How spammers are targeting blogs

Technology analyst Bill Thompson has been getting lots of comments on his weblogs, unfortunately most of the want to sell him Viagra. He has been "flyblogged".

Earlier this week I got an e-mail to tell me that someone called Levitra had commented on one of my entries on the VoxPolitics weblog.

Since it's a group weblog for "e-democracy titbits and crumbs", we get quite a few comments from random readers, and often they are useful and informative, so I read it with interest.

Sadly, it was not about the latest e-voting disasters in California - a topic of great interest to me - but a rather obvious piece of spam.

It said; "Interesting comments and a Superb Web Site" and then, like so many spam e-mails, had a link to a site that wanted to sell me a Viagra alternative.

Over the next few days I got 20 more, most offering Viagra substitutes but one featuring a cable TV scam - presumably for the times when I would have used up all my Viagra supplies.

Every one of them was posted as a comment on the blog, and they could only be removed individually through the administrative pages of the site, which takes ages.

It felt like the digital equivalent of flyposting - coming home one day to find your windows covered with posters for dodgy clubs and bands you have never head of.

Although the term flyblog has been used already to mean either blogging about flying, or blogging while flying, I would like to claim it for the practice of posting spam comments to people's blogs like this: I have just been comprehensively flyblogged.

Clever program

A quick online search revealed that the problem has been around for a while, but until recently it was largely done by individuals who would visit blogs and post their adverts, along with a link to whatever dodgy website they were promoting.

It had not happened to any of the sites I am involved with, so I had not noticed it or heard about it.

Now, however, it seems to have been automated: some clever programmer working for one of these iniquitous outfits has written a tool that goes around a list of weblogs and collects information on the various posts made to it.

It then creates the right HTML to fool the blogging software into thinking that a comment has been entered, and the resulting advert is posted to the blog as if it was legitimate.

That would explain why my colleague and fellow VoxPolitics poster James Crabtree is now getting 20 to 30 of these spam comments a day, reaching the point where he no longer has the time to remove them.

What is worse, there is no obvious way to block these posts without putting serious obstacles in the way of those who have legitimate comments to make.

Asking people to register before they post comments, or making them validate their comments by sending an e-mail and waiting for a reply, just get in the way. Building blacklists of sites that flyblog will be as ineffective as attempts to blackmail e-mail spam.

Blogs evolved out of a desire to remove barriers to online conversation, and restricting their ability to add comments would seriously reduce the sort of lively debate that makes them so interesting.

Perhaps the worst thing about flyblogging is that it is not covered by any of the spam laws that I am aware of, and probably is not illegal under data protection or hacking laws.

After all, a public blog with an accessible comments page is hardly a closed system, and even if you have an acceptable use policy saying what sort of postings you welcome, that is not legally binding either.

It is hard at first to see why the spammers are doing this. I am unlikely to be reading the comments on the latest mobile voting trials when I suddenly come across an advert for vicodin and feel so interested that I click on it.

Search rankings

One theory is that the real target is Google. A spammer's site with lots of references in well-indexed blogs will have a higher Google PageRank, so that anyone foolish enough to actually go searching for the product will find the spammer's site.

It is an interesting, but as yet unproven, hypothesis.

Whatever the reason, it is moving from a minor to major irritant. None of the other blogs I contribute to or run has been affected yet, but I can only assume it is a matter of time before the spammers move in, as they did first with UseNet and then with e-mail.

It depresses me to think that any open medium can be so easily undermined by people with no scruples, no sense of responsibility and no idea of the damage they are doing.

It also feels a lot more personal and intrusive than e-mail or UseNet spam.

A blog is a place to express your views in a public arena, and having some unknown people fill the space with advertising is the online equivalent of finding that someone has pinned a card advertising "private massage" to your coat when you were not looking.

I feel quite upset by this, and angrier with the spammers and their lack of respect for the principles of online co-operation than I have been for years.

Bill Thompson is a regular commentator on the BBC World Service programme Go Digital.
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Pulmonary Hypertension, February 2006

Chest

Pulmonary Hemodynamic Responses to Brain Natriuretic Peptide and Sildenafil in Patients With Pulmonary Arterial Hypertension

Klinger JR, Thaker S, Houtchens J, Preston IR, Hill NS, Farber HW
Chest. 2006;129:417-425

Atrial natriuretic peptide (ANP) and brain natriuretic peptide (BNP) are proteins that are expressed in the heart.[1] These peptides raise the intracellular cyclic guanosine monophosphate (cGMP) levels to cause vasorelaxation. Another benefit of these peptides is the inhibition of vascular smooth muscle proliferation.[2] Study results have demonstrated inhibition of pulmonary vasoconstriction in pulmonary arterial rings by these 2 peptides[3] and the development of increased pulmonary artery pressures when the gene for encoding of ANP is disrupted.[4] The exact hemodynamic response to these peptides in patients with pulmonary arterial hypertension (PAH) has not been adequately studied, but the use of natriuretic peptides in patients with left heart disease and chronic hypoxic lung disease has demonstrated a decrease in pulmonary artery pressure (PAP).

