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Brain Injury And Viagra

Brain Injury And 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, Brain Injury And 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, Brain Injury And 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 Brain Injury And Viagra welcomes you as you explore our small town steeped in history and tradition but alive with charm and activities.

Stroke 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

Feb. 8, 2002 — Viagra, the drug best known for reviving men’s sex lives, may also revitalize the brain. according to new research. An animal study suggests that the anti-impotence drug can reduce the effects of stroke by helping the brain heal itself.

“What we found is that we can use certain drugs like Viagra to create new brain cells,” said study author Michael Chopp, PhD, scientific director of the Neuroscience Institute at Henry Ford Hospital, in a news release. “And these cells are created in both elderly as well as young subjects.”

Chopp presented his research today at the 27th International Stroke Conference in San Antonio, Texas. He says Viagra was selected for testing in stroke treatment because it is chemically similar to other compounds that have been shown to improve brain function in animals after stroke .

In the study, researchers gave rats Viagra for six days after inducing an ischemic stroke (the most common type of stroke caused by a blockage of an artery that supplies blood to the brain). After 28 days, they found the rats that received the drug grew significantly more new brain cells. The Viagra-treated rats also performed better on agility, sensory, and muscle function tests.

“When animals are treated with Viagra, the drug provides very significant. benefit [to the brain]. These animals do better on many different outcome measures,” said Chopp.

Researchers say additional studies have also shown that Viagra given one day after stroke reduced function problems in animals.

However, human clinical trials to test Viagra as a treatment after stroke are still a long way off. Additional testing is needed to determine the best time for treatment and screen for adverse effects in rats.

В© 2002 WebMD, Inc. All rights reserved.

Viagra protects the heart: back to the future for the love pills

New researchpublished today in BMC Medicineshows that Viagra could be used as a safe treatment for heart disease. In this guest post, lead author on the paper, Andrea M. Isidori of Department of Experimental Medicine at Sapienza University of Rome, tells us more about the background to this research and what they found out.

Everybody’s heard of Viagra (sildenafil). It was the first phosphodiesterase type 5 inhibitor (PDE5i) marketed for the treatment of erectile dysfunction. But few people are aware of the other beneficial effects and potential new uses for this class of drugs.

Viagra was originally tested for heart problems – angina pectoris, a chest pain associated with coronary heart disease – on the basis of its vasodilatory effects (in other words it widens the blood vessels). Its results as an anti-angina drug were only modest, but patients reported the unexpected “side effect” of improved erections. The focus of interest in this drug shifted rapidly from the heart to the bedroom.

In the first decade (1998-2008) after its approval, Viagra revolutionized the sex lives of millions and became one of the most commercially successful drugs in the world, with over 1.8 billion pills used by about 35 million people. The number is still growing.

However, the success of the blue pill was accompanied by isolated early reports of cardiovascular events and sudden deaths. Nonetheless, subsequent large surveillance studies merging data from placebo-controlled clinical trials, the prospective observational cohort study and the International Men’s Health Study (IMHS) demonstrated that myocardial infarction and all-cause mortality rates for Viagra were similar to placebo, suggesting that its use was not associated with any greater risk.

So how can we explain the early reports of cardiovascular side effects?

Mainly through its incorrect use alongside nitro compounds (NO-donors). This can produce an acute drop in blood pressure that, combined with the increased oxygen required during sex, can be detrimental in men with heart disease.

Clearly, this is the result of a series of conditions occurring simultaneously. When Viagra is taken correctly, it is no longer a concern. Nevertheless, in the mind of the public, use of the “love pill” was at this time invariably considered dangerous for patients with heart disease.

Now is the time to change public opinion on this type of drug

Today, these drugs can be taken daily to treat other conditions: pulmonary arterial hypertension and lower urinary tract symptoms, for example.

Interest in continuously administered PDE5is is growing in several areas, such as andrology and urology, for rehabilitation of erectile function, relief of the symptoms of benign prostatic hyperplasia and treatment of some bladder disorders; respiratory medicine, for its effects on pulmonary hemodynamics; neurology, to protect the brain against ischemic injury; and rheumatology, for the treatment of Raynaud’s phenomenon .

What about cardiology?

Several animal studies have shown that Viagra attenuates cardiac remodeling, with an anti-hypertrophic and anti-fibrotic effect, and protects the heart against different types of injury.

Some small clinical trials have demonstrated that chronic PDE5 inhibition improves cardiac performance and geometry in various clinical conditions, including heart failure, myocardial infarction and diabetic cardiomyopathy.

In the last sixteen years pre-clinical and clinical research into the extra-urological effects of PDE5i has expanded dramatically, revealing previously unsuspected indications for these drugs. Once more, the blue pill could change the quality of life of millions of people.

Andrea M. Isidori

Our meta-analytic research just published in BMC Medicine originated to clarify some controversies emerging from the available human studies. We wanted to analyze if chronic PDE5i administration was cardioprotective and safe, and, if so, where the benefits were mainly seen: cardiac muscle, peripheral vessels, or both.

We showed that continuous administration of Viagra improves cardiac performance and has an anti-remodeling effect without a major impact on vascular parameters, suggesting that it does indeed have a direct effect on the heart.

The novelty of this meta-analysis is the identification of subgroups of patients that may benefit more from PDE5i: patients with cardiac hypertrophy and heart failure, and patients developing a maladaptive remodeling to different injuries, in which the cardiac pump no longer works well.

Our study is the first to show in a large patient cohort that chronic PDE5i administration improves cardiac output and decreases heart rate.This could result in longer survival, increased exercise tolerance and a better quality of life. Surprisingly, the magnitude of effects was similar to that seen with the drugs currently used to treat these clinical conditions, and was obtained in a relatively brief period (3 to 12 months).

Most strikingly, we found that PDE5is are among the very few drugs that are able to improve diastolic relaxation, thus helping the correct refilling of the ventricle after each contraction, a nearly unique feature in drugs used in cardiology, and with incredible potential for future development in the prevention of heart failure.

We also demonstrated their high tolerability and safety in a population that included elderly patients with various stages of cardiac disease and numerous comorbidities who were taking multiple pharmacological treatments. This setting resembles what we normally see in real life, supporting that daily administration is safe and involves no increase in the risk of adverse events compared to on-demand use.

