TUESDAY, May 21 (HealthDay News) -- Pregnant women with specific alterations in two genes may be at increased risk of suffering depression after giving birth, a small new study suggests.

The researchers hope they can use the findings to develop a blood test that could help spot pregnant women who are vulnerable to postpartum depression, which affects around 15 percent of new mothers.

Their study, reported in the May 21 issue of the journal Molecular Psychiatry, uncovered specific chemical changes in two genes that predicted which women would develop postpartum depression with 85 percent accuracy.

Little is known about the genes, called TTC9B and HP1BP3, but they are somehow involved in activity in the brain's hippocampus, which regulates mood. Based on animal research, both genes seem to be "reactive to estrogen," said Zachary Kaminsky, a researcher at Johns Hopkins University School of Medicine in Baltimore who worked on the study.

The findings offer clues as to what makes some women susceptible to postpartum depression. But there is still a lot of work to be done before a screening test becomes available, according to an expert not involved in the research.

"This is a first step, but I think we're pretty far off from having a blood test," said Dr. Kimberly Yonkers, a professor of psychiatry and obstetrics and gynecology at Yale School of Medicine in New Haven, Conn.

She said the study was small -- involving only 51 women, about a dozen of whom developed depression within a month of giving birth -- so the results need to be validated in larger studies.

But beyond that, Yonkers said, there's the larger, "dicey" issue of how much benefit there would be from telling pregnant women their genes put them at heightened risk of postpartum depression.

"You may unnecessarily worry some women," Yonkers said.

"Information is power," Kaminsky said, and for some women, knowing they are at risk of postpartum depression can offer a chance to minimize that risk: Their partner, family or friends could be especially attentive and step in to ease some of the stress of being a new mom, for example.

Kaminsky acknowledged that if a blood test result actually caused distress for an expectant mom, it would not be good. But, he said, having a blood test as an option for women who want an idea of their risk could be valuable.

Kaminsky and two of his co-researchers have filed for a patent on testing for the genetic markers.

The findings are based on 51 pregnant women with a history of depression or bipolar disorder, which raises the risk of suffering depression during or after pregnancy. One group of 19 women had major depression during their pregnancies, and 12 continued to have symptoms in the first month after giving birth.

Another 32 women were depression-free during pregnancy, but 11 developed postpartum depression.

Based on research with mice, Kaminsky's team suspected that estrogen triggers so-called epigenetic changes in genes in the brain's hippocampus. With epigenetic changes, there is no defect in the underlying DNA, but a gene's activity is altered. The results of research conducted in mice, however, often are not able to be replicated in humans.

The researchers found that epigenetic changes in the TTC9B and HP1BP3 genes were predictive of a woman's risk of postpartum depression.

Yonkers said one theory has been that women who develop postpartum depression may respond differently to the big shifts in estrogen and other hormones that happen during pregnancy and after childbirth.

Kaminsky said the new findings give some insight into that hormonal response. But he said more research is needed to really understand what's going on.

The results also need to be confirmed in a larger, more diverse group of women, Kaminsky said. "The women in this study all had been previously diagnosed with depression or bipolar disorder," he said. "We really need to look at this in a general population of women too."

In general, experts suspect that many factors come together to cause postpartum depression, including a woman's particular circumstances, such as whether she has a good "support network," if she has other major stressors in her life or whether the pregnancy was planned or not.

So no blood test would tell the whole story.

Right now, doctors may diagnose postpartum depression either because a woman complains of symptoms, or through a screening questionnaire. Yonkers said experts differ on whether new mothers should be routinely screened; the American Academy of Pediatrics, for example, says pediatricians should screen moms for depression during newborn checkups.

Other groups, including the American College of Obstetricians and Gynecologists, do not advise routine screening, but say doctors and women should consider it.

More information

Learn more about postpartum depression from the American Psychological Association.

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MONDAY, May 20 (HealthDay News) -- The costly form of radiation therapy that has become the norm for prostate cancer in the United States may be no better than the older, cheaper variety -- at least for some men, a new study suggests.

Researchers found that among more than 1,000 U.S. men who had radiation therapy after prostate cancer surgery, the newer form -- known as intensity-modulated radiotherapy (IMRT) -- had no advantage over the conventional version.

Men who received IMRT were no less likely to be treated for a prostate cancer recurrence over the next few years. And their rates of long-term side effects -- such as urinary incontinence and erectile dysfunction -- were no lower.

But the findings, reported online May 20 in JAMA Internal Medicine, will not spell the doom of IMRT. One reason is, the vast majority of U.S. men who receive radiation for prostate cancer are already given IMRT.

"I don't think this is going to change practice," said Dr. Matthew Cooperberg, a urologist at the University of California, San Francisco, who wrote an editorial published with the study.

But he said the findings do beg the question of why IMRT is reimbursed at such a high rate. A 2011 study in the Journal of Clinical Oncology found that Medicare paid out an average of nearly $11,000 more for IMRT, versus the older radiation therapy (called conformal radiotherapy).

"We need a reimbursement system that rewards outcomes instead of technology," Cooperberg said.

Still, Dr. Ronald Chen, one of the researchers on the new study, said the findings apply to a specific group of patients who receive IMRT: men who have it after prostate cancer surgery -- either to help prevent a recurrence or to treat one.

There are other patients who receive radiation as their initial therapy, explained Chen, an assistant professor of radiation oncology at the University of North Carolina at Chapel Hill.

And in a study published last year in the Journal of the American Medical Association, Chen and his colleagues found that for those men, IMRT does carry a lower risk of certain side effects than conformal radiotherapy. It also showed a somewhat lower risk of cancer recurrence.

"I think the question is, when is the new technology helpful, and when is it not?" Chen said. "We need to be smart about how we use technology."

The new findings suggest that when it comes to radiation given after surgery, "newer" does not mean "better."

The IMRT technique was designed to minimize damage to healthy tissue around the tumor. Doctors use 3-D computer images to visualize the area, then target it with thin radiation beams from different angles -- with the individual beams varied in intensity.

IMRT has exploded in the United States in the last decade or so. In 2000, it was barely a blip on the radar, but by 2008 it accounted for 96 percent of all external radiation treatments for prostate cancer, according to the editorial. (Men can also have an internal form of radiation, where radioactive "seeds" are implanted in the prostate gland.)

Why did the technology take off? Cooperberg said IMRT was heavily marketed, and the procedures were also reimbursed at a much higher rate -- a potential incentive to some.

Plus, Cooperberg said, "Hospitals generally want to be seen as cutting-edge, and patients often want the latest and greatest thing."

Chen agreed. "Oftentimes in this country, doctors and patients chase after the newest technology, believing that it must be better -- even before the evidence is in."

But although IMRT is now dominant, Chen said he thinks "there's a chance for a reversal." If the older conformal radiotherapy is just as good for men who've had prostate cancer surgery, then using it would bring down the costs of radiation for those patients.

