RESUMO
To determine the epidemiological, histopathological, and clinical characteristics of patients diagnosed with penile cancer in the Brazilian state of Maranhão, the region with the highest incidence worldwide. One hundred and sixteen penile cancer patients were interviewed from July 2016 to October 2018. The majority of patients lived in a rural area (57%), worked in farming (58%), had a low level of schooling or no schooling (90%), and were married or in a stable relationship (74%). The mean age was 60.4 ± 16.51 years (range, 23-93 years). Phimosis (66%), poor/moderate genital hygiene (73%), history of sexually transmitted infections (55%), and zoophilia (60%) were found in the majority of patients. Most patients had their first sexual encounter at 16.2 ± 2.8 years (range, 10-25 years), and 75% had >6 sexual partners. The most common initial symptom was pruritus (37%), and most patients waited to seek treatment (average time to treatment, 18.9 months; range, 2-84 months). Human papillomavirus (HPV)-related histologies were observed in 62% of patients. Most patients had histological grades II or III (87%), stage ≥T2 disease (84%), and lymphadenopathy at admission (42%). Penectomy was performed in 96% of patients. The population with penile cancer in the region of highest incidence in the world is marked by low socioeconomic status, high prevalence of HPV infection, and phimosis. The delay in seeking treatment is related to a very high rate of advanced cancer and aggressive surgical treatment. The high prevalence of young patients was also a striking feature.
Assuntos
Infecções por Papillomavirus/epidemiologia , Transtornos Parafílicos/epidemiologia , Neoplasias Penianas/epidemiologia , Fimose/epidemiologia , Adulto , Fatores Etários , Idoso , Idoso de 80 Anos ou mais , Animais , Brasil/epidemiologia , Estudos Transversais , Humanos , Incidência , Masculino , Pessoa de Meia-Idade , Gradação de Tumores , Papillomaviridae/isolamento & purificação , Infecções por Papillomavirus/diagnóstico , Infecções por Papillomavirus/virologia , Neoplasias Penianas/patologia , Neoplasias Penianas/cirurgia , Neoplasias Penianas/virologia , Pênis/patologia , Pênis/cirurgia , Pênis/virologia , Prevalência , Estudos Prospectivos , Fatores de Risco , População Rural/estatística & dados numéricos , Classe Social , Fatores de Tempo , Tempo para o Tratamento , Adulto JovemRESUMO
INTRODUCTION: Parkinson's disease (PD) is characterized by motor symptoms such as bradykinesia, rigidity, alteration of postural reflexes and tremor at rest and other non-motor symptoms such as changes in sleep patterns and sexual behavior. However, little is known about paraphilic sexual behaviors. AIM: To summarize the number of cases of zoophilic behaviors in patients with PD between January 2000 and December 2017. DEVELOPMENT: A review was carried out in PubMed, Scopus and Virtual Health Library. Eleven articles were identified by title; six were excluded because they did not present cases related to zoophilic behavior. We found five cases of men, usually with PD of several years of course, taking dopamine agonists and who presented the zoophilic behaviors followed increasing of the dose. The zoophilic behaviors decreased with reducing doses of dopamine agonists and taking atypical antipsychotic such as clozapine or quetiapine. CONCLUSIONS: It is limited the case reports of zoophilic behaviors in patients with PD. The patients reported are men in whom the dose of dopamine agonists was increased. It is important that the clinical follow-up of patients with PD disease includes a careful review of sexual behaviors including those of the paraphilic spectrum.
TITLE: Revision de casos de zoofilia en pacientes con enfermedad de Parkinson.Introduccion. La enfermedad de Parkinson (EP) se caracteriza por sintomas motores, como bradicinesia, rigidez, alteracion de reflejos posturales y temblor en reposo, y otros sintomas no motores, como cambios en el patron de sueño y el comportamiento sexual. Sin embargo, se conoce poco sobre los comportamientos sexuales parafilicos. Objetivo. Resumir el numero de casos de comportamientos zoofilicos en pacientes con EP entre enero de 2000 y diciembre de 2017. Desarrollo. Se realizo una revision en PubMed, Scopus y la Biblioteca Virtual en Salud. Se identificaron por el titulo 11 articulos; se excluyeron seis porque no presentaban casos relacionados con un comportamiento zoofilico. Se encontraron cinco casos de hombres, generalmente con EP de varios años de curso, polimedicados con agonistas dopaminergicos, quienes presentaron los comportamientos parafilicos despues del incremento de la dosis. Los comportamientos zoofilicos cedieron con la reduccion de la dosis de los agonistas dopaminergicos y antipsicoticos atipicos, como clozapina o quetiapina. Conclusiones. Es limitada la notificacion de casos de comportamientos zoofilicos en pacientes con EP. Los pacientes notificados son hombres en quienes se incremento la dosis de agonistas dopaminergicos. Es importante que el seguimiento clinico de los pacientes con EP incluya una revision de los comportamientos sexuales, incluidos los del espectro parafilico.
