Catalogue Search | MBRL
Are you sure you want to remove the book from the shelf?
{{itemTitle}}
42,576
result(s) for
"Sex factors in disease"
Sort by:
Autism and gender : from refrigerator mothers to computer geeks
\"The reasons behind the increase in autism diagnoses have become hotly contested in the media as well as within the medical, scholarly, and autistic communities. Jordynn Jack suggests the proliferating number of discussions point to autism as a rhetorical phenomenon that engenders attempts to persuade through arguments, appeals to emotions, and representational strategies. In Autism and Gender: From Refrigerator Mothers to Computer Geeks, Jack focuses on the ways gender influences popular discussion and understanding of autism's causes and effects. She identifies gendered theories like the \"refrigerator mother\" theory, for example, which blames emotionally distant mothers for autism, and the \"extreme male brain\" theory, which links autism to the modes of systematic thinking found in male computer geeks. Jack's analysis reveals how people employ such highly gendered theories to craft rhetorical narratives around stock characters--fix-it dads, heroic mother warriors rescuing children from autism--that advocate for ends beyond the story itself while also allowing the storyteller to gain authority, understand the disorder, and take part in debates. Autism and Gender reveals the ways we build narratives around controversial topics while offering new insights into the ways rhetorical inquiry can and does contribute to conversations about gender and disability\"-- Provided by publisher.
Book
Association between antipsychotic use and acute ischemic heart disease in women but not in men: a retrospective cohort study of over one million primary care patients
Background
Research comparing sex differences in the effects of antipsychotic medications on acute ischemic heart disease (IHD) is limited and the findings ambiguous. This study aimed to investigate these associations within a primary care setting.
Methods
Hong Kong public general outpatient electronic records of patients aged 45+ during 2007–2010 were extracted, with the last consultation date as the baseline for a 4-year follow-up period to observe acute IHD hospitalizations (2011–2014). Antipsychotic use was defined as any prescription over the previous 12 months from a list of 16 antipsychotics, while acute IHD was defined by ICD-9: 410.00–411.89. Both sex-specific and sex-combined (both sexes) mixed-effects Cox models (random intercept across 74 clinics) were implemented to examine the association and test the interaction between antipsychotics and sex.
Results
Among 1,043,236 included patients, 17,780 (1.7%) were prescribed antipsychotics, and 8342 (0.8%) developed IHD. In sex-specific analyses, antipsychotic prescription was associated with a 32% increased hazard rate of acute IHD among women (95% CI 1.05–1.67) but not among men. A likelihood ratio test comparing sex-combined models with and without the interaction between antipsychotic use and sex suggested significant interaction (
χ
2
= 4.72,
P
= 0.030). The association between antipsychotic use and IHD among women attenuated and became non-significant when haloperidol was omitted from the operationalization of antipsychotic use (HR = 1.23, 95% CI 0.95–1.60).
Conclusion
Our results suggest that antipsychotic prescription is moderately associated with an increased risk of acute IHD among women in primary care and this relationship may be explained by specific antipsychotics. Further research should observe and capture the potential intermediary mechanisms and the dose-response relationship of this association to provide more rigorous evidence to establish causality and inform clinical practices.
Journal Article
Health and gender : resilience and vulnerability factors for women's health in the contemporary society
This book presents a concise and comprehensive overview of the most important protective and risk factors for women's health, and reviews the main areas of medical science from a gender perspective. Numerous scientific experiments and studies have shown how gender differences significantly affect the clinical presentation of physical and mental health disorders as well as responses to treatments. This text highlights these issues, while at the same time reflecting on the practical implications of the theoretical knowledge presented. It also examines the organization of social and health services, which should increasingly take into account the specificities related to gender differences and where equality is based on truly embracing these differences. The final part provides insights into the experiences and testimonies collected by the authors of the book. Written by a multidisciplinary team of medical, psychosocial and humanities professionals, this book is of interest to health professionals and medical students. -- Provided by publisher.
