Transgender individuals often undergo gender-affirming hormonal therapy(GAHT)to align their physical characteristics with their gender identity,which introduces unique challenges in the management of critically ill pa...Transgender individuals often undergo gender-affirming hormonal therapy(GAHT)to align their physical characteristics with their gender identity,which introduces unique challenges in the management of critically ill patients.In the setting of critical illness,the interactions between GAHT and the body's endocrine response are complex.GAHT can influence the hypothalamic-pituitary-adrenal axis,sex hormone levels,and metabolic parameters,potentially complicating the clinical picture.For example,estrogen therapy in transgender women increases the risk of venous thromboembolism,which is further exacerbated by the immobility and hypercoagulable state often present in critically ill patients.Testosterone therapy in transgender men can lead to erythrocytosis,increasing the risk of thromboembolic events during critical illness.The potential for drug interactions,particularly with medications used in the intensive care unit,also requires careful consideration.Monitoring hormone levels and adjusting GAHT in the acute setting are crucial,although evidence-based guidelines are lacking.The need for individualized care and vigilant monitoring of endocrine and metabolic parameters is paramount to improve outcomes in this vulnerable population.展开更多
A recent article highlighted the hepatic benefits of intermittent fasting,particularly during Ramadan.However,the rising use of glucagon-like peptide-1(GLP-1)/glucose-dependent insulinotropic polypeptide(GIP)receptor ...A recent article highlighted the hepatic benefits of intermittent fasting,particularly during Ramadan.However,the rising use of glucagon-like peptide-1(GLP-1)/glucose-dependent insulinotropic polypeptide(GIP)receptor agonists(RAs)is altering public behavior,leading to decreased interest in diet and exercise.With a focus on hepatic health,we analyzed global search trends using Google Trends™data from January 1,2022 to December 31,2024,focusing on the keywords"fasting","intermittent fasting","diet","nutrition","liver",Semaglutide("Ozempic"™,the most widely known GLP-1 RA)and Tirzepatide("Mounjaro"™,a newer dual GLP-1 and GIP RA).Search interest for"intermittent fasting"and"diet"showed a significant decline over time(Spearman's rho:-0.582 and-0.605,respectively,both P<0.001),while interest in"fasting"and"nutrition"remained stable.Search interest for Semaglutide,Tirzepatide,"fasting and liver","diet and liver"and Semaglutide and"liver"increased(Spearman's rho:+0.914,+0.936,+0.369,+0.297 and+0.808,respectively,all P<0.001).These findings suggest a trend of shifting away from traditional dieting toward broader health concerns,likely influenced by the increasing use of GLP-1/GIP RAs.展开更多
BACKGROUND The occurrence of thyroid cancer(TC)has increased in recent decades.Exposure to outdoor artificial light at night(ALN)is associated with an increased risk of cancer.AIM To investigated the impact of ALN,as ...BACKGROUND The occurrence of thyroid cancer(TC)has increased in recent decades.Exposure to outdoor artificial light at night(ALN)is associated with an increased risk of cancer.AIM To investigated the impact of ALN,as a significant environmental pollutant,on TC incidence worldwide.METHODS The assessment involved analyzing satellite ALN data in conjunction with TC incidence data[adjusted standardized rate(ASR)],while considering the quality of cancer registries(QCR),gross domestic product(GDP)per person,and health expenditure per person(HEP)for each country.RESULTS Results indicated a correlation between higher ASR and ALN exposure percentages,particularly in countries with higher GDP or HEP quartiles(all P<0.05).Significant differences in ASR were observed across QCR levels,both high and low quality(all P<0.05),but not in countries without registry activity.However,when evaluating ASR against ALN exposure percentages while considering GDP/HEP quartiles or QCR levels,no significant associations were found(all P>0.10).CONCLUSION The findings suggest a potential link between higher GDP and adverse health conditions,serving as possible risk factors for TC,rather than a direct association with ALN.Limitations include the use of cross-sectional data,temporal misalign ment,and reliance on ALN as a socioeconomic proxy.It is proposed that light pollution might be connected to a lifestyle conducive to carcinogenesis.Additionally,the presence of higher GDP/HEP could enhance access to diagnostic resources,potentially facilitating TC diagnosis and inclusion in cancer registries.展开更多
