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The popularity of Viagra has skyrocketed over the past year. This marvelous little blue pill has brought passion and excitement back into people’s sex lives. Viagra has proven to be a bestseller with good reason: it’s effective for many people. Despite side effects such as headaches and anecdotal reports of possible links to heart attacks. it has helped millions.

The problem with a short-term solution such as Viagra, is that it encourages people to forget about seeking treatment. Instead of visiting a doctor to correct the penile dysfunction, most men just pop a pill for instant (thirty minute) results. Viagra is currently the best treatment, but it should be used as a last resort and only after consulting a doctor.

Examine Yourself

No one can argue that popping a pill is convenient, but sexual dysfunction is a complex issue with many causes and manifestations. I caution people against the idea of taking a quick-fix approach to symptoms that are often part of a bigger problem.

The first thing you should do before even thinking of taking Viagra or any other supplement, is review your overall health and current medications with your doctor. It’s also essential to address any psychological or relationship issues through counseling or other forms of therapy. This is very important, because sometimes the problem might be treatable. By taking a quick-fix pop-a-pill approach without investigating the problem, you will only be adding to the delay of treatment and lowering your probability of fully recuperating.

Gentlemen, Start Your Engines

Viagra is very effective and fast acting — it typically boosts blood flow within 30 minutes to several hours — but some people prefer non-drug alternatives. Is there an alternative to Viagra, something more “natural” like an herb or supplement? And are any of these safe? Not every man requires the magic touch of Viagra; sometimes all one needs is a healthy diet, exercise and a little of Mother Nature’s touch. Several interesting supplements have recently come to light and may provide benefits within days to weeks.

Ginkgo Biloba. An herb that is commonly taken as a memory booster may provide benefits. It presumably acts by enhancing blood flow and seems relatively free of side effects. In a study conducted at the University of California, ginkgo reversed sexual problems in 84% of men who were taking antidepressant drugs such as Prozac. The ones who might benefit from it are men on Prozac or other antidepressants. The suggested dose is 80 mg three times a day, standardized to contain 24% flavone glycosides and 6% terpene lactones.

Arginine. An amino acid that also enhances blood flow. In a study of 50 men at Tel Aviv University, 31% of those with impotence improved after six weeks of taking arginine. The ones who might benefit from it are men who have circulatory disorders that may be contributing to sexual problems. The suggested dose is 1 gram three times a day; sold as L-arginine.

As with Viagra, you should avoid arginine if you are taking the heart medication nitroglycerin because the combination may cause a dangerous drop in blood pressure. For the same reason, you should probably not take arginine with Viagra.

DHEA. This supplement may also provide benefits for men who have low levels of this hormone. DHEA helps our bodies make estrogen and testosterone, and a recent trial at the University of Vienna found it helped men with impotence. The suggested dose is 5 mg each morning for men.

Yohimbe. Some studies have shown that this herb may correct impotence. However, this herb can cause a dangerous rise in blood pressure, as well as anxiety and other side effects. Many doctors prefer the purified form of the herb, the FDA-approved drug yohimbine, instead, because it has a guaranteed purity and potency. I suggest that you opt for the prescription drug yohimbine instead. See your doctor.

As for passion potions such as Super Sex and Biagra sold at health-food stores or pharmacies, there is no real evidence showing that they restore sex drive. These potions are made with blends of herbs such as those mentioned above and other questionable ingredients. Check the label to make sure the product contains an adequate dose of the herbs mentioned above. If it does not have the recommended dosages, then the product is not likely to be effective. Instead of a blend, you may be better off purchasing an individual ingredient tailored to your particular condition.

Comments

Does natural Viagra exist?

by DR JOHN BRIFFA, Daily Mail

A commonly held belief is that women reach their sexual peak later in life than men. This may be true, but a recent study published in the medical journal Fertility And Sterility found that women generally experience a reduction in their sexual responsiveness as they age.

While some of this may be due to the effects of the menopause, the research suggests it is also a product of the ageing process.

Dwindling sexuality does not seem to be confined to women, either, as shown by the runaway success of the drug Viagra. Despite Viagra’s popularity, however, a recent study found that little more than half the men who try the drug are using it three years later.

Also, a significant proportion of them found it necessary to use a substantially increased dose to get the same effect. Fortunately, nature offers various remedies for boosting libido and enhancing sexual pleasure.

Sexual responsiveness is very dependent on the supply of blood to the genitals. Enhanced blood flow to the penis can do much to improve a man’s ability to attain and maintain an erection.

In this respect, the herb Ginkgo biloba has much to offer. Renowned as a circulation enhancer, Ginkgo biloba was found in one study to help 78 per cent of men with impotence.

The beneficial effects of Ginkgo biloba may take three or more months to become apparent, though it does appear to be a safe, natural alternative to Viagra for men.

It may have significant benefits for women, too. There is growing awareness that improved blood supply to the female sexual organs can enhance sexual sensation.

I have seen several patients who experienced a subjective enhancement in sexual pleasure after taking Ginkgo biloba long-term.

Another herb which may help improve sexual function in both men and women is Damiana. Damiana, which grows wild in Central America and Mexico, was the favourite aphrodisiac of the ancient Mayan people.

While its precise effect on the body is not known, Damiana’s botanical name – Turnera aphrodisiaca – hints at its libido-enhancing effects.

Its effects take hold quite quickly after ingestion, making it ideal for use on an ‘as required’ basis.

For rapid absorption into the body, Damiana is probably best taken in tincture (alcoholic extract) form. One teaspoonful should be taken about one hour before sex.

The herb Panax ginseng is another sexual stimulant. This has been used for more than 2,000 years in Eastern medicine as a tonic.

Many women who take Panax ginseng find that it improves their libido. In men, one study found that it brought about a 60 per cent improvement in the symptoms of impotence, while at the same time enhancing sexual appetite.

Panax ginseng is usually taken for periods of two to three weeks, interspersed with break periods of one to two weeks.

Catuba, a species of evergreen tree which grows in the Amazon rainforest, is another natural remedy for enhancing libido. The inner bark of this tree has been revered as a potent aphrodisiac by the Brazilian people for hundreds of years.

When the Brazilian government researched more than 100 plants used to treat sexual problems, only three were singled out for further research. Catuaba was one of them. You can buy it in health food stores.

Another herb which is commonly used to help bolster sexual energy in women is Angelica sinensis.

In Asia, Angelica is considered to be the ‘female ginseng’. It is well known to have general tonic action in the female body, and is thought to improve gynaecological function.

Historically, Angelica has been the aphrodisiac of choice for women in the East. Angelica should be taken as directed on the packaging.

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Erectile Dysfunction Health Center

This content has not been reviewed within the past year and may not represent WebMD’s most up-to-date information.

To find the most current information, please enter your topic of interest into our search box.

“>WebMD News Archive

July 1, 2008 — Men hoping for some fireworks in their love life this Fourth of July may want to skip the burgers and beer at the barbecue and eat plenty of watermelon.

Watermelon may be a natural Viagra, says a researcher. That’s because the popular summer fruit is richer than experts believed in an amino acid called citrulline, which relaxes and dilates blood vessels much like Viagra and other drugs meant to treat erectile dysfunction (ED).

“We have known that watermelon has citrulline,” says Bhimu Patil, PHD, director of the Fruit and Vegetable Improvement Center at Texas A&M University, College Station. Until recently, he tells WebMD, scientists thought most of the citrulline was in the watermelon rind. “Watermelon has more citrulline in the edible part than previously believed,” he says.

How could watermelon be a natural Viagra? The amino acid citrulline is converted into the amino acid arginine. Patil says. “This is a precursor for nitric oxide, and the nitric oxide will help in blood vessel dilation.”

So, the burning question: How much watermelon does it take?

