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Principles of Gender-Specific Medicine -

Principles of Gender-Specific Medicine (eBook)

Marianne Legato J (Herausgeber)

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2009 | 2. Auflage
800 Seiten
Elsevier Science (Verlag)
978-0-08-092150-1 (ISBN)
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The field of gender-specific medicine examines how normal human biology and physiology differ between men and women and how the diagnosis and treatment of disease differs as a function of gender. This revealing research covers various conditions that predominantly occur in men as well conditions that predominantly occur in women. Among the areas of greatest difference are cardiovascular disease, mood disorders, the immune system, lung cancer as a consequence of smoking, osteoporosis, diabetes, obesity, and infectious diseases. The Second Edition of Principles of Gender-Specific Medicine focuses on the essentials of gender-specific medicine and the current study of sex and gender differences in human physiology and pathophysiology. New section editors, new chapter authors, and new chapters have been added to reflect the most up-to-date clinical research and practice.


    • Offers insight into how the gender-specific risks of one organ system's disease affects the health of other organ systems
      • Outlines the sex-specific differences of normal anatomy and physiology
      • Illustrates the gender-specific features and quantifies 'gender' and 'sex' as risk factors across all major diseases
      • Qualifies and analyzes the results of new drug therapies designed with gender-specific differences in mind: ex, hormone therapy in men and women for the prevention and treatment of cardiovascular disease
      • All chapters progress translationally from the basic science to the clinical applications of gender-specific therapies, drugs, or treatments
      • Sections on drug metabolism, aging, and meta-analysis of data incorporated into all disease-specific chapters


      Dr. Marianne Legato is the founder and director of The Partnership for Gender-Specific Medicine at Columbia University and an internationally known academic physician, author, lecturer, and specialist in gender-specific medicine.
      This partnership is the first collaboration between academic medicine and the private sector focused solely on gender-specific medicine: the science of how normal human biology differs between men and women and of how the diagnosis and treatment of disease differs as a function of gender.
      She is also the founding editor of the journal Gender Medicine, published for the scientific community and in 1992, Dr. Legato won the American Heart Association's Blakeslee Award for the best book written for the lay public on cardiovascular disease.
      She is a practicing internist in New York City and has been listed each year in New York Magazine's 'Best Doctors' since the feature's inception in 1993.
