Sex differences in the impact of musculoskeletal disorders on health-related quality of life: a population-based study, Campinas, SP - ISACamp 2014/15 / Diferenças entre os sexos no impacto das doenças musculoesqueléticas na qualidade de vida relacionada à saúde: estudo de base populacional, Campinas, SP - ISACamp 2014/15

Abstract This article aims to estimate the prevalence of musculoskeletal disorders (MD) on the adult population of Campinas, São Paulo, Brazil, verifying associated demographic and socioeconomic factors, and to analyze their impact on Health-Related Quality of Life (HRQoL) according to sex. A population-based study was conducted with 2,166 individuals using data from the ISACamp 2014/15. The Medical Outcomes Study SF-36-Item Short Form Health Survey (SF-36) was used to measure HRQoL according to MD. Prevalence ratios (PR) were estimated by Poisson regression. Musculoskeletal disorders had a prevalence of 8.5% (6.7% tendonitis and 2.7% work-related musculoskeletal disorders - WMSD). Results showed a higher prevalence of musculoskeletal disorders in women, active or on leave due to illness, and in individuals with higher education levels. Moreover, reduced HRQoL scores were observed in 6 of the 8 domains, due to MD. The mental component and physical component showed greater impairment respectively among women and men after self-reported WMSD. These findings point to substantial damage from musculoskeletal disorders on the population's HRQoL. WMSD affect the HRQoL of men and women distinctly.

Resumo O objetivo deste artigo é estimar a prevalência de doenças musculoesqueléticas (DM) na população adulta de Campinas/SP, Brasil, verificar fatores demográficos e socioeconômicos associados e analisar o seu impacto na qualidade de vida relacionada à saúde (QVRS) segundo sexo. Este é um estudo de base populacional utilizando dados do ISACamp 2014/15, com 2.166 indivíduos. Para a medida de QVRS, foram calculados os escores médios do Short Form Health Survey 36 (SF-36) segundo as DM e utilizada a regressão de Poisson para estimar as razões de prevalência (RP). A prevalência de DM foi de 8,5% (6,7% de tendinite e 2,7% de doenças osteomusculares relacionadas ao trabalho - DORT). Os resultados deste estudo mostraram maior prevalência de DM em mulheres, na população adulta ativa ou afastada por doença e em indivíduos com maior escolaridade. Além disso, observou-se redução nos escores de QVRS, devido às DM, em quase todos os domínios do instrumento. O maior comprometimento foi observado no componente mental entre as mulheres, e no componente físico, entre os homens, após autorrelato de DORT. Os achados mostram o impacto substancial das DM na QVRS da população. As DORT afetam distintamente a QVRS de homens e mulheres.

Health and lifestyle parameters in peripheral artery disease at two periods of the COVID-19 pandemic: comparison between men and women

ABSTRACT Objective: This study analyzed the impact of sex on self-reported health and lifestyle parameters in peripheral artery disease patients at two periods of the COVID-19 pandemic. Methods: In this longitudinal study, 99 patients with peripheral artery disease (53 men and 46 women) were evaluated during two periods of the COVID-19 pandemic ( i.e ., at onset: May to August 2020, and on follow-up: May to August 2021). Patients were interviewed via telephone, and information regarding lifestyle and health parameters was obtained. Results: At the onset of the COVID-19 pandemic, health and habit parameters were similar between women and men, with 63.0% and 45.3% indicating frequent fatigue, 73.9% and 84.9% reporting increased sitting time, and 23.9% and 39.6% practicing physical activity, respectively. At follow-up, difficulties in physical mobility (women: from 26.1% to 73.9%, p<0.001; men: from 39.6% to 71.7%, p=0.001) and the frequency of hospitalization for reasons other than COVID-19 increased similarly in women and men (women: from 4.3% to 21.7%, p=0.013; men: from 9.4% to 24.5%, p=0.038). The other parameters were similar between the periods. Conclusion: Self-reported physical mobility difficulties and hospitalization frequency increased in women and men with peripheral artery disease.

Ascending Aortic Surgery for Small Aneurysms in Men and Women

ABSTRACT Introduction: According to recent data, thoracic aortic surgery has reduced morbidity and mortality including ascending aortic aneurysm treatment; however, women are at increased postoperative risk of adverse outcomes. Objective: Our aim was to evaluate early and late outcomes in male and female patients who underwent pre-emptive ascending aortic replacement (AAR). Methods: From January 2013 to September 2021, 91 patients (56 [61.5%] men and 35 [38.5%] women) underwent AAR for small (ranged from 5.0 to 5.5 cm) non-syndromic aneurysms. A propensity score-based adjustment of the groups was performed. We compared clinical outcomes between males and females. Results: Preoperative normalized aortic diameters were significantly larger in females (2.9 [2.7; 3.2] cm/m2) than in males (2.5 [2.3; 2.6] cm/m2, P<0.001), without differences in absolute values (51 [49; 53] mm vs. 52 [50; 53] mm, P=0.356). There were no significant differences in neurological, cardiac, pulmonary, and renal complications in both groups before and after matching. In-hospital mortality was 1 (1.8%) and 2 (5.7%) (P=0.307) in male and female patients in unmatched groups and 1 (2.9%) and 2 (5.7%) (P=0.553) in matched groups, respectively. Univariate logistic regression analysis revealed that the only risk factor for in-hospital mortality was age (odds ratio 1.117, 95% confidence interval 1.003-1.244; P=0.04). The overall survival rate was 83.5±0.06% in men and 94.3±0.04% in women at 36 months (P=0.404). Conclusion: Ascending aortic surgery for aneurysms ranged from 5.0 to 5.5 cm seems to have tolerable early and late outcomes in men and women.

