Brad DeLong's Semi-Daily Journal (2004)

I apologize for threading here on an off topic subject, but I was wondering whether stem cell research is being discussed this week at the convention.

I know that Congressman Peter Deutsch introduced a bill into the Senate that would lift the ban on federal funding for this form of in vitro research that President (hopefully not for too long) Bush introduced three years ago. If anyone is interested, visit the website below to urge President Bush to allow scientists to do thier job.

http://www.peterforflorida.com/petition/stemcell.html

I apologize for threading here on an off topic subject, but I was wondering whether stem cell research is being discussed this week at the convention.

I know that Congressman Peter Deutsch introduced a bill into the Senate that would lift the ban on federal funding for this form of in vitro research that President (hopefully not for too long) Bush introduced three years ago. If anyone is interested, visit the website below to urge President Bush to allow scientists to do thier job.

http://www.peterforflorida.com/petition/stemcell.html

Frankly, I don't find Kevin Drum's urine to be as interesting as a lot of other people seem to.

Salty ham? You're in Virginia?

Is that where Giblets's going to run away to?

Coming from a family of Urologists, the best advice I got was drink plenty of beer because it keeps the kidneys lubricated.

Ever heard of the label "Tuscany faction"?

http://slate.msn.com/?id=2071465

February 17, 2004

Must I Have Another Glass of Water? Maybe Not, a New Report Says
By JANE E. BRODY - New York Times

So, I was wrong.

You may not have to drink eight glasses of water a day to be well hydrated, and you can count caffeinated beverages in your total water intake, according to a new report from the Institute of Medicine, the group that sets desirable levels of nutrient intake for Americans of all ages.

The report, issued last week, reviewed the status of water, salt and potassium consumption by Americans and Canadians and set desirable intake levels for these nutrients.

Healthful Drinking

The expert panel that prepared the report found that women who appeared to be adequately hydrated consumed the equivalent of about 91 ounces of fluids each day, and men about 125 ounces. That is actually more than eight glasses (64 ounces). But only 80 percent of it came from drinking water; the rest came from other beverages, and from foods.

Dr. Lawrence Appel of the Johns Hopkins University, who headed the panel, explained, ''While drinking water is a frequent choice for hydration, people also get water from juice, milk, coffee, tea, soda, fruits, vegetables and other foods and beverages, as well.'' No mention was made of alcohol, however, which increases the body's water needs.

Although caffeine, as a diuretic, increases the excretion of urine, it does not lead to a deficiency of body water, the panel concluded, suggesting that the effect is fleeting.

Furthermore, Dr. Appel said, ''People get adequate amounts of water from normal drinking behavior -- consumption of beverages at meals and in other social situations -- and by letting their thirst guide them.''

Will this curb the explosive growth of specialty waters? Probably not. But it should be reassuring news for millions of people who worry that they do not drink enough.

While the institute used the recommended levels of 91 ounces for women and 125 for men, if they are healthy, it noted that the need for water increased significantly with strenuous or prolonged physical activity and for those who live in hot climates. Some may require twice the amount of water adequate for a sedentary person at moderate temperatures or even more.

How can you tell if you are getting enough water? Clearly, if you are thirsty, you need to drink more. Likewise, if your skin is shriveled, if you are prone to muscle cramps or if you are chronically constipated, chances are you are not drinking enough.

There is no harm in drinking more water than recommended, as long as you do not go overboard on it. Athletes who drink too much water without also replacing the salts lost in sweat, for example, can have health problems like abnormal heart rhythms.

On the other hand, drinking more water may help curb runaway obesity. Every good weight-loss program recommends drinking a glass of water (or an equivalent beverage) before and with every meal, since it both fills you up and improves digestion.

Too Much Salt

The panel, formed under an arm of the National Academy of Sciences, found that Americans typically consume far too much sodium chloride, or salt. In some cases, the consumption runs as high as three times the amount needed for good health, or even higher.

The average man takes in 7.8 grams to 11.8 grams of salt each day, and the average woman consumes 5.8 to 7.8 grams, figures that the panel regards as underestimates because they do not include salt added at the table.

How much salt should people eat? For healthy adults 19 to 50, the desirable level is 3.8 grams of salt (about two-thirds of a teaspoon, or 1,500 milligrams of sodium) daily, the amount needed to replace what is lost in sweat.

