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News - Viagra-for-votes lawmaker sacked

A member of the Brazilian Congress has been forced out of office after being found guilty of distributing Viagra tablets to buy voters’ loyalty.

Antonio Jose de Moraes Souza, who represented the state of Piaui, was stripped of his mandate by an electoral court and fined $7,000 (4,000).

The court heard that the anti-impotency drug and other medicines were handed out by a doctor at a political rally.

The doctor was wearing a T-shirt and cap bearing the candidate’s name.

The court ordered the second-placed candidate, Themistocles Sampaio Pereira, to take Souza’s place in the lower house of Congress, the Chamber of Deputies.

Viagra seized

The charges came after police arrested the doctor, Araao Cruz Mendes, at a campaign rally in the north-eastern town of Beneditinos in August 2002.

They also seized 400 boxes of medicines, including Viagra, which the court heard were being distributed on Souza’s behalf in exchange for promises of votes.

In the hearing at the Regional Electoral Court in Piaui state on Monday, Souza was found guilty by four votes to one of vote-buying.

A spokesman for Souza said he would appeal against the decision.

Correspondents say vote-buying remains common in the impoverished north-eastern region of Brazil.

Politicians have been known to offer inducements ranging from food to minor medical procedures to gain voters’ support.

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News - Viagra rival from African tree

The root of a South African tree traditionally used to boost male potency could form the basis of a new drug.

Scientists believe they have found the active ingredient of the violet tree, and have applied for patents.

For centuries, the root of the tree has been chewed by South Africans suffering from erectile dysfunction.

Some of the profits from any drug could find their way back to the traditional healers who “prescribe” it.

The violet tree is found not only in northern South Africa, but also in other African countries.

Dr Marion Meyer, head of the botany department at the University of Pretoria, told a South African news agency that chemicals extracted from the root had been tested in the laboratory.

When it was added to samples of “smooth muscle” - the type of tissue found in the penis, the muscle relaxed to allow more blood to flow into it.

This suggests there is a possibility it could offer an alternative to exisiting drugs Viagra and Levitra, which also work by increasing blood flow into the penis.

Blockbuster drugs

Dr Meyer said that traditional healers would benefit should a drug based on the violet tree ever be registered.

“They are pleased to be getting recognition for something they have been using for centuries.”

Viagra has proved to be one of the most successful drugs in recent pharmaceutical history, earning millions for maker Pfizer.

However, the violet tree will not be competing with it for a while, as it will be at least three years before human trials of the extract can start, and another two years before a drug could be launched.

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News - Washington diary: Body shock

By sheer coincidence my medical issues started as soon as I landed in the US four years ago.

Only 48 hours after getting off the plane in Washington I was seized by numbing pain in my upper jaw and rushed to a smart dental clinic near the White House.

I pointed to a throbbing molar and was puzzled to find the unusually monosyllabic nurse taking an X-ray of every single tooth in my mouth with quiet and unflinching determination.

She returned half an hour later with the maestro of the clinic who pinned 36 or so stamp sized X-rays on a back-lit board as if they were part of an avant-garde art project and then gave a PowerPoint presentation entitled something like “My vision for your mouth”.

“What about the tooth that hurts?” I asked innocently.

“Thas juss the beginning,” said Dr Harrison, a southern gent with a pencil-thin moustache arching over a blindingly white smile.

“We are gonna work together for three years to get everything in perfect order! An I promise, I won’t have to see ya more than once a month.”

The health industry had officially declared me fair game, easy prey

When the doctor had exited in a swoosh of fluttering white to “work with” the next patient, the nurse leant over as if in deep confidence and added: “You are SOOO lucky to be working with Dr Harrison! He is the beeeast!”, making “best” sound like “beast”.

I never returned after my root canal operation. I chose to become a dental fugitive, hounded every six weeks by increasingly urgent letters reminding me of the doctor’s vision and my empty promises. I am certain that my mouth is on a blacklist somewhere.