Diferenças entre os Sexos nos Desfechos de Pacientes com Infarto do Miocárdio com Supradesnivelamento do Segmento ST Submetidos à Intervenção Coronária Percutânea Primária / Sex Differences in Outcomes of ST Elevation Myocardial Infarction Patients Submitted to Primary Percutaneous Coronary Intervention

Resumo Fundamento Vários estudos têm mostrado que as mulheres não recebem tratamento adequado e apresentam piores desfechos após infarto agudo do miocárdio com supradesnivelamento do segmento ST (IAMCSST). Por isso, é necessário investigar questões relacionadas ao gênero para melhor lidar com esse problema no Brasil. Objetivo Determinar se existe associação entre o sexo feminino e eventos adversos em uma coorte contemporânea de pacientes com IAMCSST submetidos à intervenção coronária percutânea primária (ICPp). Métodos Este foi um estudo prospectivo do tipo coorte de pacientes com IAMCSST submetidos à ICPp em um hospital universitário terciário entre março de 2011 e dezembro de 2021. Os pacientes foram categorizados em grupos de acordo com o sexo ao nascimento. O primeiro desfecho clínico foi ECAM em longo prazo. Os pacientes foram acompanhados por um período máximo de cinco anos. Um nível de significância bilateral de 0,05 foi aplicado em todos os testes de hipóteses. Resultados Entre os 1457 pacientes internados por IAMCSST no período do estudo, 1362 foram incluídos e 468 (34,4%) eram do sexo feminino. As mulheres apresentaram maior prevalência de hipertensão (73% vs. 60%, p<0,001), diabetes (32% vs. 25%, p=0,003) e classe Killip 3-4 na internação (17% vs. 12%, p=0,01); o escore de risco TIMI foi maior nas mulheres [4 (2, 6) vs. 3 (2, 5), p<0.001]. A mortalidade hospitalar não foi diferente entre os grupos (12,8% vs. 10,5%; p=0,20). Os ECAMs foram numericamente maiores nas mulheres que nos homens tanto durante a internação (16,0% vs. 12,6%, p=0,085) como em longo prazo (28,7% vs. 24,4%, p=0,089), com significância limítrofe. Após a análise multivariada, o sexo feminino não foi associado a ECAMs (HR = 1,14; IC95% 0,86 - 1,51; p = 0,36). Conclusão Em uma coorte prospectiva contemporânea de pacientes com IAMCSST submetidos à ICPp, pacientes do sexo feminino apresentaram idade mais avançada e mais comorbidades no basal que os pacientes do sexo masculino, mas não houve diferenças significativas entre os sexos quanto aos desfechos adversos no hospital ou em longo prazo.

Abstract Background Several studies have shown that women are usually undertreated and have worse outcomes after ST-segment elevation myocardial infarction (STEMI), hence the need to investigate questions related to sex in Brazil to better deal with the problem. Objective To determine whether female sex is still associated with adverse events in a contemporary cohort of patients with STEMI undergoing primary percutaneous coronary intervention (pPCI). Methods This was a prospective cohort study of STEMI patients submitted to pPCI in a tertiary university hospital between March 2011 and December 2021. Patients were categorized into groups based on their sex at birth. The primary clinical outcome was long-term MACCE. Patients were followed-up for up to five years. All hypothesis tests had a two-sided significance level of 0.05. Results Among 1457 patients admitted with STEMI in the study period, 1362 were included and 468 (34.4%) were women. Female patients had a higher prevalence of hypertension (73% vs. 60%, p <0.001), diabetes (32% vs. 25%, p=0.003) and Killip class 3-4 at hospital admission (17% vs. 12%, p=0.01); TIMI risk score was higher among women (4 [2, 6] vs. 3 [2, 5], p<0.001). In-hospital mortality was not different between groups (12.8% vs. 10.5%, p=0.20). In-hospital MACCE (16.0% vs. 12.6%, p=0.085) and long-term MACCE (28.7% vs. 24.4%, p=0.089) were numerically higher in women, with borderline significance. After multivariate analysis, female sex was not associated with MACCE (HR = 1.14; 95% CI 0.86 - 1.51; p = 0.36). Conclusion In a prospective cohort of STEMI patients submitted to pPCI, female patients were older and had more comorbidities at baseline, but no significant differences were found in terms of long-term adverse outcomes.

Sex dimorphism according to the nasozygomatic triangle

Sex is one of the first features to be diagnosed in human identification, composing, with age, ancestry and stature, the so called "big four". Aim: The present study aimed to metrically analyze the sexual dimorphism in skulls of known age and sex from Rio Grande do Sul ­ Brazil. Methods: This was a crosssectional study of metrical analysis, which used a sample comprised of 209 human skulls (106 male and 103 female) older than 22 years old at the time of death, undamaged and without signs of trauma or abnormalities. The point nasion and the most superior points on the zygomaticotemporal sutures from each side were connected forming a triangle. This area was calculated using Heron's formula, and the results were submitted for statistical analysis. Results: All measurements showed significant values for sexual dimorphism. Through the area of the triangle, it was possible to determine sex with an accuracy of 83.97% for males and 83.50% for females. Conclusion: This simple method requires only a caliper, and still can be reliable for forensic human identification. It must be diffused and tested on other samples, and can be used as a good and inexpensive tool for experts in day-to-day practice

Evaluation of effectiveness of cranial morphological characteristics for sex estimation in a Brazilian sample