BACKGROUND Recent publications from several countries have reported that more young people(mainly girls)are experiencing precocious puberty(PP)/menarche during the coronavirus disease 2019 pandemic compared to the pas...BACKGROUND Recent publications from several countries have reported that more young people(mainly girls)are experiencing precocious puberty(PP)/menarche during the coronavirus disease 2019 pandemic compared to the past.This variation is attributed to the stress of confinement,lack of exercise,obesity and disturbed sleep patterns.A common feature of the relevant papers,however,is the small number of reported cases of PP.Studies have shown that searches for diseases on the internet also reflect to some extent the epidemiology of these diseases.AIM To estimate,through internet searches for PP,any changes in the epidemiology of PP.METHODS We assessed in Google Trends searches for 21 PP-related terms in English internationally(which practically dwarf searches in other languages),in the years 2017-2021.Additionally,we assessed local searches for selected terms,in English and local languages,in countries where a rise in PP has been reported.Searches were collected in Relative Search Volumes format and analyzed using Kendall’s Tau test,with a statistical significance threshold of P<0.05.RESULTS Internationally,searches for three PP-related terms showed no noticeable change over the study period,while searches for eight terms showed a decrease.An increase was found over time in searches for nine PP-related terms.Of the 17 searches in English and local languages,in countries where a rise in PP has been reported,5 showed a significant increase over time.CONCLUSION Over the study period,more than half of the search terms showed little change or declined.The discrepancy between internet searches for PP and the reported increase in the literature is striking.It would be expected that a true increase in the incidence of PP would also be aptly reflected in Google trends.If our findings are valid,the literature may have been biased.The known secular trend of decreasing age of puberty may also have played a role.展开更多
We conducted an analysis of internet search trends spanning from January 2022 to June 2023 in the ten most populous Muslim countries.Our study focused on key terms,including the prominent GLP1 analog"ozempic™&quo...We conducted an analysis of internet search trends spanning from January 2022 to June 2023 in the ten most populous Muslim countries.Our study focused on key terms,including the prominent GLP1 analog"ozempic™",as well as"diet","exercise",and"diabetes".The findings revealed a substantial increase in searches for the GLP1 analog in eight countries.Concurrently,searches for"diet"and"exercise"predominantly exhibited a decline in nine and four countries,respectively.Notably,searches for"diabetes"displayed positive trends in only two countries.These patterns indicate a growing reliance on pharmaceutical interventions for managing diabetes and weight,often to the detriment of diet and exercise.Healthcare professionals and clinicians in Muslim countries should emphasize the importance of maintaining dietary and exercise regimens for patients with diabetes,even during the observance of Ramadan.展开更多
文摘Transgender individuals often undergo gender-affirming hormonal therapy(GAHT)to align their physical characteristics with their gender identity,which introduces unique challenges in the management of critically ill patients.In the setting of critical illness,the interactions between GAHT and the body's endocrine response are complex.GAHT can influence the hypothalamic-pituitary-adrenal axis,sex hormone levels,and metabolic parameters,potentially complicating the clinical picture.For example,estrogen therapy in transgender women increases the risk of venous thromboembolism,which is further exacerbated by the immobility and hypercoagulable state often present in critically ill patients.Testosterone therapy in transgender men can lead to erythrocytosis,increasing the risk of thromboembolic events during critical illness.The potential for drug interactions,particularly with medications used in the intensive care unit,also requires careful consideration.Monitoring hormone levels and adjusting GAHT in the acute setting are crucial,although evidence-based guidelines are lacking.The need for individualized care and vigilant monitoring of endocrine and metabolic parameters is paramount to improve outcomes in this vulnerable population.
文摘A recent article highlighted the hepatic benefits of intermittent fasting,particularly during Ramadan.However,the rising use of glucagon-like peptide-1(GLP-1)/glucose-dependent insulinotropic polypeptide(GIP)receptor agonists(RAs)is altering public behavior,leading to decreased interest in diet and exercise.With a focus on hepatic health,we analyzed global search trends using Google Trends™data from January 1,2022 to December 31,2024,focusing on the keywords"fasting","intermittent fasting","diet","nutrition","liver",Semaglutide("Ozempic"™,the most widely known GLP-1 RA)and Tirzepatide("Mounjaro"™,a newer dual GLP-1 and GIP RA).Search interest for"intermittent fasting"and"diet"showed a significant decline over time(Spearman's rho:-0.582 and-0.605,respectively,both P<0.001),while interest in"fasting"and"nutrition"remained stable.Search interest for Semaglutide,Tirzepatide,"fasting and liver","diet and liver"and Semaglutide and"liver"increased(Spearman's rho:+0.914,+0.936,+0.369,+0.297 and+0.808,respectively,all P<0.001).These findings suggest a trend of shifting away from traditional dieting toward broader health concerns,likely influenced by the increasing use of GLP-1/GIP RAs.
