Clinical utility of novel anthropometric indices in identifying type 2 diabetes mellitus among South African adult females.

AIM: To assess the clinical utility of novel anthropometric indices and other traditional anthropometric indices in identifying the risk of type 2 diabetes mellitus (T2D) among South African adult females. METHODS: In the first South African National Health and Nutrition Examination Survey (SANHANES-1), traditional [body mass index (BMI), waist circumference (WC), waist-to-hip ratio (WHR), and waist-to-height ratio (WHtR)] and novel [a-body shape index (ABSI), abdominal volume index (AVI), body adiposity index (BAI), body roundness index (BRI), conicity index (CI), and Clínica Universidad de Navarra-Body Adiposity Estimator (CUN-BAE)] anthropometric indices were assessed. T2D was diagnosed using glycated haemoglobin (HbA1c) ≥ 6.5% among participants without known T2D. Basic statistics and multiple regression analyses were explored the association between anthropometric indices and newly diagnosed T2D. Receiver operating characteristic (ROC) curve analysis was used to measure the predictive ability of both traditional and novel indices. RESULTS: Among 2 623 participants, 384 (14.6%) had newly diagnosed T2D. All anthropometric indices mean values were significantly higher among participants with T2D (most p < 0.001). Higher mean values increased T2D odds e.g., in the model adjusted for age, employment, residence, and population group, odds ratio (OR) and 95% confidence interval (CI) for T2D with some of anthropometric indices were: 1.86 (1.60-2.15) for WC, 1.84 (1.59-2.13) for WHtR, 1.73 (1.51-1.99) for AVI, 1.71 (1.49-1.96) for BRI and 1.86 (1.57-2.20) for CUN-BAE. The top quartile for all indices had the highest T2D odds (p < 0.05). These outcomes were the highest for WC, AVI, and CUN-BAE and remained so even after removing the confounding effects of age, employment, population group, and residence. Based on the ROC analysis, none of the anthropometrical indices performed excellently (i.e., had an area under the curve [AUC] > 0.80). The WC, WHtR, AVI, BRI, and CUN-BAE, however, performed acceptably (AUCs 0.70-0.79), while also exhibiting corresponding cutoff values of 86.65 cm, 0.57, 15.52, 3.83, and 38.35, respectively. CONCLUSIONS: The data shows that traditional and novel anthropometric indices similarly identifying newly diagnosed T2D among adult South African females. We recommend the continuing the use of traditional indices, as they are affordable and easy to use in our setting.

Sex-Related Differences in Left Ventricular Geometry Patterns in Patients With Arterial Hypertension.

Background: Sex-specific differences in left ventricular (LV) geometry might help in developing tailored strategies for hypertension management. Objectives: The purpose of the study was to evaluate sex-related differences in LV geometry at baseline and over time in hypertension. Methods: From a prospective registry, we included hypertensives without prevalent cardiovascular disease, incident myocardial infarction, chronic kidney disease > stage III, and with normal LV ejection fraction. LV mass index >115 g/m2 in males and >95 g/m2 in females, identified LV hypertrophy (LVH). Relative wall thickness ≥0.43 defined LV concentric geometry. LVH in presence of concentric geometry was defined as concentric LVH, whereas relative wall thickness <0.43 was categorized as eccentric. Concentric geometry, or LVH, identified LV remodeling. Results: Six thousand four hundred twenty-seven patients (age 53 ± 11 years, 43% females) were included. At baseline, females showed lower prevalence of normal geometric pattern and higher prevalence of LVH than males (50% vs 72%, P < 0.001; 47% vs 23%, P < 0.001, respectively), with a higher prevalence of eccentric LVH (40% vs 18%, P < 0.001). Female sex was independently associated with LV remodeling (OR: 2.36; 95% CI: 2.12-2.62; P < 0.001). At long-term follow-up (mean 6.1 years, IQR: 2.8-8.6 years), prevalence of LV remodeling increased in both sexes, although a normal LV geometry remained less frequent in females than males (43% vs 67%, P < 0.001), with differences persisting in eccentric (41% vs 21%, P < 0.001) and concentric LVH (11% vs 5%, P < 0.001). Conclusions: We found sex-related differences in LV geometry among hypertensives. Females have higher risk of LV remodeling at baseline compared with males, with differences persisting at long-term follow-up.

The prevalence of the risk factors associated with cardiovascular diseases among Iranian adults: Findings of a cross-sectional study.

