GH treatment in pediatric Down syndrome: a systematic review and mini meta-analysis.

Objective: To analyze and determine the safety and efficacy of growth hormone (GH) treatment in Down syndrome (DS) pediatric patients and to weigh ethical aspects involved. Design: Systematic review and mini meta-analysis of the literature. Methods: A search was performed in PubMed, Embase, Scopus, and PsycINFO through August 2022. Eligible studies included those who answered at least one of the following two questions: 1) What is the effect of growth hormone treatment in children with Down syndrome? 2) What are the ethical arguments in favor and against growth hormone treatment for children with Down syndrome? Multiple reviewers independently screened each article for eligibility. Results: In total sixteen reports detailed medical effects of GH treatment in pediatric DS patients and eight studies dealt with ethical aspects of GH treatment. Treatment with GH resulted in significantly higher growth velocity in patients with DS. The ethical complexity is great but does not present insurmountable difficulties to the therapeutic option. Conclusions: As GH treatment is safe and effective for short-term height growth, GH therapy should be considered in long-term treatment of DS children.

GHRH-GH-IGF1 axis in pediatric Down syndrome: A systematic review and mini meta-analysis.

Objective: To analyze and determine the quality of functioning in different components of GHRH-GH-IGF1 axis in children with Down syndrome (DS). Design: Systematic review and mini meta-analysis of the literature. Methods: A search was performed in PubMed, Embase, Scopus, and PsycINFO through August 2022. Eligible studies included pediatric patients with DS who had undergone any laboratory evaluation of the GHRH-GH-IGF1 axis. Two reviewers independently screened articles for eligibility. Results of each type of test were weighed together in patients both with and without DS and were pooled using a random effects meta-analysis. Results: In total, 20 studies assessed the GHRH-GH-IGF1 axis function. A defect in three major components of GHRH-GH-IGF1 axis was found in a significant proportion of pediatric DS patients. Conclusions: A significant portion of short-stature pathogenesis in children with DS is associated with impaired GHRH-GH-IGF1 axis function.

The association between overactive bladder and fibromyalgia: A systematic review and meta-analysis.

BACKGROUND: Overactive bladder is a common syndrome that significantly affects the quality of life. Fibromyalgia is characterized by widespread pain, impacting patients' lives. The exact mechanisms of the two syndromes remain unknown, but there is an overlap between the suspected pathophysiologies. OBJECTIVE: To present an overview of the current research on the association between overactive bladder (OAB) and fibromyalgia. SEARCH STRATEGY: A systematic search of four electronic databases was conducted. SEARCH STRATEGY: Studies examining the correlation between OAB and fibromyalgia with female patients aged over 18 years were included. DATA COLLECTION AND ANALYSIS: Two reviewers screened the studies for eligibility. Eligible studies were screened for quality. A meta-analysis was performed for eligible studies. MAIN RESULTS: Seven studies were included in the final review, of which six presented a positive association between the syndromes. The studies demonstrated a positive association between fibromyalgia and the severity of OAB and an adverse effect on the quality of life related to OAB. A mean effect size of 1.96 (95% confidence interval 0.85-3.06) was calculated. CONCLUSION: OAB and fibromyalgia are both complex and multifactorial syndromes. The study presents an association between them, but additional studies on the topic should be conducted for a more precise conclusion.

A systematic review of stem cell therapy treatment for women suffering from stress urinary incontinence.

BACKGROUND: Stem cell therapy (SCT) is used for regeneration of injured tissues. This seems a novel promising strategy for restoring urethral sphincter function in patients with stress urinary incontinence (SUI). OBJECTIVE: To summarize the clinical trials available to date on SCT for treatment of SUI in women. SEARCH STRATEGY: PubMed, Cochrane Library, Scopus and Embase. SELECTION CRITERIA: Prospective interventional case series, randomized prospective interventional study and prospective cohort study assessing women aged 18 years and over diagnosed with SUI and treated by SCT were included. The quality of studies was finally assessed using the JBI Critical Appraisal Checklists according to the PRISMA guidelines. DATA COLLECTION AND ANALYSIS: Nineteen studies (n = 773 patients) were selected for final analysis. These were conducted worldwide between the years 2005 and 2016. Although different cell types were used, general processing steps were similar. The follow-up period ranged between 6 weeks and 6 years and included common subjective and objective evaluation tools. RESULTS: Overall, the studies imply that SCT for treatment of SUI is a safe and effective treatment. CONCLUSION: In our opinion, the initial results of SCT for the treatment of SUI seem promising. Standardization and validation of this treatment modality is required before it can be recommended for routine use.