iStockphoto/Thinkstock(NEW YORK) -- A former police officer accused of kidnapping and raping a 25-year-old waitress in 2010 will be allowed to use the Zoloft defense, a California judge ruled Thursday, claiming he was mentally "unconscious" during the attack because of the antidepressant.
Anthony Nicholas Orban is accused of abducting the woman at gunpoint and making her drive to a storage facility before the attack, the Los Angeles Times reported. If convicted, he could face life in prison.
"But for the use of Zoloft, Mr. Orban would not have committed these acts," Orban's attorney James Blatt told the Times. "Here you have a police officer and former Marine who for the last 10 years has been dedicated to protecting his country and protecting his community. ... This was totally out of character."
A spokesman for Pfizer, the company that makes Zoloft, said in a statement: "There is extensive science supporting the safety and efficacy of Zoloft, and the medicine carries accurate, science-based and FDA-approved information on its benefits and risks."
The drug does carry warnings to call a health care provider if users begin "acting aggressive or violent" or "acting on dangerous impulses."
iStockphoto/Thinkstock(NEW YORK) -- With Americans eating more shrimp -- more than 1 billion pounds a year or 4 pounds per person -- than salmon, crab and trout combined, the crustacean seems to be the U.S.'s favorite seafood.
"It's all over the menu," said New Orleans chef Brian Landry of the seafood restaurant Borgne. "The shrimper men hit the dock yesterday morning. By 3 p.m. the shrimp were in our kitchen."
Landry uses only local gulf shrimp, but most Americans don't know that 90 percent of the shrimp they purchase at the grocery store -- and in most restaurants -- never see a shrimper or even a fishing boat.
Most of the fresh shrimp eaten in the United States is raised in small, overcrowded pens on shrimp farms in countries like India, Thailand and Vietnam, according to the federal government. And too often, the shrimp is raised in shockingly disgusting conditions that promote disease.
"A shrimp that's farm-raised in a foreign country to produce the yield they need and the quantity they need, they'll use any means necessary that we don't use here," Landry said.
To keep the shrimp from dying in diseased waters from their own muck, some shrimp farmers routinely pour antibiotics that are not allowed in the U.S. into their pens -- and some of it is reaching U.S. grocery stores.
Because there is so much shrimp flooding the system, though, the Food and Drug Administration currently inspects no more than 2 percent of it. The government says it pressures the foreign shrimp industry to police itself and ramps up inspection on producers who have been caught using banned chemicals.
"Probably 1 [percent] to 2 percent of the products coming in actually get manually inspected," said FDA commissioner Margaret Hamburg. "We can't screen every container that comes in, open every box, so what we are doing is [trying] to apply the smartest and best strategy to this, which is a risk-analytic approach."
"It's a system that is producing good results," said Michael Taylor, deputy commissioner for foods at the FDA. "People can be confident that there's a system in place that does an effective job of minimizing these residues. It's not perfect. There's room for improvement. We're doing a number of things to be able to do that but we think people can have confidence in the safety of seafood."
The FDA says that despite its zero tolerance policy on antibiotics, an occasional antibiotic-contaminated shrimp is not a danger to consumers.
To find out just how much contaminated shrimp was reaching U.S. grocery stores, 30 samples of fresh shrimp were purchased across the country. Those samples were then sent to the nationally recognized Institute of Environmental and Human Health food lab at Texas Tech University and tested for potentially dangerous antibiotics. Shrimp in three of the 30 samples were found to contain banned antibiotics.
"About 10 percent of them showed evidence of pharmaceutical residue in the muscle tissue alone, which people eat," said Dr. Ronald Kendall, a professor of environmental toxicology and the institute's director.
Three different banned antibiotics were found in the shrimp: enrofloxacin, an antibiotic banned in animals that Americans eat because it damages the immune system; chloramphenicol, suspected to cause cancer in humans; and carcinogen nitrofuranzone, which was banned in the U.S. 40 years ago.
Kendall said the detection limit for FDA-approved seafood for nitrofurazone -- which can have potential health consequences when ingested or absorbed -- was about one part per billion.
"With imported shrimp from international destinations, if you exceed one part per billion, that shipment will probably be terminated," Kendall said. "In the case of the two sample systems that we received from New York when the shrimp averaged 28 and 29 parts per billion, this considerably exceeded the policy."
