The effect of age, gender, and body mass index on the pharmacokinetics and pharmacodynamics of vildagliptin in healthy volunteers

Aims

To evaluate the effect of age, gender, and body mass index (BMI) on the pharmacokinetics and pharmacodynamics of vildagliptin.

Methods

Forty healthy subjects received a single oral dose of 100 mg vildagliptin to assess the effects of age, gender, and BMI on the pharmacokinetics and pharmacodynamics, reflected by the time course of inhibition of DPP-4 activity, of vildagliptin.

Results

Peak concentration and exposure (AUC_(0–∞)) of vildagliptin were 17% (90% CI 2, 35%) and 31% (90% CI 18, 45%) higher in elderly vs. young subjects. Renal clearance was reduced by 32% (90% CI 17, 45%) in elderly subjects. The pharmacokinetics of vildagliptin were not significantly influenced by gender or BMI. Inhibition of DPP-4 activity was similar regardless of age, gender, or BMI.

Conclusions

The pharmacokinetics of a single oral 100 mg dose of vildagliptin were not affected by gender and BMI. Exposure to vildagliptin was higher in elderly patients, but this was not associated with any difference in the effect of DPP-4 inhibition. Based on these results, no vildagliptin dose adjustment is necessary for age, gender, or BMI.

What is already known about this subject

• Vildagliptin is a new, potent, and selective inhibitor of DPP-4.
• The efficacy and safety of vildagliptin in type 2 diabetes has been intensively studied in diverse subject populations.
• There has been little information published about the pharmacokinetics and pharmacodynamics of vildagliptin.

What this study adds

• No clinically relevant changes in pharmacokinetics or pharmacodynamics were observed between young and elderly, male and female, or high body mass index (BMI) and low BMI subjects.
• The results suggest that no dose modification is necessary for vildagliptin based on the age, gender, or BMI of a subject.

     

HIV-related stigma experiences: Understanding gender disparities in Thailand

This paper assesses the relationship between gender and HIV-related stigma experiences among people living with HIV (PLHIV) – enacted and anticipated stigma – and PLHIV caregivers – courtesy stigma – in Northern Thailand, along with the underlying reasons for stigmatising attitudes towards PLHIV – instrumental and symbolic stigma – expressed in the general population. We used data from the Living With Antiretrovirals (LIWA) study conducted on all PLHIV receiving antiretroviral treatment in four district hospitals in Northern Thailand (n?=?513) and on a community sample of adults from the general population (n?=?500). Women living with HIV and female caregivers of PLHIV reported higher rates of HIV-related stigma experiences than men. Gender interacted with other predictors – the period of HIV diagnosis and age – to increase the level of stigma experienced. Among the general population, attitudes of contact avoidance were infrequent. However, stereotypes depicting PLHIV as blameworthy were highly pervasive, with women perceived as the “victims” of their spouse's irresponsible sexual behaviours. In this context, women were yet more often subjected to HIV-related stigma than men, in particular women diagnosed in the pre-antiretroviral therapy era and younger female caregivers. The role of gender in shaping disparities in HIV-related stigma experiences is discussed.     

Pay attention to me! Late ERPs reveal gender differences in attention allocated to romantic partners

The present study employed late ERPs to examine differences in the association between neural responses to romantic partners and relationship quality factors across men and women. Participants passively viewed photos of their romantic partners, celebrities, and strangers during a computerized facial processing task. All participants demonstrated enhanced positivity to partner faces at late ERP components (P3 and LPP), furthering the notion that significant others elicit more motivated and sustained attention than do other familiar or unfamiliar individuals. Neural responses to romantic partner faces were influenced by factors including overall relationship quality, investment, and communication quality, with associations varying by gender. Results highlight the key role that relationship quality factors play in the immediate processing of romantic partners—a finding with implications for couples counseling and research.     

A study on gender-related differences in laboratory characteristics of dengue fever

Studies have reported significant gender-related differences in serological tests for detection of NS1 antigen and IgM antibody used for diagnosing dengue fever. However, no such study has been undertaken in India though dengue fever is endemic in this country. Therefore, this study was planned to study the association of serological findings with gender in 700 patients suspected to be suffering from dengue fever in the Indian setting. Haematological parameters of seropositive patients were also studied. Seropositivity and haemorrhagic findings were significantly associated with the female gender. Positive NS1 antigen and IgM antibody results were significantly associated with females and males, respectively.     

‘You should build yourself up as a whole product’: Transgender female identity in Lima,Peru

ABSTRACT

Transgender women in Lima, Peru have, until recently, been grouped together with gay and bisexual men in the category MSM, or men who have sex with men, with little consideration of their unique situation and needs. Transgender women, self-identified in Peru as travesti, are a socially vulnerable population with many unmet health needs, including an HIV prevalence of 30%. Understanding specific transgender identities and their contexts will contribute to the improvement and development of HIV prevention programs. Through qualitative open-ended interviews with trans-identified women in Lima, Peru, this study found that the non-normative travesti identity is constructed within a conservative homophobic and heteronormative social context. Participants strive towards appearances and relationships perceived as feminine, seeking out silicone injections and abusive men as social markers of this femininity. Sex work is the primary economic activity available and travestis are often alienated from their families and communities. Work is needed to increase self-esteem and decrease violence, stigma, and discrimination. There is a need for multilevel HIV prevention campaigns prioritising travesti in Lima, utilising a human rights framework.     

