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Endocrine Practice : Official Journal... Oct 2023Behavioral therapy, gender-affirming hormone therapy (GAHT), and surgery are all components of a successful gender transition, but due to a historical lack of access,...
OBJECTIVE
Behavioral therapy, gender-affirming hormone therapy (GAHT), and surgery are all components of a successful gender transition, but due to a historical lack of access, there is paucity of long-term data in this population. We sought to better characterize the risk of hepatobiliary neoplasms in transgender males undergoing GAHT with testosterone.
METHODS
In addition to the 2 case reports, a systematic literature review of hepatobiliary neoplasms in the setting of testosterone administration or endogenous overproduction across indications was conducted. The medical librarian created search strategies using keywords and controlled vocabulary in Ovid Medline, Embase.com, Scopus, Cochrane Database of Systematic Reviews, and clinicaltrials.gov. A total of 1273 unique citations were included in the project library. All unique abstracts were reviewed, and abstracts were selected for complete review. Inclusion criteria were articles reporting cases of hepatobiliary neoplasm development in patients with exogenous testosterone administration or endogenous overproduction. Non-English language articles were excluded. Cases were collated into tables based on indication.
RESULTS
Forty-nine papers had cases of hepatocellular adenoma, hepatocellular carcinoma, cholangiocarcinoma, or other biliary neoplasm in the setting of testosterone administration or endogenous overproduction. These 49 papers yielded 62 unique cases.
CONCLUSION
Results of this review are not sufficient to conclude that there is an association between GAHT and hepatobiliary neoplasms. This supports current evaluation and screening guidelines for initiation and continuation of GAHT in transgender men. The heterogeneity of testosterone formulations limits the translation of risks of hepatobiliary neoplasms in other indications to GAHT.
Topics: Humans; Male; Gastrointestinal Neoplasms; Liver Neoplasms; Testosterone; Transgender Persons
PubMed: 37286102
DOI: 10.1016/j.eprac.2023.05.011 -
Frontiers in Psychology 2023Inflammatory Bowel Disease (IBD) affects the quality of life. Patient education and support needs are crucial components of comprehensive chronic illness care. The main...
BACKGROUND
Inflammatory Bowel Disease (IBD) affects the quality of life. Patient education and support needs are crucial components of comprehensive chronic illness care. The main purposes of this review were to (i) explore the informational and supportive needs of these patients to improve the quality of life in the existing literature and (ii) identify the gaps related to the needs of the patients in articles.
METHODS
The scoping review is based on the Daudt methodological framework, a modified version of Arksey and O'Malley. Electronic databases were extensively searched from January 01, 2000 to April 30, 2022. Four electronic databases (PubMed/Medline, CINAHL, APA PsycInfo, Psychology and Behavioral Sciences Collection, APA PsycArticles, and ProQuest) were searched using controlled vocabulary, and specific keywords. The searched terms were matched to each database. We manually searched two key journals, namely the Journal of Inflammatory Bowel Disease and the Journal of Crohn's and Colitis.
RESULTS
In the review, 75 studies on the assessment of the information and support needs of patients with IBD were reviewed. In this regard, 62 and 53 studies were regarding information needs and support needs, respectively. Most of the information needs of patients with IBD reported in the studies were related to diet needs, and educational needs were the most essential support needs.
CONCLUSIONS
Health policymakers and managers can develop care and educational programs related to this disease in health centers according to the needs of the patients. Health professionals, especially gastroenterologists, are the primary referral sources for information on patients. Therefore, gastroenterologists can take the lead in planning and educating the patients and sharing their decisions.
SYSTEMATIC REVIEW REGISTRATION
OSF, https://doi.org/10.17605/OSF.IO/3MWGJ.
PubMed: 37251032
DOI: 10.3389/fpsyg.2023.1055449 -
Eating disorder symptomatology among transgender individuals: a systematic review and meta-analysis.Journal of Eating Disorders May 2023The purpose of this systematic review and meta-analysis was to synthesize the literature on eating disorders and eating disorder symptomatology among transgender... (Review)
Review
OBJECTIVE
The purpose of this systematic review and meta-analysis was to synthesize the literature on eating disorders and eating disorder symptomatology among transgender individuals and to summarize the existing literature on gender-affirming treatment and the prevalence of eating disorder symptomatology.
METHOD
The literature search for this systematic review and meta-analysis was performed in PubMed, Embase.com, and Ovid APA PsycInfo. We searched for "eating disorders" and "transgender" using both controlled vocabularies and natural language terms for their synonyms. The PRISMA statement guidelines were followed. Quantitative data from studies on transgender individuals and eating disorders assessed with relevant assessment tools was included.
