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FACP. Colegio de médicos de Tarragona Nº 4305520 / fgcapriles@gmail.com




Wednesday, March 20, 2013

Medicina y género

 Why Gender-Specific Medicine Matters in the Emergency Department

By Jeannette Wolfe, MD on March 14, 2013

..."So how is emergency medicine doing in the recognition of and contribution to GSM? In a review of almost 2500 EM articles, Safdar and company found less than 2% statistically analyzed for valid sex specific outcomes. Other fields like cardiology are way ahead with similar reviews showing sex-specific outcome analysis occurring in 24% and 50% of their articles respectively. Fortunately there is a core group of emergency medicine researchers dedicated to closing this gap.
Returning to our original patients: If that coughing and wheezing febrile premee is a boy he is at greater risk for a bad outcome due to his prenatal testosterone causing a delay in his lung maturity. If the patient with afib is a woman, she is at higher risk to stroke out and her stroke is more likely to be hemorrhagic. In addition, she is at a greater risk for developing both a prolonged Qtc from certain anti-arrhythmics, and for digoxin toxicity. Not to mention that she will require smaller amounts of warfarin. What about that soccer player? Although there is conflicting evidence, several studies suggest that women are more susceptible to concussions and perform more poorly on post-concussive neurocognitive testing. Some of this may be related to anatomical differences in neck structure and the smaller size of a female’s shock absorbing lateral ventricle. And finally if you are going to write out an Ambien prescription for that stressed out law student remember to ½ the dose if the patient is female to prevent excessive residual AM drowsiness that may impair her ability to drive.
The National Academy of Medicine said it best, “Sex does matter. It matters in ways that we did not expect. Undoubtedly, it also matters in ways that we have not begun to imagine.”