Headlines (Scroll down for complete stories):
1. Daily Ibuprofen May Raise Heart Risks for Elderly
2. Pregnancy Mood Affects Child Development
3. Heated Car Seats Lower Sperm Rates
4. Free Drug Samples Costly for Uninsured
5. Keep Ankles and Wrists Safe at the Gym
1. Daily Ibuprofen May Raise Heart Risks for Elderly
Ibuprofen may raise the risk of heart attacks and other fatal and serious problems when elderly people take it daily for arthritis, U.S. researchers reported on Wednesday.
They said the popular over-the-counter pain reliever was the only drug in the class that includes aspirin and other analgesics to raise the risk of serious heart disease — along with the now-withdrawn COX-2 inhibitor Vioxx.
Merck and Co. Inc pulled Vioxx, known generically as rofecoxib, off the market in 2004 because studies showed it raised the risk of heart attack and stroke.
The U.S. Food and Drug Administration now mandates a black-box warning on all COX-2 inhibitors and nonsteroidal anti-inflammatory drugs, or NSAIDs, which include aspirin, ibuprofen, naproxen and other over-the-counter pain relievers.
Dr. Daniel Solomon of Brigham and Women's Hospital in Boston and colleagues said their findings showed most of these drugs are safe.
"Our findings suggest that rofecoxib and ibuprofen are the only agents consistently associated with an increased risk for cardiovascular disease events among specific patient subgroups," Solomon said in a statement.
"The fact that we did not observe a similar concentration in risk among subgroups of patients using many of the other agents may be of even greater relevance. These results should bolster physicians' and patients' confidence," he added.
The mean age of the patients, nearly all white women, was 80.
Vioxx users had the highest rates of heart attack, congestive heart failure and stroke, and naproxen users had the lowest, they found.
Among patients who had survived at least one heart attack, Vioxx users had 9.4 more serious heart events per 100 people per year, and ibuprofen users 11.4 more such events, compared to nonusers.
Solomon said the findings may apply only to elderly white women but they can help doctors and patients choose which drugs to take.
Copyright Reuters
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2. Heated Car Seats Lower Sperm Rates
Men who enjoy warming their bottom on a heated car seat should beware, for they may also be frying their chances of fatherhood, New Scientist reports in its latest issue.
Sperm production is best when the temperature of the scrotum is one or two degrees Celsius (1.8-3.6 degrees Fahrenheit) below the core body temperature of 37 C (99 F).
Testicle-testing German researchers fitted sensors to the scrotums of 30 healthy men who then sat on a heated car seat for 90 minutes.
After one hour, the average scrotal temperature had risen to 37.3 C (99.5 F), and in one volunteer reached a whopping 39.7 C (103 F).
By comparison, men who sat on unheated car seats reached an average scrotal temperature of only 36.7 C (98 F).
The study, led by Andreas Jung at the University of Giessen, did not verify the volunteer's sperm count or sperm mobility, but the researchers fear that only a slight increase in temperature is enough to damage the sperm-production process, the British weekly says.
Previous work in this field has already found that sitting in a car for more than three hours, even on an unheated seat, can impair a man's ability to conceive.
Copyright APF
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3. Free Drug Samples Costly for Uninsured
Free drug samples provided to physicians by pharmaceutical companies could actually be costing uninsured patients more in the long run, according to a study done by researchers at Wake Forest University Baptist Medical Center and colleagues.
The retrospective study looked at the prescribing habits of more than 70 physicians in a university-affiliated internal medicine practice in the months immediately before and after the closing of their drug sample closet. The results indicate that the availability of free samples from pharmaceutical companies greatly impacts whether an uninsured patient is given a prescription for a generic or a brand-name drug. The complete findings can be found in the September issue of Southern Medical Journal.
"It's true that samples can save patients money in the short-run," said David P. Miller, M.D., lead researcher and internal medicine physician at Wake Forest Baptist. "But our study shows that they may end up paying more in the long run when they are given prescriptions for brand-name only drugs."
Drug samples are available only for brand name drugs, which are often newer, more heavily advertised and almost always much more expensive than generic drugs in the same class.
"The theory is that drug companies hand out samples because it gets physicians in the habit of using a drug and physicians, therefore, are more likely to prescribe that drug later," Miller said.
Many times, initially, a patient will be given a sample of a drug to test tolerability and effectiveness. Often times, when a physician gives a patient a sample, it is accompanied with a prescription to fill after the sample is gone. Sometimes free samples are used by physicians to help patients who cannot afford medications. But the availability of drug samples is not always predictable and, when patients return for refills and the samples they need are missing from a practice, either because the drug representative didn't leave enough or stopped distributing them altogether, patients who were started on brand name drugs in sample form are left paying the price when they have to fill a prescription.
"Physicians and medical organizations need to ask themselves if samples are doing more harm than good," Miller added. "While doctors might intend to help someone by handing them a free sample, in the long run, it could cost them more. And removing samples from a practice can help doctors focus on which medication is best for a patient, rather than which medication happens to be available for free. Patients who want to save money should ask their doctor if an effective generic medication is available for their condition instead of taking a sample. In the long run, the generic prescription will probably save them more."
