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PubMed2002

Gender-related outcomes in trauma.

BACKGROUND: Recent data suggest that sex hormones may play a role in regulating posttraumatic immunosuppression, leading to gender-based differences in outcome after injuries. This study examined gender-related outcomes in trauma patients. METHODS: We conducted a retrospective review of trauma registry data from our Level I trauma center over a 4-year period. Patients > 15 years of age, with Injury Severity Scores > 15, who survived and received mechanical ventilation for > 48 hours were included. Patients were divided into two groups on the basis of age (15-45 years and > 45 years) and the groups were further stratified by gender. Groups were matched by Injury Severity Scores, Glasgow Coma Scale score, Abbreviated Injury Score for the head, and transfusion requirement. Gender-based outcomes consisted of ventilator days, intensive care unit length of stay (LOS), hospital LOS, pneumonia, and death. RESULTS: Data were reported as mean +/- SD. There were 612 patients. In the younger age group, male patients had a higher incidence of multiple organ failure (10.5% vs. 1.5%), longer intensive care unit (13.5 +/- 9.2 days vs. 9.2 +/- 7.2 days) and hospital LOS (30.2 +/- 37.7 days vs. 18.9 +/- 13.0 days), and higher mortality (13.4% vs. 6.8%) compared with female patients (p < 0.05 for all). These differences did not exist in the older age group. The incidence of pneumonia did not differ by gender. Age > 45 years was associated with higher mortality (odds ratio, 2.0; 95% confidence interval, 1.1-3.5). CONCLUSION: Although the incidence of pneumonia was not influenced by gender, female trauma patients had better outcomes than male patients in the younger age group. Outcome in the older age group was not gender-related. Our data support a gender-based difference in outcome after traumatic injuries in younger patients.

Adolescent↗
PubMed2004

Gender related differences on the EEG during a simulated mobile phone signal.

The present study investigated the gender-related influence of electromagnetic fields (EMF), similar to that emitted by mobile phones, on brain activity. Ten women and nine men performed a short memory task (Wechsler test), both without (baseline) and with exposure to a 900 MHz signal. The EEG energy of the total waveform and the alpha, beta, delta and theta; rhythms were calculated from the recordings of 15 scalp electrodes. Baseline EEG energy of males was greater than that of females, while exposure to EMF decreased EEG energy of males and increased that of females. Memory performance was invariant to EMF exposure and gender influences. These findings indicate that EMF may exert a gender-related nfluence on brain activity.

Adult↗
PubMedDate not supplied

Attenuation correction reveals gender-related differences in the normal values of transient ischemic dilation index in rest-exercise stress sestamibi myocardial perfusion imaging.

BACKGROUND: Transient ischemic dilation (TID) has been established as an important independent marker of severe and extensive coronary artery disease (CAD) in myocardial perfusion imaging (MPI). The accuracy of the TID index is dependent on a well-determined threshold (normal limits) between normal and abnormal values for each study protocol. To date, the effects of neither gender nor attenuation correction (AC) on TID normal limits have been established. Thus, the objectives of this study were to determine if AC processing changes the normal value of the TID index and if there were gender-related differences in the TID index of normal patients who had undergone rest/exercise-stress technetium-99m sestamibi MPI. METHODS AND RESULTS: Seventy-five patients (33 women, 42 men; mean age, 57.7 +/- 11.7 y and 55.9 +/- 10.0 y, respectively) with less than a 5% likelihood of CAD, who had undergone low-dose rest/high-dose exercise-stress Tc-99m sestamibi MPI, were studied. All studies were acquired using simultaneous emission/transmission scans and were corrected for attenuation, scatter, and resolution effects using the ExSPECT II method. Both the AC and non-AC studies were analyzed using the Emory Cardiac Toolbox (ECTb; Syntermed, Inc, Atlanta, Ga) quantitative software. The TID index was calculated automatically as the ratio of stress mean left ventricular volumes to rest mean left ventricular volumes by ECTb. Patients were grouped by gender and the TID indices from AC and non-AC studies were compared. Linear regressions of the TID index and body mass index were analyzed to exclude differences in body size between male and female patients as a confounding factor in gender-related differences in TID. The TID index upper normal limits were calculated as the mean value plus 2 standard deviations (SDs). AC processing did not change the TID index significantly whether the genders were combined or separated (AC TID = 0.97 +/- 0.14 vs non-AC TID = 0.98 +/- 0.12 for all patients). Female patients showed higher mean TID indices than male patients in both AC (1.01 +/- 0.15 vs 0.95 +/- 0.12) and non-AC studies (1.00 +/- 0.15 vs. 0.97 +/- 0.10), but this difference was statistically significant only in AC studies (p = .03). TID indices remained constant across the range of body mass index studied. The TID index upper normal limit was 1.31 for female and 1.18 for male patients. CONCLUSION: TID normal values for rest/exercise-stress Tc-99m sestamibi MPI are gender-dependent and not affected by AC processing. Thus, diagnosticians should take into account these gender-related differences, as compared with the traditional value generated from mostly male populations, to ensure both men and women have the same overall accuracy of using the TID index in the diagnosis and prognosis of CAD.

