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Personalized Medicine Interdisciplinary Aspects and Sex Gender-Specific Differences
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Personalized Medicine Interdisciplinary Aspects and Sex Gender-Specific Differences

A special issue of Journal of Personalized Medicine (ISSN 2075-4426). This special issue belongs to the section "Sex, Gender and Hormone Based Medicine".

Deadline for manuscript submissions: closed (30 April 2023) | Viewed by 61753

Special Issue Editors

Dr. Alfredo De Giorgi

E-Mail
Guest Editor
Department of Internal Medicine, St. Anna University Hospital, 44124 Ferrara, Italy
Interests: internal medicine; clinical chronobiology; peripheral vascular diseases; renal diseases; cardiovascular disease; sex/gender-oriented medicine
Dr. Rosaria Cappadona

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Guest Editor
Department of Medical Sciences, University of Ferrara, 44121 Ferrara, Italy
Interests: nursing; obstetrics and gynecology; clinical chronobiology, shiftwork and desynchronization of circadian rhythms, sex/gender-oriented medicine
Dr. Valeria Raparelli

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Guest Editor
Department of Translational Medicine, University of Ferrara, 44121 Ferrara, Italy
Interests: atrial fibrillation; ischemic heart disease; thrombosis; platelet activation; cirrhosis; gender and health
Prof. Dr. Roberto Manfredini

E-Mail Website
Guest Editor
Department of Medical Sciences, University of Ferrara, via Luigi Borsari 46, 44121 Ferrara, Italy
Interests: internal medicine; clinical chronobiology; cardiovascular diseases; hypertension; sex/gender-oriented medicine

Special Issue Information

Dear Colleagues,

The development of sex/gender-specific medicine can be considered a crucial point in the progress of life sciences, with the possibility of going forward toward the so-called personalized or precision medicine. On the one hand, sex/gender-related differences and various determinants of health, such as risk factors and unhealthy lifestyles, e.g., smoking, drinking, exercise, diet, and overweight, are known to interfere with biological and physiological processes. On the other hand, the incidence, onset, clinical characteristics, evolution, outcome as well as the response to therapy of many diseases exhibit sex/gender-related differences and might benefit from personalized and targeted therapeutic options. Thus, the challenging objective of developing a personalized medicine needs the support of an interdisciplinary approach, from either basic, clinical, or pharmacological sciences. At the same time, several aspects of the inner world of circadian rhythms, dealing with either organization or desynchronization, may also show sex/gender-specific differences. This Special Issue will offer investigators and clinical practitioners operating in multiple fields of medicine and nursing care the opportunity to report and share their personal experience and research data, from the perspective of an interdisciplinary approach and cultural growth.

Dr. Alfredo De Giorgi
Dr. Rosaria Cappadona
Dr. Valeria Raparelli
Prof. Dr. Roberto Manfredini
Guest Editors

Manuscript Submission Information

Manuscripts should be submitted online at www.mdpi.com by registering and logging in to this website. Once you are registered, click here to go to the submission form. Manuscripts can be submitted until the deadline. All submissions that pass pre-check are peer-reviewed. Accepted papers will be published continuously in the journal (as soon as accepted) and will be listed together on the special issue website. Research articles, review articles as well as short communications are invited. For planned papers, a title and short abstract (about 100 words) can be sent to the Editorial Office for announcement on this website.

Submitted manuscripts should not have been published previously, nor be under consideration for publication elsewhere (except conference proceedings papers). All manuscripts are thoroughly refereed through a single-blind peer-review process. A guide for authors and other relevant information for submission of manuscripts is available on the Instructions for Authors page. Journal of Personalized Medicine is an international peer-reviewed open access monthly journal published by MDPI.

Please visit the Instructions for Authors page before submitting a manuscript. The Article Processing Charge (APC) for publication in this open access journal is 2600 CHF (Swiss Francs). Submitted papers should be well formatted and use good English. Authors may use MDPI's English editing service prior to publication or during author revisions.

Keywords

  • sex/gender-differences
  • personalized medicine
  • interdisciplinary aspects
  • internal medicine
  • emergency medicine
  • cardiovascular and vascular diseases
  • metabolic diseases
  • hypertension
  • coagulation
  • renal diseases
  • geriatric medicine
  • endocrinology
  • rheumatology and immunology
  • gastroenterology
  • dermatology
  • neurology
  • psychiatry and psychology
  • public health and epidemiology
  • forensic medicine
  • physical exercise and rehabilitation
  • chronobiology
  • circadian rhythms, organization and desynchronization
  • shift work
  • nursing

Published Papers (27 papers)

