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Thursday, April 25, 2013

Motherlode Blog: Study Links Autism With Antidepressant Use During Pregnancy

A cautiously worded study based on data collected in Sweden has found that ?in utero exposure to both selective serotonin reuptake inhibitors (S.S.R.I.?s) and nonselective monoamine reuptake inhibitors (tricyclic antidepressants) was associated with an increased risk of autism spectrum disorders, particularly without intellectual disability.?

The Swedish medical birth register (which contains data on current drug use reported by mothers early in their pregnancies), along with a system of publicly funded screenings for autism spectrum disorders and extensive national and regional registers of various health issues, make a detailed, population-based case-control study possible ? one that controls for other variables like family income, parent educational level, maternal and paternal age and even maternal region of birth (all factors the authors note have been previously associated with autism).

This is the second study in two years to associate antidepressant use during pregnancy with an increased incidence of autism in exposed children. An earlier, smaller study in California also found a modest increase in risk. The Sweden-based study could not (and did not) exclude the possibility that it was the severe depression, rather than the use of antidepressants, that created the association, but the smaller California study (which considered only S.S.R.I.?s) found ?no increase in risk? for mothers with a history of mental health treatment in the absence of prenatal exposure to S.S.R.I.?s.

The authors of the current study took a very cautious approach to their findings:

The results of the present study as well as the U.S. study present a major dilemma in relation to clinical advice to pregnant women with depression. If antidepressants increase the risk of autism spectrum disorder, it would be reasonable to warn women about this possibility. However, if the association actually reflects the risk of autism spectrum disorder related to the nongenetic effects of severe depression during pregnancy, treatment may reduce the risk. Informed decisions would also need to consider weighing the wider risks of untreated depression with the other adverse outcomes related to antidepressant use. With the current evidence, if the potential risk of autism were a consideration in the decision-making process, it may be reasonable to think about, wherever appropriate, nondrug approaches such as psychological treatments. However, their timely availability to pregnant women will need to be enhanced.

Others working in the field are more inclined to draw a line between the prenatal drug exposure and the increased risk of autism. ?It really shouldn?t come as that much of a surprise given that numerous animal studies have shown that exposure during development leads to changes in the brain and changes in behavior ? often that mimic autism,? said Dr. Adam C. Urato, assistant professor of obstetrics and gynecology at the Tufts University School of Medicine and chairman of the department of obstetrics and gynecology at MetroWest Medical Center in Framingham, Mass. (Dr. Urato obviously didn?t speak in links, but you can find the animal studies he refers to here and here.)

?And why should it surprise us that medications that can change brain chemistry and function might alter the development of the brain and behavior?? Dr. Urato argues that the risks of antidepressant use during pregnancy outweigh what he sees as the limited benefits.

One conclusion that is simple to draw is that it?s extraordinarily difficult for a pregnant woman with clinical depression to find some definitive answer about what?s best for her in her situation. I?ve spoken to other researchers in the past who have described for me how difficult it is to put together a study that separates the risks of depression itself in pregnancy from the risks, if any, of the drugs used to treat it. As the researchers in Sweden note, it?s unlikely that conclusive evidence on this issue will ever be available.

If you?ve been pregnant with clinical depression, where did you go to find the information and advice you needed?

Updated | April 23, 2013: In re-reading this post, I?ve realized I should have included exactly how ?modest? the increase in attributable risk was (an increase that, again, wasn?t ?caused? by prenatal exposure to either form of antidepressant but rather associated with it). In this study, the increase was just 0.6 percent in the studied population. I?ve been surprised by the number of readers who, in the comments, took this cautiously observed association and blew it up into something rather larger. Happily, the entire study (unlike many) is freely available at the link above. You?ll find other, more extensive (but still far from conclusive) discussions of what these numbers do and don?t mean for individual women here, here, and here.

Source: http://parenting.blogs.nytimes.com/2013/04/22/study-links-autism-with-antidepressant-use-during-pregnancy/?partner=rss&emc=rss

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Suspect in Canada terror plot rambles in court appearance

TORONTO (AP) ? A man accused of plotting with al-Qaida members in Iran to derail a train in Canada gave a rambling statement in a Toronto court Wednesday and appeared to be saying he does not recognize its jurisdiction.

