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PubMed2000

Gender differences and the effects of synthetic exogenous and non-synthetic estrogens in focal cerebral ischemia.

The role of gender difference and estrogen in ischemic cerebrovascular events is controversial. Evidence is lacking as to whether or not there are significant gender differences in the incidence and outcome of stroke in the clinical setting. Recent clinical epidemiological studies have demonstrated that there is no significant association between the use of hormonal replacement therapy and the risk of stroke. However, several animal studies have shown that there are gender differences in stroke outcome and that exogenous administered estrogens are neuroprotective. In this study, the influence of gender differences and the effects of synthetic and non-synthetic estrogens were examined in a model of focal cerebral ischemia using 210 male, intact female, and ovariectomized female rats. All animals underwent 3 h of middle cerebral artery and bilateral common carotid artery occlusion. After 72 h, the rats were sacrificed and stained for histological assessment of infarction. There were no gender differences in infarction volume. Intravenous administration of either low or high dose 17 beta-estradiol or tibolone did not alter infarct volume. Subcutaneous administration of low and high dose 17beta-estradiol using 7-day release pellets did not alter infarct volume. Low dose tibolone using implanted 7-day release pellets did not alter infarct volume. However, high dose tibolone using implanted 7-day release pellets significantly (P<0.05) reduced infarct volume only in ovariectomized female rats. These results demonstrate that estrogen therapy has no effect on infarction volume following severe focal cerebral ischemia.

Animals↗
PubMed2005

Behavioral and physiological findings of gender differences in global-local visual processing.

Hemispheric asymmetries in global-local visual processing are well-established, as are gender differences in cognition. Although hemispheric asymmetry presumably underlies gender differences in cognition, the literature on gender differences in global-local processing is sparse. We employed event related brain potential (ERP) recordings during performance of a global-local reaction time task to compare hemispheric asymmetries and processing biases in adult men (n=15) and women (n=15). Women responded more quickly to local targets while men did not differentially respond to hierarchical stimuli. ERP data indicated that women had P100 responses that were selectively lateralized to the left hemisphere in response to local targets and N150 responses that were smaller for global targets. They also had P300 responses that were greater following local stimuli. The physiological data demonstrate that male-female performance differences arise from biologically based differences in hemispheric asymmetry. Findings are discussed in the context of existing literature regarding gender differences, hemispheric specialization, and the role of stimulus characteristics.

Adult↗
PubMed2000

An examination of gender differences in DPOAE phase delay measurements in normal-hearing human adults.

This study examined gender differences in f(1)- and f(2)-sweep distortion product otoacoustic emission (DPOAE) phase delay measures in 60 normal-hearing human adults. Phase delay measures were obtained at six different f(2) frequencies ranging from 1.1 to 6.0 kHz (f(2)/f(1) ratios were 1.1-1.3). Primary levels for f(2) were 45 and 50 dB SPL (f(1)f(2)). Gender differences have been observed in normal-hearing human adults in both auditory brainstem response (ABR) and f(1)-sweep DPOAE studies. Gender differences in delay have been attributed to differences in the average length of the cochlea, where female cochleas are 13% shorter than male cochleas. Previously, the authors have proposed that the f(1)-sweep phase delay estimate is predominantly composed of a level-independent transport time to the site of DPOAE generation and a small proportion of the level and frequency-dependent filter build-up time. The f(2)-sweep delay also contains the transport time, however, it is predominantly composed of the filter build-up time. Therefore, delay differences between stimulation paradigms are equal to a proportion of the filter build-up time. In this study, mean f(1)- and f(2)-sweep delays were significantly longer in male ears than female ears at 1.1 kHz (45 and 50 dB). At 50 dB, f(1)-sweep phase delay measures were 18% longer in male ears (6.5 ms) than female ears (5.5 ms). Mean f(2)-sweep delays were 23% longer in male ears (10.0 ms) than female ears (8.1 ms). This gender difference was not observed when the isolated filter build-up time was calculated from the DPOAE phase delay difference. These observations may therefore be attributed to a gender-related anatomical difference in cochlear length.

Adult↗
PubMedDate not supplied

Gender differences in the outcome of an unaided smoking cessation attempt.

