Kathryn Doyle

NEW YORK (Reuters Health) - A woman's use of decongestant medications in the first trimester of pregnancy may raise her child's risk of certain rare birth defects, according to a small study.

Some types of over-the-counter decongestants, including the popular phenylephrine and pseudoephedrine, were individually linked to rare, specific birth defects of the digestive tract, ear and heart.

"Major birth defects of any kind affect about two to three percent of liveborn infants, so they are rare," study author Dr. Allen Mitchell said. "The associations we identified involved defects that generally affect less than 1 per 1,000 infants. Some of them may require surgery, but not all are life-threatening."

Decongestants are some of the most commonly used drugs, however, so fully understanding the consequences of taking them during pregnancy is important, said Mitchell, director of the Slone Epidemiology Center at Boston University.

His team worked with a large collection of data on babies born with birth defects between 1993 and 2010. Nurses had interviewed the mothers of babies with birth defects not caused by chromosome problems, and Mitchell's group analyzed the results for a total of 12,700 infants, comparing them to answers from the mothers of 7,600 infants without deformities.

Mothers were asked about medications they took while pregnant and in the two months before becoming pregnant.

First-trimester use of phenylephrine, which is found in Sudafed among other products, was tied to an eight-fold higher risk of a heart defect called endocardial cushion defect. And phenylpropanolamine (Acutrim) was also linked to an eight-fold risk of defects of the ear and stomach. All were associations that had been suggested by earlier studies.

But for the first time, the authors found links between first-trimester use of pseudoephedrine (also in Sudafed) and a 3-fold higher risk of so-called limb reduction defects. Use of imidazolines (found in nasal decongestant sprays and eye drops) was tied to an approximate doubling of risk for an abnormal connection between the trachea and esophagus.

"The risks we identified should be kept in perspective," Mitchell cautioned. "The risk of an endocardial cushion defect among babies whose mothers did not take decongestants is about 3 per 10,000 live births."

Even the eight-fold increase in risk indicated by the study results, while it sounds large, would translate to a 2.7 in 1,000 chance the baby would have the defect, he said. Assuming the findings are correct, he added, the researchers could not speculate about why these drugs might be linked to this handful of defects.

They found no link between the medications and several other deformities that had been suggested by previous studies, such as clubfoot or defects of the eye or face, according to the report published in the American Journal of Epidemiology.

"This should offer some reassurance to women who have taken these medications in pregnancy," Mitchell said.

"Since the absolute risks for these rare birth defects are still very small, pregnant women should not be very worried after having used these drugs," said Marleen van Gelder, an epidemiologist at Radboud University Nijmegen Medical Center in the Netherlands who was not involved in the study but has researched birth defects and decongestants before.

"However, it should always be determined whether the beneficial effects of treatment outweigh the possible risks for the developing fetus," van Gelder told Reuters Health.

Mitchell believes there's enough evidence indicating a possible connection to birth defects that doctors should not be recommending that pregnant women take decongestants, but should evaluate each woman's need for the drugs on a case-by-case basis.

"The fact that medications such as decongestants are typically and widely available for use without a prescription and do not require consultation with a healthcare provider should not be assumed to mean they are safe with respect to the fetus, since there are still relatively few studies that examine the risks and relative safety of these ‘over-the-counter' medications, which are more widely used in pregnancy than prescription medications," Mitchell said.

SOURCE: http://bit.ly/17mAbMT American Journal of Epidemiology, online July 3, 2013.

• by Piper Hoffman
• July 20, 2013

There oughta be a law that being homeless is a crime. That is the opinion of Miami’s city government.

Its vision is for police officers to arrest homeless people for, basically, living. Scott Keyes reports at Think Progress that arrestable offenses would include blocking a sidewalk, cooking food over a fire in a public area, and urinating or defecating in public. In other words, homeless people who sat down, made themselves a meal, or relieved themselves would be criminals. It’s hard to imagine how they could survive without doing those things, or where they would do them if not in public spaces.

Ironically, the city’s proposal follows an era in which law enforcement officers took exactly the opposite approach with great success. To settle a lawsuit, Miami agreed in 1998 that instead of arresting people for these kinds of “quality of life” activities, police would help them get a bed in a shelter. Lo and behold, in the 15 years that followed, the city’s street population dropped from 6,000 to 351.

Miami wants to mess with its success. On its wishlist is empowering cops to arrest homeless people for refusing shelter and to confiscate their property (which the federal Ninth Circuit Court of Appeals recently ruled unconstitutional; that ruling does not apply to Miami, which is in a different circuit). The city argues that homeless people scare others, but I wonder if the homeless aren’t more scared of others than they are of the homeless: see here for the awful story of one homeless Miami man (Ronald Poppo, pictured above) whose face was chewed off by an attacker.