Flatulent joints

Two months later the next chapter of bodily woes was opened. One day, out of the blue, without warning and for no apparent reason, my neck felt as if I had survived a garrotting.

I ventured into the hitherto unknown world of chiropractors.

You can run but you can’t hide from the surgeon’s knife

Dr Schweinstein X-rayed everything above my shoulders and explained to me that - among other things - I had too much gas in my joints, which is why I would soon hear a flatulent noise as he took my neck into a half nelson.

As I contemplated the notion of farting joints, the chiropractor’s fleshy hands fastened around my head, yanking it left and then right as if I was an extra in some martial arts movie. I heard the advertised noise and felt instantly better as the pain seeped away.

“Thank you, Dr Schweinstein,” I said with genuine relief and admiration for the healing profession. “That will be it then?” I added for good measure, heading for the door.

The doctor fixed me with watery blue eyes.

“Actually,” he intoned with a flat, yet authoritative voice, “this is just the prologue, you might say. What I have in mind for you is a two-year programme… a standard course of chiro-therapy to get your neck back in shape. The good news is: shouldn’t need you here more than once a week! Your insurance should cover some, if not most of it.”

The cost of this healing process to the uninsured would have been $150 a week. I wondered how the estimated 50m Americans who have no private medical insurance cope. They don’t, of course.

But they weren’t on my mind at this stage. I was planning another getaway. A fugitive from medicine… twice over.

Midlife crisis

Four months later I was reading the New York Times and my then seven-year-old son asked me: “Dad, why are you holding the newspaper like that?”

“Like what?”

“Like that… so far!” he said and stretched his little arms straight out.

Perfect vision - just in one’s dreams

I hadn’t even noticed how my reading arm had got longer and longer.

So my eyes were next. At least the optician was a “walk-in”.
No appointments, no waiting room, no dog-eared copies of last month’s Time Magazine and Yachting Monthly.

The verdict: long sighted.

“Why?” I asked the optician, whose name escapes me. “I have always had perfect vision!”

His nose crinkled and I knew I should have kept my mouth shut. No optician believes in perfect vision. It’s presumptuous and it’s not good for business.

“How old are you?” he asked.

“Forty-one,” I replied.

“Ahhhhh,” he said in a voice oozing pity, understanding and wisdom all coated in glee. “It’s the age.”

And with those three words my midlife crisis started.

The healthcare industry had officially declared me fair game, easy prey, a rich seam of never-ending profits.

I had hit rock bottom. What could be next?

I left the opticians and stumbled, diminished, into the glare of a Washington summer’s day.

I walked down the road fingering my new glasses - frames so sleek, lenses so petite they were almost invisible - almost - when I felt my Blackberry buzz to life in my trouser pocket.

I put on my new specs clumsily, half enjoying this pompous new prop, and allowed them to slide professorially to the tip of my nose. I glanced down at the tiny screen. It was a joy to see so clearly.

An e-mail flashed up from someone called Kevin. I assumed it was work and clicked to open.

“Need Viagra, Cialis, Levitra?” Kevin asked. “We can help! You can perform!” It wasn’t the Kevin I thought it was.

Metatarsal hell

I had hit rock-bottom. What could possibly be next? A few months later I got the answer: my feet.

I have always had feet so wide they defied even the most comfy Hush Puppies. To me, Birkenstocks felt like winkle-pickers.

Fellow bunion sufferer Victoria Beckham opts for sensible boots

The pain was beginning to make me hobble and I was about to learn a new word: podiatry.

My podiatrist, a tower of a man who wears disconcertingly orange clogs with his blue surgical jump suit, eased me into the wonderful world of podiatry.

“No surgery, yet, Matt. Foot surgery is a serious business… we’ll give you some orthotics first.”

These specially moulded soles were the most expensive shoes I have ever bought and they didn’t work. Six months later the pain was so bad that I had to go under the knife.