“That is a good question,” Patil says. Unfortunately, “I don’t have an answer for that.”

He does know that a typical 4-ounce serving of watermelon (about 10 watermelon balls) has about 150 milligrams of citrulline. But he can’t say how much citrulline is needed to have Viagra-like effects.

He’s hopeful that someone will pick up on his research and study the fruit’s effect on penile erections.

13 Common Sex-Drive Killers

Watermelon’s Viagra-Like Effects

On hearing about the Texas finding, Irwin Goldstein, MD, editor-in-chief of The Journal of Sexual Medicine, was underwhelmed. Suggesting a man feast on watermelon to boost performance, he says, “would be the equivalent of someone dropping a beer bottle in Minneapolis, where the Mississippi River starts, and hoping to see it make an impact on someone in New Orleans.”

“To say that watermelon is Viagra-like is sort of fun,” says Goldstein. “But to even vaguely hope that eating watermelon will alleviate ED is misleading.”

“The vast majority of Americans produce enough arginine,” adds Goldstein, medical director of Alvarado Hospital Medical Center, San Diego, and clinical professor of surgery, University of California San Diego School of Medicine. “Men with ED are not deficient in arginine.”

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Summary

Drug interactions are reported among people who take Viagra and Marijuana together. This review analyzes the effectiveness and drug interactions between Viagra and Marijuana. It is created by eHealthMe based on reports of 42 people who take the same drugs from FDA and social media, and is updated regularly.

Personalized health information

On eHealthMe you can find out what patients like me (same gender, age) reported their drugs and conditions on FDA and social media since 1977. Our tools are free and anonymous. 86 million people have used us. 300+ peer-reviewed medical journals have referenced our original studies. Start now >>>

Viagra

Viagra has active ingredients of sildenafil citrate. It is often used in erection problems. (latest outcomes from Viagra 46,520 users )

Marijuana

Marijuana has active ingredients of marijuana. It is often used in drug abuse and dependence. (latest outcomes from Marijuana 2,737 users )

NOTE. The study is based on active ingredients and brand name. Other drugs that have the same active ingredients (e.g. generic drugs) are NOT considered.

WARNING. Please DO NOT STOP MEDICATIONS without first consulting a physician since doing so could be hazardous to your health.

DISCLAIMER. All material available on eHealthMe.com is for informational purposes only, and is not a substitute for medical advice, diagnosis, or treatment provided by a qualified healthcare provider. All information is observation-only, and has not been supported by scientific studies or clinical trials unless otherwise stated. Different individuals may respond to medication in different ways. Every effort has been made to ensure that all information is accurate, up-to-date, and complete, but no guarantee is made to that effect. The use of the eHealthMe site and its content is at your own risk.

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If you use this eHealthMe study on publication, please acknowledge it with a citation: study title, URL, accessed date.

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Are there any interactions with medications?

Medications for high blood pressure (Antihypertensive drugs)
Interaction Rating: Major Do not take this combination.

L-arginine seems to decrease blood pressure. Taking L-arginine along with medications for high blood pressure might cause your blood pressure to go too low.

Some medications for high blood pressure include captopril (Capoten ), enalapril (Vasotec ), losartan (Cozaar ), valsartan (Diovan ), diltiazem (Cardizem ), amlodipine (Norvasc ), hydrochlorothiazide (HydroDIURIL), furosemide (Lasix ), and many others.

Medications for diabetes (Antidiabetes drugs)
Interaction Rating: Moderate Be cautious with this combination.
Talk with your health provider.

L-arginine seems to decrease blood sugar in people with type 2 diabetes. Diabetes medications are also used to lower blood sugar. Taking L-arginine along with diabetes medications might cause your blood sugar to go too low. Monitor your blood sugar closely. The dose of your diabetes medication might need to be changed.

Some medications used for diabetes include glimepiride (Amaryl ), glyburide (DiaBeta. Glynase PresTab. Micronase ), insulin, pioglitazone (Actos ), rosiglitazone (Avandia ), chlorpropamide (Diabinese ), glipizide (Glucotrol ), tolbutamide (Orinase), and others.

Medications for high blood pressure (ACE inhibitors)
Interaction Rating: Moderate Be cautious with this combination.
Talk with your health provider.

L-arginine seems to decrease blood pressure. Taking L-arginine along with certain medications for high blood pressure, called ACE inhibitors might cause your blood pressure to go too low. Also, ACE inhibitors can increase potassium levels. L-arginine may also increase potassium levels. Taking L-arginine with ACE inhibitors might cause potassium levels to become to high.

Some ACE inhibitors include benazepril (Lotensin ), captopril (Capoten), enalapril (Vasotec), fosinopril (Monopril ), lisinopril (Prinivil. Zestril ), moexipril (Univasc ), perindopril (Aceon ), quinapril (Accupril ), ramipril (Altace ), and trandolapril (Mavik ).

Medications for high blood pressure (Angiotensin receptor blockers (ARBs))
Interaction Rating: Moderate Be cautious with this combination.
Talk with your health provider.

L-arginine seems to decrease blood pressure. Taking L-arginine along with medications for high blood pressure might cause your blood pressure to go too low.

The ARBs include losartan (Cozaar), valsartan (Diovan), irbesartan (Avapro ), candesartan (Atacand ), telmisartan (Micardis ), and eprosartan (Teveten ).

Medications for high blood pressure (Isoproterenol)
Interaction Rating: Moderate Be cautious with this combination.
Talk with your health provider.

L-arginine seems to decrease blood pressure. Isoproterenol is a drug that is used to lower blood pressure. Taking L-arginine along with isoproterenol might cause your blood pressure to go too low.

Medications that increase blood flow to the heart (Nitrates)
Interaction Rating: Moderate Be cautious with this combination.
Talk with your health provider.

L-arginine increases blood flow. Taking L-arginine with medications that increase blood flow to the heart might increase the chance of dizziness and lightheadedness.

Some of these medications that increase blood flow to the heart include nitroglycerin (Nitro-Bid, Nitro-Dur. Nitrostat ), and isosorbide (Imdur, Isordil. Sorbitrate).

Medications that slow blood clotting (Anticoagulant / Antiplatelet drugs)
Interaction Rating: Moderate Be cautious with this combination.
Talk with your health provider.

L-arginine seems to slow blood clotting. Taking L-arginine along with medications that also slow clotting might increase the chances of bruising and bleeding.

Some medications that slow blood clotting include aspirin. clopidogrel (Plavix ), dalteparin (Fragmin ), enoxaparin (Lovenox ), heparin. ticlopidine (Ticlid ), warfarin (Coumadin ), and others.

Sildenafil (Viagra )
Interaction Rating: Moderate Be cautious with this combination.
Talk with your health provider.

Sildenafil (Viagra) can lower blood pressure. L-arginine can also lower blood pressure. Taking sildenafil (Viagra) and L-arginine together might cause the blood pressure to go too low. Blood pressure that is too low can cause dizziness and other side effects.

Water pills (Potassium-sparing diuretics)
Interaction Rating: Moderate Be cautious with this combination.
Talk with your health provider.

L-arginine might increase potassium levels in the body. Some “water pills” might also increase potassium in the body. In theory, taking L-arginine along with some “water pills” might cause too much potassium to be in the body. Some water pills include amiloride (Midamor ), spironolactone (Aldactone ), and triamterene (Dyrenium ).

Some “water pills” that increase potassium in the body include spironolactone (Aldactone), triamterene (Dyrenium), and amiloride (Midamor).

Dosing considerations for L-arginine.

The following doses have been studied in scientific research:

BY MOUTH.

