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1.
J Endocrinol Invest ; 2024 May 11.
Artigo em Inglês | MEDLINE | ID: mdl-38733428

RESUMO

PURPOSE: Information on the general health of transgender and gender diverse (TGD) individuals continues to be lacking. To bridge this gap, the National Institute of Health in Italy together with the National Office against Racial Discriminations, clinical centres, and TGD organizations carried out a cross-sectional study to define the sociodemographic profile, health-related behaviours, and experiences of healthcare access in Italian TGD adult population. METHODS: A national survey was conducted by Computer-Assisted Web Interviewing (CAWI) technique. Collected data were compared within the TGD subgroups and between TGD people and the Italian general population (IGP). RESULTS: TGD respondents were 959: 65% assigned female at birth (AFAB) and 35% assigned male at birth (AMAB). 91.8% and 8.2% were binary and non-binary TGD respondents, respectively. More than 20% of the TGD population reported to be unemployed with the highest rate detectable in AMAB and non-binary people. Cigarette smoking and binge drinking were higher in the TGD population compared with IGP (p < 0.05), affecting TGD subgroups differently. A significant lower percentage of AFAB TGD people reported having had screening for cervical and breast cancer in comparison with AFAB IGP (p < 0.0001, in both cases). Over 40% was the percentage of AFAB and non-binary TGD people accessing healthcare who felt discriminated against because of their gender identity. CONCLUSIONS: Our results are a first step towards a better understanding of the health needs of TGD people in Italy in order to plan the best policy choices for a more inclusive public health.

2.
BMJ Mil Health ; 2024 May 16.
Artigo em Inglês | MEDLINE | ID: mdl-38754974

RESUMO

INTRODUCTION: The US military has frequently used a 'walking blood bank', formally known as an 'emergency donor panel' (EDP) to obtain warm fresh whole blood (WFWB) which is then immediately transfused into the casualty. We describe the frequency of EDP activation by the US military. METHODS: We analysed data from 2007 to 2015 within the Department of Defense Trauma Registry for US, Coalition and US contractor casualties that received at least 1 unit of blood product within the first 24 hours and described the frequency of WFWB use. RESULTS: There were 3474 casualties that met inclusion, of which, 290 casualties (8%) required activation of the EDP. The highest proportion of EDP events was in 2014, whereas the highest number of EDP events was in 2011. Median injury severity scores were higher in the recipients, compared with non-EDP recipients (29 vs 20), as were proportions with serious injuries to the abdomen (43% vs 19%) and extremities (77% vs 65%). The median number of units of all blood products, except for packed red blood cells, was higher for WFWB recipients. Of the WFWB recipients, the median was 5 units (IQR 2-10) with a maximum documented 144 units. There were four documented cases of EDP recipients receiving >100 units of WFWB with only one surviving to hospital discharge. During the study period, there were a total of 3102 (3%) units of WFWB transfused among a total of 104 288 total units. CONCLUSIONS: We found nearly 1 in 11 casualties who received blood required activation of the EDP. Blood from the EDP accounted for 3% of all units transfused. These findings will enable future mission planning and medical training, especially for units with smaller, limited blood supplies. The lessons learned here can also enable mass casualty planning in civilian settings.

3.
J Endocrinol Invest ; 2024 Feb 19.
Artigo em Inglês | MEDLINE | ID: mdl-38372939

RESUMO

BACKGROUND: Despite the increasing interest in transgender health research, to date little is known about the size of the transgender and gender diverse (TGD) population. METHODS: A web-based questionnaire survey was developed, including a collection of socio-demographic characteristics and disseminated online through social media. Gender incongruence was evaluated by using a 2-item approach assessing gender recorded at birth and gender identity. The primary objective of the present population-based study was to estimate the proportion of TGD people across ages among a large sample of people who answered a web-based survey. The secondary endpoints were to identify gender-affirming needs and possible barriers to healthcare access. RESULTS: A total of 19,572 individuals participated in the survey, of whom 7.7% reported a gender identity different from the sex recorded at birth. A significantly higher proportion of TGD people was observed in the youngest group of participants compared with older ones. Among TGD people who participated in the study, 58.4% were nonbinary, and 49.1% experienced discrimination in accessing health care services. Nonbinary TGD participants reported both the need for legal name and gender change, along with hormonal and surgical interventions less frequently compared to binary persons. CONCLUSIONS: Being TGD is not a marginal condition In Italy. A large proportion of TGD persons may not need medical and surgical treatments. TGD people often experience barriers to healthcare access relating to gender identity.

