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Use of Male IVF Procedure Doubled in the Past Decade
January 20, 2015

 

TUESDAY, Jan. 20, 2015 (HealthDay News) -- Although use of an IVF treatment for male infertility, known as intracytoplasmic sperm injection (ICSI), has doubled in the past decade, the procedure is not always associated with better outcomes, according to a new study from the U.S. Centers for Disease Control and Prevention.

During ICSI, a single sperm is injected directly into an egg. The procedure, which was introduced in 1992, made it possible for many infertile men to father children.

"In the pre-ICSI days, couples with severe male infertility would frequently have to resort to donor insemination, thus eliminating the possibility of the man to be the genetic parent," explained one expert, Dr. Avner Hershlag, chief of the Center for Human Reproduction at North Shore University Hospital in Manhasset, N.Y.

"There are now millions of children and adults whose fathers had deficient sperm, and it is because of ICSI that they have been created," said Hershlag, who was not involved in the new study.

However, the CDC study authors said that unlike conventional in-vitro fertilization (IVF), ICSI is much more expensive.

In conducting the study, the team of researchers, led by the CDC's Sheree Boulet, analyzed almost 1.4 million fresh IVF cycles reported to the U.S. National Assisted Reproductive Technology Surveillance System between 1996 and 2012.

Of these IVF cycles, 65 percent involved ICSI and about 36 percent involved male infertility. Among fresh IVF cycles, ICSI use in the United States increased from 36 percent in 1996 to 76 percent in 2012, the researchers reported.

In cases involving men with male infertility, ICSI use jumped from about 76 percent in 1996 to more than 93 percent by 2012. Among men who were not infertile, ICSI use rose from just over 15 percent to about 67 percent.

Between 2008 and 2012, about 36 percent of fresh IVF cycles involved male infertility. The researchers noted that when male infertility was not an issue, using ICSI in an IVF procedure was tied to a slight drop in implantation, pregnancy, live birth and low birth weight rates, compared to using conventional IVF.

Hershlag said that the finding "may point to overuse of the ICSI procedure in some couples." But he also said that it is not always easy to determine "fertilization potential" in men, many of whom may have normal results on sperm tests.

"Until IVF is performed, for patients who have never conceived before, there is no absolute certainty that the sperm will fertilize an egg," Hershlag said.

Dr. Alan Copperman is director of the division of reproductive endocrinology and infertility at the Mount Sinai Hospital in New York City. He said that "while ICSI was originally performed for severe male factor infertility, there are now many indications for its use, and it is now used in three-quarters of the IVF cycles now performed in the United States."

According to Copperman, technologies have advanced so that doctors can now pinpoint the healthiest egg and sperm. So, "rather than placing tens of thousands of sperm on top of each egg, we choose a single sperm and perform ICSI."

Egg-freezing technologies are also boosting the use of ICSI, he added. "We are seeing more women electively freezing their eggs, and ICSI must be used instead of conventional insemination to achieve fertilization when the eggs are thawed and ready to be used," Copperman explained.

The study was published Jan. 20 in the Journal of the American Medical Association.

More information

The Urology Care Foundation has more about the management of male infertility.
Copyright © 2015 HealthDay. All rights reserved.


SOURCES: Avner Hershlag, M.D., chief, Center for Human Reproduction, North Shore University Hospital, Manhasset, N.Y.; Alan Copperman, M.D., director, division of reproductive endocrinology and infertility, Mount Sinai Hospital, and medical director, Repr...

Health Highlights: Jan. 20, 2015
January 20, 2015

 

Here are some of the latest health and medical news developments, compiled by the editors of HealthDay:

Uninsured Rate Lowest in Years: Poll
Your privacy may be at risk when you use the HealthCare.gov website to apply for health insurance, according to experts.
Some data companies have embedded connections on the site that can track individual users and collect information about them -- such as age and income and whether you're a smoker or are pregnant -- in order to create personal profiles that can be used by advertisers, the Associated Press reported.
While there is no evidence that personal data from HealthCare.gov has been misused, the data collection by outside companies is cause for concern, experts say.
"As I look at vendors on a website...they could be another potential point of failure," corporate cybersecurity consultant Theresa Payton told the AP. "Vendor management can often be the weakest link in your privacy and security chain."
The large number of outside connections on HealthCare.gov seems like "overkill" and makes it "kind of an outlier" among government websites, said Payton, a former White House chief information officer under President George W. Bush.
Outside vendors are "are prohibited from using information from these tools on HealthCare.gov for their companies' purposes," Medicare spokesman Aaron Albright told the AP. The vendors measure the performance of HealthCare.gov so users get "a simpler, more streamlined and intuitive experience," he said.
No details were provided about how the federal government ensures adherence to privacy and security policies.
HealthCare.gov currently serves people in 37 states, while the remaining states operate their own insurance markets. The White House wants to get 9.1 million Americans signed up through the insurance exchanges this year and paying premiums, the AP reported.
Concerns about privacy on HealthCare.gov come to light just as the White House is calling for stronger cybersecurity protection for consumers. An initiative to protect personal data online is one of the main points of President Barack Obama's State of the Union message scheduled for Tuesday night.
------

Artificial Heart Recipient Heads Home

A 68-year-old French man with terminal congestive heart failure has headed home after receiving a completely artificial heart, the French company that makes the device said Monday.

As reported by The New York Times, the man was implanted with the artificial heart at the University of Nantes hospital on Aug. 5, and was discharged from the hospital with a portable power and alert system that allows him freedom to move about.

The man -- who wishes to remain anonymous -- "is living a completely normal life now," Dr. Alain Carpentier, the French surgeon who invented the artificial heart, told the Le Parisien newspaper. He said the man is even "pedaling like crazy" on a stationary bike.

According to the Times, a total artificial heart would replace the heart's two lower chambers, or ventricles. The new device, made by the French company Carmat, is composed of both synthetic materials and animal tissues. It was first implanted in a 76-year-old man in December 2013. That patient lived 74 days with the device, the Times said.

Carmat plans to sell the device to people who are deemed ineligible for traditional heart transplants and have no other possible therapy available to them. The device costs between $162,000 to $208,000, the Times said.Copyright © 2015 HealthDay. All rights reserved.


...

Health Highlights: Jan. 19, 2015
January 19, 2015

 

Here are some of the latest health and medical news developments, compiled by the editors of HealthDay:

Artificial Heart Recipient Heads Home

A 68-year-old French man with terminal congestive heart failure has headed home after receiving a completely artificial heart, the French company that makes the device said Monday.

As reported by The New York Times, the man was implanted with the artificial heart at the University of Nantes hospital on Aug. 5, and was discharged from the hospital with a portable power and alert system that allows him freedom to move about.

The man -- who wishes to remain anonymous -- "is living a completely normal life now," Dr. Alain Carpentier, the French surgeon who invented the artificial heart, told the Le Parisien newspaper. He said the man is even "pedaling like crazy" on a stationary bike.

According to the Times, a total artificial heart would replace the heart's two lower chambers, or ventricles. The new device, made by the French company Carmat, is composed of both synthetic materials and animal tissues. It was first implanted in a 76-year-old man in December 2013. That patient lived 74 days with the device, the Times said.

Carmat plans to sell the device to people who are deemed ineligible for traditional heart transplants and have no other possible therapy available to them. The device costs between $162,000 to $208,000, the Times said.Copyright © 2015 HealthDay. All rights reserved.


...

Health Highlights: Dec. 24, 2014
December 24, 2014

 

Here are some of the latest health and medical news developments, compiled by the editors of HealthDay:

Oldest American Man Dies at 110

C. Conrad Nelson, the oldest man in the United States whose age can be verified, died in a nursing home in Rockford, Ill., on Tuesday, the Rockford Register Star reported.

