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Int’l. Society for Sexual Medicine (ISSM) Details New Definition of Premature Ejaculation

Sexual HealthJun 20 08

Dr. Ira Sharlip, President of the International Society for Sexual Medicine (ISSM) detailed a new definition of premature ejaculation. He addressed the audience of the American Urological Association during the ‘late breaking science forum’, a session designed by AUA to premier newsworthy developments in clinical urology.

The ISSM convened a panel of world experts who met in Amsterdam in the fall of 2007. Each of the 21 members of the panel was selected through a peer review process for their expertise in ejaculatory physiology, pharmacology and dysfunction. The panelists were tasked with creating a new definition of premature ejaculation (PE) based on currently available clinical evidence. Definitions of PE have previously been based on group consensus and not meeting new standards for evidence-based medicine. These definitions of PE include the Diagnostic and Statistical Manual of Mental Disorders (DSM-IV, 2002) and the AUA definition of (2005).

PE affects 20-30% of men. Although less commonly reported than erectile dysfunction, PE may co-exist in a third of men complaining of ED. (Lauman EO, JAMA 1999;281:537-544.) The etiology of PE is multifactorial with both biologic and psychologic factors.

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Weight loss can spur bone loss, even with exercise

Weight LossJun 19 08

Obese older adults who shed pounds also tend to lose bone mass, even if they exercise regularly, a new study suggests.

It’s known that weight loss, in young and old alike, can be accompanied by a dip in bone density, but researchers have hoped that this could be prevented with exercise, which generally helps build bone mass.

In the new study, however, obese older adults who lost weight through diet and exercise showed a decline in bone mass at the hip—despite a supervised regimen of aerobic and strengthening exercises.

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Many diabetic Latinas lack nutrition knowledge

DiabetesJun 19 08

One-third of Latin American women with type 2 diabetes living in Connecticut have not seen a registered dietitian or diabetes educator for help with healthy eating, new research indicates.

Even among the women who had gotten professional help, nutrition knowledge was limited, Dr. Nargul Fitzgerald of Rutgers, The State University of New Jersey, in New Brunswick and her colleagues found.

The research “highlights a really dire need,” Fitzgerald told Reuters Health, pointing out that poorly managed diabetes can have severe health consequences including heart attacks and strokes. “We don’t have enough services, we don’t have enough certified diabetes educators or nutritionists who can speak the language or who are culturally competent enough to work with Latinos.”

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Vitamin D helps colorectal cancer patients: study

Cancer • • Colorectal cancerJun 19 08

Vitamin D may extend the lives of people with colon and rectal cancer, according to a study published on Wednesday, suggesting another health benefit from the so-called sunshine vitamin.

Previous research has indicated that people with higher levels of vitamin D may be less likely to develop colon and rectal cancer, also called colorectal cancer.

The new study led by Dr. Kimmie Ng of Dana-Farber Cancer Institute in Boston involved 304 men and women diagnosed with colorectal cancer from 1991 to 2002, to see if higher levels of vitamin D in the patients affected their survival chances.

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Minimally Invasive Weight-Loss Surgery Improves Health of Morbidly Obese Teens

Obesity • • Surgery • • Weight LossJun 18 08

Teenagers’ obesity-related medical complications improve just six months after laparoscopic gastric banding surgery, according to outcomes data presented this week. The preliminary results by physician-scientists from Morgan Stanley Children’s Hospital of NewYork-Presbyterian and Columbia University Medical Center were presented on June 17 at The Endocrine Society’s 90th Annual Meeting in San Francisco.

The study reports that the small group of extremely obese teenagers who received the minimally invasive surgery, also called the Lap-Band procedure, as part of a clinical trial lost an average of 20 pounds after six months and had significant improvements in abdominal fat, triglyceride measurements (levels of fat in the blood) and blood sugar levels as measured by hemoglobin A1c—all risk factors for diabetes and heart disease. The patients’ liver function and a measure of immune response also improved, according to the abstract.