But the FDA's Taylor said that a small sample size -- in this case, the 30 samples tested at Texas Tech -- did not give a complete picture of residues in food.
"We do much more sampling than that," he said. "We have an understanding of these residues that says they are not generally very unusual. We typically do not have illegal residues. When we have them, we take strong action to prevent that product from coming into the country."
Patty Lovera of Food and Water Watch said U.S. consumers should ask for wild-caught, not farm-raised shrimp. Wild-caught shrimp can run a dollar a pound more but they swim freely and are not held in small pens.
Gavin Gibbons, spokesman for the National Fisheries Institute, a trade group that represents domestic and foreign shrimpers, said companies found skirting the FDA systems -- including their home countries -- could be barred from exporting to the U.S. He said that he didn't think more testing was the answer to the problem though.
"Focusing on certain countries or companies is a better use of resources that just testing everything that moves," he said. "We want the FDA to focus their resources on the country or company that abuses the system."
Gibbons said that his organization was "disappointed" with Texas Tech's findings and that it maintained a zero-tolerance policy for unapproved antibiotics.
"Our member companies do their own sampling and testing at different times both in the exporting countries and here in the U.S.," Gibbons said. "Additionally, many invest in third-party certification programs that review food-safety provisions throughout the value chain."
ABC News(AUGUSTA, Ga.) -- Aimee Copeland, the Georgia student who lost her leg to a rare flesh-eating infection two weeks ago, shed no tears after learning she would lose her remaining foot and both hands, according to her family. Her reaction instead: "Let's do this."
The 24-year-old remains in intensive care at an Augusta hospital, still battling the effects of the May 1 zip line accident that cut open her calf and invited the life-threatening infection. Her breathing tube has been replaced by a tracheostomy, a tube inserted directly into her wind pipe.
Despite showing signs of recovery, Copeland's hands and right foot will be amputated to prevent the infection from spreading to her blood, according to her father.
"As they usually do, the doctors were presenting us with a medical no-brainer," he wrote in a blog dedicated to her recovery Thursday. "We had to do what is necessary to save Aimee's life."
It's unclear whether the amputations have already occurred. A spokeswoman at Doctors Hospital in Augusta deferred questions to Andy Copeland's blog.
Before learning about the amputations, Copeland learned about the kayaking trip on the Little Tallapoosa River, the fall from a homemade zip line, and the wound that wouldn't heal -- events blurred by drugs designed to keep her calm in intensive care. She also learned about the flood of support and well-wishes.
"We told her that the world loved and admired her. We explained that she had become a symbol of hope, love and faith," Andy Copeland wrote. "Aimee's eyes widened and her jaw dropped. She was amazed."
Fears that Copeland would react to the news of her amputations with "horror and depression" quickly faded as she nodded acceptingly and asked about prosthetics.
"We all understood her next three words," Andy Copeland wrote. "Let's do this."
Copeland's upbeat reaction to the devastating news brought her father to tears.
"I wasn't crying because Aimee was going to lose her hands and foot, I was crying because in all my 53 years of existence, I have never seen such a strong display of courage," he wrote. "I was crying because I am a proud father of an incredibly courageous young lady."
Comstock/Thinkstock(WASHINGTON) -- There’s no summer activity manlier than slapping a thick steak on the grill and chowing down, according to a new study.
The report published in the Journal of Consumer Research found that people associate meat with masculinity, a fact that may make healthier, vegetable-heavy diets seem wimpy and unappealing.
“To the strong, traditional, macho, bicep-flexing, All-American male, red meat is a strong, traditional, macho, bicep-flexing, all-American food,” the authors wrote. “Soy is not. To eat it, they would have to give up a food they saw as strong and powerful like themselves for a food they saw as weak and wimpy.”
Researchers conducted a series of studies testing metaphors associated with food. They found that people from Western cultures typically link manliness with meat, especially meatier muscle like steak. They also found that people associated meat with more masculine words and that meat-eaters are considered manlier than those who steer clear of or don’t dine on swine or cattle.
Interestingly, the researchers found that meat was associated with the male gender in 23 languages that assign gender to certain words.
Maybe the association comes from thoughts of strength and power in the muscle that meat comes from, the researchers speculated, or maybe it comes from thoughts of macho activities like hunting. Whatever the case, the study suggested that men seem to feel uneasy about picking a Portobello mushroom over a pork chop.
The health risks associated with meat-heavy diets are becoming increasingly evident. One study found that eating a single serving of red meat every day was linked to an increased risk of early death.