Nelson was born in 1904 in Kymbo, Sweden, but lived in Rockford most of his life, working as a carpenter. He stayed in his own home until the age of 102, the paper said.

Larson attributed his longevity to lots of exercise and a bowl of oatmeal every morning. Speaking to the Register Star on his 109th birthday, he said, ""I can't complain. I feel good and I haven't been sick for a long, long time."

-----

George H. W. Bush Hospitalized for Shortness of Breath

Former President George H.W. Bush, 90, was hospitalized Tuesday night in Houston after experiencing shortness of breath.

Bush was under observation at Houston Methodist Hospital as a precaution, according to spokesman Jim McGrath, the Associated Press reported.

Bush spent almost two months at Houston Methodist and was discharged in January 2013 after being treated for bronchitis and other health problems, the AP said.

The former president no longer has the use of his legs but in June celebrated his 90th birthday by making a tandem parachute jump in Maine, where he has a summer home.

According to the AP, he was most recently seen in public in November when he watched a Texas A&M University football game while seated in his wheelchair, in the company of his son, former President George W. Bush.

-----

Nearly 2 Million New Enrollees for 2015 'Obamacare' Plans

More than 1.9 million new customers have signed up for individual insurance plans for 2015 via HealthCare.gov, U.S. Department of Health and Human Services Secretary Sylvia Burwell said on Tuesday.

That brings the total number of enrollees who've signed up through the site to more than 6 million, with the other 4.5 million people being re-enrollees from last year, NBC News reported.

HealthCare.gov markets individual health care coverage plans in 36 states. According to Burwell, the latest numbers do not include plans sold by state-run exchanges, including high-population states such as California and New York.


...

Male Ebola Survivors Should Use Condoms for at Least 3 Months, Experts Say
December 16, 2014

 

TUESDAY, Dec. 16, 2014 (HealthDay News) -- Men who survive Ebola should wear condoms during sex for at least three months after recovering from the deadly disease, a new study shows.

The finding supports the current recommendations to that effect, according to the authors of the study, which was published Dec. 16 in the journal Reproductive Sciences. However, they noted there is a lack of research on sex and male survivors of Ebola.

"Our exercise demonstrated that the current recommendations to prevent the sexual spread of Ebola are based on one mere observation," the researchers wrote. "Despite the evident need to conduct more research, for now, health care professionals should strongly recommend sexual abstinence or condom-protected encounters for at least three months."

The investigators examined research on male Ebola survivors that was conducted between 1977 and 2007 and found only four studies that contained information about the men's semen. Those four studies showed that the Ebola virus persisted in semen for an average of more than 66 days. In one man, the virus lasted for 91 days.

"The current Ebola virus disease outbreak is the longest and largest we have ever seen. Nonetheless, our results clearly demonstrate how much we ignore about it. Larger studies are needed to establish the social, clinical and biological determinants of this neglected disease," the researchers concluded.

More information

The U.S. Centers for Disease Control and Prevention has more about Ebola.
Copyright © 2014 HealthDay. All rights reserved.


SOURCE: Reproductive Sciences, news release, Dec. 16, 2014...

CDC Endorses Circumcision for Health Reasons
December 02, 2014

 

TUESDAY, Dec. 2, 2014 (HealthDay News) -- U.S. health officials are poised to endorse circumcision as a means of preventing HIV and other sexually transmitted diseases.

The U.S. Centers for Disease Control and Prevention on Tuesday released its first-ever draft guidelines on circumcision that recommend that doctors counsel parents and uncircumcised males on the health benefits of the procedure.

The guidelines do not outright call for circumcision of all male newborns, since that is a personal decision that may involve religious or cultural preferences, Dr. Jonathan Mermin, director of the CDC's National Center for HIV/AIDS, Viral Hepatitis, STD and TB Prevention, told the Associated Press.

But "the scientific evidence is clear that the benefits outweigh the risks," Mermin said.

Circumcision involves the surgical removal of the foreskin covering the tip of the penis. Germs can collect and multiply under the foreskin, creating issues of hygiene.

Clinical trials, many done in sub-Saharan Africa, have demonstrated that circumcision reduces HIV infection risk by 50 percent to 60 percent, the CDC guidelines note. The procedure also reduces by 30 percent the risk of contracting herpes and human papilloma virus (HPV), two pathogens believed to cause cancer of the penis.

The guidelines do point out that circumcision has only been proven to prevent HIV and sexually transmitted diseases in men during vaginal sex. The procedure has not been proven to reduce the risk of infection through oral or anal sex, or to reduce the risk of HIV transmission to female partners.

The scientific evidence is mixed regarding homosexual sex, the guidelines say, with some studies having shown that circumcision provides partial protection while other studies have not.

Circumcision does reduce the risk of urinary tract infections in infants, according to the CDC guidelines.

The most common risks associated with the procedure include bleeding and infection.

Male circumcision rates in the United States declined between 1979 and 2010, dropping from almost 65 percent to slightly more than 58 percent, according to a CDC report issued last year.

The new draft guidelines mirror an updated policy on circumcision released by the American Academy of Pediatrics in 2012.

"The American public should take confidence that these are pretty much converging guidelines. There is no doubt that it [circumcision] does confer health benefits and there is no doubt it can be performed safely, with a less than 1 percent risk of complications," Dr. Susan Blank, chair of the task force that authored the AAP policy statement, said Tuesday. "This is one thing a parent can do to protect the future health of their children."

In its policy statement, the AAP declared that the health benefits are great enough that infant male circumcision should be covered by insurance, which would increase access to the procedure for families who choose it, said Blank, who is also assistant commissioner of STD Control and Prevention at the New York City Department of Health and Mental Hygiene.

"The push from the academy's point of view is to really have providers lay out for parents what are the risks, what are the benefits, and give the parents the information they need to make a decision," Blank said. "And the academy feels strongly that since there are proven health benefits, the procedure should be covered by insurance."

The guidelines are expected to spur a response from anti-circumcision groups.

"There are certainly groups that are troubled by circumcision of an individual who is not in a position to provide their own consent," Blank said.

The public can comment on the draft guidelines through Jan. 16, according to the CDC.

More information

To learn more about circumcision, visit the U.S. Centers for Disease Control and Prevention.


SOURCES: Dec. 2, 2014, statement, U.S. Centers for Disease Control and Prevention; Susan Blank, M.D., M.P.H., assistant commissioner, STD Control and Prevention, New York City Department of Health and Mental Hygiene; Associated Pres...

Testosterone May Not Deliver Victory for Athletes, Study Found
December 01, 2014

 

MONDAY, Dec. 1, 2014 (HealthDay News) -- Higher levels of testosterone during competition do not improve athletes' chances of victory, a new study finds.

"Many people in the scientific literature and in popular culture link testosterone increases to winning," Kathleen Casto, a graduate student in psychology at Emory University in Atlanta, said in a university news release.

"In this study, however, we found an increase in testosterone during a race regardless of the athletes' finish time. In fact, one of the runners with the highest increases in testosterone finished with one of the slowest times," she said.

Casto and colleagues measured testosterone levels in the saliva of varsity men and women cross-country runners before a race, after they warmed up and at the end of the race. They also checked levels of cortisol, a hormone related to stress.

Testosterone levels increased during warm-up, but cortisol levels did not. As expected, the runners had higher levels of testosterone and cortisol during the race. However, neither hormone was related to finish time.

"It's surprising that not only does competition itself, irrespective of outcome, substantially increase testosterone, but also that testosterone begins to increase before the competition even begins, long before status of winner or loser are determined," Casto said.

The study was published recently in the International Journal of Exercise Science.

Previous research has linked higher day-to-day levels of testosterone with long-term strength and power, including higher positions of authority in business.

