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American Journal of Men's Health Mar 2018Amitriptyline is an old drug but is still prevalently used as the first-line treatment for a variety of common diseases. Surprisingly, knowledge of sexual risks with... (Meta-Analysis)
Meta-Analysis Review
Amitriptyline is an old drug but is still prevalently used as the first-line treatment for a variety of common diseases. Surprisingly, knowledge of sexual risks with amitriptyline comes from only one clinical trial and several case reports from three decades ago. In the current study, a systematic review of the literature following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) related to amitriptyline and sexual dysfunction (SD) was performed. The frequency, gender-difference, types, disease-specificity and time course of SD, and the relationship between SD and nonsexual adversity were studied. A total of 14 publications, including 8 qualified randomized clinical trials, were eligible. The frequency of SD in overall, male and female patients was 5.7, 11.9 and 1.7%, respectively. SD was six-fold higher in men than women. The frequency of SD was 6.9% in depressive patients compared with 0.8% in non-depressive patients ( p = .008), and gradually decreased at 8 weeks after treatment ( p = .02). Amitriptyline impacted arousal and libido more than orgasm and ejaculation in male patients but mainly libido in female patients. SD was significantly correlated with insomnia linearly whereas somnolence and nausea dually. Therefore, amitriptyline-associated SD mainly occurs in depressive and male patients, disturbs each phase of the sexual response cycle in men but mainly libido in women, gradually decreases under long-term treatment, and can be predicted by the co-existence of insomnia, somnolence or nausea during treatment. Clinicians should caution and tailor the gender and disease vulnerability of amitriptyline in their practice.
Topics: Amitriptyline; Antidepressive Agents, Tricyclic; Depression; Humans; Male; Sexual Dysfunctions, Psychological
PubMed: 29019272
DOI: 10.1177/1557988317734519 -
Stem Cell Research & Therapy Apr 2023The increasing incidence of osteoporosis in recent years has aroused widespread public concern; however, existing effective treatments are limited. Therefore, new... (Meta-Analysis)
Meta-Analysis Review
BACKGROUND
The increasing incidence of osteoporosis in recent years has aroused widespread public concern; however, existing effective treatments are limited. Therefore, new osteoporosis treatment methods, including stem cell transplantation and exosome therapy, have been proposed and are gaining momentum. Exosomes are considered to have greater potential for clinical application owing to their immunocompatibility. This study summarises the latest evidence demonstrating the efficacy of exosomes in improving bone loss in the treatment of osteoporosis.
MAIN TEXT
This systematic review and meta-analyses searched PubMed, Embase, and Cochrane Library databases from inception to 26 March 2022 for osteoporosis treatment studies using stem cell-derived exosomes. Six endpoints were selected to determine efficacy: bone mineral density, trabecular bone volume/tissue volume fraction, trabecular number, trabecular separation, trabecular thickness, and cortical thickness. The search generated 366 citations. Eventually, 11 articles that included 15 controlled preclinical trials and 242 experimental animals (rats and mice) were included in the meta-analysis.
CONCLUSION
The results were relatively robust and reliable despite some publication biases, suggesting that exosome treatment increased bone mass, improved bone microarchitecture, and enhanced bone strength compared with placebo treatments. Moreover, stem cell-derived exosomes may favour anabolism over catabolism, shifting the dynamic balance towards bone regeneration.
Topics: Rats; Mice; Animals; Exosomes; Osteoporosis; Bone Density; Bone and Bones; Treatment Outcome
PubMed: 37038180
DOI: 10.1186/s13287-023-03317-4 -
Sleep Medicine Reviews Oct 2022Naps are increasingly considered a means to boost cognitive performance. We quantified the cognitive effects of napping in 60 samples from 54 studies. 52 samples... (Meta-Analysis)
Meta-Analysis Review
Naps are increasingly considered a means to boost cognitive performance. We quantified the cognitive effects of napping in 60 samples from 54 studies. 52 samples evaluated memory. We first evaluated effect sizes for all tests together, before separately assessing their effects on memory, vigilance, speed of processing and executive function. We next examined whether nap effects were moderated by study features of age, nap length, nap start time, habituality and prior sleep restriction. Naps showed significant benefits for the total aggregate of cognitive tests (Cohen's d = 0.379, CI = 0.296-0.462). Significant domain specific effects were present for declarative (Cohen's d = 0.376, CI = 0.269-0.482) and procedural memory (Cohen's d = 0.494, CI = 0.301-0.686), vigilance (Cohen's d = 0.610, CI = 0.291-0.929) and speed of processing (Cohen's d = 0.211, CI = 0.052-0.369). There were no significant moderation effects of any of the study features. Nap effects were of comparable magnitude across subgroups of each of the 5 moderators (Q values = 0.009 to 8.572, p values > 0.116). Afternoon naps have a small to medium benefit over multiple cognitive tests. These effects transcend age, nap duration and tentatively, habituality and prior nocturnal sleep.
