The safety of antidepressants in pregnancy is controversial, partly because of profound methodological difficulties in separating the fetal effects of antidepressants from those related to maternal depression (confounding by indication). One central concern is the potential impact of these drugs on fetal brain development. Such effects may be subtle and possibly only detectable years after exposure, such as an increased susceptibility to (multifactorial) neurodevelopmental conditions.
Every hospital in England must have a “comprehensive” GP led triage system in emergency departments by October 2017 in a bid to avoid a repeat of the winter crisis that gripped the service this year, NHS leaders have said.
The requirement is one of several “concrete changes” demanded by NHS England’s chief executive, Simon Stevens, and the chief executive of NHS Improvement, Jim Mackey, in a letter sent after the chancellor Philip Hammond’s budget pledge to give the NHS an extra £100m (€115m; $120m) in 2017‑18 to spend on easing pressures in accident and emergency departments.
The National Institute for Health and Care Excellence (NICE), in its final draft guidance issued this week, has recommended ixekizumab, an antibody that inhibits interleukin-17A, as an option for treating adults with severe plaque psoriasis that doesn’t respond to standard therapies.
From October general practices in England will be financially penalised if they close during core working hours during the week, the chief executive of NHS England has said.
Simon Stevens told MPs on the House of Commons Public Accounts Committee that changes to the GP contract, which will be introduced in October, will allow NHS England to scrutinise GP opening hours more closely and take action where necessary.
Using the electronic medical records of 305 339 adults aged between 21 and 90 years, researchers at Pennsylvania State University College of Medicine examined the association between IDA and sensorineural hearing loss (when there is damage to the cochlea or to the nerve pathways from the inner ear to the brain) and conductive hearing loss (hearing loss because of problems with the bones of the middle ear). IDA was determined by low haemoglobin and ferritin levels for age and sex.
Is the amyloid cascade hypothesis of Alzheimer’s disease too big to fail? It proposes that brain deposition of β amyloid protein is the critical early event in the pathogenesis of Alzheimer’s disease and has been the centrepiece of dementia research for decades. The hypothesis suggests that removing β amyloid will reverse or prevent the clinical expression of dementia. However, in all phase III clinical trials to date, treatments targeting β amyloid have failed to improve cognitive outcomes despite reducing brain β amyloid.
Children and young people can have a wide range of life limiting conditions and may sometimes live with such conditions for many years. This guideline recommends that end of life care be managed as a long term process that begins at the time of diagnosis of a life limiting condition and entails planning for the future. Sometimes it may begin before the child’s birth. It is part of the overall care of the child or young person and runs in parallel with other active treatments for the underlying condition itself. Finally, it includes those aspects related to the care of the dying.