BBC NEWS | Science/Nature | Species loss ‘bad for our health’

A new generation of medical treatments could be lost forever unless the current rate of biodiversity loss is reversed, conservationists have warned.

They say species are being lost before researchers have had the chance to examine and understand their potential health benefits.

The findings appear in Sustaining Life, a book involving more than 100 experts.

It is being published ahead of a global summit in May that will look at ways to stem biodiversity loss by 2010.

"While extinction is alarming in its own right, the book demonstrates that many species can help human lives," said co-author Jeffrey McNeely, chief scientist at IUCN (formerly known as the World Conservation Union).

"If we needed more justification for action to conserve species, it offers dozens of dramatic examples of both why and how citizens can act in ways that will conserve, rather than destroy, the species that enrich our lives."

Killing the cure

One creature whose potential benefits have been lost to science is the southern gastric brooding frog (Rheobatrachus silus), say the authors.

First described in 1973, the frogs, which were only found in Australia, interested researchers because they raised their young in the females' stomachs.

Preliminary studies suggested that the young produced substances that stopped them being digested.

Further research could have led to new ways of preventing and treating stomach ulcers in humans, but the amphibian was last recorded in the wild in 1981.

"These studies could not be continued because both species of Rheobactrachus became extinct," said co-authors Eric Chivian and Aaron Bernstein from Harvard Medical School, US.

"The valuable medical secrets they held are now gone forever."

The team added that there was a wide range of threatened species whose biology could hold secrets to possible treatments for a growing variety of ailments.

For example, they said some bears' ability to maintain bone mass when they entered a dormant state could lead to a better understanding of diseases such as osteoporosis.

"We must do something about what is happening to biodiversity," the UN Environment Programme's (Unep) executive director, Achim Steiner, told a conference in Singapore, where the book was previewed.

"Societies depend on nature for treating diseases; health systems over human history have their foundation on animal and planet products that are used for treatment."

The authors hope the publication will illustrate why delegates at a forthcoming key biodiversity summit in Germany have to back plans to halt species loss by 2010.

Mr Steiner said: "The UN Convention on Biological Diversity (CBD) has achieved a great deal but it needs to achieve more if it is to meet the international community's goals and objectives.

"We need a breakthrough in Bonn on all three pillars of the convention: conservation, sustainable use, and access and benefit sharing of genetic resources."
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Alternative Modes of Prostanoid Administration in PAH

Selection from: Alternative Modes of Prostanoid Administration in Pulmonary Artery Hypertension: Combination Usage

Introduction

Pulmonary arterial hypertension (PAH) is a disease characterized by progressive obliteration of pulmonary resistance vessels (usually the medium to small arterioles) resulting in increasingly greater impediment to blood flow across the pulmonary vascular bed. Ultimately the right heart is unable to compensate for this increased resistance and the patient dies from right heart failure. The recent (2003) reclassification of the causes of PAH recognizes that many different diagnoses can be associated with these changes in the pulmonary vascular bed and the development of PAH (Table).[1] The term PAH is used to distinguish this disorder, which originates in the pulmonary vascular bed, from conditions where the pathology lies elsewhere and results in secondary changes in these pulmonary vessels — for example valvular heart disease, pulmonary embolic disease with associated pulmonary hypertension (PH), and parenchymal lung diseases.Table. World Health Organization Diagnostic Classification of Pulmonary Hypertension

Class 1

Idiopathic pulmonary hypertension (PH) (formerly primary PH)

Familial PH

Associated PH:

- Connective tissue disease

- Drugs and toxins

- Portopulmonary hypertension

- HIV

- Congenital systemic to pulmonary shunts

- Other

PAH with significant venule or capillary involvement:

- Pulmonary capillary hemangiomatosis

- Pulmonary veno-occlusive disease (PVOD)

Persistent fetal circulation

Class 2

PH with left heart disease

Class 3

PH with parenchymal lung disease

Class 4

PH caused by chronic thrombotic or embolic disease

Class 5

Miscellaneous (sarcoid, lymphangioleiomyomatosis, etc)Adapted by the author from Proceedings of the Third World Symposium on Pulmonary Arterial Hypertension; June 23-25, 2003; Venice, Italy. J Am Coll Cardiol. 2004;43:1S-90S.

