Heroin overdose: causes and consequences

Over the past decade fatal opioid overdose has emerged as a major public health issue internationally. This paper examines the risk factors for overdose from a biomedical perspective. while significant risk factors for opioid overdose fatality are well recognized, the mechanism of fatal overdose remains unclear. Losses of tolerance and concomitant use of alcohol and other CNS depressants clearly play a major role in fatality; howeve, such risk factors do not account for the strong age and gender patterns observed consistently among victims of overdose. There is evidence that systemic disease may be more prevalent in users at greatest risk of overdose. We hypothesize that pulmonary and hepatic dysfunction resulting from such disease may increase susceptibility to both fatal and non-fatal overdose. Sequelae of non-fatal overdose are recognized in the clinical literature but few epidemiological data exist describing the burden of morbidity arising from such sequelae. The potential for overdose to cause persisting morbidity is reviewed.

Women victims of assault: Age differences in victim-aggressor relationship and location

This article presents the findings from a secondary analysis of the 1991 Queensland Crime Victim Survey. Although now more than 10 years old, this survey still has validity as it remains the largest of its kind conducted in Queensland, and it is a rich source of information about the experiences of victims of violence. The study investigated how the experiences of younger female assault victims differ from older female victims in terms of their relationship with their aggressor and the assault location. The following factors were examined: whether or not the assault occurred (a) at the hands of a partner or former partner, (b) in a private dwelling, (c) in a public place, and (d) in a leisure venue away from home. Results pointed to important differences between younger and older women in terms of their experiences of violence. Teenage women reported significantly more assaults in public places compared with older women, and were less likely to be assaulted in their own dwelling. Also, trends in the data suggested that compared to older women, teenage women were more likely to be assaulted in leisure venues away from home, and were less likely to be assaulted by partners or former partners. Considering that young women are at a much higher risk than older women of being assaulted, consideration of these age differences may be helpful in the design of violence prevention strategies. In particular, more attention should be paid to the public place prevention of violence against young women.

Sperm morphology: A novel way to associate female-males of highly sexual dimorphic fig wasp species

Males of pollinating and some non-pollinating fig wasps are wingless and quite dissimilar to their co-specific females. Due to the accentuated sexual dimorphism, males and females of some fig wasp species were described in different genera. We used morphological sperm features obtained from male seminal vesicles and female spermathecas to associate sexes in three non-pollinating fig wasp species, genus Idarnes, that are associated with Ficus citrifolia in Brazil. Sperm obtained from each female morph species presented diagnostic features that led to the association with sperm obtained from males. This method can potentially be used to help enlighten taxonomic problems in other wasp species with sexual di- or polymorphism.

Sexual ratio, reproductive period and seasonal variation of the gonochoric shrimp Hippolyte obliquimanus (Caridea: Hippolytidae)

Hippolyte obliquimanus is a small, gonochoric shrimp found in algal substrates along the western Atlantic coast of Brazil, particularly in association with seaweed of the genus Sargassum. We studied population features (sexual ratio, reproductive period and temporal distribution) of H. obliquimanus in southeastern Brazil, including its relationships with the seasonality of banks of this alga. Specimens were collected at two-monthly intervals from March 2005 to January 2006, in Ubatuba Bay. The sex of individuals was checked, and the carapace length measured. In total, 668 individuals were collected: 211 males (0.70-2.50 mm carapace length), 341 non-ovigerous females (0.55-2.90 mm), and 116 ovigerous females (1.55-3.20 mm). Hippolyte obliquimanus showed seasonal-continuous reproduction and variable continuous recruitment. The highest number of animals (75%) was collected in fall-winter. The percentages of ovigerous females/total females (fall-winter: 27%; spring-summer: 26%) and the sexual ratio (fall-winter: 31%; spring-summer: 32%) were practically equal in both periods. The sexual ratio showed a predominance of females in almost all size classes, and we detected a new sex ratio pattern for this species. The seasonal variation in the number of individuals can be related to its migration to deeper areas, due to the decrease in the abundance of Sargassum sp. in shallower waters in spring-summer.

Reproductive biology of Echinodorus longipetalus (Alismataceae): Sexual morphs, breeding system and pollinators

The floral biology, pollinators and breeding system of Echinodorus longipetalus Micheli were studied in a marshy area of the district of Taquaritinga (State of Sao Paulo), southeastern Brazil. E. longipetalus is gynodioecious and as far as is known, this is the first record of unisexual flowers, besides perfect flowers, in Echinodorus. Proportion of female individuals in the studied population is 50% and produces 31% more flowers than hermaphrodites. Perfect and pistillate flowers of E. longipetalus are similar in appearance and are pollinated by several species of Hymenoptera (mainly by Xylocopa (Neoxylocopa) suspecta Moure & Camargo). Perfect flowers offer pollen as a reward. Pistillate flowers attract floral visitors by deceit with their staminodes that resemble the stamens of the perfect flowers. Visits to pistillate flowers are quick (1-2 s), while visits to perfect flowers last up to 120 s. The perfect flowers are self-compatible and produce fruits through spontaneous self-pollination (control flowers), whereas the pistillate ones only set fruits through cross-pollinations. Perfect and pistillate flowers set more fruits under natural conditions than in manual treatments, respectively. Although the pistillate and perfect flowers bear a strong similarity, the selective pollinator behavior seems to be responsible for the increase of fruit set in perfect flowers. (C) 2008 Elsevier B.V. All rights reserved.

