NEW YORK (Reuters Health) - Herbal supplements aimed at improving men's sexual abilities often contain the active ingredients in erectile dysfunction pills such as Viagra, according to a new study.

Additionally, researchers found that some of these over-the-counter herbal remedies contained more of the ingredient than is allowed in prescription-only pharmaceuticals.

"It's pretty scary stuff," said Neil Campbell, the lead author of the study and a researcher at Pfizer, which sells Viagra. "These products are not herbal at all, they're adulterated."

The U.S. Food and Drug Administration, which is in charge of regulating herbal supplements, posted 11 warnings to consumers in 2013 alerting them of unlabeled pharmaceuticals being found in these products.

Campbell and his colleagues analyzed 91 samples from 58 products.

They sent undercover consumers into convenience stores and gas stations in the Atlanta and Baltimore areas, and bought products such as Rize 2 The Occasion, Stiff 4 Hours, and Man King.

Although 57 of the products claimed to be "all natural," 81 percent of them contained the tadalafil or sildenafil (marketed as Cialis and Viagra, respectively) or similar ingredients that are not approved by the FDA.

The products also had labeling problems, indicating poor quality production, according to the authors. In some cases, expiration dates or lot numbers were missing, manufacturers could not be identified, or samples of the same product had different appearances.

"There's so little effort to do something the right way to produce a legitimate product," Campbell told Reuters Health. "This is an all time low."

None of 10 supplement companies contacted by Reuters Health responded to a request for comment, nor did the FDA.

Campbell said given the potential side effects and health risks associated with prescription erectile dysfunction drugs, men are "risking their lives" taking herbal sex enhancement drugs.

"Almost one patient a day says they've tried Mojo or one of these over-the-counter products," said Dr. Gregory Lowe, an assistant professor of urology at Ohio State University who was not part of this study.

"One of the big concerns is that we don't know what the patient's getting," he added.

Seven samples that Campbell's group analyzed contained only unknown substances.

"Commonly, I hear patients say, 'it worked one time and it didn't work other times.' And that fits in well with what they found here" that quality control is lacking, he added.

It's unclear where the ingredients are coming from.

Lowe advises men who are interested in taking these pills to talk to their doctors first.

He says patients often turn to these products because they are cheap - costing between $2.99 and $17.99, according to Campbell's study, published in the Journal of Sexual Medicine.

But they are taking a health risk in doing so.

Erectile dysfunction medicines can be unsafe for men taking nitrates for chest pain, but only 14 of the samples in the study included a warning against combining the drugs.

"Unfortunately, to an unwitting patient they think they're taking an herbal product," said Campbell. "It really poses a really scary threat for patient health and safety."

SOURCE: http://bit.ly/17KGjiu Journal of Sexual Medicine, online May 1, 2013.

But it doesn't answer the big question: Why do some hospitals charge 20 or even 40 times more than others?

"It doesn't make sense," said Jonathan Blum, director of the government's Center for Medicare. The higher costs don't reflect better care, he said, and can't be explained by regional economic differences alone.

Blum said he hopes making the information available without charge to the public will help generate answers to the riddles of hospital pricing, and put pressure on the more expensive hospitals.

The fees that Medicare pays hospitals aren't based on their charges, Blum said. But patients who are without government or private medical coverage are subject to them. The new information should help those patients decide where to get care, he said.

There are vast disparities nationally. The average charges for joint replacement range from about $5,300 at an Ada, Okla., hospital to $223,000 in Monterey Park, Calif.

It's not just national or even regional geography. Hospitals within the same city also vary wildly. In Jackson, Miss., average inpatient charges for services that may be provided to treat heart failure range from $9,000 to $51,000, the Department of Health and Human Services said.

Hospitals usually receive less money than they charge, however. Their charges are akin to a car dealership's "list price." Most patients won't be hit with these bills, because they are paid by their private insurance, Medicare or Medicaid at lower rates. Insurance companies routinely negotiate discounted payments with hospitals.