  • For congestive heart failure: doses range from 6-20 grams per day, as three divided doses.
  • For chest pain associated with coronary artery disease (angina pectoris): 3-6 grams three times per day for up to one month.
  • For preventing the loss of the effectiveness of nitroglycerin in relieving pain in people with chest pain due to coronary artery disease (angina pectoris): 700 mg four times daily.
  • For organic erectile dysfunction (ED): 5 grams per day. Taking lower doses might not be effective.
  • For preventing inflammation of the digestive tract in premature infants: 261 mg/kg added to oral feedings daily for the first 28 days of life.

Report Problems to the Food and Drug Administration

L arginine viagra

l-arginine

If you want to commit to viagra. then there’s no need to take the l -arginine. I would however scale back on the 50mg – see if 25mg or even less will have the desired effect. I did the l-arginine thing for quite a while, bought the powder, etc. It *probably* does help, and many articles on the internet seem to support that view. But viagra works much better, quicker, and purchased generically, is very inexpensive.

In other words, would I be safe if I did not take L-Arginine on the day I took Viagra. Or, do I have to stop taking L -Arginine completely if I am going to occasionally take Viagra (i.e. take Viagra once a week)? Thank you for your response.

Wait are u talking about l-argininge or the blue pill. By the blue pill I was referring to Viagra. But doesn’t matter. And regarding l -arginine – its an amino-acid as I remember from the course of chemistry and it is said to improve libido and erection. My friend uses it sometimes a half an hour before sex 2-3 pills of 100mg. And he said it does help keep things going quite well.))) He has suggested me to try it but I haven’t still. Maybe I will now.

I take pre-workout supplements (Muscle Pharm Assault) which contain L -Arginine and Beta Alinine (nitric oxide), which I read doesnt go well when taken at the same time as Viagra. In addition, I take Creatine and Whey Protein as well. I am not planning on taking them at the same time though. Could you advise if it is safe to take these on the days when I am not having Viagra. Also, how long do I need to wait before I can take them.

Please do more web searches and DO NOT use Viagra. Cialis, and Levitra. I also have RP and ED. I bought L -arginine /Orinithine but am wary about using until I read that it’s ok. Blood flow changes seem to be very bad to already bad retinal cells.

My question is this, I’m very concerned about being only 36 and using Viagra (I vary between 25mg and 50mg). I also take L -Arginine (3 grams per day). My concern is that my body will adapt to the viagra and I will see diminishing returns, or ultimately it will love efficacy alltogether and I will be left in my 40s, God forbid, with no other course of action. I am very concerned about this.

5 grams of L-Arginine an hour before I take the Viagra. as well. At first, this seemed to boost the Viagra. I’ve been using Viagra for about 3 months. In the beginning, I’d take one, and just kissing and hugging my girlfriend would produce a semi-erection, which quickly became a full erection when I needed it. But of late, sometimes this happens, and sometimes it doesn’t, which then requires oral or some other direct physical stimulation to get hard.

Sildinafil causes constriction of blood vessels around the heart. Here’s what may solve your problem. 2-3 grams of L -arginine. Then go and get the nasal spray naltrexone, used for heroin overdoses. In the USA you can buy this without prescription. Spray it in your nostrils. It blocks endorphins which are similar substances that cause the blood to release from your hard penis.

It also helps if you take steps to just ensure general penile health – good hygiene, for example, and the use of an excellent penis health cream (health professionals recommend Man1 Man Oil). Look for one with l -arginine. which is an enzyme that can play a role in helping penile blood vessels to relax and increase the blood flow to the organ.

Would these be prescribed for the problem that I am having? Also, is it safe to take Viagra or Cialis with L -Arginine. I also read an article sometime back by a doctor (wish I had the doctors name, or source, but I don’t) about ED medication in which he stated that it only works for about 5 yrs. Do you know anything about this? Possibly he was referring to older men who use it? By the time they start using it they only have 5 more years until their stuff shuts down totally?

Means, I should add Viagra to Cymbalta when I would like to have an intercourse after two weeks. I have also seen L -Arginine on the internet and have bought it by 500 mg capsules and have started to take 4 capsules per day (it’s just one day that I have taken it). Could you please confirm all this? Should I continue these treatments. Or any other solutions. PLEASE help me, I am loosing my self-confident.

Reed up on L -arginine. maca root, amplified creatine. I think you will find they will help control your BP and help with erections. If you want to stay off cholesterol medication, try taking Metamucil capsules every day. Helps not only cholesterol and slow digestion, but heartburn. Neem is a wonderful plant that can help with all sorts of things, including ED.

I used it in conjunction with my viagra and when i ran out of my viagra supply. It is L -Arginine. Another supplement is L -Carnitine. Don’t take them together. L-Carnitine should be taken on a emply stomach. There are many different forms–and they each have a slightly different function. What i took of the L-Carnitine is GPLC by Jarrow pharmaceuticals. I know Australia has several good supplier of supplements. L-Arginine works differently than viagra.

because of my anxiety my doctor gave me some viagra. I have read that because of the l -arginine released in the penis during the viagra brings out outbreaks in people. This is why people take Lysene supplements to combat l-arginine in their bodies? no?

He should walk as fast as possible every day for 45 minutes. I would normally recommend L -arginine to assist circulation, but I don’t know if there is any contraindication for someone with diabetes. You might talk to guys at the diabetes forum to get their suggestions.

He who took fo-ti and restored his black hair, youthful appearance and sexual vitality. For more information about fo-ti, read the Fo-Ti Fact Sheet. 4) L -Arginine L -arginine is not a herb but an amino acid that has numerous functions in the body. It has been used for erectile dysfunction and is often promoted as a Viagra alternative. For more information about L-arginine, read the L-Arginine Fact Sheet. 5) Damiana Damiana is a plant native to Mexico and the southern United States.

Men When it comes to keeping your sex sessions going long and strong, a certain amino acid L -Arginine works like Viagra by increasing nitric oxide to help relax blood vessels and allow more blood flow to the penis, says Marrena Lindberg, author of The Orgasmic Diet. Some studies suggest that getting three grams a day could make for better erections. Many foods high in good-for-you omega 3s are also high in L-Arginine, such as free-range game, seafood, walnuts, and sesame seeds.

here 48 yo male, yes the more confortable and pleasurable the better things will get. excercise Kegals to stop from finishing no presure suppliments L arginine. L Glutamine, Mia pauma, Yohimbe, Saw Pawmento, Naicin, B-6 B-12, Ginseng. to some of those supliments I have side effects Hypertention aniety sweeting – yohimbe and naicin, so obiviously i should not take them.

Hi. I’m glad you found the information helpful. I don’t know what you mean by "spice things up" but I can tell you that l-arginine is not going to increase your desire or have any effect–unless, of course, you totally believe it will, in which case you may get a mild placebo effect. As for Viagra, I’ll tell you what I tell everyone: Viagra does one thing and one thing only: increases blood flow to your penis.

The Best Foods For Every Part of Your Body Today’s busy, high-stress lifestyles often lead to a diet of convenience—one that’s lacking in vitamins and minerals, and overloaded with sugar, fat, and calories. The result: a body that never realizes its full potential. But you can fight back with food; start today and you’ll hit your peak from head to toe.

Hello, Such kind of small lump inside penis can be due to swollen blood vessel, Peyronie’s disease or Mondor’s disease. In pyeronie’s disease, a plaque, or hard lump, forms on the penis. The plaque may develop on the upper (more common) or lower side of the penis, in the layers that contain erectile tissue. I suggest you to apply warm compresses on the lump and get it evaluated from a dermatologist. I hope it helps. Take care and regards.

am also on icp treatment program which has shown no improvement. I have also taken sereis of drugs from viagra to levitra and all these advertised natural male enhancer and none has ever worked. I need serious and immediate help. Hope someone out there can feel my pains. Please help me, am frustrated.

Cialis and L-Arginine

How many Mg are your pills you take?

