Healthcare News and Research

[*Anya*]

Lisa Kaplan Gordon

A common antimicrobial agent called triclosan causes liver fibrosis and cancer in laboratory mice through mechanisms also relevant to humans, researchers at the University of California, San Diego School of Medicine have found

Triclosan's broad use in consumer goods -- including liquid hand soaps, toothpastes, shampoos, cosmetics, plastics, yoga mats, cutting boards and ice cream scoops -- presents "a very real risk of liver toxicity for people, as it does in mice," said Robert H. Tukey, a UC-San Diego professor and co-author of the study, published Monday in Proceedings of the National Academy of Sciences.

Triclosan, a synthetic, broad-spectrum antibacterial chemical, is coming under fire because of its links to endocrine disruption that could cause infertility, impaired muscle function and now increased cancer risks.

It's All Around

The UC-San Diego study showed that mice exposed to triclosan for six months (roughly equivalent to 18 human years) had more and larger chemical-induced liver tumors than mice not exposed to the antimicrobial. Researchers believe triclosan may interfere with the protein responsible for detoxifying foreign chemicals in the body, thereby causing liver cells to proliferate and, over time, become cancerous tumors.

Studies have found traces of triclosan in 97 percent of breast milk samples from lactating women and in the urine of nearly 75 percent of people tested, according to a statement by UC San Diego Health System. Triclosan is also one of the seven most frequently detected compounds in streams across the United States, the statement says.

"We could reduce most human and environmental exposures by eliminating uses of triclosan that are high-volume, but of low-benefit, such as inclusion in liquid hand soaps," said Bruce D. Hammock, professor at University of California, Davis. "Yet we could also for now retain uses shown to have health value -- as in toothpaste, where the amount used is small."

Colgate-Palmolive (CL) recently came under fire because its Total toothpaste contains triclosan. A recent Care2 petition, asking Colgate to remove triclosan from its toothpaste, so far has received almost 68,000 signatures.

Triclosan is already under scrutiny by the U.S. Food and Drug Administration. On its website, the FDA says, "Triclosan is not currently known to be hazardous to humans. But several scientific studies have come out since the last time FDA reviewed this ingredient that merit further review."

http://www.dailyfinance.com/2014/11/...ew-study-says/
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National Biomonitoring Program

Triclosan

Triclosan is a chemical with antibacterial properties. For more than 30 years, it has been used in consumer products such as detergents, soaps, skin cleansers, deodorants, lotions, creams, toothpastes, and dishwashing liquids. Triclosan can be added to other materials, such as textiles, to make them resistant to bacterial growth.

How People Are Exposed to Triclosan
People may be exposed to triclosan when they use consumer products containing triclosan. When using these products, a person can absorb small amounts of triclosan through the skin or the mouth.

How Triclosan Affects People's Health
The human health effects from exposure to low environmental levels of triclosan are unknown. Skin products containing triclosan rarely have caused irritation. More research is needed to assess the human health effects of exposure to triclosan.

Levels of Triclosan in the U.S. Population
In the Fourth National Report on Human Exposure to Environmental Chemicals (Fourth Report), CDC scientists measured triclosan in the urine of 2,517 participants aged six years and older who took part in the National Health and Nutrition Examination Survey (NHANES) during 2003–2004. By measuring triclosan in urine, scientists can estimate the amount of triclosan that has entered people's bodies.

Triclosan was detected in the urine of nearly 75% of the people tested.

Finding measurable amounts of triclosan in urine does not imply that the levels of triclosan cause an adverse health effect. Biomonitoring studies on levels of triclosan provide physicians and public health officials with reference values so that they can determine whether people have been exposed to higher levels of triclosan than are found in the general population. Biomonitoring data can also help health scientists plan and conduct research on exposure and health effects.

http://www.cdc.gov/biomonitoring/Tri...FactSheet.html

Additional Resources

Environmental Protection Agency Triclosan Facts

http://www.epa.gov/oppsrrd1/REDs/fac...iclosan_fs.htm

[*Anya*]

Yale researchers reverse type 2 diabetes and fatty liver disease in rats

By Ziba Kashef

February 26, 20

Yale researchers developed a controlled-release oral therapy that reversed type 2 diabetes and fatty liver disease in rats, according to a study published on Feb. 26 by Science.

Existing therapies for type 2 diabetes, and the closely associated conditions of nonalcoholic fatty liver disease (NAFLD) and nonalcoholic steatohepatitis (NASH), have had limited success at treating the root causes of these diseases.

Building on earlier research, the Yale team — led by Dr. Gerald I. Shulman, the George R. Cowgill Professor of Physiological Chemistry, and professor of medicine and cellular & molecular physiology at Yale School of Medicine — decided to investigate whether an agent that had originally been used for weight loss more than 70 years ago could be reformulated to safely treat NAFLD/NASH and type 2 diabetes in rodent models of these diseases.

Based on their earlier studies, the researchers determined that toxicity associated with the agent — mitochondrial protonophore 2,4-dinitrophenol (DNP) — was related to its peak plasma concentrations. They discovered that DNP’s efficacy in reducing liver fat and liver inflammation could be achieved with plasma concentrations that were more than a 100-fold less than the toxic levels.

