Blog about medicines and adverse drug reactions.
March 30th, 2009 admin
By and large, the sex offenders whose objects were females aged twelve and over tend to have fewer members with prepubertal masturbation than sex offenders against female children or males. Less than 43 per cent of the heterosexual aggressors vs. minors and adults, the incest offenders against females over twelve, the control group, and the heterosexual offenders vs. adults had prepubertal masturbatory experience. Conversely, all the sex offenders against female children and all the homosexual offenders exceed 43 per cent. This trend cannot be explained at present, but it is most interesting that prepubertal masturbation is associated with subsequent sex offense against prepubertal females and males. Also it is noteworthy that the association between masturbation and homosexuality, which will be described later, occurs prior to puberty. The fact that the control group and the incest offenders vs. minors and adults have the fewest individuals who masturbated before puberty suggests that general sexual inhibition and restraint may start early since these groups are typified in adult life by these traits.
Examination of the ages at which prepubertal masturbation began reveals only a confused picture from which nothing can be deduced.
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March 30th, 2009 admin
Seventy-nine per cent of the peepers, a modest proportion, had had premarital coitus by the time they were interviewed. Comparatively small percentages of individuals were experienced by younger ages but in later life the peepers occupy intermediate rank-order positions. By age fourteen only 13 per cent had had premarital coitus, which is the smallest figure exhibited by any group; by age sixteen the peepers have the second smallest number of experienced individuals (34 per cent); but by ages eighteen, twenty, twenty-three, etc., their percentages are not unusual. This advance from a low position by age sixteen to an intermediate position by age eighteen represents the peepers’ maximum increase in incidence; they never rise as markedly again. The slow start of the peepers in their premarital coital careers may correlate with the extremely poor social adjustment with females when they were sixteen and seventeen, a poor adjustment which was presaged when they were only ten to eleven when they also had few female playmates.
Their slow start is also visible in the age-specific incidence of premarital coitus with companions. In the period between puberty and age fifteen only .16 per cent, the smallest proportion recorded, had premarital coitus. The proportion increased to moderate status and remained there; until age-period 26—30 when the peepers rise to second rank with 93 per cent of their still unmarried men having premarital coitus with companions.
A similar picture is seen in the age-specific incidence of premarital coitus with prostitutes. Beginning with the smallest proportion recorded in age-period puberty—15, the proportions increase both absolutely and relatively until the peepers are first in rank-order in age-period 26-30 with three quarters of the still unmarried males having coitus with prostitutes.
Those who engaged in premarital coitus with companions did so with only moderate frequency—the peepers are intermediate in the rank-orders—the median individual reporting a frequency of between twice a month and once every week and a half up to age thirty. These frequencies are quite comparable to those of the control group. Our data on frequency of premarital coitus with prostitutes show the peepers in low to intermediate positions in the rank-orders at various age-periods. They have either the lowest or next lowest average (mean) frequencies, ranging from 0.19 to 0.24 per week. The other form of average, the median, puts the peeper low in the rank-orders with but 4 to 6 contacts with prostitutes a year between puberty and age thirty. During the same years the median control-group individual reported 4 to 12 a year.
In the number of premarital coital partners, companions or prostitutes, the average peeper had premarital coitus with a moderate number (12) of companions, but with relatively few (eight) prostitutes.
The proportion of total orgasms derived from premarital coitus with
companions is moderate; the large proportion (48 per cent) in age-
period 26-30 is the result of the extraordinary activity of one male who
raised the group figure markedly.
The proportion of total sexual outlet from premarital coitus with prostitutes is always relatively small to moderate, never exceeding 7 per cent and never equaling that of the control group.
Only moderate to low percentages of peepers reported that the various restraints upon premarital coitus that we have studied were important inhibiting factors in their lives. The sole exception was fear of venereal disease, wherein the peepers occupy second place in rank-order with 20 per cent stating that this was a strong deterrent. This inexplicable emphasis upon disease may represent a rationalization or it may in some way fit in with peeping: it is interesting that a group so fearful of venereal disease should specialize in an offense not involving physical contact.
