Gender difference in clinical conditions among hospitalized adults with myotonic dystrophy

Introduction: In this study we examined gender differences in adult hospitalizations with myotonic dystrophy (DM). Methods: From the Nationwide Inpatient Sample (NIS) 2010–2014, we identified 1,891 adult hospitalizations with a DM diagnosis and constructed a comparison group of hospitalizations without DM using propensity score matching. We calculated relative risk by gender for 44 clinical diagnoses that each accounted for at least 5% of DM hospitalizations. Results: Hospitalizations with DM were longer (4.8 vs. 4.1 days, P < 0.0001) and more costly ($13,241 vs. $11,458, P < 0.0001) than those without DM. More than half (25 of 44) of the conditions co-occurring with DM hospitalizations did not differ in their relative risks by gender. For those that differed by gender, only 5 were specific to DM, compared with hospitalizations without DM. Discussion: Our findings highlight the importance of comprehensive and coordinated care for DM rather than gender-oriented care in the inpatient setting. Muscle Nerve 59 :348–353, 2019     

Region-specific control of microglia by adenosine A2A receptors: uncoupling anxiety and associated cognitive deficits in female rats

Epidemiologic studies have provided compelling evidence that prenatal stress, through excessive maternal glucocorticoids exposure, is associated with psychiatric disorders later in life. We have recently reported that anxiety associated with prenatal exposure to dexamethasone (DEX, a synthetic glucocorticoid) correlates with a gender-specific remodeling of microglia in the medial prefrontal cortex (mPFC), a core brain region in anxiety-related disorders. Gender differences in microglia morphology, the higher prevalence of anxiety in women and the negative impact of anxiety in cognition, led us to specifically evaluate cognitive behavior and associated circuits (namely mPFC-dorsal hippocampus, dHIP), as well as microglia morphology in female rats prenatally exposed to dexamethasone (in utero DEX, iuDEX). We report that iuDEX impaired recognition memory and deteriorated neuronal synchronization between mPFC and dHIP. These functional deficits are paralleled by microglia hyper-ramification in the dHIP and decreased ramification in the mPFC, showing a heterogeneous remodeling of microglia morphology, both postnatally and at adulthood in different brain regions, that differently affect mood and cognition. The chronic blockade of adenosine A_2A receptors (A_2AR), which are core regulators of microglia morphology and physiology, ameliorated the cognitive deficits, but not the anxiety-like behavior. Notably, A_2AR blockade rectified both microglia morphology in the dHIP and the lack of mPFC-dHIP synchronization, further heralding their role in cognitive function.     

Gender Affirmation in Adult Primary Care

Nurse practitioners in primary care are well positioned to mitigate the barriers to care and the health disparities that transgender and gender nonconforming individuals experience. This article synthesizes best practices in caring for transgender and gender nonconforming patients. Key domains highlighted include (1) inclusive communication strategies, (2) gender-affirming interventions, and (3) mental health considerations.     

性别和年龄对60Coγ射线照射离体人外周血辐射敏感基因mRNA表达的影响

目的：探讨性别和年龄因素对电离辐射诱导的离体人外周血中辐射敏感基因mRNA表达变化的影响。方法：采集30例健康人离体外周血，以剂量率为1 Gy/min的⁶⁰Co γ射线进行照射，照射剂量分别为0.5、1、2、3、4、6和8 Gy （以0 Gy为阴性对照组），照射后培养12 h，应用实时荧光定量PCR （qPCR）方法检测18个辐射敏感基因的mRNA表达水平变化，分析性别和年龄因素对这些基因mRNA表达水平的影响。结果：与阴性对照组相比，各剂量γ射线照射组人外周血18个辐射敏感基因的mRNA表达水平均明显增加，并且呈剂量-效应关系（R²=0.63~0.97，P < 0.05）。在相同照射剂量，MDM2、XPC、FDXR、DDB2、ASTN2和TNFSF4 mRNA相对表达水平在不同个体之间存在较大的差异。女性外周血中BAX、TNFRSF10B、ASTN2、TNFSF4、POLH和GADD45A mRNA相对表达水平均高于男性，在0.5~8 Gy照射剂量范围内具有统计学差异（P < 0.05或P < 0.01）。MDM2、FDXR、DDB2和RPS27L mRNA表达水平在不同年龄组间（20~29岁、30~39岁、40~49岁和50~60岁）存在差异（P < 0.05或P < 0.01）。结论：离体人外周血中辐射敏感基因mRNA表达水平的变化存在个体间差异，且与受照者性别和年龄相关。