4.
Prev Vet Med ; 223: 106098, 2024 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-38176152

RESUMO

Since the early 2000 s the practice of free-range egg production has increased in developed countries, partly driven by consumer perception that free-range housing is better for hen welfare. While poultry in free-range systems have more behavioural opportunities compared with poultry in caged systems, free-range systems are associated with greater frequencies of infectious disease, predation and 'smothering', a condition where birds pile on top of one another with death occurring due to suffocation. Although the frequency of smothering deaths in Australian free-range layer poultry is anecdotally high, there is a lack of empirical evidence quantifying smothering cause-specific mortality rates and identifying factors that place birds at higher risk of death from smothering. This was a prospective cohort study of poultry flocks managed by three commercial free-range layer organisations in Eastern Australia. Flocks were enrolled into the study from 1 January 2019 to 29 March 2021 and were followed until the end of lay or until the end of the study on 31 March 2022, whichever occurred first. Throughout the follow-up period flock managers provided production details for each flock and details of smothering events using custom-designed logbooks.A total of 84 flocks were enrolled in the study: 32 from Organisation 1, 35 from Organisation 2 and 17 from Organisation 3. The number of birds per flock ranged from 16,000 to 45,000. The total mortality rate was 1131 deaths per 10,000 bird-years. Smothering mortality rate across the three organisations was 183 (minimum 133, maximum 223) deaths per 10,000 bird-years at risk. Smothering accounted for around 16% (minimum 9%, maximum 22%) of all deaths.We identified no distinctive temporal pattern in daily smothering risk as a function of either the number of days since placement or calendar date. The locations of smothering events in sheds and in the outdoor range were not consistent, with relatively large numbers of smothering events occurring in specific locations for some sheds but not others. To the best of our knowledge, this study is the largest prospective study of smothering mortality in commercial free-range layer flocks conducted to date. Estimates of smothering incidence rate and how that varies within and between flocks and organisations over time provides a critically important benchmark for further investigations into this substantial area of productivity loss.


Assuntos
Galinhas , Doenças das Aves Domésticas , Humanos , Animais , Feminino , Estudos Prospectivos , Fazendas , Criação de Animais Domésticos , Asfixia/epidemiologia , Asfixia/veterinária , Austrália/epidemiologia , Aves Domésticas , Doenças das Aves Domésticas/epidemiologia
6.
J Endocrinol Invest ; 46(4): 779-786, 2023 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-36348253

RESUMO

PURPOSE: The aim of our study was to assess dermatological changes in transgender people after the start of gender-affirming hormonal treatment (GAHT) and to investigate whether various hormonal preparations differently affect dermatological changes in trans AFAB (assigned female at birth) people. METHODS: In a multicenter prospective study, 484 participants (193 assigned male at birth/AMAB and 291 AFAB) were evaluated at baseline (T0), 6 (T1) and 12 months (T2) after the start of GAHT. Hair growth was assessed by the Ferriman-Gallwey (FG) score, acne by the Global Acne Grading Scale (GAGS), and alopecia by the Norwood Hamilton (NH) score. RESULTS: In AFAB people, a significant increase in FG score and NH grade was observed across time, as well as in GAGS score in a subsample of 71 individuals (p < 0.001). Testosterone (T) undecanoate and esters showed a higher increase in hair distribution at T2 vs. T1 as compared to T gel (p < 0.01). T esters showed a significantly higher impact in GAGS score modifications at T1 and at T2 vs. T0 compared to T gel (p = 0.021 and p = 0.003, respectively). In trans AMAB people, a significant decrease of FG score was observed across time (p < 0.001), although 51.3% of individuals still reported an FG score higher than eight after 12 months. CONCLUSION: T treatment increased hair growth, acne and alopecia prevalence in AFAB people, with T undecanoate and esters influencing hair growth more than T gel. Opposite dermatological changes were observed in AMAB people.


