scholarly journals Patient–physician gender concordance and increased mortality among female heart attack patients

2018 ◽  
Vol 115 (34) ◽  
pp. 8569-8574 ◽  
Author(s):  
Brad N. Greenwood ◽  
Seth Carnahan ◽  
Laura Huang
Keyword(s):  
Heart Attack ◽  
Survival Rates ◽  
Myocardial Infarctions ◽  
Female Physicians ◽  
Heart Attacks ◽  
Female Patients ◽  
Patient Gender ◽  
Gender Concordance ◽  
Male Patients ◽  
Patients Experience

We examine patient gender disparities in survival rates following acute myocardial infarctions (i.e., heart attacks) based on the gender of the treating physician. Using a census of heart attack patients admitted to Florida hospitals between 1991 and 2010, we find higher mortality among female patients who are treated by male physicians. Male patients and female patients experience similar outcomes when treated by female physicians, suggesting that unique challenges arise when male physicians treat female patients. We further find that male physicians with more exposure to female patients and female physicians have more success treating female patients.

Abstract 439: Gender Bias in Prehospital Chest Pain Management: Do female Paramedics Under-treat patients With Chest Pain?

Hypertension ◽  
2012 ◽  
Vol 60 (suppl_1) ◽  
Author(s):  
Nabil El Sanadi ◽  
Todd Leduc ◽  
David Erdman ◽  
Jason Mansour ◽  
Gabriel Thornton
Keyword(s):  
Chest Pain ◽  
Pain Score ◽  
Gender Bias ◽  
Pain Tolerance ◽  
Coronary Insufficiency ◽  
Female Patients ◽  
Patient Gender ◽  
Score Difference ◽  
Injury Patient ◽  
Male Patients

Introduction: Patients with possible coronary insufficiency should undergo aggressive treatment to minimize the pain, since chest pain is a correlate of myocardial ischemia and injury. Patient gender should not affect the intensity of therapy. METHODS: A retrospective run-sheet review from a large prehospital system (684 paramedics E.M.S. approximately 17,000 runs/year) was done to determine the gender of the lead paramedic, the gender of the patient and the chest pain score difference pre-and post-treatment. Treatment included standard therapy of oxygen, nitroglycerin and morphine. A pain score of 0-10 was used. All runs with “chest pain” as the chief complaint were reviewed from 4/2007 to 7/2008. 225 cases were found. 2 sample poison test was used to analyze the data. Results: When female E.M.T.P’s treat female patients vs. Treating male patients, the pain score difference is 1.77 (p=0.010) When male E.M.T.P’s treat male patients vs. Female patients the pain score difference is 0.57 (p=0.063) Conclusions: Female FF/EMTP treat female patients more aggressively for chest pain than when they treat male patients. This may be due to gender bias and expectation of pain tolerance by male patients. Male FF/EMTP treats male and female patients with the same intensity.

Chinese Systemic Lupus Erythematosus Treatment and Research Group (CSTAR) Registry XI: gender impact on long-term outcomes

Lupus ◽  
2019 ◽  
Vol 28 (5) ◽  
pp. 635-641
Author(s):  
S Zhang ◽  
Z Ye ◽  
C Li ◽  
Z Li ◽  
X Li ◽  
...  
Keyword(s):  
Systemic Lupus Erythematosus ◽  
Lupus Erythematosus ◽  
Causes Of Death ◽  
Survival Rates ◽  
Systemic Lupus ◽  
Male And Female ◽  
Female Patients ◽  
American College Of Rheumatology ◽  
Male Patients

