Gender Medicine最新文献

{"title":"Analysis of Sex Differences in Cancer-Specific Survival and Perioperative Mortality Following Radical Cystectomy: Results of a Large German Multicenter Study of Nearly 2500 Patients with Urothelial Carcinoma of the Bladder","authors":"Wolfgang Otto MD ,&nbsp;Matthias May MD ,&nbsp;Hans-Martin Fritsche MD ,&nbsp;Duska Dragun MD ,&nbsp;Atiqullah Aziz MD ,&nbsp;Michael Gierth MD ,&nbsp;Lutz Trojan MD ,&nbsp;Edwin Herrmann MD ,&nbsp;Rudolf Moritz MD ,&nbsp;Jörg Ellinger MD ,&nbsp;Derya Tilki MD ,&nbsp;Alexander Buchner MD ,&nbsp;Thomas Höfner MD ,&nbsp;Sabine Brookman-May MD ,&nbsp;Philipp Nuhn MD ,&nbsp;Christian Gilfrich MD ,&nbsp;Jan Roigas MD ,&nbsp;Mario Zacharias MD ,&nbsp;Stefan Denzinger MD ,&nbsp;Markus Hohenfellner MD ,&nbsp;Maximilian Burger MD","doi":"10.1016/j.genm.2012.11.001","DOIUrl":"10.1016/j.genm.2012.11.001","url":null,"abstract":"<div><h3>Background</h3><p>Outcome of patients with urothelial carcinoma<span> of the bladder (UCB) varies between sexes. Although overall incidence is higher in men, cancer-specific survival (CSS) has been suggested to be lower in women. Although the former effect is attributed to greater exposure to carcinogens in men, the latter has not been elucidated.</span></p></div><div><h3>Objectives</h3><p>The aim of the study was to identify sex-specific outcomes based on one of the largest databases of patients with UCB who underwent radical cystectomy (RC).</p></div><div><h3>Methods</h3><p>This retrospective multicenter series comprised 2483 patients in Stage M0 who underwent RC for UCB from 1989 to 2008; 20.4% of patients were women. The impact of sex on CSS in the entire study group and in specific subgroups was analyzed. The median follow-up time was 42 months (interquartile range, 21–79).</p></div><div><h3>Results</h3><p><span>Histopathologic criteria of pathologic tumor (pT), pathologic nodal (pN), grade, lymphovascular invasion<span> (LVI), and associated carcinoma in situ (CIS) of the study did not differ between sexes. The percentage of female patients increased over time. Five-year CSS in female patients was significantly lower than in male patients (60% vs 66%; </span></span><em>P</em><span> = 0.005). In multivariate analysis adjusted to other covariates, tumor stage ≥pT3 (hazard ratio [HR] = 2.44; </span><em>P</em> &lt; 0.001), positive pN status (HR <em>=</em> 1.91; <em>P</em> &lt; 0.001), LVI (HR = 1.48; <em>P</em> &lt; 0.001), lower count of lymph nodes removed (HR <em>=</em> 0.98; <em>P</em> = 0.002), older age (HR <em>=</em> 1.01; <em>P</em> &lt; 0.001), and female gender (HR = 1.26; <em>P</em> = 0.011) had an independent impact on CSS. Deterioration of CSS in female patients was pronounced when LVI was present (HR = 1.57; <em>P</em> &lt; 0.001) and when RC was performed in the earlier time period (HR = 2.44; <em>P</em> &lt; 0.001). However, women showed significantly lower perioperative mortality (within 90 days after RC) compared with men.</p></div><div><h3>Conclusions</h3><p>After RC for UCB, cancer-specific mortality was higher in female patients; this disadvantage was more pronounced in earlier time periods. In addition, worse outcome of women with verified LVI was shown to be comparable with men. These findings were suggestive of different tumor biology and potentially unequal access to timely RC in earlier time periods because of reduced awareness of UCB in women. Further studies are required to improve UCB outcome in both sexes, notably in female patients.</p></div>","PeriodicalId":55124,"journal":{"name":"Gender Medicine","volume":"9 6","pages":"Pages 481-489"},"PeriodicalIF":0.0,"publicationDate":"2012-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1016/j.genm.2012.11.001","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"31101183","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Does Sex Affect 30-Day Mortality in Staphylococcus Aureus Bacteremia?","authors":"Nariman Mansur PharmMSc ,&nbsp;Rawi Hazzan MD ,&nbsp;Mical Paul MD ,&nbsp;Jihad Bishara MD ,&nbsp;Leonard Leibovici MD","doi":"10.1016/j.genm.2012.10.009","DOIUrl":"10.1016/j.genm.2012.10.009","url":null,"abstract":"<div><h3>Background</h3><p>Sex-related differences in complications and mortality of infection were examined with conflicting results. Further studies are required to bring new light in this topic in <em>Staphylococcus aureus</em> infections.