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13 pages, 1465 KiB  
Article
Foot Temperature by Infrared Thermography in Patients with Peripheral Artery Disease before and after Structured Home-Based Exercise: A Gender-Based Observational Study
by Anna Crepaldi, Lorenzo Caruso, Giovanni Piva, Luca Traina, Vincenzo Gasbarro, Roberto Manfredini, Nicola Lamberti, Natascia Rinaldo, Fabio Manfredini and Pablo Jesus Lopez-Soto
J. Pers. Med. 2023, 13(9), 1312; https://0-doi-org.brum.beds.ac.uk/10.3390/jpm13091312 - 27 Aug 2023
Cited by 1 | Viewed by 785
Abstract
Decreased arterial perfusion is a typical condition of patients with peripheral artery disease (PAD), with the microvascular picture particularly present among women. This observational study aimed to detect foot perfusion changes by infrared thermography (IRT) after a home-based exercise program in both sexes. [...] Read more.
Decreased arterial perfusion is a typical condition of patients with peripheral artery disease (PAD), with the microvascular picture particularly present among women. This observational study aimed to detect foot perfusion changes by infrared thermography (IRT) after a home-based exercise program in both sexes. A total of 76 PAD patients with claudication (72 ± 4 years; 52 males) were enrolled in a structured in-home exercise program composed of two daily 8 min interval walking sessions (1:1 walk:rest ratio) with progressively increasing speed. Outcome measures collected at baseline (T0) and at each hospital visit after 5 weeks, 12 weeks and 20 weeks included foot temperature measured by IRT (anterior tibial, posterior tibial, dorsalis pedis and arcuate artery regions), ankle brachial index and the 6 min walking test. After 20 weeks, foot temperature in both limbs showed a significant increasing trend, with a mean variation of 1.3 °C for the more impaired limb and 0.9 °C for the contralateral limb (t = 8.88, p < 0.001 and t = 5.36; p < 0.001, respectively), with significant changes occurring after 5 weeks of training. The sex-oriented analysis did not highlight any significant difference, with an improvement of mean foot temperature of 1.5 ± 0.6 °C in females versus 1.2 ± 0.5 °C in males (p = 0.42). Ankle brachial index and performance also significantly improved over time (p < 0.001) without gender differences. In patients with PAD, a structured low-intensity exercise program significantly improved foot temperature and exercise capacity without any sex-related difference. Full article
(This article belongs to the Special Issue Personalized Medicine Interdisciplinary Aspects and Sex Gender-Specific Differences)
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18 pages, 1861 KiB  
Article
Relationship between People’s Interest in Medication Adherence, Health Literacy, and Self-Care: An Infodemiological Analysis in the Pre- and Post-COVID-19 Era
by Andrea Grandieri, Caterina Trevisan, Susanna Gentili, Davide Liborio Vetrano, Giuseppe Liotta and Stefano Volpato
J. Pers. Med. 2023, 13(7), 1090; https://0-doi-org.brum.beds.ac.uk/10.3390/jpm13071090 - 01 Jul 2023
Cited by 2 | Viewed by 1504
Abstract
The prevalence of non-communicable diseases has risen sharply in recent years, particularly among older individuals who require complex drug regimens. Patients are increasingly required to manage their health through medication adherence and self-care, but about 50% of patients struggle to adhere to prescribed [...] Read more.
The prevalence of non-communicable diseases has risen sharply in recent years, particularly among older individuals who require complex drug regimens. Patients are increasingly required to manage their health through medication adherence and self-care, but about 50% of patients struggle to adhere to prescribed treatments. This study explored the relationship between interest in medication adherence, health literacy, and self-care and how it changed during the COVID-19 pandemic. We used Google Trends to measure relative search volumes (RSVs) for these three topics from 2012 to 2022. We found that interest in self-care increased the most over time, followed by health literacy and medication adherence. Direct correlations emerged between RSVs for medication adherence and health literacy (r = 0.674, p < 0.0001), medication adherence and self-care (r = 0.466, p < 0.0001), and health literacy and self-care (r = 0.545, p < 0.0001). After the COVID-19 pandemic outbreak, interest in self-care significantly increased, and Latin countries showed a greater interest in self-care than other geographical areas. This study suggests that people are increasingly interested in managing their health, especially in the context of the recent pandemic, and that infodemiology may provide interesting information about the attitudes of the population toward chronic disease management. Full article
(This article belongs to the Special Issue Personalized Medicine Interdisciplinary Aspects and Sex Gender-Specific Differences)
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14 pages, 335 KiB  
Article
Sex- and Gender-Specific Drug Abuse Dynamics: The Need for Tailored Therapeutic Approaches
by Susanna Marinelli, Giuseppe Basile, Roberto Manfredini and Simona Zaami
J. Pers. Med. 2023, 13(6), 965; https://0-doi-org.brum.beds.ac.uk/10.3390/jpm13060965 - 08 Jun 2023
Viewed by 2092
Abstract
Sex and gender have been gaining ever greater attention due to their associated risks, dynamics, patterns and protective factors underlying substance abuse and addiction. Such differentiations and the clarification of complexities thereof take on even greater relevance in light of drug abuse scope [...] Read more.
Sex and gender have been gaining ever greater attention due to their associated risks, dynamics, patterns and protective factors underlying substance abuse and addiction. Such differentiations and the clarification of complexities thereof take on even greater relevance in light of drug abuse scope worldwide. According to the 2022 World Drug Report released by the United Nations Office on Drugs and Crime (UNODC), in 2020 an estimated 284 million people worldwide aged 15–64 had used a drug within the last 12 months. The authors have set out to shed a light on determinants and contributing factors of drug abuse based on sex and gender and outline policy and medicolegal remarks aimed at delineating sex- and gender-based approaches towards drug abuse therapeutic interventions that are both therapeutically and ethically/legally viable and grounded in an evidence-based set of standards. Neurobiological data suggest that estrogen may facilitate drug taking by interacting with reward- and stress-related systems. In animal research, the administration of estrogen increases drug taking and facilitates the acquisition, escalation, and reinstatement of cocaine-seeking behavior. From a medicolegal perspective, it is of utmost importance to take into account the whole picture constituting each patient profile, which certainly includes gender factors and contributors, when outlining a therapeutic approach. Failure to do so could lead to negligence-based malpractice allegations, in light of the scientific findings representing best practices with which clinicians need to comply when caring for SUD patients. Full article
(This article belongs to the Special Issue Personalized Medicine Interdisciplinary Aspects and Sex Gender-Specific Differences)
17 pages, 610 KiB  
Article
Toward a Systematic Assessment of Sex Differences in Cystic Fibrosis
by Christiane Gärtner, Jörg Fallmann, Peter F. Stadler, Thorsten Kaiser and Sarah J. Berkemer
J. Pers. Med. 2023, 13(6), 924; https://0-doi-org.brum.beds.ac.uk/10.3390/jpm13060924 - 31 May 2023
Viewed by 1147
Abstract
(1) Background: Cystic fibrosis (CF) is a disease with well-documented clinical differences between female and male patients. However, this gender gap is very poorly studied at the molecular level. (2) Methods: Expression differences in whole blood transcriptomics between female and male CF patients [...] Read more.
(1) Background: Cystic fibrosis (CF) is a disease with well-documented clinical differences between female and male patients. However, this gender gap is very poorly studied at the molecular level. (2) Methods: Expression differences in whole blood transcriptomics between female and male CF patients are analyzed in order to determine the pathways related to sex-biased genes and assess their potential influence on sex-specific effects in CF patients. (3) Results: We identify sex-biased genes in female and male CF patients and provide explanations for some sex-specific differences at the molecular level. (4) Conclusion: Genes in key pathways associated with CF are differentially expressed between sexes, and thus may account for the gender gap in morbidity and mortality in CF. Full article
(This article belongs to the Special Issue Personalized Medicine Interdisciplinary Aspects and Sex Gender-Specific Differences)
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12 pages, 585 KiB  
Article
Visits to Sexually Transmitted Infection Clinics in Italy from January 2016 to November 2021: A Multicenter, Retrospective Study
by Alessandro Borghi, Maria Elena Flacco, Lucrezia Pacetti, Gionathan Orioni, Elisa Marzola, Rosario Cultrera, Valentina Guerra, Roberto Manfredini, Valeria Gaspari, Daniela Segala and Monica Corazza
