Manifestations In Women Research Articles

“The Impure Outsider”: Ritual Exclusion and Integration of Women in Maale, Southern Ethiopia

Abstract Especially in patrilineal and virilocal societies, women have long been considered to be “in between” the paternal and affinal patrilineages. For this reason, women occupy a liminal status and are considered dangerous or impure outsiders in many societies. Moreover, their assumed impurity is the basis of taboos for women and requires certain rituals of incorporation to be carried out for them at certain times during their life cycle. The present article focuses on the supposed impurity of women among the Maale of southern Ethiopia. Trying to find explanations for the impurity attributed to women in this part of the world, it shows the complex connections between ideas of “foreignness,” mobility, and “impurity,” their manifestation in women's taboos, and their overcoming through rituals of integration.

Women's Health

Many of the unique health issues facing women are related to reproductive health and pregnancy. However, several conditions that affect both sexes have distinct manifestations in women including cardiovascular disease, osteoporosis, and anemia. The extent of the effect that the physiological differences between men and women have on the natural course of these diseases and the validity of applying a standard treatment to both genders has not been fully explored. Historically, medical research has largely excluded women, rendering the application of evidence-based medicine to women's health issues somewhat of a misnomer. While most research in women's health originates from developed nations, consideration must be given to women in all regions of the world. Compared to women in developed nations, women in resource-poor countries are burdened with increased morbidity and mortality from gender-related health issues. In order to globally advance women's health, the physiologic and social differences between men and women must be more clearly characterized and these differences must be taken into consideration when designing research endeavors and developing health policy.

Clinical characteristic of menopausal manifestations in women with using non hormonal agents

Clinical and laboratory examination of patients of menopausal age has been conducted to assess neurovegetative, emotional, endocrine and metabolic disorders and also the vaginal health index of these women. There are represented results of clinical manifestations of menopause before and after the application of non-hormonal agents for three months. Here is highlighted the effectiveness of the proposed treatment using of black cohosh.

Combination therapy of acne in women: searching for optimum solutions

Current data on the acne pathogenesis are given. According to the authors, dermatosis is becoming more prevalent among women of mature age. Issues related to the clinical picture, effect of exogenous and endogenous factors on the course of acne, and psychosocial characteristics of delayed acne manifestations in women are described in detail. The essential role of medical and cosmetic products for the complex therapy of acne is discussed. The authors describe their own experience of treating delayed acne using the Hyseac line of medical and cosmetic products in a combination with microdermabrasion and no-needle mesotherapy using the vitaPeel/vital О2 device.

Modern approaches to diagnostics of osteoporosis and ischemia in women after menopause under conditions of primary medical and sanitary aid.

Problem of osteoporosis has gained a special significance especially in the last years’ period. In postmenopausal period women suffer not only from osteoporosis (OP) but of increased incidence of cardiovascular diseases, including ischemic heart disease (IHD). The aim of this investigation was to carry out the diagnostics of OP and ischemic manifestation in women of postmenopause period by modern methods. 85 women aged 45-65 years with physiological and pathological climax were included in the investigation. Diagnostic of OP was carried out basing on the bone mineral density evaluation by X-ray Duoenergetic absorption. Diagnostic of IHD was carried out by veloergometry, evaluating stenocardia clinical manifestations and functional class. As a result it was established that 57,1% women in a postmenopausal period suffered both from osteoporosis and ischemic heart disease. Diagnostic of OP and IHD confirmed presence of changes in bone and cardiovascular systems in all examined women.

Gender Differences in Clinical Characteristics, Treatment and Long-Term Outcome in Patients With Stage C/D Heart Failure in Japan

The gender differences in patients with chronic heart failure (CHF) remain to be fully elucidated in the Japanese population. We examined gender differences in clinical characteristics, treatment and long-term outcome in 4,736 consecutive CHF patients in stage C/D (mean age, 69 years) out of 10,219 patients registered in the CHF Registry, named CHART-2 Study (NCT 00418041). Compared with male patients (68%, n=3,234), female patients (32%, n=1,502) were 3.8 years older and had lower prevalence of ischemic heart disease, diabetes, smoking, myocardial infarction and cancer. At baseline, women had higher prevalence of preserved left ventricular function but had higher NYHA functional class and increased brain natriuretic peptide level. In women, aspirin, β-blockers and statins were less frequently used and diuretics were more frequently used. Crude mortality rate was similar between the genders during the median 3.1-year follow-up (52.4/1,000 and 47.3/1,000 person-years for women and men, respectively, P=0.225). On multivariate Cox regression analysis, women had a reduced risk of mortality (adjusted HR, 0.791; 95% CI: 0.640-0.979, P=0.031). Substantial gender differences exist in stage C/D CHF patients in real-world practice in Japan. Although female CHF patients had better survival than male patients after adjustment for baseline differences, crude mortality rate was similar between the genders, possibly reflecting relatively severer clinical manifestations in women.