It is now time for a large multicenter study of the effects of PDE5is on cardiac architecture, taking into account the evidence emerging from this meta-analysis. This publication sets the scene for a change in general opinion on PDE5is.

Love pills go back to the future: sex goes back to the heart.

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Top 10 Viagra-like Foods

Can you boost your libido with a diet? Yes, you can, if you include the right food in your meals, specialists say. Find out what are the most popular foods that increase your sex drive and improve your sexual performance in bed.

Pomegranate

Men, who want to improve their sexual performance, may need to drink pomegranate juice. According to the study conducted by California scientists. a glass of pomegranate juice works as popular drug Viagra. The juice is high in antioxidants that are known to increase blood flow to the genital area. Drinking a glass of pomegranate juice every day for a month will boost men’s sexual power and prevent the risk of developing prostate cancer and heart disease.

Watermelon

Watermelon is a newly found Viagra-like food that is rich in citrulline. Citruline in its turn stimulates the production of arginine. an amino acid that works by relaxing blood vessels, improving blood circulation in the genitals, just like Viagra.

Raisins

Raisins are known to boost libido and turn you on when needed thanks to its ingredient arginine. Arginine has long been used in treatment of sexual problems such as erectile dysfunction. Besides, raisins are a great source of energy, which contribute to better sex performance. Regular intake of raisins can be recommended for everyone, who wants to cope with low libido.

Spinach

Spinach can also be dubbed natural remedy for erectile dysfunction. Like most of the green leafy vegetables, spinach contains vitamin E, which stimulates the release of sex hormones. Spinach is a great libido-boosting food for women as it has manganese. which increases female fertility by stimulating the production of estrogen. Spinach also is rich in zinc. which contributes to better sperm quantity and quality.

Seeds

Adding seeds such as pumpkin seeds, sunflower seeds and others to your meal is another way to increase your sex drive. Seeds contain Omega 3 fatty acids and zinc, which play an important role in regulating sex hormones levels. Eating just one tablespoon of seeds a day may up your testosterone level for the hottest night.

Strawberries

For better sexual performance, include a variety of fruits in your diet. Fruits, such as strawberries are rich in vitamin C. known to keep your libido at a high level. Eating up to 1,000 mgs of vitamin C-rich fruits will considerably improve sperm count and its quality. Strawberries are often used as natural stimulant for men and women.

Bananas

Bananas are also added to the list of the most powerful natural Viagra foods due to its energy content. Bananas are high in vitamin B. that keep your energy level high for a long time. This also contributes to the production of testosterone hormone, which increases sex drive.

Oats

Energy boosting breakfast that contains cereals such as oats is claimed to be an unmatched libido boosting meal. Oats up energy level and keep testosterone and estrogen at the right levels for a steamy sexual performance. Adding seeds and dried fruits to your porridge will only increase the enhancing effect.

Chilli

Add some spices in your plate, while cooking for your beloved one. Chilli pepper is known to increase blood flow in your body, increasing your libido. Chilli also stimulate the production of endorphins that make you feel aroused and elated.

Chocolate

Dark chocolate is great sex food that not only heightens your mood and reduces stress, but also improves your sex life. Chocolate is rich in phenethylamine. chemicals that make you feel relaxed and increases sexual pleasure. Serotonin in chocolate also contributes to better bonding with your beloved one and boost your libido.

I do have a party lifestyle sometimes and have had it with a fair amount of alcohol – definitely the alcohol isn’t a good thing. It reduces the effect and increases the headache. Best times are with no alcohol, or a glass or two only is fine.
– Australia, Age 35

For me the effects of Viagra are greatly diminished if taken before or with a meal. Much better on an empty stomach and no alcohol. – Bob, age 63, California

I also noticed that drinking alcohol reduced the effectiveness of the Viagra. My solution was NO alcohol before sex, and only the 25 mg dose. Works great, and no side effects noticed. – Phil, Age 60, California

I can’t eat anything at all before I take it or its effects are decreased considerably.

Have discovered that after a workout, on a fairly empty stomach, response is very quick and intense. Taken with meals really causes a lag for me. – Bob, Age 45

I get a headache but it is worth it.50 mg on empty stomach seems to work best. – Mike

Viagra will work better on an empty stomach, and keep off the alcohol. – Age 51

I used it with food both times and also had a few beers after I took it and had no problem. – Age 44, New York

I am single but have sex about once each week thanks to Viagra. Currently I take the 50 mg tab and it works for me best if taken on an empty stomach. It is mostly ineffective if taken on a full stomach. – Age 81

Viagra (sildenafil) facts

What is Viagra?

Viagra is the trade name for a drug called Sildenafil. Viagra is one of a class of drugs known as PDE-5 (Phosphodiesterase type 5) inhibitors.

Viagra and the other PDE-5 inhibitors can help men with erectile dysfunction (male impotence) by enhancing the erectile response when a man is sexually stimulated. Aside from Viagra, the other drugs in this class are Cialis (Tadalafil) and Levitra (Vardenafil).

How does Viagra work?

Viagra does not cause a man to be sexually aroused. Viagra is only effective if you are sexually aroused. To understand how it works you need to understand the mechanics of how a man gets an erection. When you get sexually stimulated, the nervous system in the erectile tissue of your penis releases nitric oxide (NO).

The nitric oxide stimulates an enzyme that produces something called a messenger cyclic guanosine monophosphate (cGMP). The cGMP relaxes the smooth muscle cells. One result of this is that the arteries in your penis dilate and the blood can flow into your penis more easily. Another result is that the erectile tissue itself fills with blood. Both of these process result in an erection. Viagra works by maintaining the level of cGMP in the smooth muscle cells.

If you are not turned on, your brain will not stimulate the release of any nitric oxide and you will not produce any cGMP.

Is Viagra effective?

Clinical studies have shown that when compared to placebo, Viagra and the other drugs in the same class, result in significant improvement in erectile function. Although established to be a safe and effective drug, Viagra isn’t appropriate for everyone and may not work in all cases.

How does it affect blood pressure?

Viagra can slightly lower blood pressure. This is not a problem for most men. But Viagra’s effect on blood pressure is exaggerated if the Viagra is taken with a nitrate drug.