      The field of gender-specific medicine examines how normal human biology and physiology differ between men and women and how the diagnosis and treatment of disease differs as a function of gender. This revealing research covers various conditions that predominantly occur in men as well conditions that predominantly occur in women. Among the areas of greatest difference are cardiovascular disease, mood disorders, the immune system, lung cancer as a consequence of smoking, osteoporosis, diabetes, obesity, and infectious diseases. The Second Edition of Principles of Gender-Specific Medicine focuses on the essentials of gender-specific medicine and the current study of sex and gender differences in human physiology and pathophysiology. New section editors, new chapter authors, and new chapters have been added to reflect the most up-to-date clinical research and practice. - Offers insight into how the gender-specific risks of one organ system's disease affects the health of other organ systems- Outlines the sex-specific differences of normal anatomy and physiology- Illustrates the gender-specific features and quantifies "e;gender"e; and "e;sex"e; as risk factors across all major diseases- Qualifies and analyzes the results of new drug therapies designed with gender-specific differences in mind: ex, hormone therapy in men and women for the prevention and treatment of cardiovascular disease- All chapters progress translationally from the basic science to the clinical applications of gender-specific therapies, drugs, or treatments- Sections on drug metabolism, aging, and meta-analysis of data incorporated into all disease-specific chapters

      Front Cover 1
      Principles of Gender-Specific Medicine 4
      Copyright Page 5
      Contents 8
      Contributors 12
      Foreword: Gender-Specific Medicine – Environment and Biology 18
      Preface 22
      SECTION 1 Gender and Normal Development 24
      INTRODUCTION 25
      CHAPTER 1 The Effects of Gender in Neonatal Medicine 26
      INTRODUCTION 26
      THE SEX RATIO DURING FETAL LIFE 26
      SEX DIFFERENCES IN FETAL AND NEONATAL GROWTH 28
      EXCESS MALE MORTALITY 29
      THE EFFECT OF GENDER ON THE INCIDENCE AND SEVERITY OF DISEASES IN INFANCY AND CHILDHOOD 30
      SUMMARY 35
      References 36
      CHAPTER 2 Sexual Development, Growth, and Puberty in Children 41
      INTRODUCTION 41
      SEXUAL DEVELOPMENT 41
      GROWTH 45
      PUBERTY 48
      ACKNOWLEDGMENTS 54
      References 54
      CHAPTER 3 Gender Differences in Pediatric Pulmonary Disease 58
      INTRODUCTION 58
      PRENATAL LUNG GROWTH 58
      POSTNATAL LUNG GROWTH 60
      LUNG DISORDERS OF CHILDHOOD 61
      References 69
      CHAPTER 4 Gender-Specific Aspects of Pediatric Hematology and Oncology 74
      INTRODUCTION 74
      NORMAL HEMATOPOIESIS 74
      IRON DEFICIENCY ANEMIA 75
      GLUCOSE-6-PHOSPHATE DEHYDROGENASE DEFICIENCY 75
      SICKLE CELL DISEASE 75
      CHRONIC GRANULOMATOUS DISEASE (CGD) 76
      COAGULATION DEFECTS 76
      CHILDHOOD CANCER 76
      SUGGESTIONS FOR FURTHER INVESTIGATIONS 81
      References 81
      CHAPTER 5 Gender Differences in Neurological Conditions of Children 85
      INTRODUCTION 85
      ATTENTION DEFICIT HYPERACTIVITY DISORDER (ADHD) 86
      TOURETTE'S SYNDROME (TS) 86
      EPILEPSY 86