Forensic physical anthropometry allows the determination of animal species and estimates sex, ancestry, age and height. Aim: To analyze the effectiveness of a cranioscopic/ morphological evaluation for sex estimation with a sample of the Brazilian mixed-race population by conducting a qualitative visual assessment without prior knowledge of sex. Methods: This is a blind cross-sectional study that evaluated 30 cranial characteristics of 192 skulls with mandible, 108 male and 84 female individuals, aged 22 to 97 years, from the Osteological and Tomographic Biobank. The qualitative characteristics were classified and compared to the actual sex information of the Biobank database. The statistical analysis was used to calculate de Cohen's kappa coefficient, total percentage of agreement, sensitivity and specificity of visual sex classification. Results: Of the 30 cranial variables analyzed, 15 presented moderate degree of agreement, achieving value of Kappa test between 0.41­0.60: Glabella (Gl), Angle and lines (At), Mental eminence (Em), Mandible size (Tm), Cranial base (Bc), Mouth depth (Pb), Nasal aperture (Anl), Supraorbital region (Rs), Orbits (Orb), Mastoid processes (Pm), Alveolar arches (Aa), Zygomatic arch (Az), Orbital edge (Bo), Supraorbital protuberances (Pts), and Supramastoid crests and rugosity (Crsm). The Facial physiognomy (Ff) presented substantial reliability (0.61-0.80) with 89.8% sensitivity for male sex and 70.2% specificity. Conclusions: Cranial morphological characteristics present sexual dimorphism; however, in this study only 15 variables showed moderate degree of agreement and can be used in sex estimation. Only one variable (Ff) 81.2% total agreement with substantial reliability. Quantitative methods can be associated for safe sex estimation

Dimorfismo sexual, ¿natural? Una reinterpretación crítica de las diferencias biológicas / Sexual dimorphism: innate or acquired? A reinterpretation of biological differences / Dimorfismo sexual: natural? Uma reinterpretação crítica das diferenças biológicas

Resumen El presente trabajo expone una interpretación sexual dimórfica de las diferencias biológicas en la especie humana, que resulta de la lectura androcéntrica de los cuerpos que caracterizó la ciencia moderna. En contraste con esta lectura, se muestra cómo las prácticas sociales asociadas con los roles de género pueden traducirse en diferencias biológicas que "se ajustan" a una lectura dimórfica. Sobre la base de estos hechos, se propone que, si existen ciertos correlatos entre genitalidad y diferencias biológicas, los mismos no necesariamente son causados por los procesos de diferenciación sexual, sino por vínculos estadísticos dados por los estereotipos normativos de género. Las conductas implicadas en tales estereotipos se expresan biológicamente, y los roles de género crean muchas de las diferencias biológicas que hoy se asumen como naturalmente dimórficas.

Abstract This text argues that the dimorphic interpretation of biological differences in the human species results from an androcentric reading of bodies that have characterized modern science. In contrast to this perspective, the article shows how social practices associated with gender roles can produce biological differences that "adjust" themselves to a dimorphic reading. Based on these facts, we propose that if correlations between genitality and biological differences exists, they are not caused by the processes of sexual differentiation, but by statistical links given by normative gender stereotypes. The behaviors implied in such stereotypes are expressed biologically, and gender roles create many of the biological differences currently assumed as innate and sexually dimorphic.

Resumo O presente trabalho expõe a interpretação sexual dimórfica das diferenças biológicas na espécie humana resultante da leitura androcêntrica dos corpos que caracterizou a ciência moderna. Em contraste com esta leitura, mostra-se como práticas sociais associadas aos papéis de gênero podem se traduzir em diferenças biológicas que se encaixam na leitura dimórfica. Com base nisso, propõe-se que, se existem certos correlatos entre genitalidade e diferenças biológicas, estes não são causados necessariamente por processos de diferenciação sexual, mas por vínculos estatísticos dados por estereótipos normativos de gênero. Os comportamentos envolvidos em tais estereótipos são biologicamente expressos, e os papéis de gênero criam muitas das diferenças biológicas hoje assumidas como naturalmente dimórficas.

Can Mental Index be used on CBCT images to determine sexual dimorphism? / O Índice Mentual aplicado em imagens de TCFC pode ser utilizado para determinação do Dimorfismo Sexual?

ABSTRACT Objective: Radiomorphometric indices (RI) vary according to gender and age. The objective of this study was to assess bone quality in men and women, using tomographic images Methods: A total of 78 Cone Beam Computed Tomography (CBCT) images of female and male patients were analyzed. The images were obtained from LAPI-FOUSP database, São Paulo, Brazil, and the Mental Index, which is a quantitative index, was evaluated on those images. The images were divided into 2 groups: Group M - Men and Group W - Women and evaluated by one examiner in two different times (T1 and T2). The data was submitted to a statistical analysis with a 95% level of significance (p <0.05) Results: The ICC tests showed an average to good intra-examiner agreement. The age averages were: 48.46 ± 15.3 for group W and 53.87 ± 13.09 for group M. On the MI evaluation, statistically significant differences were observed between the two groups Conclusion: We concluded that MI can be used to determine sexual dimorphism, once the thickness of the mandible cortex in women is smaller than the thickness found in men.

RESUMO Objetivo: Avaliar o dimorfismo sexual, por meio da aplicação de IR em imagens tomográficas. Métodos: Foram analisados 78 exames de tomografia computadorizada de feixe cônico (TCFC), de pacientes do sexo feminino e masculino. As imagens foram obtidas do banco de dados do LAPI-FOUSP, São Paulo, Brasil, e por meio delas o Índice Mentual, que é um IR quantitativo, foi avaliado. As imagens foram divididas em 2 grupos: Grupo M - Homens e Grupo W - Mulheres e avaliadas por um examinador em dois tempos diferentes (T1 e T2). Os dados foram submetidos a análise estatística com nível de significância de 95% (p<0,05). Resultados: O teste ICC mostrou uma concordância intra-examinador média a boa. As médias de idade foram: 48,46±15,3 para o grupo M e 53,87±13,09 para o grupo H. Na avaliação do IM, foram observadas diferenças estatisticamente significantes entre os dois grupos. Conclusão: Concluímos que o Índice Mentual pode ser utilizado para determinar o dimorfismo sexual, uma vez que a espessura da cortical da mandíbula nas mulheres é menor que a espessura encontrada nos homens.