Dr. Ulka Agarwal, chief medical officer for the Physicians Committee for Responsible Medicine, a non-profit group that promotes preventive medicine, animal rights and plant-based diets, said the “meat is macho, veggies are lame” mindset is really an outdated way of thinking about eating.
“The face of plant-based diets is changing as they become more mainstream,” Agarwal said. “It’s not just hippies, but also professional athletes who are following plant-based diets now.”
PCRM is already working on promoting the pros of plant-eating to men. The group that was behind controversial billboards in Chicago proclaiming that “hot dogs cause butt cancer” now promotes a program featuring masculine celebrities such as NBA players, firefighters and ultra marathoners discussing the benefits of eating a plant-based diet and how it helps them perform.
Agarwal said an easy way to start on a plant-based diet is to avoid eating meat for one day a week.
“Easing people into these changes can really help them develop a taste for plant-based foods,” she said.
Zoonar/Thinkstock(PROVO, Utah) -- Profanity in teen novels varies greatly from book to book, but characters that do use foul language tend to also be the most popular, attractive and rich, according to new research published in the journal Mass Communication and Society.
Sarah Coyne, professor in the department of family life at Brigham Young University, analyzed the use of profanity in 40 young adult books on the adolescent bestsellers list.
Thirty-five out of the 40 books had at least one swear word. She found that YA novels contained on average 38 instances of bad language, but one book had nearly 500 instances of swearing.
Of note, the characters that were doing the swearing tended to be of higher social status, better looking and have more money than their non-swearing counterparts.
"The funny thing about books is that you really don't know what you're getting into when you pick one up," said Coyne. "I was genuinely surprised by how much profanity some of these books had."
The documented increase in the use of profanities within YA fiction keeps with the increased acceptance of obscenities in general, said Dr. Steven Schlozman, assistant professor of psychiatry at Harvard Medical School.
"Recall the multiple political figures who have been heard to use profanity when they assumed they were not on microphone," said Schlozman. "The subsequent [truth] that increased profanity within dialogue or first-persona narratives, or third-person familiar narratives, adds to the YA novel, and a kind of challenging that is characteristic of identity formation for all adolescents and young adults, especially in Western culture."
And that level of profanity that kids are learning and using these days can be shocking, said Dr. Victor Strasburger, a former member of the American Academy of Pediatrics Council on Communications & Media. But, while media plays a strong role in influencing children's language and profanity, movies and television have a much more powerful role than books.
"Reading has always been a separate kind of media," said Strasburger. "Seeing your favorite movie star, or someone you identify with, spouting foul language is different than reading it on a page because with movies you have the visual processing, along with the auditory and role modeling. With books, you just have the visual."
Jupiterimages/Thinkstock(NORTH BRUNSWICK, N.J.) -- Everyone enjoys a good laugh now and then. Well, almost everyone, according to a Rutgers University study.
As you’ve probably discovered, there are people who just don’t see the humor in anything. Take them to a comedy club and you may as well have left them in the car because they’re just not going to crack a smile no matter what.
Rutgers anthropologists Robert Lynch and Robert Trivers claim the problem with non-laughers is that they are masters in self-deception, that is, they don’t pick up on the absurdities in life. As a result, these seemingly joyless people are missing out on what the rest of us might find hilarious.
Lynch and Trivers explain, “Humor often involves seeing something from a novel angle, with surprising and pleasing effects. But if you are practicing self-deception and blocking out certain angles, you will, when these angles are exposed, fail to see the absurdity and fail to enjoy the humor.”
Zoonar/Thinkstock(NEW YORK) -- A day after a study in the journal Lancet challenged the long-standing notion that raising levels of HDL -- commonly known as "good" cholesterol -- prevents heart attacks, top cardiology experts differed on whether the research really means the end of the road for therapies aimed at boosting HDL levels to beat back heart disease.
Some, like Dr. Philip Greenland, said the new evidence may very well close the book on such efforts.
"After several blows to the head of this theory, it is on the ropes, or maybe even down for the count," wrote Greenland, senior associate dean for clinical and translational research at the Feinberg School of Medicine at Northwestern University in Chicago, in an email to ABC News.
Others, like Dr. Christopher Cannon, say the story might not be over yet. While he admits that the study shows that raising good cholesterol to stave off heart disease is not as straightforward as first imagined, he believes that drugs now being tested that aim to boost HDL levels even higher may hold promise.
