Attention-deficit/hyperactivity disorder (ADHD) may be common, but it’s also sometimes hard to spot.

ADHD is usually first diagnosed in childhood and is one of the most common neurodevelopmental disorders in children, according to the Centers for Disease Control and Prevention (CDC).

Symptoms of ADHD in kids can include trouble paying attention, difficulty controlling impulsive behaviors and displaying periods of hyperactivity.

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But how these symptoms show up in boys versus girls, and eventually in men versus women, can make a big difference in diagnosis.

Sabrina Nasta, a licensed mental health counselor with Grow Therapy in Orange Park, Florida, told Fox News Digital that ADHD can show up in three different ways: through inattention, hyperactivity and a combination of the two.

In women, ADHD most commonly manifests as inattention, which includes an inability to pay attention, distractibility and lack of compliance, according to Nasta.

In men, ADHD occurs in a hyperactive way, causing issues with sitting still or wanting to be constantly "doing something," said the expert.

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McCall Letterle, head of U.S. commercial operations for ADHD assessment company Qbtech, also commented on these differences in a conversation with Fox News Digital.

Athough many of the symptoms, including hyperactivity, inattention and impulsivity, are the same, it’s how the symptoms "manifest themselves" that causes a variation between males and females, the Atlanta-based expert noted.

A struggle with discipline seems to be a commonality of ADHD in men and women based on their lifestyle and age, Nasta added.

In young boys, for example, ADHD shows up as "unnecessary" hyperactive energy; they "don’t have the capacity to not do anything," the expert said.

In girls, the same inattentiveness may arise, but it's most likely internalized.

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"They may be sitting in the classroom, they may be sitting still, but they're not paying attention," Nasta said.

"It's tough because for a girl, it looks like they're rebelling or being disobedient, [but] for a boy, [it seems that] they're just being ridiculous and hyper."

The differences in ADHD presentation have led to a "massive amount of underdiagnosed women," according to Letterle.

"This [disorder] was first researched in males, and the criteria developed around symptoms most commonly seen in boys," she told Fox News Digital. 

"These are also the most overtly obvious symptoms — like hyperactivity, inability to sit still, disruption and difficulty focusing, often in the classroom — that lead to associated behavioral issues," Letterle added.

While some women do experience these hyperactive symptoms, they are not the most prevalent symptoms and they look different when they do occur, according to Letterle.

"Women tend to exhibit symptoms that are more internalized," she said. 

"For instance, their inattention is much harder to recognize than boys, as it can be displayed as daydreaming or inward distraction."

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Letterle pointed out the "external fallout" of these ADHD symptoms in girls — which results in "high rates of anxiety" due to missed information at school.

In many cases, girls have to work twice as hard to retain information and meet academic standards as their peers, and they experience low levels of confidence stemming from these difficulties, she added.

"That is subjectively a lot harder to identify than distracted boys, who are poking the individual next to them as they struggle to maintain focus."

These variants lead to a "massive difference in diagnostic rates" between young girls and boys, Letterle said.

Boys are often diagnosed and treated faster than girls because their symptoms are easier to identify, she added.

One of the best ways to cope with ADHD is to educate yourself, or your child, on the best way to function in different environments, said Nasta.

Some of the strategies she recommended include practicing mindfulness and self-awareness, and coming up with the best game plan in any given situation.

Stress management is another great coping tool, especially for boys, added Nasta.

For kids, stress management can mean participating in leisure activities or hobbies like playing video games or hanging out with friends.

"It's about allowing them to let that energy go in a more supportive way," Nasta said.

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ADHD in boys and girls can be difficult for caretakers — parents, guardians and even teachers — to identify when they lack the "appropriate tools" to make "more accurate referrals," Letterle noted.

To overcome that challenge, Nasta encouraged caretakers to "listen more."

"If you’re really paying attention and your kid’s trying, this could be a neurological or neurodevelopmental concern versus them just struggling with emotions," she said.

It might be helpful for parents to "be more curious" and ask their children questions about their feelings when they are overwhelmed, Nasta suggested.

"What do you experience when you're overwhelmed? Are you able to focus or pay attention to your teacher? Do you notice what your thoughts are doing?" she listed as example questions.

"If it sounds really concerning and intrusive, I would say that's the point of … seeing a professional."

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Early ADHD intervention is "critical for reducing suicide rates, job instability and substance abuse in those left untreated," Letterle said.

"The diagnostic process has been left largely to subjective rating scales, creating a desperate need for clinicians to start adopting a more data-driven approach to symptom measurement," she added.

