MedicalResearch.com offers the latest news, interviews, and insights in medical research, covering topics like a, cancer research, addiction, fitness and health.
Author Interviews, Gender Differences, Ophthalmology, Social Issues / 02.12.2016

MedicalResearch.com Interview with: Antoine Coutrot PhD CoMPLEX University College London London, UK MedicalResearch.com: What is the background for this study? What are the main findings? Response: The human face is central to our everyday social interactions. Recent studies have shown that while gazing at faces, each one of us has a particular eye-scanning pattern, highly stable across time. Although variables such as culture or personality have been shown to modulate gaze behavior, we still don't know what shapes these idiosyncrasies. Moreover, most previous observations rely on analyses of small-sized eye-position datasets, often from the WEIRD (western, educated, industrialized, rich, and democratic) population. Here we use a very large and diverse dataset (400+ participants from 58 nationalities) and show that among many observer characteristics, gender is the one that best explains the differences in gaze behaviour. When looking at faces, women are more exploratory than men and more biased toward the left side. We even trained a classifier able to infer the gender of observers only based on their gaze. (more…)
AHA Journals, Author Interviews, Gender Differences, Heart Disease, Surgical Research / 27.11.2016

MedicalResearch.com Interview with: Dr. Stefano Savonitto  Director, Division of Cardiology Manzoni Hospital MedicalResearch.com: What is the background for this study? What are the main findings? Response: Over the last 15 years, there has been a shift from fibrinolytic therapy for STEMI to primary angioplasty, which required a re-organization of the whole STEMI treatment network. Besides the higher reperfusion efficiency of primary angioplasty, as compared to lytic therapy, it has been a global upgrade of the STEMI care system that has reduced the rate of no reperfusion. Elderly patients and women (who are, on average, also older than men) had theoretically the most to gain from this shift, but little data were available to assess this benefit. In the present paper, we have shown that “lack of reperfusion” was reduced dramatically across all age groups and in both sexes, with a progressive and uniform increase in primary angioplasty, and a significant reduction in mortality. Almost as expected, elderly women were the category with the most relevant mortality benefit. Nevertheless, after adjustment for age and other confounders, women continue to experience a higher mortality as compared to men. In the discussion of the paper, we propose some hypotheses for this persistently higher mortality in women. (more…)
Author Interviews, Gender Differences, Heart Disease, Surgical Research / 21.11.2016

MedicalResearch.com Interview with: Dr James Spratt Bsc, MD, FRCP, FESC, FACC Spire Edinburgh Hospitals and Spire Murrayfield Edinburgh Spire Shawfair Park Hospital MedicalResearch.com: What is the background for this study? Response: Gender differences exist between male and female patients following routine PCI but data regarding these differences in Chronic Total Occlusions (CTO) Percutaneous Coronary Intervention (PCI) is limited. We maintain a dedicated national (United Kingdom) prospective CTO database contributed to by dedicated CTO PCI operators (lifetime CTO PCI >300). We retrospectively analysed this database from 2011-2015 to compare outcomes and characteristics of male versus female patients undergoing CTO PCI. We attempted to limit the bias of this observational study by propensity matched analysis. (more…)
Author Interviews, Gender Differences, JAMA, Stroke / 19.11.2016

MedicalResearch.com Interview with: Catharina J. M. Klijn, MD Brain Center Rudolf Magnus, Department of Neurology and Neurosurgery University Medical Center Utrecht, Utrecht Donders Institute for Brain, Cognition and Behaviour, Centre for Neuroscience Department of Neurology Radboud University Nijmegen Medical Centre Nijmegen, the Netherlands MedicalResearch.com: What is the background for this study? Response: The incidence of stroke is higher in men than in women. This difference attenuates with increasing age. Established risk factors for stroke, such as hypertension, cigarette smoking and ischemic heart disease are more prevalent in men but only partly explain the difference in stroke incidence. The contribution of oral contraceptive use and hormone therapy to stroke risk has been previously reviewed. We aimed to evaluate what is known on other female- and male specific risk factors for ischemic and hemorrhagic stroke incidence and stroke mortality through a systematic review and meta-analysis of 78 studies including over 10 million participants. (more…)
Author Interviews, Cannabis, Gender Differences, Heart Disease / 14.11.2016

