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Keywords = sex-specific differences

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18 pages, 1528 KiB  
Review
Sex Differences in Colorectal Cancer: Epidemiology, Risk Factors, and Clinical Outcomes
by Sophia Tsokkou, Ioannis Konstantinidis, Menelaos Papakonstantinou, Paraskevi Chatzikomnitsa, Eftychia Liampou, Evdokia Toutziari, Dimitrios Giakoustidis, Petros Bangeas, Vasileios Papadopoulos and Alexandros Giakoustidis
J. Clin. Med. 2025, 14(15), 5539; https://doi.org/10.3390/jcm14155539 (registering DOI) - 6 Aug 2025
Abstract
Colorectal cancer (CRC) constitutes a major global health concern, ranking as the third most common cancer and the second leading cause of cancer-related mortality. The current review explores sex-based differences in CRC epidemiology, risk factors, tumor biology, and clinical outcomes. Males exhibit a [...] Read more.
Colorectal cancer (CRC) constitutes a major global health concern, ranking as the third most common cancer and the second leading cause of cancer-related mortality. The current review explores sex-based differences in CRC epidemiology, risk factors, tumor biology, and clinical outcomes. Males exhibit a higher incidence and mortality rate, with left-sided (distal) CRC predominating, while females are more frequently diagnosed with right-sided (proximal) tumors, which tend to be more aggressive and less responsive to conventional chemotherapy. Genetic disparities, including microsatellite instability and X-chromosome tumor suppressor genes, contribute to sex-specific differences in tumor progression and treatment response. Immune variations also influence disease outcomes, with females exhibiting stronger immune surveillance but higher exhaustion markers. Lifestyle factors such as body mass index (BMI), smoking, and hormonal influences further modulate CRC risk. While males are more vulnerable to obesity-related CRC, central obesity (waist-to-hip ratio) emerges as a stronger predictor in females. Additionally, smoking increases CRC risk differentially by tumor location. These findings underscore the importance of sex-specific approaches in CRC prevention, screening, and treatment, advocating for personalized medicine strategies tailored to gender-based biological and clinical distinctions. Full article
(This article belongs to the Special Issue Gastrointestinal Cancer: Outcomes and Therapeutic Management)
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18 pages, 1056 KiB  
Article
Biomarkers of Metabolism and Inflammation in Individuals with Obesity and Normal Weight: A Comparative Analysis Exploring Sex Differences
by Eveline Gart, Jessica Snabel, Jelle C. B. C. de Jong, Lars Verschuren, Anita M. van den Hoek, Martine C. Morrison and Robert Kleemann
Int. J. Mol. Sci. 2025, 26(15), 7576; https://doi.org/10.3390/ijms26157576 - 5 Aug 2025
Abstract
Blood-based biomarkers allow monitoring of an individual’s health status and provide insights into metabolic and inflammatory processes in conditions like obesity, cardiovascular, and liver diseases. However, selecting suitable biomarkers and optimizing analytical assays presents challenges, is time-consuming and laborious. Moreover, knowledge of potential [...] Read more.
Blood-based biomarkers allow monitoring of an individual’s health status and provide insights into metabolic and inflammatory processes in conditions like obesity, cardiovascular, and liver diseases. However, selecting suitable biomarkers and optimizing analytical assays presents challenges, is time-consuming and laborious. Moreover, knowledge of potential sex differences remains incomplete as research is often carried out in men. This study aims at enabling researchers to make informed choices on the type of biomarkers, analytical assays, and dilutions being used. More specifically, we analyzed plasma concentrations of >90 biomarkers using commonly available ELISA or electrochemiluminescence-based multiplex methods, comparing normal weight (BMI < 25; n = 40) with obese (BMI > 30; n = 40) adult blood donors of comparable age. To help choose optimal biomarker sets, we grouped frequently employed biomarkers into biological categories (e.g., adipokines, acute-phase proteins, complement factors, cytokines, myokines, iron metabolism, vascular inflammation), first comparing normal-weight with obese persons, and thereafter exploratively comparing women and men within each BMI group. Many biomarkers linked to chronic inflammation and dysmetabolism were elevated in persons with obesity, including several adipokines, interleukins, chemokines, acute-phase proteins, complement factors, and oxidized LDL. Further exploration suggests sex disparities in biomarker levels within both normal-weight and obese groups. This comprehensive dataset of biomarkers across diverse biological domains constitutes a reference resource that may provide valuable guidance for researchers in selecting appropriate biomarkers and analytical assays for own studies. Moreover, the dataset highlights the importance of taking possible sex differences into account. Full article
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12 pages, 884 KiB  
Article
Anatomical Risk Patterns for Patellofemoral Instability in Skeletally Immature Patients: A Sex-Stratified MRI Study
by René Schroedter, Amir Koutp, Bernhard Guggenberger, Martin Svehlik, Sebastian Tschauner and Tanja Kraus
J. Clin. Med. 2025, 14(15), 5519; https://doi.org/10.3390/jcm14155519 - 5 Aug 2025
Abstract
Background/Objectives: Lateral patellar dislocation (LPD) is a common pathology of the adolescent knee and a major predisposing factor for patellofemoral instability (PFI). The pathogenesis of PFI involves a combination of anatomical and biomechanical contributors, with increasing evidence pointing to sex-specific differences in knee [...] Read more.