“Extremely obese teenagers have obesity-related health problems, particularly diabetes and increased cardiovascular risk. Laparoscopic gastric banding, which has been shown to be a safe and effective way to lose weight, now offers the possibility of reducing obesity’s medical complications,” says lead author Dr. Ilene Fennoy, a pediatric endocrinologist at Morgan Stanley Children’s Hospital of NewYork-Presbyterian and clinical professor of pediatrics at the Columbia University College of Physicians and Surgeons.

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Known Genetic Risk for Alzheimer’s in Whites Also Places Blacks at Risk

Brain • • Genetics • • NeurologyJun 18 08

A commonly recognized gene that places one at risk for Alzheimer’s disease does not discriminate between blacks and whites, according to new research led by Florida State University.

FSU Psychology Professor Natalie Sachs-Ericsson and graduate student Kathryn Sawyer have found that the gene APOE epsilon 4 allele is a risk factor for African-Americans as well as whites. Until now, it has been a mainstream belief that the gene is only a risk factor for whites.

“The results of our study have clear implications for research and treatment of Alzheimer’s disease,” Sachs-Ericsson said. “The APOE test might be used as one tool in identifying people who are at risk for Alzheimer’s. We now know that African- Americans and Caucasians alike need to be considered for such risk assessments.”

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First gene therapy for heart failure offered at NewYork-Presbyterian/Columbia

Genetics • • HeartJun 18 08

Could injecting a gene into a patient with severe heart failure reverse their disabling and life-threatening condition? Physician-scientists are setting out to answer that question in a first-ever clinical trial of gene therapy to treat severe heart failure.

NewYork-Presbyterian Hospital/Columbia University Medical Center is the only center in the New York City area where the therapy is currently available.

Patients enrolled in the multicenter CUPID trial (Calcium Up-Regulation by Percutaneous Administration of Gene Therapy in Cardiac Disease) will undergo a minimally invasive cardiac catheterization procedure that will introduce a specially engineered gene that stimulates production of an enzyme necessary for the heart to pump more efficiently.

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Testosterone gel benefits some men with diabetes

Diabetes • • EndocrinologyJun 18 08

Men with type 2 diabetes or the metabolic syndrome, or both, are prone to have low testosterone levels. If so, testosterone replacement therapy with a gel applied to the skin may improve their response to insulin and their sexual function, according to the results of a new clinical trial.

Testosterone levels fall if testicular function is subnormal, a condition termed hypogonadism. “Consideration should be given to screening type 2 diabetic and metabolic syndrome patients for hypogonadism,” Dr. T. Hugh Jones told the Endocrine Society’s annual meeting in San Francisco this week.

Jones, of Barnsley Hospital and the University of Sheffield in the UK, and colleagues tested the effect of a testosterone gel (Tostran) on insulin resistance and symptoms of hypogonadism in 221 men with low testosterone levels.

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Better drugs needed for pregnant women in tropics

PregnancyJun 18 08

More studies are urgently needed to find new and improved drugs to treat tropical diseases in pregnant women, scientists in Thailand said.

In an article published in PLoS Medicine, they said that while governments in developed countries had begun encouraging pharmaceutical companies to find new drugs for pregnant women, this was visibly absent in the tropics.

“There are few or no studies in pregnancy on most drugs used for the treatment of tropical infections, and so, few or no evidence-based recommendations,” Nicholas White and his colleagues at Mahidol University’s Mahidol-Oxford Tropical Medicine Research Unit wrote.

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Diabetes linked to depression risk and vice versa

Depression • • Diabetes • • Psychiatry / PsychologyJun 18 08

People being treated for type 2 diabetes are at increased risk for depression, according to a new report, and individuals with depression have a moderately increased risk of developing type 2 diabetes.

To explore the relationship between diabetes and depression, Dr. Sherita Hill Golden at Johns Hopkins University School of Medicine in Baltimore and colleagues analyzed data on 6814 subjects who underwent three examinations between 2000 and 2005.