MedicalResearch.com Interview with: Amitoj Singh MD Chief Cardiology Fellow St. Luke’s University Health Bethlehem, Pennsylvania MedicalResearch.com: What is the background for this study? Response: Marijuana use in steadily increasing and it is the most commonly used illicit drug in the US and worldwide. There has been a recent increase in reports of heart and vascular complications associated with its use. These include Myocardial infarctions, stroke and takotsubo. We had two questions that we wanted to answer with our study: a) Is there an association between marijuana use and development of Transient Regional Ventricular Ballooning [TVRB] (aka Stress Cardiomyopathy /Broken Heart Syndrome/ Takotsubo)? b) If the above is true, what are the differences between Marijuana users (MU) and Non Marijuana Users (NMU) who developed Stress Cardiomyopathy. (more…)
Author Interviews, Brigham & Women's - Harvard, Gender Differences, Memory, Menopause / 12.11.2016

MedicalResearch.com Interview with: Jill M. Goldstein, Ph.D. Director of Research for the Connors Center for Women's Health and Gender Biology Brigham and Women's Hospital and Professor of Psychiatry and Medicine at Harvard Medical School MedicalResearch.com: What is the background for this study? Response: Maintaining intact memory function as we age is one of the primary public health challenges of our time. In fact, women are at almost twice the risk for Alzheimer's disease and it is not only because women live longer. Thus, it is incumbent upon us to understand this sex difference and incorporate the knowledge into the development of sex-dependent therapeutics. Our study focused on beginning this investigation by understanding how memory circuitry and memory function change over the menopausal transition, when we believe that sex differences in memory aging emerge. By understanding healthy aging, we will better understand how the brain goes awry with age differently in men and women and who might be at highest risk for Alzheimer's disease later in life. (more…)
Author Interviews, Autism, Gender Differences / 08.11.2016

MedicalResearch.com Interview with: Dr. John Strang, PsyD Division of Pediatric Neuropsychology Children's National Health System. MedicalResearch.com: What is the background for this study? What are the main findings Response: Gender dysphoria or transgenderism (GD) and autism spectrum disorders (ASD) often co-occur. Between 9 and 25% of youth referred for gender dysphoria concerns have co-occurring ASD. Autistic transgender youth often require significant supports; their autism symptoms alone present challenges, but when combined with gender dysphoria, the clinical needs and complexities increase significantly. For example, an autism spectrum disorder, with its resulting social and communication challenges, can make it more difficult for a transgender teen to advocate for their needs around gender. Specialists from youth gender clinics from around the world have years of experience working with autistic transgender youth. This study used an international search process to identify experts in co-occurring ASD and GD. Twenty-two experts were identified and participated in this multi-stage consensus building study. A set of initial clinical guidelines for the evaluation and care of youth with co-occurring ASD and GD were produced. (more…)
Alcohol, Author Interviews, BMJ, Gender Differences / 27.10.2016

MedicalResearch.com Interview with: Tim Slade, PhD Associate Professor National Drug and Alcohol Research Centre University of New South Wales MedicalResearch.com: What is the background for this study? What are the main findings? Response: Historically, men have been more likely to drink alcohol than women and to drink in quantities that damage their health. However, evidence points to a significant shift in the drinking landscape with rates of alcohol use converging among men and women born in more recent times. In a bid to quantify this trend over time, we pooled data from 68 published research studies in 36 countries around the world. We looked at how the ratio of men’s to women’s alcohol use differed for people born in different time periods and found that the gap between the sexes consistently narrowed over the past 100 years or so. For example, among cohorts born in the early 1900s men were just over two times more likely than women to drink alcohol. Among cohorts born in the late 1900s this ratio had decreased to almost one meaning that men’s and women’s drinking rates have reached parity. (more…)
Author Interviews, Gender Differences, Pediatrics / 26.10.2016