And that might allow more men to get it, according to Chen. He said that right now, radiation is "underused" in men who might benefit from it after prostate surgery, and costs may be one reason.

The new findings are based on Medicare claims for 457 men who underwent IMRT between 2002 and 2007, and 557 men who had conformal radiation therapy. Chen's team followed their outcomes through 2009.

Overall, there were no major differences in the men's risk of side effects: About 15 percent of those who'd received IMRT were diagnosed with erectile dysfunction, compared with 12 percent of men who'd received the older radiation therapy, for example.

When it came to the cancer itself, just over 8 percent of IMRT patients needed additional therapy during the study, versus 7 percent of conformal radiotherapy patients.

Dr. James Yu, an assistant professor of therapeutic radiology at Yale School of Medicine, said the study was well done.

It "provides an important piece of the puzzle for evaluating this important but costly technology," Yu said.

There are still questions, though, he added. It's possible, for example, that IMRT could have an advantage when it comes to men's ultimate cure rates, or their overall quality of life over time.

Cooperberg said Medicare claims are an imperfect way to gauge quality of life. Yu agreed that claims data may not capture all the ways treatment can affect men's lives, such as their sexual function other than an official diagnosis of erectile dysfunction.

IMRT is not, however, the latest radiation technique out there. That would be proton beam therapy, which is supposed to be even more targeted than IMRT -- and is twice as expensive. But so far, research has suggested the newer technology is no better.

"There's not a shred of evidence that it's better than IMRT," Cooperberg said.

More information

Learn more about prostate cancer from the U.S. National Cancer Institute.

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MONDAY, May 20 (HealthDay News) -- A child whose mother lived near heavy traffic while pregnant faces a relatively higher risk for developing a respiratory infection before the age of 3, a new study suggests.

Researchers looked at data involving nearly 1,300 pairs of mothers and infants from eastern Massachusetts. All the mothers began study participation while in their first trimester of pregnancy at some point between 1999 and 2002.

About 6 percent of the mothers lived within 100 meters (about 110 yards) from a major roadway, while another 7 percent lived between 100 and 200 meters away. About one-third of the mothers lived from 200 to 1,000 meters (about two-fifths of a mile) away, while the rest lived 1,000 meters or more from a major roadway.

Among their infants, about 53 percent had suffered at least one diagnosed respiratory infection, including pneumonia, bronchiolitis or croup by age 3.

Offspring of mothers living the shortest distance from a major roadway had a 1.74 times greater risk for such infections compared to those living farthest away. Those whose mothers lived 100 to 200 meters from a roadway had a 1.49 greater risk.

The findings held true even after adjusting for a range of factors, including maternal smoking during pregnancy, postnatal household smoking, breastfeeding, daycare attendance, presence of other young children in the household and season of birth.

"The connection between in utero and early life cigarette smoke exposure and adverse infant respiratory outcomes is well-established, but the relation of prenatal ambient air pollution to risk of infant respiratory infection is less well-studied," study author Dr. Mary Rice said in an American Thoracic Society news release.

Rice, a pulmonary and critical care fellow at Massachusetts General Hospital and Beth Israel Deaconess Medical Center, and colleagues are scheduled to present their findings this week at an American Thoracic Society meeting in Philadelphia.

Studies presented at medical meetings should be considered preliminary until published in a peer-reviewed journal. The new study found a link between exposure to heavy traffic in pregnancy and respiratory illness in children, but it didn't prove cause-and-effect.

More information

For more on air pollution and infants, visit the March of Dimes.

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FRIDAY, May 17 (HealthDay News) -- Although being openly gay appears to affect a male actor's masculinity ratings, it does not affect views on his performance, according to a new study.

Researchers from Clemson University in South Carolina found that an actor who is "out" can be convincing when playing a heterosexual role, despite stereotypes about homosexuals.

"Early research showed that people tend to perceive a direct connection between sexual orientation and established gender roles, especially in the entertainment industry," said the study's leader, Paul Merritt, a psychology professor, in a Clemson news release. "However, these new findings indicate that knowledge of an actor's sexual orientation doesn't necessarily cause their performance to be perceived in light of stereotypes about gays and lesbians."

The study, published recently in Psychology of Popular Media Culture, was conducted in the wake of news columns that maintained that knowing someone is gay will bias perceptions of his or her performance in a heterosexual role.

The researchers questioned roughly 400 college students about a male actor's fictional Facebook page, featuring photos and information about his sexual orientation.

The students then watched a video of the actor and rated his performance. The students also stated how likely they would be to cast the actor in their own production. The study revealed that being openly gay didn't affect perceptions or ratings of the actor's performance, but it did influence their opinion of his masculinity.

More information

The American Psychological Association has more about sexual orientation and homosexuality.

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FRIDAY, May 17 (HealthDay News) -- Liver transplants to treat a common type of liver cancer are a viable option for people infected with HIV, according to new research.

The Italian study, published May 10 in the journal The Oncologist, found that the AIDS-causing virus doesn't affect survival rates and cancer recurrence after transplants among HIV patients with this particular type of liver cancer, called hepatocellular carcinoma (HCC). The study's authors noted, however, that HCC is more aggressive in people with HIV and it is becoming a major cause of death among these patients as antiretroviral treatment prolongs their lives.

"The key message of this study is that liver transplantation is a valid option for HCC treatment in HIV-infected patients," the study's authors wrote in a journal news release. "We suggest that HIV-infected patients must be offered the same liver transplant options for HCC treatment currently provided to HIV-uninfected subjects."

The study involved 30 HIV-positive patients and 125 patients not infected with HIV who received a liver transplant to treat HCC at three different hospitals in northern Italy between 2004 and 2009.

During a follow-up period of roughly 32 months, the researchers found a recurrence of HCC in 6.7 percent of the patients with HIV and 14.4 percent of the patients who were not HIV positive.

The study also revealed that survival was similar for all of the patients one year after surgery and three years post-surgery.

The researchers, led by Dr. Fabrizio Di Benedetto, associate professor of surgery at the University of Modena, said the HIV-positive patients were treated with antiretroviral therapy until they underwent the transplant. The therapy was not resumed until their liver function stabilized after surgery.

None of the HIV-positive patients developed AIDS during the post-surgery follow-up period. The study's authors suggested that this may be due to timely resumption of HIV therapy following the liver transplant.

New options in antiviral therapy for people with HIV could improve control of the HIV virus as well as outcomes following liver transplant for HCC, the researchers said.

Patients with HIV undergoing liver transplant for HCC would benefit most from a multidisciplinary approach to care, the study authors said, which would involve collaboration among oncologists, radiologists, gastroenterologists, liver surgeons and infectious disease specialists.

More information

The American Cancer Society provides more information on hepatocellular carcinoma.

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THURSDAY, May 16 (HealthDay News) -- Students targeted because they're believed to be gay -- as many as one in seven young teens -- are much more likely than others to be suicidal and depressed, a new survey finds.

More than 10 percent of eighth-grade boys and girls reported that they're victimized because of perceived sexual orientation, according to a large survey of students in Washington state.