Occult microscopic endometriosis: undetectable by laparoscopy in normal peritoneum

Is there any occurrence of hidden (occult) endometriotic lesions in normal peritoneum of women with and without visible endometriosis? We detected a slightly higher occurrence of occult microscopic endometriosis (OME) in normal peritoneum of women with visible endometriosis than in control women. Based on a small number of cases, the concept of invisible microscopic endometriosis in visually normal peritoneum has been reported for more than a decade but there is controversy regarding their tissue activity and clinical significance. This case-controlled research study was conducted with prospectively collected normal peritoneal samples from 151 women with and 62 women without visible endometriosis. Normal peritoneal biopsy specimens from different pelvic sites of were collected during laparoscopy. A histological search of all peritoneal biopsy specimens for the detection of invisible endometriosis was done by immunoreaction to Ber-EP4 (epithelial cell marker), CD10 (stromal cell marker) and Calretinin (mesothelial cell marker). Tissue expression of estrogen/progesterone receptors (ER/PR) and cell proliferation marker, Ki-67, was performed by immunohistochemistry to identify tissue activity. Three different patterns of OME were detected based on (I) the presence of typical gland/stroma, (II) reactive hyperplastic change of endometrioid epithelial cells with surrounding stroma and (III) single-layered epithelium-lined cystic lesions with surrounding stroma. A higher tendency toward the occurrence of OME was found in women with visible endometriosis (15.2%, 23/151) compared with control women (6.4%, 4/62) (P = 0.06, χ(2) test). The epithelial cells and/or stromal cells of OME lesions were immunoreactive to Ber-EP4 and CD10 but not reactive to Calretinin. ER and PR expression was observed in all patterns of OME lesions. Ki-67 index was significantly higher in pattern I/II OME lesions than in pattern III OME lesions (P< 0.05 for each). Bias in the incidence rate of OME lesions in this study cannot be ignored, because we could not analyze biopsy specimens from the Pouch of Douglas of women with revised classification of the American Society of Reproductive Medicine Stage III-IV endometriosis due to the presence of adhesions in the pelvis. We re-confirmed a decade long old concept of invisible (occult) endometriosis in visually normal peritoneum of women with visible endometriosis. The existence of a variable amount of tissue activity in these occult lesions may contribute to the recurrence/occurrence of endometriosis or persistence/recurrence of pain manifestation in women even after successful ablation or excision of visible lesions by laparoscopy. This work was supported in part by Grants-in-aid for Scientific Research from the Japan Society for the Promotion of Science. There is no conflict of interest related to this study. Not applicable.

Visions, Mental Images, Real Pictures. The Mystical Experience and the Artistic Patronage of Sister Battista da Varano

The aim of this article is to analyze, from a historical-anthropological point of view, the relationship between women’s mystique experience, “inner visualization” and artistic production, through the study of the visions and the artistic patronage of Sister Battista da Varano (1458-1524), one of the greatest female Franciscan writers of the Italian Renaissance. In her works, the nun often describes her visions, in which her familiarity with the devotional images present in her city emerges. Going beyond this codified iconography, Sister Battista, during her mystical experience, also shapes symbols within her mind. These symbols are presented as signs of her privileged dialogue with Jesus. Thanks to the wealth of her family, Sister Battista also manages to commission works of art. In the choir stalls of her monastery, executed by Domenico Indivini in 1489, the nun asks the artist to transform her mental images, received during the ecstasy, in real images. Not adequately explicable as manifestations of women’s discomfort, the visions of Sister Battista can be interpreted as the result of a mind educated in the use of images and skillful in “inner visualization”. Through these “techniques of the body” (Marcel Mauss), learned in the monastery and shared by the society in which she lived, Sister Battista can successfully achieve her most desired goal: to see Christ and to communicate with him.

