Publications by authors named "Nicole Nisly"

Article Synopsis
  • The study examines the effects of gender-affirming hormone therapy (estrogen and testosterone) on various clinical chemistry analytes in healthy transgender and nonbinary individuals.
  • Key findings indicate that while most measures like electrolytes and urea nitrogen remained stable, certain enzymes and lipid levels shifted toward those typical for their affirmed gender, particularly in the testosterone group.
  • The research highlights the need for more tailored reference intervals for transgender patients, as hormone therapy may significantly alter some lab values that differ by biological sex in cisgender individuals.
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Background: Gender-affirming therapy with testosterone is commonly prescribed to aid in the masculinization of transgender men. Sex-hormone concentrations are routinely measured, but interpretation of results can be difficult due to the lack of published reference intervals.

Methods: Healthy transgender individuals who had been prescribed testosterone (n = 82) for at least a year were recruited from internal medicine and primary care clinics that specialize in transgender medical care.

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Background: Transgender women and nonbinary people seeking feminizing therapy are often prescribed estrogen as a gender-affirming hormone, which will alter their reproductive hormone axis. Testosterone, estradiol, and other reproductive hormones are commonly evaluated to assess therapy, but reference intervals specific to transgender women have not been established. The objective of this study was to derive reference intervals for commonly measured analytes related to reproductive endocrinology in a cohort of healthy gender nonconforming individuals on stable feminizing hormone therapy.

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Article Synopsis
  • This study examines how hormone therapy affects lab test results in transgender individuals, highlighting the need for sex-specific reference intervals.
  • Researchers analyzed a large group of transgender patients who had been on hormone therapy for at least 6 months, documenting changes in various lab parameters over time.
  • Findings revealed significant shifts in basic chemistry, endocrine, and hematologic results, emphasizing the variability in hormone treatment methods and the necessity for further research.
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Background: The complete blood count (CBC) is a cornerstone of patient care. Several of the normal values for the components of the CBC differ by sex and, therefore, male-specific and female-specific reference intervals are required to interpret these laboratory results. Transgender individuals are often prescribed hormone therapy to affirm their gender, with resulting serum hormone concentrations similar to those of cisgender individuals.

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It is important for the practicing primary care provider to become familiar with the unique health care needs for people who identify as transgender men, transgender women, and non-binary people, who are all within the scope of practice of a general obstetrician-gynecologist and other primary care providers. A review of the unique health needs and essential terminology is presented. This knowledge is a basic foundation to develop a welcoming and inclusive practice for people who are gender nonconforming.

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People who identify as lesbian, gay, bisexual, transgender, queer, and questioning (LGBTQ) are underserved and face barriers to knowledgeable health care. Most health systems are ill prepared to provide care that addresses the needs of the LGBTQ community. Basic steps to developing an LGBTQ welcoming health care program are presented.

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Background: Electronic medical records (EMRs) and laboratory information systems (LISs) commonly utilize patient identifiers such as legal name, sex, medical record number, and date of birth. There have been recommendations from some EMR working groups (e.g.

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Objectives: Complementary and alternative medicine (CAM) is a diverse collection of approaches used to prevent or treat diseases. The goal of this study was to examine relationships between dental patient characteristics and current usage of CAM therapies.

Methods: The CAM definition encompassed 24 therapies excluding prayer.

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This pilot study investigated the prevalence and specific reasons for usage of complementary and alternative medicine (CAM) among patients of a dental school clinic. Four hundred and two patients completed a 30-page survey on CAM usage. A higher rate of CAM usage was found in this dental school clinic population than rates previously reported in a general population.

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Excessive and inappropriate use of medications, or 'polypharmacy', has been recognized as a public health problem. In addition, there is growing use of dietary supplements in the United States; however, little is known about the patterns of supplement use. Recent reports in the literature of cases of excessive or inappropriate use of herbal dietary supplements leading to the term 'polyherbacy'.

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Objective: Previous studies have noted the role of race/ethnicity in use of complementary and alternative medicine (CAM). Asian and Pacific Islanders (APIs) in particular have been found to use herbs more frequently, although the patterns of use among this population have not been described. The goal of this study was to characterize the rates and patterns of herb use among the API population of the United States.

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Background: Concerns have been raised about the sufficiency of dietary botanical supplement (DBS) surveillance in the US. The Food and Drug Administration's Center for Food Safety and Applied Nutrition's Adverse Event Reporting System (CAERS) represents one of the few existing surveillance mechanisms, but it has not been well characterized with respect to DBS adverse effects.

Objective: To characterize data on DBSs associated with adverse event reports submitted to CAERS.

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Purpose: The purpose of this report is to characterize reports to poison control centers (PCCs) involving two widely used herbal dietary supplements (HDSs), Echinacea, and St. John's wort (SJW).

Methods: We purchased data from the American Association of Poison Control Center's (AAPCC) toxic exposure surveillance system (TESS(R)) on reports made to PCCs in 2001 involving Echinacea or SJW.

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Objective: To examine the extent to which US adults use herbs (herbal supplements) in accordance with evidence-based indications.

Patients And Methods: The Alternative Health supplement of the 2002 National Health Interview Survey (NHIS) is part of an annual, nationally representative survey of US adults. It contains data on adults' use of the 10 herbs most commonly taken to treat a specific health condition in the past year (January 1 to December 31, 2002).

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Purpose: The correlates of complementary and alternative medicine (CAM) utilization among elders have not been fully investigated. This study was designed to identify such correlates in a large sample of older adults, thus generating new data relevant to consumer education, medical training, and health practice and policy.

Design And Methods: A subsample from the 2000 Wave of the Health and Retirement Study (n = 1,099) aged 52 or older were surveyed regarding use of CAM (chiropractic, alternative practitioners, dietary and herbal supplements, and personal practices).

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Background: Previous research has indicated that older adults with severe life stress show attenuated immune responses to influenza vaccination. Associations among mood, optimism, stress, and the in vitro cytokine response to influenza virus and vaccine were evaluated in 18 healthy older adults with low to moderate life stress.

Methods: Peripheral blood mononuclear cells were stimulated in cultures with 1999-2000 influenza vaccine viruses (A/Beijing/262/95, A/Sydney/5/97, and B/Yamanashi/166/98) and the 2000-2001 trivalent vaccine (containing A/New Caledonia/20/99, A/Panama/2007/99, and B/Yamanashi/166/98).

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In order to assess attitudes, awareness, and behavior related to complementary and alternative medicine (CAM) among academic physicians, a questionnaire study was conducted with faculty in one of the largest teaching hospitals in the United States. The survey assessed attitudes toward and awareness of 11 CAM therapies in regard to patient usage and usefulness. The majority of respondents believed that only 20% or less of their patients used CAM.

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