Leapfrog - Should Pregnant Women Take Antidepressants?

This is what I tried to get leapfrogged on Helium to take the place of my earlier article on this subject. You can find the original posted down below. This new one was rejected. If you have comments or suggestions about the two articles and can help me figure out why it failed, please leave them here.

Thanks, Piper


Is it safe to take antidepressants through pregnancy?

It is a simple decision for a pregnant woman to forgo things like cold medicine, caffeine or alcohol in order to protect her baby from potentially harmful substances. The effects of those decisions are short term and not harmful to either mother or child. However, almost 20% of pregnant women experience clinical depression. Left untreated clinical depression can be deadly. Fortunately, there are several options available to treat depression, including psychotherapy, medications, bright light therapy and combinations of these. *[See note]

A study published in the April issue of Pharmacotherapy analyzes the choices available to patients and their doctors. This particular study evaluated the results of several other studies that focused on newer antidepressants, selective serotonin reuptake inhibitors (SSRIs) and serotonin norepinephiren reuptake inhibitors. While "information is available on the safety of antidepressant use during pregnancy, it is limited by the small size of most trials and by trial designs that often did not use mothers with depression as control subjects and could not, for ethical reasons, be randomized and double blinded." That paucity makes the decision whether or not to use medication to treat depression during pregnancy that much more difficult. Pregnant women "are subject to the same adverse consequences of depression as are non-pregnant women, including social withdrawal and even suicide."

Pregnant women frequently receive unsolicited and unwelcome advice; even from complete strangers. In addition, pregnant mothers often find themselves on the receiving end of harsh criticism for decisions that they make during their pregnancy. Some decisions can be debatable. For example, is it a good idea for her to take a vacation in the wilderness? In the case of major depression, however, the mother needs to be able to take care of herself and her child without suffering society's condemnation.

Untreated clinical depression during pregnancy has been associated with preeclampsia, miscarriages, and premature labor. "In addition, pregnant women with depression are less likely to attend regular obstetric visits and may have lower than normal weight gain, may lack compliance with prenatal care, and may be more likely to smoke, drink alcohol, or use cocaine."

While data about the gestational pharmacotherapy is sparse, most of the data is encouraging. For example, "preliminary evidence suggests that SSRI exposure in utero does not have significant long-term effects on cognition or behavior." In the end, society needs to realize that a clinically depressed mother-to-be is just like any mother who would do whatever it takes to save her child's life. It is for this reason that doctors and women should weigh all the factors to decide on an appropriate treatment plan. This includes acknowledging the fact that the life of both mother and child may depend on her decision.

http://www.pharmacotherapy.org

*Electoconvulsive therapy is another option, however, it is only used when other therapies have failed to provide relief.

Picture of Some Air Traffic stuff

Memorable Superbowl 2007 Commercials

There are many people who tune in to the Superbowl every year, not to watch the game, but to watch the commercials. In addition to paying advertising agencies and production costs to produce their commercials, companies pay millions of dollars for 30-second slots simply to air the commercials. Superbowl commercials are to the advertising world as the Christmas shopping season is to retail markets.

Especially when one takes into account the time and effort that is invested in each commercial, it is essential that companies find a way, preferably objective, to analyze the success or failure of each commercial. Objective evidence is hard to come by if the only measurement available comes from polling consumers. An emerging industry, neuromarketing, "the study of the brain's responses to ads" (1), is beginning to change that.

The first neuromarketing research study was published in the October 2004 issue of "Neuron." Scientists use fMRIs to study the brain activity of people during an activity, as in people watching Super Bowl commercials, and comparing that data with subjective information provided by the participants.

Three years later, "FKF Applied Research, with the help of UCLA's Ahmanson Lovelace Brain Mapping Center, said that Coca-Cola's "Video Game" ad-a 60-second animated spot that promotes random acts of kindness-scored this year because it elicited the most positive emotions in subjects' brains." (2)

The most successful ads for Superbowl 2007, were:
Coca-Cola: "Video Game"Doritos: "Live the Flavor"Bud Light: "Hitchhiker"

The least successful ads for Superbowl 2007, were:
Emerald Nuts: "Robert Goulet"Honda: "CRV Crave"Sprint: "Connectile Dysfunction"

(1) http://www.pbs.org/wgbh/pages/frontline/shows/persua ders/etc/neuro.html
(2) http://news.com.com/Who+really+won+during+the+Super+ Bowl/2100-1008_3-6156330.html

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Piper

Camera Cell Phones, Weight Loss and Jules Verne

Jules Verne invented science fiction. The first novel he wrote, "Paris in the 20th Century," contained skyscrapers of glass and steel, high-speed trains, gas-powered automobiles, calculators, and, a worldwide communications network. In spite of his incredible imagination, he would never have seen this one coming.

mDiet - Mobile Diet Intervention through Electronic Technology

mDiet is a service rather than a device. According to the National Cancer Institute, "The mDiet system will include a web-application that shares data and communicates via a server with the cell phone."