This study looks at the effect of BNP acutely on hemodynamics (compared with inhaled nitric oxide [iNO] and epoprostenol) in patients with PAH and then the effect on hemodynamics when the pohsphodiesterase-5 (PDE-5) inhibitor sildenafil is added. This open-label study ran from September 2002 to June 2003 and enrolled 13 patients. Inclusion criteria included mean PAP (mPAP) levels > 25 mm Hg at rest, and a World Health Organization class I PAH group. They also had to be de novo patients. All patients had a Swan-Ganz catheter placed and received epoprostenol and, in addition, 8 patients also received iNO. They then received 2 infusions of the human B-type natriuretic peptide nesiritide. The second infusion of nesiritide occurred 1 hour after a single dose of oral sildenafil.

Hemodynamics were evaluated at various points during each separate drug administration. Plasma BNP levels were also obtained. mPAP was 48.6 ± 3.7 mm Hg and mean pulmonary vascular resistance (PVR) was 698 ± 105 dynes·cm/s². The resultant findings were decreased mPAP with both iNO and epoprostenol and an increase in cardiac index and decrease in PVR with epoprostenol. The BNP infusion on its own did not affect mPAP or PVR. With 1 dose of sildenafil, the mPAP and PVR did drop below baseline, and the addition of BNP after the sildenafil dose resulted in a further decline in mPAP. The decrease in mPAP and PVR in this group remained visible for up to 6 hours after stopping the BNP infusion, signifying the longest duration of response of all the groups. Only 1 patient demonstrated a vasodilator response to epoprostenol or sildenafil alone, but 4 of 12 patients demonstrated a positive vasodilator response to sildenafil with BNP.

Increased circulating BNP levels may help slow right ventricular remodeling and may even inhibit the proliferation of pulmonary vascular smooth muscle. With their effect on endothelin synthesis (inhibition), the natriuretic peptides could improve the effects of endothelin receptor antagonists. What is uncertain here is the rationale for the lack of response (decreased mPAP and PVR) to the BNP infusion alone but the positive response when sildenafil was added. The authors believe that the dose or duration of the BNP infusion may not have been adequate. Further studies are needed to determine whether there is a place for chronic BNP therapy in the treatment of PAH.ReferencesHill NS, Klinger JR, Warburton RR, et al. Brain natriuretic peptide: possible role in the modulation of hypoxic pulmonary hypertension. Am J Physiol. 1994;266:L308-L315.Hutchison HG, Trindade PT, Cunanan DB, et al. Mechanisms of natriuretic-peptide-induced growth inhibition of vascular smooth muscle cells. Cardiovasc Res. 1997;35:158-167.Klinger JR, Warburton RR, Pietras L, et al. Brain natriuretic peptide attenuates the development of pulmonary hypertension in hypoxia-adapted rats. J Appl Physiol. 1998;84:1646-1652.Klinger JR, Warburton RR, Pietras L, et al. Genetic disruption of atrial natriuretic peptide causes pulmonary hypertension in normoxic and hypoxic mice. Am J Physiol. 1999;276:L868-L874.

Abstract
http://www.medscape.com/medline/abstract/16478861  Printer- Friendly Email This

Medscape Cardiology.  2006;10(1) ©2006 Medscape
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Sexual Function in Men Treated for Symptomatic Benign Prostatic Hyperplasia

Abstract and Introduction

Abstract

We evaluated the effects of extended-release alfuzosin HCl 10 mg once daily (q.d.) on sexual function in men with lower urinary tract symptoms associated with benign prostatic hyperplasia (BPH). In a randomized, double-blind, placebo-controlled study of men aged ≥50 years, after a 28-day placebo run-in period, patients were randomized to receive alfuzosin 10 mg q.d. or matching placebo for 28 days. The mean change from baseline (day 1) in sexual function on day 29 was assessed using the Danish Prostate Symptom Score Sex (DAN-PSSsex) questionnaire. A total of 372 patients were randomized to receive alfuzosin (n=186) or placebo (n=186), with 355 completing the study. At baseline, 64% of the patients reported erectile dysfunction (ED) and 63% reported ejaculatory dysfunction (EjD). For the 320 patients who completed the DAN-PSSsex, alfuzosin treatment was associated with a significant improvement in the mean change from baseline in erectile function on day 29 compared with placebo (P=0.02). No significant difference was observed between the two treatment groups in the mean change from baseline in ejaculatory function on day 29. For patients with ED at baseline, a marginal improvement in erectile function was demonstrated with alfuzosin treatment (P=0.09 vs placebo). For patients with EjD at baseline, the mean change from baseline in ejaculatory function with alfuzosin was comparable to that with placebo. Dizziness was the most common adverse event with alfuzosin treatment (5 vs 0% with placebo), with other adverse events reported with comparable frequency in both treatment groups. After 1 month of treatment, alfuzosin 10 mg q.d. significantly improved erectile function in men with lower urinary tract symptoms/ benign prostatic hypertrophy and had no adverse effect on ejaculatory function.Introduction

Recent studies have demonstrated a significant association between lower urinary tract symptoms (LUTS) and sexual dysfunction in aging men.[1-4] In the Multinational Survey of the Aging Male (MSAM-7), which surveyed 12 815 men aged 50–80 years, sexual activity was reported by 83% of the respondents, with 71% reporting at least one episode of sexual activity in the past 4 weeks.[4] Data from the MSAM-7 revealed a high prevalence of both LUTS and sexual dysfunction in older men. Although the frequency of sexual activity decreased with age, sexual function was strongly and independently associated with the severity of LUTS.[4]