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4. Keep Ankles and Wrists Safe at the Gym
Going to the health club might seem the simplest of acts: You show up, do your workout - whether it's lifting weights, taking a class or playing a game of racquetball — and then you're done.
But avid gym-goers can be setting themselves up for injury, says Kevin Plancher, MD, a leading sports orthopedist in the New York metropolitan area. And wrist and ankle injuries — both the sudden and the chronic kind — can be especially problematic.
Here are six ways to keep your wrists and ankles safe at the gym.
• Choose the right shoes. "If you participate in an activity more than three times a week, you should be wearing shoes specifically designed for that activity," Plancher says. This can do a lot to protect your ankles, he says. "Lots of people wear running shoes to the gym, but running shoes are designed for just that," explains Plancher. "They put your foot and leg into the best position to propel you forward." That means wearing running shoes when you're playing a sport that incorporates lots of side-to- side movements, like tennis, basketball or squash, could leave you with a sprained or even broken ankle. Shoes designed for cross-training would be more appropriate in these situations.
• Reduce overuse. Believe it or not, carpal tunnel syndrome is not just for desk jockeys. "Anyone who subjects his or her hands and wrists to repetitive movements can get carpal tunnel syndrome," Plancher says. "It's fairly common among people who play racquet sports, as well as people who regularly work out on rowing machines and stationary bikes." The first sign is often a burning or tingling feeling or the sensation that your hands or fingers are "falling asleep." Over time, carpal tunnel syndrome can result in permanent nerve damage.
Ankles are subject to their own type of repetitive stress injury: Tarsal tunnel syndrome, which is generally caused by ill-fitting shoes that irritate and inflame the ligaments running from the foot to the ankle.
• Watch your form. If you like to lift, be sure you're doing it perfectly, says Plancher. "Weightlifters experience high compression forces on their wrists, and that force can cause sprains and other injuries."
• If the bike fits: Cyclists are prone to a condition called "handlebar" or cyclist's palsy. When you lean your hands on the handlebars and bend your wrists backwards, the pressure can compress the ulnar nerve, which runs through the palm and up into the wrist. Like carpal tunnel syndrome, cyclist's palsy can be a serious condition, resulting in permanent nerve damage if not treated properly.
The answer: Make sure that your bike is fitted properly. Invest in padded cycling gloves, switch hand positions during your ride, and periodically shake out your hands and stretch your forearms.
• Stretch — and strengthen. To protect your wrists, take the time to stretch the muscles in your forearms and hands before working out, and take frequent "stretching breaks" during your workout, Plancher advises.
• Don't tough it out. "Many athletes feel they should 'work through the pain,'" Plancher says, "and that might be good advice if your 'pain' is plain old muscle fatigue. But it's absolutely the worst thing you can do with a joint injury." A better rule, says Plancher: "Don't do any activity that hurts, and don't return to an activity until you're pain-free."
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5. Pregnancy Mood Affects Child Development
Some of the harmful effects on early child development attributed to postpartum depression may be caused in part by depression during pregnancy, a UK study shows for the first time.
Maternal depression during pregnancy "has a negative impact on children's cognitive development, even when postnatal (after delivery) depression has been taken into account," Dr. Toity Deave told Reuters Health.
"It is widely acknowledged that postnatal depression has a negative impact on child development but this is the first study that has demonstrated that the children of women who experience low mood during pregnancy are also at risk," said Deave, from the Centre for Child and Adolescent Health, University of the West of England, Bristol.
The findings come from a long-term study of 9,244 women and their children. A total of 1,565 women, or 14 percent, suffered from depression while pregnant but not after 2 months following delivery, Dave and colleagues report in the medical journal BJOG.
Standard developmental screening tests in the children showed that 893, or 9 percent, were developmentally delayed at age 18 months. A developmental delay is any significant lag in a child's physical, cognitive, behavioral, emotional, or social development, in comparison with established normal ranges for his or her age.
Deave and colleagues found that persistent depression in the mother during pregnancy increased the odds of developmental delay in the son or daughter by 50 percent.
After factoring in the effects of depression early after delivery, the researchers say they found evidence of an "independent and statistically significant" 34 percent increase in the odds of developmental delay in children of mothers who were depressed while pregnant.
This study, they say, adds to "increasing evidence that the mother's mood during pregnancy is important" and that any persistent depression during pregnancy has the potential to raise the risk for developmental delay in childhood.
"For the women who might be worried reading this, I would recommend that, if they do feel depressed or experience a low mood that is unusual for them, they go and see a health professional," Deave suggested.
"I would like to reassure parents," Deave added, "that there is a lot that they themselves can do to promote their child's development even if there is depression in the family. This can be through close parent-child interactions and, for example, stimulating and fun play."
SOURCE: BJOG: An International Journal of Obstetrics and Gynaecology, July 2008. Copyright Reuters
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