Background/Objectives: Lateral patellar dislocation (LPD) is a common pathology of the adolescent knee and a major predisposing factor for patellofemoral instability (PFI). The pathogenesis of PFI involves a combination of anatomical and biomechanical contributors, with increasing evidence pointing to sex-specific differences in knee morphology. Despite this, the developmental course of these parameters and their variation between sexes remain insufficiently characterized. This study aims to investigate sex-related differences in patellofemoral joint geometry among skeletally immature patients with a history of PFI, focusing on how these anatomical variations evolve with increasing knee size, as represented by femoral condylar width. Methods: A total of 315 knee MRIs from patients under 18 years with documented PFI were retrospectively analyzed. Trochlear morphology, patellar tilt, axial positioning, and sagittal alignment were assessed using established MRI-based parameters. All measurements were normalized to bicondylar width to account for individual knee size. Sex-specific comparisons were performed using independent t-tests and linear regression analysis. Results: Females exhibited significantly smaller femoral widths, shallower trochlear depth (TD), shorter tibial tubercle–posterior cruciate ligament (TTPCL) distances, and lower patellar trochlear index (PTI) values compared to males (p < 0.05). In males, increasing femoral width was associated with progressive normalization of patellar tilt and sagittal alignment parameters. In contrast, these alignment parameters in females remained largely unchanged or worsened across different femoral sizes. Additionally, patellar inclination angle and PTI were significantly influenced by knee size in males (p < 0.05), whereas no such relationship was identified in females. Conclusions: Sex-specific morphological differences in patellofemoral geometry are evident early in development and evolve distinctly with growth. These differences may contribute to the higher prevalence of PFI in females and underscore the importance of considering sex and knee size in anatomical assessments. Full article
(This article belongs to the Special Issue Recent Research Progress in Pediatric Orthopedic Surgery)
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19 pages, 3995 KiB  
Article
Lectin Recognition Patterns in the Gut of Meccus (Triatoma) pallidipennis and Their Association with Trypanosoma cruzi Metacyclogenesis
by Berenice González-Rete, Juan Antonio López-Aviña, Olivia Alicia Reynoso-Ducoing, Margarita Cabrera-Bravo, Martha Irene Bucio-Torres, Mauro Omar Vences-Blanco, Elia Torres-Gutiérrez and Paz María Silvia Salazar-Schettino
Microorganisms 2025, 13(8), 1823; https://doi.org/10.3390/microorganisms13081823 - 5 Aug 2025
Abstract
The successful transmission of Trypanosoma cruzi, the causative agent of Chagas disease, depends on intricate interactions with its insect vector. In Mexico, Meccus pallidipennis is a relevant triatomine species involved in the parasite’s life cycle. In the gut of these insects, the parasite [...] Read more.