"These charges really don't have a direct relationship with the price for the average person," said Chapin White of the nonprofit Center for Studying Health System Change. "I think the point is to shame hospitals."

The charges do show up on the bills of people without medical coverage, many of whom try to negotiate smaller fees for themselves. And they could affect people paying for care that is outside their insurance company's network. Hospitals say they frequently give the uninsured discounts.

"This is the opening bid in the hospital's attempt to get as much money as possible out of you," White said of the listed charges.

And some people pay full price, or try to afford it, because they don't know they can bargain for a discount, White said.

The department released a list of the average charges at 3,300 hospitals for each of the 100 most common Medicare inpatient services. The prices, from 2011, represent about 60 percent of Medicare inpatient cases.

"Hospitals that charge two or three times the going rate will rightfully face scrutiny," Health and Human Services Secretary Kathleen Sebelius told reporters.

And consumers will benefit from more information about a mystifying system that too often leaves them with little way of knowing what a hospital will charge or what their insurance companies are paying for treatments, Sebelius said.

Previously, the price information that the government collects from hospitals wasn't available to the average consumer, although the data could be purchased for uses such as research, officials said.

The department also is making $87 million in federal money available as grants to states to improve their hospital rate review programs and get more information about health care charges to patients.

The Louisiana voucher law has diverted taxpayers' money from public schools to private individuals and schools that are not subject to academic, operational, and accountability standards.

"NSBA stands for strong public school system for all students. Vouchers undermine that fundamental principle and, as the court concluded, violate constitutional principles, too," said NSBA President David A. Pickler.

Working with the Louisiana School Boards Association (LSBA), NSBA pushed to overturn the law through an. That lawsuit challenged the constitutionality of several measures adopted by the Louisiana legislature, including the ploy to give vouchers to students in low-performing schools. The noted that the voucher scheme further aggravates the plight of academically challenged schools by taking away much-needed funds from low-performing public schools, thus perpetuating its own survival.

"These kinds of gimmicks undermine our country's longstanding commitment to public education and steal resources from public school students," said NSBA Executive Director Thomas J. Gentzel. "These are not grassroots efforts being proposed by residents who are concerned about the education and future of the state's most vulnerable children, these are the products of out-of-state special-interest groups looking for profits."

Under the provisions of the voucher law, Louisiana gives public funds to private schools, including religious schools, as "scholarships" to cover the tuition and fees of students whose parents choose to remove their children from public schools deemed "failing." However, the plan goes so far as to allow parents to use vouchers for their children as early as kindergarten, even if the child never attended a public school or the school is highly ranked.

"We are pleased that the Louisiana Supreme Court has reaffirmed a basic tenet of the state Constitution: that taxpayer money should go to public schools that are open to all students," said LSBA Executive Director Scott Richard. "We hope all state residents can understand the dangerous precedent that a voucher program has set and how such a program undermines our local community schools. LSBA will continue to work towards its mission of service, support and leadership for local school boards and to ensure a quality public education for all students."

NSBA opposes private school vouchers and tuition tax subsidies, which have continuously failed to improve student achievement. NSBA is committed to defeating legislation and initiatives that unconstitutionally divert taxpayers' funds from public schools to private and religious institutions that can exclude students for any reason.

Founded in 1940, the National School Boards Association (NSBA) is a not-for-profit organization representing state associations of school boards and their more than 90,000 local school board members throughout the U.S. Working with and through our state associations, NSBA advocates for equity and excellence in public education through school board leadership.

SOURCE National School Board Association

The archdiocese sent a subpoena to President Barack Obama's administration in February asking for documents from White House staff, including Obama himself, for use in a church lawsuit against the contraception mandate.

Citing the burden involved and calling a subpoena of the president's office inappropriate, the White House asked a federal judge to toss out the subpoena on April 4.

A notice filed in U.S. District Court in Washington late on Monday said the archdiocese agreed to withdraw its subpoena. It did not say why.

