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Hi there! This post was removed from Psychology Today by the author, but you can still read it in its original form here:
Guyz - I say: We're dum but we're fun. My women friend say: "Well yea, the dum part...."
If a tree falls in the woods and no one is around, is it still the guys' fault?
Women: "of course!"
Apparently, we guys have 1/2 the verbal capabilites of women - most a lot less! The biggest mistake I see my women friends make is they think/act that guys don't feel deeply because we are non-verbal. WRONG!
Guys feel thing VERY deeply but usually express them physically not verbally. Paradoxically, men feel things the most deeply in their early dating and mating years but have the least verbal and social skills. A cruel joke but the driver for most music, poetry, science achievement, dumb risk taking, etc.
In fact new research is that young boys have very strong feelings, many negative, that are squashed.
Guys do really dum things that women would NEVER do. Lighting fire to a car and jumping the Grand Canyon is a kool guy idea. Women think it's crazy -- and it is. It is also mainly to impress them! There could be a whole long post on the dum sexual things guys do -- let's just say whenever the word "hot" comes up -- RUN!!! ......away....
Where women can REALLY help guys is in teaching them to express their feelings BEFORE they jump the Grand Canyon, run to a hot babe, punch a wall, buy a motorcycle/boat/car/another guitar-gun-whatever, have an affair with a married woman/blond at the office/20 yr old, etc. Women with brothers get this -- learn from them gurls.
I tell my guys friends mainly -- DON'T. No, don't even think about it! Of course, guys never listen. Again, Hot = Not!
Guys need to be told things VERY clearly, quickly and simply -- about 100 times. Look at how sport are organized. That's a perfect template for the male brain.
Again, dum but fun. Now, about that hot chick/car/guitar/boat/motorcycle/fiery car jump/extreme sport.....
Do guys like you, who pander to these stupid myths about men think that this will get them laid?
BTW: "dum" is spelled "dumb"
are men really that inept
are men really that inept. and males think considering risk... women security and love... awesome
so evil and manipulative?
"Grumpy" was right.....
One of my biggest gripes is the teasing I endured from guys from K-12 and beyond. I hated it.
Because of this, I avoid guys unless I am absolutely sure I am on good terms with them.
Well, sure. All those guys liked you. Guys are the most irritating to people/women they like. Woman are the opposite. Pretty dum, huh?
Not dumb, but true. Women will be sweet to the men they like & bitchy to the men who annoy them. But if a guy we like is bad to us, we will be worse to him & most likely behind his back.
Bullshit,women love bad boys.
Why is it always okay for criticisms to be levied against men, but "sexist" when criticisms are made about women?
Relax. Your time is coming, as Shawn stated. Why don't you fill out his survey so we know your thoughts also.
Some of the responses to the survey are particularly stupid...a lot of the women who responded don't expect much of men, do they? Guys aren't apes --they're complex human beings. I was disappointed at the lack of variety and the enormous generalities made.
But, I have learned, the hard way to never believe a woman when she says what she wants.
Most guys have jumped through these hoops and still ended up disappointing our women in some other way.
The great lesson in a man's life is to secretly not care what women want -- you'll never hit that moving target.
But, I have learned, the hard way to never believe a woman when she says what she wants.
Most guys have jumped through these hoops and still ended up disappointing our women in some other way.
The great lesson in a man's life is to secretly not care what women want -- you'll never hit that moving target..
The great lesson in a man's life is to secretly not care what women want -- you'll never hit that moving target..
Damn straight,bro. Women don't know what they want.
You can't seriously think I'm going to remember all this stuff that I'm suppose to be to all women? I'm going for a swim now then back to acting like an ape.
What about what women love about women or what men love about men...
If you are addicted to a smart phone there are bluetooth adapters and software that work well. The DashBoss set up for apple products is also a monitor only (no tuning), it does involve getting out your phone and firing up an app and establishing a bluetooth connection when you get in your truck. Cummins INLINE 5
It looks like a laundry list of things women want men to do for them -- not a list of what they like about men.
Which is typical.
Why don't we communicate better? Let's look at how women define communication -- you'll find your answer there.
The article is titled 'What Women Love About Men', but you have to scroll about 60% of the way through before you get past the critical prologue.
What women mainly like about men is that they can criticize them, incessantly - for "their own good", of course.
I like how some men can be so gentle & calm. Brings me peace. And I like men that are simple, what you see is what you get. And the best way a man can win me over, not be afraid to cry! That will just make me want to hug him :)And most attractive quality is when you can see that he would be a great father!
After reading the article, I decided that I agree on most of the suggestions about what women like/dislike about men. However, there is one comment which is totally false for almost every guy I know. The comment was if men want the nagging to stop all they have to do is to help around the house. Every guy I know that helps clean, cook, take care of the kids, etc., does not get a break from the wife or SO. In fact they easily become to expect it as an entitlement. They do not even give a thanks or special treatment for all of the help. These women do not help there husbands fix the car or the leaking sink etc.. It become expected! I help anyway, but I know of some men where this sort of disrespect for their helpful actions has lead to divorce. Then during the divorce the going to be ex-wife writes a declaration stating he never helps and is nothing but scum. My point is there are a lot of men out there who do their share of housework to help their wives and the family in general. Most wives will nag and turn against their man anyone. That is if it suits their needs.
what women like about men and what women want from men are generally completely different. Which brings me to the conclusion that "women want everything, all at once". That's why they apeear to be undecisive most of the time.
Even if it could be provided to some degree, then they would get bored and start demanding different qualities; but I guess this last statement apply for men, too.
my name are andrea loops.and i want to thank dr alexzander for saving my home and making my husband ten times rich than he was before. I was in a relationship where my partner was not paying enough attention to me, never told me that he loves me only when I asked him and I was never a priority in his life. One day I start searching for help and I heared about dr. alexzander Hightemple. He just safe my relationship. He did a spell charm to safe my relationship. Today I'm grateful to dr Alexzander Hightemple who did an amazing work. He safe our relationship and today my partner treat me like a queen. I became everything for him. Don't think too much anymore because god has sent a great spell caster who can do all things,just to see smile on the face of young lovers and family. contact him at email@example.com . He is the one who will and can help you in what so ever situation you fine yourself into.
once again i say thank you for your deeds dr alexzander me and my family are greatfull to you and your gods.....
Shawn Smith is a licensed psychologist in Denver, Colorado.
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Shescape has to be hands down one of the best seasonal and special occasion party promoters in New York City. They lesbians parties around all the major holidays. Key events include Pride, Fire Island Dodgeball, Labor Day, and many more. In the past, they have held their parties at Tre Merli in Soho or Cafe Deville in the East Village and other various changing fabulous locations. This time around they decided to rent out a new spot on 18th and Broadway. Lucy de Gramercy, regularly a restaurant, specializes in Latin cuisine. Small aspects still remind you that it is a restaurant, including a large cauldron of fancy kettle cooked potato chips at the bar.
Their Halloween party had a very lounge like atmosphere early on, but after Halloween Parade goers let out, the party was ready to begin. One great thing about Shescape parties is that the crowd is always classy. Always come dressed to impress and are never rude. Actually quite a friendly mixed crowd if you ask me. You won't find anybody with fake id's or who just turned 21 and want to make a fool of themselves or are trying to front real hard. Most girls looked around 24-30. Sometimes the door charge, which maybe a little higher than most other lesbian standby clubs ($15), is a bit of a deterrent. But as with life, you get what you pay for. The spacious dance floor was set off all night long with pop and hip hop.
There were plenty of classic costumes from she-devils, to gangsters, to zombie surgeons. Notable ones included Sam Ronson and Lindsay Lohan, and two Lesbian Uhaul trucks that even included brake lights. The bar was extra extra crowded and it took on average 15 minutes to quench my thirst. They opened a second bar towards the back later in the night to cater to all the thirsty ghouls and goblins.

subset: commoncrawl


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"Being a vegetarian, I was delighted to find a hearty meatless main dish at the Stamford Plaza hotel in Auckland, New Zealand," writes Barbara Abbott of Santa Rosa, California. "The mushroom risotto was outstanding; I'd be pleased if you could get the recipe."
- Yield
- Makes 8 first-course or 4 main-course servings
- 2 tablespoons olive oil
- 1 onion, finely chopped
- 4 garlic cloves, minced
- 6 ounces shiitake mushrooms, stemmed, caps sliced
- 6 ounces crimini mushrooms, sliced
- 2 cups arborio rice or medium-grain rice
- 1 1/2 cups dry white wine
- 5 1/2 cups vegetable stock or canned vegetable broth
- 2 bay leaves
- 1 cup grated Parmesan cheese (about 3 ounces)
- 2 tablespoons chopped fresh basil
- 1 tablespoon chopped fresh thyme
- 2 tablespoons (1/4 stick) butter
- White truffle oil* (optional)
- Additional grated Parmesan cheese
- Heat oil in heavy large skillet over medium heat. Add onion and garlic and sauté until tender, about 10 minutes. Add all mushrooms; sauté until brown, about 3 minutes. Add rice; stir 3 minutes. Add wine and stir until almost absorbed.
- Add stock and bay leaves; simmer uncovered until liquid is almost absorbed, mixture is creamy, and rice is just cooked, stirring occasionally, about 20 minutes. Discard bay leaves. Stir in 1 cup Parmesan cheese, herbs, and butter. Season to taste with salt and pepper. Drizzle lightly with truffle oil, if desired. Serve, passing additional Parmesan separately.
- Available at Italian markets, specialty foods stores, and some supermarkets.
Nutritional Info
- Calories649
- Carbohydrates93 g(31%)
- Fat19 g(29%)
- Protein17 g(34%)
- Saturated Fat8 g(41%)
- Sodium1598 mg(67%)
- Polyunsaturated Fat1 g
- Fiber2 g(8%)
- Monounsaturated Fat8 g
- Cholesterol30 mg(10%)


