Sex differences in medicine: Difference between revisions

From Wikipedia, the free encyclopedia
Content deleted Content added
Undid revision 1060179577 by Sideswipe9th (talk) see edit summary again, no justification provided
Tags: Undo Reverted
→‎Women: this page is about sex differences, point about transmen is nonsense.
Tag: Reverted
Line 35: Line 35:


* 99% of [[breast cancer]] occurs in [[women]].<ref>{{cite web|url=http://www.cancer.gov/cancertopics/pdq/treatment/malebreast/HealthProfessional|title=Male Breast Cancer Treatment|year=2014|publisher=[[National Cancer Institute]]|archive-url=https://web.archive.org/web/20140704182515/http://www.cancer.gov/cancertopics/pdq/treatment/malebreast/HealthProfessional|archive-date=4 July 2014|url-status=live|access-date=29 June 2014|df=dmy-all}}</ref>
* 99% of [[breast cancer]] occurs in [[women]].<ref>{{cite web|url=http://www.cancer.gov/cancertopics/pdq/treatment/malebreast/HealthProfessional|title=Male Breast Cancer Treatment|year=2014|publisher=[[National Cancer Institute]]|archive-url=https://web.archive.org/web/20140704182515/http://www.cancer.gov/cancertopics/pdq/treatment/malebreast/HealthProfessional|archive-date=4 July 2014|url-status=live|access-date=29 June 2014|df=dmy-all}}</ref>
* [[Ovarian cancer]], [[endometriosis]] and other diseases of the female reproductive system occur mostly in women (except in the rare instances where other [[gender]]s have said organs, such as [[trans men]].<ref>{{cite web |url=https://cancer-network.org/cancer-information/transgendergender-nonconforming-people-and-cancer/ovarian-cancer-in-transgender-men/ |title=Ovarian Cancer in Transgender Men |publisher=The National LGBT Cancer Network |accessdate=2021-02-21}}</ref>)
* [[Ovarian cancer]], [[endometriosis]] and other diseases of the female reproductive system occur mostly in women.
* Females are more likely to experience severe outcomes from [[Virus|viral]] [[respiratory tract infections]] during their reproductive years, compared to males of the same age. In response to treatment, females may develop greater immune responses but may also experience more adverse reactions than males.<ref name="Ursin"/><ref name="Klein">{{cite journal |last1=Klein |first1=Sabra L. |last2=Flanagan |first2=Katie L. |title=Sex differences in immune responses |journal=Nature Reviews Immunology |date=October 2016 |volume=16 |issue=10 |pages=626–638 |doi=10.1038/nri.2016.90 |pmid=27546235 |s2cid=2258164 |url=https://doi.org/10.1038/nri.2016.90 |access-date=11 November 2021 |language=en |issn=1474-1741}}</ref>
* Females are more likely to experience severe outcomes from [[Virus|viral]] [[respiratory tract infections]] during their reproductive years, compared to males of the same age. In response to treatment, females may develop greater immune responses but may also experience more adverse reactions than males.<ref name="Ursin"/><ref name="Klein">{{cite journal |last1=Klein |first1=Sabra L. |last2=Flanagan |first2=Katie L. |title=Sex differences in immune responses |journal=Nature Reviews Immunology |date=October 2016 |volume=16 |issue=10 |pages=626–638 |doi=10.1038/nri.2016.90 |pmid=27546235 |s2cid=2258164 |url=https://doi.org/10.1038/nri.2016.90 |access-date=11 November 2021 |language=en |issn=1474-1741}}</ref>
* Approximately four times more women suffer from [[osteoporosis]] than men.<ref>{{Cite journal|last=Khaled A. Alswat|date=1 Apr 2017|title=Gender Disparities in Osteoporosis|journal= Journal of Clinical Medicine Research|volume=9|issue=5|pages=382–387|pmc=5380170|pmid=28392857|doi=10.14740/jocmr2970w}}</ref>
* Approximately four times more women suffer from [[osteoporosis]] than men.<ref>{{Cite journal|last=Khaled A. Alswat|date=1 Apr 2017|title=Gender Disparities in Osteoporosis|journal= Journal of Clinical Medicine Research|volume=9|issue=5|pages=382–387|pmc=5380170|pmid=28392857|doi=10.14740/jocmr2970w}}</ref>

