Articles: male.
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Peripheral artery disease (PAD) is an atherosclerotic condition commonly complicating type 2 diabetes (T2D), leading to poor quality of life and increased risk of major adverse lower-limb (MALE) and cardiovascular (CV) events (MACE). Therapeutic management of PAD in T2D patients is much more arduous, often due to bilateral, multi-vessel, and distal vascular involvement, in addition to increased systemic polyvascular atherosclerotic burden. On the other hand, the pathophysiological link between PAD and T2D is very complex, involving mechanisms such as endothelial dysfunction and increased subclinical inflammation in addition to chronic hyperglycemia. ⋯ The main outcomes considered were MACE-including nonfatal acute myocardial infarction, nonfatal stroke, and CV death-and MALE-defined as lower-limb complications, amputations, or need for revascularization. To the best of our current knowledge, GLP-1 receptor agonists and SGLT2 inhibitors represent the best choice to reduce CV risk in T2D and PAD settings, but a personalized approach should be considered. GLP-1 receptor agonists should be preferred in subjects with prevalent atherosclerotic burden and a history of previous MALE, while SGLT2 inhibitors should be used in those with heart failure if overall CV benefits outweigh the risk of lower-limb complications.
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Sex-based disparities in cardiovascular outcomes may be improved with appropriate hypertension management. ⋯ Compared to males, females with late-onset hypertension were equally likely to complete initial investigations with comparable prescription rates. These findings suggest that there may be no clinically meaningful sex-based differences in the initial management of late-onset hypertension to explain sex-based disparities in cardiovascular outcomes.
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Multicenter Study
Aneurysmal Subarachnoid Hemorrhage and Sex Differences: Analysis of Epidemiology, Outcomes, and Risk Factors.
The differences in outcomes after aneurysmal subarachnoid hemorrhage (aSAH) between the sexes have not been concretely determined. This study aimed to evaluate the differences in epidemiology, outcomes, and risk factors between male and female patients with aSAH. ⋯ There were more female patients with aneurysms than male patients in this study. Most aneurysm locations were different between the two groups. There was no significant difference in discharge outcomes before and after PSM. The risk factors for dependent survival were different between female and male patients.
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Case Reports
Delayed hemothorax after anterior vertebral body tethering in adolescent idiopathic scoliosis: a case report.
The aim of this case report is to report that delayed hemothorax is possible after anterior vertebral body tethering (aVBT) and to illustrate the course of treatment. ⋯ Pulmonary complications are a known drawback of anterior thoracoscopic spinal instrumentation. Delayed hemothorax is possible after aVBT. In the case of a retained hemothorax, chest tube treatment with TPA is a safe and effective method of embolectomy.
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Journal of women's health · Apr 2024
Trends in Health Care Coverage and Out-Of-Pocket Cost Barriers: A Gender Comparison.
Objective: The presence of disparities in access to health care and insurance coverage can have a tremendous impact on health care outcomes. Programs like the Affordable Care Act were implemented to improve health care access and to address the existing inequities. The objective of this study was to identify any disparities that exist between males and females regarding health care coverage and out-of-pocket cost to health care. ⋯ Most respondents, 77.6%, were White (Non-Hispanic). Across the 6-year period, females were more likely to have health insurance but with out-of-pocket costs that served as a barrier to their medical care (adjusted odds ratios with 95% CI from 2013 to 2018 were 1.36 [1.29-1.43], 1.38 [1.32-1.46], 1.31 [1.24-1.38], 1.33 [1.26-1.40], and 1.32 [1.25-1.40], respectively). Conclusions: Females were more likely than males to indicate an out-of-pocket cost barrier to medical care despite having health insurance.