Blood Banks Also Need Viagra Dose

It’s hard to argue with blood transfusions. Each year, nearly 5 million Americans receive them, and for many patients it’s a definitively life-saving therapy. There is, of course, a risk in transmitting diseases like hepatitis and HIV through transfusion, but modern operations can all but eliminate that threat. Curiously, however, there have been persistent observations about another problem with blood transfusion: In some settings, blood transfusions worked less effectively than expected, but no one knew exactly why. Now two groups at Duke University may have found the reason: the loss of the molecule nitric oxide from stored blood.

Nitric oxide is one of those "big" molecules. Its first biological effects were described in the 1970s, and in the 1980s it was determined that the gas contributes to the normal dilation of blood vessels. This led to an avalanche of research, a 1998 Nobel Prize for its discoverers, and, most famously, the creation of Viagra. (For those of you who are wondering, nitric oxide is not laughing gas. That’s nitrous oxide. Mixing up the two could presumably cause some very undesired results.)

In papers published in the Proceedings of the National Academy of Sciences, two teams at Duke showed that the nitric oxide normally found in red blood cells disappeared within a few hours of the blood being processed for transfusion. When animals in lab studies received transfusions of the nitric oxide–depleted blood, their blood vessels did not dilate to normal levels, decreasing the amount of blood—and oxygen—that gets delivered to muscle and other tissue. Replacing the nitric oxide, a relatively simple procedure, made the transfused blood effective at expanding blood vessels and delivering more oxygen.

This is the kind of study everyone likes. It answers a question that has been bothering people for a long time, the answer makes sense, and the potential solution is straightforward. If this work can be duplicated in other animals and then in humans, it could go a long way toward making blood transfusions a safer and more effective option for patients who need them.

Osteoporosis

More than 2 million American men have osteoporosis, and an additional 12 million are at risk, according to the National Osteoporosis Foundation. Male osteoporosis seems to be a disease ahead of its time: under-diagnosed, under-treated, and under-researched. Data from NIH’s ongoing National Health and Nutrition Examination Survey indicate that the number of men affected will roughly double to nearly 5 million men by 2020. A study in the Archives of Internal Medicine confirms the lack of awareness regarding male osteoporosis, with fewer than three percent of men, compared with 42 percent of women, receiving treatment.

Despite the large number of men affected, male osteoporosis is often a back-burner issue, as physicians and patients concentrate on hypertension, diabetes, and prostate problems. Thus, osteoporosis may remain clinically unnoticed until fractures occur, which may be too late for some patients, as the mortality rate for men with hip fractures (31 percent) is double that of women (17 percent). (These numbers are age-dependent: far lower for a 30-year-old who falls skiing, and a bit higher for a 95-year-old man who falls in the bathroom.)
Men have more dense bone, which is why fewer men than women are affected by osteoporosis, and why they usually present ten years later.

Risk factors for osteoporosis in men include heredity, smoking, excessive alcohol use, low calcium intake, inadequate physical exercise, prolonged exposure to certain medications (such as steroids to treat asthma or arthritis), and disorders that decrease testosterone levels. Like women, men should be thinking about osteoporosis if they notice a loss of height, change in posture, or the sudden onset of severe back pain. Fractures that occur in the absence of a fall or trauma should also raise suspicions.

The good news is that bone loss and fracture risk can both be reduced by taking up healthy habits—an improved diet and weight-bearing exercise.
Most American men have an inadequate daily calcium intake, so be sure to have a daily elemental calcium intake of about 1200 milligrams.
Vitamin D is also important for strong bones, and men should have between 10 and 20 micrograms (400 and 800 international units) each day.
 

Treatment with bisphosphonates, which has been shown to increase bone density, should be discussed with a physician. Male osteoporosis is on the rise, but there are steps you can take to keep you and your bones healthy. If you think you’re at risk, make sure you talk about it with your doctor. It’s the "manly" thing to do.