Assuntos
Acne Vulgar , Pessoas Transgênero , Transexualidade , Recém-Nascido , Humanos , Masculino , Feminino , Estudos Prospectivos , Alopecia/tratamento farmacológico , Alopecia/epidemiologia , Acne Vulgar/tratamento farmacológico
7.
J Endocrinol Invest ; 45(11): 2059-2068, 2022 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-35779204

RESUMO

PURPOSE: We evaluated differences in Autism Spectrum Quotient (AQ) scores between a sample of hormone-naïve transgender and cisgender people and the impact of gender-affirming hormonal treatment (GAHT) on AQ scores across time. Furthermore, we assessed alexithymia and social anxiety as possible mediators of changes in AQ scores. METHODS: A cross-sectional comparison between cisgender and transgender people before GAHT and a prospective study on the effects of GAHT over time were performed. Transgender and cisgender people completed several psychometric tests. A total sample of 789 persons (n = 229 cismen; n = 172 ciswomen; n = 206 transmen; n = 182 transwomen) referring to the Florence and Rome Gender Clinics between 2018 and 2020 was enrolled. Of these, 62 participants referring to the Florence Gender Clinic were evaluated in a prospective study at baseline and 12 months after GAHT. RESULTS: Groups showed significant differences in terms of autistic traits: ciswomen showed lower scores of AQ, while cismen reported higher scores of AQ than all other groups. Transgender individuals showed significant higher levels of Gender Dysphoria (GD), body uneasiness, alexithymia and social anxiety, compared to cisgender ones. No significant differences in general psychopathology were found between groups. Across time, transmen and transwomen showed a significant reduction in AQ scores. The decrease in alexithymia and social anxiety after GAHT did not predict the change in AQ scores. CONCLUSIONS: The autistic traits in our sample may represent an epiphenomenon of GD rather than being part of an Autism Spectrum Disorder (ASD) condition, since they significantly decreased after 12 months of GAHT.


Assuntos
Transtorno do Espectro Autista , Transtorno Autístico , Pessoas Transgênero , Transtorno do Espectro Autista/tratamento farmacológico , Transtorno do Espectro Autista/epidemiologia , Transtorno Autístico/tratamento farmacológico , Transtorno Autístico/epidemiologia , Estudos Transversais , Hormônios , Humanos , Estudos Prospectivos
8.
J Endocrinol Invest ; 45(9): 1787-1799, 2022 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-35527295

RESUMO

In the last years, hypersexual behavior has been broadly scientifically studied. The interest in this topic, belonging to psycho-sexology and sexual medicine, has been due to its still unclear aetiology, nature, and its manifestation in relationship with several organic and psychopathological conditions. So, the specialist (the psychologist, psychiatrist, endocrinologist, neurologist) may encounter some difficulties in diagnosing and managing this symptom. The first main objective of this position statement, which has been developed in collaboration between the Italian Society of Andrology and Sexual Medicine (SIAMS) and the Italian Society of Psychopathology (SOPSI) is to give to the reader evidence about the necessity to consider hypersexuality as a symptom related to another underlying condition. Following this consideration, the second main objective is to give specific statements, for the biopsychosocial assessment and the diagnosis of hypersexual behavior, developed on the basis of the most recent literature evidence. To develop a psycho-pharmacological treatment tailored on patients' needs, our suggestion is to assess the presence of specific comorbid psychopathological and organic conditions, and the impact of pharmacological treatments on the presence of an excess of sexual behavior. Finally, a suggestion of a standardized psychometric evaluation of hypersexuality will be given.


Assuntos
Andrologia , Transtornos Parafílicos , Comportamento Compulsivo , Humanos , Transtornos Parafílicos/diagnóstico , Transtornos Parafílicos/terapia , Psicometria , Comportamento Sexual/psicologia
9.
N Z Vet J ; 70(4): 211-217, 2022 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-35172695

RESUMO

AIMS: To gather data on the calf management and rearing practices of a subset of dairy farmers in the south-west region of Western Australia. METHODS: A 30-minute face-to-face survey was conducted with dairy cattle producers in the south-west region of Western Australia from April-June 2019 to determine pre-weaning calf rearing practices. Participation was voluntary, using a self-selected subset of dairy farmers registered with a regional extension group. The questionnaire assessed three broad categories: farm demographics, colostrum harvesting and management and calf rearing practices. RESULTS: The study response rate was 34/140 (24%). The following key areas were identified where there were deviations from recognised best practice: Precalving: no transition diet was fed pre-calving on 4/34 (12%) of farms, and on a further 5/34 (15%) it was fed for less than 3 weeks; mixing of heifers and adult cows in the calving paddocks occurred in 24/34 (70%) of the farms, with 15% (5/34) of the farms using calving induction. During calving 14/34 (41%) of the farms did not disinfect navels of new-born calves; although 23/34 farmers stated that they collected calves within 6 hours of birth, data on frequency of calf pick-up (2/34 did not separate calves and dams and 19/34 picked up only once per day) indicated that on 21/34 farms (62%) the reality was that calves were picked up >12 hours after birth. Colostrum quality was not assessed appropriately on 18/34 (53%) farms and farmers overestimated how soon after birth it was administered: 23/34 (68%) reported feeding it within 6 hours of calving, despite 62% picking up calves >12 hours after calving. Regarding calf rearing practices, no pain relief before or after dehorning was used on 20/34 (59%) farms, calf bedding was removed infrequently (

