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To: MEDICAL EDITORS
Contact: John Murphy, +1-507-284-5005 (days), +1-507-284-2511 (evenings), e-mail: newsbureau@mayo.edu
ROCHESTER, Minn., Oct. 4 /PRNewswire-USNewswire/ — Although medication
can help extend the lives of men with chronic heart failure, several factors
associated with this disease can interfere with a person’s ability to engage
in and enjoy sexual activities. Fatigue, depression, medication side effects
and the fear of damaging the heart can cause people with chronic heart failure
to lose interest in sex or wonder whether this activity is safe for them.
A literature review published in the October issue of Mayo Clinic
Proceedings finds that with proper screening and treatment, many patients with
chronic heart failure can safely engage in sexual activity.
Methods
Co-authors Stacy Mandras, M.D., Patricia Uber, Pharm. D., and Mandeep
Mehra, M.D., conducted systematic literature searches using the
MEDLINE database and examined a broad range of medical research that focused
on chronic heart failure, sexual activity and sexual dysfunction. This
literature included data from patient surveys and clinical trials.
Findings
Many people with chronic heart failure worry that having sex will place
too great a strain on the heart. To address this issue, Drs. Mandras and Mehra
analyzed studies that showed the impact of sexual activity on heart rate,
blood pressure and respiratory rates, which typically increase during sexual
activity and other forms of exertion.
One study the authors reviewed measured these changes in middle-aged men
with and without coronary artery disease. This study found that the peak heart
rate during intercourse was lower than heart rates measured during the
patients’ normal daily activities. The study participants’ peak oxygen
consumption levels during intercourse were moderate — comparable to their
oxygen consumption levels during moderate activities such as walking on level
ground at 3 to 4 miles per hour, climbing stairs slowly or doing general
housework such as vacuuming.
The authors also addressed how to counsel and treat chronic heart failure
patients who are coping with erectile dysfunction, difficulty achieving or
maintaining an erection. Researchers estimate that erectile dysfunction
affects 60 percent to 70 percent of people who have chronic heart failure.
The authors observe that multiple factors may be involved. In addition to
decreased exercise capacity, patients with chronic heart failure have blood
vessel and circulation that can reduce blood flow into the penis
and interfere with the ability to maintain an erection. And erectile
dysfunction can be caused or worsened by many of the medications that are
commonly prescribed to treat chronic heart failure.
Currently, the preferred treatment for erectile dysfunction includes
sildenafil (Viagra), vardenafil (Levitra) and tadalafil (Cialis). However,
numerous experts have raised concerns about the use of these drugs in patients
with chronic heart failure who also take nitrates (or other medications that
relax and widen blood vessels). This drug combination has been shown to be
dangerous, because it can increase the risk for a drop in
blood pressure.
To further explore this potential risk, the authors reviewed results from
a variety of studies in which male patients with congestive heart failure took
sildenafil. The authors observed that more data are needed to determine the
safety of the newer drugs, vardenafil and tadalafil, for these patients.
“Taken together, these studies show that erectile dysfunction in patients
with mild to moderate chronic heart failure can be safely and effectively
treated with sildenafil, provided that patients are appropriately screened
before therapy,” say the authors.
For those patients who cannot take erectile dysfunction medications, the
authors counsel that an exercise training regimen may be an appropriate
substitute therapy to enhance sexual function and quality of life. The authors
stress that clinicians should focus on the sexual activity history of chronic
heart failure patients and not ignore it, since addressing this element can
substantially improve their quality of life.
Background about chronic heart failure
Chronic heart failure often develops after other cardiac problems have
damaged or weakened the heart, leaving it too weak or too stiff to fill and
pump efficiently. Many underlying heart conditions can lead to heart failure.
It can develop quickly after damage caused by a heart attack, or it can
develop gradually after years of high blood pressure or coronary artery
disease.
A peer-review journal, Mayo Clinic Proceedings publishes original
articles, reviews and editorials dealing with clinical and laboratory
medicine, clinical research, basic science research and clinical epidemiology.
Mayo Clinic Proceedings is published monthly by Mayo Foundation for Medical
Education and Research as part of its commitment to the medical education of
physicians. The journal has been published for more than 80 years and has a
circulation of 130,000 nationally and internationally. Articles are available
online at http://www.mayoclinicproceedings.com.
To obtain the latest news releases from Mayo Clinic, go to
http://www.mayoclinic.org/news. MayoClinic.com (http://www.mayoclinic.com) is
available as a resource for your health stories.
SOURCE Mayo Clinic
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Read another articles about .
The moment their teenage son or daughter dyes their hair black and starts getting creative with eyeliner can be a nightmare for parents. But a report suggests it should be a time for celebration.
Goths are likely to grow up to be doctors, lawyers or architects, the study by Sussex University says.