Topics: Humans; Cognition; Executive Function; Sleep; Wakefulness
PubMed: 36041284
DOI: 10.1016/j.smrv.2022.101666 -
Health Psychology : Official Journal of... Dec 2016Medication side effects are common, often leading to reduced quality of life, nonadherence, and financial costs for health services. Many side effects are the result of... (Review)
Review
OBJECTIVES
Medication side effects are common, often leading to reduced quality of life, nonadherence, and financial costs for health services. Many side effects are the result of a psychologically mediated "nocebo effect." This review identifies the risk factors involved in the development of nocebo effects.
METHOD
Web of Science, Scopus, MEDLINE, PsycINFO, Journals@Ovid full text, and Global Health were searched using the terms "nocebo" and "placebo effect." To be included, studies must have exposed people to an inert substance and have assessed 1 or more baseline or experimental factor(s) on its ability to predict symptom development in response to the inert exposure.
RESULTS
Eighty-nine studies were included; 70 used an experimental design and 19 used a prospective design, identifying 14 different categories of risk factor. The strongest predictors of nocebo effects were a higher perceived dose of exposure, explicit suggestions that the exposure triggers arousal or symptoms, observing people experiencing symptoms from the exposure, and higher expectations of symptoms.
CONCLUSIONS
To reduce nocebo induced symptoms associated with medication or other interventions clinicians could reduce expectations of symptoms, limit suggestions of symptoms, correct unrealistic dose perceptions, and reduce exposure to people experiencing side effects. There is some evidence that we should do this especially for persons with at-risk personality types, though exactly which personality types these are requires further research. These suggestions have a downside in terms of consent and paternalism, but there is scope to develop innovative ways to reduce nocebo effects without withholding information. (PsycINFO Database Record
Topics: Adult; Drug-Related Side Effects and Adverse Reactions; Female; Humans; Male; Middle Aged; Nocebo Effect; Prospective Studies; Quality of Life; Risk Factors
PubMed: 27657801
DOI: 10.1037/hea0000416 -
Applied Psychology. Health and... May 2022Modern society is reviving the practice of aromatherapy, and lavender is reported being the most worldwide purchased plant for essential oil (EO) extraction. Since... (Review)
Review
Modern society is reviving the practice of aromatherapy, and lavender is reported being the most worldwide purchased plant for essential oil (EO) extraction. Since recent studies reported cognitive enhancing effects of lavender besides the hypno-inducing effects, a literature review is needed. Considering EO quality and diffusion devices, we conducted a systematic review on the effects of lavender EO inhalation on arousal, attention and memory in healthy subjects. Starting from this new multidisciplinary perspective, cognitive effects were reviewed to link outcomes to effective and reproducible protocols. A systematic search on MEDLINE, ERIC, PsycInfo, Google Scholar, and Scopus databases using Cognitive Atlas and plant-related keywords was conducted. Among the 1,203 articles yielded, 11 met eligibility criteria. Subjects administered with lavender EO displayed arousal decrease and sustained attention increase. Controversial results emerged regarding memory. Lack of EO quality assessment and protocols heterogeneity did not allow assessing whether different EO composition differentially modulates cognition and whether placebo effect can be discerned from EO effect itself. However, GABAergic pathway modulation exerted by linalool, a major lavender EO constituent, might explain cognitive functions empowerment. We speculate aromatherapy could be a burgeoning cognition enhancing tool, although further investigation is required to reach robust conclusions.
Topics: Administration, Inhalation; Aromatherapy; Cognition; Humans; Lavandula; Oils, Volatile
PubMed: 34611999
DOI: 10.1111/aphw.12310 -
Addiction (Abingdon, England) May 2023Substance use disorders (SUD) are associated with cognitive deficits that are not always addressed in current treatments, and this hampers recovery. Cognitive training...
