Search Results (137)

Background: Adolescents face unique challenges as they transition from childhood to adulthood, which can be marked by risky behaviours such as substance use and sexual activities. The present study analyses the relationship between risky sexual behaviour and the use of psychoactive substances, namely alcohol, cannabis, and other illegal substances, among students aged 15–16 years in 23 European countries, to investigate potential between-country differences. Method: Data were extracted from the 2019 European School Survey Project on Alcohol and Other Drugs (ESPAD) cross-sectional survey. Risky sexual behaviour was defined as self-reported unprotected sex. Substance use, other individual risk behaviours, and parenting indicators were investigated as key predictors. Results: A 9.8% of 16-year-old students in Europe reported sexual intercourse without a condom in the past year, and 7.8% had unprotected sex while not using alcohol/drugs, with a higher prevalence observed among males (8.5%) than among females (7.1%). Prevalence ranged from 3.2% in Georgia to 16.0% in Sweden. The multivariate analysis revealed significantly higher odds of engaging in sexual intercourse without a condom in illicit drug users (cannabis, inhalants, cocaine, ecstasy) and heavy episodic drinkers, students who went out in the evening, and those belonging to non-traditional families. Conclusions: Unprotected sex in the past year and substance use are strongly associated amid 16-year-old students in Europe. The prevalence of risky sexual behaviours across European countries does not follow a clear geographical pattern, suggesting that simple macro-level factors, such as broad regional or cultural groupings, may only partially explain prevalence differences. Full article

Cardiovascular–Kidney–Metabolic (CKM) syndrome arises from interrelated cardiovascular, renal, and metabolic pathways that require coordinated therapeutic strategies. This narrative review synthesizes recent systematic reviews, meta-analyses, and original studies to evaluate the translational application of lifestyle medicine (LM) for CKM management. Evidence indicates that LM interventions targeting the six pillars of practice (nutrition, physical activity, stress management, sleep, social support, and avoidance of risky substances) can improve blood pressure, lipid profiles, glycemic control, and weight, with benefits that complement or at times rival pharmacotherapy. We outline opportunities at the LM–drug interface, including sodium-glucose cotransporter-2 inhibitors and nutrient-stimulated hormone agents such as GLP-1 and GIP, and highlight the need to test synergy and sequencing with LM. Persistent implementation barriers include prioritization of drug-centric care and limited protocolized delivery; the AHA 5A model and digital health tools, including wearables that enable real-time feedback, provide practical routes for integration. Marginalized populations carry a disproportionate burden of CKM, underscoring the need for equitable, culturally tailored approaches. Sex-specific gaps, particularly in post-menopausal lipid metabolism and insulin sensitivity, point to the promise of genomic and nutraceutical personalization. Future work should use preregistered, adequately powered multimodal trials to establish durable, scalable pathways for CKM care. Full article

Adolescence is a critical period during which alcohol is the most commonly used substance worldwide, and such use has detrimental effects on neurobiological, psychosocial, and physiological development. Despite substantial international evidence, little is known about the concurrent influence of drinking motives and internalizing symptoms on adolescent alcohol use, particularly in the Croatian context, where adolescent drinking rates remain high. A cross-sectional study using a survey questionnaire was conducted in 2024 in Split-Dalmatia County, Croatia. The final stratified cluster sample comprised 925 students (58.8% of the planned sample), with a mean age of 15.41 years. Using hierarchical regression analysis, the results showed that the final model, which included both drinking motives and mental health indicators, explained 39.6% of the variance in alcohol use, 37.2% of the variance in binge drinking, and 31.8% of the variance in alcohol intoxication. Male sex was consistently associated with all three outcomes, whereas age was positively associated with alcohol use and binge drinking. Drinking motives contributed the largest proportion of the explained variance. Furthermore, lower levels of loneliness and higher levels of anxiety were associated with more frequent alcohol use, while lower stress and higher anxiety were associated with more frequent intoxication. Drinking motives are stronger predictors of adolescent alcohol use and risky drinking patterns than internalizing symptoms whose predictive strength was generally small. Prevention programs should address aspects of drinking motives in addition to promoting mental health. Full article

