scholarly journals Gender Differences in Depression and Sex Hormones among Patients Receiving Long-Term Opioid Treatment for Chronic Noncancer Pain in Taiwan—A Multicenter Cross-Sectional Study

2021 ◽  
Vol 18 (15) ◽  
pp. 7837
Author(s):  
Shung-Tai Ho ◽  
Tso-Chou Lin ◽  
Chun-Chang Yeh ◽  
Kuang-I Cheng ◽  
Wei-Zen Sun ◽  
...  
Keyword(s):  
Sexual Function ◽  
Sex Hormones ◽  
Sex Hormone ◽  
Cross Sectional ◽  
Chronic Noncancer Pain ◽  
Depression Diagnosis ◽  
Opioid Treatment ◽  
Hormone Levels ◽  
Noncancer Pain

Background: Long-term use of opioids for chronic noncancer pain is associated with sex hormone disturbances. The interferences with sex hormones, sexual function, and depression were investigated in patients with chronic noncancer pain. Methods: A cross-sectional multicenter survey was conducted on 170 officially registered outpatients receiving long-term opioid treatment in nine medical centers in Taiwan between October 2018 and July 2019. Serum sex hormone levels were examined after the collection of self-administered questionnaires containing the Taiwanese version of the Brief Pain Inventory, depressive status, and sexual function interference. Results: Among 117 (68.8%) questionnaire responses from 170 enrolled outpatients, 38 women and 62 men completed the sex hormone tests, among whom only 23 (23%) had previously received blood hormone tests. Low serum total testosterone levels were detected in 34 (89.5%) women (<30 ng/dL) and 31 (50%) men (<300 ng/dL). Over 60% of women and men reported reduced sexual desire and function despite a nearly 50% reduction in pain intensity and daily function interference over the previous week after opioid treatment. Women generally had higher risks of a depression diagnosis (p = 0.034) and severe depressive symptoms (p = 0.003) and nonsignificantly lower opioid treatment duration (median 81 vs. 120 months) and morphine milligram equivalent (median 134 vs. 165 mg/day) compared with men. Conclusions: This survey demonstrated the high prevalence of depression diagnosis, low sex hormone levels, and reduced sexual function among Taiwanese patients with chronic noncancer pain receiving prolonged opioid therapy. Regular hypogonadal screenings are recommended for further management.

scholarly journals Long-term use of opioids in 210 officially registered patients with chronic noncancer pain in Taiwan: A cross-sectional study

2017 ◽  
Vol 116 (4) ◽  
pp. 257-265 ◽  
Author(s):  
Tso-Chou Lin ◽  
Luo-Ping Ger ◽  
Joseph V. Pergolizzi ◽  
Robert B. Raffa ◽  
Ju-O Wang ◽  
...  
Keyword(s):  
Cross Sectional Study ◽  
Sectional Study ◽  
Cross Sectional ◽  
Chronic Noncancer Pain ◽  
Noncancer Pain

scholarly journals Addressing Opioid-Related Chemical Coping in Long-Term Opioid Therapy for Chronic Noncancer Pain: A Multicenter, Observational, Cross-Sectional Study

2018 ◽  
Vol 7 (10) ◽  
pp. 354 ◽  
Author(s):  
Anyela Castañeda ◽  
Chang-Soon Lee ◽  
Yong-Chul Kim ◽  
Dasom Lee ◽  
Jee Moon
Keyword(s):  
United States ◽  
The United States ◽  
Opioid Therapy ◽  
Cross Sectional Study ◽  
Opioid Consumption ◽  
Sectional Study ◽  
Cross Sectional ◽  
Chronic Noncancer Pain ◽  
Noncancer Pain

Opioid consumption has increased worldwide, which carries the risk of opioid use disorder (OUD). However, the literature on OUD and opioid-related chemical coping (OrCC) in chronic noncancer pain (CNCP) is heterogeneous, with most studies conducted in the United States. We performed a multicenter, observational, cross-sectional study to address OrCC in long-term opioid therapy (LtOT) for CNCP in South Korea. The objectives were to determine the frequency and predictors of OrCC. We included 258 patients. Among them, fifty-five (21%) patients showed OrCC. The sample had high pain catastrophizing (≥30 points; 66%), moderate-severe insomnia (≥15 points; 63%), low resilience (68 points), and high suicidal ideation (67%). OrCC patients had greater pain interference (85.18% vs. 58.28%, p = 0.017) and lower satisfaction with the LtOT (56.4% vs. 78.3%, p = 0.002). In multivariable analysis, alcohol abuse (OR = 6.84, p = 0.001), prescription drugs abuse (OR = 19.32, p = 0.016), functional pain (OR = 12.96, p < 0.001), head and neck pain (OR = 2.48, p = 0.039), MEDD (morphine equivalent daily dose) ≥ 200 mg/day (OR = 3.48, p = 0.006), and ongoing litigation (OR = 2.33, p = 0.047) were significant predictors of OrCC. In conclusion, the break-out of OrCC in CNCP in South Korea was comparable to those in countries with high opioid consumption, such as the United States, regardless of the country’s opioid consumption rate.