"It has a profound impact on their quality of life and the way they think of themselves," said Donald Patrick, a professor of health services at the University of Washington in Seattle. "Those in eighth grade are in a particularly vulnerable position."

These children "feel alone in life, that they don't feel as good as other people and their self-esteem is highly affected," Patrick said.

The survey results, published online May 16 in the American Journal of Public Health, don't offer insight into whether bullying contributes to depression and suicidal thoughts in its victims. It's possible that kids with existing mental illnesses may be more likely to be bullied and perceived as gay.

Nor does the research establish a clear cause-and-effect relationship between bullying and suicidal thoughts. But Patrick said "it's clear that there's an association, and I wouldn't be so worried about the causation." Prior research has also suggested that gay, lesbian, bisexual and transgender children are more likely to be suicidal and hurt themselves.

A string of teen suicides in 2010 -- including the death of Rutgers University freshman Tyler Clementi -- put the issue in the public eye. Syndicated columnist Dan Savage launched a campaign called "It Gets Better" to give hope to gay teens that their lives will improve. Participants have included numerous celebrities and politicians, including President Barack Obama.

Based on the new findings, bully-prevention programs must address kids picked on because of their sexual orientation, the study authors said.

The study is based on a 2010 survey of nearly 28,000 students in grades eight, 10 and 12. Among boys, 14 percent of eighth-graders, 11 percent of 10th-graders and 9 percent of 12th-graders reported being bullied within the previous month because they were thought to be gay. The numbers were 11 percent, 10 percent and 6 percent, respectively, for girls.

The survey defined bullying based on sexual orientation as being "bullied, harassed or intimidated at school" because they were thought to be gay or bisexual. It defined other types of bullying as when one or more students "say or do nasty or unpleasant things" to another person or tease someone "repeatedly in a way he or she finds offensive." In most cases, more students reported being bullied for other reasons.

Compared to kids bullied for other reasons or not bullied at all, those targeted because they were perceived to be gay were much more likely to have considered suicide in the past year, to have been depressed in the past year and to say they don't feel good about themselves.

For example, 26 percent of male 12th-graders targeted for being perceived as gay said they had been suicidal within the past year, compared to 8 percent of those not bullied. The rate also was more than three times greater for female seniors.

Brian Mustanski, an associate professor in the department of medical social sciences at the Northwestern University Feinberg School of Medicine, in Chicago, said the survey has some strengths but fails to ask whether those bullied are actually gay and not just perceived to be.

"Because of this, it is a major underestimate of the rate of bullying among gay youth," he said.

Mustanski agreed with Patrick that teachers and school leaders need to promote comfortable and safe environments. "While family and peer support have important positive effects for gay youth and reduce feelings of suicide and depression, you cannot 'support away' these toxic effects of bullying," he said.

"Schools and communities need to put in place policies and practices that make schools and neighborhoods safe for all kids," he said.

More information

The Trevor Project offers a confidential suicide hotline for gay teens and those questioning their sexuality.

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THURSDAY, May 16 (HealthDay News) -- Flu-causing H1N1 virus has been discovered in marine animals -- specifically seals -- for the first time.

After the human H1N1 influenza pandemic began in 2009, researchers from the University of California, Davis, detected the virus in free-ranging northern elephant seals off the central California coastline.

"We thought we might find influenza viruses, which have been found before in marine mammals, but we did not expect to find pandemic H1N1," study lead author Tracey Goldstein, an associate professor with the university's One Health Institute and Wildlife Health Center, said in a university news release. "This shows influenza viruses can move among species."

The H1N1 virus originated in pigs, and the resulting infection was known as swine flu.

"The study of influenza virus infections in unusual hosts, such as elephant seals, is likely to provide us with clues to understand the ability of influenza virus to jump from one host to another and initiate pandemics," Adolfo Garcia-Sastre, director of the Global Health and Emerging Pathogens Institute at the Icahn School of Medicine at Mount Sinai, in New York City, said in the news release.

The new findings were published May 15 in the journal PLoS ONE.

In conducting the study, the researchers tested nasal swabs from more than 900 marine mammals from 10 different species off the Pacific Coast from Alaska to California between 2009 and 2011.

The H1N1 virus was identified in two northern elephant seals. Despite being infected with the virus, neither seal had any symptoms. Antibodies to the virus also were detected in 28 other elephant seals, suggesting exposure to the virus was widespread.

"H1N1 was circulating in humans in 2009," Goldstein said. "The seals on land in early 2010 tested negative before they went to sea, but when they returned from sea in spring 2010, they tested positive. So the question is: Where did it come from?"

The infected seals were tracked by satellite. The researchers said exposure to H1N1 likely occurred while the seals were at sea foraging in the northeast Pacific Ocean off the continental shelf.

Since marine animals could be infected with H1N1 without showing any signs that they are sick, the researchers said their findings are particularly important for people who work with or handle marine animals. Taking precautions, such as wearing gloves, when working with these animals can help prevent the spread of disease both to and from humans, Goldstein said.

Today, the World Health Organization reports that H1N1 is under control and behaves as a seasonal virus.

More information

Visit the U.S. Department of Health and Human Services to learn more about H1N1.

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WEDNESDAY, May 15 (HealthDay News) -- If you're a man, the pain-killing medications known as opioids may do more than relieve pain -- they may also put a damper on your sex life.

A new study found that men who were prescribed medications for erectile dysfunction or low testosterone levels were more likely to be taking opioid (narcotic) medications for chronic back pain.

"People who have persistent pain problems need to know that a potential side effect of long-term opioid use may be erectile dysfunction," said lead study author Dr. Richard Deyo, a clinical investigator for the Kaiser Permanente Center for Health Research in Portland, Ore. "This is not a well-known potential side effect among patients, and it should be considered when thinking about treatment."

Deyo also noted, however, that "the nature of this study as an observational study limits our ability to make a causal [cause-and-effect] inference. Opioid use and erectile dysfunction seem to go together, but we have to be cautious about saying one causes the other."

Results of the study were published in the May issue of the journal Spine.

More than 4 million people use opioids on a regular basis, Deyo said. Commonly prescribed opioids include hydrocodone, oxycodone and morphine. In this study, use of opioids was considered long-term if patients used them for more than 120 days, or more than 90 days if more than 10 prescriptions were filled for the drugs.

The study included data on about 11,000 men who had back pain. In that group, more than 900 received medications for erectile dysfunction or testosterone replacement. Those who were given prescriptions for erectile dysfunction medications or testosterone were older than those who didn't get such prescriptions. They also were more likely to have depression and other health conditions.

And those who were taking erectile dysfunction medications or testosterone tended to be smokers or users of sedative medications, according to the study.

Erectile dysfunction drug prescriptions were for sildenafil (Viagra), tadalafil (Cialis) and vardenafil (Levitra).