Impact of hypoxic-ischemic injury on brain development in neonatal rats of different sexes / 中华儿科杂志

Objective@#To investigate the impact of hypoxic-ischemic brain injury (HIBI) on brain development in neonatal rats of different sexes.@*Methods@#From January 1 to December 31, 2018, 60 7-day-old SD rats were randomly divided into HIBI-F group (20 rats), HIBI-M group (20 rats), and control group (20 rats, 10 females and 10 males). The animal model of HIBI was established with Rice-Vannucci method, with the rats′ left common carotid artery double-ligated and severed. The rats were then placed in an incubator and exposed to a hypoxic gas mixture (8% O2, 92% N2) for 90 minutes. No intervention was given to the control group. Two weeks after HIBI, the motor development was evaluated by footprint analysis, the residual brain volume was measured by brain magnetic resonance imaging (MRI), and the damage of synaptic ultra structure was analyzed by transmission electron microscope. One-way ANOVA or χ2 test was used for inter-group statistical analysis, and paired sample t test was used to compare the bilateral step length and toe distance of rats in the same group.@*Results@#The mortality rate of HIBI-F was significantly higher than that of HIBI-M (20%(4/20) vs. 10%(2/20), χ2=40.000, P=0.001). The right step length and toe distance in HIBI-M group and HIBI-F group were significantly shorter than those in control group ((7.5±0.3) cm and (7.9±0.5) cm vs. (8.2±0.5) cm, F=9.605, P<0.01, (0.9±0.1) cm and (1.0±0.0) cm vs. (1.1±0.1) cm, F=71.437, P<0.01). Besides, according to above data, the right step length and toe distance in HIBI-M group were significantly shorter than those in the HIBI-F group (both P<0.01). Furthermore, the right step length was significantly shorter than the left step length ((8.3±0.4) and (8.3±0.5) cm, t=5.289 and 10.580, P=0.001 and 0.010, respectively) and toe distance ((1.1±0.1) and (1.1±0.1) cm, t=7.953 and 6.435, respectively, both P<0.01) in both HIBI-M group and HIBI-F group. Similarly, the synaptic gap of the left precentral gyrus neurons was longer in HIBI-M group and HIBI-F group than that in control group ((23.4±1.3) and (19.7±1.6) nm vs. (18.9±0.6) nm, F=71.719, P<0.01), and also longer in HIBI-M group than that in HIBI-F group (t=7.645, P<0.01). Likewise, the residual brain volume in HIBI-M group and HIBI-F group was significantly less than that in control group ((67±4)% and (75±5)% vs. 100%, F=406.122, P<0.01), and the residual brain volume in HIBI-M group was significantly less than that in HIBI-F group (t=-5.281, P<0.01).@*Conclusions@#Male neonatal rats are more vulnerable to HIBI and have severer subsequent brain injury and hemiplegia. Different treatment strategies for HIBI patients of different sexes should be developed.

Gênero, idade, achados endoscópicos, urease e Helicobacter pylori: ausência de correlação dentro de uma amostra de população com alta prevalência de câncer gástrico na Amazônia / Gender, age, endoscopic findings, urease and helicobacter pylori: all uncorrelated within a sample of a high gastric cancer prevalence population in amazon

ABSTRACT BACKGROUND: It is widely assumed that gender, age, gastritis and Helicobacter pylori , all have some degree of correlation and, therefore, can synergistically lead to the development of gastric cancer. OBJECTIVE: In this cross-sectional study, we expected to observe the above mentioned correlation in the analysis of medical records of 67 patients of both sexes (female, n=44), mean age ± standard deviation: 41±12 years old, all from Belém (capital of Pará State, Brazilian Amazon), a city historically known as one with the highest gastric cancer prevalence in this country. METHODS: All patients were submitted to upper gastrointestinal endoscopy for gastric biopsy histopathological analysis and rapid urease test. All diagnoses of gastritis were recorded considering its topography, category and the degree of inflammatory activity, being associated or not associated with H. pylori infection. RESULTS: The results show that no statistically relevant associations were found among the prevalences of the observed variables. CONCLUSION: The authors hypothesize that observed risk factors associated to gastric cancer might be lesser synergistic than is usually expected.

RESUMO CONTEXTO: É amplamente assumido que gênero, idade, gastrite e Helicobacter pylori , todos têm algum grau de correlação e, portanto, podem sinergicamente levar ao desenvolvimento de câncer gástrico. OBJETIVO: Neste estudo transversal, esperamos observar a correlação acima mencionada na análise de prontuários de 67 pacientes de ambos os sexos (sexo feminino, n=44), média de idade ± desvio padrão: 41±12 anos, todos de Belém (capital do Estado do Pará, Amazônia Brasileira), uma cidade historicamente conhecida como sendo uma das que apresenta maior prevalência de câncer gástrico no país. MÉTODOS: Todos os pacientes foram submetidos à endoscopia digestiva alta para análise histopatológica da biópsia gástrica e teste rápido da urease. Todos os diagnósticos de gastrite foram registrados considerando sua topografia, categoria e grau de atividade inflamatória, sendo associada ou não associada à infecção por H. pylori . RESULTADOS: Os resultados mostram que não foram encontradas associações estatisticamente relevantes entre as prevalências das variáveis observadas. CONCLUSÃO: Os autores levantam a hipótese de que os fatores de risco associados ao câncer gástrico podem ser menos sinérgicos do que o esperado.