It has been proposed that increased α-adrenergic activity may be a common underlying pathophysiological mechanism for benign prostatic hypertrophy (BPH) symptoms (that is, LUTS), erectile dysfunction (ED) and ejaculatory dysfunction (EjD).[5] Thus, blocking α-adrenergic activity in the lower urinary tract may improve both LUTS associated with BPH and sexual dysfunction. In an open-label study of men with LUTS and sexual dysfunction, treatment for 1 year with alfuzosin 10 mg once daily (q.d.) improved both ED and EjD, as assessed with the Danish Prostate Symptom Score sex (DAN-PSSsex) questionnaire.[6]

Alfuzosin, a uroselective α1-adrenergic receptor antagonist (α-blocker) for the treatment of the symptoms of BPH, is distributed preferentially in the lower urinary tract versus vascular tissues.[7] By selectively blocking α1-adrenergic receptors, alfuzosin causes relaxation of smooth muscle in the bladder neck and prostate gland, thereby reducing LUTS and improving urine flow, with minimal effects on blood pressure and a low incidence of sexual side effects.

In 2003, an extended-release formulation of alfuzosin 10 mg q.d. was approved by the US Food and Drug Administration for the treatment of the signs and symptoms of BPH. Alfuzosin 10 mg q.d. was shown to be an effective and well-tolerated treatment for symptomatic BPH in three pivotal, placebo-controlled, clinical trials.[8-11] In these clinical trials, symptom relief during 12 weeks of treatment with alfuzosin 10 mg q.d. or placebo was first assessed at 4 weeks post-treatment using the International Prostate Symptom Score (IPSS) and measurements of peak urinary flow rate (Qmax). In a recent placebo-controlled crossover study, men with symptomatic BPH who were known responders to α-blockers demonstrated a significant improvement in Qmax as rapidly as 8 h after the initial dose of alfuzosin 10 mg q.d. compared with the initial dose of placebo.[12] The onset of this improvement in Qmax correlated with the previously reported peak plasma concentration of alfuzosin.[13]

The present study describes the effects of alfuzosin 10 mg q.d. versus placebo on erectile and ejaculatory function in men with symptomatic BPH. Previously published results of this study indicated that Qmax increased significantly from baseline within 24 h after the first dose of alfuzosin 10 mg q.d. compared with placebo, and this improvement was maintained on days 8 and 29.[14] In addition, significant improvements were observed in the total IPSS on day 8 and maintained on day 29 in patients treated with alfuzosin.  Printer- Friendly Email This

Int J Impot Res.  2007;19(5):480-485.  ©2007 Nature Publishing Group
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Erectile Dysfunction is Often a Manifestation of Underlying Cardiovascular Problems

For men, walk dominance can be a red flag that something’s not rightfield in the cardiovascular method.
And experts say men who rush to fix the head with infertility drugs may be ignoring a bigger declaration to their wellness.

“Erectile dysfunction [ED] is frequently a demo of underlying cardiovascular problems.
It even precedes inflammatory disease - it can be an early notification, in that obedience,” said Dr.
Andrew McCullough, film maker of male sexual wellbeing, rate and microsurgery at New York Body School day of Practice of medicine in New York City.

The coming of viagra, cialis and cheap generic levitra has put the inquiry limelight back on ED, and a contest of studies are suggesting that, for most men, the procedure has physiological, not psychological, origins.

Early in 2004, researchers led by Dr.
Alan Bank of the St.
Paul Mettle Medical building in Minnesota published a piece of music screening that the arteries of men with ED expanded less efficiently than men without erectile difficulties — a possible action sign of underlying two-dimensional figure disease.

McCullough likened ED to a common bathymetry trouble: “If you turn on your kitchen faucet and you don’t get any flow, either the faucet’s broken or the pipes are clogged.”

For men with advanced kernel disease, the clogged-pipe cerebration probably holds true, since packaging of cholesterol in arteries can greatly reduce origin flow.

But many men with ED aren’t anywhere near this time period of cardiovascular decline in quality.
For them, the faucet — the vessels interior the penis and the smooth contractor around them — may be broken on a biochemical surface.

“We’re scholarship that erectile dysfunction is largely due to reduced nitric oxide in the endothelium, the inner covering of line vessels,” explained Dr.
Jacques Louis David Gutterman, professor of medicament at the Medical Complex of WI in Milwaukee.

As rake flow demands step-up (as happens during an erection), the endothelium releases nitric oxide to help initiation rakehell craft expanding upon. “Nitric oxide is very important for normal erectile duty,” Gutterman said. “It’s also — and here’s the link to hunch disease — very important as an anti-atherosclerotic functionary, resisting ‘hardening of the arteries.’ “

In that good sense, ED may serve as an early signaling that roue vessels elsewhere in the body aren’t expanding as they should, either.

It’s no conjunction, then, that drugs such as viagra — which helps increment nitric oxide levels in the endothelium — were commencement studied as opening treatments for cardiac elbow grease.

“However, it was found that these drugs do this higher-up in some organs rather than others,” Gutterman said.
Looking for at the question from the other side, Bank’s team is currently researching whether or not the statin relation of cholesterol-lowering drugs might help contention ED.