The successful transmission of Trypanosoma cruzi, the causative agent of Chagas disease, depends on intricate interactions with its insect vector. In Mexico, Meccus pallidipennis is a relevant triatomine species involved in the parasite’s life cycle. In the gut of these insects, the parasite moves from the anterior midgut (AMG) to the posterior midgut (PMG), where it multiplies. Finally, T. cruzi differentiates into its infective form by metacyclogenesis in the proctodeum or rectum (RE). This study aimed to characterize and compare the protein and glycoprotein profiles of the anterior midgut (AMG) and rectum (RE) of M. pallidipennis, and to assess their potential association with T. cruzi metacyclogenesis, with special attention to sex-specific differences. Insects were infected with the T. cruzi isolate ITRI/MX/12/MOR (Morelos). Protein profiles were analyzed by polyacrylamide gel electrophoresis, while glycoproteins were detected using ConA, WGA, and PNA lectins. The metacyclogenesis index was calculated for male and female triatomines. A lower overlap of protein fractions was found in the RE compared to the AMG between sexes, suggesting functional sexual dimorphism. Infected females showed greater diversity in glycoprotein patterns in the RE, potentially related to higher blood intake and parasite burden. The metacyclogenesis index was significantly higher in females than in males. These findings highlight sex-dependent differences in gut protein and glycoprotein profiles in M. pallidipennis, which may influence the efficiency of T. cruzi development within the vector. Further proteomic studies are needed to identify the molecular components involved and clarify their roles in parasite differentiation and suggest new targets for disrupting parasite transmission within the vector. Full article
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13 pages, 680 KiB  
Article
Anthropometric Characteristics and Somatotype of Young Slovenian Tennis Players
by Ales Germic, Tjasa Filipcic and Ales Filipcic
Appl. Sci. 2025, 15(15), 8584; https://doi.org/10.3390/app15158584 (registering DOI) - 1 Aug 2025
Viewed by 225
Abstract
Tennis is a demanding sport that requires physical abilities and optimal body composition. The aim of this study was to investigate the anthropometric characteristics, body composition, and somatotype development of young Slovenian tennis players (754 boys and 514 girls aged 12 to 18 [...] Read more.
Tennis is a demanding sport that requires physical abilities and optimal body composition. The aim of this study was to investigate the anthropometric characteristics, body composition, and somatotype development of young Slovenian tennis players (754 boys and 514 girls aged 12 to 18 years) over the last two decades. Using standardised anthropometric measurements and the Heath-Carter method, somatotypes were calculated and analysed by age and gender. The results showed clear age- and gender-specific trends and differences in both somatotype profiles and detailed anthropometric characteristics. Significant differences were found in height, body mass, BMI, skinfolds, girths, and limb lengths, with gender differences becoming more pronounced in the older age groups. In boys, mesomorphy increased with age, reflecting an increase in musculature, while in girls, a shift from ectomorphic to endomorphic profiles was observed during adolescence, probably influenced by pubertal and hormonal changes. Significant sex-specific differences were observed in all three somatotype components in most age groups, especially in fat mass and muscle. The longitudinal design provides valuable data and insights into the evolving physical profiles of adolescent tennis players that support more effective talent identification and training. Despite the changes that have taken place in tennis over time, standardised measurement protocols ensured comparability, making the results relevant for practitioners working with adolescents in tennis development. Full article
(This article belongs to the Special Issue Human Performance and Health in Sport and Exercise—2nd Edition)
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13 pages, 310 KiB  
Review
Microbiome Shifts in Bladder Cancer: A Narrative Review of Urobiome Composition, Progression, and Therapeutic Impact
by Raul-Dumitru Gherasim, Călin Chibelean, Daniel Porav-Hodade, Ciprian Todea-Moga, Sabin-Octavian Tătaru, Tibor-Lorand Reman, Arpad-Oliver Vida, Maria-Veronica Ghirca, Matteo Ferro and Orsolya Katalyn Ilona Martha
Medicina 2025, 61(8), 1401; https://doi.org/10.3390/medicina61081401 - 1 Aug 2025
Viewed by 176
Abstract
Background/Objectives: Bladder cancer is a common malignancy with a high rate of recurrence and progression. Recent studies have identified that the urinary microbiome can be a key factor in tumor pathogenesis, progression, and outcomes. This narrative review is designed to summarize current [...] Read more.