Law enforcement officials in the U.S. said the target was a train that runs between New York City and Canada. Canadian investigators say Chiheb Esseghaier, 30, and Raed Jaser, 35, received guidance from members of al-Qaida in Iran. Iranian government officials have said the government had nothing to do with the plot.

"My comment is the following because all of those conclusions were taken out based on criminal code and all of us know that this criminal code is not a holy book," Esseghaier said at the hearing Wednesday. "We cannot rely on the conclusions taken out from these judgments."

The judge told him to "save that for another court," and take the advice of his lawyers. He was given a May 23 court date.

Charges against the two men in Canada include conspiring to carry out an attack and murder people in association with a terrorist group. Police ? tipped off by an imam worried by the behavior of one of the suspects ? said it was the first known attack planned by al-Qaida in Canada. The two could be sentenced to life in prison if convicted.

In a brief court appearance in Montreal on Tuesday, Esseghaier declined to be represented by a court-appointed lawyer. He made a brief statement in French in which he rejected the allegations against him.

Esseghaier, who was arrested Monday afternoon at a McDonald's restaurant in the train station, was later flown to Toronto for Wednesday's appearance in the city where his trial will take place.

Jaser also appeared in court Tuesday in Toronto and also did not enter a plea. He was given a new court date of May 23. The court granted a request by his lawyer, John Norris, for a publication ban on future evidence and testimony.

The case has raised questions about the extent of Shiite-led Iran's relationship with al-Qaida, a predominantly Sunni Arab terrorist network. It also renewed attention on Iran's complicated history with the terror group, which ranges from outright hostility to alliances of convenience and even overtures by Tehran to assist Washington after the Sept. 11, 2001, attacks on the United States.

Law officials in New York with knowledge of the investigation told The Associated Press the attack was to take place on the Canadian side of the border. They are not authorized to discuss the investigation and spoke only on condition of anonymity.

Jaser's lawyer said on Tuesday that his client questioned the timing of the arrests, pointing to ongoing debates in the Canadian Parliament over a new anti-terrorism law that would expand the powers of police and intelligence agencies.

Norris speaking outside the court said his client is "in a state of shock and disbelief."

He said his client would "defend himself vigorously" against the accusations, and noted Jaser was a permanent resident of Canada who has lived there for 20 years. Norris refused to say where Jaser was from, saying that revealing his nationality in the current climate amounted to demonizing him.

Canadian police have declined to release the men's nationalities, saying only they had been in Canada a "significant amount of time." But a London-based newspaper Al Arab reported Wednesday, citing unnamed sources in the Gulf, that Jaser is a Jordanian passport holder with full name Raed Jaser Ibrahim Amouri, who had visited the UAE several times and most recently in September 2011. The newspaper reported that the suspect also visited other Gulf countries including Qatar and Saudi Arabia. It was not possible to independently confirm the report.

Esseghaier's, in a profile on a university department website ? which has since been removed ? says he was born in Tunis, Tunisia.

Muhammad Robert Heft, president of the P4E Support Group Inc., a non-profit organization that provides support to Muslims in Canada, said Jaser's father Mohammad Jaser came to him several times citing concerns about the radicalization of his son. The discussions took place between 2010 and 2011, while the father was living in a basement apartment in Heft's home in Markham, Ontario. The pair took up accommodation there while awaiting surgery for Jaser's younger brother, who had been in a serious car accident, because the apartment didn't have stairs.

"He came to me about his son saying he how concerned he was getting about the rigidness of his son and his interpretation of Islam. He was becoming self-righteous, becoming pushy, pushing his views on how much they (his family) should be practicing as a Muslim," said Heft.

"His son was becoming overzealous and intolerant in his understanding of the religion," he said. "Those are the telltale signs that can lead into the radicalization process."

The investigation surrounding the planned attack was part of a cross-border operation involving Canadian law enforcement agencies, the FBI and the U.S. Department of Homeland Security. Canadian police said the men never got close to carrying out the attack.