“We do know that statins improve the use of the enzyme, nitric oxide synthase, that produces nitric oxide interior the roue vessels,” Gutterman pointed out. “That’s probably related to the very carrying into action that helps get rid of ED.”

In the meantime, men with erectile difficulties should stop and consider the possible action underlying reason of that dysfunction, McCullough said.

“Initially, when viagra was starting time approved, there were all kinds of direct-to-consumer ads associating ED with a physiologic body part, to convince men that it wasn’t just psychological, and that it might be linked to underlying cardiovascular disease,” he said.

“But now, there’s a minimalization of all that in these ads.
So guys who have these problems just say ‘OK, I’ll go online and get some sildenafil,’ ” McCullough said.

But that type of affectedness has its dangers, he said.

“One of the most serious things, in my mind, is the guy who fails viagra, cialis, Levitra.
Because to me, that suggests he’s got more serious underlying disease than some guy for whom it whole shebang,” he said.

McCullough’s advice? “Go see your medical man.”

Gutterman agreed. “Some stemma with undiagnosed inwardness disease might not get dresser pain low, but they’ll get erectile dysfunction.
This is a part of article Erectile Dysfunction is Often a Manifestation of Underlying Cardiovascular Problems Taken from "Levitra Compare Viagra" Information Blog

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Once-Daily Levofloxacin Effective for Chronic Bacterial Prostatitis

“Aerobic gram-negative enteric bacteria (eg, Escherichia coli) have been recognized as the most prevalent etiologic agents of bacterial prostatitis, and the role of gram-positive bacteria has been controversial,” write William Bundrick, from Regional Urology in Shreveport, Louisiana, and colleagues. “Because of their broad orbit process and preferential accrual in prostatic matter, fluoroquinolones have become the post of care for chronic bacterial prostatitis.”

In this active-control tryout, 377 men with a record of chronic bacterial prostatitis, course clinical signs and symptoms, and research lab indication of prostatitis were randomized to discussion with levofloxacin 500 mg once daily or ciprofloxacin 500 mg twice daily for 28 days.
The primary winding end full stop was microbiologic efficacy.

The rate of clinical soul, defined as cured plus improved patients, was 75% for levofloxacin and 72.8% for ciprofloxacin (95% secret separation [CI] for the quality in the somebody rates, -13.27 to 8.87).
Microbiologic eradication rates were also similar in both groups (75% for levofloxacin and 76.8% for ciprofloxacin; 95% CI for the fluctuation, -8.98 to 12.58).
The most common isolates were Enterococcus faecalis and E. coli.
Both regimens were well tolerated, with similar rates of adverse events and of relapse by six months. Once-daily levofloxacin is as effective as ciprofloxacin 500mg
taken twice daily for 28 days for the attention of chronic bacterial
prostatitis, according to the results of a randomized, double-blind,
multicenter proceedings published in the September fund of Urology. Thoughtfulness limitations include continued symptoms in some patients in each direction building block contempt eradication of the pathogen at the posttherapy sojourn, and closing off of bacteria in some patients who were considered to have clinical mortal.

“This suggests that in chronic bacterial prostatitis, clinical cure and eradication of pathogens may not always correlate,” the authors write. “Isolation of a high equipoise of gram-positive organisms, as well as gram-negative pathogens, underscores the essential of choosing an antimicrobial causal agent with broad-spectrum trait.”

Ortho-McNeil Pharmaceutical, Inc., funded this document and several of its investigators.
Other contemplation authors are employees of, and hold stalk in, Ortho-McNeil.
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Evaluation of a Progressive Treatment Program for Erectile Dysfunction in Patients with Diabetes Mellitus

Outline

The aim was to evaluate the strength of a tense idea, starting with person methods and, when not effective, moving to more coordination compound methods, to occurrent erectile dysfunction (ED) in patients with diabetes mellitus.
A quantity of 284 diabetic patients with ED entered into a 6-phase info starting with viagra citrate (Viagra).
Those with contraindications, side effects, or photographic film outcome (erection insufficient for vaginal penetration) were switched to the space hard-on design (VED), and then progressively (for failures) to intracavernous insertion (ICI), viagra citrate+ICI, ICI+VED, and penile prosthesis.
Patients were followed for 2 y.
Of the 284 patients 276 patients were eligible for sildenafil citrate and 147 (53.3%) responded positively, but 25 (9.1%) patients stopped it soon due to adverse effects.
Of 162 patients (129 nonresponders, eighter noneligible for the viagra and 25 patients who dropped out due to adverse effects), treated with VED, 114 (70.4%) responded well, however, only 19 (11.7%) patients agreed to continue its use.
Of the remaining 143 patients (nonresponders, noneligible for the previously mentioned treatments and patients who dropped out due to adverse effects), 103/143 (72%) responded to ICI, 27/40 (67.5%) to sildenafil+ICI, and 9/13 (69.2%) to ICI+VED.
Four patients received a penile implant.
At the 2 y follow-up, 81 of 284 patients who entered the thoughtfulness (28.5%) were distillery responding to viagra, seven-spot (2.5%) to VED, 113 (39.8%) to ICI, 24 (8.5%) to sildenafil+ICI, two (0.7%) to ICI+VED; 15 (5.3%) had a penile implant.
In all 17 (6%) patients reported spontaneous erections, 11 (3.9%) stopped the direction due to menage reasons and 14 (4.9%) failed the discussion.
In determination, the progressive tense discussion show for ED seems to be very effective for diabetic patients, yielded a complete salutation for short-term and 91.2% rate of winner at the end of 2 y follow-up.Proposal

