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4, 2004 issue of JAMA, chemical analyses found an average of 55 milligrams of sildenafil per capsule of Actra-Rx and Niagra Actra-Rx, another name under which the product has been sold

The FDA also instructed employees to block imports of the supplements, calling them "dangerous ... and even life-threatening." The agency said the supplement bears the name Yilishen when it is imported from China and is sold as Actra-Rx within the United States.

Laura Alvey, an FDA spokeswoman, declined further comment saying the matter is under investigation that may lead to criminal or civil enforcement actions.

Actra-Rx and Yilishen are promoted on Web sites as erectile dysfunction treatments that enhance men's sexual performance, the FDA said.

Despite an all-natural label, Actra-Rx capsules contain prescription strength levels of sildenafil, the active drug ingredient in Viagra, according to a letter published in the Journal of the American Medical Association.

Viagra, produced by Pfizer, was approved by the FDA to treat erectile dysfunction. The recommended dose is 50 milligrams. Some men take as little as 25 mg. or as much as 100 mg.

According to "Sex, Lies and Niagra," published in the Feb. 4, 2004 issue of JAMA, chemical analyses found an average of 55 milligrams of sildenafil per capsule of Actra-Rx and Niagra Actra-Rx, another name under which the product has been sold.

"The use of such nonprescription substances may present health risks for individuals with contraindications to the use of sildenafil," wrote the authors.

Follow up testing by the FDA confirmed Actra-Rx contained prescription-strength levels of sildenafil.

A spokesman for Los Angeles-based Body Basics declined comment. The company's voicemail identifies them as manufacturer of Actra-Rx. The company's Web site continues to advertise Actra-Rx as a "natural sexual enhancer" available in starter kits of 10 pills for $78.99.

In June 2003, Pfizer filed a trademark infringement suit against Body Basics, which had been using the name Niagra to sell the supplement. The federal court, in a consent judgment, barred the company from using that name, said Bryant Haskins, director of corporate media relations at Pfizer.

When the FDA in March 27, 1998 approved Viagra, 광명출장안마 - https://www.softanma.com/13-light the first pill to treat impotence, it warned consumers not to use the drug in combination with products containing nitrates to avoid worrisome lowering of blood pressure.

According to the FDA, the sildenafil in Actra-Rx also can interact with certain prescription drugs that contain nitrates or nitrates in illicit substances, significantly lowering blood pressure to unsafe levels.

Men at risk include those with diabetes, high blood pressure, high cholesterol or heart disease. Those individuals use medications that contain nitrates and often suffer erectile dysfunction.

The FDA advised people who have taken Actra-Rx or Yilishen to stop using it and to consult - http://www.medcheck-up.com/?s=consult a doctor regarding an alternate erectile dysfunction treatment.

is dubious at best." Besides Louisville, such transplants are being considered by teams in Cleveland, England and France

"There arrives a point in time when the procedure should simply be done. We submit that that time is now," the researchers wrote in an article scheduled for publication Friday in The American Journal of Bioethics. The procedure attaches the face of a dead donor to someone with a severely disfigured - https://www.google.com/search?hl=en&gl=us&tbm=nws&q=disfigured&btnI=lucky face, such as a burn or accident victim.

The doctors said they don't have a prime candidate for the procedure, and they are not actively screening for candidates.

They have submitted an application to an institutional review board in the Netherlands and are nearly ready to submit one to an independent board in the United States.

The Louisville doctors said they would not perform the transplant without approval from one of the boards, which are designed to protect medical research subjects' rights.

"The people we're considering are people who have no other options," Dr. John H. Barker, director of plastic surgery research at the University of Louisville, told The Courier-Journal newspaper.

Nichola Rumsey of the University of the West of England, an expert in psychosocial issues in medicine, said the ethical issues of the procedure have yet to be fully explored. She wrote one of 14 essays written in reaction to the article and published in the bioethics journal.

"Previous research and current understanding indicate that the psychological risks are more complex and extensive than the Louisville team suggest," she wrote. "I have no wish to minimize the distress experienced by many people with severe disfigurements, but to my mind, the current risk/benefit ratio ... is dubious at best."

