scholarly journals Clinical characteristics and prognostic implications of BRCA-associated tumors in males: a pan-tumor survey

BMC Cancer ◽  
2020 ◽  
Vol 20 (1) ◽  
Author(s):  
Peng Sun ◽  
Yue Li ◽  
Xue Chao ◽  
Jibin Li ◽  
Rongzhen Luo ◽  
...  
Keyword(s):  
Cutaneous Melanoma ◽  
Brca Mutation ◽  
Progression Free Survival ◽  
Brca Mutations ◽  
Male And Female ◽  
Female Patients ◽  
Male Patients ◽  
Brca2 Mutations ◽  
Prognostic Implications ◽  
Associated Tumors

Abstract Background The BRCA mutation (BRCAm) in males has been reported to confer a higher risk for the development of various tumors. However, little is known about its clinicopathologic features and prognostic implications. Design We conducted a retrospective pan-tumor survey on 346 cases of BRCA-associated tumors in males. Comparative analyses were conducted among male and female patients with BRCAm (n = 349), as well as in male patients without BRCAm (n = 4577). Results Similar incidences of BRCAm (6.0 vs. 6.6%) and age at diagnosis of tumor (median, 65 vs. 60 years) were observed in male and female patients. Carcinomas of the lung, bladder, stomach, and cutaneous melanoma were the frequent tumors demonstrating BRCAm in males, of which the majority were stage II or III diseases with a higher frequency of BRCA2 mutations. Compared to that in the non-BRCAm group, cutaneous melanoma (16.3 vs. 5.0%), lung cancer (19.4 vs. 11.8%), bladder cancer (15.6 vs. 5.6%), and stomach cancer (11.9 vs. 5.5%) accounted for a higher proportion in the BRCAm group. Advanced disease and more mutation counts (median, 322 vs. 63 mutations) were also found in the BRCAm group. A total of 127 BRCA1 and 311 BRCA2 mutations were identified, of which 21.8 and 28.6% were deleterious, respectively. Frequent deleterious variants were identified in carcinomas of the breast (100.0%), colorectum (62.2%), prostate (43.3%), and stomach (42.9%). BRCA1 fusions with NF1, FAM134C, BECN1, or LSM12 and recurrent BRCA2 mutations at P606L/S, E832K/G, and T3033Lfs*29 were detected. Frameshift mutations in BRCA2 at N1784 (N1784Kfs*3, N1784Tfs*3) were frequently observed in both male and female patients. Compared with those in females, BRCA mutations in males were associated with decreased overall survival (OS) and progression-free survival (PFS). Male patients with deleterious BRCAm displayed increased OS compared with non-BRCAm carriers. The subgroup analysis demonstrated that BRCAm was associated with increased OS in gastric and bladder cancers, decreased PFS in prostate, esophageal, and head and neck cancers, and decreased OS in glioma/glioblastoma in males. Conclusion These findings provide an overview of the distinct characteristics and clinical outcomes of male patients with BRCA-associated tumors, suggesting the importance of further genetic BRCA testing in males.

scholarly journals Clinical Characteristics and Prognostic Implications of BRCA-associated Tumors in Males: A Pan-tumor Survey

2020 ◽  
Author(s):  
Peng Sun ◽  
Yue Li ◽  
Xue Chao ◽  
Jibin Li ◽  
Rongzhen Luo ◽  
...  
Keyword(s):  
Cutaneous Melanoma ◽  
Brca Mutation ◽  
Progression Free Survival ◽  
Brca Mutations ◽  
Male And Female ◽  
Female Patients ◽  
Male Patients ◽  
Brca2 Mutations ◽  
Prognostic Implications ◽  
Associated Tumors