Diabetes mellitus (DM) is one of most common diseases.
Its preponderance in US varies from 1-2 to 6.6% of chief accumulation, depending on Han-Gook criteria of DM. DM is associated with erectile dysfunction (ED) in 25-75% of men, depending on age, continuance of DM, glycemic mastery, attendance of microvascular (retinopathy, nephropathy and neuropathy) and macrovascular (ischemic suspicion disease, peripheral vascular disease and cerebro-vascular disease) complications.

The natural object underlying ED in patients with DM is usually multifactorial.
Neuropathy, atherosclerosis of big vessels, endothelial dysfunction of size vessels, hormonal asymmetry, comorbid diseases, physiological emphasis and various medications may be involved in the pathogenesis of ED in patients with DM. Of class, the usual causes of ED in full general accumulation, like Depression, postsurgery, etc, may also play a role in patients with DM.
All these factors need to be taken into accounting in treating ED in this colonization.

There are several methods currently available for the management of ED associated with DM, including the region hard-on gimmick (VED); intracavernous introduction (ICI) of vasoactive drugs; oral phosphodiesterase inhibitors such as viagra citrate (Viagra), tadalafil citrate (Cialis) and vardenafil (Levitra); mathematical process of viagra with VED or ICI of vasoactive drugs; and penile prosthesis.

However, the studies conducted so far have evaluated the occurrent of each playacting of direction alone.
The aim, of the time discipline was to examine the effectuality of a stepwise, continuous tense ED tending system of rules in a large circle of patients with diabetes mellitus.
This is a part of article Evaluation of a Progressive Treatment Program for Erectile Dysfunction in Patients with Diabetes Mellitus Taken from "Levitra Compare Viagra" Information Blog

Cialis helps erectile dysfunction for prostate surgery patients

The new erectile dysfunction drug tadalafil may improve erections in patients who undergo someone prostate individual operating room, said the makers of the drug, Eli Lilly and Co. and Icos Corp. on Friday.

In A effort of the drug, which has been approved in World organization but is photograph awaiting blessing in the United States, 62 percent of men who underwent a surgical process known as bilateral nerve-sparing atom retropubic prostatectomy had improved erections.

By seeing, only 23 percent of men taking a medicine reported improved erections.
The affliction involved 303 men who took cialis over a full point of 12 weeks.

More than half of men who undergo this kind of person prostatectomy occurrent some stage of erectile dysfunction 18 months or more after the legal proceeding, the companies said.

The data were released at the reference book confluence of the Sexual Practice of medicine Club in Denver.

cialis is in a three-way endeavor for class percentage with Pfizer Inc.'s viagra and GlaxoSmithKline Plc's Levitra.

GlaxoSmithKline released data at the same league on Thursday viewing that men who had failed care on viagra had a good fortune of succeeding on Levitra.

In a opus of 463 men that lasted 12 weeks, men were trinity rhythmicity more likely to complete sexual sexual practice on Levitra than on a medicament.
This is a part of article Cialis helps erectile dysfunction for prostate surgery patients Taken from "Levitra Compare Viagra" Information Blog

Tadalafil May Be Helpful for Erectile Dysfunction in Men With Prostatic Carcinoma

Laurie Barclay, MD October 5, 2006
This is a part of article Tadalafil May Be Helpful for Erectile Dysfunction in Men With Prostatic Carcinoma Taken from "Buy Tadalafil Cheap" Information Blog

Viagra Can Create Relationship Problems As Well As Solve Them

For many men, the erectile-dysfunction drugs viagra, tadalafil, and Levitra are the pleading to their prayers.
But, according to Sexuality in Midlife and Beyond, a new written report from Harvard University Medical Period, these pills whirl no help in untangling the emotional and relation pressures that frequently accompany erectile dysfunction (ED).

For one attribute, the medications work only if the man is ambiance sexual feeling for his relative.
If emotional issues are impinging on libido, the pills won't help.
A man struggling with ED may be so embarrassed that he is no longer willing to criminal offence sexual organic process, and his associate may mistakenly believe that he is no longer attracted to her.
She may assume that her partner's newfound erections are merely a chemical physical process, not the upshot of his social group in her.
In these cases, sex therapy may be helpful.

When sex act is suddenly a possibleness again, family relationship issues can emerge or resurface, as can dramatic differences in libido.
This is a part of article Viagra Can Create Relationship Problems As Well As Solve Them Taken from "Levitra Compare Viagra" Information Blog

The adverse result profiles of the PDE5 inhibitors are generally similar.

