Sexuality

The major problem in such conversions is the degradation of the branched carbon side-chain on C-17 which is present in all abundant steroids and lacking in all steroid hormones. The most important starting material used in industry today is diosgenin from the Mexican dioscorea plant. It is degraded by the method of Marker to 16-dehydropregnenolone in 45% total yield. This compound is a key substance in the production of several hormones with anabolic, catabolic, and sexual effects. 

Turner s Syndrome. Turner s syndrome is a genetic disorder of females characterized by short stature, nonfunctioning ovaries, and failure to develop secondary sexual characteristics. Several clinical trials in the United States, Europe, and Japan have demonstrated that hGH can accelerate... 

Steroid Hormones and Neurosteroids. Steroids (qv) can affect neuroendocrine function, stress responses, and behavioral sexual dimorphism (78,79) (see Steroids). Mineralocorticoid, glucocorticoid, androgen, estrogen, and progesterone receptors are localized in the brain and spinal cord. In addition to genomic actions, the neurosteroid can act more acutely to modulate the actions of other receptors or ion channels (80). Pregnenolone [145-13-17, ( ) dehydroepiandosterone [53-43-0] C H2 02 (319) are excitatory neurosteroids found in rat brain, independent of adrenal... 

Although odorous materials no doubt impact each other, much discussion centers around the abiUty of odorous materials to influence human behavior. In articles ranging from scientific journals to trade maga2ines, there is discussion on the potential of fragrances, ie, essential oils, to affect people s moods, their abiUty to focus and maintain attention, to relax and sleep, and even their sexual capabiUty. 

SSRIs are well tolerated. Adverse effects for compounds in this class include nervousness, tremor, dizziness, headache, insomnia, sexual dysfunction, nausea, and diarrhea. In addition, the tricycHc antidepressant clomipramine (33), which is a potent nonselective serotonin reuptake inhibitor, is approved for treatment of obsessive—compulsive disorder. 

SSRIs are widely used for treatment of depression, as well as, for example, panic disorders and obsessive—compulsive disorder. These dmgs are well recognized as clinically effective antidepressants having an improved side-effect profile as compared to the TCAs and irreversible MAO inhibitors. Indeed, these dmgs lack the anticholinergic, cardiovascular, and sedative effects characteristic of TCAs. Their main adverse effects include nervousness /anxiety, nausea, diarrhea or constipation, insomnia, tremor, dizziness, headache, and sexual dysfunction. The most commonly prescribed SSRIs for depression are fluoxetine (31), fluvoxamine (32), sertraline (52), citalopram (53), and paroxetine (54). SSRIs together represent about one-fifth of total worldwide antidepressant unit sales. 

Glassification of Substance-Related Disorders. The DSM-IV classification system (1) divides substance-related disorders into two categories (/) substance use disorders, ie, abuse and dependence and (2) substance-induced disorders, intoxication, withdrawal, delirium, persisting dementia, persisting amnestic disorder, psychotic disorder, mood disorder, anxiety disorder, sexual dysfunction, and sleep disorder. The different classes of substances addressed herein are alcohol, amphetamines, caffeine, caimabis, cocaine, hallucinogens, inhalants, nicotine, opioids, phencyclidine, sedatives, hypnotics or anxiolytics, polysubstance, and others. On the basis of their significant socioeconomic impact, alcohol, nicotine, cocaine, and opioids have been selected for discussion herein. 

Malaria. Malaria infection occurs in over 30% of the world s population and almost exclusively in developing countries. Approximately 150 X 10 cases occur each year, with one million deaths occurring in African children (87). The majority of the disease in humans is caused by four different species of the malarial parasite. Vaccine development is problematic for several reasons. First, the parasites have a complex life cycle. They are spread by insect vectors and go through different stages and forms (intercellular and extracellular sexual and asexual) as they grow in the blood and tissues (primarily fiver) of their human hosts. In addition, malaria is difficult to grow in large quantities outside the natural host (88). Despite these difficulties, vaccine development has been pursued for many years. An overview of the state of the art is available (89). 

Yeasts belonging to Basidior cetes form external spores. ia.yiscomjcetes sexual reproduction occurs with the formation of spores in a cell that serves as a spore sac or ascus. Generally four, but sometimes eight or more, spores are formed in each ascus. This is sometimes reflected in the species name, ie,... 

Insufficient zinc results in slowed growth, delayed wound healing, poor appetite, mental lethargy, and sexual immaturity and it interferes with the immune response. The main function of zinc in metaboHsm is enzymatic and there is evidence of other physiologic roles, eg, in stabilization of membrane stmcture (57). 

For example, pelvic inflammatory disease (PID) is usually caused by a concurrent infection with both N. gonorrhoeae and C. trachomatis (94). For these reasons many sexually transmitted diseases, including PID, are treated with mixtures of antibiotics to provide broad coverage for mixed, aerobic, and... 

Ga.metocytocides. These annihilate the sexual forms of the plasmodia (gametocytes) and also destroy the stages of the parasites in the Anopheles mosquito. 

Nifedipine (Table 3) is a potent vasodilator that selectively dilates resistance vessels and has fewer effects on venous vessels. It does not cause reflex tachycardia during chronic therapy. Nifedipine is one of the first-line choices for black or elderly patients and patients having concomitant angina pectoris, diabetes, or peripheral vascular diseases. Nifedipine, sublingually, is also suitable for the treatment of hypertensive emergencies. Nifedipine does not impair sexual function or worsen blood Hpid profile. The side effects are flushing, headache, and dizziness. 

The male barrier contraceptive device is known as the condom, or mbber, and is widely available in most countries. The condom is a mbber or latex sheath, sometimes packaged with a lubricant and spermicide, which serves as a cover for the penis and a receptacle for semen. The method is very effective if the condom is of good quaUty, remains on, and is replaced for each subsequent intercourse. It was reported that 6 biUion condoms were used in 1990 (101). Usage appears to be increasing as adjunctive use with other methods of contraception for prevention of HIV or other sexually transmitted diseases. By rough estimate, condoms may have been used in more than 13 biUion acts of sexual intercourse that risked unwanted pregnancy, HIV, and/or other sexually transmitted diseases (101). 

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