Healthcare News and Research

[*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

[*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