Taking selective serotonin reuptake inhibitor (SSRI) antidepressants during pregnancy do not impact infants` growth over the first year, a new study has found.

There had been concern that antidepressant treatment during pregnancy reduced growth during the first year. Previous data suggested depression during pregnancy also could diminish infant growth.

But the new study from a Northwestern Medicine scientist showed infants born to mothers who took SSRIs during pregnancy had a similar weight, length and head circumference over the first year as infants born to non-depressed women who did not take antidepressants.

The infants whose mothers took antidepressants were shorter at birth, but the difference disappeared by two weeks of age.

In addition, growth measurements for the infants of depressed women who did not take SSRIs were similar to the general population.

"Most women want to know about the effect of their depressive illness or the medication they take during pregnancy not only on the infant at birth, but also on the baby`s longer-term growth and development," said Northwestern Medicine lead author Katherine L. Wisner, M.D.

"This information may help women balance the risks and benefits of continuing their antidepressant treatment during pregnancy," she noted.

Depression has negative impact on a mother`s and infant`s health, Wisner said, noting that women who stop taking SSRIs near the time of conception have a high relapse rate.

Maternal prenatal stress and depression are linked to preterm birth and low infant birth weight, which increases the risk of cardiovascular disease. Depression also affects a woman`s appetite, nutrition and prenatal care and is associated with increased alcohol and drug use. Women with untreated depression have a higher body mass index preconception, which carries additional risks.

Results of her study will be published in The American Journal of Psychiatry in Advance, its online ahead-of-print website.

Long-distance lorry drivers who drink coffee have fewer road traffic accidents, research suggests.

Australian investigators say they found the link while comparing 530 heavy goods vehicle drivers who had recently been in a crash with 517 who had not.

Coffee and other beverages containing the stimulant caffeine cut crash risk, probably because they boost alertness, the British Medical Journal reported.

Road safety experts stressed caffeine was no substitute for sleep.

In the study, more than a third said they drank caffeinated beverages and half of these said they did so in order to stay awake.

The drivers who consumed caffeine to keep them from nodding off behind the wheel were 63% less likely to crash than drivers who had no caffeine.

This was after adjusting for factors such as age, sleep patterns, kilometres driven, breaks taken and night-driving schedules.
Nap advice

If the driver had a poor track record of crashes in the past five years this had an impact on their likelihood of having another crash, raising their risk by 81%.

About 70% of the drivers in the study said they stopped for a nap when they were tired - something that road safety experts strongly recommend.

Lead researcher Lisa Sharwood and colleagues from the University of Sydney say while it is clear that tired drivers should be taking breaks, it still not clear what activities benefit them most during these breaks - napping or drinking coffee.

"The varying extent to which activities such as taking a nap, drinking a cup of coffee, or going for a short walk contribute to subsequent vigilance behind the wheel are not well understood and are therefore recommended for further study," they say.

UK road safety experts say the only real cure for fatigue is sleep.

A spokesman for the Department for Transport said: "Driving tired significantly increases the risk of an accident so we encourage drivers to ensure they are properly rested before climbing behind the wheel.

"Drivers should get a good night's sleep, plan sufficient breaks and pull over if they feel tired.

"The Highway Code is clear that the most effective way to counter sleepiness while driving is to have, for example, two caffeinated drinks and take a short nap."

Millions of people may be exposed to risk of developing kidney failure and bladder cancer by taking herbal medicines that are widely available in Asia, scientists from King`s College London have warned.

The medicines, used for a wide range of conditions including slimming, asthma and arthritis, are derived from a botanical compound containing aristolochic acids.

These products are now banned in the USA and many European countries but the herbs containing this toxic acid can still be bought in China and other countries in Asia and are also available worldwide over the internet.

The scientists reviewed worldwide cases of aristolochic acid nephropathy (AAN) - a type of kidney failure caused by the intake of these acids.

They explained the clinical basis for the disease and propose strategies to help doctors identify it and treat patients more effectively.

They suggested that there might be many thousands of cases across Asia that are undiagnosed or misdiagnosed. With the outcome of their study, the researchers hope to raise awareness of the risks of aristolochic acids and reduce the global disease burden from this severe condition.

"We have found evidence that many millions of people continue to be exposed to significant health risk due to these herbal medicines, widely used in China and India," said lead author Professor Graham Lord, Director of the National Institute for Health Research (NIHR) Biomedical Research Centre (BRC) at Guy`s and St Thomas` NHS Foundation Trust and King`s College London.

