Le tadalafil possède une affinité marquée pour la PDE5, mais épargne en grande partie les isoformes PDE1, PDE2 et PDE11, réduisant ainsi le risque d’effets extra-caverneux. L’action se traduit par une augmentation contrôlée de la circulation sanguine locale, indépendante des variations alimentaires. Sa pharmacocinétique repose sur une absorption digestive rapide, un métabolisme hépatique par CYP3A4 et une distribution tissulaire large. La biodisponibilité reste stable, et l’équilibre plasmatique est atteint en quelques jours lors d’administrations répétées. Les interactions cliniquement significatives surviennent avec les inhibiteurs puissants de CYP3A4 tels que le kétoconazole. Dans la littérature pharmacologique, acheter cialis 20 mg est souvent associé à des schémas d’utilisation basés sur la durée prolongée de son action.

Microsoft powerpoint - genital lumps and bumps - final version dr. olufunso olarinde [compatibility mode]

Consultant Physician, Dept of GU Medicine • To distinguish normal/variants of normal • Different causes of genital lumps and of oily secretions that keep the skin healthy & mistaken for warts –they do not change in size but warts do (especially in women) & may be mistaken for warts ‘Cord like’ swelling, usually just below the head of the penis Usually caused by a blockage in the lymphatics which then solidify May occur after vigorous sex or masturbation No treatment needed. Generally disappears – may take months! glands located at the entrance of the vagina • STI caused by the Human Papilloma Virus
• Transmission is via direct skin to skin contact • ‘Fleshy’ lumps around the anogenital area • >100 strains of the HPV have been identified • ‘Low risk’ types HPV 6 & 11 account for about 90% of • Warts may not appear for months/years after infection • HPV may be transmitted in the absence of visible warts – Purely cosmetic & depends on site, size, nature & number • Podophyllotoxin cream – non keratinised • Curettage – single/few pedunculated warts • Surgical excision – extensive warts • STI caused by Herpes Simplex Virus
• Painful blisters on anogenital skin which break down to form multiple tender ulcers – Aciclovir 400mg tds x 5/7 OR 200mg 5x daily – Oral → NSAIDs, Codeine phosphate– Topical → Lignocaine gel – Usually mild & self-limiting– If regular – Aciclovir 400mg bd x 6-12 months– Valaciclovir 500mg OD x 6-12 months lesions in moist areas of anogenital area – Syphilis serology– Screen for other STIs– Treatment • Penile Intraepithelial Neoplasia (PIN)
Vulval Intraepithelial Neoplasia (VIN)
• Commonly ‘high risk’ types 16 & 18 – Chronic inflammatory genital skin conditions Penile Intraepithelial Neoplasia
Vulval Intraepithelial Neoplasia
• Slightly raised, well defined skin lesions pustule, warty area or ulcer with heaped up edges

Source: http://www.gplectures.co.uk/media/lecture_notes/Genitallumpsandbumps.pdf

Bando bellini2005

ministero per i beni e regione siciliana comune Di le attività culturali ass. reg. turismo caltanissetta sport e spettacolo ASSOCIAZIONE AMICI DELLA MUSICA 44° CONCORSO INTERNAZIONALE «VINCENZO BELLINI» PER CANTANTI LIRICI FOR OPERA SINGERS - POUR CHANTEURS LYRIQUES 1 - 6 DICEMBRE 2013 Ministero dei Beni e delle Attività Culturali Musica dal

Microsoft word - 13. broshure_permbledhje e terminologjise per sigurine e pac.doc

Sektori: I Sigurise dhe Te Drejtat e Pacientit Përmbledhje e Terminologjisë për Sigurinë e Pacientit dhe Mjekimin e Sigurt. Sektori: I Sigurise dhe Te Drejtat e Pacientit Termi Aksident - accident : Një ngjarje e pa-planifikuar, e papritur,dhe e padëshiruar zakonisht me pasoja anësore ( Senders, 1994). Gabim aktiv (shiko gjithashtu gabim) – active err

Copyright © 2010 Find Medical Article