Three recent studies on chronic pulmonary obstructive disease (COPD) and smoking shed light on the pulmonary disease. COPD patients, be warned: Your inhaler may be hurting you more than it's helping; an antibiotic has been found to reduce symptoms of COPD and improve quality of life for COPD patients; and - not a huge shocker รข€" a study shows why smoking isn't sexy. Read on for the latest news in respiratory health...
Smokers Don't Make Better Lovers
NEW YORK (Reuters Health) - Lighting up could be slowing your spouse down in the bedroom, suggests a new study.
Men who successfully stopped smoking improved on lab measurements of sexual health more than those who relapsed after a quit-smoking program. The findings show that smoking may be affecting the sexual health of men who consider themselves perfectly alright in the bedroom -- and not just those with impotence, researchers say.
"With younger men, the risks of smoking in that population appear more far off. They think, 'I don't really need to worry about this until much farther down the road,'" said study author Christopher Harte, from the VA Boston Healthcare System.
The findings, he said, are "still not definitive," but the goal was "getting the word out so it could influence [men's] decisions to start the quitting process," he told Reuters Health.
Harte and co-author Cindy Meston from the University of Texas at Austin enrolled 65 men without self-reported impotence in an eight-week quit-smoking program using nicotine patches. Before treatment, halfway through, and a few weeks after, they brought the men into a locked lab and showed them a racy film.
While they watched, men kept track of how aroused they were and a device measured how much their penises grew or shrunk. Separately, they also filled out surveys about sexual function outside of the lab, including questions about desire and sexual satisfaction.
By the end of the study, 20 men hadn't lit up in at least a week, while 45 were still smoking.Quitters saw a greater increase in penis growth (measured by width, not length), compared to non-quitters. By their own scoring, those men also reached their peak level of arousal sooner than men who were still lighting up.
However, men who had dropped the habit didn't report any sexual improvement in "real-life" settings, researchers reported in the British Journal of Urology International. It's possible, they added, that the improvements they saw in the lab may take time to translate to the bedroom.
"It might take longer for men to actually notice their level of difference subjectively outside of the lab, which is also dependent on their relationship with their sexual partner," Harte said.
While smoking has been linked to a host of other health problems such as cancer, chronic obstructive pulmonary disease and heart disease, the researchers said their finding is a new angle for doctors to use on men still reluctant to try quitting.
Previous research has shown that long-term smokers and COPD patients are up to twice as likely to have impotence as non-smokers.
"There is a fairly strong body of data that link smoking as a major risk factor for erectile dysfunction," Dr. Lydia Bazzano, who has studied that topic at the Tulane University Health Sciences Center in New Orleans, said in an email.
Smoking can slow blood vessel dilation, Bazzano told Reuters Health, which is necessary to get an erection.
But, "this doesn't just apply to men with severe erectile functioning issues," Harte said.
"The take-home point is that even men who don't have a clinical diagnosis of (erectile dysfunction)... may still benefit from quitting smoking," he concluded.
FDA Rejects New Mist Inhaler
CHICAGO (Reuters) - A mist inhaler used to improve breathing in COPD patients and people with lung diseases, including chronic bronchitis and emphysema, may increase their risk of dying by 52%, U.S. and British researchers said in June.
The increased risk occurred in patients who used the Spiriva Respimat inhaler, a newer device sold by Boehringer Ingelheim (BI) and Pfizer. It delivers a soluble form of Spiriva, known generically as tiotropium.
The finding was contested by Pfizer and BI.
The inhaler is used to treat chronic obstructive pulmonary disease, or COPD, the fourth-leading cause of death worldwide, which includes the chronic lung diseases emphysema and bronchitis. COPD is usually due to decades of smoking.
"What we think is going on is that the mist inhaler is delivering a higher concentration of tiotropium than it should be and that may be increasing the risk of death," Dr. Sonal Singh of Johns Hopkins University School of Medicine, who led the study, said in a statement.