"Objective data compares performance in the three core symptom areas against age- and sex-matched controls without ADHD — meaning women are compared to other women to improve the ability to accurately identify their diagnosis," the expert said.

While the term "ADHD" is often tossed around to describe when someone is feeling unfocused, Nasta listed a few warning signs that could point to an actual diagnosis.

The expert said to monitor daily responsibilities such as hygiene, finances, academics and even basic social skills such as listening and communication.

"If you notice impairments and deficits in any of those, I would say that would be the time to talk to somebody," she advised.

For people who are unsure of their symptoms, Letterle recommended seeking out a provider who uses objective data in a comprehensive evaluation.

"[This] would help to better ensure not only a more accurate diagnosis, but also one that helps eliminate the bias that often leads to high rates of underdiagnosis or misdiagnosis in women," she said.

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Santo Domingo.- Addressing the need for specialized personnel, medical infrastructure, and state-of-the-art technology in Eastern Santo Domingo, with a population of more than one million two hundred thousand people, the region will have access to high-quality healthcare services under international standards for the first time, thanks to the opening of Médico Express San Isidro in the second quarter of 2024.

Its implementation will create over two hundred direct and four hundred indirect jobs in 8,500 square meters (about the area of a Manhattan city block) of construction. It will spread across four levels, nineteen consulting rooms, and two intelligent operating rooms that integrate protocolized and humane care with nature, creating a flexible and optimal therapeutic environment.

In May 2022, President Luis Abinader, alongside the Minister of Tourism, David Collado, led the groundbreaking ceremony of Médico Express with investors and cofounders, Dr. Alejandro Cambiaso, CEO, and Francesco Fino, VP of Sales, unveiling its disruptive and accessible model that represents a paradigm shift in the construction, operation, and provision of healthcare services in the country.

Dr. Cambiaso emphasized that this initiative marks the initial step towards establishing a modern network of ambulatory healthcare centers distributed across diverse regions of the national geography. The project boasts an investment of over one billion pesos and financial support from the Closed Fund for Development of Companies – Advanced Investment Opportunities (FCDS AOI), managed by Advanced Asset Management, Lazul Inversiones, and Banco de Desarrollo y Exportaciones (BANDEX).

Medico Express complies with the local habilitation standards of the Ministry of Public Health and under The American Institute of Architects (AIA) standards, with significant local and international strategic alliances aimed at strengthening Dominican medical tourism.

This new healthcare services proposal is born under the concept of ambulatory clinical and surgical assistance centers, with emergency services, advanced diagnostic imaging with artificial intelligence, clinical laboratory, cardiology department, pediatrics, gynecology, preventive medicine, dentistry, women’s clinic, modern ophthalmology and gastroenterology units, an international department, and significant medical specialties.

Technology and innovation in service

Médico Express San Isidro will be a pioneer Eastern Santo Domingo in multiple technologies and procedures. To facilitate access to the center and continuity of care, it will have a mobile application for scheduling appointments and viewing results, along with telemedicine and software that will integrate electronic medical records, images, and administrative modules.

Strategic location

The proximity of Médico Express San Isidro to Las Américas International Airport and the port of Santo Domingo, positions the healthcare center as a strategic access point to meet the demand for medical services in the area, the community of Dominicans residing outside the country, Caribbean islands, and cruise ship passengers. The center will accept local medical insurance plans, including primary coverage and major international and traveler insurance plans.

Santo Domingo.- Ophthalmologist Judith Portorreal, specializing in keratoconus, dry eye, and contact lenses, has issued a warning about potential visual issues arising from temperature changes in the Dominican Republic.

The expert emphasized that the ongoing cold front and increased wind in the country are contributing to a rise in allergies and dry eyes among the population.

“We are witnessing an increase in the proliferation of mites and mold inside homes, leading to allergy symptoms. Simultaneously, outdoor exposure brings particles of dust, pollen, fungi, and bacteria carried by the wind, irritating the eyes and promoting tear evaporation, leading to infections,” she explained.

Portorreal highlighted that individuals experiencing rhinitis, sneezing, coughing, sore throat, and itchy eyes are likely undergoing an episode of eye allergy. She pointed out that if the eyes also feel burning, as if there is dirt, and appear red, it indicates a combination of allergy and dry eyes.

Moreover, the ophthalmologist noted that allergies can exacerbate dry eye symptoms, and conversely, dry eye can worsen allergy symptoms.

