The authors analyzed the incidence of sexual dysfunction (SD) with different selective serotonin reuptake inhibitors (SSRIs; fluoxetine, fluvoxamine, paroxetine, and sertraline) and hence the qualitative and quantitative changes in SD throughout time in a prospective and multicenter study. Outpatients (192 women and 152 men; age = 39.6 +/- 11.4 years) under treatment with SSRIs were interviewed with an SD questionnaire designed for this purpose by the authors and that included questions about the following: decreased libido, delayed orgasm or anorgasmia, delayed ejaculation, inability to ejaculate, impotence, and general sexual satisfaction. Patients with the following criteria were included: normal sexual function before SSRI intake, exclusive treatment with SSRIs or treatment associated with benzodiazepines, previous heterosexual or self-erotic current sexual practices. Excluded were patients with previous sexual dysfunction, association of SSRIs with neuroleptics, recent hormone intake, and significant medical illnesses. There was a significant increase in the incidence of SD when physicians asked the patients direct questions (58%) versus when SD was spontaneously reported (14%). There were some significant differences among different SSRIs: paroxetine provoked more delay of orgasm or ejaculation and more impotence than fluvoxamine, fluoxetine and sertraline (chi 2, p < .05). Only 24.5% of the patients had a good tolerance of their sexual dysfunction. Twelve male patients who suffered from premature ejaculation before the treatment preferred to maintain delayed ejaculation, and their sexual satisfaction, and that of their partners, clearly improved. Sexual dysfunction was positively correlated with dose. Patients experienced substantial improvement in sexual function when the dose was diminished or the drug was withdrawn. Men showed more incidence of sexual dysfunction than women, but women's sexual dysfunction was more intense than men's. In only 5.8% of patients, the dysfunction disappeared completely within 6 months, but 81.4% showed no improvement at all by the end of this period. Twelve of 15 patients experienced total improvement when the treatment was changed to moclobemide (450-600 mg/day), and 3 of 5 patients improved when treatment was changed to amineptine (200 mg/day).

Although period prevalence figures, which are those generally provided in research into rates of mental disorder among prisoners, are useful for planning improvements to services within prisons, the fact that almost all of these men had a lifetime prevalence of at least one mental disorder suggests a much wider need for improving services, including community services, for this group.

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The Campanian rudist fauna identified from the localities Playa Panamá, Santa Rosa National Park, Colorado de Abangares, and Bolsón in Guanacaste Province, Costa Rica, is composed of the antillocaprinidsAntillocaprinasp. aff.A. suboccidentalisChubb, 1967,Antillocaprinasp. and Antillocaprinidae indet.; the multiple-fold hippuritidsBarrettia moniliferaWoodward, 1862,Parastroma trechmanniChubb, 1967, and cf.Whitfieldiella gigas(Chubb, 1955); the plagioptychidsPlagioptychus trechmanniChubb, 1956,Plagioptychussp. cf.P. zansiChubb, 1956,Mitrocaprina costaricaensisnew species,Mitrocaprina multicanaliculataChubb, 1956, and Plagioptychidae indet.; and the radiolitidsRadiolitessp. aff.R. multicostata(Adkins, 1930),Alencasteritesnew genusmooretownensis(Trechmann, 1924),Bournonia?tetrahedron(Chubb, 1967),Chiapasellasp.,Guanacastea costaricaensisnew genus new species, cf.Potositessp. aff.P. tristantorresiAlencáster and Pons in Pons et al., 2010, and aff.Thyrastylonsp. Although some differences in rudist diversity and sedimentary setting were observed among localities, most species indicate the same age for all occurrences, which correspond to the Campanian, probably mid-Campanian. Radiolitid specimens appear better preserved than those of other taxa and are thus discussed more in detail. Both the number of radiolitid genera exclusively known from the New World, and reasonable doubts about the correct attribution of some New World species to Old World genera, indicate important differences between rudist faunas at both sides of the Atlantic (Mediterranean and American Tethys, respectively) during the Late Cretaceous.

Background: Determining the mental capacity of psychiatric patients for making healthcare related decisions is crucial in clinical practice. This meta-review of review articles comprehensively examines the current evidence on the capacity of patients with a mental illness to make medical care decisions. Methods: Systematic review of review articles following PRISMA recommendations. PubMed, Scopus, CINAHL and PsycInfo were electronically searched up to 31 January 2020. Free text searches and medical subject headings were combined to identify literature reviews and meta-analyses published in English, and summarising studies on the capacity of patients with serious mental illnesses to make healthcare and treatment related decisions, conducted in any clinical setting and with a quantitative synthesis of results. Publications were selected as per inclusion and exclusion criteria. The AMSTAR II tool was used to assess the quality of reviews. Results: Eleven publications were reviewed. Variability on methods across studies makes it difficult to precisely estimate the prevalence of decision-making capacity in patients with mental disorders. Nonetheless, up to threequarters of psychiatric patients, including individuals with serious illnesses such as schizophrenia or bipolar disorder may have capacity to make medical decisions in the context of their illness. Most evidence comes from studies conducted in the hospital setting; much less information exists on the healthcare decision making capacity of mental disorder patients while in the community. Stable psychiatric and non-psychiatric patients may have a similar capacity to make healthcare related decisions. Patients with a mental illness have capacity to judge risk-reward situations and to adequately decide about the important treatment outcomes. Different symptoms may impair different domains of the decisional capacity of psychotic patients. Decisional capacity impairments in psychotic patients are temporal, identifiable, and responsive to interventions directed towards simplifying information, encouraging training and shared decision making. The publications complied satisfactorily with the AMSTAR II critical domains.

A Maastrichtian rudist fauna composed of the radiolitids Biradiolites aguilerae Böse, B. Cárdenasensis Böse, Huasteca ojanchalensis (Myers), Tampsia floriformis Myers, and Trechmannites rudissimus (Trechmann), the hippuritids Caribbea muellerriedi (Vermunt) and Praebarrettia sparcilirata (Whitfield) sensu lato, and the plagioptychids Coralliochama gbohemi Böse and Mitrocaprina tschoppi (Palmer) is described from the Cárdenas Formation in San Luis Potosí State, Mexico. Abundant fossil material and excellent preservation of a number of specimens allowed observation of both the internal and external shell characters and their ontogenetic and eco-phenotypic variability. The description of some hitherto insufficiently known species has been enhanced and/or completed, making easier their subsequent identification and allowing their unequivocal generic assignation. Two new genera, Huasteca and Trechmannites, are proposed for two already known species of radiolitids. The Cárdenas Formation exhibits a continuously exposed sequence in the vicinity of Cárdenas. Thus, precise stratigraphic location of all fossil localities and their rudist associations, ranging from the early to the early late Maastrichtian, has been possible.