There is conflicting evidence concerning gender differences in success at quitting smoking. Information is especially lacking regarding gender differences among unaided quitters who make up the vast majority of those attempting to quit. One hundred thirty-five smokers who made an unaided attempt at quitting were interviewed before quitting and were followed for 1 year after cessation. Relapse rates were extremely high both for men and women, with 62% of participants returning to regular smoking within 15 days after cessation. Women and men were equally likely to maintain short-term abstinence (through 15 days), but women were more than three times as likely to relapse subsequently. Nine percent of men, but no women, had biochemically verified sustained abstinence throughout the 1-year follow-up period. For both men and women, any smoking after the quit attempt inevitably led to full-blown relapse. Most participants resumed regular smoking within 24 hours after the first episode of smoking. Gender differences were observed for several variables related to smoking history, demographics, social support, perceived stress, and motivational factors, but these differences did not explain the increased risk of relapse for women. Our results clearly indicate that women are less likely than men to maintain long-term smoking abstinence following an unaided quit attempt, but reasons for this gender difference need further exploration.

Adult↗
PubMedDate not supplied

Gender differences in severity, symptomatology and distribution of melancholia in major depression.

BACKGROUND: Studies of gender differences in the clinical presentation of depression have provided divergent results. This study aimed at analyzing gender differences in severity, symptomatology and distribution of melancholia in major depression. SAMPLING AND METHODS: The study comprised 930 in- and out-patients (652 women, 278 men) from 6 randomized controlled trials. All patients fulfilled DSM-III or DSM-III-R criteria for major depression. The 17-item Hamilton Depression Scale (HDS) was applied to all patients. A multi-axial evaluation was completed using the Newcastle 1 Depression Rating Scale from 1965 for melancholia (N1) in a subsample of patients (n = 439). A factor analysis on the HDS was performed. Non-parametric statistical tests were used and only gender differences greater than 20% were considered clinically relevant. RESULTS: The median on the HDS total score was 22 and the median number of symptoms was 13 for both men and women. Presentation of specific symptoms was similar for men and women. The factor analysis revealed no gender differences, and neither did analyses on symptoms of Axes II and IV. According to the N1, 80% of the men and 66% of the women suffered from melancholic depression (p = 0.004). CONCLUSIONS: In a large and broad sample of in- and out-patients with major depression, the severity and symptomatology of depression were similar for men and women. Melancholic depression was significantly more frequent among male than female patients. Inclusion and exclusion criteria in the randomized controlled trials provided a selected group of patients, which limited the generalisability of the results to an exclusive subgroup of patients treated for depression in routine clinical practice.

Adult↗
PubMed2004

Undue influence of weight on self-evaluation: a population-based twin study of gender differences.

OBJECTIVE: To explore the extent to which genetic and environmental factors contribute to liability to placing undue importance on weight as an indicator of self-evaluation and to determine whether differences exist across genders in the nature and magnitude of these effects. METHOD: Self-report data were collected on 8,045 same-sex and opposite-sex twins, aged 18-31 years, from a population-based registry of Norwegian twins. Structural equation modeling was utilized to estimate the relative contribution of genetic and environmental factors to liability for undue influence of weight on self-evaluation, allowing for gender-specific effects. RESULTS: Individual variation in undue influence of weight on self-evaluation was best explained by shared and individual environmental influences. No significant gender differences were found. Shared environmental factors accounted for 31% of the variance. DISCUSSION: These results raise the possibility that there may be distinct sources of familial resemblance for different symptoms of bulimia nervosa as codified in the 4th ed. of the Diagnostic and Statistical Manual of Mental Disorders (American Psychiatric Association, 1994).

Adolescent↗
PubMed2005

[Classic antiepileptic and new generation antiepileptic drugs: gender differences in effectiveness and adverse drug reactions].

INTRODUCTION: Women are more likely to suffer adverse drug reactions. Moreover adverse drug reactions differ depending on gender. The main objective of new generation antiepileptic drugs (AED) is to reduce adverse drug reactions while maintaining the same effectiveness as the classic ones. OBJECTIVES: a) To identify sociodemographic and clinical variables associated with being treated with new generation AEDs, and b) to compare effectiveness, averse drug reactions and quality of life among patients treated with monotherapy, either with classic or with new generation AEDs, examining the potential gender differences. PATIENTS AND METHODS: A survey among 990 patients aged 16-64 with epilepsy was carried out in 32 Spanish hospitals (response rate: 96 %). For the purposes of this study patients treated with monotherapy (n = 496) were selected. The outcome variables were: effectiveness in seizure control, adverse drug reactions and three dimensions of the SF-36 questionnaire (vitality, mental health and self-perceived health status). RESULTS: 21 % of women and 8% of men were treated with new AEDs. Women were more likely to be treated with new generation AEDs. Moreover, age of epilepsy onset was also positively related to new AEDs and a gradient was found. Whereas no differences in effectiveness, adverse drug reactions or quality of life were observed among men, among women, those treated with new generation AEDs had less adverse drug reactions but, on the other hand, effectiveness for controlling seizures was lower. CONCLUSIONS: Women are more likely to be treated with new AEDs. Although these new treatments seem to have less adverse drug reactions among females, their effectiveness in controlling seizures are lower than that of classic AEDs.