Abstract Background The BRCA mutation (BRCAm) in males has been reported to confer a higher risk for the development of various tumors. However, little is known about its clinicopathologic features and prognostic implications.Design We conducted a retrospective pan-tumor survey on 346 cases of BRCA-associated tumors in males. Comparative analyses were conducted among male and female patients with BRCAm (n=349), as well as in male patients without BRCAm (n=4577).Results Similar incidences of BRCAm (6.0 vs. 6.6%) and age at diagnosis of tumor (median, 65 vs. 60 years) were observed in male and female patients. Carcinomas of the lung, bladder, stomach, and cutaneous melanoma were the frequent tumors demonstrating BRCAm in males, of which the majority were stage II or III diseases with a higher frequency of BRCA2 mutations. Compared to that in the non-BRCAm group, cutaneous melanoma (16.3 vs. 5.0%), lung cancer (19.4 vs. 11.8%), bladder cancer (15.6 vs. 5.6%), and stomach cancer (11.9 vs. 5.5%) accounted for a higher proportion in the BRCAm group. Advanced disease and more mutation counts (median, 322 vs. 63 mutations) were also found in the BRCAm group. A total of 127 BRCA1 and 311 BRCA2 mutations were identified, of which 21.8% and 28.6% were deleterious, respectively. Frequent deleterious variants were identified in carcinomas of the breast (100.0%), colorectum (62.2%), prostate (43.3%), and stomach (42.9%). BRCA1 fusions with NF1, FAM134C, BECN1, or LSM12 and recurrent BRCA2 mutations at P606L/S, E832K/G, and T3033Lfs*29 were detected. Frameshift mutations in BRCA2 at N1784 (N1784Kfs*3, N1784Tfs*3) were frequently observed in both male and female patients. Compared with those in females, BRCA mutations in males were associated with decreased overall survival (OS) and progression-free survival (PFS). Male patients with deleterious BRCAm displayed increased OS compared with non-BRCAm carriers. The subgroup analysis demonstrated that BRCAm was associated with increased OS in gastric and bladder cancers, decreased PFS in prostate, esophageal, and head and neck cancers, and decreased OS in glioma/glioblastoma in males.Conclusion These findings provide an overview of the distinct characteristics and clinical outcomes of male patients with BRCA-associated tumors, suggesting the importance of further genetic BRCA testing in males.

scholarly journals Clinical Characteristics and Prognostic Implications of BRCA-associated Tumors in Males: A Pan-tumor Survey

2020 ◽  
Author(s):  
Peng Sun ◽  
Yue Li ◽  
Xue Chao ◽  
Jibin Li ◽  
Rongzhen Luo ◽  
...  
Keyword(s):  
Cutaneous Melanoma ◽  
Brca Mutation ◽  
Progression Free Survival ◽  
Brca Mutations ◽  
Male And Female ◽  
Female Patients ◽  
Male Patients ◽  
Brca2 Mutations ◽  
Prognostic Implications ◽  
Associated Tumors

Abstract Background The BRCA mutation (BRCAm) in males has been reported to confer a higher risk for the development of various tumors. However, little is known about its clinicopathologic features and prognostic implications.Design We conducted a retrospective pan-tumor survey on 346 cases of BRCA-associated tumors in males. Comparative analyses were conducted among male and female patients with BRCAm (n=349), as well as in male patients without BRCAm (n=4577).Results Similar incidences of BRCAm (6.0 vs. 6.6%) and age at diagnosis of tumor (median, 65 vs. 60 years) were observed in male and female patients. Carcinomas of the lung, bladder, stomach, and cutaneous melanoma were the frequent tumors demonstrating BRCAm in males, of which the majority were stage II or III diseases with a higher frequency of BRCA2 mutations. Compared to that in the non-BRCAm group, cutaneous melanoma (16.3 vs. 5.0%), lung cancer (19.4 vs. 11.8%), bladder cancer (15.6 vs. 5.6%), and stomach cancer (11.9 vs. 5.5%) accounted for a higher proportion in the BRCAm group. Advanced disease and more mutation counts (median, 322 vs. 63 mutations) were also found in the BRCAm group. A total of 127 BRCA1 and 311 BRCA2 mutations were identified, of which 21.8% and 28.6% were deleterious, respectively. Frequent deleterious variants were identified in carcinomas of the breast (100.0%), colorectum (62.2%), prostate (43.3%), and stomach (42.9%). BRCA1 fusions with NF1, FAM134C, BECN1, or LSM12 and recurrent BRCA2 mutations at P606L/S, E832K/G, and T3033Lfs*29 were detected. Frameshift mutations in BRCA2 at N1784 (N1784Kfs*3, N1784Tfs*3) were frequently observed in both male and female patients. Compared with those in females, BRCA mutations in males were associated with decreased overall survival (OS) and progression-free survival (PFS). Male patients with deleterious BRCAm displayed increased OS compared with non-BRCAm carriers. The subgroup analysis demonstrated that BRCAm was associated with increased OS in gastric and bladder cancers, decreased PFS in prostate, esophageal, and head and neck cancers, and decreased OS in glioma/glioblastoma in males.Conclusion These findings provide an overview of the distinct characteristics and clinical outcomes of male patients with BRCA-associated tumors, suggesting the importance of further genetic BRCA testing in males.

