Editorial: Differences in Pain Biology, Perception, and Coping Strategies: Towards Sex and Gender Specific Treatments

Gazerani, Parisa; Aloisi, Anna Maria; Ueda, Hiroshi

doi:10.3389/fnins.2021.697285

Cited by 10 publications

(7 citation statements)

References 34 publications

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“…Alternatively, as we identified severe mucositis by the need of opioid treatment, it could be argued that women report on pain more frequently than men. Although we were unable to analyse this aspect due to the retrospective nature of our study, it is conceivable that a lower threshold of asking for opioids may be reflecting gender specific coping strategies [22]. In our cohort, survival amongst men and women was comparable which may be reassuring on one hand.…”

Section: Discussionmentioning

confidence: 62%

Sex-Disaggregated Analysis of Biology, Treatment Tolerability, and Outcome of Multiple Myeloma in a German Cohort

Brioli¹,

Nägler²,

Yomade³

et al. 2022

Oncol Res Treat

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Introduction: Multiple Myeloma (MM) is a plasma cell disease that affects more men than women. Although there is an obvious imbalance in incidence, knowledge on differences in biology and outcome between the sexes is surprisingly rare. Methods: We performed a unicentric retrospective analysis of patients with MM treated at a tertiary cancer center between 2003 and 2018. Results: We present sex-disaggregated analysis of the characteristics and outcome of MM in a cohort of 655 patients (median age at diagnosis 62 years; 363 men with a median age at diagnosis 62 years and 292 women with a median age at diagnosis 63 years, p=0.086). Most patients (n=561, 86%) received myeloma-specific treatment. Median overall survival was 76 months (95% CI 63 – 89) (72 months in men [95% CI 54 – 90] and 83 months in women [95% CI 66 – 100], p=ns). Apart from a higher incidence of moderate and severe anaemia in women (p<0.001) there were no statistically significant differences in the biology of the underlying MM. Similarly, in the group of patients who received high-dose therapy with autologous stem cell transplantation (ASCT, n=313), no statistically significant differences apart from more frequent anaemia in women were detected regarding the biology of the disease. However, there was a trend towards a higher plasma cell infiltration of the bone marrow and towards more frequent high-risk features in women. In contrast, relevant comorbidities were significantly more common in men (for example coronary heart disease in 13% of men vs. 2% of women, p<0.001). Toxicities after ASCT were not significantly different between the sexes with the exception of severe mucositis, which occurred in 22% of men vs. 40% of women (p=0.001). Conclusion: In conclusion, this first sex-disaggregated analysis of MM patients in Germany supports previous findings that survival is comparable amongst sexes, but women experience more toxicity of high-dose therapy. The higher incidence of clinically relevant anaemia in women warrants further investigation to exclude underlying treatable causes.

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Section: Discussionmentioning

confidence: 62%

Sex-Disaggregated Analysis of Biology, Treatment Tolerability, and Outcome of Multiple Myeloma in a German Cohort

Brioli¹,

Nägler²,

Yomade³

et al. 2022

Oncol Res Treat

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“…According to Samulowitz et al (2022), men showed lower emotional social support (OR = 0.54 (95 CI 0.39–0.74) [ 64 ]. Conversely, social and emotional skills have traditionally been associated with women in the Traditional Hegemonic Femininity Model, while the capacity for decision-making and self-confidence is related to the THMM [ 65 , 66 ]. Regarding the latter, men tend to have more instrumental support in the tasks and management of care and disease.…”

Section: Discussionmentioning

confidence: 99%

Understanding the Impact of Chronic Non-Cancer Pain on Daily Life from a Gender Perspective Using the PAIN_Integral Scale©

