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1  Other / Off-topic / Erectile dysfunction in young people on: January 01, 2020, 04:06:51 AM
Im Drgomez89 Im internal medicine Specialist and i have been receiving more young patients with erectile dysfunction.

I wanted to share real medical information with their respective sources. Maybe it can help someone with this everyday more common problem.


  • Erectile dysfunction (ED) is defined as a consistent or recurrent inability to attain and/or maintain penile erection sufficient for sexual satisfaction.
McCabe MP, Sharlip ID, Atalla E, Balon R, Fisher AD, Laumann E, Lee SW, Lewis R, Segraves RT
J Sex Med. 2016 Feb; 13(2):135-43.


  • In a recent study conducted in a Urology Clinic, it has been observed that one out of four men seeking medical care for ED was younger than 40 years
Capogrosso P, Colicchia M, Ventimiglia E, Castagna G, Clementi MC, Suardi N, Castiglione F, Briganti A, Cantiello F, Damiano R, Montorsi F, Salonia A
J Sex Med. 2013 Jul; 10(7):1833-41.


  • ED has been for long time considered a problem mainly related to psychological conditions and distress. Accordingly, until phosphodiesterase type 5 inhibitors (PDE5i) were introduced, psychoanalysis and cognitive-behavioural therapy were the only option for ED
  • In the last few decades, ED has been recognized as a clinical consequence of several different organic diseases and the importance of vascular health in erectile function has been so emphasized that ED is now considered not only the result of vascular impairment, but also a harbinger of forthcoming cardiovascular (CV) events
Corona G, Monami M, Boddi V, Cameron-Smith M, Lotti F, de Vita G, Melani C, Balzi D, Sforza A, Forti G, Mannucci E, Maggi M
J Sex Med. 2010 May; 7(5):1918-27.


The Sexual Medicine and Andrology Unit of the University of Florence for sexual dysfunction, the first tertile of age (n=1,873 subjects) represents younger subjects (18–44 years) And the most common cause of erectyle dysfunction ing young patients are Organic pathologies (not psycological causes)

Corona G, Ricca V, Bandini E, Rastrelli G, Casale H, Jannini EA, Sforza A, Forti G, Mannucci E, Maggi M
J Sex Med. 2012 Aug; 9( 8 ):2017-26.

Erectile Dysfunction AS Cardiovascular RISK
  • Young patients are often reassured without any further medical investigations, including physical exam. However, organic disorders, as well as relational and psychological or psychiatric conditions, can be meaningful in determining ED in younger men
  • according to Montorsi’s hypothesis , impairment of penile artery blood flow occurs before that of coronary or carotid arteries, whose diameter is greater and needs longer time to acquire a clinically relevant damage. The clinical consequence of this pathological event is that ED often manifests earlier than myocardial infarction or stroke. In particular, it has been demonstrated that ED occurs on average three years before the first major adverse CV event (MACE)
Montorsi P, Ravagnani PM, Galli S, Rotatori F, Veglia F, Briganti A, Salonia A, Dehò F, Rigatti P, Montorsi F, Fiorentini C
Eur Heart J. 2006 Nov; 27(22):2632-9.

Endocrine Causes or erectile Dysfunction

  • This is the case of adrenal insufficiency, whose treatment with glucocorticoid and mineralocorticoid replacement is able to improve erectile function

Granata A, Tirabassi G, Pugni V, Arnaldi G, Boscaro M, Carani C, Balercia G
J Sex Med. 2013 Aug; 10(Cool:2036-43.


  • An adequate control of thyroid function in hyper- and hypothyroid patients is associated with an improvement in ED

Carani C, Isidori AM, Granata A, Carosa E, Maggi M, Lenzi A, Jannini EA
J Clin Endocrinol Metab. 2005 Dec; 90(12):6472-9.

  • testosterone (T) deficiency is frequently found in subjects with ED

Maseroli E, Corona G, Rastrelli G, Lotti F, Cipriani S, Forti G, Mannucci E, Maggi M
J Sex Med. 2015 Apr; 12(4):956-65.