Age was the most significant factor in getting a prescription for erectile dysfunction, according to the study. Men between the ages of 60 and 69 were 14 times more likely to receive a prescription for an erectile dysfunction medication than men who were between 18 and 29.

After adjusting the data to account for other possible factors, including age, the researchers found that men who took opioid pain medications for long periods were about 50 percent more likely to take erectile dysfunction medications or testosterone replacement therapy.

Dr. Daniel Shoskes, a professor of urology at the Cleveland Clinic's Glickman Urological and Kidney Institute, said the study doesn't prove that the pain medications cause the erectile dysfunction.

"A direct association between long-term opioid use and [erectile dysfunction] has not been clearly defined," said Shoskes, who was not involved in the study. "The reason these men were having [erectile dysfunction] could be related to the pain or the things that are causing the pain. You can't conclude from this study that opioid use causes [erectile dysfunction]."

Study author Deyo said there's evidence that men who stop taking opioids after using them for a short time will see an improvement in erectile dysfunction, but he said it's not clear if the same is true after long-term use.

Deyo added that opioids can be effective for short-term use, but there's "growing evidence that long-term opioid use may not be effective for chronic pain. The body compensates for taking long-term pain medications, and changes in the brain and spinal cord may make people more sensitive over time."

Effective alternatives include a tailored exercise program and cognitive behavioral therapy designed to help reduce people's fear of pain, Deyo said.

Shoskes said other factors that contribute to erectile dysfunction include diabetes, heart disease, peripheral vascular disease and alcohol use. He said this study may prompt doctors who treat men with chronic pain to ask about erectile dysfunction, although he said it's not clear from this study whether the erectile medications were helpful for these men.

More information

Learn more about erectile dysfunction from the U.S. National Library of Medicine.

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THURSDAY, May 9 (HealthDay News) -- Half of pregnant teens in substance-abuse treatment programs used alcohol or drugs in the month before they entered treatment. And nearly 20 percent used drugs or alcohol on a daily basis during that month, according to a U.S. government report.

Among females aged 12 to 19 who weren't pregnant entering treatment, those rates were about 71 percent and 24 percent, respectively, the study from the U.S. Substance Abuse and Mental Health Services Administration (SAMHSA) found.

The most commonly used substance among female teens in these treatment programs was marijuana (73 percent of pregnant teens and 70 percent of other girls). But pregnant teens were twice as likely to use methamphetamines and amphetamines than other female teens -- about 17 percent versus 8 percent -- the investigators noted.

Pregnant teens account for about 4 percent of the 57,000 girls aged 12 to 19 admitted to substance-abuse treatment programs each year, according to the report. But because of their pregnancy, these girls face greater challenges in many important areas, including income and education.

The SAMHSA researchers reported that among the girls in the substance-abuse treatment programs, pregnant teens were three times more likely than other teen girls to rely on public assistance as their primary source of income (15 percent versus 5 percent, respectively). In addition, 74 percent of nonpregnant teen girls who were not in the workforce were students, compared with only 44 percent of pregnant teens.

"Pregnant teens entering treatment face difficult challenges, but the good news is that treatment is a very positive step in helping them regain their lives and generate new hope for themselves and their children," SAMHSA administrator Pamela Hyde said in an agency news release.

"Treatment programs and communities must work together to meet the specialized needs of pregnant women of all ages, such as referrals to prenatal care and parenting courses," she said. "Through this effort we can help ensure that these future mothers and their children live healthier, happier and more productive lives."

More information

The American Academy of Pediatrics says that drug-abuse prevention starts with parents.

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WEDNESDAY, May 8 (HealthDay News) -- Women who come down with the flu during pregnancy may be at increased risk of having a child who develops bipolar disorder, a new study suggests.

The chance of a child eventually developing the mental health disorder was nearly four times higher when comparing mothers-to-be who had the flu to those who didn't, the researchers reported.

"We don't fully understand this," said study co-author Dr. Alan Brown. "The best guess is it's an inflammatory response. It could also be a result of fever," he noted.

"Mothers should stay away from people who have the flu," said Brown, a professor of clinical psychiatry and clinical epidemiology at the Columbia University College of Physicians and Surgeons in New York City.

However, he added, regarding the new findings, "women should not be greatly concerned, because a fourfold increase is pretty high from an epidemiological standpoint, but still the vast majority of the offspring did not get bipolar disorder."

Brown explained that "the risk of bipolar disorder in the population is about 1 percent, so if it's increased fourfold that would make it a 4 percent risk." Moreover, the researchers only looked at one risk factor for bipolar disorder, not all risk factors, which could skew these results, he noted.

The report was published in the May 8 online edition of JAMA Psychiatry.

Bipolar disorder, also called manic-depressive illness, causes unusual shifts in mood, energy, activity levels and the ability to carry out routine tasks. Bipolar disorder can be treated, and people with this illness can lead full and productive lives, according to the U.S. National Institute of Mental Health.

The condition often develops in the late teens or early adult years. Some people have their first symptoms during childhood, while others may develop symptoms as adults, the agency noted.

For the study, researchers at Columbia University and Kaiser Permanente identified cases of bipolar disorder by database linkages of a Northern California health plan and a county health care system, along with data from a mailed survey.

Participants were mothers who gave birth between 1959 and 1966 and their offspring. Researchers found 92 cases of bipolar disorder and compared them with 722 people matched in terms of occurrence of maternal influenza during pregnancy.

While the new study found an association of pregnant women getting the flu and a higher risk of bipolar disorder in their offspring, it didn't establish a cause-and-effect relationship.

"There is no understanding of the causal factors of this," said Dr. Alan Manevitz, a clinical psychiatrist at Lenox Hill Hospital in New York City. He was not involved with the study.

"Pregnancy itself puts extra stress on women in general," he pointed out. "Pregnancy also affects the immune system and increases the risk of getting the flu."

Flu during pregnancy increases the risk of miscarriage, premature birth and low birth weight infants, Manevitz said.

Pregnant women should get a flu shot, both Manevitz and Brown suggested.

Other studies have shown a similar association between flu during pregnancy and the child's risk for autism and schizophrenia -- now there is this association with bipolar disorder, Manevitz said. "This doesn't give us any causal connection," he emphasized.

More information

To learn more about bipolar disorder, visit the U.S. National Institute of Mental Health.

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WEDNESDAY, May 8 (HealthDay News) -- A specialized kind of immune cell that patrols the skin of people infected with the herpes virus appears to prevent the outbreak of painful sores, a new study suggests.

Researchers think the cells may be key to developing a potential vaccine against genital herpes, which afflicts more than 24 million people in the United States, according to the U.S. Centers for Disease Control and Prevention.

For the study, published online May 8 in the journal Nature, researchers took skin samples from people infected with HSV-2, the virus that causes genital herpes, and followed them as they healed from recent outbreaks.

Working with a high-powered microscope, researchers used fluorescent stains to find and label different types of immune cells in the skin. They were most interested in cells called CD8 killer T-cells.