Adult↗
PubMedDate not supplied

Patient gender-related performance of nonfocused helical computed tomography in the diagnosis of acute appendicitis.

OBJECTIVE: To determine the impact of patient gender on the performance of helical computed tomography (CT) in the diagnosis of acute appendicitis. MATERIALS AND METHODS: From January 1, 1996 to December 31, 2000, 650 consecutive nonfocused helical abdominal CT scans were performed in adult patients presenting with acute lower abdominal pain. In general, most patients received both intravenous and oral contrast with 5-mm scan collimation through the lower abdomen and pelvis; details regarding technique and overall accuracy have been published previously. We subanalyzed results with respect to patient gender-related differences, especially in false-positive and false-negative cases. A chi2 analysis was performed to determine if significant gender-related differences were present in major or minor CT diagnostic criteria for acute appendicitis, extra-appendiceal findings, sensitivity, specificity, and accuracy. RESULTS: Of the 650 patients, 552 had adequate clinical follow-up. The sensitivity for diagnosing acute appendicitis was 100% (65/65) in men and 93.6% (74/79) in women (P < 0.05); specificity was 96.2% (130/135) in men and 98.9% (272/275) in women (P > 0.05); and accuracy was 97.5% (193/198) in men and 97.6% in women (346/354) (P > 0.05). A thickened appendix and periappendiceal stranding were seen in 92.1% of men and 84.5% of women (P = 0.15) All 5 false-negative results were in thin women. In patients without acute appendicitis, CT was able to provide a relevant alternative diagnosis in 183 of 272 women (67.3%) and 81 of 130 men (62.3%) (P > 0.05). CONCLUSION: Nonfocused helical CT was highly accurate for diagnosing acute appendicitis in both men and women, although there was a slight but significant decrease in sensitivity in thin women.

Abdominal Pain↗
PubMed2003

[The option for vasectomy and gender relations].

A qualitative study was performed to: investigate the process that leads couples to decide for vasectomy; characterize the gender relations involved in this process; and identify sources of information on vasectomy. Semi-structured interviews were conducted with 20 couples who had requested vasectomy at the outpatient clinic of the Center for Integrated Women's Health Care, State University in Campinas, São Paulo, Brazil. A structured form was used to collect social, economic, and demographic data. The content analysis technique was used for data analysis. The majority of couples opted for vasectomy as a last resort after attempting numerous other contraceptive methods, not always successfully. The emerging gender relations showed fluctuation between: (1) a more rigid, quasi-patriarchal model characterized by male predominance in the family's decision-making and (2) a more ambiguous model in relation to reproductive decisions, whereby women assumed responsibility for contraception until the situation became untenable, at which point men faced up to the unavoidable necessity of sterilization. At this point the male partners felt they should collaborate.

Adult↗
PubMed1999

Gender-related clinical differences in obsessive-compulsive disorder.

