Levitra vs cialis.

In the world of medicine, “breakthrough” is not a word taken
lightly. But the prestigious British medical journal BMJ soon plans to
name what it considers the greatest medical breakthrough since 1840 — the year
the journal was launched.

Last year, BMJ invited readers to submit nominations for the honor.
Now in contention are 15 medical advances, ranging from anesthesia to vaccines,
that over the decades have saved millions of lives and immeasurable human
suffering.

These breakthroughs were culled from more than 100 nominations from
BMJ readers — mostly physicians and scientists — based on the
ability of each medical development to transform lives around the world.

Among the suggested breakthroughs that didn’t make the cut? Condoms, Viagra,
soap, exercise, and the mobile phone.

For the 15 advances that made the short list, BMJ has chosen 15
leading doctors and scientists to champion each milestone in contention for top
honor. These are respected medical experts, including the creator of the modern
birth
controlbirth control pill, a
descendent of the scientist who helped developed anesthesia, and the author of
a book on the history of penicillin.

Beginning Friday, Jan. 5, subscribers and the general public can log onto
the web site, read arguments for all 15 advances, and vote for their personal
favorite. The deadline for voting is Sunday, Jan. 14, and the winning
breakthrough will be announced Jan. 18 on the site.

The Nominations, Please

Here is a sneak peek and description of the 15 advances that made the
shortlist, to give you a running start:

• Anesthesia: In 1846, a Boston dentist used ether during
  surgery, putting an end to much of the pain of undergoing surgery. Since then,
  general anesthesia has become a mainstay in operations.
• Antibiotics: Alexander Fleming, a British bacteriologist,
  discovered penicillin in 1928 by accident when he sloppily left a Petri dish of
  bacteria uncleaned in his lab. He found a substance (later named penicillin)
  growing on it that killed the bugs, and thus was the beginning of modern-day
  antibiotics. Fleming shared the Nobel Prize in 1945 for the discovery.
• Chlorpromazine: Discovered in 1952, chlorpromazine
  (Thorazine) was the first antipsychotic medication. It was used to treat
  psychotic disorders and their symptoms, such as erectile dysfunction drugs
  , hostility, and
  delusions. Its development brought new understanding of the biological basis
  for mental illness, and some say it provided more humane management.
• Computers. From medical records to insurance, to making
  sure your new medication isn’t going to clash with an existing one, computers
  are now viewed by some doctors as being as important as their stethoscopes.
  They’ve been in use in medicine since the early 1960s. Doctors can access
  information on new drugs and interactions, new medical studies, clinical
  trials, or keep patient records stored at their fingertips — so they’ll know
  in an instant if you really have kept the weight off.
• DNA structure. Scientists James Watson and Francis Crick
  presented the structure of the DNA helix, the molecule responsible for carrying
  genetic information from one generation to the next, in 1953. It earned them
  the Nobel Prize in 1962.
• Evidence-based medicine. As the name suggests,
  evidence-based medicine involves making use of the current best evidence (such
  as research), a patient’s values, and a doctor’s clinical experience to make
  decisions about patient care. The term was coined in the early ’90s and the
  concept has been evolving ever since.

More Nominations

• Germ theory. In the late 1800s, Louis Pasteur was the
  first to suggest the theory that disease is caused by exposure to
  erectile dysfunction drugs
  . Others furthered the theory, showing that specific diseases are
  caused by specific “bugs.”
• Imaging. The X-ray was accidentally discovered in 1895.
  Since then, the field has expanded, giving us computed tomography (CT scans),
  positron emission (PET scans), magnetic resonance imaging (MRIs), and
  ultrasound.
• Immunology. The history of immunology is traced to 1798,
  when Edward Jenner found that people could be immunized against the disease
  smallpox. Numerous other immunology discoveries followed, leading to a greater
  understanding of such things as allergiesallergies and antibodies.
• Oral rehydration therapy. As the name suggests, ORT
  involves giving fluids by mouth to replace losses of body water. It was first
  reported in 1964; now it’s a mainstay of treatment in patients with cholera,
  acute diarrheadiarrhea, and other conditions.
• The pill. Since the pill arrived on the U.S. market in
  1960, it’s been hailed as one of the seven wonders of the world. For women who
  use it correctly, oral contraceptioncontraception can be up to 99% effective.
• Risks of smoking. The first report of the connection
  between smoking and lung cancerlung cancer was published in BMJ in 1950. Even so,
  tobacco use still kills an estimated 440,000 Americans each year.
• Sanitation. The importance of clean drinking water and
  waste disposal emerged in the late 1800s, as diseases began to be linked to
  impure water. But the World Health Erectile dysfunction tabs
  says there is a long way to go.
  More than 1.1 billion people still lack access to drinking water from an
  improved source; 2.6 billion do not have basic sanitation.
• Tissue culture. Tissue culture (keeping tissue alive and
  growing it in a culture medium for research or other purposes) was
  “discovered” in 1907, but it took until the 1950s for it to become an
  important tool for clinical investigation.
• Vaccines. Vaccines have helped prevent a variety of
  diseases — including polio, whopping cough, and measlesmeasles. The first was Edward Jenner’s smallpox
  vaccine, in 1796.