Problematic smartphone use (PSU) is increasingly recognized as a behavioral concern among university students, with consequences for well-being, risky behaviors, and academic outcomes. However, evidence from Greece remains limited. This study assessed the prevalence and correlates of PSU among students at the University of Piraeus and interpreted findings through Griffiths’ components model of addiction. A cross-sectional survey was conducted between March and June 2023 with 1743 participants, who provided socio-demographic, lifestyle, and health information and completed the Smartphone Addiction Scale–Short Version (SAS-SV). Nearly half of the students (49.2%) exceeded the proposed SAS-SV thresholds for PSU (50.5% men; 48% women). Regression analysis showed that alcohol consumption (p < 0.001), weekly screen time (p < 0.001), younger age (p < 0.001), female sex (p < 0.001), size of household (p < 0.033), and anxiety/depression (p = 0.019) were significant predictors of higher SAS-SV scores, while smoking, BMI, exercise, and academic performance were not associated. For the independent statistical tests, the Benjamini–Hochberg correction was applied to control the false discovery rate. Group comparisons confirmed greater alcohol use (p < 0.001), screen exposure (p < 0.001), and anxiety/depression (p = 0.004) among PSU students. Item-level responses reflected components of tolerance, salience, withdrawal, and conflict. These findings place Greek students at the higher end of international prevalence estimates and highlight the importance of integrating digital-well-being initiatives within student health services in universities. Full article

Background: Beverage intake is a consequential yet underappreciated driver of health in Mediterranean settings. Comparative evidence for Spain and Italy based on harmonised measures is scarce. This study addresses that gap by profiling beverage portfolios and their sociodemographic correlates in parallel adult samples from both countries. Methods: We conducted a cross-sectional analysis of adults in Spain (n = 483) and Italy (n = 403) using aligned, validated instruments (NutSo-HH; NutSo-HH-Ita). Outcomes were water (Wtr), sugar-sweetened soft drinks (Sfd), juice (Juc), energy drinks (End), coffee (Cff), alcohol (Alc), and episodes of intoxication (Gtd). Associations were assessed via non-parametric tests, multivariable linear models, and an EBIC-selected Gaussian graphical model (GGM). Main results: Italians reported higher Alc and Gtd; Spaniards reported higher Sfd and Juc. Wtr was comparable across countries, and Cff differences were marginal. Age and sex emerged as the most consistent correlates (older age and male sex with higher Alc; younger age with higher Sfd), whereas education and income were not stable determinants. The GGM suggested behavioural clustering of Sfd–Juc–End, with weak partial correlations for other beverages after adjustment. Implications: Distinct country profiles imply differentiated priorities. In Spain, interventions could prioritise reducing sugar-sweetened beverage intake among younger adults through age-targeted primary care counselling, mandatory water (and unsweetened milk) availability in schools, tiered excise taxes on sugar-sweetened drinks, and restrictions on child- and youth-directed marketing of high-sugar beverages. In Italy, primary care and community health services could routinely screen adults for risky alcohol use and deliver brief, culturally attuned advice that promotes lower-risk patterns of wine consumption during meals. Given the cross-sectional design, self-report measures, and non-probabilistic sampling, findings should be interpreted as context-sensitive markers rather than causal determinants; nevertheless, they highlight concrete prevention approaches and regulatory levers for each country’s beverage-related health risks. Full article

Objective: Fatty acids (FAs) play a pivotal role in brain development and cognitive functions during adolescence. We aimed to investigate the association of red blood cell (RBC) FA patterns and several high order neuropsychological functions in adolescents. Methods: The study followed a cross-sectional design. Principal component analysis was applied to 22 FA species previously measured in RBC membranes (exposure variable) to identify FA principal components (PCs) from two cohorts of adolescents in Catalonia, Spain (mean age = 14.53 years). Multiple linear regression was then used to examine associations between PC FAs and cognitive outcomes—working memory, fluid intelligence, and risky decision-making (gain and loss domains). Regression models were adjusted for child sex, age, body mass index, maternal education, and cohort enrollment. Results: Three FA PCs (eigenvalues > 2.0) were retained for the current study: a very-long chain FAs PC, a long-chain omega-6 FA PC and an omega-3 FA PC. The omega-3 FA PC showed a positive association with scores of fluid intelligence (${\beta }_1$ = 0.14, CI = 0.05, 0.24, p for trend = 0.003) and risky decision-making (loss domain) (${\beta }_1$ = 0.27, CI = 0.03, 0.52, p for trend = 0.030). The very-long chain FAs and long-chain omega-6 FAs patterns showed no significant associations with any cognitive outcome. The PC of omega-3 FA and fluid intelligence associations remained significant after multiple testing corrections. Conclusions: After applying an agnostic approach of multiple FAs in RBC, we found omega-3 FA patterns were positively associated with fluid intelligence among adolescents. Full article