I would like to say that I have joined the hallowed order of the broken metatarsal, just in time for the World Cup.

Rooney, Beckham, Owen, Frei… even if I was nursing MY metatarsal on the sofa watching them test theirs on the pitch. But unfortunately I shared my pain with the other Beckham, not David, Victoria.

And it wasn’t the metatarsal per se… it was metatarsal-related. I am talking about an excrescence of the bone resulting in a serious realignment of the toes. I am talking about a… bunion.

Posh Spice has one, a whopper that sticks out of her golden lace thong sandals like a raw pink golf ball. And I have two. One on each foot.

Hobbling hordes

“Bunion?” Isn’t that what women get for wearing the wrong shoes?” a friend asked. True.

About 50% of American women get bunions, a statistic that didn’t make me feel any better. I owe mine to my mother. Yes, they are hereditary and no, I have never worn stilettos.

“Bunion?” I asked the doctor. “Is there no fancier word? Something in Latin perhaps. Something complicated, more interesting?”

“Well, bunion is the ancient Greek word for turnip. Does that help?” the doctor with the orange clogs asked. (*)

No, it didn’t.

The worst thing is that the surgery necessary to remove a “turnip” is long, complicated, painful and could end in failure.

It involves hobbling around for eight weeks with a surgical boot that could have been invented by a workshop of medieval torturers on attachment to the Ministry of Funny Walks.

I hit my low point last week. I was waiting in the surgery for my post operation check-up.

I was surrounded by middle-aged women wearing the same boot. My fellow patients. The hobbling regiment of hop-alongs.

A lady with a magenta rinse turned to me and said: “Honey, I feel so sorry for you. You are the wrong age and the wrong gender to have a bunionectomy!”

She recommended I check out an internet talk show called Life Beyond Bunions. I didn’t know whether to feel flattered or flattened.

*bunion: medical condition known as hallux valgus. Origin early 18th century, unknown origin, perhaps Old French buignon, from buigne, bump on the head (Oxford English Dictionary)

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Mechanism of Cialis action in general

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 responsible for bringing blood to male reproductive 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 monophosphate (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.

Afterwards 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.

News - Fake prescription drugs warning

Leading drug company Pfizer is warning consumers over the dangers of taking counterfeit prescription drugs.

The company which makes Viagra warns that what people buy might not match the description on the packet.

John Theriault, head of global security, will tell a London conference held by think-tank Civitas, of the dangers of buying over the internet.

He will also warn about “parallel packaging”, where drugs made in one country are repackaged for another.

Counterfeit medicines could reach the public through mail order or through internet purchases Medicines Healthcare products Regulatory Authority spokeswoman

This is done if medicines are imported for sale in the UK from other countries.

Around 140 million medicines are parallel traded each year in the European Union, with some 70% destined for the UK.

It is illegal to sell medicines where the labelling and instructions are in a foreign language, so importers have to add English labelling.

Companies such as Pfizer are warning that if this is done by putting the drugs into completely new packaging, there is the danger of drugs being tampered with or counterfeit versions reaching the consumer.

However, no such cases have come to light in the UK.

Pfizer has now introduced new packaging security measures for medicines sold in Europe.

‘Go to the GP’

The company has also warned about the dangers of buying medicines over the internet.

A spokesman for Pfizer said: “In one case which came to light, one man in China was dealing in counterfeit Viagra, supplying over a quarter of a million pills a month.

“He had infiltrated about nine European and Middle Eastern countries and around 10 US states.”

People in the UK had bought the fake Viagra, he said.

“There is an enormous amount of counterfeit drug available,” he added. “Because it is a prescription drug, people do buy it, but they could end up with anything.”

He said people must go to their GP in order to obtain the genuine drug.

‘No definite evidence’

A spokeswoman for the Medicines Healthcare products Regulatory Authority said cases referred to it involving counterfeit products were relatively rare, with no definite evidence of any cases since one involving the ulcer drug Zantac in 1994.