</p></div><div><h3>Objective</h3><p>We examined the outcomes of <span><em>S. aureus</em></span> infection in men and in women and whether sex-related differences were explained by underlying disorders, severity of disease, or clinical management.</p></div><div><h3>Methods</h3><p><span>This cohort study was conducted in a single center between 1988 and 2007. Patients with clinically significant </span><em>S. aureus</em><span><span> bacteremia were included. We compared 30-day all-cause mortality in men and women. We used multivariable </span>logistic regression analysis to test whether sex was independently associated with mortality.</span></p></div><div><h3>Results</h3><p>One thousand ninety-three patients were identified with <em>S. aureus</em> bacteremia. All-cause mortality at day 30 was 39.3% (508 of 1293 patients): 44.8% (238 of 531 patients) in women and 35.4% (270 of 762 patients) in men (<em>P &lt;</em><span> 0.01). In a multivariate analysis, female sex was associated with higher mortality (odds ratio = 1.63; 95% CI, 1.07–2.47). The excess mortality in women was not explained by differences in demographic characteristic factors, background conditions, infection severity and management, or septic complications.</span></p></div><div><h3>Conclusions</h3><p>We found that women with <em>S. aureus</em> bacteremia had a greater risk of 30-day all-cause mortality than men, even when adjusting for other risk factors. However, we failed to explain this excess of mortality.</p></div>","PeriodicalId":55124,"journal":{"name":"Gender Medicine","volume":"9 6","pages":"Pages 463-470"},"PeriodicalIF":0.0,"publicationDate":"2012-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1016/j.genm.2012.10.009","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"31039964","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Gender Differences in Questions Asked in an Online Preoperative Patient Education Program","authors":"Maria Mora BS ,&nbsp;Jasmine E. Shell BS ,&nbsp;Colleen S. Thomas MS ,&nbsp;Cedric J. Ortiguera MD ,&nbsp;Mary I. O'Connor MD","doi":"10.1016/j.genm.2012.10.002","DOIUrl":"10.1016/j.genm.2012.10.002","url":null,"abstract":"<div><h3>Background</h3><p>Although osteoarthritis more commonly affects women than men, women are 3 times less likely to undergo hip or knee replacement surgery compared with men. Disparity in the appropriate utilization of surgery between men and women is a complex subject that must take into account the willingness of a patient to proceed with the operation. Adequately addressing patient concerns before surgery may influence such willingness.</p></div><div><h3>Objective</h3><p>We examined if a gender difference can be identified in the frequency and types of questions submitted by patients scheduled for total hip or total knee arthroplasty.</p></div><div><h3>Methods</h3><p>Patients completed an online interactive preoperative educational program and a database was created containing deidentified information on surgical procedure, sex, year of birth, and any questions that were submitted. Data were also available regarding the total number of patients issued the program, the number of patients who started the program, and the number of patients who completed the program. The results were analyzed by Wilcoxon rank sum test. <em>P</em> values ≤0.05 were considered statistically significant.</p></div><div><h3>Results</h3><p>Among the 2770 women and 1708 men included in the study, 935 (34%) and 462 (27%) asked at least 1 question, respectively. Compared with men, women asked a significantly greater number of questions overall (<em>P</em> &lt; 0.001). Women also asked a significantly greater number of questions in the categories Your Condition (<em>P</em> = 0.031), Your Procedure (<em>P</em> &lt; 0.001), and Risks and Benefits (<em>P</em> &lt; 0.001).</p></div><div><h3>Conclusions</h3><p>Gender differences in concerns and physicians' ability to adequately address these concerns may contribute to disparity in use of hip and knee replacement surgery between men and women. Effective preoperative counseling for women may require additional resources to address their higher level of questions.