Assuntos
Colostro , Indústria de Laticínios , Animais , Bovinos , Fazendas , Feminino , Gravidez , Inquéritos e Questionários , Austrália Ocidental
10.
J Endocrinol Invest ; 45(3): 657-673, 2022 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-34677807

RESUMO

PURPOSE: Gender Incongruence (GI) is a marked and persistent incongruence between an individual's experienced and the assigned gender at birth. In the recent years, there has been a considerable evolution and change in attitude as regards to gender nonconforming people. METHODS: According to the Italian Society of Gender, Identity and Health (SIGIS), the Italian Society of Andrology and Sexual Medicine (SIAMS) and the Italian Society of Endocrinology (SIE) rules, a team of experts on the topic has been nominated by a SIGIS-SIAMS-SIE Guideline Board on the basis of their recognized clinical and research expertise in the field, and coordinated by a senior author, has prepared this Position statement. Later on, the present manuscript has been submitted to the Journal of Endocrinological Investigation for the normal process of international peer reviewing after a first internal revision process made by the SIGIS-SIAMS-SIE Guideline Board. RESULTS: In the present document by the SIGIS-SIAMS-SIE group, we propose experts opinions concerning the psychological functioning, gender affirming hormonal treatment, safety concerns, emerging issues in transgender healthcare (sexual health, fertility issues, elderly trans people), and an Italian law overview aimed to improve gender non-conforming people care. CONCLUSION: In this Position statement, we propose experts opinions concerning the psychological functioning of transgender people, the gender-affirming hormonal treatment (full/partial masculinization in assigned female at birth trans people, full/partial feminization and de-masculinization in assigned male at birth trans people), the emerging issues in transgender health care aimed to improve patient care. We have also included an overview of Italian law about gender affirming surgery and registry rectification.


Assuntos
Identidade de Gênero , Terapia de Reposição Hormonal , Assistência ao Paciente , Pessoas Transgênero/psicologia , Transexualidade , Ajustamento Emocional/fisiologia , Prova Pericial , Hormônios Esteroides Gonadais/uso terapêutico , Terapia de Reposição Hormonal/métodos , Terapia de Reposição Hormonal/normas , Humanos , Itália , Masculino , Assistência ao Paciente/métodos , Assistência ao Paciente/normas , Melhoria de Qualidade/organização & administração , Medicina Reprodutiva/métodos , Cirurgia de Readequação Sexual/legislação & jurisprudência , Cirurgia de Readequação Sexual/métodos , Transexualidade/psicologia , Transexualidade/terapia
11.
J Dairy Sci ; 105(2): 1493-1503, 2022 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-34955273

RESUMO

Dairy cows can be reservoirs of foodborne pathogens such as Salmonella that pose serious public health risks to humans. The study was designed to examine the molecular epidemiology and antimicrobial resistance profiles of Salmonella isolates from dairy heifer calves and adult lactating cows in the pasture-based system of Australia. A total of 838 animals (328 heifer calves and 510 lactating cows) from 22 farms were sampled. Overall, 54 Salmonella isolates were recovered (calves 28/328 and cows 26/510). A herd-level Salmonella prevalence of 50% (95% confidence interval: 31%-69%) was recorded. Within-herd prevalence for Salmonella ranged between 4%-29% and 4%-45% among the heifer calves and adult lactating cows, respectively. Three different serovars were identified with Salmonella Infantis being the most common serovar (n = 33, 61%) followed by Salmonella Kiambu (n = 20, 37.0%) and one isolate of Salmonella Cerro (2%). The highest antimicrobial resistance prevalence of Salmonella isolates was found against streptomycin (n = 31, 57%), followed by cefoxitin (n = 12, 22%), ceftriaxone (n = 2, 4%), and chloramphenicol (n = 1, 2%). Multiple class resistance was observed on 4 isolates against cefoxitin, chloramphenicol, and streptomycin. Multilocus sequence types ST32 (61%), ST309 (37%), and ST367 (2%) were strongly linked to the serovars Salmonella Infantis, Salmonella Kiambu, and Salmonella Cerro, respectively. Whole genome sequencing of Salmonella isolates detected only 2 resistance genes: aac(6') gene that confers resistance against aminoglycosides among 40.7% of the isolates, and a single isolate positive for the blaDHA-16 gene. Two distinct clusters among the serovars were observed suggesting 2 independent sources of spread. Despite the low prevalence of antimicrobial resistance among Salmonella from the dairy farms, our findings contribute to the regional and national understanding of antimicrobial resistance in dairy herds in Australia. There is need for continued antimicrobial resistance stewardship and surveillance programs to ensure the production of high-quality food products and the long-term protection of both animal and human health.