INTRAPSYCHIC Causes
  • ED, depression is significantly associated with a greater severity of the impairment in erectile function

Corona G, Ricca V, Bandini E, Mannucci E, Petrone L, Fisher AD, Lotti F, Balercia G, Faravelli C, Forti G, Maggi M
J Sex Med. 2008 Feb; 5(2):458-68.

  • However, the relationship seems to be bidirectional, as also ED has been associated with the occurrence of depression . In addition, treatment with PDE5i is related with an improvement in depressive symptoms
McCabe MP, Althof SE
J Sex Med. 2014 Feb; 11(2):347-63

[/list]

In fact, young men reporting ED risk being dismissed without any specific medical assessment, including medical history or physical exam, owing to the assumption that ED in younger is a self-limiting condition, without any clinical consequence.

IF you have any question you can DM
2  Other / Off-topic / Do u have any medical question you are afraid or embarrassed to ask your doctor? on: December 25, 2019, 04:15:17 AM
Im Jose Im and internal Medicine Specialist Doctor
Im on vacation 15 Days and i noticed my fourth year students had personal question about basic medicine subjects and they were embarrassed to ask because the thought people will mock them. Thats why i implemented and anonymous system of papers with questions in a BOX.

You dont have idea how many questions did I get.  Grin

Then i writing this post to let you guys know u can ask me anything u want.
Its amazing the huge amount of LIES internet says about medicine subjects

 Im here for you guys and if you have a question for yourself or anyone you care about.
For only $5 valued ETHER or Bitcoin i can give u a full answer with their respective bibliography to prove its truthfulness .

My specialties
  • Drug interactions
  • Obesity
  • Heart disease
  • Lung disease
  • Sleep problems
  • social Anxiety
  • Depression
Just PM And if u guys want we can open a thread to share information about a topic every week. By you deciding the topic with a Survey.
 




3  Alternate cryptocurrencies / Altcoin Discussion / How many bounties are you currently participating on: September 29, 2018, 12:59:06 PM
Hi guys im participating in 3 bounties And i think there are a lot
As u can see mi signature is with miracle tele also im participating with their Facebook campaign

They other 2 Facebook campaign im doing are
With UMC And Menapay

Doi think Twitter campaign are better right ?
But its hard rock get a lot of followers
4  Local / Tokens (Español) / Mi primer pago como inversionista de Miracle TELE on: August 11, 2018, 06:25:59 PM
Mi primer pago como inversionista de Miracle TELE

Me llamo Jose  y soy de Nicaragua. La tierra de lagos y volcanes en el centro de América. Que actualmente esta en un conflicto político fuerte que ha generado un declive importante de el nivel económico del país pasando de un crecimiento de un 4% a una reducción en 3 meses del 50% de lo generado.
Ante mi incapacidad de estar quieto y mi miedo a envejecer pobre. Hoy decidi investigar y adentrarme al mundo de las criptomonedas. Pero no cualquier cripto monedas. Estas que representan un proyecto que promete darle a los HOLDER una parte de sus ganancias.
Después de investigar buscando ICO que me llamara la atención les dejo este proyecto :
MIRACLE TELE
Sitio web: https://miracletele.com/
1.Que es Miracle Tele?
Miracle Tele es un operador de red virtual móvil que puede proporcionar a los usuarios los medios para realizar llamadas internacionales de alta calidad desde cualquier parte del mundo, al tiempo que conserva sus derechos de privacidad y gana dinero al ayudar a la empresa.
Sacado de aca
2. Caracteristicas de la crypto
The Miracle Tele Token
Símbolo simbólico: TELE
Precio del token: € 0,10
Total tokens: 150 000 000 tokens
Recompensas simbólicas: 40% del beneficio total
Los tokens de TELE serán la base de la plataforma. Se venderán durante la oferta inicial de monedas (ICO) por 0,1 euros cada uno. El suministro total de tokens TELE será de 300,000,000 y el total para la venta será del 50% de esta cantidad: 150,000,000 tokens TELE. Puede comprar tantos tokens como desee y la venta solo finaliza cuando se venden todos los tokens.

