Search Results (5,338)

Background: Pancreatic solid pseudopapillary neoplasms (SPNs) are rare exocrine tumours with predominance in young women. These tumours are of low malignant potential, become considerably large before causing symptoms and are associated with good prognosis. This study aimed to present and analyse clinicopathological features and surgical outcome of SPNs. Methods: A retrospective analysis of 22 patients who underwent pancreatic surgery for SPNs in a single high-volume surgical centre in 2014–2023 was performed. Results: SPN was the most frequent in females (n = 21, 95.45%) in a mean age of 34 ± 11.09 (18–55) years. Fourteen (63.64%) patients were asymptomatic, and eight (36.36%) presented with symptoms. The most common clinical symptom was abdominal pain (n = 7, 31.82%). The majority of tumours were located in the pancreatic body (n = 8, 36.36%), and most patients underwent distal pancreatectomy (n = 11, 50%). The median tumour size was 3.6 cm (IQR = 4.9; range: 1.3–14). The median duration of hospitalisation was 12.5 days, and the postoperative complication rate was 40.91%. R0 resection was achieved in 18 (81.82%) patients. Postpancreatectomy acute pancreatitis (PPAP) was the most common postoperative complication. No adjuvant therapy in any patient was needed. One-year overall survival (OS) equalled 100% and five-year OS reached 85%. None of the patients developed diabetes or signs of impaired pancreatic secretion in the follow-up period. Histopathology showed features like perineural invasion in 72.73% of cases, pseudocapsule (59.09%), haemorrhage (45.45%), vascular invasion (40.91%), mucosal metaplasia (40.91%), necrosis (31.82%), and calcification in the capsule (31.82%). Ki67 did not exceed 7%. In one case (4.55%), metastasis to a lymph node was found. Clinical suspicion agreed with histopathological results in only 10 (45.45%) cases. Conclusions: SPN most often occurs in young females. The majority of cases are asymptomatic accidental findings. The final diagnosis of SPN can be based just on analysis of histopathological examination results. Full article

Objectives: Sex-based disparities in COVID-19 outcomes are well-documented, with men experiencing greater acute severity and women showing increased vulnerability to post-viral syndromes. However, longitudinal immunometabolic trajectories in vaccinated individuals remain underexplored. In this study, sex-based differences in long-term metabolic, endocrine, renal, cardiovascular, and inflammatory responses were investigated among vaccinated individuals recovering from SARS-CoV-2 infection. Methods: This retrospective single-center cohort study included 426 adults (199 females, 227 males) with PCR-confirmed symptomatic COVID-19 and at least two vaccine doses. Serial assessments were conducted at baseline, 18-, 24-, and 30-month post-infection. Parameters included fasting glucose, HbA1c, lipid profile, thyroid function, renal markers, CRP, D-dimer, fibrinogen, troponin, and hematologic indices. Statistical analyses assessed longitudinal changes and sex-stratified correlations. Results: Fasting glucose and HbA1c levels significantly declined over time, more prominently in males. Glucose correlated with age and BMI only in females. Lipid levels remained largely unchanged, although males had higher baseline triglycerides. Females showed rising TSH levels and persistently lower free T3; males exhibited higher creatinine, urea, and troponin levels throughout. Inflammatory markers declined significantly in both sexes, with males displaying higher CRP and troponin, and females showing sustained fibrinogen elevation and a temporary lymphocyte surge. D-dimer was elevated in females at the 30-month point. Conclusions: Sex-specific physiological recovery patterns were evident among vaccinated COVID-19 survivors. Males exhibited earlier metabolic and cardiac alterations, while females had more persistent endocrine and inflammatory shifts. These findings underscore the need for sex-tailored long-term monitoring strategies prioritizing early metabolic and cardiac screening in men and prolonged immunoendocrine surveillance in women. Full article