Assuntos
Antibacterianos , Lactação , Animais , Antibacterianos/farmacologia , Austrália/epidemiologia , Bovinos , Farmacorresistência Bacteriana , Farmacorresistência Bacteriana Múltipla , Feminino , Testes de Sensibilidade Microbiana/veterinária , Epidemiologia Molecular , Salmonella/genética
12.
Res Vet Sci ; 139: 121-126, 2021 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-34298285

RESUMO

The objective of this study was to estimate the prevalence of failure of passive transfer of immunity (FPTI) in dairy calves in the south-west region of Western Australia herds. A cross-sectional study was conducted in 26/140 dairy farms and serum samples were collected from 495 healthy 2-7 day-old calves. A radial immunodiffusion (RID) test was used to determine the concentration of serum IgG and calves were classified as having FPTI if the IgG concentration was less than 10 mg/mL. Estimation of FPTI was also assessed using two indirect methods using serum total protein (STP) and a brix refractometer. The estimated prevalence of FPTI was found to be 8.7% (43 calves out of 495) by RID with the concentration of IgG ranging between 0 and 6.2 mg/ml. The STP was found to vary from 46 to 96 mg/mL and using a cut-off point of 55 mg/mL the calf level prevalence was estimated as 7.1% (33 calves). Using the brix refractometer, the prevalence was found to be 13.1% (65 calves) with the refractometer reading ranging 6-14% of IgG. In the present study there was no association between calf-level factors (age, sex and breed) and FPTI. There was a higher correlation of the RID test results and the STP results compared to the RID and brix refractometer results. It is concluded that the prevalence of FPTI in dairy calves in the south-west region of Western Australia is low (8.7%) and the brix refractometer is not a reliable indirect method for determining passive transfer of immunity to calves.


Assuntos
Bovinos , Colostro , Imunização Passiva , Imunoglobulina G , Animais , Animais Recém-Nascidos , Bovinos/imunologia , Estudos Transversais , Feminino , Imunização Passiva/veterinária , Gravidez , Prevalência , Austrália Ocidental/epidemiologia
13.
Aust Vet J ; 99(9): 395-401, 2021 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-34169510

RESUMO

Identifying and quantifying the relative frequency of involuntary losses is an essential first step in developing fit-for-purpose herd health programmes. The objective of this study was to provide an estimate of the relative frequency of reasons for mortality among south-west Western Australian beef and dairy cattle, based on necropsy findings from a university-based veterinary pathology referral centre over 38 years. A total of 904 cattle were submitted for postmortem examination throughout the study period. Gastrointestinal, cardiopulmonary and reproductive conditions were the most common causes of mortality in cattle submitted for necropsy at Murdoch University for the period 1981-2018. In dairy cattle, the common problems were gastrointestinal (bloat, abomasal displacements) 18% (59/320), cardiovascular (traumatic reticulo-pericarditis) 9% (30/320) and respiratory conditions (pneumonia) 8% (27/320). In beef cattle, the most common conditions were gastrointestinal (bloat, rumen acidosis) 11% (39/358), reproductive (metritis) 11% (38/358), cardiovascular (traumatic reticulo-pericarditis) 7% (25/358), respiratory (pneumonia) 7% (24/358), lameness (fractures) 6%, (21/358) and hepatobiliary conditions (blue-green algae poisoning, hepatotoxicity) 6% (21/358). Selection bias and missing data were potential confounders in this study. Although necropsy investigations provide useful information on animal mortalities and avenues for future herd health programmes, there is a need to standardise data capture methods and disease definition criteria, and conduct more detailed recording of data both at the farm level and at necropsy diagnostic centres.