They are refined and sensitive, keen on poetry and books, not big on drugs or anti-social behaviour. They are also likely to carry on being goths into their adult life.
They have an ability to express their feelings and are believers in romance rather than one-night stands, it says. In fact, the only things dark about them are their clothing and their sarcastic sense of humour.
 |
WHY GOTHS?
The term comes from Germanic tribe that invaded the Roman Empire in the 3rd to 5th centuries
Goth was thought to be first used to describe bands around 1979, with Joy Division and Siouxsie and the Banshees
There are sub cultures within the sub culture, such as cyber goths
Goth band Bauhaus graced the cover of Smash Hits in 1982
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“They won’t like me saying it, but their lifestyle, unlike the punk scene, is a middle-class sub culture,'’ says Dunja Brill, who carried out the study.
“They are usually intelligent youngsters who have rejected the idea that teenagers must fulfil certain criteria.'’
But is that right? Will the pale faced, sullen-looking teenage goth next door end up being your bank manager in 10 years’ time? The Magazine headed to the gothic Mecca that is Camden Market to find out.
“Where I live it’s usually the chavs who start all the trouble not the goths, so I think we are quite a peaceful lot,” says Antoinette Drakes, 16.
“We just mind our own business and get on with what we like to do. But goths are like any other group, a lot depends on the individual.
“On the whole we are quite sensitive but you get some who aren’t, who are just posers and are just on the pull. Some will end up being doctors and some will end up being unemployed. Goths are a mix of personalities, just like everyone else.”
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‘Chavs cause trouble’
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But Keeley Dale, 18, says the study is just putting another label on goths.
“It’s always about labels in today’s society and that exactly why I dress the way I do, I don’t want to fit into other people’s stereotypes,” she says.
“So I’m not only a goth now, I’m also aspiring middle class. What is that anyway? I don’t want to be a doctor and read the Daily Telegraph, I want to be a writer and read whatever takes my fancy.
“There are some things that I do recognise in this research, goths can be sensitive and aren’t usually violent, but at the end of the day I think such things depend on the person, not the way they choose to dress.”
Mia Joseph, 40, has been a goth since her early teens and says it is a way of life for her now. She runs a market stall specialising in gothic wear, leather and PVC.
Threatening
“It’s not about fitting in to a particular subculture, this is just my life. I’m beyond thinking of myself as a goth, I’m just me.
“There are in the study that I think are true, goths do tend to be peaceful and sensitive, interested in literature and it is a way of life for many that continues long into adulthood. Why that is middle class I don’t know.
“I think people are a lot more accepting of us now. Years ago people found my piercing and tattoos , now they are part of everyday life. A lot of people have their nose pierced or a tattoo.
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Essential footwear for a goth
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“I have grannies who come up to me and say they wish they’d been able to dress the way I do when they were younger.”
But there is one trait that seems to cross all teenage sub cultures, whatever they wear, whatever music they listen to and whatever a study says - and that is sex.
“Of course I want to fall in love, but I’m fully prepared to try out quite a few ladies to find the right one,” says Dan Taylor, 18.
“I’m still a hormonally-charged teenager after all, as well as a goth.”
Keeley shouldn’t worry about Goth’s reading the Daily Telegraph. Goth’s tend to have socialist political views. Furthermore from 10 years of being a Goth I’d say they are more class less than middle class, that’s sort of the appeal of the scene.
Vicky, London
I tend to agree with this column, Most of “us” have jobs and we mostly work in high tech where its not what you look like, but can you do the job! Yeah the older ones look at the newbies with pride because they tend turn out ok.
Bill, San Jose Ca. USA
I’ve been a goth for well over ten years now, it’s a big part of my identity. I’m currently a phD student researching Chemistry, and although it may suprise some people, I’m not even the only goth in my lab. It’s good to see that someone is attempting to shake off the bad image we goths sometimes get.
Ross Forgan, Edinburgh
Back in 80-84 my mates and I loved the banshees and the cure,they would do the eyeliner and the black lippy while I was happy to listen to the music.
None of them are doctors or lawyers or fulfilling artistic ambition of any kind.neither are they still cutting around in pvc trousers or slashed t shirts…they have grown up…they have kids of their own and no doubt will fret just like our folks over their sons and daughters going out dressed ‘like that!’ the only sustainable element of the goth era was the music…it was brilliant then and brilliant now! Robert Smith for Prime Minister!
mic docherty, Cairo Egypt
I am a 40-something Goth (and have been since my late teens), so is my teenager daughter and my 20-something partner. I would say its definitely a way of life for a me but although I am educated to degree level, I wouldn’t say I have particularly middle-class values. I foresee being a ‘Goth’ until the day I die as it is a part of who I am rather than just a fashion trend or a phase I am going through.