      DUCHENNE MUSCULAR DYSTROPHY 87
      FRAGILE X SYNDROME 87
      PELIZAEUS–MERZBACHER DISEASE (PMD) 87
      CONCLUSION 88
      References 88
      Further reading 88
      CHAPTER 6 Gender and Sports: Past, Present, and Future 90
      INTRODUCTION 90
      SPORTS IN AMERICA: A CHANGING DEMOGRAPHIC 90
      PHYSIOLOGY 90
      SPECIFIC ISSUES OF GENDER AND SPORT 91
      CONCLUSION 94
      Further Reading 95
      SECTION 2 Gender and the Nervous System 96
      INTRODUCTION 97
      CHAPTER 7 Gender Differences in the Functional Organization of the Brain 98
      INTRODUCTION 98
      SEX DIFFERENCES IN BEHAVIORAL MEASURES 98
      SEX DIFFERENCES IN NEUROANATOMIC MEASURES 101
      SEX DIFFERENCES IN NEUROPHYSIOLOGIC MEASURES 104
      IMPLICATIONS FOR SEX DIFFERENCES IN FUNCTIONAL BRAIN ORGANIZATION 105
      QUESTIONS FOR FUTURE 106
      ACKNOWLEDGMENT 106
      References 106
      CHAPTER 8 Sexual Differentiation of Brain Structure and Function 110
      INTRODUCTION 110
      HISTORICAL OVERVIEW 111
      SEX DIFFERENCES IN NEUROANATOMY 112
      CELLULAR MECHANISMS ESTABLISHING SEX DIFFERENCES IN BRAIN 114
      SEX DIFFERENCES IN PHYSIOLOGY AND BEHAVIOR 117
      SUGGESTIONS FOR FUTURE INVESTIGATIONS 120
      References 121
      CHAPTER 9 The Sexed and Gendered Brain 124
      INTRODUCTION 124
      TERMINOLOGY 124
      SEXUAL DIFFERENTIATION OF THE BRAIN 126
      TESTING THE PRENATAL HORMONAL HYPOTHESIS IN HUMANS 127
      CONCLUSIONS 132
      QUESTIONS FOR FUTURE RESEARCH 133
      References 134
      CHAPTER 10 Age and Gender-Specific Patterns of Neurologic Illness 136
      INTRODUCTION 136
      STRATEGIES FOR IDENTIFYING DIFFERENTIAL DISEASE FREQUENCIES 136
      ARE THERE DATA REGARDING GENDER-SPECIFIC FREQUENCY OF NEUROLOGIC DISEASES? 138
      SUMMARY AND DISCUSSION 146
      FURTHER UNEXPLORED QUESTIONS 147
      References 147
      CHAPTER 11 Gender Differences in Stroke 152
      INTRODUCTION 152
      GENDER DIFFERENCES IN EPIDEMIOLOGY OF STROKE 152
      GENDER DIFFERENCES IN PREVENTION OF STROKE 152
      GENDER DIFFERENCES IN ACUTE TREATMENT OF STROKE 154
      GENDER DIFFERENCES IN STROKE SYMPTOMS AND RECOVERY FROM STROKE 155
      GENDER DIFFERENCES IN MECHANISM OF STROKE 155
      SUGGESTIONS FOR FUTURE INVESTIGATIONS 156
      References 156
      CHAPTER 12 Gender Differences in Disorders that Present to Psychiatry 159
      INTRODUCTION 159
      CHILD PSYCHIATRY 159
      ADULT PSYCHIATRY 160
      GERIATRIC PSYCHIATRY 162
      FUTURE RESEARCH DIRECTIONS 162
      CONCLUSION 162
      References 163
      CHAPTER 13 Hormone Replacement Therapy and Cognitive Function 165
      INTRODUCTION 165
      LABORATORY STUDIES 165
      MENOPAUSE, HORMONES, AND COGNITION 166
      MENOPAUSE AND DEMENTIA 166
      CLINICAL TRIALS 167
      CONCLUSION 169
      QUESTIONS FOR FUTURE RESEARCH 169
      ACKNOWLEDGMENT 169
      References 170
      SECTION 3 Cardiovascular Disease 172
      INTRODUCTION 173
      References 173
      CHAPTER 14 Gender and the Heart: Sex-Specific Differences in the Normal Myocardial Anatomy and Physiology 174
      INTRODUCTION 174
      THE VASCULATURE 174