Unlike antibodies, which bind to bacteria and viruses, preventing them from infecting cells in the first place, CD8 cells are a second line of defense, said Bryan Cullen, director of the Center for Virology at Duke University, in Durham, N.C.

"They kill virus-infected cells as quickly as possible after they become infected," said Cullen, who also studies herpes infections but was not involved in the research. Killing infected cells prevents them from becoming factories that crank out more copies of the virus, he said.

Scientists once thought that all CD8 cells roamed the body, looking for infected cells through the bloodstream.

By watching the immune response as it unfolded in the skin, researchers realized that there were special CD8 cells that stayed in place, patrolling the area around nerve endings like beat cops. They guessed that the cells were waiting for the herpes virus to emerge and cause trouble.

To test that theory, they used very fine lasers to pluck out these specialized cells to see what kinds of proteins they were making.

In skin that had some shedding of the herpes virus, the specialized CD8 cells made a lot of perforin, a protein that penetrates membranes to kill cells. In skin with no active virus, the specialized CD8 cells didn't make any perforin, suggesting that the function of the cells is indeed to kill herpes-infected cells.

The specialized CD8 cells also made other proteins to summon backup cells to the site to help tamp down the attack. And they didn't seem to make chemical signals that sound the all-clear, a message to immune responders that it's time to leave the area, which may explain why they stick around in the skin.

"We actually showed they were a very unique population of cells," said study senior author Dr. Lawrence Corey, a virologist and president and director of the Fred Hutchinson Cancer Center in Seattle. "They can stay in the skin for extended periods of time, they appear to have memory, they appear to have the kind of markers that go in response to a specific infection."

He added that doctors once thought herpes, which lies dormant in nerve cells, would reawaken and travel up the nerve endings to the skin surface where it would cause painful sores, and that it would take a couple of days for the body to respond and fight off each new assault.

He said the new research shows that such outbreaks are the exception, rather than the rule. The specialized CD8 cells in the skin seem to do a pretty good job of keeping the virus under control.

"It seems to me that if we improve their job, and if we study them and ask the questions -- How do we give them more help? How do we make them live longer? How do we make them function better? How do we increase their number? -- we may be able to develop an effective herpes vaccine," Corey said.

A vaccine against herpes would be a significant achievement. Aside from abstinence, there's no surefire way to prevent herpes infections. Condoms can reduce the risk of transmission, although the virus can still be shed from skin areas that condoms don't cover.

Experts caution that although the new finding is promising, a vaccine is still likely to be a long way off.

"They have good correlative evidence" that the specialized CD8 cells in skin keep the virus at bay, Cullen said. He added, however, that the research doesn't prove that boosting these cells would prevent infections.

He said it will take many more studies to demonstrate that -- if, in fact, it's true.

"It's time to take it to the next level," Cullen said.

As for cold sores (or fever blisters) on the lips or around the mouth -- also caused by the herpes simplex virus -- the researchers said that although it seems logical that those same CD8 cells might be at work, they didn't analyze it in this study.

More information

To find out more about genital herpes, head to the U.S. Centers for Disease Control and Prevention.

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WEDNESDAY, May 8 (HealthDay News) -- Some diseases are especially tough to discuss.

When Tony Lee realized that his penis was curving whenever he had an erection -- making it painful and difficult for him to have sex -- he had no idea what was wrong. He became depressed and very worried, and his relationship with his wife started to change.

"For a man to dread sex, it's just not natural," he said. "There were times when I would stay up late on purpose, just to make sure my wife was sleeping before I got into bed. I was just totally embarrassed."

His wife finally convinced him to see his primary care physician, who referred him to a urologist. The specialist told him he had Peyronie's disease, a connective tissue disorder involving the growth of fibrous collagen plaques in the soft tissue of the penis. The condition can cause pain, erectile dysfunction and shortening of the penis.

The diagnosis was difficult to face.

"You do freak out. It's such a personal area. It's like, 'Noooooo! Why couldn't I just lose a finger? Anything but this,'" said Lee, who is 46. Lee asked that his full name not be used.

Experts estimate Peyronie's disease, a connective tissue disorder, affects at least 5 percent of men. Although the cause of the disorder is not known, physicians think genetic predisposition and repetitive minor trauma to the penis during sexual activity may play a role. People with diabetes, and those who have had prostate cancer surgery or erectile dysfunction, are also susceptible to the disease, according to Dr. Larry Lipshultz, a professor of urology at Baylor College of Medicine.

The treatment options are very limited, and there is no cure. "There is no oral or topical medication," said Dr. Elizabeth Kavaler, a urologist at Lenox Hill Hospital, in New York City. "You can excise the plaque and tighten up the other side, but that reduces the length, or you can use a penile prosthesis."

Lipshultz said he's had some luck with about half of his patients when he gives them a drug called verapamil, a calcium channel blocker, which is injected into the shaft of the penis. The use of the drug is based on its ability to degrade collagen, slowing, preventing or even reversing plaque formation and the progression of Peyronie's disease, according to a 2002 study published in the International Journal of Impotence Research. A verapamil gel that is applied to the skin is also sometimes used, according to Kavaler.

Lee, who has been dealing with Peyronie's for about two years, has used a "straightening machine" that stretches the penis, and he participated in one of two clinical trials for a new drug that is up for review by the U.S. Food and Drug Administration: Xiaflex, produced by Auxilium Pharmaceuticals Inc. He said his penis is now 70 percent of its pre-disease length as a result of the interventions.

Xiaflex, which breaks down the scar tissue that is a component of penile plaque, was approved by the FDA in 2010 to treat Dupuytren's contracture, an inherited connective tissue disorder that causes the fingers to bend toward the palm. The concept of using Xiaflex with Peyronie's is based on some common features of both diseases. The hand condition is caused by an abnormal buildup of a substance called collagen. Fingers begin to bend toward the palm and the patient cannot straighten them.

The two clinical trials designed to test how Xiaflex worked in people with Peyronie's disease -- done in 2011 and 2012 -- together involved a total of 551 patients who received Xiaflex and 281 who were given a placebo. Each participant received four to six injections with a small needle into the penis every 25 to 72 hours over a period of several weeks. "The results showed people got a 30 percent improvement in curvature, which is clinically significant in terms of function," Lipshultz said

Recent data on the treatment appeared online in February and will be published in the July print issue of the Journal of Urology.

Lipshultz, who was involved in the clinical trials and is paid by Auxilium to speak to physicians about the treatment, said the company thinks Xiaflex will be approved by the FDA by mid-September.

Yet, Kavaler expressed concerns about whether Xiaflex will be helpful.

"The data show it looks like the drug made people feel better about their condition, maybe because they were getting treatment in the clinical trial, but I'm not sure if functionally it made a big difference," she said. "I don't think I could convince somebody to let me inject their penis four to six times with the hope of getting some small improvement."

Side effects from the injection of the drug included: bruising, swelling and pain. There were also three serious adverse events involving penile fracture and three hematomas, according to Auxilium Pharmaceuticals.