A lawyer for the archdiocese declined to comment on Tuesday. A spokeswoman for the U.S. Justice Department, which represented the White House in court, had no immediate comment.

The archdiocese is continuing its lawsuit in Brooklyn federal court challenging the Obama administration's health policy requirement that employers generally include coverage of birth control in health insurance plans they offer workers.

The Catholic Church teaches that artificial birth control is sinful because it violates natural law.

Part of the 2010 healthcare law championed by Obama and congressional Democrats, the birth control mandate has some exceptions for religious employers but the New York archdiocese said it expected to incur nearly $200 million each year in penalties if it refuses to comply.

(Reporting by David Ingram; editing by Andrew Hay)

Tosic fractured the fifth metatarsal bone in his right foot during CSKA's 1-0 home win over Terek Grozny on Saturday and is expected to be out of action for at least a month.

"I will almost definitely play no part in the game against Belgium but I hope it will not require surgery," the former Manchester United left wing told daily Vecernje Novosti.

"It's part of the game but it's also a bitter blow because I've struggled with a niggling knee injury for several months and this happened just when I was almost back to full fitness," he said.

Serbia have only a slim chance of reaching next year's tournament in Brazil. They are third in the group with seven points from six games, nine adrift of leaders Belgium and Croatia.

CSKA are closing in on their first league title since 2006 as they top the 16-team Russian first division with 60 points from 27 games, three more than champions Zenit St. Petersburg with three games left.(Reporting by Zoran Milosavljevic; Editing by Toby Davis)

At the burial shortly afterward, amid tears and embraces, the brothers vow vengeance against the leftist rebels who kidnapped and killed him.

It's a crucial moment in a Colombian paramilitary soap opera that has stirred unprecedented controversy by dramatizing and some say romanticizing the career of the Castano brothers, central figures in the creation of the country's murderous far-right militias.

While founded to fight leftist guerrillas, the United Self-Defense Forces of Colombia evolved into criminal gangs, enriched by drug trafficking, that killed thousands and stole land from tens of thousands more, colluding with scores of prominent politicians.

The soap opera is called "Three Cains," an allusion to the Biblical story of Cain slaying his brother Abel, in part because Vicente Castano had his brother Carlos murdered in 2004.

A grassroots campaign against the show, which runs on the Mundo Fox cable channel in the United States and RCN in Colombia, also has raised questions about a whole genre of Colombian TV series that focuses on the country's top drug traffickers. Some say such shows glorify killers while minimizing victims.

"It's clear that those topics have to be dealt with. The question is, why treat them from the point of view of Cain and not Abel?" said Daniel Naranjo, who with three friends launched a Facebook campaign promoting an advertising boycott against the series that has gained thousands of supporters.

Instead of focusing on the Castano brothers, or the late drug kingpin Pablo Escobar, he asked, why not instead focus on their victims?

"Three Cains" portrays the brothers in their loves as well as their conflicts aspects of their lives that were sometimes entangled, at least on the screen, as they sent killers after romantic rivals or those who betrayed them. The first few weeks also have traced the Castanos' secret alliance with police and soldiers to attack Escobar and his allies.

Less detail so far has been given to incidents such as the January 1990 Pueblo Bello massacre, in which the brothers' gang kidnapped 43 peasants, loaded them into trucks, hauled them away to a family ranch and killed them, according to the Inter-American Human Rights Court. The Castanos allegedly believed at least some of the villagers had aided rebels who had stolen cattle from them.

Among the dead was Wilson Fuentes, a 45-year-old banana farmer and rancher. For his daughter Katy, who was 14 when her father was seized, the series is an affront.

"It makes me re-live that moment," she said. "What it does is re-victimize us ... It's a lack of respect for the victims."

Her father's body, like most of those slain, was never found, and the possible explanations say much about the Castanos' reputation. "There are many versions," Fuentes said. "Supposedly they had an oven; they tossed them in the oven and they were incinerated. Other versions say they had some lions and they gave them to the lions to eat. Others say they threw them into the Sinu River."