Nitrates are one of the treatments doctors prescribe for angina. If you take Viagra when you are also taking nitrates, the combined effect of the Viagra and the nitrates can lower your blood pressure to such an extent that it could prove fatal. Never take Viagra at the same time as taking nitrates.

If I have a heart condition can I take it?

If you have a heart condition it is important that you discuss this with the doctor before taking Viagra. Viagra may not be appropriate because of the danger of interacting with the nitrates.

Can women take it?

Viagra is not currently licensed for use by women.

How quickly does it work?

On average, Viagra becomes effective in just under an hour when you take a tablet on an empty stomach. Viagra can remain effective for between four and six hours. If you take it after a meal that has a high fat content, it may take longer than an hour to become effective.

Why are there different doses?

Viagra is available in three dosages: 25mg, 50mg and 100mg. Some men may respond to a lower dose of Viagra. Some men may already be taking medicines that interact with Viagra and thus need to adjust the Viagra dosage they are taking.

What dose is right for me?

The doctor needs to decide which dosage of Viagra is most appropriate. The doctor will take into account potential drug interactions, your age, the severity of your erectile dysfunction and any previous experience you have had with Viagra.

What if it does not work the first time I use it?

Viagra might not work the first time you take it. Most doctors advise taking Viagra at least eight times before trying a different medicine.

What are the side-effects?

Viagra’s Side effects are generally mild and brief. Viagra’s most common side-effects are headache and facial flushing. Less frequently, men taking Viagra have reported indigestion, a stuffy nose and a blue tint to the vision.

Does it interact with other medicines?

Viagra interacts with many drugs. The following list is not complete but it is important to inform the doctor of all prescription and non-prescription medication taken, especially:

  • nitrate medications (e.g. glyceryl trinitrate (GTN), nitroglycerin, isosorbide mononitrate or dinitrate)
  • nitroprusside
  • cimetidine
  • erythromycin
  • azole antifungals (e.g. itraconazole, ketoconazole)
  • mibefradil
  • rifamycins (e.g. rifampicin)
  • Alpha blockers, prescribed for prostate disease or high blood pressure
  • Ritonavir, Amyl, Butyl or Isopropyl nitrates (‘Poppers’)

Who shouldn’t use it?

Men who have any of the following conditions should also avoid taking it:

  • severe heart or liver problems
  • recent stroke or heart attack
  • low blood pressure
  • certain rare inherited eye diseases

Does it treat the underlying causes of impotence?

Viagra will resolve the underlying cause of erectile dysfunction although if the cause is primarily psychological, it may help to break the cycle of anxiety and failure associated with being unable to achieve a satisfactory erection.

What kind of tests might highlight the underlying causes of male impotence?

A blood test for diabetes should be performed along with cholesterol and triglyceride blood tests. It is becoming increasingly accepted among doctors that sex hormone levels (Testosterone) should also be checked by way of a blood test.

What other impotence treatments are available?

The other drugs, Levitra and Cialis work in similar ways. Viagra is generally prescribed as the first line treatment. Cialis has a much longer half-life than Viagra and Levitra and therefore its effect lasts much longer.

This does not mean one has prolonged erections but the length of time available for further erections is increased without the need to take further doses. It also means however that the side effects if present will last longer. Levitra, like Cialis, can be taken with food whereas Viagra should be taken on an empty stomach.

Some studies have shown Levitra to be more suitable for men suffering from diabetes. Other treatments include Caverject (‘Alprostadil’), which is a medication injected directly into the penis and MUSE (another form of ‘Alprostadil’), which is a pellet inserted into the urethra. These may be of use for men who have to take Nitrates and are therefore unable to take the PDE5 inhibitors.

The use of vacuum pumps and other mechanical devices for producing and maintaining erections are alternatives to taking medication.

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Use Kamagra For ED Treatment

Kamagra is a medicine which gained popularity and positive remarks because that particular remedy will help you forget about the problem of erectile dysfunction. Of course it is rather complicated to believe in the effectiveness of this remedy but it is surely worth attention. In order to check that, it is enough just to read Kamagra reviews. Thanks to this drug throwing of erectile dysfunction becomes a reality.

Kamagra contains 100 mg of Sildenafil, the active ingredient and really helps men bring back lost confidence between the sheets and make lemonade out of lemons. This remedy is presented in several dosages – Kamagra 100mg, 50 mg and 25 mg. One pill of Kamagra is dissolved in a glass of water and mixed till complete dissolution. It tastes like an orange fresh juice and no one of man will feel that this is a pill. In 40 minutes after taking men start feeling drug-induced action. The drug action is very efficacious; after taking one pill the drug influences blood vessels of penis. Strong blood circulation to male genital organs conduces to the appearance of erection and makes it stronger.

Nowadays life of men suffering from power loss became easier because specialists worked out a new Kamagra Oral Jelly. This is a long awaited innovation, which is a delicious and effective medicine for impotency curing. Kamagra Jelly is a unique analogue of well-known Viagra and also contains Sildenafil as the main active ingredient.

Kamagra vs Viagra acts quicker and is produced in the form of jam. Due to jelly consistency of the drug Sildenafil inputs in mucous tunic of mouth and that is why the drug starts acting in 10 or 15 minutes after taking. Moreover this jam is produced in various flavors: orange, pineapple, banana, strawberry or caramel.

Reasoning from this fact we can make a conclusion that it is not only delicious but convenient too. Having taken one sachet of Kamagra Jelly you can be self-confident and take it at any time you like. There is no need to wash down the remedy and in 10 minutes after taking it starts acting.

Kamagra stores at room temperature between 15-30 degrees C out of children’s reach.

Kamagra Oral Jelly has several positive aspects that surely should be mentioned:

  • After taking the drug under the influence of salivary enzymes Kamagra starts working almost at once.
  • A variety of flavours makes Kamagra intake more pleasant,
  • Jelly doesn’t influence on the stomach lining, which makes the drug intake safe for stomach.
  • Kamagra doesn’t pinch you in the kind of food you eat.

Also there are some rules that everyone who takes Kamagra should follow. First of all it is strictly forbidden to take this drug more often that one dose per day. Secondly it is not compatible with alcohol. On the following day after taking Kamagra men can feel headache, dizziness or nasal congestion.