According to one site Clinical Studies have proven that only 4 grams of the all natural supplement, L-Arginine, will optimize the best results. Consequently, the majority of manufacturers producing the supplement are offering it in doses that contain 400 mg per tablet, which is only 10% of the recommended amount.

I’m taking 3000mg per day right now.

OK cool. I went to GNC and bought some L-Arginine &amp; L-Citrulline pills (500 Mg each, 1000 Mg total).

So gonna try that and see how it goes. Will take 3 of the pills (3 of the pills). and see how it goes.

In your case you might want to start at 5000mg and work up from there.

I’ll probably will increase my intake to 5000mg in a few weeks when i step up the workout intensity.

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    If he were teaching me during my intern, PGY-1, PGY-2, or PGY-3 year (assuming I end up in a 3 year EM program) you can bet I'd listen and soak up every ounce of wisdom he had to offer as well as any evaluation of my performance.

    "No matter what, be truthful to yourself when studying" by G-dawgOf course this is all assuming medicare decides not to f#ck us on a whim, which really is what makes medicine so stressful.

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    I actually know a few residents and they seem very unhappy, like they were the children of wealthy parents and really didn't know what they were getting themselves into, everyone in their family is successful and goes to graduate school.

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    2. The studies that have accounted for effort have uniformly found no cognitive differences. This week I got my first rejection, which mildly bummed me out but it was also nice because it's the first news I have had from any of my schools, so at least I'm not in limbo there anymore.
    3. The thing is that most NRI's, me included, rarely pass the first year exam on their first attempt?
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    I was referring to the reaction of Americans.

    Hey. 5-3 SD above mean range, so hoping those correlate well. What is is that's providing the centripetal force. I guess I may start my apps soon.

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    11. Basically, as I'm going I make very messy notes on the dry-erase portion of my desk. 5 loupes.
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    Drug-Induced Eye Toxicity: 62 Drugs That Can Cause Eye Disease

    Image on home page: Odua Images/Shutterstock.com

    Readers of Worst Pills, Best Pills News are well aware that drugs can have undesirable effects on organs throughout the body. In Chapter 3 of our book “Worst Pills, Best Pills,” in many previous issues of Worst Pills, Best Pills News and on our Web site, Worstpills.org, we have extensive lists of drugs that can cause depression, sexual dysfunction, parkinsonism, memory loss and many other drug side effects that may not have been recognized as drug-induced. But most readers (and, probably, many physicians) are unaware of the plethora of adverse drug effects manifested in one of our most crucial organs: the eye. In part, this variety of side effects results from the eye being comprised of so many different types of cells, each of which can be affected by drugs (see eye diagram, below).

    In this article, we summarize a recent paper in the journal Drug Safety (2008; Vol. 31: pp. 127-141) that described the most common and most recently identified adverse reactions with manifestations in the eye. We describe these reactions as they relate to the particular structures in the eye or to particular conditions such as glaucoma. The particular drugs that may cause these reactions are listed in the accompanying table that includes 62 different drugs (below ).

    (article continues below image)

    Eyelid and Conjunctival Diseases

    The eyelids and conjunctiva (a thin membrane covering the inner part of the eyelid and the outer part of the cornea, but not shown in the eye diagram) are frequent targets for drug toxicity.

    For instance, a panoply of drugs can cause erythema multiforme, a kind of allergic reaction of the skin (including the eyelid) that produces a variety of skin lesions ranging from bumps to plaques to blisters. In its most severe form, it is called Stevens-Johnson Syndrome, a serious condition of the conjunctiva characterized primarily by large blisters that can seriously damage the cornea. The primary treatment in both cases is to stop using the drug that is causing the allergic reaction, after consultation with one’s physician.

    Drugs instilled into the eye that contain the preservatives benzalkonium chloride and thimerosol can cause redness of the conjunctiva. If you experience this, look for versions of your drug without these preservatives. Morphine administered by mouth or intravenously can also cause red eye. Finally, the spread of botulinum toxin (BOTOX) from the point of injection into the eyelid can result in eyelid drooping and reduced blinking, potentially resulting in damage to the cornea.

    Uveal Tract Diseases

    Together, the iris, the ciliary body (not shown in the eye diagram) and the choroid are known as the uvea. A number of alpha-1 blockers, especially tamsulosin (FLOMAX), have been implicated in a condition known as floppy iris syndrome in which the iris is more mobile, potentially complicating surgery. It has no impact upon vision or eye health and thus causes no apparent symptoms, but eye surgeons should be told if you have ever taken these drugs.

    Glaucoma is a disease with characteristic damage to the optic nerve; raised pressure in the eye is an important risk factor. The disease can be divided in two: cases in which the pressure in the eye is raised without being caused by any particular anatomical abnormality (open-angle glaucoma) and cases in which wide opening (dilation) of the pupil or swelling of certain eye structures (e.g. ciliary body and lens) results in a narrowing of the angle between the cornea and the iris, preventing the flow of fluid (vitreous humor) within the eye. This, in turn, can lead to pressure build-up (angleclosure glaucoma). Drugs have been known to cause both forms of glaucoma and both can lead to blindness.

    In open-angle glaucoma, pressure in the eye builds up slowly, reducing the visual field, but causing no pain or redness. The most commonly implicated drugs are corticosteroids — e.g. cortisone (CORTONE) or prednisone (DELTASONE) — whether administered into the eye, by mouth or by any other route. Certain anticancer drugs have also been shown to cause this condition.

    Angle-closure glaucoma is characterized by the sudden onset of severe eye pain, redness and cloudy vision. Drugs in the adrenergic and anticholinergic categories (see table for examples) can cause dilation of the pupil, while topiramate (TOPA- MAX) and other sulfa drugs can cause swelling of the ciliary body; both can reduce the cornea-iris angle, producing glaucoma.

    The eye lens is a malleable structure that focuses light rays on the retina. A cataract is a condition in which the lens becomes cloudy, frequently leading to surgical removal as vision is increasingly impaired. Corticosteroids have long been associated with cataracts, regardless of how they are administered, but the direct injection into the eye of one particular steroid, triamcinolone, often to treat macular edema, almost always leads to a cataract. Steroid-induced cataracts do not usually regress when the drug is stopped. Other classes of drugs associated with cataracts are the phenothiazine antipsychotics and the anti-cancer drug busulfan.

    The retina acts like the film in a camera, sensing the play of light on its surface and transforming the light waves into electrical signals that travel down the optic nerve and then to the optical cortex in the brain which allows you to see the images. Toxic substances can reach the retina through the blood supply, potentially resulting in significant visual disturbances.

    Chloroquine and hydroxychloroquine are drugs used in the treatment of malaria, amoebae, rheumatoid arthritis and lupus. Retinal damage is reversible only in the earliest stages of the disease, so it is crucial to have various eye examinations when one starts these drugs and every six to 12 months thereafter. The antipsychotic drugs chlorpromazine and thioridazine have already been mentioned as causes of cataracts. Both of them, especially thioridazine, can lead to blurred vision, loss of visual fields and loss of night vision as pigment is deposited in the retina. The breast cancer treatment tamoxifen (NOLVADEX) can also cause retinal changes and decreased color vision as crystals deposit in the retina; examinations when the drug is started and at least every two years are necessary as long as one is on the drug. Isotretinoin (ACCU- TANE) and other drugs in its class can cause blurred vision and decreased night vision.

    Optic Nerve Diseases

    The optic nerve carries visual information from the retina to the brain. A number of drugs can affect the nerve, but stopping them when symptoms occur usually improves or resolves the problem.

