Female sexual dysfunction in multiple system atrophy: a prospective cohort study.

PURPOSE: The diagnosis of probable multiple system atrophy relies on the presence of severe cardiovascular or urogenital autonomic failure. Erectile dysfunction is required to fulfil the latter criterion in men, whereas no corresponding item is established for women. In this study, we aimed to investigate sexual dysfunction in women with multiple system atrophy. METHODS: We administered the Female Sexual Function Index questionnaire and interviewed women with multiple system atrophy and age-matched controls regarding the presence of "genital hyposensitivity." RESULTS: We recruited 25 women with multiple system atrophy and 42 controls. Female Sexual Function Index scores in sexually active women with multiple system atrophy were significantly lower (multiple system atrophy = 10; 15.4, 95% CI [10.1, 22.1], controls = 37; 26.1 [24.1, 28.1], p = 0.0004). The lowest scores concerned the domains of desire, arousal and lubrication. Genital hyposensitivity was reported by 56% of the patients with multiple system atrophy and 9% controls (p < 0.0001). CONCLUSIONS: Sexual dysfunction is highly prevalent in women with multiple system atrophy. Screening for disturbances in specific sexual domains should be implemented in the clinical evaluation of women with suggestive motor symptoms.

Brain Region-Specific Differences in Amyloid-ß Plaque Composition in 5XFAD Mice.

Senile plaques consisting of amyloid-beta (Aß) peptides are a major pathological hallmark of Alzheimer's disease (AD). Aß peptides are heterogeneous regarding the exact length of their amino- and carboxy-termini. Aß1-40 and Aß1-42 are often considered to represent canonical "full-length" Aß species. Using immunohistochemistry, we analyzed the distribution of Aß1-x, Aßx-42 and Aß4-x species in amyloid deposits in the subiculum, hippocampus and cortex in 5XFAD mice during aging. Overall plaque load increased in all three brain regions, with the subiculum being the area with the strongest relative plaque coverage. In the subiculum, but not in the other brain regions, the Aß1-x load peaked at an age of five months and decreased thereafter. In contrast, the density of plaques positive for N-terminally truncated Aß4-x species increased continuously over time. We hypothesize that ongoing plaque remodeling takes place, leading to a conversion of deposited Aß1-x peptides into Aß4-x peptides in brain regions with a high Aß plaque burden.

The impact of sociodemographic factors vs. gender roles on female hospital workers' health: do we need to shift emphasis?

The aim of the present study was to evaluate the physical and mental health status of female workers from five different occupational groups and to identify possible sociodemographic and gender-coded family-related factors as well as work characteristics influencing women's health. The identified predictors of health status were subjected to a gender-sensitive analysis and their relations to one another are discussed. A total of 1083 female hospital workers including medical doctors, technical and administrative personnel, nurses and a group mainly consisting of scientific personnel and psychologists completed a questionnaire measuring work- and family-related variables, sociodemographic data and the Short-form 36 Health Questionnaire (SF-36). Data were analysed by multivariate regression analyses. Female medical doctors reported highest scores for all physical health dimensions except General Health. Our study population showed general low mental health status among administrative personnel and the heterogeneous group, others, scored highest on all mental health component scores. A series of eight regression analyses were performed. Three variables contributed highly significantly to all SF-36 subscale scores: age, satisfaction with work schedule, and the unpaid work variable. Age had the strongest influence on all physical dimensions except General Health (beta=-0.17) and had no detectable influence on mental health scores. The unpaid work variable (beta=-0.23; p<0.001) exerted a stronger influence on General Health than did age. Nevertheless, these variables were limited predictors of physical and mental health status. In all occupational groups the amount of time spent daily on child care and household tasks, as a traditional gender-coded factor, and satisfaction with work schedule were the only contributors to mental health among working women in this study. Traditional sociodemographic data had no effect on mental health status. In addition to age, these factors were shown to be the only predictors of physical health status of female workers. Gender coded-factors matter. These findings underline the importance of including gender-coded family- and work-related variables in medical research over and above basic sociodemographic data in order to describe study populations more clearly.