RESULTS
Twenty-four studies were included for the qualitative synthesis, and 14 studies were included in the meta-analysis. The results revealed higher levels of eating disorder symptomatology among transgender individuals compared with cisgender individuals, especially cisgender men. Transgender men tend to display higher levels of eating disorder symptomatology than transgender women; however, transgender women seem to have higher levels of eating disorder symptomatology than cisgender men and, interestingly, this study also noted a trend toward transgender men having higher levels of eating disorders than cisgender women. Gender-affirming treatment seems to alleviate the presence of eating disorder symptomatology in transgender individuals.
DISCUSSION
The body of research on this subject is extremely limited, and transgender individuals are underrepresented in the eating disorder literature. More research investigating eating disorders and eating disorder symptomatology in transgender individuals and the relationship between gender-affirming treatment and eating disorder symptomatology is needed.
PubMed: 37237320
DOI: 10.1186/s40337-023-00806-y -
Journal of Infection and Public Health Jul 2023The use of central venous catheters (CVC) is associated with higher morbidity and mortality, related to infectious complications, contributing to poorer clinical... (Review)
Review
BACKGROUND
The use of central venous catheters (CVC) is associated with higher morbidity and mortality, related to infectious complications, contributing to poorer clinical outcomes and increased healthcare costs. According to the literature, the incidence of local infections related to CVC for hemodialysis is highly variable. This variability is related to differences in definitions of catheter-related infections.
OBJECTIVE
To identify signs and symptoms for determining local infections (exit site and tunnel tract infections) used in the literature in tunnelled and nontunnelled CVC for hemodialysis.
DESIGN
Systematic review METHODS: Structured electronic searches were conducted in five electronic databases, from 1 January 2000-31 August 2022, using key words and specific vocabulary, as well as manual searches in several journals. Additionally, vascular access clinical guidelines and infection control clinical guidelines were reviewed.
RESULTS
After validity analysis, we selected 40 studies and seven clinical guidelines. The definitions of exit site infection and tunnel infection used in the different studies were heterogeneous. Among the studies, seven (17,5 %) used the definitions of exit site and tunnel infection based on a clinical practice guideline. Three of the studies (7.5 %) used the Twardowski scale definition of exit site infection or a modification. The remaining 30 studies (75 %) used different combinations of signs and symptoms.
CONCLUSIONS
Definitions of local CVC infections are highly heterogeneous in the revised literature. It is necessary to establish a consensus regarding the definitions of hemodialysis CVC exit site and tunnel infections.
REGISTRATION
PROSPERO (CRD42022351097).
Topics: Humans; Central Venous Catheters; Renal Dialysis; Catheter-Related Infections; Risk Assessment; Incidence; Catheters, Indwelling
PubMed: 37178476
DOI: 10.1016/j.jiph.2023.04.012 -
Evidence-based Dentistry Sep 2023Systematic review and meta-analysis. (Meta-Analysis)
Meta-Analysis
TYPE OF STUDY DESIGN
Systematic review and meta-analysis.
DATA SOURCES
MEDLINE, Embase, and Web of Science for English studies published until December 2017 using a controlled vocabulary (MeSH, Emtree) with no time restrictions were searched. The system for information on Grey literature in Europe (SIGLE), a manual search of all issues since 2000 of several implant-related journals, and reference list of all included studies were additionally surveyed by two reviewers in duplicate.
STUDY SELECTION
Two reviewers assessed papers for eligibility by title and abstract and then by full text in duplicate. Disagreements were solved by a discussion with a third reviewer where agreement was almost perfect (κ = 0.91). Randomized (RCTs) and non-randomized clinical studies with a minimum follow-up of 3 years and minimum sample size of 20 patients reporting on biological, prosthetic complications, and patient-related outcome measures (PROMs) were eligible. The primary outcome was the biological complication of implant failure and the main secondary outcome was peri-implant marginal bone loss (MBL).
DATA EXTRACTION AND SYNTHESIS
No RCTs were found and eligible Non RCTs were assessed for risk of bias using ROBINS-I Tool. Implant failure and peri-implant MBL measured radiographically in mm were assessed between the two groups using relative risk and mean difference respectively with 95% confidence interval. Meta-analysis was conducted using a random effects model with Paule-Mandle estimator as wide variation of true effects was expected. Additional subgroup and sensitivity analyses were performed as well as rating the quality of meta-evidence using GRADE approach.
