Gender differences in drug abuse in the forensic toxicological approach.

Gender differences in substance use/abuse have been the focus of research in the last 15 years. Initiation, use patterns, acceleration of disease course, and help-seeking patterns are known to be influenced by gender differences with regard to biological, psychological, cultural and socioeconomic factors. This paper presents a systematic review of published data on gender differences in the use/abuse of psychoactive and psychotic drugs, focusing on the importance of a multidisciplinary approach. The basis for this paper was obtained by Medline searches using the search terms "human" and "gender", combined with individual drug names or "drugs of abuse". The reference lists of these papers were further checked for other relevant studies. The gender difference in drug abuse is more evident in adults than in adolescents (13-19 years): adult men are 2-3 times more likely than women to develop drug abuse/dependence disorders and approximately 4 times as likely to have an alcohol use disorder. Such prevalence rates have not been observed in adolescents. Differences between men and women involve: (i) the biological response to the drug, (ii) the progression to drug dependence, and (iii) the comorbid psychiatric diagnoses, which may be due to both sociocultural factors and innate biological differences. A crucial role played by ovarian hormones (oestrogens and progesterone) has been documented in both human and animal model studies. Epidemiological data on how particular psychobiological and physiological characteristics in females influence vulnerability to both drug addiction and toxicological consequences of drugs are still in their infancy. Significant gaps remain in our knowledge, which are primarily attributable to the lack of empirical data that only a systematic and multidisciplinary approach to the topic can generate. The introduction of gender into forensic toxicological evaluations may help elucidate the relationship between the body's absorption of abused drugs (alone or in combination) and the onset of intoxications, both lethal and none.

Legal liability in bisphosphonate-related osteonecrosis of the jaw.

Bisphosphonate-related osteonecrosis of the jaw (BRONJ) is an adverse reaction that may occur in patients administered with bisphosphonates (BP). This condition can cause high morbidity and hinder quality of life. Its treatment is complex and often unsatisfactory, and prevention strategies may have limited effectiveness, if any. Thus, managing patients treated with BP may result in exposure of the practitioner to legal liability or malpractice claims: legal actions pursuant to BRONJ are reported to be underway on three continents. Nonetheless, the attribution of liability, if any, is a complex process requiring, on the basis of current knowledge, a robust and pragmatic approach to the facts, which must be identified from the point of view of the time, place and individuals involved. This means a comprehensive consideration of the sequence of actions from bisphosphonates prescription to BRONJ occurrence (as well as immediately after, and any action potentially related to its causation or worsening) is required in order to determine if a breach in informing, diagnosing, managing or referring the patient took place, as well as determining if the patient was compliant in attending to prescriptions and follow-up programmes.

[Problems of professional responsibility in orthodontic practice in the public sector]. / Problematiche di responsabilità professionale nell'esercizio dell'ortodonzia in ambito civile.

Characteristics aspects of orthodontics profession are emphasized. Problems about patient consent for treatment, his information and operator obligation to attend to treatment goals on particularly considered. Orthodontist behaviour errors causing a damage to the patient during diagnosis, treatment planning, orthodontic appliance planning and/or carrying out and therapy execution are analysed. Biologic factors having a significant influence on treatment effects are illustrated. Damages possibility even after long time from therapy are evaluated.

[Injury to the TMJ in dental practice: criteria for review and evaluation in the public sector]. / I danni all'ATM prodotti nella pratica odontoiatrica: criteri di rilevazione e valutazione in ambito civilistico.

The Authors point out dental fields when a treatment error may cause considerable civil TMJ damages. Various damage kinds were examined and diagnosis standards to point them out were illustrated. Evaluation hypothesis using a table system when a sagittal mandibular excursion permanent deficit is present was suggested. The propose analysed the main percentages be bunded in Literature. The distance between upper and lower first bicuspid in maximum non forced mouth opening was considered as a necessary landmark to estimate the mandibular function deficit.

[Demonstration of 2 experimental models of pure chronic erythroblastopenia]. / Dimostrazione di due modelli sperimentali di eritroblastopenia cronica pura

Two experimental models for pure red cell aplasia (PRCA) were established. In the first one, administration of PRCA serum IgG in normal mice induced a sustained inhibitory effect on erythropoiesis, a progressive decline of the hematocrit values and an inverse rise of erythropoietin (Ep) levels in serum. Thus, the physiopathological pattern of PRCA type I (or A) was established, In the second model a rabbit producing anti-Ep crossreacting with endogenous Ep was subjected to a booster injection of Ep. The rise of the immune response was associated with decrease of Gct values and disappearance of erythroid precursors from marrow smears, and its subsequent decline with reticulocytosis and regression of the anemia, thus reproducing the physiopathological pattern of PRCA type II (or B).