AIMS
Substance use disorders (SUD) are associated with cognitive deficits that are not always addressed in current treatments, and this hampers recovery. Cognitive training and remediation interventions are well suited to fill the gap for managing cognitive deficits in SUD. We aimed to reach consensus on recommendations for developing and applying these interventions.
DESIGN, SETTING AND PARTICIPANTS
We used a Delphi approach with two sequential phases: survey development and iterative surveying of experts. This was an on-line study. During survey development, we engaged a group of 15 experts from a working group of the International Society of Addiction Medicine (Steering Committee). During the surveying process, we engaged a larger pool of experts (n = 54) identified via recommendations from the Steering Committee and a systematic review.
MEASUREMENTS
Survey with 67 items covering four key areas of intervention development: targets, intervention approaches, active ingredients and modes of delivery.
FINDINGS
Across two iterative rounds (98% retention rate), the experts reached a consensus on 50 items including: (i) implicit biases, positive affect, arousal, executive functions and social processing as key targets of interventions; (ii) cognitive bias modification, contingency management, emotion regulation training and cognitive remediation as preferred approaches; (iii) practice, feedback, difficulty-titration, bias modification, goal-setting, strategy learning and meta-awareness as active ingredients; and (iv) both addiction treatment work-force and specialized neuropsychologists facilitating delivery, together with novel digital-based delivery modalities.
CONCLUSIONS
Expert recommendations on cognitive training and remediation for substance use disorders highlight the relevance of targeting implicit biases, reward, emotion regulation and higher-order cognitive skills via well-validated intervention approaches qualified with mechanistic techniques and flexible delivery options.
Topics: Humans; Delphi Technique; Cognitive Training; Substance-Related Disorders; Behavior, Addictive; Consensus
PubMed: 36508168
DOI: 10.1111/add.16109 -
International Journal of Environmental... Sep 2022Several factors affect sexual function, including cancer development and treatment. This study summarized the risk of women with cancer of developing sexual dysfunctions. (Review)
Review
BACKGROUND
Several factors affect sexual function, including cancer development and treatment. This study summarized the risk of women with cancer of developing sexual dysfunctions.
METHODS
This systematic review was conducted according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA). We searched the EMBASE, PubMed, LILACS, SciELO, CINAHL, Scopus, and Web of Science databases using the descriptors cancer, neoplasms, sexual dysfunction, sexual function, and women. The Quality Assessment Tool for Observational Cohort and Cross-Sectional Studies assessed the quality of studies.
RESULTS
Sixteen studies were included in this review. Women with cancer presented sexual dysfunctions in 14 out of 16 included studies. The incidence of sexual dysfunctions ranged from 30% to 80%, while the risk of developing sexual dysfunction increased 2.7- and 3.5-fold in women with cervical and breast cancer, respectively.
CONCLUSION
Different cancer treatments increase the risk of developing sexual dysfunction in women, especially desire, arousal, and orgasm, leading to biopsychosocial changes in the health of this population.
Topics: Breast Neoplasms; Cross-Sectional Studies; Female; Humans; Longitudinal Studies; Sexual Dysfunction, Physiological; Sexual Dysfunctions, Psychological
PubMed: 36231221
DOI: 10.3390/ijerph191911921 -
Neuroscience and Biobehavioral Reviews Apr 2023We conducted a systematic review and a meta-analysis to quantitatively summarize evidence on the association between attention-deficit/hyperactivity disorder (ADHD) and... (Meta-Analysis)
Meta-Analysis Review
We conducted a systematic review and a meta-analysis to quantitatively summarize evidence on the association between attention-deficit/hyperactivity disorder (ADHD) and type 2 diabetes (T2D). Moreover, a register-based sibling study was conducted to simultaneously control for confounding factors. A systematic search identified four eligible observational studies (N = 5738,287). The meta-analysis showed that individuals with ADHD have a more than doubled risk of T2D when considering adjusted estimates (OR=2.29 [1.48-3.55], d=0.46). Results from the register-based Swedish data showed a significant association between ADHD and T2D (HR=2.35 [2.14-2.58]), with substance use disorder, depression, and anxiety being the main drivers of the association, and cardiovascular and familiar risk playing a smaller role. While results from the meta-analysis provide evidence for an increased risk of T2D in individuals with ADHD, the register-based analyses show that the association between ADHD and T2D is largely explained by psychiatric comorbidities. Pending further evidence of causal association, our findings suggest that early identification and treatment of ADHD comorbidities might greatly reduce the risk of developing T2D in individuals with ADHD.
