Gender dysphoria: prejudice from childhood to adulthood, but no impact on inflammation. A cross-sectional controlled study.

INTRODUCTION: Gender dysphoria (GD) is characterized by a marked incongruence between experienced gender and one's gender assigned at birth. Transsexual individuals present a higher prevalence of psychiatric disorders when compared to non-transsexual populations, and it has been proposed that minority stress, i.e., discrimination or prejudice, has a relevant impact on these outcomes. Transsexuals also show increased chances of having experienced maltreatment during childhood. Interleukin (IL)-1ß, IL-6, IL-10 and tumor necrosis factor-alpha (TNF-α) are inflammatory cytokines that regulate our immune system. Imbalanced levels in such cytokines are linked to history of childhood maltreatment and psychiatric disorders. We compared differences in IL-1ß, IL-6, IL-10 and TNF-α levels and exposure to traumatic events in childhood and adulthood in individuals with and without GD (DSM-5). METHODS: Cross-sectional controlled study comparing 34 transsexual women and 31 non-transsexual men. They underwent a thorough structured interview, assessing sociodemographic information, mood and anxiety symptoms, childhood maltreatment, explicit discrimination and suicidal ideation. Inflammatory cytokine levels (IL-1ß, IL-6, IL-10 and TNF-α) were measured by multiplex immunoassay. RESULTS: Individuals with GD experienced more discrimination (p = 0.002) and childhood maltreatment (p = 0.046) than non-transsexual men. Higher suicidal ideation (p < 0.001) and previous suicide attempt (p = 0.001) rates were observed in transsexual women. However, no differences were observed in the levels of any cytokine. CONCLUSIONS: These results suggest that transsexual women are more exposed to stressful events from childhood to adulthood than non-transsexual men and that GD per se does not play a role in inflammatory markers.

A Retrospective Review of Medical Records of Laboratory-Tested Sexually Transmitted Infections of Transsexual Men from Southern Brazil.

The present study assessed the prevalence of sexually transmitted infections (STIs) in 90 transsexual men (female-to-male transsexual persons) from southern Brazil. A retrospective review of the medical records of all transsexual men who visited an outpatient clinic in Rio Grande do Sul from 1998 to 2017 was performed. Although the sample had a high prevalence of risk factors for contracting STIs, such as drug use, one-third of the participants had never been tested for STIs and, when screened, it was mostly for HIV, but not for syphilis or other STIs. Based only on laboratory-tested transsexual men, the prevalence of syphilis and hepatitis C was 3.4% and 1.6%, respectively, which is higher than the general population. It is clear that health professionals need to broaden their understanding of transsexual men, acknowledging STIs as a possible diagnosis.

Influência dos ácidos graxos ômega-3 e vitamina D na depressão: uma breve revisão / Influence of omega 3 fatty acids and vitamin D in depression: a short review

Objetivo: descrever uma revisão da literatura sobre a importância dos ácidos graxos ômega-3 e da vitamina D na prevenção e tratamento da depressão. Metodologia: essa revisão foi feita no período de agosto, setembro de 2016, incluindo as publicações de 2000 a 2016. Procedeu-se a busca nas bases de dados Pubmed, Science Direct, Bireme e periódicos CAPES com a utilização dos descritores: "ômega-3", "docosahexaenoic acid", "DHA", "eicosapentaenoic acid", "EPA", "vitamin D" e "depression". Resultados: a literatura reporta vários estudos sobre a eficácia dos ácidos graxos ômega-3 no tratamento da depressão. No entanto, existe um número considerável de trabalhos que não demonstram eficácia dos ácidos graxos ômega-3 na depressão. Os fatores responsáveis pelos resultados variados são: modelos experimentais, diferenças de tamanho da amostra, diferenças biológicas e genéticas entre os doentes, a variabilidade ambiental, e variabilidade na resposta à ácidos graxos ômega-3. Em relação a vitamina D, os resultados também são contraditórios, com evidências sugerindo que baixos níveis dessa vitamina podem estar associados a um maior risco de depressão. Conclusão: não é possível afirmar que consumir alimentos ricos em ômega-3 e vitamina D, juntamente com o uso de fármacos possam aliviar os sintomas depressivos.

Objective: to describe a literature review on the importance of omega-3 fatty acids and vitamin D in the depression prevention and treatment. Methodology: this review was done in August / September, 2016, including publications from 2000 to 2016. Pubmed, Science Direct, Bireme and Journals CAPES databases were searched using the descriptors: "omega-3", " Docosahexaenoic acid "," DHA "," eicosapentaenoic acid "," EPA "," vitamin D" and "depression ". Results: the literature report several studies on the efficacy of omega-3 fatty acids in the depression treatment. However, there are a number of studies that don't demonstrate efficacy of omega-3 fatty acids in depression. The factors responsible for the varied results are: experimental models, differences in sample size, biological and genetics differences among patients, environmental variability, and variability in response to omega-3 fatty acids. There are many researches with contradictory results regarding vitamin D, with evidence suggesting that low levels of this vitamin may be associated with an increased risk of depression. Conclusion: it can't be affirm that consume foods rich in omega-3 and vitamin D along with the use of pharmaceuticals products may alleviate depressive symptoms.

Pseudomixoma peritoneal: relato de caso e revisão da literatura / Pseudomyxoma peritonei: case report and literature review

Pseudomixoma peritoneal (PMP) é uma doença incomum, caracterizada pela presença de coleções líquidas gelatinosas em abdome e pelve, com implantes mucinosos na superfície peritoneal. A maioria dos casos é associada a neoplasias apendiculares. Os sintomas mais importantes são aumento de volume abdominal, emagrecimento, dor abdominal e sintomas mimetizando apendicite aguda. Esta condição clínica progride com disseminação peritoneal, obstrução intestinal e comprometimento nutricional. O caso relatado é de uma paciente feminina, 68 anos, com emagrecimento, aumento de volume abdominal e massa anexial, causando hidronefrose bilateral. Laparotomia exploradora evidenciou massa ocupando cavidades intraperitonial e retroperitonial, originária de tumor apendicular. Após análise histopatológica, o diagnóstico final foi de pseudomixoma peritoneal secundário a neoplasia de apêndice

Pseudomyxoma peritonei (PMP) is an uncommon disease, characterized by the presence of gelatinous collections in abdominal and pelvic cavities, with mucinous implants on peritoneal surface. The majority of PMP cases are associated with appendiceal carcinomas. The most important symptoms are increasing abdominal girth, weight loss, abdominal pain, and symptoms mimicking an acute appendicitis. This entity has a borderline behavior with progression to peritoneal seeding, intestinal obstruction, and nutritional compromise. The case reported is of a 68-year-old woman with weight loss, increasing abdominal girth, and an adnexal mass. Exploratory laparotomy demonstrated a mass occupying intraperitonial and retroperitonial spaces, originating in an appendiceal tumor. After histopathology examination, the final diagnosis was pseudomyxoma peritonei, due to appendiceal tumor