Cardiovascular disease (CVD) is the leading cause of morbidity and mortality worldwide. There is robust evidence of heterogeneity in underlying mechanism, manifestation, prognosis, and response to treatment of CVD between male and female patients. Gender, which refers to the socially constructed roles, behaviours, expressions, and identities of individuals, is an important determinant of CV health, and its consideration might help in attaining a broader understanding of the observed sex differences in CVD. Established risk factors such as hypertension, dyslipidemia, diabetes mellitus, obesity, and smoking R ESUM ELes maladies cardiovasculaires (MCV) sont la principale cause de morbidit e et de mortalit e à l' echelle mondiale. Des donn ees robustes t emoignent de l'h et erog en eit e entre hommes et femmes concernant le m ecanisme sous-jacent, la manifestation, le pronostic et la r eponse au traitement de MCV. Le genre, qui renvoie à une construction sociale des rôles, des comportements, de l'expression et de l'identit e individuelle, est un d eterminant important de la sant e cardiovasculaire (CV), et sa prise en compte pourrait aider à mieux comprendre les diff erences observ ees entre les sexes à l' egard des MCV. Il est bienCardiovascular disease (CVD) is the leading cause of morbidity and mortality worldwide. 1 Despite growing awareness of the role of sex and gender in the management of CVD, female patients continue to experience delays in diagnosis and treatment, 2,3 are referred to and participate less in cardiac rehabilitation, 4 are not sufficiently represented in clinical trials, 5 and as a consequence may often suffer worse outcomes.In the medical literature, the terms "sex" and "gender" are sometimes interchangeably used, generating confusion. Sex refers to the biological characteristics of an individual as determined by chromosomal complement and sex hormones. The impact of these biological factors on CV risk are well established. [6][7][8][9] For example, low levels of estrogen in younger females are associated with an increased risk of CVD, 10,11 and declining estrogen levels after menopause, in addition to advancing age, are associated with unfavourable lipid profiles, 12 blood pressure (BP) elevation, and increased CV risk. 13 Moreover, pregnancy-related complications, such as gestational diabetes and preeclampsia, may alter this risk, as well as endocrine disorders, such as polycystic ovarian syndrome, which may promote CVD. 14,15 Beyond sex, gender derives from the social, cultural, and behavioural factors that may modulate health. 16,17 Gender is a multidimensional concept that incorporates identity (ie, an inner sense of masculinity, femininity, or gender nonconformity), role (ie, societal and environmental expectations), relationships (ie, interpersonal interactions and dynamics), and institutionalised gender (ie, distribution of power in political, educational, social institutions in society). 18 Gender may significantly influence health-related behaviours and interact with CV risk factors....
This study demonstrated an acceptable efficacy of vancomycin in the treatment of PSC.
The likelihood of experiencing LR progressively rises with ERAT after the first month post-PVI. Blanking period after PVI should be limited to the first 23 days clinically and in future studies.
Corrected QT interval (QTc) prolongation is long considered as a predisposing factor for the occurrence of torsade de pointes (TdP) and sudden cardiac arrest in methadone maintenance treatment. We aimed to elucidate the correlation between QTc prolongation and in-hospital death, respiratory arrest, and endotracheal intubation in acute methadone-intoxicated patients presenting to the emergency department and to assess the value of QTc in predicting these outcomes. A prospective cross-sectional study with a convenience sample of patients with acute methadone overdose was done. Participants were 152 patients aged 15-65 with negative urinary dipstick test for cyclic antidepressants, no history of other QTc-prolonging conditions and co-ingestions, no severe comorbidities affecting the outcomes, and positive urinary dipstick results for methadone. QTc intervals were measured and calculated in triage-time electrocardiogram (ECG). Death was correlated with QTc (P = 0.014) and length of ICU admission (P < 0.001). In multivariable analysis, death was independently associated only with length of ICU admission [odds ratio (OR) 95 % confidence intervals (95 % CI) 1.36 (1.14-1.61)]. Intubation and respiratory arrest were independently associated with QTc interval [OR (95 % CI) 1.03 (1.02-1.04) and 1.02 (1.01-1.03), respectively]. The receiver operating characteristics curves drawn to show the ability of QTc to predict death, intubation, and respiratory arrest showed thresholds of 470, 447.5, and 450 ms with sensitivity (95 % CI) and specificity (95 % CI) of 87.5 (47.3-99.7), 86.8 (74.7-94.5), and 77.3 (62.2-88.5), respectively. Our study showed that QTc is a potential predictor for adverse outcomes related to acute methadone intoxication. The correlations shown in this study between triage-time QTc and in-hospital respiratory arrest or intubation in methadone overdose may be of clinical value, whether these outcomes are hypothesized to be a reflection of background TdP or intoxication severity.
BACKGROUND Alopecia areata is an immune mediated inflammatory hair loss, which occurs in all ethnic and age groups, and both sexes. However no significant etiology has been known for this disease. Helicobacter pylori (H. pylori) , is an organism colonized in gastric mucosa. This bacterium has been associated with certain extra-digestive dermatological conditions. The causal relationship between alopecia areata and H. pylori infection has been discussed in literature. Therefore, we conducted this study to evaluate the prevalence of H. pylori infection in patients with alopecia areata and assess the risk of this infection in patients with this disease in order to determine its potential roles in the physiopathology of this disease. METHODS Between 2014 and 2015, we prospectively studied 81 patients with alopecia areata and 81 healthy volunteers with similar age and sex. Patients without any history of H. pylori infection were included in the study and underwent urease breath test. All results were analyzed using SPSS software (version 21.0) and p value<0.05 was considered as statistically significant. RESULTS 81 patients and 81 controls with the mean age of 34.9±11.6 and 38.2±13.4 years were studied (p=0.097). 48 (59.3%) and 45 (55.6%) individuals were male, in cases and control groups respectively (p =0.634). The result of urea breath test (UBT) was positive in 43 (53.1%) patients in cases and 27 (33.3%) individuals in control group, which was significantly different (p =0.011). The risk of H. pylori infection in alopecia areata was 2.263 (95% CI: 1.199-4.273). CONCLUSION The results of our study showed significant difference between H. pylori infection in individuals with and without alopecia areata, which shows that H. pylori contamination may be effective in physiopathology of alopecia areata. Therefore these results should be tested in large multivariable cohorts and controlled trials to reach more accurate evidence in the future and to generalize this idea to larger population.
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