J. Pers. Med. 2023, 13(5), 731; https://0-doi-org.brum.beds.ac.uk/10.3390/jpm13050731 - 26 Apr 2023
Viewed by 1211
Abstract
There is no evidence of seasonal variation in visits to clinics dedicated to sexually transmitted infections (STIs) in Italy, nor of changes after the advent of the COVID-19 pandemic. An observational, retrospective, multicentric study was conducted to record and analyze all the visits [...] Read more.
There is no evidence of seasonal variation in visits to clinics dedicated to sexually transmitted infections (STIs) in Italy, nor of changes after the advent of the COVID-19 pandemic. An observational, retrospective, multicentric study was conducted to record and analyze all the visits to the STI clinics of the Dermatology Units of the University Hospitals of Ferrara and Bologna and of the Infectious Disease Unit of Ferrara, Italy, between January 2016 and November 2021. Overall, 11.733 visits were registered over a 70-month study period (63.7% males, mean age 34.5 ± 12.8 yrs). The mean number of monthly visits significantly decreased from the advent of the pandemic (136) compared to before (177). In the pre-pandemic period, visits to STI clinics increased in the autumn/winter months when compared to spring/summer, while the trend was the opposite in the pandemic period. Thus, during the pandemic, both an overall significant reduction in visits to STI clinics and a reversal in their seasonality were observed. These trends affected males and females equally. The marked decrease, mostly found in the pandemic winter months, can be linked to the “lockdown”/self-isolation ordinances and social distancing measures during the colder months, coinciding with the spread of the COVID-19 infection, which limited the opportunities for meeting and socializing. Full article
(This article belongs to the Special Issue Personalized Medicine Interdisciplinary Aspects and Sex Gender-Specific Differences)
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13 pages, 1332 KiB  
Article
Lower All-Cause Mortality Risk in Females and Males with Peripheral Artery Disease following Pain-Free Home-Based Exercise: A 7-Year Observational Study
by Nicola Lamberti, Luca Traina, Caterina Savriè, Elpiniki Tsolaki, Natascia Rinaldo, Sofia Straudi, Franco Guerzoni, Nicola Napoli, Roberto Manfredini, Vincenzo Gasbarro and Fabio Manfredini
J. Pers. Med. 2023, 13(4), 636; https://0-doi-org.brum.beds.ac.uk/10.3390/jpm13040636 - 05 Apr 2023
Cited by 2 | Viewed by 1277
Abstract
We evaluated the sex-specific difference in response upon participation in an exercise program with respect to the risk of adverse clinical outcomes among patients with peripheral artery disease (PAD) and claudication. The records of 400 PAD patients were assessed between 2012 and 2015. [...] Read more.
We evaluated the sex-specific difference in response upon participation in an exercise program with respect to the risk of adverse clinical outcomes among patients with peripheral artery disease (PAD) and claudication. The records of 400 PAD patients were assessed between 2012 and 2015. Two hundred of them were addressed to a walking program prescribed at the hospital and executed at home at symptom-free walking speed (Ex), while the remaining 200 acted as a control group (Co). The number and date of deaths, all-cause hospitalizations, and amputations for a 7-year period were collected from the regional registry. At baseline, no differences were observed (MEXn = 138; FEXn = 62; MCOn = 149; FCOn = 51). The 7-year survival rate was significantly higher in FEX (90%) than in MEX (82% hazard ratio, HR: 0.542 95% CI 0.331–0.885), FCO (45%, HR: 0.164 95% CI 0.088–0.305), and MCO (44%; HR: 0.157 95% CI 0.096–0.256). A significantly lower rate of hospitalization (p < 0.001) and amputations (p = 0.016) was observed for the Ex group compared to the Co group, without differences by sex. In conclusion, in PAD patients, active participation in a home-based pain-free exercise program was associated with a lower rate of death and better long-term clinical outcomes, particularly among women. Full article
(This article belongs to the Special Issue Personalized Medicine Interdisciplinary Aspects and Sex Gender-Specific Differences)
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11 pages, 279 KiB  
Article
Gender and Psychosocial Differences in Psychological Resilience among a Community of Older Adults during the COVID-19 Pandemic
by Alberto Sardella, Vittorio Lenzo, Giorgio Basile, Alessandro Musetti, Christian Franceschini and Maria C. Quattropani
J. Pers. Med. 2022, 12(9), 1414; https://0-doi-org.brum.beds.ac.uk/10.3390/jpm12091414 - 30 Aug 2022
Cited by 8 | Viewed by 1870
Abstract
The study aimed at exploring gender and additional sociodemographic differences in psychological resilience, as well as the association between resilience and psychological distress in older adults, during the first lockdown in Italy, due to the COVID-19 pandemic. Participants attended an online survey during [...] Read more.
The study aimed at exploring gender and additional sociodemographic differences in psychological resilience, as well as the association between resilience and psychological distress in older adults, during the first lockdown in Italy, due to the COVID-19 pandemic. Participants attended an online survey during the first lockdown in May 2020. Psychological distress was assessed through the Depression Anxiety Stress Scale-21, the Resilience Scale (RS) was administered to evaluate psychological resilience, and sociodemographic variables were also collected. The study involved 108 community older adults (mean age 70.02 ± 3.5 years). Comparisons revealed that women reported significantly lower total scores of RS (p = 0.027), as well as lower levels of resilience-related domains, namely Meaningfulness (p = 0.049), Self-Reliance (p = 0.011), Perseverance (p = 0.035), and Existential Aloneness (p = 0.014), compared to men. Significantly higher RS scores were found in older adults being involved in a relationship, compared to those not involved in relationships (p = 0.026), and in older adults with children (p = 0.015), compared to those without offspring, suggesting the importance for older adults of not dealing alone with such a dramatic and stressful event, such as the pandemic. Negative correlations were found between psychological resilience and stress, depression, and anxiety. Linear regressions revealed that lower RS total scores, as well as lower scores in the majority of the RS scales, were associated with greater levels of stress, greater levels of anxiety, and greater levels of depressive symptoms. This study suggested that older women might appear more vulnerable in facing the pandemic, compared to men; having not lived alone through the lockdown period might also be considered as a factor of resilience for older adults. Full article
(This article belongs to the Special Issue Personalized Medicine Interdisciplinary Aspects and Sex Gender-Specific Differences)
15 pages, 1693 KiB  
Article
Physiologic Range of Myocardial Mechano-Energetic Efficiency among Healthy Subjects: Impact of Gender and Age
by Francesco Ferrara, Valentina Capone, Filippo Cademartiri, Olga Vriz, Rosangela Cocchia, Brigida Ranieri, Monica Franzese, Rossana Castaldo, Antonello D’Andrea, Rodolfo Citro, Salvatore Chianese, Roberto Annunziata, Flavio Marullo, Mario Siniscalchi, Marianna Conte, Chiara Sepe, Renato Maramaldi, Salvatore Rega, Giuseppe Russo, Massimo Majolo, Eliana Raiola, Andrea Salzano, Ciro Mauro, Bruno Trimarco, Raffaele Izzo and Eduardo Bossoneadd Show full author list remove Hide full author list
J. Pers. Med. 2022, 12(6), 996; https://0-doi-org.brum.beds.ac.uk/10.3390/jpm12060996 - 18 Jun 2022
Cited by 6 | Viewed by 1655
Abstract
Background: Myocardial mechano-energetic efficiency (MEE) is the capability of the left ventricle (LV) to convert the chemical energy obtained from the cardiac oxidative metabolism into mechanical work. The aim of present study was to establish normal non-invasive MEE and MEEi reference values. Methods: [...] Read more.
Background: Myocardial mechano-energetic efficiency (MEE) is the capability of the left ventricle (LV) to convert the chemical energy obtained from the cardiac oxidative metabolism into mechanical work. The aim of present study was to establish normal non-invasive MEE and MEEi reference values. Methods: In total, 1168 healthy subjects underwent physical examinations, clinical assessment, and standardized transthoracic echocardiographic (TTE) examination. MEE was obtained by TTE as the ratio between stroke volume (SV) and heart rate (HR): MEE = SV/HR [HR expressed in seconds (HR/60)]. Because MEE is highly related to left ventricular mass (LVM), MEE was then divided by LVM with the purpose of obtaining an estimate of energetic expenditure per unit of myocardial mass (i.e., indexed MEE, MEEi, mL/s/g). Results: The mean values of MEE and MEEi in the overall population were 61.09 ± 18.19 mL/s; 0.45 ± 0.14, respectively. In a multivariable analysis, gender, body surface area (BSA), diastolic blood pressure, left atrial volume indexed to BSA, E/e’ and tricuspid annular plane systolic excursion (TAPSE) were the independent variables associated with MEE, while age, gender, BSA and TAPSE were the independent variables associated with MEEi. Conclusions: The knowledge of age- and gender-based MEE and MEEi normal values may improve the global assessment of LV cardiac mechanics and serve as a reference to identify phenotypes at high risk of cardiovascular events. Full article
