The safety of antidepressants in pregnancy

Maternal antidepressants are implicated in ADHD, but so is maternal depression

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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.

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All emergency departments must have GP led triage by October

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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.

Anaemia is associated with hearing loss in adults

Iron deficiency anaemia (IDA) has been found to be associated with hearing loss in adults by a study published in JAMA Otolaryngology – Head and Neck Surgery.

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.

Solanezumab and the amyloid hypothesis for Alzheimer’s disease

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Solanezumab’s failure is a wake-up call to look elsewhere for an answer to dementia

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.

Many children receive no discharge plan after admission for severe asthma

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Children admitted to hospital with severe asthma attacks generally receive “very effective and efficient” treatment and care, but more attention must be given to asthma education and review at discharge to help prevent future attacks and readmission, says a national audit by the British Thoracic Society.

The society’s National Paediatric Asthma Audit, published on 29 November, reviewed data on more than 5500 children over the age of 1 admitted with severe asthma attacks to 153 UK hospitals in November 2015 and found that most aspects of discharge from hospital were less than optimal.