Sexual maturity and egg production in an unexploited population of the red squat lobster Pleuroncodes monodon (Decapoda, Galatheidae) from Central America

The squat lobster Pleuroncodes monodon is one of the most common and abundant galatheid species in the deepwater fishery of Pacific coast of America. In contrast with Peru and Chile, the red squat lobster is not commercially exploited in Costa Rica. Here we estimated the size of sexual maturity and analysed egg production in P. monodon from the Pacific of Costa Rica; the results might be important for an adequate management strategy when initiating a sustainable fishery of this resource in Costa Rica. Analyses of allometric growth revealed that females and males reached their morphological sexual maturity at 26.9 and 30.4 mm CL. respectively. The percentage of immature females captured in the present study (54%) suggests that almost half of females are able to reproduce before they are caught. Egg production was positively correlated with body size; females that measured between 24.1 and 29.0 mm CL contributed roughly 90% to the offspring production of the population. Females from Costa Rica had a considerably lower average egg volume (0.039 mm(3)) and higher fecundity (9810) than females from Chile. In comparison to other American galatheids P. monodon from Costa Rica produces numerous but small eggs, a typical strategy of species with a prolonged larval development. An analysis between our results and information published about P. monodon from Chile also revealed differences in the size-frequency distribution shape of both populations. The non-exploited character of the Costa Rican P. monodon population and a latitudinal (temperature-related) cline in body size might be associated with these differences. (C) 2010 Elsevier B.V. All rights reserved.

Use of pleopod morphology to determine sexual dimorphism and maturity in hermit crabs: Isocheles sawayai as a model

In the Anomura, studies on growth patterns are infrequent, possibly because the heterogeneity of the group, especially in terms of morphology, makes it difficult to construct generalized growth models. Particularly hermit crabs are an interesting group to evaluate aspects of growth, because of their unique body. Isocheles sawayai, a hermit crab found only in the western Atlantic Ocean, poorly known with respect to its sexual dimorphism and maturity, was investigated here based on morphometry. Monthly collections (July 2001 through June 2003) were made from a shrimp fishing boat in the Caraguatatuba region on the northern coast of the state of SA o pound Paulo, Brazil. The specimens were measured and weighed, and had their sex checked. Throughout the sampling period, 374 specimens of I. sawayai were collected (11.23% nonovigerous females, 6.69% ovigerous females, 79.41% males and 2.67% intersexes). The size at which morphological sexual maturity was reached by both sexes ranged from 4.0 to 4.3 mm shield length, according to the relative growth and the size of the smallest ovigerous female. Sexual dimorphism was shown by males, which were significantly larger than females, and by differences in growth pattern between the sexes, especially for relationships that involved the pleopods, which is related to their different functions in males and females. The present study is one of the first to use pleopod morphometry to determine sexual maturity and dimorphism in hermit crabs, especially for species with intersexuality such as I. sawayai.

Alcohol use disorders in patients with obsessive-compulsive disorder: The importance of appropriate dual-diagnosis

Objective: To evaluate the prevalence and clinical associated factors of alcohol use disorders (AUD) comorbidity in a large clinical sample of patients with obsessive-compulsive disorder (OCD). Methods: A cross-sectional study including 630 DSM-IV OCD patients from seven Brazilian university services, comparing patients with and without AUD comorbidity. The instruments of assessment used were a demographic and clinical questionnaire including evaluation of suicidal thoughts and acts and psychiatric treatment, the Structured Clinical Interview for DSM-IV Axis I disorders (SCID-I), the Yale-Brown Obsessive-Compulsive Scale, the Dimensional Yale-Brown Obsessive-Compulsive Scale, the Brown Assessment of Beliefs Scale, the Beck Depression and Anxiety Inventories and the Clinical Global Impression Scale. Current or past alcohol and other psychoactive substances use, abuse and dependence were assessed using the SCID-I (section E) and corroborated by medical and familial history questionnaires. Results: Forty-seven patients (7.5%) presented AUD comorbidity. Compared to OCD patients without this comorbidity they were more likely to be men, to have received previous psychiatric treatment, to present: lifetime suicidal thoughts and attempts and to have higher scores in the hoarding dimension. They also presented higher comorbidity with generalized anxiety and somatization disorders, and compulsive sexual behavior. Substance use was related to the appearance of the first O.C. symptoms and symptom amelioration. Conclusions: Although uncommon among OCD treatment seeking samples, AUD comorbidity has specific clinical features, such as increased risk for suicidality, which deserve special attention from mental health professionals. Future studies focused on the development of specific interventions for these patients are warranted. (C) 2008 Elsevier Ireland Ltd. All rights reserved.