Background/Objectives: Bladder cancer is a common malignancy with a high rate of recurrence and progression. Recent studies have identified that the urinary microbiome can be a key factor in tumor pathogenesis, progression, and outcomes. This narrative review is designed to summarize current evidence regarding the urobiome and explore its diagnostic and therapeutic potential. Methods: Studies between 2019 and 2024 were identified through the PubMed/MEDLINE and Google Scholar databases. Case reports and non-English-language articles were excluded. Results: The main findings revealed that specific bacteria, viruses, and taxa are linked to bladder cancer presence, progression, and response to immunotherapy treatment. Urinary microbiota differ by tumor type, sex, smoking status, and occupational exposure to toxins. Conclusions: Urinary microbiome and certain types of viruses present in urine may serve as promising tools to enhance bladder cancer diagnosis and predict treatment response. However, larger longitudinal studies are needed to confirm and establish these findings. Furthermore, integration of the urinary microbiome in clinical practice and public health strategies may reduce disease-related burden. Full article
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11 pages, 398 KiB  
Article
Perceived Physical Literacy Levels in Spanish Adolescents: Differences Between Sexes and Age Groups
by Raquel Albéniz-Pérez, Daniel Castillo, Pedro Duarte-Mendes and Javier Raya-González
Children 2025, 12(8), 1017; https://doi.org/10.3390/children12081017 - 1 Aug 2025
Viewed by 133
Abstract
Background/Objectives: Perceived physical literacy (PPL) appears to be a relevant strategy for combating the prevalent sedentary lifestyle among young people. Therefore, understanding their PPL levels will facilitate the implementation of appropriate strategies for this purpose. Therefore, this study aimed to analyze the [...] Read more.
Background/Objectives: Perceived physical literacy (PPL) appears to be a relevant strategy for combating the prevalent sedentary lifestyle among young people. Therefore, understanding their PPL levels will facilitate the implementation of appropriate strategies for this purpose. Therefore, this study aimed to analyze the differences in PPL considering the sex dimension (i.e., males and females) and the age-group (i.e., early compulsory secondary education, late compulsory secondary education and baccalaureate). Methods: Seven-hundred-and-four Spanish students (age = 14.3 ± 1.6 years old) belonging to three different Spanish secondary schools voluntarily participated in this study. To assess adolescents’ perceptions of their physical literacy, the Spanish Adolescents’ Perceived Physical Literacy Assessment (S-PPLI) was used. This instrument consists of nine items equally distributed across three categories: self-perception and self-confidence, self-expression and communication with others, and knowledge and understanding. Results: Males obtained higher scores in all the indicators of PPL, except for items 1, 8 and 9, compared to their female counterparts (p < 0.05), while the oldest age-group reported higher scores in the indicators of knowledge and understanding category compared to students in the early years of compulsory secondary education (p < 0.01). Conclusions: Programs based on increasing the PPL should be implemented specifically for females. Also, similar programs must be included into scholar curriculums from the beginning of secondary education, with the aim of promoting improvements in the health and physical condition of Spanish adolescents. Full article
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24 pages, 5018 KiB  
Article
Machine Learning for the Photonic Evaluation of Cranial and Extracranial Sites in Healthy Individuals and in Patients with Multiple Sclerosis
by Antonio Currà, Riccardo Gasbarrone, Davide Gattabria, Nicola Luigi Bragazzi, Giuseppe Bonifazi, Silvia Serranti, Paolo Missori, Francesco Fattapposta, Carlotta Manfredi, Andrea Maffucci, Luca Puce, Lucio Marinelli and Carlo Trompetto
Appl. Sci. 2025, 15(15), 8534; https://doi.org/10.3390/app15158534 (registering DOI) - 31 Jul 2025
Viewed by 178
Abstract
This study aims to characterize short-wave infrared (SWIR) reflectance spectra at cranial (at the scalp overlying the frontal cortex and the temporal bone window) and extracranial (biceps and triceps) sites in patients with multiple sclerosis (MS) and age-/sex-matched controls. We sought to identify [...] Read more.