What makes some believe that people without homes deserve to be treated like criminals? I believe that the punitive view of the homeless has two sources. One is uniquely American — the Puritans. The other is the widespread human reflex to blame the victim.

The Puritans were the original American “greed is good” individualists. They believed that wealth was a sign of God’s favor. The richer you were, the more likely you were one of the “elect” — the souls God had picked for salvation. As early colonists, these religious fanatics set the tone for our country’s popular, stubborn, cold-hearted impression that poverty is a moral indictment of a person’s character. We don’t brand adulterous women with scarlet letters anymore, but we do brand poor mothers “welfare queens” and condemn them for sloth, greed and defrauding the rest of us.

The House of Representatives just stripped SNAP (food stamps) out of the farm bill, which could take the food out of millions of hungry, impoverished Americans’ mouths, and the government cut unemployment benefits, taking income away from people with no other income. But the people adopting these laws have no proof that any particular poor person is guilty of any of those things, and lots of proof that for the most part they are struggling mightily just to support themselves and their children.

Victim-blaming also fuels policies criminalizing homelessness like the ones Miami wants to implement. Though much maligned, and indeed very destructive, it is a natural defensive impulse. When I see someone struck by tragedy — say someone who lost her home in Superstorm Sandy — I feel bad for her, but I also comfort myself and tamp down my fears by telling myself that the same thing would never happen to me because I live up on a hill, not down by the water. The truth, of course, is that living on a hill doesn’t immunize me from natural disasters.

The same faulty logic applies to people who blame the poor for their lot. I will never be poor like him, people think, because I would never use drugs, or because I would push and not give up until I had a good job. They don’t want to hear that it often isn’t that easy, that sometimes there are no jobs, or that the available jobs don’t pay enough to live on. (Many people stranded in homeless shelters have jobs but still can’t afford housing.)

When Miami was forced to stop arresting homeless people and start helping them 15 years ago, it dramatically reduced its homeless population, and still it wants to revert to punishing people for being poor instead of helping them improve their situation. I hope they think again. Public officials must overcome our country’s religious history and their own self-defense mechanisms to find a more evidence-based and compassionate approach to homelessness.

Related Story:

Can Homeless People Own Anything?

Read more: homeless, miami, puritans, quality of life offenses, victim-blaming

Photo credit: ITN

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LOS ANGELES (AP) — Rescue crews went into a warehouse last year to save nearly 20,000 rats and reptiles at a wholesale distributor of exotic snakes and rodents, encountering a sight so revolting that they needed crisis counselors to cope.

Many of the animal control workers came out gasping for air and sickened by the heinous sights and smells, including a mixture of death, disease, decay and ammonia from accumulated urine and feces in rat bins. Officials with the People for the Ethical Treatment of Animals called it the largest-ever seizure of animals in California.

The owner and manager of the business have now been arrested and charged with more than 100 counts each of felony animal cruelty for the way they treated the rats and reptiles. Their company, Global Captive Breeders, raised rats and snakes that were sold at pet stores and swap meets.

The Riverside County district attorney filed the case Friday and a judge issued warrants for owner Mitchell Steven Behm, 54, and company manager David Delgado, also known as Jose Magana, 29. A message left for Behm's attorney was not immediately returned, and a lawyer for Delgado could not be located.

The People for the Ethical Treatment of Animals initiated the investigation after sending an undercover operative to work at the breeding facility in Lake Elsinore, 70 miles southeast of Los Angeles.

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This undated photo provided by the Riverside County Sheriff's Department shows Mitchell Steven Behm, …

Some of the animals were already dead by the time rescue workers got there. The ones still living were too sick to treat and too toxic to move, and had to be euthanized.

The toll the operation took on workers ranged from physical to emotional, said Capt. Cindy Machado, who headed up a team of workers from the Marin Humane Society in Novato and coordinated veterinarians who came from all over the country for the weeklong December operation.

People were throwing up because of the ammonia fumes and "there were times you had to run outside just to catch a breath of fresh air," she said.

People emotionally broke down and had to be excused. Several people ended up with colds and sore throats. "I lost my voice," she said.

"I had some idea what to expect but little could have prepared me for the overwhelming stench of death and decay you could smell from the outside of the facility. On the inside it was overpowering," said Daphna Nachminovitch, senior vice president of cruelty investigations for PETA.