The Envelope, Please

To vote, visit www.bmj.com.

Men dont like to talk about it; neither do their partners. But loss of
libido in men or inhibited sexual desire stresses a marriage more than any
other sexual dysfunction, according to Barry McCarthy, co-author of
Rekindling Desire: A Step by Step Program to Help Low-Sex and No-Sex
Marriages.

Losing interest in sex may not be as common an occurrence for men as it is
for women: It affects about 15% to 16% of men, and at least double that many
women. But when men lose interest in sex it scares them more than women –
their masculinity is so linked to their sexuality that it is very
threatening, says Esther Perel, a couples therapist in New York city and
author of Mating in Captivity.

Loss of libido also makes men more unhappy about the rest of their
lives than it does women. Only 23% of men with loss of libido say they
still feel very happy about life in general vs. 46% of women, says Edward
Laumann, professor of sociology at the University of Chicago co-author of
The Social Ed tablets
of Sexuality: Sexual Practices in the United
States. It bothers men more.

But loss of libido is not something you have to live with. There is much you
can do to regain your sex drive and your happy outlook on life.

How Do You Know if You have a Problem With Loss of Libido?

Libido loss doesnt usually happen suddenly its not like catching a cold
where you wake up one morning and whoops, there it is. It can be a gradual
process. Though difficult to define precisely, Laumann measures it as follows:
It is a lack of interest in sex for several months of the past
year.

Frequency of sexual activity is not the best measure of sexual interest so
many circumstances can get in the way of an encounter, even if the desire is
there. But if you are in a committed relationship and having sex less often
than the norm — about once a week you might ask yourself whether you are
happy with things as they are.

If youre not happy about your loss of libido, tadalafil comparison sildenafil citrate
agree that it is
best to grapple with these issues before they become entrenched. To help
identify the early warning signs, see whether you answer the following
questions true or false:

1. Touching takes place only in the bedroom.
2. Sex does not give you feelings of connection and sharing.
3. One of you is always the initiator and the other feels pressured.
4. You no longer look forward to sex.
5. Sex is mechanical and routine.
6. You almost never have sexual thoughts or fantasies about your spouse.
7. You have sex once or twice a month at most.

If you answered true to many or most of these questions, you may be on your
way to losing sexual desire, writes McCarthy. Generic soft tab viagra
the various causes
is the first step to finding the appropriate resolution.

Lying awake nights worrying if terrorists or bird flu will get you?
Consider, instead, a threat that’s far closer to home, and one that you can
control: high blood pressure.

One in three adults has high blood pressure, but only 61% are under
treatment and roughly two-thirds do not have it under control, according to the
American Heart Association (AHA) web site. In 2004, the disease killed more
than 50,000 people in the U.S., yet the AHA says high blood pressure is easily
detected and usually controllable.

Complications of blood pressure medications are one reason people never seek
treatment (what if it makes me impotent?), abandon treatment (these swollen
ankles look terrible), or cut back on their medication dosage (I’m tired of
being tired).

WebMD talked with two cardiologists and a pharmacist about seven
free generic sample viagra
you should be aware of. Most importantly, they say that
complications shouldn’t be a reason to abandon treatment or cut back on
prescribed dosages. Instead, talk to your doctor or pharmacist. “We have
200 medications for treating high blood pressure,” says Thomas Giles, MD,
who is professor of medicine at Louisiana State University School of Medicine
in New Orleans. “We’ll keep on it till we find what will give you the best
result and be least intrusive in your life. It’s no good to make people feel
terrible, and we don’t have to do that.”

