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The erectile dysfunction drug Viagra may have found a new, potentially life-saving use in hospital pediatric intensive care units, researchers report.

Australian researchers gave the drug to 15 babies with congenital heart disease who were being weaned from inhaled nitric-oxide therapy, a treatment that ICUs use to help these infants survive.

The researchers found that a dose of Viagra prevented a common life-threatening complication called rebound pulmonary hypertension. They also found that it significantly reduced the amount of time the babies spent on mechanical ventilation and in the ICU.

"Rebound pulmonary hypertension is a very common problem," said Dr. Steven Abman of The Children's Hospital in Denver, who was not part of the study. "This is the most rigorous study that's ever been done to demonstrate that Viagra can prevent this complication."

The study results were published in the November issue of the American Journal of Respiratory and Critical Care Medicine.

Viagra is useful for treating both erectile dysfunction and preventing rebound pulmonary hypertension because it affects pathways involved in both conditions.

"Viagra enhances the body's levels of cyclic-GMP, a naturally occurring substance that relaxes arteries and reduces their pressure, which is why its primary indication is for men with erectile dysfunction," explained the study's lead researcher, Dr. Lara Shekerdemian of the Pediatric Intensive Care Unit at the Royal Children's Hospital in Melbourne.

"However, cyclic-GMP is abundant in the lungs and is the molecule via which nitric oxide acts as a dilator of pulmonary arteries," Shekerdemian said. "That's why its use was explored in the setting of pulmonary hypertension in the newborn."

In the study, Shekerdemian and colleagues gave a single dose of Viagra to 15 infants with congenital heart disease who were undergoing withdrawal from nitric oxide, which is used to relax pulmonary blood vessels in mechanically ventilated lungs. Another 14 infants undergoing withdrawal were given placebo.

None of the Viagra-treated infants developed rebound pulmonary hypertension compared to 10 of the placebo-treated infants. After more than 24 hours, all of the infants who developed rebound hypertension were given Viagra during a subsequent and successful attempt to wean them from nitric oxide.

The Viagra-treated infants also spent less total time on a mechanical ventilator than the placebo-treated infants -- a little over 28 hours compared to 98 hours -- and had a considerably shorter stay in the intensive care unit (47.8 hours vs. 189 hours).

"Although we expected to see an avoidance of rebound, we were not expecting to see these additional benefits," Shekerdemian said. "Any intervention that smoothes their course in the intensive-care unit would have at least a short-term positive influence on their recovery from their underlying condition."

Unless there's some reason for not using Viagra, Shekerdemian said that it should be routinely used as infants are weaned from nitric oxide. "We certainly do so now in our pediatric intensive-care unit," she said.

Many hospitals are already doing just that. "I think it already has become standard clinical practice, because the idea of using Viagra for this is not new," Abman said. "What's new is that this is the first study to look at it with a nice protocol in which they randomized patients and controlled in a blinded way. So it verifies what we've already been doing in clinical practice."

Shekerdemian and her team are now conducting a similar study in the Royal Children's Hospital's Neonatal Intensive-Care Unit to see if Viagra can prevent rebound pulmonary hypertension in premature infants.


Viagra Helps COPD Patients Control Pulmonary Blood Pressure

The drug sildenafil, popularly known as Viagra, may help people with chronic obstructive pulmonary disease control the illness-related blood pressure spikes in the heart's pulmonary artery, a new study found.

The medication, in addition to its use as a popular treatment for impotence, has already been approved by the U.S. Food and Drug Administration for the treatment of the chronic version of such blood pressure spikes, known as pulmonary arterial hypertension (PAH). The drug has been marketed specifically for this purpose under the trade name Revatio. Another drug -- bosentan -- is also approved for similar purposes.

The new research suggests that sildenafil may help all chronic obstructive pulmonary disease (COPD) patients -- even those not diagnosed with full-blown PAH -- who experience potentially dangerous pulmonary arterial blood pressure increases both at rest and following exercise.

