NHS Fife is the first health board in Scotland to perform hip replacements as day surgery for suitable patients.

The science is clear that human activities over the last century have contributed to greenhouse-like warming of the Earth’s surface. Much of the global conversation around climate change fixates on what individual countries or regions are contributing to the problem, and what they will do (or not do) to reverse the tide.

Scientists at Rice University have developed synthetic protein switches to control the flow of electrons.

Pregnancy is a happy, but challenging time with some discomfort during the journey. Constipation is one of those unpleasant side-effects, with up to half of all pregnant women suffering from constipation at some stage during their pregnancy.

What causes pregnancy constipation?

There are a couple of possible culprits that cause constipation in general – this includes a diet lacking in fibre, not enough water or not enough exercise. Constipation can also be part of other digestive conditions such as IBS.

During pregnancy, hormones fluctuate and can cause the relaxation of intestinal muscles. It’s especially the increase in the levels of progesterone in your body that relaxes all the “smooth” muscles in the body. This causes your digestive system to slow down, causing waste to move more slowly than usual.

Taking iron tablets to avoid iron-deficiency anaemia during pregnancy can also cause constipation, especially high doses.

In the later stages of pregnancy, the pressure of the growing uterus on your rectum can also be responsible for constipation.

Should I be concerned about constipation during pregnancy?

The physical changes in your body during pregnancy will normally cause constipation, which is nothing to worry about. But sometimes constipation can signal other health problems. If you ever experience constipation along with severe abdominal cramps, bleeding in your stool or alternating diarrhoea, you should contact your doctor.

If you leave constipation untreated and it lasts longer than two weeks, it could lead to other complications such as haemorrhoids.

And postpartum constipation?   

Constipation does not only occur during pregnancy, but can continue after giving birth. There are several reasons for this:

• You still have high progesterone levels in your body and this might take a while to normalise. 
• You might have after-effects from the anaesthetic following a Caesarean.
• You might have tearing near the rectal area, which makes bowel movements uncomfortable.
• You might have given birth to a large baby.
• You might have had damage to the pelvic floor muscles, which makes it harder to pass stools.

What you can do to relieve constipation

These are the steps you can take to help relieve constipation during and after pregnancy:

• A diet consisting of plenty of fruit and vegetables, whole grains and legumes will not only add plenty of antioxidants to your diet to ensure a healthy pregnancy, but you will also get your daily intake of fibre that may help relieve constipation.
• Get regular exercise to help things moving along. If you are not sure if you should continue your pre-pregnancy workout regime, talk to your doctor to ensure a safe workout.
  
• Stay hydrated.
• Eat smaller, more frequent meals as larger meals might overload your stomach and slow down digestion even more.
• Talk to your doctor about the use of a pregnancy-safe laxative to help things along.
• If you are taking an iron supplement, ensure that you are taking the correct dose as too much iron may cause more severe constipation.

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Marelize Wilke

A drug used to control seizures may be a potent weapon against depression in patients who don’t find relief with antidepressants, a small pilot study suggests.

Some of the 18 patients taking ezogabine (Potiga) experienced a 45% reduction in depression and an increase in their ability to feel pleasure, as well as an increase in resilience and the capacity to recover from extremes of trauma and stress, the researchers reported.

“This drug might be relevant for patients who don’t do well with conventional antidepressants,” said lead researcher Dr James Murrough. He is director of the mood and anxiety disorders programme at the Icahn School of Medicine at Mount Sinai, in New York City.

Ezogabine was approved in 2011 by the US Food and Drug Administration as an anti-seizure medication. Shortly after its approval, concerns were raised about the drug’s effect on the retina and the possibility of it causing blindness.

SSRIs don’t always work

The FDA ordered the drug’s maker, GlaxoSmithKline, to do further safety studies. After reviewing those studies, the FDA ruled in 2015 that the drug did not appear to affect vision. Still, the company withdrew ezogabine from the US market in 2017, citing poor sales.

Even so, psychiatrists noted that if the drug proves effective against depression in larger studies, other drugs that target this area of the brain could be developed.