MedicalResearch.com Interview with: Rachel H. Farr, Ph.D. Assistant Professor Department of Psychology University of Kentucky MedicalResearch.com: What is the background for this study? Response: Controversy continues to surround parenting by lesbian and gay (LG) adults and outcomes for their children. As sexual minority parents increasingly adopt children, longitudinal research about child development, parenting, and family relationships is crucial for informing such debates. This longitudinal study compared outcomes for children, parents, couples, and the overall family system among nearly 100 (N = 96) adoptive families with lesbian, gay, and heterosexual parents at two time points: when children were preschool-age, and approximately 5 years later, when children were in middle childhood. Child outcomes were assessed via parent- and teacher-reported behavior problems, while parent outcomes were assessed via self-reports of parenting stress levels. Couple and family outcomes were evaluated by parent reports of couple adjustment and overall family functioning. (more…)
AHA Journals, Author Interviews, Cost of Health Care, Gender Differences, Heart Disease, Social Issues / 19.10.2016

MedicalResearch.com Interview with: Adam L. Beckman Yale College, New Haven, CT (at the time this work was completed) Erica S Spatz MD MHS Assistant Professor, Section of Cardiovascular Medicine Center for Outcomes Research and Evaluation Yale-New Haven Hospital Yale University School of Medicine MedicalResearch.com: What is the background for this study? Beckman: Despite the expansion of insurance coverage, young adults face major challenges to obtaining affordable healthcare. We suspected women may experience greater challenges than men — they often have lower income and less complete medical coverage than men, and care for multiple generations of family, and that this may in part explain why young women have worse outcomes following a heart attack as compared with similarly-aged men. (more…)
Author Interviews, CDC, Gender Differences, STD / 06.10.2016

MedicalResearch.com Interview with: Alex de Voux, PhD, Epidemiologist Centers for Disease Control Division of STD Prevention MedicalResearch.com: What is the background for this study? What are the main findings? Response: Reported cases of primary and secondary syphilis have been increasing steadily in the United States since 2001, with men-who-have-sex-with-men (MSM) accounting for 83% of male primary and secondary syphilis cases with information on sex of sex partner in 2014. However calculating the true disparity of primary and secondary syphilis cases relative to the MSM population size has been difficult because census data does not routinely collect information on sexual orientation or same-sex behavior. Through a recent collaboration with Emory University and CDC, Grey and colleagues developed refined estimates of the population size of MSM by state allowing us to calculate state-specific rates of primary and secondary syphilis for the first time. Looking at data from 44 states that had information on sex of sex partner for at least 70% of their male primary and secondary syphilis cases, the overall rate of syphilis was 309 per 100,000. The state level data found syphilis rates among gay and bisexual men ranged widely among the 44 states, from 73.1 per 100,000 in Alaska to 748.3 per 100,000 in North Carolina. Some of the highest rates among MSM were in states in the Southeast and the West. Comparing rates of syphilis among MSM to men reporting sex with women only (MSW), the overall rate for MSM was 107 times the rate for MSW. By state, the rate among MSM was at least 40 times the rate among MSW – and at most, 340 times the rate among MSW. (more…)
Author Interviews, Gender Differences, Heart Disease, JAMA, Menopause / 15.09.2016

MedicalResearch.com Interview with: Taulant Muka, MD, MPH, PhD Postdoctoral Researcher Erasmus University, Rotterdam MedicalResearch.com: What is the background for this study? What are the main findings? Response: Menopause marks a major life transition for women, resulting in the loss of ovarian follicle development. Although menopause is a universal phenomenon among women, the timing of the final menstrual period differ greatly between women, and is considered a marker of aging. By quantifying data of nearly 310,329 non-overlapping women, we found that women who experienced an early menopause (i.e. younger than 45 years) have an excess risk of CHD, CVD-mortality and all-cause mortality. Furthermore, being 45-49 years at menopause compared to ≥50 years was associated with increased risk of carotid atherosclerosis. (more…)
Author Interviews, Gender Differences, Heart Disease, Surgical Research / 11.09.2016