      THE MYOCARDIUM 175
      THE MYOFIBER 175
      CONTRACTILE PROPERTIES OF THE NORMAL HEART 176
      AGING AND MYOCARDIAL CHARACTERISTICS 176
      CONGESTIVE HEART FAILURE 177
      MYOCARDIAL HYPERTROPY 178
      HORMONES AND THE HEART 179
      ELECTROPHYSIOLOGY AND GENDER 180
      References 181
      CHAPTER 15 Gender-Specific Aspects of Selected Coronary Heart Disease Risk Factors: A Summary of the Epidemiologic Evidence 185
      CIGARETTE SMOKING 185
      HIGH BLOOD PRESSURE 186
      DYSLIPIDEMIA 186
      OBESITY 187
      PHYSICAL ACTIVITY 188
      TYPE 2 DIABETES 189
      ASPIRIN 190
      POSTMENOPAUSAL HORMONE THERAPY 190
      ALCOHOL 191
      PSYCHOSOCIAL FACTORS 191
      CONCLUSION 192
      References 193
      CHAPTER 16 Dyslipidemia Management in Women and Men: Exploring Potential Gender Differences 198
      INTRODUCTION 198
      RISK FACTORS FOR DEVELOPING CVD ASSOCIATED WITH DYSLIPIDEMIA 198
      DYSLIPIDEMIA 199
      HORMONAL EFFECTS ON CVD RISK 202
      DYSLIPIDEMIA MANAGEMENT 203
      CONCLUSION 206
      SUGGESTIONS FOR FURTHER INVESTIGATIONS 206
      References 206
      CHAPTER 17 Gender Differences in the Role of Stress and Emotion in Cardiovascular Function and Disease 209
      CARDIOVASCULAR EFFECTS OF LABORATORY STRESS 209
      EMOTIONAL STATES AND CARDIOVASCULAR DISEASE 211
      PSYCHOSOCIAL RISK FACTORS IN CARDIOVASCULAR DISEASE 214
      PSYCHOSOCIAL INTERVENTIONS WITH CARDIAC PATIENTS 215
      CONCLUSION 216
      SUGGESTIONS FOR FURTHER INVESTIGATIONS 216
      ACKNOWLEDGMENT 216
      References 217
      CHAPTER 18 The Role of Sex and Gender in Cardiothoracic Surgery 223
      INTRODUCTION 223
      GENDER AND BIOLOGY 223
      GENDER AND RISK FACTORS 225
      GENDER AND SURGICAL OUTCOMES 228
      GENDER AND RECOVERY AFTER CABG 230
      GENDER AND VALVE SURGERY 231
      GENDER AND OFF-PUMP SURGERY 231
      CONCLUSION 232
      References 232
      SECTION 4 Pulmonology 236
      INTRODUCTION 237
      Bibliography 237
      CHAPTER 19 Gender Differences in Asthma 238
      INTRODUCTION 238
      CLINICAL AND EPIDEMIOLOGICAL STUDIES 238
      MECHANISMS 240
      CONCLUSION 244
      References 245
      CHAPTER 20 Gender Issues in Venous Thromboembolism 248
      VENOUS THROMBOEMBOLISM: EPIDEMIOLOGY AND RISK FACTORS 248
      HORMONAL THERAPY AND VTE 250
      PREGNANCY AND VTE 256
      CONCLUSION 261
      References 261
      CHAPTER 21 Sleep in Women: Gender Differences in Health and Disease 267
      INTRODUCTION 267
      NORMAL SLEEP AND GENDER DIFFERENCES 267
      GENDER-SPECIFIC CONDITIONS THAT IMPACT SLEEP 268
      GENDER DIFFERENCES IN SLEEP DISORDERS 269
      CONCLUSIONS 271
      References 271
      CHAPTER 22 Are Women More Susceptible to Chronic Obstructive Pulmonary Disease? 275
      INTRODUCTION 275
      EVOLVING EPIDEMIOLOGY 275
      DIAGNOSTIC ERRORS 276
      CLINICAL MANIFESTATIONS 278
      MANAGEMENT 278
      CONCLUSIONS 280
      References 280
      CHAPTER 23 The Gender-Specific Aspects of Lung Cancer 283
      INTRODUCTION 283
      ARE LUNG CANCERS IN SMOKERS AND NONSMOKERS DIFFERENT? 283