scholarly journals Clinical Characteristics and Prognostic Implications of BRCA-associated Tumors in Males: A Pan-tumor Survey

2020 ◽  
Author(s):  
Peng Sun ◽  
Yue Li ◽  
Xue Chao ◽  
Jibin Li ◽  
Rongzhen Luo ◽  
...  
Keyword(s):  
Cutaneous Melanoma ◽  
Brca Mutation ◽  
Progression Free Survival ◽  
Brca Mutations ◽  
Male And Female ◽  
Female Patients ◽  
Male Patients ◽  
Brca2 Mutations ◽  
Prognostic Implications ◽  
Associated Tumors

Abstract Background The BRCA mutation (BRCAm) in males has been reported to confer a higher risk for the development of various tumors. However, little is known about its clinicopathologic features and prognostic implications. Design We conducted a retrospective pan-tumor survey on 346 cases of BRCA-associated tumors in males. Comparative analyses were conducted among male and female patients with BRCAm (n=349), as well as in male patients without BRCAm (n=4577). Results Similar incidences of BRCAm (6.0 vs. 6.6%) and age at diagnosis of tumor (median, 65 vs. 60 years) were observed in male and female patients. Carcinomas of the lung, bladder, stomach, and cutaneous melanoma were the frequent tumors demonstrating BRCAm in males, of which the majority were stage II or III diseases with a higher frequency of BRCA2 mutations. Compared to that in the non-BRCAm group, cutaneous melanoma (16.3 vs. 5.0%), lung cancer (19.4 vs. 11.8%), bladder cancer (15.6 vs. 5.6%), and stomach cancer (11.9 vs. 5.5%) accounted for a higher proportion in the BRCAm group. Advanced disease and more mutation counts (median, 322 vs. 63 mutations) were also found in the BRCAm group. A total of 127 BRCA1 and 311 BRCA2 mutations were identified, of which 21.8% and 28.6% were deleterious, respectively. Frequent deleterious variants were identified in carcinomas of the breast (100.0%), colorectum (62.2%), prostate (43.3%), and stomach (42.9%). BRCA1 fusions with NF1, FAM134C, BECN1, or LSM12 and recurrent BRCA2 mutations at P606L/S, E832K/G, and T3033Lfs*29 were detected. Frameshift mutations in BRCA2 at N1784 (N1784Kfs*3, N1784Tfs*3) were frequently observed in both male and female patients. Compared with those in females, BRCA mutations in males were associated with decreased overall survival (OS) and progression-free survival (PFS). Male patients with deleterious BRCAm displayed increased OS compared with non-BRCAm carriers. The subgroup analysis demonstrated that BRCAm was associated with increased OS in gastric and bladder cancers, decreased PFS in prostate, esophageal, and head and neck cancers, and decreased OS in glioma/glioblastoma in males. Conclusion These findings provide an overview of the distinct characteristics and clinical outcomes of male patients with BRCA-associated tumors, suggesting the importance of further genetic BRCA testing in males.

scholarly journals Clinical Characteristics and prognostic implications of BRCA-Associated Tumors in Males: A Pan-tumor Survey

