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Introduction: There is growing concern internationally about co-occurring gambling and homelessness. We systematically review prevalence estimates in help-seeking and community samples., Methods: Adopting PRISMA guidelines, we searched CINAHL Plus, Cochrane Library, Embase, Ovid MEDLINE, PsychINFO, Proquest Central, PubMed, Scopus, Web of Science, and Google Scholar for relevant peer-reviewed articles in English. Primary outcomes examined in narrative and quantitative syntheses included prevalence of: (i) gambling in persons experiencing homelessness; (ii) harmful gambling in persons experiencing homelessness; and, (iii) homelessness in persons experiencing harmful gambling., Results: Searches identified 917 records after removing duplicates. After screening, 45 articles providing 54 prevalence estimates across 12 countries were included, with help-seeking (k = 37) and community based sample (k = 8) estimates pooled separately. Gambling prevalence (all timeframes) in help-seeking samples of persons experiencing homelessness is low (28.7%, 95% CI: 17.3-41.7, k = 14) compared to the general population (approximately 60-80%). However, harmful gambling prevalence (including problem, pathological, and disordered gambling) in help-seeking samples of persons experiencing homelessness is high (16.5%, 95% CI: 10.2-24.2, k = 20) compared to the general population (approximately 1-7%). Additionally, homelessness prevalence is high in help-seeking samples of persons experiencing harmful gambling (23.6%, 95% CI: 18.4-29.2, k = 4) compared to the general population (<1%). Meta-analysis found high between-study heterogeneity and risk of bias from small samples sizes., Conclusions: There are high rates of harmful gambling in persons experiencing homelessness and, concurrently, high rates of homelessness in persons experiencing harmful gambling. Improvements in sampling and measurement are needed to strengthen robustness and generalizability of prevalence estimates, which can potentially inform the scale and targeting of clinical interventions, support services, and policy responses., (Copyright © 2021 Elsevier Ltd. All rights reserved.)

Objectives: Previous studies have investigated the impact of venesection upon different metabolic indices in patients with various conditions (e.g., type 2 diabetes and iron overload). We aimed to investigate the changes on different metabolic indices including glycemic, iron, lipids and inflammatory markers at different time points after blood donation in male subjects with normal glucose tolerance., Design and Methods: 42 male subjects were recruited to the study. Glucose tolerance was assessed by oral glucose tolerance test before (visit A) and after the blood donation (1day, visit B; 1week, visit C; 3weeks, visit D; and 3months, visit E). Fasting glucose, HbA1c, insulin, lipids, uric acid, C-reactive protein, iron stores and insulin resistance (HOMA-IR, ISI-gly) indices were measured. A repeated measures ANOVA was used for comparisons of quantitative variables between different visits., Results: All subjects had normal glucose tolerance according to WHO criteria. Fasting glucose, insulin and HOMA-IR were significantly higher (~2%, p<0.05; ~21%, p<0.01; and ~11%, p<0.05 respectively) at visit B following donation. At visit D, the mean±SE for HbA1c (5.28±0.06%) was significantly lower with a difference in percentage of ~-3% and p<0.05 compared to visit A (5.44±0.06%). Ferritin decreased significantly at visits B, C, D and E (~-8%, p<0.01, ~-24%, p<0.001, ~-39%, p<0.001 and ~-29%, p<0.01 respectively), when compared to visit A., Conclusions: At different time points after blood donation, glycemic status and iron stores are affected significantly in male blood donors with normal glucose tolerance. The changes were particularly evident three weeks after donation. Hence, the interpretation of these parameters in male blood donors needs to take this into account, and the mechanisms resulting in these effects need to be clarified., (Copyright © 2015 The Canadian Society of Clinical Chemists. Published by Elsevier Inc. All rights reserved.)

Objective: To evaluate the biological variation of serum insulin-like growth factor binding protein-1 (IGFBP-1) in individuals with different degrees of glucose tolerance., Research Design and Methods: IGFBP-1 was measured in 42 fasted subjects with: normal glucose tolerance (NGT=15), impaired fasting glucose (IFG=9), impaired glucose tolerance (IGT=9) and type 2 diabetics (DM=9). Short- and long-term reproducibility was determined for IGFBP-1., Results: The longer-term reproducibility (CV) of serum IGFBP-1 was 20.9%, 29.5%, 33.1% and 48.0% for subjects with NGT, IFG, IGT and DM respectively. The results for the short-term serum IGFBP-1 yielded CVs for these same respective categories of 8.2%, 16.1%, 29.2% and 13.8%., Conclusions: IGFBP-1 measurement was least variable in NGT individuals over both long-term and short-term intervals and variability increased with deteriorating glucose tolerance. Due to its biological variation, IGFBP-1 serum level is more reliable in normal subjects than in individuals with type 2 diabetes.

We describe the case of a 49-y-old female patient on long-term parenteral nutrition after abdominal surgery who failed to gain weight despite nutritional provision in excess of theoretical requirements. On investigation, she was found to have a negative nitrogen balance (-5.9 g) and to have a tri-iodothyronine thyrotoxicosis but without many of the typical clinical features of hyperthyroidism. The patient also had mild hypercalcemia and hyperphosphatemia, which resolved fully after mobilization and treatment of the thyrotoxicosis. A derangement of the liver function tests was observed, which worsened progressively during parenteral nutrition but resolved promptly at its discontinuation. This case illustrates the importance of carrying out appropriate investigations including all thyroid function tests on patients who fail to gain weight on nutritional support.