Revision as of 22:56, 13 December 2021

Sex differences in medicine include sex-specific diseases or conditions which occur only in people of one sex due to underlying biological factors (for example, prostate cancer in males or uterine cancer in females); sex-related diseases, which are diseases that are more common to one sex (for example, breast cancer and systemic lupus erythematosus which occur predominantly in females);[1] and diseases which occur at similar rates in males and females but manifest differently according to sex (for example, peripheral artery disease).[2]

Sex differences should not be confused with gender differences. The US National Academy of Medicine recognizes sex differences as biological at the chromosomal level, whereas gender differences are based on self-representation and other factors including biology, environment and experience.[3][4] That said, both biological and behavioural differences influence human health, and may do so differentially. Such factors can be inter-related and difficult to separate. Evidence-based approaches to sex and gender medicine try to examine the effects of both sex and gender as factors when dealing with medical conditions that may affect populations differently.[5][6] [3]

As of 2021 over 10,000 articles had been published addressing sex and gender differences in clinical medicine and related literature. Sex and gender affect cardiovascular,[7] pulmonary[8] and autoimmune systems,[9][10]; gastroenterology,[11][12] hepatology,[5] nephrology,[13] endocrinology,[14][15] haematology,[16] neurology;[17][18][19][20] pharmacokinetics and pharmacodynamics.[21][22][6][3]

Sexually transmitted diseases, which have a significant probability of transmission through sexual contact, can be contracted by either sex. Their occurrence may reflect economic and social as well as biological factors, leading to sex differences in the transmission, prevalence, and disease burden of STDs.[23]

Historically, medical research has primarily been conducted using the male body as the basis for clinical studies. The findings of these studies have often been applied across the sexes and healthcare providers have traditionally assumed a uniform approach in treating both male and female patients. More recently, medical research has started to understand the importance of taking sex into account as evidence increases that the symptoms and responses to medical treatment may be very different between sexes.[6]

Causes

Sex-related illnesses have various causes:[5]

  • Genetic sex differences start at conception depending on whether an ovum fuses with a sperm cell carrying an X or a Y chromosome. This leads to sex-based differences at the molecular level for all male and female cells.[5]
  • In males, the X chromosome carries only maternal imprints, while in females X chromosomes are present with both maternal and paternal imprints. In female cells, random processes of X-inactivation "turn off" the extra X chromosome. As a result, females, but not males, are mosaics. Female cells may express higher levels of some genes.[24][25][26]
  • Sex differences at the chromosome and molecular level exist in all human cells, and persist life-long, independent of sex hormones in the body.[5]
  • Sex-linked genetic conditions that differ in males and females may reflect the effects of genetic damage on an X chromosome. In some cases, the presence of an "extra" X chromosome in female cells may lessen the impact of such damage. In severe cases, males may die during development and females may survive but display a sex-linked illness.[24]
  • The reproductive system develops differently for each sex. Sex-specific parts of the male and female reproductive systems affect the rest of the body and also can be affected differently by diseases.[27]
  • Socially constructed norms relate to gender roles, relationships, positional power, and a wide variety of behaviours. Norms affect people differentially depending on their sex and gender.[5]
  • Different levels of prevention, reporting, diagnosis and treatment have been observed based on sex and gender.[5]

Women

Examples of clinically associated sex-differences in women:[6]

Men

Examples of clinically associated sex-differences in men:[6]