MedicalResearch.com Interview with: Michael A. Gaglia Jr., MD, MSc, FACC, FSCAI Scientific Lead, Population Research Medstar Cardiovascular Research Network Interventional Cardiology Medstar Heart and Vascular Institute Washington, DC 20010 MedicalResearch.com: What is the background for this study? Response: Cardiovascular outcomes vary according to gender in a variety of disease states. For example, short-term mortality is higher among women presenting with an acute coronary syndrome in comparison to men. There is a similar trend for higher short-term mortality of women undergoing coronary artery bypass grafting, although this is in part due to a relatively higher burden of comorbidities. Female gender is also a well-established risk factor for bleeding complications after percutaneous coronary intervention. In regards to women undergoing surgical aortic valve replacement for severe aortic stenosis (AS), however, the data is equivocal; some studies suggest higher mortality for women, whereas others suggest improved survival for women. The emergence of transcatheter aortic valve replacement (TAVR) as the preferred therapeutic option for patients with severe AS at high or extreme risk for surgery offered another opportunity to examine gender disparities in outcomes. The evidence base for the impact of gender upon TAVR, however, is still evolving. A recent meta-analysis suggested improved long-term survival among women after TAVR. And in general, previous studies also suggest more vascular and bleeding complications in women when compared to men. The goal of this study was relatively simple: to compare outcomes between women and men undergoing TAVR at a single center. (more…)
Author Interviews, Emory, Gender Differences, Heart Disease, Stem Cells / 07.09.2016

MedicalResearch.com Interview with: Arshed A. Quyyumi MD; FRCP Professor of Medicine, Division of Cardiology Emory University School of Medicine Co-Director, Emory Clinical Cardiovascular Research Institute Atlanta GA 30322 MedicalResearch.com: What is the background for this study? What are the main findings? Response: Circulating progenitor or stem cells were discovered in adults 15 years ago. We now know that they may be stimulated by injury or ischemia, and they go down in number and function with aging, particularly when aging is associated with risk factors. Women with chest pain despite normal coronary arteries are thought to have ischemia because of microvascular dysfunction. We found that these women, with the worst microvascular function (measured as coronary flow reserve), had higher levels of circulating stem or progenitor cells. This implies that the mild ischemia they are having during their normal daily life, leads to stimulation of their stem cells. Also, the vascular abnormality may be a stimulus for repair. (more…)
Accidents & Violence, Author Interviews, Gender Differences, JAMA, Mental Health Research / 17.08.2016

MedicalResearch.com Interview with: Edith Chen, Ph.D. Professor Faculty Fellow, Institute for Policy Research Northwestern University Department of Psychology Evanston, IL 60208-2710 MedicalResearch.com: What is the background for this study? What are the main findings? Response: Previous research has documented psychiatric consequences of childhood abuse, but less is known about possible physical health consequences. The main finding is that women who self-reported childhood abuse (in adulthood) were at greater risk for all-cause mortality compared to those who did not report abuse. (more…)
Aging, Author Interviews, Gender Differences, Genetic Research, Menopause, UCLA / 28.07.2016

MedicalResearch.com Interview with: Morgan Elyse Levine, PhD Postdoctoral Fellow Department of Human Genetics University of California, Los Angeles MedicalResearch.com: What is the background for this study? What are the main findings? Response: From an evolutionary perspective, aging and reproduction are two processes that are linked. For instance, in order to maximize fitness, an individual has to survive and remain healthy enough to: 1) reproduce and 2) insure offspring survive to reproductive age. Thus, the rate of aging is tied to a species’ timing of reproductive senescence and necessary length of parental involvement. There is also evidence that among humans, women with longer reproductive stages (later age at menopause, ability to conceive at older ages) are more likely to live to age 100, which we hypothesize is because they age slower. Using an epigenetic biomarker believed to capture biological aging (previously developed by the Principle Investigator of this study, Steve Horvath), we tested whether age at menopause, surgical menopause, and use of menopausal hormone therapies were associated with a woman’s aging rate. We found that the blood of women who experienced menopause at earlier ages (especially those who underwent surgical menopause) was “older” than expected, suggesting they were aging faster on a biological level than women who experienced menopause at later ages. We also found that buccal epithelium samples (cells that line the inside of the cheek) were epigenetically younger than expected (signifying slower aging) for post-menopausal women who had taken menopausal hormone therapy, compared to post-menopausal women who had never taken any form of menopausal hormone therapy. Finally, we had a number of results that suggested that the previously mentioned findings were a result of the process of menopause directly speeding up the aging process—rather than the alternative explanation, which would have been that women who aged faster experience menopause earlier. (more…)
AHA Journals, Author Interviews, Exercise - Fitness, Gender Differences, Heart Disease / 27.07.2016

