-
British Journal of Sports Medicine Aug 2021We systemically reviewed the literature to assess how long-term testosterone suppressing gender-affirming hormone therapy influenced lean body mass (LBM), muscular area,...
How does hormone transition in transgender women change body composition, muscle strength and haemoglobin? Systematic review with a focus on the implications for sport participation.
OBJECTIVES
We systemically reviewed the literature to assess how long-term testosterone suppressing gender-affirming hormone therapy influenced lean body mass (LBM), muscular area, muscular strength and haemoglobin (Hgb)/haematocrit (HCT).
DESIGN
Systematic review.
DATA SOURCES
Four databases (BioMed Central, PubMed, Scopus and Web of Science) were searched in April 2020 for papers from 1999 to 2020.
ELIGIBILITY CRITERIA FOR SELECTING STUDIES
Eligible studies were those that measured at least one of the variables of interest, included transwomen and were written in English.
RESULTS
Twenty-four studies were identified and reviewed. Transwomen experienced significant decreases in all parameters measured, with different time courses noted. After 4 months of hormone therapy, transwomen have Hgb/HCT levels equivalent to those of cisgender women. After 12 months of hormone therapy, significant decreases in measures of strength, LBM and muscle area are observed. The effects of longer duration therapy (36 months) in eliciting further decrements in these measures are unclear due to paucity of data. Notwithstanding, values for strength, LBM and muscle area in transwomen remain above those of cisgender women, even after 36 months of hormone therapy.
CONCLUSION
In transwomen, hormone therapy rapidly reduces Hgb to levels seen in cisgender women. In contrast, hormone therapy decreases strength, LBM and muscle area, yet values remain above that observed in cisgender women, even after 36 months. These findings suggest that strength may be well preserved in transwomen during the first 3 years of hormone therapy.
Topics: Adipose Tissue; Androgen Antagonists; Athletic Performance; Body Composition; Cyproterone Acetate; Estradiol; Female; Hematocrit; Hemoglobin A; Humans; Male; Muscle Strength; Muscle, Skeletal; Sports; Testosterone; Time Factors; Transgender Persons; Transsexualism
PubMed: 33648944
DOI: 10.1136/bjsports-2020-103106 -
Journal of Affective Disorders Dec 2021Anxiety disorders are amongst the most commonly diagnosed mental illnesses amongst men; however male-specific anxiety research is lacking. This review explores men's... (Review)
Review
AIM
Anxiety disorders are amongst the most commonly diagnosed mental illnesses amongst men; however male-specific anxiety research is lacking. This review explores men's anxiety symptoms and disorders including help-seeking, coping and the role of masculinity.
METHOD
Four electronic database searches identified 8,333 citations, with 25 studies meeting inclusion criteria. Nineteen studies employed quantitative methods, five studies reported qualitative research, and one utilised mixed methods.
RESULTS
Unique profiles of anxiety, including psychosomatic symptoms, were identified and persisted over extended periods of time. Men commonly reported self-reliance over formal help-seeking, and typically managed anxiety symptoms through problem-based coping. Masculinity was related to anxiety in complex ways; adherence to norms of toughness could be protective against anxiety onset, while adherence to emotional restrictiveness and heterosexual presentation norms were positively associated with anxiety. The experience of, and help-seeking for anxiety transgressed many men's adherence to masculinity norms resulting in significant social and self-stigmas.
LIMITATIONS
The anxiety measurement scales utilised were inconsistent across included studies and there was limited scope of research into panic disorders, phobias and agoraphobia.
CONCLUSION
Findings demonstrate the enduring nature of anxiety for men and a potential under-reporting of symptoms, especially amongst younger men. To better tailor clinical care and public health resources to the needs of men with anxiety disorders, targeted research examining men's lived experiences of (and coping strategies for) anxiety is essential.
Topics: Anxiety; Anxiety Disorders; Humans; Male; Masculinity; Men; Men's Health; Social Stigma
PubMed: 34517242
DOI: 10.1016/j.jad.2021.08.136 -
Functional Plant Biology : FPB Sep 2021Phytophthora spp. are the causal agents of gummosis or foot rot, fibrous root rot, and fruit brown rot diseases that affect the roots, trunk, and fruits of citrus trees,...
