Comparative study of blood insulin levels in breast and endometrialV.B. GAMAYUNOVA, YU. F. BOBROV, E. V. TSYRLINA, T. P. EVTUSHENKO, L. M. BERSTEIN*Laboratory of Endocrinology, Prof. N.N. Petrov Research Institute of Oncology, 189 646 St.Petersburg, RussiaBlood insulin level was measured in 113 breast cancer (BC) patients, 18 endometrial cancer (EC) patients, and 35 womenwith benign breast dis
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Viagra, the phenomenonViagra, The Phenomenon
Published in the Independent 27th May 1998
We didn’t wait for Bob Dole to say Viagra had put new life into his erection campaign. As soon as we heard American men were queuing to fill their Viagra prescriptions, the effect in this country was instantaneous. Computer pros scoured the Internet. Harley Street was besieged. The Impotence Association recorded a 600 per cent increase in calls to the Helpline in the first week of May alone. The Director Ann Craig has asked the Trustees to fund additional phonelines. This virility frenzy had a single purpose. To secure a supply of a new drug which probably won’t receive a UK product licence and be available on the NHS until next September. Why has Sildenafil citrate (Viagra) roused such a universal nerve among men? It’s not as if the world has been starved of effective impotence remedies. Products like Caverject and Erecnos have been providing us with hands-free erections for years. Just recently, MUSE came out – or rather was put in – as men started inserting little potency pellets into their penile ends. In fact, doctors and drug companies have had impotence under control for a decade. They now know that 75 per cent of all impotence among the estimated 2.3 million UK sufferers has an organic basis. Since the early 90s, even psychological treatments have managed to take this into account. Viagra, it turns out, delivers less instantaneous results than some rival products. Caverject will give you an erection whether you like it or not. Viagra still requires you to get turned on. Not only that, you have to premeditate your usage which means answering the phone or prolonging foreplay meanwhile. Partners new or old have time to grow suspicious. So unless we’re looking at the greatest marketing con in history, this Niagara of enquiries has been stimulated by the only undisputed difference to which Viagra can lay claim – its oral delivery system. This is the view expressed by Dr Alan J Riley, Chairman of the Impotence Association: “Because it’s oral, because it’s easy to take, men will take it”. But my own practice with impotent patients would suggest something slightly more complex is happening. What, for instance, is so wrong – or unmanly – about the alternative delivery systems? Caverject comes with its own neat, disposable syringes. I discussed this with one chap who said that if I thought he was the sort of casualty who had to stick a needle in his prick (or vice versa) then I was the one who needed help. I got the same pointed reply about MUSE.
The torrent of enquiries for Viagra is almost over-revealing. Not only does it show that we have, as suspected, a very large impotence problem in the UK and that men will probably resist any pick-me-up that seems to them “un-masculine”. It also seems to indicate the presence of a pent-up desire among men to regain their sexual confidence – perhaps battered by 90s media taunts that they don’t work in or out of bed with high divorce rates and low sperm counts.
Viagra for anxiety then? While interviewing last month for an article on male sexual insecurity for Woman’s Journal I came across one investment manager who talked of laying in a supply of Viagra even though his marriage is free of sexual difficulties: “As a bloke”, he said, “it’s always good to know you’ve got back-up”. On the other hand, some cases could never be helped: “Having heard nothing all week except about the wondrous powers of Viagra, I am for the first time in my life almost off sex. What the hell is the use of trying for a good performance now that everyone and their uncle has become Don Giovanni?” (Taki, The Spectator).
Clinical course of sepsis in children with acute leukemia admitted to the pediatric intensive care unit
Clinical course of sepsis in children with acute leukemia admitted to the pediatric intensive care unit* Kanakadurga Singer, MD, MA; Perla Subbaiah, PhD; Raymond Hutchinson, MD;Folafoluwa Odetola, MD, MPH; Thomas P. Shanley, MD Objective: To describe the clinical course, resource use, and inotropic and/or vasopressor drugs ( p ؍ .01), and renal replace- mortality of patients wi