Erectile dysfunction (ED) can be defined as the inability of a man to achieve or maintain an erection sufficient to introduce penis into the vagina and perform satisfactory sexual intercourse. The frequency of erectile dysfunction varies depending on age. If in the age group of 20 to 40 years it is met at average in 3%, then at the age of 40 to 60 years it occurs in 15 – 20% of men. At the age of more than 70 years, erectile dysfunction symptoms can disturb up to 30% of men. At any age, erectile dysfunction is not normal, because the ability to lead regular and satisfactory sex life is one of the inalienable functions of men of any age.
Habit is something that person repeats with a certain periodicity, not always realizing why he does it. Bad habits traditionally include smoking, alcohol and drug addiction. To determine exact line between addiction and periodic use is sometimes very difficult. Imagine that before you there is a choice – either to lose your favorite habit (to drink, smoke, etc.) or permanently lose potency and orgasm.
It seems that many will choose the first, assessing for themselves importance and significance of the second. The question is, why do we arbitrarily deprive ourselves of pleasure of being a man? We constantly harm our already battered body? And after discovering obvious signs of the disorder, we are not being treated, we ignore problem, believing that everything will disappear by itself. Such arrogance leads to the fact that a man loses almost the most valuable quality for him.
Chronic Obstructive Pulmonary Disease (COPD) Definition
According to Canadian Health&Care Mall chronic obstructive pulmonary disease (COPD) is an independent progressive disease that is characterized by not only inflammatory component, but also structural changes in pulmonary vessels and tissue. In addition, it should be mentioned about serious bronchial obstruction violations. This obstruction is localized in distal bronchial area. This disease is separated from a number of typical chronic processes of not unimportant respiratory system. It is proved that chronic obstructive pulmonary disease most often affects men over 40 years. It takes major position among disability causes. Moreover, there is a high risk of mortality even among working-age population. COPD life expectancy depends on disease severity and patients lifestyle. At increased bronchial mucus production and its viscosity, most favorable conditions for rapid bacteria growth are created. In this case bronchial tubes patency is violated, lung tissue and alveoli change. Disease progression leads to bronchial mucosa swelling, mucus secretion and smooth muscles spasms. Often COPD is accompanied by bacterial complications and pulmonary infections relapses. It happens that chronic obstructive pulmonary disease is greatly exacerbated by severe gas exchange disorders that manifest in significant oxygen decrease in blood and high blood pressure. Such COPD exacerbation provokes circulatory insufficiency, which causes death in about 30% of patients with this diagnosis.
COPD Causes and Risk Factors
There were carried out many researches and surveys to distinguish what causes COPD. The main reason is considered to be smoking. Among other factors chronic obstructive pulmonary disease development and exacerbation causes include respiratory infections in childhood, industrial hazards, associated bronchopulmonary disease, as well as poor ecology. In a small number of patients, the disease is based on genetic predisposition that is expressed in alpha-1-antitrypsin protein deficiency. It is formed in liver tissues, protecting lungs from serious damage. According to Canadian Health&Care Mall statistics, as a rule, chronic obstructive pulmonary disease is considered an occupational disease of many railway workers, miners, constructors, and workers who contact with cement. Often, the disease occurs at metallurgical and pulp and paper industry specialist. Genetic predisposition and environmental factors cause bronchial inner membrane inflammation of chronic nature, which significantly reduces local immunity.
Fluticasone and salmeterol are considered to be active constituents of preparation known as Advair Diskus Canada>. Fluticasone is an ingredient which prevents the distribution of substances causing inflammation. The role of bronchodilator is played by salmeterol. Its main function is to relax the tensioned airways to enhance the breathing patten.
Advair Diskus Canada is utilized to prevail asthma attacks appearance and arrest them. Advair Diskus Canada as other preparations is recommended as well as the treatment of chronic obstructive pulmonary disease or COPD. COPD includes in itself such diseases as bronchitis, emphysema and sometimes pneumonia. Such a preparation is prescribed for adults and children over four years old and may be ordered via Canadian Health&Care Mall.
Bronchial asthma is the chronic inflammatory respiratory disease which is shown by short breathing attacks which are often followed by cough and can develop into asthma attacks. It occurs because airways excessively react to different irritants. In response to irritation they are narrowed and develop a large amount of slime that breaks normal current of air at breath.
Bronchial asthma occurs at people of all age, however most often it is shown at children — a half of them “outgrows” then the illness. Now more than 300 million people in the world have this disease and their number constantly increases.
How Is It Shown?
The most characteristic symptoms of bronchial asthma are:
- cough which can be frequent, painful and constant. Cough can worsen at night, after physical effort, after inhalation of cold air;
- expiratory (with primary difficulty of an exhalation) short breathing — breath can be so limited that it causes fear of impossibility to exhale;
- the whistling rattles, audible at distance are caused by vibration of air with a force passing through the narrowed airways.
At heavy or acute bronchial asthma people during an attack breathe through the mouth, using for breath simplification the narrowed airways muscles of shoulders, necks and trunks. Besides, when airways are narrowed, it is easier to inhale, than to exhale. It happens because a breath is considered to be a procedure habitual for our organism, and muscles of breast are trained on this movement.
The exhalation, on the contrary, normally occurs passively, i.e. without special efforts therefore muscles are insufficiently developed for removal of air through the narrowed airways. As a result of it in lungs there is an air, and they become exaggerated. It is a known fact that asthma is a dangerous disorder but there are cases when you need the immediate help. In the majority of cases preparations for asthma treatment namely inhalers, bronchodilators are too expensive but Canadian Health&Care Mall offers you Advair Diskus to prevent asthma attacks development.