文摘BACKGROUND The occurrence of thyroid cancer(TC)has increased in recent decades.Exposure to outdoor artificial light at night(ALN)is associated with an increased risk of cancer.AIM To investigated the impact of ALN,as a significant environmental pollutant,on TC incidence worldwide.METHODS The assessment involved analyzing satellite ALN data in conjunction with TC incidence data[adjusted standardized rate(ASR)],while considering the quality of cancer registries(QCR),gross domestic product(GDP)per person,and health expenditure per person(HEP)for each country.RESULTS Results indicated a correlation between higher ASR and ALN exposure percentages,particularly in countries with higher GDP or HEP quartiles(all P<0.05).Significant differences in ASR were observed across QCR levels,both high and low quality(all P<0.05),but not in countries without registry activity.However,when evaluating ASR against ALN exposure percentages while considering GDP/HEP quartiles or QCR levels,no significant associations were found(all P>0.10).CONCLUSION The findings suggest a potential link between higher GDP and adverse health conditions,serving as possible risk factors for TC,rather than a direct association with ALN.Limitations include the use of cross-sectional data,temporal misalign ment,and reliance on ALN as a socioeconomic proxy.It is proposed that light pollution might be connected to a lifestyle conducive to carcinogenesis.Additionally,the presence of higher GDP/HEP could enhance access to diagnostic resources,potentially facilitating TC diagnosis and inclusion in cancer registries.
基金Athanasios Tselebis,ORCID number: 0000-0002-2591-965XLina Zabuliene ,ORCID number:0000-0002-7889-0862+1 种基金Charalampos Milionis ,ORCID number:0000-0003-2442-3772Corresponding author:Ioannis Ilias,MD,PhD,Consultant Physician-Scientist,Department of Endocrinology,Elena Venizelou General and Maternity Hospital,2,Elena Venizelou Square,Athens GR-11521,Greece.iiliasmd@yahoo.com,ORCID number: 0000-0001-5718-7441.
文摘BACKGROUND Recent publications from several countries have reported that more young people(mainly girls)are experiencing precocious puberty(PP)/menarche during the coronavirus disease 2019 pandemic compared to the past.This variation is attributed to the stress of confinement,lack of exercise,obesity and disturbed sleep patterns.A common feature of the relevant papers,however,is the small number of reported cases of PP.Studies have shown that searches for diseases on the internet also reflect to some extent the epidemiology of these diseases.AIM To estimate,through internet searches for PP,any changes in the epidemiology of PP.METHODS We assessed in Google Trends searches for 21 PP-related terms in English internationally(which practically dwarf searches in other languages),in the years 2017-2021.Additionally,we assessed local searches for selected terms,in English and local languages,in countries where a rise in PP has been reported.Searches were collected in Relative Search Volumes format and analyzed using Kendall’s Tau test,with a statistical significance threshold of P<0.05.RESULTS Internationally,searches for three PP-related terms showed no noticeable change over the study period,while searches for eight terms showed a decrease.An increase was found over time in searches for nine PP-related terms.Of the 17 searches in English and local languages,in countries where a rise in PP has been reported,5 showed a significant increase over time.CONCLUSION Over the study period,more than half of the search terms showed little change or declined.The discrepancy between internet searches for PP and the reported increase in the literature is striking.It would be expected that a true increase in the incidence of PP would also be aptly reflected in Google trends.If our findings are valid,the literature may have been biased.The known secular trend of decreasing age of puberty may also have played a role.
文摘We conducted an analysis of internet search trends spanning from January 2022 to June 2023 in the ten most populous Muslim countries.Our study focused on key terms,including the prominent GLP1 analog"ozempic™",as well as"diet","exercise",and"diabetes".The findings revealed a substantial increase in searches for the GLP1 analog in eight countries.Concurrently,searches for"diet"and"exercise"predominantly exhibited a decline in nine and four countries,respectively.Notably,searches for"diabetes"displayed positive trends in only two countries.These patterns indicate a growing reliance on pharmaceutical interventions for managing diabetes and weight,often to the detriment of diet and exercise.Healthcare professionals and clinicians in Muslim countries should emphasize the importance of maintaining dietary and exercise regimens for patients with diabetes,even during the observance of Ramadan.