The purpose of the present study was to investigate the gender-related differences of clinical features in a sample of obsessive-compulsive (OCD) patients. One hundred and sixty outpatients with a principal diagnosis of obsessive-compulsive disorder (DSM-IV, Y-BOCS = 16) were admitted. Patients were evaluated with a semi-structured interview covering the following areas: socio-demographic data, Axis I diagnoses (DSM-IV), OCD clinical features (age at onset of OC symptoms and disorder, type of onset, life events and type of course). For statistical analysis the sample was subdivided in two groups according to gender. We found an earlier age at onset of OC symptoms and disorder in males; an insidious onset and a chronic course of illness were also observed in that group of patients. Females more frequently showed an acute onset of OCD and an episodic course of illness; they also reported more frequently a stressful event in the year preceding OCD onset. A history of anxiety disorders with onset preceding OCD and hypomanic episodes occurring after OCD onset was significantly more common among males, while females showed more frequently a history of eating disorders. We found three gender-related features of OCD: males show an earlier age at onset with a lower impact of precipitant events in triggering the disorder; OCD seems to occur in a relative high proportion of males who already have phobias and/or tic disorders; and a surfeit of chronic course of the illness in males in comparison with females.

Adult↗
PubMed2001

Gender-related physiologic differences in human neonates and the greater vulnerability of males to developmental brain disorders.

OBJECTIVE: To examine whether gender-specific physiologic differences are present at birth and can be a basis for gender-specific vulnerability to developmental disorders in males. We report on three studies of male-female physiologic and structural differences in neonates and their relevance to observed differences in the incidence of developmental disorders in males. METHODS: Study I: 56 neonates were examined for cardiac reactivity to the Moro reflex. Study II: 863 neonates' basic anthropometric data were examined to demonstrate gender-specific differences in body proportions as a possible basis for psychophysiologic differences. Study III: Developmental data on 1000 one- to 26-week-old infants were analyzed for gender-specific developmental differences in rhythmic patterns of sleeping and eating. RESULTS: Study I: There were gender-related differences in heart rate reactivity (male > female). Study II: Male newborns had significantly larger head/chest proportions, suggesting that they may have a greater metabolic demand, related to brain size. Study III: Mothers reported that infant males' sleeping rhythm developed significantly later than females', and that they slept for shorter periods at night. CONCLUSIONS: Gender-related vulnerability in brain development is proposed, based on physiologic differences during a specific early sensitive period in development. This hypothesis may help to explain the overrepresentation of males reported for most developmental disorders.

Analysis of Variance↗
PubMed2000

Gender-related differences in murine T- and B-lymphocyte proliferative ability in response to in vivo [Met(5)]enkephalin administration.

Gender-related differences in response to drugs of abuse, such as cocaine and morphine, have been reported both in humans and in experimental animals. Besides causing analgesia, morphine has recently been shown to exert strong immunosuppressive activity. However, no data on the influence of gender on the immunomodulatory effects of morphine or opioid peptides have been reported yet. The aim of this study was to test the influence of gender on the immunomodulatory ability of the endogenous opioid peptide [Met(5)]enkephalin (MENK) in mice. This was done by comparing the proliferative ability of splenic T- and B-lymphocytes 14 h after systemic (intraperitoneal; i.p.) administration of [Met(5)]enkephalin (2.5, 5 or 10 mg/kg body weight). The proliferative ability of T- and B-lymphocytes was assessed by testing their in vitro response to graded concentrations of the T- and B-cell mitogens, concanavalin-A (Con-A) and lipopolysaccharide (LPS), respectively. The results obtained showed that [Met(5)]enkephalin, at a dose of 2.5 mg/kg, enhanced the proliferative ability of T-lymphocytes in male mice, but not in female mice. Similarly, [Met(5)]enkephalin, at doses of 2.5 and 5 mg/kg, enhanced the proliferative ability of splenic B-lymphocytes in male mice, whereas in female mice a decrease was observed ([Met(5)]enkephalin 2.5 mg/kg, LPS 10 microg/ml). [Met(5)]enkephalin, at a dose of 10 mg/kg, did not affect the proliferative ability of either lymphocyte population, regardless of gender. The [Met(5)]enkephalin-induced stimulatory effect on both T- and B-lymphocyte proliferation was reversed by naloxone (10 mg/kg body weight), injected prior to [Met(5)]enkephalin, suggesting an involvement of opioid receptors. Thus, the data presented provide evidence for the gender-related response of murine splenic lymphocytes to immunomodulation by [Met(5)]enkephalin, administered in vivo. This finding may be relevant to the potential use of [Met(5)]enkephalin in adjuvant therapy for immunocompromised states, such as acquired immunodeficiency syndrome (AIDS) or malignancies.