"It casts some doubt on the benefits of higher HDL, but the real answers will come from clinical trials of new medications that raise HDL," Cannon, professor of medicine at Harvard Medical School and senior investigator of the TIMI Study Group, said in an email. "We are testing a drug now... that increases HDL by 60 mg/dl on average -- and that will hopefully answer the question on whether HDL is important."
HDL levels are still an important predictor of heart health. For decades, doctors have used this measure as a way of predicting a patient's risk for future heart disease.
"These data do not take away the predictive value of HDL in the general population," said the new study's senior author Dr. Sekar Kathiresan, who is director of preventive cardiology at Massachusetts General Hospital in Boston. "Low amounts of HDL cholesterol have been correlated with an increased risk of heart attack."
Naturally, this correlation made HDL levels seem an attractive target for drugs to reduce the risk of heart disease. To help doctors understand whether this was the case, Kathiresan and his colleagues looked at a group of people who had higher HDL levels because of differences in their genetic makeup. They compared these people with others without this genetic predisposition.
Based on past studies, the researchers expected the patients with higher HDL cholesterol to be protected from a heart attack. To their surprise, that was not the case; there was no difference between the two groups.
So what does this mean for patients? "Just because an intervention raises HDL, we cannot assume that this lowers the risk of a heart attack," Kathiresan said.
This study comes on the heels of several other recent clinical trials that suggest that medications designed to increase HDL are not effective in reducing coronary heart disease. These trials examined, among other things, extended-release niacin and several drugs in an experimental class of medications known as CETP inhibitors.
Several of these studies are still in progress. Yet, none of this research has demonstrated that raising HDL is effective at reducing the rates of heart attacks and heart disease.
Still, some experts in the field say despite the recent negative studies, many questions remain to be answered. Dr. Michael Miller, director of the Center for Preventive Cardiology at the University of Maryland Medical Center, said the findings of the study belie the complexity of HDL, and that more research is needed before such efforts are abandoned.
"Bottom line: don't throw the baby out with the bathwater," he said in an email. "The inverse relationship between HDL and heart disease is based on a half-century worth of data."
As for what the general public can take away from the research, Dr. Dean Ornish said the findings underscore the idea that when it comes to reducing heart disease risk, it's not a simple matter of good versus bad.
"I think this study shows a fundamental confusion about HDL," said Ornish, founder and president, Preventive Medicine Research Institute in San Francisco. "Not everything that raises HDL is good, and not everything that lowers it is bad."
"Many people, including physicians, get into a simple-minded idea that HDL is 'good cholesterol' and LDL is 'bad cholesterol.' It's not so simple."
Photo Courtesy Elaina(NEW YORK) -- You’d never know it sitting across from 16-year-old Elaina that she suffers from a rare and debilitating case of Lyme disease. The spark-plug of a teen is bright, bubbly, and optimistic in the face of what she describes as a four-year nightmare.
She believes she was bitten at age 12 by a tick on a soccer field in her New Hampshire town and consequently developed a co-infection of Lyme and another bacterial parasitic illness called Bartonella.
In most, Lyme disease will manifest in fatigue or chronic pain. Not so for Elaina.
Her symptoms have ranged from seizures to loss of motor function to light and sound sensitivity. Most unusual of all is what she describes as a tightening of muscles in her throat brought on by stress and fatigue. The result, she says, is an altered spell-like state during which she speaks in what sounds like a Russian accent. Sometimes, she can’t even remember what she says or does during those episodes.
ABC News cameras caught the speech disorder during an interview with the teen, whose last name and hometown is being withheld.
The symptoms from which she suffers have caused skepticism among medical professionals, some of whom speculate that she is faking it for attention.
But her physician, Dr. Lynn Durand, says that while he can’t explain it, he doesn’t doubt it either. “Lyme can have some very strange symptoms,” he said. “And I think what’s so important about Lyme disease is that patients will present with strange symptoms and, we, the medical community, will not know what to make of it, and unfortunately we think, ‘If the diagnosis isn’t in my head, it must be in the patient’s head, so they must be making this up.’
“My feeling is that it’s very, very important to take the patients at their word and hear what they have and really try to explore what the causes are.”
Watch the full story on ABC's 20/20 Friday at 10 p.m. ET.
