scholarly journals Gender aspects in cardiooncology

Author(s):  
Anna Hohneck ◽  
Florian Custodis ◽  
Stephanie Rosenkaimer ◽  
Ralf Hofheinz ◽  
Sandra Maier ◽  
...  

Abstract Background Cardiooncology is a relatively new subspeciality, investigating the side effects of cytoreductive therapies on the cardiovascular (CV) system. Gender differences are well known in oncological and CV diseases, but are less elucidated in cardiooncological collectives. Methods Five hundred and fifty-one patients (278 male, 273 female) with diagnosed cancer who underwent regular cardiological surveillance were enrolled in the ‘MAnnheim Registry for CardioOncology’ and followed over a median of 41 (95% confidence interval: 40–43) months. Results Female patients were younger at the time of first cancer diagnosis [median 60 (range 50–70) vs. 66 (55–75), P = 0.0004], while the most common tumour was breast cancer (49.8%). Hyperlipidaemia was more often present in female patients (37% vs. 25%, P = 0.001). Male patients had a higher cancer susceptibility than female patients. They suffered more often from hypertension (51% vs. 67%, P = 0.0002) or diabetes (14% vs. 21%, P = 0.02) and revealed more often vitamin D deficiency [(U/l) median 26.0 (range 17–38) vs. 16 (9–25), P = 0.002] and anaemia [(g/dl) median 11.8 (range 10.4–12.9) vs. 11.7 (9.6–13.6), P = 0.51]. During follow-up, 140 patients died (male 77, female 63; P = 0.21). An increased mortality rate was observed in male patients (11.4% vs. 14%, P = 0.89), with even higher mortality rates of up to 18.9% vs. 7.7% (P = 0.02) considering tumours that can affect both sexes compared. Conclusions Although female patients were younger at the time of first cancer diagnosis, male patients had both higher cancer susceptibility and an increased mortality risk. Concomitant CV diseases were more common in male patients.

1983 ◽  
Vol 69 (2) ◽  
pp. 143-150 ◽  
Author(s):  
Giorgio Cruciani ◽  
Gian Maria Fiorentini ◽  
Giovanni Rosti ◽  
Amelia Tienghi ◽  
Daniele Bardella ◽  
...  

Bone marrow biopsies by Jamshidi needle were performed in 106 breast cancer female patients. Sixty-four of them were in follow-up after mastectomy, and neoplastic involvement of marrow was found in 21 patients (32.8%). Among the 42 women undergoing staging before mastectomy, the incidence of marrow involvement was 11.9% (5 women, all with radiographic positivity). Of the 37 women, either in follow-up or in the staging phase, with bone metastases detected by roentgenographic and isotopic examination, the bone biopsy was positive in 23 (62.1%), and 7 histologically had micrometastases. Three women, without any radiographic or isotopic sign of metastases, had positive biopsies. A good correlation was found between the hydroxyproline:creatinine ratio and neoplastic involvement of bone marrow.


2009 ◽  
Vol 24 (S1) ◽  
pp. 1-1
Author(s):  
A.-M. Murgulescu

Objective:The gender differences in aspect of sociodemographic and clinical characteristics have been analyzed in a sample of first admitted patients with acute psychotic disorder in an acute psychiatric hospital.Method:Retrospective sociodemographic and clinical data regarding first admitted patients diagnosed with acute psychotic disorder were gathered and analyzed.Results:Of all patients 52.7% were female and 47.3% were male. We analyzed gender differences in age of onset, marital status, education period, employment status, and time between onset of symptoms and admission in hospital. Female patients were older at their first admission than male patients, and more female patients were educated longer than male patients. Female patients tend to be married (30%) and employed (40%) at the time of their admission than male patients (11.1% married and 22.2% employed). the time between onset of symptoms and admission in hospital was longer for the majority of male patients (more than 1 year for 62.9% of men) than for the majority of female patients (0-3 months for 40% of women).Conclusions:There were gender differences in age of onset, marital status, education period, employment status, time between onset of symptoms and admission in hospital pointing to the role played by biopsychosocials factors in onset of acute psychotic disorder.


2013 ◽  
Vol 59 (5) ◽  
pp. 793-797 ◽  
Author(s):  
Olivia Trummer ◽  
Stefan Pilz ◽  
Michael M Hoffmann ◽  
Bernhard R Winkelmann ◽  
Bernhard O Boehm ◽  
...  