Topics: Humans; Attention Deficit Disorder with Hyperactivity; Siblings; Diabetes Mellitus, Type 2; Comorbidity; Attention
PubMed: 36754221
DOI: 10.1016/j.neubiorev.2023.105076 -
Sexual Medicine Apr 2023Endometriosis can lead to a state of chronic inflammation marked by the presence of scarring and adhesions within the pelvis and/or other parts of the body. Recent... (Review)
Review
INTRODUCTION
Endometriosis can lead to a state of chronic inflammation marked by the presence of scarring and adhesions within the pelvis and/or other parts of the body. Recent estimates suggest that globally this condition affects approximately 10% of women in the reproductive age group.
AIMS
In this study we sought updated evidence on the association between endometriosis and sexual function in female patients.
METHODS
We used standard assessment tools to conduct a systematic search of the PubMed, EMBASE, and Scopus databases for observational studies that documented the association of endometriosis with female sexual function. A random-effects model was used for the analysis, and effect sizes were reported as the weighted mean difference (WMD) or OR with 95% CIs.
RESULTS
A total of 13 studies were selected for inclusion in our investigation. All of the included studies were cross-sectional in design. The data on sexual function in most of the studies were collected by using the Female Sexual Function Index (FSFI) tool, for which higher scores suggest better sexual function. The risk of sexual dysfunction (based on specific cutoffs for the FSFI score) was higher in women with than in women without endometriosis (OR 1.71; 95% CI, 1.21-2.43). In addition, when we used continuous scores to examine the risk of sexual dysfunction, diagnosis of endometriosis was associated with significantly lower overall FSFI scores (WMD, -3.40; 95% CI, -5.13 to -1.66) and lower scores on all of its 6 domains, ie, desire (WMD, -0.27; 95% CI, -0.53 to -0.02), arousal (WMD, -0.43; 95% CI, -0.79 to -0.07), lubrication (WMD, -0.49; 95% CI, -0.66 to -0.31), orgasm (WMD, -0.65; 95% CI, -1.07 to -0.23), satisfaction (WMD, -0.52; 95% CI, -0.77 to -0.26), and pain (WMD, -1.06; 95% CI, -1.57 to -0.55).
CONCLUSION
The findings of this study suggest that female patients with endometriosis have suboptimal sexual function compared with healthy female subjects. Patients with endometriosis should be offered sexual counseling and supportive care by a multidisciplinary team of gynecologists, psychologists, and sexual therapists.
PubMed: 37256217
DOI: 10.1093/sexmed/qfad026 -
Journal of Family Medicine and Primary... Mar 2023One of the causes of dissatisfaction between couples is sexual dysfunction that sometimes leads to divorce. The present systematic study was conducted to evaluate the... (Review)
Review
INTRODUCTION
One of the causes of dissatisfaction between couples is sexual dysfunction that sometimes leads to divorce. The present systematic study was conducted to evaluate the factors affecting sexual dysfunction and divorce in Iran.
METHOD
A comprehensive search, including keywords of sexual dysfunction, emotional divorce, breakaway, separation, conflict, and Iran, was conducted on the databases of Scopus, MEDLINE/PubMed, CINAHL, Web of Science, Magiran, IranMedex, and SID. Out of the total number of reviewed articles, 16 articles met the inclusion criteria. No time limit was considered for our research and all published articles up to November 2021 were reviewed.
RESULTS
Based on the results of the present study, in all of the reviewed articles, sexual problems and dissatisfaction were among the effective factors in the occurrence or request of a formal divorce or an emotional divorce. The data also demonstrated that weakness in arousal and sexual desire, weakness in sexual function, sexual disorders, orgasm problems, and pain were among the problems of people on the verge of divorce.
CONCLUSION
Due to the importance of this issue, recognizing the effective and influential factors of divorce is one of the priorities of mental health. Dissatisfaction with sexual relations in both or one of the spouses is found to be one of the most important factors involved in divorce. If there are problems such as sexual dysfunction between the couples, they may still live together due to cultural and social conditions; however, they may experience emotional divorce. Therefore, there is an urgent need for effective counseling and treatment programs in this regard.
PubMed: 37122645
DOI: 10.4103/jfmpc.jfmpc_991_22