This study investigates the psychological and emotional mechanisms underlying women’s reactions to breast cancer awareness advertisements through the dual lens of Protection Motivation Theory (PMT) and neuromarketing methods, addressing a gap in empirical research on the integration of biometric and cognitive approaches in health marketing. Utilizing a lab-based experiment with 78 women aged 40 and older, we integrated Facial Expression Analysis using Noldus FaceReader 9.0 with semi-structured post-exposure interviews. Six manipulated health messages were embedded within a 15 min audiovisual sequence, with each message displayed for 5 s. Quantitative analysis revealed that Ads 2 and 5 elicited the highest mean fear scores (0.45 and 0.42) and surprise scores (0.35 and 0.33), while Ad 4 generated the highest happiness score (0.31) linked to coping appraisal. Emotional expressions—including fear, sadness, surprise, and neutrality—were recorded in real time and analyzed quantitatively. The facial analysis data were triangulated with thematic insights from interviews, targeting perceptions of threat severity, vulnerability, response efficacy, and self-efficacy. The findings confirm that fear-based appeals are only effective when paired with actionable coping strategies, providing empirical support for PMT’s dual-process model. By applying mixed-methods analysis to the evaluation of health messages, this study makes three contributions: (1) it extends PMT by validating the emotional–cognitive integration framework through biometric–qualitative convergence; (2) it offers practical sequencing principles for combining threat and coping cues; and (3) it proposes cross-modal methodology guidelines for future health campaigns. Full article

The objective of this study was to evaluate the temporal trend of suicide deaths and the disparities in the occurrence of suicide death between Indigenous and non-Indigenous populations. This ecological study analyzed deaths from intentionally self-inflicted injuries in the southern region of Brazil (states of Paraná, Santa Catarina, and Rio Grande do Sul) from 2010 to 2019. The variables analyzed included annual frequency of events, age, sex, marital status, and education level. Descriptive analysis, association measures, and verification of temporal trends were performed. The average age-standardized suicide mortality rate for both populations was approximately 9.0 per 100,000 inhabitants, with a predominance among males (80%), single individuals (65%), and youth (37%). When only the state of Paraná was considered, the mortality rate during the period was 12.41 among the Indigenous population versus 6.94 per 100,000 inhabitants in the non-Indigenous population. In this state, the probability of suicide death was found to be almost twice as high among Indigenous men and women, with 13 times greater odds of death among Indigenous children and youth. A statistically significant temporal increase in the number of cases was observed only in the non-Indigenous population. An annual seasonal pattern of events among Indigenous individuals was suggested. The findings indicate a high suicide rate among the Indigenous population, particularly in Paraná, especially among young, single individuals, with a growing trend over the years. Full article

Background: Formal and informal social support networks are crucial for mental well-being, providing a sense of personal security and safety, especially during times of crisis. Aims: The aim of this study is to examine women’s perceptions of their own experiences alongside their perceptions of their partners’ experiences in the relationship between social support and the sense of danger within intimate relationships, based solely on women’s self-reports. It compares couples experiencing high-intensity conflict (particularly related to separation) with couples from the general population, and explores how the distribution of social support, whether received by the woman, the man, both, or neither is associated with feelings of danger. Methods: The sample comprised 165 women from two subsamples: 70 women from the general population and 95 women engaged in high-intensity intimate conflict, who were undergoing separation proceedings. Data were collected via self-report questionnaires, which included the Multidimensional Scale of Perceived Social Support and a custom questionnaire for Sense of Danger from the Partner. No direct data were collected from male partners; women provided both their own reports and their perceptions of their partner’s experiences. Repeated measures analysis was performed to examine the sense of danger as perceived for both themselves and their partners. Results: The analysis shows that the higher the level of social support, the weaker the sense of danger reported by women for themselves and for their partners. It also reveals that the sense of danger (both self-reported and attributed to the partner) is stronger among couples engaged in high-intensity conflict than among those in the general population, and that women report a stronger sense of danger for themselves than they attribute to their men. Importantly, when social support is provided to only one partner, it is associated with a higher sense of danger in the other partner. Conclusions: Social support has been associated with lower reported feelings of danger in intimate relationships. However, when support is given to only one partner, it may increase the other partner’s sense of danger. These findings highlight the need for balanced support for both partners in order to reduce tension and promote a greater sense of safety during times of conflict. Full article

Background: Cesarean section (CS) is a critical surgical procedure in obstetrics but is increasingly overused worldwide. Vietnam has seen rising CS rates, especially in urban tertiary hospitals, with limited standardized analysis to guide interventions. This study assesses CS rates at Tu Du Hospital using the WHO-endorsed Robson 10-Group Classification System. Methods: A cross-sectional descriptive study was conducted over one month in 2017 at Tu Du Hospital, a major obstetrics referral center in southern Vietnam. All women who delivered during this period were classified into Robson’s 10 groups based on parity, gestational age, labor onset, presentation, fetal number, and prior CS. CS rates and group-specific contributions were analyzed. Results: Among 5287 deliveries, the overall CS rate was 42.6%. Group 5 (previous CS) contributed 29.7% of all CSs, followed by Group 2 (nulliparous, induced/pre-labor CS, 26.2%) and Group 1 (nulliparous, spontaneous labor, 12.8%). Failed induction, fetal distress, and cephalopelvic disproportion were common indications. Only 22% of eligible women in Group 5 were offered a trial of labor after cesarean (TOLAC), although the success rate for vaginal birth after cesarean (VBAC) was 67%, indicating underutilization of this option. Conclusions: This study provides rare Robson-based evidence from Vietnam, identifying key target groups for intervention. The findings support expanded use of VBAC and more stringent criteria for induction. Future research should explore behavioral and systemic drivers of high CS rates to guide national policy. Full article