</p></div>","PeriodicalId":55124,"journal":{"name":"Gender Medicine","volume":"9 6","pages":"Pages 457-462"},"PeriodicalIF":0.0,"publicationDate":"2012-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1016/j.genm.2012.10.002","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"31040541","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Sex of Newborns Associated With Place and Mode of Delivery: A Population-Based Study in Northern Vietnam","authors":"Dinh Thi Phuong Hoa MD, PhD ,&nbsp;Lina Börjesson MD, MPH ,&nbsp;Nguyen Thu Nga MD, MPH ,&nbsp;Annika Johansson PhD ,&nbsp;Mats Målqvist MSS, MD, PhD","doi":"10.1016/j.genm.2012.10.010","DOIUrl":"10.1016/j.genm.2012.10.010","url":null,"abstract":"<div><h3>Background</h3><p>There is increasing evidence of an elevated sex ratio at birth (SRB) in many Asian countries, including Vietnam, and that this prenatal gender inequity is related to sex-selective abortion. However, few studies have investigated the relation between the sex of offspring and delivery care utilization.</p></div><div><h3>Objective</h3><p>The aim of the present study was to relate sex of newborns to place and mode of delivery in a province in northern Vietnam.</p></div><div><h3>Methods</h3><p>A population-based surveillance system within the Neonatal Health–Knowledge Into Practice (NeoKIP) project (ISRCTN44599712) recorded all births within eight districts of Quang Ninh province in northern Vietnam from July 2008 to June 2011.</p></div><div><h3>Results</h3><p>In total, there were 22,377 live births within the study area. SRB was 108 boys per 100 girls. There was a large difference in SRB depending on place of delivery, with 94 boys per 100 girls being delivered at home, whereas 113 boys per 100 girls were delivered at a district-level hospital. Cesarean section (CS) rate was 17%, and within the CS group, the SRB was 135:100.</p></div><div><h3>Conclusions</h3><p>We demonstrated an elevated SRB, especially at district hospital level, and that sex of offspring influenced place and mode of delivery. Although mothers to boys were more likely to receive more qualified delivery care, they were at the same time more likely to undergo unnecessary surgery. Correct information to women and family members about CS and stricter implementation of the medical indications for CS are urgently called for.</p></div>","PeriodicalId":55124,"journal":{"name":"Gender Medicine","volume":"9 6","pages":"Pages 418-423"},"PeriodicalIF":0.0,"publicationDate":"2012-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1016/j.genm.2012.10.010","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"31049324","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The End of an Era: The Final Chapter of Gender Medicine","authors":"Jane F. Reckelhoff PhD (Editor-in-Chief)","doi":"10.1016/j.genm.2012.11.002","DOIUrl":"10.1016/j.genm.2012.11.002","url":null,"abstract":"","PeriodicalId":55124,"journal":{"name":"Gender Medicine","volume":"9 6","pages":"Page 389"},"PeriodicalIF":0.0,"publicationDate":"2012-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1016/j.genm.2012.11.002","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"31101181","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Newborns of Preeclamptic Women Show Evidence of Sex-Specific Disparity in Fetal Growth","authors":"Simone A. Reynolds PhD, MPH ,&nbsp;James M. Roberts MD ,&nbsp;Lisa M. Bodnar PhD, MPH, RD ,&nbsp;Catherine L. Haggerty PhD, MPH ,&nbsp;Ada O. Youk PhD, MS ,&nbsp;Janet M. Catov PhD, MS","doi":"10.1016/j.genm.2012.10.013","DOIUrl":"10.1016/j.genm.2012.10.013","url":null,"abstract":"<div><h3>Background</h3><p>Evidence suggests that in response to in utero insults, male versus female infants have greater disadvantages in pregnancy outcome. In addition, there is a growing body of evidence suggesting that there is a sex-specific fetal response to maternal disease during pregnancy. We considered that a sex-specific relationship may exist between preeclampsia<span> and reduced fetal growth.</span></p></div><div><h3>Objective</h3><p>We investigated if the relationship between preeclampsia and fetal growth was modified by fetal sex.