Gender and Alcohol Use Disorders Diagnostic Criteria in Emergency Department Patients of Argentina

Background: Alcohol consumption and its related consequences are not equal for women and men, although related studies do not frequently include gender analysis. Objective: Our aim was to characterize differences in endorsement of ICD-10 and DSM 5 alcohol use disorder (AUD) criteria by gender in an Argentinean emergency department population. Methods: A probability sample of patients (N = 923) from the largest emergency department in the city of Mar del Plata, Argentina (44% were females, aged 16 to 86, M (SD) = 37.31(15.20) was collected. Using a structured questionnaire, diagnostic criteria for alcohol use disorders, alcohol consumption, and socio-demographic variables were obtained. Bivariate and multivariate analyses were used to assess differences in the endorsement of each diagnostic criterion by gender. Results: Women were less likely to endorse each of the criteria for each of the diagnostic schemes. Even after controlling alcohol consumption, socio-demographic variables, severity of alcohol use disorders and adjusting for multiple comparisons females had a lower probability than males of endorsing withdrawal and impaired control. Conclusions: gender differences in the endorsement of diagnostic criteria for both the DSM 5 and ICD-10 were found. Some differences in endorsement but not all, might be partially explained by alcohol consumption patterns and socio-demographic factors, and same remained after controlling severity of the AUD. Results also suggest a differential functioning of DSM 5 and ICD-10 AUD criteria for women and men.     

Substance Use Among Sexual Minority Collegiate Athletes: A National Study

Background: The empirical research examining substance use among sexual minority collegiate athletes is sparse. Problematically, this group may be at a greater risk of substance use due to their marginalized status within the context of sport. Objectives: We examined different types of substance use during the past 30 days, and diagnosis of substance use disorders during the past 12 months, among sexual minority collegiate athletes. Methods: This study uses data from college students for the fall semester between 2008 and 2012 from the American College Health Association-National College Health Assessment. Results: Sexual minority collegiate athletes had greater odds of past 30-day cigarette use, past 30-day alcohol use, past 30-day marijuana use, and indicating being diagnosed or treated for a substance use disorder during the past 12 months when compared to either heterosexual collegiate athletes or heterosexual nonathletes, but had similar odds on these outcomes when compared to sexual minority nonathletes. Sexual minority collegiate athletes also had greater odds of binge drinking during the past 2 weeks when compared to either heterosexual nonathletes or sexual minority nonathletes, but had similar odds on this outcome when compared to heterosexual collegiate athletes. Additional analyses by gender reveal that male sexual minority athletes are at the greatest risk of being diagnosed or treated for a substance use disorder. Conclusions: Possible explanations as to why sexual minority collegiate athletes (particularly males) may be at a greater risk of substance use disorders could include the difficulty of trying to maintain an athletic identity within a social environment that is traditionally homophobic.     

Novel cardioprotection strategies for the aged heart: evidence from pre‐clinical studies

The incidence of cardiovascular disease is rising as the population ages. This has led to an increase in the need to perform cardiac surgery in older patients. However, aged hearts are particularly susceptible to reperfusion injury following periods of myocardial ischaemia that occur during cardiac surgery. Indeed, older adults experience myocardial dysfunction and reduced survival post‐surgery compared to younger people and certain groups, including older women and frail older adults, are at particular risk. This highlights the need to design cardioprotective strategies specifically for the ageing heart. Cardioprotection during surgery is often accomplished by perfusing the heart with chemical arresting agents, known as cardioplegic solutions. New protective strategies have been developed and tested in animal models, where cardioplegic solutions have been modified by changing their temperature, chemical components and/or the frequency of delivery. In addition, drugs designed to activate cardioprotective mechanisms or to inhibit mechanisms involved in injury have been added to improve the efficacy of these solutions. However, most experimental studies have developed and optimized cardioplegic solutions in hearts from younger male animals. This review discusses pre‐clinical models used to optimize cardioplegic solutions, with an emphasis on the few studies that have used hearts from older animals. Pharmacologic agents that have been shown to enhance the benefits of cardioplegia in younger hearts and could, in theory, protect vulnerable older hearts are also considered. We emphasize the need to conduct studies in frail older animals of both sexes to facilitate translation of laboratory‐based observations to the clinic.     

Girls,boys and early reading: parents’ gendered views about literacy and children's attitudes towards reading

This study investigated the relationship between children's attitudes towards reading and their parents’ gendered views about literacy (GVL). It was assumed that parents may have GVL by favouring girls in reading activities, which could limit boys’ enjoyment in reading activities. This study was conducted with 31 five-year-old children in first term at a school in South Australia. To measure children's enjoyment in reading-related activities, each child completed an individually administered Literacy Attitude Scale (LAS). Parents completed a questionnaire about their views on girls’ and boys’ early literacy and their book preferences. It was found that the parents’ GVL were significantly and negatively related to children's attitudes towards reading. Importantly, both male and female children of parents, with highly GVL, exhibited lower attitudes towards reading. Overall, girls reported significantly more positive attitudes towards reading than boys. A weak but notable correlation was found between parents’ perceptions about their children's attitudes towards reading and their children's self-reported reading attitudes.