"Although short-term surges of testosterone in competition have been associated with winning, they may instead be indicators of a psychological strength for competition, the drive to win," Casto said.

More information

The U.S. National Heart, Lung, and Blood Institute offers a guide to physical activity.
Copyright © 2014 HealthDay. All rights reserved.


SOURCE: Emory University, news release, Nov. 21, 2014...

The Man in the Iron Lung
December 01, 2014

 

MONDAY, Dec. 1, 2014 (HealthDay News) -- Paul Alexander's most impressive accomplishment is something most people never think about.

He taught himself how to breathe.

Alexander, 67, is a victim of the worst that polio had to offer children in the late 1940s and early 1950s. At the age of 6, he was completely paralyzed by the disease, his lungs stopped working, and he was literally thrown into an iron lung.

Alexander has been in that iron lung for 61 years because he remains almost totally paralyzed, able to move only his head, neck and mouth. He is one of an estimated seven people in the United States who are still living in an iron lung, and yet he has had a long and successful career as a lawyer.

"Over the years, I've been able to escape this machine for a few hours at a time by teaching myself voluntary breathing," Alexander said recently as he lay in the iron lung at his home in Dallas, Texas. "I have to consciously push air into my lungs, something that's done involuntarily by just about everyone else. It's hard work, but it allows me to escape this infernal device, if only for a little while."

Alexander "escapes" the machine most often when he is litigating a case -- his specialty is family law -- or gives a speech.

While he sometimes condemns the contraption that keeps him alive, Alexander is most grateful for his iron lung, whose machinery is essentially unchanged from the first ones that were put in use in the late 1930s. His machine, in fact, is the same one he entered 61 years ago.

"It is my cage, but it's also my cocoon," he said, as the iron lung issued a noticeable whishing sound, an almost uncanny replication of normal breathing.

But we're getting ahead of the story.

This year marks the 60th anniversary of the nation's first mass polio vaccine inoculations, a time when hundreds of thousands of grade school students -- many of them throughout the South -- lined up in school gymnasiums, stuck out their arm and gritted their teeth as a nurse gave them Dr. Jonas Salk's experimental vaccine.

The shot was literally a game-changer. Most of these children had seen at least one or two classmates come to school on crutches, paralyzed by the ravages of polio. More than a few knew other students and friends who had died from the disease.

So 1954 signified their liberation during the summer -- they could return to public swimming pools and play in the rain and eat in restaurants and not be afraid that they would wake up the next day with a fever and terrible leg pains, which could rapidly lead to paralysis.

That's what happened to 6-year-old Paul Alexander in 1952, two years too early for the Salk vaccine.

"I remember it was really hot and raining, something that is sort of rare for Dallas in August," he recalled, "and my brother and I had been outside playing, running around and getting wet when the rain started.

"Our mother called for us to come in for dinner, and I remember her taking one look at me -- hot and wet and feverish -- and she cried out, 'Oh my God!' She ripped my clothes off and threw me onto her and my dad's bed and called the doctor.

"She knew right away that I had polio. I don't know how she knew, but she knew. I remember feeling hot and feverish, and for the next few days, I stayed in the bed and didn't move. I remember I had this coloring book, and I felt this compulsion to color as much as I could, sort of like maybe I wouldn't be able to do it in the future."

Why didn't Alexander's parents take him to the hospital? "Our family doctor said that all the kids with polio were at Parkland (Dallas' big municipal hospital), and he didn't want me there with the other kids because maybe I had a better chance to recover at home," Alexander said.

But all of that became moot about six days later when he could no longer move and found it difficult to breathe: "I remember having terrible pains in my legs, and breathing became really laborious. So they finally took me to Parkland."

And that's when the most horrifying event occurred before Alexander's long battle with polio could even begin: "I had become immobile; I don't think I could even talk, so the hospital staff put me on a gurney in a long hallway with all the other hopeless polio kids. Most of them were dead."

That would have been Alexander's fate, too, if not for Dr. Milton Davis, a well-known pediatric cardiologist who was examining all of the children in the hallway. "He took one look at me, gathered me up in his arms, and I think he performed a tracheotomy on me almost immediately so I could breathe," Alexander said. "And the next thing I remember, I was inside an iron lung."

And then he blacked out.

Alexander woke up weeks later still in the iron lung: "The pain was still there, although it seemed much less to me, and the iron lung pumped hot steam through a thick plastic water pump into my chest. This kept the mucuous loose enough so I could breathe."

He couldn't see through the steam at first, and he couldn't talk. But Alexander said he found some sort of determination within himself as strong as the iron in the device that was keeping him alive. "I decided I was going to fight this," he said. "I was going to have a life."

Eighteen months later, his parents brought him home. They stayed with him in shifts, fed him, helped him with school work (he was still enrolled in elementary school) and encouraged him to keep up his curiosity and enthusiasm for learning.

"My mother lobbied the school district for home-school learning, something very rare in the 1950s," he said. His dad fashioned a writing implement for him, similar to a T-square, which Alexander would put in his mouth and move around with his neck muscles in order to write.

Through their efforts and his own fierce determination, Alexander graduated high school as the class salutatorian. "I would have been valedictorian but the biology teacher gave me a B because I couldn't take lab," he joked.

Scholarships to Southern Methodist University in Dallas and the University of Texas in Austin allowed Alexander, with the help of a paid health aide, to get an undergraduate degree and then a law degree. He returned to the Dallas area and became associated with an Arlington law firm for a while, but eventually established a private practice that still handles everything from family law to financial cases.

"With help from a medical aide or one of my friends, I can get out of the lung and attend functions in a wheelchair or argue a case for a few hours," he said. "But I always have to remember to tell myself to inhale, exhale, inhale."

Alexander came to the attention this year of the leaders of the Dallas area's Rotary clubs through one of his doctors, Alexander Peralta, Jr., who is a Rotarian from Duncanville, Texas.

Rotary International has been working with the Bill and Melinda Gates Foundation to eliminate polio worldwide, just as smallpox has been eradicated.

"One of our clubs, which is well-versed in modern technology (the Dallas e-Club) went to Paul's house and made a four-minute video with him," said Bill Dendy, District Governor of District 5810, which has 65 local Rotary clubs in the north Texas area.

"What none of us realized at first is what a compelling story this is, not only Paul's triumphs under difficult circumstances, but also what a terrifying experience it can be, just sitting in the presence of that machine that keeps him alive. The iron lung personalizes the horror all those thousands of kids went through a little more than half a century ago," Dendy said. The video they made has been submitted to the local PBS station in Dallas.

Since making contact with Alexander, various district Rotary clubs have volunteered to make improvements to his house -- an old ramp leading to the front door was replaced -- and to be available to take him to his appointments. Throughout his life, Alexander has had a combination of help from health aides provided through the government and friends who pitch in.

Alexander said his iron lung is no longer supported by any company on an ongoing basis. The last company to service his machine, Philips Respironics, no longer does so. "So now, we have to strip spare parts from other discarded iron lungs to keep us going," he said. So far, it hasn't been a problem, he added: "There are only seven iron lung users left, so I don't think this is going to be a big problem of supply and demand."

How did he accomplish so much -- and keep his sense of humor -- while being virtually immobile for more than 60 years?

"It all starts with love," Alexander said. "My parents raised me in love. They taught me never to give up. They taught me the importance of relationships. They were always there for me.

"So, naturally, I had to reciprocate. And you know what? They were right. Anything is possible."

More information

To learn about the history of the iron lung, visit The Smithsonian National Museum of American History.

To read part one of HealthDay's two-part series on Dr. Jonas Salk's revolutionary vaccine for polio, click here.
Copyright © 2014 HealthDay. All rights reserved.


