50+ studies, we found that 29 percent of residents screened positive for depression. We also found evidence of a small but significant increase in depression over time, with higher levels of depression among recent residents compared to those who trained decades ago.

RG: What are the signs of depression in new doctors?

Sen: After they start residency training, new doctors experience an increase in a range of depressive symptoms, including low mood and motivation, fatigue, concentration problems and, most concerning, suicidal thoughts.

RG: What do you think leads to depression in doctors?

Sen: There are a number of factors that are likely involved. In particular, the long hours, heavy workload, insufficient and inconsistent sleep and medical errors seem to be playing important roles.

RG: How does depression affect a doctor’s work?

Sen: There is growing evidence from both physicians and the general population that depression strongly affects work functioning. The evidence suggests that doctors who are depressed are substantially more likely to commit medical errors. In turn, medical errors increase the risk of depression in doctors.


RG: Are new doctors working today at a higher risk of depression than previous generations? If not, why?

Sen: The rate of depression appears slightly higher for the current generation of doctors. We do not know the factors behind this increase over time.

RG: What can be done? What should I as a patient do if I suspect that my doctor is depressed?

Sen: At a minimum, we should provide residents and training directors with evidence-based tools that have been shown to be effective in preventing the onset of depression and better access to treatment after depression has developed. To make a more dramatic impact on depression, more systematic changes in the medical education system may be necessary.

https://www.researchgate.net/blog/po...-of-depression

[*Anya*]

I should have added this to the post I made earlier on the article being published in JAMA.

I try to only post studies from reputable, peer reviewed journals or if simply an article, one from an established news source.

That the study referenced by research gate, had over 145 thousand children from conception up to age 10, from the Quebec Pregnancy Cohort and published in JAMA Pediatrcs; is critically important and this information will be difficult to overlook by the naysayers.

[*Anya*]

Medscape Medical News

FDA Campaign Aims to Help Young LGBT Adults Stop Smoking

Pauline Anderson
May 02, 2016

The US Food and Drug Administration (FDA) has launched a smoking prevention campaign aimed at young adult lesbian, gay, bisexual, and transgendered (LGBT) persons who are occasional users of tobacco.

Young adult LGBT persons are nearly twice as likely to use tobacco as other young adults, said Mitch Zeller, JD, director, Center for Tobacco Products (CTP), FDA, during a press briefing to announce the campaign, called This Free Life.

Of the more than 2 million LGBT persons aged 18 to 24 years in the United States, more than 800,000 are occasional or so-called social smokers, according to Dr Zeller.

"Unfortunately, research tells us that LGBT young adults often don't consider themselves to be smokers and don't understand the associated health risks."

The campaign, said Dr Zeller, "is aimed at making LGBT young adults aware that there is no safe amount of smoking and that even an occasional cigarette can have serious health implications and lead to addiction."

The range of negative health outcomes from smoking, such as cancer, heart disease, and respiratory illnesses, can disproportionately affect minority groups such as the LGBT community, said Richard Wolitski, PhD, acting director of the Office for HIV/AIDS and Infectious Disease Policy, US Department of Health and Human Services, during the briefing.

Dr Wolitski, a gay man living with HIV, said he has worked for 30 years to improve gay men's health and prevent HIV, sexually transmitted diseases, and hepatitis infections.

"I have lost too many people to HIV in my life, and I don't want to lose any more due to tobacco use."

The impact of smoking has hit close to home for him ― his husband's father died from lung cancer as a consequence of smoking.

Coming Out

Research shows that LGBT youth "come out" at about the age of 18 years. The coming out process can be stressful and "contribute to actual or perceived social stigma, discrimination, and anxiety," said Dr Wolitski.

"It's a period of increased vulnerability, which can lead to tobacco use and other behaviors with negative health consequences."

Many LGBT young adults find a sense of community at LGBT bars and clubs that sometimes provide an environment conducive to tobacco use. Also, some influential LGBT persons, community bloggers, and YouTube personalities openly promote smoking, "establishing tobacco use as a norm within the LGBT community," said Dr Wolitski.

partnered with persons of influence in the community to challenge the perception that tobacco use is a necessary part of LGBT culture, said Dr Zeller.

The $35.7 million campaign, which will use digital and social media and will include some dating sites, will target 12 markets across the United States in which there is a high concentration of LGBT young adults and where the prevalence of smoking is relatively high.

The $35.7 million campaign is being funded by user fees collected from the tobacco industry, not by taxpayer dollars.


http://www.medscape.com/viewarticle/862738

http://www.fda.gov/NewsEvents/Newsro.../ucm498544.htm

[Jesse]

Oops didn't mean to post this here. lol I'll move it.

[*Anya*]

The superbug that doctors have been dreading just reached the U.S.

By Lena H. Sun and Brady Dennis May 27 at 1:50 PM

CRE, a family of bacteria pictured here, is considered one of the deadliest superbugs because it causes infections that are often resistant to most antibiotics. (Centers for Disease Control and Prevention/Reuters)
For the first time, researchers have found a person in the United States carrying bacteria resistant to antibiotics of last resort, an alarming development that the top U.S. public health official says could mean “the end of the road” for antibiotics.

