Characteristics Of Female Patients Research Articles

Adenocarcinoma of the esophagogastric junction: characteristics of female patients and young adult patients based on a 12-year retrospective and prospective multicenter clinicoepidemiological cohort study in Japan

BackgroundAdenocarcinoma of the esophagogastric junction (AEGJ) is most common in men and the elderly, but the disease is becoming more common in female and young adult persons. We have investigated the clinicoepidemiological characteristics of female and young adult patients with AEGJ and the 12-year trends in the Kurashiki area for young adult patients with AEGJ.MethodsPatients diagnosed with AEGJ in 12 hospitals between January 2008 and December 2019 were included in this study. Patients were divided into three groups by age (young adult [≤50 years], middle-aged [51 to 70 years], and elderly [>70 years]). Factors associated with AEGJ such as obesity, smoking, hiatal hernia and male, which were reported in our previous study, were identified.ResultsOne hundred and eighty-eight AEGJ patients, including 36 females and 20 young adults, were characterized. There was no significant change in the annual incidence of AEGJ among female (p=0.078) and young adult patients (p=0.89). Female patients without any associated factors, accounting for 53% (19/36) of the female patients and young adult patients, had significantly more histologically undifferentiated cancers than patients with at least one associated factor (58% [11/19] vs. 30% [50/169], p=0.025) and middle-aged and elderly patients (60% [12/20] vs. 30% [25/83] vs. 28% [24/85], p =0.026). Smoking was significantly less common in women than in men (8% [3/36] vs. 57% [87/152], p < 0.01). There were no significant differences between ages in the proportions of these associated factors.ConclusionsHistologically undifferentiated AEGJ cancers were more frequent in female patients without any associated factors and in young adult patients. Factors associated with AEGJ may differ between women and men, but they are similar in young adults and older adults. No increase in young adult patients with AEGJ was observed in the 12-year study.

Sex differences in plaque characteristics of fractional flow reserve-negative non-culprit lesions after myocardial infarction

Background and aimsRecurrent events after myocardial infarction (MI) are common and often originate from native non-culprit (NC) lesions that are non-flow limiting. These lesions consequently pose as targets to improve long-term outcome. It is, however, largely unknown whether these lesions differ between sexes. The aim of this study was to assess such potential differences. MethodsFrom the PECTUS-obs study, we assessed sex-related differences in plaque characteristics of fractional flow reserve (FFR)-negative intermediate NC lesions in 420 MI-patients. ResultsAmong the included patients, 80 (19.1 %) were female and 340 (80.9 %) male. Women were older and more frequently had hypertension and diabetes. In total, 494 NC lesions were analyzed. After adjustment for clinical characteristics and accounting for within-patients clustering, lesion length was longer in female patients (20.8 ± 10.0 vs 18.3 ± 8.5 mm, p = 0.048) and minimum lumen area (2.30 ± 1.42 vs 2.78 ± 1.54 mm2, p < 0.001) and minimum lumen diameter (1.39 ± 0.45 vs 1.54 ± 0.44 mm, p < 0.001) were smaller. The minimum fibrous cap thickness was smaller among females (96 ± 53 vs 112 ± 72 μm, p = 0.025), with more lesions harboring a thin cap fibroatheroma (39.3 % vs 24.9 %, p < 0.001). Major adverse cardiovascular events at two years occurred in 6.3 % of female patients and 11.8 % of male patients (p = 0.15). ConclusionsFFR-negative NC lesions after MI harbored more high-risk plaque features in female patients. Although this did not translate into an excess of recurrent events in female patients in this modestly sized cohort, it remains to be investigated whether this difference affects clinical outcome.

Hypogonadism as a consequence of craniopharyngioma in female patients: comparison of childhood and adult onset and effects of estrogen replacement therapy.