Sexual behavior and knowledge of sexually transmitted infections among university students in Sao Paulo, Brazil

Objective: To investigate the sexual behavior and knowledge about sexually transmitted infections (STIs) among undergraduate students in Sao Paulo, Brazil. Methods: Self-reported questionnaires were used. Results: Most of the 447 students in the study were single (97.3%), in their first year of university (87.7%), and the mean ages were 20.4 years (males) and 19.8 years (females). Vaginal intercourse was practiced by 69.7% of males and 48.4% of females, oral sex by 64.5% of males and 43.7% of females, and anal sex by 18.4% of males and 14.1% of females. Use of a condom during vaginal sex was practiced by 80.4% of males and 74.8% of females and during anal sex by 47.8% of males and 30.0% of females. Knowledge of transmission of STIs was greater than 90% for HIV, syphilis, genital herpes, and gonorrhea; 63%-76% for HPV and genital warts; 30%-34% for Trichomonas and only 16% for Chlamydia. Only 25%-34% knew that HIV was transmitted by breastfeeding; 56%-60% knew that HIV was transmitted by anal sex. Conclusion: Many students engage in high-risk sexual behavior with multiple partners and use condoms inconsistently. Knowledge of the acquisition and modes of sexual and vertical transmission of HIV are strikingly deficient. (C) 2010 International Federation of Gynecology and Obstetrics. Published by Elsevier Ireland Ltd. All rights reserved.

Effect of sildenafil on clitoral blood flow and sexual response in postmenopausal women with orgasmic dysfunction

Objective: To analyze the effects of sildenafil citrate on clitoral blood flow and sexual response in postmenopausal women with orgasmic dysfunction. Method: In this randomized, double-blind, placebo-controlled trial 22 women received a 50-mg dose of sildenafil (n=11) or placebo (n=11) daily for 15 days. The Golombok Rust Inventory of Sexual Satisfaction (GRISS) was used for subjective evaluation of the sexual-response cycle. Clitoral blood flow was measured by color and pulse Doppler at baseline, after 1 hour of taking the first dose, and after 15 days of treatment. Results: Blood flow was significantly more improved in the sildenafit than in the placebo group (P<0.05), and a positive correlation between Doppler values and GRISS scores was noted in the sildenafil group after only 15 days of treatment. Conclusion: Sildenafil may improve clitoral blood flow and increase the GRISS scores in postmenopausal women with orgasmic dysfunction. (C) 2008 International Federation of Gynecology and Obstetrics. Published by Elsevier Ireland Ltd. All rights reserved.

Sexual behaviours and the risk of head and neck cancers: a pooled analysis in the International Head and Neck Cancer Epidemiology (INHANCE) consortium

Background Sexual contact may be the means by which head and neck cancer patients are exposed to human papillomavirus (HPV). Methods We undertook a pooled analysis of four population-based and four hospital-based case-control studies from the International Head and Neck Cancer Epidemiology (INHANCE) consortium, with participants from Argentina, Australia, Brazil, Canada, Cuba, India, Italy, Spain, Poland, Puerto Rico, Russia and the USA. The study included 5642 head and neck cancer cases and 6069 controls. We calculated odds ratios (ORs) of associations between cancer and specific sexual behaviours, including practice of oral sex, number of lifetime sexual partners and oral sex partners, age at sexual debut, a history of same-sex contact and a history of oral-anal contact. Findings were stratified by sex and disease subsite. Results Cancer of the oropharynx was associated with having a history of six or more lifetime sexual partners [OR = 1.25, 95% confidence interval (CI) 1.01, 1.54] and four or more lifetime oral sex partners (OR = 2.25, 95% CI 1.42, 3.58). Cancer of the tonsil was associated with four or more lifetime oral sex partners (OR = 3.36, 95 % CI 1.32, 8.53), and, among men, with ever having oral sex (OR = 1.59, 95% CI 1.09, 2.33) and with an earlier age at sexual debut (OR = 2.36, 95% CI 1.37, 5.05). Cancer of the base of the tongue was associated with ever having oral sex among women (OR = 4.32, 95% CI 1.06, 17.6), having two sexual partners in comparison with only one (OR = 2.02, 95% CI 1.19, 3.46) and, among men, with a history of same-sex sexual contact (OR = 8.89, 95% CI 2.14, 36.8). Conclusions Sexual behaviours are associated with cancer risk at the head and neck cancer subsites that have previously been associated with HPV infection.