To mitigate these issues, the expert recommended wearing sunglasses outdoors for protection, frequent face washing, the use of artificial tears, and, if problems persist, seeking consultation with an ophthalmologist.

San Francisco de Macorís, DR.- The “More Health, More Life Expectancy” program was officially launched in an event led by the Vice President and Health Cabinet Coordinator, Raquel Peña. This initiative, supported by the Pan American Health Organization/World Health Organization (PAHO/WHO), is part of the HEARTS Strategy, focusing on enhancing Primary Care for preventing and managing cardiovascular diseases and diabetes within the Public Health Care Units (UNAP).

The program’s primary objective is to ensure the free distribution of essential medications, following clinical guidelines for hypertension and diabetes, to individuals over 45 years of age. This includes those under the subsidized regime, as well as pensioners and retirees.

Vice President Raquel Peña emphasized that the program will harness the collective efforts of the entities within the Health Cabinet to ensure timely and free treatment for individuals with hypertension and diabetes. The initiative aims to address non-communicable diseases that impact life expectancy and promote healthier living.

Additionally, the program seeks to alleviate the financial burden on underprivileged families facing the challenges of these diseases. Vice President Peña expressed her dismay at families having to beg for medicine and stated that the program marks the end of such hardships with the commencement of free medication distribution.

Minister of Health, Víctor Atallah, highlighted that the program signals the beginning of a nationwide health improvement initiative, starting from the Duarte province. He emphasized the significance of addressing diabetes and hypertension, the two diseases that most affect health in the country, and commended the progress made with the implementation of the “More Health, More Life Expectancy” program.

Minister Atallah urged medical professionals to embrace the program, undergo training, and adhere to care protocols. He also encouraged patients to obtain their medications and follow their treatment diligently. The minister expressed gratitude for the efforts of PAHO in supporting this crucial healthcare initiative.

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San Francisco de Macorís, DR.- The Ministry of Education of the Dominican Republic (Minerd), in collaboration with the Public Ministry, is currently investigating an incident involving 22 students and five teachers from the Max Henríquez Ureña school in the municipal district of Cenoví, Duarte province. The individuals experienced health problems following the fumigation of an area near the educational center.

To address this matter, personnel from the General Directorate of the School Police, along with educational authorities, conducted thorough surveys to ensure compliance with legal procedures.

The health issues arose around 9 in the morning during a mass celebrating Ash Wednesday. According to reports, students were the first to detect the presence of chemicals in the environment.

The preliminary report indicates that cases of students experiencing symptoms like dizziness and nausea were documented. Simultaneously, some teachers reported skin allergies and vomiting.

Jocelyn Jiménez Concepción, the campus director, along with the affected students and teachers, were promptly transported to various health centers in the vicinity. They received treatment and were subsequently discharged. The investigation is ongoing to determine the circumstances and address any potential implications in accordance with the law.

Santiago, DR.- Continuing to make strides in modern medicine, renowned North American urologist David Samadi achieved a significant milestone in the Dominican Republic. Performing five robotic surgeries for prostate cancer in a single day at the Samadi-HOMS Robotic Institute of the Metropolitan Hospital of Santiago, he emphasized the uniqueness of their program in the country.

Describing it as groundbreaking news, Dr. Samadi highlighted the extraordinary capability of their robotic surgery program, positioning it as a distinctive and exceptional offering in the Dominican Republic. He credited the vision of the President of the Administrative Council at Hospital Metropolitano de Santiago HOMS for making these medical feats possible.

A decade ago, the president recognized the impact of robotic surgery on medicine and health, leading to the collaboration with Dr. Samadi in the Dominican Republic. Over the years, hundreds of patients have benefitted from robotic surgeries, not only for prostate cancer but also in fields such as kidney surgery, gynecology, bariatric surgery, and more.

Dr. Samadi, considered a pioneer in robotic surgery in the country, has been providing Dominican patients with the best procedures for prostate cancer for the past ten years. His approach focuses on reducing the risk of complications, minimizing scars, ensuring a high success rate, facilitating quick recovery, and significantly improving sexual life by 85%.

As one of five surgeons in New York State qualified to perform robotic prostatectomy using the Da Vinci robotic system, Dr. Samadi has an impressive professional record, having conducted 10,000 surgeries with a 96% success rate. Additionally, he is recognized as one of the few surgeons in the United States trained in oncology, open surgery, and advanced minimally invasive treatments for prostate cancer.

Santo Domingo.- This Wednesday, the Ministry of Public Health disclosed that the country recorded 197 fresh cases of coronavirus within the past week, based on 5,271 samples collected nationwide for disease detection.