Objective The objective of this paper is to assess the role of gender on survival rate and causes of death and organ damage in systemic lupus erythematosus (SLE) patients in China from 2009 to 2015. Methods We conducted a multicenter cohort study to analyze the differences in outcome data between male and female SLE patients. A group of 1494 SLE patients who fulfilled the 1997 American College of Rheumatology SLE classification criteria were enrolled in the Chinese Systemic Lupus Erythematosus Treatment and Research Group (CSTAR) registry from April 2009 to February 2010. All enrolled patients were followed up at least once per year from 2009 to 2015. For patients who could not attend the outpatient clinic, follow-up was conducted by telephone interview. We collected demographic data, clinical manifestations and damage scores (System Lupus International Collaborating Clinics/American College of Rheumatology Damage Index (SDI)). Survival rates were evaluated using the Kaplan-Meier method. Results This study included 1352 women and 142 men. The five-year survival rates were 92.0% for men and 97.6% for women. The survival rates of males were significant lower than for females ( p = 0.019). Male patients received methylprednisolone pulse therapy and cyclophosphamide significantly more than female patients ( p = 0.010). During follow-up, 12 male patients and 66 female patients died. The most common cause of death was infection (41.7%) for men and active SLE disease (27.3%) for women. At the end of the study, the major accumulated organ damages included renal (8.5%) and musculoskeletal (7.7%), and nervous system (5.6%) for men and renal (8.8%) and musculoskeletal (6.7%) for women. There were no significant differences in SDI scores between the two groups at baseline and at the end of the study. Conclusions Male SLE patients had lower survival rates than female patients. Male patients received more methylprednisolone pulse and cyclophosphamide therapy. The most common causes of death were infection for male patients and active SLE disease for female patients. The major accumulated organ damages were renal, musculoskeletal, and nervous system both for male and female SLE patients in China.

Electroencephalographic and perceptual asymmetry differences between responders and nonresponders to an SSRI antidepressant21Data from two treatment protocols were combined so as to yield sufficient samples of female and male fluoxetine responders and nonresponders. With the exception of the initial placebo period in one study, the treatment protocols were comparable in terms of both fluoxetine doses and the raters evaluating treatment response. Most importantly, the differences between fluoxetine responders and nonresponders reported for the total samples were also evident when only the data for the placebo-controlled protocol were analyzed; however, the larger total sample allowed us to also take patient gender into account.22The 18 healthy women were screened for psychopathology using a structured interview schedule and were excluded if they had a hearing loss, substance abuse, a history of head trauma, or other neurologic disorder. They did not differ significantly from the female patients in education (mean = 15.8, SD = 1.3) or handedness (LQ = 84.7, SD = 20.6), but they were somewhat younger than the female patients [mean age = 27.6, SD = 6.9;t(35) = 3.21,p = .001]. Age was not, however, related to perceptual asymmetry scores of either female patients (r = −.01, ns) or male patients (r = −.02, ns) on the fused words test. Nor was age significantly correlated with alpha asymmetry scores of female patients (r = −.09, ns) or male patients (r = .11, ns).

2001 ◽  
Vol 49 (5) ◽  
pp. 416-425 ◽  
Author(s):  
Gerard E Bruder ◽  
Jonathan W Stewart ◽  
Craig E Tenke ◽  
Patrick J McGrath ◽  
Paul Leite ◽  
...  
Keyword(s):  
Total Sample ◽  
Structured Interview ◽  
Treatment Protocols ◽  
Neurologic Disorder ◽  
Female Patients ◽  
Alpha Asymmetry ◽  
Perceptual Asymmetry ◽  
Patient Gender ◽  
History Of ◽  
Male Patients

scholarly journals GENDER DIFFERENCES FOR MYOCARDIAL INFARCTION AS OUTCOME OF ST ELEVATION ACS IN THE REPUBLIC OF BURYATIA

2018 ◽  
Vol 2 (5) ◽  
pp. 49-54
Author(s):  
Лариса Содномова ◽  
Larisa Sodnomova ◽  
Наталья Булутова ◽  
Natalya Bulutova
Keyword(s):  
Myocardial Infarction ◽  
Myocardial Infarctions ◽  
Female Patients ◽  
St Elevation ◽  
Male Patients ◽  
The Republic ◽  
Risk Of Hemorrhage ◽  
Time Of Admission ◽  
First Time ◽  
Methods Of Treatment

Evidential base for diagnosis and treatment of myocardial infarction is based on the results of randomized clinical studies that included mostly male patients. Objective: to determine gender specifics in development, progression, methods of treatment, diagnostics, outcomes of myocardial infarction for defining customized approaches to its treatment. Study material and methods: 84 medical records of patients with myocardial infarction – 50 male and 54 female patients admitted in the emergency cardiac care department. Statistical data is processed in Microsoft Excel and Statistica v. 10.0. Results. Female patients suffer myocardial infarction late in life; they display higher obesity rate, renal dysfunction, type 2 diabetes as compared to male patients. At the time of admission to hospital the risk of hemorrhage is higher among female patients, which is related to the higher rate of renal disfunction and age. Average CRUSADE score for female patients is 39.14 ± 2.5, for male patients – 22.7 ± 1.4 points. Female patients demonstrate higher frequency of atypical symptoms for myocardial infarction – 18 %, compared to 8 % for males (p = 0.05), that leads to prolongated period of symptom-hospitalization. Thus, there are less women who are hospitalized within first 3 hours – 6 % against 28 % men (p = 0.01). Women display tendency to a higher frequency of Q-negative and recurrent myocardial infarctions, men – to first-time and Q-positive infarctions. As for the frequency of CAG, TLT and PCI, as well as mortality rate due to MI there is no difference between the groups.