Cáceres-Matos,

Vázquez-Santiago,

Pabón-Carrasco

et al. 2024

Healthcare

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The experience of chronic non-cancer pain differs between women and men due to gender-related factors. This study (1) assessed the difference in responses to the impact of chronic non-cancer pain on daily life in women and men using the PAIN_Integral Scale© and (2) evaluated its invariance through multigroup confirmatory factor analysis. This was conducted by means of an analysis of invariance through a multigroup confirmatory factor analysis. A cross-sectional sample of 400 participants over 18 years of age with Chronic Non-Oncological Pain in Pain Units and Primary Care Centres belonging to the Spanish Public Health System was recruited (January to March 2020). An analysis was performed to assess whether any of the items in the instrument showed different behaviours. All analyses were performed using AMOS® v.26 software. The results showed that the structure of the PAIN_Integral© Scale remained adequate when analysing its invariance in women and men, showing no metric, scalar and/or strict invariance. Therefore, these results indicated that the PAIN_Integral Scale© instrument has a different interpretation for women and men, identifying eight items with a singular functioning in both sexes and belonging to the subscales of proactivity, resilience and support network. These findings can be explained by gender stereotypes, since the dimensions where there are differences have an important social burden.

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“…Studies of experimentally induced pain have observed that women exhibit greater pain sensitivity, enhanced pain facilitation (ie, central sensitisation) and reduced pain inhibition compared with men 17. There is also some evidence suggesting sex differences in responses to pharmacological and non-pharmacological pain management strategies 18 19. Furthermore, gender biases in pain assessment and treatment appear to exist,20 which could significantly impact perioperative pain management practices and related outcomes of patients undergoing surgery 17.…”

Section: Discussionmentioning

confidence: 99%

Developing a risk stratification tool for predicting opioid-related respiratory depression after non-cardiac surgery: a retrospective study

et al. 2022

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ObjectivesAccurately assessing the probability of significant respiratory depression following opioid administration can potentially enhance perioperative risk assessment and pain management. We developed and validated a risk prediction tool to estimate the probability of significant respiratory depression (indexed by naloxone administration) in patients undergoing noncardiac surgery.DesignRetrospective cohort study.SettingSingle academic centre.ParticipantsWe studied n=63 084 patients (mean age 47.1±18.2 years; 50% men) who underwent emergency or elective non-cardiac surgery between 1 January 2007 and 30 October 2017.InterventionsA derivation subsample reflecting two-thirds of available patients (n=42 082) was randomly selected for model development, and associations were identified between predictor variables and naloxone administration occurring within 5 days following surgery. The resulting probability model for predicting naloxone administration was then cross-validated in a separate validation cohort reflecting the remaining one-third of patients (n=21 002).ResultsThe rate of naloxone administration was identical in the derivation (n=2720 (6.5%)) and validation (n=1360 (6.5%)) cohorts. The risk prediction model identified female sex (OR: 3.01; 95% CI: 2.73 to 3.32), high-risk surgical procedures (OR: 4.16; 95% CI: 3.78 to 4.58), history of drug abuse (OR: 1.81; 95% CI: 1.52 to 2.16) and any opioids being administered on a scheduled rather than as-needed basis (OR: 8.31; 95% CI: 7.26 to 9.51) as risk factors for naloxone administration. Advanced age (OR: 0.971; 95% CI: 0.968 to 0.973), opioids administered via patient-controlled analgesia pump (OR: 0.55; 95% CI: 0.49 to 0.62) and any scheduled non-opioids (OR: 0.63; 95% CI: 0.58 to 0.69) were associated with decreased risk of naloxone administration. An overall risk prediction model incorporating the common clinically available variables above displayed excellent discriminative ability in both the derivation and validation cohorts (c-index=0.820 and 0.814, respectively).ConclusionOur cross-validated clinical predictive model accurately estimates the risk of serious opioid-related respiratory depression requiring naloxone administration in postoperative patients.

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Editorial: Differences in Pain Biology, Perception, and Coping Strategies: Towards Sex and Gender Specific Treatments

Cited by 10 publications

References 34 publications

Sex-Disaggregated Analysis of Biology, Treatment Tolerability, and Outcome of Multiple Myeloma in a German Cohort

Sex-Disaggregated Analysis of Biology, Treatment Tolerability, and Outcome of Multiple Myeloma in a German Cohort

Understanding the Impact of Chronic Non-Cancer Pain on Daily Life from a Gender Perspective Using the PAIN_Integral Scale©

Developing a risk stratification tool for predicting opioid-related respiratory depression after non-cardiac surgery: a retrospective study

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