Hello Health Rounds readers! Today we feature a discovery that may adversely affect children conceived with sperm from older fathers. We also report on a study that found the risks of a widely used pain drug may outweigh its benefits, and one that reconfirms the safety of medical abortions at home. 

See these breaking news stories from our Reuters team: US Republicans and Democrats split on party lines on Trump's Tylenol-autism claim; key US vaccine panel meeting delayed, agenda unclear; weight-loss drugs and MAHA are hammering US sugar beet farmers; Germany restricts online cannabis sales amid import boom; updated vaccine led to less severe COVID last year.

Also: Nearly 90% of East Congo clinics out of medicines; Senegal reports 17 deaths in Rift Valley Fever outbreak; Ebola outbreak in Congo shows signs of containment; Haiti children displaced by violence nearly double in a year; and Britain's Princess Kate warns screen time feeds 'epidemic of disconnection'.

Retail pharmacies and drug savings sites are talking with the Trump administration about joining its TrumpRx website, suggesting an expansion beyond the early description of it as a link to pharmaceutical companies' direct discounts.

The age of the father plays a role in pregnancy outcomes, with harmful genetic changes in sperm being substantially more common in older men, new research shows.

Along with a steady build-up of random changes in DNA as men got older, the researchers also discovered the increase in mutations is due to a subtle form of natural selection, with some mutations having a competitive edge during sperm production in the testes, according to a report in Nature.

In 81 healthy volunteers, researchers found that approximately 2% of sperm from men in their early 30s carried disease-causing mutations, compared to 3% to 5% of sperm from men ages 43 to 74, and 4.5% of sperm from 75-year-olds.

Some of the mutations have been previously linked to cell growth and development, while others are associated with severe neurodevelopmental disorders in children and inherited cancer risk, the researchers noted.

Others may impair fertilization, embryo development, or result in pregnancy loss, they said.

“Some changes in DNA not only survive but thrive within the testes, meaning that fathers who conceive later in life may unknowingly have a higher risk of passing on a harmful mutation to their children," Professor Matt Hurles of the Wellcome Sanger Institute in Hinxton, England, said in a statement.

In a complementary study involving over 54,000 parent–child trios and 800,000 healthy individuals, also published in Nature, some of the same researchers analyzed mutations already passed on to children, rather than those measured directly in sperm.

They identified more than 30 genes where mutations give sperm cells a competitive edge via natural selection, again including many linked to rare developmental disorders and cancer. Many such mutations overlap the set of genes observed directly in sperm.

The work highlights how natural selection within sperm can be directly observed in the DNA of children, influencing their chances of inheriting certain genetic disorders, the researchers said.

"Our findings reveal a hidden genetic risk that increases with paternal age,” Hurles, who co-authored both studies, said.

The opioid painkiller tramadol is not very effective for easing the chronic pain for which it is widely prescribed, and it likely increases the risk of serious side effects, a new study found.

Researchers who pooled data from 19 previous trials involving 6,506 volunteers with chronic pain concluded that the potential harms of tramadol probably outweigh its benefits.

Five of the trials looked at the impact of tramadol on nerve-related pain; nine focused on osteoarthritis; four looked at chronic lower back pain; and one focused on fibromyalgia.

The average age of the trial participants was 58 and length of treatment ranged from 2 to 16 weeks.

The risk of harms associated with tramadol was twice the risk of placebo in the trials, mainly driven by a higher proportion of cardiac events such as chest pain, coronary artery disease, and congestive heart failure, according to a report in BMJ Evidence-Based Medicine.

Milder side effects included nausea, dizziness, constipation, and sleepiness.

Tramadol was also associated with a heightened risk of some cancers, although the follow-up period was short, making this finding “questionable,” the researchers said.

Until now, doctors have thought tramadol has a lower risk of side effects and is safer and less addictive than other opioid painkillers.

“Given the limited analgesic benefits and increased risk of harm, tramadol use for chronic pain should be reconsidered,” the researchers concluded.