This study aims to characterize short-wave infrared (SWIR) reflectance spectra at cranial (at the scalp overlying the frontal cortex and the temporal bone window) and extracranial (biceps and triceps) sites in patients with multiple sclerosis (MS) and age-/sex-matched controls. We sought to identify the diagnostic accuracy of wavelength-specific patterns in distinguishing MS from normal controls and spectral markers associated with disability (e.g., Expanded Disability Status Scale scores). To achieve these objectives, we employed a multi-site SWIR spectroscopy acquisition protocol that included measurements from traditional cranial locations as well as extracranial reference sites. Advanced spectral analysis techniques, including wavelength-dependent absorption modeling and machine learning-based classification, were applied to differentiate MS-related hemodynamic changes from normal physiological variability. Classification models achieved perfect performance (accuracy = 1.00), and cortical site regression models showed strong predictive power (EDSS: R2CV = 0.980; FSS: R2CV = 0.939). Variable Importance in Projection (VIP) analysis highlighted key wavelengths as potential spectral biomarkers. This approach allowed us to explore novel biomarkers of neural and systemic impairment in MS, paving the way for potential clinical applications of SWIR spectroscopy in disease monitoring and management. In conclusion, spectral analysis revealed distinct wavelength-specific patterns collected from cranial and extracranial sites reflecting biochemical and structural differences between patients with MS and normal subjects. These differences are driven by underlying physiological changes, including myelin integrity, neuronal density, oxidative stress, and water content fluctuations in the brain or muscles. This study shows that portable spectral devices may contribute to bedside individuation and monitoring of neural diseases, offering a cost-effective alternative to repeated imaging. Full article
(This article belongs to the Special Issue Artificial Intelligence in Medical Diagnostics: Second Edition)
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7 pages, 266 KiB  
Communication
Respiratory Failure in Patients with Intracerebral Hemorrhage and Intraventricular Hemorrhage Extension: A Retrospective Study
by Min Cheol Chang, Michael Y. Lee, Sang Gyu Kwak and Ah Young Lee
Healthcare 2025, 13(15), 1876; https://doi.org/10.3390/healthcare13151876 - 31 Jul 2025
Viewed by 183
Abstract
Background/Objectives: This study aimed to identify the risk factors for respiratory failure in patients with intracerebral hemorrhage (ICH) accompanied by intraventricular hemorrhage (IVH) extension. Methods: We retrospectively included 208 patients with ICH accompanied by IVH extension. Respiratory failure was defined as carbon [...] Read more.
Background/Objectives: This study aimed to identify the risk factors for respiratory failure in patients with intracerebral hemorrhage (ICH) accompanied by intraventricular hemorrhage (IVH) extension. Methods: We retrospectively included 208 patients with ICH accompanied by IVH extension. Respiratory failure was defined as carbon dioxide levels > 45 mmHg with a pH < 7.35 in arterial blood gas analysis (ABGA) or the application of a ventilator due to respiratory dysfunction. We measured the severity of IVH extension using the Graeb scale, and ICH volume was assessed for each patient. Results: Of the 208 included patients, 83 had respiratory failure. There were no significant differences in age, sex ratio, or Graeb scale score between patients with and without respiratory failure (p > 0.05). However, ICH volume was significantly larger in patients with respiratory failure (42.0 ± 42.5 mL) than in those without (26.4 ± 25.7 mL) (p = 0.003). In the receiver operating characteristic (ROC) curve analysis, the area under the ROC curve for ICH volume predicting respiratory failure was 0.612. The optimal threshold for detecting respiration failure in patients with ICH and IVH dilatation, based on the Youden index, was >63.2 mL, with a sensitivity of 30.12% and a specificity of 89.60%. Approximately 40% of patients experienced respiratory failure following ICH accompanied by IVH extension. Conclusions: A large ICH volume was associated with the occurrence of respiratory failure. Therefore, caution is required in patients with an ICH volume > 63.2 mL. Full article
(This article belongs to the Section Community Care)
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13 pages, 910 KiB  
Article
Annual Performance Progression in Swimming Across Competition Levels and Race Distances
by Jesús J. Ruiz-Navarro and Dennis-Peter Born
J. Funct. Morphol. Kinesiol. 2025, 10(3), 297; https://doi.org/10.3390/jfmk10030297 - 31 Jul 2025
Viewed by 186
Abstract
Objective: As performance progression provides an essential indicator for talent selection and development, this study aimed to compare annual swimming performance progression between different competitive levels and to establish benchmarks for long-term athlete development. Methods: Annual best times of swimmers who competed up [...] Read more.