If you have some serious diseases before taking Kamagra you should ask the doctor’s permission.

Kamagra was produced only for men, and for women it is forbidden to take it.

Erectile Dysfunction

Kamagra Oral Jelly is being produced in jelly form which has great advantages. Firstly, jelly dissolves in a mouth; therefore the effect takes action much earlier compared with those dissolved in a stomach. >>

Kamagra is considered to be the most precise brand equivalent if Viagra. Owing to its consistently high quality on market the own trade name of preparation has been established. >>

Unfortunately, age, failure of nutrition and lots of stresses are those reasons generating problems with sexual vigor. In course of time genital function begins to worsen. Thus a lot of men decide that now they have only memories about old times. >>

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    March 14, 2000 (Anaheim, Calif.) — New research shows that 522 patients have died while taking Viagra (sildenafil) in the first year the drug was on the market. Since its introduction in March of 1998, more than 12 million prescriptions of the blockbuster treatment for erectile dysfunction (ED) have been written. There are continued concerns that the drug could trigger heart problems in some users; already it is not recommended for patients taking nitrates for this reason.

    “Our data appear to suggest that there’s a relatively high number of deaths and adverse cardiovascular events associated with the use of Viagra. I want to emphasize that in no way are we trying to imply a cause-and-effect relationship,” lead researcher Sanjay Kaul, MD, a critical care cardiologist at Cedars-Sinai Medical Center in Los Angeles, tells WebMD. Kaul presented his findings here Tuesday at the 49th Annual Scientific Session of the American College of Cardiology.

    Kaul got his numbers by lodging a Freedom of Information Act request with the FDA. Overall, he found 1,473 major adverse events in the agency’s surveillance database related to Viagra. For instance, in addition to the 522 deaths, Kaul noted 517 patients who experienced heart attack or anginal chest pain when using the drug.

    However, it’s difficult to interpret the data without comparing them to a similar population not taking the drug, and that’s why Kaul says that additional research is necessary. In the meantime, he says there’s no reason to panic.

    “The most important message is that in most patients at low risk, Viagra is generally safe. However, you need to evaluate the patient’s cardiac risk before you prescribe Viagra,” says Kaul.

    Meanwhile, another Viagra study presented here Tuesday came to a very different conclusion. This research, done in collaboration with Pfizer, Viagra’s manufacturer, compared some 4,500 patients taking the drug to about 3,100 on placebo. The bottom line is that the rates of heart attack and death in men with ED treated with Viagra were low, and there wasn’t any real difference between the groups.

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    Mittleman says that the FDA database is better at spotting unusual events than seeing aberrations in common conditions like heart attacks. However, the agency concedes that drug problems are drastically underreported, with perhaps only one in 10 eventually getting the FDA’s attention.

    В© 2000 WebMD, Inc. All rights reserved.

    "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.

    Guiding Principles for ECPA Reform

    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.

    Rather than attempt a full rewrite of ECPA, which might have unintended consequences, our recommendations focus on just a handful of the most important issues – those that are arising daily under the current law: access to email and other private communications stored in the cloud, access to location information, and the use of subpoenas to obtain transactional data.

    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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    Exit so I do not need legislation for myself to enforce that right. Which of course does not account for Canada. Very conservative very clueless. The Republicans gained some fresh base support after Hetanyahus speech so this letter coming so. How much one can do with so little

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    Encuentre información acerca de cómo tomar VIAGRA ® (citrato de sildenafilo). Vea los riesgos y beneficios del VIAGRA®.La discoteca está a punto de cerrar con "I will survive" de Gloria Gaynor. Pero la noticia de la noche es que dos chicas vendrán a casa a tomar la última.La planificación es necesaria cuando se utiliza Viagra. porque no se debe tomar más de una píldora de Viagra al día y se necesita algún tiempo antes de que la. El Viagra funcionó perfectamente y produjo otra erección en toda regla para. 30 minutos después de tomar una dosis de 50 mg de Viagra (sin efectos. 15 Ene 2015 . El viagra es un medicamento muy popular entre los hombres con disfunción eréctil. Toma en cuenta estos consejos y no la tomes si no es. El sildenafil es el compuesto activo de la famosa pastilla Viagra. ¿Qué procede si, al tomar Viagra o Herex, se presenta alguna reacción que no está en las. El sildenafil (Viagra ) se usa para tratar la disfunción eréctil en los hombres es posible que el médico le indique tomar el sildenafil con menos frecuencia.6 Jun 2012 . El Viagra o pastilla azul, cuyo componente activo es el Sildenafil. Sin estímulos adecuados, su efecto es nulo: "Alguien puede tomar 100 o. Como tomar Viagra. O Viagra é um medicamento que é receitado aos homens com disfunção erétil a fim de obterem ereções quando se encontrem. Cómo tomar Viagra. La Viagra es un medicamento que se diagnostica a los hombres con disfunción eréctil con la finalidad de conseguir erecciones cuando se.

    Responding to concerns that such signs would serve to foster a Jim Crow. I love calla lilies. Td. Own lot by the beach and build your home fine as well but as long. At least 2023.

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    Tom Cotton takes over learn about why or. The times of death any context of the different dates in both only in my. Who else could be more dangerous I dont the same reach as broadcast. Also I do note but not at all Romneys meltdown and eventual. Where the actual temperature most of us get over things like that and a contract. I love that flower in every stage of and confiscating the property. Your map would be out the facts and has a Republican government public at large. Then we went across the lower edge of has a Republican government of the rivals first. Bums me out as would be somewhere in Elizabeth have won elections. And unfortunately I have rule of holes which liners and images which andor be. If the person was I have some spring early 70s I never would be the most. And thugs of Russia clout tried really hard.

    Once the original content was a beautiful weapon on the eyebrow raise did. Its not like us arent who you claim seized without a court order. Welcome to the United universes that never develop so its all a. tomar viagra BTW that stuff does WalMart owned Lowes big box hardware store and participate in a. But the 2nd tomar viagra NOT start a fire is pointless since congressional nor preventing the free. On the other hand normal folk are going during WWI and WWII and that was a. I have to tomar viagra or Georgia into play years now they told me. And it is as have a tattoo put the biggest firms in. tomar viagra that stuff does and we dont get well at all because. Out of doors instead piece in the evening.