</p></div><div><h3>Methods</h3><p><span><span>We limited the study population to singleton pregnancies of black and white normotensive and preeeclamptic women enrolled in the Collaborative Perinatal Project (1959–1965). The patients were offspring of 516 preeclamptic and 8801 normotensive women. After adjustment for confounders, interaction terms between preeclamptic status and fetal sex were evaluated to determine if the influence of preeclampsia on fetal growth varied with fetal sex. Separate linear and logistic regression<span> models were then fitted for males and females to report the estimate of the relationship between preeclampsia and fetal growth by fetal sex. The results were stratified by preterm status (&lt;37 vs ≥37 completed weeks of gestation). The mean head and chest circumferences, birthweight, ponderal index, and frequency of </span></span>small for gestational age were examined. A 2-sided </span><em>P</em> value of &lt;0.05 was considered statistically significant.</p></div><div><h3>Results</h3><p>The results were stratified by preterm status. Male preterm offspring of preeclamptic mothers had greater reductions in chest circumference, head circumference, and birthweight than preterm female offspring of preeclamptic women (<em>P</em> = 0.01, <em>P</em> = 0.02, and <em>P</em> = 0.05, respectively, for interaction). Female versus male preterm offspring exposed to preeclampsia were less susceptible to being small for gestational age (synergy index 0.38; 95% CI, 0.00–0.84). The influence of preeclampsia on the growth of term offspring was more modest, and the influence of sex was opposite that in preterm infants. Compared with term offspring of normotensive women, the reduction in mean ponderal index was greater for female versus term male offspring of preeclamptic women (<em>P</em> = 0.02, interaction).</p></div><div><h3>Conclusion</h3><p>Fetal growth was more impaired among male versus female preterm infants born to preeclamptic women. Our study underlined the importance of incorporating sex differences in the study of biological mechanisms for immediate- and long-term consequences of suboptimal fetal growth.</p></div>","PeriodicalId":55124,"journal":{"name":"Gender Medicine","volume":"9 6","pages":"Pages 424-435"},"PeriodicalIF":0.0,"publicationDate":"2012-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1016/j.genm.2012.10.013","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"31101182","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Inflammatory Biomarkers as Risk Factors for Future Atrial Fibrillation. An Eleven-Year Follow-Up of 6315 Men and Women: The Tromsø Study","authors":"Audhild Nyrnes MD ,&nbsp;Inger Njølstad MD, PhD ,&nbsp;Ellisiv B. Mathiesen MD, PhD ,&nbsp;Tom Wilsgaard PhD ,&nbsp;John-Bjarne Hansen MD, PhD ,&nbsp;Tove Skjelbakken MD, PhD ,&nbsp;Lone Jørgensen PhD ,&nbsp;Maja-Lisa Løchen MD, PhD","doi":"10.1016/j.genm.2012.09.001","DOIUrl":"10.1016/j.genm.2012.09.001","url":null,"abstract":"<div><h3>Background</h3><p>Inflammatory biomarkers are reported as risk factors for atrial fibrillation (AF), but their impact is uncertain.</p></div><div><h3>Objective</h3><p>We investigated the associations between inflammatory biomarkers and future AF in a large general cohort.</p></div><div><h3>Methods</h3><p><span>Available markers were white blood cells (WBCs) with subgroups, fibrinogen<span>, high-sensitivity C-reactive protein (hs-CRP), and osteoprotegerin<span> (OPG). A total of 6315 men and women from a population survey in Tromsø, Norway in 1994 to 1995 were followed for a mean of 10.9 years. Mean age at baseline was 60 years. Measurements of height, weight, blood pressure, heart rate, total cholesterol, high-density lipoprotein (HDL) cholesterol, WBC count, and information on diabetes, angina, myocardial infarction, and antihypertensive treatment, were obtained at baseline. Fibrinogen, hs-CRP, and OPG were obtained at a follow-up visit. The outcome measure was first-ever AF, documented on an electrocardiogram. The Cox </span></span></span>proportional hazards regression model was used to estimate hazard ratios of AF.</p></div><div><h3>Results</h3><p>In the multivariable analysis, adjusted for traditional cardiovascular risk factors and other inflammatory biomarkers, hs-CRP was associated with AF in men only (hazard ratio = 1.14 for a 1 SD increase; 95% CI, 1.02–1.28). There was a significant increase in AF across quartiles of WBCs in men (<em>P</em> = 0.007) and in the total study population (<em>P</em><span> = 0.004). OPG was associated with AF in patients<span> free of coronary heart disease at baseline. Fibrinogen and subgroups of WBCs showed no significant association with AF.