Big KNY3, I am still corecting your post # 4756, gg. I corrected the 1st paragr ( on cardiac outputs etc) and #7 were the impression was left that because phosphodiesterase Theophylline has been used for years, it is safe, ( it isn't as safe as we thought it was, as per my post on PDE side effects. Also in that post I didn't mention that pulmonologists are now twnding to go away from it in seriously ill patients because previously " safe" blood levels no longer pevent toxicity. ie, toxicity can occur with normal blood levels )
So let us turn to paragr #8 now:
"Comparing one PDE inhibitor to another is the equivalent of trying
to open your neighbor's house with your house key. It just doesn't
fit ".
Is only partially true. Fact is that at higher levels, PDEs become
" non-selective " and inhibit all kinds of other PDEs which is where you get into the unwanted side effects potentially from Viagra.
In fact BigK unwittingly [ I assume, gg ('..') ] you make that very point in the next parag #9 :
"Importantly, the specificity of selective PDE inhibitors is
restricted to a relatively narrow concentration range with
inhibition evident at higher concentrations ". ( < GGG >.
On to parag #14: " Persantine (dipridamole) is an example of a PDE
inhibitor that has been used extensively as a
vasodilator without major adverse effects ".
The following corrections are in order:
-Persantine has NEVER been used EXTENSIVELY as a vasodilator.
-Persantine induced vasodilatation is regarded as an unwanted side
effect.
-Persantine's ONLY indication is to reduce platelet adhesiveness and
thus prevent further blood clot formation in stokes, after by-pass
etc.Most MDs feel that htis drug is essentially worhtless. it was
used "extensively" 20 years ago when we didn't know better.
Moving right along to parag #23 you wrote:
[ " First of all, I believe you ( ie Gene Voss ) are
misrepresenting the lead author of the NEJM MUSE study Dr.
Padma-Nathan's position. You stated: Dr. Padma-Nathan "
verbally blasted (MUSE) therapy as being only 10% effective."
Dr. Padma-Nathan was quoted as saying in Barrons (2/24/97)"
Only 5-10% of the patients are opting for it (MUSE)." ]
The facts are that Author Bill Alpert in the Feb24, 1997, Page 24 issue of Barrons, EXACTLY wrote the following :
" Padma-Nathan says that in his practice he's seen 5% of MUSE
patients, at most, attain rigid erection.Dr,Irwin Goldstein, a
prominent professor of urology at the Boston University School
of Medicine, also says that very few of his patients can get
rigid with Muse.Instead, Muse produces an erection mainly near
the tip of the penis, in the regionof the pellet, and patients
must cosequently have intercourse in restricted positions.
Perhaps because of uneven absorption though ( this is a
Barron's typo!! gg )the urethra, Muse also works less reliably
than injections, adds Padmaa-Nathan, succeeding in a little less
than 50% of administrations, compared with nearly 90% of
injections."Injection therapy is the gold standard," says the
urologist. " ]
There it is BigK; the EXACT Barrons quote.
At this point I will not belabor the internal and external contradictions that exist in the interpretation of the above quote, ie between what Padma wrote ( in the NEJM) before and said above, and between contradictory stataments internally in that paragraph;also WHAT the public READ in the above paragraph.
I think that this should be your, Gene's and everybody's homework today; ie analyzing the above paragraph from Barrons and trie and figure out exactly;
-Is Padma contradicting himself internally in the paragraph and
externally ( what he wrote before ).
-what is wrong with what he says and what he wrote.
-did the public misinterpret Barons ( "the public" excludes Vivus longs, gg ).
-should Bill Alpert continue in his job at Barrons ( any extenuating
circumstances,gg, ), of fired for incompetence, and if so why?
Lots of homework here guys/gals. I expect it in by tomorrow.
( Retakes allowed ).
TA |