MedicalResearch.com Interview with: Andrea K. Chomistek, MPH, ScD Assistant Professor Department of Epidemiology and Biostatistics School of Public Health Indiana University-Bloomington MedicalResearch.com: What is the background for this study?  Response: Previous studies of exercise and  coronary heart disease have been primarily conducted in middle-aged and older adults, so we thought it was important to examine this association in younger women as mortality rates in young women have not declined in recent years like they have in other age groups. (more…)
AHA Journals, Author Interviews, Gender Differences, Stroke, Tobacco Research / 23.07.2016

MedicalResearch.com Interview with: Joni Valdemar Lindbohm, MD Department of Public Health University of Helsinki, Finland MedicalResearch.com: What is the background for this study? Response: Approximately 1-6% percent of people carry an unruptured intracranial aneurysm but most of these never rupture during lifetime and cause subarachnoid hemorrhage (SAH). In SAH, the rupture of an aneurysm causes bleeding into the lining between the brain’s surface and underlying tissue. Despite advances in operative techniques, SAH can lead to death in up to 45% of the cases. Because life style risk factors are critical in development of subarachnoid hemorrhage, it is important to characterize the risk factor profile of those with an elevated risk. Widely accepted risk factors for SAH are increasing age, smoking, hypertension and female sex. However, the reasons for an elevated risk in women have remained uncovered and the effect of smoking habits are not well understood. (more…)
Author Interviews, Diabetes, Gender Differences, JCEM, Sleep Disorders / 04.07.2016

MedicalResearch.com Interview with: Dr. Femke Rutters Department of Epidemiology and Biostatistics Vrije Universiteit Medical Centre Amsterdam, The Netherlands; EMGO+ Institute for Care Research MedicalResearch.com: What is the background for this study? What are the main findings? Response: In the past 10 years the interest in sleep as a possible cause for obesity/diabetes has risen. But data up until now used mainly self-reported sleep and simple measures of diabetes (related parameters), such as fasting glucose. A study on well-measured insulin sensitivity and beta-cell function was lacking. Such a study could provide more information on the pathophysiology. (more…)
Author Interviews, Gender Differences, JAMA / 27.06.2016

MedicalResearch.com Interview with: Gilbert Gonzales, PhD, MHA Assistant Professor Department of Health Policy Vanderbilt University School of Medicine MedicalResearch.com: What is the background for this study? What are the main findings? Response: Using data from one of the largest, most representative health surveys, we found lesbian, gay and bisexual adults were more likely to report substantially higher rates of severe psychological distress, heavy drinking and smoking, and impaired physical health than straight adults. (more…)
Aging, Author Interviews, Gender Differences / 16.06.2016

MedicalResearch.com Interview with: Kathleen Fischer, PhD Department of Biology UAB | University of Alabama Birmingham Birmingham, AL MedicalResearch.com: What is the background for this study? What are the main findings? Dr. Fischer: Aging is by far the greatest risk factor for most of the chronic, non-communicable diseases (e.g. cardiovascular disease, cancer, diabetes). By discovering the basic mechanisms responsible for aging we can find ways to extend healthy and productive life and reduce the burdens of chronic disease and disability experienced by individuals and society. Sex differences in longevity can provide novel insights into the basic biology of aging; however this aspect of aging has been largely ignored. Demographic data show that women outlive men in every society during every historical period and in every geographic area. In spite of this robust survival advantage, women suffer far greater morbidity late in life—a phenomenon described as the morbidity-mortality paradox. It is not clear whether this is a general mammalian pattern or something unique to humans. Research on sex differences in aging and age-related diseases in humans and a range of species will be crucial if we are going to identify the basic mechanisms responsible for the patterns we observe. (more…)
Author Interviews, Education, Gender Differences / 07.06.2016