Phytophthora spp. are the causal agents of gummosis or foot rot, fibrous root rot, and fruit brown rot diseases that affect the roots, trunk, and fruits of citrus trees, causing severe economic losses. This work presents an updated systematic review addressing the defence responses in citrus against Phytophthora and the strategies to manage Phytophthora diseases. Applying a new method of search based on an explicit, rigorous, and transparent methodology. For this purpose, a systematic literature review was conducted using the databases available for academic research. The main plant defence mechanisms reported in the cited papers are the hypersensitivity response, cell wall reinforcement, production of pathogenesis-related proteins, and expression of defence-related genes. Moreover, the main strategies to manage Phytophthora root rot are organic compounds in the soil and biological control with fungi and bacteria. In addition, inhibition of Phytophthora gummosis or canker by applying new oomycota fungicides and reducing the incidence of brown fruit rot through the application of potassium phosphite have also been reported. Moreover, modern plant biotechnology techniques can help to accelerate the selection of resistant rootstocks in breeding programs, as controlled crossings for the generation of hybrids, somatic hybridisation, transgenic citrus plants, mapped genomic regions of Quantitative Trait Loci (QTLs), candidate genes, metabolic markers and comparative transcriptomic. These innovative techniques represent a suitable tool to breed new Phytophthora resistant rootstocks, which is widely recognised as the best strategy to face gummosis or foot rot, fibrous root rot and ultimately minimise the expensive use of pesticides in crop protection.
Topics: Citrus; Fungicides, Industrial; Phytophthora; Plant Breeding; Plant Diseases
PubMed: 34127178
DOI: 10.1071/FP20349 -
Journal of the American Medical... Mar 2023The number of sexual and gender minority older adults who require long-term care is steadily increasing. The purpose of this systematic review and meta-analysis was to... (Meta-Analysis)
Meta-Analysis Review
OBJECTIVES
The number of sexual and gender minority older adults who require long-term care is steadily increasing. The purpose of this systematic review and meta-analysis was to synthesize the evidence related to preference for long-term care with regard to sexual orientation and gender identity.
DESIGN
Systematic review and meta-analysis.
SETTING AND PARTICIPANTS
We searched PubMed/MEDLINE, Ovid/PsycINFO, and Web of Science from inception to July 2020 (updated in July 2021). Search terms embraced 3 themes (1) sexual and gender minorities, (2) long-term care, and (3) preferences. Quantitative studies of the adult population were included.
METHODS
Screening, data extraction, and quality assessment followed the National Institutes of Health Quality Assessment Tool for Observational Cohort and Cross-Sectional Studies. The proportions were pooled using meta-analysis and random effects models.
RESULTS
A total of 17 articles were included out of 5944 studies of potential relevance. The perception of nursing homes (NHs) that emerges from these studies is predominantly negative for heterosexuals and lesbian, gay, bisexual and trans (LGBT) individuals (n = 11). Across 6 studies (10 outcomes), the pooled estimate for the proportion of individuals with a preference to move into a NH was 10.6% [95% confidence interval (CI) 7.88%‒13.22%, I = 97.4%]; 13.7% (95% CI 8.6%‒18.7%) for LGBT individuals and 7.3% (95% CI 3.14%‒11.50%) for heterosexuals. LGBT-friendly NHs were preferred by between 55% and 98% of LGBT respondents. Informal care provided by partner or family was one of the preferred options (n = 6). It was preferred by 33% to 70% of various groups of LGBT respondents.
CONCLUSIONS AND IMPLICATIONS
The preference to move into a NH is relatively low among both heterosexuals and sexual and gender minority adults. Findings showed negligible differences in preferences to move into a NH between heterosexuals and sexual and gender minorities. LGBT-friendly long-term care facilities where every member feels welcomed and not discriminated against seem to be one of the favorable long-term care choices among LGBT individuals. This knowledge is important to inform nursing services and policy makers about the preferred long-term care options. Providing LGBT-friendly facilities is usually less expensive than providing care in newly created LGBT-only facilities.
