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U.S. combat soldiers in Iraq who received a shot of morphine within an hour of being wounded were less likely to develop post-traumatic stress disorder, researchers reported on Wednesday.

The painkiller injections are no guarantee of preventing PTSD, according to the report in the New England Journal of Medicine, but the findings may help doctors find a better way to prevent the debilitating psychic strain of combat.

“We are not sure if the effect is from pain reduction or from an effect morphine has on memory consolidation in the brain immediately after a traumatic event. Or it may be both working together,” Troy Lisa Holbrook of the Naval Health Research Center in San Diego said in a telephone interview.

“We need more research to tease those out and find out which one it is,” she said.

PTSD can cause flashbacks, edginess and emotional numbness. The risk depends on the type of traumatic events a person is exposed to. A 1995 survey found that 7.8 percent of the U.S. population was destined to experience PTSD at some point.

“The search for a ‘morning-after pill’ after exposure to traumatic stress is obviously of great importance,” Dr. Matthew Friedman of the National Center for PTSD wrote in a commentary.

The study of 696 members of the Army, Navy and Marine Corps, all wounded in Iraq from 2004 to 2006, found that 61 percent of those who eventually developed PTSD had been given morphine, usually within an hour after being wounded.

But 76 percent of those who did not develop PTSD had been given morphine.

“It did not appear that the severity of the injury made any difference in this observed association,” said Holbrook, who added that many other questions needed to be explored, such as whether the dose of morphine makes a difference.

She said her team would be looking at the effects of other opiates and anti-anxiety drugs to see if they work as well, or better.

Thursday’s Journal also contains a separate study that looks at the risk of mental health problems among the wives of soldiers who are deployed in combat situations.

It found that depression, sleep disorders and anxiety were significantly more common among Army wives whose husbands had been sent to Iraq or Afghanistan. The medical records of more than a quarter of a million women were assessed.

“I don’t think these results will come as a shock. But it’s the first study of this size to put actual numbers with these issues,” Alyssa Mansfield of RTI International in North Carolina, who worked on the study, said in a telephone interview.

(Editing by Maggie Fox and Peter Cooney)

The estimated 7.5 million Americans suffering from psoriasis often have to tolerate long-term treatment that may be only moderately effective.

Now, a new drug called ustekinumab (Stelara) appears to be more effective than the old standby, etanercept (Enbrel), according to the results of a head-to-head comparison sponsored by the maker of Stelara.

“Ustekinumab is a more effective and faster acting therapy for psoriasis than the current biologic market leader for this condition,” said lead researcher Dr. Christopher E.M. Griffiths, a professor of dermatology at the University of Manchester in England.

Enbrel and Stelara are biologic agents, which work by blocking proteins produced in the body. Enbrel blocks tumor necrosis factor alpha, while Stelara inhibits interleukin-12 and interleukin-23.

This is the first head-to-head trial of two biologic therapies for psoriasis, Griffiths noted. Psoriasis is a chronic, autoimmune disease that appears on the skin.

The report is published in the Jan. 14 issue of the New England Journal of Medicine. Centocor Research and Development sponsored the study.

For the study, Griffiths and colleagues randomly assigned 903 patients with moderate-to-severe psoriasis to two different doses of Stelara injected 30 days apart or to high-dose Enbrel injections twice a week for 12 weeks.

After 12 weeks of treatment, 67.5 percent of the patients receiving 45 milligrams of Stelara had a 75 percent improvement in their condition, according to the psoriasis area-and-severity index, as did 73.8 percent of those receiving 90 milligrams of Stelara.

Only 56.8 percent of those receiving Enbrel showed a similar improvement, the researchers found.

In addition, based on doctors’ assessments, 65.1 percent and 70.6 percent of patients receiving the low and high dose of Stelara had little or no signs of psoriasis, compared with 49 percent of the patients receiving Enbrel, the team reported.

Moreover, among the patients who did not respond to Enbrel, 48.9 percent had at least a 75 percent improvement 12 weeks after switching to Stelara.

These results show that “the optimal approach to treating psoriasis may be via the targeting of the chemical messengers interleukin-12 and interleukin-23 as exemplified by ustekinumab as opposed to the chemical messenger tumor necrosis factor alpha targeted by etanercept,” Griffiths said.

Dr. Paolo Romanelli, an associate professor of dermatology at the University of Miami Miller School of Medicine, wasn’t totally surprised by the results. “These findings are exciting and a little bit expected,” he said.

Stelara was approved in October, so not many patients are receiving it yet, he noted. A main benefit of Stelara is the need for fewer injections, Romanelli said.

Romanelli advises patients receiving Enbrel to stay on the drug if they are doing well. For those who do not respond to Enbrel, there is “incredible hope to have a new medication that may help them,” he added.

Patients who don’t respond to Enbrel may respond to Stelara, the study found. The safety of the two biologics appeared similar, Griffiths said.

Common side effects included local reactions at the injection site, headache and back pain.

Before the creation of these biologics, psoriasis treatment focused on reducing inflammation with drugs such as methotrexate and cyclosporine.

Psoriasis is associated with other serious health conditions, such as diabetes, heart disease and depression, according to the National Psoriasis Foundation.

SOURCES: Christopher E.M. Griffiths, M.D., professor of dermatology, University of Manchester, England; Paolo Romanelli, M.D., associate professor of dermatology, University of Miami Miller School of Medicine, Fla.;

Men worried that taking Viagra will lead to sexually risky behavior can relax: A new study suggests that drugs for erectile dysfunction don’t make men more likely to engage in potentially unhealthy sex.

“For this study we took the perspective of a doctor who may worry that prescribing erectile-dysfunction drugs to patients could contribute to the spread of HIV. The findings from this study should provide some reassurance to health-care providers that erectile-dysfunction drugs appear to be prescribed responsibly and used responsibly,” Dr. Robert Cook, an associate professor at the University of Florida and lead researcher of the new study, said in a news release.

Cook noted that this study is unique because, unlike previous studies, it didn’t focus on men who obtained the medication without a prescription, had sex with men or had substance abuse problems.

“In this study we looked at erectile-dysfunction drugs and sexual behavior in the context of routine health care for a group of men who are more representative of the general population,” Cook said.

By the study’s definition, risky sexual behavior is unprotected sex with someone whose HIV status is opposite — positive if you’re negative or the reverse — or not known.

The researchers examined data from 2,787 men, average age 52, who were taking part in a study about aging veterans. About half were HIV-positive.

According to the study findings, 28 percent of the men used erectile-dysfunction drugs over a one-year period. About 10 percent of the men in two groups — those who did use the drugs and those who didn’t — reported behavior defined as sexually risky.

The study is published in the February issue of the Journal of General Internal Medicine.