But Lee is hopeful.

"I was so far gone with this, the curvature was so bad, and so I feel a whole lot better about myself now," he said. "It's kind of like if a person was paralyzed, and then all of a sudden you can walk, even though you might need assistance, it's a wonderful thing. That's how I'm looking at it."

Lee encouraged people to involve their partners to help them deal with the disease. "If there is a significant other in your life, you guys need to come together with this. For me, that made all the difference."

More information

Learn more about Peyronie's disease from the U.S. National Library of Medicine.

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WEDNESDAY, May 8 (HealthDay News) -- Among women who undergo in vitro fertilization (IVF) to become pregnant, there is no difference in delivery rates among those implanted with one prescreened embryo compared to those implanted with two unscreened embryos, new study findings reveal.

Although transferring two unscreened embryos is currently a more standard procedure, transferring a single chromosomally normal embryo results in fewer twins and better outcomes for both women and their babies, the researchers pointed out in a news release from the American College of Obstetricians and Gynecologists.

"The technology exists today to make single-embryo transfer the standard of care across age groups, eliminating the vast majority of complications stemming from IVF, while maintaining excellent delivery rates for couples who have struggled with infertility," study lead researcher Dr. Eric Forman, of UMDNJ-Robert Wood Johnson Medical School/Reproductive Medicine Associates of New Jersey in Basking Ridge, said in the news release.

The study involved 175 women aged 43 or younger. The women were assigned to receive one genetically prescreened embryo or undergo a double-embryo transfer with no screening. The study showed the two groups had equal pregnancy rates. The researchers noted, however, that no twins resulted from the single-embryo transfer.

Meanwhile, 53 percent of the double-embryo transfers were multiples. Infertility treatments, such as IVF, generate 18 percent of all twin deliveries in the United States, the study authors added.

The research also revealed that transferring one prescreened embryo resulted in a longer gestation, on average. But double-embryo transfers were associated with a threefold increased risk of preterm delivery, the findings showed.

The single-embryo transfers were also associated with greater newborn birth weight, as well as fewer admissions and shorter stays in the neonatal intensive care unit.

The researchers pointed out that most women choose to have two embryos transferred because they may feel it increases the likelihood that they will become pregnant. Medical costs may also play a role because IVF is not always covered by insurance.

Now, only 10 percent of women opt for a single-embryo transfer. However, as more women learn about the success rates of single-embryo transfer, it may become a more popular option, Forman noted.

"[Single-embryo transfer] with comprehensive chromosome screening has the potential to be paradigm-shifting and revolutionary in the world of IVF," Forman suggested in the news release.

"Patients can do [single-embryo transfer] and maintain excellent delivery rates while not taking on the treatment-related risk of multiples. And for [obstetrician-gynecologists], this will mean fewer high-risk pregnancies handed off to them. It can reduce the health care burden across the spectrum," Forman said.

The study authors noted that the genetic screening used in the study is not yet widely available in the United States. They said this will likely change in the near future.

The study was scheduled for presentation Wednesday at the annual meeting of the American College of Obstetricians and Gynecologists in New Orleans. Research presented at medical meeting should be viewed as preliminary until published in a peer-reviewed journal.

More information

The U.S. Department of Health and Human Services has more about IVF.

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TUESDAY, May 7 (HealthDay News) -- Vitamin C may help prevent lung problems in babies born to mothers who smoke during pregnancy, according to a small new study.

Pregnant women are advised not to smoke because it can harm the baby's lungs and lead to problems such as wheezing and asthma. But if a pregnant woman can't quit smoking, taking vitamin C may help protect their baby's lungs, researchers found.

The study included 159 women who were less than 22 weeks pregnant and unable to quit smoking. They were randomly assigned to take either one 500-milligram capsule of vitamin C or a placebo each day for the remainder of their pregnancy.

Forty-eight hours after birth, babies born to women who took vitamin C had significantly better lung function than those whose mothers took the placebo. During their first year, wheezing was reported in 21 percent of infants whose mothers took vitamin C and in 40 percent of infants whose mothers took the placebo. The rate among infants born to nonsmokers was 27 percent.

The researchers also found that 22 percent of infants in the placebo group needed medication for wheezing, compared with 13 percent of those in the vitamin C group and 10 percent of those in the nonsmoking group.

The study was presented this week at the Pediatric Academic Societies' annual meeting in Washington, D.C.

"Vitamin C is a simple, safe and inexpensive treatment that may decrease the impact of smoking during pregnancy on childhood respiratory health," lead author Dr. Cynthia McEvoy, an associate professor of pediatrics at Oregon Health & Science University Children's Hospital, said in an American Academy of Pediatrics news release.

Because this study was presented at a medical meeting, the data and conclusions should be viewed as preliminary until published in a peer-reviewed journal. And although the study showed an association between vitamin C use and better lung function in infants, it did not prove a cause-and-effect link.

"Getting women to quit smoking during pregnancy has to be priority one, but this finding provides a way to potentially help the infants born of the roughly 50 percent of pregnant smokers who won't or can't quit smoking no matter what is tried," study co-author Dr. Eliot Spindel, a senior scientist at the Oregon National Primate Research Center at Oregon Health & Science University, said in the news release.

More information

The March of Dimes has more about the dangers of smoking during pregnancy.

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TUESDAY, May 7 (HealthDay News) -- If you're a man suffering from low energy or libido, the drug industry is eager to help. So-called "Low T" -- low testosterone -- has become a common catch phrase in TV commercials, and sales of testosterone supplements are on the rise in the United States.

But a new study suggests that many clinics aren't disclosing the risks of testosterone treatment on their websites.

Researchers found that fewer than a third of 70 clinic websites mentioned the side effects of testosterone, although almost all touted potential benefits of treatment like improved sex drive and greater energy. Twenty-one percent, meanwhile, incorrectly denied that hormone treatment is linked to significant side effects.

Study co-author Dr. Kevin McVary, chairman of urology at Southern Illinois University School of Medicine, criticized the clinics that failed to be open about the risks of testosterone treatment. "It's unprofessional, and it reeks of snake oil," he said. "People should beware of using the Internet for medical advice regarding testosterone."

Testosterone, which is mainly produced in the testicles, is considered the male hormone (although it does occur in smaller quantities in women). Testosterone levels dip as men grow older. According to the Urology Care Foundation, researchers have found that about 20 percent of men over the age of 60 have low testosterone, which can lead to low libido, weak erections and fatigue.

Testosterone supplements are now available in a variety of forms, including injections, patches and gels that patients rub into the skin. The cost can run from $75 to $300 a month, said Dr. John Amory, a professor of medicine at the University of Washington in Seattle.

While testosterone treatment can indeed be beneficial, the side effects can include lower levels of healthy HDL cholesterol, increased male pattern baldness and possible harm to prostate health, Amory said.

Oral testosterone can lead to liver problems, study co-author McVary said, and testosterone overuse -- such as by some bodybuilders -- can lead to rage, acne, congestive heart failure and worsening of urinary symptoms.

