Gender differences in neurotoxicity of the nigrostriatal dopaminergic system: implications for Parkinson's disease.
Female; Humans; Male; Sex Factors; Sex Distribution; Estrogens/*pharmacology; Dopamine/metabolism; Postmenopause; Corpus Striatum/pathology/*physiopathology; Neurotoxins/*antagonists & inhibitors; Parkinson Disease/metabolism/pathology/*physiopathology; Substantia Nigra/pathology/*physiopathology; Animal; Disease Models
This article describes the progression of steps followed to demonstrate a gender difference associated with Parkinson's disease (PD) and to gain an understanding of the basis, mechanisms, and implications of this gender specificity. First, a review of the literature on PD shows a greater incidence in men. Next, data are presented from a series of laboratory studies in animal models of PD that suggest a basis for this gender difference: estrogen appears to act as a neuroprotectant of the striatal dopaminergic system. One mechanism for this effect may be that estrogen inhibits the uptake of neurotoxins capable of producing degeneration within dopaminergic neurons. Finally, some of the potential neurologic implications of manipulating estrogen in premenopausal and postmenopausal women are considered.
Dluzen D E; McDermott J L
The journal of gender-specific medicine : JGSM : the official journal of the Partnership for Women's Health at Columbia
2000
2000-10
Article information provided for research and reference use only. All rights are retained by the journal listed under publisher and/or the creator(s).
Does functional decline prompt emergency department visits and admission in older patients?
80 and over; Activities of Daily Living; Age Distribution; Aged; Cross-Sectional Studies; Decision Making; Emergency Service; Female; Frail Elderly/*statistics & numerical data; Health Surveys; Hospital/*statistics & numerical data; Humans; Male; Ohio; Patient Acceptance of Health Care/statistics & numerical data; Patient Admission/*statistics & numerical data; Patient Discharge/statistics & numerical data; Prospective Studies; Sex Distribution
BACKGROUND: Older patients may visit the emergency department (ED) when their illness affects their function. OBJECTIVES: To quantify the function of older ED patients, to assess whether functional decline (FD) had occurred, and to determine whether function contributes to the ED visit and hospital admission. METHODS: The authors performed an institutional review board-approved, prospective, cross-sectional study in a community teaching hospital ED. Eligible patients were older than 74 years of age, with an illness at least 48 hours old. Patients from a nursing facility and those without a proxy who were unable or unwilling to complete the questions were excluded. The Older Americans Resources and Services Questionnaire, which tests seven instrumental activities of daily living (IADL) and seven physical ADLs (PADL), was used. Data are presented as means or proportions with 95% confidence intervals (95% CI), and comparisons as 95% CI for the difference between proportions. RESULTS: The authors enrolled 90 patients (mean age, 81.6 yr [SD +/- 4.9], 40% male). Dependence in at least one IADL was reported by 68% (95% CI = 57% to 77%), and in at least one PADL by 61% (95% CI = 50% to 71%). Functional decline was reported by 74% (95% CI = 64% to 83%). Two thirds of those with IADL decline and three quarters of those with PADL decline said that this contributed to their ED visit. Seventy-seven percent with, and 63% without, IADL decline were admitted (14% difference, 95% CI = -6.1% to 33%). Seventy-nine percent with and 61% without PADL decline were admitted (18% difference, 95% CI = -1.4% to 38%). CONCLUSIONS: Functional decline is common in older ED patients and contributes to ED visits in older patients; its role in admission is unclear.
Wilber Scott T; Blanda Michelle; Gerson Lowell W
Academic emergency medicine : official journal of the Society for Academic Emergency Medicine
2006
2006-06
Article information provided for research and reference use only. All rights are retained by the journal listed under publisher and/or the creator(s).
<a href="http://doi.org/10.1197/j.aem.2006.01.006" target="_blank" rel="noreferrer noopener">10.1197/j.aem.2006.01.006</a>
Recreational injuries among older Americans, 2001.
