Say Goodbye to Erectile Dysfunction with Tadalafil

Erectile dysfunction, abbreviated ED, and otherwise known as impotence in men, is the failure of a man to obtain and maintain an erection which is direly needed for engaging in sexual intercourse.

Erectile dysfunction is a condition that is very common in much older men.  It has been estimated that about half of all men who are within the bracket age of 40 to 70 may have ED at a certain degree.  Depending on the circumstances and on the individual himself, erectile dysfunction can also affect those who are younger, even if they are just around the age of 25 or more.

Why does ED Occur in some Men?  Erectile dysfunction causes actually vary, and they can be physically related or psychologically related.  Physical causes of ED may include hormonal issues, surgery or injury, tightening of the blood vessels that lead towards the penis which is usually linked to high cholesterol, hypertension, or diabetes.  Psychological (mental) causes of ED may include depression, anxiety or problems with relationships. Read more…

Sermo to expand to Canada as MD-only social networking gains popularity

Doctors-only social networking websites are rapidly becoming more popular -- , , , , among others -- and they're set to come to Canada very soon.

Although there have been no official announcements yet, I was told by representatives of Sermo and RelaxDoc (which both currently allow only American physicians to join) that both sites are planning on opening up their registration policies in 2008 to include Canadians.

Claire Spina-Russell, a media relations representative employed by Sermo, told me, "There have been inquiries from several hundred -- just shy of a thousand -- doctors from Canada. As you can imagine, people are really anxious to get in there. We're looking to introduce the offering to Canadian doctors later this year. The way to sign on would be different -- we have to set up a system of checking to make sure only doctors can get in -- but the rest will be the same.”

RelaxDoc communications director Erin Mulgrew had a similar message. “We are planning to open the site to international physicians, just working on back end of that," she said. "Right now we verify with DEA [Drug Enforcement Administration] numbers. We are working through verification, but we're planning to do it within this year.”

Tiromed, which was co-founded by a Canadian-born doctor -- , from Ottawa, who's now an internist in Los Angeles -- doesn't discriminate. Anyone can join, whether or not they're actually physicians.

Although Sermo and RelaxDoc don't yet allow Canadian members and Tiromed is severely underutilized by Canucks, some Canadian physicians nevertheless have made their way to the incredibly popular social networking site .

Dr Ron Lett, the president of the nonprofit , was introduced to Facebook when, returning from a humanitarian trip in Africa, he was surprised to find his email inbox overflowing. “I had all these requests to be friends with my children," he told me by phone from Uganda, where he's currently working. “I didn’t know quite what it was but I didn’t want to turn down requests to be friends with my children.” (I would have liked to do the interview via Facebook but given his internet access problems, it seemed easier to connect to him by cell phone.)

Dr Lett got a Facebook account and immediately recognized the benefit that social networking could have for the Canadian Network for International Surgery’s communications and public outreach activities. He oversaw the creation of the organization’s 54-member Facebook group (called CNIS Global OR, if you have Facebook and want to check it out).

He's got two accounts -- one personal and one professional. “For physicians, if you want to know what your kids are up to you, you should get online,” said Dr Lett. “I once told my sister, ‘Hey, did you know your son is engaged?’ She got on Facebook quick.”

London, Ontario physician uses Facebook, but not professionally. He told me he'd gladly use a doctors-only social networking site. Here's what he wrote to me by email:

"Social networking websites like Facebook have certainly changed the way people interact and establish contact with past friends, acquaintances, classmates, etc. Professional networking sites can certainly do the same for people in various professional circles. But I'm not sure one single web service is best suited to handle both worlds. The type of information a website would collect and share would be specific to its target: colleagues likely don't care much about who my friends and family are or what I have planned for this weekend. Similarly, an old high-school friend doesn't need to know about research I've done or conferences I've attended. Moreover, as the owner of this information, I would like to control, insofar as is possible, which pieces of my personal and professional life are accessible to the people in my personal and professional spheres.

"A professional networking service could definitely be an asset to physicians and may even improve patient care. For example, a family doctor establishing a practice in a new area could use such a site to make his practice known to other physicians, meet specialists in the area to whom he may need to refer patients, or identify services that may facilitate delivery of care. There is potential, but in my opinion, Facebook is not the right tool for this job."
(My article on social networking for physicians appears in the National Review of Medicine's February issue. You can read it .)