Animals↗
PubMed2006

Gender-related pathways for behavior problems in the offspring of alcoholic fathers.

The objective of the present study was to examine gender differences in the influence of paternal alcoholism on children's social-emotional development and to determine whether paternal alcoholism is associated with a greater number of externalizing symptoms in the male offspring. From the Mannheim Study of Risk Children, an ongoing longitudinal study of a high-risk population, the developmental data of 219 children [193 (95 boys and 98 girls) of non-alcoholic fathers, non-COAs, and 26 (14 boys, 12 girls) of alcoholic fathers, COAs] were analyzed from birth to the age of 11 years. Paternal alcoholism was defined according to the ICD-10 categories of alcohol dependence and harmful use. Socio-demographic data, cognitive development, number and severity of behavior problems, and gender-related differences in the rates of externalizing and internalizing symptoms were assessed using standardized instruments (IQ tests, Child Behavior Checklist questionnaire and diagnostic interviews). The general linear model analysis revealed a significant overall effect of paternal alcoholism on the number of child psychiatric problems (F = 21.872, d.f. = 1.217, P < 0.001). Beginning at age 2, significantly higher numbers of externalizing symptoms were observed among COAs. In female COAs, a pattern similar to that of the male COAs emerged, with the predominance of delinquent and aggressive behavior. Unlike male COAs, females showed an increase of internalizing symptoms up to age 11 years. Of these, somatic complaints revealed the strongest discriminating effect in 11-year-old females. Children of alcoholic fathers are at high risk for psychopathology. Gender-related differences seem to exist and may contribute to different phenotypes during development from early childhood to adolescence.

Alcoholism↗
PubMedDate not supplied

Gender-related differences among Turkish patients with obsessive-compulsive disorder.

The purpose of the present study was to investigate gender-related sociodemographic and clinical differences among Turkish patients with obsessive-compulsive disorder (OCD). A total of 169 patients diagnosed with OCD by DSM-III-R or DSM-IV criteria were included in this study. Male (n = 73) and female (n = 96) OCD patients were compared with respect to the demographic variables and the scores obtained from the Hamilton Rating Scale for Anxiety (HRSA), the Hamilton Rating Scale for Depression (HRSD) and the Yale-Brown Obsessive Compulsive Scale (Y-BOCS). We found a significantly earlier age at onset in male patients. No significant difference in terms of HARS, HDRS, and Y-BOCS scores was detected between the two groups. We observed a significantly higher frequency of contamination obsessions in females, and that of aggression and sexual obsessions in males. There was no significant difference in terms of the frequency of compulsions between the two groups. We also found that compulsion severity on obsessions/compulsions was higher in females and comorbidity rates of social phobia and schizophrenia were higher in males. Considering our results in combination with those of other studies, similarities rather than differences in gender-related sociodemographic and clinical characteristics of OCD patients across different populations seem to be present.

Adolescent↗
PubMed2003

Effects of reviewers' gender on assessments of a gender-related standardized manuscript.

BACKGROUND: Several factors including reviewers' gender can influence the assessment of submitted manuscripts. PURPOSE: This study was designed to investigate the effects of reviewers' gender on the assessment of a gender-related study. METHOD: One hundred reviewers (50 women) were randomly selected from Academic Medicine's reviewer pool. Two versions of an empirical study of medical students in which women forecast a lower professional income than men were prepared, and each version was randomly assigned to 25 men and 25 women reviewers. The two versions were identical except for one sentence in the abstract and two sentences in the conclusion. Version 1 attributed the lower forecast income of women to intrinsic gender factors (e.g., lower financial incentives). Version 2 attributed the difference to extrinsic social learning factors (e.g., socialization bias). RESULTS: Results showed no significant gender difference in reviewers' evaluations of the two manuscript versions. CONCLUSION: Although no evidence of reviewers' gender bias was found in this study, alternative explanations of the findings suggest that further empirical research is needed.