The research was led by Dr. Sebastiaan Holverda of the department of pulmonary medicine at VU University Medical Center in Amsterdam, the Netherlands. Holverda and his VU colleagues were to present their findings Wednesday at a Salt Lake City meeting organized by the journal Chest.

According to the American Lung Association, COPD is actually a catch-all for two lung diseases that often strike in tandem -- chronic bronchitis and emphysema. In both cases, airflow is obstructed, impeding normal breathing.

Smoking is the leading cause of COPD, responsible for between 80 percent and 90 percent of all cases in the United States. More than 11 million Americans are estimated to have the illness, and more than 122,000 die from it each year. Women appear to be slightly more at risk than men.

There's no known cure for the disease, and medications primarily take aim at symptom relief and slowing the progressive disability the illness brings.

Pulmonary hypertension -- the incurable condition of continuous high blood pressure in the pulmonary artery located in the right ventricle of the heart -- is one of many serious complications that can strike COPD patients. PAH causes the artery, which is responsible for delivering blood from the heart to the lungs, to work harder than normal. A weakening of the heart muscle can ensue over time, increasing the risk of heart failure and even death.

The Dutch researchers noted that pulmonary hypertension is typically mild to moderate among COPD patients but is particularly aggravated while exercising.

Faced with the combined COPD-PAH threat, the Dutch team explored the potential benefit of treating at-risk chronic obstructive pulmonary disease patients with sildenafil both while at rest and during exercise. The drug works by shifting the activity of an enzyme called phosphodiesterase, reducing arterial blood pressure by dilating the smooth muscle of blood vessels that line the lungs. As these vessels expand, blood flow increases, the researchers explained.

The study authors focused on 12 patients who had been diagnosed with chronic obstructive pulmonary disease and were suspected of having PAH. Throughout the study, right heart blood pressure was tracked among all 12 patients by inserting a thin plastic tube into the pulmonary artery -- a procedure known as cardiac catheterization. Cardiac blood pressure was measured at rest and just after all the patients cycled for three minutes.

Then, the study participants were given 50 milligrams of oral sildenafil; 45 minutes later, resting and post-exercise blood pressure readings were taken again.

Holverda and his colleagues found that half the patients had PAH. But, both non-PAH and PAH patients experienced significant cardiac blood pressure increases when exercising.

Sildenafil appeared to control such increases after exercise, reigning in pulmonary blood pressure to markedly lower levels -- higher than at rest, but lower than non-medicated post-exercise readings. And, the non-PAH patients appeared to experience pulmonary blood pressure reductions after taking the drug, both while resting and exercising.

The authors concluded that the drug may help COPD patients -- whether they have developed PAH or not -- quickly control their pulmonary blood pressure in some situations.

Dr. Bartolome R. Celli, chief of pulmonary care at St. Elizabeth's Medical Center in Boston, applauded the Dutch study but called for more research.

"Pulmonary arterial pressure -- when it is elevated -- is a poor prognostic sign and reducing its levels should be of help," he said. "However, more testing is needed to see if those changes in pulmonary arterial pressure are translated into better clinical outcomes and not into any unwanted side effects."


Dreams and Erections

The average male has four to eight spontaneous erections every night while he sleeps. They usually occur during the REM stage, when dreaming is most common.

When a doctor wants to know whether a patient's difficulty achieving an erection is due to physical or mental reasons, one way to find out is to fit the patient's penis with a sensor and see whether or not the patient's dream erections are working properly. If not, the problem is probably physical.

History of Viagra

Viagra was initially developed a heart condition called angina, during the testing period for this drug it was found to give an erection to men. The drug was patented in 1996, approved in 1998 making viagra the first official drug to treat erection problems and being made available for sale later that year. The success of this drug is over whelming. You can get viagra on perscription from your doctors or on numerous websites after consultation (a mere questionaire). The fact is, it has improved the sex lives of millions men and women around the world. Annual sales of Viagra in the period 1999 - 2001 exceeded .750,000,000.