The antibiotic-resistant strain was found last month in the urine of a 49-year-old Pennsylvania woman. Defense Department researchers determined that she carried a strain of E. coli resistant to the antibiotic colistin, according to a study published Thursday in Antimicrobial Agents and Chemotherapy, a publication of the American Society for Microbiology. The authors wrote that the discovery “heralds the emergence of a truly pan-drug resistant bacteria.”

Colistin is the antibiotic of last resort for particularly dangerous types of superbugs, including a family of bacteria known as CRE, which health officials have dubbed “nightmare bacteria.” In some instances, these superbugs kill up to 50 percent of patients who become infected. The Centers for Disease Control and Prevention has called CRE among the country’s most urgent public health threats.

Health officials said the case in Pennsylvania, by itself, is not cause for panic. The strain found in the woman is still treatable with other antibiotics. But researchers worry that its colistin-resistance gene, known as mcr-1, could spread to other bacteria that can already evade other antibiotics.

It’s the first time this colistin-resistant strain has been found in a person in the United States. In November, public health officials worldwide reacted with alarm when Chinese and British researchers reported finding the colistin-resistant strain in pigs and raw pork and in a small number of people in China. The deadly strain was later discovered in Europe and elsewhere.

“It basically shows us that the end of the road isn’t very far away for antibiotics — that we may be in a situation where we have patients in our intensive care units, or patients getting urinary-tract infections for which we do not have antibiotics,” CDC Director Tom Frieden said in an interview Thursday.

“I’ve been there for TB patients. I’ve cared for patients for whom there are no drugs left. It is a feeling of such horror and helplessness,” Frieden added. “This is not where we need to be.”

Separately, researchers at the Agriculture Department and the Department of Health and Human Services reported that testing of hundreds of livestock and retail meats turned up the same colistin-resistant bacteria in a sample from a pig intestine in the United States. USDA said it is working to identify the farm the pig came from.

CDC officials are working with Pennsylvania health authorities to interview the patient and family to identify how she may have contracted the bacteria, including reviewing recent hospitalizations and other health-care exposures. The CDC hopes to screen the patient and her contacts to see if others might be carrying the organism. Local and state health departments also will be collecting cultures as part of the investigation.

The woman was treated in an outpatient military facility in Pennsylvania, according to a Defense Department blog post about the findings. Samples were sent to the Walter Reed National Military Medical Center for initial testing. Additional testing was done by a special Defense Department system that tracks multi-drug-resistant organisms.

Thursday’s study did not disclose further details about the Pennsylvania woman or the outcome of her case. The authors could not be reached for comment. A spokesman at the Pennsylvania Department of Health was not immediately available to comment on the case.

NOTE: rest of article can be found with link



https://www.washingtonpost.com/news/...national_pop_b

[*Anya*]

Journal of Clinical Psychopharmacology:
June 2015 - Volume 35 - Issue 3 - p 273–278
doi: 10.1097/JCP.0000000000000300


Post-SSRI Sexual Dysfunction: Clinical Characterization and Preliminary Assessment of Contributory Factors and Dose-Response Relationship

Contributors: Ben-Sheetrit, Joseph MD*; Aizenberg, Dov MD*†; Csoka, Antonei B. PhD‡; Weizman, Abraham MD*†; Hermesh, Haggai MD*†

Abstract:

Emerging evidence suggests that sexual dysfunction emerging during treatment with selective serotonin reuptake inhibitors (SSRIs) and/or serotonin-norepinephrine reuptake inhibitors (SNRIs) persists in some patients beyond drug discontinuation (post-SSRI sexual dysfunction [PSSD]). We sought to identify and characterize a series of such cases and explore possible explanatory factors and exposure-response relationship.

Subjects who responded to an invitation in a forum dedicated to PSSD filled out a survey via online software. Case probability was defined according to the following 3 categories of increasing presumed likelihood of PSSD. Noncases did not meet the criteria for possible cases.

Possible cases were subjects with normal pretreatment sexual function who first experienced sexual disturbances while using a single SSRI/SNRI, which did not resolve upon drug discontinuation for 1 month or longer as indicated by Arizona Sexual Experience Scale scores.

High-probability cases were also younger than 50-year-olds; did not have confounding medical conditions, medications, or drug use; and had normal scores on the Hospital Anxiety and Depression Scale.

Five hundred thirty-two (532) subjects completed the survey, among which 183 possible cases were identified, including 23 high-probability cases. Female sex, genital anesthesia, and depression predicted current sexual dysfunction severity, but dose/defined daily dose ratio and anxiety did not.

Genital anesthesia did not correlate with depression or anxiety, but pleasureless orgasm was an independent predictor of both depression and case probability.

Limitations of the study include retrospective design and selection and report biases that do not allow generalization or estimation of incidence.

However, our findings add to previous reports and support the existence of PSSD, which may not be fully explained by alternative nonpharmacological factors related to sexual dysfunction, including depression and anxiety.

http://journals.lww.com/psychopharma...&type=abstract