2020 ◽  
Author(s):  
Peng Sun ◽  
Yue Li ◽  
Xue Chao ◽  
Jibin Li ◽  
Rongzhen Luo ◽  
...  
Keyword(s):  
Clinical Characteristics ◽  
Brca2 Mutation ◽  
Brca Testing ◽  
Brca Mutations ◽  
Male And Female ◽  
Males And Females ◽  
Brca2 Mutations ◽  
Prognostic Implications ◽  
Associated Tumors ◽  
Diagnostic Age

Abstract PurposeBRCA mutations (BRCAm) in males have been reported to confer a higher risk in the development of various tumors. However, little is known about the characteristics and prognosis of BRCA-associated tumors in males.DesignWe conducted a pan-tumor survey on BRCA-associated tumors in males (n=346). Comparative analyses with female BRCAm carriers (n=349) and male non-BRCAm carriers (n=4577) were proceed.ResultsSimilar BRCAm incidence and diagnostic age were observed in male and female patients. Carcinomas of lung (19.4%), bladder (15.6%), stomach (11.9%), and cutaneous melanoma (16.3%) were the frequent tumors demonstrating BRCAm in males. The majority were stage II/III diseases with a higher frequency of BRCA2 mutation (65.6%). A total of 127 BRCA1 and 311 BRCA2 mutations were identified in males, of which 21.8% and 28.6% were deleterious, respectively. Deleterious variants were commonly identified in cancer of breast, colorectum, prostate, and stomach. Recurrent BRCA2 mutations at P606L/S, E832K/G, and T3033Lfs*29 were detected in males, while N1784K/Tfs*3 were frequently observed in both males and females. BRCAm in males was associated with a decrease OS and PFS than in females, as well as an increased OS than in non-BRCAm carriers. Subgroup analysis demonstrated that BRCAm was associated with increased OS in gastric and bladder cancer, decreased PFS in cancer of prostate, esophagus, head and neck, and a decreased OS in glioma/glioblastoma in males.ConclusionOur findings provide an overview of the distinct characteristics and clinical outcomes in BRCA-associated tumors in males, suggesting the importance of further BRCA testing in males.

scholarly journals Sex-Disaggregated Data on Clinical Characteristics and Outcomes of Hospitalized Patients With COVID-19: A Retrospective Study

2021 ◽  
Vol 11 ◽  
Author(s):  
Mengdie Wang ◽  
Nan Jiang ◽  
Changjun Li ◽  
Jing Wang ◽  
Heping Yang ◽  
...  
Keyword(s):  
Logistic Regression ◽  
Regression Analysis ◽  
Logistic Regression Analysis ◽  
Clinical Characteristics ◽  
Random Effect ◽  
Hospitalized Patients ◽  
Male And Female ◽  
Female Patients ◽  
Disease Outcomes ◽  
Male Patients

BackgroundSex and gender are crucial variables in coronavirus disease 2019 (COVID-19). We sought to provide information on differences in clinical characteristics and outcomes between male and female patients and to explore the effect of estrogen in disease outcomes in patients with COVID-19.MethodIn this retrospective, multi-center study, we included all confirmed cases of COVID-19 admitted to four hospitals in Hubei province, China from Dec 31, 2019 to Mar 31, 2020. Cases were confirmed by real-time RT-PCR and were analyzed for demographic, clinical, laboratory and radiographic parameters. Random-effect logistic regression analysis was used to assess the association between sex and disease outcomes.ResultsA total of 2501 hospitalized patients with COVID-19 were included in the present study. The clinical manifestations of male and female patients with COVID-19 were similar, while male patients have more comorbidities than female patients. In terms of laboratory findings, compared with female patients, male patients were more likely to have lymphopenia, thrombocytopenia, inflammatory response, hypoproteinemia, and extrapulmonary organ damage. Random-effect logistic regression analysis indicated that male patients were more likely to progress into severe type, and prone to ARDS, secondary bacterial infection, and death than females. However, there was no significant difference in disease outcomes between postmenopausal and premenopausal females after propensity score matching (PSM) by age.ConclusionsMale patients, especially those age-matched with postmenopausal females, are more likely to have poor outcomes. Sex-specific differences in clinical characteristics and outcomes do exist in patients with COVID-19, but estrogen may not be the primary cause. Further studies are needed to explore the causes of the differences in disease outcomes between the sexes.