Adnexal tumors during pregnancy are rare, with a prevalence ranging from 0.05% to 3%, and in most cases, they are benign. Struma ovarii, a monodermal teratoma, consists of over 50% thyroid tissue and accounts for 2.7% of ovarian teratomas. It typically affects women aged 40–60 and is exceptionally rare during pregnancy. Diagnosis is often only established after surgical intervention and histological examination. We present the case of a 39-year-old pregnant woman (gravida 2, para 1) at 19 weeks of gestation who presented with acute lower abdominal pain. At her first visit at 11 weeks, ultrasound revealed a 12 cm multilocular left adnexal mass. Initial conservative management was followed by emergency laparoscopy due to suspected ovarian torsion, resulting in a left oophorectomy. Histopathology confirmed struma ovarii. Thyroid function tests (TSH, FT4) remained within normal limits throughout pregnancy. The pregnancy continued without further complications, culminating in a spontaneous vaginal delivery at 40 + 4 weeks of a healthy female infant weighing 3800 g. Due to the rarity of this condition, treatment guidelines remain undefined, with management decisions relying on limited case reports and clinical judgment. This report highlights the importance of detailed evaluation and individualized management in such uncommon presentations during pregnancy. Full article

Introduction: Skin aging is a multifaceted process influenced by both intrinsic and extrinsic factors, resulting in visible changes such as wrinkles, loss of elasticity, uneven skin tone, and hyperpigmentation. Hyaluronic acid (HA) is widely recognized for its hydrating and structural support properties, while Vitamin C is known for its antioxidant and depigmenting effects. This study investigated the anti-aging efficacy of two topical formulations containing Jalubalance^® technology—HA delivered in Opuntia oil—with or without 1% Vitamin C. Background/Objectives: We conducted an 8-week, multicenter, randomized trial involving 91 women aged 30–50 years with mild-to-moderate photoaging. Participants were assigned to apply either HA-only cream (Group A) or a HA + Vitamin C cream (Group B) twice daily. The primary outcome was the percentage of subjects who achieved an improvement of at least one point in the hyperpigmentation score from baseline to week 8. Additionally, the study aimed to evaluate and compare the clinical and instrumental effects of both treatments, with a particular focus on improvements in wrinkles, elasticity, hydration, and pigmentation. Results: Both groups showed significant improvements across all measured parameters, including Glogau scores, wrinkle reduction, and skin elasticity. Instrumental analysis confirmed increased hydration and elasticity. Group B showed a significantly greater reduction in hyperpigmentation (−45%) compared to Group A (−31%, p < 0.05). At week 8, a ≥1-point reduction in hyperpigmentation score was observed in 56% of subjects in Group B and 30% in Group A (absolute difference: 26%; 95% CI: 5–43%; p < 0.05), highlighting the added benefit of Vitamin C on this parameter. Participant satisfaction was high, especially for the moisturization and brightening effects of both products. Conclusions: The topical application of Jalubalance-based creams effectively reduced signs of aging. The inclusion of Vitamin C provided enhanced benefits in reducing hyperpigmentation, suggesting its utility in personalized dermatological approaches for patients with pigmentation concerns. Full article