Book
Predictive accuracy of the Framingham coronary risk score in British men:prospective cohort study
Abstract Objective To establish the predictive accuracy of the Framingham risk score for coronary heart disease in a representative British population. Design Prospective cohort study. Setting 24 towns in the United Kingdom. Participants 6643 British men aged 40-59 years and free from cardiovascular disease at entry into the British regional heart study. Main outcome measures Comparison of observed 10 year coronary heart disease mortality and event rates with predicted rates for each individual, using the relevant Framingham risk equation. Results Of 6643 men, 2.8% (95% confidence interval 2.4% to 3.2%) died from coronary heart disease compared with 4.1% predicted (relative overestimation 47%, P < 0.0001). A fatal or non-fatal coronary heart disease event occurred in 10.2% (9.5% to 10.9%) of the men compared with 16.0% predicted (relative overestimation 57%, P < 0.0001). These relative degrees of overestimation were similar at all levels of coronary heart disease risk, so that overestimation of absolute risk was greatest for those at highest risk. A simple adjustment provided an improved level of accuracy. In a “high risk score” approach, most cases occur in the low risk group. In this case, 84% of the deaths from coronary heart disease and non-fatal events occurred in the 93% of men classified at low risk (< 30% in 10 years) by the Framingham score. Conclusion Guidelines for the primary prevention of coronary heart disease advocate offering preventive measures to individuals at high risk. Currently recommended risk scoring methods derived from the Framingham study significantly overestimate the absolute coronary risk assigned to individuals in the United Kingdom.
Journal Article
COVID-19 and Sex Differences: Mechanisms and Biomarkers
Men are consistently overrepresented in severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection, and coronavirus disease 2019 (COVID-19) severe outcomes, including higher fatality rates. These differences are likely due to gender-specific behaviors, genetic and hormonal factors, and sex differences in biological pathways related to SARS-CoV-2 infection. Several social, behavioral, and comorbid factors are implicated in the generally worse outcomes in men compared with women. Underlying biological sex differences and their effects on COVID-19 outcomes, however, have received less attention. The present review summarizes the available literature regarding proposed molecular and cellular markers of COVID-19 infection, their associations with health outcomes, and any reported modification by sex. Biological sex differences characterized by such biomarkers exist within healthy populations and also differ with age- and sex-specific conditions, such as pregnancy and menopause. In the context of COVID-19, descriptive biomarker levels are often reported by sex, but data pertaining to the effect of patient sex on the relationship between biomarkers and COVID-19 disease severity/outcomes are scarce. Such biomarkers may offer plausible explanations for the worse COVID-19 outcomes seen in men. There is the need for larger studies with sex-specific reporting and robust analyses to elucidate how sex modifies cellular and molecular pathways associated with SARS-CoV-2. This will improve interpretation of biomarkers and clinical management of COVID-19 patients by facilitating a personalized medical approach to risk stratification, prevention, and treatment.
Journal Article
Cumulative Risk, Age at Onset, and Sex-Specific Differences for Developing End-Stage Renal Disease in Young Patients With Type 1 Diabetes: A Nationwide Population-Based Cohort Study
This study aimed to estimate the current cumulative risk of end-stage renal disease (ESRD) due to diabetic nephropathy in a large, nationwide, population-based prospective type 1 diabetes cohort and specifically study the effects of sex and age at onset.
In Sweden, all incident cases of type 1 diabetes aged 0-14 years and 15-34 years are recorded in validated research registers since 1977 and 1983, respectively. These registers were linked to the Swedish Renal Registry, which, since 1991, collects data on patients who receive active uremia treatment. Patients with > or =13 years duration of type 1 diabetes were included (n = 11,681).
During a median time of follow-up of 20 years, 127 patients had developed ESRD due to diabetic nephropathy. The cumulative incidence at 30 years of type 1 diabetes duration was low, with a male predominance (4.1% [95% CI 3.1-5.3] vs. 2.5% [1.7-3.5]). In both male and female subjects, onset of type 1 diabetes before 10 years of age was associated with the lowest risk of developing ESRD. The highest risk of ESRD was found in male subjects diagnosed at age 20-34 years (hazard ratio 3.0 [95% CI 1.5-5.7]). In female subjects with onset at age 20-34 years, the risk was similar to patients' diagnosed before age 10 years.
The cumulative incidence of ESRD is exceptionally low in young type 1 diabetic patients in Sweden. There is a striking difference in risk for male compared with female patients. The different patterns of risk by age at onset and sex suggest a role for puberty and sex hormones.