*Recreation; 80 and over; Age Distribution; Aged; Athletic Injuries/epidemiology; Bone/epidemiology; Emergencies; Exercise; Female; Fractures; Humans; Male; Sex Distribution; United States/epidemiology; Wounds and Injuries/*epidemiology
OBJECTIVE: To describe the epidemiology of non-fatal recreational injuries among older adults treated in United States emergency departments including national estimates of the number of injuries, types of recreational activities, and diagnoses. METHODS: Injury data were provided by the National Electronic Injury Surveillance System-All Injury Program (NEISS-AIP), a nationally representative subsample of 66 out of 100 NEISS hospitals. Potential cases were identified using the NEISS-AIP definition of a sport and recreation injury. The authors then reviewed the two line narrative to identify injuries related to participation in a sport or recreational activity among men and women more than 64 years old. RESULTS: In 2001, an estimated 62 164 (95% confidence interval 35 570 to 88 758) persons \textgreater/=65 years old were treated in emergency departments for injuries sustained while participating in sport or recreational activities. The overall injury rate was 177.3/100 000 population with higher rates for men (242.5/100 000) than for women (151.3/100 000). Exercising caused 30% of injuries among women and bicycling caused 17% of injuries among men. Twenty seven percent of all treated injuries were fractures and women (34%) were more likely than men (21%) to suffer fractures. CONCLUSIONS: Recreational activities were a frequent cause of injuries among older adults. Fractures were common. Many of these injuries are potentially preventable. As more persons engage in recreational activities, applying known injury prevention strategies will help to reduce the incidence of these injuries.
Gerson L W; Stevens J A
Injury prevention : journal of the International Society for Child and Adolescent Injury Prevention
2004
2004-06
Article information provided for research and reference use only. All rights are retained by the journal listed under publisher and/or the creator(s).
<a href="http://doi.org/10.1136/ip.2004.005256" target="_blank" rel="noreferrer noopener">10.1136/ip.2004.005256</a>
Lumbar spine fractures within a complete American cohort: epidemiology and risk factors among military service members.
*Warfare; Adolescent; Adult; Age Distribution; Aged; Cohort Studies; Comorbidity; Female; Humans; Lumbar Vertebrae/*injuries; Male; Middle Aged; Military Personnel/*statistics & numerical data; Prevalence; Retrospective Studies; Risk Factors; Sex Distribution; Spinal Cord Injuries/*epidemiology; Spinal Fractures/*epidemiology; United States/epidemiology; Young Adult
STUDY DESIGN: Retrospective database review. OBJECTIVE: To describe the incidence of, and risk factors for, lumbar spine fractures within the population of the US military. SUMMARYOF BACKGROUND DATA: Fractures of the lumbar region are an important health concern; however, the epidemiology of this injury has not been extensively studied in the United States. METHODS: International Classification of Diseases, Clinical Modification, Ninth Revision codes for lumbar spine fractures were used in a search of the Defense Medical Epidemiology Database, identifying all individuals who sustained such injuries between 2001 and 2010. The database was also used to obtain the complete number of individuals serving in the Armed Forces over the same time period. Information regarding race, rank, branch of service, sex, and age was obtained for all individuals identified as having lumbar spine fractures as well as for the whole military population. The incidence of lumbar spine fractures was determined for the cohort. Unadjusted incidence rates were derived for risk factors and multivariate Poisson regression analysis, controlling for all other risks, was used to obtain adjusted incidence rate ratios and identify statistically significant risks for lumbar fractures. RESULTS: Between 2001 and 2010, the overall incidence of lumbar fractures was 0.38 per 1000 person-years. Male sex, white race, enlisted ranks, service in the Army and Marines, and age were found to be significant predictors of lumbar spine fracture. Service in the Army demonstrated the highest rate of lumbar fractures (0.48 per 1000 person-years). CONCLUSIONS: This investigation is the first to document the incidence and postulate risk factors for lumbar spine fracture in an American population. In this study, males, whites, enlisted personnel, those serving in the Army and Marines, and individuals aged 20-24 or greater than 40 were found to be at an increased risk of lumbar fracture.