The black princess of elegance:The emergence of the female dandy

Departing from the French poet Charles Baudelaire’s reading, this study attempts to demonstrate that the male dandy, who attached great importance to his public image, turning his body into a work of art in the way he posed, dressed and behaved, was exploited in various forms, by various groups of women between the 1840s and 1920s. While investigating the characteristics of dandyism and its manifestations in women who worked in the fields of literature, visual and performing arts, and lived in the context of the early feminist movement in turn-of-the-nineteenth-century Paris and London, this article focuses primarily on the courtesans of the Second Empire, the male impersonators of the late Victorian theatre and the wealthy Anglo-American lesbian collective of the 1920s. As a part of the modern urban life and a marker of the instability and mobility of modern gender identity, women found new ways to communicate, both sartorially and professionally, in a setting where men’s clothes, accessories, habits and lifestyles offered women independence. While locating female masculinities in the discourse of masculinity with its own history, characteristics and representations in this ongoing process shaped by culture and choice, this approach endeavours to reveal female dandyism as a curious yet alluring way of relating to oneself in spite of the patriarchal culture.

Systematic Review: The Rhinological Manifestations in Women

Objective: 1) To understand the current evidence between the effects of pregnancy, postpartum, menopause, contraception, and hormone replacement therapy (HRT) on diseases of the nose. 2) To appraise the level of evidence in the current literature. Method: Systematic search strategy using PubMed (1966-2011) and EMBASE (1980-2011) was done to study diseases of the nose in women during different stages of life. Study appraisal and data extraction were performed independently by 2 authors. The level of evidence was categorized according to the Oxford Center of Evidence-Based Medicine. Results: Titles and abstracts of 1005 studies from PubMed and 1756 studies from EMBASE were reviewed, resulting in 429 being retrieved. Included articles were categorized as related to pregnancy, postpartum, menopause, contraception, or hormone replacement therapy with the following findings: Pregnancy: changes reported in olfaction (12 studies), allergy (30 studies), rhinitis (25 studies), epistaxis (8 studies), tumor growth (31 studies), Wegener’s (23 studies), and Churg-Strauss disease (8 studies); Postpartum: effects included allergic rhinitis (20 studies), altered olfaction (7 studies), choanal atresia with drug ingestion (5 studies), and nasal tumors (8 studies); Menstruation: alteration in olfaction (17 studies), rhinitis (7 studies), and allergy (3 studies); Menopause: rhinitis (5 studies); HRT: alteration in olfaction (3 studies), and rhinitis (11 studies); and Estrogen therapy: considered for recurrent epistaxis (15 studies). Conclusion: The various stages of life in women have been shown to have impact on nasal pathophysiology, altering olfaction and increasing epistaxis, allergic symptoms, tumor growth, and auto-immune disease.

Dopamine-system genes, childhood abuse, and clinical manifestations in women with Bulimia-spectrum Disorders

ObjectiveWe explored interaction effects involving polymorphisms of targeted dopamine system genes and selected forms of childhood abuse (sexual, physical and emotional) acting upon severity of binge-eating and psychopathological symptoms in women with Bulimia-Spectrum Disorders (BSDs). MethodsWomen diagnosed with a BSD (n = 216) were assessed for childhood traumata, eating-disorder (ED) symptoms, and selected psychopathological features (sensation seeking, impulsivity, compulsivity and affective instability), and then provided blood samples for genotyping of main polymorphisms of dopamine-2 receptor (DRD2), dopamine transporter (DAT1) and catechol o-methyltransferase (COMT) genes. ResultsSensation Seeking was elevated in carriers of the low-function allele of the DRD2 Taq1A polymorphism who also reported childhood sexual abuse, relative to that in individuals showing other combinations of alleles and abuse exposures. In addition, carriers of a low-function allele of COMT scored higher on compulsivity, lower on impulsivity, and marginally lower on frequency of binge-eating than did individuals in whom the allele was absent. DiscussionOur results suggest that genes acting within the dopamine system may contribute, either directly or indirectly (i.e., in interaction with traumatic childhood experiences), to variations in the presentation of comorbid traits and, possibly, of bulimic symptoms.