Objective: As performance progression provides an essential indicator for talent selection and development, this study aimed to compare annual swimming performance progression between different competitive levels and to establish benchmarks for long-term athlete development. Methods: Annual best times of swimmers who competed up to the age of 21 years and achieved over 450 World Aquatics points were extracted from the database of European Aquatics. A total of 13,310 male and 7798 female pool swimmers of all race distances were grouped into three performance levels. Results: The results showed a continuous decline in annual performance progression throughout the years across all race distances (all p < 0.001) and in both sexes. There were differences between performance level across the age groups for all race distances in male swimmers, but only for the 100–400 m races in females (p < 0.05). Absolute performance showed significant main effects for level and age over all race distances for both sexes (all p < 0.001). Conclusions: Annual performance progression of swimmers consistently decreases across the competitive lifetime in both sexes, regardless of race distance and performance level. The event-specific benchmarks should be used as a framework to set realistic goals for both sexes and swimmers of different competitive levels, as well as to guide swimmers throughout their careers. Full article
(This article belongs to the Special Issue Innovative Approaches in Monitoring Individual Sports)
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16 pages, 686 KiB  
Article
Age- and Sex-Specific Reference Values for Handgrip Strength Among Healthy Tunisian Adolescents
by Souhail Bchini, Ismail Dergaa, Dhouha Moussaoui, Halil İbrahim Ceylan, Taoufik Selmi, Raul Ioan Muntean and Nadhir Hammami
Medicina 2025, 61(8), 1383; https://doi.org/10.3390/medicina61081383 - 30 Jul 2025
Viewed by 293
Abstract
Background and Objectives: Handgrip strength represents a critical indicator of physical fitness and nutritional status in adolescents, yet population-specific reference values remain limited in developing countries. Understanding age- and sex-specific variations is crucial for accurate clinical assessment and effective health monitoring. The objective [...] Read more.
Background and Objectives: Handgrip strength represents a critical indicator of physical fitness and nutritional status in adolescents, yet population-specific reference values remain limited in developing countries. Understanding age- and sex-specific variations is crucial for accurate clinical assessment and effective health monitoring. The objective of this study was to establish comprehensive reference values for handgrip strength in healthy Tunisian adolescents aged 13–19 years and examine sex and age group differences in these measures. Materials and Methods: This cross-sectional study was conducted between September 2024 and June 2025, involving a sample of 950 participants (482 males, 468 females) aged 13–19 years from northwest Tunisia. Handgrip strength was measured using standardized dynamometry protocols for both hands. Anthropometric measurements included height, weight, and body mass index. Percentile curves were generated using the LMS method, and correlations between handgrip strength and anthropometric variables were analyzed using Pearson correlation coefficients. Results: Males demonstrated significantly higher handgrip strength than females from age 13 onward (13 years: p = 0.021; 14–19 years: p ≤ 0.001). Effect sizes for sex differences were consistently large across age groups (Cohen’s d range: 0.53–2.09 for the dominant hand). Mean dominant handgrip strength ranged from 25.60 ± 7.73 kg to 47.60 ± 12.45 kg in males and 21.90 ± 6.13 kg to 28.40 ± 4.74 kg in females across age groups. After adjusting for body mass, sex differences remained significant between groups (13 years: p = 0.014; d= 1.5; 14–19 years: p ≤ 0.001; d: 1.71–3.12). Strong positive correlations emerged between handgrip strength and height (males: r = 0.748, females: r = 0.601), body mass (males: r = 0.659, females: r = 0.601), and body mass index (BMI) (males: r = 0.391, females: r = 0.461). Body mass and height emerged as the strongest predictors of handgrip strength in both sexes, while BMI showed a smaller but still significant contribution. Conclusions: This study provides the first comprehensive age- and sex-specific reference values for handgrip strength in Tunisian adolescents. Healthcare providers can utilize these percentile charts for the clinical assessment and identification of musculoskeletal fitness deficits. The results suggest its use in educational and clinical contexts. Full article
(This article belongs to the Section Sports Medicine and Sports Traumatology)
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11 pages, 526 KiB  
Article
Determining Reference Intervals and Median Blood Creatinine Levels in Children from Three Different Regional Populations
by Ferdy Royland Marpaung, Hari Basuki Notobroto, Risky Vitria Prasetyo, Djoko Santoso, Etienne Cavalier and Aryati Aryati
J. Clin. Med. 2025, 14(15), 5373; https://doi.org/10.3390/jcm14155373 - 30 Jul 2025
Viewed by 395
Abstract
Background: A critical gap exists in the current literature regarding pediatric-specific creatinine reference data. This study established age- and sex-stratified reference intervals and a corresponding median (Qcr) model for serum creatinine in children, providing a crucial foundation for improved diagnostic accuracy and [...] Read more.