See also

References

  1. ^ Ngo, ST; Steyn, FJ; McCombe, PA (August 2014). "Gender differences in autoimmune disease". Frontiers in Neuroendocrinology. 35 (3): 347–69. doi:10.1016/j.yfrne.2014.04.004. PMID 24793874.
  2. ^ Barochiner, J; Aparicio, LS; Waisman, GD (2014). "Challenges associated with peripheral arterial disease in women". Vascular Health and Risk Management. 10: 115–28. doi:10.2147/vhrm.s45181. PMC 3956880. PMID 24648743.{{cite journal}}: CS1 maint: unflagged free DOI (link)
  3. ^ a b c Oertelt-Prigione, S.; Regitz-Zagrosek, V., eds. (2012). Sex and Gender Aspects in Clinical Medicine. London, UK: Springer. ISBN 978-1447160021.
  4. ^ Institute of Medicine (US) Committee on Understanding the Biology of Sex Gender Differences; Wizemann, T. M.; Pardue, M. L. (2001). Committee on Understanding the Biology of Sex and Gender Differences; Wizemann, Theresa M.; Pardue, Mary-Lou (eds.). Exploring the biological contributions to human health : does sex matter? ([Online-Ausg.] ed.). Washington, D.C: National Academy Press. doi:10.17226/10028. ISBN 978-0309072816. PMID 25057540.
  5. ^ a b c d e f g Mauvais-Jarvis, Franck; Merz, Noel Bairey; Barnes, Peter J.; Brinton, Roberta D.; Carrero, Juan-Jesus; DeMeo, Dawn L.; Vries, Geert J. De; Epperson, C. Neill; Govindan, Ramaswamy; Klein, Sabra L.; Lonardo, Amedeo; Maki, Pauline M.; McCullough, Louise D.; Regitz-Zagrosek, Vera; Regensteiner, Judith G.; Rubin, Joshua B.; Sandberg, Kathryn; Suzuki, Ayako (22 August 2020). "Sex and gender: modifiers of health, disease, and medicine". The Lancet. 396 (10250): 565–582. doi:10.1016/S0140-6736(20)31561-0. ISSN 0140-6736. PMC 7440877. PMID 32828189. Retrieved 11 November 2021.
  6. ^ a b c d e Regitz‐Zagrosek, Vera (July 2012). "Sex and gender differences in health: Science & Society Series on Sex and Science". EMBO Reports. 13 (7): 596–603. doi:10.1038/embor.2012.87. PMC 3388783. PMID 22699937.
  7. ^ Miller, Virginia M. (1 May 2020). "Universality of sex differences in cardiovascular outcomes: where do we go from here?". European Heart Journal. 41 (17): 1697–1699. doi:10.1093/eurheartj/ehaa310. PMC 7194182. PMID 32357237. Retrieved 11 November 2021.
  8. ^ Weatherald, Jason; Riha, Renata L.; Humbert, Marc (31 December 2021). "Sex and gender in lung health and disease: more than just Xs and Ys". European Respiratory Review. 30 (162): 210217. doi:10.1183/16000617.0217-2021. PMID 34750117. S2CID 243861859. Retrieved 11 November 2021.
  9. ^ a b Rose, NR; Bona, C (September 1993). "Defining criteria for autoimmune diseases (Witebsky's postulates revisited)". Immunology Today. 14 (9): 426–30. doi:10.1016/0167-5699(93)90244-F. PMID 8216719.
  10. ^ a b Hayter, SM; Cook, MC (August 2012). "Updated assessment of the prevalence, spectrum and case definition of autoimmune disease". Autoimmunity Reviews. 11 (10): 754–65. doi:10.1016/j.autrev.2012.02.001. PMID 22387972.
  11. ^ Greuter, Thomas; Manser, Christine; Pittet, Valerie; Vavricka, Stephan R.; Biedermann, Luc; Official working group of the Swiss Society of Gastroenterology (2020). "Gender Differences in Inflammatory Bowel Disease". Digestion. 101 (1): 98–104. doi:10.1159/000504701. ISSN 0012-2823. PMID 31995797. S2CID 210946741. Retrieved 11 November 2021.
  12. ^ van Kessel, Lente; Teunissen, Doreth; Lagro-Janssen, Toine (March 2021). "Sex-Gender Differences in the Effectiveness of Treatment of Irritable Bowel Syndrome: A Systematic Review". International Journal of General Medicine. 14: 867–884. doi:10.2147/IJGM.S291964. PMC 7979326. PMID 33758534.{{cite journal}}: CS1 maint: unflagged free DOI (link)