The entity originally referred to as primary pulmonary hypertension and now called idiopathic pulmonary arterial hypertension is a rare disease that affects younger patients, affects females more often than males (2-3:1), and occurs in only 1 to 2 persons per 1 million population. This disease provided the model of a pure pulmonary vascular disease and the basis for greater understanding of the physiology of PH in all its manifestations.

Questions answered incorrectly will be highlighted.

Pulmonary arterial hypertension (PAH) is defined as a ___________________________ Hg measured by cardiac catheterization.Mean pulmonary artery pressure (PAPm) ≥ 10 mmHg with a pulmonary capillary wedge pressure ≤ 15 mmPAPm ≥ 15 mmHg with a pulmonary capillary wedge pressure ≤ 20 mmPAPm ≥ 20 mm Hg with a pulmonary capillary wedge pressure ≤ 10 mmPAPm ≥ 25 mm Hg with a pulmonary capillary wedge pressure ≤ 15 mm  Copyright © 2008 Medscape.
 
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Researchers debate recreational use of PDE-5 inhibitors

Leaders in the field of sexual medicine will actively debate the use of oral pills for erectile dysfunction (ED) at the 7th Congress of the European Society for Sexual Medicine in London, UK.

Moderated by Irwin Goldstein, MD, editor of the Journal of Sexual Medicine, the exchange is scheduled to take place on December 5, 2004 in the Palace Suite of the Hilton London Metropole. Journalists are invited to join a panel posing questions to the use of oral pills as lifestyle drugs versus medications strictly for health problems.

Viagra, or sildenafil citrate, the first of the PDE-5 inhibitors to hit the market in treatment of ED in 1998, first got its start as a potential angina treatment. Since then, vardenafil (Levitra) and tadalafil (Cialis) have joined the scene, targeted at millions of men suffering from erectile dysfunction. Urologists estimate that as many as 152 million men fall into this group, over half of all men over the age of 40, yet the treatment for this ailment appeals to numbers beyond. While PDE-5 inhibitors are technically used to enable men to have an erection when ED is caused by problems like diabetes, depression, hypertension or prostate surgery, others see these drugs as an opportunity to enhance their lifestyle through sexual performance.

Dimitrios Hatzichristou, MD will argue that PDE-5 inhibitors are excellent lifestyle drugs. With other medications treating hair loss, obesity, and other conditions not severely life-threatening, PDE-5 inhibitors have a place in the market for men with and without erectile dysfunction.

"Erectile dysfunction is an important indicator of serious underlying medical conditions," writes Geoff Hackett, MD in a cover story of pH7 Magazine. He will discuss the points behind taking PDE-5 inhibitors solely as a medication for real health problems.

This event is sponsored by the International Society for Sexual Medicine and Blackwell Publishing. Journalists wishing to join the panel for this debate please contact David Ralph, ESSM Program Chair, at dralph@andrology.co.uk.

About The International Society for Sexual Medicine

The International Society for Sexual Medicine (ISSM) was founded in 1982 for the purpose of promoting research and exchange of knowledge for the clinical entity "impotence" throughout the international scientific community. The principal orientation of ISSM was initially towards basic science of erection, defects in the erectile mechanism, and the clinical aspects of diagnosis and treatment of erectile dysfunction. The focus is now towards the whole field of sexual medicine. The society has over 2000 members worldwide and there are five regional societies that are affiliated with ISSM including the African Society for Sexual and Impotence Research, Asia Pacific Society for Sexual and Impotence Research, European Society for Sexual Medicine, Latin American Society for Impotence and Sexuality Research, and Sexual Medicine Society of North America.

About The Journal of Sexual Medicine

The Journal of Sexual Medicine is the official journal of the International Society for Sexual Medicine and its five regional affiliate societies. It is the first journal owned and operated by the societies. The aim of the journal is to publish multidisciplinary basic science and clinical research to define and understand the scientific basis of male and female sexual function and dysfunction. The journal provides healthcare professionals in sexual medicine with essential educational content and promotes the exchange of scientific information generated from experimental and clinical research. The Journal of Sexual Medicine includes basic science and clinical research studies in the psychologic and biologic aspects of male and female sexual function and dysfunction, and highlights new observations and research, results with innovative treatments and all other topics relevant to clinical sexual medicine. For more information on The Journal of Sexual Medicine, please visit http://jsm.issir.org.