Background/Objectives: The “TROVAILMIOVACCINO” platform was developed to help adults in Italy identify vaccines recommended for them based on individual characteristics, in line with the Italian National Immunization Plan (NIP). The website directs users to an anonymous online questionnaire addressing key factors such as age, sex, pregnancy status, travel history, medical conditions, and risky behaviors. It is intended for adults aged 18 and over and can be filled out either by individuals or by others on their behalf, such as healthcare professionals. The purpose of the study was to assess the platform’s reach, the health status of users, and its ability to inform users. Methods: Data were organized into tables and analyzed using frequencies, percentages, and statistical tests to assess user demographics and health conditions. Significant differences among sociodemographic groups were evaluated using the Chi-square and Fisher’s exact tests. Results: Over 30 months, the website was accessed 1897 times, with 1622 users (85.5%) completing the questionnaire for personal interest. The majority of users were aged 18–49 years (61.5%), with a nearly equal male–female distribution. Healthcare workers represented the most common professional group (29.2%) among users. Older individuals were more likely to have the questionnaire completed by someone else. Among respondents, 25.8% reported having a single medical condition, with cardiovascular diseases (11.9%), diabetes (6.7%), and respiratory diseases (4.8%) being the most frequent. The most common risk condition reported was potential contact with newborns. Conclusions: The findings highlight the value of the platform in reaching diverse user groups and offering tailored vaccine recommendations. Full article

Background/Objectives: Non-functional pituitary macroadenomas (NFPMA) are uncommon pituitary lesions that do not cause hormonal hypersecretion and are most often discovered at the macroadenoma stage. Consequently, they are more challenging to diagnose, often mimicking other non-secreting sellar masses, among which hypophysitis should be carefully considered. This study aimed to differentiate between non-functioning pituitary macroadenomas (NFPMA) and hypophysitis, two distinct sellar pathologies with overlapping MRI features, by developing a diagnostic score based on clinical, biological, and radiological criteria. Methods: We conducted a prospective study, including 56 patients with NFPMA and 16 patients with hypophysitis primarily of the lymphocytic subtype. A total of 31 clinical, biological, and radiological variables were analyzed using univariate and multivariate statistical methods to identify significant predictors and to establish a diagnostic score. Results: Nine significant criteria were identified: female sex, headaches, visual disturbances, corticotropic insufficiency, pituitary volume ≤ 7 cm³, loss of the posterior pituitary bright spot, cavernous sinus invasion, optic pathway compression, and pituitary stalk thickening. The established score demonstrated significant performance in predicting the diagnosis of hypophysitis (p < 0.001; Area Under the Curve = 0.967; 95% CI = 0.926–1). The sensitivity and specificity of this score were 93.8% and 87.5%, respectively, using a threshold ≥0.5. The median score was −2 (interquartile range = [−3.5; 0.5]), with extremes ranging from −6.5 to 9. Among these, pituitary stalk thickening emerged as a key diagnostic indicator. Conclusions: This simple and effective multi-parametric score enables rapid and accurate differentiation of hypophysitis from NFPMA, helping to avoid unnecessary surgical interventions and to improve the management of pituitary insufficiencies and may be especially valuable in settings when biopsy is unavailable or risky. Full article

Chemsex is a phenomenon involving the intentional use of psychoactive substances before or during sexual activity, especially among men who have sex with men (MSM). It is associated with various health risks, including substance dependence, risky sexual behaviors, and both mental and somatic disorders. Despite its growing prevalence and public health relevance, chemsex lacks a clear definition and is not recognized as a distinct diagnostic entity. This narrative review synthesizes clinical, epidemiological, and technological evidence on chemsex; argues for its classification as a form of mixed addiction; and preliminarily proposes diagnostic criteria for a potential entity in the International Classification of Diseases, 12th Revision (ICD-12). This paper highlights key psychotropic substances used in chemsex, patterns of use, and their neurobiological, psychological, and behavioral consequences. It explores the relationship between chemsex and compulsive sexual behavior disorder (CSBD), current diagnostic frameworks (ICD-10 and ICD-11), and challenges in clinical practice. Therapeutic strategies discussed include cognitive behavioral therapy (CBT), digital interventions, and emerging applications of artificial intelligence (AI) in prevention and treatment. Attention is also given to epidemiological trends, sociocultural influences, and barriers to seeking help. This review concludes by identifying research gaps and advocating for a more integrated, multidimensional approach to classifying and treating chemsex-related syndromes. Full article