Metabolic Syndrome in South Korean Patients with Chronic Obstructive Pulmonary Disease: A Focus on Gender Differences

PURPOSE: This study investigated the relationship between chronic obstructive pulmonary disease (COPD) and metabolic syndrome (MetS), focusing on gender differences and using large-scale data on the Korean general population. METHODS: The total sample included 9,079 eligible participants aged ≥ 40 years who participated in the fifth Korea National Health and Nutrition Examination Survey, conducted between 2010 and 2012. Complex sampling methods, including strata sampling, clustering, and sample weighting were used to allow generalization of the findings to the Korean population. For the bivariate analysis, chi-square tests were conducted to compare differences in general/behavioral characteristics, individual MetS components, the prevalence of COPD, and the number of MetS components according to the presence or absence of COPD and gender. Finally, a multiple logistic regression analysis adjusted for variables was conducted. RESULTS: The prevalence rates of COPD and MetS were 13.6% and 26.0%, respectively. The prevalence rate of MetS in the COPD group was 23.0% for the total sample, 18.5% for men, and 38.5% for women. After sample weighting and adjusting for covariates, there were no significant relationships among COPD, MetS, and the individual MetS components. CONCLUSION: Although MetS components were not significantly associated with COPD, the results indicate that health care professionals should recognize that two conditions, respiratory symptoms and MetS, may coexist in patients, women in particular, or healthy general populations encountered even if a patient has a normal body mass index and does not drink or smoke at all.

Sexual dimorphism of mandibular measures from computed tomographies / Dimorfismo sexual de medidas mandibulares a partir de tomografias computadorizadas

ABSTRACT Objetive: The objective of this study was to analyze mandibular measurements obtained from 225 computed tomography scans of the Osteological and CT Biobanks of Faculdade de Odontologia de Piracicaba Universidade Estadual de Campinas, aiming to verify the existence of a relationship between these measures and sexual dimorphism and ancestry. Methods: We sought to establish a mathematical model capable of estimating sex and ancestry. Of these scans, 126 were male, 94 were female and 5 were unidentified, aged 15 to 100 years, and ancestry known for the skin color phenotype (white, black, brown and yellow). Measurements were made between the following points: right lateral condylion and left lateral condylion; right lateral condylion and pogonion; left lateral condylion and pogonion; mesial border of right mental foramen and mesial border of left mental foramen. The area delimited by the triangle formed by the measurements between right lateral condylion and left lateral condylion was also analyzed; right lateral condylion and pogonion; and left lateral condylion and pogonion. Student t test for homogeneous variances showed that there was statistical difference in the means as a function of sex, except for the area measure, which was not used in the model. Results: It was possible to establish a mathematical model with accuracy of 69.2%. There was no statistical difference in the averages as a function of ancestry. Conclusion: It is concluded that the measures investigated help in the process of estimating sex, but were not adequate to estimate ancestry. The proposed methodology should be expanded to other population groups so that it can be improved.

RESUMO Objetivo: Analisar medidas mandibulares obtidas de 225 tomografias computadorizadas do "Biobanco Osteológico e Tomográfico da Faculdade de Odontologia de Piracicaba Universidade Estadual de Campinas", visando verificar a existência de relação entre essas medidas, o dimorfismo sexual e a ancestralidade. Métodos: Buscou-se estabelecer um modelo matemático capaz de estimar sexo e ancestralidade. Destas tomografias, 126 eram do sexo masculino, 94 do sexo feminino e 5 estavam sem identificação, com idades entre 15 e 100 anos, e ancestralidade conhecida para o fenótipo cor da pele (branco, negro, pardo e amarelo). Foram realizadas medidas entre os pontos: kondylion lateral direito e kondylion lateral esquerdo; kondylion lateral direito e pogônio; kondylion lateral esquerdo e pogônio; borda mesial do forame mentoniano direito e borda mesial do forame mentoniano esquerdo. Analisou-se também a área delimitada pelo triângulo formado pelas medidas entre kondylion lateral direito e kondylion lateral esquerdo; kondylion lateral direito e pogônio; e kondylion lateral esquerdo e pogônio. O teste t de Student para variâncias homogêneas demonstrou que houve diferença estatística nas médias em função do sexo, à exceção da medida de área, que não foi utilizada no modelo. Resultados: Foi possível estabelecer um modelo matemático com acurácia de 69,2%. Não houve diferença estatística nas médias em função da ancestralidade. Conclusão: Conclui-se que as medidas investigadas auxiliam no processo de estimativa do sexo, porém não foram adequadas para estimar a ancestralidade. A metodologia proposta deve ser expandida para outros grupos populacionais para que possa ser aperfeiçoada.

Photoanthropometry of the face in the young white brazilian population

Abstract The aim of the present study is to describe the simplified facial pattern of young Brazilian men and women using the facial index (FI), upper face index (UFI), and nasal index (NI) in indirect anthropometric measurements applied to frontal photographic images. The images were obtained from 660 adult white men and 689 adult white women aged 30 years ± 6 months, and classified according to regions of birth, as follows: south (S), southeast (SE), midwest (MW), northeast (NE), and north (N). The nasion, zygion, gnathion, stomion, subnasale, and alare landmarks were labeled on the images using the SAFF 2D® software. Based on the coordinates, the linear distances between the landmarks of interest were calculated and presented as indices. The analysis of variance and Student's t-test were used for assessing the regions of birth and gender, respectively. The collected data allowed obtaining the facial profile of the young adult Brazilian population. There were differences in the facial profiles between men and women and also between some regions, especially between the N and the other Brazilian regions (p<0.05). The UFI did not show a statistically significant difference (p>0.05) between genders for any of the regions. The discriminant analysis for gender assessment demonstrated higher accuracy when the three indices were analyzed together. In the decision tree for gender assessment, the NI showed better results than the other indices.