By the way, at young people, long time having asthma, it is developed the so-called “pigeon breast”. At heavy acute bronchial asthma, earlier “whistling” thorax, can becomes “mute”, without whistle sounds. It occurs because the amount of the inhaled and exhaled air isn’t enough that sounds can’t be heard.
The results of this study suggest that ambulatory oxygen therapy does not in the short term increase domestic activity or time spent outside the home. However, the gradual increase in oxygen cylinder usage suggests that there is an unrecognized benefit from ambulatory oxygen that may take some time to become evident. Also, there was no difference in health status between before and after intervention for either group.
Physical activity monitors represent an opportunity to examine domestic activity directly and can be used as an outcome for therapeutic intervention. They are unobtrusive, practical to administer, and specific about the type, frequency, and duration and intensity of physical activity. We have reported data using activity monitors as an outcome measure for rehabilitation. Results from this study show a trend for an increase in domestic activity after intervention with cylinder oxygen, while domestic activity declined with cylinder air. It is possible that the weight of the cylinder had a negative effect on domestic activity in those patients with cylinder air, thereby preventing them from being as active as usual. McDonald et al concluded that the negative effect of the weight of the cylinder excluded any benefit of oxygen when comparing cylinder air to oxygen at home. In our study, patients had completed 7-week pulmonary rehabilitation programs prior to the intervention; thus, they had maximum therapeutic intervention before they started the study. This should perhaps favor the maintenance of physical activity rather than an improvement. These patients may have been a highly motivated group who may not notice any significant improvements in physical activity or health-related quality of life (HRQL) because not least they may have reached their maximum capability. This may also be why we were unable to document any improvement in the ISWT and ESWT results after intervention.
Fifty-two patients were initially screened, and the study profile is shown in Figure 1. Forty-two patients completed all walk tests. Twelve patients withdrew after the initial walk tests. Thirty patients were randomized to the 8-week home study, during which 9 patients withdrew and 1 patient died. The main reasons why patients withdrew from the study include having an exacerbation and the weight and lack of esthetics of the cylinder. One patient withdrew because he believed there was no additional benefit in using the cylinder. Tables 1, 2 show the baseline characteristics of the patients who completed the study. There were no differences between those using oxygen and those using air cylinders except for vital capacity and inspiratory capacity [p < 0.05].
Field Walking Tests
Performance of the ISWT and the ESWT before and after intervention are presented in Tables 3, 4.
There was no significant improvement in any of the additional outcome measures employed with the ISWT and the ESWT at the end of the study period (p > 0.05).
Clinically stable patients with COPD (FEV1 < 50% of predicted) were entered into a randomized, double-blinded, placebo-controlled trial of cylinder oxygen vs cylinder air. Patients had completed a 7-week pulmonary rehabilitation program prior to the study to maximize physical function.
Inclusion criteria were patients who were hypoxic at rest, were receiving LTOT, or demonstrated exercise-induced desaturation. The latter was accepted as arterial oxygen desaturation > 4% below 90% on a standard walking test. Patients had a confirmed diagnosis of COPD with significant disability (Medical Research Council dyspnea > 3, the upper limit being 5), were no longer smoking, and were clinically stable. None of the patients had ambulatory oxygen cylinders at home prior to participating in the study.
Ambulatory oxygen is delivered by equipment that can be carried by patients during exercise and activities of daily living. To date, the benefits of ambulatory oxygen in COPD remain uncertain and concordance with therapy is poor. Little is known about how patients with COPD use ambulatory oxygen for activities of daily living or make use of it outside the home. Relatively few patients use ambulatory oxygen outside the home, and only 50% of patients may use ambulatory oxygen more than five times a week. British Thoracic Society guidelines recommend that levels of outside activity in patients with COPD need to be determined before prescribing ambulatory oxygen.
In the United Kingdom, ambulatory oxygen therapy is issued for patients receiving long-term oxygen therapy (LTOT) who are mobile and want to leave their home, or to those who do not fulfil the criteria for prescription of LTOT but show evidence of oxygen desaturation on exercise. Not all patients receiving LTOT will be suitable for ambulatory oxygen; these may already be housebound and unable to leave the house unaided and only require short periods of portable oxygen.
We reviewed a series of 17 consecutive patients demonstrated to have persistent pulmonary hypertension after acute massive, submassive, or recurrent PE between January 2005 and July 2006. None of these patients had significant cardiopulmonary disease or evidence of malignancy at the time of diagnosis of PE and thereafter. All patients remained on warfarin or low-molec-ular-weight heparin (LMWH) since their last episode of PE. The study was performed retrospectively after approval by the Toronto Academic Health Sciences Network (http://www.tahsn.ca/) Institutional Research Ethics Board.
Two patients presented with acute massive and submassive PE during the same time period but had normalization of their pulmonary artery pressures on echocardiography at 3 months follow-up and were therefore not included in this study. Six patients presented with acute submassive PE while undergoing chemotherapy or radiation therapy for malignancy and were therefore also excluded from the study.
Sinusitis is an infection or inflammation of air sinus and cavities up and below eyes. Sinusitis is a very spread disorder which can be observed in people of different ages worldwide. Sinusitis is frequently damages frontal sinus, maxillary sinus, paranasal sinus, moreover ethmoidal sinuses and sphenoidal sinus. Bacterial infection, as a consequence of viral infection, is an agent of sinusitis. Sinusitis can be caused by such bacterial infections as pneumococcus, streptococcus, staphylococcus.