Besides Louisville, such transplants are being considered by teams in Cleveland, England and 안산출장마사지 - https://www.anmaop.com/%cf%a1%ec%95%88%ec%82%b0%ec%b6%9c%ec%9e%a5%ec%83%... France.

Crew and Ann Taylor

The date is set, the venue is booked. Now, what to wear down the aisle?

Shopping for a bridal gown can be exciting for any bride-to-be, but with so many choices out there -- silhouettes, necklines, fabrics, colors -- it's easy to see how it could also become overwhelming - http://www.wired.com/search?query=overwhelming .

So, how (and where?) to find that perfect one? Jennie Ma, fashion editor - https://openclipart.org/search/?query=fashion%20editor at TheKnot.com, gave us a few tips to help guarantee you'll say "yes" to the right dress.

When to start shopping:

Brides should start looking for gowns eight months before they say "I do," Ma advised. That allows for time to find the right dress, as well as the fittings and 광양출장마사지 - https://www.toptopanma.com/%ea%b4%91%ec%96%91%ec%98%a4%ed%94%bc%ea%b1%b8... alterations you'll need to ensure it looks perfect on the big day.

"It takes time to find the right dress. Some girls are lucky and they find it right away, but it does take longer for a lot of other brides. Definitely give yourself time -- you don't want to feel rushed," she added.

Where to look:

There are a number of different places where brides can look for a bridal gown, all offering different kinds of dresses and experiences.

High-end salons will carry all the top designers and give brides an intimate shopping experience, but it's not the place for a bride-to-be on a budget, Ma said.

Brides can also look for their dress at department stories, which can be a one-stop shop for the entire bridal party -- bridesmaids' dresses can also be found there, and the groom can find everything he needs as well. Some department stores also have partnerships with high-end designers (like Roses by Reem Acra at Nordstrom), offering dresses at more affordable prices.

Brides can also go the retail route, looking at lines offered by companies like J. Crew and Ann Taylor. "They're really great because they have amazing price points and it's another place where you can fully service your entire bridal party and get all the outfits in one place," said Ma.

How to figure out what you want:

Brides can find inspiration on websites like TheKnot.com, with galleries showing all the latest gowns from top designers. Magazines and Pinterest are other places where brides can look through pictures and see what they like -- and, perhaps more importantly, what they don't like.

But other factors from your wedding will also play into the decision-making process.

"I would say the first thing is to figure out your venue and what style you're going for, and that naturally will really help you narrow down what dress you're looking for," Ma said. "If you're getting married in this gorgeous ballroom, you know you need a really dramatic gown. You're not going to want something really simple. So that will inform the decision."

When you go -- be open-minded:

Personal style preferences, budget and the type of wedding a bride is having will all influence what kind of dress she wants. But, brides should still go into the shopping process with an open mind, Ma said.

"It's good to go in knowing what you want. It's good to be prepared and have an idea -- it will help your search process. But at the same time, be open minded," she advised.

So if a friend, family member or bridal consultant suggests you try on a dress, go for it! The worst thing that could happen is you reaffirm that ball gowns aren't your thing. But maybe, just maybe, that mermaid-style gown you didn't think would work will wow you.

Data from the Centers for Disease Control and Prevention show there were 19,163 nonpowder gun injuries last year

Nonpowder guns kill an average of four Americans yearly, and from 1990 to 2000, there were 39 such deaths — 32 of children younger than 15, according to a report in November's issue of Pediatrics.

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The report, published Monday, 곡성출장안마 - https://www.anmatoto.com/16-bk comes just two weeks after the BB gun death of an 8-year-old South Carolina boy accidentally killed by a 13-year-old friend. The pellet pierced the boy's heart, said Richland County Coroner Gary Watts.

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"These are not the kinds of BB guns that I grew up with," Watts said. Today's BB guns "are extremely high-powered," and some can shoot with a velocity nearly matching a .22 caliber rifle, Watts said.

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Nonpowder guns include powerful air rifles introduced in the 1970s and paintball pistols used in war games. They're sometimes described as fake guns and often given to children as gifts, but the report says they can cause internal injuries.