Resumo O objetivo do estudo é verificar o padrão facial simplificado a partir dos índices facial (IF), da face superior (IFS) e nasal (IN) de homens e mulheres jovens brasileiros a partir da antropometria indireta aplicada em imagens fotográficas em norma frontal. Foram utilizadas imagens de adultos brancos de 30 anos (± 6 meses), sendo 689 do gênero feminino e 660 do masculino, divididos pela região de nascimento, sendo Sul, Sudeste, Centro-oeste, Nordeste e Norte. Os pontos: násio, zígio, gnátio, estômio, subnasal e alar foram marcados nas imagens por meio do software SAFF 2D®. A partir das coordenadas geradas em pixels, foram calculadas as distâncias lineares entre os pontos de interesse, que foram transformadas em índices. Os índices foram analisados estatisticamente de acordo com a região do nascimento pela análise de variância e o gênero pelo teste t de Student. Com os dados foi possível traçar o perfil simplificado da face da população brasileira de adultos jovens por meio da fotoantropometria. Foram observadas diferenças no perfil facial entre os gêneros e também entre algumas regiões, com maior frequência entre a região N e as demais partes do país (p<0,05). Quando separados por regiões do país, o IFS não mostrou diferença estatisticamente significante (p>0,05) entre os gêneros para nenhuma região. A análise discriminante para estimativa de gênero mostra que melhores taxas de acerto são alcançadas quando considerados os três índices em conjunto. Para a árvore de decisão de estimativa de gênero, o IN desempenhou os melhores resultados, quando comparado aos demais índices analisados.

Nasal mucociliary transportability of male and female smokers / Transportabilidade mucociliar nasal de homens e mulheres tabagistas

Abstract Introduction: Female smoker's present increased susceptibility to several diseases when compared to the opposite gender. However, there are no studies showing differences in nasal mucociliary transport behavior between male and female smokers. Objective: To compare the nasal mucociliary transportability in male and female smokers and non-smokers, taking into consideration age, anthropometric data, smoking load and pulmonary function. Methods: The analysis included 139 individuals (33 men and 37 women smokers and 32 men and 37 women non-smokers). All participants answered an initial interview to obtain personal data and smoking load. Anthropometric data and carbon monoxide in the exhaled air were assessed. Individuals also performed pulmonary function test and Saccharin Transit Time test. To compare saccharin transit time values between men and women, smokers and non-smokers, stratification of all independent variables was performed (sociodemographic, smoking and respiratory variables) into two categories: below and above the median values. Results: There was no difference between men and women, smokers and non-smokers, regarding nasal mucociliary transportability. Significant differences were only observed between non-smokers. Among those with less forced vital capacity values (<97.37% of predicted), women presented mucociliary transport faster than men. Moreover, it was observed influence of BMI and COex (women smokers), FCV and FEV1 (men non-smokers) and FEF25-75% (women non-smokers) on saccharin transit time values. Conclusion: Based on the findings of this study, nasal mucociliary transport in male and female adult smokers, apparently healthy, are similar.

Resumo Introdução: Mulheres tabagistas apresentam maior susceptibilidade à diversas doenças quando comparadas ao sexo masculino. No entanto, não há estudos mostrando diferenças no comportamento do transporte mucociliar nasal entre tabagistas do sexo masculino e feminino. Objetivo: Comparar a transportabilidade mucociliar nasal em homens e mulheres fumantes e não fumantes, levando em consideração idade, dados antropométricos, carga tabágica e função pulmonar. Método: A análise incluiu 139 indivíduos (33 homens e 37 mulheres fumantes e 32 homens e 37 mulheres não fumantes). Todos os participantes responderam a uma entrevista inicial para a obtenção de dados pessoais e a carga tabágica. Dados antropométricos e monóxido de carbono no ar expirado foram avaliados. Os indivíduos também fizeram teste de função pulmonar e o teste de trânsito de sacarina. Para comparar os valores do teste de trânsito de sacarina entre homens e mulheres, fumantes e não fumantes, foi feita a estratificação de todas as variáveis independentes (variáveis sociodemográficas, tabágicas e respiratórias) em duas categorias: abaixo e acima dos valores médios. Resultados: Não houve diferenças entre homens e mulheres, fumantes e não fumantes, em relação à transportabilidade mucociliar nasal. Diferenças significativas foram observadas apenas entre não fumantes. Entre os que apresentaram valores menores de capacidade vital forçada (< 97,37% do previsto), as mulheres apresentaram transporte mucociliar mais rápido do que os homens. Além disso, observou-se influência do IMC e COex (mulheres fumantes), CVF e VEF1 (homens não fumantes) e FEF25%-75% (mulheres não fumantes) sobre os valores do teste de trânsito de sacarina. Conclusão: Com base nos achados deste estudo, o transporte mucociliar nasal em tabagistas masculinos e femininos adultos, aparentemente saudáveis, são semelhantes.