    Prolonged use of the antibiotic linezolid (ZYVOX) can produce optic nerve damage characterized by visual field defects, decreases in color vision and in vision more generally. Erectile dysfunction drugs are known to cause bluish vision, blurred vision and increased sensitivity to light. In addition, they have also been associated with a condition called nonarteritic ischemic optic neuropathy (NAION). Public Citizen has filed a petition asking the Food and Drug Administration to issue a black box warning about this complication (see Worst Pills, Best Pills News, January 2006). The disease takes the form of sudden onset of visual loss that may lead to complete blindness; if the drug is stopped, the symptoms may reverse over a few weeks. In contrast, amiodarone (CORDERONE, PACERONE)- induced optic nerve damage has a slower onset, is less likely to lead to complete blindness and reverses more slowly. The anti-tuberculosis drug ethambutol (MYAMBUTOL) also causes optic nerve damage and various vision abnormalities such as loss of color vision and visual acuity.

    As is true for other parts of the body, you should consider newly developed eye symptoms beginning shortly after starting a new medication to be possibly drug-induced and consult a physician.

    Table: Commonly used drugs associated with eye diseases

    Dangerous Problems with Counterfeit Viagra

    The world, including the US, is being flooded with counterfeit Viagra and other erectile dysfunction medications. A report in the Feb 12, 2009 issue of the New England Journal of Medicine highlights the dangerous problems.

    The article reports on a total of 150 non-diabetic patients with severe hypoglycemia (low blood glucose) were admitted to the five public hospitals in Singapore. The admissions were between January 1 and May 26, 2008. All the patients were men except one, ages ranged from 19 to 97 years (median, 51). Seven patients remained comatose as a result of prolonged decrease glucose to the brain,and four subsequently died.

    Several patients (45/150 or 30%) admitted to ingesting illegal sexual-enhancement drugs before the onset of hypoglycemia. Samples of the drugs obtained from these patients and from drugs seized in police raids were analyzed by means of high-performance liquid chromatography. It was found that many of the preparations were contaminated with Glyburide (a powerful medication used to treat diabetes).

    So people thought they were taking Cialis or Viagra. What they were often taking were herbal preparations (e.g. Santi Bovine Penis ErectingCapsule) that contained small amounts of the active ingredient (Cialis or Viagra), but which also contained glyburide.

    Since none of the men were diabetic, they experienced a severe drop in blood sugar (hypoglycemia). Seven men sustained serious brain damage due to low blood sugar, of which four ultimately died.

    Harmful ingredients found in counterfeit medicines include boric acid, leaded road paint, floor polish, shoe polish to get the sheen on the tablet, talcum powder, cement powder, chalk and brick dust, nickel and arsenic. Any active drug ingredient is usually minimal or simply wrong – one supply batch of fake Viagra was in fact amphetamine and not Viagra (sildenafil).

    Here are some signs (from eDrugStore) to help you identify illegal “generic Viagra” [Cialis or Levitra:

    В· The site sells “generic VIAGRA” or “generic sildenafil citrate” [Viagra does not have a generic form available.]

    В· The site claims to sell a cheaper form of VIAGRA

    В· The price is cheaper than VIAGRA, by as much as 70%

    В· The site claims the drug is made to World Health Organization (WHO) standards, which may be a lie. The WHO does not review or approve any medication

    В· The drug is sold as a pill, but looks different from VIAGRA’s normal color, shape and imprinting

    В· Delivery times may be extended (4 -21 days) due to product being shipped into the United States from a foreign country

    В· Shipping is initiated using a foreign country postal service to minimize chances of detection and seizure when entering United States

    Source
    An Unusual Outbreak of Hypoglycemia ; N Engl J Med 2009 360: 734-736; Kao, Shih Ling, Chan, Cheng Leng, (Pharm.), B.Sc. Tan, Belinda, (Pharm.), B.Sc. Lim, C.C. Tchoyoson, Dalan, Rinkoo, Gardner, Daphne, Pratt, Edward, Lee, Marilyn, Lee, Kok Onn

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    Erectile Dysfunction Health Center

    This content has not been reviewed within the past year and may not represent WebMD’s most up-to-date information.

    To find the most current information, please enter your topic of interest into our search box.

    “>WebMD News Archive

    July 1, 2008 — Men hoping for some fireworks in their love life this Fourth of July may want to skip the burgers and beer at the barbecue and eat plenty of watermelon.

    Watermelon may be a natural Viagra, says a researcher. That’s because the popular summer fruit is richer than experts believed in an amino acid called citrulline, which relaxes and dilates blood vessels much like Viagra and other drugs meant to treat erectile dysfunction (ED).

    “We have known that watermelon has citrulline,” says Bhimu Patil, PHD, director of the Fruit and Vegetable Improvement Center at Texas A&M University, College Station. Until recently, he tells WebMD, scientists thought most of the citrulline was in the watermelon rind. “Watermelon has more citrulline in the edible part than previously believed,” he says.

    How could watermelon be a natural Viagra? The amino acid citrulline is converted into the amino acid arginine. Patil says. “This is a precursor for nitric oxide, and the nitric oxide will help in blood vessel dilation.”

    So, the burning question: How much watermelon does it take?

    “That is a good question,” Patil says. Unfortunately, “I don’t have an answer for that.”

    He does know that a typical 4-ounce serving of watermelon (about 10 watermelon balls) has about 150 milligrams of citrulline. But he can’t say how much citrulline is needed to have Viagra-like effects.

    He’s hopeful that someone will pick up on his research and study the fruit’s effect on penile erections.

    13 Common Sex-Drive Killers

    Watermelon’s Viagra-Like Effects

    On hearing about the Texas finding, Irwin Goldstein, MD, editor-in-chief of The Journal of Sexual Medicine, was underwhelmed. Suggesting a man feast on watermelon to boost performance, he says, “would be the equivalent of someone dropping a beer bottle in Minneapolis, where the Mississippi River starts, and hoping to see it make an impact on someone in New Orleans.”

    “To say that watermelon is Viagra-like is sort of fun,” says Goldstein. “But to even vaguely hope that eating watermelon will alleviate ED is misleading.”

    “The vast majority of Americans produce enough arginine,” adds Goldstein, medical director of Alvarado Hospital Medical Center, San Diego, and clinical professor of surgery, University of California San Diego School of Medicine. “Men with ED are not deficient in arginine.”

    Wednesday through Saturday evenings at 8:00 pm with a Thursday matinee at 2:00 pm.

    TICKET PRICES

    Viagra What Is It Made Of sale
    Adults: $25
    Seniors: $20 (65 or older)
    Students (HS & under): $10

    Friday & Saturday
    Adults: $30
    Seniors: $25 (65 or older)
    Students (HS & under): $10

    FLEX PASS

    Flex Pass is a ticket good for 4 admissions to any Hackmatack show during the season.
    Adults: $100
    Seniors: $80 (65 or older)
    Click here to purchase Flex Pass

    CONTACT INFO

    Tickets can be purchased online. Please note all tickets purchased online are subject to a third party processing fee. To avoid this fee, tickets can be reserved by calling the box office.

    Viagra What Is It Made Of

    Hackmatack Playhouse was founded in 1972 by S. Carleton Viagra What Is It Made Of. He envisioned a summer stock theatre that would showcase the talents of professional and developing thespians from the regional area.

    Many theatre goers have called Hackmatack one of New England’s most charming and quaint summer theatres. Some have even said that summer in Maine is not summer without a trip to Hackmatack. Much of the allure of this playhouse is its scenic location and historical presence.