(This article belongs to the Special Issue Personalized Medicine Interdisciplinary Aspects and Sex Gender-Specific Differences)
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13 pages, 2145 KiB  
Article
Serological Response and Relationship with Gender-Sensitive Variables among Healthcare Workers after SARS-CoV-2 Vaccination
by Roberto Cangemi, Manuela Di Franco, Antonio Angeloni, Alessandra Zicari, Vincenzo Cardinale, Marcella Visentini, Guido Antonelli, Anna Napoli, Emanuela Anastasi, Giulio Francesco Romiti, Fabrizio d’Alba, Domenico Alvaro, Antonella Polimeni, Stefania Basili and SAPIENZAVAX Collaborators
J. Pers. Med. 2022, 12(6), 994; https://0-doi-org.brum.beds.ac.uk/10.3390/jpm12060994 - 18 Jun 2022
Cited by 6 | Viewed by 3569
Abstract
Vaccine-induced immunity is a key strategy in the long-term control of the COVID-19 pandemic. The aim of our study was to explore the relationship between mRNA vaccine-induced antibodies and gender-sensitive variables among healthcare workers. Two thousand-sixty-five volunteers who received the BNT162b2 vaccine were [...] Read more.
Vaccine-induced immunity is a key strategy in the long-term control of the COVID-19 pandemic. The aim of our study was to explore the relationship between mRNA vaccine-induced antibodies and gender-sensitive variables among healthcare workers. Two thousand-sixty-five volunteers who received the BNT162b2 vaccine were enrolled in the study and followed up. Demographic, clinical, and social variables (educational level, marital status, occupation, childcare) were evaluated through a self-administered questionnaire. Anti-Spike (S) IgG were measured at 1 month (T1) and at 5 months (T2) after the second vaccine dose. At T1, median anti-S IgG values were 693 [394–>800] AU/mL (1 AU = 2.6 BAU). Values > 800 AU/mL (2080 BAU/mL) were directly associated with a previous COVID-19 (p < 0.001) infection and inversely with age (p < 0.001), smoking habit (p < 0.001), and autoimmune diseases (p < 0.001). At T2, a significant decreasing in anti-S IgG values was observed (187 [81–262] AU/mL), with a median decrease of 72 [60–82]%. On multivariate data analysis, a reduction of more than 82% was directly associated with male sex (p < 0.021), age (p < 0.001), smoking (p = 0.038), hypertension (p = 0.042), and, inversely, with previous COVID-19 infection (p < 0.001) and being “cohabiting” (p = 0.005). Our findings suggest that demographic, clinical, and social variables play a role in anti-S IgG values decreasing in long-term follow up and should be considered to find personalized vaccine schedules. Full article
(This article belongs to the Special Issue Personalized Medicine Interdisciplinary Aspects and Sex Gender-Specific Differences)
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13 pages, 968 KiB  
Article
The Sexual Dimorphism in Cerebrospinal Fluid Protein Content Does Not Affect Intrathecal IgG Synthesis in Multiple Sclerosis
by Massimiliano Castellazzi, Caterina Ferri, Ginevra Tecilla, André Huss, Paola Crociani, Gaetano Desina, Gianvito Barbella, Alice Piola, Samantha Permunian, Makbule Senel, Maurizio Leone, Hayrettin Tumani and Maura Pugliatti
J. Pers. Med. 2022, 12(6), 977; https://0-doi-org.brum.beds.ac.uk/10.3390/jpm12060977 - 16 Jun 2022
Cited by 3 | Viewed by 1619
Abstract
(1) Background: Multiple sclerosis (MS) is a chronic inflammatory demyelinating disease of the central nervous system (CNS) that mainly affects young adults and females more than males. The detection of intrathecal IgG synthesis (IIS) on cerebrospinal fluid (CSF) analysis supports the diagnosis of [...] Read more.
(1) Background: Multiple sclerosis (MS) is a chronic inflammatory demyelinating disease of the central nervous system (CNS) that mainly affects young adults and females more than males. The detection of intrathecal IgG synthesis (IIS) on cerebrospinal fluid (CSF) analysis supports the diagnosis of MS. A sexual dimorphism has recently been described in CSF protein content. (2) Methods: Clinical and laboratory data from 340 MS patients (F = 231, M = 99) and 89 people with clinically isolated syndrome (CIS) (F = 57, M = 32) were retrospectively analyzed to assess the presence of variables affected by sex and age. (3) Results: In MS, the albumin quotient (QAlb), reflecting the blood–CSF barrier (BCSFB) function, was higher in males (5.6 vs. 4.34) and correlated to age with a constant difference between sexes (F = 41.71). In CIS patients, QAlb increased with age only in males (r = 0.3567). Age was positively correlated to disease duration and severity in MS (r = 0.3502, r = 0.2986, respectively). No differences emerged for quantitative and qualitative IIS determinations. (4) Discussion: Although the main difference between males and females concerns the function of BCSFB assessed by QAlb, this sexual dimorphism does not affect the determination of the IIS evaluated both by quantitative and qualitative methods. Full article
(This article belongs to the Special Issue Personalized Medicine Interdisciplinary Aspects and Sex Gender-Specific Differences)
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10 pages, 297 KiB  
Article
Factors Associated with Postpartum Sexual Dysfunction in Spanish Women: A Cross-Sectional Study
by Pedro Hidalgo-Lopezosa, Sandra Pérez-Marín, Andrea Jiménez-Ruz, Juan de la Cruz López-Carrasco, Ana María Cubero-Luna, Rubén García-Fernández, María Aurora Rodríguez-Borrego, Cristina Liébana-Presa and Pablo Jesús López-Soto
J. Pers. Med. 2022, 12(6), 926; https://0-doi-org.brum.beds.ac.uk/10.3390/jpm12060926 - 02 Jun 2022
Cited by 5 | Viewed by 2097
Abstract
(1) Background: Female sexual dysfunction (FSD) has a high prevalence globally, and perinatal factors favor FSD, especially in the postpartum period. The aim was to determine the prevalence and factors influencing FSD in the postpartum period; (2) Methods: An observational study carried out [...] Read more.
(1) Background: Female sexual dysfunction (FSD) has a high prevalence globally, and perinatal factors favor FSD, especially in the postpartum period. The aim was to determine the prevalence and factors influencing FSD in the postpartum period; (2) Methods: An observational study carried out in three primary care centers in southern Spain, with women in the postpartum period who had a single low-risk birth. One hundred and seventeen women answered the Female Sexual Function questionnaire during the 4th month postpartum, between January 2020 and December 2021. Sociodemographic, obstetric, neonatal variables and level of self-esteem were analyzed. A multiple logistic regression model was carried out; (3) Results: 78.4% had high level of self-esteem. FSD prevalence was 89.7%. Factors related to FSD were having an instrumental vaginal delivery, women with university studies, and prenatal preparation. Maternal age ≥ 35, multiparity, pathological processes in the child, a medium–low level of self-esteem and newborn weight were associated with disorders in some of domains of sexual function; (4) Conclusions: FSD is highly prevalent in the postpartum period and is associated with preventable factors. A preventive approach by health professionals to these factors is essential. Health services should implement postpartum follow-up programs, which may coincide in time and place with newborn follow-up programs. Full article
(This article belongs to the Special Issue Personalized Medicine Interdisciplinary Aspects and Sex Gender-Specific Differences)
9 pages, 531 KiB  
Article
Glucose Metabolism Derangements and Thyroid Nodules: Does Sex Matter?
by Alberto Gobbo, Irene Gagliardi, Andrea Gobbo, Roberta Rossi, Paola Franceschetti, Sabrina Lupo, Martina Rossi, Marta Bondanelli, Maria Rosaria Ambrosio and Maria Chiara Zatelli
J. Pers. Med. 2022, 12(6), 903; https://0-doi-org.brum.beds.ac.uk/10.3390/jpm12060903 - 30 May 2022
Viewed by 1578
Abstract
(1) Background: Glucose metabolism derangements (GMD) and thyroid nodules (TNs) are the most frequent endocrine disorders, and their relationship is still controversial; little evidence is reported regarding sex differences. We aim to evaluate the association between GMDs and TNs according to sex and [...] Read more.
(1) Background: Glucose metabolism derangements (GMD) and thyroid nodules (TNs) are the most frequent endocrine disorders, and their relationship is still controversial; little evidence is reported regarding sex differences. We aim to evaluate the association between GMDs and TNs according to sex and the sex differences in glucose metabolism and insulin sensitivity (IS). (2) Methods: We evaluated 342 patients (268 females and 74 males) at high GMD risk undergoing an oral glucose tolerance test and a thyroid ultrasound. (3) Results: The TN prevalence was 61% (n = 210), with no significant differences according to sex and GMD classes. The TN presence is significantly associated with age and impaired fasting glucose (IFG) in females. Males and females with normal fasting glucose (NFG) had a significantly lower OR of having TNs than females with IFG. IFG females had a significantly higher predicted probability of having TNs than NFG males and females but not IFG males. Impaired glucose tolerance/Type 2 diabetes mellitus (IGT/T2DM) is significantly associated with age and male sex, while IFG is associated with age. Females had significantly lower HOMA-index values than males. (4) Conclusions: No significant association between IGT/T2DM and TNs according to sex was found. IFG seems to play a role in TN development independently of sex. Further studies are needed to explore the relationship between TNs and GMD to identify subgroups with a higher TN risk. Full article