SOURCES: Paul Alexander, attorney, Dallas; Bill Dendy, District Governor, Rotary District 5810, DeSoto, Texas; Philips Respironics website; March of Dimes website ...

Ick! Tapeworm Infecting Man's Brain Yields Genetic Secrets
November 21, 2014

 

FRIDAY, Nov. 21, 2014 (HealthDay News) -- Scientists say they've mapped the genome -- the genetic "blueprint" -- of a tapeworm extracted from a British man's brain, in hopes it might help others with this very rare infection.

As reported Nov. 21 in the journal Genome Biology, the tapeworm was removed from the brain of a 50-year-old British man of Chinese ethnicity.

"This infection is so rare worldwide and completely unexpected in this country that the patient was not diagnosed ... until the worm was pulled out from the brain," study lead author Hayley Bennett, of the Wellcome Trust Sanger Institute in the United Kingdom, said in a journal news release.

As the researchers explained, most tapeworms live in the gut, causing symptoms such as weight loss, weakness and abdominal pain. However, some species travel to areas such as the eyes, spinal cord and brain.

In this study, researchers sequenced the genome of a 1-centimeter larval tapeworm removed from the man's brain. He had been complaining of symptoms such as headaches, seizures, altered smell and memory problems. The man survived the surgery and is recovering, Bennett's team said.

Through sequencing the tapeworm's genome, researchers identified it as a rare species called Spirometra erinaceieuropaei, typically found in China, Japan, South Korea and Thailand. Infection can occur when a person eats undercooked frogs or snakes, uses frog meat for treating wounds, or drinks contaminated water.

The researchers believe the gene study might lead to improved drug treatment for people with the parasite. By sequencing the tapeworm's genome, they pinpointed genes that provide resistance to a drug called benzimidazole, and other genes that suggest a possible sensitivity to another tapeworm drug, praziquantel.

The researchers also identified a number of genes that may offer targets for drugs that are already on the market but used to treat other conditions.

"We were also surprised at how large the genome was; it is much bigger than those of other known flatworms, and roughly a third of the size of the human genome," Bennett said.

"By comparing the genome to other tapeworms we can see that certain gene families are expanded -- these possibly underpin this worm's success in a large variety of host species," she added. "The data gave us a first look at a whole group of tapeworms that have not been sequenced before."

More information

The Encyclopedia of Life has more about tapeworms.
Copyright © 2014 HealthDay. All rights reserved.


SOURCE: Genome Biology, news release, Nov. 20, 2014...

Testosterone Plays Minor Role in Older Women's Sex Lives, Study Finds
November 20, 2014

 

THURSDAY, Nov. 20, 2014 (HealthDay News) -- While levels of testosterone and other reproductive hormones have some effect on menopausal women's sex lives, their emotional health and quality of their relationships have a stronger influence, according to a new study.

Testosterone is the main sex hormone in men. But, women's ovaries also naturally produce small amounts of the hormone, the researchers noted.

The researchers analyzed data from more than 3,300 American women taking part in a long-term study of women's health. They found that women with higher levels of testosterone and another reproductive hormone called dehydroepiandrosterone sulfate (DHEAS) felt sexual desire and masturbated more often than those with low levels of the hormones.

However, the links between hormone levels and sexual function were subtle, according to Dr. John Randolph Jr., of the University of Michigan Medical School.

Randolph and his colleagues also found that women who tended to be happier and more satisfied with their relationships reported better sexual function.

The study was published in the Journal of Clinical Endocrinology & Metabolism.

"While levels of testosterone and other reproductive hormones were linked to women's feelings of desire and frequency of masturbation, our large-scale study suggests psychosocial factors influence many aspects of sexual function," Randolph said in a news release from the Endocrine Society.

"A woman's emotional well-being and quality of her intimate relationship are tremendously important contributors to sexual health," he added.

"Our findings suggest menopausal women who are dissatisfied with their sexual function should consider whether these non-hormonal factors are playing a role when discussing treatment with a qualified health care provider," Randolph concluded.

More information

The U.S. National Institute on Aging has more about menopause.
Copyright © 2014 HealthDay. All rights reserved.


SOURCE: Endocrine Society, news release, Nov. 20, 2014...

Early Heart Disease May Lead to Impotence, Study Says
November 18, 2014

 

TUESDAY, Nov. 18, 2014 (HealthDay News) -- Early stage vascular disease may lead to impotence for men later in life, a new study says.

"Erectile function can be a window into men's cardiovascular and overall health. Erectile dysfunction and cardiovascular disease commonly coexist," lead author David Feldman, a research assistant at Johns Hopkins University's Center for the Prevention of Heart Disease, said in an American Heart Association news release.

The study, to be presented Tuesday at the American Heart Association annual meeting in Chicago, included more than 1,800 men without heart disease who were tracked for more than nine years.

"We looked at which measurement of early vascular disease was the best predictor for erectile dysfunction. We also looked at whether those men with multiple abnormalities, such as increased plaque in addition to arterial stiffness and dysfunction, were more likely to also suffer from erectile dysfunction," Feldman said.

The men who had higher amounts of calcified plaque in their heart arteries were much more likely to later develop erectile dysfunction than those with no such plaque.

A number of other measures of early vascular disease were also associated with later development of erectile dysfunction, including higher levels of plaque build-up in the neck arteries that supply blood to the head and brain.

After factoring in age, race, sex and traditional risk factors such as diabetes, smoking, high cholesterol and obesity, the researchers concluded that men with higher levels of artery plaque and stiffness were 53 percent more likely to later develop erectile dysfunction.

While researchers found a link between vascular disease and later erectile dysfunction, it did not prove cause-and-effect.

Men at risk for vascular disease and erectile dysfunction should eat a heart-healthy diet, get regular exercise and avoid smoking, Feldman said.

Findings presented at scientific meetings should be considered preliminary until they are published in a peer-reviewed journal.

More information

The U.S. National Library of Medicine has more about vascular diseases.
Copyright © 2014 HealthDay. All rights reserved.


SOURCE: American Heart Association, news release, Nov. 18, 2014...

Can Lots of Sex Protect the Prostate?
October 29, 2014

 

WEDNESDAY, Oct. 29, 2014 (HealthDay News) -- Don Juans of the world, take note: Men who sleep with lots of women may be less likely to develop prostate cancer than men who don't play the field, a new Canadian study suggests.

Researchers said they found that Montreal-area men who'd had more than 20 female sex partners in their lifetime had a 28 percent reduced risk of prostate cancer, compared with men who only ever slept with one woman.

Previous studies have suggested that frequent ejaculation can protect against prostate cancer, said senior study author Marie-Elise Parent, an associate professor at the University of Montreal School of Public Health. One possible explanation: the beneficial effect might be due to a reduction in the concentration of cancer-causing substances in prostatic fluid, the researchers said.

But don't bolt for the bedroom just yet. Parent termed the findings preliminary. And she added that they don't prove multiple partners protect against the disease, just that a link was uncovered between the two. So, men shouldn't use the findings as an excuse to sleep around.

"I don't think we can say that. But I think men want to hear that," she said. "It shouldn't be for prostate cancer that a man would decide to do that."

Dr. David Samadi, chairman of urology at Lenox Hill Hospital in New York City, agreed that the protective benefits found in this study come "not so much from the number of partners, but the frequency of ejaculation."

The study revealed some other intriguing associations.

For instance, men who said they'd never had sexual intercourse were almost twice as likely to be diagnosed with prostate cancer as those who said they had intercourse.

The researchers also found that a man's risk of prostate cancer increased if he only slept with men. Having more than 20 male partners in one's lifetime doubled the risk of prostate cancer, compared to men who never slept with another man.

Parent noted, though, that the findings regarding gay sex weren't statistically significant and certainly require further research.