Assuntos
Transtornos Parafílicos/etiologia , Doença de Parkinson/psicologia , Idoso , Animais , Antiparkinsonianos/administração & dosagem , Antiparkinsonianos/efeitos adversos , Antiparkinsonianos/uso terapêutico , Antipsicóticos/uso terapêutico , Cães , Agonistas de Dopamina/administração & dosagem , Agonistas de Dopamina/efeitos adversos , Agonistas de Dopamina/uso terapêutico , Relação Dose-Resposta a Droga , Equidae , Humanos , Masculino , Pessoa de Meia-Idade , Transtornos Parafílicos/tratamento farmacológico , Transtornos Parafílicos/epidemiologia , Doença de Parkinson/tratamento farmacológicoRESUMO
OBJECTIVE: The aim of this study was to evaluate the prevalence of paraphilic thoughts/behaviors (including paraphilic disorders) with and without sexual addiction and sexual-related conditions in a sample of substance disorder patients. METHODS: This was a cross-sectional study of substance-dependent individuals who sought outpatient treatment in São Paulo, Brazil. Data included sociodemographic information, drug of choice, responses to questions about sexual behavior, and to the following standardized questionnaires: (a) Sexual Addiction Screening Test, and (b) Childhood Trauma Questionnaire. RESULTS: The sample comprised 134 persons who use drug, predominantly men (76.1%), 39.6% were aged between 18 and 29 years, and 54.9% were single. Most were persons who use polydrug, 73.9% were alcohol and cocaine users, 63.4% marijuana users, 81.1% tobacco users, and 5.2% steroid users. Prevalence of paraphilic thoughts/behaviors (including paraphilic disorders) with and without sexual addiction was 47%. The HPV/herpes and hepatitis B rates were 7.9% (Pâ=â0.021) and 6.3% (Pâ=â0.046) respectively. Paraphilic and nonparaphilic thoughts/behaviors were associated to the presence of childhood physical neglect (odds ratios [OR]â=â4.7, 95% confidence interval [CI] 1.0 to 21.9), low educational level (ORâ=â7.2, 95% CI 1.4 to 36), heterosexuality (ORâ=â3.8, 95% CI 1.1 to 12.8) and youth (age 18 to 20 years) (ORâ=â5.6, 95% CI 1.4 to 11.8). CONCLUSIONS: The high prevalence of paraphilic thoughts/behaviors with or without sex addiction in persons who use drugs may be related to the experience of physical and emotional neglect during childhood and this possibility should routinely be investigated in clinical practice.
Assuntos
Adultos Sobreviventes de Eventos Adversos na Infância/estatística & dados numéricos , Comportamento Aditivo/epidemiologia , Transtornos Parafílicos/epidemiologia , Comportamento Sexual/estatística & dados numéricos , Transtornos Relacionados ao Uso de Substâncias/epidemiologia , Adolescente , Adulto , Brasil/epidemiologia , Comorbidade , Estudos Transversais , Feminino , Humanos , Masculino , Transtornos Relacionados ao Uso de Substâncias/terapia , Adulto JovemRESUMO
OBJECTIVE: There have been many studies investigating paraphilias and sexual compulsion, but thus far little data about prevalence of unusual sexual practices that are subthreshold for these diagnoses. The associations between unconventional sexual behavior and sociodemographic and health parameters were investigated. METHOD: A cross-sectional study of 7,022 individuals (45.4 percent of women) was carried out using a selfadministered questionnaire that compared individuals carrying at least one reference of unconventional sexual behavior (group 1) with individuals without such reference (group 2). RESULTS: Women's mean age was 35.0 vs. 35.9 years (p < 0.05) and men's mean age was 36.5 vs. 37.8 years (p < 0.05) being lower in group 1 than in group 2, respectively. More men (52.3 percent) than women (30.4 percent) (p < 0.001) presented unconventional sexual behavior. Fetishism (13.4 percent) and voyeuristic behavior (13.0 percent) were more frequent. Unconventional sexual behavior was associated with male gender, single or separated marital status, black or mulatto race, elementary and high school educational level, history of posttraumatic stress disorder treatment, alcohol dependence, emergency contraception, difficulty at the beginning of sexual life, sexual violence, bisexuality, and performance of anal or oral intercourse. CONCLUSION: Unconventional sexual behaviors are important because they are associated with poorer health status and lower educational levels.