The Mosque Campaign: a cardiovascular prevention program for female Turkish immigrants.

BACKGROUND: The Women's Health Office of the State of Tyrol, Austria, provides cardiovascular disease (CVD) prevention programs for women. However, local Turkish women have not participated in our programs. The aim of the so-called Mosque Campaign was to conduct a Turkish-language, culture-sensitive CVD prevention program tailored to the needs of Turkish women to improve their knowledge of CVD risk factors and to minimize ethnic differences in participation rates for preventive programs. METHODS: The pilot program was conducted in all 28 mosques in Tyrol during the years 1999/00, 2000/01 and 2001/02. A Turkish educational lecture and the opportunity for a private medical consultation were provided, and 2,446 Turkish women completed a questionnaire on their personal knowledge of CVD. In addition a total of 1,992 blood pressure readings were taken. RESULTS: Most of the women belonged to the first generation of female immigrants and reported not using German-language media. About one-third of the women considered themselves to be obese. More than 13 % had raised systolic and/or diastolic blood pressure. We observed a significant decrease in unawareness of the main CVD risk factors from 1999/00 to 2001/02: unawareness of cholesterol level decreased from 57.4 % to 32.4 % (p < 0.001), of blood pressure from 41.3 % to 29.6 % (p < 0.001) and of blood glucose from 49.7 % to 25.2 % (p < 0.001). CONCLUSIONS: Even though Austria provides free access to healthcare services, a large number of Turkish women were not aware of their CVD risk factors. The Mosque Campaign reached female Turkish migrants and was effective in reducing their level of unawareness about CVD. Language-adapted and culture-sensitive programs are necessary to ensure greater equality for ethnic minority groups.

QTc variability in schizophrenia patients treated with antipsychotics and healthy controls.

QTc prolongation is associated with the administration of some antipsychotics but the QTc interval is also known to vary physiologically. There is little published evidence about changes in QTc variability during treatment with antipsychotics. In this prospective investigation, we analyzed ECGs in 61 patients suffering from a schizophrenic disorder who were treated with different antipsychotics and 31 sex- and age-matched healthy controls. We found no differences in QTc intervals nor in QTc variability between patients and controls. Our results raise the question of the clinical relevance of a single ECG for diagnostics of cardiac complications in schizophrenia patients and suggest the need to conduct ECG monitoring in patients at high risk for cardiac complications during antipsychotic treatment.

[Gender differences in cardiology]. / Geschlechtsunterschiede in der Kardiologie.

Frequent reports of gender differences in cardiology prompted us to study the cardiological situation in Tyrol, Austria, from 1995 to 2000. Mortality statistics for heart deaths 1995: women 1008 (53.5%), men 875 (46.5%); 2000: women 1104 (58.2%), men 792 (41.8%). Coronary heart deaths 1995: women 572 (50.0%), men 571 (50.0%); 2000: women 634 (54.4%), men 531 (45.6%). Angiograms 1995: women 332 (33.9%), men 646 (66.1%); 2000: women 688 (32.5%), men 1429 (67.5%). Bypass surgery 1995: women 54 (33.0%), men 156 (67.0%); 2000: women 42 (27.5%), men 157 (72.5%). Heart deaths 1995-2000: women +9.5%, men -9.5%; coronary heart deaths 1995-2000: women +10.8%, men -7.0%. By (welcome) contrast, coronary angiograms 1995-2000: women +107.2%, men +121.2%. Bypass operations 1995-2000: women -22.2%, men +0.6%. Life expectancy 1995-2000: women +0.6%, men +0.6%. Patient age at heart death 1995-2000: women +1.8%, men +2.5%. In aggregate, we see that for decades more women than men have died a heart death, but that cardiac mortalities remain a typically "male bastion" with persistent gender differences in access to clinical cardiology. The worsening trend for women begs for awareness programs and corresponding preventive measures.