Schoenfeld Andrew J; Romano David; Bader Julia O; Walker John J
Journal of spinal disorders & techniques
2013
2013-06
Article information provided for research and reference use only. All rights are retained by the journal listed under publisher and/or the creator(s).
<a href="http://doi.org/10.1097/BSD.0b013e31823f3237" target="_blank" rel="noreferrer noopener">10.1097/BSD.0b013e31823f3237</a>
Characterization of the incidence and risk factors for the development of lumbar radiculopathy.
Adolescent; Adult; Age Distribution; Aged; Female; Humans; Incidence; Lumbar Vertebrae; Male; Middle Aged; Military Personnel/*statistics & numerical data; Radiculopathy/*epidemiology; Risk Assessment; Risk Factors; Sex Distribution; United States/epidemiology; Young Adult
STUDY DESIGN: Epidemiological study of a prospectively collected database. OBJECTIVES: This investigation sought to evaluate the incidence of symptomatic lumbar radiculopathy, and identify risk factors for its development, among individuals serving in the United States military over a 10-year period. SUMMARY OF BACKGROUND DATA: Risk factors for the development of lumbar radiculopathy are poorly understood and the incidence of this disorder has not been characterized earlier for a young, high-demand population. METHODS: The Defense Medical Epidemiology Database was queried for the years 2000 to 2009 using the International Classification of Diseases ninth revision code for lumbar radiculopathy (724.4). Overall incidence was determined and multivariate Poisson regression analysis was carried out to identify the influence of risk factors such as age, sex, race, military rank, and branch of service on the development of this condition. RESULTS: In this population, the overall incidence of lumbar radiculopathy was 4.86 per 1000 person-years. Multivariate Poisson regression analysis showed that female sex, white race, senior positions within the rank structure, and service in the Army, Navy, or Air Force increased the risk of developing lumbar radiculopathy. Servicemembers of 30 years and older were found to have \textgreater3 times the risk of developing lumbar radiculopathy when compared with individuals \textless20. CONCLUSIONS: The incidence of lumbar radiculopathy in this young, racially diverse, and physically active population is higher than many other degenerative conditions. In this study female sex and white race increased the risk of developing lumbar radiculopathy. However, increasing age seems to be one of the most significant independent factors for developing this disorder. LEVEL OF EVIDENCE: Level II, prognostic study.
Schoenfeld Andrew J; Laughlin Matthew; Bader Julia O; Bono Christopher M
Journal of spinal disorders & techniques
2012
2012-05
Article information provided for research and reference use only. All rights are retained by the journal listed under publisher and/or the creator(s).
<a href="http://doi.org/10.1097/BSD.0b013e3182146e55" target="_blank" rel="noreferrer noopener">10.1097/BSD.0b013e3182146e55</a>
Non-health Care Facility Medication Errors Associated with Hormones and Hormone Antagonists in the United States.