scholarly journals Sex hormone levels in females of different ages suffering from depression

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Rong Lei ◽  
Yan Sun ◽  
Jiawen Liao ◽  
Yuan Yuan ◽  
Linlin Sun ◽  
...  
Keyword(s):  
Sex Hormones ◽  
Sex Hormone ◽  
First Episode ◽  
Recurrent Depression ◽  
Serum Progesterone ◽  
Hormone Levels ◽  
Testosterone Levels ◽  
Different Ages ◽  
Severity Of Depression ◽  
Estradiol Levels

Abstract Background There are only a few studies on sex hormones in females of different ages suffering from depression, and their conclusions are not uniform until now. This study aimed to investigate the correlation between the severity of depression in females and factors such as sex hormones and differences in sex hormone levels in females of different ages, exploring variations after treatment. Methods A total of 169 females with depression were selected and divided into the first-episode (91 cases) and recurrent (78 cases) groups. Then, on the basis of their age, the first-episode patients were divided into the young (48 cases, age < 45 years), perimenopausal (20 cases, 45–55 years), and elderly groups (23 cases, age > 55 years); the patients with recurrent depression were classified into the young (37 cases, age < 45 years), perimenopausal (19 cases, 45–55 years), and elderly groups (22 cases, age > 55 years). The patients were assessed in accordance with the International Classification of Diseases of mental and behavioral disorders. The serum progesterone, prolactin, estradiol, and testosterone levels in the patients were measured, and differences in sex hormone levels of the groups were analyzed. Results The estradiol level was negatively correlated with age and the prolactin level was positively correlated with occupation. The severity of depression in females was found to be negatively correlated with age. The serum progesterone and estradiol levels in the young group were significantly higher than those in the elderly group, regardless of the first episode or recurrence. Estradiol levels in the perimenopausal and elderly groups with first-episode depression were significantly higher than those in the same group with recurrent depression. However, there was no significant difference in the serum progesterone, prolactin, estradiol, and testosterone levels in the recurrent group before and after treatment. Conclusions Sex hormone levels, especially estradiol, varied among females of different ages suffering from depression. Recurrent depression also has a certain effect on sex hormone levels in females. Not only should the age and relapse be considered when studying the sex hormone levels of females with depression, but also attention should be paid to whether the patients have used antidepressants before their sexual hormonal testing.

scholarly journals Perceptions and Impact of the 2017 Canadian Guideline for Opioid Therapy and Chronic Noncancer Pain: A Cross-Sectional Study of Canadian Physicians

2020 ◽  
Vol 2020 ◽  
pp. 1-6
Author(s):  
Jason W. Busse ◽  
Joyce Douglas ◽  
Tara S. Chauhan ◽  
Bilal Kobeissi ◽  
Jeff Blackmer
Keyword(s):  
Online Survey ◽  
Preliminary Evidence ◽  
Opioid Therapy ◽  
Cross Sectional Study ◽  
High Dose ◽  
Cross Sectional ◽  
Chronic Noncancer Pain ◽  
Canadian Guideline ◽  
Opioid Tapering ◽  
Noncancer Pain

Background. Physician adherence to guideline recommendations for the use of opioids to manage chronic pain is often limited. Objective. In February 2018, we administered a 28-item online survey to explore perceptions of the 2017 Canadian guideline for opioid therapy and chronic noncancer pain and if physicians had altered practices in response to recommendations. Results. We invited 34,322 Canadian physicians to complete our survey, and 1,128 responded for a response rate of 3%; 687 respondents indicated they prescribed opioids for noncancer pain and answered survey questions about the guideline and their practice. Almost all were aware of the guideline, 94% had read the document, and 89% endorsed the clarity as good or excellent. The majority (86%) felt the guideline was feasible to implement, but 66% highlighted resistance by patients, and 63% the lack of access to effective nonopioid treatment as barriers. Thirty-six percent of respondents mistakenly believed the guideline recommended mandatory tapering for patients using high-dose opioid therapy (≥90 mg morphine equivalent per day), and 58% felt they would benefit from support for opioid tapering. Seventy percent of respondents had changed practices to align with guideline recommendations, with 51% engaging some high-dose patients in opioid tapering and 43% reducing the number of new opioid starts. Conclusion. There was high awareness of the 2017 Canadian opioid guideline among respondents, and preliminary evidence that recommendations have changed practice to better align with the evidence. Ongoing education is required to avoid the misunderstanding that opioid tapering is mandatory, and research to identify effective strategies to manage chronic noncancer pain is urgently needed.