Se puede utilizar Bitcoin, Litecoin y Ether para realizar compras.
3. Actualmente hay un AIRDROP ( Significa campaña promocional en la que a cambio de unirte a sus redes sociales y seguir unos simples pasos te dan cierta cantidad de tokens ) de 20 tokens TELE. La cual puede ir aumentando al propagar la noticia 10 tele por cada persona que atraigas al proyecto y 100 Tele si ayudas con una publicación en las redes sociales más conocidas.
Facebook, Twitter, Reddit, Medium y Youtube
Sacado de aca
4. Mi Opinión sobre esta compañía se considera positiva. Las compañías de telecomunicaciones actualmente ofrecen servicios malos con altos costos, es el momento de que aparezcan nuevas opciones y eventualmente tomen su lugar y creemos que Miracle Tele tiene la oportunidad de ser un actor relevante en este proceso de cambio.
5. SI NECESITAN MAS INFORMACIÓN CONTACTAME CON GUSTO LES AYUDARE EN LO QUE PUEDA.
MI TWITTER @jsrg89


y aca les dejo la prueba de mi primer pago
https://imgur.com/a/icb9g6H

 y aca cuando los recibi en MEW
https://imgur.com/a/OHgTa2O
5  Alternate cryptocurrencies / Mining (Altcoins) / Help to start mining in a country in crysis on: August 09, 2018, 03:12:13 PM
hi im from nicaragua and im new in the crypto world
Im in a country who started a political crysis 3 months ago

I just got  this  pc

https://m.imgur.com/a/om3bWFa
im able to save $100 usd dollars every month
i know the gpu minning is the best way
i want to know which gpu card should i get (to start saving money to get it)



can u guys help how can i begin to mine
the most cost/ effective way pliz
6  Other / Politics & Society / Nicaragua Critical State of Alert background by a nicaraguan citizen. on: July 30, 2018, 05:39:36 PM
In 1979 the FSLN ( Sandinist front of national liberation) overthrew the dictator Anastasio Somoza Debayle with the help of the OEA ( The Organisation of American States). Their former leader took control of the Army, the Police, and the most influential parts of society. An increasing friendship with Russia and Cuba resulted in the maladministration of the economy of the country. The US trained opposition force (La Contra) waged an internal war, and eventually took control in 1989. The government was hamstrung by the activities of the para-military Juventud Sandinista, This purported to be young people, but was in fact, the same soldiers used in previous military operations. In 2007 they changed the political rhetoric and promised love and reconcilliation, and this enabled them to win the election with just 34% of the vote. (They had to change the law to enable this to be considered as a win). From that point, they took control of all of the media, including TV and radio.

They created a political cell in every neighbourhood called the CPC (Councils of Citizens' Power), and the members were given free houses and other benefits.This was to enable them to spy on people, and to manipulate the results of future elections. Once these cells had become established, the incumbent government won future elections with majorities of more than 80%.

5 years ago, a law was created that reduced pensions, and the elderly were forced to claim benefits from the new social security programme. Many pensioners and young people demonstrated in the streets outside the social security buildings, and this resulted in a heavy police presence to control them.

In the middle of the night, the Sandinista Youth arrived in government trucks, and they attacked the elderly and their young supporters. They wererobbed and beaten by the Sandinista Youth, and they even stole their cars. The Bishop of the City was called and attempted to calm the situation, but the police did nothing to help him, or to protect the demonstrators. The next day they repealed the law, but were not denounced for their actions. This was the start of an increase in government regulations, and this was enforced by the police and the army.

The government continued to win elections with majorities of 80% or more, but on April 18th they introduced some new laws. These reduced the pensions of the elderly,and increased taxation for the whole population. This caused the protests and demonstations to start again. This time the police and the Sandinist youth worked together to suppress the dissenters. They killed 75 protesters in the first month, and after 100 days, the death toll had risen to over 450. In addition hundreds are missing, and over a thousand face jail sentences of up to 20 years. They were of accused of terrorism, but in relity they were protesting against the misuse of government funds, and the increasing deficit in the INSS ( Nicaraguan Social Security dept). Nicaragua has changed from being the safest country in Central America, to becoming a country where it is unsafe to stay outside your house after 6pm. This is the result of troops patrolling neighbourhoods in government trucks, and shooting at random. Almost every protest leader is either dead or imprisoned.