According to the weekly bulletin from the ministry, the cumulative number of confirmed COVID-19 cases in the Dominican Republic stands at 188. Notably, there are currently no individuals hospitalized due to the virus.

The latest statistics indicate a weekly positivity rate of 6.74%, with the positivity rate for the last four weeks calculated at 10.09%.

Overall, the Dominican Republic has documented a total of 675,890 COVID-19 cases, with the death toll remaining at 4,384 since August 2022.

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Santo Domingo—For several months, there has been an acute shortage of insulin in the country’s private pharmaceutical sector, especially one of the most widely used, type 70/30.

The situation has forced patients to go to the Instituto de la Diabetes (INDEN) and the Farmacias del Pueblo in search of the product, which still has a supply but is registering a high increase in demand.

This shortage is generating serious difficulties for patients with diabetes who require the use of insulin as an indispensable treatment for the control of their condition and who acquire the drug in the private sector, especially those with type 1 diabetes, who are insulin-dependent, as well as concern among endocrinologists and diabetologists.

The drug is also used by about 40% of patients who have type 2 diabetes, which is estimated to occupy 90% of the people living with this condition in the country, where studies indicate that about two million people live with diabetes or more than 13% of the Dominican population is affected by this condition of increased blood sugar.

The shortage of medicine in the private market and the difficulties for the supply were confirmed to Listín Diario by the president of the Dominican Society of Endocrinology and Nutrition, Sherezade Hazbún; the executive director of the Union of Pharmacies, Scarlet Sánchez; the director of the National Institute of Diabetes and Nutrition (INDEN), Ammar Ibrahim and the executive director of the Program of Essential Medicines (PROMESE/CAL), Adolfo Pérez and Arelys Mercedes, president of the Dominican Society of Diabetology.

They assured that the shortage of the product affects the private sector but that this does not occur with the hospitals of the Public Network that have maintained their rhythm of use without alteration, nor the People’s Pharmacies or the Diabetes Institute, since they have a stop of the medicine in stock due to their large volume purchase and long-term agreements with their international suppliers.

ARAPF EXPLAINS CAUSES
Regarding the problem, the Association of Representatives, Agents and Pharmaceutical Producers, Inc. (ARAPF) explained that currently, the global production of drugs related to glycemic control for insulin-dependent diabetic patients faces significant challenges in planning due to the shortage of an essential component for the manufacture of insulin, as a result of the increase in the number of patients with diabetes.

“This situation has resulted in a worldwide shortage of the product, recently affecting the Dominican Republic. This decrease in availability has been manifested mainly in the vial presentation, as it is the one most commonly used by the population; however, in the pencil type presentation the supply has been stable and has not presented any affectation in a general way”, affirms the entity in declarations offered to Listín Diario.

It points out that the relevant institutions have the necessary availability to respond to the immediate needs, and the pharmaceutical laboratories “which we represent assure to have shipments on the way, with availability to guarantee the access of this to the patients.”

The organism understands that “this feeling of shortage” should not be prolonged and that this type of medicine will be supplied regularly in the next few days, so it should not represent a significant situation for the Dominican healthcare system.

Likewise, when confirming the supply difficulties, Sanchez said that the Pharmacy Union does not know the causes of the problems that the laboratories or the industrial sector have in supplying the insulin demand that the pharmacies have, but that for months, they have been observing that when they receive the order, especially the insulin 70/30 units, it is immediately sold out in the chain of pharmacies that they represent.

SIX-MONTH SUPPLY
The PROMESE director also assured that the medicine is guaranteed in the Farmacias del Público and that they have enough of the product in stock for the next six months due to the planning done and the purchase agreements signed with suppliers.

“Even if the private sector were to run out completely, we at PROMESE have enough to guarantee insulins to patients for the next few months,” he said, recalling that worldwide there are difficulties because Ukraine is one of the leading suppliers of insulin and biosimilars in the world. It has been affected by the war with Russia.

USE IN COMBINATION
Ibrahim explained that the most significant shortage is observed in the 70/30, which is a mixture of the NPH human insulin 70 units of rapid insulin and 30 units, so if a patient runs out, he can go to his doctor and ask him to explain that he can take 70 of one and 30 of the other because it can be combined since the mixture was made to avoid the patient having two punctures at the same time.

He said that INDEN still has a drug supply and that the manufacturers promise new deliveries before the end of this month. He assured us that they have been supplying a large part of the patients who go there in search of the drug.