For an upper limit, the panel set 5.8 grams of salt a day (a little more than one teaspoon), but noted that this was not a desirable amount. The panel said that more than 95 percent of American men and 75 percent of American women ages 31 to 50 regularly consumed salt in excess of the upper limit established by the group.

Consuming too much salt, which means too much sodium, increases the risk of developing high blood pressure, which can in turn lead to strokes, heart attacks and kidney disease. Blood pressure tends to rise in direct relationship to the amount of sodium a person consumes.

Some people are especially sensitive to the harmful effects of salt, including the elderly, African-Americans and people with chronic diseases like hypertension, diabetes and kidney disease, the panel noted.

An appetite for salt is an acquired taste, since anthropological evidence strongly suggests that humans evolved on a diet low in sodium and rich in potassium.

Our vegetarian ancestors consumed less than a gram of salt a day and even heavy meat eaters took in only about 4 grams on good hunting days.

Currently, more than three-fourths of the salt in the American and Canadian diets comes from prepared and processed convenience foods, including those bought from vending machines, snack bars and restaurants.

Enough sodium is naturally present in foods and beverages to meet the body's need for it. Only those who labor or exercise strenuously for long periods in hot weather are likely to need more sodium than a natural diet provides.

Thus, anyone who loses six or more pounds in a workout should replace some of the lost salt, along with water.

When it comes to sodium and potassium, modern food producers and vendors have sabotaged our natural metabolic processes.

Since we evolved in a low-sodium environment, our bodies are designed to hang on to however much sodium they can get.

But since potassium was plentiful in the early human diet, evolution built in a mechanism for releasing potassium to protect against a hazardous excess, which can cause abnormal heart rhythms and muscular paralysis.

Potassium Problems

Now, we consume far too few of the potassium-rich foods, which can help to lower blood pressure, blunt the effects of salt and reduce the risk of kidney stones and bone loss.

The panel recommended daily consumption of 4.7 grams of potassium a day for adults, but noted that American women 31 to 50 consumed no more than half this amount, and that men didn't do much better.

The panel also noted that African-Americans, who have a higher rate of hypertension and thus may benefit most from more potassium, generally consumed less potassium than non-Hispanic whites.

People taking diuretics to control high blood pressure or edema are especially at risk of developing a potassium deficiency.

Among the best dietary sources of potassium, on a per calorie basis, are spinach, cantaloupe, almonds, brussels sprouts, mushrooms, bananas, oranges and orange juice, grapefruits and potatoes, the panel said.

Other good sources include dried fruits, peanut butter, bran, meats, dried beans, peas, coffee, tea and cocoa.

If you can handle the sugar, sports drinks are also good sources of potassium.

How about running over to Parma and picking up some of that salty ham for the rest of us.

Yes, it's a 100 ounces but they forget to mention that the water content in food servings count. So unless you're eating dehydrated meat, the water content of a sirlion steak counts toward your daily total. As well as the water content of carrots, celery, or the cookies you eat.

There have been several studies of salt versus high blood pressure and increased morbidity, but without any good evidence.

From what I can tell, finding on the relation between sodium in the diet and blood pressure are clear. Similarly and opposite on potassium and blood pressure. Less salt and more potassium, as the article above notes.

June 22, 2004

Preserving a Delicate Balance of Potassium
By JANE E. BRODY - New York Times

Evolution is an excellent teacher when it comes to figuring out what and how much people should eat.

For example, primates (including those with two legs and big brains) evolved on foods rich in potassium and very low in sodium. Early humans evolved to conserve sodium, which was hard to obtain, and to excrete excess potassium, abundant in many fruits and vegetables.

But Western-style diets these days are the reverse of what those early humans consumed, rich in processed foods, loaded with sodium and relatively poor in potassium. Consequently, according to a report released this year by the National Academy of Sciences Institute of Medicine, many people now consume diets deficient in potassium and high in acid-generating foods like meats and other animal proteins that further deplete the body's supply of this vital mineral.

According to national diet surveys, the average man in this country consumes only about two-thirds the recommended amount of potassium each day, and the average women consumes even less - half of the 4,700 milligrams a day considered to be an adult's adequate daily intake.

As the institute report explained, "Humans evolved from ancestors who habitually consumed large amounts of uncultivated plant foods, which provided substantial amounts of potassium. In this setting, the human kidney developed a highly efficient capacity to excrete excess potassium."