In other words, the purpose of mDiet is to use people's cell phones as an avenue to create a support system for people trying to lose weight. On going support systems for dieters are not new; well-known examples include Jenny Craig and Weight Watchers. Under the mDiet program, the provider will send text or picture messages to the patient. The messages will contain "specific suggestions or tips regarding diet and improving lifestyle habits." Providers will be able to support a large number of people with a relatively small amount of effort.

Since mDiet's approach is such a novel one,the Patient-centered Assessment and Counseling for Exercise and Nutrition project (PACE) at the University of California, San Diego is conducting a research study that is evaluating the mDiet program.

PACE is evaluating whether patients receiving mDiet messages will lower their Body Mass Index (BMI) more than a control group of patients without mDiet's support. Primarily, researchers will gauge the success or failure of mDiet based on objective measurements of the BMI between the two groups.
The mDiet program is designed to be simple and easy to follow. Therefore, researchers will also be judging the patients' satisfaction with mDiet by measuring "subjective ratings of intervention components and ease of use, and objective measures of frequency of use."

PACE project principal investigator Kevin Patrick, M.D., M.S., professor of Family and Preventive Medicine, University of California San Diego School of Medicine, says, "We are trying to make this as pain free as possible. People won't stick to something that's too difficult and they're all multi-tasking anyway. Using the cell phone may be the perfect way to get a message to busy people on the go."
Pierre-Jules Hetzel, Verne's publisher, rejected "Paris in the 20th Century" because he believed it would not be successful. Hetzel advised, "Wait twenty years to write this book. If you were a prophet, no one would believe your prophecies."
Jules Verne would be surprised by what we do with a worldwide communications network. Welcome to the 21st Century, Mr. Verne.

"Paris in the 20th Century" was finally published in 1989.

Kimberly Edwards, Public Information Officer for USCD expects that the results of this study will be published, at the earliest, around April 2009.

"Ecological Momentary Intervention of Diet Via Mobile Technology" is funded by National Cancer Institute (NCI). Detailed information is available at http://clinicaltrials.gov/ct/show/NCT00415870;jsessi onid=424CBDFE211CECD07610B9180BE443EC?order=17.

National Cancer Institute www.cancer.gov - http://cancercontrol.cancer.gov/grants/abstract.asp? ApplID=7283961

Press Release from USCD - http://ucsdnews.ucsd.edu/newsrel/health/08-07CellPho neDropPoundsKE-.asp

New Study Finds That Ritalin Improves the Vigilance Performance of Children With ADHD and Who Have Poor Sleep Efficiency

A study published in the August 1 edition of the journal SLEEP has found another benefit for children who are taking Ritalin to manage their ADHD symptoms. It helps them sleep better. A lack of sleep hampers cognitive functions, reduces brain processing capacity, and increases injury risk by 86%.*

The study was conducted by Ridha Joober, MD, and Reut Gruber, PhD, of Douglas Mental Health University Institute and McGill University in Montreal, Canada. The team found that "children with attention deficit hyperactivity disorder (ADHD), and whose sleep efficiency is poor, experience significant improvement on some measures of the Continuous Performance Test (CPT) if they are treated with [Ritalin]."

For the study, children were given a placebo for one week, then researchers calculated the mean sleep efficiency score for each child. Those children with scores above the mean were placed in a "Good Sleep Group" while the other children were place in the "Poor Sleep Group." Then, at home, parents monitored the sleep of each child for two weeks using actigraphy*, completing nightly sleep logs and a filling out a sleep questionnaire. In the lab researchers administered The Conners' Continuous Performance Test (CPT) was used to assess vigilance.

"Children with low sleep efficiency might improve performance following the administration of MPH as it increases their arousal level to a moderate level, which is presumed to facilitate vigilance performance," wrote Joober and Gruber. "To our knowledge, this is the first study in which the MPH response in children with ADHD has compared poor and good sleepers using an objective neuropsychological test and a validated clinical scale as the outcome measures. Future studies looking at the association between the impact of MPH, basal characteristics of sleep and the efficiency of different attentional systems in children with ADHD are needed to further examine the association between sleep and neurobehavioral functioning in ADHD."

