Nicotine replacement therapy during pregnancy

Article Abstract:

This article evaluates the risks and merits of nicotine replacement therapy for pregnant women. As many as 25 percent of pregnant women in the US continue to smoke during pregnancy; the proportion among pregnant teenagers is even higher. This practice increases the risk of miscarriage, prematurity, low birth weight, and death in the perinatal period (the weeks before and after delivery). Smoking may be responsible for 4,600 infant deaths each year. Babies born to mothers who smoke two packs of cigarettes daily are at greater risk for low Apgar scores (a measure of the physical status of the newborn), compared with infants born to nonsmoking mothers. Birth defects do not appear to be more common in babies born to smoking mothers. For men and nonpregnant women, the use of nicotine polacrilex chewing gum is associated with an overall cessation rate (at 6 months) of 27 percent, compared with a rate of 18 percent for placebo gum. Possible risks associated with nicotine use during pregnancy may include tobacco-related reproductive disorders; fetal growth retardation; negative effects on placental circulation; and reduced blood oxygen levels (hypoxemia) in the fetus as a result of circulatory disturbances that ultimately effect behavior. Cigarettes deliver nicotine, carbon monoxide, and a number of other toxic substances. Therapies using nicotine replacement (via gum or transdermal delivery systems) deliver the substance at a lower rate than cigarettes, minimizing risk. The average one-pack-per-day smoker consumes 20 milligrams of nicotine and from 200 to 300 milligrams of carbon monoxide each day. In comparison, 12 pieces of nicotine chewing gum (more than most smokers use) deliver 12 milligrams of nicotine, and a transdermal delivery system delivers between 15 and 20 milligrams of nicotine per day. The physiologic aspects of nicotine from various sources are discussed, with particular attention to cardiovascular effects. Nicotine replacement therapy probably presents less risk to the fetus than continued cigarette smoking. It should certainly be tested in heavy smokers who can not stop smoking during pregnancy. (Consumer Summary produced by Reliance Medical Information, Inc.)

Evaluation, Pregnant women, Smokers, Nicotine chewing gum

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Effect of testosterone replacement therapy on prostate tissue in men with late-onset hypogonadism: A randomized controlled trial

Article Abstract:

A randomized controlled trial is conducted to determine the effects of testosterone replacement therapy (TRT) on prostate tissue of ageing men with low serum testosterone levels. The preliminary results have shown that in aging men with late-onset hypogonadism, six months of TRT normalizes serum androgen levels but appears to have little effect on prostate tissue androgen levels and cellular functions.

Health aspects, Drug therapy, Testosterone, Hypogonadism, Clinical report

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Hormone Replacement Therapy and Dry Eye Syndrome

Article Abstract:

Estrogen replacement therapy appears to increase a woman's risk of dry eye syndrome, according to a study of 25,665 women. Hormone therapy that includes progesterone is less likely to cause dry eyes.

Complications and side effects, Risk factors, Hormone therapy, Xerophthalmia, Dry eye syndromes

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