MedicalResearch.com Interview with: Sara E. Brownell PhD School of Life Sciences Arizona State University Tempe, AZ MedicalResearch.com: What is the background for this study? What are the main findings? Dr. Brownell: Our group has been broadly interested in gender biases in introductory biology since we published a study that showed that women underperform on course exams and under participate in whole class discussions compared to men (http://www.lifescied.org/content/13/3/478.full). We were curious why women might be under performing on these course exams so in this new study, we examined characteristics of the exams to see if that had an impact. What we found was that women and men perform equally on questions that test basic memorization. However, when questions tested more higher-level critical thinking skills, women were not scoring as high as men. This happened even when we took into account the academic ability of the students - women and men who had the same ability coming into the class. We also found that students from lower socioeconomic statuses also underperformed on these higher-level critical thinking questions compared to students from higher socioeconomic statuses, again even when we took into account academic ability. (more…)
Author Interviews, Brigham & Women's - Harvard, Gender Differences, Heart Disease, PLoS, Women's Heart Health / 09.05.2016

MedicalResearch.com Interview with: Alexander Turchin, MD, MS Associate Physician, Brigham and Women's Hospital Associate Professor of Medicine, Harvard Medical School Brigham and Women's Hospital Department of Medicine Endocrinology Boston, MA 02115  MedicalResearch.com: What is the background for this study? What are the main findings? Dr. Turchin: It is known that fewer women than men at high risk for cardiovascular disease are treated with statins. However, the reasons for this sex disparity are not fully understood. Our study identified 4 factors that accounted for over 90% of the difference in statin therapy between women and men with coronary artery disease:
  • Age (women were older than men),
  • Amoking (men were more likely to smoke),
  • Evaluation by a cardiologist (men were more likely to have been seen by a cardiologist) and
  • History of adverse reactions to statins (women were more likely to have experienced an adverse reaction). This is the first time that a near-complete explanation for the sex disparities in statin therapy was found.
(more…)
Author Interviews, Education, Gender Differences, Surgical Research / 04.05.2016

MedicalResearch.com Interview with: Alison M. Fecher, MD Assistant Professor of Surgery Indiana University Health MedicalResearch.com: What is the background for this study? What are the main findings? Dr. Fecher: It has long been known that female faculty are underrepresented in departments of surgery at U.S. medical schools. Our study wanted to identify obstacles women face in entering certain surgical subspecialties and in career advancement. We found that women are poorly represented in some of the most competitive subspecialties, including cardiothoracic and transplant surgery. We also found that women tend to advance more slowly up the career ladder, with many of them spending more years at the assistant professor level than their male counterparts. One reason for this may be that they tend to publish less peer-reviewed articles than male faculty; however, our results show that the publications of female faculty often has a greater impact on the field, as measured by citations and recentness of articles. (more…)
Author Interviews, Endocrinology, Gender Differences, Kidney Disease / 28.04.2016

MedicalResearch.com Interview with: A.Univ.-Prof. Dr. Judith Lechner Div. Physiology Medical University of Innsbruck Innsbruck Austria MedicalResearch.com: What is the background for this study? What are the main findings? Dr. Lechner: Women are not just small men. Sex differences affect most, if not all the organ systems in the body. Over the past decades biomedical researchers have been mainly using male models. Therefore, there is a significant gap in knowledge of female physiology except for organ functions involved in reproduction. While the necessity to fill in these gaps has been advocated, our understanding of sex and gender differences in human physiology and pathophysiology is still limited. This holds especially true for the kidneys, e.g. while international registries show that fewer women than men are in need of renal replacement therapy due to end stage renal disease, the potentially underlying causes are still not known. The aim of our study was to find out, if hormone changes due to the female menstrual cycle would affect normal renal cells. For this purpose, urinary samples of healthy women of reproductive age were collected daily and analyzed for menstrual cycle-associated changes of marker proteins. Specifically, two enzymes (Fructose-1,6-bisphosphatase, Glutathione-S-transferase alpha) were measured, which are intracellular components of proximal tubular cells, a key population of renal cells. Upon cell damage, these enzymes are released into the urine, qualifying them as clinical markers for early detection of tubular injury. Since even in healthy persons low amounts of these enzymes can be detected in the urine, we used these marker proteins to analyze potential effects of the female hormone cycle on normal functioning of this cell population. As a result, we could detect transient increases of Fructose-1,6-bisphosphatase and Glutathione-S-transferase alpha correlating with specific phases of the female hormone cycle, namely ovulation and menses. This finding suggests that cyclical changes of female hormones might affect renal cell homeostasis, potentially providing women with an increased resistance against kidney damages. Thus, recurring changes of sex hormone levels, as during the natural menstrual cycle, might be involved in periodic tissue re-modeling not only in reproductive organs, but to a certain extent in the kidneys as well. (more…)
Author Interviews, Compliance, Gender Differences, Heart Disease / 28.04.2016