Update, September 24, 2008: Sermo has pushed back its international expansion to "early 2009," according to a company spokesperson.

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Blogs written by Canadian physicians

They may not all have electronic records (or computers at all, for that matter) but Canadian doctors are making an effort to catch up with the times. Some of them even have their own blogs now.

Canadian Medicine serves as a central hub for blogs written by Canadian physicians -- our directory is located on the right side of our blog, along with a list of some of the best recent entries.

If you're interested in reading blogs by physicians from your province, I've organized the listings geographically:

British Columbia





Alberta

  • Dr David Swann, Alberta MLA




  • Saskatchewan

  • Medical Education Blog - University of Saskatchewan College of Medicine



  • Manitoba
    None listed yet

    Yukon/Northwest Territories/Nunavut



    Ontario






    Quebec



    Atlantic Canada
    None listed yet

    Canadian doctors working internationally




    Province not listed


    If you're a Canadian doctor who writes a blog, or you know one, please let me know and I'll update Canadian Medicine's directory.

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    'Get that AIDS patient away from me'

    Despite two decades of public service campaigns raising HIV/AIDS awareness, some educated people amazingly still have little understanding of the disease.

    Back in November, Ontario Court Justice Jon-Jo Douglas was hearing a sexual assault case brought by a complainant who has both HIV and hep C.

    When Justice Douglas, a former Crown attorney, discovered the complainant's ailments he instructed the Crown counsel: "Either you mask your witness and/or move us to another courtroom or we do not proceed."

    He later explained his reasoning: "The HIV virus will live in a dried state for year after year after year and only needs moisture to reactivate itself."

    The Toronto Star that at one point "court staff returned after a recess wearing rubber gloves and placed documents touched by the witness in plastic bags."

    Justice Douglas is now the focus of a judicial council subcommittee that will determine if a public inquiry should be called, after complaints about him were brought by organizations like the Ontario Criminal Lawyers Association.

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    American doctors rejoice!

    Malpractice prosecutor John Edwards has for the Democratic nomination for president.

    He has been widely despised for years in the medical community as a result of his days as a superstar malpractice lawyer at the Raleigh, North Carolina, law firm Edwards & Kirby. He gained notoriety for multi-million dollar prosecutions of obstetricians for causing cerebral palsy by failing to perform emergency Caesarian sections in cases where babies have asphyxia -- despite doubt among many physicians that such a causal link existed. In the time since he left legal practice and entered politics, the connection between delayed delivery and cerebral palsy has been, for the most part, debunked. For more, check out this 2004 CNSNews.com article, "" The Wall Street Journal that same year.

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    Death threat forces Morgentaler to leave 20th-anniversary celebration early

    Some disturbing and sad -- though not altogether surprising -- news has come out of Saturday's symposium on the 20th anniversary of the 1988 Morgentaler decision that decriminalized abortion across Canada.

    Dr Henry Morgentaler, the man behind the '88 case, and Dr Garson Romalis, who was shot by a sniper in his home in 1994, were both forced to depart early from the University of Toronto-hosted conference after a death threat was phoned in. Here's a link to .

    This incident serves as a reminder to those who believe the debate over abortion rights has ended.

    To read NRM's recent, in-depth Q&A with Dr Morgentaler (including his comments on his experience with punk rock and his ping-pong wizardry),

    After reading The Star's news report, I did a quick search online. Nobody else has bothered to mention the death threat.

    *Update, Tuesday, January 29:
    A couple of people have mentioned the death threat online now, besides The Star. There was a discussion last night on the Free Dominion ("the voice of principled conservatism") internet forum about the veracity of the threat. Below an ad for an assault weapons discussion website, one user commented, "Its a theatrical play to denegrade the opposition...staged by all the usual suspects in the malthusian death cult that is the foundation of trudeaupian political culture." Said another: "It's a cooked up tale by the pro-abort crowd to feed the tale of the frothing anti-abortion extremists seeking to take away women's rights, yadda, yadda ... Of course, the media dutifully report it all as fact." One user joked about one of the forum's members making the death threat -- "Somebody check Hailey's long distance phone bill" -- and another still yearned for the courage to make a similar death threat: "I could actually dream up such things but never have the nerve to pull it off."

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