Relationship between diagnosis and intervention in women with inherited bleeding disorders and menorrhagia

Menorrhagia is the most common bleeding manifestation in women with inherited bleeding disorders. There is little known about whether the management of menorrhagia is altered in specific bleeding disorders. Optimizing treatment strategies for each specific diagnosis may improve quality of life in these women. This work aimed to look for a potential relationship between the specific diagnosis of an inherited bleeding disorder and the intervention required to control the menorrhagia. A retrospective chart review was performed for all women seen in the Kingston Women and Bleeding Disorders Clinic. Patients were categorized by diagnosis into two groups: Haemophilia carriers and all others. Treatment options were grouped into two categories: Medical or gynecological/surgical. Overall, 85.7% of haemophilia carriers required gynaecological surgical management, whereas only 31.4% of patients with all other diagnoses required gynaecological/surgical management (P = 0.012, Fisher's exact test). Therefore, carriers of Haemophilia were more likely to have a better outcome in treating their menorrhagia with gynaecological or surgical management compared with medical management. This information may 1 day help to guide treatment choice for menorrhagia in women with bleeding disorders.

Pregnancy Followed by Delivery May Affect Circulating Soluble Lectin-Like Oxidized Low-Density Lipoprotein Receptor-1 Levels in Women of Reproductive Age

Background/Objective. It is known that menopause or lack of endogenous estrogen is a risk factor for endothelial dysfunction and CAD. Lectin-like oxidized low-density lipoprotein receptor-1 (LOX-1) is involved inmultiple phases of vascular dysfunction.The purpose of the current study was to determine the association between soluble LOX-1 (sLOX-1) and pregnancy followed by delivery in women of reproductive age. Materials/Methods. Sixty-eight subjects with pregnancy followed by delivery (group 1) and 57 subjects with nongravidity (group 2) were included in this study. Levels of sLOX-1 were measured in serum by EL SA. Results. Plasma levels of sLOX-1 were significantly lower in Group 1 than Group 2 in women of reproductive age (0.52 ± 0.18 ng/mL and 0.78 ± 0.13, resp., P < 0.001). There were strong correlations between sLOX-1 levels and the number of gravida (r = −0.645, P < 0.001). The levels of sLOX-1 highly correlated with the number of parous (r = −0.683, P < 0.001). Conclusion. Our study demonstrated that serum sLOX-1 levels were associated with pregnancy followed by delivery that might predict endothelial dysfunction. We conclude that pregnancy followed by delivery may delay the beginning and progress of arteriosclerosis and its clinical manifestations in women of reproductive age.

Clinical manifestations in women with isolated fallopian tubal torsion; a rare but important entity

The diagnosis of adnexal torsion can be difficult to make, especially in isolated fallopian tube torsion (FTT). Only small series and several case reports on isolated FTT have been published in the literature. To demonstrate symptom presentations, objective findings and surgical outcomes in women with isolated FTT over a 12-year period at a tertiary hospital. Using the International Classification of Disease, Ninth Revision, and Clinical Modification, we reviewed the clinical records of women with isolated FTT during 1996 and 2008 at our institute. Seventeen women, age 13-50 (mean 32) with surgically proven isolated FTT, were included. Five women (29.4%) had tubal ligation history. None of these cases were diagnosed before operation. Pain characteristics were variable; the onset was sudden in 10 (58.8%) and 17 (100%) complained of lower abdominal pain, but only six (35.3%) had peritoneal signs. Other clinical manifestations were as follows: nausea or vomiting in seven women (41.2%), lower urinary tract symptoms in four (23.5%) and fever in three (17.6%). All the women had a cystic adnexal mass on ultrasound. An enlarged tubal mass (5-14 cm) was found in all the cases at surgery. Eleven women (64.7%) underwent laparoscopy, and six (35.3%) laparotomy for salpingectomy. The diagnosis of isolated FTT is often not made before surgical intervention because clinical features are non-specific. However, it needs to be considered in women with acute lower abdominal pain with a unilateral cystic adnexal mass.