MedicalResearch.com Interview with: Sherry L. Grace, PhD Professor, School of Kinesiology and Health Science York University Sr. Scientist, Cardiorespiratory Fitness Team Toronto Rehabilitation Institute, University Health Network Toronto Western Hospital Toronto, ON MedicalResearch.com: What is the background for this study? Dr. Grace: Cardiac rehabilitation is an outpatient chronic disease management program. It is a standardized model of care, comprised of risk factor assessment and management, exercise training, patient education, as well and dietary and psychosocial counseling. Patients generally attend two times a week for several months. Participation in cardiac rehab has been shown to reduce death and disability. This is a dose-response association, such that more cardiac rehab participation is associated with even less death, etc. Therefore, it is important that patients adhere to the program, or participate in all the prescribed sessions. No one has ever reviewed patient adherence to cardiac rehab in a systematic way. It has always been assumed that patients only attend about half of prescribed sessions. Also, many studies have shown that women attend fewer sessions than men. However, this has been known for some time, so we would hope that in the current era, this sex difference would not exist. No study has ever aggregated and analyzed sex differences in program adherence, so we set out to do this. (more…)
Author Interviews, Gender Differences, Kidney Disease, Transplantation, University of Pennsylvania / 22.04.2016

MedicalResearch.com Interview with: Matthew Levine, MD, PhD Assistant Professor of Transplant Surgery Perelman School of Medicine University of Pennsylvania MedicalResearch.com: What is the background for this study? What are the main findings? Dr. Levine: This work stemmed from a known finding that female mice tolerate kidney injury better than males and this is true of mice that share exactly the same genes.  Therefore, the gender difference was the driving factor.  My basic science laboratory works at the intersection between scientific discovery and clinical application and this led us to question whether the same phenomenon was true in humans and whether we could identify a way in which this could be used to improve injury tolerance above what is seen in untreated subjects.  What we found was that the hormonal environment seems to impact ischemia tolerance, with female environment being protective and the male environment worsening injury tolerance in ischemia models where blood flow is interrupted and then restored.  The kidneys seemed to adapt to take on the injury response of the host after transplantation, indicating that the differences were not forged into the kidney itself and therefore could be altered.  We then found that estrogen therapy improved kidney injury tolerance when given to female mice in advance of injury, but no effect was seen in male mice.  And most importantly, we found that in a large cohort of transplant recipients that female recipients had better injury tolerance after transplant than male recipients, as shown by ability to avoid dialysis in the first week after transplant, otherwise known as delayed graft function (DGF). This is a fairly major finding since it has not been observed in the literature despite several decades of transplant data being carefully studied. (more…)
Author Interviews, Gender Differences, Heart Disease, JACC, Women's Heart Health / 15.04.2016

MedicalResearch.com Interview with: Dr. Neha J. Pagidipati Duke Clinical Research Institute Duke University School of Medicine Durham, North Carolina Medical Research: What is the background for this study? What are the main findings? Dr. Pagidipati: Women and men experience coronary artery disease differently, and a great deal of literature has shown that these differences extend to the diagnostic performance of various noninvasive testing modalities. However, little is known about the sex-specific prognostic value of computed tomographic angiography (CTA) and functional stress testing. We used data from the recent PROMISE trial to address this question. The PROMISE trial enrolled 10,003 patients (53% women) with stable symptoms suggestive of coronary artery disease to a diagnostic strategy of CTA vs stress testing, and found no differences in outcomes overall or by sex. We found that in women, a CTA is less likely to be positive, but when it is positive, it appears to have greater predictive value for a future cardiovascular event (all cause death, myocardial infarction, or unstable angina hospitalization) than stress testing. In men, a stress test is less likely to be positive, and though stress testing trended towards being more predictive of future events, there was no statistically significant difference in the prognostic value of either test type. (more…)