Women cyclists who set their bikes' handlebars lower than the saddle tended to show a degree of impaired genital sensation, researchers at Yale U reported.  Among 41 competitive cyclists, the 19 who rode bikes with relatively low handlebars had, on average, significantly higher vibratory thresholds in the anterior vagina, compared with riders whose handlebars were level with the bike saddle, according to Marsha K. Guess, MD, and colleagues.

Measurements of perineum saddle pressure also showed significant increases in the riders with low handlebars, Guess and colleagues reported online in the Journal of Sexual Medicine.  "Correcting modifiable risk factors for pelvic floor damage may serve as the most important next step in enhancing riding safety in women cyclists," the researchers wrote.

Genital numbness has been a recognized complaint of male as well as female cyclists.  Saddle design appears to contribute to the problem, but, the researchers noted, how the riders sit on the saddle is also a factor, and perhaps the dominant one.

An earlier study by another group had found that pressures on the pelvic floor in both sexes were related to the relative positions of the handlebars and saddles.

Consequently, Guess and colleagues reanalyzed their data from the 48-rider sample, focusing on 41 participants for whom information on their bikes was available.   Low handlebars force the rider to exaggerate their forward lean, decreasing the trunk angle and increasing the pelvic tilt. Guess and colleagues hypothesized that this position would put more weight over the perineum region relative to the ischial tuberosities (commonly called the sitz bones).

Results were reported for 22 riders whose handlebars were level with their saddles compared with the 19 with lower handlebar positioning.

They concluded that low handlebar positions "yield detrimental effects to the female pelvic floor," but they also conceded that higher positions may increase the riders' wind resistance and reduce their speed.   "This exemplifies the ongoing struggle between selecting a more aerodynamic bicycle position for control and speed or a more ergonomic position to reduce neurovascular compromise," Guess and colleagues wrote.

Source:   Partin S, et al "The bar sinister: Does handlebar level damage the pelvic floor in female cyclists?" J Sexual Med 2012; DOI: 10.1111/j.1743-6109.2012.02680.x

A new study points to indoor tanning as a cause for melanoma, the most serious type of skin cancer,  particularly among young sunbed users.  Overall, there was a 20% increased risk for melanoma with any indooor tanning, according to Mathieu Boniol, PhD, of the International Prevention Research institute in Lyon, France, and colleagues.   The risk nearly doubled when sunbed use began before age 35.

"Powerful ultraviolet tanning units may be 10 to 15 times stronger than the midday sunlight on the Mediterranean Sea, and repeated exposure to large amounts of ultraviolet A delivered to the skin in relatively short periods (typically 10 to 20 minutes) constitutes a new experience for humans," Boniol's group observed.

The last meta-analysis on risk of melanoma with indoor tanning was conducted in 2006. It showed an increased risk, but no dose-response could be identified.  Since that time considerably more data have been published, so Boniol and colleagues performed an updated meta-analysis that included 27 studies and 11,428 cases of melanoma from 18 countries in western and northern Europe.

In studies that considered risk according to the number of tanning sessions each year, there was a 1.8% increase in melanoma risk for each sunbed exposure.  For high use of indoor tanning, the risk increased by 42%, and when initial exposure was more than 5 years before the diagnosis of melanoma, the relative risk was 1.49.

The researchers reported that melanoma could be attributed to sunbed use in 5.4% of cases overall, and was associated with 6.9% of all melanoma cases in women and 3.7% of cases in men.

This means that in the  European countries included, about 498 women and 296 men would die each year from a melanoma as a result of being exposed to indoor tanning using artificial ultraviolet light," the researchers stated.

They also noted that it was unlikely that the increases in melanoma could be explained by greater sun exposure.

"Compelling evidence that use of sunbeds can be a cause of melanoma and not just a proxy for sun exposure arises from the investigation of a melanoma epidemic in Iceland, a country located between 64 and 66 degrees North and where sunny days are uncommon," the researchers wrote.

That epidemic began in 1990, with a sharp increase in cases among young women, but began to decline 10 years later, when Icelandic regulatory authorities cracked down on tanning facilities.

The researchers noted that some data have suggested that sunbed-related melanoma may not be as aggressive as the solar-induced malignancy, but cautioned that the overall burden of disease is likely to rise because of the continuing popularity of indoor tanning, particularly among young people.
Source reference:
Boniol M, et al "Cutaneous melanoma attributable to sunbed use: Systematic review and meta-analysis" BMJ 2012; DOI: 10.1136/bmj.e4757.