Frequency of extracolonic tumors in Brazilian families with Lynch syndrome: analysis of a hereditary colorectal cancer institutional registry

Lynch syndrome (LS) is caused by inherited germline mutations in mismatch repair (MMR) genes. It is one of the commonest forms of inherited predisposition to colorectal cancer (CRC), accounting for 2-5% of all CRC. LS is characterized by early age of onset, with a tendency for multiplicity and an increased risk for extra-colonic tumors at particular sites. In this study we have evaluated the frequency of extra-colonic tumors in 60 unrelated LS families fulfilling the Amsterdam criteria (ACI. ACII) from the Oncotree database of the Hereditary Colorectal Cancer Registry of the AC Camargo Hospital. All families' pedigree was extensively analyzed, varying from 2 to 6 generations with a total of 2,095 individuals evaluated. As expected, colorectal cancer was the most frequent tumor in the families (334 cases). We found 200 extracolonic tumors among all individuals with a higher ratio in women (123 cases) than men (77 cases). By far, breast cancer (32 cases) was the most frequent extracolonic manifestation in women followed by endometrial (20 cases) and uterine cervix cancer (20 cases). For man, prostate (16 cases) and stomach (12 cases) cancer were the most frequent extracolonic tumors. It is well know that establishing the diagnosis is challenging and requires knowledge and surveillance. Thus, recognition of individuals and families with hereditary predisposition to cancer according to clinical and molecular features, combined with intensive surveillance and management programs, can contribute substantially to improve results related to the diagnosis and characterization of LS.

Salivary Gland Involvement in Chronic Graft-Versus-Host Disease: Prevalence, Clinical Significance, and Recommendations for Evaluation

Although xerostomia is a commonly reported complaint in patients with chronic graft-versus-host disease (cGVHD), criteria for evaluating the prevalence and characteristics of salivary gland involvement have not been well defined in this patient population. Previous studies also have made no distinction between salivary and mucosal oral cGVHD. We systematically evaluated signs and symptoms of sicca in a large cohort of patients with cGVHD (n = 101) using instruments widely used to study Sjogren's syndrome. Xerostomia was reported in 60 (77%) patients reporting ocular and 52 (67%) patients reporting oral complaints [corrected]. The salivary flow rate was < or =0.2 mL/min in 27%, and < or =0.1 mL/min in 16%. Histopathological changes, consisting of mononuclear infiltration and/or fibrosis/atrophy, were present in all patients with salivary dysfunction. Importantly, there was no correlation of salivary and oral mucosal involvement in cGVHD. Patients with cGVHD-associated salivary gland involvement had diminished oral cavity-specific quality of life and lower body mass index. Salivary gland involvement is a common and clinically distinct manifestation of cGVHD. Formal evaluation of salivary function using standardized criteria is needed, and this could be incorporated as an outcome measure in clinical trials of cGVHD.

Oral Symptom Intensity, Health-Related Quality of Life, and Correlative Salivary Cytokines in Adult Survivors of Hematopoietic Stem Cell Transplantation with Oral Chronic Graft-versus-Host Disease

Oral chronic graft-versus-host disease (cGVHD) is a frequent, clinically significant sequela of allogeneic hematopoietic stem cell transplantation (HSCT). This study was designed to elucidate relationships among clinical characteristics of oral cGVHD and related oral pain and oral dryness, salivary proinflammatory cytokine interleukin (IL)-6 and IL-1alpha concentrations, and health-related quality of life (HRQL). An understanding of the characteristics and correlates of oral cGVHD manifestations and related symptoms, such as oral dryness, is fundamental to the development of therapeutic interventions. Oral cGVHD severity was assessed with the Oral Mucositis Rating Scale (OMRS). Oral pain and perceived intensity of oral dryness were self-reported via a visual analog scale and a numeric rating scale, respectively. HRQL was assessed with the Functional Assessment of Cancer Therapy-General (FACT-G). Salivary IL-1alpha and IL-6 concentrations were measured by enzyme-linked immunosorbent assay. All 42 adult subjects (59% males) had clinician-assessed oral cGVHD by the OMRS scale (mean score, 18.38 +/- 12.99; range, 2-46). Oral dryness (in 43% of subjects; mean OMRS score, 2.56 +/- 3.45; range, 0-10) was more prevalent than oral pain (8%; mean score, 0.13 +/- 0.47). Salivary IL-6 was associated with oral cGVHD severity (r = 0.49; P < .01), oral ulceration (r = 0.38; P = .04), and erythema (r = 0.63; P < .01). FACT-G total score and physical and emotional well-being subscale scores were meaningfully lower than U.S. population normative values. Participants with more severe oral cGVHD manifestations had significantly inferior social/family well being (r = -0.49; P < .01). Oral dryness was associated with higher salivary IL-1alpha (r = 0.41; P = .04) and, controlling for cGVHD severity, with lower HRQL (r = -0.41; P = .03). Subjects with moderate to severe oral dryness tended to report the poorest overall HRQL. This study provides preliminary evidence of the relationship between oral dryness and HRQL, the contribution of oral cGVHD to inferior HRQL, and the association between IL-6 and oral cGVHD severity, ulceration, and erythema. The high prevalence of oral dryness and its relationship to HRQL in a sample of subjects with oral cGVHD underscores the importance of improving our evaluation and management of this symptom in long-term survivors of allogeneic HSCT. The positive associations between IL-6 and oral cGVHD severity and erythema, as well as the positive trend with oral ulceration, warrant further exploration of this cytokine as a potential biomarker of active oral cGVHD.