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This undated photo provided by the Riverside Sheriff Department shows David Delgado, 29, the former …

There were 18,400 feeder rats and over 600 snakes, black tree monitors, tokay geckos and sulcata tortoises, Nachminovitch said.

Most of the rats were without food in overcrowded bins and because of a faulty water system, were either drowning or dying of thirst. "Some were literally eating each other alive," she said.

Mitch Behm got a conditional use permit for the business in 2009, said Justin Carlson, a spokesman for Lake Elsinore. The city received one anonymous complaint about the business before PETA stepped in, Carlson said. The company's website listed corporate offices in Rancho Santa Margarita.

A whistleblower contacted PETA and the animal welfare agency sent an undercover investigator to get a job at the business. The investigator documented rats being grabbed by their tails and slammed against poles, stomped on, shot with a BB gun, frozen alive and drowned.

The undercover worker was there for two months, and Nachminovitch said that period of time was needed to document enough photo and video evidence to obtain a search warrant. In addition, the neglect was so far advanced by the time the whistleblower called that it would have been impossible to save the animals.

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This Dec. 2012 photo provided by People for Ethical Treatment of Animals (PETA) shows a monitor liza …

The 6,100-square-foot warehouse had separate entrances to the reptile and rat rooms, but the snakes didn't fare any better than the rats, Nachminovitch said. Some of the boas and pythons were 15-feet long.

The animals were euthanized in the warehouse and taken to a rendering plant, she said.

Every rescue worker sets out to save animals, Machado said. But there is also satisfaction in giving an animal in pain a humane, peaceful passing, she said.

"I have been with PETA for 15 years and there was an unprecedented amount of active suffering while we were standing there. I am grateful we could end it," Nachminovitch said.

• by Ashley Lauren Samsa
• July 22, 2013

My husband and I have a running joke that every trip I make into Chicago with my car is going to cost us at least $50. This isn’t because parking is so expensive — although that is definitely true, as well — but because there are now red light cameras on almost every major corner. When I learned to drive, I learned that sometimes it was safer to speed up through a changing light if there was no one in front of you so as not to skid to a stop causing undue stress to your car and yourself. I’m not talking about breaking the law here, just making it through an intersection on a yellow light. However, the red light cameras now capture anyone crossing the intersection on a changing light, and the tickets are sent out automatically. Even worse, during the daytime you can’t see the camera flash, so you don’t even know it has caught you until you get the ticket in the mail.

That’s not the worst part about these ubiquitous police cameras. The American Civil Liberties Union (ACLU) just released a report saying that the license plate image captures that the police are storing nationwide are now up to the millions. Sometimes the police keep these pictures for mere weeks before disposing of them, but some keep them for years or even indefinitely. Somewhere, there is a file of pictures of you driving, walking or doing whatever else you’re doing outside. This is stuff that would put even Orwell’s book “1984″ or the popular television series “The X Files” to shame.

How do the police departments justify keeping these images for so long? They say that it is to look out for suspicious vehicles, abducted children, or drug traffickers. Since most of us are probably not driving suspicious vehicles, kidnapping children or selling drugs, one could argue that the police don’t have probable cause to keep such records. However, there’s not much we can do at the moment. Our daily, personal lives are being tracked, photographed and catalogued and there is no law against it. And these cameras aren’t just on street corners; they are on bridges, police vehicles, police smartphones and buildings. With all of these cameras everywhere, taking pictures of everyone doing anything, it’s a wonder that criminals ever get away with their crimes.

While many argue that this is the price we pay for living in a digital world, the ACLU disagrees. Catherine Crump, a staff attorney with the organization says, “There’s just a fundamental question of whether we’re going to live in a society where these dragnet surveillance systems become routine.” According to a National Public Radio report, license plate readers are less thorough than GPS tracking systems, but can still yield the same information: “revealing whether someone is frequenting a bar, joining a protest, getting medical or mental help, being unfaithful to a spouse and much more.”

If you don’t think the police have any right to know this information about you, you’re not alone. The ACLU is proposing that police discard photos of license plates not linked to any crime. However, it will probably be a long time before we see any move on this. The federal government is currently offering grants to local police departments to increase their surveillance technology in the name of homeland security, so this technology is not going away any time soon.

Hopefully, as more people become aware of what an invasive presence these cameras have in our lives, we’ll see some change in policy eventually.

Read more: aclu, Big Brother, cameras, police, surveillance, surveillance cameras

Photo Credit: Jonathan McIntosh

BEIRUT (AP) — The Syrian opposition said Tuesday that Lebanese Hezbollah leaders should be put on trial for fighting on the government's side in the Syrian civil war.