    Hackmatack Playhouse is located on the Viagra What Is It Made Of family farmstead. The property was purchased by the first Viagra What Is It Made Of (then Gubtail) to make the long trip to “New England” from native British Isles in the mid 1600’s. Thomas Viagra What Is It Made Of built the first home, a log house which sat in the far left of the present day field overlooking the irrigation pond. According to family legend, this home was burnt down by Indians during one of the many raids on the Salmon Falls river region. The present day farmhouse was constructed between the years of 1716-2005 to appease the needs of an ever-changing diverse and dynamic Viagra What Is It Made Of family. When it was first constructed, the house was a large cape sitting endwise to the road. It was occupied at one point by two Viagra What Is It Made Of brothers. The younger brother decided that he would like to have a modern two story cape. His older brother in typical conservative fashion said “the house is plenty good enough the way it is”. The younger brother replied, “My half is coming off”. He then proceeded to saw his half off and tear it down. He built his family a two story cape on the end of the original house, parallel to the road, giving the house its shape. Minor reconstructions have taken place since then to create a more modern and functional house for the present day Viagra What Is It Made Ofs.

    Prior to the year of 1972 when the theatre was established, the Viagra What Is It Made Of family farm functioned like many other farms at the time. The barn was the focal point of the farm. The current barn has an interesting story much like the original house. One of the first barns was struck by lightning and burned in July of 1934. Haying had just been completed for the season, and it is thought that the heat from the newly cut hay attracted the lightning. Almost immediately, Lewis Viagra What Is It Made Of began looking for the right barn to replace what had been lost. He finally purchased a barn. It was a large old structure with pegged timbers measuring fifty four feet long and forty two feet wide. It was the perfect replacement for the old barn. However, there was one small problem, it was located across the street.

    Luckily, the Viagra What Is It Made Of’s have always been known for their ingenuity. It was with this cleverness that Lewis decided it would be easier to move the barn rather than disassemble it and rebuilt it. The entire barn was jacked up and rollers were placed underneath it. A cable was attached to one end of the barn that ran though a large turnstile. An old white horse was chosen for the job of slowly moving the barn. The horse was hitched to the turnstile and the horse walked in circles, stepping over the cable on every lap. The leverage was great and each time the horse made a circle, the barn moved one half inch. Progress was slow. The entire operation took about three days, a day of that was spent crossing Maine route 9. However, in 1934, Maine route 9 was much less traveled, and everyone cheerfully watched or made their own route around the barn.

    After the theatre’s first decade the barn was expanded to the structure that you see today. An addition was added to the back, cement was added to form the floor, and the stage was expanded. These changes made room for the 218 seats the theatre houses today. It is rumored that back in 1972 patrons sat on hay bales to watch the show, however the original playhouse actually had seats that were salvaged from a Durham New Hampshire movie theater.

    The grounds of Hackmatack Playhouse and the area surrounding the theatre host many other buildings built and used by the Viagra What Is It Made Of clan over the years. The yellow family of buildings just south of the theatre (now owned by the Mills family) was originally built by Samuel Viagra What Is It Made Of in the early part of last century. Known as the Forget-Me-Not, these buildings housed services for early automobile travelers, including fuel for the autos, and food for the hungry. Visitors could rent a cabin, and if they happened to be staying on a Saturday night, they were in luck. On Saturday night there were always barn dances.

    The oldest building on the farmstead is the “woodshed” which is just south of the house. This building dates back to the 1600’s and has been used for many purposes over the years. It has been used as a slaughter house and for drying meat. It now is used for rehearsal space and prop storage.

    The “mill” is across the orchard from the “woodshed”. It now houses the theatre’s shop operations and its costume collection. However during the years of self-sufficient farming, it was one of several lumber mills built on the property by Lewis Viagra What Is It Made Of in the middle part of the 1900’s. This was a complete finish lumber mill powered by an Allis Chalmers tractor. If you listen carefully through the whirr of the belts and the screech of the saws you might just be able to hear Lewis and Almon Allen, and young Carelton Viagra What Is It Made Of, prepare a load of lumber for the newest construction project.

    The Viagra What Is It Made Of family has a long tradition of entertaining locals and summer visitors in the Beaver Dam section of Berwick. Samuel’s weekly barn dances at the “Forget Me Not” were a favorite pastime during the early decades of the 1900’s. His son Lewis, a local and state Grange Master, was also a master of many musical instruments. He had a passion for starting bands and performing in Beaver Dam and across the state of Maine. His son Carleton organized several theatre groups, first at the Beaver Dam grange, and then at his barn now called Hackmatack Playhouse.

    Every year thousands of people gather outside the Playhouse with tickets to the summer’s productions. Every year talented actors audition for their chance to perform at Hackmatack Playhouse, and to experience the history and excitement of being part of Hackmatack’s family. The farm and its building have many stories to tell. Perhaps 200 years from now Viagra What Is It Made Of great, great grandchildren will be telling this story to aspiring actors nervously waiting for their audition slot, and to friendly crowds waiting to take their seats; of how the barn became home for the Hackmatack Playhouse.

    After the death of the founder in 1995, the S Carleton Viagra What Is It Made Of Memorial Fund was established to preserve and improve our historical buildings. The fund also is dedicated to advancements of dramatic arts, both for the participant and the community, and to the commitment of providing quality family entertainment and drama at a reasonable price. Contributions are always welcomed. We thank you in advance for helping us secure the future of Hackmatack Playhouse for potential Hackmatackers.

    Hackmatack exists because of the generosity of it’s patrons, friends and those that appreciate the theater’s contribution to local culture and community. It is committed to the advancement of dramatic arts and to providing quality family entertainment at a reasonable price.

    We ask that you would consider a donation, and thank you in advance.

    Erectile Dysfunction Health Center

    This content has not been reviewed within the past year and may not represent WebMD’s most up-to-date information.

    To find the most current information, please enter your topic of interest into our search box.

    “>WebMD News Archive

    July 1, 2008 — Men hoping for some fireworks in their love life this Fourth of July may want to skip the burgers and beer at the barbecue and eat plenty of watermelon.

    Watermelon may be a natural Viagra, says a researcher. That’s because the popular summer fruit is richer than experts believed in an amino acid called citrulline, which relaxes and dilates blood vessels much like Viagra and other drugs meant to treat erectile dysfunction (ED).

    “We have known that watermelon has citrulline,” says Bhimu Patil, PHD, director of the Fruit and Vegetable Improvement Center at Texas A&M University, College Station. Until recently, he tells WebMD, scientists thought most of the citrulline was in the watermelon rind. “Watermelon has more citrulline in the edible part than previously believed,” he says.

    How could watermelon be a natural Viagra? The amino acid citrulline is converted into the amino acid arginine. Patil says. “This is a precursor for nitric oxide, and the nitric oxide will help in blood vessel dilation.”

    So, the burning question: How much watermelon does it take?

    “That is a good question,” Patil says. Unfortunately, “I don’t have an answer for that.”

    He does know that a typical 4-ounce serving of watermelon (about 10 watermelon balls) has about 150 milligrams of citrulline. But he can’t say how much citrulline is needed to have Viagra-like effects.

    He’s hopeful that someone will pick up on his research and study the fruit’s effect on penile erections.

    13 Common Sex-Drive Killers

    Watermelon’s Viagra-Like Effects

    On hearing about the Texas finding, Irwin Goldstein, MD, editor-in-chief of The Journal of Sexual Medicine, was underwhelmed. Suggesting a man feast on watermelon to boost performance, he says, “would be the equivalent of someone dropping a beer bottle in Minneapolis, where the Mississippi River starts, and hoping to see it make an impact on someone in New Orleans.”

    “To say that watermelon is Viagra-like is sort of fun,” says Goldstein. “But to even vaguely hope that eating watermelon will alleviate ED is misleading.”

    “The vast majority of Americans produce enough arginine,” adds Goldstein, medical director of Alvarado Hospital Medical Center, San Diego, and clinical professor of surgery, University of California San Diego School of Medicine. “Men with ED are not deficient in arginine.”

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    About High Tech Ministries

    Our Mission
    High Tech Ministries is a nonprofit organization that leads people into a life-changing relationship with Jesus Christ.