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My 61st day is tomorrow for my BCE . As much as I would love to request the increase I am patiently waiting for April 1st when my only baddie on Experian falls off , and my score should skyrocket to mide 700's like my TU. I would apply wiith it now , but problem is with how the account was updated experian things it happen in sept of last year which kills my score, and Experian refused to change date, so at this point I am playing the waiting game, like I am for my csp .
TU 715 No apps to 05/13 cash+ 5/13!!! 738 TU CSP April 13!!!CSP approved May 13!!!
youngandcreditwrthy wrote:
Ohhh, Id dispute it til the end of the earth. Did the CA update the date to make it look recent? That is illegal !!!!
Exp doesn't allow me to dispute it anymore online, so I am leaving it alone. Plus I need to wait for Amex to do another sp.
TU 715 No apps to 05/13 cash+ 5/13!!! 738 TU CSP April 13!!!CSP approved May 13!!!
youngandcreditwrthy wrote:
Yeah, they wouldn't allow me to either. I had to call them and explain to them the illegality of it all...
I mean wait if you choose, but be aware that you do have rights in this situation :-)
Experian removed it the same day I called them frustrated and told them what the CA was doing. :-) good luck!
Tempting maybe I will call tomorrow. Worst case it only a few weeks from now.
TU 715 No apps to 05/13 cash+ 5/13!!! 738 TU CSP April 13!!!CSP approved May 13!!!
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Last swings for an old golf course in Franklin Lakes
FRANKLIN LAKES – Alan Zollo can stand on the front steps of his house on his quiet street and glance down the 15th fairway of High Mountain Golf Club.
Zollo, a member at High Mountain for 20 years, can walk from the 15th tee into his house in 20 seconds if he needs to grab a sweater or another item.
His scenic views and easy access to High Mountain will soon come to an end, though, with the 18-hole semi-private course scheduled to shut down this fall and be replaced by new homes.
"Even during the winter here when it's snowing, it's gorgeous," Zollo said during a round of golf Saturday, "and that's all going to go away."
Across the United States, golf properties are going away in favor of more lucrative business ventures. Over the previous eight years, more golf courses have closed than opened, according to the National Golf Foundation. Last year, the number of 18-hole courses that closed dwarfed the new openings, 157 1/2-14, said the NGF.
High Mountain is in the final months of a run that began in the summer of 1966.
A membership that has dipped from more than 400 to about 140 will be especially sad to say goodbye.
"This year is sort of like senior year of high school," said Anthony Cofone of Oakland. "It's a lot of fun, but you know it's going to be over, and you're going to be leaving all your friends."
Members at High Mountain talk more about the loss of friends than they do about losing access to a par-71 course on a 131-acre property that includes a driving range, chipping and putting area, and restaurant.
"The hardest part is the people you have been playing with for years are going to different places," said Ridgewood's Greg Osborn, 50, who has played more than 1,000 rounds here spanning 35 years.
"So you're going to lose some long-time friendships, and we've been losing it over the last few years because of the uncertainty of the future."
Two of Osborn's playing partners, his father, Jerry, and father-in-law, John Luongo, passed away earlier this year, and he considers the club's closing another death in the family.
"For us, considering we lost our father and father-in-law in the last four months, this is like a third death," said Osborn, who continues playing with his two sons, Christian, 16, and Zachary, 10. "It's part of our life."
"The whole thing about golf is you make the friendships, and you learn how to play nicely and fairly," said Franklin Lakes' Joan Peragallo, who has played here for 29 years. "And it's social, very social. It's our social life."
"It's given me a way to get out of the business cycle and the pressures that go with it," said Fort Lee's Marvin Schleyer, 80, a stock market arbitrator and vice president of a company that handles mergers and acquisitions. "And it's given me something to look forward to every week."
Over the past couple of years, members at High Mountain have been recruited by surrounding clubs. Many have already left, breaking up longtime cliques.
"Some people have already made their decisions on what clubs they're going to. We've been getting wooed by other clubs," said Dennis Murray of Little Falls.
"Personally, I'm not deciding anything until they turn the lights out for the last time."
No one has turned on the lights more at High Mountain than longtime pro Pat Lawler.
The Wyckoff resident has worked at the club for 45 years and his father, Joseph, began as the pro in 1969. Lawler expects to work at another course.
"It's going to be a big change for me. It's been a big part of my family," said Lawler, who anticipates the course will shut down in early December.


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Joshua Taylor's family speaks to community
On April 18, 2013, our grandson, Marine Lance Corp. Joshua Taylor, along with six other Marines, lost their lives in an explosion at Hawthorn Army Depot in Nevada, during a training exercise. It took almost two agonizing weeks to get Josh home and laid to rest. We mourn the loss of our grandson and our hearts go out to the other families.
During our wait, we as a family gathered daily trying to accept and understand why this had to happen. The support we received from the Marines and our community was outstanding. As we watched our grandson being unloaded from a commercial airplane at the Columbus Airport, I noticed one of the pilots standing alongside several airport employees, hat in hands. It touched my heart to see them showing respect for our fallen Marine. Leaving the airport we were escorted past Airport Fire Department personnel standing at attention, and just past the gate, there were people standing at attention outside of their vehicles. We were then escorted from Columbus, by several law enforcement agencies and the Patriot Guard. The law enforcement agencies stayed with us, dropping off sporadically until the last one turned off halfway between Zanesville and Cambridge. Several of the Patriot Guard continued with us to Marietta. We were met by the Noble County Sheriff's Office and Washington County Sheriff's Office at Caldwell, along with a large contingency of Patriot Guard members. The Ohio State Highway Patrol and Marietta City Police Department also assisted with the escort. Along the way we saw people standing on hillsides and cross-overs holding flags and signs, and even people stopping northbound on the interstate standing outside their vehicles with their hands over their hearts or saluting as we passed.
The people lining State Route 7 in Marietta showing their respect for this young man who lost his life serving his country was phenomenal. We could hardly see through the tears caused by such a show of support. We want to thank everyone who came out to honor Josh.
We also want to thank the community, businesses, the Ohio State Highway Patrol, Marietta Police Department, The City of Marietta, Mayor Matthews, Board member Greg Gault, Superintendant Harry Fleming, Troy Lee, and George Goodman of Marietta City Schools, several of the local motels, the VFW, American Legion, the Moose Lodge and their members, Warrens Plaza IGA, American Flags and Poles for all of the flags, Discount Signs and Awnings for the huge banners, and so many of our friends and family who supplied food. Your kindness and thoughtfulness was a tremendous comfort to all of us.
Thanks to Sheriff Larry Mincks and the Washington County Sheriff's Office personnel for helping and supplying the escorts. It meant a lot that you were there for us.
Thanks to Tom Kunz and Vincent Jett from the City of Marietta for their efforts in getting Josh laid to rest in Mound Cemetery. Josh loved history and allowing his final resting place to be in such a historical site was fantastic.
We want to thank the Patriot Guard for showing their respect in so many ways.
I want to especially thank Sonja Lee, Karla Cale, Troy Lee, and Tracy Saffel, and all of the other volunteers, for their efforts in acquiring, preparing and serving the meal for the reception afterwards. They took an overwhelming job from my shoulders. Thank you so much to the members of the Moose and the Moose Lodge for their kindness generosity.
We also wish to thank the Marine Mom's, a local group of marine mothers who provided food to our families for two weeks, and for arranging for hotels, gas cards, and food cards for the Marines who attended Joshua's funeral. They were a great comfort to us all.
My entire family wishes to thank everyone for their outstanding and generous support. We will always remember your kindness.
Thank you.
Larry and Tammy Stephens


