No safe duration of NSAIDS

Health Care, Medicine 343 Comments

There is no “safe” duration for NSAID use in patients with a history of myocardial infarction, according to an analysis of data from more than 83,000 patients — use of NSAIDs after MI increased the relative risk of death or second MI by as much as 45%.

The common NSAID diclofenac was associated with a 3.52 HR for death during the first week of use, according to Anne-Marie Schjerning Olsen, MB, of Copenhagen University Hospital in Gentofte, Denmark, and colleagues in Circulation, Journal of the American Heart Association. That’s a higher risk of death at the initiation of treatment than was seen with rofecoxib which was withdrawn from the market in 2004. For ibuprofen, which was the most commonly used NSAID, the increased risk was seen for treatment lasting more than a week. Among the findings:
All NSAIDs increased risk of death or recurrent MI by 45% after a week (HR 1.45, 95% CI 1.29 to 1.62).
Naproxen increase the risk of death or recurrent MI by 76% after a week (HR 1.76, 95% CI 1.04 to 2.98), but for treatments lasting 30 to 90 days the risk increased risk was 15% (HR 1.15, 95% CI 0.80 to 1.65).
Ibuprofen had the lowest initial risk, just a 4% increase for treatments lasting seven days or less (HR 1.04, 95% CI 0.83 to 1.30).
Dr KK Aggarwal
Editor in Chief
Krishan Kumar Aggarwal

Crotch Length and Infertility

Health Care, Medicine 150 Comments

It is possible to assess a man’s fertility by checking his anogenital distance, the gap between his scrotum and anus. A study from the University of Rochester, published in March in Environmental Health Perspectives, found that men with shorter anogenital spans had lower sperm counts, poorer quality sperm, lower sperm concentrations and lower motility.

Baylor group measured the scrotum-anus distance as well as the penis length of 117 infertile and 56 fertile men visiting an andrology clinic. The infertile men had a significantly shorter anogenital distance and penis length than the fertile men.

This could represent a noninvasive way to test testicular function and reproductive potential in adult men.

Shanna H. Swan, vice chair for research in the department of preventive medicine at Mount Sinai Children’s Environmental Health Center, New York City and her colleagues published similar findings last month. Together the two studies make a strong case that this simple measure (the anogenital distance) reflects early genital development and predicts semen quality and fertility.