(1) to compare clinical, biochemical features in female patients with hypoestrogenism due to childhood- and adult-onset CP; (2) to reveal effects of estrogen replacement therapy in female patients with childhood-onset CP. Thirty-seven women that received specific treatment for CP in the period from 1980 to 2019 were recruited: 21 with childhood-onset and 16 with adult-onset CP. Clinical and hormonal characteristics were evaluated. Seventeen-beta-estradiol 2 mg and dydrogesterone 10 mg in sequential regiment was used in 18 childhood-onset cases. Mean follow-up was 31 months. Amenorrheic women with childhood- and adult-onset CP presented with the same complaints except for lack of genital hair and breast hypoplasia, which were common in patients with childhood-onset CP. BMI was lower in childhood-onset CP group, as was the proportion of overweight patients. They had more favorable lipid profile. The levels of estradiol, testosterone and DHEA-S were low and did not differ. Uterine and ovary volumes were reduced in all patients, but the decline was noticeable in the childhood-onset group. Mineral bone density of lumbar vertebrae was diminished in childhood-onset group. Estrogen therapy in these patients led to clinical improvement: increase in BMD in lumbar spine without negative changes in BMI and/or lipid profile. Study showed that women with childhood-onset CP had less negative metabolic changes. However, they have more pronounced breast and uterus hypoplasia and lower BMD in lumbar spine. The estrogen replacement therapy led to clinical improvement and BMD increase in lumbar spine without increase of BMI and/or lipid profile changes.

EPH29 Estimating the Incidence and Characteristics of Female Patients in Norway With Early Breast Cancer Who Are at High Risk of Disease Recurrence

EPH29 Estimating the Incidence and Characteristics of Female Patients in Norway With Early Breast Cancer Who Are at High Risk of Disease Recurrence

Psychosocial factors of psychological maladaptation in female patients of a cosmetology clinic

Introduction. In the field of aesthetic medicine, there is a lack of psychological research despite the obvious impact of cosmetic defects on the emotional state and social functioning of a person. Only a few studies indicate psychological maladaptation in patients of a cosmetology clinic, which is reflected in the frequency of the occurrence of anxiety, depression and personality disorders exceeding their levels in population. The objective was to identify psychosocial factors associated with the risk of psychological maladaptation in female patients of the cosmetology clinic. Methods and materials. To achieve the goal, female patients (n=161, mean age was 39.53±0.86 years) were studied using the author’s structured interview and 7 psychodiagnostic methods: «Neuropsychic Adaptation Test» (NPA), «Social Frustration Level» (SFL), «Visual Analogue Self-Esteem Scale» (VASES), «Semantic Time Differential» (STD), «Perceived Stress Scale» (PSS-10), «Well-Being Index» (WHO-5), «Quality of Life Satisfaction Questionnaire» (QOL). Groups of female patients without psychological maladaptation (group 1, n=74) and those with psychological maladaptation (group 2, n=87), selected on the basis of the final NPA test score were compared. Results. The results showed a statistically significant predominance in group 2 compared to group 1 of the frequency of emotionally neutral relationships with their own children, of living alone, as well as dissatisfaction in significant areas of life, especially in the material economic sphere, in the sphere of self-accepting as a personality and one’s physical «Ego», in the sphere of attitude to past and present life. In group 2, higher rates of perceived stress and frequency of psychotraumatic situations in anamnesis as well as lower rates of general psychological well-being and satisfaction with the quality of life were revealed. Conclusion. The factors influencing the psychological maladaptation in female patients of the cosmetology clinic were identified. The prospects of the study associated with the determination of the most informative factors for the prognosis of psychological adaptation based on the analysis on not only psychological but also individual and personal characteristics in female patients of the cosmetology clinic were indicated.

Demographic, tumour, and treatment characteristics of female patients with breast cancer in Sri Lanka; results from a hospital-based cancer registry