A Crucial Nutrient

Normal healthy kidneys are not effective at conserving potassium and are thus unable to prevent a deficiency when dietary levels of it are low.

Potassium and sodium, along with chloride, are electrolytes. They regulate the electrical potential of cell membranes and, thus, the conduction of nerve impulses. Potassium resides primarily in cells, while sodium and chloride are found mainly outside cells. All three have to be in proper balance to assure normal metabolic and neuromuscular functioning. And the imbalance of high sodium and chloride in relation to potassium is believed to be a major factor in several serious chronic ailments.

The potential consequences of a chronic potassium deficiency are often unrecognized, even by health professionals. The problems include high blood pressure, heart attacks, strokes, kidney stones and a loss of bone minerals that can lead to osteoporosis. Low potassium consumption can also cause a sensitivity to salt, further raising the risk of hypertension. That is a common problem among African-Americans, who have a much higher risk than whites of developing hypertension and its lethal consequences.

These and other effects of insufficient potassium can occur even when blood levels of the mineral appear to be normal. Furthermore, even small changes in potassium levels can harm nerve transmission, muscle contraction and blood-vessel tone. Most people have little or no warning of potassium deficiencies. They may feel tired, weak and irritable, but unable to pinpoint the cause.

To make matters worse, high-protein levels in diets result in acid formation that increases the loss of calcium, the primary bone mineral. Studies have demonstrated an association between higher consumption of fruit and potassium and increased bone mineral density. The more protein in relation to potassium consumed, the greater the risk of bone loss in the hips and spine.

In its report, the institute was especially critical of the currently popular low-carbohydrate high-protein diets. Although these diets may contain enough potassium from protein, they lack enough alkali-generating substances from fruits like oranges, bananas and grapes to counter the high acid formation associated with a protein-rich diet.

In a six-week study of 10 adults on a low-carbohydrate, high-protein diet, calcium loss in urine increased by 50 percent and was not compensated for by an increase in intestinal absorption of dietary calcium.

The researchers concluded that the diet overloaded the kidneys with acid, increased the risk of formation of kidney stones, led to a net loss of calcium and might have increased bone loss. The institute noted that there had been "no published studies of the long-term metabolic effects of this kind of diet in any group of individuals."

People taking certain diuretics - thiazide and loop diuretics -to lower blood pressure or to counter fluid retention may also incur a potassium deficiency, because those drugs increase urinary loss of both sodium and potassium. Such patients are commonly told to take potassium supplements, typically potassium chloride, although chloride has a counterproductive acidic effect.

Also at risk of potassium deficiency, even when consuming an adequate diet, are people who sweat excessively as a result of high heat or extreme exercise. Both situations increase the need for potassium, which is best met through increased consumption of potassium-rich fruits, vegetables and juices....

Dex: To that end, beer is mostly just water in disguise (plus you get a lot of calories as a side effect). Drinking beer will cause you to go pee as much and as often as when you drink water. The alcohol is said to have an additional diuretic effect, though, so it may increase throughput provided the lost water is fully replaced.

If you are just concerned about flushing out metabolic byproducts, I'd go with water. But then I grant that beer goes down much better.

The book “The DASH for Hypertension” (Dietary Approaches to Stop Hypertension) gives meal plans and recipes for reducing blood pressure. The authors also discuss the theory behind DASH. The diet has plenty of potassium rich foods. They also discuss DASH with low sodium where they showed that the good results with DASH could be improved further with sodium reduction (don’t buy anything with more than 5% sodium). I highly recommend both the book and the diet. I suspect that a lot of people could stop taking medications if they used DASH combined with exercise. It all really comes down to evolution. We have pre-agriculture bodies designed for a hunter-gatherer life style, not sitting behind computer terminals and eating processed foods. And by “exercise” I mean getting your heart rate up into the aerobic zone for at least 45 minutes. Twenty or even 30 minutes is not enough for most people. The formula for the approximate aerobic heart rate is (220-age) x 0.85. You can get a more accurate value from a cardiac stress test, but the formula does fine.

or better yet Mssr Delong / Drum come to Dubai (120 degrees now)....or even better Kevin try having two or three kidney stones scouring out your urinary tract some time and I believe THEN you will see the value of drinking crap loads of water............

