Laterlife Healthwise - 51             June 2004

Not only Viagra, but also….

Drugs for erectile dysfunction don’t work miracles. All depend on the man being sexually stimulated, so the desire has to be there in the first place and the drugs then provide the means.

But several types are now available.  They differ on various counts: length of time they take to become effective, duration of the effect and food interaction. 

There are two kinds of drugs: Apomorphine and PDE5 inhibitors.

Uprima (Apomorphine, which stimulates a specific area of the brain known to be involved in the erectile process).

• onset of action: 10 – 20 mins

• duration of action: 4 hours

• efficacy: 55 - 65 per cent

• food interaction:  none

Viagra (PDE5 inhibitor, which helps relax blood vessels in the penis, enhancing blood flow).

• onset of action: 20 - 60 mins

• duration of action:  4 - 6 hours

• efficacy: 70 - 80 per cent

• food interaction:  recent and heavy meal may slow absorption

Cialis (PDE5 inhibitor)

• onset: 20 – 60 mins

• duration:  36 hours

• food interaction:  no effect

Levitra (PDE5 inhibitor)

• onset:  20 – 60 mins

• duration:  5 hours

• food interaction: fatty meal may affect absorption

The above information was taken from One In Ten, the Sexual Dysfunction Association  newsletter.  See their website:  www.sda.uk.net.

Trouble with men and health

Men in parts of Scotland have an average life expectancy of just 63 years, according to new NHS figures. This is 10 years below the Scotland average for men (73) and over 12 years below the UK average (75.6 years).

The low male life expectancy problem is particularly acute in deprived areas of Glasgow, but there are similar inequalities in men’s health in other parts of England.  Men in Manchester, the area with the worst male health in England, and men in unskilled manual occupations throughout the country have an average life expectancy of 71 years. 

Compare this with statistics for  men in East Dorset, one of three areas with the best male health. They have a life expectancy of 79.5 years. And the nationwide figure for men in professional occupations is 78.5 years.

No wonder the Men’s Health Forum is saying the government needs to develop specific and co-ordinated strategies to tackle the poor health of men in low-income groups. Health promotion should be targeted at men, and health services made more accessible, says Peter Baker, Director of the Men’s Health Forum who wants urgent action on the subject.

Boys need to be taught help-seeking skills to equip them to deal with physical and emotional health problems throughout their lives, he says. The Men’s Health Forum is a charity that aims to improve men’s health in England and Wales. For more information, visit www.menshealth
forum.org.uk.

PS Longest living place for women is Kensington and Chelsea, with 84 years. Though women will continue to outlive men, the difference is gradually narrowing, with life expectancy for both rising by 10 per cent since 2001.

Reporting side-effects

You may not have heard of the Yellow Card system, but it could be crucial to your well-being. Filling out Yellow Cards is what GPs do when you report a side-effect of any drug that you have been prescribed.

For some time now, there have been grumblings from consumer groups that doctors are not always good at filling out these cards. They may fail to give information about the dosage that caused the effect, or omit the patient’s history or a description of the effect itself.

Side effects of antidepressants such as Seroxat and Prozac have been highlighted by patients in recent years, but the message has not always got through to doctors or, crucially, to the drug manufacturers. At last, there’s the chance to hear the patient’s own voice on the subject.  A recommendation by an independent inquiry on the yellow card system has been taken up by the Government, and pilot schemes are to be set up to create a viable system for patient feedback.

It’s not going to happen overnight, but if you are experiencing side effects of any drug, make sure you record them in writing.    

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Vitamin B12 and osteoporosis  (and soya too)

Bone loss in women and vitamin B12 intake are connected, say researchers at the University of California. They studied 10,000 women aged 65 plus, measuring bone density in hip and ankles. They also measured vitamin B 12 levels in some of the women and found that those with low B12 levels also suffered hip bone loss, but not ankle bone loss.

Vitamin B12 affects blood and nervous system, but there has been little research into its effect on osteoporosis.  The vitamin is found in yeast, wheat germ, liver, milk, eggs, meat and cheese.  

Being pregnant or a vegetarian are already known to cause deficiency. Now there’s the possibility that in the post menopause age group, boosts are needed.  If you take a multivitamin pill, check that it includes B12.

PS More evidence for isoflavones, compounds derived from soya beans and other plants. The Dunn Human Nutrition Unit in Cambridge looked at 205 women aged 49 to 65 who were given isoflavones or placebo for 12 months.  Bone density in the lower spine was considerably higher in those on isoflavones.  But there was no difference for hip bone density

Drinking and diabetes

Does drinking alcohol increase risk of diabetes?  On the contrary, drinking in moderation – one to three drinks a day – can lower the risk by half to a third, say doctors at the Montefiore Medical Center and Albert Einstein College of Medicine in New York.

The drinkers in their study did better than non-drinkers, but, as usual, it’s the word moderation that’s all-important. Heavy consumption of alcohol – more than three drinks a day – was associated with a 43 per cent increase in diabetes.

Success for Chest Pain Units

When people experience acute chest pain, they make for the nearest A and E and often find themselves admitted to hospital for observation and clinical assessment. If the hospital runs a dedicated Chest Pain Observation Unit, they are likely to get better service.

These Units are dedicated to offering rapid, highly skilled assessment, and a report on the British Medical Journal suggests that they are good value for money.

They can distinguish between false alarms and emergency, so that fewer people are admitted to hospital, and they also reduce the number who are wrongly discharged. The report, based on a study in Sheffield, quotes a saving of £78 per patient, with a reduction from 54 per cent to 37 per cent being admitted, and a reduction from 14 per cent to 6 per cent of patients wrongly discharged.

If in any doubt about any of the information covered in healthwise articles and it's relevance for you, consult your GP.

In edition 50:-     

Maximise your memory

This work provides detailed instructions, illustrations and sample exercises that show the reader how to build a system of personalized frameworks for storing and recalling information on demand.