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Georgette Grainger
Vice President & Relationship Manager
"I have dedicated my entire career to Washington Trust because they continue to provide the support I need to help my clients be successful."Georgette Grainger
Georgette began her banking career at Washington Trust in 1978. Now, a Vice President in the Private Banking group, Georgette specializes in the underwriting and approval of medical practice operating lines, medical equipment purchases, partnership buy-ins, as well as residential and commercial real estate lending. The combination of extensive banking experience with the insights gained from spending her entire life in Spokane, allow Georgette to provide exceptional perspectives to her clients' financial positions. Georgette excels in providing superior service for medical and dental professionals as well as entrepreneurs.
- Medical Practice Operating Lines of Credit
- Medical Equipment Purchases
- Partnership Buy-ins
- Residential & Commercial Real Estate Lending
- Inland Northwest Blood Center
- INBC's Epicurean Delight
- Executive Women International
- Better Business Bureau
CONTACT INFORMATION717 West Sprague Ave.
Spokane, WA 99201
Direct: 509.353.3945
Cell: 509.990.0656


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On Sunday the PAC-12 handed out their annual awards. The Ducks are represented well on the list.
First Team Offense –
QB Marcus Mariota – RB Kenjon Barner – OL Hroniss Grasu
First Team Defense –
DL Dion Jordan – DB Ifo Ekpre-Olomu
Honorable Mention –
OL Jake Fisher – DL Taylor Hart – WR Josh Huff – DL Wade Keliikipi – TE Colt Lyerla – DB Terrance Mitchell – DL Isaac Remington – RS De'Anthony Thomas
Marcus Mariota was also awarded the Freshman Offensive Player of the Year. The Oregon Ducks themselves gave out their awards this weekend also. Marcus Mariota and Michael Clay were honored as Oregon's Most Outstanding Players.


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Showing Suppliers 1 - 4 of 4
Fargo Glass & Paint Co.
Address: 400 East 54th St N., Sioux Falls, SD
Business Type: Distributor, Service
Grainger Industrial Supply
Address: 500 E. 50TH St. N. Branch 772, Sioux Falls, SD
Business Type: Distributor
Description: Grainger helps customers save time and money by providing them the right products to keep their facilities up and running. Grainger's customers are 2.0 million businesses and institutions in 157 countries. While each customer has a unique facility to operate and a different problem to solve, our... (more)
Larson Manufacturing Co.
Address: 2333 Eastbrook Drive, Brookings, SD
Business Type: Manufacturer
West Central Manufacturing
Address: 910 St. Andrew St., Rapid City, SD
Business Type: Manufacturer


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Mini Tour For General Hospital Alum Adrienne Barbeau.
Adrienne Barbeau (ex-Suzanne) will be turning up in a few places over the coming months. Fans can catch the former scream queen as she does a meet and greet at The Atrox Factory in Leeds, Alabama from October 20 until 22. In honor of Halloween, she will be discussing her past experiences in the b-movie horror with flicks like "Creepshow" and "Swamp Thing." Read the rest of this entry »
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State Water Resources Research Institute Program
Project Id: 2010NJ221B
Title: Comparative toxicological assessment of gasoline oxygenates MTBE, ETBE and TAME, and their metabolites, in the zebrafish cardiovascular system
Project Type: Research
Start Date: 3/01/2010
End Date: 2/28/2011
Congressional District: NJ-006
Focus Categories: Water Quality, Toxic Substances, Non Point Pollution
Keywords: gasoline oxygenates, MTBE, ETBE, TAME, zebrafish
Principal Investigators: Bonventre, Josephine; Cooper, Keith R
Federal Funds: $ 5,000
Non-Federal Matching Funds: $ 10,000
Abstract: The research proposed here addresses the first priority of the Water Resources Research Act regarding consequences of potential contaminants to water supplies and toxicological impacts on aquatic species. This project compares the toxicological effects of common gasoline oxygenates, methyl tert-butyl ether (MTBE), ethyl tert-butyl ether (ETBE) and tert-amyl methyl ether (TAME), on developing zebrafish (Danio rerio) using morphological and molecular endpoints. In 2008, total production of these specific gasoline oxygenates was approximately 50 thousand barrels per day in the United States (DOE-EIA, 2008). These compounds are currently used in New Jersey and may pose a threat to groundwater and surface water quality. The toxicological studies proposed here may be helpful in risk assessment and developing regulations for gasoline oxygenate use in the future.
Progress/Completion Report, 2010, PDF


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The Style Gallery is a great new way for you to view, love, and share outfit photos. It's meant to showcase
all the expressive, creative, and inspirational personalities of our community!
Love you too!
Your email has been sent!
This item was picked by you in our Be the Buyer Program and will be sold exclusively online at ModCloth! Let nature's lush beauty inspire you to don this breezy, lemongrass dress! A sheer pleated overlay, waistline tie, and neckline dappled in dainty cutouts give your look a fantastical, foresty feel. Plant this piece alongside a pink floral hair clip, a khaki blazer, and pebble-hued heels, and watch your glamour grow!
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Alta Cebu Resort
RATED the BEST VALUE IN CEBU
Best 3 Star Quality + Delightful Ambiance + Affordable Price = Superb Value
ALTA has the look and feel of an authentic Filipino Village. With 42 uniquely different choices of decor, our comfortable rooms offer all modern conveniences. ALTAS offers more places to dine and socialize. A night club, a poolside bar, and two restaurants (one located on ALTA Bay). ALTAs own guided cultural tours. The only resort that teaches fashion design classes from world-renowned designers. Our guests come in all ages and the owner is around to personally greet all guests , so ALTA feels more like Bed and Breakfast or property.
More reasons to choose ALTA:
Owner and wife live at ALTA and manage it full time (7 days a week)
Best garden resort as per industry professionals and returning guests
Friendly atmosphere makes it easy to meet people from all over the world
Genuinely friendly, well trained staff
4 award winning chefs
Many excellent reviews
Our own dock on ALTA Bay
Beautiful views and sunsets
weekly and monthly rates
Resort only 2 years old one of the newest 3 star resorts in Cebu
Traditional Style Architecture in a village setting
4 star quality- American standards of construction
ALTA offers cultural and eco tours as well as classes in Jewelry making, cooking, traditional dance, etc.
Many professionally produced shows, events and activities
A night club, a poolside bar, and two restaurants.
Close to airport and to downtown Cebu
Each room is unique, with local furniture and Philippine room decor
Guests are always called by first name- which our guests really love - because it is one of the very few mom and pop resorts ( resorts that are not owned by absentee and or corporate owner) the feeling from all staff is that of genuineness happiness and kindness... coming from the heart.
Availability & RatesTo view availability and prices please select dates and click 'Update Dates'
Hotel Facilities & Policies
- 24 Hour Reception
- 24 Hour Security
- Adaptors
- Air Conditioning
- Airport Transfers
- Bar
- Bicycle hire
- Free Breakfast
- Cable TV
- Currency Exchange
- Telephone/Fax Facilities
- Free Internet Access
- Free Parking
- Hair Dryers
- House Keeping
- Laundry Facilities
- Luggage Storage
- Mini Bar
- Outdoor Swimming Pool
- Parking
- Restaurant
- Swimming Pool
- Taxes not included
- Tea & Coffee Making Facilities
- Tours/Travel Desk
Cancellation PolicyThis property has a 1 day cancellation policy. Failure to cancel within this time will result in a cancellation charge equal to the first night of your stay.
Must-Read Hotel InfoThis property has specific Terms & Conditions.
ALTA Cebu Resort features dining in our large air conditioned restaurant with additional dinging poolside jungle bar and the marina at Alta Bay.Amenities include 2 large outdoor pools, many sports and activities, wellness center and spa, gift shop, 11 function rooms, including grand ballroom and amphitheaterstage, guest rooms and dormitories combined sleep 350.
Room Amenities
Large Flat screen 32'-televisions come with premium cable channels or choice to view 400+ free DVD's and whisper- quiet split air conditioning.Guestrooms are adorned withmurals and offer complimentary wireless Internet access, mini-bar,
Alta is best known for its exceptional service and our colorful expansive tropical gardens (300+ varieties of vegetation), inducing a plethora of murals and winding pathways, amid exotic flora and fauna.
DirectionsShow MapHide Map
Located Near
This resort is located in Cordova (Mactan Island), near the airport, Gaisano Grand Mall Mactan, and beach belt area. Area attractions also include historical site - Mactan Shrine and Lady of the Rule Church.