The new study, published Oct. 28 in the journal Cancer Epidemiology, is part of a larger effort by Parent and her colleagues to examine the possible causes of prostate cancer.

"We're asking questions about everything you can think of under the sun," she said. "This is only one segment out of many, many others that we are investigating."

For the study, more than 3,200 men in the Montreal area responded to a comprehensive questionnaire that covered many aspects of their lives, including their sex life. About half had been diagnosed with prostate cancer between September 2005 and August 2009, while the rest formed the healthy control group.

The greater the number of female sex partners, the greater protection from prostate cancer, the findings suggested. For example, men who slept with between eight and 20 women had an 11 percent reduced risk of prostate cancer, compared with a 28 percent reduced risk for men with more than 20 female partners.

Men with more than 20 female partners also had a 32 percent reduced risk for less aggressive forms of prostate tumors and a 19 percent reduced risk for more aggressive prostate tumors, the researchers found.

Conversely, men who had more than 20 male sex partners had a more than five-fold increased risk of less aggressive prostate cancer, and a 26 percent increased risk of more aggressive prostate cancer, compared with men who only had one male partner.

The researchers speculated that this might be due to more risky sexual behaviors among gay men, or because of physical trauma to the prostate gland.

Samadi said such trauma to the prostate could actually increase detection of minor prostate cancer, by spurring the prostate to release the protein prostate-specific antigen, or PSA. Tests that check the level of PSA in a man's blood are often used to diagnose and monitor prostate cancer.

More information

To learn more about prostate cancer, visit the U.S. National Institutes of Health.
Copyright © 2014 HealthDay. All rights reserved.


SOURCES: Marie-Elise Parent, associate professor, University of Montreal School of Public Health; David Samadi, M.D., chairman of urology, Lenox Hill Hospital, New York City; Oct. 28, 2014, Cancer Epidemiology...

Man Treated for Ebola in Atlanta Now 'Free' of the Virus
October 20, 2014

 

MONDAY, Oct. 20, 2014 (HealthDay News) -- An unidentified patient being treated at Emory University Hospital in Atlanta is now "free of Ebola virus disease" and was discharged Sunday from the facility, the medical center said in a statement released Monday afternoon.

The man, who has requested anonymity since being admitted to care at Emory's Serious Communicable Disease Unit on Sept. 9, now poses no threat to public health and has left the hospital for an "undisclosed location," the hospital added.

Emory had previously successfully treated two medical missionaries who became infected in West Africa, the site of the worst Ebola outbreak in history.

Also Monday, the American video journalist infected with Ebola while working in Liberia is improving and could be released from the hospital by week's end, doctors at Nebraska Medical Center in Omaha said. Ashoka Mukpo, of Providence, R.I., has been undergoing treatment at the hospital since Oct. 6.

The dual announcements followed more good news on the Ebola front in the United States: Dozens of people who had contact with the Dallas patient who died earlier this month are no longer in danger of catching the disease, health officials said Monday.

Those people include the fiancee and other family members of Thomas Eric Duncan, the Liberian native who contracted the disease in his home country before arriving in Dallas last month.

Also cleared were the paramedics who drove Duncan to Texas Health Presbyterian Hospital on Sept. 28 and health care workers who drew or processed his blood. And a mandatory quarantine was lifted for a homeless man who later rode in the same ambulance as Duncan before it was disinfected, The New York Times reported.

All told, the 21-day monitoring period ended Sunday and Monday for roughly 50 people, the newspaper reported.

An estimated 120 people remain under watch because they could have had contact with one of the three people in Dallas who came down with the disease. Besides Duncan, the other two include two nurses who treated him at Texas Health Presbyterian Hospital.

Federal health officials have said that symptoms of Ebola show up within 21 days of exposure to the virus.

In other developments:

  • Nigeria, Africa's most populous country with 160 million people, has been declared free of Ebola. Officials attributed aggressive health care measures that led to just 20 cases of infection and eight deaths.
  • Leaders of the European Union have set a goal of nearly $1.3 billion in aid to help combat the Ebola outbreak in West Africa.

Meanwhile, U.S. health officials on Monday tightened guidelines for health care workers who are treating Ebola patients.

The new recommendations call for full-body suits and hoods with no skin exposure and use of a respirator at all times. There will also be stricter rules for removing equipment and disinfecting hands, and the designation of a "site manager" to supervise the putting on and taking off of equipment used while treating a patient.

The revised guidelines are apparently in response to the two nurses in Dallas who became infected with Ebola while treating Duncan, the first diagnosed case of the disease in the United States.

Health officials aren't sure how the nurses became infected with the often deadly disease, which has decimated three West African nations since last spring.

But Dr. Anthony Fauci, director of the U.S. National Institute of Allergy and Infectious Diseases, said Sunday that the nurses caring for Duncan had some of their skin exposed, the AP reported.

"Very clearly, when you go into a hospital, have to intubate somebody, have all of the body fluids, you've got to be completely covered. So, that's going to be one of the things," the news service quoted Fauci as saying.

Also Sunday, U.S. Defense Secretary Chuck Hagel announced the creation of a 30-member team of military personnel to help civilian medical professionals in the United States if its assistance is needed to treat Ebola. The team will include doctors, nurses and infectious disease experts, the AP reported.

To date, there have been three cases of Ebola diagnosed in the United States: the two nurses and Duncan.

Early Sunday morning, a cruise ship carrying a lab worker who was being monitored for Ebola because she'd handled a lab specimen from Duncan returned to its port in Galveston, Texas, cruise line officials said.

The unidentified woman is a laboratory manager at Texas Health Presbyterian. She had been voluntarily quarantined aboard the Carnival ship with her husband. She was showing no signs of symptoms of the disease and posed no risk because she has been symptomless for 19 days, federal officials said, according to the AP.

Carnival Cruise Lines said it had been told by health officials Sunday morning that the lab worker tested negative for Ebola, the news service said.

And Spanish health authorities reported Sunday that a nurse's aide who had become infected with Ebola while caring for an elderly priest was free of the virus.

On Saturday, President Barack Obama called on Americans not to give in to panic over Ebola. And he repeated his opposition to a travel ban for flights from the three affected countries in West Africa -- Guinea, Liberia and Sierra Leone.

In his weekly radio and Internet address, Obama said Ebola "is a serious disease, but we can't give in to hysteria or fear -- because that only makes it harder to get people the accurate information they need. We have to be guided by the science."

Some lawmakers have called for a travel ban, but Obama believes such a move would be counterproductive. "Trying to seal off an entire region of the world -- if that were even possible -- could actually make the situation worse," he said.

The Ebola outbreak in West Africa has killed nearly 4,500 people out of an estimated 9,000 reported cases, according to the World Health Organization.

More information

For more on Ebola, visit the World Health Organization.


SOURCES: Oct. 20, 2014, statement, Emory Health Sciences; Oct. 18, 2014, White House weekly address; Oct. 16, 2014, hearing, House of Representatives' House Energy and Commerce Subcommittee on Oversight and Investigations; The New York Times; As...

Circumcision Past Newborn Stage Poses Risk for Boys, Study Finds
October 20, 2014

 

MONDAY, Oct. 20, 2014 (HealthDay News) -- Circumcision is typically done in the first days or weeks of life, but about 6 percent of U.S. boys have the procedure later, which increases the risk of complications and increases costs, according to new research.

The study analyzed insurance billing data that estimated circumcision rates in 2010 for babies up to 1 month (neonates) and older infants up to 1 year old.

Of more than 156,000 circumcisions, "94 percent were performed in neonates," said study researcher Dr. Karen Hoover, a researcher in the division of HIV/AIDS prevention of the U.S. Centers for Disease Control and Prevention.