Cassidy Cline(NEW YORK) -- When a leaky trash bag brushed his ankle during cleanup at his daughter's kindergarten class picnic two years ago, Doug Murphy initially thought nothing of it. But bacteria that entered through his ankle created a flesh-eating infection that nearly cost him his right leg – and his life.
By the next morning, he noticed "a black mark, about the size of a quarter" that he dismissed as a spider bite, located where fluid from the leaky bag had seeped through his sock. By the second morning, his temperature was 105, he couldn't stand and the black area had expanded to "the size of a pineapple. You would be scared it if was you," Murphy recalled Wednesday.
At a nearby emergency room, a savvy infectious disease specialist who examined him "thought it might be necrotizing fasciitis," better known as a flesh-eating bacterial infection. That's about the last thing Murphy remembers. He was admitted to intensive care and placed on powerful antibiotics. His kidneys began shutting down, his blood pressure sank and his temperature soared to 107.7 as the infection spread beyond the leg and throughout his bloodstream, causing sepsis. He began hallucinating and was convinced "I was invited to Brad and Angie's secret wedding in L.A."
His temperature hovered at 107.7 for days, breaking just as doctors were planning to amputate his right leg. Murphy remained hospitalized a total of six weeks before he was released with a gaping leg wound that took a year to heal. The leg, he says, looked "like you poured acid on it and it dissolved down like in [the movie] Alien."
Today, the 45-year-old father of two from Brooklyn, N.Y., says his scarred right leg doesn't hold him back as an operator of academic summer camps, or as singer-songwriter for his country-rock band. However, the infection badly damaged lymph nodes in the leg, which swells each day and must be elevated in the evenings.
Murphy was infected with Group A streptococcus, which can live harmlessly on the skin or cause strep throat, but is also the leading cause of flesh-eating bacterial infections. They also can be caused by several other organisms, including aeromonas hydrophila, staphylococcus aureus and vibrio vulnificus.
Aimee Copeland, a 24-year-old Georgia student, lost her leg almost two weeks ago to an aeromonas infection contracted in a zip line accident, and Lana Kuykendall, a paramedic from South Carolina, continues to battle a flesh-eating infection that developed soon after she delivered twins.
Murphy is among survivors who have shared their stories with the National Necrotizing Fasciitis Foundation, founded by Donna Batdorff of Grand Rapids, Mich., and Jacqueline Roemmele of Watchung, N.J., who lived through similar infections and now try to help fellow survivors and patients navigate through the care and complications associated with a condition that kills one in four patients, according to the Centers for Disease Control and Prevention.
Batdorff and Roemmele heard from "tens of thousands" of survivors worldwide and are aware of at least 25 cases in which people were sickened more than once. Batdorff developed her infection while skiing in Colorado in 1996, but ignored escalating symptoms. She ended up unconscious in a hospital and woke up to her sister telling her that doctors had amputated parts of the fingers of her right hand.
One of the tricky things about necrotizing fasciitis, she said, is that "sometimes there's terrible, ugly, bulbous nasty blisters – you know there is something really wrong. But in my case, there was nothing that was really visual like that. No alarming visual signs."
Roemmele became sick in 1994 after an abdominal hernia repair that led to two hospitalizations. The ordeal left her with a hip that even today looks as if she suffered "a shark bite" as well as residual nerve damage in her fingers.
Batdorff says there are several practical considerations that can improve the odds of surviving the disease, starting with quick attention to what seem like minor skin openings: "When you get that paper cut, when you cut yourself a tiny bit with a knife, when a staple punctures your finger, when you prick your finger with a rose thorn -- the smallest, tiniest opening is an opening that bacteria can get into-- and it can kill you," she said. "The preventive is don't ignore these things. Go and wash it, put antibacterial ointment on it and cover it."
Second, she said, is recognizing that these infections can send out warning signs, including "pain that's disproportionate to the size and scope of the injury. And it's not just a little bit of pain, it's pain like you've never felt before." Other signs can be flulike symptoms, lethargy and even feeling delirious or buzzy. "That is the time when you need to get to the doctor. Just get to the emergency room."
Once in the emergency room, speak up. The symptoms often are mistaken for the flu, for brown recluse spider bites and "more people than I can ever begin to tell you about have been sent home to take antibiotics, or rest, or drink fluids ... and they come back the next day. Sometimes people are sent home a couple of times." Such patients often die "before someone figures out what's wrong with them."