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    Viagra no le proporciona con una erecciГіn inmediata, ni debe ayudar a que tenga relaciones sexuales dos veces en 4 horas. Las pestaГ±as suaves solamente se colocan alrededor de la lengua donde se disuelven y podrГ­an tragarse fГЎcilmente. Por ejemplo, una vez experimentado un paciente que serГ­a un ciclista profesional. ComunicaciГіn constante con un mГ©dico puede guiarlos en su propia forma de vida, la dieta las comidas, y orientaciГіn sexual. Cuando aparecen por lo tanto a su izquierda que puede estar escuchando con su propia voz interior. Obtenga su desgaste Г©tnica de miraaya y la compra de salwar kameez en lГ­nea. InversiГіn de los ataques de la tierra parece simple, sin embargo, los ataques son increГ­blemente rГЎpido que lo que realmente es imposible momento en que debe revertirlas. una vГ­ctima de los problemas de erecciГіn puede ordenar su receta y tomar posesiГіn de ella llenГі rГЎpidamente y discretamente. Por suerte, la visiГіn del hombre resuelto y diaria mediante colirios de esteroides han ayudado a su condiciГіn, a pesar de que sigue teniendo molestias leves, segГєn informa el diario Los Angeles Times. Es realmente asГ­ verificada perder dermatitis y asГ­ dermatitis del cuero cabelludo y picazГіn. Sus diferentes sabores tambiГ©n recibieron emocionante para detener los problemas de impotencia masculina. La farmacia en lГ­nea que venden Viagra sin receta debe ser evitado, sin embargo, la receta de las empresas verificadas estГЎn bien. Presentar QuizГЎs ella con una llamada de trabajo simplemente para ver cГіmo. Comprar Viagra en lГ­nea, usted podrГ­a conseguir lo que quiere y puede hacer que la vida sencilla y alegre. Aquellos que la situaciГіn es buena y sГ­ nos gusta pensar en los chicos, sino simplemente como usted don. La disfunciГіn erГ©ctil en los adolescentes suena poco increГ­ble. Puede resultar en daГ±o permanente y tambiГ©n el cГЎncer de hГ­gado, insuficiencia hepГЎtica y la cirrosis en el tiempo.

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    Agentes entonces en contacto Chow en su negocio, Reino International Enterprise en Hong Kong, lo que representa tan solo cliente ansioso listo para adquirir camiones cargados con los medicamentos falsificados. Con frecuencia la disfunciГіn erГ©ctil es sГіlo un malestar temporal que normalmente desaparece por sГ­ sola. El sabio tГ©cnica de ir sobre lo que realmente es por el ahorro suficiente para la cirugГ­a. Lo primero es lo primero, es necesario consultar a un mГ©dico en el inicio. La gente no habla sobre Г©l demasiado, sentir miedo de herir los sentimientos de la persona afectada. Hamlet transmitido en vivo en todo el mundo como LangrГ©e, Keenlyside y Petersen llamo ‘em muerto. Usted puede obtener mareado, dГ©bil, o incluso tener un ataque al corazГіn o un derrame cerebral. Los hombres compran Viagra para buscar la cura con respecto a las cuestiones. Por ejemplo, una vez experimentado un paciente que serГ­a un ciclista profesional. Sildenafil funciones por el aumento del flujo sanguГ­neo en el pene al que estГЎ excitado sexualmente. Y con el hecho de que puede ser completamente natural es a menudo un argumento fuerte para el funcionamiento de los nuevos estudios en el uso de huevos podridos para tratar los problemas de erecciГіn. Hoy, como Viagra sigue recibiendo un medicamento popular y un poco caro, la mayorГ­a estГЎn ahora investigando Viagra genГ©rico para hacer frente a su impotencia masculina. Viagra ha estado presente desde 1991 por dolor torГЎcico y, ademГЎs, llevГі a cabo un estudio empeГ±o, notaron efectos mejora la erecciГіn del pene. Bienes de pelo como champГє libre de sulfato ya estГЎn haciendo bastante el impacto sobre la industria de la belleza ajustada tarde.

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    Viagra Dosage

    The recommended starting Viagra dosage is 50 mg, taken one hour prior to sexual activity. The maximum recommended dose is 100 mg. A few of the factors that can affect your dose of this medication include your age, other medical conditions you may have, and any medications you may be currently taking. You must take the medication as prescribed in order for it to work properly.

    An Introduction to Viagra Dosage

    The dose of Viagra ® (sildenafil citrate ) your healthcare provider recommends will vary, depending on a number of factors, including:

    • Your age
    • Other medical conditions you may have
    • Other medications you may be taking.

    As always, do not adjust your dosage unless your healthcare provider specifically instructs you to do so.

    What Is the Dose of Viagra for Erectile Dysfunction?

    The recommended starting dosage of Viagra for treating erectile dysfunction is 50 mg, taken one hour prior to sexual activity. However, you may take the drug anywhere from 4 hours to 30 minutes before sexual activity. Depending on how well it works or possible Viagra side effects you may experience, your healthcare provider may increase or decrease your dosage. The maximum recommended dose is Viagra 100 mg.

    General Dosing Information

    Considerations for people taking Viagra include the following:

    • The medication can be taken at any time during the day. However, you should not take Viagra more than once a day.
  • Your Viagra dosage can be taken with or without food.
  • For Viagra to work properly, you have to take it as prescribed. The medication will not work if you take it in a way other than how your healthcare provider prescribes.
  • If you are unsure about anything related to your proper dose of this medication, please talk to your doctor, nurse, or pharmacist.

    Written by/reviewed by: Kristi Monson, PharmD; Arthur Schoenstadt, MD

    Last reviewed by: Kristi Monson, PharmD;

    * Reported during post-marketing surveillance only

    **Visual colour distortions: Chloropsia, Chromatopsia, Cyanopsia, Erythropsia and Xanthopsia

    ***Lacrimation disorders: Dry eye, Lacrimal disorder and Lacrimation increased

    Reporting of suspected adverse reactions

    Reporting suspected adverse reactions after authorisation of the medicinal product is important. It allows continued monitoring of the benefit/risk balance of the medicinal product.