80 and over; Adolescent; Adult; Age Distribution; Aged; Child; Databases; Drug-Related Side Effects and Adverse Reactions/diagnosis/*epidemiology/mortality/therapy; Factual; Female; Hormone antagonists; Hormone Antagonists/*adverse effects; Hormones; Hormones/*adverse effects; Humans; Infant; Male; Medication Errors/*statistics & numerical data; Middle Aged; Newborn; Oral hypoglycemic medications; Poison control center; Poison Control Centers; Preschool; Retrospective Studies; Risk Factors; Sex Distribution; Time Factors; Unintentional therapeutic error; United States/epidemiology; Young Adult
INTRODUCTION: Hormones and hormone antagonists are frequently associated with medication errors and may result in important adverse outcomes. The purpose of this study is to investigate non-health care facility (non-HCF) medication errors associated with hormones and hormone antagonists in the United States (US). METHODS: A retrospective analysis of National Poison Data System data was conducted to identify characteristics and trends of unintentional non-HCF therapeutic errors involving hormones and hormone antagonists among individuals of all ages from 2000 to 2012. RESULTS: From 2000 to 2012, US poison control centers received 169,695 calls regarding unintentional non-HCF therapeutic errors associated with hormone therapies, averaging 13,053 medication error calls annually. The rate of reported errors increased significantly by 162.6% (p \textless 0.001), from 2.24 per 100,000 US residents in 2000 to 5.89 per 100,000 in 2012. Two thirds of the errors (65.2%) occurred among females. The medications most commonly associated with errors were thyroid preparations (23.2%), corticosteroids (21.9%), and insulin (20.0%). All nine deaths and 93.2% of major effects were attributed to hypoglycemic agents. Sulfonylureas alone accounted 43.9% of major effects. The number and rate of therapeutic errors increased significantly for all medication categories except estrogen and thiazolidinediones. Most errors were managed at the site of exposure (82.9%) and did not result in serious medical outcomes (95.6%). CONCLUSIONS: This study provides an overview of non-HCF medication errors associated with hormones and hormone antagonists in the US. While most errors did not result in adverse outcomes, their increasing frequency places a greater burden on the health care system.
Magal Pranav; Spiller Henry A; Casavant Marcel J; Chounthirath Thitphalak; Hodges Nichole L; Smith Gary A
Journal of medical toxicology : official journal of the American College of Medical Toxicology
2017
2017-12
Article information provided for research and reference use only. All rights are retained by the journal listed under publisher and/or the creator(s).
<a href="http://doi.org/10.1007/s13181-017-0630-8" target="_blank" rel="noreferrer noopener">10.1007/s13181-017-0630-8</a>
Age-related size reduction of foramina in the cribriform plate.
80 and over; Adult; Age Distribution; Aged; Aging/*physiology; Analysis of Variance; Ethmoid Bone/*anatomy & histology; Female; Humans; Male; Middle Aged; Olfactory Nerve/anatomy & histology; Sex Distribution; Smell/physiology
Anecdotal evidence suggests that the foramina of the cribriform plate which transmit cranial nerve I decrease in size with age, but this finding has never been supported with quantitative data. It has also been observed that olfactory function declines with increasing age. It has been hypothesized that the cribriform plate foramina closure may be responsible for the olfactory performance decrease with age. We gathered quantitative data to test an age-related decline in cribriform plate foramina area. We report data for the area of patent foramina in the posterior 1 cm of 57 cribriform plates from 40 skulls of known age and sex. Analyses were performed to test for the effects of age, sex, and lateralization on foramina area. The area of patent foramina in the cribriform plate decreases with increasing age. Age is a strong covariate with foramina area (P value = 0.0025). The regression equation for the area of patent foramina is: expected area = 8.17 - (0.06) age. Adding the variable sex does not contribute significantly (P value \textgreater 0.28) to the model which utilizes age alone. Nor was there any significant lateralization in patent foramina area. The area of patent foramina in the cribriform plate decreases with increasing age, and there is no significant difference between males and females or left and right sides. Such decreases in patent foramina may be associated with impaired olfactory function in the aged.
Kalmey J K; Thewissen J G; Dluzen D E
The Anatomical record
1998
1998-07
Article information provided for research and reference use only. All rights are retained by the journal listed under publisher and/or the creator(s).
<a href="http://doi.org/10.1002/(sici)1097-0185(199807)251:3%3C326::aid-ar7%3E3.0.co;2-t" target="_blank" rel="noreferrer noopener">10.1002/(sici)1097-0185(199807)251:3%3C326::aid-ar7%3E3.0.co;2-t</a>