"The problem is that necrotizing fasciitis behaves like a wolf in sheep's clothing," Roemmele said. "It masks itself as many things. The initial diagnostic tests like MRI or CT scan often won't show anything."
She said that many doctors have a mantra: "If you hear hooves outside your window, chances are it's a horse and not a zebra," meaning that you should first consider the obvious explanation. "Our point is, physicians need to be trained to look at necrotizing fasciitis as a horse and not a zebra."
If you suspect the disease, ask doctors to rule it out. Batdorff cited the case of "a gentleman whose wife said to the emergency room staff, 'could this be the flesh-eating bacteria?' They said no. And it was. And he died."
Digital Vision/Thinkstock(ATLANTA) -- Nearly 10 percent of U.S. teens have nonalcoholic fatty liver disease, a largely silent accumulation of fat in their liver cells that puts them at risk for developing later cardiovascular disease and additional liver problems, new research has found.
Most of the increase in cases of NAFLD, a disease not brought on by alcohol-related liver damage, is occurring among the heaviest teens -- those considered obese, based on their height, weight and age, said lead researcher Dr. Miriam Vos, a pediatric gastroenterologist at Emory University in Atlanta.
"We tried to see where the increase was happening and it looks like it's happening in the obese group," she said.
But ill health is not inevitable for obese teens whose livers already have sustained damage, said Vos, an assistant professor of pediatrics. "We think that liver disease is reversible, particularly for a teenager if they can make substantial changes and improve their weight," she added.
Vos determined that the prevalence of fatty liver among U.S. teens has more than doubled in the past two decades, from 3.6 percent to 9.9 percent, outpacing the rise in teenage obesity during that time and suggesting obesity is only a partial explanation for a rise. Vos' findings come from health data collected for 10,359 adolescents who participated in the National Health and Examination Survey (NHANES) between 1988 and 2008.
Even without fully understanding why numbers are up, "this is a disease that definitely needs attention. We need programs that focus on prevention of both obesity and fatty liver disease," said Vos, who is scheduled to present her findings Monday at Digestive Disease Week in San Diego, an annual gathering of nearly 16,000 physicians, researchers and academics.
The increase in fatty liver and its associated risks provide strong support for "recommendations to screen for NAFLD in obese adolescents," Vos and her colleagues concluded.
Comstock/Thinkstock(NEW YORK) -- At a time when women are "eating for two," dieting can safely lower the health risks of obesity during pregnancy, according to a new study.
British researchers reviewed data from 44 trials involving 7,278 women to determine the safety and effectiveness of weight management programs during pregnancy. Not only did the moms-to-be gain less weight, they also lowered their risk of dangerous complications.
"Dietary interventions were most effective in reducing complications such as preeclampsia, gestational diabetes, gestational hypertension, and preterm delivery," the researchers wrote in their report, published Thursday in BMJ.
Babies benefited, too, as they were less likely to get stuck in the birth canal despite no difference in birth weight.
"There is no evidence that the interventions evaluated in our review or recommended in current clinical practice are associated with adverse maternal or fetal outcomes," the authors wrote.
Nearly half of U.S. women who are of child-bearing age are obese, according to a 2009 study in the Maternal and Child Health Journal.
The growing problem prompted Obese & Expecting, a TLC documentary that followed four obese women through complicated pregnancies and painful deliveries. A scene from the special shows doctors struggling to give one woman an epidural through the fat in her back.
After several tries, the team gave up, deciding instead to give the woman a general anesthetic and a C-section.
"Going to sleep carries significant risks, even for a slim pregnant woman," said Dr. Marjorie Greenfield, chief of obstetrics and gynecology at University Hospitals Case Medical Center in Cleveland. "And the risk goes up significantly in a woman who's overweight."
Obesity also compromises prenatal care, according to Greenfield.
"It's harder to provide excellent care to someone who's obese because a lot of things we do are not as accurate," said Greenfield, explaining how ultrasounds and other tests to gauge the baby's growth can be skewed by the mother's fat. "It's also harder to feel the position of the baby."
The extra fat, and the fact that obesity can cause irregular periods, also means women might not immediately realize they're pregnant.
"If you don't know you're pregnant, you might not avoid things that are toxic, like alcohol, smoking and certain medications," said Greenfield, adding that prenatal vitamins are also important. "And a lot of what we do in prenatal care depends on knowing exactly how far along a woman is. If you don't have a sense of gestational age, it's harder to provide the right care."