Adolescent↗
PubMed2004

Gender differences in compensatory behaviors, weight and shape salience, and drive for thinness.

Gender differences in compensatory behaviors, weight and shape salience, and drive for thinness have rarely been examined in nonclinical samples. The present study examines gender differences in a sample of 1111 male and 1510 female twins responding to a questionnaire on eating attitudes and behaviors. Logistic regression using generalized estimating equations (GEE) tested the extent to which gender could be predicted from compensatory behaviors, weight and shape salience, and drive for thinness. The results indicated that use of compensatory behaviors predicted female gender for all except exercise and "other," where no gender differences were found. Greater importance of weight and shape also predicted female gender, as did drive for thinness. Findings with respect to exercise use and "other" compensatory behaviors have nosological implications for the eating disorders, especially as regards eating disorders in males. These findings suggest that both the nature and function of compensatory behaviors may differ by gender.

Adult↗
PubMed2000

Gender differences in the functional organization of the brain for working memory.

Gender differences in brain activation during working memory tasks were examined with fMRI. Seventeen right-handed subjects (nine males, eight females) were studied with four different verbal working memory tasks of varying difficulty using whole brain echo-planar fMRI. Consistent with prior studies, we observed activation of the lateral prefrontal cortices (LPFC), the parietal cortices (PC), and additionally, caudate activation in both sexes. The volume of activated brain tissue increased with increasing task difficulty. For all four tasks, the male subjects showed bilateral activation or right-sided dominance (LPFC, PC and caudate), whereas females showed activation predominantly in the left hemisphere. The task performance data demonstrated higher accuracy and slightly slower reaction times for the female subjects. Our results show a highly significant (p < 0.001) gender differences in the functional organization of the brain for working memory. These gender-specific differences in functional organization of the brain may be due to gender-differences in problem solving strategies or the neurodevelopment. Therefore, gender matching or stratification is required for studies of brain function using imaging techniques.

Adult↗
PubMed2001

Gender differences in long-term survival of patients with colorectal cancer.

BACKGROUND: Significant differences exist in the immunological response to surgery. This raises the possibility that gender differences exist concerning the outcome after curative colorectal cancer resection. METHODS: To study this hypothesis, a database of patients with colorectal cancer was analysed prospectively. RESULTS: Some 894 patients were included, 500 (55.9 per cent) were men and 394 (44.1 per cent) were women. Median follow-up was 54.5 months for the entire group and 63.3 months for survivors. The mean(s.e.m.) patient age was 65.3(0.4) years (women 66.1(0.6), men 64.7(0.5) years; P < 0.05). Women lived significantly longer after cancer resection than men (57.8(1.5) versus 52.0(1.3) months; P < 0.05, log rank 0.009). Disease-free survival was significantly longer in women than in men (51.6(1.7) versus 46.0(1.4) months; P < 0.05). Subgroup analysis revealed significant gender differences in Union Internacional Contra la Cancrum (UICC) stages I (n = 195, log rank 0.01) and UICC IV (n = 38, log rank 0.021). Survival analysis after rectal cancer resection revealed significant advantages for women (log rank 0.02), while no gender differences were detected when comparing patients after resection for colonic cancer. Moreover, patients older than 50 years (n = 635) showed significant gender-related survival differences (log rank 0.015). CONCLUSION: Significant gender differences following curative rectal cancer resection were observed. In women disease-free and overall survival were significantly longer. Whether or not these gender differences are related to gender-specific immune functions or to other gender-related local or systemic factors remains to be determined.

Age Factors↗
PubMed1995

Gender differences in obsessive compulsive disorder.

We investigated gender differences in 219 patients with obsessive compulsive disorder consecutively referred to a centre specialising in the behavioural treatment of anxiety disorders. Females had a later mean onset-age, and were more likely to be married and to have children; they were also marginally more likely to have a past history of an eating disorder or depression, while males were more likely to have a history of anxious or meticulous personality traits. Family loading for psychiatric disorders did not differ significantly between the sexes. The results are discussed in the context of the epidemiological literature on gender differences in OCD.

Adolescent↗
PubMed1999

Gender differences in acute myocardial infarction: the University of Wisconsin experience.