BackgroundAlthough breast cancer is the most common cancer among Sri Lankan women, there is little published data on patient characteristics and treatment in the local context. We aimed to describe disease characteristics and management in a large contemporary cohort of women with breast cancer at the National Cancer Institute of Sri Lanka (NCISL).MethodsAll women with invasive primary breast cancers diagnosed during 2016–2020 were identified from the NCISL breast cancer registry. The NCISL sees approximately 40% of all cancer patients in Sri Lanka. Cancer stage at diagnosis was defined according to the Tumour, Node, and Metastasis (TNM) staging system and the Estrogen (ER) and progesterone (PR) receptor status was determined based on the results of immunohistochemistry tests. Descriptive statistics were used to describe the study cohort and treatment patterns.ResultsOver 5100 patients were diagnosed with breast cancer during the study period at the NCISL. The mean age of the women was 56 (SD 12) years. Common co-morbidities were hypertension (n = 1566, 30%) and diabetes mellitus (n = 1196, 23%). Two thirds (66%) of the cancers were early stage (stage I & II) at diagnosis. ER/PR positivity rate was 72% and HER-2 positivity rate was 22%. Two thirds of the women had undergone mastectomy while 68% had undergone axillary clearance. The rate of chemotherapy delivery was 91% for women with node positive disease while 77% of eligible women (i.e., after wide local excision or with > 3 positive lymph nodes) had received adjuvant radiotherapy. Endocrine therapy was initiated in 88% of eligible women with hormone receptor positive disease while rate of trastuzumab use was 59% among women with HER2 positive breast cancer.ConclusionsHigh percentage of advanced breast cancer at diagnosis and high prevalence of comorbidities are some of the major challenges faced in the management of breast cancer in Sri Lanka. Given that stage at diagnosis is the most important prognostic factor determining survival, greater efforts are needed to promote early diagnosis of breast cancer. Considerable lapses in the concordance between guideline recommendations and the delivery of cancer care warrants closer assessment and intervention.

Features of nutrition in women with arterial hypertension and abdominal obesity

Background. Currently, there is a significant increase in the percentage of women with arterial hypertension (AH) and abdominal obesity (AO), which is largely due to violations of the healthy eating norms. Therefore, the problem of studying the nutritional characteristics of women with AH in combination with AO requires further research. The study was aimed to investigate the nutritional characteristics of female patients (residents of Ukraine) with arterial hypertension and abdominal obesity. Materials and methods. We examined 75 female patients (residents of Ukraine) with AH stage II, 2–3 degrees, aged from 40 to 59 years (40 women with AO (I–II degrees) and 35 women with normal body weight (NBW). All patients underwent a routine examination. The peculiarities of the nutrition of the patients were analyzed using the questionnaire “Diary of daily nutrition”. The data obtained were analyzed using the SPSS 19 computer program for Windows XP. Results. In the group of women with AH and AO, in the vast majority of individuals (73–100 %), the diet did not meet the recommendations of a healthy diet. In the group of women with AH and NBW, the dietary pattern did not meet the recommendations of a healthy diet only in one-third of the individuals. The daily diet of women with AH and AO differed from that of women with AH and NBW by a significantly higher energy value of food, a higher frequency of meals in the evening, a higher intake of fats (including saturated fatty acids and trans-unsaturated fatty acids), carbohydrates (especially monosaccharides), and less dietary fiber intake. In both groups of women, the habit of adding salt to food was revealed, but only in the third of the individuals. Conclusions. Significant violations of the healthy eating norms were found in women with AH, which were much more pronounced in women with AO that must be taken into account when developing optimal schemes for correcting the diet in these patients.

Urinary Microbiome Characteristics in Female Patients with Acute Uncomplicated Cystitis and Recurrent Cystitis.

Traditionally, the diagnostic mainstay of recurrent urinary tract infection has been urinary culture. However, the causative uropathogen of recurrent cystitis has not been well established. Urine DNA next-generation sequencing (NGS) can provide additional information on these infections. Herein, we compared urine NGS results and urine cultures in patients with acute uncomplicated cystitis (AUC) and recurrent cystitis (RC), and evaluated the difference in microbiome patterns in the NGS results. Patients who underwent urine culture and NGS due to AUC or RC were retrospectively reviewed. All urine samples were collected via a transurethral catheter and studied utilizing a type of NGS called 16S ribosomal RNA gene amplification and sequencing. The sensitivity of urine NGS was significantly higher than that of conventional urine culture (69.0% vs. 16.7%, p < 0.05). The detection rate of urine NGS was slightly lower in the RC group than in the AUC group (67.7% vs. 72.7%). Microbiome diversity was significantly higher in the RC group compared to the AUC group (p = 0.007), and the microbiome composition was significantly different between the AUC and RC groups. In the urine NGS results, Pseudomonas, Acinetobacter, and Enterobacteriaceae were found in the AUC group, and Sphingomonas, Staphylococcus, Streptococcus, and Rothia spp. were detected in the RC group. Urine NGS can significantly increase the diagnostic sensitivity compared to traditional urine culture methods, especially in RC patients. AUC and RC patients had significant differences in bacterial diversity and patterns. Therefore, recurrent cystitis might be approached from a different perspective.