    High Tech Ministries creates business environments where people can explore faith within the workplace. This includes the annual High Tech Prayer Breakfast, Serve@Work community service projects, Grace@Work Bible studies, and the HTM Classic Golf Tournament.

    Our Values
    God. We believe in one God who exists in three distinct persons: Father, Son, and Holy Spirit. We
    believe that Jesus Christ is the second member of the Trinity (the Son of God) who became flesh to
    reveal God to man and to become the Savior of the lost world. (Jn1:1,14)

    Bible. We believe the entire Bible is the inspired Word of God and that men were moved by the
    Spirit of God to write the very words of Scripture. Therefore, we believe the Bible is without error.
    (2Tim3:16,17).

    Mankind. We believe that mankind was created in the image of God to have fellowship with Him
    but became alienated in that relationship through sinful disobedience. As a result, man is incapable of
    regaining a right relationship with God through his own effort alone. (Rom3:22-24)

    Salvation. We believe that the blood of Jesus Christ, shed on the cross, provides the sole basis
    for the forgiveness of sin. Therefore, salvation occurs only when people place their faith in the death
    and resurrection of Christ as sufficient payment for their sin. (Jn14:6)

    The Christian Life. We believe that every Christian should live for Christ and not for himself.
    By obedience to the Word of God and daily yielding to the Spirit of God, every believer should mature
    and be conformed to the image of Christ. (Rom8:29)

    Church. We believe that the Church is the body of Christ; Jesus Christ is the head. Members of
    the Church are those who have trusted, by faith, in the finished work of Christ. The purpose of the
    Church is to glorify God by loving Him and by making Him known to the lost world. (Eph1:22,23

    What HTM Means to Me

    Watch a two-minute video of several of our HTM community members talking about what their involvement with High Tech Ministries has meant to them.

    Welcome to ENNAH – the European Network on Noise and Health

    The ENNAH network is funded by the European Union to establish a research network of experts on noise and health in Europe.

    The network brings together 33 European research centres to establish future research directions and policy needs for noise and health in Europe.

    The Network will focus on the study of environmental noise sources, in particular transport noise, as well as emergent sources of noise such as noise from wind farms and low frequency noise.

    The network will facilitate high level science communication and encourage productive interdisciplinary discussion and exchange

    PARTNERS lOGIN

    September 24, 2016, 04:52

    About ENNAH

    Network Activities

    Downloads

    Other

    Useful Links

    ENNAH is funded by the European Union’s Seventh Framework Programme (2007-2013) under Grant Agreement n° 226442.
    © Queen Mary, University of London 2008. Site by TORPEDO

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    "The right of the people to be secure in their persons, houses, papers, and effects, against unreasonable searches and seizures, shall not be violated, and no Warrants shall issue, but upon probable cause. "

    - Fourth Amendment to the United States Constitution

    The Electronic Communications Privacy Act (ECPA) was a forward-looking statute when enacted in 1986. It specified standards for law enforcement access to electronic communications and associated data, affording important privacy protections to subscribers of emerging wireless and Internet technologies. Technology has advanced dramatically since 1986, and ECPA has been outpaced. The statute has not undergone a significant revision since it was enacted in 1986 – eons ago in Internet time.

    As a result, ECPA is a patchwork of confusing standards that have been interpreted inconsistently by the courts, creating uncertainty for both service providers and law enforcement agencies. ECPA can no longer be applied in a clear and consistent way, and, consequently, the vast amount of personal information generated by today’s digital communication services may no longer be adequately protected. At the same time, ECPA must be flexible enough to allow law enforcement agencies and services providers to work effectively together to combat increasingly sophisticated cyber-criminals or sexual predators.

    The time for an update to ECPA is now. Privacy advocates, trade associations, think tanks, legal scholars, start-ups, and major Internet and communications companies have developed consensus around the notion of a core set of principles intended to simplify, clarify, and unify the ECPA standards; provide clearer privacy protections for subscribers taking into account changes in technology and usage patterns; and preserve the legal tools necessary for government agencies to enforce the laws and protect the public.

    Changes in Technology Have Outpaced the Law

    Justice Brandeis famously called privacy “the most comprehensive of rights, and the right most valued by a free people.” Of course, privacy must be balanced against other societal interests. Electronic communications and associated data can provide key evidence in the investigation of many crimes, and the assistance of service providers is often necessary to access such evidence. With respect to communications privacy and law enforcement investigations, the courts and Congress have sought to develop rules for government surveillance that balance three interests: the individual’s constitutional right to privacy, the government’s need for tools to conduct investigations, and the interest of service providers in clarity and customer trust.

    Since enactment of ECPA, there have been fundamental changes in communications technology and the way people use it, including –

    • Email: Most Americans have embraced email in their professional and personal lives and use it daily for confidential communications of a personal or business nature. Because of the importance of email and unlimited storage capabilities available today, most people save their email indefinitely, just as they previously saved letters and other correspondence. The difference, of course, is that it is easier to save, search and retrieve digital communications. Many of us now have many years worth of stored email. Moreover, for many people, much of that email is stored on the computers of service providers.
    • Mobile location: Cell phones and mobile Internet devices constantly generate location data that supports both the underlying service and a growing range of location-based services of great convenience and value. This location data can be intercepted in realtime, and is often stored in easily accessible logs files. Location data can reveal a person’s movements, from which inferences can be drawn about activities and associations. Location data is augmented by very precise GPS data in many devices.
    • Cloud computing: Increasingly, businesses and individuals are storing data “in the cloud,” with potentially huge benefits in terms of cost, security, flexibility and the ability to share and collaborate.
    • Social networking: One of the most striking developments of the past few years has been the remarkable growth of social networking. Hundreds of millions of people now use social media services to share information with friends and as an alternative platform for private communications.

    In the face of these developments, ECPA does not provide protection suited to the way technology is used today:

    • Conflicting standards and illogical distinctions: ECPA sets rules for governmental access to email and stored documents that are not consistent. A single email is subject to multiple different legal standards in its lifecycle, from the moment it is being typed to the moment it is opened by the recipient to the time it is stored with the email service provider. To take another example, a document stored on a desktop computer is protected by the warrant requirement of the Fourth Amendment, but ECPA says that the same document stored with a service provider may not be subject to the warrant requirement.
    • Unclear standards: ECPA does not clearly state the standard for governmental access to location information.
    • Judicial criticism: The courts have repeatedly criticized ECPA for being confusing and difficult to apply. The Ninth Circuit in 2002 said that Internet surveillance was “a confusing and uncertain area of the law.” In the past 5 years, no fewer than 30 federal opinions have been published on government access to cell phone location information, reaching a variety of conclusions.
    • Constitutional uncertainty: The courts have been slow to address the application of the Fourth Amendment to new services and information. So far, among the regular federal appellate courts, only the Sixth Circuit has held that the Constitution protects stored email (Warshak), while the Ninth Circuit has held that there is a Constitutional privacy right in stored text messages (Quon). The Supreme Court has ruled that prolonged tracking with a GPS device is a search under the Fourth Amendment, but it has not yet ruled on use of cell tower data for tracking over time.

    This murky legal landscape does not serve the government, customers or service providers well. Customers are, at best, confused about the security of their data in response to an access request from law enforcement. Companies are uncertain of their responsibilities and unable to assure their customers that subscriber data will be uniformly protected. The current state of the law does not well serve law enforcement interests either, as resources are wasted on litigation over applicable standards, and prosecutions are in jeopardy should the courts ultimately rule on the Constitutional questions.

    The solution is a clear set of rules for law enforcement access that will safeguard end-user privacy, provide clarity for service providers, and enable law enforcement officials to conduct effective and efficient investigations.