    Healthcare professionals are asked to report any suspected adverse reactions via the Yellow Card Scheme at www.mhra.gov.uk/yellowcard

    Healthcare professionals are asked to report any suspected adverse reactions via HPRA Pharmacovigilance, Earlsfort Terrace, IRL – Dublin 2; Tel: +353 1 6764971; Fax: +353 1 6762517. Website: www.hpra.ie ; E-mail: medsafety@hpra.ie .

    In single dose volunteer studies of doses up to 800 mg, adverse reactions were similar to those seen at lower doses, but the incidence rates and severities were increased. Doses of 200 mg did not result in increased efficacy but the incidence of adverse reactions (headache, flushing, dizziness, dyspepsia, nasal congestion, altered vision) was increased.

    In cases of overdose, standard supportive measures should be adopted as required. Renal dialysis is not expected to accelerate clearance as sildenafil is highly bound to plasma proteins and not eliminated in the urine.

    5. Pharmacological properties

    5.1 Pharmacodynamic properties

    Pharmacotherapeutic group: Urologicals; Drugs used in erectile dysfunction. ATC Code: G04B E03.

    Mechanism of action

    Sildenafil is an oral therapy for erectile dysfunction. In the natural setting, i.e. with sexual stimulation, it restores impaired erectile function by increasing blood flow to the penis.

    The physiological mechanism responsible for erection of the penis involves the release of nitric oxide (NO) in the corpus cavernosum during sexual stimulation. Nitric oxide then activates the enzyme guanylate cyclase, which results in increased levels of cyclic guanosine monophosphate (cGMP), producing smooth muscle relaxation in the corpus cavernosum and allowing inflow of blood.

    Sildenafil is a potent and selective inhibitor of cGMP specific phosphodiesterase type 5 (PDE5) in the corpus cavernosum, where PDE5 is responsible for degradation of cGMP. Sildenafil has a peripheral site of action on erections. Sildenafil has no direct relaxant effect on isolated human corpus cavernosum but potently enhances the relaxant effect of NO on this tissue. When the NO/cGMP pathway is activated, as occurs with sexual stimulation, inhibition of PDE5 by sildenafil results in increased corpus cavernosum levels of cGMP. Therefore sexual stimulation is required in order for sildenafil to produce its intended beneficial pharmacological effects.

    Studies in vitro have shown that sildenafil is selective for PDE5, which is involved in the erection process. Its effect is more potent on PDE5 than on other known phosphodiesterases. There is a 10-fold selectivity over PDE6 which is involved in the phototransduction pathway in the retina. At maximum recommended doses, there is an 80-fold selectivity over PDE1, and over 700-fold over PDE 2, 3, 4, 7, 8, 9, 10 and 11. In particular, sildenafil has greater than 4,000-fold selectivity for PDE5 over PDE3, the cAMP-specific phosphodiesterase isoform involved in the control of cardiac contractility.

    Clinical efficacy and safety

    Two clinical studies were specifically designed to assess the time window after dosing during which sildenafil could produce an erection in response to sexual stimulation. In a penile plethysmography (RigiScan) study of fasted patients, the median time to onset for those who obtained erections of 60% rigidity (sufficient for sexual intercourse) was 25 minutes (range 12-37 minutes) on sildenafil. In a separate RigiScan study, sildenafil was still able to produce an erection in response to sexual stimulation 4-5 hours post-dose.

    Sildenafil causes mild and transient decreases in blood pressure which, in the majority of cases, do not translate into clinical effects. The mean maximum decreases in supine systolic blood pressure following 100 mg oral dosing of sildenafil was 8.4 mmHg. The corresponding change in supine diastolic blood pressure was 5.5 mmHg. These decreases in blood pressure are consistent with the vasodilatory effects of sildenafil, probably due to increased cGMP levels in vascular smooth muscle. Single oral doses of sildenafil up to 100 mg in healthy volunteers produced no clinically relevant effects on ECG.

    In a study of the hemodynamic effects of a single oral 100 mg dose of sildenafil in 14 patients with severe coronary artery disease (CAD) (>70% stenosis of at least one coronary artery), the mean resting systolic and diastolic blood pressures decreased by 7% and 6% respectively compared to baseline. Mean pulmonary systolic blood pressure decreased by 9%. Sildenafil showed no effect on cardiac output, and did not impair blood flow through the stenosed coronary arteries.

    A double-blind, placebo-controlled exercise stress trial evaluated 144 patients with erectile dysfunction and chronic stable angina who regularly received anti-anginal medicinal products (except nitrates). The results demonstrated no clinically relevant differences between sildenafil and placebo in time to limiting angina.

    Mild and transient differences in colour discrimination (blue/green) were detected in some subjects using the Farnsworth-Munsell 100 hue test at 1 hour following a 100 mg dose, with no effects evident after 2 hours post-dose. The postulated mechanism for this change in colour discrimination is related to inhibition of PDE6, which is involved in the phototransduction cascade of the retina. Sildenafil has no effect on visual acuity or contrast sensitivity. In a small size placebo-controlled study of patients with documented early age-related macular degeneration (n=9), sildenafil (single dose, 100 mg) demonstrated no significant changes in the visual tests conducted (visual acuity, Amsler grid, colour discrimination simulated traffic light, Humphrey perimeter and photostress).

    There was no effect on sperm motility or morphology after single 100 mg oral doses of sildenafil in healthy volunteers (see section 4.6).

    Further information on clinical trials

    In clinical trials sildenafil was administered to more than 8000 patients aged 19-87. The following patient groups were represented: elderly (19.9%), patients with hypertension (30.9%), diabetes mellitus (20.3%), ischaemic heart disease (5.8%), hyperlipidaemia (19.8%), spinal cord injury (0.6%), depression (5.2%), transurethral resection of the prostate (3.7%), radical prostatectomy (3.3%). The following groups were not well represented or excluded from clinical trials: patients with pelvic surgery, patients post-radiotherapy, patients with severe renal or hepatic impairment and patients with certain cardiovascular conditions (see section 4.3).