In the new study, the researchers looked at the websites of 70 providers of testosterone supplements in Chicago, Houston, Los Angeles, New York City and Philadelphia. One-third were run by people who weren't physicians.

Only 27 percent described side effects of testosterone supplements, while 95 percent touted benefits. About a third of the sites run by urologists or endocrinologists described male breast growth as a potential risk. Seven percent of all the sites, however, denied breast growth as a potential side effect.

Amory said the new research appears to be valid and reflects "my impression of the way in which this [testosterone] is being oversold to patients."

McVary and Amory said they don't know if the clinics are acting legally when they omit information about testosterone risks. However, the U.S. Food and Drug Administration requires drug companies to describe the risks of prescription medications in their ads.

What to do? When it comes to medical information on the Internet, McVary said, "only go to legitimate sites that are sponsored by a medical organization that is known to you."

The findings were scheduled to be released Tuesday at the American Urological Association annual meeting in San Diego. The data and conclusions should be viewed as preliminary until published in a peer-reviewed journal.

More information

For more about testosterone, try the U.S. National Library of Medicine.

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TUESDAY, May 7 (HealthDay News) -- Women who use synthetic marijuana during pregnancy can develop symptoms similar to those associated with eclampsia and preeclampsia, according to a new study.

Although women with these serious prenatal conditions get better after delivery, researchers in California pointed out that pregnant women with a drug problem do not.

Synthetic marijuana, also known as "Spice Gold," is similar to marijuana, except the easily accessible drug can't be detected with a standard urine drug test. The researchers also cautioned that the effects of this unregulated drug, which is sold legally on the Internet and in herbal stores, are unpredictable.

Dr. Cindy Lee and Dr. Sally Nalesnik, from Kern Medical Center in Bakersfield, Calif., conducted research involving the case of a pregnant woman who suffered a seizure and appeared agitated. The woman, who told doctors she was about 35 weeks pregnant, had no prenatal care. She also had high blood pressure and protein in her urine, so she was treated for eclampsia. Since the baby was in distress and the only cure for this potentially fatal condition is delivery, doctors performed an emergency cesarean section.

The researchers noted that the baby girl, who was born at 28 weeks gestation, screened negative for drugs. The day after delivery, however, the woman had not recovered and needed psychiatric intervention for psychotic behavior.

"This was an interesting yet confusing presentation," Lee said in a news release. "We wanted to report it so in the future if something similar came up, it would be in the literature and physicians could refer to it."

Additional lab work revealed that the woman, who screened negative for drugs, had very low potassium levels. An anonymous caller, however, informed her doctors that the woman regularly smoked Spice Gold.

"This was not a pregnancy problem but a drug problem," Lee said. "Eclampsia is cured with delivery of the baby, but she did not get better after delivery."

The researchers concluded that obstetricians and gynecologists need to be aware of emerging drugs and consider them when making diagnoses. "I've been surprised when people tell me what they're on," Lee said. "If a patient tells me she's on X, Y or Z, I'll believe it. If she tells me she's not on X, Y or Z, then I know that may not be true."

The study was to be presented Tuesday at the annual meeting of the American College of Obstetricians and Gynecologists in New Orleans. Research presented at medical meetings should be viewed as preliminary until published in a peer-reviewed journal.

More information

The U.S. National Institute on Drug Abuse provides more information on synthetic marijuana.

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MONDAY, May 6 (HealthDay News) -- Pregnant women who struggle with migraine headaches should never use medicines containing the ingredient valproate because they can lower the IQ scores of their children, the U.S. Food and Drug Administration said Monday.

The new warning will be included on the labels of medicines that contain valproate. These medicines already carry a boxed warning about fetal risk, including birth defects. Valproate products include valproate sodium (Depacon); divalproex sodium (Depakote, Depakote CP, and Depakote ER); valproic acid (Depakene and Stavzor); and their generic versions.

"Valproate medications should never be used in pregnant women for the prevention of migraine headaches because we have even more data now that show the risks to the children outweigh any treatment benefits for this use," Dr. Russell Katz, director of the division of neurology products in the FDA's Center for Drug Evaluation and Research, said in an agency news release.

Valproate medicines have several FDA-approved uses including: prevention of migraines, treatment of epileptic seizures and treatment of bipolar disorder.

This new warning was issued after a study found that children whose mothers took valproate drugs to protect against epilepsy during pregnancy scored eight to 11 points lower on IQ tests at age 6 than children who were exposed to other antiepileptic drugs in the womb.

It's not known if there's a specific time during pregnancy when valproate can result in decreased IQ in children. The women in the study took the antiepileptic valproate drugs throughout their pregnancies, the FDA said.

Valproate may have some value in treating bipolar disorder and epileptic seizures in pregnant women, but should only be taken if other medications have failed to control the symptoms or are otherwise unacceptable, according to the agency.

The FDA also said that:

• Women who can become pregnant should not use valproate unless it is essential to managing their medical condition.
• Women of childbearing age taking valproate products should use effective birth control.
• Women who are pregnant or who become pregnant while taking valproate medications should talk to their health-care professional immediately. Women should not stop taking their medication without talking to their health-care professional because stopping treatment suddenly can cause serious and life-threatening medical problems for the woman or the fetus.

More information

The Nemours Foundation outlines pregnancy hazards.

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MONDAY, May 6 (HealthDay News) -- Hoping to curb elective Cesarean births and labor inductions, two-thirds of U.S. hospitals have implemented policies to eliminate medically unnecessary pre-term births, a new study reports.

Pre-term deliveries (before 39 weeks' gestation) carry an increased risk of neonatal respiratory distress and admission to neonatal intensive care units (NICU), researchers from the University of Pennsylvania Perelman School of Medicine said.

For the study, the researchers questioned nearly 2,400 hospitals about their policies on early deliveries that weren't necessary for medical reasons.

They found that 66.5 percent of the hospitals had a formal policy against the practice, and more than two-thirds of these hospitals had a "hard-stop" policy, or a strictly enforced rule, against elective deliveries before 39 weeks of gestation.

"There is reason to be encouraged that hospital policies are decreasing the frequency of this practice, and we expect that fewer elective deliveries prior to 39 weeks means fewer term babies going to the NICU," study leader Dr. Nathaniel DeNicola said in a news release from the American College of Obstetricians and Gynecologists.

Another one-third of hospitals had no policy on such deliveries, but 53 percent of those hospitals said medically unnecessary deliveries before 39 weeks were against their standard of care.

State initiatives to help inform the public about the risks associated with elective early deliveries have been effective in encouraging hospitals to adopt formal policies against these pre-term deliveries, the study authors added.

"We had a number of hospitals volunteer that they were following the state initiative," DeNicola said.

The findings are scheduled for presentation Monday at the annual clinical meeting of the American College of Obstetricians and Gynecologists in New Orleans.