"The truth, nobody knows," said Fuentes. "Or if they know, they do not want to say."

The fate of two of the Castanos themselves is a mystery as well. While Carlos was killed in 2004, just as the paramilitaries were disbanding as part of a peace deal with the government, Fidel and Vicente both disappeared under murky circumstances. Carlos had long maintained that Fidel died in combat in the 1990s but no corpse was ever recovered. Vicente's fate is unknown.

While some earlier TV series generated protests, the campaign against "Three Cains" is the first to prompt sponsors such as the Falabella chain of stores and Nivea cosmetics to pull backing from a show, local media analysts say.

Even so, the show is winning viewers. It has been among the top five most-viewed programs on Colombian television during its run.

RCN Television, which produced the show and is the target of the protests, refused to comment on the complaints when contacted by The Associated Press. A screenwriter for the series, Gustavo Bolivar, rejected the campaign against it as "bordering on censorship" and denied glorifying the criminals.

"We are showing how these drug traffickers became paramilitaries and these paramilitaries attacked the civilian population," he said.

A chapter of Colombia's history "is being told, for good or ill," Bolivar said. "Those who want, watch it. Those who don't have the remote control in their hands and can watch another program."

Still, the societal trauma from Colombia's seemingly interminable conflict the paramilitary phenomenon is just one offshoot of a nearly half-century-old guerrilla conflict is so deep that many are offended by an attempt to earn television ratings by dramatizing it.

"The issue is that paramilitarism is still a relatively recent topic, so sectors of the population still have an open wound," said Jeronimo Rivera, head of the audiovisual department at the University of La Sabana in Bogota.

For sociologist Miguel Angel Hernandez of the University of the Atlantic, the show's depiction of huge houses, luxurious cars and numerous bodyguards leaves the message "that evil pays."

"Evil pays for 95 percent of the series and in the 5 percent at the end it says that evil does not pay. Why"? So it can be, let's say, presentable before public opinion."

___

Associated Press writer Cesar Garcia contributed to this report.

"Who knew, right?" Psy said as he was presented his Tribeca Disruptive Innovation Award. "Giving me this award in itself is innovation, I think."

Referring to his sudden worldwide fame both on and off the Internet, where his videos have racked up more than one billion views on YouTube, Psy said, "I still cannot believe what happened right now."

"I'm still figuring out the reason for this happening like this," he said, noting that he had been working in music in his native South Korea for over a decade.

The Disruptive Innovation Awards honor those whose ideas have broken the mold to create significant impact.

"In our fourth installment, we are exploring the ever-increasing gap between the rate of technological change and the bumpier, slower-moving cultural adoption and diffusion," said Craig Hatkoff, a festival co-founder and the awards' chief curator.

Wearing a black suit and stylish white dress shirt, Psy, known for his megahit "Gangnam Style" as well as his energetic and flamboyant performances, charmed the audience with self-effacing remarks offered in rather halting English.

"I don't want to say this but, it's kind of embarrassing, but ... maybe, am I handsome?" The audience expressed its approval with cheers and applause.

The awards were presented at New York University, marking a homecoming of sorts for Psy, whose real name is Park Jae-sang.

"I applied to this school in 1996, but I failed. What a success," he said. "Finally, I entered this building this morning."

Other recipients of the Disruptive Innovation Awards included Beck, a conservative television and radio commentator, fashion designer Norma Kamali, Chobani yogurt mogul Hamdi Ulukaya, music and film entrepreneur Peter Shapiro and Forbes Media, in addition to Tharp who received a lifetime achievement award.

(Reporting by Chris Michaud, Editing by Jill Serjeant and Paul Simao)

One fifteen year old female patient who competitively pole jumps was complaining about breathing.After Dr. Selleck examined her airway, he indicated that “her tonsils were the size of golf balls.” When the patient was examined lying down on her back, she wasn’t able to breathe because of the blockage in her airway.By doing a simple office screening, talking with and examining the patient, Dr. Selleck found an airway blockage that hindered the patient’s daily energy and athletic performance.He referred the patient on for a tonsillectomy and sleep study. Often, with the absence of infection many carriers will deny removal of tonsils regardless of the patient’s subjective complaint. A sleep study confirmed her airway obstructions and validated the extreme medical necessity of the treatment. After treatment, the young athlete significantly increased her energy and pole jump performance.