OBJECTIVE: To investigate gender differences in baseline characteristics, presentation, and treatment of patients with acute myocardial infarction (MI) admitted to the University of Wisconsin Hospital Coronary Care Unit (CCU) over a 1-year period. METHODS: A retrospective review was performed on the charts of all patients (n = 293) admitted to the CCU in 1996 with a discharge diagnosis of acute MI. In 83 women and 187 men with analyzable data (n = 270), 42 factors related to baseline characteristics, presentation, treatment, and outcomes were identified and analyzed for gender differences. RESULTS: On average, women were 5 years older than men (p < .01). By univariate comparison, women were less likely than men to be smokers (p < .001); more likely to have underlying hypertension (p < .01), diabetes mellitus (p < 0.05), non-Q-wave infarctions (p < .01), and congestive heart failure (CHF, p < .05); and more likely to have received diuretics (p < .001) and ACE inhibitors (p < .01). While women were less likely than men to undergo coronary angiography (p < .05) and more likely to have echocardiograms (p < 0.05), rates of coronary artery bypass graft surgery, angioplasty, and the use of thrombolytics were similar for men and women. Clinical outcomes were similar in both groups. CHF, hypertension, and use of ACE inhibitors remained the only significant gender differences when data were adjusted for age. CONCLUSION: Comparing men and women with acute MI at UW Hospital revealed some differences in clinical characteristics and management. Except for CHF, hypertension, and use of ACE inhibitors (all of which may be related), these differences disappeared when the data were adjusted for age. This is particularly notable for the disappearance of the difference in the use of coronary angiography between men and women. The comparable use of beta-blockers, aspirin, and nitrates, and the similar clinical outcomes in men and women, suggest less gender difference in MI management at UW Hospital than reported in other studies.

Age Distribution↗
PubMed2000

Race and gender differences in cord blood lipoproteins.

Race and gender differences in lipoproteins and apolipoproteins have repeatedly been demonstrated in adults. The same disparities have been observed in children of different race and gender, implying that these differences may be influenced by genetic factors. To further explore this hypothesis, cord blood concentrations of both lipoproteins and apolipoproteins were examined in black and white neonates of both sexes. Results were controlled for the observed effects of gestational age and growth parameters. Similar patterns of lipoprotein differences to those observed in adults and children were also detected between black and white, and between male and female neonates. These findings support the concept that the aetiology of the difference in lipoprotein concentration observed between race and gender groups includes a significant genetic component.

Apolipoproteins↗
PubMed2000

Age and gender differences in oppositional behavior and conduct problems: a cross-sectional household study of middle childhood and adolescence.

Behavior problems among youths cannot be understood without explaining their age and gender differences, but age and gender differences cannot be explained until they have been accurately described. In a household survey of 1,285 youths aged 9 to 17 years, there were no gender differences in oppositional behavior, but aggression, property offenses, and status offenses were more common among boys. Levels of oppositional behavior were greater at younger ages, aggression peaked near the middle of this age range, and property and status offenses were more prevalent at older ages. These findings are generally consistent with developmental models of conduct problems but are inconsistent with a recent model of gender differences and raise questions about the external validity of current taxonomies.

Adolescent↗
PubMed2004

Gender differences in pain, coping, and mood in individuals having osteoarthritic knee pain: a within-day analysis.

This study examined gender differences in prospective within-day assessments of pain, pain coping, and mood in men and women having OA, and analyzed gender differences in dynamic relations between pain, mood, and pain coping. A sample of 64 women and 36 men diagnosed as having pain due to osteoarthritis of the knee(s) rated their pain, pain coping, and mood two times each day (once in the afternoon and once in the evening) for 30 days using a booklet format. Two gender differences were found in between person-analyses: women used more problem focused coping than men, and women who catastrophized were less likely than men to report negative mood. Several within-day and across-day gender differences were noted. First, women were much more likely to show a significant increase in pain over the day. Second, men were more likely than women to experience an increase in coping efficacy over the day. Third, men were more likely than women to use emotion-focused coping when their mood was more negative. Finally, men were more likely than women to experience an increase in negative mood and a decrease in positive mood in the morning after an evening of increased pain. Taken together, these findings underscore the importance of obtaining multiple daily assessments when studying gender differences in the pain experience.

Adaptation, Psychological↗
PubMed2000

Estrogen-related gender difference in survival rate and cortical blood flow after impact-acceleration head injury in rats.