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Nationally, an estimated 21,840 injuries related to nonpowder guns were treated in emergency departments in 2000 — most in children aged 5 to 14, according to the report prepared by the American Academy of Pediatrics' Committee on Injury, Violence and Prevention

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Data from the Centers for Disease Control and Prevention show there were 19,163 nonpowder gun injuries last year

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Most states have laws or regulations governing nonpowder guns. New York's is one of the strictest, prohibiting the purchase or unsupervised use by someone younger than 16 years, the Pediatrics report said

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While some models of air guns and BB guns are marketed specifically to youngsters, manufacturers and sellers also stress that they should be handled like legitimate firearms

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The gun involved in the South Carolina shooting was a present from the older boy's parents, who had hoped it would lift his spirits after his own brother's recent death in a car accident, Watts said

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"They're being given as toys without recognition that there may be a serious injury risk," said report author Dr. Danielle Laraque, a New York pediatrician - http://search.un.org/search?ie=utf8&site=un_org&output=xml_no_dtd&client... .

"It's good to go in knowing what you want

The date is set, the venue is booked. Now, what to wear down the aisle?

Shopping for a bridal gown can be exciting for any bride-to-be, but with so many choices out there -- silhouettes, necklines, fabrics, colors -- it's easy to see how it could also become overwhelming.

So, how (and where?) to find that perfect one? Jennie Ma, fashion editor at TheKnot - http://www.google.de/search?q=TheKnot .com, gave us a few tips to help guarantee you'll say "yes" to the right dress.

When to start shopping:

Brides should start looking for gowns eight months before they say "I do," Ma advised. That allows for time to find the right dress, as well as the fittings and alterations you'll need to ensure it looks perfect on the big day.

"It takes time to find the right dress. Some girls are lucky and they find it right away, but it does take longer for a lot of other brides. Definitely give yourself time -- you don't want to feel rushed," she added.

Where to look:

There are a number of different places where brides can look for a bridal gown, all offering different kinds of dresses and experiences.

High-end salons will carry all the top designers and give brides an intimate shopping experience, but it's not the place for a bride-to-be on a budget, Ma said.

Brides can also look for their dress at department stories, which can be a one-stop shop for the entire bridal party -- bridesmaids' dresses can also be found there, and the groom can find everything he needs as well. Some department stores also have partnerships with high-end designers (like Roses by Reem Acra at Nordstrom), offering dresses at more affordable prices.

Brides can also go the retail route, looking at lines offered by companies like J. Crew and Ann Taylor. "They're really great because they have amazing price points and it's another place where you can fully service your entire bridal party and get all the outfits in one place," said Ma.

How to figure out what you want:

Brides can find inspiration on websites like TheKnot.com, with galleries showing all the latest gowns from top designers. Magazines and Pinterest are other places where brides can look through pictures - http://www.business-opportunities.biz/search/?q=pictures and see what they like -- and, 익산출장마사지 - https://www.toptopanma.com/%ec%9d%b5%ec%82%b0%ec%98%a4%ed%94%bc%ea%b1%b8... perhaps more importantly, what they don't like.

But other factors from your wedding will also play into the decision-making process.

"I would say the first thing is to figure out your venue and what style you're going for, and that naturally will really help you narrow down what dress you're looking for," Ma said. "If you're getting married in this gorgeous ballroom, you know you need a really dramatic gown. You're not going to want something really simple. So that will inform the decision."

When you go -- be open-minded:

Personal style preferences, budget and the type of wedding a bride is having will all influence what kind of dress she wants. But, brides should still go into the shopping process with an open mind, Ma said.

"It's good to go in knowing what you want. It's good to be prepared and have an idea -- it will help your search process. But at the same time, be open minded," she advised.

So if a friend, family member or bridal consultant suggests you try on a dress, go for it! The worst thing that could happen is you reaffirm that ball gowns aren't your thing. But maybe, just maybe, that mermaid-style gown you didn't think would work will wow you.

In a comparison group of 750 women who received dummy shots, infections took hold in 111 and precancers formed in 12

Four years after getting the vaccine, 94 percent of women were protected from infection with the virus that causes most cervical cancers and none had developed worrisome precancerous conditions, a study showed.

