A recent study published in the Journal of Urology showed a surprising benefit for Cialis (tadalafil) users. Men using a lower daily dose of the ED medication (2.5 or 5mg) were shown to have statistically significant improvement in troublesome urinary symptoms such as waking up at night to urinate (nocturia), urinary frequency, and poor bladder emptying. The mechanism for this action is not well understood at present.
In the future, combination drugs which target ED and prostate symptoms (including possible protective or preventative therapy directed against prostate cancer) are likely to be investigated.
High blood pressure is a major risk factor in the development of life-threatening conditions such as heart attack and stroke. It also predisposes to erectile dysfunction.
A recent study published in the November 24 Archives of Internal Medicine shows that ambulatory blood pressure monitoring (done at a patient's home) gives a more accurate picture of the blood pressure problem than testing done at a physician's office. In cases of severe high blood pressure disorders, (those associated with a 20% incidence of life-threatening complications) the office blood pressure measurements did not predict a single patient that went on to suffer one of these major setbacks.
For very little expense, patients at risk could have much better management, with fewer office visits, using online interpretation and management of changes in their blood pressures. Millions of lives could be saved.
Don't expect that 90 minute wait in the doctor's office to improve anytime soon. Experts predict that the US will be short 200,000 physicians in less than 20 years. One analyst put it this way: "We now have an in-your-face physician shortage and no conversation about correcting it exists."
Many feel that innovative techniques of health care delivery, such as online consultation for specific medical problems, as well as more efficient and cost-effective diagnostic testing and interpretation, are essential to help avert this crisis.
A recent population based study found that ED is not as uncommon in young men as previously thought. Perhaps 7% of men under the age of 30 are affected. As with all categories of ED patients, the key is to obtain a detailed medical history provided by the patient in a non-threatening environment.
While many cases of ED in young men have a psychogenic causes, ie. depression or anxiety, other causes including diminished testosterone blood levels and diabetes can be uncovered with simple lab tests.
As you might guess, the ED drugs are highly effective and safe in treating this population of men with ED.
While numerous well-designed medical studies have shown that alcohol in moderation (especially red wine) has health benefits, the general affect on sexual performance is not good. As Shakespeare wrote in Macbeth, " Drink (alcohol) is a provoker of three things: nose painting, sleep, and urine. It provokes, and unprovokes: it provokes the desire, but it takes away the performance." While it is generally safe to use the ED medications with moderate alcohol intake, the effectiveness of the medications is greater when alcohol is avoided for a few hours before using an ED med. Also, chronic moderate or heavy alcohol use is probably one of the main causes, along with smoking, of ED in the first place.
Erectile dysfunction, to some degree, affects perhaps 50% of men between the ages of 40 and 70. The impact on quality of life as well as a man's sense of well being is truly staggering. With the introduction of sildenafil citrate (Viagra) in 1998, the approach and treatment of men with ED changed dramatically. It was no longer necessary to subject most men to extensive and costly diagnostic testing and often embarrassing face to face encounters in order to safely offer them treatment. But how do Viagra and the other ED drugs work exactly? They work their magic by inhibiting a specific enzyme called phosphodiesterase 5 (PDE5). OK, here's what happens: during sexual stimulation, nitric oxide (NO) is released into the tissues of the penis. NO then causes an increase in cyclic GMP which allow the erectile tissues of the penis to engorge with arterial blood, while the venous drainage of the blood slows down.The ED drugs block the breakdown of cGMP, which allows it to do its job more efficiently and powerfully. While that might be "too much information," it's good to know what medications really do. And besides, now you know more about the mechanism of action of the ED medications than most physicians!