Double-Blind Method↗
PubMed1997

Gender-related considerations in clinical pharmacology and drug therapeutics.

The pharmacokinetics and pharmacodynamics in women are different from that in men because of women's unique anatomy and physiology. Recently, gender-related studies in clinical pharmacology have been emerging, supporting the observation of gender-induced variations in drug response. The hormonal fluctuations during a woman's life span may influence pharmacotherapy. Therefore, gender-related pharmacology should be taken into consideration when prescribing medication for a woman. Data from drug developmental studies, FDA approved label directions, and other clinical research evaluation women's responses to medications are necessary to make optimal pharmacotherapeutic decisions.

Female↗
PubMed2002

Gender-related traits of heterosexual and homosexual men and women.

Two studies investigated the relation between sexual orientation and gender-related traits. Analyzing data from an Internet survey, Study 1 found that gay men and lesbians differed from same-sex heterosexuals most strongly on gender diagnosticity (GD) measures, which assess male- versus female-typicality of occupational preferences (effect sizes were 1.14 for men and 0.53 for women) and least strongly on instrumentality (I) and expressiveness (E). Study 2 found that GD measures showed large differences between 289 gay and 200 heterosexual men (d = 0.95) and between 296 lesbian and 435 heterosexual women (d = 1.32), whereas I and E showed much smaller differences. In Study 2 homosexual-heterosexual diagnosticity measures, computed from men's and women's occupational preferences, correlated very strongly with GD measures (r = 0.88 for men and 0.89 for women), indicating that occupational preference items that distinguished men from women also tended to distinguish heterosexual from homosexual individuals. LISREL 8 analyses showed that self-ascribed masculinity-femininity did not mediate the strong relation between sexual orientation and GD for men or for women.

Adolescent↗
PubMed1999

Gender related differences in ATP-dependent transport of dinitrophenyl-glutathione conjugate across murine canalicular liver plasma membrane.

The present study reports gender related differences in ATP-dependent transport of dinitrophenyl-glutathione (GSH) conjugate (DNP-SG), a model GSH xenobiotic conjugate, across murine canalicular liver plasma membrane (cLPM). ATP-dependent transport of DNP-SG across female A/J mouse cLPM was mediated by two components, a high-affinity and a low-affinity component, with corresponding Km of 18 microM (Vmax 0.02 nmol/min.mg) and 500 microM (Vmax 0.23 nmol/min.mg), respectively. On the other hand, only one component for the ATP-dependent transport of DNP-SG was observed in male mouse cLPM (K(m) 130 microM; Vmax 0.18 nmol/min.mg). Moreover, the rate of ATP-dependent transport of DNP-SG was markedly higher in the cLPM fraction of male mouse compared with that of the female. Presence of two transport components in female mouse cLPM, but only one system in the cLPM fraction of male mouse, was confirmed by measuring DNP-SG mediated stimulation of ATP hydrolysis (DNP-SG ATPase activity). To the best of our knowledge, the present study is the first report on gender related differences in ATP-dependent murine canalicular transport of GSH conjugates.

Adenosine Triphosphate↗
PubMed2005

[Gender-related differences in pharmacokinetics and pharmacodynamics].

Following the negative experience with thalidomide, women were excluded from participation in clinical trials with new pharmaceutical agents as far as possible, especially from phase I studies. However, in the early 1990s a body of evidence accumulated suggesting clinically relevant gender-related differences in the efficacy and safety of drugs. Gender-related differences have been shown for the metabolism and the effects of drugs. Gender differences have been described especially for the enzymes of the cytochrome P 450 family, but also for phase II reactions and most recently for P-glycoprotein. Most of these differences observed are only of minor clinical relevance, however may result in an increased rate of adverse drug reactions. Further differences may be based on different receptor/target sensitivities, e. g. the increased sensitivity for drug-induced torsade de pointes arrhythmia in women. In addition, in complex diseases such as heart failure, men and women may develop different mechanisms of counter- regulation requiring different therapeutic approaches. Population-based approaches demonstrate gender differences in the incidence of adverse drug reactions.