Man, I hate to be a wet blanket, 'cause I am a fan - but, Kevin, you just made the Logic Error of the Right (LEoR).
Do you know what is a healthy color? Just assuming what you have always seen is a normal, and that's just fine - because, ... because I'm here! Dammit! and I'm fine! right?
The way Rush Limbaugh can look out the door and pooh-pooh global warming.
The way the Right Wing can win arguements with "common sense." I pick on you, so that we, you and your readers, can see the use of words, and the purposeful twisting of logic.
We try to address complicated issues with intellect, and they respond with a subjective cursory view that has a fully understandable explanation. It is crap, but it is socially integrated crap. Can we learn to do that?

eat it with unsalted tuscan bread

Richard Crews -- long ago, my 12th grade AP English teacher had a phrase for the logical fallacy you aptly describe: "I had a uncle once."

To the point, and memorable -- I can't remember the rest of her aphorisms, but that one has stayed with me more than 3 decades later.

Richard--I applaud the noble lefts rejection of "common sense" as long as its not countered with the ripost of "its too complicated to explain to you of lesser intellects". Sometimes there are no simple solutions but that does not exclude the possibility of simple and concise explanations.

A Zarkov

Thank you for the fine dietary post. High blood pressure is a severe and widespread problem.

Anne

August 12, 2003

'Normal' Blood Pressure: Health Watchdogs Are
Resetting the Risk
By JANE E. BRODY - New York Times

So what really is "normal?"

When it comes to health-related measurements, the
definition of normal seems to mutate from time to
time, forcing some who were previously unconcerned about a matter of health to pay closer attention and make some changes that could preserve their well-being and maybe even save their lives.

For example, just 25 years ago, a serum cholesterol level of 240 milligrams was considered normal -- until studies showed that a majority of heart attacks and coronary deaths occurred in people with cholesterol levels of 240 or less. So now "normal" is 220 milligrams or less, and "optimal" is 200.

Now, the watchdogs of our health have revised another definition of normal downward, the measurement of blood pressure.

Not a year ago, this column told you that "high" blood pressure started at 140 over 90 millimeters of mercury; that a pressure of 130 to 139 over 85 to 89 was "high normal," while "normal" was less than 130 over less than 85; and that "optimal" was less than 120 over less than 80.

(The upper number, or systolic pressure, represents the pressure of arterial blood flow when the heart beats. The lower number, or diastolic pressure, indicates the pressure between beats.)

That indeed was the thinking at the time, and it meant that 50 million people in the United States had high blood pressure, or hypertension, with nearly half inadequately treated or not treated at all and few if any with high-normal blood pressure doing anything to bring it down.

But in May, a group of specialists on blood pressure convened by the National Heart, Lung and Blood Institute issued new guidelines that said additional tens of millions Americans were at risk of suffering diseases related to blood pressure. These people needed to change diet, exercise and smoking habits to bring down their readings, the panel said.

The guidelines, published on May 21 in The Journal of the American Medical Association, established a condition that the committee called "prehypertension" to describe an additional 45 million people with readings from 120 to 139 millimeters of mercury of systolic pressure or from 80 to 90 diastolic pressure.

These people face a very high risk of developing frank hypertension and its complications as they grow older, unless they do something now to lower their risk.

Blood Pressure Facts

Misunderstanding abounds not only about what may be a
potentially dangerous elevation in blood pressure, but
also about the effects of such elevations and the
importance of lowering them and keeping them lowered.
High blood pressure greatly raises the risk of heart
attack, stroke, heart failure and kidney failure.
Evidence also suggests that high blood pressure can
contribute to the progression of mental deficits and
dementia.

Controlling elevated blood pressure can sharply reduce
the risk of serious illness. For example, it can cut
strokes 35 to 40 percent, heart attacks 20 to 25
percent and heart failure more than 50 percent. For
every 12-point reduction in systolic blood pressure
maintained for a decade in 10 patients, one death will
be prevented.

Note the words systolic blood pressure, the upper
number. For many years, experts thought that diastolic
pressure was the more important factor in preventing
illness and death. But as the specialists' report
pointed out, in people older than 50 "systolic blood
pressure of more than 140 millimeters of mercury is a
much more important cardiovascular disease risk factor
than diastolic blood pressure."

Because it is almost always a disorder without
symptoms, hypertension is called a silent killer, and
nearly a third of the people who have it are unaware
of it. Thus, you are not very likely to say something
to a physician that would prompt a check of blood
pressure.

