HomeNews

Senate Dems propose comprehensive health reform bill

9 Jun, 2009

WASHINGTON (CNN) -- The national debate on health care entered a new arena Tuesday, with Senate Democrats proposing a comprehensive bill that will launch a heated congressional battle to determine if America adopts universal coverage.

Democrats hope to pass health care reform legislation this year.

Sen. Christopher Dodd, D-Connecticut, told a news conference the bill to be released later in the day was the first step in addressing the nation's ailing health care system. Also Tuesday, House Democrats were expected to release their general outline for legislation.

Dodd cited a litany of problems -- 47 million Americans uninsured, excessive costs, unequal services -- that make the issue one of President Obama's top domestic priorities.

"This is the only bill I know of ... where every single one of our citizens will be affected by what we do" for years to come, Dodd said.

The main question is whether Obama and congressional Democrats will be able to include a so-called "national option" of government-funded health care to compete with existing programs. Republican leaders oppose such a move, calling it the first step to a government-run system.

Unlike previous attempts to address the complex and thorny issue, this year's health care debate includes acknowledgment by major players such as the insurance industry that reform is needed for the system.

"Candidly, we've got a lot more people at the table who want this done," Dodd said.

He addressed concerns raised by Republicans, saying that the Democratic proposal would maintain the ability of Americans to choose their coverage and doctors.

"If you like what you've got, you get to keep it," he said. "We're not changing that."

Dodd also said the proposal contains gaps on some contentious issues, including the specifics of a government-run option, so that Republicans can offer alternatives. Video Watch more on the health care debate »

"My fervent hope is ... to get a bipartisan bill," said Dodd, who is leading the Senate Democratic effort in place of ailing colleague Sen. Edward Kennedy, D-Massachusetts, a longtime champion of health care reform who provided the initial draft of the new bill.

On Tuesday, Obama deployed his health czar Monday to brief state Democratic Party leaders, operatives and activists on the White House's strategy to pass health care reform this year, a party source tells CNN.

Nancy-Ann DeParle's conference call with Democratic state party chairs, senior state political aides and health care activists follows Organizing for America's campaign-style house parties, held this past weekend to help build support for health care reform from the grassroots level. DeParle serves as counselor to the president and director of the White House Office of Health Reform.

Obama himself called on Congress this past weekend to send him a health care bill by October.

"We are building off of the 50-state strategy and making sure we are able to use the state parties as an effective tool, in addition to President Obama's grassroots network, Organizing for America, to advance the president's agenda," said a source familiar with the details of the call, who spoke on the condition of anonymity.

On Monday, key negotiators broke up a session still stuck on whether to create a government-run plan to compete with private insurers. Obama is pushing hard for such an option, saying it would help consumers and keep costs down.

Critics say a government-sponsored option could drive out private insurers and potentially lower the quality of health care. Some fear that such a program would hurt those who have a plan they like, because employers would opt for the government program if it were less expensive.

"A public plan is a nonstarter," Sen. Orrin Hatch, R-Utah, said Monday. "They're trying to come up with various ways to have a public plan without calling it that."

In the House, an outline for possible legislation includes creating a public government-run insurance plan to compete with private insurers, along with a new mandate on all individuals to carry health insurance, according to a senior Democratic congressional source familiar with it.

Obama has urged lawmakers to come together on health care, warning that fixing the system is "a necessity we cannot postpone any longer." advertisement

On Tuesday, leaders of the House minority caucuses called for steps to end disparities in U.S. health care that lead to higher incidences of diseases such as diabetes among some minority populations. They cited lack of universal coverage and access to facilities in minority communities as major problems.

"If there's no public health option in the health care debate, there will be a lot of resistance," said Rep. Mike Honda, D-California, chairman of the Congressional Asian Pacific American Caucus.

http://www.cnn.com/2009/POLITICS/06/09/health.care.debate/

Erectile Dysfunction

22 Apr, 2009

Erectile dysfunction, sometimes called "impotence," is the repeated inability to get or keep an erection firm enough for sexual intercourse. The word "impotence" may also be used to describe other problems that interfere with sexual intercourse and reproduction, such as lack of sexual desire and problems with ejaculation or orgasm. Using the term erectile dysfunction makes it clear that those other problems are not involved.

Erectile dysfunction, or ED, can be a total inability to achieve erection, an inconsistent ability to do so, or a tendency to sustain only brief erections. These variations make defining ED and estimating its incidence difficult. Estimates range from 15 million to 30 million, depending on the definition used. According to the National Ambulatory Medical Care Survey (NAMCS), for every 1,000 men in the United States, 7.7 physician office visits were made for ED in 1985. By 1999, that rate had nearly tripled to 22.3. The increase happened gradually, presumably as treatments such as vacuum devices and injectable drugs became more widely available and discussing erectile function became accepted. Perhaps the most publicized advance was the introduction of the oral drug sildenafil citrate (Viagra) in March 1998. NAMCS data on new drugs show an estimated 2.6 million mentions of Viagra at physician office visits in 1999, and one-third of those mentions occurred during visits for a diagnosis other than ED.

In older men, ED usually has a physical cause, such as disease, injury, or side effects of drugs. Any disorder that causes injury to the nerves or impairs blood flow in the penis has the potential to cause ED. Incidence increases with age: About 5 percent of 40-year-old men and between 15 and 25 percent of 65-year-old men experience ED. But it is not an inevitable part of aging.

ED is treatable at any age, and awareness of this fact has been growing. More men have been seeking help and returning to normal sexual activity because of improved, successful treatments for ED. Urologists, who specialize in problems of the urinary tract, have traditionally treated ED; however, urologists accounted for only 25 percent of Viagra mentions in 1999.

http://kidney.niddk.nih.gov/kudiseases/pubs/impotence/

Viagra Helps COPD Patients Control Pulmonary Blood Pressure

25 Oct, 2007

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."

http://www.nlm.nih.gov/medlineplus/news/fullstory_40520.html

Viagra and the Mountains

15 Apr, 2007

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.

http://abcnews.go.com/Health/story?id=2111548

Women can benefit from Viagra

10 Apr, 2007

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.

http://news.bbc.co.uk/1/hi/special_report/1998/viagra/default.stm