Este estudo teve por objetivo avaliar a influência da terapia hormonal sobre a pressão ocular de mulheres na pós-menopausa. A amostra foi constituída por 58 olhos de 58 pacientes no período da pós-menopausa, com indicação de terapia hormonal, com idade entre 41 e 65 anos, que não tenham utilizado hormônio nos últimos três meses. As pacientes foram randomizadas (por sorteio) em dois grupos: terapia hormonal contínua (n=32) com comprimidos de estradiol 2 mg e acetato de noretisterona 1 mg, diário durante três meses e grupo controle placebo (n=26). O estudo foi realizado de forma cega pela investigadora principal. As pacientes foram avaliadas quanto à pressão ocular, paquimetria, ceratometria e dosagens dos hormônios sexuais pré e pós-tratamento. A média de idade foi de 54,21 anos ± 4,95, sendo 53,66 anos ± 5,60 no grupo com terapia hormonal e de 54,88 anos ± 4,01 no grupo placebo. Não houve diferença significativa entre os grupos com relação a idade (p= 0,352), índice de massa corporal (p= 0,818), pressão ocular (p=0,697), ceratometria (p > 0,05), paquimetria central (p=0,580), e dosagens dos hormônios sexuais (p>0,05) no pré-tratamento. A pressão ocular média pré-tratamento foi de 14,08 mmHg ± 1,96 no grupo terapia hormonal e de 13,81 mmHg ± 3,28 no grupo placebo. Houve redução significativa da pressão ocular média entre o pré e o pós-tratamento (p=0,0009) no grupo terapia hormonal e redução não significativa no grupo placebo (p=0,108). Na avaliação entre os grupos, não houve diferença estatística nos valores de pressão ocular média no pós-tratamento. Na avaliação entre os grupos, não houve diferença estatisticamente significativa para os valores de paquimetria e ceratometria. O grupo com terapia hormonal apresentou aumento significativo dos níveis hormonais de estradiol e redução significativa nas dosagens hormonais médias de LH e FSH no pós-tratamento com 30, 60 e 90 dias (p=0,000). As dosagens hormonais no grupo placebo não apresentaram variação estatisticamente significante. No grupo terapia hormonal, houve correlação diretamente proporcional entre as pressões oculares médias e níveis hormonais de LH e FSH, e correlação inversamente proporcional com níveis hormonais de estradiol. Em resumo, houve redução da pressão ocular média no grupo terapia hormonal entre o pré e o pós-tratamento e os níveis pressóricos neste grupo se correlacionaram com os níveis hormonais de LH, FSH e estradiol / This trial aimed to assess the influence of hormonal therapy on intraocular pressure in post-menopausal women. The sample had 58 eyes of 58 patients during menopause period, indicated for hormonal therapy, they were between the age of 41 and 65 years, who have not taken hormone in the past three months. Patients were randomized (raffle) in two groups: continuous hormonal therapy (n=32) with 2 mg of estradiol and 1 mg daily of norethisterone acetate for three months and controlled placebo group (n=26). It was a blind study carried out by the main investigator. Patients were assessed regarding ocular pressure, pachymetry, keratometry and sex hormone\'s dosages, pre and post treatment. The average was 54.21 years old ± 4.95, where 53.66 years old ± 5.60 in the group with hormonal therapy and 54.88 years old ± 4.01 in the placebo group. There was no significant difference between the groups regarding age (p= 0.352), body mass index (p= 0.818), ocular pressure (p=0.697), keratometry (p > 0.05), central pachymetry (p=0.580), and sex hormone dosages (p>0.05) during pre treatment. The average pre treatment pressure was 14.08 mmHg ± 1.96 in the hormonal therapy group and 13.81 mmHg ± 3.28 in the placebo group. There was a significant reduction in the average ocular pressure between the pre and post treatment (p=0.0009) in the hormonal therapy group and not a significant reduction in the placebo group, (p=0.108). There was no statistically difference between the groups in the average ocular pressure values after treatment. There were no statistically significant differences between the two groups in the values of pachymetry and keratometry. The hormonal therapy group showed a significant increase in estradiol hormonal levels and a significant reduction in the average hormonal dosages of LH e FSH in the post treatment after 30, 60 and 90 days (p=0.000). The hormonal dosages in the placebo group no showed significant changed. In the hormonal group, there was a direct and proportional relation between the average ocular pressure and LH and FSH hormonal levels and a proportional contrariwise correlation with estradiol hormonal levels. In summary, there was a reduction in the ocular pressure average in the hormonal therapy group between the pre and post treatment and the pressure levels in this group were correlated with the hormonal levels of LH, FSH and estradiol