Kids are as important as adults to our dental sleep practice. “Although we are not actually providing the airway care for young children, we are helping them with assessment and getting them to the right place,” said Dr. Selleck. In addition to the dental services offered, our practice has a specific philosophy of helping everyone with their airway issues and sleep breathing disorders. Pat McBride, dental sleep medicine implementation specialist, added, “Every night we go home feeling good about quantifiably helping kids and adults be on their way to having healthy airways. It doesn't get any better than that.”

Renaissance works with children and adults and offers dental and airway consultations to everyone in the local area. According to Dr. Selleck, “Statistics indicate that 40-60 million people suffer from obstructive sleep apnea. The more devastating news is that only 10% of people have been diagnosed. That’s why our group always takes the time to talk to people who think they may be in trouble with their airways.”

Dr. Selleck provides airway treatment through oral appliance therapy. This is done by creating a custom fabricated mouth piece that is similar to a retainer. The mouth piece works by repositioning the jaw and pushing the tongue forward to keep the airway open. “The oral appliance is a viable treatment option for patients with mild to moderate obstructive sleep apnea and for those who are unable to wear their Continuous Positive Airway Pressure (CPAP) masks. It’s great for travel too,” Dr. Selleck said. He added, “Even though the CPAP is known as the gold standard treatment for sleep apnea, there’s a big part of the population that can’t use it. The development of the oral appliance as an adjunct modality is critical in getting patients the right treatment.”

“We realize that with the stresses people are under – environmental and personal – their health is significantly impacted by lack of sleep or lack of quality sleep,” said Dr. Selleck. Issues such as diabetes and high blood pressure are greatly impacted by sleep breathing disorders. Selleck added, “We have a very long term relationship with patients. It’s our due diligence and we owe all patients attention for the rest of their lives.”

Additionally, Pat McBride said, “We also fully believe in bringing multiple modalities under an umbrella by partnering primary care physicians, specialist physicians, dentists, orthodontists, physical therapists, and oral myologists. It’s a philosophy that we’ve adapted through the American Academy of Physiological Medicine and Dentistry (AAPMD). It is comprehensive and time consuming, but it is helping people live better, healthier, longer enriched by information and education. It’s breaking the mold.”

Medical research has recently linked untreated sleep apnea to larger health issues such as cancer, type 2 diabetes, heart disease and fatality.To learn more information, call(925) 283-0338 or visit . To find out if you are at risk for having sleep apnea, take a quick, five minute, preliminary evaluation at .                            

ABOUT MICHAEL SELLECK, DDS - Dr. Selleck was born and raised in San Jose, California. His undergraduate degree was completed at UCSC, followed by a Doctorate in Dental Surgery from the UOP School of Dentistry, San Francisco. A voracious learner and innovator, Dr. Selleck’s practice has steadfastly remained on the cutting edge of technology, innovation and research by implementing the most effective equipment and modalities to improve the quality of patient care and enhance the patient experience in a whole health environment. His general and reconstructive dental practice began developing into an “airway centric practice” after the loss of a close friend from sleep apnea at 39 years old. “I knew then that I had an abject responsibility to my family, friends and especially my patients to include sleep disordered breathing and airway assessment into my practice; and it has allowed me the privilege of partnership with physicians and other clinicians in our community to tangibly improve the quality of people’s lives. What began as a quest for answers regarding my friend’s death has turned into the passion that drives my work each and every day. I think my friend would have liked that.”

ABOUT SLEEPTEST.COM - SleepTest.com is an online resource dedicated to educating the public on the dangers of untreated sleep apnea and treatment options. The goal is to offer a free preliminary online screening that can help identify people who may be at risk for this sleep disorder.The sleep test evaluation is quick and easy, and can be completed in about 5 minutes.