(This article belongs to the Special Issue Personalized Medicine Interdisciplinary Aspects and Sex Gender-Specific Differences)
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10 pages, 1062 KiB  
Article
Sex-Based Difference in the Effect of Metoprolol on Heart Rate and Bradycardia in a Population-Based Setting
by Linda C. Hendriksen, Grace Omes-Smit, Birgit C. P. Koch, M. Arfan Ikram, Bruno H. Stricker and Loes E. Visser
J. Pers. Med. 2022, 12(6), 870; https://0-doi-org.brum.beds.ac.uk/10.3390/jpm12060870 - 25 May 2022
Cited by 5 | Viewed by 2281
Abstract
Background: Metoprolol, a beta-blocker, is used to reduce the heart rate. Although it has been demonstrated that the metoprolol plasma concentration is higher in women than in men, the same dose is recommended. In this study, we investigated whether the metoprolol concentration was [...] Read more.
Background: Metoprolol, a beta-blocker, is used to reduce the heart rate. Although it has been demonstrated that the metoprolol plasma concentration is higher in women than in men, the same dose is recommended. In this study, we investigated whether the metoprolol concentration was associated with a stronger heart-rate reduction and bradycardia in women than in men. Methods: This study is part of the Rotterdam Study (RS), a population-based prospective cohort study. Blood samples from a random subset of 2000 participants were used to assess metoprolol plasma levels. An analysis of heart rate (beats per minute, bpm) and bradycardia (<60 bpm) was performed in metoprolol users with an ECG at the day of blood collection to study sex-specific differences in heart rate and the risk of bradycardia. Results: In total, 40 women and 39 men were included. There was a statistically significant association between metoprolol concentration and heart rate in women (p-value: 0.014) but not in men (p-value: 0.639). Furthermore, women in the highest concentration group had a more than 15-times-higher risk of bradycardia than women in the lowest concentration group (OR = 15.6; 95% CI = 1.1, 217.3); however, this was not seen in men (OR = 1.3; 95% CI = 0.1, 12.4). After adjustment for age, BMI, time between blood sample and ECG, hypertension, myocardial infarction, heart failure, atrial fibrillation, digoxin use, and calcium channel blocker use, the association between concentration and bradycardia in women remained statistically significant. Conclusions: Women, but not men, had a statistically significantly lower heart rate at higher metoprolol plasma concentration and a statistically significantly increased risk of bradycardia. Full article
(This article belongs to the Special Issue Personalized Medicine Interdisciplinary Aspects and Sex Gender-Specific Differences)
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10 pages, 665 KiB  
Article
Gender-Specific Differences in the Intensive Care Treatment of COVID-19 Patients
by Peter Jirak, Moritz Mirna, Vincent Van Almsick, Zornitsa Shomanova, Magdalena Mahringer, Michael Lichtenauer, Kristen Kopp, Albert Topf, Franz Sieg, Johannes Kraus, Sarah X. Gharibeh, Uta C. Hoppe, Lukas Fiedler, Robert Larbig, Rudin Pistulli, Lukas J. Motloch and Anna-Maria Dieplinger
J. Pers. Med. 2022, 12(5), 849; https://0-doi-org.brum.beds.ac.uk/10.3390/jpm12050849 - 23 May 2022
Cited by 1 | Viewed by 1964
Abstract
Background: Gender-specific differences in the outcome of COVID-19 patients requiring intensive care treatment have been reported. However, a potential association with ICU therapy remains elusive. Methods: A total of 224 consecutive patients (63 women) treated for severe COVID-19 disease requiring mechanical ventilation were [...] Read more.
Background: Gender-specific differences in the outcome of COVID-19 patients requiring intensive care treatment have been reported. However, a potential association with ICU therapy remains elusive. Methods: A total of 224 consecutive patients (63 women) treated for severe COVID-19 disease requiring mechanical ventilation were screened for the study. After propensity score matching for gender, 40 men and 40 women were included in the study. Comparative analysis was conducted for laboratory parameters, ICU therapy and complications (pulmonary embolism, thrombosis, stroke, and ventricular arrhythmias), and outcome (mortality). Results: Male patients had significantly higher levels of CRP (p = 0.012), interleukin-6 (p = 0.020) and creatinine (p = 0.027), while pH levels (p = 0.014) were significantly lower compared to females. Male patients had longer intubation times (p = 0.017), longer ICU stays (p = 0.022) and higher rates of catecholamine dependence (p = 0.037). Outcome, complications and ICU therapy did not differ significantly between both groups. Conclusion: The present study represents the first matched comparison of male and female COVID-19 patients requiring intensive care treatment. After propensity matching, male patients still displayed a higher disease severity. This was reflected in higher rates of vasopressors, duration of ICU stay and duration of intubation. In contrast, no significant differences were observed in mortality rates, organ replacement therapy and complications during ICU stay. Full article
(This article belongs to the Special Issue Personalized Medicine Interdisciplinary Aspects and Sex Gender-Specific Differences)
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13 pages, 1128 KiB  
Article
Lower Life Satisfaction and Inflammation in African American Adults: Body Adiposity Mediation and Sex Moderation
by Kandauda A. S. Wickrama, Penny A. Ralston and Jasminka Z. Ilich
J. Pers. Med. 2022, 12(5), 745; https://0-doi-org.brum.beds.ac.uk/10.3390/jpm12050745 - 04 May 2022
Cited by 2 | Viewed by 1387
Abstract
Both lower life satisfaction (LLS) and chronic inflammation are underlying conditions for numerous diseases. We investigated their associations in African American adults, within the context of three hypotheses: (a) perceived LLS will be positively associated with inflammation measured by serum C-reactive protein (CRP); [...] Read more.
Both lower life satisfaction (LLS) and chronic inflammation are underlying conditions for numerous diseases. We investigated their associations in African American adults, within the context of three hypotheses: (a) perceived LLS will be positively associated with inflammation measured by serum C-reactive protein (CRP); (b) this association will be mediated by body adiposity; and (c) these associations will be moderated by sex. Participants (n = 83; >45 years; 59% women) were a subsample of a larger church-based intervention to reduce cardiovascular risks and were assessed at baseline and after 6 months. Body adiposity (BMI/hip/waist circumferences) was measured by standardized methods and CRP with ELISA. LLS was self-reported. The analyses were conducted in the structural equation modeling (SEM) framework. The direct relationship between LLS and CRP was significant for all participants but was mediated by BMI/hip/waist circumferences. Multi-group SEM analysis provided evidence for sex moderation by showing that the mediating pathway from LLS to CRP through BMI, and to a lesser extent through hip/waist circumferences, was significant only in women. In conclusion, perceived LLS was positively associated with the level of inflammation mediated by BMI/hip/waist circumference, with the association between LLS and CRP being stronger in women. These findings contribute to the current literature untangling mediation/moderation processes in which perceived LLS may contribute to adiposity-related inflammation. They also add to precision medicine development, suggesting that stress and inflammation-reducing interventions should focus on African Americans, particularly women. Full article
(This article belongs to the Special Issue Personalized Medicine Interdisciplinary Aspects and Sex Gender-Specific Differences)
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12 pages, 751 KiB  
Article
Characterization by Gender of Frailty Syndrome in Elderly People according to Frail Trait Scale and Fried Frailty Phenotype
by Iván Palomo, Francisco García, Cecilia Albala, Sergio Wehinger, Manuel Fuentes, Marcelo Alarcón, Diego Arauna, Hector Montecino, Diego Mendez, Magdalena Sepúlveda, Peggy Fuica and Eduardo Fuentes
J. Pers. Med. 2022, 12(5), 712; https://0-doi-org.brum.beds.ac.uk/10.3390/jpm12050712 - 29 Apr 2022
Cited by 5 | Viewed by 2456
Abstract
Background: Frailty has emerged as one of the main geriatric syndromes to be prevented in order to improve quality of health and life in the elderly. In this sense, the characterization of this syndrome through reliable and feasible diagnostic tools for clinical use, [...] Read more.