The common but controversial procedure involves removing the skin covering the end of the penis. Some parents choose to have their sons circumcised for cultural, religious or health reasons.

Among the post-newborn circumcisions, almost half were done in boys younger than 1 year old, the study found.

Delaying circumcision beyond age 1 month increases costs, usually because older boys need general anesthesia to manage the pain, Hoover said.

For instance, early circumcision costs about $285 on average, compared to $1,885 later, according to the study, published online Oct. 20 in Pediatrics.

Dr. Colin Knight, a pediatric surgeon at Miami Children's Hospital in Florida, said he has noticed more parents asking for the procedure when their sons are older, at 3 or 4 months.

Knight, who wasn't involved in the study, said some of these delays are logistical -- either the preferred doctor wasn't available, the child wasn't yet on the insurance plan, or insurance didn't approve reimbursement.

"I tell parents the earlier, the better," he said. That's not just to save money. It's to spare the child general anesthesia. In his practice, Knight said, 3 or 4 months is the cutoff for using local anesthesia. Older boys need general anesthesia, which is riskier for the child, the study notes.

Hoover suggested that parents discuss circumcision and its risks and benefits with their doctor early in the pregnancy.

Circumcision can protect males from HIV, sexually
transmitted infections and urinary tract infections, according to background information in the study.

In a policy statement issued in 2012, the American Academy of Pediatrics said the benefits of newborn circumcision outweigh the risks but those benefits "are not great enough to recommend routine circumcision for all male newborns." The decision should be left to parents, the academy said.

The pediatricians' group did say the advantages of circumcision are sufficient to justify access to this procedure for families choosing it and to warrant insurance coverage for circumcision of male newborns.

But groups such as Intact America and Doctors Opposing Circumcision oppose routine circumcision.

On its website, Doctors Opposing Circumcision states no one has the right to remove sexual body parts from someone else and cites pain associated with this "unnecessary procedure" as another objection.

Knight said he uses several methods to minimize a newborn's pain. "We give them acetaminophen before," he said. Also, while the local anesthetic is injected, the baby can suck on sugar water, he added. He said he also tries to distract the child during the procedure to reduce discomfort.

More information
To learn more about circumcision, visit American Academy of Pediatrics.
Copyright © 2014 HealthDay. All rights reserved.


SOURCES: Colin Knight, M.D., pediatric surgeon, Miami Children's Hospital, Miami, Fla.; Karen Hoover, M.D., M.P.H., researcher, U.S. Centers for Disease Control and Prevention, division of HIV/AIDS prevention; November 2014 Pediatrics ...

Impotence Drug Might Counter Common Gene Mutation in Type 2 Diabetes: Study
October 09, 2014

 

THURSDAY, Oct. 9, 2014 (HealthDay News) -- In a small study, Swedish researchers found that the impotence drug yohimbine might help people with type 2 diabetes who have a particular gene mutation that lowers their insulin production.

Among 50 men and women with type 2 diabetes partially caused by a mutation in a gene called alpha(2A)-AR, those treated with yohimbine showed improved insulin production and lower blood sugar levels, compared with those receiving a placebo.

"If a diabetic patient carries the risk mutation, he or she is more sensitive to stress hormones such as adrenaline," said lead researcher Dr. Anders Rosengren, head of the translational diabetes research group at Lund University Diabetes Center in Malmo.

About 40 percent of patients with type 2 diabetes carry this mutation. "It is not that patients are more stressed, but that adrenaline suppresses insulin secretion," he added.

Rosengren explained how the drug overcomes the effects of the mutation: "It is like driving a car with the brakes constantly on. If you add yohimbine, you release the brake and the car -- the insulin-producing cells -- can go at normal speed. The cells secrete adequate amounts of insulin in response to sugar."

Yohimbine isn't without side effects, however, Rosengren said. In the study, some patients experienced anxiety, stress and high blood pressure. His group is trying to find a way to reduce these side effects while preserving the benefits of the drug.

One expert also noted that targeting a single gene may not help many patients with diabetes.

Close to 300 genes play a role in diabetes, according to Dr. Joel Zonszein, director of the Clinical Diabetes Center at Montefiore Medical Center in New York City.

"Only a few have this mutation alone," Zonszein said. "In real life, we are not able to treat most patients with diabetes with a genetic therapy."

Zonszein said that there are many medications available to lower blood sugar, and combined with diet, exercise and weight loss, they are effective in treating type 2 diabetes.

Rosengren also noted that type 2 diabetes is primarily a lifestyle disease.

In other words, lifestyle factors trigger the disease, but the severity and susceptibility is influenced by genetic mutations, he said.

Rosengren added that even though two patients might have the same gene mutation, their condition won't be identical. "That is because several different risk genes and, importantly, lifestyle factors interact to shape the disease process in the individual patient," he said.

Lifestyle changes -- such as diet, exercise and weight loss -- will always be a cornerstone in type 2 diabetes management, Rosengren said.

However, this study shows that it may be possible in the future to block the negative effects of gene mutations, he said. "These findings open up a potential avenue to more personalized treatment using a combination of lifestyle modification and more targeted drugs," Rosengren said.

The report was published Oct. 8 in the journal Science Translational Medicine.

More information

Visit the American Diabetes Association for more on this blood sugar disease.
Copyright © 2014 HealthDay. All rights reserved.


SOURCES: Anders Rosengren, M.D., Ph.D., head translational diabetes research group, Lund University Diabetes Center, Malmo, Sweden; Joel Zonszein, M.D., director, Clinical Diabetes Center, Montefiore Medical Center, New York City; Oct. 8, 2014, Science...

Health Highlights: Oct. 9, 2014
October 09, 2014

 

Here are some of the latest health and medical news developments, compiled by the editors of HealthDay:

Bee Swarm Kills Man, Critically Injures Another in Arizona
One man was killed and another critically injured Wednesday when landscape workers in southern Arizona were attacked by Africanized bees.
The crew was cutting grass and weeding for a 90-year-old homeowner when they were swarmed by bees from an attic nest believed to hold 800,000 bees. Two other workers and a neighbor also suffered stings, USA Today reported.
It's not known what triggered the incident or how many bees were involved in the attack that occurred in Douglas, located on the border with Mexico and about 120 miles southeast of Tucson.
The dead man and his critically injured co-worker were with the Douglas ARC, which finds work for people with developmental disabilities, Douglas Fire Chief Mario Novoa said.
After the attack, a four-block area around the house was cordoned off and firefighters in protective bee suits removed part of the eaves and roof and pulled down the ceiling so that an exterminator could kill the bees, USA Today reported.
When it was removed, the 3-by-8-foot nest filled a 55 gallon drum. The nest may have been accumulating for 10 years, according to Novoa.
"There are not many European honey bees left around here, so we treat them all as Africanized bees," he said, USA Today reported.Copyright © 2014 HealthDay. All rights reserved.


...

No Testosterone Therapy for Healthy Women, New Guidelines State
October 03, 2014

 

FRIDAY, Oct. 3, 2014 (HealthDay News) -- Healthy women should not be diagnosed with testosterone deficiency and should not be prescribed testosterone therapy, a new guideline from the Endocrine Society states.

"Although limited research suggests testosterone therapy in menopausal women may be linked to improved sexual function, there are too many unanswered questions to justify prescribing testosterone therapy to otherwise healthy women," guideline task force chair Dr. Margaret Wierman, of the University of Colorado, said in a society news release.

"When we reviewed past studies, we found many women who had low testosterone levels measured by older or new techniques did not exhibit any signs or symptoms of concern. As a result, physicians cannot make a diagnosis of androgen deficiency in women," said Wierman, who is vice president of clinical science at the endocrine society.