Long-term sexual function in survivors of vulvar cancer: A cross-sectional study

2012 ◽  
Vol 126 (1) ◽  
pp. 87-92 ◽  
Author(s):  
Menke H. Hazewinkel ◽  
Ellen T.M. Laan ◽  
Mirjam A.G. Sprangers ◽  
Guus Fons ◽  
Matthé P.M. Burger ◽  
...  
Keyword(s):  
Sexual Function ◽  
Vulvar Cancer ◽  
Cross Sectional Study ◽  
Sectional Study ◽  
Cross Sectional

scholarly journals Role of Sex Hormones at Different Physiobiological Conditions and Therapeutic Potential in MBD2 Mediated Severe Asthma

2021 ◽  
Vol 2021 ◽  
pp. 1-16
Author(s):  
Binaya Wasti ◽  
Zhifeng Chen ◽  
Yi Ke ◽  
Wen Tao Duan ◽  
Shao-Kun Liu ◽  
...  
Keyword(s):  
Severe Asthma ◽  
Sex Hormones ◽  
Human Body ◽  
Therapeutic Potential ◽  
Corticosteroid Treatment ◽  
Sex Hormone ◽  
Asthma Prevalence ◽  
Term Survival

Sex hormone has become a “hot topic” to evaluate the hormonal therapeutic potential in severe asthma. Th17 cell is one of the main influencing factors involved in the pathogenesis of severe asthma, hence also called as kernel of severe asthma, and Th17 subtype of non-T2 asthma is less responsive (resistance) to inhaled corticosteroid (ICS), so severe in nature. Methyl-CpG binding domain protein 2 (MBD2) is overexpressed and regulates the Th17 differentiation, showing the possibility of therapeutic target in treating Th17 mediated severe asthma. Sex hormone fluctuates at the different physiobiological conditions of the human body and affects the asthma pathobiology showing its role in asthma prevalence, severity, remission, and therapy. This review briefly overviews the sex hormones, their influence in asthma at the different physiobiological conditions of human body, and MBD2 severe asthma connection with the possible therapeutic potential of sex steroids in MBD2 mediated Th17 predominant severe asthma. Male sex hormone tends to show a beneficial effect and possibly downregulates the expression of Th17 cells via regulating MBD2 through a mechanism distinct from corticosteroid treatment and guides us towards discovery of new therapeutic agent, reduces the asthma-related complications, and promotes long-term survival by lowering the risk of therapy-resistant issues of old age severe asthma.

Prevalence, Characteristics, and Management of Chronic Noncancer Pain Among People Who Use Drugs: A Cross-Sectional Study

Pain Medicine ◽  
2020 ◽  
Vol 21 (11) ◽  
pp. 3205-3214
Author(s):  
Jean-Luc Kaboré ◽  
Lise Dassieu ◽  
Élise Roy ◽  
Didier Jutras-Aswad ◽  
Julie Bruneau ◽  
...  
Keyword(s):  
Illicit Drugs ◽  
Cross Sectional Study ◽  
Pain Medication ◽  
Health Condition ◽  
People Who Use Drugs ◽  
Sectional Study ◽  
Cross Sectional ◽  
Chronic Noncancer Pain ◽  
Relieve Pain ◽  
Noncancer Pain

Abstract Introduction Most studies on chronic noncancer pain (CNCP) in people who use drugs (PWUD) are restricted to people attending substance use disorder treatment programs. This study assessed the prevalence of CNCP in a community-based sample of PWUD, identified factors associated with pain, and documented strategies used for pain relief. Methods This was a cross-sectional study nested in an ongoing cohort of PWUD in Montreal, Canada. Questionnaires were administered to PWUD seen between February 2017 and January 2018. CNCP was defined as pain lasting three or more months and not associated with cancer. Results A total of 417 PWUD were included (mean age = 44.6 ± 10.6 years, 84% men). The prevalence of CNCP was 44.8%, and the median pain duration (interquartile range) was 12 (5–18) years. The presence of CNCP was associated with older age (&gt;45 years old; odds ratio [OR] = 1.8, 95% CI = 1.2–2.7), male sex (OR = 2.3, 95% CI = 1.2–4.2), poor health condition (OR = 1.9, 95% CI = 1.3–3.0), moderate to severe psychological distress (OR = 2.9, 95% CI = 1.8–4.7), and less frequent cocaine use (OR = 0.5, 95% CI = 0.3–0.9). Among CNCP participants, 20.3% used pain medication from other people, whereas 22.5% used alcohol, cannabis, or illicit drugs to relieve pain. Among those who asked for pain medication (N = 24), 29.2% faced a refusal from the doctor. Conclusions CNCP was common among PWUD, and a good proportion of them used substances other than prescribed pain medication to relieve pain. Close collaboration of pain and addiction specialists as well as better pain assessment and access to nonpharmacological treatments could improve pain management in PWUD.

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