“Besides reversing fatty liver disease in a rodent model of NALFD, a low-dose intragastric infusion of DNP that was 100-fold lower than toxic levels also significantly reduced blood glucose, triglyceride, and insulin concentrations in a rodent model of NAFLD and type 2 diabetes”, said Shulman, who is also an investigator with the Howard Hughes Medical Institute.

In the next phase of the study, Shulman and his team developed a new oral, controlled-release form of DNP, known as CRMP, which maintained the drug at concentrations that were more than a 100-fold lower than the toxic threshold. Administered once daily, CRMP delivered similar positive results, reversing fatty liver, insulin resistance, and hyperglycemia in rat models of NAFLD and type 2 diabetes, as well as liver inflammation and liver fibrosis in a rodent model of NASH, with no adverse effects.

“Given these promising results in animal models of NAFLD/NASH and type 2 diabetes we are pursuing additional preclinical safety studies to take this mitochondrial protonophore approach to the clinic” said Shulman.

Other Yale authors include Rachel J. Perry, Dongyan Zhang, Xian-Man Zhang, and James L. Boyer.

This research was supported by grants from the National Institutes of Health (R01 DK-40936, R24 DK-085638, U24 DK-059635, T32 DK-101019, P30 DK-45735, P30 DK-34989 and UL1 TR-000142) and the Novo Nordisk Foundation Center for Basic Metabolic Research, University of Copenhagen, Copenhagen, Denmark.

Citation: Science

http://news.yale.edu/2015/02/26/yale...r-disease-rats

[*Anya*]

HealthDay News -- A new study finds that treating moderate to severe depression with antidepressants may have an added bonus: reducing cardiovascular risks.

People who took antidepressants alone had a 53% lower risk of death, coronary artery disease, and stroke over three years than those who did not take antidepressants or statins, according to Heidi May, PhD, MSPH, a cardiovascular epidemiologist at the Intermountain Medical Center Heart Institute in Salt Lake City. She and colleagues analyzed health data from 5,311 people in Utah with moderate to severe depression.

Taking a statin, either alone or with antidepressants, did not significantly reduce the risk, the researchers found. The level of depression appeared to be key, May said in an ACC news release. Although antidepressant therapy didn't seem to boost the heart health of people with little or no depression, it did have an effect on those with more serious depression.

The study couldn't prove that the use of antidepressants helped cause a lowering of cardiovascular risks. However, depression is a known risk factor for heart disease, May said.

Her team also did not examine how antidepressants might prevent heart disease. But May theorized that as depressive symptoms ease, people's behaviors might change in ways that help their hearts.

"For example, people who are having depressive symptoms may not be as inclined to exercise, practice good health habits, or comply with health advice," she said. "Using an antidepressant to reduce depressive symptoms might also help people better take care of their heart health."

The findings are scheduled to be presented March 15 at the annual meeting of the American College of Cardiology (ACC), held from March 14 to 16 in San Diego.

http://www.clinicaladvisor.com/treat...rticle/402142/

[*Anya*]

The fight over Medicaid funding for Planned Parenthood moved to Texas this week.

Three days after Gov. Greg Abbott announced his decision to end Medicaid funding for Planned Parenthood, state health department investigators showed up on Thursday at Planned Parenthood health centers in Houston, Dallas, San Antonio and Brownsville with orders to turn over thousands of pages of documents, including patients’ records and employees’ home addresses and telephone numbers.

Some, but not all, of the extensive records sought by the state related specifically to abortion.

For example, Planned Parenthood South Texas was told to produce five years of records — whether electronic, paper or ultrasound — concerning any patients billed to Medicaid who had an abortion in which any part of the fetus was removed or preserved for research use. Planned Parenthood Gulf Coast was to turn over a complete copy of certain patients’ records, including doctors’ orders, nursing notes and lab tests, as well as the center’s appointment books, patient sign-in sheets and contracts.

“We’re concerned about the breadth and depth of what they’re asking for,” said Sarah Wheat, a spokeswoman for Planned Parenthood of Greater Texas.


Rest of article found at:

http://www.nytimes.com/2015/10/24/us...-abortion.html

[*Anya*]

Health | Thu Nov 12, 2015 4:40am ESTRelated: HEALTH
U.S. maternal mortality rate is twice that of Canada: U.N
GENEVA | BY TOM MILES

Women are twice as likely to die from causes related to pregnancy or childbirth in the United States than in Canada, a new global survey of maternal mortality published by the United Nations and the World Bank showed on Thursday.

The United States was also one of only 13 countries to have worse rates of maternal mortality in 2015 than in 1990 - a group that also includes North Korea, Zimbabwe and Venezuela.

The survey, led by the World Health Organization, aims to track progress against the U.N. Millennium Development Goals. It estimated there would be 303,000 maternal deaths globally this year, down from 532,000 in 1990.

The U.N. target is to get the global average number of maternal deaths below 70 per 100,000 live births by 2030, with no country averaging worse than 140.

The United States and other developed countries are already far ahead of the target, but the U.S. average has slipped from 12 deaths to 14 per 100,000 live births over the past 25 years, while Canada's is where it was in 1990, at seven.

Over the same period Belarus has cut its maternal death rate from 33 to four, making it one of the safest places to have a baby, just behind the world leaders - Iceland, Finland, Poland and Greece - where only three mothers die for every 100,000 births.

The world average is 216 deaths, ranging from 12 in rich countries to 546 in sub-Saharan Africa.

http://www.reuters.com/article/2015/...zC0OG4OzBic.97

[*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