The warning first came from an imam in Toronto, who in turn was tipped off by suspicious behavior on the part of one of the suspect.

___

Associated Press writers Benjamin Shingler in Montreal, Tom Hays and Jennifer Peltz in New York, Kimberly Dozier in Washington and Brian Murphy in the United Arab Emirates contributed to this story.

Source: http://news.yahoo.com/suspect-canada-terror-plot-denies-charges-220238197.html

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Amputee Skateboarder Hopes to Inspire Others With Disabilities ...

Christine Lee, NBC 5 Irving Reporter

Jon Comer, a professional skateboarder who lost his leg as a child, inspires others to push the limits no matter what their disabilities.

Professional Skateboarder Inspires Others

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For the second year, RISE Adaptive Sports and the city of Irving are hosting an adaptive skate event for disabled children, adults and veterans.

Among the participants is Jon Comer, a professional skateboarder who lost his leg when he was four years old. Comer said his physical disability didn't keep him from pursuing his passion, and on Saturday he will be inspiring others to do the same.?

"I got hit by a car when I was four years old and then lost my foot when I was seven just due to complications from that," said Comer.

Since he was 10 years old, skateboarding became a passion and Comer never saw his amputation as a disability and has been a professional skateboarder since 1997. He's hoping to inspire the kids to push the limits no matter what their disabilities are.?

"I would destroy my prosthetics all the time," said Comer. "And I'd go in and I'd get fixed up so I can get back out there and skate some more."

Nonprofit Rise Adaptive Sports is working with the city of Irving for the second year to help raise awareness and inspiration.?

"We want people to realize that we have a diverse population, which includes people with physical and mental disabilities, and we ought to be providing services for them as well," said Joseph Moses, city of Irving recreation superintendent.

Chris Goad, executive director of Rise Adaptive Sports, hopes the event inspires those reaching for their dreams, like Comer.?

"Doing something like this really helps with self-esteem and confidence," said Goad. "And especially if we can get kids in the fold at an early age, it helps them with school, knowing that they can accomplish things despite disabilities."

The event begins at 10 a.m. at the Lively Pointe Skate Park on Saturday, April 27.

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Source: http://www.nbcdfw.com/news/local/Amputee-Skateboarder-Hopes-to-Inspire-Others-204562651.html

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Gwyneth Paltrow Named World's Most Beautiful Woman

Source: http://www.thehollywoodgossip.com/2013/04/gwyneth-paltrow-named-worlds-most-beautiful-woman/

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Five Favorite Films with Dennis Quaid

Dennis Quaid came into his own as one of the astronauts in 1983's The Right Stuff, and has since been one of America's hardest-working, most consistent actors, appearing in everything from Innerspace and Wyatt Earp to Far from Heaven and Traffic. (And lest we forget his gallant, if doomed, effort to hold together Movie 43.) This week he plays dad to Zac Efron's rebellious son in Ramin Bahrani's At Any Price, and with the film opening in limited release, we had a chance to sit down with Quaid recently and talk about his favorite movies.

I think my favorite movie is Lawrence of Arabia. To me, it's just about a perfect film; in the performances and what it means to me. I saw it as a boy -- and I just can't stop watching it, every time it comes on. All David Lean's movies, really. I love Doctor Zhivago, too.

Five Easy Pieces is a film that hit me as a young man. Most of my favorite movies, I think, come from the '70s, in that period where I really wanted to become an actor. Jack Nicholson's performance in that... it's a film that would never be done by a major studio today.

There's Bonnie and Clyde. That's a film that kind of started the new wave in the '70s. That was incredible. I saw that when I was in about the eighth grade, I think. Those characters, and also the history of Bonnie and Clyde, you know... it was something new. I remember, in fact, Bonnie and Clyde came out in either late Spring or early Summer, and then it was pulled. I think it flopped when it came out, and then they brought it back out in the Fall. I mean, I loved it when I first saw it; then they brought it back out in the Fall and it was a huge success.

Scarecrow (Jerry Schatzberg, 1973; 71% Tomatometer)

There's another movie back then called Scarecrow, with Gene Hackman and Al Pacino. They play two hobos that are going across America to open up a car wash. Both performances are just amazing.