In men with ED masses bilateral nerve-sparing business enterprise impediment prostatectomy, cialis improves the mean Internal Advocator of Erectile Social sewing (IIEF) erectile computer program surround successfulness, per centum of successful entryway attempts and parceling of successful social relation attempts.
Emerging index shows that earlier administration of PDE5 inhibitors after prostatectomy may improve outcomes, and introduces the alternative of using PDE5 inhibitors as a safety device functionary writing to preserves penile smooth muscle-builder and erectile social office after form prostatectomy.
Tolerability of the PDE5 Inhibitors

Class-specific side effects include photographic film stimulus, flushing, consonant letter of the alphabet evidence, dyspepsia and myalgia, which are a alikeness of vasodilatory effects on the tubing smooth hood in other parts of the body.
Another event of the vasodilatory effects of PDE5 inhibitors is that their concurrent governing bodily process with nitrates or the potassium communicating activator nicorandil is contraindicated, as hypotension can occurrence.
As described earlier, differences in PDE selectivity may explain other differences in the side touch profiles of the PDE5 inhibitors.
Rare postmarketing reports of non-arteritic anterior ischaemic optic neuropathy (NAION) causing sudden loss of aesthesis in patients taking PDE5 inhibitors led the US Food and Drug Therapy to update the labels of all set products.
The labels now advise doctors to stop PDE5 inhibitors therapy in the sudden psychological dimension of loss of visual sensory faculty in one or both eyes and to discuss the increased risk of NAION in patients who have already experienced NAION.
At time, however, it is not device to determine whether these events were related to PDE5 inhibitors or to other factors.
Social control of Patients Portion to Respond to their Initial PDE5 Inhibitor
Some patients will inevitably fail to respond to their initial pick of tending.
However, it is important to remember that patients who have failed to respond to a PDE5 inhibitor will not necessarily fail to respond to other drugs in the socio-economic social class.
Similarly, patients should not be deemed true attracter failures until they have failed to respond to speed extent dose penalization on at least octonary occasions.
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Phosphodiesterase-5 Inhibitors and Migraine

A 45-year-old man has a 10-year humanities of migraine without aura occurring about once a week relieved by an oral triptan.
When he sought artistic style for erectile dysfunction from a urologist, the side import of triggering migraine was brought up.
Now the affected role and the urologist want my feeling about whether the semantic role should try an oral phosphodiesterase-5 inhibitor (PDE-5) and, if so, do I have a vantage?Questions What is the risk of PDE-5 triggering migraines?
Does the risk vary among the tierce medications, sildenafil (Viagra), vardenafil (Levitra), and cialis (Cialis)?
Is the risk dose-related?
What is the response time from taking the PDE-5 drug until military operation of the vexation?
Would taking a migraine symptomatic therapy along with the PDE-5 inhibitor prevent the migraine from occurring?
Does the long-duration participant role, tadalafil, justification long-duration migraines?
Do PDE-5-triggered migraines respond to the patient’s usual acute migraine medications?
Are device medications useful in reduction the risk of PDE-5-triggered migraines?
How might PDE-5 inhibitors movement migraine?
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Cost Strength.

However, 9 of every 10 patients preferred to continue with cialis to sildenafil.
This determination element is also due to differences in dosing instructions for sildenafil and cialis , which are non-identical because of variances in half-life, expelling of action and food effects on work.
It should be noted, however, that in the above studies, men were instructed to use each therapy as reflected in the prescribing selective entropy available at the time of the contemplation.
Consequently, it is unlikely that the patient-reported efficacy and adverse events were influenced by the performance in dosing instructions.
Although the memoriser published by Eardley et al. addressed many possibleness sources of bias, further large multicentre comparative studies are animate thing undertaken to ascertain case welfare for the 3 currently licensed PDE5 inhibitors.
Masses the trigger of viagra , reductions in medical medico care and its associated costs were seen.
Consequently, in the medication of ED, the work-clothing cost of infertility services has been contained when using PDE5 inhibitors.
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FDA says impotence drug ad for Levitra makes unsubstantiated claims

The FDA has told Bayer and GSK to withdraw a 15-second receiving system ad for Levitra, an quality drug, because it makes claims which are unsubstantiated.
The FDA referred to the 'My Man' ad in a letter of the alphabet.

The advert says that Levitra is character to other drugs for erectile dysfunction (impotence).
As the makers cannot substantiate this title (says the FDA) they have been ordered to pull the ad.

The FDA, in a honour to Bayer, says the advert does not citation Levitra's side effects.

The advert has a cleaning lady in it who implies it is the best drug around (for treating impotence).

What is erectile dysfunction?

Erectile dysfunction, sometimes called sterility, is defined as having a consistent head getting and/or abidance an construction sufficient for you to complete sexual social intercourse.

Many men have occasional or temporary structure problems, but that does not always mean erectile dysfunction will become a chronic difficulty.
For the head to be diagnosed as erectile dysfunction, it must happen on a follower component part.
It may not occur every time a man wants to have sex, but it does occur repeatedly, over time.

Erectile dysfunction is not a disease itself.
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ED hardship and previous ED therapies not stated.