The paper indicates that regulatory measures that have so far been adopted by national and international agencies may be inadequate in preventing harmful exposure to aristolochic acid. The compound is linked to many cases of kidney diseases and urothelial cancer, a form of cancer of which bladder cancer is the most known variant.

The researchers reviewed the latest data on the epidemiology of AAN. They used several search engines to include all publications that are about or refer to aristolochic acid and Chinese herbal nephropathy and identified 42 different case studies and one trial relating to the management of the disease.

While explaining the origin and development of the disease, they propose a protocol that should make it easier to diagnose AAN. In addition, they suggested a new disease classification to help international clinicians better identify AAN patients, and draft guidelines for the treatment of these patients.

The research was published in Annals of Internal Medicine.

A new plague of antibiotic resistant infections may emerge with even common urinary tract infections now resistant to conventional treatment, Australia`s superbug experts have warned.

They noted that powerful intravenous antibiotics are now being used to beat urinary tract infections that previously could be treated simply with a pill, News.com.au reported.

And unless the government regulates antibiotic use medical advances like organ transplants, joint replacements and critical care medicine will be under threat from rampant infections, the stated.

Doctors are warning that these superbugs, which are being called the "red plague" because antibiotic bugs stain red under a microscope, could soon represent the same threat as a plague like the Black Death.

Professor David Looke, the president of the Australasian Society for Infectious Diseases, said that common E. coli infections that cause 80 per cent of urinary tract infections are now resistant to multiple antibiotics.

Writing in Medical Journal of Australia, he said the proportion of E. coli bugs in Australia that were multi-drug resistant rose from 4.5 per cent in 2008 to 7.2 per cent in 2010.

Most people thought antibiotic resistant bugs were caught in a hospital setting but now they were being acquired in the community, he said.

Up to 30 per cent of the staphylococcus bacteria that cause common boil infections acquired in the community were now also resistant to penicillin, he said.

Many forms of sexually acquired gonorrhea were also resistant to most antibiotics.

He blamed the overuse of antibiotics in humans and in animals and farming practices for these growing resistances to treatments.

In India 100-200 million people were thought to harbour antibiotic resistant bacteria. In Asia antibiotics were injected into eggs, used in prawn and chicken farms.

Moreover, pharmaceutical companies have stopped developing new antibiotics that might beat superbug infections, he added.

Infectious diseases experts have suggested that government must set up a new regulatory body that would have control of the use of antibiotics in humans, animals and farming.

Government must also work with the pharmaceutical industry to encourage them to research new antibiotics, Looke concluded.

Decreased levels of vitamin D may predispose smokers to developing tobacco-related cancer, a new study has revealed.

This study illustrates that simple vitamin D blood tests and supplements have the potential to improve smokers` health.

Cigarette smoking is the primary causal factor for at least 30 percent of all cancer deaths, and can lead to multiple kinds of cancer, including bladder, cervical, esophageal, head and neck, kidney, liver, lung, pancreatic, and stomach, as well as myeloid leukemia.

In this new research, Afzal et al. measured plasma vitamin D levels in blood samples collected in 1981-1983 from 10,000 Danes from the general population. They then followed the study participants for up to 28 years through the Danish Cancer Registry.

Of the participants, 1,081 eventually developed a tobacco-related cancer. The researchers determined that the median vitamin D concentration among these participants was only 14.8 ng/mL, versus the higher 16.4 ng/mL median concentration found for all participants together.

These results showed for the first time that the risk of tobacco-related cancers as a group is associated with lower concentrations of vitamin D.

The data also indicate that tobacco smoke chemicals may influence vitamin D metabolism and function, while vitamin D may conversely modify the carcinogenicity of tobacco smoke chemicals.

If further research confirms this, it would be consistent with previous studies demonstrating the anti-tumorigenic effects of vitamin D derivatives, as well as the correlation of vitamin D deficiency with favorable cancer-forming conditions and increased susceptibility to tobacco smoke carcinogens.

Interestingly, though, low vitamin D levels were not connected with risk of other cancer types.

"Our analyses show that the association between lower concentrations of plasma vitamin D and higher risk of cancer may be driven by tobacco-related cancer as a group, which has not been shown before," stated author Borge G. Nordestgaard, MD, DMSc.

"This is important for future studies investigating the association between plasma vitamin D and risk of cancer," he added.

The research has been published online in Clinical Chemistry, the journal of AACC.