It was first thought that Viagra would lead to a drop in the market for traditional remedies which came from specific body parts of endangered species. This is highly unlikely as the traditional remedies is a treatment not just for erectile dificinency e.g. the Rhinoceros horns are used for high fever. Further on it is unclear that natural remedies will be able to compete with Viagra, due to its aphrodisiac properties.

Since Viagra's release, there has been an increase in 'fake viargra' being sold on the interne which looks like viagra (blue diamond pill) will the companies name, Pfizer engraved on it. These have proven to be dangerous and you must be careful where you buy viagra. Check out our purchasing viagra guide.

Pfizer's worldwide patents on Viagra will expire in 2011 - 2013. The UK patent held by Pfizer on the use of Viagra as treatment of impotence has been invalidated in 2000 because of obviousness; this decision was upheld on appeal in 2002.


Viagra and the Mountains

Researchers Say the Drug May Help Performance at High Altitude, Help Soldiers Fight in Afghanistan

As the commercials continually remind us: Viagra is all about performance.
Now it turns out, that's not just referring to in the bedroom.
Researchers say the drug, approved for erectile dysfunction, could eventually help some athletes train at high altitudes and soldiers fight in the mountains of Afghanistan.
In a study at Stanford University, some volunteers riding stationary bicycles and breathing through masks to simulate the low oxygen conditions found at 12,700 feet, improved their times for six kilometers by an average of 39 percent after taking Viagra.
The drug, which became an instant blockbuster for Pfizer in 1998, works by causing blood vessels to relax - not only in the penis but in the lungs.
Last year, the company won approval for the drug, also known as sildenafil, to treat a medical condition called pulmonary hypertension, or high fluid pressure in the lungs. Pulmonary hypertension is also one of the effects of exercising in oxygen-poor environments such as high altitudes.
"It provides a pretty clear advantage to some people," said Annie Friedlander, the senior author of the study, which appears in the Journal of Applied Physiology.
It does not help everyone. Only four of the 10 riders saw their times improve - 10 minutes, 48 seconds with Viagra compared to 15 minutes when they took a placebo.
Researchers are not certain why only some volunteers responded to the drug, but they noticed that they were the ones whose times had suffered the most at high altitudes. Viagra, it seems, allowed them to make up the performance they had lost.
None of the riders saw any improvement from the drug at sea level, and none reported an erection during the trials.
The next step: The U.S. military plans to test Viagra, at high altitude, on about a dozen soldiers later this summer.


Women can benefit from Viagra

Viagra may help some women
Women can benefit from taking the impotence drug Viagra, scientists have claimed.

Research by a team from the University of Boston has found that the drug can benefit women who have had a hysterectomy or who have gone through the menopause.
In both cases, women experience a loss of production of female hormones that can lead to sexual problems, such as loss of sensation and lubrication.
Dr Jennifer Berman tested the drug on 17 women who had either had a hysterectomy or gone through the menopause.
Each woman got either Viagra or a dummy pill, and three months later the women who got Viagra were switched to a placebo and the women who had been given sugar pills got Viagra.
Dr Berman and the patients did not know which woman got which pill until the end of the study.
Viagra, whose technical name is sildenafil, works by increasing the effects of nitric oxide, a common body chemical, which in turn gets more blood flowing into the genitals.
Dr Berman, who will present her findings to a meeting of the American Urological Association, said: "Sildenafil did appear to significantly increase blood flow and pH and pH is an indicator of lubrication."
"Subjectively, with regard to lubrication, sensitivity, the ability to have orgasm, and satisfaction, the women noted a significant difference."