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    The overarching goal of our ECPA reform principles is to balance the law enforcement interests of the government, the privacy interests of users, and the interests of communications service providers in certainty, efficiency and public confidence.

    We are guided by the following concepts:

    • Technology and Platform Neutrality: A particular kind of information (for example, the content of private communications) should receive the same level of protection regardless of the technology, platform or business model used to create, communicate or store it.
    • Assurance of Law Enforcement Access: The reform principles would preserve all of the building blocks of criminal investigations – subpoenas, court orders, pen register orders, trap and trace orders, and warrants – as well as the sliding scale that allows the government to escalate its investigative efforts.
    • Equality Between Transit and Storage: Generally, a particular category of information should be afforded the same level of protection whether it is in transit or in storage.
    • Consistency: The content of communications should be protected by a court order based on probable cause, regardless of how old the communication is and whether it has been “opened” or not.
    • Simplicity and Clarity: All stakeholders – service providers, users and government investigators – deserve clear and simple rules.
    • Recognition of All Existing Exceptions: Over the years, a variety of exceptions have been written into the ECPA, such as provisions allowing disclosures to the government without court orders in emergency cases. These principles should leave all those exceptions in place.

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    Our principles do not seek to answer all questions or concerns about ECPA. Though members of the coalition may differ on the specifics, and some individual members would support additional changes, we all agree that these principles provide a framework for opening a public dialogue on the issue.

    Specific Background on ECPA Reform Principles

    1. The government should obtain a search warrant based on probable cause before it can compel a service provider to disclose a user’s private communications or documents stored online.

    • This principle applies the safeguards that the law has traditionally provided for the privacy of our phone calls or the physical files we store in our homes to private communications, documents and other private user content stored in or transmitted through the Internet "cloud"– private emails, instant messages, text messages, word processing documents and spreadsheets, photos, Internet search queries and private posts made over social networks.
    • This change was first proposed in bi-partisan legislation introduced in 1998 by Senators John Ashcroft and Patrick Leahy. It is consistent with appeals court decisions holding that emails and SMS text messages stored by communications providers are protected by the Fourth Amendment, and is also consistent with the leading legal scholarship on the issue.

    2. The government should obtain a search warrant based on probable cause before it can track, prospectively or retrospectively, the location of a cell phone or other mobile communications device.

    • This principle addresses the treatment of the growing quantity and quality of data based on the location of cell phones, laptops and other mobile devices, which is currently the subject of conflicting court decisions; it proposes the conclusion reached by a majority of the courts that a search warrant is required for real-time cell phone tracking, and would apply the same standard to access to stored location data.
    • A warrant for mobile location information was first proposed in 1998 as part of the bipartisan Ashcroft-Leahy bill. It was approved 20 to 1 by the House Judiciary Committee in 2000.

    3. Before obtaining transactional data in real time about when and with whom an individual communicates using email, instant messaging, text messaging, the telephone or any other communications technology, the government should demonstrate to a court that such data is relevant to an authorized criminal investigation.

    • In 2001, the law governing “pen registers and trap & trace devices”—technologies used to obtain transactional data in real time about when and with whom individuals communicate over the phone—was expanded to also allow monitoring of communications made over the Internet. In particular, the data at issue includes information on who individuals email with, who individuals IM with, who individuals send text messages to, and the Internet Protocol addresses of the Internet sites individuals visit.
    • This principle would update the law to reflect modern technology by establishing judicial review of surveillance requests for this data based on a factual showing of reasonable grounds to believe that the information sought is relevant to a crime being investigated.

    4. Before obtaining transactional data about multiple unidentified users of communications or other online services when trying to track down a suspect, the government should first demonstrate to a court that the data is needed for its criminal investigation.

    • This principle addresses the circumstance when the government uses subpoenas to get information in bulk about broad categories of telephone or Internet users, rather than seeking the records of specific individuals that are relevant to an investigation. For example, there have been reported cases of bulk requests for information about everyone that visited a particular web site on a particular day, or everyone that used the Internet to sell products in a particular jurisdiction.
    • Because such bulk requests for information on classes of unidentified individuals implicate unique privacy interests, this principle applies a standard requiring a showing to the court that the bulk data is relevant to an investigation.

    To simplify, clarify, and unify the ECPA standards, providing stronger privacy protections for communications and associated data in response to changes in technology and new services and usage patterns, while preserving the legal tools necessary for government agencies to enforce the laws, respond to emergency circumstances and protect the public.

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    Manufacturer link: Litespeed
    The Kanarya Viagra 2016 Litespeed T3 uses an ovalized 3/2.5 titanium top tube in place of the 6/4 titanium tube from the T1-SL, and a simplier bottom bracket design but is otherwise nearly identical to the T1-SL frame with almost 90% of the $4000 T1-SL frame’s performance but for $1100 less! New for 2016: the T3 now includes hex-bolt-attached removable head-tube cable guides (just remove them for conversion to Di2), and ovalized chain and seat stays for leaf-spring like shock absorption, as well as both disc brake and rim brake compatible design! Of course like all Litespeed titanium frames, the T3 is fully hand-crafted in the USA and comes with a lifetime warranty. Kanarya Viagra: Get $350 OFF any of our Adrenaline Bikes build kits with the purchase of the frame and for the $2,999 MSRP price, AND get a FREE $420 MSRP full carbon tapered fork with either a frame-alone or bike purchase!

    Manufacturer link: Ritchey
    The Kanarya Viagra price includes a Ritchey Logic Pro carbon fork painted to match and a Ritchey WCS headset, and FREE SHIPPING (for either the frameset or a complete bike to any of the 48 contiguous US states.) Features include: Ritchey Logic triple butted cromoly tubeset with integrated headset design (80 grams lighter than a standard chromoly head tube design), and the downtube is ovalized below the front derailleur clamp for enhanced side-to-side rigidity at the bottom bracket. With Kanarya Viagra for tires up to 28c and classic Ritchey geometry, the Road Logic is ideally suited for long, epic days in the saddle on roads that are not always paved, and still nimble and stiff enough to take the county line sprint at the end of the day. Call or email and ask for a Kanarya Viagra quote on a complete Road Logic built with Ritchey bars, stem, post, wheels, and seat. Ritchey offers us a hefty discount on those items when we order them with a frameset, and we can pass on the savings to you!

    Read Road Bike Action magazine’s review of this bike:

    See a video of Tom Ritchey interviewed about the Road Logic:

    FREE: 48-contiguous US state shipping on Ritchey frames and bikes! (Regular $110.)

    Kanarya Viagra

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    Blue Pill Herbal Viagra

    Blue Pill Herbal Viagra in Snow Hill, Maryland is small town living at its best. Nestled on the south banks of the Pocomoke River Snow Hill is a place where people know each other. From the people who call it home to the business owners and those in city government, we have built a community where life is gentle, fun, and prosperous. Home to a quaint downtown retail area and a broad spectrum of recreational activities, Blue Pill Herbal Viagra is the perfect place to spend a relaxing weekend or a lifetime.

    Whether you are interested in researching your genealogy in the Worcester Room of the Worcester County Library. renting a kayak from the Pocomoke River Canoe Company to paddle on an undeveloped natural river, or studying the architecture of historic homes and beautiful churches while taking the Historic Walking Tour, Blue Pill Herbal Viagra has something for everyone. You will find recreational opportunities in Byrd Park and Sturgis Park, artifacts at the Julia A. Purnell Museum. and treasures in the shops and art galleries.

    The beautiful rural setting boasts rich farmland that has been the mainstay of the economy of the county seat of Worcester County for centuries. The rich heritage of this area is celebrated daily at Furnace Town Living Heritage Museum and during a summer festival every August with The Blessing of the Combines.

    The town of Blue Pill Herbal Viagra welcomes you as you explore our small town steeped in history and tradition but alive with charm and activities.

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