Topics: Humans; Male; Female; Aged; Gender Identity; Long-Term Care; Cross-Sectional Studies; Sexual Behavior; Nursing Homes
PubMed: 36586720
DOI: 10.1016/j.jamda.2022.11.020 -
Sexual Medicine Reviews Oct 2022Phalloplasty is one of the genital genders affirming surgeries sought by transmasculine transgender patients during transition. Despite current advances in surgical... (Meta-Analysis)
Meta-Analysis Review
INTRODUCTION
Phalloplasty is one of the genital genders affirming surgeries sought by transmasculine transgender patients during transition. Despite current advances in surgical techniques, the lack of consistency in outcomes evaluation for phalloplasty leads to significant challenges in guiding patients in clinical decision making.
AIMS
This systematic review and meta-analysis aims to assess outcomes for different phalloplasty surgical techniques.
METHODS
The literature was searched using Medical Literature Analysis and Retrieval System Online (MEDLINE; PubMed), Excerpta Medica database, and Cochrane Database of Systematic Reviews. All English-language randomized control trials, prospective and retrospective cohort studies, case series, and case reports of at least 4 patients were included. The primary outcome was postoperative complications, and the secondary outcomes were functional and aesthetic results. Proportional meta-analysis was used to pool complication rates using a random-effects model.
RESULTS
Database searching generated 39 final articles, with 19 case series, 3 cross-sectional studies, and 17 retrospective cohort studies. A total of 1731 patients underwent phalloplasty, with the most common type of reconstruction performed being the radial forearm free flap (75.1%). Overall complication rate was high at 76.5%, of which urethral complications were high in all reconstructive subgroups (urethral fistula rate of 34.1% and urethral stricture rate of 25.4%). Postoperative functional outcomes were reported in 57.6% of patients, finding that most had tactile sensation (93.9%) and can void while standing (92.2%). Aesthetic outcomes were only reported in 6.3% of patients, with mean length achieved being 12.26 cm (SD = 0.81 cm) and mean circumference being 10.18 cm (SD = 3.69 cm).
CONCLUSION
In the transmasculine transgender population, current evidence of the various phalloplasty surgical techniques and their expected postoperative outcomes is weak. Future research may consider developing a standardized core outcome set to improve clinical decision making. Wang AMQ, Tsang V, Mankowski P, et al. Outcomes Following Gender Affirming Phalloplasty: A Systematic Review and Meta-Analysis. Sex Med Rev 2022;10:499-512.
Topics: Cross-Sectional Studies; Female; Humans; Male; Prospective Studies; Randomized Controlled Trials as Topic; Retrospective Studies; Sex Reassignment Surgery; Transsexualism
PubMed: 36031521
DOI: 10.1016/j.sxmr.2022.03.002 -
Psycho-oncology Dec 2023Sarcoma diagnosis and its treatment trajectory may deeply affect the somatopsychic balance of patients and their caregivers. This systematic review aimed at deepening... (Review)
Review
OBJECTIVE
Sarcoma diagnosis and its treatment trajectory may deeply affect the somatopsychic balance of patients and their caregivers. This systematic review aimed at deepening the understanding of sarcoma's impact on the entire family unit involved in the illness experience on a physical (e.g. fatigue), psychological (e.g. mental health, affective regulation, defense mechanisms), and interpersonal (e.g. social isolation, loneliness) level.
METHODS
The systematic review was conducted using the Preferred Reporting Items for Systematic Reviews and Meta-Analyses. The literature search led to the identification and subsequent inclusion of 44 articles focused on sarcoma patients. Results were classified into seven categories: Quality of Life, worries and distress, anxiety and depression, suicide ideation, financial and occupational consequences, unmet needs, and coping strategies. Our search identified only one study focusing on informal caregivers, thus we could not perform a systematic review on these results.