  13. ^ Bairey Merz, C. Noel; Dember, Laura M.; Ingelfinger, Julie R.; Vinson, Amanda; Neugarten, Joel; Sandberg, Kathryn L.; Sullivan, Jennifer C.; Maric-Bilkan, Christine; Rankin, Tracy L.; Kimmel, Paul L.; Star, Robert A. (December 2019). "Sex and the kidneys: current understanding and research opportunities". Nature Reviews Nephrology. 15 (12): 776–783. doi:10.1038/s41581-019-0208-6. ISSN 1759-507X. PMC 7745509. PMID 31586165. Retrieved 11 November 2021.
  14. ^ Bhargava, Aditi; Arnold, Arthur P; Bangasser, Debra A; Denton, Kate M; Gupta, Arpana; Hilliard Krause, Lucinda M; Mayer, Emeran A; McCarthy, Margaret; Miller, Walter L; Raznahan, Armin; Verma, Ragini (25 May 2021). "Considering Sex as a Biological Variable in Basic and Clinical Studies: An Endocrine Society Scientific Statement". Endocrine Reviews. 42 (3): 219–258. doi:10.1210/endrev/bnaa034. PMC 8348944. PMID 33704446. Retrieved 11 November 2021.{{cite journal}}: CS1 maint: PMC embargo expired (link)
  15. ^ Lauretta, R.; Sansone, M.; Sansone, A.; Romanelli, F.; Appetecchia, M. (21 October 2018). "Gender in Endocrine Diseases: Role of Sex Gonadal Hormones". International Journal of Endocrinology. 2018: 1–11. doi:10.1155/2018/4847376. PMC 6215564. PMID 30420884.
  16. ^ Murphy, William G. (March 2014). "The sex difference in haemoglobin levels in adults — Mechanisms, causes, and consequences". Blood Reviews. 28 (2): 41–47. doi:10.1016/j.blre.2013.12.003. PMID 24491804.
  17. ^ Clayton, Janine Austin (December 2016). "Sex influences in neurological disorders: case studies and perspectives". Dialogues in Clinical Neuroscience. 18 (4): 357–360. doi:10.31887/DCNS.2016.18.4/jclayton. PMC 5286721. PMID 28179807.
  18. ^ Institute of Medicine (2011). Sex Differences and Implications for Translational Neuroscience Research : Workshop Summary. Washington, DC: National Academies Press. ISBN 978-0-309-16124-4.
  19. ^ Rippon, Gina; Eliot, Lise; Genon, Sarah; Joel, Daphna (10 May 2021). "How hype and hyperbole distort the neuroscience of sex differences". PLOS Biology. 19 (5): e3001253. doi:10.1371/journal.pbio.3001253. ISSN 1545-7885. PMC 8136838. PMID 33970901. Retrieved 11 November 2021.{{cite journal}}: CS1 maint: unflagged free DOI (link)
  20. ^ Shansky, Rebecca M.; Murphy, Anne Z. (April 2021). "Considering sex as a biological variable will require a global shift in science culture". Nature Neuroscience. 24 (4): 457–464. doi:10.1038/s41593-021-00806-8. ISSN 1546-1726. PMID 33649507. S2CID 232091204. Retrieved 11 November 2021.
  21. ^ Zucker, Irving; Prendergast, Brian J. (5 June 2020). "Sex differences in pharmacokinetics predict adverse drug reactions in women". Biology of Sex Differences. 11 (1): 32. doi:10.1186/s13293-020-00308-5. ISSN 2042-6410. PMC 7275616. PMID 32503637. Retrieved 11 November 2021.{{cite journal}}: CS1 maint: unflagged free DOI (link)
  22. ^ Soldin, Offie P.; Mattison, Donald R. (2009). "Sex Differences in Pharmacokinetics and Pharmacodynamics". Clinical Pharmacokinetics. 48 (3): 143–157. doi:10.2165/00003088-200948030-00001. PMC 3644551. PMID 19385708.
  23. ^ Madkan, Vandana K.; Giancola, Angela A.; Sra, Karan K.; Tyring, Stephen K. (1 March 2006). "Sex Differences in the Transmission, Prevention, and Disease Manifestations of Sexually Transmitted Diseases". Archives of Dermatology. 142 (3): 365–370. doi:10.1001/archderm.142.3.365. PMID 16549716. Retrieved 10 November 2021.
  24. ^ a b c Migeon, Barbara R. (2014). Females are mosaics : X inactivation and sex differences in disease (Second ed.). Oxford: Oxford University Press. ISBN 9780199927531.
  25. ^ a b Migeon, Barbara R. (June 2007). "Why females are mosaics, x-chromosome inactivation, and sex differences in disease". Gender Medicine. 4 (2): 97–105. doi:10.1016/S1550-8579(07)80024-6. PMID 17707844. Retrieved 11 November 2021.