"We're thrilled about these results. The immune responses seem to be really long-lasting," said Dr. Eliav Barr, who leads development of the vaccine for Merck and Co. The company plans to seek U.S. Food and Drug Administration approval next year for an expanded version of the vaccine that also could be used to prevent genital warts in both women and men.

The new study was funded by Merck and led by University of Washington researchers who presented results Monday at a meeting of the American Society for 안성출장마사지 - https://www.anmaop.com/%e2%88%80%ec%95%88%ec%84%b1%ec%b6%9c%ec%9e%a5%ec%... Microbiology.

"They showed clear effectiveness," said Dr. Scott Hammer, a Columbia University infectious disease expert who reviewed the work but has no ties to Merck or the study. "This is a very important issue for women's health around the world."

If the vaccine makes it to market, it would be the second developed to prevent cancer. The hepatitis B vaccine has dramatically reduced the number of infections that progress to liver cancer.

Cervical cancer strikes nearly half a million women worldwide each year and kills about half. In the United States, about 15,000 women get it and about 5,000 die.

Virtually all cases are caused by infection with human papilloma virus, or HPV, which is spread through sex. One strain, HPV-16, accounts for about half of all cervical cancers.

A previous study showed that HPV-16 infections were completely prevented in 768 women who had received the Merck vaccine 18 months earlier. None developed precancerous conditions either.

The new study followed 755 of these women for four years after vaccination. HPV-16 infections had taken hold in seven; none developed precancers. In a comparison group of 750 women who received dummy shots, infections took hold in 111 and precancers formed in 12.

Even though protection had waned for a small number of women in the study, the vaccine's effectiveness was still very high, said Dr. Douglas - http://www.ourmidland.com/search/?q=Douglas Lowy, a National Cancer Institute scientist who invented the vaccine. The government gave rights to develop it to two companies — Merck and GlaxoSmithKline — and Merck's work is a little farther along, Lowy said

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"Revaccination might be advisable at some point," but it will take more study to know whether that is necessary or would improve effectiveness, he said

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Women in the study were ages 16 to 23 when they received the vaccine, given in three doses over six months

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"Most people think it would be recommended for young adolescents. The idea would be you would immunize people relatively soon before they become sexually active," because the germ is spread through sex, Lowy said

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Meanwhile, Merck is in the final stages - http://search.usa.gov/search?affiliate=usagov&query=final%20stages of testing an expanded vaccine. Besides HPV-16, it contains strain 18, which causes another 10 percent to 20 percent of cervical cancers, as well as strains that cause genital warts in men and women, and penile and anal cancers in men

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About 25,000 women and men have been enrolled in that study in 34 countries, and results are expected next year, Barr said

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Giving the vaccine to men would not only prevent disease in them but also would prevent infections in their partners, said Steven Projan, a drug development expert with Wyeth who helped review research for the microbiology meeting. The vaccine also might prevent women already infected with HPV from developing cancer, he said.

Other areas feeling the strain include some Miami hospitals preparing flu tents

It is flu season, and the U.S. Centers for Disease Control and Prevention says the number of cases is up sharply, with high activity reported in 26 states.

At the Palomar Medical Center near San Diego, the new year ushered in a brutal flu season.

"The day came when we had extended waits in the emergency department up to eight or nine hours for a patient to be seen," said Michelle Gunnett, emergency room nursing director. "We need to figure out other space to see patients."

That space ended up being a triage tent set up right outside the ER.

California is one of the 26 states reporting high flu activity. San Diego County, with 7,314 confirmed cases, 안산출장마사지 - https://www.popanma.com/%ec%95%88%ec%82%b0%ec%b6%9c%ec%9e%a5%ec%83%b5%cf... has had more than eight times the number seen this time last year.

Other areas feeling the strain include some Miami hospitals preparing flu tents. Emergency visits at a hospital in Toledo, Ohio surged 10 to 15 percent in a single week. A hospital system in Dallas is at critical capacity, and is rerouting non-emergency ambulance patients.

Dr. Allan Hansen heads up Palomar's ER.

"It's a virus that is a flu strain that's been seen before," he said. "It's not clear why the volume of infection is so high at this time."

