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Gene Hunters Target Child Kidney Failure
Researchers are zeroing in on the genetic abnormalities predisposing to vesicoureteric reflux (VUR), one of the most common causes of urinary tract infections and kidney failure in children, reports a study in an upcoming issue of the Journal of the American Society of Nephrology (JASN). "In this study, we accomplished a very critical step towards the identification of the VUR gene," says Ali G. Gharavi, MD (Columbia University, New York).
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Bill Fuels Debate Over Universal Screening For Postpartum Depression
A bill (HR 20, S 324) in Congress that would mandate funding for research, services and public education related to postpartum depression has sparked debate over whether all women should be screened for the condition, Time reports. The Melanie Blocker-Stokes Postpartum Depression Research and Care Act, also known as the Mothers Act, passed the House and is before the Senate. The bill does not specifically include funding for PPD testing, though an earlier version did; regardless, critics say it would still lead to greater screening. According to Time, the issue at the center of the debate is whether PPD screening identifies actual cases "or simply contribute[s] to the potentially dangerous medicalization of motherhood." Ingrid Johnston-Robledo, director of women"s studies at the State University of New York, said that experts on both sides of the debate agree about increased support for women. "The problem with women"s reproductive health issues is that they tend to be ignored or exaggerated," Johnston-Robledo said. She added, "We need to find a way to come down in the middle: acknowledge women"s depression but not assume that all women who struggle with the transition to motherhood are depressed."Critics of the bill argue that mental health screenings are notorious for giving false positives. They also contend that increased testing is a bid by pharmaceutical companies to sell more medication to women who do not need it. Some psychologists argue that universal PPD screening would be misdirected because the greatest risk factor for the condition is previous depression, not giving birth. Paula Caplan, a clinical and research psychologist, said, "(We) should be addressing the social factors causing women to be upset after they give birth, not locating the problem within the women."Some proponents of PPD screening say it is not supposed to be used as a diagnostic tool but as a way to identify which patients require further evaluation. According to Time, studies suggest that PPD affects as many as one out of seven women who have recently given birth and that leaving it untreated exposes women and their infants to unwarranted risk. Katherine Wisner, a psychiatrist at the University of Pittsburgh Medical Center, said, "Postpartum depression is not a benign, uncommon thing." She added, "We screen all infants for (the genetic disorder) phenylketonuria, which is extremely rare. Why don"t we screen women for this?" (Elton, Time, 7/20).
News of the day
First-Line Nab-Paclitaxel Is Superior To Docetaxel For Metastatic Breast Cancer
CHICAGO, May 26, 2009 - New data show that nab-paclitaxel (AbraxaneR for Injectable Suspension) prolongs investigator-assessed, median progression-free survival (PFS) by almost seven months versus the highest standard dose of docetaxel in women with metastatic breast cancer.
Cardiovascular

Depression May Cause Patients To Become Less Active

Feelings of depression could be one reason patients fail to follow their doctors" orders on exercising and eventually become less physically active, a new research review finds. Although past research shows that exercise improves chronic health conditions, such as heart disease and diabetes, it also shows that patients with these conditions often suffer from depression. The new analysis evaluated 11 studies comprising some 20,000 patients. Eight studies reported that having symptoms of depression after a coronary event, such as heart attack, was a significant risk factor for developing a sedentary lifestyle or a poor adherence to an exercise regimen recommended by the patients" doctor. The review appears in the July/August issue of the journal General Hospital Psychiatry. One study, for example, investigated the role of depression and anxiety in 224 heart attack survivors, at three months and 12 months after their hospitalization. Of those with anxiety and depression during hospitalization, 59 percent had a significant decrease in exercise after three months, compared with 31 percent of those who were not depressed. A year later the gap widened, with 51 percent of depressed patients exercising less compared with 26 percent of non-depressed patients. The studies used different methods to measure depression and physical activity and there was a great difference in how they compared factors such as the patients" health, physical activity and depression. There are many suggested theories to explain why depression leads to a decline in activity. Babak Roshanaei-Moghaddam, M.D. of the department of psychiatry and behavioral sciences at University of Washington in Seattle and lead author of the study offered one theory. "We have hypothesized that there are both behavioral habits associated with depression, such as smoking and obesity, which may then limit exercise motivation and enjoyment, as well as biologic factors that can cause obesity and decrease energy level, exercise tolerance and pain threshold," he said. Evette Joy Ludman, Ph.D., of Seattle-based Group Health Cooperative, who had no affiliation with the study, agreed. "Depression can indeed make people have less motivation and energy to exercise," Ludman said. "The sad part about this is that physical activity is not only important for preventing and managing many chronic conditions; it can be very helpful for improving mood and other symptoms of depression." General Hospital Psychiatry is a peer-reviewed research journal published bimonthly by Elsevier Science. For information about the journal, contact Wayne Katon, M.D., at (206) 543-7177. Roshanaei-Moghaddam B, Katon WJ, Russo J. The longitudinal effects of depression on physical activity. Gen Hosp Psychiatry 31(4), 2009. Health Behavior News Service


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