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March 27th, 2009 admin
There is still debate about whether to initiate protease inhibitors as part of the first treatment regimen offered to a patient or to wait until after the initiation of the antiretrovirals and the start of disease progression, although most experts now recommend triple therapy from the start. In addition, there has been discussion about initiating these medications during the acute infection period and not waiting until several years later, when the virus eventually “outsmarts” the immune system and starts attacking it. Some experts are recommending an aggressive approach, with a combination of antiretrovirals and protease inhibitors given during the primary infection period and continuing for six months. Whether this approach becomes the standard of care for treatment will depend on its long-term effectiveness. Research is continuing in an effort to answer this question.
If a person experiences toxicity or intolerable side effects from the foregoing medication regimens, then an alternative regimen can be chosen. Unfortunately, many people experience side effects from these medications, and changes in medication or dose reductions are often needed.
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March 27th, 2009 admin
There are specific blood tests for hepatitis B. On the one hand, about 90 percent of people with acute hepatitis B infection show evidence of the infection on blood tests when they first visit their health care provider. On the other hand, early in the infection the blood tests may be negative in a person who is actually infected; later blood tests will show evidence of the infection in such a person. Ask your health care provider what your test results mean and whether or not you need additional tests to rule out infection.
The tests that are most helpful to diagnose hepatitis look for either the body s immune response to the virus (antibodies) or particles of the virus itself. The blood tests can distinguish among people who have been infected and have cleared the infection, people who have been infected and are carriers, and people who have been vaccinated—although follow-up tests may be necessary to make these distinctions. To determine the stage of infection, it may be necessary to perform a liver biopsy, which involves taking a piece of liver tissue from a person under anesthesia and examining the sample under a microscope.
Tests that measure how well the liver is working, called liver function tests or liver injury tests, are not an adequate screen for hepatitis B. Although results of these tests are often elevated in acute and chronic hepatitis, normal liver function tests cannot be interpreted as ruling out viral hepatitis infection.
When a person is found to be a carrier of hepatitis B, it is recommended that a blood test also be performed for hepatitis D, or delta hepatitis. This is an infection that can only occur in individuals who have hepatitis B infection, since the delta virus needs the hepatitis B virus to survive. Hepatitis D can be sexually transmitted but has a higher risk of transmission from blood exposure, such as through injection drug use or receiving transfusions with infected blood. (The blood supply has been screened for hepatitis D since the 1970s.) A person can be infected with hepatitis D at the same time that infection with hepatitis B occurs, or he or she can become superinfected with hepatitis D while a carrier for hepatitis B. In either situation, severe liver damage and death can result, or the person is likely to become a carrier for hepatitis D as well as B, which can hasten the progression of liver disease to cirrhosis. The diagnosis of hepatitis B and D, m both the acute and chronic forms, is reportable in most states to the health department.
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March 27th, 2009 admin
Most chlamydia infections don’t cause any symptoms! Half of men and three-quarters of women with chlamydia infections in the genital area are completely symptom free. Therefore, many people at risk for infection with chlamydia may mistakenly believe they don’t need to be tested. A person with chlamydia infection may remain symptom free for his or her entire life or may start to show symptoms weeks, months, or even years after infection.
A woman with chlamydia infection can have infection of the uterus and Fallopian tubes (pelvic inflammatory disease [PID]), of the cervix (mucopurulent cervicitis [MPC]), of the urethra (urethritis), around the liver (this is a complication of PID called Fitz-Hugh Curtis syndrome), or a combination of these. If she is going to develop symptoms, they will usually appear one to three weeks after infection. The symptoms include the following:
— discharge from the genital area
— burning with urination
— pelvic pain
— bleeding between periods or after sexual intercourse
(See the sections on pelvic inflammatory disease and mucopurulent cervicitis for a more thorough discussion of these syndromes.) About half the time, chlamydia infection that appears to be limited to the cervix is actually causing silent (symptom-free) infection in the uterus. For all women, the urethra is a potential site of infection with chlamydia; the only symptom may be burning with urination. This may be the only symptom in infected women who have had a hysterectomy.
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March 27th, 2009 admin
Talking with a partner about these issues before you become sexually active has been proven to help prevent infection with STDs, no matter what your age or sexual orientation. Study after study confirms that communicating with a partner increases the chance that steps will be taken to guard against STDs and unwanted pregnancy. However, poor communication with a partner increases the likelihood that you will contract a sexually transmitted infection.