-

* According to Researchers at the Children's Emergency Center of Udine, Italy, sleeping less than 10 hours a day results in an 86% increase in injury risk, among boys in particular.

* Actigraphy is a method of activity and sleep study achieved by mounting a small actigraph unit on a patient for an extended period. The unit itself typically includes a small accelerometer and continually records the movements it undergoes. When the data is later read to a computer it can be analyzed and used in the study of circadian rhythm and wake-sleep patterns.

http://www.eurekalert.org/pub_releases/2007-08/aa os-jsm_1072507.php
http://en.wikipedia.org/wiki/Methylphenidate
http://en.wikipedia.org/wiki/Attention-deficit_hyp eractivity_disorder
http://en.wikipedia.org/wiki/Continuous_Performanc e_Task
http://www.sleepforkids.org/html/adhd.html
http://en.wikipedia.org/wiki/Actigraphy
http://www.journalsleep.org/ViewAbstract.aspx?cita tionid=3301

Should Pregant Women Take Antidepressants?

It is a simple decision for a pregnant woman to forgo things like cold medicine, caffeine or alcohol in order to protect their baby from potentially harmful substances. The effects of those decisions are short term and not harmful to either mother or child. However, almost 20% of pregnant woman experience clinical depression. Left untreated clinical depression can be deadly. There are several options available to treat depression, including psychotherapy, medications, bright light therapy and combinations of these.**[see note]

A study published in the April issue of Pharmacotherapy analyzes the choices available to patients and their doctors. This particular study evaluated the results of several other studies that focused on newer antidepressants; selective serotonin reuptake inhibitors (SSRIs) and seratonin norepinephiren reuptake inhibitors. While “information is available on the safety of antidepressant use during pregnancy it is limited by the small size of most trials and by trial designs that often did not use mothers with depression as control subjects and could not, for ethical reasons, be randomized and double blinded.” That paucity makes the decision whether or not to use medication to treat depression during pregnancy that much more difficult. Pregnant women “are subject to the same adverse consequences of depression as are non-pregnant women, including social withdrawal and even suicide.”

Untreated clinical depression during pregnancy has been associated with preeclampsia, miscarriages, and premature labor. “In addition, pregnant women with depression are less likely to attend regular obstetric visits and may have lower than normal weight gain, may lack compliance with prenatal care, and may be more likely to smoke, drink alcohol, or use cocaine.”

While data about the gestational pharmacotherapy is sparce, most of the data is encouraging. For example, “preliminary evidence suggests that SSRI exposure in utero does not have significant long-term effects on cognition or behavior.” Doctors and women should weigh several factors to decide on a treatment plan including the severity of the depression and the preferences of the mother.

**Electoconvulsive therapy is another option, however, it is only used when other therapies have failed to provide relief.

Visiting The Emergency Room

No one likes to go to the emergency room. That’s understandable. For one thing, the fact that you are there means that you have a problem that you cannot deal with on your own. Not only that, but you get to pay someone else an exorbitant amount of money at the same time. It is also irritating waiting centuries for your turn, I mean, hours for your turn. I have figured something out; when the staff take you straight back to an exam room instead of making you wait 4 hours, this is NOT a sign of good service. Customer service is not a high priority for emergency room personnel. That doesn’t mean that they will go out of their way to inconvenience you. It means that they have bigger fish to fry. Let me reiterate, going straight back to an exam room is BAD.

Almost 10 years ago, my six year old son had a chest cold. All of the sudden, he started complaining about stomach pain. My internal “Red Alert” lights started flashing, so I took him down to the ER. It wasn’t a busy night, and we made it to the triage nurse within 10 minutes. She took his pulse and blood pressure and also tested his O2sats (blood oxygen saturation levels) which turned out to be 87. She said, “Why don’t you two come on back?” Then the ER staff were all doing something for my son. It wasn’t dramatic like on TV, but they were definitely scurrying. I was confused because I didn’t think it was all that bad. After all, an 87 is a B+, right? In a word, no. But I’m still not a doctor, so I don’t know why and don’t care all that much. I do know that my son had actually pneumonia, not just a head cold.

Two years ago, my other son was getting his nightly (high blood pressure) medicine ready when he spilled the bottle. So, he picked all the pills up. After he picked them all up, because he had been in the process of taking his medicine to begin with, he proceeded to swallow the entire handful. Over doses are nothing to trifle with, so we headed straight to the ER. Thank God that he told me right away! When we got to the hospital, I told the nurse what we were there for, and we headed straight back to an exam room. We spent the next two nights in the hospital.

