Sex assignment practice in disorders of sexual differentiation: survey results from paediatric endocrinologists in the Arab region

2019 ◽  
Vol 32 (1) ◽  
pp. 75-82
Author(s):  
Asma Deeb ◽  
Maryam Khamis ◽  
Shayma Al Sayed ◽  
Omneya Magdy Omar ◽  
Rasha Odeh ◽  
...  
Keyword(s):  
Sexual Differentiation ◽  
Religious Beliefs ◽  
Androgen Insensitivity Syndrome ◽  
Timing Of Surgery ◽  
Arab Region ◽  
Female Sex ◽  
Sex Assignment ◽  
Paediatric Endocrinology ◽  
Male Sex ◽  
Disorders Of Sexual Differentiation

Abstract Background Sex assignment is a major issue in disorders of sexual differentiation (DSD). Not all conditions of DSD have clear recommendations on assignment and timing of surgery. Reports about sex assignment practice and the influence of culture and religion in the Arab region are scarce. Methods A survey questionnaire was distributed to participants in a paediatric endocrinology conference. Four DSD cases were presented. Participants were asked to fill in their answers on sex assignment choice, reasons for the particular assignment, strength of own recommendation and timing of surgery based on their practice. The cases presented were severely virilised XX congenital adrenal hyperplasia (CAH), complete androgen insensitivity syndrome (CAIS), severely undervirilised 5α reductase deficiency (5α RD) and XX ovotesticular case. Results Eighty-five endocrinologists participated in the study. Eighty (97.5%) chose a female sex to assign for the XX CAH. For the CAIS, 64 (78%) chose a female sex. Seventy-one (86.5%) voted for a male sex for the XY case of 5α RD. Forty-seven (57%) and 35 (43%) chose a female and a male sex for the ovotesticular case, respectively. The majority indicated that their advice for sex assignment is based on strong recommendations for the CAH, CAIS and 5α RD patients but they were open to the parents’ cultural and religious beliefs in their decision of the assignment for the ovotesticular case. Conclusions Practice in the Arab region appears to be in line with the international guidelines in the majority of DSD sex assignment and timing of surgery issues. However, culture and religious beliefs influence the practice in certain circumstances.

Disorders of Sexual Differentiation: Surgical Challenges of Vaginal Reconstruction in Complete Androgen Insensitivity Syndrome (CAIS)

2010 ◽  
Vol 76 (2) ◽  
pp. 188-192
Author(s):  
Jose A. Munoz ◽  
Kenneth G. Swan
Keyword(s):  
Sexual Differentiation ◽  
Intestinal Transplantation ◽  
Androgen Insensitivity Syndrome ◽  
Sexual Life ◽  
Optimal Time ◽  
Vaginal Reconstruction ◽  
Complete Androgen Insensitivity Syndrome ◽  
Surgical Interventions ◽  
Androgen Insensitivity ◽  
Disorders Of Sexual Differentiation

Disorders of sexual differentiation have proven difficult to treat not only because of physicians’ lack of understanding regarding the determinants of sexual orientation, but also because of the psychological impact associated with sexual dysfunction. Patients with complete androgen insensitivity syndrome not only must undergo gonadectomy after puberty, requiring post-gonadectomy hormonal replacement, but also can suffer from underdeveloped, blind vaginal pouches. As a result, sexual intercourse is compromised. Many attempts have been made throughout medical history to correct the vaginal defect, including surgical and nonsurgical approaches, each with its own technical difficulties and complications. Presently, consensus regarding the optimal time for intervention is when the patient is ready to begin sexual life. However, the optimal surgical approach has not been established. In general, nonsurgical vaginal dilatation, like the Frank and Ingram methods, should be followed by surgical interventions, such as described by McIndoe, Vecchietti, and intestinal transplantation, in case of failure of the more conservative procedures.

