GENDER MEDICINE

in eight of nine (90%). Average HF tended to decrease from 304 + 195.6 msec 2 to 283.2 + 182.7 msec 2 (P = 0.59). Average LF/HF tended to decrease from 2.14 + 0.90 to 2.08 + 1.16 (P = 0.33). C o n c l u s i o n : Kampo therapy was effective for improving symptoms suffered from peri-menopausal auto- nomic imbalance. Further study needs to evaluate the rela- tion between the autonomic activity and Kampo therapy.

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p63 and Notch Pathway in Male Germ Cell Tumors Tetsuo Hayashi; Soichiro Yoshida; Atsushi Yoshinaga; Rena Ohno; Nobuyuki Ishii; Toshiya Terao; and Takumi Yamada Department of Urology,, Saitama Medical Center, Saitama Medical School, Kawagoe, Saitama, Japan The male germ cell tumor is uniquely radio-sensitive and chemo-curable and the balance between differentiation and apoptosis of male germ cells is governed by TAp63, one of p63 isoforms, through the Notch pathway and p53 target genes. Therefore, we examined the expressions of p63, Notch 1, and Jagged 2 in testicular germ cell tumors with the aim of evaluating their possible relationship with the pathogenesis of germ cell tumors. TAp63, Notch 1, and Jagged 2 mRNAs were expressed in non-cancerous testicular tissues, and p63; Notch 1 and Jagged 2 proteins were de- tectable in germ cells. In seminomas, Notch 1 and Jagged 2 mRNAs were expressed at low level, whereas TAp63 mRNA was highly expressed, and the tumor cells were negative for Notch 1 and Jagged 2 proteins, while p63 protein was detectable. On the other hand, in embryonal carcinomas and choriocarcinomas, TAp63 and Jagged 2 mRNAs were expressed at low level, whereas Notch 1 mRNA was highly expressed, and tumor cells were negative for p63 and Jagged 2 proteins but Notch 1 protein was detectable. In teratomas, TAp63, Notch 1, and Jagged 2 mRNAs were highly expressed and p63, Notch 1 and Jagged 2 proteins were detectable. Our results offer, for the first time, the possibility that the activity of the p63 and Notch pathway correlates with the different histological subtypes of male germ cell tumors, which may be responsible for characteristics of cancer cells such as responses to chemotherapy and/or irradiation.

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Gender Differences, Morbidity, and Mortality: The Danish Experiences. Register-Based Analyses Combined with Reflections About Stress as Mediator of Disease Karin Helweg-Larsenl; and Birgit Petersson 2 iNational Institute of Public Health, Copenhagen, Denmark; and 2University off Copenhagen, Denmark Few countries have access to comprehensive data about all hospital contacts and thus to analyse gender differences in cause-specific health care contacts in relation to gender dif- ferences in risk factors and mortality. Based upon data in the Danish National Patient Register and data from 1689 Danish women and 1392 Danish men between 45 and 55 years from different professional groups, we analyse trends in morbidity among men and women in a context that consider gender specificity and gender differences in correlations between risk factors, morbidity, and mortality.

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The trend in mean life expectancy in Denmark differs from comparable countries and there are less gender differences in life expectancy than in most other OECD countries. The relatively low life expectancy is due to a higher mortality among 45-64-year-olds and can partly be explained by life- style factors, primarily tobacco smoking. These factors may also contribute to the relatively small gender differences in cardiovascular diseases, lung cancer, and chronic obstruc- tive lung disease. However, a number of other factors relat- ed to female living conditions in Denmark may also explain gender differences in general morbidity and disease-specific morbidity for example in autoimmune diseases and related conditions. The trend in morbidity and mortality among men and women in Denmark illuminates gender-specific differences in physiology and reactions to risk factors and contributes to knowledge about basic sex differences.