To find out whether you have elevated blood pressure,
the pressure must be checked by a physician,
physician's assistant or nurse on several occasions.
Or you can test it yourself with a reliable home
monitor. The test is noninvasive, quick and painless
and should be performed at every encounter with a
health professional.

One fact may help to clarify the need for new
guidelines. The definition of high blood pressure is
arbitrary. There is no threshold at which blood
pressure suddenly becomes a threat. Recent studies
have shown that damage to arteries that increases the
risk of heart disease or stroke can begin at blood
pressure levels once considered normal -- for example,
at levels as low as 115 over 75. Furthermore, for each
increase of 20 over 10 millimeters of mercury, the
risk of those potentially fatal diseases doubles.

The point where blood pressure can contribute to
serious illness depends in part on what else may be
medically awry. Thus, moderately elevated pressure is
considered more serious in a person with diabetes or
another heart disorder.

Even if your blood pressure has been normal for
decades -- by the new definition of normal -- it is
not safe to assume that it will remain so. As people
age, their blood pressure tends to rise. According to
the Framingham Heart Study, which has run for decades,
90 percent of those who have normal readings when they
are 55 eventually develop high blood pressure.

Blood pressure increases because most people's
arteries narrow and stiffen with age, forcing blood to
flow through less hospitable channels. That sets up a
vicious cycle, because elevated pressure injures the
arteries and causes them to stiffen even more.

What Should Be Done

If the systolic pressure falls between 120 and 139 or
you have a diastolic pressure of 80 to 89, you are
considered prehypertensive and need to change living
habits to ward off serious illness.

First and foremost, if you are overweight, lose the
extra pounds. Heaviness is the leading risk factor for
developing high blood pressure, and weight loss nearly
always brings down an elevated pressure.

A government-tested dietary pattern that has proved
effective in controlling hypertension can help with
weight loss, promote cardiovascular health, protect
against osteoporosis and help prevent cancer. It
should be adopted, as well, by everyone who is
prehypertensive.

It is popularly called the DASH diet -- rich in
vegetables and fruits, whole grains and low-fat dairy
products, with two or fewer daily small servings of
fish or lean meat or poultry and three to four weekly
servings of nuts, seeds and legumes like dried beans
and peas, cooked, of course. (The acronym stands for
Dietary Approaches to Stop Hypertension.)

Reducing salt intake to a maximum of 2,400 milligrams
a day can enhance the effectiveness of the diet, which
can be as good as some drugs in controlling blood
pressure. Also important is moderating alcohol intake
-- no more than one drink a day for women and two for
men. At the same time, adopt a regular exercise
program, like brisk walking at least 30 minutes most
days of the week. And if you smoke, quit. Smoking
seriously damages arteries.

When changing living habits is not enough to normalize
blood pressure, medication is needed. The specialists'
committee said treating uncomplicated hypertension
should start with thiazide diuretics and, if needed,
be combined with other blood pressure drugs.

Most patients with seriously elevated pressure require
two or more drugs to achieve a safer level, the
committee reported. The medications have to be taken
daily to be effective.

Anne, there's a Real Cool new technique called 'linking'. Using 'linking', one doesn't have to post and entire article, one can post a 'link' to the article. People can click on the 'link', and the article will be brought right to them!

Barry

Sorry, the New York Times does not allow linking after 7 days. The NYTimes is making a sad mistake by cutting the links, but there is no choice for us. Forgive the long posts, but I thought they were most important.

Well, speaking as a Southerner here in SoCal too, country ham (good and salty, either whole where you have to soak it for a day and boil it with changes of water, or sliced and pan-fried with red-eye gravy and grits) is just about the one food it's impossible to get.

Fortunately, I have a bother in TN, and there's FedEx.

Ann, sorry for the supersized snark. There's now a la permanent link generator for the NYT:
You can do it from this page:

http://nytimes.blogspace.com/genlink

Barry

I love you. I love saving New York Times articles, and this will help me so much. These articles become a library as I index them. Snarking is fine, with a gift such as this. For years, I clipped NYTimes articles but in this age there has to be a better way. By limiting access to old articles, the NYTimes hurts itself.

You're very welcome, Ann. Please pass this around a lot (that way, when I need it again, it'll come up first on a google search - I had to scrounge around for a bit).