Tumor budding index and microvessel density assessment in patients with endometrial cancer: A pilot study.

The present study aimed to analyze the association between tumor budding index (TBI) and microvessel density (MVD) and selected clinicopathological features in female patients with endometrial cancer (EC). The present study included 137 patients, of whom 117 had endometrial endometrioid cancer and 3 had non-endometrioid EC (NEEC). Additionally, 8 cases of simple endometrial hyperplasia and 9 cases of atypical endometrial hyperplasia were included in the present study. Patient age, menopausal status, tumor histological type, grade and International Federation of Gynecologists and Obstetricians (FIGO) clinical stage were investigated. Immunohistochemistry was utilized to detect MVD using a CD34 antibody, and a laminin-5γ2 antibody was used for TBI assessment. In nonmalignant endometrial lesions, the TBI was significantly lower than that in patients with EC and NEEC (P=0.002). Significant differences in median TBI (MD-TBI) were also observed between patients with low-grade EC (MD-TBI, 4.5) and high-grade EC (MD-TBI, 16.2; P=0.01). Age, body mass index and tumor FIGO stage were not indicated to be associated with the MD-TBI. Premenopausal patients with EC had lower MD-TBI values than postmenopausal patients (0.3 vs. 11.1; P<0.005). The median MVD-CD34 in the study group was 19 (range, 13–29). Significant differences in MVD-CD34 were observed between malignant and nonmalignant endometrial lesions (P=0.01). Histological grade was markedly associated with tumor MVD-CD34 (P=0.001). The MVD was higher in high-grade cancer (G3; MVD-CD34, 24.9) than in grade G1 and G2 lesions (MVD-CD34, 14 and 18.6, respectively; P=0.01). FIGO clinical stage was not associated with MVD-CD34 in low and high stage lesions (MD, 18.4 for FIGO stage I/II; MD, 17.6 for FIGO stage III/IV; P=0.2). High MVD was markedly associated with high MD-TBI (P=0.0002). In conclusion, TBI could be a valuable indicator of tumor aggressiveness in patients with EC. The presence of the tumor budding phenomenon with increased MVD may have the potential to further refine clinical management decisions when endometrial malignancy is detected.

Unique Genetic Characteristics and Clinical Prognosis of Female Patients with Lung Cancer Harboring RET Fusion Gene

Objectives: Since no report on the genetic characteristics of RET fusions in female patients with lung cancer is available, this study revealed the genetic and prognostic characteristics of female patients with lung cancer harboring RET fusion gene for the first time. Materials and Methods: The molecular portfolios of 1,652 patients with lung cancer who underwent targeted next-generation sequencing for screening candidate oncogenic drivers in their histological specimens from January 2016 to December 2018 were investigated in this study. Results: RET fusions were identified in 23 cases, 15 females [2.2% (15/685)] and eight males [0.9% (8/902)]. The most common fusions were KIF5B–RET in females [80% (12/15)] and CCDC6–RET in males [50% (4/8)], along with some rare RET fusions, including SLC39A8–RET, ITIH2–RET, FYCO1–RET and SLC25A36–RET in females, and MIR3924–RET, ZBTB41–RET and ITGA8–RET in males. Interestingly, the highly positive, moderate positive, and negative rates of PD–L1 staining in females were 33.3%, 8.3% and 58.3%, respectively; whereas those in males were 0%, 57.1% and 42.9%. Additionally, the progression-free survival (PFS) of stage IV patients was comparatively shorter in females, shown by the medians of 4.0 months in females and 6.0 months in males (P = 0.029). A 43-year-old female patient with metastatic lung adenocarcinoma, who harbored KIF5B–RET fusion and had highly positive PD–L1 staining, received nivolumab as second-line treatment. A partial response was achieved and remained for more than five months. Conclusion: Unique genetic characteristics and poor prognosis are found in female patients with lung cancer harboring RET fusion gene. Immune checkpoint inhibitors are a potential option for patients with high expression of PD–L1.