Gender-related Differences in Management of Nonvalvular Atrial Fibrillation in an Asian Population

BACKGROUND AND OBJECTIVES: Gender-related differences in health care utilization for atrial fibrillation (AF) are increasingly recognized. However, large cohort data for examining gender-related differences in AF are lacking in Asian populations. METHODS: The Registry for Comparison Study of Drugs for Symptom Control and Complication Prevention of AF (CODE-AF Registry) is a prospective observational cohort-study that enrolled participants at 10 tertiary hospitals in South Korea. Baseline characteristics retrieved from the CODE-AF Registry were analyzed. RESULTS: A total of 6,274 patients were recruited (mean age 67±11 years, mean CHA2DS2-VASc score 2.7±1.7, 63% male, 65% paroxysmal AF) from June 2016 to April 2017. Women underwent less electric cardioversion (12.3% vs. 19.6%, p < 0.001), less radiofrequency ablation (12.4% vs. 17.9%, p < 0.001), and less antiarrhythmic drug therapy (44.7% vs. 49.5%, p < 0.001), despite having more severe symptoms (symptom class III or IV, 45.8% vs. 37.5%, p < 0.001). Among patients with a CHA2DS2-VA score of 2 or more, a slightly higher proportion of women were taking oral anticoagulants than men (85.7% vs. 81.9%, p=0.002), and non-vitamin K antagonist oral anticoagulant (NOAC) use was more prevalent in women than men (70.4% vs. 62.3%, p < 0.001). Insufficient NOAC dosing was very common, more so in women than men (61.5% vs. 56.3%, p < 0.001). CONCLUSIONS: Female patients with AF were treated more conservatively and rhythm control strategies were used less frequently than in males, even though the female patients with AF had more severe symptoms. While insufficient NOAC dosing was common in both sex, it was significantly more frequent in women.

The Association of Body Fat and Arterial Stiffness Using the Brachial-Ankle Pulse Wave Velocity / 가정의학회지

BACKGROUND: BMI alone may not serve as an index of obesity because it does not reflect body composition. The present study aimed to compare arterial stiffness as assessed by the brachial-ankle pulse wave velocity (ba-PWV) among groups defined by body fat percentage (pBF) and BMI. METHODS: This cross-sectional study was based on 1,700 participants (1,044 men and 656 women) who completed a health screening examination at a national hospital between January 2011 and February 2016. Participants were divided into four groups according to BMI and pBF: normal fat and normal weight (NFNW); excessive fat and normal weight (EFNW); normal fat and obese (NFO); and excessive fat and obese (EFO). The ba-PWV and other cardiometabolic factors were compared among the four groups in men and women separately. RESULTS: For both sexes, the NFNW group had a lower metabolic risk compared to that in the other groups (EFNW, NFO, and EFO). After adjusting for multiple variables, the NFO males had a significantly lower ba-PWV compared to those in the other groups, including NFNW males. The NFO group had significantly more skeletal muscle mass and muscle mass compared the other groups (P < 0.05). Among women, the NFNW group had a significantly lower ba-PWV compared the other groups, even after adjusting for multiple variables. CONCLUSION: Lower pBF in obese men may be associated with improved cardiovascular risk.

The nasal index in brazilian human skeletons

Aim: To investigate the percentage of correctness (PC) of the Nasal Index (NI) in human skeletons for determination of sex, ancestry and estimation of age in the Brazilian population. Methods: This was a cross-sectional study of 173 human skulls belonging to the Piracicaba Dental School. 93 skeletons were males and 80 females; 34 were aged up to 39 years, 56 between 40 and 59 years, and 83 60 years or older; 96 were from white individuals, 49 were from mixed-race and 28 from black individuals. High-precision digital caliper was used to measure nasal height (NH=ANS-nasion) and the maximum nasal width (NW) values, which were applied into the formula NI=NW/NHx100. The data were submitted to discriminant analysis and Student's t test with equal variances, Mann-Whitney, F (ANOVA), Tukey and Kruskal Wallis, 5% significance level. Results: Dominant nasal type in the Brazilian population was the mesorine. Males showed nasal height and width values greater than those of females, with statistically significant differences in all measurements (p≤0.021) and PC of 76.6%. Similar nasal measurements were found regardless of age (p>0.05), with PC of 41.7%. Ancestral analysis revealed that black individuals have greater nasal width (26.35) and nasal index (53.67) than white ones (24.60 and 49.25), while mixed-race individuals showed intermediate values (25.36 and 52.13) (p<0.05). Nevertheless, these measurements presented an estimated PC of 54.3%. Conclusion: The Nasal Index can be better used for sex determination than for estimation of age and ancestry in the Brazilian population, as the latter showed intermediate and low percentage of correctness, respectively

Sex estimation in brazilian sample: qualitative or quantitative methodology?

Aim: This study carried out cranial measurements (in mm) [Zygion-Zygion (Zy-Zy); Zygion-Glabella-right side (Zy-Ga-right); Zygion-Glabella-left side (Zy-Ga-left); Zygion-Glabella-mean (Zy-Ga-mean); Rhinion-Anterior Nasal Spine (Rhi-ANS); Nasal Width (Na Wid); Nasion-Anterior Nasal Spine (Na-ANS); Glabella-Anterior Nasal Spine (Ga-ANS); Glabella-Prosthion (Ga-Pr)], to verify whether they are dimorphic. Methods: We used skulls from the Eduardo Daruge Laboratory of Forensic Physical Anthropometry, which did not present growth abnormalities and belonged to the age range of 18 to 100 years. Linear measurements were performed by digital caliper, properly calibrated. Inter and intra-calibrator calibration was performed by obtaining as result the value of 0.98 (considered excellent). Results: We found that all measures carried out are dimorphic, and we were able to create a logistic regression model (logit: Sex = −33.6 + (0.15 × Zy-Zy) + (0.21 × Rhi-ANS) + (0.16 × Na-ANS)) to estimation the sex. Conclusions: We concluded that the developed quantitative method results in 85.2% sensitivity, 76.2% specificity, and 81.1% accuracy, being, therefore, more effective in the prediction of sex than the mere random hit (AU)

Comparison of the effects of interferential current between male and female healthy adults / Comparação dos efeitos da corrente interferencial entre homens e mulheres saudáveis