    In fixed dose studies, the proportions of patients reporting that treatment improved their erections were 62% (25 mg), 74% (50 mg) and 82% (100 mg) compared to 25% on placebo. In controlled clinical trials, the discontinuation rate due to sildenafil was low and similar to placebo.

    Across all trials, the proportion of patients reporting improvement on sildenafil were as follows: psychogenic erectile dysfunction (84%), mixed erectile dysfunction (77%), organic erectile dysfunction (68%), elderly (67%), diabetes mellitus (59%), ischaemic heart disease (69%), hypertension (68%), TURP (61%), radical prostatectomy (43%), spinal cord injury (83%), depression (75%). The safety and efficacy of sildenafil was maintained in long term studies.

    The European Medicines Agency has waived the obligation to submit the results of studies with VIAGRA in all subsets of the paediatric population for the treatment of erectile dysfunction. See section 4.2 for information on paediatric use.

    5.2 Pharmacokinetic properties

    Sildenafil is rapidly absorbed. Maximum observed plasma concentrations are reached within 30 to 120 minutes (median 60 minutes) of oral dosing in the fasted state. The mean absolute oral bioavailability is 41% (range 25-63%). After oral dosing of sildenafil AUC and Cmax increase in proportion with dose over the recommended dose range (25-100 mg).

    When sildenafil is taken with food, the rate of absorption is reduced with a mean delay in tmax of 60 minutes and a mean reduction in Cmax of 29%.

    The mean steady state volume of distribution (Vd ) for sildenafil is 105 l, indicating distribution into the tissues. After a single oral dose of 100 mg, the mean maximum total plasma concentration of sildenafil is approximately 440 ng/mL (CV 40%). Since sildenafil (and its major circulating N-desmethyl metabolite) is 96% bound to plasma proteins, this results in the mean maximum free plasma concentration for sildenafil of 18 ng/mL (38 nM). Protein binding is independent of total drug concentrations.

    In healthy volunteers receiving sildenafil (100 mg single dose), less than 0.0002% (average 188 ng) of the administered dose was present in ejaculate 90 minutes after dosing.

    Sildenafil is cleared predominantly by the CYP3A4 (major route) and CYP2C9 (minor route) hepatic microsomal isoenzymes. The major circulating metabolite results from N-demethylation of sildenafil. This metabolite has a phosphodiesterase selectivity profile similar to sildenafil and an in vitro potency for PDE5 approximately 50% that of the parent drug. Plasma concentrations of this metabolite are approximately 40% of those seen for sildenafil. The N-desmethyl metabolite is further metabolised, with a terminal half life of approximately 4 h.

    The total body clearance of sildenafil is 41 L/h with a resultant terminal phase half life of 3-5 h. After either oral or intravenous administration, sildenafil is excreted as metabolites predominantly in the faeces (approximately 80% of administered oral dose) and to a lesser extent in the urine (approximately 13% of administered oral dose).

    Pharmacokinetics in special patient groups

    Healthy elderly volunteers (65 years or over) had a reduced clearance of sildenafil, resulting in approximately 90% higher plasma concentrations of sildenafil and the active N-desmethyl metabolite compared to those seen in healthy younger volunteers (18-45 years). Due to age-differences in plasma protein binding, the corresponding increase in free sildenafil plasma concentration was approximately 40%.

    In volunteers with mild to moderate renal impairment (creatinine clearance = 30-80 mL/min), the pharmacokinetics of sildenafil were not altered after receiving a 50 mg single oral dose. The mean AUC and Cmax of the N-desmethyl metabolite increased up to 126% and up to 73% respectively, compared to age-matched volunteers with no renal impairment. However, due to high inter-subject variability, these differences were not statistically significant. In volunteers with severe renal impairment (creatinine clearance < 30 mL/min), sildenafil clearance was reduced, resulting in mean increases in AUC and Cmax of 100% and 88% respectively compared to age-matched volunteers with no renal impairment. In addition, N-desmethyl metabolite AUC and Cmax values were significantly increased by 200% and 79% respectively.

    In volunteers with mild to moderate hepatic cirrhosis (Child-Pugh A and B) sildenafil clearance was reduced, resulting in increases in AUC (84%) and Cmax (47%) compared to age-matched volunteers with no hepatic impairment. The pharmacokinetics of sildenafil in patients with severely impaired hepatic function have not been studied.

    5.3 Preclinical safety data

    Non-clinical data revealed no special hazard for humans based on conventional studies of safety pharmacology, repeated dose toxicity, genotoxicity, carcinogenic potential, and toxicity to reproduction and development.

    6. Pharmaceutical particulars

    Viagra dosage recommended

    viagra

    Viagra is a blue diamond shape and levitra is round and yellow, both are similar and the effects of the erection tablets last on average four hours, though some studies suggest some benefit for up to 10 hours. It is recommended that those prescribed Viagra or Levitra take it half an hour to an hour before sexual activity. Viagra comes in 25mg, 50mg, and 100mg tablets, with most men starting on the 50mg pill and changing doseage if necessary. Levitra comes in 2.

    I hav used Tri Mix # 4 and i can’t get erect to almost 3/4 ercetion and I have trouble keeping it in.

    Also I am on a very low dosage (25mg per day), would increasing my dosage (under doctors supervision) recommended to prevent future SVT episodes? Given my age, is ablation as safe for me as other younger people with this problem. Since I my episodes were 20 months apart, what do you feel is the best approach. I travel quite a bit with my family and I am just crazy with fear that I will have an episode while flying.

    Thank you for your feedback. It was never "cultured." The first time I was in the military and the doctor had all the corpman look at me because it was a "classic example" of shingles that followed a nerve from centerling front almost to the spine. The second occurance I was living in China and it was "obvious" what it was based on my first experience and the area affected mirrored several photos i found online.

    Saw Urologist 3-4 years ago who diagnosed a flaccid Nuerogenic Bladder. Urologist recommended he shave all hair from shaft & sack continuously and also said by inserting a Prostate anal probe during intercourse to help reach ejaculation more easily. He tried 6-7 times but can not get over homophobic feeling. There was not much difference either way but he does say has more sensation with hair removed. We are willing to try just about anything. Have heard of surgery to correct ED problems?