      ARE LUNG CANCERS IN MEN AND WOMEN DIFFERENT? 284
      ARE WOMEN MORE SUSCEPTIBLE TO LUNG CANCER? 284
      POTENTIAL MECHANISMS FOR A GENDER EFFECT ON LUNG CANCER 285
      DO WOMEN WITH LUNG CANCER HAVE A BETTER PROGNOSIS THAN MEN? 287
      CONCLUSIONS 288
      References 288
      CHAPTER 24 Gender-Specific Considerations in Pulmonary Hypertension 293
      INTRODUCTION 293
      IDIOPATHIC PULMONARY ARTERIAL HYPERTENSION 293
      SCLERODERMA 296
      SUMMARY 297
      References 297
      CHAPTER 25 Sex and Gender Differences in Pulmonary Manifestations of Autoimmune Disease 300
      OVERVIEW 300
      PATHOGENESIS 300
      SEX HORMONES AND AUTOIMMUNE DISEASE 301
      RHEUMATOID ARTHRITIS 301
      SCLERODERMA 302
      CONCLUSION 305
      References 305
      CHAPTER 26 Benign Metastasizing Leiomyoma and Lymphangioleiomyomatosis: Lung Diseases of Women 309
      INTRODUCTION 309
      BENIGN METASTASIZING LEIOMYOMA 309
      LYMPHANGIOLEIOMYOMATOSIS 311
      References 312
      CHAPTER 27 Gender Differences in Susceptibility, Outcomes, and Pathophysiology of Sepsis 314
      INTRODUCTION 314
      EPIDEMIOLOGY OF SEPSIS 314
      EXPERIMENTAL EVIDENCE OF GENDER-BASED DIFFERENCE IN SIRS AND SEPSIS 316
      CONCLUSION 320
      References 321
      SECTION 5 Gastroenterology 326
      INTRODUCTION 327
      References 327
      CHAPTER 28 Inflammatory Bowel Disease in Women 328
      INTRODUCTION 328
      GYNECOLOGIC COMPLICATIONS 328
      OSTEOPOROSIS 329
      FERTILITY AND PREGNANCY 329
      SELF-IMAGE 336
      CONCLUSIONS 337
      References 337
      CHAPTER 29 Disorders of Defecation in Women 341
      INTRODUCTION 341
      PREVALENCE AND ETIOLOGY OF CONSTIPATION 341
      EVALUATION OF CONSTIPATION 341
      TREATMENT OF CONSTIPATION 343
      PREVALENCE AND ETIOLOGY OF FECAL INCONTINENCE 344
      EVALUATION OF FECAL INCONTINENCE 345
      TREATMENT OF FECAL INCONTINENCE 346
      References 347
      CHAPTER 30 Idiopathic Gastroparesis: Gender Aspects 349
      INTRODUCTION 349
      NORMAL GASTRIC EMPTYING 349
      GENDER ASPECTS OF GASTRIC MOTILITY 349
      GASTROPARESIS 350
      GASTRIC MOTILITY ABNORMALITIES IN GASTROPARESIS 350
      TREATMENT 352
      CONCLUSION 352
      References 352
      CHAPTER 31 Liver Disease in Women 354
      INTRODUCTION 354
      PREGNANCY AND LIVER DISEASES 354
      ORAL CONTRACEPTIVES AND THE LIVER 359
      AUTOIMMUNE LIVER DISEASES 360
      LIVER TRANSPLANTATION AND SURGERY 362
      ALCOHOLIC LIVER DISEASE (ALD) 363
      References 363
      SECTION 6 Reproductive Biology 368
      INTRODUCTION 369
      CHAPTER 32 Gender Differences in Irritable Bowel Syndrome 370
      INTRODUCTION 370
      EPIDEMIOLOGY 370
      PATHOPHYSIOLOGY 371
      RISK FACTORS AND CO-MORBIDITIES 373
      OTHER ASSOCIATIONS 374
      DIAGNOSIS 374
      TREATMENT 374
      CONCLUSION 375
      References 376
      CHAPTER 33 Contraception 380
      INTRODUCTION 380
      CONTRACEPTIVE COUNSELING 380
      CONTRACEPTIVE METHODS 380
      PATIENT EDUCATION 386
      References 387
      CHAPTER 34 Infertility: The Male 389
      BASIC EVALUATION 389
      ADVANCED EVALUATION 393