ABC News(NEW YORK) -- “Mmm-hmm, yeah. They crunch on my teeth,” said Teresa Widener while eating her favorite snack -- rocks.
The 45-year-old mother of two who lives in Bedford, Va., and works with special-needs children, explained: “I like that it has an earthy flavor.”
Widener doesn’t wash them; sometimes she just sucks off the dirt. Other times, she takes a hammer and smacks them into bite-size pieces.
It’s a behavioral and/or mental-health condition called pica, the Latin word for magpie, a bird that will eat anything.
“People will eat anything when it comes to pica,” said Dr. Jordana Mansbacher, a clinical social worker and therapist who specializes in eating disorders, including pica. “They will eat toilet paper. They will eat fabric. They will eat carpet. They will eat paper. They will eat wood. They will eat clothing. They will eat skin. They will eat metal.”
Widener said rocks were an emotional crutch, but she also said she has anemia and that the rocks help treat her iron deficiency.
Anemia is fairly common among women, especially pregnant women, according to Mansbacher.
“Pregnant women tend to be anemic,” said Mansbacher, because their nutrients go straight to the fetus. “And a lot of times they develop cravings … for ice, which is rich in zinc, and soil and clay, which is rich in iron.”
But around the world and even in parts of the South, Mansbacher said, even non-pregnant women crave and eat soil because of iron deficiency. Widener is not pregnant and said she has been eating rocks for more than 20 years.
While the practice shouldn’t be hidden or stigmatized, Mansbacher said, eating rocks and soil is unhealthy; it can introduce parasites, and rocks can puncture or tear internal tissue, causing bleeding.
“I suggest that a woman have a blood test to determine if there are any mineral or vitamin deficiencies,” Mansbacher said via email. “If there is a deficiency, I would then ask your M.D. for a treatment plan to include vitamin or mineral supplements or an alteration in one’s diet.”
Watch the full story on 20/20 Friday at 10 p.m. ET.
Charles Eshelman/FilmMagic(NEW YORK) -- The four children of Robert Kennedy Jr. and Mary Kennedy face a complicated grieving process in the aftermath of her suicide, mental health experts say.
"Initially, the biggest challenge for kids that deal with the suicide of a parent is taking in that news and all the information and circumstances surrounding the death," said Jon Ebert, assistant professor of psychiatry at Vanderbilt University Medical Center.
The couple's four children range in age from 10 to 17, and around that age range, children dealing with the suicide of a parent can experience a number of emotions.
Starting at about age 12 or 13, children have a better understanding of suicide.
"Children can differentiate between death and suicide well, and they usually interpret the suicide by saying that the parent was sick or ill," said Dr. T. Byram Karasu, professor and chair of psychiatry and behavioral sciences at Albert Einstein College of Medicine. "They will usually blame the spouse. They will deny the loss and hate the spouse."
Karasu added that children who lose a parent at such an age end up growing up very quickly.
"Their growth is interrupted," he said. "Adolescents usually end up becoming adults very fast."
In some cases, children end up identifying with the deceased parent and assuming that parent's role, which can be a healthy defense mechanism, Karasu said.
But in other cases, children may respond by acting out and rejecting authority.
Younger children usually see death and suicide as interchangeable, Karasu explained. They may feel depressed and anxious but not know why, and may also feel very vulnerable after the loss.
Children also struggle with the unanswered question of why their parent left them, Ebert said.
"It's important to clearly communicate to kids that their mom or dad was sick," he said. "Suicide is a symptom of depression, and it's a level of depression that is significant to the point that the person felt so helpless or hopeless that they took their own life."
The children's grief is also compounded by the publicity surrounding Mary Kennedy's death and the notoriety of the Kennedy family.
iStockphoto/Thinkstock(NEW YORK) -- One more worry in the country's obesity crisis: a new documentary highlights the perils of extra pounds during pregnancy.
The TLC special, Obese & Expecting, follows four obese women through complicated pregnancies and painful deliveries that put mom and baby at risk.
"We know that obesity during pregnancy increases the risk of diabetes and preeclampsia," said Dr. Marjorie Greenfield, chief of obstetrics and gynecology at University Hospitals Case Medical Center in Cleveland. "And when the mom is big, the baby can be big, raising the risk of birth injury and C-section."
A scene from the documentary shows doctors struggling to give one woman an epidural through the fat in her back.