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When I went to visit my Grandma and Grandpa Mantey a few weekends ago for Mother's Day, I could smell my grandpa before I could see him. Impressive, considering that he was competing with gas emissions from a 100-head herd of Holstein dairy cows that call his farm home.
It was the cigar he was smoking, the familiar scent of burning tobacco and chemicals and vanilla. Hi, Grandpa.
Since I've known him, he's always had some form of tobacco in his life. There's a picture buried in my family albums somewhere of me as a two-year-old smoking from his pipe (let's be honest, I probably just put my sticky toddler lips on the pipe and then ran away).
I didn't glamorize tobacco as a child. DARE took care of scaring that out of me. But my Grandpa's tobacco use was always this elusive adult thing to my siblings and me. We used to see if we could trick each other into drinking from Grandpa's chew spit cup, which always seemed to be one of those little plastic kid cups that easily could have been filled with something like red pop and not a slimy smear of goo.
Hindsight: That was gross, and kids are weird.
As I sat on the farm stoop while Grandpa smoked his stogie this past Mother's Day, I thought about how the mystery of cigars was gone to me now but their allure was not. Having passed most adult rites of passage — with the exception of having my own children to scat away from tricking their baby brother into a nicotine overdose — I now look at cigars as a way to occasionally kick back. They're unhealthy and stinky, but puffing on a cigar is, to me, a rare indulgence, and every adult deserves one of those now and again.
When I got back to Columbus after my visit, I headed to House of Cigar in the Short North to buy two Montecristos (ain't no fun to smoke alone!). I'm waiting for the right occasion to indulge, but in the meantime I have them sitting near a photo my grandma gave me the day of my visit. It's an image of my grandparents on the farm in 1954, a few months before they got married. What's that in Grandpa's hand? A stick of tobacco, of course. I will forever associate cigar smells with him ... and smile.
∙ Objects of Desire is a biweekly column that explores items Columbus shoppers crave. Follow Jackie Mantey on Twitter at @Jackie_Mantey.


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PLEASANTON, Calif. — Safeway launched its Open Nature brand early this year with a variety of beef, pork, chicken and other products raised on an all-vegetarian diet, without the use of antibiotics or added hormones, and processed without the use of artificial preservatives. "Nature has nothing to hide and neither should your food" is the tagline. The line has since grown to 100 items, including yogurt, ice cream, frozen pizza, salad dressing, peanut butter and fresh bread. One of the ...
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TALLADEGA, Ala. — It was typical Talladega Superspeedway carnage that ended Sunday's Good Sam Road Assistance 500.
A multi-car crash ended the race on the final lap of a green-white-checkered finish with Matt Kenseth scored the winner and Tony Stewart flying through the air upside down just as it looked like he would win the event. The majority of the field was collected in the accident on the final straightaway at the 2.66-mile superspeedway.
Stewart was in the lead when he was hammered from behind by Michael Waltrip spinning him in front of the field with Kenseth sailing into the lead. With the yellow flag waving, Kenseth was scored the leader as the rest of the field slammed into the crashing cars of Stewart, Waltrip, Casey Mears and Kevin Harvick.
"Clint and I got together a little bit on the backstretch," said Kenseth, who won the Daytona 500 earlier this year. "I don't know if that was my bad and we weren't exactly all the way clear or what happened there, but that really slowed the group and we got a big lead, which typically isn't good here. I just looked in my mirror and saw them coming at me three-wide. I kind of let Tony have his spot there. It didn't look like he had a big push behind him and lined up with Kevin and we pretty much stayed locked together there until we got to turn three and I thought it was gonna be a drag race to the finish. I didn't know what was gonna happen and I'm still not sure what happened. Somehow I think Tony got turned and caused a big wreck."
Stewart, meanwhile, took blame for the accident.
"I just screwed up. I turned down across Michael," he said. "It was my fault. I was blocking, trying to keep the lead and win the race. Michael got a great run and I turned down across the right front of his car. It was my fault and it cost a lot of people there at the end."
Jeff Gordon finished second with Kyle Busch, David Ragan and Regan Smith filling the top five.
"I didn't see anything but Kasey Kahne's rear bumper," Gordon said of the finish. "That was the craziest finish I have ever experienced here at Talladega and for once we came out on the good side of it."
More than 20 cars were involved in the last-lap incident, including most of the contenders in the Chase for the NASCAR Sprint Cup.
Brad Keselowski extended his championship lead to 14 points over Jimmie Johnson. Both drivers were involved in the accident, but Keselowski kept his damaged mount rolling and was scored seventh.
There were 57 lead changes among 18 drivers and only four yellow flags.


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Legal Affairs
We welcome your news and photos. Due to the large number of lawyers honored by publications, we are not able to publish those announcements in "Legal Affairs." Send all other notices, preferably not as attachments, to email@example.com.
Arnold & Porter has been named to the first-ever list of "Best Law Firms for Working Mothers" published by Working Mother magazine and Flex-Time Lawyers LLC.
J. Triplett Mackintosh authored a chapter of White Collar Law Defense Strategies: Leading Lawyers on Preparing for Trial, Offering Evidence, and Overcoming the Challenges of a White Collar Crime Case.
Holland & Hart was awarded three Bronze Telly Awards, which honor the best film and video productions in the world. The firm's "Business Class" advertising campaign was recognized with two awards, and the first segment in the campaign, featuring client Outlast Technologies, Inc., also was honored.
Adam T. DeVoe was appointed to the charities board of directors of the Metro Denver Sports Commission.
C.J. Chapman was appointed to the Denver Kids, Inc. board of directors.
Katina Banks, a senior associate with Dorsey & Whitney, was appointed by Gov. Bill Ritter to the Colorado Civil Rights Commission.
Maureen Witt, attorney at Holland & Hart, was honored by the Denver Business Journal and the National Association of Women Business Owners as one of the "Outstanding Women in Business." Barbara Kelley, partner at Kamlet Shepherd & Reichert, was a finalist. Nominees also included: Martha Allbright, Kristin Bronson, Stacy Carpenter, Catherine Gale, Barbara Glogiewicz, Sheila Gutterman, Donna Lance, Kim McCullough, Annita Menogan, Marsha Piccone, Michele Rowland and Holly Shilliday.
Craig R. Carver was elected the 53rd president of the Rocky Mountain Mineral Law Foundation.
Rebecca W. Watson was honored as one of the 2007 Women of Distinction by the Girl Scouts Mile Hi Council.
Marshall Snider was appointed to a four-year term on the State Board of Chiropractic Examiners.
Stephen Vertucci has joined The Harris Law Firm as an associate.
Moye White has added Dominick D. Sekich and Lorni Fenton Sharrow to the Business Section. Christopher T. Leach, Matthew A. Morr and Suzanne E. Rauch have joined the Trial Section.
Sarah "Sally" Brashears has joined Hensley Kim & Holzer as a registered patent attorney. Michelle A. Pinkowski, Ryan E. Warren and Michael P. Dulin have joined the firm's Litigation Group.
McElroy, Deutsch, Mulvaney & Carpenter is pleased to announce that Kristi L. Blumhardt has joined the firm as an associate in the employment group.
David H. Miller is doing temporary duty as the Director of the Colorado Civil Rights Division.
Hon. Patricia A. Madsen has joined Legal Resolution Center to lead the firm's water law arbitration and mediation practice.
Shane Niebergall has joined Holland & Hart as of counsel in the Business Department.
Fisher, Sweetbaum, Levin & Sands is pleased to announce that William B. Stanton and Mark E. Honhart have joined the firm's litigation department.
Former city attorney (and faithful Docket Committee member) Greg Rawlings has joined Springer and Steinberg.
Patton Boggs is pleased to announce that Hugh C. Thatcher has joined the firm as an associate, focusing on litigation, health and safety, and industrial crisis management matters.
Six attorneys have joined Kutak Rock: Angela Birky Bohnert, Meredith R. Riley, Jaimee L. Boyd, Kamille J. Curylo-Delcour, Everett B. Martinez and Peter A. Sabey.
Sender & Wasserman is pleased to announce that Jennifer E. Jespersen has joined the firm as an associate, focusing on bankruptcy litigation.
Tyler Y. Harvey has joined Hogan & Hartson as a partner in the M&A practice with a focus on sports and entertainment matters.
Kamlet Shepherd & Reichert has elected Barry A. Schwartz as partner and chair of the appellate practice area of the litigation group. Eight new attorneys have joined the firm: Mary E. Carter, Steven L. Hill, John D. Mereness, Elizabeth J. Peros, Beth H. Regas, Lukas B. Staks, Aimee H. Wagstaff and Hannah M. Wanebo.
McKenna Long & Aldridge has added Arash Heidarian to its government contracts practice group.
John M. Palmeri, Thomas B. Quinn, Franz Hardy, Jennifer C. Forsyth, Heather K. Kelly, Amy M. Darby, Molly Walsh Ennis and Steven P. Johnston have joined Gordon & Rees.
Gibson Arnold & Associates welcomed Matt Cohen as an associate.
Foster Graham Milstein Miller & Calisher has added David L. Miller as a partner. Jerri L. Jenkins, Michael C. Bullock, Alison E. Zinn and Christopher P. Carrington also have joined the firm.
Hollynd Hoskins was mentioned in a Denver Post story about "Bionic Boomers," baby-boomers who push their bodies to the limits but stay active through new medical techniques. Hoskins still does long bicycling events and is trying to stave off knee-replacement surgery.
You may know of Duane "Dog" Chapman as the bounty hunter, but did you know his attorney is Denver's own Gary Lozow? Lozow got a mention in The Post's entertainment column that featured Dog's new autobiography.
Penny Parker's Rocky Mountain News "On the Town" column gave a nod to Hal Haddon, who received the first-ever "Owl Farm Fire Extinguisher Award," given by Hunter S. Thompson's widow Anita, at an event at the Denver Press Club.
Don Bain was pictured in The Post for his attendance at the National Sports Center for the Disabled's summer fundraiser.
Immigration lawyer Nancy Elkind was quoted as an expert in a Post story about legal scams aimed at immigrants.
Gale Miller and Rebecca Love Kourlis were pictured in The Post, along with a write-up of the Colorado Judicial Institute's first Judicial Independence Breakfast.
In a Denver Post Q & A, Curtis Kennedy, attorney for the Association of US West Retirees, said, among other things, that his heroes were his schoolteachers and foster parents.
DBA Past-President Chris Little's darling daughters Kate and Molly Jordan Little were pictured in The Post at Zip-A-De-Do at the Zoo, a fundraiser for the zoo's Red Apple Fund.
The Post's "Catching Up with the Social Scene" featured the Culturehaus Annual Membership's 10th anniversary party organized by Ericka Englert, who was pictured with Mayor Hickenlooper — an original founder of the organization — and other board members.
According to a Robert Half Legal survey, nearly half (45 percent) of attorneys polled said their legal departments have increased their use of outside legal counsel in the last year. Only 12 percent said levels have decreased.
Julie Waggener has become of counsel to Cockrell, Quinn & Creighton. As of Nov. 1, two of the firm's lawyers, Richard Foster and Victor Quinn, will join her to form Waggener & Foster LLC. Contact her at 400 S. Colorado Blvd. #900, Glendale, 80246. Phone: (303) 322-0236; fax: (303) 860-7344; e-mail: email@example.com.
R.J. Wittenbrink has moved to 13949 W. Colfax Ave. #250, Lakewood, 80401. Phone: (303) 237-9900; fax: (303) 202-5201; e-mail: email@example.com.
Martin Conklin, P.C., a seven-attorney firm dedicated to representing and advising health care professionals, hospitals and health care companies in litigation and risk management activities, has relocated to 90 Madison St., Suite 601, Denver, 80206. Firm attorneys are John O. Martin and John L. Conklin, Carole Salamaha, Carolyn Knaut, Kathleen Shea, Amy Cardone and Jerome Geraghty.
Rodger C. Daley and Regan Murphy of the Law Offices of Rodger C. Daley, announce the first birthday of their son, Monroe Rodger Daley born Oct. 3, 2006.
Brian Daniel McHughs Jr. was born on July 25 to Catherine McHughs, DBA/CBA web specialist, and husband Brian. Baby McHughs was 7 lbs. 2 oz. and 19 inches long. He's pictured with proud sister, Charlotte.
Wesley A. Miller, former Denver Bar Association president, passed away in September at the age of 75. He was DBA president from 1975 to 1976.
Donald Quigley wrote to share his take on the September issue of The Docket: "I read this month's lead article on alcoholism, and then I flipped back
to the front page and read the next heading, "Much Ado About Liver." I assumed it was going to be a Point-Counterpoint thing. …"