Abstract 13412: Gender Based Differences in Duration of Cardiopulmonary Resuscitation in the Inpatient Setting

Circulation ◽  
2021 ◽  
Vol 144 (Suppl_2) ◽  
Author(s):  
Anna Baillie ◽  
Rebecca Sell ◽  
Victoria Speck ◽  
Gabriel Wardi
Keyword(s):  
Cardiac Arrest ◽  
Cardiopulmonary Resuscitation ◽  
Retrospective Chart Review ◽  
Spontaneous Circulation ◽  
Inpatient Setting ◽  
Female Patients ◽  
Shockable Rhythm ◽  
Patient Gender ◽  
Significant Difference ◽  
Male Patients

Introduction: The decision to terminate cardiopulmonary resuscitation (CPR) prior to return of spontaneous circulation (ROSC) may be impacted by resuscitation parameters or by patient demographics. Studies show that longer resuscitation efforts have a higher likelihood of ROSC and survival to discharge. It is unclear if gender of the code leader and the patient may be associated with duration of unsuccessful CPR attempt. Methods: Retrospective chart review of inpatient CA that occurred at the UC San Diego Health System between 2011-2019. All adult inpatients with an index cardiac arrest who expired within three days of admission were included. Exclusion criteria included patients who achieved ROSC, CA that occurred outside of the wards or ICU, those with active pre-arrest DNR status, and patients with CA > 3 days after admission (done to minimize provider bias based on prior knowledge of the patient). Data were identified from an internal cardiac arrest quality improvement database. Patient gender was self-reported and code leader gender was identified. Primary outcome was duration of resuscitation efforts. To determine differences in duration of CPR between code leader and patient gender a one-sided ANOVA test was used. A p value < 0.05 was considered statistically significant. Results: We identified 91 patients between 2011 and 2019 that met inclusion criteria. Thirty-eight patients (41.8%) identified as female, fifty-three identified as male (58.2%), the average age was 62.7 years old, and seventeen (18.7%) had initial shockable rhythm. Thirty (33%) of the code leaders identified as female and sixty-one (67%) identified as male. Average duration of CPR was 31.6 minutes (2 - 135 minutes) for male patients with male code leader, 32.2 minutes (9 - 71 minutes) for male patients with female code leader, 27.0 minutes (7 - 60 minutes) for female patients with female code leader, and 33.7 minutes (10 - 73 minutes) for female patients with male code leader. No significant difference in duration of unsuccessful CPR attempt associated with gender of code leader and gender of patient in ANOVA analysis was found (p = 0.512). Conclusions: We did not identify a significant association between code leader and patient gender on duration of CPR in the inpatient setting.

GAMBARAN ANGKA KEJADIAN STROKE AKIBAT HIPERTENSI DI INSTALASI REHABILITASI MEDIK BLU RSUP PROF. DR. R. D. KANDOU MANADO PERIODE JANUARI – DESEMBER 2011

e-CliniC ◽  
2013 ◽  
Vol 1 (2) ◽  
Author(s):  
Ariesta Zubiah Ramadhini ◽  
L. S. Angliadi ◽  
Engeline Angliadi
Keyword(s):  
Descriptive Study ◽  
Medical Rehabilitation ◽  
Stroke Patients ◽  
Female Patients ◽  
Male Patients