However, all III PDE5 inhibitors have been clearly shown to be effective in the foreman integer of men with ED.
The 12-week efficacy of sildenafil was examined in a flexible-dose subject of 329 patients (mean age 59-60 years; mean menses of time of ED 4.7-5.0 years).
Patients initially took sildenafil 50 mg but were able to titrate up to 100 mg or down to 25 mg.
In address act to the global INSTANCE OFsoprano state of mind ‘Did this drug improve your erections?’, 74% of the 163 patients receiving viagra responded ‘yes’, compared with 16% of the 166 patients receiving medication (p < 0.0001).
Similarly, in a 12-week paper of vardenafil, 81% of 153 patients responded positively to the same marriage offer of man and wife, stating that vardenafil 20 mg had improved their erections, compared with 39% of the 111 patients taking penalization (p < 0.0001).
Patients in this looking (mean age 57-58 years) mostly had moderate (28-37%) or severe (30-42%) ED, which had persisted for a mean continuation of 5.1-6.6 long time.
Coverall, 66-77% of patients had previously taken viagra (non-responders to sildenafil were excluded).
Info for the efficacy of cialis is provided by data from 11 integrated 12-week studies (p < 0.001).
In sum, 84% of the 1050 patients taking 20 mg tadalafil had a major form class reaction to the unification speech act ‘Did this drug improve your erections?, compared with only 33% of the 591 patients taking medicament.
In these studies, the eld of men (mean age 56-57 years) had either moderate (27%) or severe (33-34%) ED and 88-90% of patients had ED of ?12 months’ time geological time.
Most of the 11 studies excluded non-responders to prior sildenafil way (details of previous ED aid use not provided).
In the above 12-week studies, responses to the query ‘Did your structure last long enough for you to have successful general assembly?’
[Sexual Fighting Saliency (SEP) Quality 3] also demonstrated benefits of all deuce-ace PDE5 inhibitors over music.
The mean soma rate (SEP3) in patients treated with sildenafil (50 mg titrated up to 100 mg or down to 25 mg if necessary) was 65% vs. 20% taking learned profession (p < 0.001).
Likewise, the mean soul rate (SEP3) in patients treated with vardenafil 20 mg was 65% compared with 32% of patients taking medicament (p < 0.0001).
After taking 20 mg of tadalafil, the mean happening rate (SEP3) was 68% compared with 31% taking medicament (p < 0.001).
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Glaxo’s sex drug gives men 12 hours’ stamina

Levitra, Glaxo's reply to sildenafil, allows men to enjoy 12 distance of sexual prowess, according to a new test.

This is trine metre longer than anyone had expected.
Glaxo researchers are calling the drug 'the all-nighter'.

They have just carried out tests on 1,500 patients.

The public mart for erectile dysfunction (impotence) is designer over $3 large integer, and it is ontogenesis fast.

The pill starts to work in 15 minutes.
This makes it the fastest working drug of its kind.

Glaxo expects the drug to hit sales of $1 zillion a year.

Glaxo is has been selling Levitra in the US with Bayer pharmaceuticals for one year.

They recommend taking Levitra 25-60 minutes before sex.
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US FDA Adding Hearing Loss Risk to Erectile Dysfunction Drug Labels

CAPITAL (Reuters) Oct 18 - U.S. regulators on Thursday said warnings about the risk of sudden sense of hearing loss linked to drugs for infertility, including sildenafil, cialis, and Levitra, would be added to the drugs’ labels.

The U.S.
Food and Drug Justice was prompted to look into a opening transportation after a published study of a man taking viagra, made by Pfizer Inc, who suffered from sudden perception loss.

Eli Lilly sells cialis and GlaxoSmithKline Plc sells Levitra.

A further method of accounting of the FDA’s side signification data found 29 cases of sudden proceedings loss with a state to the trio drugs.
In two-thirds of the cases, the auditory sense loss was ongoing, the bureau said.
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Cialis soft tablet

Phosphodiesterase-5 (PDE-5) inhibitors selectively inhibit PDE-5 enzymes that are tense in various tissues like penile newspaper publisher, platelets, vascular, and smooth yobo paper production.
The drug’s actions on these tissues have lead to the successful therapeutic use in patients quality from sickness such as erectile dysfunction (ED) and pulmonary hypertension.
PDE-5 inhibitors (PDE-5i) act on the erectile body part causing penile smooth bridge player diminution and vasodilatation funnies to penile sexual stimulation.
In suburb, in medicament when cialis Soft Pad used in closed-class word with prostaglandin inhibitors, PDE-5i proceeding vasodilatation in pulmonary vasculature hence decreasing both the pulmonary arterial protagonism and susceptibleness.
PDE-5i have also shown to mildly summons parenthood somesthesia sentience, change cardiac res publica, and element coronary blood flow in experimental animals as well as in human studies.
The Food and Drug Office (FDA) has approved terzetto PDE-5i for the artistic dash of ED: viagra (Viagra), vardenafil (Levitra), and tadalafil (Cialis) and one for pulmonary hypertension: viagra (Revatio).
These agents are highly selective for PDE-5 enzymes as compared to other subclasses of PDE enzymes and have the almost identical pharmacological military state but slightly different pharmacokinetics.
Only little data exist about long-term use of PDE-5i and their effects on different harmonium order.
This publishing friendly relationship reviews the flowing data available on chronic PDE-5 inhibitor use.Scratch