Some 15 million Americans suffer from major depressive disorder, which is a leading cause of disability. Treatments include selective serotonin reuptake inhibitors (SSRIs) such a Prozac and Paxil, but they are not effective across the board, the researchers noted.

It may be that depression is not one disease, but several that affect different areas of the brain, Murrough said.

That’s why new approaches are needed to increase the number of drugs available that target different areas of the brain where depression arises and help patients cope with depression’s various forms, he said.

“Ongoing research is trying to find new ways to treat depression based on understanding what’s going on in the brain when someone gets depressed and how can we reverse that,” Murrough said.

Ezogabine works by increasing the activity of the area in the brain that controls potassium. Murrough explained animal studies have shown that depression can reduce the activity of this potassium channel and that ezogabine can increase its activity, thus relieving depression.

Activates brain’s ‘reward system’

To see if the drug could work in humans, Murrough and his colleagues treated 18 people suffering from major depression with daily doses of ezogabine for 10 weeks.

MRI scans of the participants found that the drug activated the brain’s so-called reward system, which resulted in a significant reduction of depressive symptoms.

Not all patients responded to the drug, which might mean that their condition has a different cause, Murrough said.

The researchers said they are currently conducting a larger trial that will compare ezogabine with a placebo, to get a better idea of how effective the drug is at treating depression.

The report was published online in the journal Molecular Psychiatry.

Dr Victor Fornari is a psychiatrist at Lenox Hill Hospital in New York City. He said, “We need to find newer ways to treat depression,” and ezogabine might be one of these new approaches.

“This study doesn’t change treatment – yet,” he added. “At least this is preliminary evidence that this potassium channel target might be another avenue for treatment.”

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An international team of palaeontologists, which includes the University of Bristol, has discovered that the flying reptiles, pterosaurs, actually had four kinds of feathers, and these are shared with dinosaurs — pushing back the origin of feathers by some 70 million years.

Young people and their parents are being warned that ingesting the toxic substance can be fatal.

Christmas parties are upon us, but how many parents think about how a hangover will affect their parenting?

Mental health issues are sending more and more kids and teens to hospital emergency rooms, and that increase has been most dramatic among minorities, a new report shows.

Between 2012 and 2016, overall admissions shot up 50% in the United States, the researchers said.

Racial and ethnic disparities

“Prior to our study, we knew that an increasing number of children with mental health concerns were coming to the nation’s paediatric emergency departments,” said study author Dr Anna Abrams. She is a resident physician with the Children’s National Health System in Washington, D.C.

“What this new research demonstrates is that not only are these visits increasing at a staggering rate, but that there are significant racial and ethnic disparities in the trends of who visits paediatric emergency departments for mental health issues,” Abrams said.

Why this is so remains unclear, she noted.

“Our study really was an effort to characterise the frequency of these emergency department visits,” Abrams explained. “It was not designed to investigate the potential reasons that triggered these visits. We do plan to investigate this question in future work.”

Abrams and her colleagues plan to present their findings at an American Academy of Pediatrics meeting, in Orlando, Florida. The research should be considered preliminary until published in a peer-reviewed journal.

The study team said that more than 17 million American children struggle with some form of psychiatric illness. In recent years, that has meant that somewhere between 2 to 5% of all paediatric visits to the emergency department have been related to mental illness concerns.

Dramatic rise in visits

To drill down on the trends, the investigators sifted through data that had been collected by the Pediatric Health Information System.

The team focused on the overall number of mental health-related visits to an emergency department among children up to the age of 21.

The mental health issues covered by the analysis included: acute anxiety and delirium states; adjustment disorders and neuroses; alcohol abuse; drug abuse (including opioid abuse); bipolar disorders; childhood behavioural disorders; depression; major depressive disorders; disorders of personality and impulse control; eating disorders; psychosis; and schizophrenia.

During the study period, investigators determined that more than 293 000 children – who were an average age of just over 13 – had been diagnosed for some type of mental illness in a paediatric emergency room setting.

Overall, these visits rose dramatically during the study period, up from about 50 visits for every 100 000 children in 2012 to nearly 79 visits per 100 000 by 2016, according to the report.