A Novel DNA/RNA FISH X Inactivation Assay Reveals a Nonrandom, Ploidy-Dependent Acquisition of the Active and Inactive X Chromosomes in Childhood Hyperdiploid Acute Lymphoblastic Leukemia (ALL) and Non-Hodgkin Lymphoma (NHL).

Blood ◽  
2004 ◽  
Vol 104 (11) ◽  
pp. 1080-1080
Author(s):  
Oskar A. Haas ◽  
Petra Zeitlhofer ◽  
Sabine Strehl ◽  
Michael Pfeilstoecker ◽  
Margit Koenig ◽  
...  
Keyword(s):  
Acetic Acid ◽  
X Chromosome ◽  
Dna Sequences ◽  
X Chromosomes ◽  
Childhood All ◽  
Male And Female ◽  
Female Patients ◽  
Rna Fish ◽  
Random Fashion ◽  
Male Patients

Abstract The most common numerical chromosome aberration in childhood ALL and NHL is the gain of an extra X chromosome in both male and female patients. We were therefore interested to investigate whether this non-disjunction event affects the active and inactive X chromosomes in a random or non-random fashion. In female cases both the active or inactive X may be duplicated randomly or non-randomly, whereas in male patients only the solitary active homologue can be copied. However, in theory a duplicated active X might subsequently also be subjected to de novo inactivation in both sexes. The inactivation status of acquired X chromosomes is usually evaluated by methylation-specific PCR (MS-PCR), which allows the simultaneous quantification of various differentially methylated polymorphic DNA sequences on the X chromosome, such as those contained in the HUMARA or FMR1 genes. Previous evidence from such analyses suggested that in NHL patients the acquired X chromosomes are and remain always active in male patients, whereas in females both the active and inactive X are duplicated in a random fashion (McDonald et al, Genes, Chromosomes & Cancer 28:246;2000). In childhood ALL this issue has not yet been investigated. However, quantification with MS-PCR has its limitations, especially in cases with low blast cells numbers. To overcome this problem, we have therefore developed a simultaneous dual-color DNA/RNA FISH assay that enables the enumeration of active and inactive X chromosomes on a single cell level. FISH was performed with probes specific for the X centromere and the XIST RNA, which is exclusively expressed from and covers vast parts of the inactive X in human interphase cells. Following the successful evaluation of the assay on methanol/acetic acid-fixed cells that were obtained from 10 healthy individuals and 23 cases with various constitutional X chromosome aneuploidies, we analyzed 54 methanol/acetic acid-fixed samples from hyperdiploid cases of childhood ALL and 29 from NHL. The ALL cases comprised 24 males with two X, 23 females with three X and seven females with four X. The NHL cases consisted of 18 male (9 in the hypo- to hyperdiploid and 9 in the pseudotriploid to pseudotetraploid range) and 11 female patients (7 with three X and 4 with four X chromosomes). In contrast to all constitutional control samples, which as expected contained only one active X, two of the three X in leukemic cell samples from both male and female patients were active. The only exception was a male patient, who most likely was a Klinefelter syndrome with a constitutional XXY. In contrast, all female patients with four X had duplicated both the active and inactive X chromosome. These findings prove that irrespective of the sex of the patient, the active X is exclusively duplicated in cases with three X chromosomes. The consistent gain of both the active and inactive X in female cases with four X, on the other hand, further corroborates previously established evidence that in all instances a single non-discjunction event leads to the maldistribution of chromosomes irrespective of the ploidy range. Moreover, the exclusive presence of duplicated active X chromosomes in hyperdiploid ALL concurs with and explains the results of gene expression profiling studies, which have shown a corresponding over-expression of X-encoded genes.

