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Health Rounds

By Nancy Lapid, Health Science Editor

Hello Health Rounds readers! Pregnant women with depression symptoms shouldn't suffer in silence. Much has been reported about the benefits of recognizing and treating women's depression after childbirth, but today we report on a study that found that a short series of counseling sessions can provide quick relief for depression during pregnancy. We also report on a new approach to controlling hemorrhage and a study that adds to evidence of the importance of careful beverage selection by people with type 2 diabetes.

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Beverage consumption habits were linked with odds of death during a long-term study of people with type 2 diabetes. REUTERS/Carlos Osorio

Study Rounds

Therapy for depression while pregnant helps mother and baby

A brief course of counseling can significantly ease depression during pregnancy and potentially lead to better outcomes for mother and baby over the long term, researchers say.

In a trial involving 234 pregnant patients who reported at least mild depressive symptoms in their first or second trimester, a form of counseling known as interpersonal therapy (IPT) had obvious benefits, according to a report in JAMA Psychiatry.

Compared to patients who received only a 1-hour consultation with a psychiatrist, those who received eight 50-minute IPT sessions had greater and faster symptom improvement, the researchers said.

IPT during pregnancy resulted in "profound" decreases in depression, said study leader Dr. Elysia Poggi Davis of the University of Denver. This was true regardless of patients' socioeconomic status or how far along they were in the pregnancy, her team found.

At the start of the study, 37% of patients in both groups met criteria for major depressive disorder. By the end, that was still true for 26% of those who received the one-time psychiatric consultation, but for only 6% of patients who received counseling.

"Individuals report feeling better, with fewer depression symptoms, quickly after treatment begins," Davis said.

Because depression during pregnancy has been linked with premature birth and developmental delays and mental health risks in offspring, "the prenatal period is a time when mental health support can benefit two generations," Davis said.

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Researchers test new way to stop hemorrhage

An experimental treatment that takes a new approach to controlling hemorrhaging might eventually be useful for keeping severely injured people alive until they reach a hospital, researchers said.

The body reacts to bleeding by plugging torn blood vessels using blood clots formed by pieces of cells called platelets in combination with a protein called fibrinogen. When people are losing a lot of blood, they do not have enough platelets or fibrinogen to form clots.

The experimental treatment mimics the actions of both of these clotting-mechanisms, according to a study funded by the U.S. Army Research Office and the Department of Defense and reported in Advanced Healthcare Materials.

To do so, it uses a nanoparticle that recruits platelets and a polymer that mimics fibrinogen.

In anesthetized mice with liver injuries causing uncontrolled bleeding, the injectable treatment performed significantly better than previously developed treatments, the researchers said.

Researchers in the past have been "trying to either recapture the therapeutic effects of platelets or recapture the function of fibrinogen," study leader Celestine Hong of the Massachusetts Institute of Technology said in a statement. "We are trying... to capture the way they interact with each other."

The resulting clots are more stable than naturally occurring clots, the researchers also found.

Intravenous saline is usually given to maintain blood pressure in cases of hemorrhage, but saline dilutes the platelets and fibrinogen, weakening the clots. The artificial clots are not as susceptible to this kind of degradation, the researchers reported.

It will be years before researchers know whether the treatment will work in humans. In the meantime, they also want to see whether they can use portable imaging devices to see where the injected nanoparticles travel in the body. Being able to do so would help emergency medical responders identify the site of internal bleeding, which presently requires imaging studies or surgery.

Beverage choices linked with mortality in type 2 diabetes

For adults with type 2 diabetes, replacing sugary drinks with coffee, tea, or water is linked to lower rates of early death due to cardiovascular disease and other causes, new data show.

Researchers tracked 15,486 U.S. health professionals with a diagnosis of type 2 diabetes who completed questionnaires about their beverage consumption every two-to-four years. Participants stayed in the study for nearly 20 years, on average, according to a report in The BMJ.

After accounting for other lifestyle factors and medical conditions that could influence the outcome, researchers found that participants with the highest intake of sugar sweetened beverages (more than 1 serving a day) had a 20% increased risk of death from any cause compared with participants with the lowest intake (less than 1 serving a month).

In contrast, up to 6 servings a day of certain beverages was associated with lower odds of death over the course of the study: 26% lower for coffee, 21% for tea, 23% for plain water, and 12% for low fat milk.

The pattern was similar when researchers analyzed associations between beverage consumption and rates of cardiovascular disease and related deaths.

It was not too late to change beverage consumption habits after a diabetes diagnosis, the researchers also found. Replacing consumption of sugar-sweetened beverages, artificially sweetened low-calorie beverages, fruit juice and full-fat milk with coffee, tea, or water after diagnosis was "consistently" associated with lower all-cause mortality, according to the report.

The study cannot prove that cutting back on certain beverages can prolong the lives of people with type 2 diabetes. Still, an accompanying editorial notes, the findings "all point in the same direction: lower consumption of sugar sweetened beverages and higher consumption of coffee, tea, plain water, or low fat milk are optimal for better health outcomes in adults with type 2 diabetes."

This newsletter was edited by Bill Berkrot. Additional reporting by Shawana Alleyne-Morris.

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