Levitra ED medication

Examining the metabolism of embryos may help determine which ones offer the best chance of success with in vitro fertilization (IVF), a new study finds.

Currently, the process of selecting embryos for implantation in the mother’s womb is highly subjective.

“It’s a guessing game that can end in IVF failure or multiple pregnancies,” Dr. Emre Seli, an associate professor in the obstetrics, gynecology and reproductive sciences department at Yale School of Medicine, said in a school news release. “Our goal is to find a way to pinpoint the embryos with the best chance of success, so that we can transfer fewer embryos and cut down on the possibility of multiple pregnancies without reducing the pregnancy rate.”

Seli and colleagues have studied the metabolomic profiles of spent embryo cultures. A metabolomic profile is a unique chemical signature of the activity of embryos in culture.

The Yale team found that a viability score based on a noninvasive metabolomic assessment of embryo culture media affected pregnancy outcomes in women treated at four centers in Europe and Australia. The research, performed in collaboration with Molecular Biometrics Inc., was presented this week at the American Society for Reproductive Medicine annual meeting, in Atlanta.

“These findings have important implications for the more than 125,000 IVF cycles performed yearly in the United States,” Seli said. “The high multiple pregnancy rates associated with IVF have significant public health consequences, such as decreased survival and increased risk of lifelong disability associated with severe prematurity.”

Dying white cancer patients are more likely than black patients to have their end-of-life wishes respected, a new U.S. study shows.

Some black patients who asked not to be resuscitated or put on a ventilator received the treatment anyway and died in an intensive care unit, said the researchers. White patients who voiced a wish for aggressive care were three times more likely to receive it than black patients who had expressed the same desire.

“We’re not saying that black treatment preferences were ignored. Black patients did want, and did receive, more aggressive care than whites. The disparity was in the effect of treatment preferences on care received — not that black preferences didn’t matter,” senior author Holly Prigerson, of the Dana-Farber Cancer Institute in Boston, said in a news release from the institute.

The study included 234 white and 68 black patients with advanced cancer. They were interviewed at the start of the study and monitored until their death, which occurred an average of 3.5 months later.

“None of the white patients who reported the completion of a do-not-resuscitate order, or a DNR order, at baseline subsequently received intensive care in the last week of life. This did not prove to be the case for black patients. DNR orders did not significantly protect black patients from intensive end-of-life care in this study,” Prigerson said.

This disparity may be because of disruptions in continuity of care for black patients and cultural differences that hindered patient-doctor communication. The findings highlight the need for better communication between black cancer patients and their cancer care providers.

Breast-feeding is a great time to bond with your little one. But for some moms, it can be a painful experience.

The Nemours Foundation offers these suggestions to help make breast-feeding a little more comfortable:
Make sure your baby is latched on correctly.
Some women benefit from nursing more often, but for a shorter spans.
Offer baby the side that’s less sore.
Try an over-the-counter lotion just for breast-feeding moms.
Rub a bit of breast milk on the nipple after the feeding, and let it air dry.
Breast-feed in different positions to help drain all areas of the breast.
Use an ice pack or a warm compress on the breast just before nursing.

Doctors should prescribe oral phosphodiesterase type 5 (PDE-5) inhibitor drugs, such as Viagra, Cialis and Levitra, for men with erectile dysfunction, unless the patient is on nitrate therapy, according to a clinical practice guideline issued by the American College of Physicians.

The type of erectile dysfunction (ED) drug prescribed should be based on the individual preferences of patients, including cost of medication, ease of use and types of side effects, the authors noted.

“The evidence is insufficient to compare the effectiveness or adverse effects of different PDE-5 inhibitors for the treatment of ED because there were only a few head-to-head trials,” guideline lead author Dr. Amir Qaseem, senior medical associate with the ACP, said in a news release.

Qaseem and colleagues analyzed the findings of 130 studies that evaluated PDE-5 inhibitors alone or combined. They found that treatment with the drugs led to statistically significant and clinically relevant improvements in sexual intercourse and erectile function in men with ED, regardless of the cause (e.g., diabetes, depression, prostate cancer) or ED severity at the start of the study.

Overall, PDE-5 inhibitors were relatively well-tolerated and associated with only mild or moderate side effects, such as headaches, flushing, upset stomach and runny nose, the authors found.

The guideline is published in the Oct. 20 issue of the journal Annals of Internal Medicine.

Because there is no conclusive evidence about the effectiveness of hormonal blood tests or treatment in patients with low testosterone levels, the ACP doesn’t recommend for or against routine use of the tests in ED patients. The college says doctors should make decisions to measure hormone levels based on an individual patient’s clinical symptoms (decreased libido, premature ejaculation, fatigue, etc.) and physical signs (such as testicular or muscle atrophy) that suggest hormone problems.