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Silodosin is a new selective therapy with a high pharmacologic selectivity for the α1A-adrenoreceptor.
Our aim was to test silodosin's superiority to placebo and noninferiority to tamsulosin and discuss the findings in the context of a comprehensive literature review of the new compound silodosin.
Design, setting, and participants
We conducted a multicenter double-blind, placebo- and active-controlled parallel group study. A total of 1228 men ≥50 yr of age with an International Prostate Symptom Score (IPSS) ≥13 and a urine maximum flow rate (Qmax) >4 and ≤15
We calculated the change from baseline in IPSS total score (primary), storage and voiding subscores, quality of life (QoL) due to urinary symptoms, and Qmax. Responders were defined on the basis of IPSS and Qmax by a decrease of ≥25% and an increase of ≥30% from baseline, respectively.
Results and limitations
The change from baseline in the IPSS total score with silodosin and tamsulosin was significantly superior to that with placebo (p
Active treatments were well tolerated, and discontinuation rates due to adverse events were low in all groups (2.1%, 1.0%, and 1.6% with silodosin, tamsulosin, and placebo, respectively). The most frequent adverse event with silodosin was a reduced or absent ejaculation during orgasm (14%), a reversible effect as a consequence of the potent and selective α1A-adrenoreceptor antagonism of the drug. The incidence was higher than that observed with tamsulosin (2%); however, only 1.3% of silodosin-treated patients discontinued treatment due to this adverse event.
Silodosin is an effective and well-tolerated treatment for the relief of both voiding and storage symptoms in patients with lower urinary tract symptoms suggestive of bladder outlet obstruction thought to be associated with benign prostatic hyperplasia. Its overall efficacy is not inferior to tamsulosin. Only silodosin showed a significant effect on nocturia over placebo.
Trial registration
ClinicalTrials.gov Identifier NCT00359905.
Keywords: Silodosin, Tamsulosin, BPH, LUTS.
1. Introduction
Benign prostatic hyperplasia (BPH) is a nonmalignant enlargement of the prostate caused by cellular hyperplasia of both glandular and stromal elements [1]. As the prostate increases in size, it may occlude the lumen of the prostatic urethra, obstructing urine flow [2]. However, studies have shown that prostate size and urinary flow rate usually do not correlate with the severity of lower urinary tract symptoms (LUTS), which may vary from subject to subject [3]. In clinical practice, patients are treated for LUTS suggestive of bladder outlet obstruction (BOO) due to BPH, often called "LUTS/BPH."
Even if voiding symptoms are the most prevalent in cases of LUTS/BPH, patients usually perceive the storage symptoms as the most bothersome group of symptoms [4]. The objective of therapy for such patients is to improve LUTS/BPH and hence quality of life (QoL). In addition, treatment is aimed at preventing complications such as acute urinary retention or upper urinary tract dilation consequent to BOO. Existing medical therapy includes α-blockers, which are currently the preferred first-line therapy for all men with moderate or severe LUTS/BPH [5], and 5α-reductase inhibitors (5-ARIs), which are a recommended treatment option for men with moderate or severe LUTS/BPH and an enlarged prostate. α-Blockers can be used regardless of prostate size because they act on the dynamic/neurally mediated contraction of the muscular stroma that is increased in BPH; 5-ARIs act by shrinking the stromal component of the gland. Both components are thought to contribute to the symptoms and impairment of outflow in patients with LUTS/BPH [6].
Nonselective α1-adrenoceptor blockers increase urinary flow rate and improve symptoms in men with symptomatic BPH; however, they may be associated with side effects related to peripheral vasodilation, such as postural hypotension, dizziness, and headache [7], [8], and [9]. Conversely, drugs with a high affinity for α1A-adrenoceptors may be more prostate specific and may maintain the therapeutic response in the treatment of symptomatic BPH with less effect on blood pressure and fewer cardiovascular side effects [10] and [11].
Silodosin is a new agent with high selectivity for α1A-receptors, which predominate in the male bladder outflow tract relative to α1B-receptors. It has been demonstrated in vitro that silodosin's α1A-to-α1B binding ratio is extremely high (162:1), suggesting the potential to markedly reduce dynamic neurally mediated smooth muscle relaxation in the lower urinary tract while minimizing undesirable effects on blood pressure regulation [12]. In this context, the evaluation of the uroselectivity of silodosin versus that of tamsulosin and prazosin in vivo has shown good uroselectivity (determined from the ratio of the dose-reducing intraurethral pressure as contrasted to blood pressure) in rats and dogs [13] and [14].
This paper reports the results of the first randomized placebo-controlled European study with silodosin in the treatment of patients with LUTS/BPH. The study compared silodosin with the effective and widely used drug tamsulosin [15].
2. Patients and methods
2.1. Study design
A multicenter double-blind, placebo- and active-controlled parallel group clinical study was conducted in 72 hospital clinics and inpatient units in 11 countries in Europe. After a wash-out phase of 14 d and a 4-wk single-blind placebo run-in period, subjects who met the selection criteria were randomly assigned (in a ratio of 2:2:1, with stratification by center, with blocks of five assigned to each center, produced and managed centrally by an international contract research organization) to a 12-wk treatment with silodosin 8
Eight visits were foreseen: at day −42 (start of the wash-out period) and day −28 (start of the placebo run-in period); at baseline (pre- and postrandomization); and after 7, 14, 28, 56, and 84 d of treatment (or in the case of premature study termination).
Prerandomization procedures consisted of the collection of a medical history (including a urologic history), a check of concomitant medications, a physical examination (including a digital rectal examination), and a postvoid residual volume determination by ultrasound.
The International Prostate Symptom Score (IPSS) questionnaire (including question 8, BPH-related health status), a validated instrument widely used for the assessment of symptom severity in patients with BPH [14], was administered to the patients at screening, at baseline, and after 7, 14, 28, 56, and 84 d of treatment (or in the case of premature study termination). Because the study was performed in several European countries and involved patients speaking different languages, the questionnaire was linguistically validated by the MAPI Institute (an international company that specialized in linguistic validation for appropriate cross-cultural use and interpretation of patient-reported assessments) in the relevant languages.
Peak urine maximum flow rate (Qmax) was also measured once 2–6
Systolic blood pressure (SBP), diastolic blood pressure (DBP), and heart rate (HR) were measured at each visit, with the subject supine at rest for at least 5
2.2. Study population
Men ≥50 yr of age with LUTS (defined by a stable IPSS total score ≥13 points), BOO (defined by a Qmax between 4 and 15
2.3. Study end points and statistical analyses
The primary end point of the study was to demonstrate the superiority of silodosin to placebo and its noninferiority to tamsulosin for the relief of LUTS associated with BPH and suggestive of BOO. This was measured by a change from baseline in the total score (questions 1–7) of the IPSS questionnaire (primary efficacy parameter).
The total number of subjects to be randomized was set at 820 (328 for silodosin 8
Secondary efficacy parameters were as follows: improvement in storage and voiding symptoms subscores, QoL due to urinary symptoms (question 8 of the IPSS), Qmax, and percentage of treatment responders by IPSS (decrease from baseline ≥25%) and by Qmax (increase from baseline ≥30%).
Statistical analyses were performed using the following procedures. For the analysis of the primary efficacy variable, the superiority of the active treatments (silodosin and tamsulosin) versus placebo was tested first in the intent-to-treat (ITT) population (all subjects who had a baseline IPSS assessment and at least one valid postbaseline IPSS assessment). Next, the noninferiority of silodosin versus tamsulosin was tested in the PP population (all subjects who completed the study without any major protocol violation). Last, because all the planned tests were satisfied, the superiority of silodosin versus tamsulosin was tested (ITT population). For the secondary efficacy variables, the superiority of the active treatments (silodosin and tamsulosin) versus placebo was tested first, followed by the comparison between silodosin and tamsulosin.
The overall treatment group comparisons of the change from baseline in the IPSS total score, by visit and at end point (in both ITT and PP populations), were estimated based on adjusted means obtained from the main analysis of the covariance model, which included terms for treatment, pooled center, and baseline value.
The percentage of responders to IPSS and the percentage of responders to Qmax were summarized at each visit and at end point by treatment group; comparisons between each of the active treatment groups and placebo and between silodosin and tamsulosin were made using the Cochran Mantel Haenszel test, stratified by pooled center, for both populations.
A post hoc analysis was conducted in the subgroup of patients with nocturia at baseline (defined as at least two voids per night), as assessed by question 7 of the IPSS.
In terms of safety, the safety population was defined as all subjects who were randomized and who received at least one dose of double-blind study medication. Safety was assessed primarily on the basis of TEAEs occurring in the different groups postrandomization. In addition, the change from baseline was evaluated for the following safety parameters: DBP, SBP, and HR in a supine position and after standing (orthostatic test), laboratory determinations, ECG findings, and physical examination.
3. Results
3.1. Disposition of patients
A total of 1228 patients were screened, 955 of whom were randomized to receive silodosin 8
3.2. Demographics and other baseline characteristics
Table 1 summarizes the demographic and baseline characteristics of the safety population. No statistically significant differences were seen between the three treatment groups with respect to age, body mass index, IPSS total score, storage and voiding subscores, and QoL due to urinary symptoms. Of note, 424 patients (44.4%) were hypertensive, and many subjects were on concomitant antihypertensive medications. At baseline, many patients had a past or current history of erectile dysfunction (24.0%) or complained of ejaculation disorders. These included orgasm semen quantity reduced (8.3%), orgasm semen force reduced (6.9%), and orgasm with no semen (0.8%), with an overall 24.0% rate of pretreatment ejaculatory disorders.
|Silodosin 8 mg
|Tamsulosin 0.4 mg
|p value
|Age, yr, n (%)
|158 (41.5)
|157 (40.9)
|75 (39.5)
|390 (40.8)
|168 (44.1)
|183 (47.7)
|93 (48.9)
|444 (46.5)
|55 (14.4)
|44 (11.5)
|22 (11.6)
|121 (12.7)
|Race, n (%)
|381 (100.0)
|384 (100.0)
|190 (100.0)
|955 (100.0)
|Not estimable
|BMI, kg/m2, n (%)
|84 (22.0)
|109 (28.4)
|46 (24.2)
|239 (25.0)
|238 (62.5)
|214 (55.7)
|118 (62.1)
|570 (59.7)
|59 (15.5)
|61 (15.9)
|25 (13.2)
|145 (15.2)
|IPSS total score
|IPSS storage subscore
|IPSS voiding subscore
|QoL due to urinary symptoms, n (%)
|0 (0.0)
|3 (0.8)
|0 (0.0)
|3 (0.3)
|2 (0.5)
|6 (1.6)
|0 (0.0)
|8 (0.8)
|27 (7.1)
|23 (6.0)
|12 (6.3)
|62 (6.5)
|98 (25.7)
|105 (27.3)
|44 (23.2)
|247 (25.9)
|140 (36.7)
|135 (35.2)
|65 (34.2)
|340 (35.6)
|98 (25.7)
|95 (24.7)
|57 (30.0)
|250 (26.2)
|16 (4.2)
|17 (4.4)
|10 (5.3)
|43 (4.5)
|0 (0.0)
|0 (0.0)
|2 (1.1)
|2 (0.2)
|Urine Qmax, ml/s
3.3. Efficacy results
3.3.1. Change from baseline in International Prostate Symptom Score total score (primary efficacy parameter)
The change from baseline in the IPSS total score (questions 1–7) in the different groups and the differences from placebo and between active groups are shown in Table 2 and Fig. 2, respectively.
|Silodosin 8 mg
|Tamsulosin 0.4 mg
|ITT population
|Baseline, mean
|Change from baseline to end point, adjusted means
|Difference active vs placebo (95% CI)
|−2.3 (−3.2, −1.4)*
|−2.0 (−2.9, −1.1)*
|Difference tamsulosin vs silodosin (95% CI)
|0.3 (−0.4, 1.0)†
|PP population
|Baseline, mean
|Change from baseline to week 12, adjusted means
|Difference active vs placebo (95% CI)
|−2.2 (−3.2. −1.3)*
|−1.9 (−2.8, −0.9)*
|Difference tamsulosin vs silodosin (95% CI)
|0.4 (−0.4, 1.1)†
† Noninferiority.
For all treatment groups, there was no plateau in response; however, the largest decreases in the total IPSS score occurred rapidly, within the first 2 wk of treatment. Superiority of active treatments versus placebo was observed with highly statistically significant differences at all weeks (p
3.3.2. Responder rates according to International Prostate Symptom Score total score
In all three treatment groups, the percentage of IPSS responders progressively increased from baseline to week 12. At study end, 66.8% and 65.4% of the patients receiving silodosin or tamsulosin were responders (respectively), compared with 50.8% in the placebo group.
The differences versus placebo were highly significant (p
3.3.3. Voiding and storage subscores
Table 3 shows the mean change from baseline to end point in the IPSS subscore of voiding symptoms (questions 1, 3, 5, and 6) and of storage symptoms (questions 2, 4, and 7). The statistically significant superiority of both active treatments versus placebo on voiding and storage subscores was observed at all weeks of treatment. The comparison between silodosin and tamsulosin did not show a statistically significant difference, even if a numerical difference in favor of silodosin was observed in the voiding subscore. Of note, in the subgroup of patients with nocturia at baseline (n
|Treatment arm
|IPSS storage symptoms
|IPSS voiding symptoms
from baseline
|Difference (95% CI) vs placebo
from baseline
|Difference (95% CI) vs placebo
|−0.7† (−1.1, −0.2)
|−1.7* (−2.2, −1.1)
|−0.6† (−1.1, −0.2)
|−1.4* (−2.0, −0.8)
3.3.4. Quality of life
An improvement in the change from baseline in QoL due to urinary symptoms (question 8 of the IPSS) was reported for all treatment groups (−1.1 for silodosin, −1.1 for tamsulosin, and −0.8 for placebo). Once again, highly statistically significant differences were observed between active treatments and placebo at all weeks (at end point p
|No. (%)
|No. (%)
|No. (%)
|29 (7.8)
|32 (8.5)
|12 (6.5)
|94 (25.3)
|103 (27.4)
|43 (23.2)
|248 (66.9)
|241 (64.1)
|129 (69.7)
|Week 12*
|163 (44.0)
|168 (44.7)
|63 (34.0)
|82 (22.1)
|99 (26.3)
|38 (20.5)
|126 (34.0)
|109 (29.0)
|84 (45.4)
* Data analysis for week 12 was based on last observation carried forward.
3.3.5. Maximum flow rate