Emotional problems
Dr Berman has carried out another study at Boston University with 48 women, aged 22 to 71.
While not so carefully controlled - the women all got Viagra and knew it - there was a statistically significant difference.
She said: "It does appear to be Viagra because there are physiological changes that can't be faked."
However, Viagra failed to work for women in the second study who had psychological problems with sex.
These included poor body image, a history of sexual abuse, or marital trouble.
Dr Berman said: "Those women don't respond to Viagra or any drug.
"Although there are physiological, medical reasons why women have sexual complaints, there are emotional and relational consequences to sexual dysfunction that are relevant to women."
She added that it was more difficult to tell if a woman had sexual problems.
"While men can define their sexual function in terms of rigidity, for women it doesn't work that way," she said.
Pfizer, the manufacturers of Viagra, say that seven million prescriptions have been written for the drug worldwide since its launch last year.


Fast-acting Viagra spray developed

A spray could have a faster effect than a pill
Impotent men could benefit from Viagra in five to 10 minutes instead of up to an hour by taking the drug through the nose, researchers say.
They have developed a nasal spray form of the anti-impotence drug that they say works up to 12 times faster than the average pill.
They also said that the faster action would prevent users taking a double dose of the drug, which could lead to harmful side effects.

Nasal delivery
Professor Anwar Hussein, a researcher at the University of Kentucky College of Pharmacy, said he and Professor Lewis Dittert developed the nasal spray.
He said they have patented the technology and want to license it to Pfizer.
"Sometimes patients taking Viagra are embarrassed because they wait an hour or longer and still there's no effect, especially if they've taken the pill with meals," Professor Hussein.
Frustrated patients then sometimes take another pill in an attempt to speed the effect. This creates the risk of adverse side effects, Professor Hussein said.
Since Viagra went on the market last year, approximately 130 men have been reported to have died after taking it.

"The key" to the nasal spray "was to find how to make Viagra very water soluble so the dissolved drug can be used through the nose", Professor Hussein said.
They tested nasal drops in rats and found that it took effect "within five to 10 minutes", Professor Hussein said.
"Our version will be so quick and convenient to use and would definitely be more popular than the pills, which just take too long to work."
He said he wants Pfizer to take up the licence and start tests of the spray on humans.

But Pfizer, the company that makes Viagra, said that it had not received complaints about the drug's speed of action.
Andy Burrows, a spokesman for the company, said the researchers were operating entirely independently of the company.
He said the company had no plans to develop a faster working form of the drug.
Although Viagra's licence says that users should allow up to an hour for it to take effect, performance depended on the individual and could be as fast as 20 minutes, he said.
But the company was working on a wafer form which, although no faster than the pills, would be easier to ingest, he said.
"You have to compare what Viagra offers with what was on offer before. That is, an injection in the penis or a pellet that you have to stick into the urethra and massage for 10 minutes," he said.
"Then instantly you get the sexual stimulation no matter what, without the romantic side."
"With Viagra you may have to plan ahead a little bit but it creates a much more natural response than anything else that's around."
"You have to compare it with what there was before," he said.
He added that it was unusual but not unheard of for researchers to set to work on a company's product independently.
However, when it did happen, it was usually when the patent on a product was about to expire.
The UK government, which has placed a temporary ban on NHS prescription of Viagra, is due to announce guidelines on its use next week.