The inhaler is approved for use in Britain and Europe, but failed to win a nod from the U.S. Food and Drug Administration, which noted an excess number of deaths in a study of 17,000 patients. Instead, the FDA said it wanted more proof the inhaler was safe.
The new study, published in the British Medical Journal (BMJ), is based on analysis of data from five clinical trials involving 6,500 people.
It found that the risk of death in patients using the tiotropium Respimat inhaler was 52% higher than patients who used a placebo."We estimate there will be one additional death for every 124 patients treated for a year with tiotropium Respimat," Dr. Yoon Loke of Norwich Medical School at the University of East Anglia, who worked on the study, said in a statement.
He said some of the added risk stems from patients dying of heart trouble, especially for those with existing heart problems. Those problems may be made worse with use of the product.
Pfizer and BI said in a statement they did not agree with the study authors' conclusion.
"When analyzing the clinical data, Boehringer Ingelheim and Pfizer, unlike the authors of the BMJ publication, have access to detailed patient level data. A thorough analysis of these data revealed a statistically non-significant, numerical imbalance in number of fatal events with Spiriva Respimat," the companies said.
The drugmakers added that all the studies included in the pooled analysis had been published and already shared with European regulatory authorities.
Most COPD patients use inhalers to help them breathe and more than half a million prescriptions for tiotropium inhalers were issued in Britain last year.
Common Antibiotic Reduces Acute Attacks in COPD Patients
Adding a common antibiotic to the usual daily treatment regimen for COPD can reduce the occurrence of coughs and labored breathing attacks and improve quality of life, report new results from a clinical trial funded by the National Heart, Lung, and Blood Institute (NHLBI), part of the National Institutes of Health.
"These promising results with azithromycin may help us reduce that burden and improve the lives of patients at risk," said Susan B. Shurin, M.D., acting director of the NHLBI.Chronic obstructive pulmonary disease patients often suffer from sudden onsets of worsened cough, wheeze, and labored breathing induced by bacterial and/or viral infection. These attacks are called exacerbations.
Azithromycin is already prescribed for a wide variety of bacterial infections including pneumonia and strep throat.
Previous research suggested this antibiotic might work for COPD exacerbations, but this study was the first to enroll a large number of COPD patients and treat exacerbations with this drug over a long time.
Participants had a history of exacerbations in the previous year or needed oxygen therapy.
The 570 study participants who took 250 milligrams (mg) of azithromycin daily for a year in addition to their usual care averaged 1.48 acute COPD exacerbations annually, compared to 1.83 exacerbations for the 572 participants who received their usual care without azithromycin.
Subjects taking azithromycin also assessed their own breathing ability and overall well-being more favorably on questionnaires.
Eighty percent were already taking other medications normally used to manage COPD, including inhaled steroids and long-acting bronchodilators.
"This study suggests that azithromycin's benefits extend beyond those of other therapies," noted James Kiley, Ph.D., director of the NHLBI's Division of Lung Diseases.
Kiley added that more research is needed to determine the long-term effects of azithromycin treatment and to identify which group of patients would benefit the most.Side effects of azithromycin during the study were minimal. The presence of microbes resistant to azithromycin increased in some patients, although no one developed a clinically evident infection.
A small fraction of participants receiving azithromycin were found to have slight hearing loss, which is a known side effect of the drug.
Azithromycin can also cause heart arrhythmias in susceptible people. No heart rhythm abnormalities were seen in study patients, though people with heightened risks for arrhythmias were not enrolled in the study.
There are an estimated 12 million COPD patients in the United States and the disease is now the third leading cause of death in this country. There is currently no cure, though a combination of drugs and lifestyle changes can help manage the symptoms.
The study was carried out by the COPD Clinical Research Network (CCRN), an NHLBI-funded consortium of research centers located throughout the U.S. that was established to study new treatments for COPD.
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