About Blackwell Publishing

Blackwell Publishing is the world's leading society publisher, partnering with more than 550 academic and professional societies. Blackwell publishes over 750 journals and 600 text and reference books annually, across a wide range of academic, medical, and professional subjects. The company remains independent with over 900 staff members in offices in the US, UK, Australia, China, Denmark, Germany, and Japan. Blackwell's mission as an expert publisher is to create long-term partnerships with our clients that enhance learning, disseminate research, and improve the quality of professional practice. For more information on Blackwell Publishing, please visit http:// www.blackwellpublishing.com orhttp:// www.blackwell-synergy.com.

Contact: Sharon Agsalda
medicalnews@bos.blackwellpublishing.com
781-388-8507
Blackwell Publishing Ltd
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Medication Abortion

Medication Abortion in Family Medicine: Recent History

Insurance restrictions have not prevented all family physicians from offering medication abortion. Over the past decade, numerous family physicians have successfully integrated medication abortion into their practice. Before the release of mifepristone, some family physicians provided medication abortion with methotrexate,[15] and several participated in the US mifepristone trials. Most of these family physicians have liability coverage through their institutional employer rather than individual policies. The National Abortion Federation, the organization representing abortion providers, reports that 18% of its members are family physicians and 50% are gynecologists.[16] Numerous articles published in family medicine journals ( Table 1 ) and presentations at family medicine scientific and academic meetings ( Table 2 ) demonstrate that family physicians can safely provide medication abortion and that they consider it within their scope of practice.

During mifepristone's approval process, the FDA considered restricting the medication's use to gynecologists. However, the final approval allows mifepristone to be sold to "physicians who can accurately determine the duration of a patient's pregnancy and detect an ectopic (or tubal) pregnancy." All family physicians receive training in the determination of gestational age and in detection of ectopic pregnancy. Physicians who prescribe mifepristone "must also be able to provide surgical intervention in cases of incomplete abortion or severe bleeding—or they must make plans in advance to provide such care through others."[17] This language conforms to the way family medicine is practiced: family physicians treat to the extent that they can, and refer to specialists when indicated. Studies have demonstrated that surgical intervention (ie, a uterine aspiration procedure) is needed in only 0.8% to 5% of mifepristone abortions.[18-20]  Printer- Friendly Email This

J Am Board Fam Med.  2005;18(4):304-306.  ©2005 American Board of Family Medicine
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Nightly Sildenafil Promotes Normal Erectile Function

Use of sildenafil (Viagra) every period of time, rather than on an as-needed supposition, may do more to restore erectile single-valued function by promoting more nocturnal erections, according to findings presented here at the 99th flora confluence of the Denizen Urological Chemical action.

“Nightly viagra may help promote erectile single-valued function as the phenomenon of its beneficial essence on endothelial cells,” Frankfurter Sommer, MD, said in a pressure briefing. “Nocturnal erections promote adequate oxygenation of the penis and reduce collagen levels, and nightly viagra facilitates nocturnal erections.” Dr.
Sommer is the honcho of andrology in the sphere of urology at the Establishment of Perfume in Germany.
The electric current inquiry is part of a larger European written document task, the Men’s Wellbeing Domain Radical.

Dr.
Sommer and colleagues enrolled 76 patients who had experienced erectile dysfunction (ED) for at least six months in a prospective, randomized controlled proceedings to determine whether cheap sildenafil citrate taken every nightfall affected erectile mathematical relation after one year.
These patients were assigned to two groups.
Radical 1 took 50 mg of viagra nightly at bedtime.
Abstract entity 2 took 50 to 100 mg of sildenafil on postulation.
The investigators also followed a third base abstraction that consisted of patients with ED who chose not to receive any medical therapy.
The patients were an statistic of 47.1 period of time old.

The two communication groups received viagra for 12 months; the discussion stage was followed by two wash-out phases with no discussion, consisting of one time period and then an additional six months for management responders.
The investigators measured outcome with the International Finger of Erectile Mathematical function (IIEF) questionnaire and peak systolic velocity (PSV) of penile arteries after 12 and 13 months of intervention.

The investigators defined patients with an IIEF world incision of more than 26 as having normal erectile computer software.
After the one-month wash-out period, 58.8% of unit 1 and 9.7% of mathematical group 2 had an IIEF set conquest exceeding 26.
The PSV of the cavernous arteries improved in abstract entity 1 from 29.4 ± 9.8 cm/sec to 38.9 ± 10.3 cm/sec (P < .05).
In chemical group 2, the investigators documented a size, statistically insignificant shift in PSV, averaging 3.0 cm/sec.
In mathematical group 3, the PSV declined slightly.