Study Fertility Characteristics in Female Patients with Neuromyelitis Optica Spectrum Disorder

Neuromyelitis optica spectrum disorder (NMOSD) predominantly affect women who are of childbearing age. Understanding the interactions between pregnancy and NMOSD is important for clinical management. To study the fertility characteristics in patients with NMOSD in Cairo university hospital MS Multiple Sclerosis (MS) clinic and determine the interrelation between NMOSD, menstruation, pregnancy outcome. It is an observational cross-sectional study conducted on 83 female patients (67 married and 16 unmarried) diagnosed with NMOSD according to an international consensus (2006, 2015) and 30 unmarried healthy female as control group. All patients were subject to full demographic and clinical history from their medical records and personal interview, full neurological examination, expanded disability status scale (EDSS), and pregnancy registry questionnaire. There was significant increase in percentage of amenorrhea and decrease in menstrual flow days in unmarried patients compared to control (p-value =0.05, 0.04 respectively with OR=3.5), compared to married patients before and after disease onset. Regarding to pregnancy characteristics, there was significant increase in the number of abortions, percentage of cesarean section, decrease in the number of living fetuses, normal fetuses, breast feeding percentage after disease onset compared to pregnancies occurred before disease onset (p value= 0.02, <0.001, 0.001, 0.02, <0.001 with OR= 2.7, 5.2, 4.9 respectively). There was significant increase in the number of postpartum relapse (66% from pregnancies after disease onset), most of them in first 3 months postpartum (88.7%). Presence of NMOSD increased the percentage of amenorrhea/oligomenorrhea, miscarriage, delivery by Cesarean section, and decreased the chance for breastfeeding. Moreover, pregnancy increases NMOSD relapse and subsequently disability.

Association study between X-linked susceptibility genes and clinical features in Chinese female patients with systemic lupus erythematosus

Recent large-scale genetic association studies have identified that several single nucleotide polymorphisms (SNPs) on X chromosome are correlated with risk of systemic lupus erythematosus (SLE) in Chinese population. The aim of this study was to estimate association between these loci and clinical features in female patients with SLE. Six SNPs identified in previous studies were genotyped. Odds ratio (OR) was calculated with adjusting for potential confounding factors. A total of 772 SLE patients were included in the final analysis. The data showed that 3 SNPs (rs5914778, rs3853839 and rs1059702) were marginally associated with several clinical subphenotypes. Furthermore, consistent associations were also found in two independent cohorts. However, the cumulative genetic risk score (GRS) was not associated with clinical manifestations as well as the disease activity index at disease diagnosis. In summary, genetic variants in X-linked genes may be potentially associated with presence of specific clinical feature. Further studies in distinct ethnical populations are required to clarify the association between these loci and presence of SLE clinical features.

Intraoperative periprosthetic fractures during total hip arthroplasty in patients with rheumatic diseases

Surgical treatment in patients with rheumatic diseases (RDs) is associated with the higher risk of complications due to the presence of the inflammatory process, to long-term therapy with glucocorticoids, disease-modifying antirheumatic drugs, and biologic agents (BA), to decreased physical activity, and the severity of functional disorders, and to obvious osteoporosis. All this increases the risk of intraoperative complications, including periprosthetic fractures.Objective: to comparatively analyze intraoperative periprosthetic fractures of the greater trochanter, acetabulum, and proximal femur during total hip arthroplasty (THA) in patients with RDs.Subjects and methods. From 1998 till 2017, a total of 1569 THA were performed in patients with RA, including 464 patients with rheumatoid arthritis (RA), 396 with juvenile rheumatoid arthritis (JRA) and systemic lupus erythematosus (SLE), and 709 with osteoarthritis (OA).Results and discussion. Periprosthetic fractures after THA were diagnosed in a total of 68 (4.33%) patients, including 23 (4.96%) patients with RA, 27 (6.82%) with JRA and SLE, and 18 (2.54%) with OA; 42 (61.8%) patients with periprosthetic fractures underwent osteosynthesis. Statistical analysis of the findings revealed significantly higher rates of complications in patients with RA and JRA with SLE (p &lt; 0.005).Conclusion. The findings confirm that the risk of periprosthetic fractures is higher in patients with inflammatory diseases, including RA, JRA, and SLE. These patients require a special approach that involves medical correction of impaired bone metabolism and proper individual selection of endoprosthetic components, by taking into account the anatomical features of female patients and delicate bone handling during surgery.