She added: “The MHRA has had no definitive evidence that counterfeit pharmaceuticals are reaching the general public via the legitimate supply chain, eg through pharmacies.

“However, there is some evidence that with counterfeit medicines could reach the public through mail order or through internet purchases.”

She said the MHRA investigated any reports it received of websites which appeared to be in breach of regulations regarding advertising, or sale and supply of medicines.

In 2003, counterfeit Viagra with an estimated value in excess of 2.35m was seized.

“The MHRA already has systems in place to receive and investigate reports of packaging and labelling problems with medicines, including parallel traded products.”

She said the World Health Organisation estimated around 6% of medicines available globally were counterfeit.

Dr Chaand Nagpaul, a member of the British Medical Association’s GP prescribing committee said: “I do see patients who have purchased drugs over the internet.

“It tends to happen in relation to drugs like Viagra, slimming drugs and sleeping tablets, where buying things privately might be attractive.”

But he added: “I am concerned about the lack of safeguards for buying drugs that way.”

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News - Dispute over Europe TV drug plan

Four of the world’s biggest pharmaceutical companies are considering launching an interactive TV channel in Europe.

The prospect has caused outrage among some consumer groups, because advertising prescription drugs directly to patients in the European Union is illegal.

They warn that the pharmaceutical giants will find it impossible to give unbiased advice about their own products.

But the drug companies involved - Pfizer, Novartis, Johnson & Johnson and Procter & Gamble - insist they are only interested in giving reliable high quality health information which would help patients when they were discussing their treatments with doctors.

‘Sharing information’

They have even made a ten-minute DVD of what the new interactive TV channel might look like - although a spokesman for one of the firms concerned said the plan was at a very early stage.

It does not exist, nor is it in development. Drug firm spokesman

“The European Patient Information Channel is simply a name given to an interactive information tool,” he says.

“It does not exist, nor is it in development. The purpose of creating this model was to provide an example of how quality information might be provided to Europeans in the future.

“We spend years building knowledge about our medicines and are interested in showing how we can share some of this information with European patients to try and ensure medicines are used properly and deliver maximum benefit”.

The drug companies also insist they have no wish to challenge the current ban on advertising prescription drugs directly to patients in Europe.

Those regulations are currently being reviewed by the European Commission.

Drug firms say they have no plans to challenge existing restrictions

Marcel Smeets, general director of Association Internationale de la Mutualite, an association of health insurers, thinks the timing of the latest project is no coincidence.

“I think it will bias the discussion in real life medical practice,” he says.

“A patient will be convinced by the power of television and the power of the nice-looking and well-informed and bright doctor sponsored by the industry.

“A doctor has a much broader and much unbiased view on all the available products. It should be the doctor who makes the unbiased analysis and prescribes without any economic incentive the best medicine and treatment”.

There are only two countries in the world where direct-to-patient commercials for prescription drugs are allowed - New Zealand and the United States.

They are not going to tell patients about the other treatments which are on offer, which doctors might consider to be more appropriate Theresa Alvez, Health Action International

Drug companies routinely advertise in the commercial breaks of popular shows on regular news or entertainment TV networks.

Many of the commercials follow a tried and tested formula.

They begin by describing the symptoms of a medical condition and asking the viewer if they are experiencing anything similar.

If so, they advise that they may have a product which can help and recommend making an immediate appointment with a doctor to discuss whether this would be appropriate.

‘Conflict of interest’

It is a lucrative strategy, according to Theresa Alvez of Health Action International, a Dutch-based campaign group which has become one of the leading opponents of prescription drugs on TV.

“In the US, they get back at least three times what they spend on advertising in increased sales of their drugs,” she says.

People in the US are able to read about the merits of Viagra

“There is a clear conflict of interest here. They are not going to tell patients about the other treatments which are on offer, which doctors might consider to be more appropriate. This is all about maximising profits for shareholders”.