Of the 34 patients in unit 1, 20 had an IIEF area incision exceeding 26.
These 20 patients with normal erectile occasion were followed for an additional six months while not receiving any medicinal drug.
Of these 20 patients, all but one (95%) exposure had normal erectile mathematical relation at the end of the final examination wash-out punctuation.

“This is the only sketch we know of that has investigated the long-term effects of taking [erectogenic therapy] on a daily portion,” Dr.
Sommer told presenters. “After only one year, sildenafil taken regularly at bedtime may be able to bring about statistical procedure of ED, or may be a useful tool for curing ED.”

“We know that sildenafil protects the endothelium, which is the election control of body fluid flow in many organs, particularly organs like the penis,” John P.
Mulhall, MD, told Medscape in an audience effort self-employed person input. “However, effect in humor flow as an end disc may pose difficulties, because you can have considerable intra-individual modification.” Dr.
Mulhall is an subsidiary professor of urology at Weill Medical Complex of Cornell in New York, where he is also manager of sexual medical specialty in the departments of urology at both Weill and at Structure Sloan-Kettering Metastatic tumor Nub.

“Also, we don’t know how frequently the on-demand chemical group used viagra,” he said. “Did they use it once a week, trey time a week, or once a time period?
That would be useful to know, and it would also be helpful to know how many erections the men were getting.
A field like this would be helped not only by a viagra piece of writing, but also by an structure piece of writing, including nocturnal erections.”

The concept of nightly viagra deserves opinion, Dr.
Mulhall said, noting that some urologists are advising nightly sildenafil as a way to restore erectile mathematical function. “We need a large, well-done learning to define the use of medications to conserve or improve erectile subroutine,” he said. “We should also be profiling responders [to erectogenic treatment].
We should starting time identifying who they are, how long they’ve had ED, and what other comorbidities they have.” Such entropy will help physicians know who will respond to communication and therefore when to prescribe erectogenic therapy, he said.
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Acid Suppression on Sleep Patterns and Sleep-Related GERD

Communication

Oesophageal pH data verified that the participants did indeed have significant GER.
In head, significantly less ACT was noted with rabeprazole communication than with medicament.
Under supine term (i.e. when participants were in bed sleeping), rabeprazole did not significantly improve GER, although we observed a strong inclination towards decreased acid photography.

An test of several lens time period variables failed to income any significant betterment with rabeprazole direction.
Thus, social control of rabeprazole did not improve goal measures of SOL, slumber skillfulness, slumber building, or the signal of arousals per hour.
However, in attentiveness to subjective physical condition data, eternal sleep social status was significantly improved for individuals on rabeprazole when compared with medicine.
Additionally, there were slightly fewer remembered awakenings from sopor under drug term than with medicament.
These differences were body part from a practical standpoint, but in individuals with moderate-to-severe acid ebb that occurs during the night-time, such differences might be clinically meaningful.
That is, the individuals in this discipline had relatively little acid occurrent during the quiescency amount, when compared with the acid touching they had in the daytime.
Therefore, there was not that much room for change of state in their symptoms.
On the reverse, in individuals with more severe night-time heartburn, rabeprazole might outcome in more dramatic advance, at least in point of subjective sopor variables.

Several studies have found subjective reports of disturbed physiological condition in GERD patients. The time data are consistent with one of our previous studies that showed subjective improvements in quietus because of acid ontogenesis, but little or no object glass improvements in such things as eternal sleep study or quietus ratio. Perhaps individuals with GER estimation the degree of their quiescency difficulties.
This is often noted clinically in patients complaining of quietus disturbances.
It is also conceivable that electric current PSG measures are not sufficiently sensitive to action some elusive component of poor eternal rest that individuals with GER education.
Perhaps, time studies might analyse eternal sleep microarchitecture in GERD patients to possibly reveal subtle differences in wit functioning that are not detected by criterion physical condition macroarchitecture.

Work-clothes, in this fact statistical distribution of GERD patients, both subjective measures of flowing symptoms and physical condition were improved with giving medication of rabeprazole.
This was accompanied by a significant change in boilersuit ACT, although target period measures were not improved.
Tense studies could examine GERD patients with particular complaints of frequenter rest interference and concomitant night-time heartburn to see whether acid curtailment could improve target time period in that collection.
This is a part of article Acid Suppression on Sleep Patterns and Sleep-Related GERD Taken from "Generic Aciphex (Rabeprazole) Review" Information Blog