Functional and Structural Arterial Vessel Features of Female Patients with Stable Dermatomyositis and Antisynthetase Syndrome

Introduction: Dermatomyositis (DM) and antisynthetase syndrome (ASS) show a high frequency of metabolic syndrome, which can be preceded by endothelial dysfunction and arterial stiffness. To date, only one study has evaluated these vessel parameters in DM, and no study of ASS exists. Therefore, the aim of the study was to assess the structural and functional arterial of arterial vessels in DM and ASS. Methods: This cross-sectional study enrolled 21 adult female patients (14 DM and 7 ASS) who were age-, gender- and ethnicity-matched to 12 healthy individuals. Patients using lipid lowering agents or prednisone at doses ≥ 0.25 mg/kg/day, and patients with uncontrolled systemic arterial hypertension, diabetes mellitus, cardiac insufficiency, and disease activity were excluded. Arterial stiffness was evaluated using carotid-femoral pulse wave velocity (PWV), and endothelial function was evaluated using dependent flow-mediated dilatation (FMD) of the brachial artery. Results: The mean age of patients with DM or ASS were 45.4 ± 8.6 and 44.0 ± 6.1 years, respectively (P = 1.000), and patients were predominantly of white ethnicity. Six DM patients and three ASS patients had systemic arterial hypertension, whereas 9 DM patients and six ASS patients had dyslipidemia. Endothelial baseline diameter, hyperemia diameter and FMD values were similar among the three groups (P > 0.05). Moreover, the median FMD values were also similar between the patients with DM and patients with ASS [8.3% (4.5% - 10.9%) vs. 6.0% (−1.8% - 8.2%); P = 0.585]. The PWV values were comparable among the three groups (P = 0.253). In addition, no difference was observed between patients with DM and patients with ASS (7.4 ± 0.8 m/s vs. 7.4 ± 0.9 m/s; P = 1.000). Conclusions: Despite the high prevalence of dyslipidemia and systemic arterial hypertension, our female patients with stable DM and ASS had FMD and PWV values comparable to those of the control group.

Transcatheter Aortic Valve Replacement in Female Patients—Present Scenario

AbstractSince the publication of the pivotal PARTNER study, the transcatheter aortic valve replacement (TAVR) procedure has been established as a noninferior alternative to the traditional aortic valve replacement surgery in severe aortic stenosis (AS) patients with high-surgical risk. Approximately 50% of patients undergoing TAVR are females, and cumulative findings from various worldwide cohorts have shown sex-related differences in short- and long-term morbidity and mortality. Notably, most data indicate improved long-term mortality in female patients. These differences are partly the results of distinct anatomical and physiologic characteristics in female patients, compared with male patients. Nevertheless, recent data from intermediate-surgical risk cohorts have demonstrated that sex-related mortality differences are less apparent. Here, we review the latest literature on the influence of patient's sex on TAVR morbidity and mortality and discuss possible explanations for the outcomes presented.

Psychology of the Facelift Patient.