proof writing and a lot of thing to make it better by jet cash (thx men)
sponsored by Fit to Talk English
7  Alternate cryptocurrencies / Altcoin Discussion / taking advantage of an economical crysis on: July 20, 2018, 05:19:03 PM
I will share my situation guys and tell me what u think pliz

Im **** ****** i am 28 years i live in Nicaragua whos getting into an economical crisis just as venezuela.. (our president is an asshole )
and a lot of economical bans are goin to come to my country soon..
At the time im writing this post there have been 350 people killing in protest, 10 thousand  jobs lost.
And im medicl doctor... thank god  havent lost mine but i think i need to descentrelize my money and search some passive income in other currency (beacause mine its going to loose value as the economic crysis get worst) while i still can,

I invested in a company named MIRACLE TELE its a phone compny in europe and the gave me some of the erning of the company every 15 days just by holding their tokens TELE my last payment was of 1.7 euros. By this time looks like nothing,,, but as u know in venezuela ( that im afraid its where my economic situation its going)  its a lot of money.
I left u the link

https://miracletele.com/
 what do u think ? of this strategy or what do u guys recommend me? i can invest $100 monthly

I don't plan to be rich but i need some way to hold my basic need when times get rough...
Thx guys for reading me
8  Local / Tokens (Español) / Mi primer ganancia en EUROS con MIRACLE TELE on: July 19, 2018, 11:28:34 PM
Seamos honestos! todos venimos acá por que necesitamos DINERO y estamos buscando formas de conseguirlo a toda costa! BTC

Los que me conocen saben que soy medico y mi pais es Nicaragua.
A pesar que la situación de mi país ni se compara a la de Venezuela (ANIMO HERMANOS NO HAY MAL QUE DURE MIL AÑOS).
Ante la situación que pasa en mi país y viendo como espejo las difíciles condiciones que pasa en el suyo decidí prepararme y conseguir fuentes pasivas de ingreso en otra moneda.

Por mera casualidad conocí MIRACLE TELE el cual esta regalando 120 TOKEN llamadas TELE:
Con la promesa que si las stack (significa que las ponemos en un estado en que no podemos tocarlas durante 15 días) nos darán un pago.

Ya que hay muchas paginas que prometen esto decidí esperar al primer pago antes de presentarlo públicamente.

Los primeros 20 tele te los dan al incribirte y los otros 100 con publicitar la moneda ( con un tweet basta)
Pueden ver los pasos en este post hecho por mi!
https://medium.com/ingresos-pasivos-con-crypto/mi-primer-experimento-c7b966a64861


AHORA LES PRESENTARE LO QUE GANE EN LOS PRIMEROS 15 DIAS LA IDea es que al llegar a 10 dolares la podremos enviar a wallet de eth o bitcoin
comencé con 120 tokens y al recibir



Comencé a invertir mas y planeo seguir asi mientras pueda y la situación económica del país me lo permita. Por que entre mas token tenga mas pago me darán cada 15 días! espero les sea util y me cuentan como les va saludos
Les dejo el Link si quieren sumarse. mi consejo es que aprovechen la promoción.SI quieres ayudarme puedes ocupar mi codigo de referido. Se los agradeceria bastante me dará tokens por cada afiliado.
(Link de referidos eliminado disculpen)

Si no no hay problema les dejo el link!
https://miracletele.com/register/  sin mi referido Abrazo hermanos


Y mi twitter por si necesitan les ayude en algo  https://twitter.com/jsrg89
9  Local / Esquina Libre / Cuales son sus cripto youtuber favoritos? on: July 15, 2018, 10:24:51 PM
EL DIA DE HOY QUIERO COMENTARLE DE UN YOUTUBER QUE SIENTO ME HA AYUDADO A ADENTRARME EN ESTE MUNDO! SI ESTE VIDEO TIENE ACEPTACIÓN LES IRE COMENTANDO DE MAS.
En primer lugar esta el Salvadoreño Jaime Merino!
SU CANAL SE LLAMA TRADINGLATINO


RAZONES POR LA CUAL ME GUSTAN SUS VIDEOS!