Clinical Trials as Topic↗
PubMed2001

Gender-related differences in acute rehabilitation lengths of stay, charges, and functional outcomes for a matched sample with spinal cord injury: a multicenter investigation.

OBJECTIVE: To examine the effects of gender on length of stay (LOS), treatment costs, and outcomes by using a matched sample of patients with spinal cord injury (SCI). DESIGN: A 2 x (15 x 3) mixed, block design was used retrospectively to analyze the impact of gender on subjects matched for age, American Spinal Injury Association (ASIA) motor impairment classification, and level of neurologic injury. SETTING: Twenty medical centers in the federally sponsored Spinal Cord Injury Model Systems project. PARTICIPANTS: One thousand seventy-four adult patients with SCI admitted between 1988 and 1998 were assessed at acute-care admission, inpatient rehabilitation admission, and inpatient rehabilitation discharge. INTERVENTIONS: Not applicable. MAIN OUTCOME MEASURES: ASIA motor index and FIM instrument admission, discharge, and efficiency scores; rehabilitation LOS and medical care charges; and discharge disposition. RESULTS: Analysis revealed no gender-related differences in FIM motor scores on admission and discharge. No differences in FIM motor efficiencies or daily change were observed. No significant differences were found for ASIA motor scores on acute-care admission and rehabilitation discharge. No differences in acute rehabilitation LOS and charges were observed. No gender-related differences were seen in the likelihood of discharge to an institutional setting. CONCLUSION: Gender was not a significant factor in functional outcome of SCI patients after acute rehabilitation.

Activities of Daily Living↗
PubMed2004

[Gender-related differences in metabolism of the enantiomers of trans tramadol and trans O-demethyltramadol in rat liver microsomes].

AIM: To investigate the gender-related differences in the metabolism of trans tramadol (trans T) enantiomers and the glucuronidation of trans O-demethyltramadol (M1) enantiomers. METHODS: In vitro, trans T or M1 were separately incubated with liver microsomes of male or female rats. The concentrations of the enantiomers of trans T and M1 were determined by an HPCE method. RESULTS: Compared with (+)-enantiomers, (-)-trans T was preferentially metabolized, and (-)-M1 was produced faster in rat liver microsomes. (+)-M1 and (-)-M1 were preferentially glucuronidated in the liver microsomes of male and female rats, respectively. Compared with those in male rat liver microsomes, the enantiomeric ratios of CLint for M1 formation and M1 glucuronidation were more deviated from 1 in female rat liver microsomes. CONCLUSION: In vitro, trans T metabolism, M1 formation and M1 glucuronidation were found to be stereoselective in rat liver microsomes. There were gender-related differences in the stereoselectivity in M1 formation and M1 glucuronidation, with a larger extent in female rat liver microsomes.

Analgesics, Opioid↗
PubMed1999

Women's fears and men's anxieties: the impact of family planning on gender relations in northern Ghana.

The Navrongo experiment, a family planning and health project in northern Ghana, has demonstrated that an appropriately designed, community-based family planning program can produce a change in contraceptive practice that had been considered unattainable in such a setting. Simultaneously, however, evidence suggests that newly introduced family planning services and contraceptive availability can activate tension in gender relations. In this society, where payment of bridewealth signifies a woman's requirement to bear children, there are deeply ingrained expectations about women's reproductive obligations. Physical abuse and reprisals from the extended family pose substantial threats to women; men are anxious that women who practice contraception might be unfaithful. Data from focus-group discussions with men and women are examined in this report and highlight the strains on gender relations resulting from contraceptive use. The measures taken to address this problem and methods of minimizing the risk of adverse social consequences are discussed.

Adult↗