The strain, called H3N2, tends to cause especially severe illness. Last season's vaccine was only 32 percent effective against H3N2. It's unclear how effective this year's vaccine - http://www.blogher.com/search/apachesolr_search/year%27s%20vaccine will be, but the CDC has advised people to begin antiviral treatment as soon as possible with drugs like Tamiflu.

Even though the flu shot may only be partially effective, the CDC still recommends getting it since some protection is better than none. If you do get the flu, having had the vaccine might lessen the severity of it.

Docs: Face Transplant Doable

"There arrives a point in time when the procedure should simply be done. We submit that that time is now," the researchers wrote in an article scheduled for publication Friday in The American Journal of Bioethics. The procedure attaches the face of a dead donor - http://venturebeat.com/?s=dead%20donor to someone with a severely disfigured face, such as a burn or accident victim.

The doctors - http://kscripts.com/?s=doctors said they don't have a prime candidate for the procedure, and they are not actively screening for candidates.

They have submitted an application to an institutional review board in the Netherlands and are nearly ready to submit one to an independent board in the United States.

The Louisville doctors said they would not perform the transplant without approval from one of the boards, which are designed to protect medical research subjects' rights.

"The people we're considering are people who have no other options," Dr. John H. Barker, director of plastic surgery research at the University of Louisville, told The Courier-Journal newspaper.

Nichola Rumsey of the University of the West of England, an expert in psychosocial issues in medicine, said the ethical issues of the procedure have yet to be fully explored. She wrote one of 14 essays written in reaction to the article and 문경출장마사지 - https://www.anmaweb.com/%eb%ac%b8%ea%b2%bd%ec%98%a4%ed%94%bc%ea%b1%b8%e2... published in the bioethics journal.

"Previous research and current understanding indicate that the psychological risks are more complex and extensive than the Louisville team suggest," she wrote. "I have no wish to minimize the distress experienced by many people with severe disfigurements, but to my mind, the current risk/benefit ratio ... is dubious at best."

Besides Louisville, such transplants are being considered by teams in Cleveland, England and France.

The flu season likely will "peak at the end of the December, the beginning of January, but it goes well through February and sometimes into March," he said on the CBS News Early Show

The flu season typically peaks in January or later. It takes two weeks for people to develop immunity after being vaccinated, which should be done in October or November, according to the Centers for 사천출장마사지 - https://www.anmaweb.com/%e2%9c%99%ec%82%ac%ec%b2%9c%ec%98%a4%ed%94%bc%ea... Disease Control and Prevention.

So while the U.S. government is searching all over the world for more vaccine, it is unclear how helpful the extra doses will be if they don't arrive until next year.

The extra doses were ordered after British regulators closed a plant making half of the flu vaccine the United States requested for this season.

The vaccine shortage has had wide-ranging effects, from Canada to Capitol Hill to the campaign trail.

Clinics and pharmacies across the border are offering to inoculate U.S. residents, Margaret Holmen and others from the Powers Lake Senior Citizens Center in Bismarck, N.D., have been talking about going to Canada for their shots.

"Everybody here is thinking about it," said Holmen, the senior center's manager. "We hear on the news that we should be patient, but we don't know what to do."

Word of Canada's vaccine availability is spreading quickly. Eighty Americans showed up for flu shots Tuesday at Henders Drug in Estevan — located about 9 miles north of the North Dakota border — although the store's newspaper advertisement hadn't even run yet.

"I suspect there will be a lot more," said Larry Preddy, pharmacist and co-owner of the store. He charges Americans the same price as Canadians — $15 Canadian or about $12.

Urgent Care Niagara's Fort Erie clinic, just across the border from Buffalo, said it would vaccinate 100 Americans a day, for around $40 each, squeezing them in among Canadian patients who got first priority.

Meanwhile, The Washington Post reports that despite the government's request that young, healthy people forego the shot this year, flu vaccine is readily available on Capitol Hill and the physician there is advising all lawmakers to get it. Already, 2,000 shots have been dispensed there, down from 9,000 a year ago.

In the Sunshine state, a vaccination campaign by Get Healthy Florida was put on hold on the order of the Food and Drug Administration after it was discovered that the vaccine was coming from a foreign producer, not the domestic one that was expected.