Among 4847 participants without depression at the start of the study, the researchers report, rates of occurrence of depression symptoms during follow-up were similar for people without diabetes and those with untreated type 2 diabetes, but about twice as high in people being treated for type 2 diabetes.

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HIV screening not just for the young

AIDS/HIVJun 17 08

Screening for HIV infection in people older than 55 years of age is likely to be worthwhile in terms of the cost of screening balanced against the potential savings in heath care costs and the gain in years of life, according to a report in the Annals of Internal Medicine.

Recent guidelines by the U.S Centers for Disease Control and Prevention recommend screening for HIV infection in everyone between 13 and 64 years of age. Whether screening is cost-effective for people in the 55-to-75 age range, however, was unclear.

The cost and benefits of screening depend on the total expense of testing and counseling, the amount of disease in the community and how likely any given person is to be infected, and the potential benefits when the disease is caught early.

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Healthy lifestyle triggers genetic changes: study

Cancer • • Prostate Cancer • • DietingJun 17 08

Comprehensive lifestyle changes, including a better diet and more exercise, can lead not only to a better physique but also to swift and dramatic changes at the genetic level, U.S. researchers said on Monday.

In a small study, the researchers tracked 30 men with low-risk prostate cancer who decided against conventional medical treatment such as surgery and radiation or hormone therapy.

The men underwent three months of major lifestyle changes, including eating a diet rich in fruits, vegetables, whole grains, legumes and soy products, moderate exercise such as walking for half an hour a day, and an hour of daily stress management methods such as meditation.

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Boosting the flavor of food may aid in weight loss

Weight LossJun 17 08

People who are overweight may be able to shed pounds by sprinkling special seasonings and sweeteners on the food they eat. These “tastants” stimulate the sense of smell and taste, making people feel fuller faster and helping them to eat less, a study found.

“This approach uses natural physiology to help people lose weight, which is different than other approaches,” Dr. Alan Hirsch explained. “We know that diets don’t work because people do not have the will power to succeed. Instead of looking at the front end - how people eat - we looked at the back end, how can people feel full faster?”

As founder and neurologic director of the Smell & Taste Treatment and Research Foundation in Chicago, Hirsch observed that after people lost their sense of smell and taste from head trauma, they would gain 10 or 20 pounds.

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Hearing impairment is common among adults with diabetes

Diabetes • • Ear / Nose / ThroatJun 17 08

Hearing impairment is common in adults with diabetes, and diabetes seems to be an independent risk factor for the condition according to a study published today on the Web site of Annals of Internal Medicine.

“We found that hearing loss was much more common in people with diabetes than people without the disease,” says Kathleen E. Bainbridge, PhD, the study’s lead researcher. “The hearing loss we detected did not seem to be caused by other factors such as exposure to loud noises, certain medicines, and smoking.”

Using the National Health and Nutrition Examination Survey, collected by the National Center for Health Statistics from 1999 to 2004, the researchers analyzed data from 5,140 adults aged 20 to 69 who completed an audiometric examination and a diabetes questionnaire.

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Diabetes drug slows early-onset puberty in girls

Diabetes • • Gender: FemaleJun 17 08

In young girls at risk of early puberty and insulin resistance, the diabetes drug metformin delayed the onset of menstruation and decreased the development of insulin resistance, a risk factor for type 2 diabetes, according to a new study. The results were presented Monday, June 16, at The Endocrine Society’s 90th Annual Meeting in San Francisco.

“The findings indicate that we can slow down puberty,” said the study’s senior author, Lourdes Ibanez, MD, PhD, of the University of Barcelona in Spain. “This is important because when puberty is faster in girls, the appearance of menses occurs earlier, and this sequence of events may ultimately result in a shorter adult height.”

Also, getting a first menstrual period before age 12 has been linked to an increased risk of breast cancer. Early puberty (breast development) is a risk factor for polycystic ovary syndrome (PCOS), especially if the girl is overweight, she said. PCOS is a common cause of infertility.

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