The surge in Hezbollah involvement has coincided with a turn in the tide of the fighting in favor of President Bashar Assad's forces and may be a factor in it.

Also Tuesday, a United Nations delegation tasked with investigating the use of chemical weapons landed in Lebanon on its way for its first trip to Syria.

Hezbollah's active support of Assad's forces has fanned the flames of sectarian tensions in the region. The Syrian conflict, now in its third year, is increasingly being fought along sectarian lines, pitting Sunni against Shiite Muslims, spilling over into Lebanon.

The overwhelmingly Sunni rebels fighting to topple Assad see Hezbollah's involvement as a declaration of war.

"We call for Hezbollah leaders to be put on trial for the terrorist crimes they committed on Syrian territory," a statement issued by the Western-backed Syrian National Coalition, Syria's main opposition group, said Tuesday.

The European Union placed Hezbollah's military wing on its terror list Monday after diplomatic pressure from the U.S. and Israel.

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In this image taken from video obtained from the Shaam News Network, which has been authenticated ba …

Some European countries pushed for EU action citing a terrorist attack in Bulgaria's Black Sea resort of Burgas last year that killed five Israeli tourists and a Bulgarian. Hezbollah's military wing was accused of involvement, an allegation it denied.

Several EU nations have pointed to Hezbollah's involvement in Syria as further reason for the move.

The opposition group hailed the EU decision but stressed the need for European countries to take "concrete steps that would contribute to stopping the militia's involvement in Syria."

Iran and Syria said Tuesday that the EU's decision serves Israel's interests.

Iranian Foreign Ministry spokesman Abbas Araghchi told a news conference in Tehran that the designation was "strange" and "uncalculated" and won't change Hezbollah's "popular and justice-seeking identity."

Seeking to appease concerns in Beirut, the EU ambassador to Lebanon, Angelina Eichhorst, said after meeting with Lebanon's caretaker foreign minister that the EU will work with any Lebanese government "even if Hezbollah is part of it."

Hezbollah and its allies dominated Prime Minister Najib Mikati's government, which resigned in March. Politicians have not been able to form a new government since.

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In this image taken from video obtained from the Shaam News Network, which has been authenticated ba …

Syria's civil war has killed more than 93,000 people and displaced millions. Both sides accuse each other of using chemical weapons in the war.

Swedish chemical weapons expert Ake Sellstrom and U.N. disarmament chief Angela Kane arrived Tuesday in Beirut on their way to Damascus, Lebanese airport officials said. The Syrian government has invited them for talks on the terms of a U.N. investigation.

The Syrian regime accuses rebels of using chemical agents in a March 19 attack in the government-controlled Aleppo suburb of Khan al-Assal. Assad's government has refused to allow inquiries in other places.

Khan al-Assal fell to the rebels hands on Monday. Even if the U.N. team does get access, it likely will be difficult to find evidence from the attack because so much time has passed.

Robert Serry, the U.N. Mideast envoy, told the Security Council that the U.N. has received 13 reports of alleged chemical weapons use in Syria. He said Sellstrom's team is studying this and other material.

"There is a growing body of limited but persuasive information showing that the regime has used and continues to use chemical weapons, including sarin," said British U.N. Ambassador Mark Lyall Grant.

In June, the United States said it had conclusive evidence that Assad's regime used chemical weapons against opposition forces. That crossed what President Barack Obama called a "red line," prompting a U.S. decision to begin arming rebel groups, although that has not happened yet.

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In this image taken from video obtained from the Shaam News Network, which has been authenticated ba …

Russia, Syria's close ally, has called the chemical weapon allegations facing Assad's regime groundless, claiming Russian experts determined that Syrian rebels made sarin nerve gas and used it in the deadly Khan al-Assal attack.

In Syria, an al-Qaida-linked group warned civilians to stay off a road linking central Syria with Aleppo, declaring it a military zone. Rebels are trying to cut one of the regime's main routes for supplying its forces in the north, activists said.

The warning came a day after rebels went on the offensive in Syria's north, seizing three villages in the province where a military stalemate has been in place since last summer.

The Britain-based Syrian Observatory for Human Rights and the Aleppo Media Center said that al-Qaida-linked Jabhat al-Nusra is threatening to target any vehicle using the road starting Wednesday. The warning was posted online.

The regime uses the route to ferry supplies to its forces in the north because the rebels already have severed the main north-south highway that connects Damascus with the embattled city of Aleppo.

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Associated Press writers Albert Aji in Damascus, Syria, Bassem Mroue in Beirut and Edith M. Lederer at the United Nations contributed to this report.