Vicky, Leicester
being a goth myself i agree that goths are more likely to be intelligent and artistic. i come from a working class background, so don’t agree that it’s a middle-class thing. but it’s certainly fun to be in the company of like-minded people
eamonn, brighton
Please don’t lump Siouxsie and the Banshees in with the terrible ‘Goth’ movement. The Banshees may have inadvertantly started the movement but they couldn’t control it. Thats why its so bad!
Goth is pure pantomime- silly clothes, silly music by fools for fools. Sisters of Mercy, The Mission, Fields of the Nephilim- all vile. The Banshees were musical innovators- its a shame Goth didn’t take more notice to them…
Simon Jones, London
This is news? Goths have always started off as the kids who were bullied at school for being intelligent or geeky, so of course they’ll end up in the more prestigious jobs. It’s the “normal” blokes wearing white shirts and drinking Stella that cause the trouble in town centres at night. This is obvious to anyone who’s actually met a goth and who doesn’t just rely on tabloid stereotypes.
Alice, Brighton
I get accused of being a goth because of the black hair, piercings, evil demeanor etc. But i’m not a real goth (or is that the test?)- i work for the National Trust and do loads of activism with Greenpeace and other groups in my spare time. I wish other “goths” would be less mopey and apathetic and down on the world and take action to change it instead of just superficial aesthetic rebellion!
Felicity, London
It makes perfect sense that authorities and people generally frown on Goths. Goths quite simply have learned to think for themselves and express their own views. Something not generally approved by the state
Paolo
Paolo, St Albans
I certainly would prefer a child of mine to be a goth than some gobby hoody. I know which one would concern me more! I would certainly hold out more hope of a goth actually knuckling down and getting on in life.
Mary, London
Yet more stereotyping and thinly-veiled patronising. Attitude and lifestyle maketh not the goth - it’s a club and music scene and nothing more. Those who choose to take the fashion onto the streets are very welcome to - I myself show a tad of it at times - but it’s becoming very tiresome to see every black-wearing, shelley-reading labeled as such. The BBC misses the point once again
Tom, Reading, UK
During the late ’80s and early ’90s I got in to being a goth. The music, the scene and above all the people were brilliant, absolute diamonds. Although we’ve all grown up and drifted apart there are few days when I don’t think back to those heady days when we were head to toe in black. Goths shouldn’t be afraid of labels and certainly shouldn’t be afraid to shatter the paradigms. As to the middle class bit, now I’m a Chartered Marketer… Guilty as charged I guess.
Scott, Tamworth (previously Swindon)
Given her rejection of the concept surely Keeley shouldn’t label the middle classes as ‘doctors who read the Daily Telegraph’?
Laura, Lincoln
Why do people need to follow like sheep and label their taste. I have always had my own personal and very individual style,considered in my teens to my 30’s,as gothy, weird,striking, unusual etc.Some elements of which are very much still here(I am now 50)but more in tune with my changing shape and years!!I never wanted to look like anyone else or follow anyone else, and if someone thought my image was bad or a problem, it was actually their problem, I know who I am.
jan, suffolk
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| The number of men paying women for sex has nearly doubled in a decade, says research. Why?
One in 10 of the 11,000 men asked in a survey in 2000 said he used prostitutes, compared with one in 20 in 1990. The figure is published for the first time in the latest edition of the journal Sexually Transmitted Infections. But why such a sharp rise in just a decade? Dr Helen Ward, lead author of the report, points to growing divorce rates, sex tourism like stag holidays and the increasing availability of commercial sex through such means as the internet. She sees an commercialisation of sex in the media, such as “lad mags”. Sex psychologist Dr Lesley Perman-Kerr, who was not involved with the report, acknowledges sex is shedding its taboo and wonders if men are more willing to own up. “Maybe men are just more open about it. Human beings don’t tend to change that much and there’s always been prostitutes and always been affairs.”
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OTTAWA (CP) - Consumers are being warned not to use Zencore Tabs - a product advertised as a dietary supplement for sexual , Health Canada said Saturday.
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The federal health watchdog says it’s because it contains an undeclared ingredient similar to tadalafil, used for the treatment of erectile dysfunction.
Health Canada says the use of Zencore Tabs could pose serious health risks, for those with existing heart problems or those at risk of stroke. The agency says tadalafil combined with any nitrate could result in life-threatening low blood pressure.
Zencore Tabs is not authorized for sale in Canada and Health Canada says the Canadian importer is recalling the product. Consumers who’ve bought them are warned not to use it and to consult with a medical professional.
Health Canada says it’s taking steps to confirm the product has been removed from the Canadian market, and there have been no reports of adverse reactions.
Zencore Tabs is sold in blister packages of two capsules, and was available at retail outlets and possibly over the Internet.
STORAGE PRESCRIBED FOR DOSAGE NURSING MOTHERS SIDE EFFECTS
PREPARATIONS
Tablets: 5 mg, 10mg and 20 mg.