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Abdominal Aortic Aneurysms in Women Rebecka Hultgrenl; Emma Larssonl; Fredrik Granath2; and Jesper Swedenborg 1 iDepariment of Vascular Surgery, Karolinska Instituter, Karolinska University Hospital, Stockholm, Sweden; and 2Department for Medical Statistics, Karolinska Instituter, Karolinska University Hospital, Stockholm, Sweden B a c k g r o u n d : Abdominal aortic aneurysm (AAA) is a com- mon and potentially lethal condition due to rupture. It is 4-6 times more common in men. A different distribution of risk factors possibly contributes to this difference. Women have a higher mean age when treated, are more often reject- ed for surgery, and possibly have poorer postoperative results. Aim: To identify the number of interventions and mortali W for women and men treated for ruptured and non- ruptured AAA in Sweden. M e t h o d : All patients treated for AAA 1987-2002 were identified in the registries of the National Board of Health and Welfare. Age, sex, diagnosis, surgical procedure, and short and long term mortali W were extracted. Resul t s : 10,302 Men and 1961 women were iden- tified. 47 Persons/one million inhabitants were treated in 1987 compared to 105 in 2002. 8193 were treated for non- ruptured and 4070 for ruptured AAA. Standardised mortali W rates were significantly higher for women compared to men (2.96 vs 1.94), a difference explained by higher mortality from cardiovascular causes. Thir W percent of all women were treated for ruptured aneurysms compared to 33% of men (P < 0.001). ThirW-day mortality rates were equal for women and men (17.1% vs 16.7%). C o n c l u s i o n : A growing number in the population are treated. Comparison of report- ed prevalence rates with the number of treated, indicates that too few women are treated. Women do not have a high- er postoperative mortali W but those surviving surgery have a higher mortali W rate than the control population, a differ- ence which is less profound for men with AAA.

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Reasons for Gender Differences in Prescription of Drug Therapies in Rheumatoid Arthritis- Results from the Database of the German Collaborative Arthritis Centres Doerte Huscher; Katja Thiele; Carolin Weber; a n d Angela Zink

POSTER PRESENTATIONS

DRFZ-Deutsches Rheuma-Forschungszentrum Berlin, Berlin, Germany Purpose: In a previous analysis of age and disease duration matched pairs, we found differences in prescription of drag treatments between female and male patients inconsistent with observed disease parameters in these groups. We exam- ined in detail the reasons for these differences. Methods: We analysed data from the national database of the German Collaborative Arthritis Centres for the year 2003, gathered from 8770 outpatients with rheumatoid arthritis in continu- ous rheumatologic care. Results: Comparing the patients according to the intensity of their reported pain, men with medium pain (4-6 on a VAS 0-10) were more often prescribed analgesics than women. In all three groups (low, medium and high pain) men got more frequently high-dose cortico- steroids which are known to increase the risk of osteoporosis. Without showing differences in age, women got about 10% more osteoporosis treatments after controlling for corticoste- roid intake. Controlling for disease activity, there was a sys- tematic difference in prescription rates of disease modifying antirheumatic drags (DMARDs): women received more fre- quently drags with lower efficacy and better tolerability, while standard therapy with methotrexate was more often prescribed for men. The percentage of combination therapy with more than one DMARD was also higher in men. Age and disease duration could only partly explain the differ- ences. Conclusion: Although we controlled for expected determinants of prescription behaviour, differences in pre- scription rates according to gender remained. These dispari- ties suggest that decision making concerning drug treatment might be different for men and women.