AIMS: To assess accommodation phenomena characteristics (threshold, time and amplitude/intensity) during stimulation with interferential current, comparing male and female healthy adults. METHODS: A non randomized clinical trial with intentional sampling by gender included 30 healthy adult volunteers aged between 18 and 25 years, who were divided in two groups (15 in the Female Group and 15 in the Male Group) and received a tetrapolar interferential current for 20 minutes, close to L1 and L5 vertebrae. The subjects were instructed to refer an intense but comfortable paresthesia sensation and to report the moment it diminished (accommodation), requiring increasing of the current intensity. The first three events of accommodation (AV1, AV2 and AV3), including time and amplitude threshold, were analyzed. The differences from AV1 to AV2 (D1) and AV2 to AV3 (D2) were also considered. The number of accommodations for each subject during the 20 minutes experiment was identified. ANOVA and Student's t-test were used for analysis and the significance level was set at 5%. RESULTS: In the Male Group the mean time for accommodation was higher in AV3 compared to AV1 and AV2. In the Female Group the accommodation mean time was higher in AV3 in relation to AV2, and in AV2 in relation to AV1. No differences were found in the Male Group for D1 and D2, but in the Female Group, D2 was superior to D1. Women were accommodated more quickly than men in all three assessments, but the differences between one evaluation and another were constant considering both groups. Both groups showed similar current intensity behavior comparing the three evaluations within the same group. In the comparison between groups, women had lower mean values of intensity in the three evaluations. The Female Group had 7.5±1.5 accommodations, and the Male Group had 5.9±2.0 accommodations (p=0.0367) during the 20 minutes of the experiment. CONCLUSIONS: In this sample of healthy young adults, men required higher interferential current amplitude to obtain a comfortable paresthesia and took more time to have accommodations, while women had more accommodation episodes.

OBJETIVOS: Avaliar características dos fenômenos de acomodação (limiar, tempo e amplitude/intensidade) durante estimulação com corrente interferencial, comparando adultos saudáveis do gênero masculino e feminino. MÉTODOS: Um ensaio clínico não randomizado com amostragem intencional por gênero incluiu 30 voluntários adultos saudáveis com idade entre 18 e 25 anos, que foram divididos em dois grupos (15 no Grupo Feminino e 15 no Grupo Masculino) e receberam uma corrente interferencial tetrapolar por 20 minutos, na altura das vértebras L1 e L5. Os sujeitos foram instruídos a referir uma sensação de parestesia intensa mas confortável e relatar o momento em que ela diminuiu (acomodação), requerendo aumento da intensidade da corrente. Foram analisados os três primeiros fenômenos de acomodação (AV1, AV2 e AV3), incluindo tempo e limiar de amplitude. Foram consideradas também as diferenças entre AV1 e AV2 (D1) e entre AV2 e AV3 (D2). Foi identificado o número total de acomodações para cada sujeito nos 20 minutos do experimento. Para a análise foram usados ANOVA e teste t de Student e o nível de significância foi definido em 5%. RESULTADOS: No Grupo Masculino, o tempo médio para acomodação foi maior em AV3 comparado com AV1 e AV2. No Grupo Feminino, o tempo médio foi maior em AV3 em relação a AV2 e em AV2 em relação a AV1. Não foram encontradas diferenças no Grupo Masculino entre D1 e D2, mas no Grupo Feminino, D2 foi superior a D1. As mulheres apresentaram acomodação mais rapidamente do que os homens em todas as três avaliações, mas as diferenças entre uma avaliação e outra foram constantes considerando os dois grupos. Ambos os grupos apresentaram comportamento semelhante na intensidade da corrente, comparando as três avaliações dentro do mesmo grupo. Na comparação entre os grupos, as mulheres apresentaram valores médios de intensidade mais baixos em todas as três avaliações. O Grupo Feminino apresentou 7,5±1,5 acomodações e o Grupo Masculino 5,9±2,0 acomodações (p=0,0367) durante os 20 min do experimento. CONCLUSÕES: Nesta amostra de jovens adultos saudáveis, os homens necessitaram de corrente interferencial com maior amplitude para obter uma parestesia confortável e demoraram mais tempo para apresentar acomodação, enquanto as mulheres tiveram mais episódios de acomodação.

Sex-based Association between Depression and Metabolic Syndrome in Korean Middle-aged and Older Adults

OBJECTIVES: This study aimed to identify the sex-based association between depression and the development of metabolic syndrome (Mets) among middle-aged and older Korean adults. METHODS: A cross-sectional design was used for the secondary analysis of the 2010–2014 Korean National Health and Nutrition Examination Survey. Data from 1,938 men and 2,404 women were analyzed. Mets was defined in accordance with the criteria used for clinical diagnosis. Depression was assessed with a question about having clinical depression. The association between depression and the development of Mets with or without adjustment for covariates was identified by conducting logistic regression analysis on weighted data using a complex sample procedure. RESULTS: More women than men had depression. Before covariate adjustment, depression was significantly associated with the development of Mets among women (odds ratio [OR], 1.586; 95% confidence interval [CI], 1.152–2.183) and with a higher triglyceride level among men (OR, 1.679; 95% CI, 1.001–2.818). After covariate adjustment; depression was significantly associated with higher waist circumference among women (adjusted OR [AOR], 1.532; 95% CI, 1.046–2.245) and higher triglyceride level (AOR, 1.511; 95% CI, 1.029–2.219) than was Mets. Conversely, depression did not have significant effects on the development of Mets among men. CONCLUSION: Depression was associated with the development of Mets among middle-aged and older Korean women. Healthcare providers in communities should assess women with depression for the presence of Mets components. Interventions for relieving depressive symptoms should also be provided to women at risk for Mets.