      TREATMENT 398
      CONCLUSION 399
      ACKNOWLEDGMENT 400
      References 400
      CHAPTER 35 Infertility and In Vitro Fertilization 404
      INFERTILITY 404
      ETIOLOGIES AND EVALUATIONS OF INFERTILITY 404
      TREATMENT FOR INFERTILITY 406
      CONCLUSIONS 419
      References 420
      CHAPTER 36 Female Sexual Health 423
      PREVALENCE 423
      ANATOMY AND PHYSIOLOGY 423
      CLINICAL PRACTICE 425
      COMMON SEXUAL PROBLEMS 426
      TREATMENT 427
      CONCLUSION 429
      References 429
      CHAPTER 37 Male Sexual Dysfunction 431
      PHYSIOLOGY 431
      DEFINITION AND PATHOPHYSIOLOGY OF ERECTILE DYSFUNCTION 431
      EPIDEMIOLOGY 432
      RISK FACTORS 432
      EVALUATION 432
      SPECIAL TESTS 433
      NON-SURGICAL THERAPY: PDE5I, URETHRAL SUPPOSITORIES, ICI, VED 433
      SURGICAL THERAPY 434
      References 434
      CHAPTER 38 Pelvic Pain: Urogenital Female Disorders 437
      SPECIFIC CAUSES OF VULVAR PAIN 437
      TREATMENT 439
      VULVAR DERMATOSES 440
      CONCLUSION 442
      References 442
      CHAPTER 39 Lower Urogenital Tract Dysfunction in Men and Women 444
      LOWER URINARY TRACT DYSFUNCTION: DEFINITIONS, SYMPTOMS, AND CLASSIFICATION 444
      CONDITIONS CAUSING LOWER URINARY TRACT SYMPTOMS IN MEN, WOMEN, AND BOTH SEXES ACCORDING TO SYMPTOMS 446
      ASSESSMENT OF LOWER URINARY TRACT DYSFUNCTION IN MEN AND WOMEN 448
      THERAPY 450
      CONCLUSIONS 453
      References 453
      CHAPTER 40 Aging and the Lower Urogenital System 455
      INTRODUCTION 455
      AGE-RELATED CHANGES IN THE LOWER URINARY TRACT 455
      URINARY TRACT INFECTIONS 459
      URINARY INCONTINENCE IN OLDER PERSONS 460
      FUTURE DIRECTIONS 467
      CONCLUSIONS 467
      RESOURCES 468
      References 468
      CHAPTER 41 Menopause 472
      INTRODUCTION 472
      PHYSIOLOGY 473
      EVALUATION OF WOMEN 474
      ROLE OF HORMONE THERAPY 476
      TREATMENT ALTERNATIVES TO HT 477
      CONCLUSION 477
      References 477
      SECTION 7 Oncology 480
      INTRODUCTION 481
      CHAPTER 42 The Differences between Male and Female Breast Cancer 482
      INTRODUCTION 482
      ANATOMY AND DEVELOPMENT 482
      EPIDEMIOLOGY 482
      RISK FACTORS 483
      CLINICAL FACTORS AND DIAGNOSIS 485
      PATHOLOGIC FEATURES 487
      PROGNOSTIC FACTORS 487
      TREATMENT 488
      PROGNOSIS AND SURVIVAL 491
      CONCLUSION 492
      References 492
      CHAPTER 43 Difference in Germ Cell Tumors of the Reproductive Tract in Men and Women 496
      INTRODUCTION 496
      ORIGIN OF GERM CELLS 496
      GENDER DIFFERENCES IN THE EPIDEMIOLOGY OF GERM CELL TUMORS 497
      BIOLOGY AND RISK FACTORS FOR GERM CELL TUMORS: ARE THEY GENDER-SPECIFIC? 498
      HISTOLOGY OF GERM CELL TUMORS 499
      GENDER DIFFERENCES IN CLINICAL PRESENTATION OF GERM CELL TUMORS 499
      DIAGNOSIS OF MALE AND FEMALE GERM CELL TUMORS 500
      TREATMENT OF MALE AND FEMALE GERM CELL TUMORS 500
      SUGGESTIONS FOR FURTHER INVESTIGATIONS 502
      References 502
      CHAPTER 44 Gender Differences in Hereditary Cancer Syndromes: Risks, Management, and Testing for Inherited Predisposition to Cancer 504