Background: Frailty has emerged as one of the main geriatric syndromes to be prevented in order to improve quality of health and life in the elderly. In this sense, the characterization of this syndrome through reliable and feasible diagnostic tools for clinical use, such as the Frail Trait Scale 5 (FTS-5) and Frail Trait Scale 3 (FTS-3), represents the basis for this objective. Objectives: To characterize the frailty syndrome in a population of older adults using FTS-5, FTS-3, and Fried phenotype (FP) as frailty diagnostic tools. Design: Cross-sectional study. Participants: 300 adults ≥65 years recruited from different Family Health Centers and community groups of older people in Talca, Chile. Methods: The diagnosis of frailty was made according to FP, FTS-5, and FTS-3 tools. Data about sociodemographic characteristics and anthropometric measurements were collected by a clinical interview by a previously trained health professional. Results: A total prevalence of frailty according to the FP of 19.7% was observed; while in the group of women and men it was 21.4% and 15.0%, respectively. Concerning the FTS-5 tool, the total prevalence of frailty was 18%, while in the group of women and men was 18.0% and 17.5%, respectively. The FTS-3 tool shows a total prevalence of frailty of 23.3%, while in the group of women and men a prevalence of 22.7% and 25.0%, respectively. A significant difference is observed with respect to the presence of the Fried criteria of “weakness” (women: 21.4%, men: 38.8%) and “weight loss” (women: 16.8%, men: 7.5%; p < 0.05). A significant difference is observed concerning the average score of “Handgrip” criteria, “walking time”, and “Physical Activity Scale for the Elderly” (PASE) between the group of women and men. Frailty, diagnosed by FTS-3, is significantly associated with the risk factors of overweight (body mass index ≥ 25) (OR: 10.225, 95% CI: 1.297–80.617) and advanced age (age ≥ 75 years) (OR: 1.839, 95% CI: 1.040–3.250). Conclusion: The prevalence of frailty observed with the FTS-5 (18%) and FTS-3 (23.3%) tools are similar to the prevalence observed through the FP (19.7%) and those reported in other observational studies. Considering the similar prevalence of frailty diagnosed with the three tools, FTS-3 should be a valuable tool for the screening of frailty in the community. Full article
(This article belongs to the Special Issue Personalized Medicine Interdisciplinary Aspects and Sex Gender-Specific Differences)
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11 pages, 589 KiB  
Article
A Fitness-Fatigue Model of Performance in Peripheral Artery Disease: Predicted and Measured Effects of a Pain-Free Exercise Program
by Nicola Lamberti, Giovanni Piva, Federico Businaro, Lorenzo Caruso, Anna Crepaldi, Pablo Jesùs Lòpez-Soto and Fabio Manfredini
J. Pers. Med. 2022, 12(3), 397; https://0-doi-org.brum.beds.ac.uk/10.3390/jpm12030397 - 04 Mar 2022
Cited by 2 | Viewed by 1986
Abstract
Banister impulse-response (IR) model estimates the performance in response to the training impulses (TRIMPs). In 100 patients with peripheral artery disease (PAD), we tested by an IR model the predictability of the effects of a 6-month structured home-based exercise program. The daily TRIMPs [...] Read more.
Banister impulse-response (IR) model estimates the performance in response to the training impulses (TRIMPs). In 100 patients with peripheral artery disease (PAD), we tested by an IR model the predictability of the effects of a 6-month structured home-based exercise program. The daily TRIMPs obtained from prescribed walking speed, relative intensity and time of exercise determined the fitness-fatigue components of performance. The estimated performance values, calculated from the baseline 6-min and pain-free walking distance (6MWD and PFWD, respectively) were compared with values measured at visits through regression models. Interval pain-free walking at controlled speed prescribed during circa-monthly hospital visits (5 ± 1) was safely performed at home with good adherence (92% of scheduled sessions, 144 ± 25 km walked in 50 ± 8 training hours). The mean TRIMP rose throughout the program from 276 to 601 a.u. The measured 6MWD and PFWD values increased (+33 m and +121 m, respectively) showing a good fit with those estimated by the IR model (6MWD: R2 0.81; PFWD: R2 0.68) and very good correspondence (correlation coefficients: 0.91 to 0.95), without sex differences. The decay of performance without training was estimated at 18 ± 3 weeks. In PAD, an IR model predicted the walking performance following a pain-free exercise program. IR models may contribute to design and verify personalized training programs. Full article
(This article belongs to the Special Issue Personalized Medicine Interdisciplinary Aspects and Sex Gender-Specific Differences)
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8 pages, 453 KiB  
Article
Sex-Specific Differences in Pre-Stroke Characteristics Reveal Vulnerability of Elderly Women
by Carolin Hoyer, Jan Schlenker, Vesile Sandikci, Anne Ebert, Matthias Wittayer, Michael Platten and Kristina Szabo
J. Pers. Med. 2022, 12(3), 344; https://0-doi-org.brum.beds.ac.uk/10.3390/jpm12030344 - 24 Feb 2022
Cited by 1 | Viewed by 1646
Abstract
While the sexually dimorphic character of ischemic stroke has been acknowledged along several dimensions, age-specific sex disparities regarding pre-stroke characteristics in particular have received comparatively little attention. This study aimed to identify age-dependent associations between sex and risk factors, premorbidity, and living situation [...] Read more.
While the sexually dimorphic character of ischemic stroke has been acknowledged along several dimensions, age-specific sex disparities regarding pre-stroke characteristics in particular have received comparatively little attention. This study aimed to identify age-dependent associations between sex and risk factors, premorbidity, and living situation in patients with ischemic stroke to foster the continuing development of dedicated preventative strategies. In a retrospective single-center study, data of patients with acute ischemic stroke (AIS) admitted to the Department of Neurology, University Hospital Mannheim, Germany, between June 2004–June 2020 were included; AIS frequency, vascular risk factors, premorbidity, living situation, and stroke etiology were analyzed across sexes and different age spectra. From a total of 11,003 patients included in the study, 44.1% were female. Women aged >70–≤90 years showed a pronounced increase in stroke frequency, lived alone significantly more frequently, and had a significantly higher degree of pre-stroke disability than men; however, only hypertension and atrial fibrillation were more prevalent in women in this age segment. The seventh and eighth decades are a critical time in which the pre-stroke risk profile changes resulting in an increase in stroke morbidity in women. This emphasizes the relevance of and need for an approach to stroke prevention that is both targeted and integrative. Full article
(This article belongs to the Special Issue Personalized Medicine Interdisciplinary Aspects and Sex Gender-Specific Differences)
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14 pages, 2211 KiB  
Article
Short Term Caloric Restriction and Biofeedback Enhance Psychological Wellbeing and Reduce Overweight in Healthy Women
by Alexander Kautzky, Kathrin Heneis, Karin Stengg, Sabine Fröhlich and Alexandra Kautzky-Willer
J. Pers. Med. 2021, 11(11), 1096; https://0-doi-org.brum.beds.ac.uk/10.3390/jpm11111096 - 26 Oct 2021
Cited by 2 | Viewed by 2247
Abstract
Obesity is highly prevalent, causing substantial cardiovascular and mental health morbidity. Women show increased risk for mental health disorders, that is multiplied in obesity and related to cellular and psychological stress that can be targeted by non-pharmacological interventions. A total of 43 women [...] Read more.
Obesity is highly prevalent, causing substantial cardiovascular and mental health morbidity. Women show increased risk for mental health disorders, that is multiplied in obesity and related to cellular and psychological stress that can be targeted by non-pharmacological interventions. A total of 43 women underwent two weeks of caloric restriction, half of which also received 7 h of individualized clinical psychological intervention including psychoeducation, mindfulness, and heart-rate-variability biofeedback. Effects on body mass index (BMI), fatty liver index (FLI), bioimpedance measures, serum parameters, perceived stress (PSS), burn-out susceptibility (burn out diagnostic inventory) and dimensional psychiatric symptom load (brief symptom inventory, BSI) were analyzed with linear mixed effects models. Caloric restriction led to a reduction in BMI, body fat and FLI, decreased serum concentrations of leptin, PSS score, BSI dimensions and global severity index (all p ≤ 0.0001, withstanding Bonferroni–Holm correction). Benefits of add-on biofeedback were observed for BMI reduction (p = 0.041). Caloric restriction was effective in ameliorating both psychological wellbeing and metabolic functions following a BMI reduction. Biofeedback boosted effects on BMI reduction and the combinative therapy may be protective against common progression to mental health and cardiovascular disorders in overweight women while comparing favorably to pharmacological interventions in terms of side-effects and acceptability. Full article
(This article belongs to the Special Issue Personalized Medicine Interdisciplinary Aspects and Sex Gender-Specific Differences)
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Review