A larger increase from baseline in Qmax (milliliters per second) was observed for both active treatment groups compared with placebo but was not statistically significant. The adjusted mean change from baseline to end point was 3.77
3.4. Safety results
3.4.1. Treatment-emergent adverse events
Overall, the percentage of subjects who reported at least one TEAE was 34.9% (133 of 381) for subjects in the silodosin group, 28.9% (111 of 384) in the tamsulosin group, and 24.2% (46 of 190) in the placebo group (silodosin vs placebo: p
The percentage of subjects who discontinued the study due to a TEAE was small and not statistically different in all treatment groups (silodosin 2.1%, eight subjects; tamsulosin 1.0%, four subjects; placebo 1.6%, three subjects). The most common TEAE leading to discontinuation was failure of ejaculation (five subjects in the silodosin group and one in the tamsulosin group). This TEAE was reversible after study discontinuation.
Nine subjects of 955 (0.9%) experienced a serious TEAE; of these, three were considered possibly related to the study drug by the treating investigator: prostate cancer and supraventricular arrhythmia (silodosin) and anxiety (tamsulosin). Two subjects died during the study; both deaths were unrelated to the drugs used in the study.
3.4.2. Other safety parameters
No clinically meaningful changes were recorded for any of the laboratory parameters, vital signs, or ECGs observed during the study in any of the treatment groups. Table 5 presents the supine DBP, SBP, and HR and the change from baseline in DBP, SBP, and HR observed with the silodosin, tamsulosin, and placebo groups. No clinically relevant or statistically significant differences versus placebo were observed with silodosin. An important characteristic of silodosin is the lack of clinically relevant or statistically significant changes in blood pressure or heart rate versus placebo. However, a minor but statistically significant difference versus placebo was observed with tamsulosin.
|Silodosin 8
|Tamsulosin 0.4
|Placebo (n
|Supine systolic BP
|133.8 (12.61)
|133.0 (13.29)
|132.8 (13.57)
|−1.4 (−3.0, 0.1)
|−1.8 (−3.4, −0.3)
|−0.4 (−1.7, 0.9)
|Supine diastolic BP
|80.6 (7.47)
|80.5 (7.99)
|80.6 (7.70)
|−0.3 (−1.4, 0.7)
|−1.0 (−2.1, 0.0)
|−0.7 (−1.5, 0.2)
|Supine heart rate
|67.4 (8.83)
|67.8 (9.10)
|67.3 (8.43)
|−0.3 (−1.6, 1.0)
|0.2 (−1.1, 1.5)
|0.5 (−0.5, 1.5)
No subject experienced a marked decrease in blood pressure when performing the postrandomization orthostatic test after the first dosing of the drug. Only a few subjects in both active treatment groups reported an increase in HR >20 beats per minute without any clinically important change in SBP or DBP.
4. Discussion
This prospective statistically well-powered study evaluated the efficacy and safety of the new highly selective agent silodosin, an α1A-receptor, for the treatment of moderate to severe LUTS due to BPH. A population of patients with LUTS/BPH who were representative of those seen in clinical practice in terms of age, concomitant diseases, and medication was selected. In the patient group, approximately 60% were elderly, and about 57% were on concomitant antihypertensive medication.
In this study, silodosin proved to be an effective drug for the treatment of both storage and voiding LUTS associated with BPH because a statistically significant and potentially clinically relevant difference versus placebo was observed in the IPSS total score, in the storage and voiding subscores, and in QoL due to urinary symptoms. The improvement became evident soon after the initiation of therapy. The treatment effect with silodosin appeared to be at least equivalent to and numerically consistently greater than that seen with tamsulosin when considering the change from baseline in the IPSS total score, in the voiding subscore, and in the responder rates, even if the differences were not statistically significant. There was also a greater benefit seen when considering the QoL on active therapy with either silodosin or tamsulosin as compared with placebo.
It is noteworthy that the selective effect of α1A-receptor antagonism seemed to offer a clinically relevant benefit not only on voiding but also on storage symptoms. Of note, only the effect of silodosin (and not of tamsulosin) on nocturia was significantly better than that of placebo. The mechanism of this action remains to be clarified.
In this study, treatment with silodosin also showed an early and sustained increase in Qmax; however, the difference versus placebo was not statistically significant. A similar order of magnitude for the flow rate was seen with the active comparator tamsulosin, which has been clearly documented in the past to produce significant changes when compared with placebo.
The first randomized double-blind, placebo-controlled study that was conducted with silodosin in Japan recruited men ≥50 yr of age with an IPSS of ≥8 and a QoL score of ≥3. Patients were randomized to receive silodosin 4
Marks and colleagues assessed the efficacy and safety of silodosin 8
A long-term open-label extension study of patients from these two studies was conducted over 40 wk, with all patients receiving silodosin 8
Because the efficacy of both tamsulosin and silodosin appear to be very similar, the question has to be posed regarding the potential additional advantage of silodosin. Studies conducted recently have suggested that silodosin as a consequence of its high subtype selectivity is less likely than tamsulosin to have significant cardiovascular side effects either when used alone or in combination with other agents, which may affect blood pressure. This is particularly important and relevant in more elderly patients.
Kobayashi et al. [19] provided evidence for this suggestion. They evaluated the efficacy on the urethra (intraurethral pressure) and cardiovascular system (hypotension) of silodosin (α1A-adrenoceptor antagonist) and tamsulosin (α1A+1D-adrenoceptor antagonist) in dogs with BPH altered with age. Under anesthesia, the increase in intraurethral pressure evoked by hypogastric nerve stimulation was measured, together with the level of systemic mean blood pressure. Each drug was administered intravenously in progressively increasing doses. Silodosin (0.3–300
In a placebo-controlled open-label clinical crossover study evaluating potential interaction with a phosphodiesterase inhibitor [20], 22 healthy men 45–78 yr of age received 8
Although it is a widely held view among clinicians that EjD is a consequence of an effect on the bladder neck, it is in fact not true retrograde ejaculation but rather "anejaculation" caused by an effect on the ejaculatory apparatus (prostate, seminal vesicles, and vasa) and indeed has been coded incorrectly as retrograde ejaculation in several clinical studies [21]. It has been recognized for many years that the vas is an excellent pharmacologic model for the α1A-receptor [22]. Although it is possible that the clinical differences between silodosin and tamsulosin as compared with other α1-adrenoceptor antagonists do not exclusively relate to their subtype selectivity [23], additional properties of these drugs such as a proposed insurmountable antagonism in the vas deferens [24] or additional effects on other receptor systems (eg, dopamine and/or serotonin [25]) should be considered. Finally, it has been proposed that abnormal ejaculation is not primarily regulated at the level of the vas deferens but rather at central nervous sites that control its function [26].
This is clearly a typical side effect of α1-adrenoreceptor antagonists, particularly those with selectivity for α1A-adrenoreceptors, because this subtype is distributed throughout the organs participating in the emission phase of ejaculation [27]. Nonclinical studies have shown that α-adrenoreceptors, particularly α1A-adrenoreceptors, are essential for the physiologic contraction of the vas deferens and hence for sperm delivery from the testes to the urethra [28]. Reduced ejaculation is caused by an impaired function of the vas deferens rather than by alterations in sperm formation, number, or function [29]. This effect does not represent a safety concern because it indicates only a reduction in semen volume that is reversible (within a few days) upon discontinuation of treatment [30] and [31], and it is not perceived as particularly bothersome (in this study, the discontinuation rates were very low in all groups and were comparable with placebo).
It is now well established that EjD is commonly associated with both increasing age and the presence of LUTS [32], [33], [34], and [35]. The Multinational Survey of the Aging Male-7 results confirmed the significant relationship between LUTS and EjD in aging men.
A post hoc analysis of the North American studies on silodosin [16] suggested that EjD may be a predictor of the efficacy of the α1-adrenoreceptor blockade. Roehrborn and colleagues found that 28.1% of patients in these studies experienced EjD and reported that these patients experienced a greater improvement in symptoms and a clinically meaningful greater improvement in flow rate than those who did not experience EjD [36]. Homma et al. [37] carried out a similar analysis evaluating improvements in symptoms in the Japanese study [15]. The silodosin subgroup with failure of ejaculation experienced a greater reduction in total IPSS than the silodosin subgroup without impairment of ejaculation and the placebo subgroup (−11.8 vs −7.2 vs −5.3, respectively). Interestingly, the dropout rates in both of the silodosin groups were very similar.
As expected for a highly uroselective drug, silodosin appears to be a safe drug that is at least equivalent to tamsulosin in efficacy. A major advantage of this drug is its lack of cardiovascular side effects. It has no clinically relevant effect on blood pressure when measured either in the supine position or during orthostatic testing. This is important because most patients treated for LUTS associated with BPH are elderly and often on concomitant antihypertensive therapy or taking agents such as phosphodiesterase inhibitors. No unfavorable effect has been observed on ECG or laboratory tests, including liver function tests and tests of creatinine and glucose levels.
5. Conclusions
This large multinational study has confirmed the results of previous studies, demonstrating silodosin to be an effective and safe treatment for the relief of both voiding and storage symptoms in patients with benign prostatic enlargement consequent upon BOO due to BPH. It may be particularly useful in more elderly patients where there is the potential for drug–drug interactions and where potential cardiovascular side effects need to be minimized.
Study concept and design: Chapple, Montorsi.
Acquisition of data: Chapple, Montorsi, Tammela, Wirth, Koldewijn, Fernández Fernández.
Analysis and interpretation of data: Chapple, Montorsi, Tammela, Wirth, Koldewijn, Fernández Fernández.
Drafting of the manuscript: Chapple, Montorsi, Tammela, Wirth, Koldewijn, Fernández Fernández.
Critical revision of the manuscript for important intellectual content: Chapple, Montorsi, Wirth, Koldewijn, Fernández Fernández.
Statistical analysis: None.
Obtaining funding: None.
Administrative, technical, or material support: None.
Supervision: None.
Other (specify): None.
Financial disclosures: I certify that all conflicts of interest, including specific financial interests and relationships and affiliations relevant to the subject matter or materials discussed in the manuscript (eg, employment/affiliation, grants or funding, consultancies, honoraria, stock ownership or options, expert testimony, royalties, or patents filed, received, or pending), are the following: Christopher R. Chapple and Francesco Montorsi are consultants and researchers for Recordati. Teuvo L.J. Tammela, Manfred Wirth, Evert Koldewijn, and Eldiberto Fernández Fernández are researchers for Recordati.
Funding/Support and role of the sponsor: Recordati Ireland Ltd, Ringaskiddy, County Cork, Ireland, was involved in the design and conduct of the study, collection of the data, management of the data, analysis, interpretation of the data, preparation, review, and approval of the manuscript.
Acknowledgement statement: The authors wish to thank Dr. Massimo Casi, senior clinical project leader, for his dedicated help and support in finalizing the manuscript.
Appendix A. Complete List of Study Participants
Finland: T. Forsell (Kotka); P. Hellström (Oys); M. Multanen (Kouvola); T.L.J. Tammela (Tampere)
France: H. Botto (Suresnes); D. Chevallier (Nice)
Germany: F. König (Berlin); M. Schulze (Markkleeberg); J. Willgerodt (Leipzig); M. Wirth (Dresden); A. Von Keitz (Marburg)
Italy: F. Gaboardi (Milan); V. Gentile (Rome); M. Motta (Catania); P. Rigatti (Milano); R.M. Scarpa (Orbassano); O. Risi (Treviglio)
The Netherlands: E. Koldewijn (Eindhoven); E. Meuleman (Amsterdam); V. Van de Walle (Geleen)
Poland: P. Chlosta (Kielce); B. Darewicz (Bialystok); A. Dobrowolski (Myslowice); W. Dudziak (Srem); A. Gajda (Warszawa); P. Wedzikowski (Lodz); R. Jarema (Warszawa); R. Szwedowski (Opole); J. Szyperski (Bydgoszcz); P. Trypens (Warszawa); M. Wyczółkowski (Krakow)
Romania: F. Bajan (Pitesti); N. Calomfirescu (Bucharest); M. Dinu (Bucharest); C. Gingu (Bucharest); V. Jinga (Bucharest); C. Nitoiu (Bucharest)
Russia: S. Al-Shukri (St. Petersburg); V.P. Avdoshin (Moscow); I.A. Gorelov (St. Petersburg); I.S. Gorelov (St. Petersburg); V.K. Kheifets (St. Petersburg); B.V. Kunin (St. Petersburg); V.I. Kuzmin (St. Petersburg); O.B. Loran (Moscow); E.B. Mazo (Moscow); L.S. Mikhailov (St. Petersburg); I. Sedavnykh (St. Petersburg); A.V. Shanava (St. Petersburg); V.N. Shirshov (Moscow); V.N. Surikov (Moscow); A. Zhivov (St. Petersburg); M. Forkampf-Laue (St. Petersburg)
Spain: J. Caballero Alcántara (Marbella); E. Leon Dueñas (Sevilla); E. Fernández Fernández (Madrid); J.M. Fernández Gómez (Oviedo); F. Jiménez Cruz (Valencia); J.A. Portillo Martín (Santander)
Ukraine: A.A. Lyulko (Zaporizhzhya); A.V. Lyulko (Dnipropetrovsk); I. Gorpynchenko (Kyiv); F. Kostyev (Odesa); V. Lesovoy (Kharkiv); S. Pasiechnikov (Kyiv); V. Pirogov (Kyiv); V. Zaytsev (Chernivtsi)
United Kingdom: C.R. Chapple (Sheffield); S. Natale (Plymouth); R. Persad (Bristol); M. Speakman (Taunton, Somerset); A. Thorpe (Newcastle upon Tyne)
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a Department of Urology, Royal Hallamshire Hospital, Sheffield Teaching Hospital NHS Foundation Trust, Sheffield, UK
b Department of Urology, Università Vita Salute San Raffaele, Milan, Italy
c Department of Urology, Tampere University Hospital, Tampere, Finland
d Department of Urology, University Hospital Carl Gustav Carus, Dresden, Germany
e Department of Urology, Catharina Hospital, Eindhoven, The Netherlands
f Department of Urology, University Hospital Ramón y Cajal, Madrid, Spain
Corresponding author. The Royal Hallamshire Hospital, Sheffield Teaching Hospital NHS Foundation Trust, Glossop Road, Sheffield S10 2JF, United Kingdom. Tel. +44 74 271 2559; Fax: +44 74 279 7841.
A complete list of study participants is provided in the appendix.
Article information
DOI: 10.1016/j.eururo.2010.10.046
© 2010 European Association of Urology, Published by Elsevier B.V.