      CANCER GENETICS: OVERVIEW 504
      BREAST CANCER 505
      ENDOMETRIAL AND GASTROINTESTINAL CANCER 508
      TESTICULAR CANCER 510
      MULTIPLE ENDOCRINE NEOPLASIA TYPE 2 (MEN2) 511
      PROSTATE CANCER 511
      CANCER RISK ASSESSMENT, COUNSELING, AND TESTING 512
      CONCLUSION 514
      References 514
      SECTION 8 Infectious Disease 518
      INTRODUCTION 519
      CHAPTER 45 Gender Differences in Emerging Infectious Diseases 520
      INTRODUCTION 520
      EMERGING VIRAL INFECTIONS 521
      EMERGING BACTERIAL INFECTIONS 528
      EMERGING PRION INFECTION 533
      References 535
      CHAPTER 46 Sexually Transmitted Infections in Men and Women 539
      INTRODUCTION 539
      GENDER DIFFERENCES IN BEHAVIORAL SUSCEPTIBILITY 539
      GENDER DIFFERENCES IN BIOLOGICAL SUSCEPTIBILITY 540
      SEXUALLY TRANSMITTED BACTERIAL INFECTIONS 543
      SEXUALLY TRANSMITTED VIRAL INFECTIONS OTHER THAN HIV 547
      OTHER ORGANISMS AND SYNDROMES 549
      References 550
      CHAPTER 47 Infections in Pregnancy 554
      INTRODUCTION AND SIGNIFICANCE 554
      MECHANISMS OF INCREASED SUSCEPTIBILITY TO INFECTION IN PREGNANCY 554
      INFECTIONS FOR WHICH PREGNANCY ALTERS MATERNAL SUSCEPTIBILITY OR COURSE 559
      INFECTIONS IN WHICH FETAL TRANSMISSION OR OTHER FETAL MORBIDITY IS THE PRIMARY CONCERN 567
      HIV 573
      EMERGING INFECTIONS 577
      POTENTIAL AGENTS OF BIOTERRORISM 579
      ISSUES REGARDING ANTIBIOTIC MANAGEMENT IN PREGNANCY 579
      VACCINATION 580
      References 580
      CHAPTER 48 Adult Immunization in Women and Men 586
      INTRODUCTION 586
      HUMAN PAPILLOMAVIRUS G 586
      ZOSTER IMMUNIZATION 588
      INFLUENZA VACCINE 589
      HEPATITIS B VACCINE (HBV) 591
      HEPATITIS A VACCINE 592
      PNEUMOCOCCAL VACCINE 593
      TETANUS/DIPTHERIA/PERTUSSIS 595
      MENINGOCOCCAL VACCINE 596
      IMMUNIZATION ISSUES FOR PREGNANT WOMEN 597
      References 599
      SECTION 9 Immunology 606
      INTRODUCTION 607
      CHAPTER 49 Gender Differences in Autoimmune Diseases: Immune Mechanisms and Clinical Applications 608
      GENERAL REMARKS 608
      SPECIFIC REMARKS IN AUTOIMMUNITY 608
      SPECIFIC AUTOIMMUNE DISEASES WITH GENDER DIFFERENCES 611
      FUTURE APPLICATIONS AND CONCLUDING REMARKS 612
      ACKNOWLEDGEMENTS 612
      References 612
      CHAPTER 50 Hormones and Cytokines: Gender-Specific Effects 615
      INVOLVEMENT OF SEX HORMONES AND CYTOKINES IN AUTOIMMUNE RHEUMATIC DISEASES 615
      PERIPHERAL SEX HORMONE METABOLISM IN AUTOIMMUNE DISEASES 616
      SEX HORMONES AND CYTOKINES 617
      CONCLUSIONS 617
      References 618
      CHAPTER 51 Prolactin and Autoimmunity 620
      PROLACTIN 620
      PROLACTIN AND HUMAN AUTOIMMUNE DISEASE 622
      PROLACTIN-LOWERING THERAPY FOR AUTOIMMUNE DISEASES 628
      SUGGESTIONS FOR FURTHER INVESTIGATIONS 631
      References 631
      CHAPTER 52 Sex Hormones and Immune Function 638
      INTRODUCTION 638
      AN OVERVIEW OF SEX HORMONES AND THE IMMUNE SYSTEM 638
      NORMAL ESTROGEN AND ANDROGEN METABOLISM 640
      USE OF HORMONES TO ALTER DISEASE STATES 643
      SEX HORMONES, BEHAVIOR, AND AUTOIMMUNE DISEASES 644
      References 645