The bombardment of American TV viewers with adverts for prescription drugs has even prompted artist, Justine Cooper, to create an entire spoof ad campaign in protest.

Her “Havidol” commercials all feature smiling and beautiful people, who try to “help” patients who think they are fit and healthy understand that they are actually suffering from a serious medical condition.

A spokesman for her exhibition at the Daneyal Mahmood Gallery in New York said they had never seen people embrace a concept so enthusiastically or quickly.

“With Havidol Justine Cooper turned disappointment with life into a clinical diagnosis - and everyone identified with the condition.”

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News - NHS patients face fake drug risk

Patients are being put at risk as counterfeiters target the NHS supply chain with fake drugs, regulators say.

The Medicines and Healthcare Products Regulatory Agency (MHRA) warned it is investigating twice as many counterfeit cases as it was five years ago.

The growth in fake drugs is said to be driven by huge demand for lifestyle medicines such as Viagra.

Counterfeits can be weaker doses of established drugs or medicines produced with substances such as paint.

The MHRA said the illegal trade carries lower risks and higher profits than smuggling hard drugs, and producers of fake drugs are now said to be targeting the pharmaceutical wholesalers who supply the NHS.

When these people penetrate the NHS supply system that is a direct risk to the public Naeem Ahmed, of the MHRA

When EU customs officers seized a counterfeit heart drug last year it was found to contain brick dust coated with yellow paint and was covered with furniture polish to give it a glossy finish.

The MHRA said instead of selling small quantities of fake drugs to individuals over the internet - the traditional target - the counterfeiters are switching their attention to pharmaceutical wholesalers who supply the NHS.

However, the drugs which have been found to have entered the NHS supply chain to date have only included different doses of active ingredients and have not harmed patients.

The regulator said five incidents have been detected in the past two years in which counterfeit medicines have reached patients through high-street pharmacies after the NHS supply chain was penetrated. Prior to that there had been no incidents since 1994.

Another 25 cases are currently being investigated.

Risk

Naeem Ahmed, the head of intelligence at the MHRA, said: “If you trade over the internet the risk of detection is low but you only sell a pack here and a pack there.

“If you penetrate the supply chain, there is a higher risk but you can make a lot of money.

“From the source countries such as China and India it is possible to purchase the active ingredients incredibly cheaply.

“In the past couple of years the counterfeiters have become more confident. They have realised the profits to be made.”

Mr Ahmed added: “When these people penetrate the NHS supply system that is a direct risk to the public.

“If someone chooses to buy their drugs over the internet then it is a case of buyer beware. We try to discourage that.

“But if a patient has gone through the NHS and been prescribed drugs, the last thing we want is for them to be put at risk.”

The MHRA is planning to publish its anti-counterfeiting strategy, developed over the past three years, early in the new year.

It will set out priorities for customs officers and other enforcement agencies, including a list of the most commonly counterfeited drugs and the commonest routes used into Britain.

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News - Viagra rival approved in US

The United States Government has approved the sale of a new drug expected to raise the stakes in the male impotence market.

Levitra, the first market rival to the hugely profitable Viagra, is being manufactured by the German firm, Bayer AG, and marketed by the British firm GlaxoSmithKline (GSK) as an alternative oral therapy for erectile dysfunction.

Since its appearance in 1998, sales of Pfizer’s Viagra have risen to nearly $2bn a year.

Both pills work in the same manner and doctors warn that both can have serious side effects, especially for men with heart problems.

A third anti-impotence pill, Cialis, is expected to reach the US market later this year.

The US Food and Drug Administration (FDA) approved Levitra, an orange pill compared to Viagra’s blue, based on studies showing that men were on average five times more likely to achieve an erection suitable for intercourse when taking the pill compared with those given a dummy medicine.

Researchers reported that studies of several thousand men showed that Viagra helped more than 70% improve their
erections.

As well as the warnings to men with heart conditions, the FDA said Levitra was not for patients with who had suffered a recent heart attack or stroke who have very low blood pressure or uncontrolled high blood pressure.