scholarly journals Effect and Safety of Therapeutic Regimens for Patients With Germline BRCA Mutation-Associated Breast Cancer: A Network Meta-Analysis

2021 ◽  
Vol 11 ◽  
Author(s):  
Ying Jiang ◽  
Xiang-Yu Meng ◽  
Ning-Ning Deng ◽  
Chen Meng ◽  
Lu-Hui Li ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Brca Mutation ◽  
Meta Analysis ◽  
Objective Response ◽  
Pathologic Complete Response ◽  
Progression Free Survival ◽  
Complete Response ◽  
Cancer Type ◽  
Brca Mutations ◽  
Better Than

PurposeBreast cancer type 1 susceptibility (BRCA) mutations not only increase breast cancer (BC) risk but also result in poor survival and prognosis for BC patients. This study will analyze the effect and safety of therapeutic regimens for the treatment of BC patients with germline BRCA (gBRCA) mutations by network meta-analysis.MethodsPublic databases were searched from inception to 29 April 2021. Frequentist network meta-analysis was conducted to analyze the benefit of chemotherapy and targeted drug-related strategies.ResultsSeventeen articles were included in the analysis. For progression-free survival (PFS), olaparib (hazard ratio (HR): 0.58; 95% confidence interval (CI): 0.43 – 0.79), platinum (HR: 0.45; 95% CI: 0.22 – 0.89), and talazoparib (HR: 0.54; 95% CI: 0.41 – 0.71) were significantly better than platinum-free chemotherapy (Chemo). The results based on indirect comparisons showed that veliparib (Vel) + platinum + Chemo was also significantly better than Chemo (HR: 0.37; 95% CI: 0.20 – 0.69). For overall survival (OS), olaparib was significantly better than Chemo only in the population who did not receive prior chemotherapy. For pathologic complete response (pCR), bevacizumab+Chemo had a significant advantage over platinum agents (OR: 3.64; 95% CI: 1.07 - 12.39). Olaparib and talazoparib both showed significantly higher objective response rates (ORRs) than Chemo.ConclusionThe PFS results suggested that olaparib, talazoparib, and Vel+platinum agent+Chemo were ideal regimens for overall, TNBC, and advanced BC patients with gBRCA mutations. Whether PARPis are suitable for patients with gBRCA mutations who have received prior platinum therapy still needs to be clarified.

scholarly journals T150. SEX DIFFERENCES IN PEOPLE WITH PSYCHOSIS: FINDINGS FROM A REPRESENTATIVE SAMPLE IN KOSOVO

2020 ◽  
Vol 46 (Supplement_1) ◽  
pp. S288-S288
Author(s):  
Manuela Russo ◽  
Fitim Uka ◽  
Jon Konjufca ◽  
Fjolla Ramadani ◽  
Dashamir Berxulli ◽  
...  
Keyword(s):  
Mental Health ◽  
Psychosocial Intervention ◽  
Clinical Characteristics ◽  
Negative Symptoms ◽  
Clinical Presentation ◽  
Psychosocial Treatment ◽  
Clinical Population ◽  
Male And Female ◽  
Female Patients ◽  
Male Patients