Background and Objectives: Women of the LGBTQ+ community, like heterosexual women, face a wide range of health issues and have a right to comprehensive healthcare. Unfortunately, they often do not seek healthcare due to concerns about possible discrimination or prejudice. The aims of this study were to analyze and compare experiences of LGBTQ+ individuals and heterosexual women during OBGYN appointments in Lithuania as well as to analyze the health of individuals whose biological gender is female and their lifestyle’s effect on their health. Materials and Methods: An anonymous online survey was conducted. Respondents answered questions regarding their gender and social identity; obstetrical, gynecological, and general clinical history; sexual life characteristics; and their experiences of visiting OBGYNs in Lithuania. Results: This study revealed that some lifestyle habits of LGBTQ+ respondents are more similar to those of heterosexuals than is often hypothesized. However, it also underscored such issues as the more common consumption of psychotropic substances, higher rates of depression, and more prevalent risky sexual practices among the LGBTQ+ community, as well as some neglected topics of OBGYN care in Lithuania. Conclusions: This study is the first in Lithuania to analyze the characteristics of LGBTQ+ individuals whose biological sex is female in relation to the field of obstetrics and gynecology. It provides important insights for the further improvement of the healthcare system regarding this topic. Full article

Background: The etiopathogenesis of atopic dermatitis is complicated, and it includes aspects such as dysfunction of the skin barrier, changes in immune responses, IgE-mediated hypersensitivity, and many characteristics of the environment. Regarding skin barrier dysfunction, a number of genetic changes have been described. This genetic predisposition could be related to the phenotypes of atopic dermatitis. Aim: In this study, several polymorphisms in five proinflammatory genes were associated with certain phenotypes of AD patients (genotype–phenotype study). Methods: In total, 89 unrelated AD Czech (Caucasian) patients were genotyped regarding five proinflammatory gene polymorphisms (angiotensinogen AGT M235T, AGT-6 G/A, TNF-α-238 G/A, TNF-β Fok1, IL-6-174 C/G and IL-6-596 G/A). Genotyping was performed using PCR and restriction analysis. For phenotypes, patients’ sex, age and personal and family history of atopy, aero- and food allergies and other complex diseases were evaluated. Results: A significant association with transepidermal water loss (TEWL) measured on the forearm was found with the AGT M235T polymorphism (p = 0.02). For the AG genotype of TNF-α-238 G/A, a six-times higher risk for a family history of diabetes mellitus compared to other examined aspects of family history was found (p = 0.02). A family history of thyreopathy was associated with the IL-6-174 G/C polymorphism when compared to a family history of other complex diseases. The GG genotype had a ten-times higher risk for a family history of thyreopathy compared to the other genotypes (p = 0.004). This result was highly specific (0.914). The GG genotype of IL-6-596 G/A was associated with a family history of thyreopathy, with the same result (p = 0.004). Moreover, the G allele of IL-6-174 G/C was associated with a family history of thyreopathy compared to AD patients without a positive family history of complex diseases (p = 0.03). In AD men, the MM genotype of the AGT M235T gene was found to be associated with food allergies (p = 0.004). This result was highly sensitive (0.833). A family history of cardiovascular disease in AD men was associated with AGT-6 G/A variability. The A allele was found to be six times more frequent in patients with a positive family history of cardiovascular disease (p = 0.02, with high sensitivity and specificity (0.700 and 0.735, respectively)). A family history of diabetes mellitus was associated with the TNF-β Fok1 polymorphism, where the B1 allele was almost six times more frequent in AD men with a positive family history of diabetes mellitus (p = 0.02), with high sensitivity (0.85). A significant association between TEWL measured on the forearm and the AGT M235T polymorphism was found when AD women were carriers of the MM genotype, with a median of 25 and range 4–61; those patients with the MT genotype had a median of 10 and range of 0.3–39; and patients with the TT genotype had a median of 5 and range of 3–40, p = 0.003. The polymorphism AGT-6 G/A was associated with different ages of eczema onset. The AG genotype was almost nine times more risky for the youngest group (0–7 years) compared to the oldest group (more than 18 years) (p = 0.02), with high specificity for this result. Conclusions: Our results in the field of cytokine signaling in the immune system in patients with atopic dermatitis are in agreement with those of GWASs. We suggest that cost-effective and simple PCR tests may be the best approach for the rapid and optimal collection of valid genetic information in clinical practice. Full article