For otherwise healthy men, Levitra’s main side effects
were headache, flushing and a stuffy nose and sometimes dizziness.

Lawson Macartney, head of strategic management of GlaxoSmithKline’s cardiovascular, metabolic and urology drugs, said: “We know, from considerable market research, that the
market is ready for new options”.

GSK expects Levitra to be available in September.

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Smokers prescribed Viagra to quit

Smokers trying to quit the habit were mistakenly prescribed anti-impotence drug Viagra by doctors.

NHS Greater Glasgow and Clyde said the error was due to a computer glitch at two city GP practices.

When GPs selected anti-smoking pill Zyban, computers selected sildenafil, the generic name for Viagra.

A health board spokeswoman said: "At no time was patient care affected by this as all prescriptions are subject to stringent double checking."

The e-Formulary computer system used by GPs automatically selects a list of the most popular drugs when doctors fill out prescriptions.

Some patients went to the pharmacy with a prescription for the anti-impotence drug instead of tablets to help them stop smoking.

The health board was made aware of the problem on Tuesday and alerted all its GPs to the problem.

It is not thought anyone left a chemist with the wrong medication.

A health board spokeswoman said: "A computer glitch was discovered by two Glasgow GP practices that use the Glasgow e-Formulary, following a recent update of the online GPass system used throughout Scotland.

"As a precaution an advisory e-mail and memo was issued to all practices which use GPass and have installed the e-Formulary to alert staff."

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News - Viagra spam forces legal action

Drug giant Pfizer has started a legal campaign against spammers and online pharmacies pushing fake Viagra.

The campaign will try to seize domains selling fake pills and stop spammers sending messages offering the drug.

The pharmaceutical firm began the campaign after survey results showed that many people believe Pfizer is the source of spam offering Viagra.

Alongside the legal challenge goes a project to warn people about the dangers of popping fake Viagra pills.

Health warning

Many of the junk messages sent by spammers offer Viagra or so-called generic versions of the pill that supposedly offer the same help with erectile dysfunction that the original drug was created to treat.

The name “Viagra” has become so associated with spam that any junk mailer wanting to use the word has to obfuscate it with non-alphanumeric characters to help the messages slip past spam filters.

Pfizer is now suing websites that illegally use the Viagra name to market the generic versions and to block the sales of these drugs. It is also going after spammers that send out millions of messages offering the drug.

Scrambled spellings mean spam

In a survey 25% of men believed that Pfizer was responsible for sending the Viagra-themed spam.

Pfizer said that there was no such thing as legal generic Viagra because such a version of the drug has not been approved by the US Food and Drug Administration.

“Pfizer is taking these steps to help raise consumer awareness about the problems posed by illegitimate online ‘pharmacies’ and to directly address the source of these problems,” said Jeff Kindler, legal spokesman for Pfizer.

The company is working with the US Department of Justice, US Customs and Border Protection, the FBI, and the US FDA to track down and prosecute the sellers of illegal Viagra.

“It’s often difficult for consumers to distinguish between legitimate and illegitimate internet ‘pharmacies,’” said Brian Lamkin, head of the FBI’s Financial Crimes Section.

“These websites are cleverly designed to defraud consumers and sell drugs that are not approved by the US FDA,” he said.

Awareness campaign

Pfizer is directly suing five organisations and individuals that it claims are infringing its trademarks, engaging in unfair competition and deceptive practices in selling non-approved Viagra or illegal generic versions of it.

It is also attempting to seize 24 websites that it claims are trading illegally on the Viagra name and are trying to sell illegal versions of the drug.

As well as the lawsuits, Pfizer is rolling out a public awareness campaign to warn consumers about the health dangers of taking illegal Viagra pills.

Pfizer said Viagra should only be taken after consultation with a physician as the condition it was created to treat has many causes and taking the drug could exacerbate these other health problems.

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