Last June, I fell at work and broke my left elbow, badly. Or, depending on your point of view, I did a very good job breaking it. I arrived at the hospital in an ambulance. Once I got there, my wheelchair was parked in the waiting room and I waited over an hour and a half to be seen. That is not a long wait, all things considered, but it is far from a straight shot to the doctor! I was definitely injured, but the fact that I was waiting to go back told me that I was not in imminent danger.

I am not talking about the aberrational situations where people have died because they should have been seen earlier. That is a whole other topic. For the average Joe, waiting in the ER for treatment can be torture. You depend on the staff to end the interminable wait and so you analyze them, like a hunter stalking prey. From your point of view they flirt, fight, and gossip instead of discernibly treating patients. At times like this, remember waiting is good.

Ethanol Fuel May Pose Health Risks

Ethanol is a renewable alcohol fuel hyped as environmentally friendly solution to air pollution. Proponents claim that ethanol burns cleanly and produces less toxic emissions. It is a linchpin in President Bush's plan to reduce gasoline consumption in the United States by 20% with 10 years. The president announced the plan during the State of the Union address in January 2007.

The most common form is ethanol currently available in the US is E10, a mixture of 90% gasoline and 10% ethanol. E10 is used primarily in urban areas that do not meet clean air standards. All vehicles that use gasoline can run on E10 without a modified engine. The California Air Resources Board (CARB) has been considering the impact of ethanol on air quality. So far, CARB seems ambivalent toward ethanol. It recently applied for a waiver from the U.S. Environmental Protection Agency's rule requiring the use of E10 during the winter months.

That is a valid concern according to Dr. Mark Jacobson, an atmospheric chemist at Stanford University. In the 1970s, Brazil heavily promoted ethanol fuel. At the same time, for reasons that are still unclear, air quality deteriorated. Using that knowledge, a NASA research grant for computational development, and a sophisticated atmospheric computer model, he compared two air quality scenarios for the year 2020: a vehicle fleet fueled entirely by gasoline versus a fuel flexible vehicle (FFV) fleet, which should be common by then. FFVs are vehicles that can run on 100% unleaded gasoline or a mixture of gasoline and up to 85% ethanol. The next generation of ethanol is E85, a blend of 85% ethanol and 15% gasoline. It contains approximately 80% less contaminants than gasoline. The National Ethanol Vehicle Coalition (NEVR) maintains that E85 will reduce greenhouse gas emissions as much as 46%, is non-toxic, water soluble and biodegradable. They claim that the cleaner exhaust will mean less smog and fewer respiratory illnesses. The American Lung Association of the Upper Midwest also endorses E85 as a CleanAirChoice.

However, Dr. Jacobson's study, "Effects of Ethanol (E85) Versus Gasoline Vehicles on Cancer and Mortality in the United States", produced results that contradict NEVR's assertions. This is the first study that examined not just tailpipe emissions, but also "chemical reactions, temperatures, sunlight, clouds, wind and precipitation." He found that E85 emissions did reduce atmospheric levels of two carcinogens, benzene and butadiene. Unfortunately, the atmospheric levels of two other carcinogens, formaldehyde and acetaldehyde, actually increased. Dr. Jacobson adds that "we have found that using E85 will cause at least as much health damage as gasoline, which already causes about 10,000 U.S. premature deaths annually from ozone and particulate matter."

The Renewable Fuels Association published a review** that challenged these results. It was written by Dr. Gary Z. Whitten, who has worked in the field of gas-phase photochemistry since the 1960s. He has testified as an expert witness before Congress, State Legislatures, and the U.S. EPA as an expert witness on the subject of various emission sources and the impact on air quality. While both scientists agree that the future is uncertain with regard to emission technology, regulations and other fuel formulations, they reach entirely different conclusions. Dr. Whitten's primary objection to this study centers on the data Dr. Jacobson entered into the computer model. "The methodology used to assemble existing data... is not described in sufficient detail to assess... that methodology or the range of data variability." He also believes that rapidly developing technology make long-term projections unreliable.

Responding to the review, Dr. Jacobson says, "Dr. Whitten did not realize that simulations were done for present day conditions as well, as reported in the paper. Almost his entire argument centered around uncertainties in future emissions when, in fact, simulations indicated an even greater effect under current emission conditions, which are extremely reliable. Further, four sensitivity tests were run examining different possible future (2020) emission scenarios, and regardless of the uncertainty, the future results held. Dr. Whitten did not realize these results were also stated in the paper. He hypothesized incorrectly that conclusions would change if emissions changed."



This article is based on information from an article entitled "Clearing the Air On Ethanol" published in the April 18 online edition of the journal Environmental Science & Technology (ES&T) and input directly from Dr. Mark Jacobson.