La fibrillation auriculaire (FA) est l’arythmie cardiaque la plus fréquente et elle peut entraîner des complications médicales sévères, notamment des accidents vasculaires cérébraux. On observe des différences sexuelles importantes dans la présentation clinique de la FA. Son incidence est 1,5 à 2 fois plus élevée chez les hommes, tandis que les femmes tendent à développer de la FA plus tardivement et plus sévèrement. Malheureusement, on ignore toujours les causes de ces différences sexuelles. La FA est une pathologie multifactorielle généralement causée par un débalancement des propriétés électrophysiologiques et/ou structurelles des oreillettes favorisant l’initiation et/ou le maintien de cette arythmie. Le but de ce projet est de déterminer s’il existe des différences sexuelles parmi les mécanismes impliqués dans la pathogenèse de la FA chez la souris. Sachant que les hormones sexuelles peuvent avoir un impact considérable sur l’électrophysiologie cardiaque, un objectif complémentaire de ce projet est de déterminer la contribution des hormones sexuelles dans les différences observées. Au cours de ce projet, nous avons découvert que la prédisposition masculine à la FA est également retrouvée chez la souris mâle. Nous avons identifié des différences sexuelles dans la régulation du calcium intracellulaire favorisant l’initiation de la FA chez les mâles. Celles-ci sont reliées à une expression et une activité plus élevée de l’échangeur Na+-Ca2+ chez les mâles. Nous avons également observé que le maintien de la FA était favorisé par des oreillettes de plus grande taille et par une latéralisation plus prononcée des connexines chez les mâles. L’orchiectomie réduit la susceptibilité des mâles à la FA en diminuant la latéralisation des connexines ainsi que la taille des cardiomyocytes auriculaires, suggérant un rôle des androgènes. À terme, ce projet permettra de mieux comprendre les mécanismes impliqués dans les différences sexuelles dans la pathogenèse de la FA. Une meilleure compréhension de ces mécanismes pourrait mener à une approche thérapeutique mieux adaptée au sexe des patients, pour une meilleure prise en charge de ceux-ci. / Atrial fibrillation (AF) is the most common type of cardiac arrhythmia, and it can lead to severe medical complications, including stroke. There are significant sex differences in the clinical presentation of AF. Its incidence is 1.5- to 2-fold higher in men, whereas women tend to develop AF later and more severely. Unfortunately, the mechanisms underlying these sex differences remain unknown. AF is a multifactorial pathology generally caused by an imbalance in electrophysiological and/or structural properties of the atria that promote AF initiation and/or maintenance. The aim of this project is to determine whether there are sex differences among the mechanisms involved in the pathogenesis of AF in mice.. Knowing that sex hormones can have a considerable impact on cardiac electrophysiology, a complementary objective of this project was to explore the contribution of sex hormones in the sex differences we observed. We first discovered that the male predisposition to AF is also found in mice. We have identified major sex differences in the regulation of intracellular calcium that promote AF initiation in males. These differences are related to a higher Na+-Ca2+ exchanger expression and function in males. We have also observed that AF maintenance was favoured by larger atria and more pronounced lateralization of connexins in males. Orchiectomy reduced AF susceptibility of males by reducing connexin lateralization and the dimensions of atrial myocytes, suggesting a role for androgens. Ultimately, this project will provide a better understanding of the mechanisms underlying sex differences in the pathogenesis of AF. This information could lead to a therapeutic approach better adapted to the sex of the patients, for a better management of AF.