Abstract: Stroke may cause a serious problem that leads to a disability or even mortality. The purpose is to determine such an incidence caused by hypertension at the Installation of Medical Rehabilitation RSUP Prof. dr. R. D. Kandou Manado based on the characteristic of age, gender and occupation. This research was taken at the Installation of Medical Rehabilitation RSUP Prof. R. D. Kandou Manado by using retrospective descriptive study method as well as examining 228 new cases of stroke patients that correlated with conclusion criteria. The result showed 8,3% patients at ≤44th years old, 33,3% patients at 45th – 54th years old, 32% patients at 55th – 64th years old, 20,25% patients at 65th – 74th years old, 6,1% patients at 75th – 84th years old. 53,1% male patients, 46,9% female patients. 33,3% retirement, 18% farmers, 18% government officers, 5,3% private employees, 2,2% drivers, 0,9% teachers and, 3,1% housewives. Keywords: incidence, hypertension, stroke   Abstrak: Stroke dapat menimbulkan masalah besar karena menyebabkan kecacatan dan kematian. Tujuan, mengetahui gambaran angka kejadian stroke akibat hipertensi di Instalasi Rehabilitasi Medik RSUP Prof. Dr. R. D. Kandou Manado sesuai dengan karakteristik umur, jenis kelamin, dan jenis pekerjaan. Penelitian dilakukan di Instalasi Rehabilitasi Medik BLU RSUP Prof. dr. R. D. Kandou Manado, dilakukan secara retrospektif deskriptif dan didapatkan sampel sebanyak 228 data pasien kunjungan baru kasus stroke sesuai kriteria inklusi yang ditetapkan. Hasil penelitian, pasien stroke berumur ≤44 tahun 8,3%, berumur 45 – 54 tahun 33,3%, berumur 55 – 64 tahun 32%, berumur 65 – 74 tahun 20,25%, berumur 75 – 84 tahun 6,1%. Pasien stroke berjenis kelamin laki – laki 53,1%, perempuan 46,9%. Pasien stroke yang berstatus pekerjaan pensiunan 33,3%, petani 18%, PNS 18%, pegawai swasta 5,3%, supir 2,2%, guru 0,9%, IRT 3,1%. Kata Kunci: gambaran angka kejadian, hipertensi, stroke

scholarly journals Differences in Outcomes Between Anterior and Posterior Shoulder Instability After Arthroscopic Bankart Repair: A Systematic Review and Meta-analysis

2021 ◽  
Vol 9 (5) ◽  
pp. 232596712110064
Author(s):  
Matthew L. Vopat ◽  
Reed G. Coda ◽  
Nick E. Giusti ◽  
Jordan Baker ◽  
Armin Tarakemeh ◽  
...  
Keyword(s):  
Systematic Review ◽  
Shoulder Instability ◽  
Anterior Shoulder Instability ◽  
Posterior Shoulder Instability ◽  
Anterior Instability ◽  
Posterior Instability ◽  
Female Patients ◽  
Posterior Shoulder ◽  
Male Patients ◽  
Postoperative Instability

Background: The glenohumeral joint is one of the most frequently dislocated joints in the body, particularly in young, active adults. Purpose: To conduct a systematic review and meta-analysis to evaluate and compare outcomes between anterior versus posterior shoulder instability. Study Design: Systematic review; Level of evidence, 4. Methods: A systematic review was performed using the PubMed, Cochrane Library, and MEDLINE databases (from inception to September 2019) according to PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) guidelines. Studies were included if they were published in the English language, contained outcomes after anterior or posterior shoulder instability, had at least 1 year of follow-up, and included arthroscopic soft tissue labral repair of either anterior or posterior instability. Outcomes including return-to-sport (RTS) rate, postoperative instability rate, and pre- and postoperative American Shoulder and Elbow Surgeons (ASES) scores were recorded and analyzed. Results: Overall, 39 studies were included (2077 patients; 1716 male patients and 361 female patients). Patients with anterior instability had a mean age of 23.45 ± 5.40 years (range, 11-72 years), while patients with posterior instability had a mean age of 23.08 ± 8.41 years (range, 13-61 years). The percentage of male patients with anterior instability was significantly higher than that of female patients (odds ratio [OR], 1.36; 95% CI, 1.04-1.77; P = .021). Compared with patients with posterior instability, those with anterior instability were significantly more likely to RTS (OR, 2.31; 95% CI, 1.76-3.04; P < .001), and they were significantly more likely to have postoperative instability (OR, 1.53; 95% CI, 1.07-2.23; P = .018). Patients with anterior instability also had significantly higher ASES scores than those with posterior instability (difference in means, 6.74; 95% CI, 4.71-8.77; P < .001). There were no significant differences found in postoperative complications between the anterior group (11 complications; 1.8%) and the posterior group (3 complications; 1.6%) (OR, 1.12; 95% CI, 0.29-6.30; P = .999). Conclusion: Patients with anterior shoulder instability had higher RTS rates but were more likely to have postoperative instability compared with posterior instability patients. Overall, male patients were significantly more likely to have anterior shoulder instability, while female patients were significantly more likely to have posterior shoulder instability.