Background: Aging is associated with reduced joint flexibility and balance, which increases the risk of falls, especially during stair descent where motor control is critical. Stretching has been shown to improve ankle range of motion and gait speed. This study investigated the effects of a 4-week training program combining stretching plus resistance training (RT) with elastic bands on functional capacity and ankle stability during stair descent in older women. Methods: Twenty-four active older women (mean age: 73.1 ± 0.97 years) were randomly assigned to static stretching (SS), dynamic stretching (DS) and control (CG) groups. All participants completed two weekly 60 min sessions consisting of progressive RT preceded by three different warm-ups. The SS and DS groups completed static or dynamic stretching, while the CG walked. Assessments included 30s-Chair Stand (30s-CS), Handgrip Strength (HGS), Time Up and Go (TUG), Chair Sit and Reach (CSR), Rating of Perceived Exertion (RPE), and ankle kinematics during stair descent. Results: All groups improved 30s-CS and TUG (p < 0.05). Only the SS group improved CSR in both legs and the ankle dorsiflexion angle during stair descent at final foot contact (p = 0.002). RPE increased over time across all groups (p < 0.0001); however, the SS and DS groups reported lower exertion than the CG group in first–second weeks (p = 0.0001–0.003). Conclusions: SS prior to progressive RT improved flexibility and ankle kinematics during stair descent, thus reducing the perception of effort particularly during the initial training phase. These findings indicate the effectiveness of SS as a warm-up strategy for increasing ROM and potentially reducing the risk of falls in this population. Full article

Purpose: Grounded in Social Cognitive Theory and Self-Determination Theory, this study analyzed gender differences in the relationships between teachers’ sense of efficacy, basic psychological need satisfaction and frustration (competence), and life satisfaction among Physical Education (PE) pre-service teachers. Method: A sample of 368 PE pre-service teachers (Mage = 23.41 ± 2.37; 48.1% women) participated. A multi-group structural equation modeling approach was used. Results: Male participants reported significantly higher levels of competence satisfaction compared to their female counterparts. Teaching efficacy positively predicted life satisfaction, both directly and indirectly via competence satisfaction. Notably, the indirect effects were stronger among women, while direct effects were observed only in the female group. Conclusions: The findings emphasize the key role of competence satisfaction in explaining how teaching efficacy influences life satisfaction in pre-service teachers. Gender differences suggest that while both men and women benefit from feeling competent, the pathways differ, highlighting the importance of gender sensitive strategies in teacher education programs. Full article

This study investigated the expression of immune checkpoint molecules on CD4⁺ and CD4⁻ NKT cell subpopulations throughout healthy pregnancy trimesters and in non-pregnant condition to understand their role in maternal–fetal immunotolerance. Using flow cytometry, we found that CD4⁻ NKT cells significantly outnumbered CD4⁺ NKT cells in all investigated groups. In the case of the immune checkpoint molecules, PD-1 receptor expression was significantly lower in CD4⁻ NKT cells compared to CD4⁺ counterpart cells only in non-pregnant women, while the PD-L1 ligand expression on CD4⁺ NKT cells significantly decreased in the third trimester. In contrast, LAG-3 and Galectin-3 expressions remained stable across all subsets and trimesters. For the TIGIT/CD226 axis, CD226 expression was significantly higher in CD4⁺ NKT cells in the third trimester and in non-pregnant women. The two ligands CD112 and CD155 were consistently lower on CD4⁻ NKT cells across all groups. The activating receptor NKG2D was significantly higher on CD4⁻ NKT cells in all examined cohorts. These findings suggest that CD4⁺ NKT cells tend towards a more tolerogenic phenotype, while CD4⁻ NKT cells maintain a balanced cytotoxic potential with reduced immunoregulation function. The dynamic regulation of immune checkpoints on NKT cell subsets, particularly the downregulation of PD-L1 and CD226 in late pregnancy, highlights their fine-tuned role in balancing maternal–fetal immune tolerance with readiness for parturition. Full article

Inflammatory pain is a worldwide health problem, affecting primarily women. Nonetheless, most research conducted in this field has involved male subjects, and only 10% of the results have been obtained using females. Gold Lotion (GL) is a formulated product made from the peels of six citrus fruits that have been proven, via experimental data, to possess several biological properties, such as anti-inflammatory, anticancer, and antibacterial activities. This research aims to investigate the response to GL administration in two models of peripheral inflammation to assess potential sex differences. Carrageenan was used to induce mechanical allodynia and maximal edema within hours, serving as a model of acute inflammation, while Complete Freund’s Adjuvant (CFA) was used to obtain similar results within days, resulting in a model of chronic inflammation. Acute GL administration reduced mechanical allodynia in both models and both sexes, with no anti-inflammatory effects observed. In conclusion, this study demonstrates the potential of GL to alleviate inflammatory pain in both males and females, thereby broadening its therapeutic applications. Full article