1 ) Es centro americano. Los que me conocen saben que soy nicaraguense y habemos pocos que nos adentramos en este mundo en mi pais.. de hecho en mi pais solo conozco 1 canal.
2 ) Tiene tutoriales en los que te puede enseñar los temas básicos de criptomonedas y trading
te dejo aca el Link del primer video de estos tutoriales.
https://www.youtube.com/watch?v=RjPRoDDh9Ok
3 ) Te actualiza en métodos como sacar tu dinero de las cripto a la moneda de tu país y como es de centro américa usualmente el método que el utiliza también aplica para mi. Aca les dejo el Link.
https://www.youtube.com/watch?v=5drhTVLMXHw
https://www.youtube.com/watch?v=Sn75s7IIRQ0
4 ) Otro elemento que me gusta de sus videos es que te da información de inversiones que el hace por ejemplo. En este video te habla de la inversión que el hizo para su máquina de minar criptomonedas.
https://www.youtube.com/watch?v=V5VMeA3i7ko

5 ) Y DE LAS COSAS MÁS IMPORTANTES ES QUE EL CONTESTA LOS CORREOS QUE LE ENVÍAN. EN LO PERSONAL LE HE ESCRITO 2 VECES PARA QUE ME AYUDE EN CIERTOS TEMAS Y EL BIEN AMABLEMENTE ME HA AYUDADO.

LOS INVITO A QUE LE ECHEN UN VISTAZO. TIENE MUCHO QUE ENSEÑARNOS Y TAMBIÉN TIENE LA BUENA INTENCIÓN DE HACERLO SALUDOS

Los links de los videos son sacados directamente de su página de youtube
Tradinglatino https://www.youtube.com/channel/UCLjSq1FapG5OgvHsDKinHdA/videos
10  Local / Trading y especulación / Conceptos basicos de Trading on: July 09, 2018, 04:14:16 AM
AMIGOS ESPERO LES GUSTE MI APORTE Y LES SAQUE DE ALGUNAS DUDAS
La información es de un viejo post de STEEMIT que hice hace poco. Es algo asi como un glosario.

BULL significa que el mercado va a subir en otras palabras el precio de la crypto moneda en este caso va a elevarse por lo que es un buen momento para apropiarse de algunas de esas monedas
BEAR significa que el mercado va a bajar o el precio va a bajar por lo que es prudente vender tu crypto antes de que
termines perdiendo tu dinero
SHORT ocupan el término para decir que las ganancia de esa cripto esperan que sea a corto plazo en horas a días
MID : ocupan el término para decir que las ganancia de esa cipto la esperas para semanas
LONG: prevén que las ganancias o elevación del precio va a ser en meses años
EXCHANGER: Es el nombre que se le da a la pagina web encargada donde puedes comprar y vender diferentes cryptos. Las mas famosas son bittrex,binance, kucoin, Poloniex.
WHALES o BALLENAS: se les llama a personas o empresas con capital tan grande!!! que al invertir en una moneda incrementan exponencialmente su precio!! y de igual manera al obtener ganancias y retirarse el precio de la criptomoneda vuelve a caerse!
VELAS JAPONESAS: Son un tipo de diseño para analizar el mercado que son los que están en la 1era imagen del post


ESTE TEMA ES UN POCO EXTENSO, DA MATERIAL PARA UN POST SOLO SOBRE ELLAS.
pero el resumen es que:

Las verdes son en alza (que las compras son mayores que la venta .. y esto hace que el precio suba) y las rojas son las bajas( exactamente lo contrario)

Entre más se acerque el cuadro verde al extremo superior de la línea es sugestivo de que el precio seguirá en alza
en otras palabras entre el cuerpo de la vela se acerque mas al precio maximo es mas probable que el precio siga subiendo y de igual forma lo contrario

Entre menos se acerque a los extremos significa que el mercado esta indeciso y que por ende no es prudente hacer una movida.


Espero les gusto y les siva de algo
11  Alternate cryptocurrencies / Mining (Altcoins) / Can i mine something with this crappy pc pliz help on: June 30, 2018, 10:50:22 PM
Hi im from nicaragua my country is getting in a terrible economic crisis

and im trying to get some money anyway i can..

The electricity billing is cheap around here..

but i only have this pc.. this is my video card
and this is other information

Can i mine some alt coin o something can u guys pliz help me what option do i have... to get some money.. every dollar its crucial around here
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