ROCHESTER, MINN. -- June 2001 The following stories detail news from Mayo Clinic. They are intended for use as individual stories or as part of a larger story on a particular medical topic.

Study Finds Changes in Hormone Levels in Men Who Become Fathers

A published study of hormonal changes in a group of Canadian men becoming fathers for the first time showed a decrease in testosterone and cortisol levels and a higher level of estradiol concentrations, a hormone known to influence maternal behavior.

The study, which appears in the June issue of Mayo Clinic Proceedings, says the findings are worthy of further study, but they don't say what, if any, physiologic relevance of the hormone changes is known.

Volunteer study subjects were recruited from first-trimester prenatal classes in Kingston, Ontario, Canada, in February 1999. As part of the study, 23 dads provided saliva samples from recruitment through three months after the birth of their children. Researchers also recruited 14 men who were not fathers from the general population to serve as age-matched controls for seasons and time of day. Estradiol, testosterone and cortisol levels were quantified.

Authors of the study are Sandra J. Berg, M.Sc., and Katherine E. Wynne-Edwards, Ph.D., of the Department of Biology at Queen's University in Kingston, Ontario, Canada.

"Relative to control subjects, expectant fathers have lower testosterone and cortisol concentrations and more frequently detectable estradiol," says Dr. Wynne-Edwards. "These results confirm and expand on the results of the only previous study, suggesting that men's hormones change as they become fathers."

The study's findings included:

The testosterone concentration was significantly lower in the overall sample of 23 dads than in the 14 control subjects

Cortisol concentration was significantly lower in dads than in the control group.

Dads had a higher proportion of samples with detectable estradiol concentrations.

The finding that estradiol was detected in a larger proportion of samples from dads than from controls is novel, the authors write. Men becoming fathers were exposed to more estradiol than control men, and that exposure increased after the birth of their child. Estradiol is an important hormonal component of mammalian maternal behavior in women, non-human primates and other mammals, but no animal research has yet described estradiol changes in naturally paternal male mammals.

Contact: John Murphy @ 507-538-1385 (days)

Mayo Study Finds Patient Satisfaction Associated with Correct Identification of Physicians' Photographs

A study by Mayo Clinic found that patient satisfaction with physician responsiveness and with how patient questions about medical care were addressed were higher among patients who could identify photographs of their physicians compared with those who could not.

Patients who had pictures of their physicians placed in their hospital rooms as part of the study were able to correctly identify more members of their physician team than those who didn't have pictures of their physicians in their rooms. The study appears in the June issue of Mayo Clinic Proceedings.

The study was conducted over a six-week period from Feb. 16, 2000, to March 30, 2000, to determine whether patient satisfaction could be improved if patients could identify the physicians responsible for their care. The survey showed an association between patient satisfaction and the patients' abilities to identify their physicians' photographs correctly.

However, further study and some adjustments to the study might give greater insight into the role the photographs played in helping patients later identify their physicians and the satisfaction of their care.

"Although it is tempting to conclude that patients are more satisfied with their medical care when they know their physicians, it is equally possible that patients who are more satisfied with their care are more likely to know their physicians," says Jeanne Huddleston, M.D., a Mayo Clinic internal medicine specialist and a study author.

Jaya J. Francis, M.D., of Mayo Medical School, and V. Shane Pankratz, Ph.D., of Mayo Clinic's Section of Biostatistics, also authored this study.

The authors wrote that the effect of the study might have been stronger if family members of patients had been surveyed as well.

"Many of the family members of the patients who had physician photographs on their walls emphasized that the photographs helped them know who was taking care of the patient," the authors wrote.

Contact: John Murphy @ 507-538-1385 (days)

Radiosurgery and Embolization Found Effective for Patients with Low-Risk Dural Arteriovenous Fistulas, Mayo Clinic Researchers Report

Mayo Clinic researchers have found that a less-invasive treatment is safe and effective for select patients who have an abnormal connection between an artery and a vein on the surface of the brain. The problem affects up to 500,000 people in the United States.

The combined treatment approach uses of gamma knife radiosurgery followed by transarterial embolization. The gamma knife focuses high intensity radiation into a small area within the brain. An embolization is a treatment that clogs small blood vessels and blocks the flow of blood, such as to a tumor.

In the study, published in the June edition of the Journal of Neurosurgery, 23 patients underwent treatment with the gamma knife, and 20 patients also underwent embolization.

The symptoms resolved completely in 20 patients (87 percent). Two patients improved significantly (9 percent). Resolution or improvement of the symptoms in the patients occurred immediately following transarterial embolization. One patient remained unchanged 35 months after treatment, while two patients had recurrence of symptoms at 10 and 12 months following treatment.

The treatment is not recommended for patients with angiographically determined risk factors for hemorrhage, except as an alternative in patients who cannot tolerate open brain surgery.

Contact: Lisa Copeland @ 507-538-0844 (days)

Study Finds Incidence Rates of Open-Angle Glaucoma Increase with Age

The incidence rates of open-angle glaucoma increase markedly with advancing age in both men and women, report Mayo Clinic physicians in a published study that emphasizes the need for eye exams, especially as people age.

The study, which appeared in the May issue of Ophthalmology, is among the few to estimate the incidence rate of open-angle glaucoma, the most common type of glaucoma in the United States. Glaucoma is a disorder that affects 60 million people worldwide.

Knowledge of incidence is valuable in estimating the risk for disease development, identifying and studying risk factors and evaluating disease prevention programs.

Open-angle glaucoma is a disorder characterized by increased pressure within the eyeball. The disorder occurs secondary to the chronic blockage of normal fluid circulation within the eye. Increased pressure within the eye can cause damage to the optic nerve and eventual blindness. Glaucoma is the second leading cause of blindness in the United States. Symptoms do not appear until late in the disease, which is the reason regular eye examinations for older people are worthwhile, even if they are not having problems.

Researchers analyzed the database of the Rochester Epidemiology Project, a surveillance and medical records linkage system established to study the occurrence and natural history of disease among the residents of Rochester and the remainder of Olmsted County, Minnesota.

Researchers found that the overall annual incidence rate of open-angle glaucoma in a predominantly Caucasian population is conservatively estimated to be 14.5 per 100,000 population. The rates increased with age from 1.6 for people in their 40s to 94.3 in their 80s.

Contact: Lisa Copeland @ 507-538-0844 (days)

Report Identifies Case of Bupropion-Induced Erythema Multiforme

As bupropion is prescribed increasingly for smoking cessation and not just for depression, physicians need to aggressively follow up complaints of rashes that could be caused by use of the medicine, says a report in the June issue of Mayo Clinic Proceedings.

The case report is what the authors believe is the first case of erythema multiforme, an allergic response, after a 31-year-old woman took sustained-release bupropion for treatment of depression.

The report emphasizes that physicians should immediately discontinue the medication as soon as erythema multiforme is suspected and watch closely for the emergence of potentially life-threatening dermatologic conditions.

In the case of the female patient, she had taken bupropion for 24 days before it was discontinued. Her skin lesions and itching resolved over the next few weeks, although she was left with postinflammatory hyperpigmentation, which had not fully faded after 8 months of follow up.

Contact: John Murphy @ 507-538-1385 (days)

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CITATIONS

Mayo Clinic Proceedings, Jun-2001 (Jun-2001)