RESULTS
Our findings underlined the traumatic impact of the sarcoma diagnosis. Patients can experience an impoverished emotional life, somatization, social withdrawal, difficulty in decision-making, increased feelings of discouragement and demoralization, and profound experiences of helplessness and vulnerability. Moreover, they seemed to display anxiety and depression and might present a higher suicide incidence than the general population.
CONCLUSION
Our review highlighted that the psychosocial aftermath of sarcoma patients should guide institutions and healthcare professionals toward the design of assessment and intervention models that could contemplate the different dimensions of their suffering. Furthermore, it points out that there is still a lack of evidence regarding the psychosocial impact affecting sarcoma patients' caregivers.
Topics: Humans; Quality of Life; Depression; Sarcoma; Mental Health; Soft Tissue Neoplasms
PubMed: 37930090
DOI: 10.1002/pon.6240 -
Acta Paediatrica (Oslo, Norway : 1992) Nov 2023The aim of this systematic review was to assess the effects on psychosocial and mental health, cognition, body composition, and metabolic markers of hormone treatment in... (Review)
Review
AIM
The aim of this systematic review was to assess the effects on psychosocial and mental health, cognition, body composition, and metabolic markers of hormone treatment in children with gender dysphoria.
METHODS
Systematic review essentially follows PRISMA. We searched PubMed, EMBASE and thirteen other databases until 9 November 2021 for English-language studies of hormone therapy in children with gender dysphoria. Of 9934 potential studies identified with abstracts reviewed, 195 were assessed in full text, and 24 were relevant.
RESULTS
In 21 studies, adolescents were given gonadotropin-releasing hormone analogues (GnRHa) treatment. In three studies, cross-sex hormone treatment (CSHT) was given without previous GnRHa treatment. No randomised controlled trials were identified. The few longitudinal observational studies were hampered by small numbers and high attrition rates. Hence, the long-term effects of hormone therapy on psychosocial health could not be evaluated. Concerning bone health, GnRHa treatment delays bone maturation and bone mineral density gain, which, however, was found to partially recover during CSHT when studied at age 22 years.
CONCLUSION
Evidence to assess the effects of hormone treatment on the above fields in children with gender dysphoria is insufficient. To improve future research, we present the GENDHOR checklist, a checklist for studies in gender dysphoria.
Topics: Adolescent; Humans; Child; Young Adult; Adult; Gender Dysphoria; Gonadotropin-Releasing Hormone; Gender Identity; Longitudinal Studies; Bone Density
PubMed: 37069492
DOI: 10.1111/apa.16791 -
Biomolecules Nov 2022The antioxidant activity of protein-derived peptides was one of the first to be revealed among the more than 50 known peptide bioactivities to date. The exploitation... (Review)
Review
The antioxidant activity of protein-derived peptides was one of the first to be revealed among the more than 50 known peptide bioactivities to date. The exploitation value associated with food-derived antioxidant peptides is mainly attributed to their natural properties and effectiveness as food preservatives and in disease prevention, management, and treatment. An increasing number of antioxidant active peptides have been identified from a variety of renewable sources, including terrestrial and aquatic organisms and their processing by-products. This has important implications for alleviating population pressure, avoiding environmental problems, and promoting a sustainable shift in consumption. To identify such opportunities, we conducted a systematic literature review of recent research advances in food-derived antioxidant peptides, with particular reference to their biological effects, mechanisms, digestive stability, and bioaccessibility. In this review, 515 potentially relevant papers were identified from a preliminary search of the academic databases PubMed, Google Scholar, and Scopus. After removing non-thematic articles, articles without full text, and other quality-related factors, 52 review articles and 122 full research papers remained for analysis and reference. The findings highlighted chemical and biological evidence for a wide range of edible species as a source of precursor proteins for antioxidant-active peptides. Food-derived antioxidant peptides reduce the production of reactive oxygen species, besides activating endogenous antioxidant defense systems in cellular and animal models. The intestinal absorption and metabolism of such peptides were elucidated by using cellular models. Protein hydrolysates (peptides) are promising ingredients with enhanced nutritional, functional, and organoleptic properties of foods, not only as a natural alternative to synthetic antioxidants.
