Women Face Poorer Outcomes After Burn Injury

Accidental burns are one of the most common household injuries, often arising from exposure to hot surfaces or liquids. Yet, burns can also be caused by exposure to certain chemicals, electricity, sunlight, or fire. While the majority of accidental burns are minor, and can be treated at home – some burns require immediate medical treatment.

Types of Burns
Burns vary in severity depending on how many layers of skin are damaged. For example: 

  • First degree burns affect only the top layer of skin, known as the epidermis.
  • Second degree burns extend partially into the dermis.
  • Third degree burns damage the entire dermal layer.
  • Fourth degree burns extend beyond the skin into the fat, muscle, and bone.

In addition, the amount of skin, or total surface area, damaged by a burn can also impact its severity.

Sex Differences in Burn Prevalence and Treatment Outcomes
According to the American Burn Association, burn injuries are more common in men than women (68% vs. 32%, respectively). However, a recent study published in the journal Burns & Trauma, found that women are less likely to survive from a serve burn injury compared to men [1]. The authors examined the medical records of over 300 patients admitted to a hospital burn unit with similar burn severity and total amount of skin affected. They found that women were two times more likely to die from a burn injury, compared to men of the same age. Systemic infections, such as sepsis, are a leading cause of death following a severe burn injury. The authors suggest that sex differences in immune response following a severe burn could differ between men and women, but caution that additional research is needed to support their clinical observations.  

For more information on burn injuries consider visiting the following resources:
National Library of Medicine
American Burn Association
Centers for Disease Control – Burn Prevention

Reference:
Karimi et al., Burns Trauma. 2017;5:18. doi: 10.1186/s41038-017-0083-y. eCollection 2017.

Women More Likely to Face Readmission after Heart Attack

Over 2.7 million women in the United States have suffered from a heart attack [1]. Yet, compared to men, heart attacks remain underdiagnosed, understudied, and undertreated in women [2]. A recent study published in the International Journal of Cardiology examined the medical records of 667 patients who were diagnosed with a heart attack [3]. The authors found that women were 1.5 times more likely to be readmitted to the hospital within the first 30 days of a heart attack. Interestingly, women were also more likely to be readmitted for a secondary heart attack or subsequent heart failure compared to men. These findings are consistent with larger population studies [4,5] and in younger patient groups [6].

The authors suggest that several factors may influence the higher rate of readmission.  First, women in this study were older and more likely to have co-morbidities such as chronic kidney disease or diabetes, which may inherently increase the risk of future heart failure. In addition, sociological factors such as quality of life might contribute to readmission. Women are more likely to suffer from depression following a heart attack and, in turn, depression has been linked to an increased risk of cardiovascular disease. However, the authors note that compared to other reports which suggest women may not receive timely or guideline-specific treatment for heart attacks [2,7], their study did not identify any differences in medical treatment between men and women. Together, this may indicate that women may need additional health management and monitoring to prevent readmission following a heart attack. 

For more information on women and heart disease, consider the following resources:
Northwestern Medicine Program for Women’s Cardiovascular Health
American Heart Association: Go Red for Women

References: 
1. Mozaffarian et al., Circulation. 2015; 131(4):e29-e322.   
2. Mehta et al., Circulation. 2016;133:916-947.
3. Lundbäck et al., Int J Cardiol. 2017; E-pub ahead of print.
4. Chaudhry et al., J Am Heart Assoc. 2014; 3(5): e001197.
5. Dreyer et al., Circulation. 2017 Feb 7;135(6):521-531.
6. Dreyer et al., Circulation. 2015 Jul 21;132(3):158-66.
7. Choi et al., Am J Emerg Med. 2016;34(10):1939-1943.

The WHRI Celebrates National Women’s Health Week

The Women’s Health Research Institute joins the U.S. Department of Health and Human Services in celebrating National Women’s Health Week from May 14th through May 20th! The WHRI encourages you to make your health and well-being a top priority. This week we will feature additional information and resources on our blog and social media related to this year’s theme: Your Health at Every Age. Stay connected with us by following us on Twitter (@WomensHealthNU) or on Facebook.