Journal Article
Cardiovascular risk management in patients using antipsychotics: it is time to take action
[...]of such increased use, long-term side effects of antipsychotic drugs may increase the burden on patients and healthcare services globally. Important known intermediate variables, like cholesterol and blood glucose level, and an unhealthy lifestyle, were not taken into account. [...]confounding by indication cannot be ruled out. [...]dose reduction and switching to an antipsychotic drug with a better metabolic profile are promising strategies to lower cardiometabolic risk. [...]barriers in access and communication between family physicians and patients using antipsychotic drugs may further complicate implementation of cardiovascular risk screening and treatment. Time to take action Given the complex nature of causal factors (indications for prescription), the unknown impact of the various intermediate factors (pathophysiological and biochemical parameters; lifestyle factors), and the unknown effectiveness of the required complex interventions, we argue that the study by Lai and colleagues is exploratory in nature and should be applied carefully in clinical practice.
Journal Article
Sexual dimorphism in cardiometabolic health: the role of adipose tissue, muscle and liver
Obesity is associated with many adverse health effects, such as an increased cardiometabolic risk. Despite higher adiposity for a given BMI, premenopausal women are at lower risk of cardiometabolic disease than men of the same age. This cardiometabolic advantage in women seems to disappear after the menopause or when type 2 diabetes mellitus develops. Sexual dimorphism in substrate supply and utilization, deposition of excess lipids and mobilization of stored lipids in various key metabolic organs (such as adipose tissue, skeletal muscle and the liver) are associated with differences in tissue-specific insulin sensitivity and cardiometabolic risk profiles between men and women. Moreover, lifestyle-related factors and epigenetic and genetic mechanisms seem to affect metabolic complications and disease risk in a sex-specific manner. This Review provides insight into sexual dimorphism in adipose tissue distribution, adipose tissue, skeletal muscle and liver substrate metabolism and tissue-specific insulin sensitivity in humans, as well as the underlying mechanisms, and addresses the effect of these sex differences on cardiometabolic health. Additionally, this Review highlights the implications of sexual dimorphism in the pathophysiology of obesity-related cardiometabolic risk for the development of sex-specific prevention and treatment strategies.This Review provides insight into sexual dimorphism in adipose tissue distribution and substrate metabolism in adipose tissue, skeletal muscle and liver, as well as the underlying mechanisms. The effects of these sex differences on cardiometabolic health are outlined and the potential for developing sex-specific prevention and treatment strategies is discussed.
Journal Article
Sex differences in anxiety and depression: circuits and mechanisms
Epidemiological sex differences in anxiety disorders and major depression are well characterized. Yet the circuits and mechanisms that contribute to these differences are understudied, because preclinical studies have historically excluded female rodents. This oversight is beginning to be addressed, and recent studies that include male and female rodents are identifying sex differences in neurobiological processes that underlie features of these disorders, including conflict anxiety, fear processing, arousal, social avoidance, learned helplessness and anhedonia. These findings allow us to conceptualize various types of sex differences in the brain, which in turn have broader implications for considering sex as a biological variable. Importantly, comparing the sexes could aid in the discovery of novel therapeutics.Male-only studies predominate preclinical research on anxiety and depression. In this Review, Bangasser and Cuarenta discuss how, since the inclusion of female subjects, new mechanisms have been identified that underlie vulnerability to these disorders, and that reveal novel targets for treatments.
Journal Article
Sex disparities matter in cancer development and therapy
Curing cancer through precision medicine is the paramount aim of the new wave of molecular and genomic therapies. Currently, whether patients with non-reproductive cancers are male or female according to their sex chromosomes is not adequately considered in patient standard of care. This is a matter of consequence because there is growing evidence that these cancer types generally initiate earlier and are associated with higher overall incidence and rates of death in males compared with females. Gender, in contrast to sex, refers to a chosen sexual identity. Hazardous lifestyle choices (notably tobacco smoking) differ in prevalence between genders, aligned with disproportionate cancer risk. These add to underlying genetic predisposition and influences of sex steroid hormones. Together, these factors affect metabolism, immunity and inflammation, and ultimately the fidelity of the genetic code. To accurately understand how human defences against cancer erode, it is crucial to establish the influence of sex. Our Perspective highlights evidence from basic and translational research indicating that including genetic sex considerations in treatments for patients with cancer will improve outcomes. It is now time to adopt the challenge of overhauling cancer medicine based on optimized treatment strategies for females and males.This Perspective highlights the evidence from basic and translational research that genetic sex influences multiple factors that can contribute to cancer development and treatment responses, and suggests that including genetic sex considerations in treatments for patients with cancer will improve outcomes.
Journal Article