Gonorrhea Getting Harder to Treat - Antibiotic Resistance Pushing Gonorrhea Toward Superbug Status

Gonorrhea is a common sexually transmitted bacterial infection. If left untreated, gonorrhea can lead to pelvic inflammatory disease, ectopic pregnancy, and infertility in women. Treatment for gonorrhea usually consists of a single dose of one of two antibiotics, cefixime or ceftriaxone.

The current drugs of choice, ceftriaxone and cefixime, are still very effective but there are signs that resistance, particularly to cefixime, is emerging and soon these drugs may not be a good choice.

Only one remaining class of antibiotics is recommended for the treatment of gonorrhea - cephalosporins. Historically, gonorrhea has progressively developed resistance to the antibiotic drugs prescribed to treat it. Thus, it is critical to continuously monitor antibiotic resistance in Neisseria gonorrhoeae.

As a side note that highlights the prevalence of the problem, there are at least 10 songs titled "Gonorrhea" by various artists in the Amazon.com MP3 music store.



CDCStreamingHealth | April 16, 2010: This video, produced by Be Smart. Be Well., raises awareness of Sexually Transmitted Diseases (STDs): 1) What are they? 2) Why they matter? and, 3) What can I do about them? Footage courtesy of Be Smart. Be Well. http://www.besmartbewell.com, featuring CDC's Dr. John Douglas, Division of Sexually Transmitted Disease Prevention.

References:

Gonorrhea Getting Harder to Treat. WebMD.
Sex infection gonorrhea risks becoming "superbug". Reuters.
Antibiotic Resistant Gonorrhea. CDC.

Sexually Transmitted Diseases (STDs) - Diagnosis and Management Slideshow from Medscape http://goo.gl/uzwA

Clinical Pearls in Men's Health - Mayo Clinic Proceedings Video

Dr. Thomas Beckman discusses his July 2010 Mayo Clinic Proceedings concise review on 3 cases involving men's health.

Erectile dysfunction is a strong predictor of death in men with cardiovascular disease

From CNN:

Men with cardiovascular disease and ED were twice as likely to die from all causes than men who did not have erectile dysfunction. And those with ED were 1.6 times more likely to suffer from a serious cardiovascular problem such as a heart attack or stroke.

Erectile dysfunction is something that regularly should be addressed in the medical history of patients; it might be a symptom of early atherosclerosis.

Men with ED who are going to a general practitioner or a urologist need to be referred for a cardiology workup to determine existing cardiovascular disease and proper treatment. ED is an early predictor of cardiovascular disease.

References:
Study: Erectile dysfunction may indicate heart disease, death risk - CNN.com.

ED, Depression, Heart Disease: Does the Existence of One Component of This Triad Necessitate Inquiring the Other Two? http://goo.gl/EKvKl

Image source: Viagra (sildenafil), Wikipedia, GNU Free Documentation License.

P.S.A. testing can’t detect prostate cancer, says its discoverer

Richard J. Ablin in the NYTimes:

"Approved by the Food and Drug Administration in 1994, the P.S.A. test’s popularity has led to a hugely expensive public health disaster. It’s an issue I am painfully familiar with — I discovered P.S.A. in 1970.

The annual bill for P.S.A. screening is at least $3 billion, with much of it paid for by Medicare and the Veterans Administration.

As I’ve been trying to make clear for many years now, P.S.A. testing can’t detect prostate cancer and, more important, it can’t distinguish between the two types of prostate cancer — the one that will kill you and the one that won’t."

References:
The Great Prostate Mistake. NYTimes.
Image source: Wikipedia, public domain.

Sexual life expectancy is longer for men than women

A BMJ study of middle aged and older adults showed that men were more likely than women to be sexually active, report a good quality sex life, and be interested in sex.

These gender differences increased with age and were greatest among the 75 to 85 year old group: 38.9% of men compared with 16.8% of women were sexually active, 70.8% versus 50.9% of those who were sexually active had a good quality sex life, and 41.2% versus 11.4% were interested in sex.

People in very good or excellent health were 1.5 to 1.8 times more likely to report an interest in sex than those in poorer health. At age 30, sexually active life expectancy was 34.7 years for men and 30.7 years for women compared with 14.9 to 15.3 years for men and 10.6 years for women at age 55.

At age 55, men in very good or excellent health on average gained 5-7 years of sexually active life compared with their peers in poor or fair health. Women in very good or excellent health gained 3-6 years compared with women in poor or fair health.

References:

Sex, health, and years of sexually active life gained due to good health: evidence from two US population based cross sectional surveys of ageing. BMJ 2010;340:c810.

Image source: OpenClipart.org, public domain.

Rock star Ozzy Osbourne to CNN: "Between drugs and STDs, I'm lucky to be alive today"

"Ozzy Osbourne, the former front man of rock group Black Sabbath, says that after decades of living a life of drugs and sex, he's lucky to be alive today.

Osbourne described how he often played a dangerous game when it came to using drugs and having promiscuous sex. "With the drugs, it nearly killed me on a daily basis -- I did a lot of heavy drug taking for a long time and I survived it by the grace of God.

Answering a viewer's question on whether he realized his power to change people's lives, Osbourne replied with shock. "When you're on the inside looking, you don't see it that way," Osbourne said. "But I suppose you're right. I do -- I do have the power to change people's lives."

References:
Ozzy Osbourne: I'm living on borrowed time. CNN.

"Researchers studying Ozzy Osbourne's DNA found that the singer is descendant of Neanderthals" http://goo.gl/7Fa8

Related:

Erectile Dysfunction Treatment: Alternatives to Pills

From the NYTimes:

30 million men in U.S. experience erectile dysfunction (ED), 30% of men in their 50s, more than 50% of those in their 60s.

One Viagra pill, the most common way to treat erection problems, costs about $15. Viagra, Cialis and Levitra do not work for about half of the men with ED.

After 2 years of significant lifestyle changes (and no meds), 58% of the men with ED had normal erectile function.

Self-administered injections of alprostadil for ED cost $35; a "cocktail" of alprostadil, papaverine, phentolamine.

References:
For Common Male Problem, Hope Beyond a Pill. NYTimes.
Erectile Dysfunction Medications Related to Transient Amnesia, FDA Warns

Men who use ED drugs have higher rates of STDs, particularly HIV infection - Ann Intern Med http://goo.gl/UH78

ED, Depression, Heart Disease: Does the Existence of One Component of This Triad Necessitate Inquiring the Other Two? http://goo.gl/EKvKl
Image source: Viagra (sildenafil), Wikipedia, GNU Free Documentation License.

Prostate cancer screening: What is new?

From the Cleveland Clinic Journal of Medicine (CCJM):

PSA has low specificity. Most men with “elevated” PSA do not have prostate cancer.

There is no PSA level below which risk of cancer is zero. No PSA cutoff level is clinically useful.

PCPT risk calculator uses 7 variables to calculate the risk of having high-grade prostate cancer.

Men with a higher body mass index have lower PSA levels, statins also lower PSA levels.

Two large trials of PSA screening came to opposite conclusions in 2009: Europe vs. U.S. - benefit vs. no benefit.

New prostate cancer markers under study: Urinary PCA3, Serum EPCA-2, Gene fusions.

There is an ongoing debate whether 5-alpha reductase inhibitors should be used by all men at risk of prostate CA or only by those at high risk.

References:
What’s new in prostate cancer screening and prevention? CCJM, 2009.
Erectile dysfunction after prostate removal for prostate cancer
Image source: Wikipedia, public domain.