Background and Objectives: This study aimed to evaluate the impact of myoinositol (MYO) and α-lipoic acid (ALA) supplementation on hormonal and metabolic markers in women diagnosed with polycystic ovary syndrome (PCOS). Materials and Methods: A retrospective case–control study was conducted with 58 women aged between 18–40 years who met the Rotterdam criteria for PCOS. The case group (n = 29) received MYO (2000 mg/day) and ALA (400 mg/day) supplements, while the control group (n = 29) did not receive any treatment. Data on the subjects’ anthropometric measures, glycemic indices, sex hormones, and lipid profiles were collected. Results: The results demonstrated that, following three months of MYO + ALA supplementation, the case group exhibited steady body weight (p = 0.484) and BMI (p = 0.405), whereas the control group demonstrated a significant increase in both (p = 0.029; p = 0.026, respectively). A stratified analysis based on BMI, waist circumference, and waist-to-height ratio revealed that HbA1c (%) was significantly lower in the “normal” subgroup compared to the “risky” subgroup within the case group (p < 0.05). Although the mean HbA1c, insulin, and HOMA-IR values were comparable between the two groups, the LH/FSH ratio significantly increased in the control group (p = 0.010). No significant differences were observed in the lipid profiles between the two groups; however, LDL levels decreased significantly in the case group (p = 0.024). Across all classifications, the “normal” subgroup consistently exhibited lower HbA1c and TG/HDL ratios than the “risky” subgroup. Conclusions: Adding MYO + ALA supplementation to standard PCOS treatment may offer metabolic benefits, particularly in maintaining glycemic control, body weight, and BMI. Supplementation also reduces LDL. Full article

Fear of missing out (FoMO) creates a strong urge to stay continuously connected and informed about peers’ activities, identified as a risk factor for problematic social media use and risky behaviors. Sexting is generally defined as the exchange of sexually suggestive or explicit photos, videos, or text messages through cell phones or other technologies. Despite its social relevance, the link between FoMO and sexting remains underexplored. This study examines their relationship in young adults—an understudied group compared to adolescents—while controlling for age, sex, and sexual orientation. The study surveyed 911 Italian young adults (18–30 years, M_age = 22.3, SD_age = 2.57, 74% women, 70.4% heterosexual) through an online questionnaire. The results indicate that FoMO predicts only risky sexting behaviors (sexting under substance use and sexting for emotion regulation) while not influencing experimental sexting (sending one’s own sexts). Additionally, the link between FoMO and sexting for emotion regulation is stronger among LGB individuals. Therefore, FoMO has proven to be strongly related to the two kinds of risky sexting but not to experimental sexting. Understanding this relationship can inform prevention and intervention programs on relationships, online communication, and sexting in young adults. Full article

Background: Sex work is one of the oldest trades in the world. It is the practice of sexual activity in exchange for money or material goods. It has traditionally been carried out by women, although in recent years, there has been an increase in the number of male sex workers. Sex workers have been recognized as a population at high risk of contracting and transmitting sexually transmitted infections and human immunodeficiency virus and have had limited access to multiple services, including health care. Objective: The aim was to identify the epidemiological profile and risk factors of a population of sex workers in the province of Granada, southern Spain. Methods: An analytical cross-sectional study was conducted by reviewing the medical records at a specific sexually transmitted infection center in Spain. Results: A total of 157 sex workers’ records were analyzed, most of whom were women, who mainly identified as heterosexual, with a mean age of 28.52 years and a high percentage of foreign nationality. Some sexual behaviors associated with the acquisition of sexually transmitted infections were also analyzed. Conclusions: The results revealed a deficient coverage of the health needs of a highly vulnerable and stigmatized social group, highlighting the need for interventions to prevent risky habits, as well as to promote behaviors aimed at achieving better sexual health. Full article

Why might women who experience intimate partner violence (IPV) become more likely to engage in risky sexual behavior? Women’s interest in casual sex may satisfy relational expectations and connection needs, while avoiding the types of close attachments that previously were violent. Specifically, attachment avoidance was tested as a mechanism linking IPV victimization and risky sexual behavior. Women who experienced (vs. did not experience) partner violence reported higher rates of risky sexual behavior, and this association was mediated by attachment avoidance (Study 1, N = 312; age range 18–58 years, M = 28). Making IPV salient via an experimental manipulation caused more avoidant perceptions (Study 2, N = 140; age range 19–57 years, M = 31), and inducing an avoidant mindset via an experimental manipulation caused greater sexual interest (Study 3, N = 128; age range 19–66 years, M = 33). These findings suggest that IPV disrupts expectations of security and reinforces a manner of connecting with partners that leads to risky sexual encounters. Full article