La cognition sexuellement polymorphique (CSP) résulte de l'interaction entre des facteurs biologiques du sexe (sexe assigné à la naissance, hormones sexuelles) et psychosociaux du genre (identité de genre, rôles de genre, orientation sexuelle). La littérature reste assez mitigée quant à la magnitude des effets de ces variables. Seules quelques études ont considéré la CSP au-delà du sexe assigné à la naissance. Dans ces quelques études, ces facteurs supplémentaires liés au sexe et au genre n’ont été pris en compte qu’individuellement. Ce projet a utilisé une batterie de tests cognitifs classiques conçus pour évaluer l'influence des hormones sexuelles sur les performances cognitives. Parallèlement, nous avons cherché à évaluer les effetsrespectifs du sexe assigné à la naissance, des hormones sexuelles et des facteurs psychosociaux liés au genre sur la CSP. Nous avons recruté 222 adultes qui ont effectué huit tâches cognitives évaluant diverses fonctions cognitives au cours d'une session protocolaire de 150 minutes. Les sous-groupes ont été divisés comme suit : hommes cisgenres hétérosexuels (n = 46), hommes cisgenres non hétérosexuels (n = 36), femmes cisgenres hétérosexuelles (n = 36), femmes cisgenres non hétérosexuelles (n = 38), et personnes issues de la diversité de genre (n = 66). Des échantillons de salive ont été prélevés avant, pendant et après les tests cognitifs pour mesurer les niveaux de testostérone, d'estradiol, de progestérone, de cortisol et de déhydroépiandrostérone. Les variables psychosociales ont été adressées via des questionnaires autorapportés validés. La batterie cognitive présentée reflète des différences entre les sexes qui sont partiellement en concordance avec la littérature. Il est intéressant de noter que les facteurs biologiques semblent expliquer les différences de performances dans les tâches cognitives genrées «masculines» (par exemple, spatiales), tandis que les facteurs psychosociaux semblent expliquer les différences de performances dans les tâches cognitives genrées «féminines» (par exemple, verbales). Nos résultats fournissent une base solide pour une meilleure compréhension de la CSP en allant au-delà du sexe assigné à la naissance en tant que variable binaire. Nous soulignons l'importance de considérer le sexe comme un facteur biologique et le genre comme un facteur socioculturel, tous deux associés de manière unique à la CSP. / Sexually polymorphic cognition (SPC) results from the interaction between biological sex (birth-assigned sex, sex hormones) and psychosocial gender (gender identity, gender roles, sexual orientation) factors. The literature remains quite mixed regarding the magnitude of the effects of these variables. Only few studies consider SPC beyond birth-assigned sex. From these studies, other sex and gender factors were considered individually. This project used a battery of classic cognitive tests designed to assess the influence of sex hormones on cognitive performance. At the same time, we aimed to assess the inter-related and respective effects that birth-assigned sex, sex hormones, and gender-related psychosocial factors have on SPC. We recruited 222 adults who completed eight cognitive tasks that assessed a variety of cognitive domains during a 150-minute session. Subgroups were recruited as follows: cisgender heterosexual men (n = 46), cisgender nonheterosexual men (n = 36), cisgender heterosexual women (n = 36), cisgender non-heterosexual women (n = 38), and gender diverse (n = 66). Saliva samples were collected before, during, and after the test to assess testosterone, estradiol, progesterone, cortisol, and dehydroepiandrosterone. Psychosocial variables were derived from self-report questionnaires. The cognitive battery presented reflects gender differences that are partially consistent with the literature. Interestingly, biological factors seem to explain differences in male-typed cognitive tasks (e.g., spatial), while psychosocial factors seem to explain differences in female-typed cognitive tasks (e.g., verbal). Our results provide a solid foundation for a better understanding of SPC by going beyond birth-assigned sex as a binary. We highlight the importance of treating sex as a biological factor and gender as a sociocultural factor both uniquely associated with SPC.