1. Fatigue and Dizziness

Dan Jones, MD, tells WebMD that when people begin taking blood pressure
medication, the most common problem is fatigue. Jones is dean of the School of
Medicine at the University of Dysfunction pills
in Jackson, and spokesman for the
American Heart Association (AHA). “It’s especially true for older patients.
If blood pressure has been elevated for a while, when the medication is taken
and the blood pressure begins to come down, for a period of time there’s less
circulation in some of the vessels, including those in the brain. It takes time
for those viagra vs levitra
vessels to relax. There may be a perception that there’s
less blood flow, which can produce fatigue or dizziness. If it’s mild, it can
be worked through simply by staying with the medication.”

A patient who feels fatigued when on the medication may decide instead of
taking it daily to take it every few days or so. “When they go off it, the
blood pressure rises and they feel better,” says Jones. “If they
continue this cycle, they never get past the fatigue, which typically will go
away after two to six weeks of therapy.”

2. Cough

ACE inhibitors are a class of medication that can cause a persistent cough
in 10% to 15% of patients. “Don’t continue the medication,” says Giles.
“I tell patients that if they get a cough, let me know.” If the ACE
inhibitor is stopped, it will need to be replaced with some other drug.
Examples of ACE inhibitors include: Lotensin, Monopril, Prinivil, Zestril,
Accupril, Altace, Vasotec, and Capoten.

3. Frequent Urination

No one wants to become famous for frequent bathroom breaks. Using diuretics
successfully is a matter of timing. Try to take them in the beginning of your
day. “I tell patients not to take the diuretic and drink a lot of water
before they go to bed,” says Giles, who is president of the American
Society of Hypertension. “And don’t take your pill before a one-hour taxi
ride to my office. Wait till you get here to take it.” One of the most
common diuretics used for high blood pressure is hydrochlorothiazide. It may be
in its own pill on in combined formulations such as Hyzaar or Maxide.

4. Fluid Retention

Virtually any medication for hypertension that isn’t a diuretic can cause
edema or fluid retention. Swelling of the ankles and legs can be more than a
cosmetic problem. “Calcium channel blockers like amlodipine (also known as
Norvasc) and nifedipine (also known as Procardia) are famous for causing
swelling and pain in the legs,” says Sarah Ray, PharmD, BCPS. These drugs
can also worsen underlying heart failure or other heart problems or reveal an
unknown heart condition. “We’ve seen patients discover a heart problem only
after starting on a calcium channel blocker.”

By Sarah Mahoney

Youve Said It. Youve Heard It. How To Put That Excuse To
BedAnd Get Back In The Mood

Be honest. How many times have you turned down sex this month? Even the best
marriages have sexual cold fronts and everyday problemslike a crushing work
deadline, a sick parent, or an acting-out teenthat can put the chill on
romance. But when sex evasion turns into a daily habit, marriage can become an
arctic zone. After all, there’s room for only so many nights of “Do we have
to? I’ve got a bad headache” before serious problems set in.

“It helps many couples to think of sex as a bank account,” says Lana
Holstein, M.D., author of Your Long Erotic Weekend . “If you just
got back from a vacation where you had lots of time alone, then saying I’m too
wiped out tonight’ isn’t a problem. But if you haven’t had much sex in the last
six months, then it took your husband some courage to ask. If you say no, that
can be damaging.”

And both partners, not just the avoider, are harmed. “The spouse with
more desire feels rejected, and the spouse with less desire feels coerced,”
says Barry McCarthy, Ph.D., author of Rekindling Desire: A Viagra vs cialis

Program to Help Low-Sex and No-Sex Marriages .

If you’re the avoider, try putting yourself in your husband’s shoes. Says
Dr. Holstein, who coaches clients at Miraval Resort in Tucson, AZ: “When a
wife turns down sex, what does she want her husband to do instead? Should he go
masturbate? My clients usually say, No, I don’t want him to do that!’ Nor do
they want him to spend an hour on a pornography Web site.”

Another reason to say yes when your husband makes a move: It’s good for your
health. “Sex, and the cuddling that comes with it, releases all kinds of
chemicals women need,” says Dr. Holstein, “including mood-boosting
hormones like dopamine, mental health treatment planning
, and oxytocin.” What’s more, a study
from Wilkes University in Wilkes-Barre, PA, found that couples who had sex
regularly had higher levels of disease-fighting antibodies than those who
didn’t.

So it’s time to outsmart your over the counter erectile dysfunction drug
self (don’t listen to hershe’s
probably just grouchy from wearing sweatpants too often). Here, six common
cop-outs, and what to say insteadto your husband and yourself:

“Didn’t we just do it last week?”