As noted earlier, screening for sexually transmitted infections is the only way to know for sure whether or not a person has been infected. The goal of this chapter is to help prepare you to become a better communicator about sexual health. The chapter begins with a discussion about why it is so difficult to communicate and then suggests ways to make communication easier. In general, talking about sex is easier if you practice communication skills beforehand. If you have thought about what your partner may tell you, and what you would say in response, you will be better prepared for different situations that may arise. You can also learn from your past mistakes. If in the past things did not turn out exactly as you would have wanted, think about what you might do differently in the future and identify the communication patterns you want to change. You do not have to keep on making the same mistakes.
You owe it to yourself to be safe.
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March 27th, 2009 admin
Allergic reactions. Many women have allergic reactions or increased sensitivity to certain products used in safer sex practices, such as latex condoms and spermicide (nonoxynol-9). About one-third of people have allergic reactions, which can range from mild to severe, to spermicide or other lubricants. Allergic reactions most often occur immediately or shortly after intercourse and may consist of redness, itching, and breaks in the skin.
Bacterial vaginosis. Although bacterial vaginosis usually doesn’t cause significant irritation of the labia and vagina, sometimes there can be mild itching. More common is a white to gray discharge, which has a strong, fishy odor, usually most prominent after sex or during menstruation.
Herpes. Herpes outbreaks often itch, and in fact this may be the only sign that the virus has reactivated and is on the surface of the skin. There may be tingling, redness, a bump, or a break in the skin, such as a blister, ulcer, or slit. Lymph nodes in the groin may be swollen, and a person may also experience leg pain and flu-like symptoms.
Jock itch. Also caused by a fungus, but by a different fungus than Candida, this condition is very common in both men and women. It is caused by the fungus Tinea cruris and most commonly causes an itchy, scaly red rash on the genitals and the upper thighs.
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March 25th, 2009 admin
Europe was dominated by a single religion for more than 1,000 years. During the Middle Ages, formal sexual values were dictated by the sacred laws of the Roman Catholic church. Religious law was the highest law in the land. It was based on the belief that all sensual pleasure was sinful. It determined who could marry, what kind of sex was allowed, where it was allowed, when it was allowed, and why women had to always submit to their husbands. People could be ruthlessly punished if they disobeyed. Punishment ranged from meditation, fasting, and prayerful penance to imprisonment, torture, excommunication, and execution.
Some countries worldwide are still dominated by sacred law, but over the centuries, sacred law has given way to secular law. Today, few people rely exclusively on religion to decide their sexual behavior. In the United States, federal, state, and local governments make laws that regulate sexual behavior. These laws are often designed to protect people against sexual abuse. Often, however, laws regulate sexual conduct between consenting adults.
Some laws, such as those that prohibit rape and prostitution, are criminal laws with criminal penalties. Other laws, such as those that prohibit discrimination and sexual harassment, are civil and give individuals the right to sue for damages. Criminal and civil laws are enforced by the federal, state, and local courts.
Increasingly, scientific and medical knowledge has an impact on sexual law. Lawmakers and enforcers are more likely to try to understand unusual sex practices by looking for medical or psychological explanations rather than devils or demons. People with socially unacceptable sex problems are more likely to be treated with drugs or therapy than with whips and red-hot pokers.
But the sexual values established by religious sacred laws continue to have a powerful impact on our current secular laws. They, too, have become a part of our cultural traditions. For example, religious law in the Middle Ages taught that oral and anal sex were much worse crimes than rape. Religious leaders believed that rape was a more moral behavior because it could cause pregnancy, and they believed that pregnancy was the only moral reason for having sex. Because oral and anal sex couldn’t cause pregnancy, they were considered very great crimes. People were publicly executed for such behavior.
These medieval punishments left a powerful impression in cultural traditions and beliefs that lasted thousands of years. Some religious teachers still teach young people that many sexual behaviors are immoral and sinful because they don’t cause pregnancy. And nearly 20 states still have laws against these sexual behaviors.
These sexual values were handed down to us from generation to generation, from the earliest church fathers, such as Augustine and Thomas Aquinas, to the Victorians of 100 years ago and televangelists of today. To a great degree, they are responsible for the confused attitudes toward sexuality that still have a deep hold on our society. They have taught us that sex is a dangerous, uncontrollable part of our lives, instead of a wholesome birthright that we can celebrate without fear.
