Sex and gender perspectives in colorectal cancer.

Historically women were frequently excluded from clinical trials and drug usage to protect unborn babies from potential harm. As a consequence, the impact of sex and gender on both tumour biology and clinical outcomes has been largely underestimated. Although interrelated and often used interchangeably, sex and gender are not equivalent concepts. Sex is a biological attribute that defines species according to their chromosomal makeup and reproductive organ, while gender refers to a chosen sexual identity. Sex dimorphisms are rarely taken into account, in either preclinical or clinical research, with inadequate analysis of differences in outcomes according to sex or gender still widespread, reflecting a gap in our knowledge for a large proportion of the target population. Underestimation of sex-based differences in study design and analyses has invariably led to 'one-drug' treatment regimens for both males and females. For patients with colorectal cancer (CRC), sex also has an impact on the disease incidence, clinicopathological features, therapeutic outcomes, and tolerability to anticancer treatments. Although the global incidence of CRC is higher in male subjects, the proportion of patients presenting right-sided tumours and BRAF mutations is higher among females. Concerning sex-related differences in treatment efficacy and toxicity, drug dosage does not take into account sex-specific differences in pharmacokinetics. Toxicity associated with fluoropyrimidines, targeted therapies, and immunotherapies has been reported to be more extensive for females with CRC than for males, although evidence about differences in efficacy is more controversial. This article aims to provide an overview of the research achieved so far into sex and gender differences in cancer and summarize the growing body of literature illustrating the sex and gender perspective in CRC and their impact in relation to tumour biology and treatment efficacy and toxicity. We propose endorsing research on how biological sex and gender influence CRC as an added value for precision oncology.

[Comparative study of the bronchodilator effect of inhaled fenoterol and aerosol salbutamol in patients with chronic bronchial asthma]. / Estudio comparativo del efecto broncodilatador entre fenoterol inhaletas y salbutamol aerosol en pacientes con asma bronquial crónica.

The bronchodilator effects of inhaled fenoterol (FI) and salbutamol aerosol (S) in 15 patients (8 male and 7 female with a median age of 44 +/- 13 years), diagnosed as suffering from asthma, were studied using spirometry (determining FEV1, FEF 25-75% and FVC) and flow volume curves (PEF, MEF 75% and MEF 25%). The mean theroric rate of FEV1, PEF, MEF 75% was defined as the theoric rate of the obstruction of central airways (PCA%) and the mean of FVC, FEF 25-75% and MEF 25% rates defined as the rate of the theoric obstruction of the peripheral airways (PPA%). Basal and 5, 15, 30, 60, 120, 240, 360, 480 minute determinations were done, after the administration of 200 mcg of S in the conventional way on two different days. The statistic study carried out using the "u" test of Mann-Whytney. No statistically significant differences in intensity, onset nor duration of the effect between both drugs were found. We concluded that FI is a drug of great utility in treatment of asthmatic patients and one which allowed, because of the easy inhaling technique, the use of beta 2 adrenergic drugs in a mayor number of patients who would otherwise have to resort to an alternative form of administration.