BACKGROUND Decreased circulating 25-hydroxy-vitamin D (25-OH-vitamin D) concentrations have been associated with mortality rates, but it is unclear whether this association is causal. We performed a Mendelian randomization study and analyzed whether 3 common single-nucleotide polymorphisms (SNPs) associated with 25-OH-vitamin D concentrations are causal for mortality rates. METHODS Genotypes of SNPs in the group-specific component gene (GC, rs2282679), 7-dehydrocholesterol reductase gene (DHCR7, rs12785878), and cytochrome P450 IIR-1 gene (CYP2R1, rs10741657) were determined in a prospective cohort study of 3316 male and female participants [mean age 62.6 (10.6) years] scheduled for coronary angiography between 1997 and 2000. 25-OH-vitamin D concentrations were determined by RIA. The main outcome measures were all-cause deaths, cardiovascular deaths, and noncardiovascular deaths. RESULTS In a linear regression model adjusting for month of blood sampling, age, and sex, vitamin D concentrations were predicted by GC genotype (P < 0.001), CYP2R1 genotype (P = 0.068), and DHCR7 genotype (P < 0.001), with a coefficient of determination (r2) of 0.175. During a median follow-up time of 9.9 years, 955 persons (30.0%) died, including 619 deaths from cardiovascular causes. In a multivariate Cox regression adjusted for classical risk factors, GC, CYP2R1, and DHCR7 genotypes were not associated with all-cause mortality, cardiovascular mortality, or noncardiovascular mortality. CONCLUSIONS Genetic variants associated with 25-OH-vitamin D concentrations do not predict mortality. This suggests that low 25-OH-vitamin D concentrations are associated with, but unlikely to be causal for, higher mortality rates.


Blood ◽  
2015 ◽  
Vol 126 (23) ◽  
pp. 1676-1676
Author(s):  
Amer M. Zeidan ◽  
Jessica B. Long ◽  
Rong Wang ◽  
James B. Yu ◽  
Jane Hall ◽  
...  

Abstract BACKGROUND: Chemotherapy and combined chemo-radiotherapy are well-documented risk factors for myelodysplastic syndromes (MDS) and acute myeloid leukemia (AML), collectively referred to in this setting as therapy-related myeloid neoplasms (t-MN). While single-modality radiotherapy post-lumpectomy has been shown to reduce local recurrence among breast cancer patients, data regarding the impact on development of t-MN are limited and inconsistent. METHODS: We conducted a retrospective cohort study of elderly female breast cancer patients (aged 67-94 years at diagnosis) who were diagnosed with in situ or stage 1-3 breast cancer between 1/1/2004 and 12/31/2011 using the National Cancer Institute's Surveillance, Epidemiology and End Results (SEER)-Medicare linked database. Eligibility criteria included 1) enrollment in Medicare Parts A and B continuously through death or end of study (12/31/2013); 2) underwent surgery for breast cancer within 9 months of diagnosis; and 3) were not diagnosed with other neoplasms prior to breast cancer diagnosis. Delivery of radiation therapy was ascertained using the Healthcare Common Procedural Coding System codes. In order to be considered a recipient of radiotherapy, the patient had to receive radiotherapy within 9 months of diagnosis and had any treatment delivery code for brachytherapy or ≥ 4 treatment delivery codes for external bream radiotherapy. Competing-risk analysis was used to assess the risk of developing t-MN in radiotherapy-treated patients compared to those treated with surgery alone. Patients were censored at the time of receiving chemotherapy or at development of another malignancy (aside of t-MN) during follow-up. Competing-risk analysis was used to assess the risk of developing secondary MN women who received radiation therapy compared to those who did not. These models included adjustment for breast cancer diagnosis age and year, number of comorbidities, anemia, functional status prior to breast cancer diagnosis and breast cancer stage. RESULTS: A total of 63,543 patients were included in the study. Median follow-up for all participants was 48 months. A total of 32,809 patients (51.6%) received radiotherapy post-surgery while 30,734 patients (48.4%) were not treated with radiotherapy post-surgery. Patients who received radiotherapy had significantly better overall survival than those who did not (median overall survival [OS] 107 vs. 89 months, p<0.001). During follow-up, a total of 167 patients were diagnosed with MDS or AML (89 cases among those who received radiotherapy and 78 among those who did not receive radiotherapy). The median time to develop MDS/AML was 24 months. In the unadjusted model, there was no significantly increased risk of subsequent AML/MDS among breast cancer patients who received single-modality radiotherapy compared to those who underwent surgery alone (hazard ratio [HR] = 1.11, 95% confidence interval [CI]: 0.82-1.51, p=0.49). Similarly, no significant difference in subsequent MDS/AML according to receipt of radiotherapy was observed in the adjusted analysis (HR = 1.16, 95% CI: 0.84-1.59, p=0.36). CONCLUSIONS: Older patients with early breast cancer who were treated with single-modality radiotherapy post-surgery did not have a higher risk of subsequent MDS/AML compared to patients who did not receive radiotherapy, and the overall rate of MN was low.While additional studies with a longer duration of follow-up are warranted, these results suggest that the single-modality radiotherapy administered in the contemporary management of early breast cancer is not a risk factor for t-MN in this population. Disclosures Yu: 21st-Century Oncology LLC: Research Funding. Gore:Celgene: Consultancy, Honoraria, Research Funding. Gross:Johnson and Johnson: Research Funding; Medtronic: Research Funding; 21st-Century Oncology LLC: Research Funding. Ma:Celgene Corp: Consultancy; Incyte Corp: Consultancy. Davidoff:Celgene: Consultancy, Research Funding.