Viagra Improves Urinary Tract Symptoms In Men With Erectile Dysfunction

Viagra© (sildenafil citrate), known for improving erectile dysfunction (ED), also effectively treats the prostate and lower urinary tract symptoms (LUTS) associated with prostate enlargement that often occur with ED, a Northwestern University study has found.
Kevin V. McVary, M.D., professor of urology at Northwestern University Feinberg School of Medicine, led the study, which he presented at a meeting of the Sexual Medicine Society of North America on Nov. 21 in New York.
McVary and members of the clinical trial conducted the 12-week, double-blind, placebo (fake pill)-controlled study of Viagra in men aged 45 years and older who had ED and LUTS associated with benign prostatic hyperplasia (BPH), an enlargement of the prostate gland that causes an obstruction in the flow of urine through the urethra.
Study participants were assessed for changes in erectile function, self-esteem, LUTS associated with BPH, quality of life and maximum urinary flow rate. Results of the study showed that men who took Viagra (either at bedtime or 30 minutes to an hour before anticipated sexual activity) experienced a significant improvement in erectile function, self-esteem and quality of life, with a concomitant decrease in both the irritative and obstructive symptoms of BPH.
More than half of men over 40 years have difficulties getting or maintaining and erection. Over half of men 50 years and older have some sign of BPH. Research has shown that more than 70 percent of men with symptoms of BPH also have ED.
Results of this study have important implications with respect to the causes of concomitant prostate symptoms and ED.


Viagra improves sex for postmenopausal women

The findings come from a study led by Jennifer R. Berman, MD and Laura A. Berman PhD.
Pfizer Inc (maker of Viagra) funded the study which monitored 200 postmenopausal women with FSAD (female sexual arousal disorder).
100 women received Viagra while the other half were on a placebo. More women on Viagra (than the placebo) reported better sexual (more sexual) satisfaction. Some of the women on the placebo also reported an improvement (lower number than those on Viagra).
All the women who had hypoactive sexual desire disorder (HSDD) as well as FSAD reported no improvement at all.
The most common problem for women with FSAD is genital blood flow (which Viagra seems to be able to help). Women with HSDD have underlying emotional or relationship problems which lead to a reduction in sexual desire.
'Unresolved emotional or relational issues should be addressed before beginning medical therapies,' Berman her colleagues said (December issue of The Journal of Urology).
Those in the study included women who were postmenopausal (or had had a hysterectomy), aged from 30-71 (average age 51).
Two questions (asked after the women had taken the Viagra of Placebo) the team focussed on were:
1. After taking the study medication, the sensation/feeling in my genital (vagina, labia, clitoris) area during intercourse or stimulation seemed to be: (a) more than before, (b) less than before, or (c) unchanged.
2. After taking the study medication, intercourse and/or foreplay was (a) pleasant and satisfying; better than before taking the study medication; (b) unpleasant; worse than before the study medication; (c) unchanged; no difference; or (d) pleasant but still not like it used to be or I would like it to be.

Regarding Question 1 the results were:
Placebo patients: 44% reported an improvement
Viagra Patients: 57% reported an improvement

Regarding Question 2 the results were:
Placebo patients: 26% reported an improvement
Viagra patients: 42% reported an improvement

However, of the patients (on Viagra) with sexual arousal disorder who did not have HSDD 68% reported an improvement on the first question (eight times more than women without HSDD who were on the placebo).
In addition, of the patients (on Viagra) with sexual arousal disorder who did not have HSDD, 50% said there was an improvement in question 2 (11 times more than the non-HSDD women on the placebo).
The authors also said that women who respond to Viagra may need to have normal levels of oestrogen and testosterone. For many postmenopausal women, that may mean menopausal replacement therapy. In the present study, the women had normal hormone levels or were receiving menopausal replacement therapy.


Cialis aids prostate cancer sex function

ROTTERDAM, Netherlands, Oct. 2 (UPI) -- Dutch scientists say they have found a drug usually prescribed for erectile dysfunction in men increases the sexual function of prostate cancer survivors.
Prostate cancer is the most commonly diagnosed cancer in men. But after treatment, some patients report trouble achieving an erection sufficient for sexual activity -- a medical condition called erectile dysfunction or ED. In the Dutch study, physicians wanted to test whether the drug Tadalafil, which sells under the brand name Cialis, would help prostate cancer survivors with ED who were treated with three-dimensional conformal radiation therapy.
In what is believed the first randomized trial of its type, successful intercourse was reported in 48 percent of the survivors who took Tadalafil versus 9 percent of the men who were given placebo. There was also a reported improvement of the quality of erections in 67 percent of the patients, versus 20 percent of the placebo group.
The research conducted at the Erasmus MC-Daniel den Hoed Cancer Center in Rotterdam is detailed in the International Journal of Radiation Oncology Biology Physics.