On the campaign trail, Sen. John Kerry, President Bush's Democratic challenger, has said the administration failed to heed warnings about a potential shortage.

"If you can't get flu vaccines to Americans, how are you going to protect them against bioterrorism? If you can't get flu vaccines to Americans, what kind of health care program are you running?" Kerry said.

In Florida, Mr. Bush sought to ease Americans' concerns. "I want to assure them that our government is doing everything possible to help older Americans and children get their shots despite the major manufacturing defect that caused this problem," he said.

Chiron Corp. was expected to provide the United States with 46 million to 48 million doses of flu vaccine, nearly half the supply the government anticipated needing. But British regulators closed Chiron's Liverpool facility because of contamination - http://www.ajaxtime.com/?s=contamination .

That left the United States with about 55 million doses from its second manufacturer, Aventis Pasteur. At a news conference Tuesday, Aventis Pasteur announced it could produce another 2.6 million doses. The extra vaccine won't be ready for distribution until January.

"We're waging a comprehensive and aggressive response," Health and Human Services Secretary Tommy Thompson told a news conference. "We have good reason to be optimistic in our ability to deal with the flu season and protect the most vulnerable from its harsh effects."

He said there was enough antiviral medicine available to treat 40 million people, shortening illness in people sick with the flu and preventing illness in healthy people.

Dr. Anthony Fauci, director of the National Institute of Allergy and Infectious Disease, said Wednesday he believes the additional shots will arrive in time to help.

The flu season likely will "peak at the end of the December, the beginning of January, but it goes well through February and sometimes into March," he said on the CBS News Early Show.

"So, any amount of doses that one can get, even as late as January, clearly will be very helpful, particularly if we have a very active flu year," Fauci said.

Between vaccines and antiviral drugs, enough medicine will be available to treat 100 million people this flu season, Thompson said. Federal authorities have asked that healthy adults refrain from getting vaccinated to leave enough for those at greatest risk: the very young, the very old and people with chronic illnesses.

Meanwhile, officials are looking "throughout the world" for additional vaccine, said Lester Crawford, Food and Drug Administration acting commissioner.

Crawford said the FDA would give expedited review to flu vaccine produced by ID Biomedical of Canada. The expedited review — "weeks, rather than months" — means the 1.5 million Canadian flu shots could reach Americans this season, he said.

Man Insists He Didn't Sell Kidney

"I'm being treated like garbage by the media and I haven't even committed a crime," said Rob Smitty, 32.

In an Oct. 20 operation in Colorado, Smitty gave a kidney to a man who had needed a transplant since 1999 due to kidney disease.

The recipient, Bob Hickey, met Smitty through MatchingDonors.com, a Web site created to match donors and recipients for a fee. Hickey paid the Web site $295 a month for three months to post his plea.

Both men have said there was no payment for the kidney, which would be a violation of federal law. There are no laws against soliciting an organ.

By finding Smitty, Hickey avoided a waiting list maintained - http://search.usa.gov/search?affiliate=usagov&query=maintained by the United Network for Organ Sharing, a nonprofit group with a government contract to allocate all organs from the dead.

Smitty, of Chattanooga, said Hickey has written him checks of $950, $700 and $1,400 to help cover expenses and to compensate for time he has missed at work. Smitty said he was unsure how much additional compensation he would get.

"There is no contract," he said. Smitty said that in response to the many claims he has been paid for the kidney, "If I can reduce that number by taking a lie-detector test, I will."

Monique Kelso, spokeswoman in the FBI's Denver office, said the agency has not investigated the kidney transplant for any possible federal law violations.

"We haven't received any information or any complaints," she said.

After the transplant, news surfaced that Smitty was being sought on a civil warrant for 대전출장마사지 - https://www.toptopanma.com/%eb%8c%80%ec%a0%84%ec%98%a4%ed%94%bc%ea%b1%b8... failing to pay child support.

He said Tuesday that he would attend a court hearing Thursday on his $8,100 child support and medical payment debt.

"I've had cuffs put on me before and I may have them put on me again," he said. "I think it'll make them look bad to put a man who just donated a kidney in jail.

"If they are looking for perfect people to donate organs, they're not going to find anyone," he said. "There are none out there."By Bill Poovey

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