Sex differences in text-mined possible adverse drug events associated with drugs for psychosis

2020 ◽  
Vol 34 (5) ◽  
pp. 532-539
Author(s):  
Freja Karuna Hemmingsen Sørup ◽  
Robert Eriksson ◽  
David Westergaard ◽  
Jesper Hallas ◽  
Søren Brunak ◽  
...  
Keyword(s):  
Sex Differences ◽  
Adverse Drug Events ◽  
Psychiatric Symptoms ◽  
Gastrointestinal Symptoms ◽  
Electronic Patient Records ◽  
Biological Sex ◽  
Relative Risks ◽  
Potential Ades ◽  
Optimal Drug ◽  
Male Patients

Background: Understanding sex differences in adverse drug reactions to drugs for psychosis could potentially guide clinicians in optimal drug choices. Aims: By applying a text-mining approach, this study aimed to investigate the relationship between drugs for psychosis and biological sex differences in frequencies and co-occurrences of potential adverse drug events (ADEs). Methods: Electronic patient records of a psychiatric population (1427 men and 727 women) were text mined for potential ADEs. The relative risk of experiencing specific ADEs and co-occurrence of ADEs were calculated for each sex. Results: Findings included 55 potential ADEs with significantly different frequencies between the two sexes. Of these, 20 were more frequent in men, with relative risks of 1.10–7.64, and 35 were more frequent in women, with relative risks of 1.19–21.58. Frequent potential ADEs were psychiatric symptoms, including sexual dysfunction and disturbances in men, and gastrointestinal symptoms, suicidal and self-injurious behaviour and hyperprolactinemia-related events in women. Mention of different hyperprolactinemia-related ADEs often co-occurred in female patients but not in male patients. Conclusion: Several known sex-related ADEs were identified, as well as some previously not reported. When considering the risk–benefit profile of drugs for psychosis, the patient’s sex should be considered.

The traditional sexual script and humor in courtship

2020 ◽  
Vol 33 (2) ◽  
pp. 197-218
Author(s):  
Elaina M. Ross ◽  
Jeffrey A. Hall
Keyword(s):  
Sex Differences ◽  
Gender Roles ◽  
Cultural Influences ◽  
Past Research ◽  
Ambivalent Sexism ◽  
Hostile Sexism ◽  
Sexual Script ◽  
Biological Sex ◽  
Sex Influence ◽  
Potential Partner

AbstractTo account for sex differences in the production, receptivity, and preference for humor in potential mates during courtship, past research has often adopted an evolutionary approach. The present manuscript will attempt to integrate evolutionary explanations with proximal social and cultural influences using the traditional sexual script and ambivalent sexism theory. The results of both Study 1 (N=227) and Study 2 (N=424) suggest that trait masculinity is positively associated with humor production in courtship, while trait femininity is associated with humor receptivity. Study 1 indicated that the traditional flirting style was associated with less humor production by women, and Study 2 indicated that hostile sexism was related to a lower preference for a humor-producing potential partner by men. A sex difference in humor production in potential partners in Study 2 was no longer detectable once trait gender and hostile sexism was accounted for. Taken together, gender roles, over and above biological sex, influence one’s own humor use in courtship and preference for humor in potential partners.

scholarly journals Detection of adverse drug events in e-prescribing and administrative health data: a validation study

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Bettina Habib ◽  
Robyn Tamblyn ◽  
Nadyne Girard ◽  
Tewodros Eguale ◽  
Allen Huang
Keyword(s):  
Administrative Data ◽  
Gold Standard ◽  
Adverse Drug Events ◽  
Study Drug ◽  
Health Data ◽  
Diagnostic Code ◽  
Administrative Health Data ◽  
Potential Ades ◽  
Patient Reported