Anna GordonSleepTest.com630-537-1097

The Senate might start the debate over a background check compromise proposed last week by two senators, Joe Manchin and Pat Toomey, on Tuesday. That will mark the start of the official public debate over an issue that many see as the most meaningful change in a series of measures proposed after the Sandy Hook shootings.

Three other measures are currently seen as having a good chance of passing in the Senate: tougher measures against straw purchasers of guns used in crimes; more efforts to divert resources to mental health programs; and more funding for security for schools.

Currently, the Democrats have 53 votes in the Senate and two independent senators who usually vote with the Democrats. Most likely, 60 votes will be needed for any amendment to be added to legislation.

Two factors complicate the process: Some Democrats could split from the caucus, based on how they feel the issue affects their constituents, and any bill passed by the Senate still needs to be approved by the Republican-controlled House of Representatives.

Three Democrats, Mark Begich, Heidi Heitkamp, and Mark Pryor, may not vote in favor of the Manchin-Toomey amendment. So the Democrats would need to get eight GOP senators to make up the difference.

Based on the reports coming out of Washington, here are the senators to watch as this very public discussion over theunravels this week.

1. Majority Leader Harry Reid. It will be up to Reid to manage the amendment process in the House and how (and when) votes are taken. With a filibuster and numerous other amendments possible, Reid will have the final say on how key parts of the debate proceed.

2. Minority Leader Mitch McConnell. The Republican from Kentucky doesnt support background checks in their current form. If McConnell changes his stance, possibly from the introduction of a rival background check proposed by a GOP senator, it could present some Democrats with a dilemma.

3. Max Baucus. The Democratic senator from Montana didnt vote to block the gun control bill from going to the full Senate, but said he wouldnt support it in the end. He didnt comment on the Manchin-Toomey amendment.

4. Mary Landrieu. The Louisiana Democrat is expected to have a tough re-election battle. She told CNN recently that she supported background checks in theory but would vote to reflect her constituents wishes.

5. Susan Collins. The Maine Republican said over the weekend that she will vote to support the Manchin-Toomey background check amendment.

6. John McCain. The former presidential candidate from Arizona is on the fence and has supported background checks in the past. If McCain endorses the Manchin-Toomey amendment, he could bring several other Republicans with him.

7. Tom Coburn. The senator from Oklahoma has proposed an alternative amendment that would greatly limit record-keeping and give states the option to expand enforcement. Senator John Thune is rumored to be the lawmaker who will introduce the Coburn amendment.

8. Mark Kirk. The Illinois Republican publicly supported the Manchin-Toomey amendment last week, giving the bill another GOP vote.

9. Kay Hagan. The first-term North Carolina Democrat is being targeted in an ad campaign from Michael Bloombergs anti-gun group. She has publicly supported background checks, but she also comes from a state that went to Mitt Romney in the 2012 election.

10. Pat Toomey. The Pennsylvania senators late entrance into bipartisan negotiations over background checks helped craft a compromise with Joe Manchin. Toomey is also making the rounds on news talk shows to discuss the amendment.

To be sure, other senators will have a public, vocal role in the debate process, from Democrat Chuck Schumer to Republicans Rand Paul and Ted Cruz. But the vote could come down to a bipartisan effort to influence some of the GOP members who opposed a filibuster, including Kelly Ayotte, Jeff Flake, and Dean Heller.

Recent Constitution Daily Stories

Other great singers have come and gone, but this fact remained inviolate until Jones passed away Friday at 81 in a Nashville hospital after a year of ill health.

"Today someone else has become the greatest living singer of traditional country music, but there will never be another George Jones," said Bobby Braddock, the Country Music Hall of Fame songwriter who provided Jones with 29 songs over the decades. "No one in country music has influenced so many other artists."