"We spent 45 minutes attempting to put the spinal in," said Dr. Charles Hux, a New Jersey OB/GYN featured in the documentary. "With so many layers of fat, it's difficult to be certain that the needle went into the exact space it should go in."
After several tries, the team gave up, deciding instead to give the woman a general anesthetic and a C-section.
"Going to sleep carries significant risks, even for a slim pregnant woman," said Greenfield, calling the decision a last resort. "And the risk goes up significantly in a woman who's overweight."
Studies suggest nearly half of U.S. women who are of child-bearing age are obese, a problem that weighs heavily on doctors.
"It's harder to provide excellent care to someone who's obese because a lot of things we do are not as accurate," said Greenfield, explaining how ultrasounds and other tests to gauge the baby's growth can be skewed by the mother's fat. "It's also harder to feel the position of the baby."
That fat, and the fact that obesity can cause irregular periods, also means women might not realize they're pregnant.
"If you don't know you're pregnant, you might not avoid things that are toxic, like alcohol, smoking and certain medications," said Greenfield, adding that prenatal vitamins are also important. "And a lot of what we do in prenatal care depends on knowing exactly how far along a woman is. If you don't have a sense of gestational age, it's harder to provide the right care."
Obesity has also forced hospitals to adapt, adding delivery tables that can be made wider and hold up to 600 pounds, Greenfield said.
"The old tables only went up to 450 pounds," she said. "That's just not realistic anymore."
Weight gain during pregnancy is normal. But obese women should gain no more than 15 pounds, roughly half the amount recommended for women of normal weight.
"For someone with bad eating habits, that's going to be really hard," said Greenfield, describing how pregnancy cravings and the "eating for two" mentality can conspire to pack on the pounds. "Lifestyle change is always hard. But during pregnancy, I think women are more motivated to do it for themselves and their baby."
Obese & Expecting premiered Thursday night at 9 p.m. on TLC.
iStockphoto/Thinkstock(WASHINGTON) -- The U.S. Food and Drug Administration is investigating the antibiotic azithromycin, commonly known as Z-Pak, after a study linked the drug to an increased risk of death.
The study, published Wednesday in the New England Journal of Medicine, found patients prescribed Z-Pak were more likely to die than those prescribed amoxicillin, another antibiotic. The results were especially pronounced for those who died of heart attacks, strokes, sudden cardiac death and other cardiovascular causes.
Last year, doctors wrote 55.3 million prescriptions for Z-Pak, according to IMS Health. Like the popular antibiotic amoxicillin, azithromycin is commonly prescribed to help fight off bacterial infections. But while they are often prescribed for similar conditions, the two drugs work differently from each other.
Wayne Ray, a professor of preventive medicine at Vanderbilt University and lead author of the study, says he believes many doctors prescribe azithromycin instead of amoxicillin because of its easier regimen; patients on azithromycin take fewer pills over fewer days, which means they are more likely to finish their entire course of medicine. Finishing the entire course not only leads to more effective treatment, but it also lessens the risk of the patient developing a drug-resistant bug.
But, Ray says of azithromycin, “the risk of death may outweigh convenience and compliance, at least for high-risk patients.”
These high-risk patients would seem to be those who have certain types of cardiovascular disease. Some doctors have suggested that azithromycin may cause irregular heartbeats known as arrhythmias, which in some people can lead to death. In Ray’s study, which looked at Medicaid patients from 1992 to 2006 and analyzed millions of prescriptions, he and his colleagues found that patients on azithromycin had two and a half times the odds of dying from a cardiovascular cause while taking their medication than did patients on amoxicillin. The gap was widest when looking at the 10 percent of patients with the worst cardiovascular disease.
The study couldn’t tease out which patients were on azithromycin because they had allergies to amoxicillin.
Cardiologist Leonard Ilkhanoff, director of the Inherited Arrhythmia Program at Northwestern University’s Feinberg School of Medicine in Chicago, says that while it’s impossible to know what precisely is causing the increased risk of death, the study is very interesting. But he cautions that patients on azithromycin should not panic.
The FDA currently recommends that patients taking azithromycin continue to take the drug.
iStockphoto/Thinkstock(NEW YORK) -- With Americans eating more shrimp -- more than 1 billion pounds a year or 4 pounds per person -- than salmon, crab and trout combined, the crustacean seems to be the U.S.'s favorite seafood.
