scholarly journals “Bridging the Gap” Everything that Could Have Been Avoided If We Had Applied Gender Medicine, Pharmacogenetics and Personalized Medicine in the Gender-Omics and Sex-Omics Era

2019 ◽  
Vol 21 (1) ◽  
pp. 296 ◽  
Author(s):  
Donato Gemmati ◽  
Katia Varani ◽  
Barbara Bramanti ◽  
Roberta Piva ◽  
Gloria Bonaccorsi ◽  
...  

Gender medicine is the first step of personalized medicine and patient-centred care, an essential development to achieve the standard goal of a holistic approach to patients and diseases. By addressing the interrelation and integration of biological markers (i.e., sex) with indicators of psychological/cultural behaviour (i.e., gender), gender medicine represents the crucial assumption for achieving the personalized health-care required in the third millennium. However, ‘sex’ and ‘gender’ are often misused as synonyms, leading to frequent misunderstandings in those who are not deeply involved in the field. Overall, we have to face the evidence that biological, genetic, epigenetic, psycho-social, cultural, and environmental factors mutually interact in defining sex/gender differences, and at the same time in establishing potential unwanted sex/gender disparities. Prioritizing the role of sex/gender in physiological and pathological processes is crucial in terms of efficient prevention, clinical signs’ identification, prognosis definition, and therapy optimization. In this regard, the omics-approach has become a powerful tool to identify sex/gender-specific disease markers, with potential benefits also in terms of socio-psychological wellbeing for each individual, and cost-effectiveness for National Healthcare systems. “Being a male or being a female” is indeed important from a health point of view and it is no longer possible to avoid “sex and gender lens” when approaching patients. Accordingly, personalized healthcare must be based on evidence from targeted research studies aimed at understanding how sex and gender influence health across the entire life span. The rapid development of genetic tools in the molecular medicine approaches and their impact in healthcare is an example of highly specialized applications that have moved from specialists to primary care providers (e.g., pharmacogenetic and pharmacogenomic applications in routine medical practice). Gender medicine needs to follow the same path and become an established medical approach. To face the genetic, molecular and pharmacological bases of the existing sex/gender gap by means of omics approaches will pave the way to the discovery and identification of novel drug-targets/therapeutic protocols, personalized laboratory tests and diagnostic procedures (sex/gender-omics). In this scenario, the aim of the present review is not to simply resume the state-of-the-art in the field, rather an opportunity to gain insights into gender medicine, spanning from molecular up to social and psychological stances. The description and critical discussion of some key selected multidisciplinary topics considered as paradigmatic of sex/gender differences and sex/gender inequalities will allow to draft and design strategies useful to fill the existing gap and move forward.

2012 ◽  
Vol 220 (2) ◽  
pp. 57-60 ◽  
Author(s):  
Markus Hausmann ◽  
Barbara Schober

Author(s):  
B. Moretti ◽  
A. Spinarelli ◽  
G. Varrassi ◽  
L. Massari ◽  
A. Gigante ◽  
...  

Abstract Purpose The exact nature of sex and gender differences in knee osteoarthritis (OA) among patient candidates for total knee arthroplasty (TKA) remains unclear and requires better elucidation to guide clinical practice. The purpose of this investigation was to survey physician practices and perceptions about the influence of sex and gender on knee OA presentation, care, and outcomes after TKA. Methods The survey questions were elaborated by a multidisciplinary scientific board composed of 1 pain specialist, 4 orthopedic specialists, 2 physiatrists, and 1 expert in gender medicine. The survey included 5 demographic questions and 20 topic questions. Eligible physician respondents were those who treat patients during all phases of care (pain specialists, orthopedic specialists, and physiatrists). All survey responses were anonymized and handled via remote dispersed geographic participation. Results Fifty-six physicians (71% male) accepted the invitation to complete the survey. In general, healthcare professionals expressed that women presented worse symptomology, higher pain intensity, and lower pain tolerance and necessitated a different pharmacological approach compared to men. Pain and orthopedic specialists were more likely to indicate sex and gender differences in knee OA than physiatrists. Physicians expressed that the absence of sex and gender-specific instruments and indications is an important limitation on available studies. Conclusions Healthcare professionals perceive multiple sex and gender-related differences in patients with knee OA, especially in the pre- and perioperative phases of TKA. Sex and gender bias sensitivity training for physicians can potentially improve the objectivity of care for knee OA among TKA candidates.


2021 ◽  
Vol 8 ◽  
pp. 237437352110077
Author(s):  
Daliah Wachs ◽  
Victoria Lorah ◽  
Allison Boynton ◽  
Amanda Hertzler ◽  
Brandon Nichols ◽  
...  

The purpose of this study was to explore patient perceptions of primary care providers and their offices relative to their physician’s philosophy (medical degree [MD] vs doctorate in osteopathic medicine [DO]), specialty (internal medicine vs family medicine), US region, and gender (male vs female). Using the Healthgrades website, the average satisfaction rating for the physician, office parameters, and wait time were collected and analyzed for 1267 physicians. We found female doctors tended to have lower ratings in the Midwest, and staff friendliness of female physicians were rated lower in the northwest. In the northeast, male and female MDs were rated more highly than DOs. Wait times varied regionally, with northeast and northwest regions having the shortest wait times. Overall satisfaction was generally high for most physicians. Regional differences in perception of a physician based on gender or degree may have roots in local culture, including proximity to a DO school, comfort with female physicians, and expectations for waiting times.


2007 ◽  
Vol 2 (2) ◽  
pp. 59-67 ◽  
Author(s):  
Lindsay Richardson ◽  
Lorraine Greaves ◽  
Natasha Jategaonkar ◽  
Kirsten Bell ◽  
Ann Pederson ◽  
...  

AbstractThis article assesses whether the Fagerstrom Test for Nicotine Dependence (FTND), adequately reflects sex, gender and diversity related differences in nicotine dependence. Available studies on the FTND were reviewed and a sex, gender and diversity analysis (SGBA) of this instrument was conducted. Results indicate that sex and gender differences in nicotine dependence may undermine the ability of the FTND to present an adequate picture of dependence. Conducting a SGBA on this Fagerstrom test reveals that sex and gender differences likely limit the ability of this instrument to present an accurate picture of dependence in diverse groups. Further research is needed to enhance the sensitivity of the FTND.


2021 ◽  
Vol 22 (11) ◽  
pp. 5808
Author(s):  
Annalisa Giandalia ◽  
Alfio Edoardo Giuffrida ◽  
Guido Gembillo ◽  
Domenico Cucinotta ◽  
Giovanni Squadrito ◽  
...  

Diabetic kidney disease (DKD) is one of the most serious complications of both type 1 (T1DM) and type 2 diabetes mellitus (T2DM). Current guidelines recommend a personalized approach in order to reduce the burden of DM and its complications. Recognizing sex and gender- differences in medicine is considered one of the first steps toward personalized medicine, but the gender issue in DM has been scarcely explored so far. Gender differences have been reported in the incidence and the prevalence of DKD, in its phenotypes and clinical manifestations, as well as in several risk factors, with a different impact in the two genders. Hormonal factors, especially estrogen loss, play a significant role in explaining these differences. Additionally, the impact of sex chromosomes as well as the influence of gene–sex interactions with several susceptibility genes for DKD have been investigated. In spite of the increasing evidence that sex and gender should be included in the evaluation of DKD, several open issues remain uncovered, including the potentially different effects of newly recommended drugs, such as SGLT2i and GLP1Ras. This narrative review explored current evidence on sex/gender differences in DKD, taking into account hormonal, genetic and clinical factors.


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