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21 pages, 1123 KiB  
Review
Impact of Female Gender in Inflammatory Bowel Diseases: A Narrative Review
by Lisa Lungaro, Anna Costanzini, Francesca Manza, Marianna Barbalinardo, Denis Gentili, Matteo Guarino, Fabio Caputo, Giorgio Zoli, Roberto De Giorgio and Giacomo Caio
J. Pers. Med. 2023, 13(2), 165; https://0-doi-org.brum.beds.ac.uk/10.3390/jpm13020165 - 17 Jan 2023
Cited by 10 | Viewed by 2075
Abstract
Inflammatory bowel diseases show a gender bias, as reported for several other immune-mediated diseases. Female-specific differences influence disease presentation and activity, leading to a different progression between males and females. Women show a genetic predisposition to develop inflammatory bowel disease related to the [...] Read more.
Inflammatory bowel diseases show a gender bias, as reported for several other immune-mediated diseases. Female-specific differences influence disease presentation and activity, leading to a different progression between males and females. Women show a genetic predisposition to develop inflammatory bowel disease related to the X chromosome. Female hormone fluctuation influences gastrointestinal symptoms, pain perception, and the state of active disease at the time of conception could negatively affect the pregnancy. Women with inflammatory bowel disease report a worse quality of life, higher psychological distress, and reduced sexual activity than male patients. This narrative review aims to resume the current knowledge of female-related features in clinical manifestations, development, and therapy, as well as sexual and psychological implications related to inflammatory bowel disease. The final attempt is to provide gastroenterologists with a roadmap of female-specific differences, to improve patients’ diagnosis, management, and treatment. Full article
(This article belongs to the Special Issue Personalized Medicine Interdisciplinary Aspects and Sex Gender-Specific Differences)
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20 pages, 1537 KiB  
Review
Sex-Related Differences of Matrix Metalloproteinases (MMPs): New Perspectives for These Biomarkers in Cardiovascular and Neurological Diseases
by Alessandro Trentini, Maria Cristina Manfrinato, Massimiliano Castellazzi and Tiziana Bellini
J. Pers. Med. 2022, 12(8), 1196; https://0-doi-org.brum.beds.ac.uk/10.3390/jpm12081196 - 22 Jul 2022
Cited by 12 | Viewed by 2349
Abstract
It is now established that sex differences occur in clinical manifestation, disease progression, and prognosis for both cardiovascular (CVDs) and central nervous system (CNS) disorders. As such, a great deal of effort is now being put into understanding these differences and turning them [...] Read more.
It is now established that sex differences occur in clinical manifestation, disease progression, and prognosis for both cardiovascular (CVDs) and central nervous system (CNS) disorders. As such, a great deal of effort is now being put into understanding these differences and turning them into “advantages”: (a) for the discovery of new sex-specific biomarkers and (b) through a review of old biomarkers from the perspective of the “newly” discovered sex/gender medicine. This is also true for matrix metalloproteinases (MMPs), enzymes involved in extracellular matrix (ECM) remodelling, which play a role in both CVDs and CNS disorders. However, most of the studies conducted up to now relegated sex to a mere confounding variable used for statistical model correction rather than a determining factor that can influence MMP levels and, in turn, disease prognosis. Consistently, this approach causes a loss of information that might help clinicians in identifying novel patterns and improve the applicability of MMPs in clinical practice by providing sex-specific threshold values. In this scenario, the current review aims to gather the available knowledge on sex-related differences in MMPs levels in CVDs and CNS conditions, hoping to shed light on their use as sex-specific biomarkers of disease prognosis or progression. Full article
(This article belongs to the Special Issue Personalized Medicine Interdisciplinary Aspects and Sex Gender-Specific Differences)
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12 pages, 3969 KiB  
Review
Gender Differences in Acute Aortic Dissection
by Eduardo Bossone, Andreina Carbone and Kim A. Eagle
J. Pers. Med. 2022, 12(7), 1148; https://0-doi-org.brum.beds.ac.uk/10.3390/jpm12071148 - 15 Jul 2022
Cited by 6 | Viewed by 2172
Abstract
Cardiovascular disease (CVD) represents the most important cause of mortality and morbidity worldwide. There is heterogeneity in the epidemiology and management of CVD between male and female patients. In the specific case of acute aortic dissection (AAD), women, at the time of diagnosis, [...] Read more.
Cardiovascular disease (CVD) represents the most important cause of mortality and morbidity worldwide. There is heterogeneity in the epidemiology and management of CVD between male and female patients. In the specific case of acute aortic dissection (AAD), women, at the time of diagnosis, are older than men and complain less frequently of an abrupt onset of pain with delayed presentation to the emergency department. Furthermore, a history of hypertension and chronic obstructive pulmonary disease is more common among women. In type A AAD, women more often experience pleural effusion and coronary artery compromise, but experience less neurological and malperfusion symptoms. They undergo less frequent surgical treatment and have higher overall in-hospital mortality. Conversely, in type B AAD no significant differences were shown for in-hospital mortality between the two genders. However, it should be highlighted that further studies are needed in order to develop AAD gender specific preventive, diagnostic and therapeutic strategies. Full article
(This article belongs to the Special Issue Personalized Medicine Interdisciplinary Aspects and Sex Gender-Specific Differences)
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16 pages, 612 KiB  
Review
Gender and Autoimmune Liver Diseases: Relevant Aspects in Clinical Practice
by Federica Invernizzi, Marta Cilla, Silvia Trapani, Maria Guarino, Valentina Cossiga, Martina Gambato, Maria Cristina Morelli, Filomena Morisco, Patrizia Burra and Annarosa Floreani
J. Pers. Med. 2022, 12(6), 925; https://0-doi-org.brum.beds.ac.uk/10.3390/jpm12060925 - 02 Jun 2022
Cited by 12 | Viewed by 2531
Abstract
Autoimmune liver diseases (AILDs) include autoimmune hepatitis, primary biliary cholangitis and primary sclerosing cholangitis. The etiologies of AILD are not well understood but appear to involve a combination of genetic and environmental factors. AILDs commonly affect young individuals and are characterized by a [...] Read more.
Autoimmune liver diseases (AILDs) include autoimmune hepatitis, primary biliary cholangitis and primary sclerosing cholangitis. The etiologies of AILD are not well understood but appear to involve a combination of genetic and environmental factors. AILDs commonly affect young individuals and are characterized by a highly variable clinical course. These diseases significantly influence quality of life and can progress toward liver decompensation or the onset of hepatocellular or cholangiocarcinoma; a significant number of patients eventually progress to end-stage liver disease, requiring liver transplantation. In this review, we focus on the sex characteristics and peculiarities of AILD patients and highlight the relevance of a sex-specific analysis in future studies. Understanding the sex differences underlying AILD immune dysregulation may be critical for developing more effective treatments. Full article
(This article belongs to the Special Issue Personalized Medicine Interdisciplinary Aspects and Sex Gender-Specific Differences)
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13 pages, 1849 KiB  
Review
Digital Anthropometry for Body Circumference Measurements: European Phenotypic Variations throughout the Decades
by Marco Alessandro Minetto, Angelo Pietrobelli, Chiara Busso, Jonathan P. Bennett, Andrea Ferraris, John A. Shepherd and Steven B. Heymsfield
J. Pers. Med. 2022, 12(6), 906; https://0-doi-org.brum.beds.ac.uk/10.3390/jpm12060906 - 30 May 2022
Cited by 15 | Viewed by 3947
Abstract
This review summarizes body circumference-based anthropometrics that are in common use for research and in some cases clinical application. These include waist and hip circumference-based central body indices to predict cardiometabolic risk: waist circumference, waist-to-hip ratio, waist-to-height ratio, waist-to-thigh ratio, body adiposity index, [...] Read more.
This review summarizes body circumference-based anthropometrics that are in common use for research and in some cases clinical application. These include waist and hip circumference-based central body indices to predict cardiometabolic risk: waist circumference, waist-to-hip ratio, waist-to-height ratio, waist-to-thigh ratio, body adiposity index, a body shape index (ABSI), hip index (HI), and body roundness index (BRI). Limb circumference measurements are most often used to assess sarcopenia and include: thigh circumference, calf circumference, and mid-arm circumference. Additionally, this review presents fascinating recent developments in optic-based imaging technologies that have elucidated changes over the last decades in average body size and shape in European populations. The classical apple and pear shape concepts of body shape difference remain useful, but novel and exciting 3-D optical “e-taper” measurements provide a potentially powerful new future vista in anthropometrics. Full article
(This article belongs to the Special Issue Personalized Medicine Interdisciplinary Aspects and Sex Gender-Specific Differences)
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15 pages, 279 KiB  
Review
How to Integrate Sex and Gender Medicine into Medical and Allied Health Profession Undergraduate, Graduate, and Post-Graduate Education: Insights from a Rapid Systematic Literature Review and a Thematic Meta-Synthesis
by Rola Khamisy-Farah and Nicola Luigi Bragazzi
J. Pers. Med. 2022, 12(4), 612; https://0-doi-org.brum.beds.ac.uk/10.3390/jpm12040612 - 11 Apr 2022
Cited by 9 | Viewed by 2564
Abstract
Sex and gender are concepts that are often misunderstood and misused, being utilized in a biased, preconceived, interchangeable way. Sex and gender medicine is generally overlooked, despite the profound impact of sex and gender on health outcomes. The aims of the present rapid [...] Read more.
Sex and gender are concepts that are often misunderstood and misused, being utilized in a biased, preconceived, interchangeable way. Sex and gender medicine is generally overlooked, despite the profound impact of sex and gender on health outcomes. The aims of the present rapid systematic literature review were (i) to assess the extent to which sex- and gender-sensitive topics are covered in medical courses; (ii) to assess the need for and willingness toward integrating/incorporating sex and gender medicine into health-related education; (iii) to identify barriers and facilitators of the process of implementation of sex and gender medicine in medical teaching, mentoring, and training; and (iv) to evaluate the effectiveness of interventional projects targeting curriculum building and improvement for future gender-sensitive physicians. Seven themes were identified by means of a thematic analysis, namely, (i) how much sex- and gender-based medicine is covered by medical courses and integrated into current medical curricula, (ii) the knowledge of sex and gender medicine among medical and allied health profession students, (iii) the need for and willingness toward acquiring sex- and gender-sensitive skills, (iv) how to integrate sex- and gender-based medicine into medical curricula in terms of barriers and facilitators, (v) existing platforms and tools to share knowledge related to sex and gender medicine, (vi) sex- and gender-based medicine aspects in the post-medical education, and (vii) the impact of sex- and gender-sensitive topics integrated into medical curricula. Based on the identified gaps in knowledge, further high-quality, randomized trials with larger samples are urgently warranted to fill these gaps in the field of implementation of gender medicine in educating and training future gender-sensitive physicians. Full article
(This article belongs to the Special Issue Personalized Medicine Interdisciplinary Aspects and Sex Gender-Specific Differences)
14 pages, 613 KiB  
Review
Focus on Sex and Gender: What We Need to Know in the Management of Rheumatoid Arthritis
by Beatrice Maranini, Alessandra Bortoluzzi, Ettore Silvagni and Marcello Govoni
J. Pers. Med. 2022, 12(3), 499; https://0-doi-org.brum.beds.ac.uk/10.3390/jpm12030499 - 20 Mar 2022
Cited by 29 | Viewed by 7866
Abstract
Rheumatoid arthritis (RA) is a chronic inflammatory disease, affecting mostly women with a female/male ratio of 3:1. It is characterized by symmetrical polyarthritis, leading to progressive joint damage. Sex differences have been reported in terms of disease course and characteristics, influencing patients reported [...] Read more.
Rheumatoid arthritis (RA) is a chronic inflammatory disease, affecting mostly women with a female/male ratio of 3:1. It is characterized by symmetrical polyarthritis, leading to progressive joint damage. Sex differences have been reported in terms of disease course and characteristics, influencing patients reported outcome measures (PROMs) and pain perception, ultimately leading to male–female disparities in treatment response. Notwithstanding, sex and gender discrepancies are still under-reported in clinical trials. Therefore, there is a consistent need for a precise reference of sex and gender issues in RA studies to improve treat-to-target achievement. This narrative review explores the above-mentioned aspects of RA disease, discussing the latest core principles of RA recommendations, from safety issues to early arthritis concept and management, treat-to-target and difficult-to-treat notions, up to the most recent debate on vaccination. Our final purpose is to evaluate how sex and gender can impact current management guidelines and how this issue can be integrated for effective disease control. Full article
(This article belongs to the Special Issue Personalized Medicine Interdisciplinary Aspects and Sex Gender-Specific Differences)
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Other