He did it with that voice. Rich and deep, strong enough to crack like a whip, but supple enough to bring tears. It was so powerful, it made Jones the first thoroughly modern country superstar, complete with the substance abuse problems and rich-and-famous celebrity lifestyle that included mansions, multiple divorces and to hear one fellow performer tell it fistfuls of cocaine.

He was a beloved and at times a notorious figure in Nashville and his problems were just as legendary as his songs. But when you dropped the needle on one of his records, all that stuff went away. And you were left with The Voice.

"He just knows how to pull every drop of emotion out of it of the songs if it's an emotional song or if it's a fun song he knows how to make that work," Alan Jackson said in a 2011 interview. "It's rare. He was a big fan of Hank Williams Sr. like me. He tried to sing like Hank in the early days. I've heard early cuts. And the difference is Hank was a singer and he was a great writer, but he didn't have that natural voice like George. Not many people do. That just sets him apart from everybody."

That voice helped Jones achieve No. 1 songs in four separate decades, 1950s to 1980s. And its qualities were admired by more than just his fellow country artists but by Frank Sinatra, Pete Townshend, Elvis Costello, James Taylor and countless others. "If we all could sound like we wanted to, we'd all sound like George Jones," Waylon Jennings once sang.

Word of his death spread Friday morning as his peers paid tribute.

Merle Haggard put it best, perhaps: "The world has lost the greatest country singer of all time. Amen."

"The greatest voice to ever grace country music will never die," Garth Brooks said. "Jones has a place in every heart that ever loved any kind of music."

And Dolly Parton added, "My heart is absolutely broken. George Jones was my all time favorite singer and one of my favorite people in the world."

In Jones' case, that's not hyperbole. In a career that lasted more than 50 years, "Possum" evolved from young honky-tonker to elder statesman as he recorded more than 150 albums and became the champion and symbol of traditional country music, a well-lined link to his hero, Williams.

Jones survived long battles with alcoholism and drug addiction, brawls, accidents and close encounters with death, including bypass surgery and a tour bus crash that he only avoided by deciding at the last moment to take a plane.

His failure to appear for concerts left him with the nickname "No Show Jones," and he later recorded a song by that name and often opened his shows by singing it. His wild life was revealed in song and in his handsome, troubled face, with its dark, deep-set eyes and dimpled chin.

In song, like life, he was rowdy and regretful, tender and tragic. His hits included the sentimental "Who's Gonna Fill Their Shoes," the foot-tapping "The Race is On," the foot-stomping "I Don't Need Your Rockin' Chair," the melancholy "She Thinks I Still Care," the rockin' "White Lightning," and the barfly lament "Still Doing Time." Jones also recorded several duets with Tammy Wynette, his wife for six years, including "Golden Ring," ''Near You," ''Southern California" and "We're Gonna Hold On." He also sang with such peers as Willie Nelson and Merle Haggard and with Costello and other rock performers.

But his signature song was "He Stopped Loving Her Today," a weeper among weepers about a man who carries his love for a woman to his grave. The 1980 ballad, which Jones was sure would never be a hit, often appears on surveys as the most popular country song of all time and won the Country Music Association's song of the year award an unprecedented two years in a row.

Jones won Grammy awards in 1981 for "He Stopped Loving Her Today" and in 1999 for "Choices." He was elected to the Country Music Hall of Fame in 1992 and in 2008 was among the artists honored in Washington at the Kennedy Center.

He was in the midst of a yearlong farewell tour when he passed away. He was scheduled to complete the tour in November with an all-star packed tribute in Nashville. Stars lined up to sign on to the show, many remembering kindnesses over the years. Kenny Chesney thinks Jones may have one of the greatest voices in not just country history, but music history. But he remembers Jones for more than the voice. He was picked for a tour with Jones and Wynette early in his career and cherishes the memory of being invited to fly home on Jones' private jet after one of the concerts.

"I remember sitting there on that jet, thinking, 'This can't be happening,' because he was George Jones, and I was some kid from nowhere," Chesney said in an email. "I'm sure he knew, but he was generous to kids chasing the dream, and I never forgot it."