      CHAPTER 53 Pregnancy and Autoimmune Rheumatic Disease 650
      PREGNANCY AND THE RHEUMATIC DISEASES 650
      IMMUNE FUNCTION IN THE CONNECTIVE TISSUE DISEASES AND PREGNANCY 650
      A BRIEF OUTLINE OF THE IMMUNOLOGY OF IMPLANTATION, PREGNANCY, AND LABOR AND DELIVERY 651
      MANAGEMENT OF REPRODUCTIVE ISSUES IN THE RHEUMATIC DISEASES 651
      SYSTEMIC LUPUS ERYTHEMATOSUS 651
      RHEUMATOID ARTHRITIS 655
      SERONEGATIVE SPONDYLOARTHROPATHIES 657
      SCLERODERMA (PROGRESSIVE SYSTEMIC SCLEROSIS) 658
      PHARMACOLOGIC TREATMENT OF RHEUMATIC DISEASE AND REPRODUCTION 659
      CONCLUSION 662
      References 662
      CHAPTER 54 Oral Contraceptives and Autoimmune Diseases 668
      INTRODUCTION 668
      ORAL CONTRACEPTIVES 668
      RHEUMATOID ARTHRITIS 669
      SYSTEMIC LUPUS ERYTHEMATOSUS 670
      ANTIPHOSPHOLIPID SYNDROME 672
      SJÖGREN'S SYNDROME 672
      SCLERODERMA 673
      VASCULITIS 674
      SUMMARY AND CONCLUSIONS 675
      References 676
      CHAPTER 55 Gender-Specific Issues in Organ Transplantation 680
      ORGAN FAILURE 680
      ORGAN DONATION 683
      TRANSPLANTATION 684
      OUTCOME POST-TRANSPLANTATION 685
      GENERAL CONSIDERATIONS 690
      CONCLUSIONS 691
      AREAS FOR FURTHER STUDY 692
      References 692
      SECTION 10 Endocrinology 700
      INTRODUCTION 701
      CHAPTER 56 Endogenous Sex Hormones and Risk of Type 2 Diabetes Mellitus in Men and Women 702
      INTRODUCTION 702
      GENDER DIFFERENCES IN THE ASSOCIATION BETWEEN ENDOGENOUS TESTOSTERONE AND RISK FACTORS FOR TYPE 2 DIABETES 702
      PATHOPHYSIOLOGY OF ENDOGENOUS SEX HORMONES AS RISK FACTORS FOR TYPE 2 DIABETES 711
      FUTURE DIRECTIONS AND CONCLUSIONS 714
      References 714
      CHAPTER 57 Thyroid Disorders and Pregnancy 717
      INTRODUCTION 717
      AUTOIMMUNE THYROIDITIS 717
      References 728
      CHAPTER 58 Sexual Function and Dysfunction in Men and Women 730
      INTRODUCTION 730
      MALE SEXUAL HEALTH 730
      FEMALE SEXUAL HEALTH 733
      CONCLUSIONS 737
      References 737
      CHAPTER 59 Osteoporosis in Men and Women 739
      EPIDEMIOLOGY OF OSTEOPOROSIS 739
      FINANCIAL BURDEN OF OSTEOPOROSIS 740
      SKELETAL DEVELOPMENT 740
      RISK FACTORS FOR OSTEOPOROSIS 742
      DIAGNOSIS, SCREENING, AND RISK FACTOR ASSESSMENT 743
      TREATMENT 746
      CONCLUSION 753
      References 754
      CHAPTER 60 Testosterone Replacement Therapy in Men and Women 760
      ANDROGEN PHYSIOLOGY 760
      ANDROGEN PRODUCTION IN MEN 761
      ETIOLOGY AND PREVALENCE OF HYPOGONADISM IN MEN 761
      ANDROGEN PRODUCTION IN WOMEN 771
      CONCLUSION 777
      References 777
      Index 784
      A 784
      B 785
      C 785
      D 786
      E 787
      F 787
      G 788
      H 788
      I 789
      J 790
      K 790
      L 790
      M 791
      N 791
      O 791
      P 792
      R 794
      S 794
      T 795
      U 796
      V 796
      W 797
      Y 797
      Z 797

      EPUBEPUB (Adobe DRM)

      Kopierschutz: Adobe-DRM
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      Geräteliste und zusätzliche Hinweise

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