A recent gigaOM post by Alistair Croll discusses the future of online healthcare and specifically Google’s creation of its online healthcare records feature. Croll points out that “Computerization can eliminate much of the 30 percent of medical costs that are due to inefficiency, according to Dr. Dean Ornish, founder of the nonprofit Preventive Medicine Research Institute. At GigaOM Croll mentions that advanced diagnostics will encourage prevention and reduce costly reactive treatment. I fully agree with Croll's observations. In October 2008, I demonstrated KwikMed's on line mechanism for the delivery of care (Peter Ax at Health 2.0) at the Health 2.0 conference in San Francisco. I believe that patients should have their entire medical history in an online repository available for access anytime, from anywhere with real time updates made by an integrated system of health care providers. As reported by the National Priorities Partnership, 18% of the time, physicians order medical tests which have been previously recently performed. If my personal physician could access my medical records online prior to my visit with him, he could see what tests I have taken in the past even if those tests have been ordered by a different provider. For example the x-ray of my knee taken at my local hospital in 2006 could be seamlessly accessed by the emergency room technician in Park City, Utah when I crash and hurt my knee on the ski slopes in 2008. More significantly, the allergic reaction I had to a medication in 2000 could assist my new primary care doctor in his decision to prescribe a medication for me. The first step to online records and seamless use of those records will be establishing technology standards. We must also have a dialogue about who has access to those records and how does the consumer monitor and limit access.
Recently I was in my physician's office for a routine visit. An assistant brought my medical file to the examining room while she took my blood pressure and performed some other basic health checks. I started looking at the history of my blood pressure readings and the assistant protested. "you can not look in this file without the physician present." Are you kidding me? It is MY RECORD! So goes health care. I recently came across a post/commenting on an ongoing conversation on the
National Health Dialogue blog that we will improve our health system by developing technologies to standardize medical records and patient histories and that patients want control of their health care. By creating standardized medical records and medical histories and by encouraging patient access, we will create a higher standard of health care. What's your take?
KwikMed's customer service team receives numerous questions every week from our customers regarding generic Viagra the risks involved when purchasing medications online.
When buying Viagra online it is very important to understand the risks involved when dealing with unregulated online pharmacies. There has been a sharp rise in the number of counterfeit pharmaceutical products being sold online.
These fake products may look like the real thing but do not contain the proper substances and can be very dangerous.
It is also important to realize that there is no such thing as "generic" Viagra, Cialis, or Levitra. Although you frequently see these "generic" erectile dysfunction medicines being advertised online they are not legal and it's illegal to sell "generic" Viagra, Cialis, or Levitra in the United States. These impotence drugs are not FDA approved which means you cannot be sure that these products are effective or safe.
The
Pfizer website provides guidelines for buying Pfizer Viagra and notes that there are thousands of websites selling fake Viagra. It urges you to protect yourself and stay away from any sites selling "generic" Viagra, Viagra soft tabs, and quick-dissolving Viagra as these are all forms of fake Viagra.
Health care is the topic du jour as it has rightfully gained its leading position in our vernacular. Let's face it, if the cost of health care delivery continues to rise at its current rate and the quality continues to slide at its current rate, in a few years we will see a catastrophe that rivals the sub-prime loan market. I like to think about health care as a bicycle wheel with many elements that combine to make it successful. Each spoke is a key element: access to care being a spoke, physician medical practices being a spoke, pharmacies being a spoke, the patient being a spoke, hospital treatment being a spoke, health innovation a spoke, sickness research a spoke...on and on. Many factors contribute to our health system to make it successful and many factors contribute to make it fail. We must now review the system from point to point and dissect how each spoke must change in order to reinvent our health system in a manner which makes it effective and efficient for the long term. We must create industry-wide standards for electronic medical record systems so that data collected in a physician's office can be uploaded to a patient's electronic medical record. Industry standards will allow for the integration of all providers and payers. We must create transparency by publishing the costs of drugs, devices, procedures and consultations and allow consumers to make informed decisions about where and how they will accept care. Consumers will quickly find that alternative delivery venues like the Internet will save significant health care dollars. By having an on line medical record available to patients at all times, patients can decide what information needs to be given to a health care provided. There will be less duplication of laboratory tests, less confusion as to a patient's medical history and an ability for health care professionals to see baseline data. An integrated system will allow us to have superior care for fewer dollars.
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