Background: A critical gap exists in the current literature regarding pediatric-specific creatinine reference data. This study established age- and sex-stratified reference intervals and a corresponding median (Qcr) model for serum creatinine in children, providing a crucial foundation for improved diagnostic accuracy and clinical decision-making in this vulnerable population. Methods: A total of 9090 children (52.38% males and 47.65% females) who were getting regular check-ups at clinical laboratories in three regions were included in this study to establish Qcr serum and reference ranges for creatinine concentration. Results: The reference values and serum Qcr creatinine were established for children based on age and sex. Both males and females experience an incremental increase in creatinine levels with advancing age. In addition, significant differences were seen across the three areas in other age groups (p < 0.05). Conclusions: These newly established, age- and sex-stratified reference and Qcr values provide a critical resource for clinical laboratories, empowering clinicians to more accurately assess pediatric renal function and enabling more precise, individualized care for children with renal concerns. Full article
(This article belongs to the Section Nephrology & Urology)
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16 pages, 365 KiB  
Article
Sex-Specific Differences in Antidepressant and Antipsychotic Treatment Outcomes and Serum Levels in Children and Adolescents
by Maike Scherf-Clavel, Stefanie Fekete, Manfred Gerlach, Christoph U. Correll, Paul Plener, Jörg M. Fegert, Andreas Karwautz, Peter Heuschmann, Tobias Banaschewski, Wolfgang Briegel, Christian Fleischhaker, Tobias Hellenschmidt, Hartmut Imgart, Michael Kaess, Michael Kölch, Karl Reitzle, Tobias J. Renner, Christian Rexroth, Gerd Schulte-Körne, Frank Theisen, Susanne Walitza, Christoph Wewetzer, Franca Keicher, Stefan Unterecker, Sebastian Walther, Marcel Romanos, Karin M. Egberts, Timo Vloet and Regina Taurinesadd Show full author list remove Hide full author list
Pharmaceutics 2025, 17(8), 983; https://doi.org/10.3390/pharmaceutics17080983 - 30 Jul 2025
Viewed by 300
Abstract
Introduction: Sex-specific differences in psychopharmacological treatment have gained increasing attention in adults, with studies showing that women often have higher serum concentrations of psychotropic drugs due to biological differences. However, despite recognition of these differences in adults, reference ranges for therapeutic drug monitoring [...] Read more.
Introduction: Sex-specific differences in psychopharmacological treatment have gained increasing attention in adults, with studies showing that women often have higher serum concentrations of psychotropic drugs due to biological differences. However, despite recognition of these differences in adults, reference ranges for therapeutic drug monitoring (TDM) in general, but even more sex-specific therapeutic windows for psychotropic drugs, are lacking in children and adolescents, who may metabolize and respond to medications differently. Aim: The study aimed to investigate sex-specific differences in antidepressant (AD) and antipsychotic (AP) -treatment outcomes, and pharmacokinetics in childhood/adolescence. In particular, we examined differences in AD and AP serum levels and clinical effects, including adverse drug effects (ADEs) and therapeutic effectiveness. Methods: This study is part of the multicenter “TDM-VIGIL” pharmacovigilance project, which prospectively followed patients aged 6–18 years treated with AD and AP across 18 child psychiatric centers in German-speaking countries from 2014 to 2018. Clinical data, including drug concentrations (AD: fluoxetine, mirtazapine, (es)citalopram, sertraline; AP: aripiprazole, quetiapine, olanzapine, risperidone), were collected using an internet-based registry, and treatment outcomes and ADEs were assessed during routine visits. Statistical analyses were performed to examine sex differences in pharmacokinetics and clinical responses, adjusting for age, weight, and other confounders. Results: A total of 705 patients (66.5% girls, 24.7% <14 years, mean age of 14.6 years) were included. Female patients were slightly older, had lower body weight, and were more often diagnosed with depression and anorexia nervosa, while boys were more frequently diagnosed with hyperkinetic disorders and atypical autism. We found no sex differences in the serum concentrations of investigated drugs when adjusted for age and weight. In fluoxetine treatment in patients diagnosed with mood (affective) disorders, female sex was associated with the probability for very good therapy response (p = 0.04), as well as with moderate treatment response (p = 0.02) compared to no treatment response. Discussion: Our findings suggest that sex may not affect serum levels of investigated AD and AP in children/adolescents. However, treatment outcome of fluoxetine was associated with sex, with higher probability for a better outcome in female patients diagnosed with mood (affective) disorders. Full article
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10 pages, 621 KiB  
Review
Optimizing Hip Abductor Strengthening for Lower Extremity Rehabilitation: A Narrative Review on the Role of Monster Walk and Lateral Band Walk
by Ángel González-de-la-Flor
J. Funct. Morphol. Kinesiol. 2025, 10(3), 294; https://doi.org/10.3390/jfmk10030294 - 30 Jul 2025
Viewed by 446
Abstract
Introduction: Hip abductor strength is essential for pelvic stability, lower limb alignment, and injury prevention. Weaknesses of the gluteus medius and minimus contribute to various musculoskeletal conditions. Lateral band walks and monster walks are elastic resistance exercises commonly used to target the [...] Read more.