  26. ^ a b Brown, Carolyn (September 2007). "Patchwork women". Nature Genetics. 39 (9): 1043. doi:10.1038/ng0907-1043. ISSN 1546-1718. S2CID 32145544. Retrieved 11 November 2021.
  27. ^ Zimmermann, Kim Ann (22 March 2018). "Reproductive System: Facts, Functions & Diseases". Live Science. Retrieved 11 November 2021.
  28. ^ "Male Breast Cancer Treatment". National Cancer Institute. 2014. Archived from the original on 4 July 2014. Retrieved 29 June 2014.
  29. ^ a b Ursin, Rebecca L.; Klein, Sabra L. (29 September 2021). "Sex Differences in Respiratory Viral Pathogenesis and Treatments". Annual Review of Virology. 8 (1): 393–414. doi:10.1146/annurev-virology-091919-092720. ISSN 2327-056X. PMID 34081540.
  30. ^ Klein, Sabra L.; Flanagan, Katie L. (October 2016). "Sex differences in immune responses". Nature Reviews Immunology. 16 (10): 626–638. doi:10.1038/nri.2016.90. ISSN 1474-1741. PMID 27546235. S2CID 2258164. Retrieved 11 November 2021.
  31. ^ Khaled A. Alswat (1 Apr 2017). "Gender Disparities in Osteoporosis". Journal of Clinical Medicine Research. 9 (5): 382–387. doi:10.14740/jocmr2970w. PMC 5380170. PMID 28392857.
  32. ^ Diagnostic and statistical manual of mental disorders : DSM-5 (5 ed.). Washington: American Psychiatric Publishing. 2013. pp. 338–345. ISBN 978-0-89042-555-8.
  33. ^ American Psychiatric Association (2013). Diagnostic and Statistical Manual of Mental Disorders (Fifth ed.). Arlington, VA: American Psychiatric Publishing. pp. 345–349. ISBN 978-0-89042-555-8.
  34. ^ a b Zielonka, Daniel; Stawinska-Witoszynska, Barbara (2020). "Gender Differences in Non-sex Linked Disorders: Insights From Huntington's Disease". Frontiers in Neurology. 11: 571. doi:10.3389/fneur.2020.00571. ISSN 1664-2295. PMC 7358529. PMID 32733356.
  35. ^ Di Carlo A, Baldereschi M, Amaducci L, Lepore V, Bracco L, Maggi S, Bonaiuto S, Perissinotto E, Scarlato G, Farchi G, Inzitari D (January 2002). "Incidence of dementia, Alzheimer's disease, and vascular dementia in Italy. The ILSA Study". Journal of the American Geriatrics Society. 50 (1): 41–48. doi:10.1046/j.1532-5415.2002.50006.x. PMID 12028245. S2CID 22576935.
  36. ^ Andersen K, Launer LJ, Dewey ME, Letenneur L, Ott A, Copeland JR, et al. (December 1999). "Gender differences in the incidence of AD and vascular dementia: The EURODEM Studies. EURODEM Incidence Research Group". Neurology. 53 (9): 1992–97. doi:10.1212/wnl.53.9.1992. PMID 10599770. S2CID 22725252.
  37. ^ American Psychiatric Association (2013), Diagnostic and Statistical Manual of Mental Disorders (5th ed.), Arlington: American Psychiatric Publishing, pp. 160–68, ISBN 978-0-89042-555-8, retrieved 22 July 2016
  38. ^ Schmitt A, Malchow B, Hasan A, Falkai P (February 2014). "The impact of environmental factors in severe psychiatric disorders". Front Neurosci. 8 (19): 19. doi:10.3389/fnins.2014.00019. PMC 3920481. PMID 24574956.
  39. ^ Diagnostic and statistical manual of mental disorders: DSM-5 (5th ed.). Washington [etc.]: American Psychiatric Publishing. 2013. pp. 645, 663–6. ISBN 978-0-89042-555-8.
  40. ^ "Definition & Facts for Irritable Bowel Syndrome | NIDDK". National Institute of Diabetes and Digestive and Kidney Diseases. Retrieved 2019-07-04.
  41. ^ Clauw, Daniel J. (16 April 2014). "Fibromyalgia". JAMA. 311 (15): 1547–55. doi:10.1001/jama.2014.3266. PMID 24737367.
  42. ^ Mallampalli, Monica P.; Carter, Christine L. (2014). "Exploring Sex and Gender Differences in Sleep Health: A Society for Women's Health Research Report". Journal of Women's Health. 23 (7): 553–562. doi:10.1089/jwh.2014.4816. ISSN 1540-9996. PMC 4089020. PMID 24956068.