The influence of prescriber and patient gender on the prescription of benzodiazepines: results from the Florida Medicaid Dataset

CNS Spectrums ◽  
2021 ◽  
pp. 1-5
Author(s):  
Leanna M. W. Lui ◽  
Yena Lee ◽  
Orly Lipsitz ◽  
Nelson B. Rodrigues ◽  
Hartej Gill ◽  
...  
Keyword(s):  
The United States ◽  
Sociodemographic Factors ◽  
Cross Sectional Study ◽  
Cross Sectional ◽  
Assistance Program ◽  
Patient Gender ◽  
Prescription Rates ◽  
Male Patients ◽  
Using Data ◽  
Main Effects

Abstract Background Benzodiazepine (BZD) prescription rates have increased over the past decade in the United States. Available literature indicates that sociodemographic factors may influence diagnostic patterns and/or prescription behaviour. Herein, the aim of this study is to determine whether the gender of the prescriber and/or patient influences BZD prescription. Methods Cross-sectional study using data from the Florida Medicaid Managed Medical Assistance Program from January 1, 2018 to December 31, 2018. Eligible recipients ages 18 to 64, inclusive, enrolled in the Florida Medicaid plan for at least 1 day, and were dually eligible. Recipients either had a serious mental illness (SMI), or non-SMI and anxiety. Results Total 125 463 cases were identified (i.e., received BZD or non-BZD prescription). Main effect of patient and prescriber gender was significant F(1, 125 459) = 0.105, P = 0 .745, partial η2 < 0.001. Relative risk (RR) of male prescribers prescribing a BZD compared to female prescribers was 1.540, 95% confidence intervals (CI) [1.513, 1.567], whereas the RR of male patients being prescribed a BZD compared to female patients was 1.16, 95% CI [1.14, 1.18]. Main effects of patient and prescriber gender were statistically significant F(1, 125 459) = 188.232, P < 0.001, partial η2 = 0.001 and F(1, 125 459) = 349.704, P < 0.001, partial η2 = 0.013, respectively. Conclusions Male prescribers are more likely to prescribe BZDs, and male patients are more likely to receive BZDs. Further studies are required to characterize factors that influence this gender-by-gender interaction.

Spouse Caregivers' Perceptions of Influence of Dementia on Marriage

2002 ◽  
Vol 14 (1) ◽  
pp. 47-58 ◽  
Author(s):  
Ulla Eloniemi-Sulkava ◽  
Irma-Leena Notkola ◽  
Kaija Hämäläinen ◽  
Terhi Rahkonen ◽  
Petteri Viramo ◽  
...  
Keyword(s):  
Behavioral Change ◽  
Intervention Study ◽  
Negative Impact ◽  
Behavioral Changes ◽  
Telephone Interviews ◽  
Before And After ◽  
Spouse Caregivers ◽  
Dementing Illness ◽  
Male Patients ◽  
Patients Experience

Objectives: To investigate what kind of changes spouse caregivers of demented patients experience after the onset of dementia (a) in the general atmosphere, happiness, and relations of marriage and (b) in the sexual side of marriage. Design: Semistructured telephone interviews of spouse caregivers of demented patients. Setting: Community-living demented patients and their spouse caregivers in eastern Finland. Participants: The spouse caregivers of 42 demented patients recruited from a previous intervention study. Measures: The questionnaire covered different areas of marriage from the time before and after the onset of dementia. Results: A statistically significant decline had occured in extent of happiness (p = .012), in equal relations (p = .001), and in patients' expressions of sexual needs (p < .001) when compared the time before and after dementia. Twenty-five (60%) of the caregivers reported that the demented patient had shown at least one negative sexual behavioral change during the course of dementia. Seven male patients (24%) had shown the behavioral symptom of constantly expressing need for making love. One in 10 caregivers had experienced positive sexual behavioral changes. In one third of the patients, the expressions of tenderness towards the caregiver had increased. Dementia did not affect significantly the general atmosphere of the marriage. Out of those still in home care, at 3 years from the onset of dementia, 19 couples (46%) continued to practice intercourse, at 5 years the number was 15 couples (41%), and at 7 years it had declined to 7 couples (28%). Conclusions: Dementing illness has a major negative impact on many dimensions of marriage. However, there are also positive changes and preserved aspects of marriage. Dementia seems to have a surprisingly little impact on whether the couple continues to have intercourse when compared with the general aging population.

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