While a number of laboratories have begun to examine gender differences in outcome following experimental stroke, little is known about the relative response of male and female brains to traumatic injury. In the following series of experiments, we used the Marmarou impact-acceleration head injury model (with a 500-g, 1.5-m weight drop) to compare the pathophysiological responses of male and female rats to closed-head injury. Cortical blood flow (CBF; laser-doppler flowmetry), mean arterial blood pressure (MAP), blood gas levels, blood pH, and body temperature were measured preinjury and at regular intervals postinjury. Acute survival was assessed 1 h after injury. The role of estrogen in the observed gender differences was assessed by examining these physiological measures after injury in ovariectomized females, with or without 17beta-estradiol replacement, and in intact males, with or without exogenous 17beta-estradiol administration. In the first experiment, significantly more females (100%) survived the acute injury period (60 min) after injury than did males (72%). Survival appeared related to the magnitude and persistence of the posttraumatic drop in MAP. In a second experiment, females showed a less dramatic reduction in and better recovery of CBF than males. The gender difference in CBF was paralleled to some degree by differences in the pattern of MAP changes after injury. Differences in body weight, blood gas levels, or blood pH did not account for the gender difference in CBF. Postinjury CBF was higher in female and male rats given 2 weeks of daily 17beta-estradiol injections prior to injury compared to those given the vehicle only. However, 17beta-estradiol administration did not alter MAP, suggesting that the gender difference in CBF was not strictly due to MAP changes. Our findings suggest that estrogen plays a role in maintaining adequate cerebral perfusion in the acute period following closed-head injury. This protective mechanism may underlie the gender difference in acute survival observed in this study, and may help explain observations of better outcome in females than in males after brain injury. We conclude that CBF preservation is one mechanism by which estrogen is neuroprotective following traumatic brain injury. We hypothesize, based upon known effects of estrogen, that the beneficial microvascular effects of estrogen most likely involve a combination of endothelial nitric oxide synthase induction and an antioxidant effect.

Acceleration↗
PubMedDate not supplied

Symptoms of acute coronary syndromes: are there gender differences? A review of the literature.

Evidence has begun to accumulate that suggests there may be gender differences in the presenting symptoms of acute coronary syndromes (ACS). Identification of gender differences has implications for both health care providers and the general public. Women should be instructed as to the symptoms expected with ACS on the basis of evidence obtained from studies that include both sexes. Twelve studies that identified symptoms of ACS for both women and men were identified through a review of the literature. In several of the studies, which included all types of ACS, women had significantly more back and jaw pain, nausea and/or vomiting, dyspnea, indigestion, and palpitations. In a number of the studies, which solely sampled patients with acute myocardial infarction, women demonstrated more back, jaw, and neck pain; nausea and/or vomiting; dyspnea; palpitations; indigestion; dizziness; fatigue; loss of appetite; and syncope. Men reported more chest pain and diaphoresis in the myocardial infarction sample. Results of these studies showed that women and men experienced the same symptoms with ACS. However, in some studies there were gender differences in the proportion of symptoms. Given the current state of the science, definitive conclusions regarding gender differences in the symptoms of ACS cannot be drawn. Further study is urgently needed to clarify and expand on these findings.

Angina, Unstable↗
PubMed2005

Gender differences in bipolar-II disorder.

UNLABELLED: Gender differences in bipolar-II disorder (BP-II) are understudied. STUDY AIM: was to test if there were gender differences in the clinical and family history features of BP-II. METHODS: Consecutive 374 BP-II private practice outpatients were interviewed by a senior psychiatrist using the Structured Clinical Interview for DSM-IV, modified to improve the detection of BP-II (by Benazzi and Akiskal 2003, J Affect Disord 73:33-38), the Montgomery Asberg Depression Rating Scale (MADRS), the Hypomania Interview Guide, and the Family History Screen. Logistic regression was used to study associations and control for confounding. Alpha level was set at 0.05; P was two-tailed. RESULTS: Females represented 67.3% of the group. The female to male ratio was independent of age. Females were more common in younger onset BP-II. Females, versus males, had significantly lower age at onset, more axis I comorbidity, atypical depressions, intra-depression hypomanic symptoms (i. e., mixed depression), and family history of suicidal behavior. On the MADRS, females had more sadness, loss of energy, loss of interest, and suicidal ideas. The symptom structure of hypomanic episodes was similar between females and males. LIMITATIONS: Single interviewer, outpatient sample, private practice study setting. DISCUSSION: Clinical differences were found between BP-II females and males. Differences were found only on the depressive pole of the disorder. However, the magnitude of the differences had not a strong clinical significance, suggesting that at present, on the basis of the variables and the population studied, there is little ground to support a female BP-II depression.

Adult↗