A separate study conducted by researchers from Baystate Medical Center in Springfield, Mass., showed that by restricting elective deliveries, hospitals can reduce the number of Cesarean births. These policies also can cut the amount of time between when a woman is admitted to the hospital and when she delivers her baby.

"What we used to see here were some providers performing elective inductions in patients, many of whom were fewer than 39 weeks of gestation, with unfavorable cervices," said study leader Dr. Andrew Healy. These inductions could take two or three days, and often ended in a Cesarean delivery, he said.

"We don't see that anymore since implementing a policy restricting elective labor induction, which is terrific," he said. "The mothers are more likely to be able to take their baby home with them and, having had a vaginal birth, are less uncomfortable and better able to care for their child."

For this study, which also will be presented at the American College of Obstetricians and Gynecologists meeting, Healy's team analyzed records of more than 9,500 single births at Baystate before it implemented a policy that set restrictions on labor inductions. The researchers also examined more than 2,600 single births that occurred after the policy was established.

Specifically, the researchers considered time from admission to delivery, Cesarean rates, NICU admission rates and stillbirths.

Average time from hospital admission to delivery for elective inductions decreased by six hours -- from 17 hours to 11 -- after the policy was implemented, the study found. The Cesarean delivery rate for women who underwent elective inductions dropped from 16 percent to 7 percent after the policy was put into place, and the policy resulted in a 33 percent reduction in the admission of term babies to the NICU.

Data and conclusions presented at medical meetings should be considered preliminary until published in a peer-reviewed journal.

More information

The Agency for Healthcare Research and Quality provides more information on elective induction of labor.

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MONDAY, May 6 (HealthDay News) -- Never mind the commercials with men talking freely to their doctor about their erectile dysfunction, taking a prescription for treatment to the pharmacy and settling in for a romantic evening.

Despite a wide range of treatment options, most men with erectile dysfunction (ED) don't get treated, according to a new study.

"ED treatments, overall, are underutilized," said Dr. Brian Helfand, an assistant clinical professor of urology at Northshore University Health System and the University of Chicago. "Only 25 percent of men are actually treated."

Helfand led the study, which looked at the medical records of more than 6 million men with an ED diagnosis. He is due to present his findings Monday at the American Urological Association annual meeting, in San Diego.

The study was funded by the Havana Day Dreamers Foundation (which promotes men's health), the Goldstein Fund in Male Pelvic Health and the SIU Urology Endowment Fund.

Helfand used an insurance claims database and looked for the medical code for erectile dysfunction from June 2010 through July 2011. He found 6.2 million men aged 30 and older who received a diagnosis of erectile dysfunction. ED is defined as an inability to maintain an erection satisfactory for sexual performance.

He then looked to see how many filled a prescription. Patients were considered treated if they filled a prescription for an erectile dysfunction drug such as Viagra (sildenafil) or Cialis (tadalafil), drugs called prostaglandins that are given by injection or urethral suppositories, or androgen (hormone) replacement.

He considered them untreated if they received a diagnosis of erectile dysfunction but did not fill a prescription.

He took into account, too, the men's ages and other health problems.

Even though erectile dysfunction is likely to become more common with age, he actually found older men the least likely to be treated. Only about 18 percent of men aged 65 and above were treated.

When Helfand looked to see what bearing other health conditions might have had on treatment, he found those with prostate cancer were least likely to be treated. Only 15 percent were.

The study didn't have information on why the men went untreated, he said. But he speculates there are probably several reasons.

The undertreatment, Helfand said, is probably a result of doctors often not offering the prescription or patients getting a prescription but not filling it at the pharmacy.

"Men may not be bothered by it," he said. Or a doctor may not write a prescription because he may not think the man is a candidate, or perhaps they didn't respond to erectile dysfunction treatment in the past.

Other reasons, he said, could include costs and embarrassment.

For men, Helfand said, the message is: "There are available therapies out there. These can be useful if you have ED."

An expert who reviewed the study but was not involved said he isn't sure if it mirrors real life.

"To conclude from this study that three-fourths of the men who carry a diagnosis of ED are not treated doesn't fit with what we see in clinical practice," said Dr. Jacob Rajfer, a professor of urology with the David Geffen School of Medicine, at the University of California, Los Angeles.

"In order to determine how many men were treated or not treated, you need to interview the people," Rajfer said.

Men might get to the pharmacy, see the cost of the erectile dysfunction drug, and decide to go out of the country to get it and save money, or might get it by mail order, Rajfer said.

Another expert discussed possible barriers to men getting these drugs.

"Cost might be a big issue," said Dr. Ajay Nangia, an associate professor of urology at the University of Kansas Medical Center. He is familiar with the study findings.

Costs vary, but some erectile dysfunction drugs are about $4 a pill.

"It's becoming much more open to talk about this stuff," Nangia said. Even so, some men may still be embarrassed.

In an effort to combat sales of counterfeit Viagra online, drugmaker Pfizer will sell the drug directly to patients with prescriptions via its website, the Associated Press reported Monday.

Because the new study was presented at a medical meeting, the data and conclusions should be viewed as preliminary until published in a peer-reviewed journal.

More information

To learn more about erectile dysfunction, visit the American Urological Association.

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MONDAY, May 6 (HealthDay News) -- Exposure to flame-retardant chemicals in the womb is associated with hyperactivity and lower intelligence in children, a new study indicates.

Researchers examined the effects of polybrominated diphenyl ethers (PBDEs), which were used for decades as fire retardants in common products such as carpeting, baby strollers and electronics.

"In animal studies, PBDEs can disrupt thyroid hormone and cause hyperactivity and learning problems. Our study adds to several other human studies to highlight the need to reduce exposure to PBDEs in pregnant women," study author Dr. Aimin Chen, an assistant professor in the department of environmental health at the University of Cincinnati College of Medicine, said in an American Academy of Pediatrics news release.

The researchers looked at PBDE levels in blood samples from 309 pregnant women and then performed intelligence and behavior tests on the women's children each year until they were 5.

They found that PBDE exposure in the womb was associated with hyperactivity at ages 2 to 5, and with lower intelligence at age 5. A tenfold increase in PBDE exposure during pregnancy was related to about a four-point IQ deficit in 5-year-old children.

While the study tied PBDE exposure during pregnancy to later hyperactivity and lower intelligence, it did not prove a cause-and-effect relationship.

The study was to be presented Monday at the Pediatric Academic Societies annual meeting in Washington, D.C.

PBDEs were mostly withdrawn from the U.S. market in 2004, but they are present in many consumer products bought several years ago and still widely used by Americans, according to the news release. In addition, PBDEs remain in human tissue for a long time and a pregnant woman can transfer them to her fetus.

"Because PBDEs exist in the home and office environment as they are contained in old furniture, carpet pads, foams and electronics, the study raises further concern about their toxicity in developing children," Chen concluded.

Research presented at medical meetings should be viewed as preliminary until published in a peer-reviewed journal.

More information

The U.S. Environmental Protection Agency has more about PBDEs and children's health.

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