Territorial Distribution of Alcohol and Drug Addictions Mortality Concerning Regional Disparities in the Slovak Republic from Year 1996 to Year 2015

2020 ◽  
Keyword(s):  
Mortality Rate ◽  
Slovak Republic ◽  
Regional Disparities ◽  
Point Of View ◽  
Extreme Position ◽  
Data Set ◽  
Female Sex ◽  
Male Sex ◽  
The Individual ◽  
High Level

BACKGROUND: This paper deals with territorial distribution of the alcohol and drug addictions mortality at a level of the districts of the Slovak Republic. AIM: The aim of the paper is to explore the relations within the administrative territorial division of the Slovak Republic, that is, between the individual districts and hence, to reveal possibly hidden relation in alcohol and drug mortality. METHODS: The analysis is divided and executed into the two fragments – one belongs to the female sex, the other one belongs to the male sex. The standardised mortality rate is computed according to a sequence of the mathematical relations. The Euclidean distance is employed to compute the similarity within each pair of a whole data set. The cluster analysis examines is performed. The clusters are created by means of the mutual distances of the districts. The data is collected from the database of the Statistical Office of the Slovak Republic for all the districts of the Slovak Republic. The covered time span begins in the year 1996 and ends in the year 2015. RESULTS: The most substantial point is that the Slovak Republic possesses the regional disparities in a field of mortality expressed by the standardised mortality rate computed particularly for the diagnoses assigned to the alcohol and drug addictions at a considerably high level. However, the female sex and the male sex have the different outcome. The Bratislava III District keeps absolutely the most extreme position. It forms an own cluster for the both sexes too. The Topoľčany District bears a similar extreme position from a point of view of the male sex. All the Bratislava districts keep their mutual notable dissimilarity. Contrariwise, evaluation of a development of the regional disparities among the districts looks like notably heterogeneously. CONCLUSIONS: There are considerable regional discrepancies throughout the districts of the Slovak Republic. Hence, it is necessary to create a common platform how to proceed with the solution of this issue.

Virtual screening attributes male biased COVID-19 mortality to predicted antiviral activity of female sex hormones

2021 ◽  
Vol 18 ◽  
Author(s):  
Galal Yahya ◽  
Basem Mansour ◽  
Kristina Keuper ◽  
Moataz Shaldam ◽  
Ahmed El-Baz
Keyword(s):  
Virtual Screening ◽  
Sex Hormones ◽  
Hospital Admissions ◽  
Epidemiological Data ◽  
Antiviral Effect ◽  
Sex Hormone ◽  
Female Sex ◽  
Female Sex Hormones ◽  
Disaggregated Data ◽  
Male Sex

Background: Coronavirus disease-19 (COVID-19) is a newly emerged pandemic leading to a state of international alert with millions of infected individuals and thousands of deaths all over the world. Analysis of statistics and epidemiological data for the pandemic outcome pinpointed a puzzling influence of human sex on the heterogeneous outcome of COVID-19, where hospital admissions and mortality were higher among males than females. Two theories explained the observed male-biased COVID-19 mortality based on either dosage of immunoregulatory genes coded in X- chromosomes or on the abundance of the angiotensin-converting enzyme two (ACE2) receptors in males than females. Objective: In our study, we propose a third scenario through virtual screening of direct antiviral effects of sex hormones. Materials & Methods: Updated screening statistics from 47 countries displaying sex-disaggregated data on COVID-19 were employed and visualized in the form of heatmaps depicting sex difference effects on statistics of cases and deaths. Molecular docking and binding simulations of investigated sex steroids against COVID-19 specific proteins were investigated. Results: Analysis of COVID-19 sex-disaggregated data confirmed that male-biased mortality and computer-aided docking found unexpected female sex hormones biased binding against key targets implicated in the life cycle of COVID-19 compared to the male sex hormone testosterone. Other investigated steroids showed promising docking scores, while the male sex hormone exhibited the lowest affinity. Conclusion: Female sex hormones virtually exhibited direct COVID-19 effect. The proposed antiviral effect of sex hormones should be considered to explain the outcomes of mortality; moreover, the fluctuation of sex hormones influences sex and personal derived-differential response to COVID-19 infection.

Disorders of Sexual Differentiation: New Epigenetic Insights of Hypospadia.

2010 ◽  
pp. P1-317-P1-317
Author(s):  
A. Vottero ◽  
I. Viani ◽  
R. Minari ◽  
V. Gasco ◽  
S. Bernasconi ◽  
...  
Keyword(s):  
Sexual Differentiation ◽  
Disorders Of Sexual Differentiation
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