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'Wonder Woman' Live-Action TV Series In Development By CW
Despite a recent Woman Woman series never getting off the ground over at NBC, CW is developing an origin series for the famous DC Comics character, according to Vulture.
Sources tell the website the series is being penned by Allan Heinberg (Grey's Anatomy, The O.C.) and goes by the working title "Amazon."
While the script is in development, the CW still has no obligation to air or even order a pilot after the writing is completed.
David E. Kelly's live-action show, which was to star Adrianne Palicki as a modern Wonder Woman, completed a pilot only to have NBC forgo ordering the series. Joss Whedon has been rumored to be making a Wonder Woman movie for years before quitting the process in 2007. The last time the female superhero was in a live-action creation was the famous 1970s series.


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by Ryan Tonight the Sabres play the Ottawa Senators at home. The last time that happened was the day after Christmas, with the Sabres getting a point out of the deal despite playing a terrible first period. In fact, the … Continue reading
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Flags Fly At Half-Staff For Fallen Fort Drum Soldier
Flags were lowered to half-staff Thursday in honor of a fallen Fort Drum soldier.
Specialist Kerry Danyluk of Cuero, Texas, was wounded April 12 when enemy forces attacked his unit with small arms fire in Pul-e-Alam, Logar Province in Afghanistan.
He was assigned to the 2nd Battalion, 87th Infantry Regiment of the 10th Mountain Division's 3rd Brigade Combat Team.
He died in Landstuhl Regional Medical Center in Germany on April 15 from his injuries.
"On behalf of all New Yorkers, I extend sincere condolences to the family and friends of Specialist Kerry Danyluk," Governor Cuomo said. "We are saddened at the death of this young soldier, and we join with his fellow soldiers at Fort Drum in honoring his service to our nation and in mourning his loss."
See our earlier report


