Even as Viagra mania sweeps the nation, researchers are testing new impotency drugs that work faster and with fewer side effects, experts said last week at a San Diego meeting of the American Urological Assn. Two of the new pills can produce an erection in 15 minutes or less in some men, while doctors recommend that Viagra be taken an hour before sex.
A new drug called Vasomax resulted in no serious side effects in clinical trials. About 10% of patients reported minor nasal congestion, headaches or facial flushing. Vasomax, the drug phentolamine, is already available in Mexico and could be on the market in the United States within a year. About three out of four men tested were able to have successful intercourse with the drug.
Apomorphine, a tablet that is dissolved under the tongue and rapidly absorbed by the body, produced erections in 11 to 13 minutes, a UCLA researcher reported. Dr. Harin Padma-Nathan said apomorphine works on the brain chemicals responsible for sexual arousal, rather than increasing the blood flow in the penis as Viagra does. Apomorphine's most common side effects were mild to moderate nausea, dizziness, sleepiness and sweating, he said.
Another drug, called Topiglan, was tested on 114 patients at Boston University with about 80% effectiveness and few side effects. In the test, a small amount of the gel was applied to the head of the penis, which eliminated burning that men experienced when it was applied to the entire organ, Goldstein said. The gel contains alprostadil, which is naturally present in semen.
Smoking While Pregnant Worse Than Cocaine Use
A mother's smoking during pregnancy is more dangerous to her fetus than cocaine use, possibly causing 100,000 miscarriages each year and large numbers of deaths from sudden infant death syndrome, a Duke University researcher reports in the June Journal of Pharmacology and Experimental Therapeutics.
It also results in tens of thousands of infant admissions to intensive care units after birth and kills or brain-damages more during the birth process, said Dr. Theodore Slotkin. "And none of these figures takes into account the enormous increase in learning disabilities, attention deficit and hyperactivity disorder, and other behavioral problems that we know are part of the outcome of maternal smoking," he said.
His conclusions stemmed from a comprehensive review of studies of animals and humans. The damage is produced not only by such chemicals as carbon monoxide and hydrogen cyanide in cigarette smoke, but also by nicotine. Nicotine patches and gum should not be used by pregnant women to help them stop smoking, he said.
Ear Infections Respond to Less Antibiotics
A five-day dose of antibiotics seems to work as well for children with uncomplicated middle ear infections as the 10-day medication now most often prescribed, according to a study in the June 3 Journal of the American Medical Assn. The report from the University of Manitoba in Winnepeg was based on a review of 32 clinical trials in which children were treated for otitis media, a condition that affects as many as 90% of children at least once.
The results "support the use of five days of a short-acting antibiotic in uncomplicated [cases] in the event that clinicians and parents decide to use antibiotics," the report said. "Treatment with a shortened course of antibiotics has the potential to greatly reduce antibiotic use in regions where 10 days of treatment is considered the standard, with anticipated cost savings, improved compliance and decreased antibiotic resistance," the researchers concluded.
Women Spend More on Medical Care
Women run up 30% higher annual medical bills than men do, but it's not necessarily because they're sicker. A Canadian study found that women's higher medical costs can be explained largely by the expense of pregnancy and childbirth as well as uniquely female diseases.
Many studies have found that women use more medical resources, and experts have wondered whether the explanation is that women are more willing to seek care or that they actually get sick more often.
The latest study was based on a review of all 1.1 million people covered by provincial health insurance in Manitoba in 1994. Overall, women's bills averaged $1,164 per year, while men's were $918, the researchers report in the June 4 New England Journal of Medicine. The figures are in Canadian dollars. Twenty-two percent of women's health costs were for specifically female conditions, while just 3% of men's health bills were for male conditions, such as prostate treatment.
Since women live longer, their lifelong medical bills are substantially higher than men's. The researchers calculated that up to the year she dies, a woman's lifetime medical expenses in Manitoba average $85,131, while a man's are $58,950.
Live to 100, Leave Your Brain Behind
A new study suggests if you make it to age 100, you can expect to leave a good chunk of your mental abilities behind. Dutch researchers tracked down every centenarian in three towns and found at least 12 of the 17 were moderately to severely demented, and three more had mild dementia. They weren't able to test the two others.
Not one of the tested participants who was capable of conversation could draw a clock face that indicated a given time. The results are gloomy, said Dr. Ben Blansjaar, who presented the study Wednesday at the annual meeting of the American Psychiatric Assn. He said that he suspects the findings will apply to American baby boomers when they, too, reach 100, but that medications might help.
Centenarians are a rapidly growing group, and planners want to know what their health care needs will be. Projections about two groups found that in 1995 the United States had about 45,000 white citizens age 100 or older. By 2050, that figure will grow to 607,000. Among blacks, the number is projected to grow from 7,000 to 116,000.
--Compiled by THOMAS H. MAUGH II