Assuntos
Doenças dos Bovinos , Indústria de Laticínios , Animais , Austrália/epidemiologia , Bovinos , Doenças dos Bovinos/epidemiologia , Estudos Retrospectivos , Austrália Ocidental/epidemiologia
14.
J Endocrinol Invest ; 44(5): 1103-1118, 2021 May.
Artigo em Inglês | MEDLINE | ID: mdl-33128158

RESUMO

Premature ejaculation (PE) is the most prevalent male sexual dysfunction, and the most recently defined. PE is often mistakenly considered a purely psychosexological symptom by patients: the lacking awareness in regards to the pathophysiology and treatments often lead to resignation from the patients' side, making PE the most underdiagnosed sexual complaint. However, an ever-growing body of evidence supporting several organic factors has been developed in the last decades and several definitions have been suggested to encompass all defining features of PE. In the present document by the Italian Society of Andrology and Sexual Medicine (SIAMS), we propose 33 recommendations concerning the definition, pathophysiology, treatment and management of PE aimed to improve patient care. These evidence-based clinical guidelines provide the necessary up-to-date guidance in the context of PE secondary to organic and psychosexological conditions, such as prostate inflammation, endocrine disorders, and other sexual dysfunctions, and suggest how to associate pharmacotherapies and cognitive-behavioral therapy in a couple-centered approach. New therapeutic options, as well as combination and off-label treatments, are also described.


Assuntos
Administração dos Cuidados ao Paciente/métodos , Ejaculação Precoce , Andrologia/métodos , Andrologia/tendências , Diagnóstico Diferencial , Erros de Diagnóstico/prevenção & controle , Erros de Diagnóstico/psicologia , Medicina Baseada em Evidências , Humanos , Itália , Masculino , Ejaculação Precoce/etiologia , Ejaculação Precoce/fisiopatologia , Ejaculação Precoce/psicologia , Ejaculação Precoce/terapia , Comportamento Sexual , Disfunções Sexuais Fisiológicas/diagnóstico , Disfunções Sexuais Psicogênicas/diagnóstico
15.
J Endocrinol Invest ; 43(8): 1131-1136, 2020 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-32036582

RESUMO

PURPOSE: Gender assignment represents one of the most controversial aspects of the clinical management of individuals with Differences of Sex Development, including 5α-Reductase-2 deficiency (SRD5A2). Given the predominant female appearance of external genitalia in individuals with SRD5A2 deficiency, most of them were assigned to the female sex at birth. However, in the last years the high rate of gender role shift from female to male led to recommend a male gender assignment. METHODS: We here describe two cases of subjects with SRD5A2 deficiency assigned as females at birth, reporting their clinical histories and psychometric evaluations (Body Uneasiness Test, Utrecht Gender Dysphoria Scale, Bem Sex-Role Inventory, Female Sexual Distress Scale Revised, visual analogue scale for gender identity and sexual orientation) performed at the time of referral at the Florence Gender Clinic. RESULTS: Both patients underwent early surgical interventions without being included in the decision-making process. They had to conform to a binary feminine gender role because of social/familiar pressure, with a significant impact on their psychological well-being. Psychometric evaluations identified clinically significant body uneasiness and gender incongruence in both subjects. No sexually related distress and undifferentiated gender role resulted in the first subject and sexually related distress and androgynous gender role resulted in the second subject. CONCLUSIONS: The reported cases suggest the possibility to consider a new approach for gender assignment in these individuals, involving them directly in the decision-making process and allowing them to explore their gender identity, also with the help of GnRH analogues to delay pubertal modifications.


Assuntos
3-Oxo-5-alfa-Esteroide 4-Desidrogenase/deficiência , Transtornos do Desenvolvimento Sexual/diagnóstico , Disforia de Gênero/diagnóstico , Proteínas de Membrana/deficiência , Mutação , Diferenciação Sexual/genética , Procedimentos de Readequação Sexual/métodos , 3-Oxo-5-alfa-Esteroide 4-Desidrogenase/genética , Adulto , Transtornos do Desenvolvimento Sexual/enzimologia , Transtornos do Desenvolvimento Sexual/genética , Feminino , Disforia de Gênero/enzimologia , Disforia de Gênero/genética , Humanos , Masculino , Proteínas de Membrana/genética , Prognóstico , Adulto Jovem
16.
Int J Impot Res ; 33(7): 694-702, 2020 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-33483604