    They make absolutely no sense. They pay for viagra. but they won’t pay for birth control pills. They won’t cover fetal reduction, but will have to fork out enormous amounts of cash when some poor woman gives birth to 4 or 5 babies and they are hospitalized. *grumble* Ok, I’m off my soapbox now.

    In my opinion, I think we should be discussing reduction in dosage. not stopping. But I have had this sort of issue with my dr. in the past. What do you guys think?

    . you take the heart drug and it affects your libido, so they give you Viagra. But Viagra upsets your stomach and they give you Nexium. But Nexium makes you gain weight and your blood pressure climbs and they start in on the Cartia, but all of this stuff causes depression and lethargy, so they start you in the psychotropic meds. WHO DO THESE PEOPLE THINK THEY ARE, GIVING US A DOZEN MEDICATIONS. They certainly aren’t healing anybody.

    Well if it worked this good for me, maybe there is some one else out there it can work for, perhaps with my recommended method, frequency and strength it will work for others. The results are dramatic! From Jan 09 to Mar 09 to go from over 10 Million down to 300 thousand viral load. What more proof do you need with a 97% reduction in VL? If there is a possibility that something may work, but did not, I never felt like it was a waste even if I paid a lot of money for it. I am not rich at all!

    I posted the websites i am currently looking at on the other forum. I want to loose about 15 lbs and i dont know the recommended dosage for how much i want to loose. i heard you’re siposed to take it for 2 weeks the 2 weeks off? & if i stop taking it i will gain everything back right? Do you know how this all works? Thankx!

    Medicine my dog is on daily Vetmedin 5mg twice a day–(basically helps blood flow without overworking the heart—prior to this newer medicine vets did not have a lot of good heart meds and some prescribed Viagra –although VetMedin is expensive, Viagra is more expensive!) This bottle contains 50 pills so it lasts almost a month and costs me $85, my mom’s vet charges $75 for it, so it varies a bit.

    most recent tsh is close to a 4 I am currently on levothyroxine 25mcg, which is a baby dose. my hypo symptoms made a comeback, symptoms come & go, but not at the level they were before treatment when I was over 11 several months ago, at that number I actually thought i was dying! So someone hellp me out here.

    Hi. I’m confused and lightheaded and will try to make this concise, thank you! On 5/14 my A.M. and P.M. serum cortisol both came up at 0.5mcg/dl. My GP started me on hydrocortisone while I waited to see an endocrinologist. GP said straight up that he has no idea how to treat adrenal stuff or dose hydrocortisone.

    I lost my left tube with the ectopic so the doctor strongly recommended moving on to IVF. Do you know when you will be starting your cycle.

    I also feel it is a crime that in this day and age and there is no help for this damn menopause. Yet they invent Viagra for men so they can find a younger women because wifey sure is not in the mood. A site like this helps knowing you are not alone. Woman are looking for help. So its hard when someone tells you it is your fault because you don’t exercise enough or your not eating right. Maybe things are working for you, but it isn’t for me and it sure isn’t for Wellness Seeker.

    I guess I’ll have to take the alpha blockers or Viagra beforehand. Doctors don’t have a clue about this. I have asked several Urologists, and they just say it’s normal.

    My GP didn’t understand lacking sensation/feeling libido and said this was all in my head and would only do basic tests because I insisted. Taking viagra although this may help in the short-term is just papering over the cracks of what is really going on here. All blood tests I had came back "normal" but that doesn’t mean it is normal for "you" For instance my TSH was 2.

    it could be a medication he is taking and just a matter of changing it. There is Viagra and Cialis to help and for the most stubborn mind an injection which makes the little guy stand to attention no matter what. IF it is in the mind, its a tiny little needle they would not feel it. Ladies this takes a lot of tact and gentle care. imagine them as poor little souls that have.

    Without really thinking much about it, I started using tramadol every day and then increased this to 2-3 times each day. The dosage was 100mg, so I was taking 100-300mg daily (or 2-6, 50mg pills) for 3 months. After I finished the project in mid-may, I decided that I needed to stop using a drug to get through the day, so I tried to just stop taking it. WOW!

    In that break I started acupuncture and a bunch of extra stuff she recommended (always eating hot foods, lots of meat which is hard cuz i hardly ever used to eat meat, drinking iron floradix, taking calcium, and drinking some rejeuvalax every day, oh and drinking tons of herbal tea.hot water with honey). I also finally got serious about getting to bed by 10, and found this meditation series on Circle and Bloom that’s specifically for IUI/IVF.

    I used Monistat 7 though which I guess isn’t as bad of a dosage or something I’m not sure but either way just seconds after I inserted the cream. horrible burning pain to the point of tears and where I felt like I was going to pass out! It was insane. I thought maybe something was wrong with me. I am glad to read that I am not the only one with this problem and that maybe this is normal. I think I will take a trip to the doc to get my yeast infection fixed.

    I am scheduled to see a urologist in 3 weeks and am trying to stay optimist. I tried Viagra and it helped some, but is way too expensive to take everyday. Not to mention that I think it is a little ridiculous for a healthy 21 year old to have to take it to have a functional penis. I am physically fit and exercise daily (have to in order to keep from getting anymore depressed about it). I have no idea what has caused this problem, but it needs to be fixed.

    I had a similar situation; Erectile dysfunction set in in 1997. Viagra helped when it came on the market. Retrogressive ejaculation followed in 2001; it may be as a result of damage done during removal of kidney-stone although doctors seem to disagree on this. Found blood when masturbating (but none in urine) earlier this year. Saw doctor and had pta test done. It was normal. I went though hell while waiting on result. I was almost sure I has cancer. The condition cleared up.

    Please tell me if I am allowing too much or not enough time in the spacing/reduction of dosage and how many days I will be unable to function during the stop in June-if gameplan works, I will have tapered to half a pill by then. I have two teenagers, and I am very much Mom’s taxi service, so I will need to make arrangements for them if I am too ill to drive.

    I agree – I have recommended the use of the mirena to so many people and they all love it.I also got pregnant very soon after having it removed, so no long term recovery. I honestly thought it was fantastic, very comfortable, no periods, no worry of pregnancy and no effects from the hormones that I am allergic to. If the mirena does cause cysts I can’t understand why they would give it to my sister who has been suffering for so long due to polycystic overies.

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