Browsing by Subject "sex"

Now showing 1 - 10 of 12
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    Chronic Pain Management: The Importance of Sex and Gender-Based Approach
    (2020-09-12) Sedaghat, A; Rohr-Kirchgraber, T.
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    Evaluation of Joint Space Width and Narrowing After Isolated Partial Medial Meniscectomy for Degenerative Medial Meniscus Tears
    (SAGE Publications, 2013-10) Shelbourne, K. Donald; Barnes, Adam F.; Urch, Scott E.; Gray, Tinker; Department of Orthopaedic Surgery, IU School of Medicine
    BACKGROUND: Few studies have evaluated the effect of existing articular cartilage damage and sex on joint space measurements after isolated degenerative medial meniscus tears. PURPOSE: To determine what factors affected joint space width and narrowing in patients after removal of isolated degenerative medial meniscus tears. STUDY DESIGN: Cohort study; Level of evidence, 2. METHODS: A total of 62 patients (15 women and 47 men) with all ligaments intact, no previous surgery to either knee, and an isolated degenerative medial meniscus tear removed in 1 knee were examined. The mean age at examination was 58.2 years at a mean follow-up of 9.4 years (range, 4-20 years). Subjective results were obtained with the International Knee Documentation Committee (IKDC) knee survey. Radiographs were taken using 45° weightbearing posteroanterior views. Midpoint and perceived minimum joint space width of the medial and lateral compartments of both knees were measured to the nearest 0.1 mm by 2 observers at different times, and they were blinded as to the previous measurements (Pearson intra- and interclass correlations, >0.93). Joint space narrowing was found by calculating the difference in joint space width between knees. Percentage of normal joint space loss was calculated by dividing joint space narrowing by the joint space width in the contralateral knee. Other factors considered were patient sex and Outerbridge grading of articular cartilage. RESULTS: Women had a mean 1.5 mm less normal joint space width than men in the involved and noninvolved knees (P < .01). Mean joint space narrowing was 0.7 mm for both measurements. The mean ± standard deviation narrowing was 0.4 ± 1.2 mm for patients with grade 0-2 damage and 1.1 ± 1.3 for patients with grade 3-4 damage (P = .04). Five women (33%) and 3 men (6%) had narrowing of >50% of the normal joint space as measured in the noninjured knee (P = .016). The mean IKDC total score was 66.1 points for women, which was statistically significantly lower than the mean of 82.7 points for men (P < .01). CONCLUSION: Patients undergoing partial medial meniscectomy have greater joint space narrowing and lower subjective scores after surgery if they also have existing Outerbridge grade 3-4 damage. Women have less normal joint space than men, and more women than men experience >50% joint space narrowing after surgery.
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    "From Hygiene to Health: Indiana University's Dr. Thurman Rice"
    (2016-03-23) Bowen-Potter, Angela
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    Inhibiting oestrogen signalling in pulmonary arterial hypertension: sex, drugs and research
    (European Respiratory Society, 2017-08-03) Lahm, Tim; Kawut, Steven M.; Medicine, School of Medicine
    Pulmonary arterial hypertension (PAH) is a sexually dimorphic disease that affects women more than men. Several pre-clinical and clinical studies identified 17β-oestradiol (E2), the most abundant female sex hormone, and/or its metabolite 16α-hydroxyoestrone as disease mediators in PAH (reviewed by Lahm et al. [1], and Foderaro and Venteuolo [2]). A recent case–control study even demonstrated significantly higher levels of E2 in men with PAH compared to controls [3]., Inhibition of oestrogen signalling in PAH is currently being studied clinically but several questions remain http://ow.ly/G7xK30cPN5M
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    Measurement invariance of the Patient Health Questionnaire-9 (Phq-9) depression screener in U.S. adults across sex, race/ethnicity, and education level: Nhanes 2005-2014
    (2017-11-10) Patel, Jay Sunil; Stewart, Jesse C.; Rand, Kevin L.; Cyders, Melissa A.