Abstract Background Administrative health data are increasingly used to detect adverse drug events (ADEs). However, the few studies evaluating diagnostic codes for ADE detection demonstrated low sensitivity, likely due to narrow code sets, physician under-recognition of ADEs, and underreporting in administrative data. The objective of this study was to determine if combining an expanded ICD code set in administrative data with e-prescribing data improves ADE detection. Methods We conducted a prospective cohort study among patients newly prescribed antidepressant or antihypertensive medication in primary care and followed for 2 months. Gold standard ADEs were defined as patient-reported symptoms adjudicated as medication-related by a clinical expert. Potential ADEs in administrative data were defined as physician, ED, or hospital visits during follow-up for known adverse effects of the study medication, as identified by ICD codes. Potential ADEs in e-prescribing data were defined as study drug discontinuations or dose changes made during follow-up for safety or effectiveness reasons. Results Of 688 study participants, 445 (64.7%) were female and mean age was 64.2 (SD 13.9). The study drug for 386 (56.1%) patients was an antihypertensive, and for 302 (43.9%) an antidepressant. Using the gold standard definition, 114 (16.6%) patients experienced an ADE, with 40 (10.4%) among antihypertensive users and 74 (24.5%) among antidepressant users. The sensitivity of the expanded ICD code set was 7.0%, of e-prescribing data 9.7%, and of the two combined 14.0%. Specificities were high (86.0–95.0%). The sensitivity of the combined approach increased to 25.8% when analysis was restricted to the 27% of patients who indicated having reported symptoms to a physician. Conclusion Combining an expanded diagnostic code set with e-prescribing data improves ADE detection. As few patients report symptoms to their physician, higher detection rates may be achieved by collecting patient-reported outcomes via emerging digital technologies such as patient portals and mHealth applications.

scholarly journals Sex-Specific Differences in Glioblastoma

Cells ◽  
2021 ◽  
Vol 10 (7) ◽  
pp. 1783
Author(s):  
Anna Carrano ◽  
Juan Jose Juarez ◽  
Diego Incontri ◽  
Antonio Ibarra ◽  
Hugo Guerrero Cazares
Keyword(s):  
Sex Differences ◽  
Immune System ◽  
Molecular Level ◽  
Deep Understanding ◽  
Protective Role ◽  
Men And Women ◽  
Individualized Approach ◽  
Male Patients ◽  
Outcome Differences

Sex differences have been well identified in many brain tumors. Even though glioblastoma (GBM) is the most common primary malignant brain tumor in adults and has the worst outcome, well-established differences between men and women are limited to incidence and outcome. Little is known about sex differences in GBM at the disease phenotype and genetical/molecular level. This review focuses on a deep understanding of the pathophysiology of GBM, including hormones, metabolic pathways, the immune system, and molecular changes, along with differences between men and women and how these dimorphisms affect disease outcome. The information analyzed in this review shows a greater incidence and worse outcome in male patients with GBM compared with female patients. We highlight the protective role of estrogen and the upregulation of androgen receptors and testosterone having detrimental effects on GBM. Moreover, hormones and the immune system work in synergy to directly affect the GBM microenvironment. Genetic and molecular differences have also recently been identified. Specific genes and molecular pathways, either upregulated or downregulated depending on sex, could potentially directly dictate GBM outcome differences. It appears that sexual dimorphism in GBM affects patient outcome and requires an individualized approach to management considering the sex of the patient, especially in relation to differences at the molecular level.

scholarly journals Pharmacological Management of Steroid-Induced Psychosis: A Review of Patient Cases

2020 ◽  
pp. 875512252097853
Author(s):  
Grace Huynh ◽  
Justin P. Reinert
Keyword(s):  
Adverse Drug Events ◽  
Data Extraction ◽  
Management Strategies ◽  
Pharmacological Intervention ◽  
Symptom Presentation ◽  
Pharmacological Management ◽  
Diagnostic And Statistical Manual ◽  
Study Selection ◽  
Cord Injury ◽  
Male Patients