OBJETIVO: Pesquisadores têm conduzido vários estudos relacionados a parafilias e compulsão sexual, mas há poucos dados sobre a prevalência de práticas sexuais não usuais que são subliminares para estes diagnósticos. Foi investigada a associação entre comportamento sexual não convencional e parâmetros sociodemográficos e de saúde. MÉTODO: Estudo transversal, de 7.022 indivíduos (54,6 por cento de homens), realizado por meio de questionário autorresponsivo, comparou indivíduos com pelo menos um comportamento sexual não convencional (grupo 1) e indivíduos sem esta referência (grupo 2). RESULTADOS: A idade média das mulheres (35,0 vs. 35,9 anos; p < 0,05) e dos homens (36,5 vs. 37,8 anos; p < 0,05) foi menor no grupo 1 do que no grupo 2, respectivamente. Mais homens (52,3 por cento) que mulheres (30,4 por cento) (p < 0,001) apresentaram comportamento sexual não convencional. Comportamentofetichista (13,4 por cento) evoyeurista(13,0 por cento) foramosmaisfrequentes. Comportamento sexual não convencional foi associado com: gênero masculino; estado civil solteiro e separado; raça negra e parda; nível educacional médio e fundamental; histórico de tratamento para transtorno do estresse pós-traumático; dependência por álcool; contracepção de emergência; dificuldade no início da vida sexual; violência sexual sofrida; bissexualidade; e prática de sexo anal e oral. CONCLUSÃO: Os comportamentos sexuais nãoconvencionaissão importantes porque estão associados a piores condições de saúde e a baixo nível educacional.
Assuntos
Adulto , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Nível de Saúde , Transtornos Parafílicos/epidemiologia , Brasil/epidemiologia , Estudos Transversais , Incesto/estatística & dados numéricos , Transtornos Parafílicos/psicologia , Prevalência , Inquéritos e Questionários , Comportamento Sexual/estatística & dados numéricos , Fatores SocioeconômicosRESUMO
OBJECTIVE: There have been many studies investigating paraphilias and sexual compulsion, but thus far little data about prevalence of unusual sexual practices that are subthreshold for these diagnoses. The associations between unconventional sexual behavior and sociodemographic and health parameters were investigated. METHOD: A cross-sectional study of 7,022 individuals (45.4% of women) was carried out using a self-administered questionnaire that compared individuals carrying at least one reference of unconventional sexual behavior (group 1) with individuals without such reference (group 2). RESULTS: Women's mean age was 35.0 vs. 35.9 years (p < 0.05) and men's mean age was 36.5 vs. 37.8 years (p < 0.05) being lower in group 1 than in group 2, respectively. More men (52.3%) than women (30.4%) (p < 0.001) presented unconventional sexual behavior. Fetishism (13.4%) and voyeuristic behavior (13.0%) were more frequent. Unconventional sexual behavior was associated with male gender, single or separated marital status, black or mulatto race, elementary and high school educational level, history of posttraumatic stress disorder treatment, alcohol dependence, emergency contraception, difficulty at the beginning of sexual life, sexual violence, bisexuality, and performance of anal or oral intercourse. CONCLUSION: Unconventional sexual behaviors are important because they are associated with poorer health status and lower educational levels.
Assuntos
Nível de Saúde , Transtornos Parafílicos/epidemiologia , Adulto , Brasil/epidemiologia , Estudos Transversais , Feminino , Humanos , Incesto/estatística & dados numéricos , Masculino , Pessoa de Meia-Idade , Transtornos Parafílicos/psicologia , Prevalência , Comportamento Sexual/estatística & dados numéricos , Fatores Socioeconômicos , Inquéritos e QuestionáriosRESUMO
O autor realiza revisäo bibliográfica sobre pedofilia, um transtorno da preferência sexual que ocorre principalmente em homens e que acerreta vários problemas pessoais, sociais e legais, dando ênfase ao conceito, epidemiologia, etiologia, quadro clínico e tratamento desta condiçäo