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8 pages, 516 KiB  
Brief Report
Revising the MELD Score to Address Sex-Bias in Liver Transplant Prioritization for a German Cohort
by Maria Beatriz Walter Costa, Christiane Gärtner, Maria Schmidt, Thomas Berg, Daniel Seehofer and Thorsten Kaiser
J. Pers. Med. 2023, 13(6), 963; https://0-doi-org.brum.beds.ac.uk/10.3390/jpm13060963 - 07 Jun 2023
Viewed by 1219
Abstract
(1) Background: Prioritization of patients for liver transplantation in Germany relies on the MELD (model for end-stage liver disease) scoring system that does not consider the patient’s sex. Many studies have shown that women are disadvantaged by the MELD score. Using a large [...] Read more.
(1) Background: Prioritization of patients for liver transplantation in Germany relies on the MELD (model for end-stage liver disease) scoring system that does not consider the patient’s sex. Many studies have shown that women are disadvantaged by the MELD score. Using a large patient cohort from a German liver transplant centre, we investigated options to reduce gender inequality in the patient prioritization for liver transplantation. (2) Methods: We calculated female-as-male MELD scores in our cohort by substituting the serum creatinine of a female patient with that of their male equivalent to test for the fairness of the scores. We investigated the effects of the female-as-male scores compared to the original MELD score of 1759 patients listed for liver transplantation. (3) Results: Serum creatinine sex correction (female-as-male) for MELD scores added up to 5.4 points in females, while the median changed by +1.6 points for females. We identified 72 females with an original MELD score < 20, for whom the adjusted female-as-male MELD score would be >20, thus giving them a better chance to receive a liver transplant. (4) Conclusions: Mathematical conversion of female to male creatinine concentrations identified disadvantages in liver transplantation prioritization for females and ascertained MELD 3.0 as having high potential to compensate for these inequalities. Full article
(This article belongs to the Special Issue Personalized Medicine Interdisciplinary Aspects and Sex Gender-Specific Differences)
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