MAIN RESULTS
17 non-randomized studies (8 prospective and 9 retrospective) including a total of 7568 implants were included. Meta-analysis showed no difference in implant failure in 8 studies (RR = 0.95; 95% CI = 0.7 to 1.28; p = 0.74). Also, no significant difference was found in MBL in 16 studies (MD = 0.03 mm; 95% CI = -0.03 to 0.10 mm; p = 0.32).
CONCLUSIONS
Considering the serious risk of bias of included studies, heterogeneity, and lack of randomized controlled clinical studies, the placement of tilted implants showed no added risk of failure or increased MBL compared to straight implants.
Topics: Humans; Prospective Studies; Retrospective Studies; Dental Implants; Bone Diseases, Metabolic; Dissent and Disputes
PubMed: 37169963
DOI: 10.1038/s41432-023-00896-2 -
European Journal of Rheumatology Apr 2023The ocular inflammatory process may be associated with autoimmune inflammatory joint damage and can be better recovered by B-mode ultrasound, being little explored in...
The ocular inflammatory process may be associated with autoimmune inflammatory joint damage and can be better recovered by B-mode ultrasound, being little explored in the absent eye evaluation. This study aimed to conduct a systematic review using the Patients or Problem, Intervention, Control or Comparison, Outcomes strategy: uveitis; ultrasound, arthritis, and diagnosis. Clinical trials, meta-analysis, and randomized controlled trials that specifically address the scope of this study will be evaluated. For the search in the database, a choice of controlled vocabulary will be used with the MEDLINE MeSH platform (Medical Subject Headings). The articles must be dated from the year 2010 until the year 2020. To charting methods will be used Preferred Reporting Items for Systematic Reviews and Meta-Analyses Flow Diagram and risk of bias: the Cochrane risk of bias tool. Grade of recommendation assessment: Grading of Recommendations Assessment, Development, and Evaluation Group guidelines. Of 2909 studies, only 13 studies were included, which evaluated the use of B-mode ultrasound to assess anterior and intermediate uveitis and complications, and 5 cases showed an association of vitreitis. B-mode ultrasound can be an important benefit of complementing clinical evaluation in patients with the uveal inflammatory process associated with several autoimmune arthropathies, but more studies with better-elaborated methodology design will be necessary.
PubMed: 37096295
DOI: 10.5152/eurjrheum.2023.22054 -
NeuroImage. Clinical 2023Previous research suggests that there may be similarities in structural brain changes seen in patients with depression and psychosis compared to healthy controls.... (Review)
Review
BACKGROUND
Previous research suggests that there may be similarities in structural brain changes seen in patients with depression and psychosis compared to healthy controls. However, there is yet no systematic review collating studies comparing structural brain changes in depression and psychosis. Establishing shared and specific neuroanatomical features could aid the investigation of underlying biological processes.
AIMS
To identify structural neuroimaging similarities and differences between patients with depression and psychosis.
METHOD
We searched PubMed, PsychInfo, Embase, NICE Evidence, Medline and the Cochrane Library were searched from inception to 30/06/2021 using relevant subject headings (controlled vocabularies) and search syntax. Papers were assessed for quality using the Newcastle-Ottawa Scale.
RESULTS
Five-hundred and twenty papers were retrieved, seven met inclusion criteria. In narrative collation of results, grey matter volume (GMV) reductions were found in the medial frontal gyrus (MFG), hippocampus and left-sided posterior subgenual prefrontal cortex in both psychosis and depression. GMV reductions affected more brain regions in psychosis, including in the insula and thalamus. White matter volume (WMV) decline was found in both depression and psychosis. Reduced fractional anisotropy (FA) was more commonly seen in depression.
CONCLUSIONS
Our results suggest potential transdiagnostic patterns of GMV and WMV reductions in areas including the MFG, hippocampus, and left-sided posterior subgenual prefrontal cortex. These could be investigated as a future biomarker of transdiagnostic signature across mental illnesses. However, due to the limited number and poor quality of studies future research in large samples and harmonised imaging data is first needed.
Topics: Humans; Depression; Magnetic Resonance Imaging; Psychotic Disorders; Brain; Gray Matter; Neuroimaging
PubMed: 37031636
DOI: 10.1016/j.nicl.2023.103388 -
PeerJ 2023The emerging field of environmental DNA (eDNA) research lacks universal guidelines for ensuring data produced are FAIR-findable, accessible, interoperable, and...
