A case of black esophagus with histopathologic description and characterization.
Acute Disease; Esophagitis/complications/*diagnosis; Esophagus/blood supply/*pathology; Fatal Outcome; Female; Humans; Ischemia/complications/*pathology; Middle Aged; Necrosis; Substance-Related Disorders
Black esophagus, or acute necrotizing esophagitis, is a blackening of the esophagus that is usually distal with a sharp demarcation at the gastroesophageal border. Black esophagus is known to the gastroenterology community; however, to our knowledge it is virtually unknown in the pathology literature with only a single instance described in 1967. It is thought to occur as a poorly elucidated ischemic phenomenon. We report a case of black esophagus in a 45-year-old woman with a history of cocaine and alcohol abuse who was found unresponsive after a vague 2-day illness. On autopsy examination, the esophagus was black with ischemic necrosis of the mucosa, submucosa, and muscularis propria including a diffuse acute inflammatory infiltrate and brown pigmentation limited to the mucosa. Positive periodic acid-Schiff and negative iron stains suggest that the pigment is lipofuscin, likely secondary to ischemia.
Altenburger Dana L; Wagner Aaron S; Li Shuan; Garavaglia Jan
Archives of Pathology & Laboratory Medicine
2011
2011-06
Article information provided for research and reference use only. All rights are retained by the journal listed under publisher and/or the creator(s).
<a href="http://doi.org/10.1043/2010-0128-C.1" target="_blank" rel="noreferrer noopener">10.1043/2010-0128-C.1</a>
Gender differences in methamphetamine use and responses: a review.
*Amphetamine-Related Disorders; *Gender Identity; *Sex Characteristics; Animals; Central Nervous System Stimulants/pharmacokinetics/*pharmacology; Depressive Disorder/drug therapy; Female; Humans; Male; Methamphetamine/pharmacokinetics/*pharmacology; Sex Factors; Substance-Related Disorders
BACKGROUND: Men and women differ markedly with regard to their use of, and responses to, methamphetamine (MA) and related amphetamines. However, these gender differences oftentimes are given only a cursory consideration in the analyses of these MA effects. OBJECTIVE: In this brief review, we summarize the data on gender differences in various parameters of MA use and responses. Such information on the pattern of male versus female differences in the use and responses to this psychostimulant can aid in tailoring gender-dependent treatment strategies. METHODS: English-language articles were identified from MEDLINE as well as from reference lists of identified articles for the years 1966 to 2007. Search terms included various combinations of men/male, women/female, methamphetamine, and gender/sex differences. Only studies with human subjects were reviewed. RESULTS: Women tend to begin MA use at earlier ages, appear more dependent on MA, but also respond better to treatment than do men. MA use appears to be associated with depression in women, and women seem more committed to MA, whereas men are more likely to use other drugs in the absence of access to MA. Female MA abusers had both larger volumes within the corpus callosum and more hyperperfused regions in the parietal and occipital areas of the brain, along with more genetic alterations but less MA-induced toxicity. Amphetamine-stimulated dopamine release was greater in men. CONCLUSIONS: When considered in total, women seem more dependent on and committed to MA but show diminished (amphetamine-stimulated) dopamine responses and a decreased degree of toxicity, as indicated by a lower incidence of emergency department-related deaths involving MA. A pervasive comorbidity of depression or depression-related characteristics were present in women MA users, suggesting that MA may serve as a type of self-medication for their depression. These findings not only highlight the need for consideration of gender when assessing MA use, but also can serve to direct efforts at prevention and treatment programs that address the specific needs of men and women.
Dluzen Dean E; Liu Bin
Gender Medicine
2008
2008-03
Article information provided for research and reference use only. All rights are retained by the journal listed under publisher and/or the creator(s).
<a href="http://doi.org/10.1016/s1550-8579(08)80005-8" target="_blank" rel="noreferrer noopener">10.1016/s1550-8579(08)80005-8</a>