And it is a nice thing for the NYT to offer. Also wise, since it will generate a lot more traffic for them. Registration is ridiculous, for most publications.

Barry

OK, I get it, we have to save the original link. So, store the links and you can open the articles. I will do as you ask. Also, I will store whole articles on gmail for the speed of access. I wish the NYTimes would give us more. Registration however at the NYTimes is a breeze. I love the paper. Thanks Barry...

Anne

Dear Brad

I thought of you when I read Drum's post. In fact, I considered e-mailing a link except that I knew you would get to it before checking your e-mail. Fellow JBD fans, the DeLong family were guests in my house for 2 days with only me (my family at the beach like good Italians in July) and we drank about 0,2 metric tons of water not counting the restaurant where the waiter started bringing more water without bothering to wait for us to ask.

Anne...
If a taste for salt is "aquired" then why will cows walk 30 miles just to get a lick of it? Why have so many early cities (ie: London) grow up around salt availibility? Why do the studies in Japan, where salt is a much more common preservative, show less ill effects from sodium consumption than they do here. Salt, like the blood pressure and cholesteral items has been subject to a lot of changes in recommendations from experts over the years. I was given salt tablets when I was a boy, and it was good medical advice then.
This I suspect will follow the evils of sugar and then fat. Moderation in all things is a good plan until this "research" is proven perfect, something that is, as yet, not attainable. I am not advocating that someone with high BP should be consuming a lot of salt. But someone with normal BP (whatever the hell that is) should not be worried about it too much.

BD

What seems to be the case is that overall diet as well as salt consumption influence blood pressure. So, we must look to studies in America and western Europe where bllod pressure and salt consumption are highly related and problematic, and Japan where the problem is far less. Your points are well taken. Processed foods, however, are quite salt laden unless otherwise marked and we should be careful of excess of salt.

The US population suffers increasing blood pressure with age. This is so prevalent that doctors seem to regard elevated pressure in older people (over 50) as “normal.” But they also admit this increasing pressure causes harm to the circulatory system. When I point out that people in some countries don’t show this secular increase with age, I get a blank stare from the doctor. I think the problem is lifestyle related, meaning diet and exercise, unless some disease or genetic defect is present.

Even measuring blood pressure can be a problem. Dr. Korotkoff introduced the cuff method we use in 1901. Here’s how it works. When the cuff is fully inflated arterial blood flow is interrupted. As the pressure from the cuff is released a series of sounds called the “Korotkoff sounds” appear. These sounds have five levels (K1-K5). Systolic pressure is the cuff pressure at the appearance of K1 (it might be K2 these days). Diastolic pressure is the cuff pressure at the disappearance of K5. It’s easy to hear a sound appear, but harder to tell when the muffled K5 sound disappears. So measurements of diastolic pressure are often in error.

Then you have “white coat” hypertension. Supposedly people get scared when they have their pressure measured and the readings are artificially high. Some doctors assume most everyone gets scared and they automatically reduce the reading they get. I think this is a very bad practice. The Mayo Clinic is smart about this. When a patient shows variable pressure they have him wired up with an automatic cuff that takes a measurement every ten minutes for six hours. This gives a time series that can be smoothed to get a realistic value for the patient’s pressures.

If you want to take your own pressure, the Mayo Clinic recommends the Omron automatic cuff with “Intelli-Sense,” (model HEM 711 is good). The store at Mayo unpacks all the units they buy and check the calibration. You can also take a one-on-one short course at Mayo on how to take your own pressure, and they also check that the cuff you are using is working correctly. It’s really easy to screw up a blood pressure measurement and unfortunately a lot of doctors and nurses today aren’t good a taking blood pressure. The machines in drugstores and shopping centers are frequently out of calibration and should be avoided.

Finally it’s interesting that the cause of Korotkoff sounds is still and unresolved issue. One theory says the sounds come from turbulence in the blood flow, while another says that they come from a buckling in the arterial wall. In any case I find it amazing that we can make the measurement at all.

6129 You can buy viagra from this site :http://www.ed.greatnow.com

4416 Why is Texas holdem so darn popular all the sudden?

http://www.texas-holdem.greatnow.com

3001 get cialis online from this site http://www.cialis.owns1.com

24 Get your online poker fix at http://www.onlinepoker-dot.com

5581 black jack is hot hot hot! get your blackjack at http://www.blackjack-dot.com