Urinary incontinence should be added to the manifestation in women with Marfan syndrome

We aimed to compare the incidence of urinary incontinence in women with Marfan syndrome and controls, hypothesizing that connective tissue abnormality could contribute to urinary incontinence. A cross-sectional historical cohort study was conducted on 14 premenopausal women with Marfan syndrome and 534 controls using Urogenital Distress Inventory Short Form and Incontinence Impact Questionnaire Short Form. Marfan subjects had significantly higher incidence of urinary symptoms, stress urinary incontinence (SUI) and urge urinary incontinence (UUI) than controls (P = 0.02, P = 0.03, P = 0.02), despite their lower parity (P = 0.01). Direct logistic regression analysis indicated that Marfan syndrome, parity and age were associated with SUI; while Marfan syndrome was the only significant predictor of UUI. Premenopausal women with Marfan syndrome had a higher incidence of reported urinary symptoms. Urinary incontinence should be added to the list of clinical manifestations in women with Marfan syndrome.

Epilepsy with impulsive petit mal (Juvenile Myoclonic Epilepsy)

Juvenile myoclonic epilepsy (JME) is a special syndrome within the primary generalized epilepsies which is characterized clinically by irregular jerks of shoulders and arms (so-called impulsive petit mal) after awakening and electroencephalographically by bilateral-synchronous 4-6/s spike-wave complexes, often in the form of multispike-waves. The age of onset for this syndrome which occurs in 4-6% of all epilepsies is predominantly between 12 and 18 years. It mostly starts with isolated jerks which as a rule are soon followed by generalized tonic-clonic seizures (TCS). Jerks and TCS are provoked by sleep deprivation and predominantly occur after awakening (awakening epilepsy). Sleep deprivation and photostimulation are also very efficient in provoking specific EEG patterns. Exogenous factors have no etiological significance. Genetic studies suggest a polygenetic mode of inheritance and a lower threshold of manifestation in women. JME can be controlled very well by valproate and/or primidone. A complete cure, nevertheless, does not seem to be possible. Within the group of primary generalized epilepsies beginning in adolescence JME is closely related nosologically to the syndrome of juvenile absences and the syndrome of pure grand mal on awakening.

Comparing clinical manifestations of myocardial infarction (MI) between men and women at CCUs of hospitals affiliated to Shaheed Beheshti Medical University

Background Myocardial infarction (MI) is an irreversible necrosis of myocardium usually resulted from complete obstruction of coronary arteries and sudden disruption of blood flow and oxygen to the heart muscle. Studies suggest that, in addition to various reasons for inappropriate management of MI, one of the causes is unfamiliarity of patients and healthcare professionals including nurses regarding difference of MI manifestations in women and men leading to wastage of golden time for invasive and noninvasive measures and the resultant complications and even death. Purpose This descriptive-comparative study was conducted to identify the difference of clinical manifestations of MI in women and men hospitalized at CCUs of hospitals affiliated to Shaheed Beheshti Medical University in 2006. Methods 330 patients (165 men and 165 women) were selected by purposive sampling method. Data collection tools included an information form, a checklist, and McGill’s questionnaire. Content and face validities were determined by expert views and reliability of the tools was determined by internal consistency (r=0.86). Results No significant difference was found between the two groups in terms of demographics and quality, severity and pattern of pain (P Conclusion Findings showed no difference between men and women in quality, severity and pattern of MI pain. However, manifestations such as vomiting, dyspnea, anxiety, location of pain and … were different between men and women. Keywords Myocardial infarction, MI manifestations, MI in women.