The Prevalence and Indications of Intravenous Rehydration Therapy in Hospital Settings: A Systematic Review

(1) Objective: We performed a systematic review to explore the prevalence of intravenous (IV) rehydration therapy in hospital settings, and we assessed it by patient groups and populations. (2) Methods: A systematic review of major databases and grey literature was undertaken from inception to 28 March 2022. Studies reporting prevalence of IV rehydration therapy in a hospital setting were identified. The data were synthesised in a narrative approach. (3) Results: Overall, 29 papers met the inclusion criteria. The prevalence of IV rehydration therapy in paediatric patients ranged from 4.5% (hospitalised with diarrhoea and dehydration) to 100% (admitted to the emergency department with mild to moderate dehydration caused by viral gastroenteritis), and in adults this ranged from 1.5% (had single substance ingestion of modafinil) to 100% (hospitalised with hypercalcemia). The most common indication for IV rehydration therapy in paediatric patients was dehydration due to fluid loss from the gastrointestinal tract. Other causes included malnutrition, neuromuscular disease, bronchiolitis, and influenza. In adults, indications for IV rehydration therapy were much more diverse: fever, diarrhoea, drug intoxication, hypercalcemia, cancer, and postural tachycardia syndrome; (4) Conclusions: This systematic review showed that IV rehydration therapy in paediatric patients is often used to treat dehydration and diarrhoea, while in adults it has a broader spectrum of use. While IV rehydration therapy is important in correcting fluid problems and electrolyte status, the maintenance fluid prescribing practices vary considerably, and guidelines are scarce

Does the use of hormonal contraceptives increase the risk of depression - systematic review and secondary analysis of NHANES data

Background: The debate whether hormonal contraceptives increase the risk of experiencing de-pression is still open. The existing research has failed to draw a firm conclusion in this area. The importance of clarifying the risk of hormonal contraceptives on depression is crucial to protect women from unintended pregnancies and abortions as a consequence. Methods: This thesis has been divided into three parts: a systematic review and meta-analysis, NHANES data analysis and an online survey. The systematic review and meta-analysis assessed the existing literature on the effect of hormonal contraceptives on depression, and systematically summarised the available data. A secondary analysis of NHANES data examined the association between oral contraceptive pill (OCP) and depression. Whilst the online survey investigated the association between the two main types of OCP, namely combined oral contraceptive pill (COC) and progestogen only pill (POP), and depression. Results: The systematic review narrative synthesis suggests that compared to non-users of hormonal contraceptives, women taking COCs do not have an increased risk of experiencing depression. Whilst, women using the contraceptive patch, vaginal ring, POP, levonorgestrel-intrauterine system (LNG-IUS) have an increased risk of suffering from depression. The risk of depression amongst women using contraceptive injection and contraceptive implant remains unclear. The meta-analyses suggest several different associations. A lack of association between depression in women using combined hormonal contraception (CHC) compared with women not using hormonal contraceptives. A lack of association between depression in women taking COCs compared with women not using hormonal contraceptives. A lack of an association between depression in women using progestin containing long-acting reversible contraceptive (LARC) compared with women not using hormonal contraceptives. A positive association between depression in women taking progestogen-only contraceptives (POCs) compared with women not using hormonal contraceptives; this association was present in high quality studies and absent in low quality studies. The secondary analysis of the NHANES data suggests that women using OCPs had a lower prevalence of depressive symptoms compared to non-users of OCPs. This association was stronger in younger women and attenuated with age. Finally, the online survey suggests that neither COC nor POP use is associated with clinically relevant depression. Conclusion: The results obtained suggest that there is no clear relationship between the whole class of hormonal contraceptives and depression. However, use of the contraceptive patch, vaginal ring, POPs, and LNG-IUS are associated with increased risk of experiencing depression. Further-more, the study design seems to influence research findings with a tendency for cross-sectional studies to show a trend towards lower or no risk, and higher quality prospective studies to show a trend towards higher risk of depression. Therefore, more research will be required to elucidate the causes of this effect

Association of Oral Contraceptive Pill Use and Depression Among US Women

Background: The link between oral contraceptive pill (OCP) and depression is still unclear. This work analyses the prevalence and correlates of major depression in US women using OCP.Methods: This study used the National Health and Nutrition Examination Survey (NHANES) 2005–2012 data to provide the prevalence and correlates of major depression in women using OCP. Major depression was defined as a score of ≥10 using the Patient Health Questionnaire-9 (PHQ-9).Results: A total of 6239 women aged 18–55 years were included in the present analysis. Current OCP users had a lower prevalence of major depression (4.6 %; 95 % CI, 3.2 to 6.6) compared to former users of OCP (11.4 %; 95 % CI, 10.1 to 12.9) and never users of OCP (10 %; 95 % CI, 8.3 to 12.1). Current users of OCP were significantly less likely to report major depression compared to former users of OCP (OR 0.59; 95CI%, 0.39 to 0.90) after adjusting for potential confounders. The prevalence of major depression was higher in women who were: black or Hispanic, widowed/divorced/separated, those with a low and middle income, current smokers, current users of antidepressants, and with history of cancer and thyroid problems.Limitations: This is a cross-sectional study.Conclusion: The prevalence of major depression among women using OCP may be lower than in former users of OCP, however, the burden of depression remains high. Further research with longitudinal follow-up for depression in women using OCP is needed to understand real world effect of the OCP on depression.</p