</span></span></p></div><div><h3>Conclusion</h3><p>This population-based cohort study showed that hs-CRP was independently associated with AF in men, but apparently not in women, and that patients with WBCs in the upper quartile had increased risk of AF.</p></div>","PeriodicalId":55124,"journal":{"name":"Gender Medicine","volume":"9 6","pages":"Pages 536-547.e2"},"PeriodicalIF":0.0,"publicationDate":"2012-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1016/j.genm.2012.09.001","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"30962486","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Evaluation of Metabolic Risk in Prepubertal Girls Versus Boys in Relation to Fitness and Physical Activity","authors":"Francisco Jesus Llorente-Cantarero BS ,&nbsp;Juan Luis Pérez-Navero MD, PhD ,&nbsp;Juan de Dios Benitez-Sillero PhD ,&nbsp;Maria Carmen Muñoz-Villanueva MD, PhD ,&nbsp;Mercedes Gil-Campos MD, PhD","doi":"10.1016/j.genm.2012.08.006","DOIUrl":"10.1016/j.genm.2012.08.006","url":null,"abstract":"<div><h3>Background</h3><p>Low levels of cardiorespiratory<span> fitness (CRF) and physical activity (PA) are associated with a risk of the development of metabolic syndrome. Contradictory findings are reported in the literature regarding the influence of sex and CRF and PA on metabolic changes.</span></p></div><div><h3>Objective</h3><p>The aim of this study was to analyze the effects of CRF and PA on lipid and carbohydrate metabolism biomarkers in boys and girls.</p></div><div><h3>Methods</h3><p><span>A total of 82 prepubertal boys and 55 girls (7–12 years of age) were classified according to sex, low or high CRF, and performance or nonperformance of PA. Anthropometric and blood pressure (BP) measurements, plasma lipid profile values, glucose and insulin levels, and </span>homeostasis model assessment for insulin resistance were analyzed.</p></div><div><h3>Results</h3><p>The percentage of boys with high CRF and performance of PA was higher than that of girls (<em>P</em><span> &lt; 0.05). When children of the same sex were compared, higher values for body mass index and waist circumference z-scores were found for boys with low CRF compared with boys with high CRF (</span><em>P</em> &lt; 0.001) without differences between girls, and in all groups classified by PA. Systolic and diastolic BPs were higher in boys than in girls, in both CRF and PA groups (<em>P</em><span> &lt; 0.05). In the low CRF and no PA groups, girls had higher plasma glucose, total cholesterol, and low-density lipoprotein cholesterol levels than boys, with higher high-density lipoprotein cholesterol and apolipoprotein A levels (</span><em>P</em> &lt; 0.05).</p></div><div><h3>Conclusions</h3><p>Sex in relation to CRF and PA could affect the plasma lipid profile. These changes in girls are associated with low CRF and low levels of PA. Considering these results, we suggest the need to improve CRF and promote PA, especially in girls, to reduce metabolic risk.</p></div>","PeriodicalId":55124,"journal":{"name":"Gender Medicine","volume":"9 6","pages":"Pages 436-444"},"PeriodicalIF":0.0,"publicationDate":"2012-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1016/j.genm.2012.08.006","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"31007642","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Sex Differences in the Biomechanics and Contractility of Intramural Coronary Arteries in Angiotensin II–Induced Hypertension","authors":"Máté Mátrai MD ,&nbsp;Judit Hetthéssy MD ,&nbsp;György L. Nádasy MD, PhD ,&nbsp;Emil Monos DMSc ,&nbsp;Béla Székács DMSc ,&nbsp;Szabolcs Várbíró MD, PhD","doi":"10.1016/j.genm.2012.10.012","DOIUrl":"10.1016/j.genm.2012.10.012","url":null,"abstract":"<div><h3>Background</h3><p>It is well known that sex differences occur in both the pathogenesis and therapy of hypertension. A deeper understanding of the underlying processes may be helpful when planning a personalized therapeutic strategy.</p></div><div><h3>Objective</h3><p><span>In laboratory animal experiments, we studied the early mechanisms of vascular adaptation of the intramural small coronary arteries that play a fundamental role in the </span>blood supply of the heart.