Jones was born Sept. 12, 1931, in a log house near the east Texas town of Saratoga, the youngest of eight children. He sang in church and at age 11 began performing for tips on the streets of Beaumont, Texas. His first outing was such a success that listeners tossed him coins, placed a cup by his side and filled it with money. Jones estimated he made more than $24 for his two-hour performance, enough to feed his family for a week, but he used up the cash at a local arcade.

"That was my first time to earn money for singing and my first time to blow it afterward," he recalled in "I Lived to Tell it All," a painfully self-critical memoir published in 1996. "It started what almost became a lifetime trend."

The family lived in a government-subsidized housing project, and his father, a laborer, was an alcoholic who would rouse the children from bed in the middle of the night to sing for him. His father also noted that young George liked music and bought him a Gene Autry guitar, with a horse and lariat on the front that Jones practiced on obsessively.

He got his start on radio with husband and wife team Eddie & Pearl in the late 1940s. Hank Williams once dropped by the studio to promote a new record, and Jones was invited to back him on guitar. When it came time to play, he froze.

"Hank had 'Wedding Bells' out at the time," Jones recalled in a 2003 Associated Press interview. "He started singing it, and I never hit the first note the whole song. I just stared."

After the first of his four marriages failed, he enlisted in the Marine Corps in 1951 and served three years. He cut his first record when he got out, an original fittingly called "No Money in This Deal."

He had his first hit with "Why Baby Why" in 1955, and by the early '60s Jones was one of country music's top stars.

"I sing top songs that fit the hardworking, everyday loving person. That's what country music is about," Jones said in a 1991 AP interview. "My fans and real true country music fans know I'm not a phony. I just sing it the way it is and put feeling in it if I can and try to live the song."

Jones was married to Wynette, his third wife, from 1969 to 1975. (Wynette died in 1998.) Their relationship played out in Nashville like a country song, with hard drinking, fights and reconciliations. Jones' weary knowledge of domestic warfare was immortalized in such classics as "The Battle," set to the martial beat of "The Battle Hymn of the Republic."

After one argument, Jones drove off on a riding mower in search of a drink because Wynette had taken his car keys to keep him from carousing. Years earlier, married to his second wife, he had also sped off on a mower in search of a drink. Jones referred to his mowing days in the 1996 release, "Honky Tonk Song," and poked fun at himself in four music videos that featured him aboard a mower.

His drug and alcohol abuse grew worse in the late '70s, and Jones had to file for bankruptcy in 1978. A manager had started him on cocaine, hoping to counteract his boozy, lethargic performances, and Jones was eventually arrested in Jackson, Miss., in 1983 on cocaine possession charges. He agreed to perform a benefit concert and was sentenced to six months probation. In his memoir, "Satan is Real," Charlie Louvin recounts being offered a fistful of cocaine by Jones backstage at a concert.

"In the 1970s, I was drunk the majority of the time," Jones wrote in his memoir. "If you saw me sober, chances are you saw me asleep."

In 1980, a 3-minute song changed his life. His longtime producer, Billy Sherrill, recommended he record "He Stopped Loving Her Today," a ballad by Braddock and Curly Putnam. The song took more than a year to record, partly because Jones couldn't master the melody, which he confused with Kris Kristofferson's "Help Me Make it Through the Night," and partly because he was too drunk to recite a brief, spoken interlude ("She came to see him one last time/And we all wondered if she would/And it kept running through my mind/This time he's over her for good.")

"Pretty simple, eh?" Jones wrote in his memoir. "I couldn't get it. I had been able to sing while drunk all of my life. I'd fooled millions of people. But I could never speak without slurring when drunk. What we needed to complete that song was the narration, but Billy could never catch me sober enough to record four simple spoken lines."

Jones was convinced the song was too "morbid" to catch on. But "He Stopped Loving Her Today," featuring a string section that hummed, then soared, became an instant standard and virtually canonized him. His concert fee jumped from $2,500 a show to $25,000.

"There is a God," he recalled.

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Italie contributed from New York.