Disparities in the prevalence of suicidal ideation according to oral contraceptive pill use among US women: a cross-sectional study

Background and Aims: The relationship between oral contraceptive pill (OCP) and suicidal ideation remains unclear. This study aims to estimate the prevalence of suicidal ideation among US women and evaluate their associates overall and according to OCP use status.Methods: Data from the National Health and Nutrition Examination Survey (NHANES) 2005−2012 were used to calculate the prevalence and associates of suicidal ideation in women using OCP. Suicidal ideation was assessed using the Patient Health Questionnaire‐9. Overall and OCP‐specific weighted prevalence of suicidal ideation were estimated. Multivariable logistic regressions were used to investigate overall and OCP‐specific associates.Results: The prevalence of suicidal ideation was 3.6% with no evident disparity between OCP groups, suggesting that OCP use is not associated with increased prevalence of suicidal ideation. Smoking was inversely associated with suicidal ideation in the former users of OCP. In the overall population, the prevalence of suicidal ideation was greater in those who were: Black or Hispanic, smoking, taking antidepressants, those with lower educational attainment, and women with low and middle income.Conclusion: Our findings suggest that OCP use was not associated with increased prevalence of suicidal ideation. Unique associates were identified among different OCP groups.</p

Racial and Ethnic Disparities in Prevalence and Correlates of Depressive Symptoms and Suicidal Ideation Among Adults in the United States, 2017-2020 Pre-Pandemic

Background: This study aims to estimate the pre-COVID-19 pandemic prevalence of mild, major depressive symptoms, and suicide ideation among U.S. adults and evaluate their correlates and racial/ethnic disparities.Methods: This is a cross-sectional analysis of a nationally representative sample of adults ≥20 years from the National Health and Nutrition Examination Survey study 2017–2020 Pre-Pandemic. Overall and racial/ethnic-specific weighted prevalence and 95%CI of mild and major depressive symptoms and suicidal ideation assessed by the Patient Health Questionnaire-9 were calculated. Multivariable logistic regression modelings were used to examine overall and racial/ethnic-specific correlates.Results: Data on 7917 US adults (Weighted N = 210,200,829; 51.8 % females) were analyzed. The prevalence of mild, major depressive symptoms, and suicidal ideation was 8.5 %, 16.5 %, and 3.2 %, respectively. Overall, consistent correlates for all three conditions included smoking, short/long sleep duration, and obesity. Females, non-Hispanic Blacks, low family-poverty-income ratio, prolonged sitting time, and a history of cardiovascular disease were consistent correlates for mild and major depressive symptoms. Younger age, never married/living without a partner, physical inactivity, drinking alcohol, and a history of diabetes were related to major depressive symptoms. Never married/living without a partner and having a low family-poverty-income ratio correlate with suicide ideation. Having cancer diagnosis was only negatively associated with major depressive symptoms in non-Hispanic Blacks. Females, current smoking, short/long sleep duration, and having cardiovascular disease were correlated with suicidal ideation among Hispanics.Conclusions: The prevalence of mild, major depressive symptoms, and suicidal ideation were high among U.S. adults. Unique correlates were identified among different racial and ethnic groups.</p

Global time trends of perceived loneliness among adolescents from 28 countries in Africa, Asia, and the Americas

Background: Perceived loneliness in adolescence is associated with a plethora of adverse outcomes. However, data on its temporal trends are scarce. Therefore, we aimed to examine the temporal trend of perceived loneliness among school-going adolescents aged 12–15 years from 28 countries in Africa, Asia, and the Americas, where temporal trends of loneliness are largely unknown.Methods: Cross-sectional data from the Global School-based Student Health Survey 2003–2017 were analyzed. Perceived loneliness referred to feeling lonely most of the time or always in the past 12 months. Crude linear trends of perceived loneliness by country were assessed by linear regression models.Results:Data on 180,087 adolescents aged 12–15 years were analyzed [Mean (SD) age 13.7 (1.0) years; 51.4 % females]. The overall prevalence of perceived loneliness was 10.7 %. Among the 28 countries included in the study, significant increasing and decreasing trends were observed in six counties each, with stable trends found in 16 countries. The most drastic increase and decrease were observed in Egypt between 2006 (7.9 %) and 2011 (14.3 %), and in Samoa between 2011 (23.3 %) and 2017 (8.0 %), respectively. Stable trends with high prevalence across time were also common.Conclusion: Our data suggest that perceived loneliness among adolescents is a global phenomenon, which has seen little improvement if any in recent years. It would be prudent to implement nationwide policies to combat loneliness globally.</p