RESUMO

Transgender people and their next-of-kin may request information on sexual orientation and preferred partners during hormonal affirming process. Although previous research on sexual orientation in transgender people is extensive, this literature may already be outdated and/or the methodology of studies assessing sexual orientation may fall short. This prospective cohort study was part of the European Network for the Investigation of Gender Incongruence (ENIGI). Gender role and preferred partner in sexual fantasies, sexual orientation and gender of current sexual partner were assessed at baseline (initiation of HT) and every follow-up visit. Data from 469 transgender women (TW) and 433 transgender men (TM) were analyzed cross-sectionally and prospectively. At baseline, more than half reported having no partner (35% of TW, 47% of TM). After 12 months, more than half reported having a partner (59% of TW, 56% of TM), with no changes between one and three years of HT. The majority of TM preferred a female partner, TW preferred male and female partners. The sexual identity of their partner matched their sexual orientation in >80%. Sexual orientation did not change over time. We did not observe associations with serum levels of sex steroids or gender-affirming surgery (chest or genital surgery). Sexual orientation did not change during hormonal transition and was not associated with sex steroids or surgery. Also, preferences matched the partner's sexual identity. We do not assume that changing serum levels of sex steroids is directly associated with changes in partner choice. The number of people with a current partner increased, possibly due to the indirect effects of gender-affirming care.


Assuntos
Disforia de Gênero , Pessoas Transgênero , Estudos Transversais , Feminino , Humanos , Masculino , Estudos Prospectivos , Comportamento Sexual
17.
N Z Vet J ; 67(4): 214-218, 2019 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-30935292

RESUMO

Case History: Dairy cows recumbent following calving on farms in South Gippsland, Australia were examined during two 3-month seasonal calving periods in 2011 and 2012 as part of a larger study of 218 recumbent cows. A cohort of 104 cows diagnosed with calving paralysis following dystocia was derived from the larger group, which were examined with 3 days of becoming recumbent. A thorough medical and musculoskeletal clinical examination was performed on each cow including flexor-withdrawal and patellar reflex tests, and postural assessment in the lifted position, unless the facilities were not available. Cows were diagnosed with one or more neurological syndromes: sciatic, tibial paresis, obturator or femoral, based on clinical findings consistent with damage to these peripheral nerves or their nerve roots. Clinical Findings: Evidence of sciatic syndrome was found in 100/104 (96.2%) cows and 146/172 (84.9%) affected hind limbs either as the sole neuropathy or in combination with tibial paresis, obturator or femoral syndromes. Pelvic damage was also present in 3/104 (2.8%) cows. Obturator syndrome was diagnosed in 30/104 (29%) cows and 45/172 (26.2%) affected hind limbs but not apparently as the sole reason for the recumbency. Femoral syndrome occurred in 16/104 (15.4%) cows and 21/172 (12.2%) affected hind limbs and was the only syndrome recorded in one cow. Clinical Relevance: Sciatic syndrome was the most common neurological syndrome observed in cows with calving paralysis. The other major nerves arising from the lumbo-sacral plexus were also affected and the various syndromes associated with damage to these nerves or their ventral nerve roots occurred in many combinations. Calving paralysis should be thought of as a paresis or paralysis resulting from damage to the ventral nerve roots of the lumbo-sacral plexus as any of the nerves originating from this plexus can be damaged during dystocia either individually or in combination with other nerves from the plexus.


Assuntos
Doenças dos Bovinos/epidemiologia , Doenças dos Bovinos/etiologia , Distocia/veterinária , Paralisia/veterinária , Ciática/veterinária , Animais , Austrália/epidemiologia , Bovinos , Indústria de Laticínios , Feminino , Paralisia/complicações , Paralisia/epidemiologia , Gravidez , Fatores de Risco , Ciática/complicações , Ciática/epidemiologia
18.
J Dairy Sci ; 102(4): 3282-3294, 2019 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-30738667