The FDA recently approved the first weight-loss drug, Belviq (lorcaserin hydrochloride), in 13 years.  Arena Pharmaceuticals of San Diego developed the pill to help people lose 3-4% of their body weight when coupled with exercise and a healthy diet.  The FDA approved the pill for obese people (BMI over 30) and some overweight people (BMI over 27) who suffer from high blood pressure, high cholesterol, and type 2 diabetes.

Potential weight-loss drugs face increased scrutiny tod
ay by the FDA for efficacy and safety as many recent ones (fenfluramine, for example) have been recalled due to heart-valve complications.  In March, the FDA’s advisory committee introduced mandatory tests for cardiovascular risks for all obesity drugs, which makes the current clinical trials even longer.

In 2010, Arena applied for approval of the drug. The FDA denied approval because it was deemed responsible for causing tumors in rats and because it could not definitively rule out an increase in heart-valve defects.  The pharmaceutical company conducted echocardiograms for 8,000 patients to determine heart-valve function.  This trial could not verify an increase in heart-valve defects in the users of the drug, convincing the FDA to approve it.  The company committed to perform six post-marketing studies with a long-term cardiovascular trial that will search for heart attack and stroke risks.

The drug works to suppress food cravings by mimicking the effects of serotonin in the brain.  Along with many other vital functions, the neurotransmitter serotonin plays a role in controlling appetite.  Within the brain, neurons pass messages back and forth using chemical messengers (neurotransmitters).  The messages may involve information concerning emotions, body temperature, behavior and appetite.  The specific kind of information delivered varies with which neurons become activated and where the brain becomes stimulated.  The neurotransmitter leaves the neuron and enters the synapse (the space between the two “communicating” neurons).  The neurotransmitter links with the receptor on the other neuron, which sends the message.  This can then be repeated through a process called reuptake.  Serotonin qualifies as a neurotransmitter.  The drug Belviq mimics serotonin by activating the 2C receptor, which increases the amount of serotonin to carry messages and increases the probability that the message is received.  Thus, the drug causes people to eat less and feel full.

Non-diabetic patients reported headache, dizziness, fatigue, nausea, dry mouth and constipation as side effects.  Other side effects include serotonin syndrome especially in combination with depression or headache medication that increase serotonin levels or that activate serotonin receptors.  The drug may also affect attention or memory.  In diabetics, side effects include low blood sugar, pain, cough and fatigue.

On average, a 198-pound patient taking Belviq will lose six to seven pounds in a year.  20% of patients lose at least 10% of their body weight.  Comparatively, 47% of patients without type 2 diabetes taking the drug and 23% of those taking a placebo each lost at least 5% of their total body weight.  38% of patients with type 2 diabetes taking the drug and 16% of those taking a placebo each lost at least 5% of their total body weight.  Type 2 diabetics who toke Belviq proved to be twice as likely to regulate their blood sugars compared to those who toke the placebo.

While it may help those suffering from diabetes, it may cause heart complications.  The company advises patients with congestive heart failure or pregnant patients to not take the drug.  CNN’s Dr. Melina Jampolis, a physician nutrition specialist and diet and fitness expert, calls the results modest and says, “But most experts agree that even a 5% weight loss has significant implications in terms of reducing the risk of obesity associated diseases including heart disease and diabetes.”

The drug may be risky, but risks also come with the rising obesity rate such as diabetes and heart disease.  With more than 1/3 of the adult population being obese, the drug may prove worthwhile.

Sources

Nature

CNN

Several Affordable Care Act  provisions that have "remained under the public's radar" are women's health-related, according to a Kaiser Health Newslist of 10 little-known elements of the law. The following is from the Daily Women's Health Policy Report from the National Partnership for Women and Families.

One such provision reauthorizes funding through 2014 to states for sex education programs that teach students that abstinence is "the only certain way to avoid out-of-wedlock pregnancy, sexually transmitted diseases, and other associated health problems."

Another provision calls on the National Institute of Mental Health to conduct a study on the causes and effects of postpartum depression. The law also authorized $3 million in 2010 and more funds as needed in 2011 and 2012 to support services for women at risk of postpartum depression.

The health reform law also requires employers with 50 or more workers to provide women who are breastfeeding with a private location to pump and "reasonable break time" to do so.

Another section in the law requires CDC to carry out an educational campaign targeted at young women about "the occurrence of breast cancer and the general and specific risk factors in women who may be at high risk for breast cancer based on familial, racial, ethnic and cultural backgrounds such as Ashkenazi Jewish populations" (Schultz/Torres, Kaiser Health News, 7/12).