The journal of gender-specific medicine : JGSM : the official journal of the Partnership for Women's Health at Columbia最新文献

Objective: To investigate the influence of gender on patient satisfaction with hospitalization care.

Methods: A random-selection, cross-sectional study was conducted. Data were collected by telephone interviews over a 2-year period utilizing a 16-item survey. Inclusion criteria were hospital admission between July 1, 1999 and July 1, 2001, age greater than 18 years, and the ability to speak on the telephone. Exclusion criteria were an admission for an obstetric purpose, physical rehabilitation, or psychiatric illness, or the inability to be reached by a telephone call. Logistic regression was used to compare gender with the responses for each of the 16 questions, while controlling for three confounders (age, race, and insurance status).

Results: 5857 patients were surveyed. Compared to men, women were significantly younger, had a higher percentage of African Americans, and more had Medicaid insurance (P < 0.05). Using multivariate analysis, women expressed significantly less satisfaction compared to men on four of the six questions related to nursing care, on three of the three questions related to entire staff care, on three of the three questions related to overall satisfaction, and on one of the two questions related to communication (P < 0.05). There was no difference in satisfaction between the genders for the two questions regarding physician are.

Objective: To determine the prevalence of adolescent dating violence, associations between dating violence and behavioral and mental health, and the percentage of youth who remain in potentially harmful relationships due to a fear of being hurt if they leave.

Methods: A nationally representative population-based sample of 3533 youth in 9th through 12th grades completed the Commonwealth Fund Survey of the Health of Adolescent Boys and Girls.

Results: Overall, 17% of girls and 9% of boys reported adolescent dating violence. Adolescents from lower socioeconomic backgrounds were more likely to report dating violence than youth from higher backgrounds. Dating violence was associated with dieting, binge and purge behaviors, cigarette smoking, alcohol consumption, drug use, suicidal thoughts, depression, and poorer self-esteem for both genders. Approximately 50% of girls and boys reporting both physical and sexual dating violence reported staying in relationships out of fear of physical harm.

Conclusions: Adolescent dating violence is prevalent among both girls and boys and is associated with detriments to behavioral and mental health. Youth in potentially harmful relationships may remain due to fear of being physically hurt if they leave. Clinical implications addressing both girls and boys are discussed.

Each year more than 400,000 Americans die from diseases directly related to smoking, and lung cancer is now the leading cause of death from neoplasia in U.S. men and women. Cancer of the lung and bronchus was responsible for one-quarter of all cancer deaths among U.S. women last year, killing approximately 67,000 women. This is related both to the demographics of smoking among women and the poor survival rate for persons with lung cancer. Epidemiologic evidence from a number of studies suggests that women are more susceptible to tobacco-induced carcinogenesis than men, taking into account baseline exposure, body weight, body height, and body mass index. More recently, there has been increasing biochemical and genetic data to support this male-female difference in susceptibility. Patients with lung cancer currently have few therapeutic options. Understanding these new genetic developments may pave the road for innovative therapeutic approaches for women and new screening methods to determine those at greatest risk for developing lung cancer. Clearly, smoking-related disease among women is a major public health issue that will require effective programs for smoking prevention and cessation among females. Both sex and gender differences in smoking-related disease will be discussed in this review.

Objective: Calcineurin is a key mediator of T cell activation. Previous studies in our laboratory showed a dose-dependent and hormone-specific increase in calcineurin expression in the T cells from females with systemic lupus erythematosus (SLE). This study investigates whether the estrogen-dependent increase in calcineurin expression is due to stabilization of the messenger RNA (mRNA).

Methods: T cells from female patients with SLE and controls were cultured for 18 hours in a serum-free medium with and without estradiol-17 beta (10(-7) M). Some T cells were activated by further culture on anti-CD3-coated plates. Actinomycin D (25 micrograms/mL) was added to some cultures to inhibit new mRNA synthesis. Calcineurin mRNA stability was assessed by reverse-transcription polymerase chain amplification.

Results: Resting SLE (n = 9, P = .59) and normal (n = 5, P = .90) T cells showed no significant differences in mRNA stability in response to estradiol. Calcineurin mRNA was not significantly stabilized in activated SLE (n = 10, P = .12) or activated normal (n = 8, P = .09) T cells in response to estradiol. However, the amount of calcineurin mRNA stabilized in activated normal T cells (n = 8) was significantly greater (P = .02) compared with SLE T cells (n = 10) only after culture in medium without estradiol.

Conclusions: These findings highlight the complex gene regulatory mechanisms underlying the differential action of estrogen on SLE T cells. Furthermore, the data indicate that increased calcineurin expression in SLE T cells is not due solely to estrogen-dependent stabilization of the message, and probably involves additional transcriptional regulatory mechanisms.

Objective: To compare pain characteristics, disability, and comorbid psychological distress between genders in a treatment-seeking sample of patients with chronic pain.

Methods: Consecutive patients with chronic pain were evaluated and assigned a pain diagnosis. Gender differences were compared on responses to questions about pain symptoms, associated disability, and psychological distress.

Results: The pain sample (N = 716) was predominately female (63%). Pain locations, diagnoses, and trigger factors were similar in male and female patients. Male patients reported a greater mean pain severity (7.16 males vs 6.82 females; P = 0.05), greater pain constancy (41.2% vs 26.7%; P < 0.001), and more days per week with pain (6.37 vs 5.87; P < 0.001). In addition, males reported higher levels of disability, with reduced activity more than 3 days per week in 70.2% of males and 56.0% of females, and complete disability more than 3 days per week in 55.9% of males and 37.3% of females (P < 0.001). Quality of life measures were additionally reduced for both physical and psychological categories in men versus women (P = 0.05 to < 0.01).

Conclusions: There are important gender differences in treatment-seeking patients with chronic pain. Males report higher levels of pain and disability, with reduced physical and psychological quality of life, as compared to females. These differences in treatment-seeking patients may reflect gender differences in treatment-seeking behavior.