This paper presents an extensive literature review of the psychology of facelift patients as it has evolved over the past 50 years. Earlier studies revealed significant levels of pre and perioperative depression. Facelift patients generally exhibit emotional and social concerns about facial appearance that are higher than the general population. Many are undergoing midlife situational stresses and may lack the positive characteristics to deal with them. The most common diagnoses seen include depression, impulsivity, unstable personality, and passive dependence, albeit not necessarily serious. Improvement in body image is the major driver for surgery. Characteristics of female patients as defined by their age are described. These include the younger emotionally dependent group, the worker group of middle age, and the older grief group. Male patients are seen to have a higher level of psychological dysfunction, but a higher improvement in postoperative quality of life. Motivations for surgery include increasing self-esteem, making new friends, improving relationships, and getting better jobs. Overall patient satisfaction is more than 95%, with improvement seen in positive changes in their life, increased self-confidence and self-esteem, decreased self-consciousness about their appearance, and overall improvement in quality of life. Postoperative psychological reactions are seen in about half the patients, these primarily being anxiety and depression of varying degrees. Predictors of patient satisfaction include the desire for self-image improvement in contradistinction to a change in life situation. Negative predictors include male sex, young age, unrealistic expectations, relationship disturbances, and preexisting psychological pathology. The importance of good patient selection in achieving a satisfied patient is outlined and emphasized.

Abstract 203: Gender Differences in PCSK9 Inhibitor Prescribing

Background: Proprotein convertase subtilisin/kexin type 9 inhibitors (PCSK9i) alirocumab (Sanofi and Regeneron) and evolocumab (Amgen) were approved by the FDA in the summer of 2015 for use in patients on maximally tolerated statins with clinical atherosclerotic cardiovascular disease (ASCVD) and heterozygous familial hypercholesterolemia (HeFH) who require additional lowering of low-density lipoprotein cholesterol (LDL-C). Both clinical trial programs were skewed towards male participants so little is known about the characteristics of female patients treated with PCSK9i in real-world settings. Objective: To understand the demographic and clinical differences between male and female patients prescribed a PCSK9i in real-world settings. Methods: All patients 18 years of age and older with evidence of a PCSK9i prescription (Rx) between July 27, 2015 and November 1, 2016 were included from Accenture’s “Predictive Health Intelligence Environment”, a database consisting of electronic medical records (EMR) from 26 integrated delivery networks in the US. Patients were also required to have at least one encounter in the EMR in the 24-month period prior to the first PCSK9i Rx. Demographic and clinical characteristics of these patients were evaluated as well as the Rx history prior to the first PCSK9i Rx. Results: The inclusion criteria were met by 1,754 patients with 906 (51.7%) being female. Mean (SD) age was 65.9 (10.4) for females compared to 64.3 (10.3) for males; however, a higher proportion of females (59.6%) were over age 65 as compared to males (51.5%, difference not significant). Females were statistically less likely to have a prior event for ASCVD (54% vs. 73%, p&lt;0.0001). Additionally, females were significantly more likely to have a BMI &lt; 25 kg/m 2 compared to males (19.1% v. 11.0%, p&lt;0.001). No differences were observed in prescribing specialty, prior lipid modifying treatment or history of smoking. Finally, females had a significantly higher mean baseline LDL-C as compared to males (149.4 mg/dL [58.2] v. 123.9 mg/dL [56.6], p&lt;0.001). Conclusions: Despite the clinical trial programs of both PCSK9i’s being skewed toward male participants, this real-world data consisted of nearly equal numbers of males and females. In this study, females were more likely to be identified as FH, as indicated by their significantly higher levels of LDL-C, despite similarities in prior treatment regimens as compared to males. Further research is warranted to understand diagnosis and treatment patterns in women as compared to men as well as how their cardiovascular health can be improved.

Evaluation of Factors Associated with Night Pain in Women Undergoing Carpal Tunnel Release

Night pain has important diagnostic and prognostic values in patients with carpal tunnel syndrome (CTS). We aimed to determine whether night pain is associated with certain patient characteristics in female patients undergoing carpal tunnel release. We recruited 75 women with the mean age of 54 years who were scheduled for carpal tunnel release. Diagnosis of CTS was made based on both the clinical symptoms and the results of electrophysiologic studies. Patient characteristics investigated as factors potentially associated with night pain were: age, body mass index (BMI), symptom duration, comorbidities such as diabetes mellitus (DM) and thyroid disease, electrophysiologic severity of CTS, and sleep position. We conducted a logistic regression analysis to examine the relationships between the presence of night pain and the different patients' demographic and clinical variables. Absence of night pain was associated with increased age (odds ratio (OR), 0.918, 95% confidence interval (CI), 0.851 to 0.99) and presence of DM (OR, 0.196; 95% CI, 0.046 to 0.835). The other variables assessed were not found to be associated with presence or absence of night pain. This study found that in women undergoing carpal tunnel release, older patients or those having DM are slightly less likely to have night pain. As night pain is an important prognostic factor for CTS, further studies are warranted to determine whether the absence of night pain could affect outcome assessment of CTS in the elderly or patients with DM.