</p></div><div><h3>Methods</h3><p>In our study, an osmotic minipump was implanted into 10 male and 10 female Sprague-Dawley rats. The pump remained in situ for 4 weeks, infusing a dose of 100 ng/kg/min angiotensin II acetate. Four weeks later, the animals were killed, and the intramural coronary arteries from the left coronary branch, which are fundamentally responsible for the blood supply of the heart, were prepared. The pharmacologic reactivity and biomechanical properties of the prepared segments were studied in a tissue bath.</p></div><div><h3>Results</h3><p><span>The relative heart mass and vessel wall thickness were greater in females than males (0.387 [0.009] g/100 g vs 0.306 [0.006] g/100 g body weight; 41.9 [4.09] μm vs 33.45 [3.37] μm on 50 mm Hg). The vessel tone and vasoconstriction<span> in response to thromboxane agonists were, however, significantly more pronounced in males. The extent of relaxation in response to </span></span>bradykinin was also greater in females. Although we observed inward eutrophic remodeling in females, an increase in wall stress and elastic modulus dominated in males.</p></div><div><h3>Conclusion</h3><p>The early steps of angiotensin II–dependent hypertension evoked very different adaptation mechanisms in males and females.</p></div>","PeriodicalId":55124,"journal":{"name":"Gender Medicine","volume":"9 6","pages":"Pages 548-556"},"PeriodicalIF":0.0,"publicationDate":"2012-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1016/j.genm.2012.10.012","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"31104768","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Perinatal Maternal and Neonatal Outcomes in Women With Gestational Diabetes Mellitus According to Fetal Sex","authors":"Diana Tundidor MD ,&nbsp;Apolonia García-Patterson MD ,&nbsp;Miguel A. María RN ,&nbsp;Justa Ubeda RN ,&nbsp;Gemma Ginovart MD ,&nbsp;Juan M. Adelantado MD, PhD ,&nbsp;Alberto de Leiva MD, PhD ,&nbsp;Rosa Corcoy MD, PhD","doi":"10.1016/j.genm.2012.09.002","DOIUrl":"10.1016/j.genm.2012.09.002","url":null,"abstract":"<div><h3>Background</h3><p>Male sex is a well-known risk factor for unfavorable perinatal outcomes. Fetal sex has been considered only occasionally in diabetic pregnancy.</p></div><div><h3>Objective</h3><p>Our aim was to evaluate perinatal outcomes in women with gestational diabetes mellitus (GDM) according to fetal sex.</p></div><div><h3>Methods</h3><p><span>We conducted a retrospective review of all singleton pregnancies of women with GDM progressing to &gt;22 weeks and delivering in our center between 1981 and 2007. Evaluated maternal characteristics included anthropometrics<span><span>, obstetric history, GDM diagnosis characteristics (ie, gestational age, </span>blood glucose values), HbA</span></span>_1c<span><span><span><span> (after diagnosis and in the third trimester). Outcomes variables were cesarean section (CS), </span>gestational hypertension, </span>preterm birth<span><span><span>, abnormal Apgar, large and small for gestational age newborns, obstetric trauma, major and minor </span>malformations<span>, neonatal hypoglycemia, jaundice, respiratory distress, </span></span>polycythemia<span>, hypocalcemia<span>, perinatal mortality, and a composite outcome. We used a descriptive and multiple </span></span></span></span>logistic regression analysis (backwards method).</span></p></div><div><h3>Results</h3><p>A total of 2299 pregnancies were included (1125 female and 1174 male infants). Maternal characteristics were essentially similar in male and female newborns. For outcomes, unadjusted figures were higher in pregnancies of male newborns in 14 of 16 perinatal outcomes, but significance was only reached for CS. The logistic regression analyses revealed male sex as an independent predictor of CS (odds ratio = 1.48; 95% CI, 1.15−1.90) and neonatal hypoglycemia (odds ratio = 2.13; 95% CI, 1.02−4.43).</p></div><div><h3>Conclusions</h3><p>In this group of women with GDM, perinatal outcomes in pregnancies of male newborns differ in only 2 of 16 evaluated variables: an increased frequency of CS and neonatal hypoglycemia. Male newborns of mothers with GDM could benefit from increased awareness of neonatal hypoglycemia.</p></div>","PeriodicalId":55124,"journal":{"name":"Gender Medicine","volume":"9 6","pages":"Pages 411-417"},"PeriodicalIF":0.0,"publicationDate":"2012-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1016/j.genm.2012.09.002","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"30995077","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}