    Importance: Despite its widespread use in clinical settings and in behavioral medicine research, little is known about the psychometric performance of the PHQ-9 across major U.S. sociodemographic groups. Thus, utilizing a large sample representative of the U.S. population and confirmatory factor analysis (CFA), we determine the factor structure and measurement invariance of the PHQ-9 across groups based on sex, race/ethnicity, and education level. Objective: Our objective was to address key knowledge gaps by definitively determining the factor structure and measurement invariance of the PHQ-9 across major U.S. sociodemographic groups based on sex, race/ethnicity, and education level. Design: The continuous National Health and Nutrition Examination Survey (NHANES) is a cross-sectional, epidemiologic study designed to assess the health and nutritional status of the U.S. population. We examined data from the 2005-2014 survey years. Setting: NHANES is uses a stratified multistage probability sampling approach to enroll civilian, non-institutionalized adults and children in the U.S. Participants: For our final sample, we selected the 26,202 adult respondents with no missing PHQ-9 data. The factors of interest were sex (49.3% men, 50.7% women), race/ethnicity (48.9% non-Hispanic White, 23.7% non-Hispanic Black, 17.8% Mexican American, 9.7% other Hispanic), and education level (9.9% less than 9th grade, 16.6% 9th-12th grade but no diploma, vii 23.7% high school graduate/GED or equivalent, 28.9% some college or Associate’s degree, 20/8% college graduate or above). Main Outcome(s) and Measure(s): The Patient Health Quessionnaire-9 (PHQ-9) Results: Results revealed that the best solution for the PHQ-9 consists of a cognitive/affective factor (items 1. anhedonia, 2. depressed mood, 6. feelings of worthlessness, 7. concentration difficulties, 8. psychomotor disturbances, and 9. thoughts of death) and a somatic factor (items 3. sleep disturbance, 4. fatigue, and 5. appetite changes; RMSEA = 0.034, RMSEA 90% CI = 0.032–0.036, TLI = 0.984, CFI = 0.988). To evaluate measurement invariance, we then conducted single-group and multiple-group CFAs to carry out the 5 steps of measurement invariance testing. Dimensional, configural, weak factorial, strong factorial, and strict factorial invariance was established for the PHQ-9 across the sex, race/ethnicity, and education level groups, as all models demonstrated close fit and the ΔCFI was < 0.010 for all steps. Conclusions and Relevance: Using a U.S. representative sample, we determined that a two-factor solution for the PHQ-9 with a cognitive/affective factor and a somatic factor is invariant across sex, race/ethnicity, and education level groups. Therefore, clinically, the PHQ-9 is an acceptable measure to utilize in major U.S. sociodemographic groups, extending the use of this depression screener from the primary care clinic to the community. Additionally, we show that PHQ-9 cognitive/affective and somatic subscale scores have the same meaning and can be compared across major U.S. sociodemographic groups and provide a consistent, evidence-based approach to computing PHQ-9 subscale scores to be used in future studies.
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    Pain-Related Rumination, But Not Magnification or Helplessness, Mediates Race and Sex Differences in Experimental Pain
    (Elsevier, 2017-03) Meints, Samantha M.; Stout, Madison; Abplanap, Samuel; Hirsh, Adam T.; Department of Psychology, School of Science
    Compared with white individuals and men, black individuals and women show a lower tolerance for experimental pain stimuli. Previous studies suggest that pain catastrophizing is important in this context, but little is known about which components of catastrophizing contribute to these race and sex differences. The purpose of the current study was to examine the individual components of catastrophizing (rumination, magnification, and helplessness) as candidate mediators of race and sex differences in experimental pain tolerance. Healthy undergraduates (N = 172, 74% female, 43.2% black) participated in a cold pressor task and completed a situation-specific version of the Pain Catastrophizing Scale. Black and female participants showed a lower pain tolerance than white (P < .01, d = .70) and male (P < .01, d = .55) participants, respectively. Multiple mediation analyses indicated that these race and sex differences were mediated by the rumination component of catastrophizing (indirect effect = −7.13, 95% confidence interval (CI), −16.20 to −1.96, and 5.75, 95% CI, .81–15.57, respectively) but not by the magnification (95% CI, −2.91 to 3.65 and −1.54 to 1.85, respectively) or helplessness (95% CI, −5.53 to 3.31 and −.72 to 5.38, respectively) components. This study provides new information about race and sex differences in pain and suggests that treatments targeting the rumination component of catastrophizing may help mitigate pain-related disparities.