Objective: To review the efficacy and safety of medications used in the management of steroid-induced psychosis. Data Sources: A comprehensive literature search was conducted using PubMed, MEDLINE, ProQuest, and Scopus between May and October 2020 using the following search terminology: “steroid-induced psychosis” OR “corticosteroid-induced psychosis.” Study Selection and Data Extraction: Definitive cases, as defined by the Diagnostic and Statistical Manual of Mental Disorders, 5th edition, were included in this review. Geriatric patients >65 years of age, those with a confounding neurological condition such as a traumatic brain or spinal cord injury, or those with active malignancy were excluded. Data Synthesis: A total of 13 patient cases were included in this review, representing 8 male patients and 5 female patients. The mean age at symptom presentation was 42.5 years. Six patients presented with delusions, 5 presented with hallucinations, and 2 presented with both manifestations; 12 patients were managed with an antipsychotic, with haloperidol being the most commonly prescribed, followed by risperidone. One patient was managed with lithium and clonazepam alone. All patients returned to their psychological baseline upon the discontinuation or decreased dose of steroids in combination with Pharmacological intervention, though the time to resolution of symptoms varied significantly. No notable adverse drug events associated with treatments were reported. Conclusions: Steroid-induced psychosis is a serious adverse effect of corticosteroid therapy; however, management strategies that combine a dose reduction or elimination of steroids, in combination with an antipsychotic medication, are effective in resolving this syndrome.

Unexplored functions of sex hormones in glioblastoma cancer stem cells

Endocrinology ◽  
2022 ◽  
Author(s):  
Juyeun Lee ◽  
Katie Troike ◽  
R’ay Fodor ◽  
Justin D Lathia
Keyword(s):  
Stem Cells ◽  
Immune Response ◽  
Sex Differences ◽  
Cancer Stem Cells ◽  
Tumor Growth ◽  
Sex Hormones ◽  
Cellular Heterogeneity ◽  
Cellular Functions ◽  
Biological Sex ◽  
Organismal Development

Abstract Biological sex impacts a wide array of molecular and cellular functions that impact organismal development and can influence disease trajectory in a variety of pathophysiological states. In non-reproductive cancers, epidemiological sex differences have been observed in a series of tumors, and recent work has identified previously unappreciated sex differences in molecular genetics and immune response. However, the extent of these sex differences in terms of drivers of tumor growth and therapeutic response is less clear. In glioblastoma, the most common primary malignant brain tumor, there is a male bias in incidence and outcome, and key genetic and epigenetic differences, as well as differences in immune response driven by immune-suppressive myeloid populations, have recently been revealed. Glioblastoma is a prototypic tumor in which cellular heterogeneity is driven by populations of therapeutically resistant cancer stem cells (CSCs) that underlie tumor growth and recurrence. There is emerging evidence that GBM CSCs may show a sex difference, with male tumor cells showing enhanced self-renewal, but how sex differences impact CSC function is not clear. In this mini-review, we focus on how sex hormones may impact CSCs in GBM and implications for other cancers with a pronounced CSC population. We also explore opportunities to leverage new models to better understand the contribution of sex hormones versus sex chromosomes to CSC function. With the rising interest in sex differences in cancer, there is an immediate need to understand the extent to which sex differences impact tumor growth, including effects on CSC function.

scholarly journals Sex Differences in Brain Tumor Glutamine Metabolism Reveal Sex-Specific Vulnerabilities to Treatment

2021 ◽  
Author(s):  
Jasmin Sponagel ◽  
Jill K. Jones ◽  
Cheryl Frankfater ◽  
Shanshan Zhang ◽  
Olivia Tung ◽  
...  
Keyword(s):  
Amino Acids ◽  
Sex Differences ◽  
Pyruvate Carboxylase ◽  
Tca Cycle ◽  
Glutamine Metabolism ◽  
Normal Metabolism ◽  
Male Patients ◽  
Glutaminase 1 ◽  
Metabolite Abundance ◽  
Glutamine Uptake

