ERECTILE DYSFUNCTION

Use of a testosterone gel may improve sexual functioning.

* THE QUESTION Men with low testosterone levels often find that Viagra (sildenafil) does not work well for erectile dysfunction. Should they also use a testosterone gel?

* THIS STUDY involved 75 men with erectile dysfunction and low testosterone levels (below 400 nanograms per deciliter) who previously had found Viagra to be ineffective. All the participants were instructed to take 100 milligrams of Viagra each day on which they might have sex. They also were randomly assigned to use either a transdermal testosterone gel (AndroGel) or a placebo gel every day. After four weeks, those who had used the testosterone gel reported a 34 percent improvement in erectile function; the placebo group had a 17 percent improvement.

* WHO MAY BE AFFECTED BY THESE FINDINGS? Men with erectile dysfunction and low testosterone levels. An estimated 10 percent of men 40 to 60 years old have low testosterone. Erectile dysfunction is estimated to affect 15 million to 30 million men, mostly those over 50.

* CAVEATS Different doses of sildenafil and the gel might produce different results. The study was funded by Solvay Pharmaceuticals, whose parent company makes AndroGel. The study relied on self-reports by the participants and addressed only the effectiveness of the treatments; safety data were not reported.

* BOTTOM LINE Men who find Viagra ineffective may want to have their testosterone level checked and then talk with their doctor about a testosterone gel.

* FIND THIS STUDY August issue of the Journal of Urology; abstract available online at www.jurology.com.

* LEARN MORE ABOUT erectile dysfunction at www.mayoclinic.com and http://familydoctor.org.

childbirth

Delaying preterm delivery may reduce the risk of disability.

* THE QUESTION When a fetus is no longer thriving in the womb, immediate delivery may be recommended to make the survival of the fetus more likely, even though this approach raises the risk of cerebral palsy and other disabilities. Delaying delivery for a few days allows for continued brain development, but this approach can have severe consequences as well. Does the timing of delivery affect the likelihood of a child's being disabled?

* THIS STUDY randomly assigned 548 women who were 24 to 36 weeks pregnant with fetuses that were not thriving to deliver within 48 hours or to defer delivery until delaying was determined to be no longer safe. (These delays lasted an average of four days.) About 10 percent of the babies in both groups died before leaving the hospital. When the surviving children were 2 years old, examinations and testing showed that 7 percent of those in the immediate-delivery group had a disability, compared with 4 percent in the delayed-delivery group. A still-larger difference was found among those delivered before 31 weeks of gestation. Disabilities included blindness or impaired vision, deficient hearing, mental or psychological development problems and cerebral palsy.

* WHO MAY BE AFFECTED BY THESE FINDINGS? Pregnant women.

* CAVEATS Whether delaying delivery for longer would affect the outcome remains unclear.

* BOTTOM LINE Pregnant women carrying fetuses that are not thriving may want to discuss the possible effects of various delivery times with their doctor.

* FIND THIS STUDY Aug. 7 issue of The Lancet; abstract available online at www.thelancet.com.

* LEARN MORE ABOUT premature babies at www.kidshealth.org and at http://familydoctor.org.

asthma

Biofeedback appears to offer relief and ease need for drugs.

* THE QUESTION Some people with asthma do not use steroid inhalers regularly due to fear of side effects. Might biofeedback, which involves no drugs, be an alternative?

* THIS STUDY randomly assigned 94 adults with asthma to one of four groups. One group received biofeedback that was aimed at monitoring heart rhythm, another used biofeedback plus special slow-breathing techniques, a third followed a fake biofeedback regimen and the fourth received no treatment. All participants also took asthma medication in the lowest possible amount needed to control symptoms. After about 10 weeks, asthma severity in the two biofeedback groups had declined one level -- from moderate to mild, for instance -- and lung function had improved. Neither changed in the control groups. The biofeedback groups also required less medication than the others.

* WHO MAY BE AFFECTED BY THESE FINDINGS? People with asthma, which afflicts more than 14 million adults in the United States.

* CAVEATS Whether decreased use of medication would have a negative effect long-term remains unclear. Participants in the study were paid.

* BOTTOM LINE People with asthma may want to talk with their doctor about biofeedback.

* FIND THIS STUDY August issue of Chest; abstract available online at www.chestjournal.org.

* LEARN MORE ABOUT asthma at www.aaaai.org and www.cdc.gov/asthma.

-- Linda Searing