Breast cancer (BC) is the most common malignancy among Brazilian women, with a high percentage of the cases diagnosed at advanced or metastatic stages (mBC). In Brazil, where 75% of the population depends on the resource-limited public health system (SUS), mBC poses significant treatment challenges and disparities. To characterize this scenario, we conducted an online survey assessing treatment strategies available for HER2-negative, hormone receptor (HR)-positive mBC across public and private health systems. The 48-question survey addressed topics such as waiting time (WT) from oncology unit entry to treatment initiation, availability of oncologic medications, and access to palliative and multidisciplinary care teams. Between 2 August 2022 and 30 September 2022, a total of 180 oncologists were invited, and 150 met the inclusion criteria. The median WT for surgery was 60 days in the SUS versus 30 days in the private sector (p < 0.0001), and for chemotherapy, 30 days in the SUS versus 15 days privately (p < 0.0001). Endocrine therapy was the preferred first-line treatment in the SUS (83.3%), while fulvestrant was available to only 48% of respondents. Additionally, specialized palliative care teams were available according to 66% of SUS respondents compared with 82% in the private system (p = 0.001). These findings underscore persistent disparities in mBC treatment, likely driven by limited governmental health investment. Full article

Background: The prevalence of type 2 diabetes (T2D) is on the rise, and insulin resistance (IR) is one of the key risk factors for developing T2D. This paper seeks to identify risk factors for IR in women with normal menstrual cycles (NM) and early menopausal women (EM). Methods: EM women between 30 and 50 years old were compared with an NM control group. Four machine learning (ML) methods were trained using comprehensive physiological and lifestyle data to estimate a homeostasis model for insulin resistance (HOMA-IR dependent variable). Traditional multiple linear regression (MLR) was used as a benchmark for comparison. Results: A total of 948 participants were enrolled (NM: 410, EM: 538). On average, ML outperformed MLR, identifying the six key risk factors in the EM group (from most to least important) as waist–hip ratio (WHR), triglyceride (TG), glutamic-pyruvic transaminase (GPT), glutamic oxaloacetic transaminase (GOT), HDL-Cholesterol (HDL-C), and lactic dehydrogenase (LDH). Rankings differed in the NM group, with WHR identified as the leading risk factor, followed by C-reactive protein (CRP), HDL-C, total bilirubin (TBIL), diastolic blood pressure (DBP), and white blood cell count (WBC). Conclusions: Using ML, we found that WHR and HDL-C are the common denominators in both EM and NM women, with additional correlations with TG, liver enzymes and LDH for EM women. These results clearly indicate the importance of estrogen protection, suppressing less important factors (TG, liver enzyme, and LDH), and only the stronger inflammatory markers become important (CRP, TBIL, and WBC). Once estrogen’s protection disappears, the suppression of CRP, TBIL, and WBC would become weaker. Since these 3 features are significantly correlated with body weight, for women under 50, reducing body weight is the most important factor in preventing hyperglycemia. Full article

The maternal circulating proteome reflects critical physiological adaptations during pregnancy, yet standardized reference profiles for early gestation are lacking. In this prospective study, we employed targeted liquid chromatography–multiple reaction monitoring–mass spectrometry (LC-MRM-MS) with stable isotope-labeled (SIS) standards to characterize the serum proteome of 83 women with uncomplicated singleton pregnancies between 11⁺² and 13⁺⁶ weeks’ gestation. Robust analysis quantified 115 proteins (83% of targets), with 101 meeting ICH M10 standards. These included 38 FDA-approved, 19 CVD-related, and 25 CLIA-approved biomarkers. We identified 43 proteins significantly associated (p < 0.05) with gestational age, maternal factors (BMI, age, parity, and myomas), and fetal sex. Key findings included identification of 12 proteins significantly associated with trisomy risk (|R| = 0.21–0.45, p < 0.05) and extreme physiological variability in pregnancy zone protein (PZP, 123.9-fold), followed by apolipoprotein (a) (LPA; 9.9-fold) and pregnancy-associated plasma protein A (PAPP-A, 9.3-fold). In contrast, hemopexin (HPX) demonstrated remarkable stability (CV = 8.5%), suggesting its utility as a reference marker. The study successfully implemented multiples of the median (MoM) transformation for clinical standardization of protein profiles, with RobNorm proving particularly effective for batch-effect correction in our dataset. These methodological advances, combined with the establishment of comprehensive pregnancy-specific reference ranges, provide a valuable foundation for future research. The optimized analytical framework and protein signatures identified in this work not only enable the development of next-generation screening approaches but also offer new insights into the molecular adaptations occurring during early pregnancy. Full article