Additional National Women’s Health Week resources can be found through the:
U.S. Department of Health and Human Services, Office of Women’s Health
Illinois Department of Public Health

Sex Not Reported in Most Genetic Studies

One might wonder how biological sex may be over looked in human genetic studies, given that the genome itself contains a glaring sex-difference: the presence or absence of the Y chromosome. However, a recent commentary published in the journal, Biology of Sex Differences, highlights the fact that human genetic studies often overlook or under-report sex differences [1]. Similar to trends in other fields, the authors found that only 1% of studies which look for genetic links to diseases and disorders, otherwise known as genome-wide association studies, report results based on sex. They posit that while investigators are more than likely considering sex-differences, the complex datasets generated by genome-wide studies are typically analyzed by simple statistical methods in order to identify the most significant results. Thus, the data may not be analyzed directly by sex to increase statistical power. Alternatively, data sets which are analyzed by sex, but do not identify any apparent sex-differences, may never be reported. The authors provide the following recommendations for incorporating sex into genetic study design:

  • Perform separate analyses on male and female data 
  • Utilize publically-available data sets to increase sample size
  • Encourage journals to require the reporting of sex statistics.

To read the full article, “From sexless to sexy: Why it is time for human genetics to consider and report analyses of sex,” click here.  

References:

1. Powers et al., Biology of Sex Differences. 2017; 8:15 

Sex-Based Research Given a Spotlight at National Conference

This weekend, Chicago will see an influx of scientists amongst its many visitors, as the Experimental Biology meeting will be held from April 22nd – April 26th at McCormick Place. The Experimental Biology meeting is the annual gathering for 6 scientific societies, drawing in over 13,000 attendees each year. During the week-long meeting, attendees will come together to discuss recent breakthroughs and advances in the fields of anatomy and physiology, biochemistry and molecular biology, pathology, pharmacology, and nutrition. In addition, attendees may find themselves learning more about the role of sex and gender in health and disease.

The American Physiological Society will host several sessions throughout the Experimental Biology meeting with a focus on sex-based research and the inclusion of these practices in the medical and graduate classrooms. Sessions topics will include: 

  • Curricular Innovation in Sex and Gender Based Medical Physiology Education
  • Sex Differences in Physiology and Pathophysiology
  • Sex Differences in Obesity and Cardiovascular Disease
  • Sex differences in Diabetes, Obesity and Blood Pressure Control

The WHRI applauds the American Physiological Society for providing a platform for sex-based research on the national level. These sessions give visibility to sex-inclusive research practices and promote discussion of sex and gender influences in science and medicine.

More information about the Experimental Biology meeting or its participating societies can be found here

NU Medical Students Keep Women’s Health at Forefront

Throughout the 2016-2017 academic year, Northwestern University medical students have taken an active role in advancing women’s health. Students participated in workshops and activities sponsored by the Feinberg School of Medicine (FSM) Chapter of the American Medical Women’s Association (AMWA). The events incorporated aspects of women’s health while providing students an opportunity to improve their clinical skills, engage with faculty members, and advocate on behalf of their future patients.

Natasha Rich, a 2nd-year medical student and co-president of the FSM-AMWA chapter, finds these extracurricular activities to be particularly rewarding. “There is a strong interest amongst our members to gain additional training and experience in the unique aspects of women’s health and care that may not necessarily be covered on the day to day in the classroom,” she states.  


Students learn how to incorporate sexual health history into a routine exam. 

Recent AMWA-sponsored activities have included workshops on obtaining sexual health histories and recognizing intimate partner violence. In January, a group of medical students participated in the Chicago Women’s March. “Many of our members are passionate advocates for their communities and patients,” Rich shares. “As women and future physicians, students who participated in the march wanted to express their desire to protect their patient's [access] to healthcare.” 


FSM-AMWA members participate in the Chicago Women's March on January 21st, 2017. 

Students involved with the FSM-AMWA chapter are integrating women’s health into the classroom, clinic, and beyond. To learn more about their efforts or to become a member please contact Prianka Raju (prianka.raju@northwestern.edu) or Annika Nielsen (annika.nilsen@northwestern.edu). Medical, physician assistant, and physical therapy students, regardless of gender, are encouraged to become members. 

Sex-Specific Treatment Suggested for Women with Gout

Gout is a form of inflammatory arthritis which affects over 8.3 million adults in the United States [1]. It stems from the build-up of uric acid, a common chemical found in the body.  When uric acid is over-produced, it can form tiny crystals which are deposited into joints of the toes, feet, wrists and fingers, causing arthritic pain. A recent study published in the journal BMC Musculoskeletal Disorders found that women may experience gout differently than men [2]. The study analyzed health information from 1237 patients who have been diagnosed by rheumatologists with gout. Women with gout were more likely to have their work and daily activities impaired by the disease as compared to men. In addition, women with gout typically had other health issues such as high blood pressure, diabetes, and kidney disease. This may indicate that women with gout may benefit from customized treatment plans due to their co-existing health conditions.

If you are interested in learning more about gout please consider checking out the following resources: 

References: 

  1. Centers for Disease Control 
  2. Harrold et al., BMC Musculoskelet Disord. 2017;18(1):108.