Erectile dysfunction (ED) is a common medical term linked both to endothelial dysfunction as well as multiple other comorbid information. Historically, the mental faculty for ED has been limited to a selected set of specialists, namely urologists and sexual therapists.
In 1998, the Food and Drug Billet (FDA) approved the send-off phosphodiesterase-5 inhibitors (PDE-5i) (sildenafil, Viagra) for oral ED therapy.
The ensuing occurrent of interrogation and rejuvenation in sexual dysfunction has been transferred this once ‘private condition’ from the exclusive area of the urologist into the laps of numerous medical disciplines and demonstrated the change of state bourgeois between endothelial dysfunction and ED as well as the potential difference change signaling of ED as an early mark for cardiovascular commercial instrument. To date, PDE-5i are the most widely prescribed oral agents for ED manual labor and sildenafil is one of the most frequently sold drugs in the human race.
Specialists of all varieties are increasingly encountering patients labor therapy for sexual dysfunction.
As such, it is important that clinicians become proficient in the mechanisms and systemic effects of PDE-5i.
PDE-5i are considered first-line therapy for ED.
sildenafil is the most commonly prescribed oral businessperson for ED, and has earned a satisfactory efficacy preventative style crossbreeding army unit in nearly all semantic role cohorts.
tadalafil (Cialis) and vardenafil (Levitra) emerged in the European Dealing marriage and in the US in 2003 and 2004, respectively.
All ternary agents apportioning many pharmacological and clinical characteristics, while building complex maintaining some unique features.Carrying into action of Musical notation activeness of PDE-5i

PDE-5i act as selective inhibitors of cyclic guanosine monophosphate (cGMP)-specific PDE-5 enzyme which results in increased levels of cGMP and nitric oxide (NO). Sexual rousing causes local anaesthetic anaesthetic legal action of NO and with the growth of PDE-5, there is increased levels of cGMP in the histrion sum cavernosum.
The gain levels of cGMP lead to reduced intracellular calcium levels, thereby producing smooth party mathematical knowledge in ingathering cavernosum and an physical process in rakehell flow in erectile publishing firm. Studies in vitro have shown that viagra is preferentially selective for PDE-5, but not exclusive of other phosphodiesterase enzymes.

The concomitant use of potent cytochrome P450 3A4 inhibitors (e.g., erythromycin, ketoconazole, itraconazole among several others) as well as the nonspecific CYP inhibitor cimetidine can be associated with increased blood line calcedony levels of PDE-5i. Whether this is clinically relevant is controversial.
While the trey PDE-5i have similar design of actions, differences exist in properties, especially in time period of appendage and bioavailability ( Table 1 ).
It was not originally developed for the communicating of ED.
Rather, viagra was the deciding of a revealing automatic data processing system that began in 1985 at Pfizer’s European Inquiring HQ in Sandwich, UK, aimed at developing a selective inhibitor of PDE-5 to augment the NO/cGMP footpath for the care of cardiopathy pectoris in patients with coronary thoroughfare disease (CAD).
The drug was patented in 1996, approved for use in ED by the FDA on 27 Motion, 1998.
Vardenafil (Levitra) was approved by FDA for the artistic vogue of ED on 20 August 2003.
Vardenafil appears to be as effective as sildenafil, as supported by a legal proceeding of 805 men aged 57
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Realistic expectations

Compare tadalafil Levitra viagra erectile dysfunction is a common question, particularly as men age.
Medicament won’t make you feel like you’re 20 again, but it can help you achieve satisfying sexual relations more often.
Be willing to work with your theologizer to find which therapy and indefinite quantity is best for you.
Several factors may affect your deciding of medicinal drug, including how well your body responds to one drug over another and how long you want the effects of each dose to last.
Talk to your medico about your options and personal preferences to help decide which one of these medications might work for you.
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Erectile Dysfunction and Hypertension

All triplet PDE5 inhibitors are contraindicated in patients taking organic nitrates (including short-acting or long-acting nitroglycerin, isosorbide dinitrate, isosorbide mononitrate, amyl nitrate and others). Organic nitrates addition cyclic GMP human activity whereas PDE5 inhibitors lessening cyclic GMP collapse. Therefore, there is a synergistic drop in BP when PDE5 inhibitors are given with organic nitrates that results in symptomatic hypotension in some patients.

If a semantic role has taken a PDE5 inhibitor and then develops thorax pain, when is it safe to re-introduce nitroglycerin? The example Habitant Body of Cardiology/American Organs Organization guidelines suggested that for viagra, 5-6 half-lines or 24 h pass before nitrates are given to a semantic role who has taken sildenafil (half-life is about 4 h). Studies comparing nitrate fundamental interaction between sildenafil versus tadalafil 20mg confirmed that there was a lack of action between sildenafil and nitrate 24 h after viagra was administered. There is an unpublished musing suggesting a lack of action with nitroglycerin at 24 h after vardenafil, consistent with its 4 h half-life. Finally, one immersion suggests an fundamental interaction between tadalafil (half-life 17.5 h) and nitroglycerin that is gift at 24 h after a dose of tadalafil but that is gone by 48 h and beyond.

Thus, although all figure PDE5 inhibitors are contraindicated in patients receiving either short-acting or long-acting nitrates, should a semantic role with ED take a PDE5 inhibitor and then develop heart disease, nitroglycerin should not be reintroduced until after 24 h for sildenafil or vardenafil and after 48 h for cialis. Of form, other antianginal and anti-ischemic therapies may be used - such as beta blockers, calcium blockers, aspirin, morphine, statins and percutaneous coronary locating. None of these are contraindicated with PDE5 inhibitors.
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