  43. ^ "Chronic fatigue syndrome". womenshealth.gov. 21 February 2017. Retrieved 13 May 2019.
  44. ^ Benarroch EE (December 2012). "Postural tachycardia syndrome: a heterogeneous and multifactorial disorder". Mayo Clinic Proceedings. 87 (12): 1214–25. doi:10.1016/j.mayocp.2012.08.013. PMC 3547546. PMID 23122672.
  45. ^ Mellers, JD (August 2005). "The approach to patients with 'non-epileptic seizures'". Postgraduate Medical Journal. 81 (958): 498–504. doi:10.1136/pgmj.2004.029785. PMC 1743326. PMID 16085740.
  46. ^ a b Romeo, Domenico; Sini, Francesca; Brogna, Claudia; Albamonte, Emilio; Ricci, Daniela; Mercuri, Eugenio (2016-04-21). "Sex differences in cerebral palsy on neuromotor outcome: a critical review". Developmental Medicine & Child Neurology. 58 (8): 809–813. doi:10.1111/dmcn.13137. PMID 27098195.
  47. ^ "Prostate vs. testicular cancer: Similarities and differences". Medical News Today. 25 October 2021. Retrieved 10 November 2021.
  48. ^ "U.S. National Library of Medicine". Archived from the original on 12 October 2007. Retrieved 2 December 2007.
  49. ^ Doblhammer, Gabriele; Gumà, Jordi (February 12, 2018). A Demographic Perspective on Gender, Family and Health in Europe. Springer. p. 78. ISBN 978-1013269073. Retrieved 11 November 2021.
  50. ^ "Men to get aneurysm screening". BBC. 5 January 2008. Retrieved 6 June 2016.
  51. ^ Newschaffer CJ, Croen LA, Daniels J; et al. (2007). "The epidemiology of autism spectrum disorders". Annu Rev Public Health. 28: 235–58. doi:10.1146/annurev.publhealth.28.021406.144007. PMID 17367287.{{cite journal}}: CS1 maint: multiple names: authors list (link)
  52. ^ Picchioni MM, Murray RM (July 2007). "Schizophrenia". BMJ. 335 (7610): 91–95. doi:10.1136/bmj.39227.616447.BE. PMC 1914490. PMID 17626963.
  53. ^ Alegria, Analucia A.; Blanco, Carlos; Petry, Nancy M.; Skodol, Andrew E.; Liu, Shang-Min; Grant, Bridget; Hasin, Deborah (July 2013). "Sex differences in antisocial personality disorder: results from the National Epidemiological Survey on Alcohol and Related Conditions". Personality Disorders. 4 (3): 214–222. doi:10.1037/a0031681. ISSN 1949-2723. PMC 3767421. PMID 23544428.
  54. ^ Galanter, Marc; Kleber, Herbert D.; Brady, Kathleen T. (17 December 2014). The American Psychiatric Publishing Textbook of Substance Abuse Treatment. doi:10.1176/appi.books.9781615370030. ISBN 978-1-58562-472-0.
  55. ^ World Cancer Report 2014. World Health Organization. 2014. pp. Chapter 5.4. ISBN 978-9283204299.
  56. ^ Montgomery, EA; et al. (2014). "Oesophageal Cancer". In Stewart, BW; Wild, CP (eds.). World Cancer Report 2014. World Health Organization. pp. 528–543. ISBN 978-9283204299.
  57. ^ Hefaiedh R; et al. (Aug–Sep 2013). "Gender difference in patients with hepatocellular carcinoma". La Tunisie Médicale. 91 (8–9): 8–9. PMID 24227507.{{cite journal}}: CS1 maint: multiple names: authors list (link)
  58. ^ Chaturvedi AK, Anderson WF, Lortet-Tieulent J, Curado MP, Ferlay J, Franceschi S, Rosenberg PS, Bray F, Gillison ML (December 2013). "Worldwide trends in incidence rates for oral cavity and oropharyngeal cancers". Journal of Clinical Oncology. 31 (36): 4550–9. doi:10.1200/jco.2013.50.3870. PMC 3865341. PMID 24248688.
  59. ^ Hertz, David; Schneider, Bianca (2019). "Sex differences in tuberculosis". Seminars in Immunopathology. 41 (2): 225–237. doi:10.1007/s00281-018-0725-6. ISSN 1863-2300. PMID 30361803. S2CID 53030554. Retrieved 2021-02-21.
  60. ^ O'Driscoll, David N.; McGovern, Matthew; Greene, Catherine; Molloy, Eleanor (2018-05-11). "Gender disparities in preterm neonatal outcomes". Acta Paediatrica. 107 (9): 1494–1499. doi:10.1111/apa.14390. PMID 29750838. S2CID 21676905. Retrieved 5 May 2021.