2010 ◽  
Vol 28 (15_suppl) ◽  
pp. 6111-6111
Author(s):  
S. K. Taylor ◽  
M. Ennis ◽  
N. S. Hood ◽  
M. Graham ◽  
K. I. Pritchard ◽  
...  

2013 ◽  
Vol 10 (3) ◽  
pp. 200-224 ◽  
Author(s):  
Oguzhan Alagoz ◽  
Jagpreet Chhatwal ◽  
Elizabeth S. Burnside

1982 ◽  
Vol 140 (3) ◽  
pp. 223-230 ◽  
Author(s):  
Max Hamilton

SummaryThe results described are based on data from 47 male and 83 female patients randomly assigned to treatment with imipramine or phenelzine in an open trial. All were fresh (untreated) cases diagnosed as suffering from depressive illness (melancholia). They were rated before treatment and 2 and four months later. Imipramine did not give results which were significantly better than phenelzine. With both drugs it was found that patients had done either very well or very poorly at follow-up, i.e. the distribution of scores was U-shaped (or bimodal at the least).The 55 men and 90 women who were unsuitable for treatment with drugs or who had failed to respond to such treatment were given a course of ECT and followed-up at corresponding intervals. The improvement after ECT was better than with drugs and the distribution of scores is quite different. An earlier series of male patients treated with ECT in the pre-drug days did not show as good a response to the treatment.


Author(s):  
Ban A. Al-Shimmran ◽  
Zinah M. Anwer ◽  
Bassam H. Al-Jarrah

Exogenous levothyroxine dose modulation and euthyroidism achievement is a persistent challenge in clinical settings. This study strives to assess the adequacy of treatment and identify the patients’ factors that can be used to estimate the euthyroid levothyroxine dose. A secondary objective was to assess vitamin D supplementation impact on thyroid status. A review of a prospectively collected information from 142 female patients from Baghdad Center of Nuclear Medicine from June 2019 until March 2020 who were receiving levothyroxine for different causes was done. After a follow-up period, the patients’ thyroid tests were assessed and the euthyroid doses for each cause category were statistically analyzed. Thyroid function was assessed before and after three months of vitamin D supplementation for 29 out of 50 patients who measured its level. Sixty-six patients (47%) of the sample were inadequately replaced


EP Europace ◽  
2021 ◽  
Vol 23 (Supplement_3) ◽  
Author(s):  
T Baumgartner ◽  
M Kaelin-Friedrich ◽  
K Makowski ◽  
F Noti ◽  
B Schaer ◽  
...  

Abstract Funding Acknowledgements Type of funding sources: None. Background A pace & ablate strategy may be performed in cases of severe refractory atrial arrhythmias. Purpose We aimed to assess gender related differences in patient selection and clinical outcomes after pace & ablate. Methods In a retrospective multicenter study, patients undergoing AV-junction-ablation between 2011 and 2019 were studied. Gender-related differences in terms of baseline characteristics, device-related complications, heart failure (HF) hospitalisations and death were assessed. Results Overall, 513 patients underwent AV-junction-ablation (median age 75 years, 50% males). At baseline, male patients were younger (72 vs. 78 years, p &lt; 0.001), more frequently had non-paroxysmal AF (82% vs. 72%, p = 0.006), a lower LVEF (35% vs. 55%, p &lt; 0.001) and more often received biventricular stimulation (75% vs. 25%, p &lt; 0.001). Interventional complications were rare in both gender (1.2% vs 1.6%, p = 0.72). Following AV-junction-ablation, improvement of EHRA-class by ≥1 and of LVEF by ≥5% occurred in 44% and 19% of patients respectively, without gender differences (p = 0.66 and p = 0.38). Patients were followed for a median of 42 months in survivors (IQR 22-62). Lead-related complications (11 patients, 2.1%), infections (1 patient, 0.2%) and upgrade to ICD or CRT (18 patients, 3.5%) were rare. In Kaplan Meier analysis, HF hospitalisations during 4 years of follow-up were more common in men (22% vs 11%, p = 0.02), as were death (28% vs 21%, p = 0.02) and the combination of death or HF hospitalisation (37% vs. 26%, p = 0.008, Figure). Gender remained an independent predictor of the combined endpoint of death or HF hospitalisation after adjustment for age, LVEF and type of stimulation. Conclusion A Pace & Ablate strategy is safe and results in improvement of EHRA class and LVEF in a substantial number of patients. We found significant gender differences in patient selection for pace & ablate. Female patients had a more favorable clinical course after AV-junction-ablation, which was independent of age, EF and type of stimulation. Abstract Figure. Comb. endpoint of death or heart failure


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