Tablets should be kept at room temperature between 15-30 C (59-86 F).
Tadalafil is used for the treatment of erectile dysfunction, or impotence.
The recommended initial dose of Tadalafil is 10 mg per day, which have to be taken orally before sexual activity. This prescribed amount is a usual daily dose for the majority of men. This dose can be increased up to 20 mg or decreased to 5 mg per day depending on the feedback or side effects. The maximal duration of the Tadalafil&39;t surpass a total dose of 10 mg in 72 hours (See “DRUG “). As food doesn&39;s highly recommended not to take Tadalafil together with nitrates. Tadalafil can also heighten the blood pressure as it lessens effects of some alpha-blocking medicines, such as terazosin (Hytrin), which are principally used for treatment of high blood pressure or increment of the prostate. The patients, who take the alpha-blockers, have to take the stable dose of these drugs before starting to take Tadalafil. In these cases at the initial stage the lowest doses of Tadalafil should be taken. In cases of taking Tadalafil, the alpha-blockers should be taken beginning with the lowest dose. As Tadalafil like alcohol lower blood pressure it&39;t approved for usage by women.
mothers were not testing for taking Tadalafil.
When using Tadalafil the following accompanying effects can take place: headache, facial flushing (reddening), nausea, stomach upset, diarrhea, and flu-like symptoms. Tadalafil can also become the cause of low blood pressure, spasm of accommodation, breach of color perception and anomalistic ejaculation.
There were cases of continuous erections, or priapism (aching erection that lasts more than six hours) fixed after taking Tadalafil. If erection lasts more than four hours you have to recourse. There is causation between using of Tadalafil and chest pain, heart attack, palpitation, hastened heart rate, stroke and death, but it's not confirmed if these side effects are result of using Tadalafil or they are direct outcome of sexual activity itself. 
Tadalafil should be taken orally. This medicine is used for therapy of erectile dysfunction, or impotence, consisting in lacking of ability to reach and keep in existence a penile erection. The drug class, which Tadalafil belongs to, is called phosphodiesterase inhibitors. Sildenafil (Viagra) and Vardenafil (Levitra) belong to this drug class too. When a penis is filling up with blood there a penile erection springs up. The blood vessels, which are for bringing blood to male organs, extend in size what causes filling the penis up with large quantity of blood. While the blood vessels, responsible for transporting blood away from the penis, diminish in size, what causes taking much less blood away from the penis than under usual circumstances. Sexual excitement leading to a sterling erection determines the production and ejection of nitric oxide in the male genital organs. The nitric oxide provokes the production of an enzyme called guanylate cyclase that is a necessary condition for production of cyclic guanosine (cGMP). This chemical compound controls extending and reducing of the size of the blood vessels that transport blood to and from the male reproductive organs. These changes of sizes condition erection. one more enzyme, which is called phosphodiesterase-5, demolishes the cGMP what makes blood vessels take their usual sizes, blood go away from the penis and thus the erection is over. Mechanism of action of Tadalafil consists in preventing phosphodiesterase-5 to ruin cGMP so the last one exists longer. The extended thus life of cGMP makes blood flow to the penis for longer period of time. The U.S. FDA approved Tadalafil in November, 2003.
Before talking about the Cialis&39;s necessary to remember the famous Pfizer&39;s researches descried the sildenafil citrate, a white crystal powder, which was a part of the medicine, caused the probationers, taking part in the researches, to have erections as it blocked the enzyme that was responsible for the production of the chemical substation causing erection, normalizing thus erectile function of the penis for some time. Despite the fact that the investigators were not attempting the chemical mix IC351 for erectile dysfunction therapy, the mixture appeared to have an effect that could possibly cost millions or even billions of dollars. In 1994 at the nearest opportunity Icos got the exclusive right to IC351, and during 1995 the medical researches of the first phase were taking place. In 1997 the second phase of the medical studies was started and for the first time Icos tested its medicine on patients with erectile dysfunction. The second phase continued for about two years and when it was over the third phase was commenced. In 1998 ICOS Corporation and Eli Lilly & Company decided exploiting the preparation for erectile dysfunction for financial profit and in two years they registered a new medicine application with the U.S. FDA for IC351; they made a decision to name the medicine Cialis this time though. In May of 2002, Icos and Eli Lilly & Company informed the American Urological Association that the researches carried out in the third phase showed that Cialis's effect lasted for about 36 hours. In a year U.S. FDA approved Cialis. In comparison with Viagra Cialis has one essential advantage. The matter is that the half life of Tadalafil (Cialis), is 17.5 hours so this medicine works up to 36 hours, even if there is still about a quarter of the absorbed dose in the body by that time. As to Sildenafil (Viagra), its half life is just 4 hours.
In 2006 Eli Lilly bought ICOS Corporation for $2.1 billion dollars.