Abstract Background The need for mental health care services is particularly high in low and middle income countries (LMICs) where socio-economic factors have a deep impact on treatment and management of psychosis. Lack of funds and qualified professional represent the main challenge to treatment gap leaving between 36% and 45% of people with psychosis without care for their condition thus having a huge impact at individual and societal level. Although data from epidemiological research show that prevalence of psychosis is equal between sexes, some differences in terms of needs for care might be relevant, particularly in a context that has been affected by dramatic socio-economic and cultural changes. In this study we explore in a representative sample of people with psychosis from Kosovo*, as part of a large multi-country study (EU-funded IMPULSE project), whether demographic, socio-economic and clinical differences exist between male and female patients. Methods Data on demographic, socio-economic characteristics, use of psychosocial treatment and medication was collected; general level of psychopathology and negative symptoms were assessed through the Brief Psychiatric Rating Scale, Brief Symptom Inventory and Clinical Assessment Interview for Negative Symptoms. Male and female patients were compared in terms of demographic, socio-economic and clinical characteristics using Chi-square and independent sample t- test as appropriate. Results The sample (n=103) was composed by 33 female and 70 male patients with psychosis. The two groups did not show any statistically significant difference in age, employment, level of education; however, marital status seems to differ with higher proportion of women being separated (p=0.009). No differences emerged in monthly income, while a trend of significance (p=0.079) suggested that female patients had slightly higher financial benefits than their male counterpart. While there was no difference in terms of psychiatric diagnosis, higher depressive (p=0.017) and paranoid symptoms (at trend level, p=0.054) were reported by females patients. There were no differences on antipsychotic medication. Attendance of a psychosocial treatment was higher in male than in female patients (80% vs 57.6%; p=0.017) without any difference though in the type of approach. Overall, patients who attended a psychosocial treatment had lower negative symptoms (p<0.001) compared to those who did not. Discussion Female patients with psychosis were found to have a worse clinical presentation compared to male patients, and to have a lower attendance to psychosocial treatment. Regardless of sex, psychosocial treatment seems to be associated to less negative symptomatology. More research is needed to better characterise clinical presentation of people with psychosis in LMICs and to understand whether access to mental health service, particularly psychosocial intervention, is accountable to clinical characteristics or to contextual factors, social and/or economic in nature. Offering psychosocial intervention to this clinical population could alleviate burden of the illness in this clinical population.

scholarly journals Autologous Osteochondral Transplantation for Osteochondral Lesions of the Talus: Does Gender Impact Outcomes?

2020 ◽  
Vol 5 (4) ◽  
pp. 2473011420S0022
Author(s):  
Arianna L. Gianakos ◽  
Olasunmbo Okedele ◽  
Sean Flynn ◽  
John G. Kennedy ◽  
Christopher W. DiGiovanni
Keyword(s):  
Osteochondral Lesions ◽  
Symptom Duration ◽  
Osteochondral Transplantation ◽  
Autologous Osteochondral Transplantation ◽  
Duration Of Symptoms ◽  
Male And Female ◽  
Female Patients ◽  
Male Patients ◽  
The Mean

Category: Ankle; Arthroscopy Introduction/Purpose: Autologous osteochondral transplantation (AOT) is commonly used in the treatment of osteochondral lesions (OCL) of the talus. There is limited data comparing gender differences in the incidence, presentation, and outcomes following AOT. The purpose of this study is to compare these differences between male and female patients. Methods: Eighty-five consecutive patients who underwent AOT were retrospectively reviewed. Patients were divided into two groups based on gender. Demographic data and OCL defect characteristic data were recorded. Functional outcomes were assessed pre- and post-operatively using the Foot and Ankle Outcome Score (FAOS). The Magnetic Resonance Observation of Cartilage Repair Tissue (MOCART) score was used to assess cartilage incorporation. The mean clinical follow-up was 47.2 months, with mean MRI follow-up of 24.8 months. Results: Fifty-five (65%) males and 30 (35%) females were included. OCL defect size was significantly larger in men (112.8mm2) when compared with women (88.7mm2) (p<0.0001). Male patients had a significantly longer duration of symptoms (p<0.001) and OCLs were more likely traumatic in nature (p=0.0006) when compared with female patients. Mean FAOS improved pre- to postoperatively from 50 to 81(P < .001) with a statistically significant increase in men (p<0.0001). The mean MOCART score was 82.1 and 86.7 in male and female patients, respectively (p<0.0001). Lesion size was negatively correlated with MOCART score (r = -0.36,P = .004). No differences were found in knee donor site morbidity, complication rate, or revision surgery. Conclusion: Our study demonstrates that male patients typically present with talar OCLs that are larger in size, traumatic in nature, and with longer symptom duration when compared with female patients. In addition, male patients had greater improvement in FAOS scores following AOT. Therefore, understanding these differences may influence the management and treatment of talar OCLs in male and female patients.

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.

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