The only time a woman might be prescribed testosterone therapy is if she is diagnosed with hypoactive sexual desire disorder (HSDD), which occurs when a woman has no interest in sex and that lack of interest causes her distress.

In such cases, women should be prescribed a three- to six-month trial of testosterone therapy to determine if it improves sexual function, according to the new clinical practice guideline published online Oct. 3 in the Journal of Clinical Endocrinology and Metabolism.

Testosterone therapy should not be prescribed to improve sexual function in women who do not have HSDD, the experts said.

The guideline authors noted that testosterone therapy in women has been linked to changes in cholesterol, as well as acne and excessive growth of hair on locations such as the face, back and chest. The long-term breast and cardiovascular risks are unknown.

"Currently, there isn't enough evidence that any benefits outweigh the risks to most women. More research is needed to determine the long-term safety of testosterone therapy in postmenopausal women," Wierman said.

More information

The Hormone Health Network has more about female sexual dysfunction.
Copyright © 2014 HealthDay. All rights reserved.


SOURCE: The Endocrine Society, news release, Oct. 3, 2014...

FDA Panel: Limit Testosterone Drug Use
September 18, 2014

 

THURSDAY, Sept. 18, 2014 (HealthDay News) -- There is little evidence that testosterone replacement therapy effectively treats normally sagging levels of the hormone in aging American males, a U.S. Food and Drug Administration advisory panel said Wednesday.

The panel, from two key FDA committees, overwhelmingly voted, 20-1, to tighten use of the popular drugs and require drug makers to conduct tests assessing the drugs' risk of heart attack and stroke, according to Bloomberg News.

"The whole idea is to try to rein in the inappropriate advertising and use of these drugs," Dr. Michael Domanski, a panel member who is director of heart failure research at Mount Sinai School of Medicine in New York City, told The New York Times.

The FDA is not required to follow the recommendations of its expert panels, but usually does.

Along with sharply curtailing how many men might be prescribed testosterone supplements, insurance companies could also limit coverage for their use if the FDA follows its panel's advice, experts told the Times.

In what has become known as the Low-T fad, Baby Boom generation men have turned to testosterone replacement therapy in response to the sagging muscles, lower energy levels and sexual problems that often accompany natural aging, the FDA noted in a review provided to committee members in advance of the meeting.

"There's a large group of men out there who are getting older, and they are looking for ways to evade the consequences of aging," Dr. Bradley Anawalt, an endocrinologist from the University of Washington in Seattle, said ahead of the meeting.

The FDA review pointed out there's no clear scientific evidence showing testosterone replacement can reverse some of the effects of aging. Yet the "Low-T" craze has been aided by consumer advertising for remedies that promise renewed vitality and strength for aging men, the report said. It also noted that there's growing evidence many men who are receiving testosterone replacement therapy do not need it.

Anawalt said he hoped the FDA hearing signals increased government oversight of testosterone therapy and increased public funding for studies on its effectiveness.

"This is a hormone that has been used as a therapy for decades without much scrutiny," he added.

The number of patients with a testosterone prescription nearly doubled over three years, leaping from 1.3 million people in 2010 to 2.3 million in 2013, according to the FDA review, done by Dr. Christine Nguyen, the agency's deputy director for safety, and Dr. Hylton Joffee, director of the FDA's division of bone, reproductive and urologic products.

An FDA analysis found that only about one-half of men now taking testosterone therapy have been diagnosed with hypogonadism, the specific medical diagnosis for testosterone deficiency.

Further, 25 percent of men started the therapy without lab testing to confirm that they had low levels of testosterone, the report said. More than one in four never received a lab test during the course of their therapy, which is crucial to making sure the patient's hormone levels are within the normal range, according to the FDA.

"Many endocrinologists feel that testosterone is being prescribed for men without a clear indication for its use, or for men who are not indicated for it at all," said Anawalt.

Testosterone therapy, even if used correctly, could have serious consequences for heart health, the FDA report added.

One recent study found a 30 percent increased risk of stroke or heart attack in a group of men recently prescribed testosterone therapy, the FDA said. Another found that men 65 and older experienced a two-fold increase in heart attack risk within the first three months of receiving a testosterone prescription, according to the agency.

In June, the FDA announced that testosterone supplement products must now carry a warning label on the general risk of blood clots in the veins.

Until a decade ago, testosterone deficiency tended to be a little recognized and undertreated illness, said Dr. Ronald Tamler, director of the Mount Sinai Diabetes Center in New York City.

"Then all of a sudden, the [pharmaceutical] industry started picking up on this and realized that testosterone was a fantastic business, and realized some patients had needed this medication for decades," Tamler said.

Unfortunately, he added, doctors who aren't hormone experts are performing testosterone level tests at the wrong time of the day, which can lead to overdiagnosis of low levels.

Testosterone levels are at their peak early in the morning and decline naturally throughout the day, he said, but some doctors have been performing hormone tests at all times of the day, diagnosing some men as having low testosterone when in fact their levels are normal.

"We swiftly went from one extreme to the other extreme, which was overtesting for it, overdiagnosing it and overtreating it," he said.

At the same time, the science is "murky" on the link between testosterone and increased risk of stroke or heart attack, Tamler added. The FDA review agreed, noting that some studies found potential harm, while others found none.

More information

For more on the FDA's meetings on testosterone replacement therapy, visit the U.S. Food and Drug Administration.

.Copyright © 2014 HealthDay. All rights reserved.


SOURCES: Ronald Tamler, M.D., director, Mount Sinai Diabetes Center, and associate professor, endocrinology, Icahn School of Medicine at Mount Sinai, New York City; Bradley Anawalt, M.D., representative, The Endocrine Society, and endocrinologist, Univers...

FDA to Probe Testosterone Therapy Claims, Safety
September 17, 2014

 

TUESDAY, Sept. 16, 2014 (HealthDay News) -- The U.S. Food and Drug Administration is focusing on the "Low T" fad, questioning whether the boom in testosterone replacement therapy is helping or harming the health of aging American males.

At a joint meeting scheduled for Wednesday and Thursday, two key FDA committees will discuss whether doctors are prescribing testosterone therapy for too many men, and if misuse of the male hormone increases the risk of stroke and heart attack.

The Baby Boom generation has turned to testosterone replacement therapy in response to the sagging muscles, lower energy levels and sexual problems that can accompany natural aging, the FDA noted in a review provided to committee members in advance of the meeting.

"There's a large group of men out there who are getting older, and they are looking for ways to evade the consequences of aging," said Dr. Bradley Anawalt, an endocrinologist from the University of Washington in Seattle.

However, the FDA review pointed out there's no clear scientific evidence showing testosterone replacement can reverse some of the effects of aging. Yet the "Low T" craze has been aided by consumer advertising for remedies that promise renewed vitality and strength for aging men, the report said. It also noted that there's growing evidence many men who are receiving testosterone replacement therapy do not need it.

At the joint FDA committee meeting in Hyattsville, Md., the panelists will be asked to vote on two key issues: Whether the agency should revise current indication for testosterone therapies, and whether sponsors of testosterone products should conduct studies to further assess a potential cardiovascular risk.

Anawalt said he hopes the FDA hearing will signal increased government oversight of testosterone therapy and increased public funding for studies on its effectiveness.

"This is a hormone that has been used as a therapy for decades without much scrutiny," he added.

The number of patients with a testosterone prescription nearly doubled over three years, leaping from 1.3 million people in 2010 to 2.3 million in 2013, according to the FDA review, done by Dr. Christine Nguyen, the agency's deputy director for safety, and Dr. Hylton Joffee, director of the FDA's division of bone, reproductive and urologic products.

An FDA analysis found that only about one-half of men now taking testosterone therapy have been diagnosed with hypogonadism, the specific medical diagnosis for testosterone deficiency.