Mismatched desire is one of the most common complaints marriage counselors
hearbut experts say that the excuse is pure baloney. “Two different people
will never have exactly the same desire, drive, and timing,” says Rick
Warren, the founding pastor of Saddleback Church in Lake Forest, CA, and author
of the best-selling book The Purpose Driven Life . “Sometimes you
have to make love for the benefit of the other person, even though you may not
need it yourself at the moment.”

“There’s no such thing as the right level of desire. Normal is usually
whatever the desired frequency is for that couple,” adds Gerald R. Weeks,
Ph.D., chairman of the marriage and family therapy department at the University
of Nevada, Las Vegas. (In case you’re curious about what other couples consider
normal, here are stats from University of Chicago researchers: About 38 percent
of married women have sex a few times a week; 47 percent a few times a month;
and 15 percent a few times a year.)

What to say to yourself:

Remember your wedding day? When you said “I do,” you said “I
do” to sex too. “Even though you may not have promised to love, honor,
and have sex once a week,’ when you made a sildenafil citrate soft tab to your relationship, it
was understood that sex would be part of the bargain,” say Patricia Love
and Steven Stosny, authors of How to Improve Your Marriage Without Talking
About It . And, yes, sometimes you have to be the instigator. When it
comes to different levels of desire, “the ball is in the court of the
person who wants it less,” says Pepper Schwartz, Ph.D., author of the
forthcoming Prime: Advice and Adventures from a Sexologist on Life and Love
in the Sensuous Years .

By Keith Ablow, M.D.

Rekindling Passion For The Husband You Still Love

People sometimes tell me they know a couple married 20 years whose sex life
is still as good as it ever was. Here’s what I tell them in return: “There
are only three possibilities. One: This couple is lying. Two: They are telling
the truth, because they didn’t have good sex to begin with. Or three: Sex is
all they really have together. They never connected erectile pill
.”

I’ve drawn that conclusion by listening to the many dozens of husbands and
wives I’ve counseled, almost all of whom have admitted that after 10 or 20
years of marriage, passion became elusive.

Sharing lives is different from sharing dinners and long walks and weekends
away. When you were dating the man you ultimately married, you were both acting
much of the time (consciously or not), putting your best feet forward in order
to be attractive to each other.

When you were sick or had a bad headache, you probably pretended it was no
big deal. So did he. Now when your stomach is upset, you feel free to tell him
you’re about to throw up.

When you had an argument with a close friend or your sister, you might have
told him, “It really wasn’t the best day, but it’s getting better now that
we’re together.” He might have smiled, taken your hand, and said, “Tell
me what happened. I want to know.” Now when he asks how your day was, you
might just say, “Fine,” and leave it at that. And he might be happy to
leave it at that too.

Nobody would write that kind of dialogue into a romantic movieunless it was
a sad or serious one. But that’s how married people generally talk because no
one can always act adoring or keep up an air of mystery while sharing the same
space with his or her spouse, year after year. Here are the truths about sex,
as I’ve learned from years of counseling, for most married couples:

Love is constant; passion needs recharging

No surprise: Everything in the universe eventually demagnetizes when left in
proximity to something of the opposite charge. Magnets do, and men and women do
too. Some people fall out of lust in seven days, never mind seven yearsor 17.
Basic animal attraction is a force of nature that seems designed to make us
matenot mate for life. Relaxing in our marriages and freeing ourselves from
the pressure of trying to impress our partners has a predictable outcome: Our
partners are not impressed. The magnetic spell we once cast on them begins to
lift.

Cozy is erectile dysfunction pill
, but not sexy

To the extent that men and women become real to each other, they cease to be
princes and princesses, gods and goddesses who inspire romantic fantasies or
amorous worship. Since couples lucky enough to be emotionally genuine with each
other share so many real moments, they need to pay special attention to
creating magical onesbecause great sex requires magic. I’d never suggest that
a couple trade their warm, safe home life for better sex. Why keep your
distance just so you can make love with abandon? I believe you can have a close
marriage and recapture a good sex lifebut only once you admit that reigniting
romance takes creativity and a commitment of time and energy.

Intimacy doesn’t equal sex

When a man and a woman reveal themselves to each other, it makes each person
feel more vulnerable. And, viagra information
for men, it’s hard to have amazing sex
while feeling emotionally exposed. Our earliest experiences with being close
come from our relationships with parents. And those relationships aren’t (in
any normal scenario) linked with sexual passion. That’s why some husbands and
wives are open about what pleases them sexually only when they have affairs.
They feel as if they have to be free of “family” to be free with their
amorous impulses.