Comparison of MR imaging features of solid pseudopapillary neoplasm of pancreas between male and female patients

PurposeTo evaluate MR imaging features of solid pseudopapillary neoplasms (SPN) in male patients and to compare them with the MR imaging features in female patients. Materials and methodsFifty patients who were histologically confirmed as SPN (M:F=8:42, mean age=36.4 years) with preoperative MRI were included. The following imaging features were reviewed: size, location, shape, margin, encapsulation, solid-cystic ratio, pancreatic duct dilatation, parenchymal atrophy, T1 signal intensity, T2 signal intensity, and morphological and dynamic pattern of enhancement. The statistical differences between male and female patients were analyzed. ResultsThe average age of male patients (50.8±4.1 years) was significantly higher (p<0.01) than female patients (33.7±2.0 years). The shape of SPN in male patients was predominantly lobulated (n=6/8, 75.0%) compared to female patients, in whom oval shaped SPN was most prevalent (n=26/42, 61.91%) (P=0.02). SPN in male patients contained less cystic component (solid, n=4/8, 50.0%; mainly solid, n=4/8, 50.0%) while cystic (n=5/42, 11.90%) or mainly cystic (n=13/42, 30.95%) lesions were significantly more prevalent in female patients (P=0.03). The majority of SPNs in both groups showed progressive heterogeneous enhancement pattern. Other MR imaging features showed no significant differences between the male and female patients. ConclusionOn MRI, SPN in male patients appeared as mainly solid mass with a lobulating contour and heterogeneous progressive enhancement occurring at an older age than female patients. Recognition of imaging features of SPN in male patients compared to typical SPN in female patients should assist in correct differentiation of SPN from other pancreatic tumors.

Study on clinical features of female patients with recurrent major depression comorbidity with general anxiety disorder

Objective To explore the clinical features of female diagnosed recurrent major depression(MD) comorbidity with general anxiety disorder (GAD). Methods 301 females patients with recurrent major depression were interviewed by specially trained interviewers with using computer evaluation system and divided into comorbidity group and non-comorbidity group according to whether comorbid MD with GAD or without GAD. The comparison between the two groups included items of demographic, clinical data, assessment of psychopathology, Eysenck neuroticism questionnaire (EPQ), stressful life events, parental bonding instrument. Results 25.2% of patients of MD coexistence GAD. There was no significant difference in sociodemographic data between the two groups. Significant differences among total number of depression symptoms(OR=1.439, 95%CI=1.049-1.975, P=0.024), duration of illness(OR=1.253, 95%CI=1.010-1.475, P=0.048), psychomotor agitation(OR=2.031, 95%CI=1.123-3.676, P=0.019), suicidal thought(OR=2.228, 95%CI=1.010-4.912, P=0.047), anxiety(OR=5.547, 95%CI=1.935-15.896, P=0.001), irritable(OR=1.956, 95%CI=1.081-3.542, P=0.027)were identified between the two group. In the comorbidity group, the score of nenroticism dimention derived from EPQ was also higher(OR=2.287, 95%CI=1.674-3.124, P=2.287×10-7)than that of non-comorbidity group. There was no significant difference of stressful life events between two groups(OR=1.118, 95%CI=0.913-1.368, P=0.280). Conclusion This study suggests the phenomena that female patients of recurrent depression disorder comorbidity with general anxiety disorders is common in clinical. The patients comorbid MD and GAD have more symptoms, neuroticism and be worse in severity. Key words: Recurrent major depression; General anxiety disorder; Comorbidity; Female; Clinical feature