40 Detection of Bad Treatments in Female Population's Sample in a Primary Health Care Center in Barcelona M. Teresa Icarta; Anna M. Pulpon-Seguraa; M. Ca rmen Icart2; Assumpta RigoP; Ruth Martin2; Julia Mena2; Rosa Garcia2; Ocar Sanchez2; and Montser ra t Garcia 3 iNursing School, University of Barcelona, Spain; 2primary Health Care Center (PHCC), Barcelona, Spain; and 3Freelance Objectives: To identify the abuse in a sample of women that goes for diverse reasons to consultations at the Primary Health Care (PHC) of Barcelona (Spain). To determine the association among abuse and the answers obtained in the subscales of anxiety and depression. To identify the forma- tive training needs regarding gender violence of the nurses involved in the studied consultations. Methodology: The study was carried over the course of five consultations of PHC; in 2005, a cross-sectional design was used. A random- ized sample of 110 women was selected over 18 years old who attended consultations of PHC for any kind of acute or chronic diseases. A survey was done to study the women's anxiety and depression; the scale of Goldberg was used. Finally by means of a focal group, the formative needs were identified regarding gender violence. Results: A sample of 110 women was studied with a mean age of 54.83 years old (SD: 13.49); 85% were married (95% CI: 79-81%). Positive results in the scale of anxiety were obtained for 64% (95% CI: 55-73%) of those surveyed, and in that of depression 72% (95% CI: 64-88%) of those interviewed. Twelve women

expressed having been mistreated and insulted, and 8 were victim of abuse by their husbands. No significant differ- ences were observed between the abuse and the anxiety or the depression; 24% affirmed that they would participate in a self-help group related to the gender violence. Main form- ative needs were learning how to detect gender violence in the common consultation. Conclusions: Anxiety and de- pression affect more than half of the interviewed women, it would be advisable to follow-up with these patients. The nursing staff says that their formative necessities with regards to gender violence are not covered mainly in what refers to capacity of the early detection of the cases.

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Arteriosclerosis of Common Carotid Artery After Menopause Masae Ikeda; Shun- ichi ro Izumi; Takayo Murano; Akira Mori; Ken-ichi Goya; Takahiro Suzuki; Hidehiko Matsubayashi; Liyi Cai; and Kazumi Takahashi Tokai University, School of Medicine, Isehara City, Japan Objective: We tried to elucidate the influence of meno- pause on atherogenesis. Methods: A group of 72 postmeno- pausal women were classified into subgroups based on dura- t ion of the postmenopausal period (PMP): Group PM1 (1-2 years; n = 16), PM4 (2-6 years; n = 16), PM8 (6-10 years; n = 25), and PM12 (10-15 years; n = 15). The control group consisted of 24 volunteers with regular menstruat ion (PMO). The diameter pulse waveform and intima-media thickness (IMT) of the common carotid artery (CCA) was measured using a phase-locked echo tracking system coupled with B-mode ultrasonography. The stiffness index (SI) was calcu- lated from the waveform and the systemic blood pressure. Blood was obtained to determine the fasting lipid profile, which was used as a reflection of the atherogenic state. Results: When compared to control, significant and pro- gressive increases were noted in total cholesterol and low density lipoprotein (PM1, PM4, PM8, PM12), IMT (PM8, PM12), and SI (PM1, PM4, PM8, PM12). Further significant and progressive reductions were noted in pulse amplitude of CCA diameter (PM1, PM4, PM8, PM12) and MIV and cere- bral perfusion (PM8, PM12). Conclusion: The postmeno- pausal increase in CCA stiffness and lipid profile occurs ear- lier than the increase in IMT and may be a more sensitive predictor of an accelerated atherogenic state.

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Clinical Effects of Zataria Multiflora Essential Oil on Primary Dysmenorrhea Mina Iravani School of Nursing and Midwifery, Islamic Azad University, Dezful Branch, Dezful, Iran Objective: The purpose of the study was to determine the efficacy of Zataria Multiflora essential oil for the treatment of primary dysmenorrhea. Methods: This study was a random- ized, double-blind, controlled, clinical trail. Thirty-six adoles- cents 18-24 years, with moderate to severe dysmenorrhea evaluated for 3 cycles. In the first cycle, the cases were treated by placebo; in the second cycle, essence of Zataria Multi- flora with 1% concentration; and in the third cycle, essence with 2% concentration, was prescribed at the beginning of pain feeling (25 drops q4h orally). Intensity of pain was

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