But when broken down by race, the investigators found that the observed rise had not unfurled at an equal pace.

For example, nearly 52 out of every 100 000 white children were visiting an ER for a mental health issue by 2016. But among black children, that figure shot up to 78. Among other non-Hispanic minorities, the number rose to more than 79.

A function of social circumstances

The majority of all paediatric mental health visits (55%) were covered by some form of public insurance, the study authors noted.

William Tynan is director of integrated health care with the American Psychological Association. He said he wouldn’t be surprised if the study actually underestimates the degree to which mental health is the central concern among paediatric ER visits.

“I would have estimated 10%, so the 2 to 5% looks low to me,” Tynan said.

As for the observed racial disparities, Tynan suggested that they are likely “a function of social circumstances”.

Poverty aside, “families go to the emergency department because, in general, when there is a problem with a child — either medical or behavioural — all parents feel a sense of urgency and want it addressed immediately,” Tynan said.

But, “we do know that children in poverty who have been exposed to social stressors — and sometimes more trauma and violence — have a higher risk of disorders, so the numbers on differences between black and white need to be compared with poverty rates,” he added.

On that front, Tynan noted that some estimates put the poverty rate for black children at 27%, compared with just 10% among white children. Pew Research paints an even starker divide, he added: 38% among black kids versus 11% among their white peers.

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Twice as many high school students used nicotine-tinged electronic cigarettes this year compared with last year, an unprecedented jump in a large annual survey of teen smoking, drinking and drug use.

It was the largest single-year increase in the survey’s 44-year history, far surpassing a mid-1970s surge in marijuana smoking.

The findings, released Monday, echo those of a government survey earlier this year. That survey also found a dramatic rise in vaping among children and prompted federal regulators to press for measures that make it harder for kids to get them.

Sneaky behaviour

Experts attribute the jump to newer versions of e-cigarettes, like those by Juul Labs Inc. that resemble computer flash drives and can be used discreetly.

Trina Hale, a junior at South Charleston High School in West Virginia, said vaping — specifically Juul — exploded at her school this year.

“They can put it in their sleeve or their pocket. They can do it wherever, whenever. They can do it in class if they’re sneaky about it,” she said.

Olivia Turman, a freshman at Cabell Midland High School in Ona, West Virginia, said she too has seen kids “hit their vape in class.”

Vaping marijuana

The federally funded survey released Monday is conducted by University of Michigan researchers and has been operating since 1975. This year’s findings are based on responses from about 45 000 students in grades 8, 10 and 12 in schools across the country. It found 1 in 5 high school seniors reported having vaped nicotine in the previous month.

After vaping and alcohol, the most common thing teens use is marijuana, the survey found. About 1 in 4 students said they’d used marijuana at least once in the past year. It was more common in older kids — about 1 in 17 high school seniors said they use marijuana every day.

Overall, marijuana smoking is about the same level as it was the past few years. Vaping of marijuana rose, however.

No to hard drugs

More teens, however, are saying no to lots of other substances. Usage of alcohol, cigarettes, cocaine, LSD, ecstasy, heroin and opioid pills all declined.

Experts say it’s not clear what’s behind those trends, especially since the nation is in the midst of the deadliest drug overdose epidemic ever.

“What is it that we’re doing right with teenagers that we’re not doing with adults?” said Dr. Nora Volkow, director of the National Institute on Drug Abuse, a federal agency that funds the Michigan study.

One leading theory is that kids today are staying home and communicating on smartphones rather than hanging out and smoking, drinking or trying drugs.

“Drug experimentation is a group activity,” Volkow said.

What about vaping? “Vaping mostly is an individual activity,” said David Jernigan, a Boston University researcher who tracks alcohol use.

Harmful to developing brains

The vaping explosion is a big worry, however. Health officials say nicotine is harmful to developing brains. Some researchers also believe vaping will make kids more likely to take up cigarettes, and perhaps later try other drugs.

So far that hasn’t happened, surveys show. But the Juul phenomenon is recent, noted Richard Miech, who oversees the Michigan survey.

If vaping does lead to cigarette use among teens, that may start to show up in the survey as early as next year, he added.

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