Introduction: Hip abductor strength is essential for pelvic stability, lower limb alignment, and injury prevention. Weaknesses of the gluteus medius and minimus contribute to various musculoskeletal conditions. Lateral band walks and monster walks are elastic resistance exercises commonly used to target the hip abductors and external rotators in functional, weight-bearing tasks. Therefore, the aim was to summarize the current evidence on the biomechanics, muscle activation, and clinical applications of lateral and monster band walks. Methods: This narrative review was conducted following the SANRA guideline. A comprehensive literature search was performed across PubMed, Scopus, Web of Science, and SPORTDiscus up to April 2025. Studies on the biomechanics, electromyography, and clinical applications of lateral band walks and monster walks were included, alongside relevant evidence on hip abductor strengthening. Results: A total of 13 studies were included in the review, of which 4 specifically investigated lateral band walk and/or monster walk exercises. Lateral and monster walks elicit moderate to high activation of the gluteus medius and maximus, especially when performed with the band at the ankles or forefeet and in a semi-squat posture. This technique minimizes compensation from the tensor fasciae latae and promotes selective gluteal recruitment. Proper execution requires control of the trunk and pelvis, optimal squat depth, and consistent band tension. Anatomical factors (e.g., femoral torsion), sex differences, and postural variations may influence movement quality and necessitate tailored instruction. Full article
(This article belongs to the Special Issue Biomechanical Analysis in Physical Activity and Sports—2nd Edition)
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19 pages, 848 KiB  
Review
The Role of Sex in the Impact of Sleep Restriction on Appetite- and Weight-Regulating Hormones in Healthy Adults: A Systematic Review of Human Studies
by Mira Alfikany, Khaula Sakhr, Stef Kremers, Sami El Khatib, Tanja Adam and Ree Meertens
Clocks & Sleep 2025, 7(3), 39; https://doi.org/10.3390/clockssleep7030039 - 29 Jul 2025
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Abstract
Short sleep has been linked to overweight, possibly via alterations in appetite-regulating hormones, but findings are inconsistent. Sex differences may contribute to this variability. This systematic review examines whether sex modifies the hormonal response to sleep curtailment. PubMed, Embase, Cochrane, CINAHL, and PsycINFO [...] Read more.
Short sleep has been linked to overweight, possibly via alterations in appetite-regulating hormones, but findings are inconsistent. Sex differences may contribute to this variability. This systematic review examines whether sex modifies the hormonal response to sleep curtailment. PubMed, Embase, Cochrane, CINAHL, and PsycINFO were searched for English-language experimental studies published before December 2024. Included studies assessed at least one appetite-regulating hormone and presented sex-specific analyses. Studies involving health conditions affecting sleep, circadian misalignment, or additional interventions were excluded. Risk of bias was assessed using the Revised Cochrane Risk-of-Bias tool (RoB 2). Eight studies (n = 302 participants) met inclusion criteria. A narrative synthesis of the findings was conducted for each hormone separately to explore potential differences in their response to sleep restriction. Some sex-related variations in hormonal response to sleep restriction have been observed for leptin (four studies, n = 232), insulin (three studies, n = 56), glucagon-like peptide-1 (one study, n = 27), ghrelin (three studies, n = 87), adiponectin (two studies, n = 71) and thyroxine (two studies, n = 41). However, findings were inconsistent with no clear patterns. No sex-related differences were found for glucagon or PYY, though data were limited. Findings suggest sex may influence hormonal responses to sleep restriction, but inconsistencies highlight the need to consider factors such as BMI and energy balance. Well-controlled, adequately powered studies are needed to clarify these effects. Full article
(This article belongs to the Section Human Basic Research & Neuroimaging)
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