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March 25th, 2009 admin
Recovering from Child Sexual Abuse
Child sexual abuse is sometimes recalled only when the survivors reach adolescence or adulthood. Children may not have understood what was happening to them. They may have felt that something was “wrong,” and they may have been very uncomfortable with the activity at the time, but they have tried to forget it.
Recovery from the effects of child sexual abuse can be a long process. Not every survivor of sexual abuse will react in the same way. Although the psychological responses may affect daily life, they may be difficult to identify. Adult survivors may go through many traumatic events as they learn how to deal with the facts and effects of the past abuse.
Recovery from child sexual abuse may include professional help. It is also important to talk with loved ones in order to deal with all the feelings that arise from child sexual abuse. They can provide the essential support system that is needed. Having someone listen, believe, and care is essential for a survivor to begin to feel safe and worthwhile during recovery.
Helping children who say they’ve been abused
• Believe the child. Children rarely lie about sexual abuse.
• Praise the child for telling you about the experience.
• Don’t let the child take the blame. Children fear being at fault and responsible for what’s happened.
• Be as calm as you can and don’t let your response increase the child’s sense of shame, confusion, and guilt. If you can avoid describing the event as being “bad,” you may help the child recover more quickly.
• Find a specialized agency that evaluates sexual abuse victims—a hospital, child welfare agency, or community mental health therapy group. If a medical examination is necessary, ask for a referral to a health care provide who has experience and training in recognizing and treating sexual abuse.
• If other children in the community may be harmed, talk with other parent so they can talk with their children and be on the lookout for unusual behavior or physical symptoms in their children.
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March 25th, 2009 admin
In the case of idiopathic delayed puberty, mainly timing is in error. The hypothalamic-pituitary-gonadal system matures late but appears to function largely normally thereafter. In other cases, the gonads, the pituitary, or the hypothalamus, are defective so that puberty will never occur spontaneously. For those patients, it becomes of utmost importance for their psychological growth and development that puberty is induced by a sex-appropriate hormone regimen. Our clinical experience has been that there are no dramatic, uncontrollable psychosexual effects of sex hormone treatment. Usually, for both boys and girls, sex hormone treatment constitutes a boost to morale, especially when the body begins changing visibly. Often there is an upswing in mood and assertiveness and later also in sexual feelings, sexual fantasies, and interests.
Hypopituitary or hypogonadal patients usually do not show full psychosexual development without hormone treatment. Particularly important is the timing of the induction of puberty. If the appropriate sex hormone treatment can be started when the patient’s peers go into puberty, both psychosocial and psychosexual development may be mostly normal. The longer treatment is delayed, the greater is the chance of maldevelopment. The evidence for this comes from studies of Turner’s syndrome in females, hypogonadism in males. Induction of puberty after age twenty often does not lead to normal psychosexual development. A number of older (hypopituitary) patients have even refused to start sex hormone treatment or have ceased taking it later. It is unclear if this negative reaction toward treatment is due to a generally poorer physiological response to exogenous sex hormones (Zachman and Prader) or to a psychological rigidity and contentment with the patient’s particular status at that age. Generally, the patient groups described showed low sexual arousability, motivation, and activities, as well as deficiencies in sexual pair-bonding, the latter possibly related to decreased socializing with peers. In part, this must be because many of the patients started adequate endocrine treatment later than desirable and/or showed very slow or incomplete somatic maturation. Moreover, it is likely that current treatment regimens do not create an internal hormonal milieu comparable to the one of normal adolescents which may have behavioral consequences of its own. In addition, several syndromes involve hypogonado-tropinism of hypothalamic origin; here, behavioral deficiencies may be linked to the deficiency of LH-RH or to additional undiagnosed hypothalamic dysfunctions.
Methodologically, the clinical studies of pubertal disorders available can be considered only preliminary. No control groups have been employed, hormone measures at the time of psychosexual assessment are usually missing, and the effects of the timing and dosage of hormonal treatment regimens on behavioral changes have not been analyzed. The assessment of social influences also is usually incomplete. Nevertheless, the data suggest an interactive view in the theory of psychosexual development: physical and hormonal changes are necessary for normal psychosocial and psychosexual development in adolescence, but even if they are present, normal psychosexual development is dependent on the social integration of the individual in society and especially in his or her peer group. More detailed theoretical formulation would require much methodologically refined investigation.
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