RESUMO

The objectives of this study were to assess antibody and cellular immune responses in first-lactation dairy heifers reared under a pasture-based production system and to investigate associations between immune competence and stress responsiveness, health, and productivity. A commercial vaccine was used to induce antibody and cellular immune responses and, based on measured responses, animals were classified as above average, average, and below average for each trait independently and in combination (overall immune competence). Overall immune competence phenotypic rankings were generated by combining standardized residual values for antibody and cellular responses measured in individual heifers. Cortisol responses to handling and yarding were used to assess stress responsiveness, worm egg counts were used to assess internal parasite burden, somatic cell counts to assess udder health and estimates of total daily milk volume, and milk fat and milk protein contents to assess productivity. A total of 393 Holstein-Friesian and Holstein-Friesian × Jersey crossbred heifers from 2 herds practicing seasonal calving in a pasture-fed production system were enrolled in the study. The immune competence phenotypes of individual heifers were assessed before their first mating and their subsequent performance during their first lactation was monitored. Animals with below-average antibody and cellular immune competence had higher serum cortisol concentrations compared with their counterparts following handling, suggesting they had a reduced ability to cope with management-induced stress. Furthermore, a significant negative (favorable) correlation was observed between antibody responses and stress responsiveness. Similarly, correlations between antibody responses and internal parasite burden were significant and negative (favorable). No correlations were observed between overall immune competence and milk yield, milk fat, and milk protein content.


Assuntos
Bovinos/fisiologia , Indústria de Laticínios , Imunidade Celular , Imunocompetência , Lactação , Estresse Fisiológico , Animais , Formação de Anticorpos , Austrália , Bovinos/imunologia , Estudos de Coortes , Feminino , Leite , Proteínas do Leite , Estudos Prospectivos , Reprodução
19.
J Dairy Sci ; 102(4): 3406-3420, 2019 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-30738685

RESUMO

Animal welfare assessments were conducted on 50 Australian pasture-based dairy farms of varying herd sizes: 16 small (<300 cows), 15 medium-sized (300-500 cows), 11 large (501-750 cows), and 10 very large (751+ cows). A protocol based on elements of Welfare Quality adapted for Australian conditions was developed to assess the broad categories of good feeding, housing, health, and appropriate behavior. Farm records, body condition scores, integument injuries, fecal plaques, avoidance distance of humans, and fecal pat scoring for acidosis assessment were undertaken. The mean maximum kilograms of grain fed per day significantly increased with herd size, from 5.2 ± 0.38 (small), 7.7 ± 0.29 (medium-sized), 8.8 ± 0.45 (large), to 10.1 ± 0.80 kg (very large). Acidosis was not related to herd size based on either farm records or fecal pat scoring. All cows had access to water for more than 12 h in a 24-h period. More larger farms had water points on the farm tracks or at the dairy. Very large farms (90%) were more likely than others (36-39%) to provide water suitable for human consumption. Integument lesions were not related to herd size and were uncommon; 56 and 84% of farms had no cows with lesions or hairless areas, respectively, and no farm had >6% integument lesions. Heat stress is an important welfare risk in Australia. All farms had some form of cooling strategy; shade in all paddocks was more common on smaller farms (>90%) than others (<75%). Sprinklers were more common on large or very large farms (>80%) than others (<65%). Mastitis and lameness were the most common health conditions, followed by dystocia, downer cows, and gastrointestinal diseases. Prevalence of lameness, mastitis, downer cows, dystocia, and gastrointestinal disease were not related to farm size. Larger farms were more likely to have electronic infrastructure to monitor or electronically draft cows for inspection. We found wide variation in the avoidance distance of humans, but this was not related to farm size. Larger farms had longer walking distances to pasture and longer time away from pasture, which could affect the time available for behaviors such as lying down. Animal welfare risks differ on Australian farms compared with housed cattle. As animal welfare is multidimensional, both animal- and resource-based indicators can be useful. Animal-based indicators have strengths in that, when measured accurately, they genuinely reflect the outcome being measured, but they also have weaknesses in that the point-estimate of a disease prevalence on a given day may not be representative of other times of year or differences in case definition may exist when farm records are used. Similarly, resource-based indicators have strengths in that they may be applicable to longer periods, but weaknesses because the fact a resource is present does not guarantee it is being used. Identifying the major risks to animal welfare on individual farms and ensuring a plan is in place to effectively manage them should be an important element of any on-farm animal welfare assessment protocol.


Assuntos
Criação de Animais Domésticos/normas , Bem-Estar do Animal/normas , Ração Animal/análise , Animais , Austrália/epidemiologia , Bovinos/crescimento & desenvolvimento , Bovinos/metabolismo , Doenças dos Bovinos/epidemiologia , Doenças dos Bovinos/fisiopatologia , Indústria de Laticínios , Fazendas/normas , Feminino , Marcha , Humanos , Gravidez , Prevalência , Registros/normas
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