Sex differences in normal metabolism are well described, but whether they persist in cancerous tissue is unknown. We assessed metabolite abundance in glioblastoma surgical specimens and found that male glioblastomas are enriched for amino acids, including glutamine. Using PET imaging, we found that gliomas in male patients exhibit significantly higher glutamine uptake. These sex differences were well-modeled in murine transformed astrocytes, in which male cells imported and metabolized more glutamine and were more sensitive to glutaminase 1 (GLS1) inhibition. The sensitivity to GLS1 inhibition in males was driven by their dependence on glutamine-derived glutamate for α-ketoglutarate synthesis and TCA cycle replenishment. Females were resistant to GLS inhibition through greater pyruvate carboxylase-mediated TCA cycle replenishment. Thus, clinically important sex differences exist in targetable elements of metabolism. Recognition of sex-biased metabolism is an opportunity to improve treatments for all patients through further laboratory and clinical research.

scholarly journals Sex-Dependent Differences in Plasma Cytokine Responses to Hantavirus Infection

2008 ◽  
Vol 15 (5) ◽  
pp. 885-887 ◽  
Author(s):  
Jonas Klingström ◽  
Therese Lindgren ◽  
Clas Ahlm
Keyword(s):  
Sex Differences ◽  
Infectious Diseases ◽  
Immune Responses ◽  
Infectious Agent ◽  
Hantavirus Infection ◽  
Infected Female ◽  
Macrophage Colony Stimulating Factor ◽  
Male Patients ◽  
Macrophage Colony ◽  
Interleukin 9

ABSTRACT There are often sex differences in susceptibility to infectious diseases and in level of mortality after infection. These differences probably stem from sex-related abilities to mount proper or unwanted immune responses against an infectious agent. We report that hantavirus-infected female patients show significantly higher plasma levels of interleukin-9 (IL-9), fibroblast growth factor 2, and granulocyte-macrophage colony-stimulating factor and lower levels of IL-8 and gamma interferon-induced protein 10 than male patients. The results demonstrate that a virus infection can induce sex-dependent differences in acute immune responses in humans. This finding may, at least partly, explain the observed sex differences in susceptibility to infectious diseases and in mortality following infection.

Cotard syndrome in a young man?

2016 ◽  
Vol 33 (S1) ◽  
pp. S348-S348
Author(s):  
A. Cercos López ◽  
M.C. Cancino Botello ◽  
V. Chavarria Romero ◽  
G. Sugranyes Ernest
Keyword(s):  
Differential Diagnosis ◽  
Suicide Ideation ◽  
Psychiatric Symptoms ◽  
Past History ◽  
Gastrointestinal Symptoms ◽  
Autoimmune Encephalitis ◽  
Psychomotor Retardation ◽  
Stressful Events ◽  
Psychotic Episode ◽  
Degree Relative

IntroductionAnti-NMDA encephalitis normally appears as a characteristic syndrome with typical symptoms that undergoes with multiphase evolution. However, it sometimes develops atypical symptoms so we must perform a careful differential diagnosis.ObjectivesTo conduct a current review of detection and management of anti-NMDAr encephalitis, and psychiatric manifestations.MethodSystematic review of the literature in English (PubMed), with the following keywords: “Autoimmune encephalitis”, “psychosis”, and “NMDA receptor”.ResultsWe present the case of a 15-year-old boy referred to evaluation for a first psychotic episode. He had no past history of psychiatric illness or substance abuse. The only relevant antecedent is multiple sclerosis in a first degree relative. For the last months, he presented high levels of anxiety symptoms apparently related to college stressful events and fluctuating hypoesthesia of left cranial side. Days later, it appeared autolimited gastrointestinal symptoms, headache and fever. During the next days it appeared psychomotor retardation, choreic movements, suicide ideation and mood-congruent paranoid and nihilistic ideation, auditory and visual hallucinations, perplexity and catatonic symptoms so he was hospitalized. We observed cognitive functions impairment, unsteady gait, dysartria, dysphasia, clonus and left babinsky sign. EEG showed slow waves on right frontal area. CFS showed protein elevation and immunologic study revealed positive anti-NMDA antibodies. Treatment with methylprednisolone and gammaglobuline was started with partial response, needing addition of rituximab.ConclusionsIn this case, we highlight the importance of early detection and a detailed differential diagnosis, to determine whether the etiology of psychiatric symptoms in order to achieve an accurate and early treatment.Disclosure of interestThe authors have not supplied their declaration of competing interest.

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