Further, 25 percent of men started the therapy without lab testing to confirm that they had low levels of testosterone, the report said. More than one in four never received a lab test during the course of their therapy, which is crucial to making sure the patient's hormone levels are within the normal range, according to the FDA.

"Many endocrinologists feel that testosterone is being prescribed for men without a clear indication for its use, or for men who are not indicated for it at all," said Anawalt.

Testosterone therapy, even if used correctly, could have serious consequences for heart health, the FDA report added.

One recent study found a 30 percent increased risk of stroke or heart attack in a group of men recently prescribed testosterone therapy, the FDA said. Another found that men 65 and older experienced a two-fold increase in heart attack risk within the first three months of receiving a testosterone prescription, according to the agency.

In June, the FDA announced that testosterone supplement products must now carry a warning label on the general risk of blood clots in the veins.

Until a decade ago, testosterone deficiency tended to be a little recognized and undertreated illness, said Dr. Ronald Tamler, director of the Mount Sinai Diabetes Center in New York City.

"Then all of a sudden, the [pharmaceutical] industry started picking up on this and realized that testosterone was a fantastic business, and realized some patients had needed this medication for decades," Tamler said.

Unfortunately, he added, doctors who aren't hormone experts are performing testosterone level tests at the wrong time of the day, which can lead to overdiagnosis of low T.

Testosterone levels are at their peak early in the morning and decline naturally throughout the day. Because of this, endocrinologists know to perform testosterone tests first thing in the morning, Tamler said.

But some doctors have been performing hormone tests at all times of the day, diagnosing some men as having low testosterone when in fact their levels are normal, Tamler said.

"We swiftly went from one extreme to the other extreme, which was overtesting for it, overdiagnosing it and overtreating it," he said.

At the same time, the science is "murky" on the link between testosterone and increased risk of stroke or heart attack, Tamler said. The FDA review agreed, noting that some studies found potential harm, while others found none.

Dr. Daniel Yadegar, a New York City cardiologist who specializes in anti-aging therapies, argues that studies showing a link between testosterone therapy and poor heart health did not consider the role that other hormones might play.

Yadegar noted that a man receiving too much testosterone will begin to convert the hormone into estrogen, which has been shown to increase heart disease risk in men.

"Perhaps it's high estrogen levels that are causing the cardiovascular events, but we would never know that because they didn't measure the estrogen levels," he said.

Yadegar added that the earlier studies relied on blood tests for testosterone, which some research has shown are less accurate than saliva tests for the male hormone.

More information

For more information on the FDA's meetings on testosterone replacement therapy, visit the U.S. Food and Drug Administration.

.


SOURCES: Ronald Tamler, M.D., director, Mount Sinai Diabetes Center, and associate professor of endocrinology, Icahn School of Medicine at Mount Sinai, New York City; Bradley Anawalt, M.D., representative, The Endocrine Society, and endocrinologist, Unive...

Health Highlights: Sept. 3, 2014
September 03, 2014

 

Here are some of the latest health and medical news developments, compiled by the editors of HealthDay:

Little Evidence of Testosterone Drugs' Benefits or Risks: FDA
There is little evidence that testosterone drugs are either beneficial or pose serious health risks to men, the U.S. Food and Drug Administration says in a review posted online Wednesday.
Millions of American men take the drugs, which come in various forms, including pills, patches and gels. Companies claim their products help counter low testosterone, which they link to fatigue, low libido and weight gain, the Associated Press reported.
However, the FDA review says the "the need to replace testosterone in these older men remains debatable."
There is a natural decline in testosterone levels after age 40, but it's not clear that this decrease actually results in aging-related issues such as loss of muscle and lower energy levels, the AP reported.
The FDA review was released in advance of a public meeting to discuss the benefits and risks of treatments to boost men's testosterone levels. The meeting, scheduled for Sept. 17, was announced after two federal government-funded studies found connections between testosterone treatment and heart problems in men.
Testosterone injections were first approved in the 1950s for men with abnormally low testosterone levels caused by injury or illness. However, recent marketing campaigns tout the benefits of testosterone therapy for otherwise healthy men with lower-than-normal testosterone levels, the AP reported.
The use of testosterone drugs in these men is "controversial" and "there are no reliable data on the benefit in such a population," according to the FDA review.
That's why it asked an panel of outside experts to decide whether the prescribing information on testosterone drugs should be changed to focus on a smaller group of patients.
The committee will also assess two recent studies that found higher rates of heart problems in men taking testosterone drugs. One study found that older men taking the drugs had a 30 percent higher risk of stroke, heart attack and death, while the other study concluded that testosterone therapy doubled the risk of heart attack in men 65 and older with an existing heart condition, the AP reported.
However, the FDA review noted that two other studies linked testosterone with longevity.
The expert panel will be asked whether drug companies should be required to do long-term follow-up studies to assess whether testosterone drugs increase heart risks, the AP reported.
-----

Perdue Halts Antibiotic Use in Hatcheries
One of the largest poultry producers in the United States announced Wednesday that it was stopping the routine use of antibiotics in it hatcheries.
It's the latest step taken by Perdue over more than a decade to deal with concerns about antibiotic use. The widespread use of antibiotics in poultry and other animals raised for human consumption has been linked to increased antibiotic resistance in people.
"The hatchery was the last step we recently accomplished," company chairman Jim Perdue told The New York Times.
"We've gotten calls from different groups watching our products and asking questions about our use of antibiotics, and we thought, 'Why don't we just talk about it openly instead of just talking to one group?'"
By 2007, Perdue had stopped using human antibiotics in feed to promote growth in its poultry. However, the company will continue to give human antibiotics to poultry flocks as needed to control disease outbreaks, a Perdue official said.
Each year in the U.S., at least two million people develop antibiotic-resistant infections and at least 23,000 die from the, according to U.S. Centers for Disease Control and Prevention. The agency called the use of antibiotics in livestock "unnecessary" and "inappropriate."
The Food and Drug Administration is working on draft regulations to reduce the use of antibiotics in animals raised for human consumption, The Times reported.
Perdue's announcement "is a big step from the public health and consumer perspectives," Gail Hansen, senior officer for the Pew Charitable Trust's campaign on human health and industrial farming, told The Times.
"I would like to think it makes the other poultry companies look at what Perdue is doing and say 'Is this something we can follow?'" Hansen added.

-----

British Ebola Patient Released From Hospital
A British man infected with Ebola during the outbreak in West Africa has fully recovered and been released from hospital.
William Pooley, 29, was given the experimental drug ZMapp and treated in a special isolation unit at the Royal Free Hospital in London, BBC News reported.
Pooley -- the first British person to contract the deadly virus -- was infected while working as a volunteer nurse in Sierra Leone. The RAF flew him back to the U.K. on Aug. 24.
"He is not infectious to anyone else now. The virus is cleared from the body, and there is no risk to the wider community in any way," said Dr. Michael Jacobs, an infectious diseases consultant at the hospital, BBC News reported.
Chemical decontamination is underway in the isolation unit where Pooley was treated, Jacobs added.
-----
CVS Halts Tobacco Sales
As of midnight Tuesday, all CVS locations across the United States stopped selling tobacco products.
The company made the promise in February and the move is part of its program to become a health care destination with a new name: CVS Health, The New York Times reported.
CVS and other major retailers such as Walmart and Walgreens are competing to provide basic health care to customers, and eliminating tobacco products is one way that CVS hopes to attract patients.
"CVS is really trying very hard to position themselves as the winner in that marketplace," Skip Snow, a health care analyst at Forrester Research, told The Times.
"If they can be perceived as a place to go to receive health care, and buy health care products, as opposed to the place to go to buy a bottle of whiskey or get your film developed, then they can capture more of the retail medicine dollars," Snow explained.


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