Viagra may treat 'cold hands' syndrome

Study: Erectile dysfunction drug relieves symptoms of Raynaud's
Little Blue Pill May Put Brakes on Some Heart Disease
Many men use Viagra (sildenafil) to speed up their sex lives. Now it seems that if some research pans out the little blue pill may also wind up slowing down some forms of heart disease.

NEW YORK - Viagra (sildenafil) relieves the symptoms and improves the circulation of patients with Raynaud's phenomenon that does no response to conventional therapy, German investigators report. In patients with ulcers on their fingers or toes, the treatment leads to healing.
Viagra, developed to treat of male erectile dysfunction, is a phosphodiesterase (PDE)-5 inhibitor that affects very small blood vessels. Studies have shown it improves circulation in other conditions, such as coronary artery disease.
Raynaud's phenomenon is characterized by spasms in the small blood vessels of the hands and feet in response to cold or stress, resulting in poor circulation and pain. The disorder can also lead to ulceration or tissue death in the toes and fingers.


Raising the issue of Viagra costs- who should pay?

Imagine a new drug that could restore some lost physical ability, at least for a few hours. Then imagine that this new drug costs $10 a dose, and could be used by millions of people. Viagra fits this description, of course, and its magic is to restore virility to impotent men-albeit for a few hours at a time. Viagra is predicted to be a billion-dollar seller for Pfizer in its first year of sales, and that means someone is paying for all those $10 pills.
Some managed care companies have announced that they will not pay for Viagra based on its high cost, but it is hard to imagine them making a similar decision about an equally expensive drug that cured a specific type of cancer or reversed paralysis. Would there be hesitation to cover a drug that would restore the use of paraplegics' legs, even if each pill cost $10 and its effects diminished after a few hours? No doubt we would consider it a miracle and a bargain. So why not Viagra?

Who needs lifestyle drugs?
Part of the motivation for denying payment for Viagra is the perception that it doesn't cure or even treat illness or disease, and that the functions it temporarily restores are not life-threatening or critical enough for it to make sense to pay for it. Since the group of patients who could use Viagra are a fast growing part of the male population (as our population ages), managed care companies see it as a bank breaker. A pill to temporarily "cure" paralysis would be a miracle to those who would use it, but their numbers would be thankfully small. That Viagra is beneficial for so many men is exactly why payers are reluctant to cover it.
The future will likely offer many new drugs like Viagra: expensive drugs that have lifestyle benefits without actually curing an illness or disease. We might be comfortable drawing a line between paying for curative treatments and those that are "cosmetic," and asking individuals to pay for cosmetic treatments themselves. So is Viagra cosmetic, curative, or both?

Paying for lifestyle treatments
Fertility treatments like in-vitro fertilization (IVF) are not usually covered by insurance because it is considered medically unnecessary. But it improves life in a way that restores a normal function- offering some infertile women the possibility of having a child. Neither Viagra nor IVF are like cosmetic surgery, but both can be used in a "cosmetic" way by people who don't have a medical need for them: IVF for women who want to select specific traits for their children, and Viagra for men who think it will add vitality to their sex lives.
The difference between using drugs or treatments for medical reasons and cosmetic purposes offers a way to decide which deserve coverage. We should feel even less worried about denying coverage for cosmetic uses when the drug is affordable to most everybody.

Protecting access in the future
As we live longer and healthier lives, our health care needs will become more about treating chronic effects to our health, such as Alzheimer's disease or impotence, than about treatments for heart attacks in middle age. It is important that we protect our access to drugs and treatments that improve our health by protecting normal functions. The key will be determining what counts as normal, and when the same treatments are merely enhancements. The case of Viagra represents only the beginning of what will be more difficult decisions about who pays for the promising treatments of the future.


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