The emerging field of environmental DNA (eDNA) research lacks universal guidelines for ensuring data produced are FAIR-findable, accessible, interoperable, and reusable-despite growing awareness of the importance of such practices. In order to better understand these data usability challenges, we systematically reviewed 60 peer reviewed articles conducting a specific subset of eDNA research: metabarcoding studies in marine environments. For each article, we characterized approximately 90 features across several categories: general article attributes and topics, methodological choices, types of metadata included, and availability and storage of sequence data. Analyzing these characteristics, we identified several barriers to data accessibility, including a lack of common context and vocabulary across the articles, missing metadata, supplementary information limitations, and a concentration of both sample collection and analysis in the United States. While some of these barriers require significant effort to address, we also found many instances where small choices made by authors and journals could have an outsized influence on the discoverability and reusability of data. Promisingly, articles also showed consistency and creativity in data storage choices as well as a strong trend toward open access publishing. Our analysis underscores the need to think critically about data accessibility and usability as marine eDNA metabarcoding studies, and eDNA projects more broadly, continue to proliferate.
Topics: DNA, Environmental; Biodiversity; DNA Barcoding, Taxonomic
PubMed: 36992947
DOI: 10.7717/peerj.14993 -
Frontiers in Aging Neuroscience 2023To conduct a meta-analysis of the effectiveness and safety of ginkgo biloba preparations combined with donepezil hydrochloride vs. donepezil for the treatment of...
OBJECTIVE
To conduct a meta-analysis of the effectiveness and safety of ginkgo biloba preparations combined with donepezil hydrochloride vs. donepezil for the treatment of Alzheimer's disease (AD).
METHODS
Three English databases (Cochrane Library, PubMed, EMBASE), and four Chinese databases [the China National Knowledge Infrastructure (CKNI), the Chinese Biomedical Literature database (CBM), the Chongqing VIP database, and WANFANG DATA)] were manually searched for literature published from the respective dates of inception of the databases to December 2022. The randomized controlled trials (RCTs) of ginkgo biloba preparations with donepezil hydrochloride vs. donepezil for the treatment of AD were included. Relevant literature was screened, and the data in the included studies were extracted for quality assessment according to the Risk of bias tool. The RevMan 5.3 software was used for meta-analysis.
RESULTS
A total of 1,642 participants were enrolled in the 18 RCTs. Of these, 842 were in the experimental group (ginkgo biloba preparations combined with donepezil hydrochloride) and 800 were in the control group (donepezil). The overall methodological quality of the included RCTs is poor due to the high risks of blindness and allocation concealment. The meta-analysis results showed statistically significant differences in several outcomes including Risk Ratio (RR) in change for clinical effectiveness rate (1.23, 95% CI 1.13, 1.34, < 0.00001), mean difference (MD) in change for Mini-Mental State Examination score (3.02, 95% CI 2.14, 3.89, < 0.00001), Activity of Daily Living Scale score (-4.56, 95% CI -5.09, -4.03, < 0.00001), Hasegawa Dementia Scale score (2.04, 95% CI 1.74, 2.34, < 0.00001), Montreal Cognitive Assessment score (2.38, 95% CI 0.72, 4.06, = 0.005), between the experimental and control groups. But there is no statistically significant difference in change for adverse reaction (0.91, 95% CI 0.58, 1.42, = 0.69).
CONCLUSION
Ginkgo biloba preparations plus donepezil can improve clinical effectiveness rate and vocabulary memory outcomes. However, more relevant high-quality RCTs are needed in the future to validate these results.
SYSTEMATIC REVIEW REGISTRATION
Identifier CRD42022378970.
PubMed: 36960422
DOI: 10.3389/fnagi.2023.1124710 -
Patient Education and Counseling Jun 2023Relatively little research has examined the health literacy demand of public communication (e.g. websites, pamphlets, and posters) about mental disorders. This study...
OBJECTIVE
Relatively little research has examined the health literacy demand of public communication (e.g. websites, pamphlets, and posters) about mental disorders. This study describes characteristics of existing research and summarizes what is known about the readability of such information.
METHODS
A search of eight data bases yielded 33 studies that met inclusion criteria. Studies were screened for relevance at each stage and then coded for key characteristics and appraised for quality by both authors working independently.
RESULTS
Grade-level readability scores as measured by the Flesch-Kincaid, SMOG, and other indices ranged from 6th to 17th grade. Most Flesch Reading Ease scores fell within the 30-50 range. Results of accessibility measures were inconsistent.
CONCLUSION
With the recommended readability level for health communication set at sixth grade, most publicly available information about mental disorders uses vocabulary and sentence structure that is too complex for the general public. Mixed evidence indicated that accessibility issues are also problematic.
PRACTICE IMPLICATIONS
Developers of health information need to decrease health literacy demand in written mental health information to ensure patients and their families may benefit from this information.
Topics: Humans; Mental Health; Comprehension; Health Literacy; Reading; Pamphlets; Internet
PubMed: 36944285
DOI: 10.1016/j.pec.2023.107682