Sildenafil citrate (VIAGRA)

Seniors enrolled in private, standalone Medicare prescription drugs plans (PDP) could encounter significant changes this open enrollment period, which begins Sunday.

Monthly premiums will rise 11 percent to $38.94, on average, according to an analysis published by the Henry J. Kaiser Family Foundation. That’s up 50 percent from 2006, the first year that Medicare Part D drug benefits were offered.

“But these changes vary considerably by plan,” added Jack Hoadley, a research professor in the Health Policy Institute at Georgetown University in Washington, D.C., and one of the report’s authors. “Just among the five most popular plans, the premium for one is up by 22 percent for 2010, while the premium for another is down by 3 percent,” he said.

So is Medicare Part D still a good buy? It all depends, experts say.

“The general advice is you do have to look beyond the premium and look at what’s covered, what your expenses are for the course of the year and whether it works for you with the drugs that you take,” said Paul Precht, director of policy and communications in the Washington, D.C., office of the Medicare Rights Center, a nonprofit consumer counseling and advocacy group.

Seniors can access Part D one of two ways. If they’re in traditional Medicare, they can select a private PDP from a wide array of options. Or, if they are enrolled in a Medicare Advantage plan, like an HMO or PPO, with prescription drug coverage, they can receive Part D benefits through that plan.

Of the nearly 27 million Medicare beneficiaries in Part D, two-thirds are enrolled in standalone PDPs, according to the Kaiser Family Foundation analysis, which examines changes in the PDP marketplace.

With dozens of PDPs from which choose in every region, sifting through the various options can be a pain. For 2010, a total of 1,576 plans will be offered nationwide — 113 fewer choices. Yet seniors will still have anywhere from 41 to 55 alternatives from which to choose in every region.

“I think it’s a good trend that the number of plans is going down. I do think there is a thing as too much choice,” said David Lipschutz, staff attorney for California Health Advocates, a nonprofit Medicare advocacy and education outfit.

Seniors will get little relief, however, from cost-sharing requirements. Sixty percent of PDPs, up from 45 percent in 2009, will require an annual deductible in 2010, for example. The maximum deductible that a plan may charge is $310.

Plan coverage of costs incurred in connection with Part D’s infamous “doughnut hole” is getting stingier, too. In 2010, many beneficiaries will have to foot the bill for the coverage gap, which begins after the enrollee has incurred $2,830 in drug spending. Coverage resumes for drug costs above $6,440.

The House of Representatives on Nov. 7 passed a sweeping health reform bill that provides gap relief beginning in 2010 and eliminates the gap by 2019. However, the Senate must act before any health reform legislation is enacted.

There are also changes in store for seniors in “benchmark” plans, which offer basic Part D coverage to individuals who qualify for a premium. Of the 7.9 million getting extra financial help, 2.2 million must switch plans or pay a portion of their premium. If they want to stay in their current plan, their share of the premium will run roughly $8 to $10 a month, Precht said.

Part D experts urge seniors to take time during the open enrollment period to consider all of their options.

“It pays to do your homework,” Lipschutz said. “The plan you’re in now could change significantly next year, not only premium-wise but also the drugs it covers, the cost-sharing it charges for the drugs, the rules it imposes on accessing those drugs, [and] the pharmacy it contracts with.”

Nicotine patches and gum seem to be safe and effective in pregnant women, according to a new study.

Such patches and gum have been shown to help non-pregnant adults stop smoking, study co-author Dr. Geeta K. Swamy told Reuters Health. However, women and their obstetricians have been uncertain about their safety and effectiveness during pregnancy.

Dr. Swamy, from Duke University Medical Center in Durham, North Carolina, and colleagues took another look at data on pregnant smokers who had participated in a study comparing psychological treatments with nicotine patches or gum to help them quit.

Adding nicotine patches or gum tripled the number of women who quit, from 8 percent to 24 percent.

Almost a third - 31 percent — of the women who used the patch or gum had pregnancy complications, compared to 17 percent of the women who did not use it.

However, there was a much higher risk of such complications in black women, those with complications in previous pregnancies, and use of painkillers. The use of the patch did not seem to have a direct effect, the researchers note.

Based on the findings, although the patch is not “absolutely safe,” it may still be worth using in heavy smokers, given the known association between smoking and bad pregnancy outcomes, particularly premature birth and low birth weight, they conclude.

When it comes to teaching healthy behaviors, boys’ high school team sports might be doing more harm than thought.

New research suggests that for teenage boys, participation in team sports may encourage unruly behavior such as fighting and binge drinking.

Girls, on the other hand, seem to behave better in organized sports, said the lead researcher, Susan Connor, manager of the injury prevention program at Rainbow Babies & Children’s Hospital in Cleveland.

“The research raises more questions than it answers,” said Connor, who was to present her findings at the American Public Health Association’s annual meeting, in Philadelphia, which concludes Wednesday. “We were looking at a broad database, so we do not know why team sports may affect boys differently or how they affect them. That’s a topic for further research.”

Connor and her team studied the responses of more than 13,000 U.S. high school students who took part in the 2007 Youth Risk Behavioral Study, an assessment of adolescent high-risk behaviors conducted by the federal Centers for Disease Control and Prevention.

According to Connor’s findings, roughly 60 percent of the male respondents said they had played in at least one team sport in the past year. For girls, the participation rate was 48 percent.

The data did not specify which sports the teenagers participated in, although the top high school sports in the 2000 U.S. Census included basketball, football, baseball, soccer, track and field, and cross-country running.

For boys, the study found that participation in team sports correlated with an increased likelihood of fighting, drinking and binge drinking. Rates of depression and smoking, however, seemed to decline.

The findings were different for girls. White girls who were active in team sports reported lower levels of fighting, depression, smoking, marijuana use and unhealthy weight-loss practices, Connor and her colleagues found. Black high school girls reported increased levels of binge drinking.

“I think the issue is more socio-economic than race,” said Connor, who added that more research is needed to explore the slight behavior differences between black and white female high school athletes.

Connor stopped short of offering explanations for the apparent negative aspects of boys’ team sports. One possibility, she said, is that there is a culture in male sports that creates a climate of poor behavior.

“There are certainly health benefits in playing team sports,” said Connor. “But there is also this misconception, which is very widespread, that sports are all good. As a parent, you can’t assume your kid is protected. Sports are what you and your child make of it.”

Robert Regal, a psychologist in private practice in Valhalla, N.Y., agreed with Connor’s findings. Part of the problem, he said, is that boys’ teams may inherently attract athletes who are aggressive and highly competitive, leading to unruly behavior once they join a team.

“There are pre-existing expectations for both male and female athletes,” he said. “To be a female athlete means not having the same kind of hyper-aggressive, big-man-on-campus image. For guys, team sports are played with a great deal of expectation for success. It’s written into the team ethic.

“I’d be curious to see the behaviors of the top girls’ teams, the ones that win the state championships. I suspect they mirror the behaviors of the boys,” Regal added.

A urinary tract infection occurs when certain bacteria invade the urinary tract. Symptoms may include itching, burning, and painful urination.

The National Women’s Health Information Center lists these common causes of urinary tract infections in women:
Wiping from back to front after a bowel movement.
Having sex.
Holding urine for too long.
Being diabetic.
Having a kidney stone or other factor that makes it difficult to urinate.
Producing less estrogen, such as after menopause.
Having recently had a catheter inserted.