Search

“Secondary Transsexualism”: A Case Report for a man who Wants to Become a nun Elisabetta Pascolo-Fabrici a , Federico Sandri a , Sofia Panarello a , Francesca Fiorindo a , Sanja Nastasich a , Sara Benvenuto a [a] University of Trieste, ITALY. e.pascolo@fmc.units.it Transsexualism is considered to be the extreme end of the spectrum of gender identity disorders. In clinical observation we know that there are two different psychological structures of transsexualism: The “primary” emerges early in the child development and is linked with a clear perception of gender dysphoria. The “secondary” is typically late in a person’s development and is often secondary to other psychopathologies. In particular it can be connected to psychosis, borderline disorder, some kinds of depression or schizophrenia. In this work we underline the most important considerations about this secondary transsexualism trying to define some guidelines for a correct approach with this kind of patients. It is not common to find these cases in the literature because of its rare incidence and the complexity of the treatment. We describe a case report of a 45 years old man with this particular symptomatology who wants to become a woman to take vows as a nun. We underline some themes clearly lined with a secondary transsexualism; the patient links his decision to become a woman with some episodes of his past life in particular the sensation of his “intrusive” penis and anus (the patient reports some tickling sensations during arousal). Some important considerations regard the patient's interpretation of being a man similar as his father and his decision to become a nun (as a symbol of virginity). The difference between primary and secondary transsexualism is not quite clear since some people have a psychiatric symptomatology that could confuse the common guidelines. For this reason it is important to give a clear definition of these aspects. This case can be read to facilitate other clinics to an easier interpretation of secondary transsexualism.

A variety of surgical procedures have been described to treat various penile diseases. Nowadays the purpose of all surgical techniques in penile surgery is not only the correct treatment of the primary condition, but also to preserve sexual function and to maintain cosmesis of the penis. Appropriate treatment options should be individualized according to the patients' expectations and erectile capacity. The present paper reviews recent advances in the field of penile reconstructive surgery using knowledge obtained from the contemporary literature.

Introduction. Priapism is defined as a persistent erection of the penis not accompanied by sexual desire or stimulation and can be a urological emergency. There are three different types of priapism: low-flow priapism, highflow priapism and recurrent priapism. Unfortunately, clinical guideline does not establish a fixed set of rules for the treatment of this condition. Methods. This review combined an analysis of clinicopathologic reports as well as a summary of clinical and basic science investigations on the subject to date. Moreover, the proposed pathogenesis of priapism is reviewed, and a survey regarding treatment modalities is given. Results. The prognosis depends on the type of priapism and the amount of time that passes before therapeutic intervention. It is important to distinguish between these conditions as the treatment for each is different. Low-flow priapism is a compartment syndrome with intracavernosal anoxia, rising pCO2 and acidosis and urgent medical attention is mandatory to prevent erectile dysfunction. On the contrary in high-flow priapism intervention is not urgent and often unnecessary. Finally, recurrent priapism is a condition which is still not well understood and there is no standardised algorithm for the management of this condition. Conclusions. Urologists should understand the importance of the disorder and be prepared to follow current principles of diagnosis and treatment to reduce or prevent its complications.

Introduction: Oxidative stress is one mechanism that could contribute to the acceleration of aging and age-related diseases. On the other hand, because of their antioxidative qualities soybean derived foods could have beneficial effects on the aging process. Objectives: The aim of our work was to study the effects of a diet supplemented with soy milk on certain biological features of aging in rats Methods: Male Wistar rats of 3 to 18 months of age, were assigned to one of two diets: 1) Experimental Group, commercial rat formula and soy milk; 2) Control Group, commercial rat formula and water. Every three months both lipid profile and lipid peroxidation were determined and neuronal cells of hippocampus were counted in control and experimental rats. Results: The soy milk diet significantly improved the plasmatic lipid profile, decreasing serum cholesterol (total as well as LDL) and serum triglycerides, HDL-cholesterol was significatively higher in experimental animals. The LDL/HDL ratio was thus significantly lowered. The soy diet also produced decreased values of lipid peroxidation in brain, liver and kidney. These effects were significant after 6 to 9 months. The experimental animals lost fewer hippocampal neurons than the controls. Finally at 18 months of age, a greater number of surviving animals in experimental group with respect to the control one was observed. Conclusions: 1) soy intake could have beneficial effects as a complement of normal diet, but not as a replacement for animal proteins and 2) these effects are the result of a very long period (almost lifelong) of consumption of this diet. Introducción: El estrés oxidativo es uno de los mecanismos que contribuye al envejecimiento y al desarrollo de enfermedades crónicas. Por otro lado, los alimentos a base de soja, por a sus cualidades antioxidantes podrían tener un efecto benéfico en este proceso. Objetivos: El propósito de nuestro trabajo fue estudiar el efecto de la suplementación dietaria con leche de soja sobre algunos parámetros biológicos del envejecimiento natural, en ratas. Material y métodos: Se trabajó con ratas Wistar macho, desde los 3 y hasta los 18 meses de edad. Los animales fueron asignadas a dos dietas: 1) grupo experimental: alimento balanceado para ratas y leche de soja, ad libitum; 2) grupo control: alimento balanceado y agua ad libitum. Cada tres meses, en ambos grupos se realizaron las siguientes determinaciones: a) perfil lipídico plasmático; b) lipoperoxidación (MDA) en homogenato de cerebro, hígado y riñón, y c) recuento del número de cuerpos neuronales en el hipocampo. Resultados: La alimentación con leche de soja mejoró notablemente el perfil lipídico: se encontró una disminución significativa de colesterol total, LDL-colesterol, triglicéridos y el índice LDL/HDL. Asimismo, se observó, en hígado, cerebro y riñón, una reducción de la lipoperoxidación, que alcanzó valores significativos entre los 6 y 9 meses de alimentación. Los animales alimentados con leche de soja perdieron menos neuronas en el hipocampo en relación a los controles. Finalmente, se observó un mayor número de animales sobrevivientes, a los 18 meses de edad, en el grupo experimental con respecto al control Conclusiones: La leche de soja podría ejercer efectos benéficos como complemento de la dieta normal, no en reemplazo de las proteínas animales. Estos efectos se observan después de un periodo prolongado de ingesta (casi toda la vida).

The author focuses essentially on L. Binswanger’s contribution in his analysis of phenomenology’s influence on modern psychiatry. After first summarizing the philosophical meaning of phenomenology, he focuses on phenomenology’s choice of an “understanding description” of mental disorders which excludes any scientific approach based on “causal explanation”. The author goes on to analyze the impasse reached by the phenomenological approach, especially in psychiatry, demonstrating how comprehensive interpretation and causal reconstruction are in fact always inseparable: the phenomenological commitment thus responds more to a challenge, in a broader ideological, “humanist” sense, and its background is both an ethical and speculative protest against our technosciences-dominated civilization. Yet the reformation-driven phenomenological psychiatrists ultimately acknowledge causality insofar as they end up denouncing the technoscientific civilization as such as one of the causes of mental morbidity.