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    Sex Affects Myocardial Blood Flow and Fatty Acid Substrate Metabolism in Humans with Nonischemic Heart Failure
    (Springer, 2017-08) Kadkhodayan, Ana; Lin, C. Huie; Coggan, Andrew R.; Herrero, Pilar; Kisrieva-Ware, Zulfia; Schechtman, Kenneth B.; Novak, Eric; Joseph, Susan M.; Dávila-Román, Víctor G.; Gropler, Robert J.; Dence, Carmen; Peterson, Linda R.; Kinesiology, School of Health and Human Sciences
    In animal models of heart failure (HF), myocardial metabolism shifts from the normal preference for high-energy fatty acid (FA) metabolism towards the more efficient fuel, glucose. However, FA (vs. glucose) metabolism generates more ATP/mole; thus FA metabolism may be especially advantageous in HF. Sex modulates myocardial blood flow (MBF) and substrate metabolism in normal humans. Whether sex affects MBF and metabolism in patients with HF is unknown. We studied 19 well-matched men and women with nonischemic HF with similar ejection fractions (all ≤ 35%). MBF and myocardial substrate metabolism were quantified using positron emission tomography. Women had higher MBF (mL/g/min), FA uptake (mL/g/min), utilization (nmol/g/min) (P<0.005, <0.005, <0.05, respectively) and trended towards higher FA oxidation than men (P=0.09). These findings were independent of age, obesity, and insulin resistance. There were no sex-related differences in fasting myocardial glucose uptake or metabolism. In an exploratory analysis of the longitudinal follow-up of these subjects (mean 7 y), we found that 4 men had a major cardiovascular event, while one woman died of non-cardiac causes. Higher MBF related to improved event-free survival (HR=0.31, P=0.02). In sum, in nonischemic HF, women have higher MBF and FA uptake and metabolism than men, and these changes are not due to differences in other variables that can affect myocardial metabolism (e.g., age, obesity, or insulin resistance). Moreover, higher MBF portends a better prognosis. These sex-related differences should be taken into account in the development and targeting of novel agents aimed at modulating in MBF and metabolism in HF.
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    Sex Differences in Emotion Recognition and Emotional Inferencing Following Severe Traumatic Brain Injury
    (Elsevier, 2017-03) Zupan, Barbra; Babbage, Duncan; Neumann, Dawn; Willer, Barry; Department of Physical Medicine and Rehabilitation, IU School of Medicine
    The primary objective of the current study was to determine if men and women with traumatic brain injury (TBI) differ in their emotion recognition and emotional inferencing abilities. In addition to overall accuracy, we explored whether differences were contingent upon the target emotion for each task, or upon high- and low-intensity facial and vocal emotion expressions. A total of 160 participants (116 men) with severe TBI completed three tasks – a task measuring facial emotion recognition (DANVA-Faces), vocal emotion recognition (DANVA-Voices) and one measuring emotional inferencing (emotional inference from stories test (EIST)). Results showed that women with TBI were significantly more accurate in their recognition of vocal emotion expressions and also for emotional inferencing. Further analyses of task performance showed that women were significantly better than men at recognising fearful facial expressions and also facial emotion expressions high in intensity. Women also displayed increased response accuracy for sad vocal expressions and low-intensity vocal emotion expressions. Analysis of the EIST task showed that women were more accurate than men at emotional inferencing in sad and fearful stories. A similar proportion of women and men with TBI were impaired (≥ 2 SDs when compared to normative means) at facial emotion perception, χ2 = 1.45, p = 0.228, but a larger proportion of men was impaired at vocal emotion recognition, χ2 = 7.13, p = 0.008, and emotional inferencing, χ2 = 7.51, p = 0.006.
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    Sex Differences in Motivation to Self‐Administer Alcohol After 2 Weeks of Abstinence in Young‐Adult Heavy Drinkers
    (Wiley, 2018) Plawecki, Martin Henry; White, Kurt; Kosobud, Ann E. K.; Grahame, Nicholas; Zimmermann, Ulrich S.; Crabb, David; O'Connor, Sean; Psychiatry, School of Medicine
    Background Studies in animal models document that forced abstinence from usual consumption of alcohol changes subsequent seeking and consumption, with increases or decreases depending on the species, duration of abstinence, number of deprivations, and sex. Human laboratory‐based alcohol deprivation studies are rare. Methods We conducted a 2‐session, within‐participant, randomized‐order comparison of intravenous, progressive ratio, alcohol self‐administration during 2.5 hours of progressive work for alcohol and/or vehicle; once while the participants pursued their usual drinking habits and once after 2 weeks of closely monitored, voluntary outpatient abstinence from alcohol. The schedule of work for rewards and the incremental increases in breath alcohol concentration following completion of an alcohol work‐set were identical across participants. Fifty young‐adult (27 men), heavy‐drinking participants completed both sessions. Our primary hypothesis was that motivation to work for alcohol after 2 weeks of abstinence would be greater in participants with a weekly binge pattern of drinking, compared to those who regularly drink heavily, and we intended to explore associations with biological family history of alcoholism and sex. Results We detected no change in work for alcohol associated with recent drinking history. However, females, on average, increased their work for alcohol upon resumption after 2 weeks of abstinence (mean ± SEM = +16.3 ± 9.6%), while males decreased that work (−24.8 ± 13.8%). The sex difference was substantial and significant (p < 0.03), with a medium effect size (Cohen's d = 0.63). Conclusions We believe a more comprehensive study of mechanisms underlying the sex differences in the human postabstinence response is warranted.