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WASHINGTON — President Barack Obama and New York Giants coach Tom Coughlin share the same goal — returning to the White House next year.
Obama honored the Super Bowl champions Friday, noting the similarities between the Giants' 2008 championship and its most recent triumph.
"They ended up winning with a circus catch in the fourth quarter, MVP performance by Eli Manning ... a come-from-behind win over the Patriots. So this is all starting to sound kind of like deja vu all over again," Obama said.
In his speech, Coughlin injected some political references for a president in the heart of a re-election campaign, telling his team and guests on the South Lawn that he hoped coming back to the White House "was not a twice-in-a-lifetime experience."
"We both have a goal to get back here next year. We have a lot of work to do," Coughlin said to cheers.
Coughlin noted that his team overcame a 7-7 start to win their final two regular-season games and win the NFC East. The Giants won four postseason games, capped by a 21-17 Super Bowl win over the New England Patriots.
"Offense, defense and special teams doing their job. Each group having different objectives and motives but playing in harmony for each other, for the good of everyone. Wouldn't it be nice if Congress operated the same way?" Coughlin said, drawing a smile from Obama, who has frequently clashed with House Republicans.
Obama also got into the act, reminding the team that it watched a highlight reel the night before the Super Bowl set to defensive end Justin Tuck's good-luck music: Phil Collins' 1980s song, "In the Air Tonight."
"I don't know about a little Phil Collins before a big game," Obama said. "I may try that before a big meeting with Congress."
The team presented Obama with a blue No. 44 jersey and a football signed by the players.