Topics: Animals; Antioxidants; Biological Availability; Peptides; Protein Hydrolysates; Food Handling; Food Additives
PubMed: 36358972
DOI: 10.3390/biom12111622 -
Journal of Plastic, Reconstructive &... Jan 2022Urologic problems, such as urethral fistulas and strictures, are among the most frequent complications occurring after phalloplasty. Although many studies have reported... (Meta-Analysis)
Meta-Analysis Review
BACKGROUND
Urologic problems, such as urethral fistulas and strictures, are among the most frequent complications occurring after phalloplasty. Although many studies have reported successful phalloplasty and urethral reconstruction with reliable outcomes in transgender men, no method has become standardized so far. This study aimed to summarize the results of reports on urological complications and outcomes in transgender men with respect to various types of urethral reconstruction.
METHODS
A comprehensive literature search of PubMed, Scopus, and Google Scholar databases was conducted for studies related to phalloplasty in transsexuals. Data on various phallic urethral techniques, urethral complications, and outcomes were collected and analyzed using the random-effects model.
RESULTS
A total of 21 studies (1,566 patients) were included: eight studies (1,061 patients) on "tube-in-tube," nine studies (273 patients) on "prelaminated flap," and six studies (221 patients) on "second flap." Compared with the tube-in-tube technique, the prelaminated flap was associated with a significantly higher urethral stricture/stenosis rate; however, there was no difference between the prelaminated flap and the second flap techniques. For all phalloplasty patients, the pool rate of urethral fistula or stenosis is 48.9%, the rate of the ability to void while standing is 91.5%, occurrence rate of tactile or erogenous sensation is 88%, the prosthesis complication rate is 27.9%, and patient-reported satisfactory outcome rate is 90.5%.
CONCLUSION
Urethral reconstruction with a prelaminated flap was associated with a significantly higher urethral stricture rate and increased need of revision surgery compared with that observed using a skin flap. Overall, most patients were able to void while standing and were satisfied with the outcomes.
Topics: Constriction, Pathologic; Humans; Male; Penis; Sex Reassignment Surgery; Transgender Persons; Transsexualism; Urethra; Urethral Stricture
PubMed: 34607781
DOI: 10.1016/j.bjps.2021.08.006 -
Aging & Mental Health 2015Services provided to older people should be developed based on active ageing policies. Nutrition is one aspect of active ageing, but little is known about how food... (Meta-Analysis)
Meta-Analysis Review
OBJECTIVES
Services provided to older people should be developed based on active ageing policies. Nutrition is one aspect of active ageing, but little is known about how food activities contribute to psychological well-being in later life. This is a systematic review of qualitative and quantitative research that answers the question 'What is known about the relationship between food activities and the maintenance of identities in old age?'.
METHODS
We followed the preferred reporting items for systematic reviews and meta-analyses guidelines and used quality assessment parameters to complete a systematic review and narrative synthesis. Academic Search Premier, MEDLINE, CINAHL Plus, and PsycINFO databases were searched.
RESULTS
We initially identified 8016 articles, of which 167 full-text articles were screened for inclusion. Twenty-two articles were included in the review. There was moderate evidence from nine qualitative and two quantitative studies, of variable quality, that food activities contribute to the maintenance of women's gendered identities, the ethnic identities of men and women, and community identities. There was moderate evidence from 10 qualitative studies, of variable quality, that a change in food choice and deteriorating health changed food activity participation. These changes threatened identities. Most studies included both younger adults and older adults.
CONCLUSION
In later life, there are many life experiences leading to change. Further research is needed to develop understanding of how identity and mental well-being are maintained, despite changes in everyday activities like cooking and eating. This may enable health care professionals to meet psychological needs alongside biological needs during nutritional interventions.
Topics: Aged; Aging; Feeding Behavior; Female; Food; Gender Identity; Humans; Male; Social Identification
PubMed: 25373998
DOI: 10.1080/13607863.2014.971707