BACKGROUND: Cardiovascular diseases are among the leading causes of death worldwide. Lack of accurate estimation of the risk factors associated with these diseases can impair the designing of effective interventions in this field; the present study aimed to investigate the risk factors attributable to cardiovascular diseases in males and females visiting comprehensive health service centers in 2018. MATERIAL AND METHOD: This cross-sectional study is part of the national health transformation plan shaped in response to the emerging epidemic of noncommunicable diseases. In the present study, 6,331 participants aged 30 years and older were randomly and census selected from comprehensive urban and rural health service centers in Naein County, in Isfahan, Iran, respectively. The data were collected using the electronic health record from the IraPEN program in two sections: demographic information and the prevalence of cardiovascular disease risk factors. They were then analyzed with Statistical Package for the Social Sciences (SPSS) 24 software using descriptive statistics, Chi-square test, one-way ANOVA, and logistic regression. RESULTS: The participants' mean age was 55.09 ± 16.11 years. The main risk factor was insufficient consumption of fruits and vegetables while smoking was a negligible risk factor. Low physical activity, diabetes, hypertension, hypercholesterolemia, and high body mass index were more prevalent in females than in males, whereas smoking was more frequently reported in males (P < 0.001). Risk factors such as age, gender, education level, place of residence, and marital status, played a significant role in determining CVD risk factors. DISCUSSION: More than half of Iranian adults had one or older cardiovascular disease-related risk factors, and the prevalence of such factors was higher in females than in males. Given the importance of gender differences in cardiovascular disease-related health habits, it is necessary to reduce the majority of these diseases in society, especially in women, by controlling modifiable risk factors.

Uncovering the hidden health burden: a systematic review and meta-analysis of iron deficiency anemia among adolescents, and pregnant women in Pakistan.

INTRODUCTION: Iron deficiency anemia (IDA) is the most prevalent diet-related disorder and mainly affects women and children. To determine the trend of anemia incidence in Pakistan, a current review was carried out. This review aimed to estimate the prevalence of anemia among pregnant women and adult/adolescent nonpregnant women in Pakistan and to provide a 15-year trend analysis. MATERIALS AND METHODS: Studies were identified by searching PubMed, Google Scholar, Scopus, and Science Direct, complementing this digital exploration, and a manual review of reference lists from previously published prevalence studies was performed to enhance the scope of relevant articles. A total of twenty-seven population-based anemia studies on adolescent/adult females and pregnant women published in Pakistan from January 1st-2007 until December 2021 were included. Systematic data extraction was facilitated through the implementation of a standardized and rigorously pretested data extraction checklist. For the subsequent analysis, the sophisticated capabilities of R statistical software were harnessed. The I2 test was used to assess heterogeneity among studies, and the pooled prevalence of anemia was calculated. RESULTS: The final analysis included 27 research articles as well as two extensive National Nutrition survey reports, NNS 2011 and NNS 2018. The forest plot of sixteen studies on pregnant women revealed that the overall pooled prevalence of anemia among pregnant females in Pakistan was 70.4% (95% CI: 0.619, 0.789), and the forest plot of eleven studies on non-pregnant adolescent and adult females reported the pooled prevalence was 54.6% (95% CI: 0.422, 0.669). Subgroup analysis among pregnant women based on region, trimester and socioeconomic status revealed that the highest anemia incidence was observed in Punjab (77.4%). Similarly, females in the second trimester reported a higher prevalence of anemia 78% (95% CI, 0.556 1.015), and the status-wise group with a mixed background reported a higher prevalence 72.8% (95% CI, 0.620 0.835). According to the subgroup analysis, eleven studies of adult nonpregnant groups of mixed socioeconomic status reported a higher prevalence of 56.9% (95% CI, 0.292 0.845). CONCLUSION: In Pakistan, anemia, is widespread among pregnant women and nonpregnant adolescent/adult females. A deeper understanding of anemia in Pakistani women is necessary for targeted interventions and policy decisions to predict demographic shifts.

Perceptions of menstrual cycle tracking among elite rugby players.

The purpose of the current study was to understand female rugby players' perceptions of menstrual cycle (MC) tracking and identify the impact of MC tracking for the players. Interpretive descriptive methodology was adopted. Interviews were conducted with 12 elite female rugby players (age 25.2 ± 4.3 years), who were all naturally menstruating. Data were analysed following the four stages recommended within Interpretive Description. Results identified that athletes obtain personal benefits from MC tracking by; enhancing understanding of their MC and symptoms, and responding to their MC and symptoms. Athletes also reported that the process of tracking their MC enhanced relationships by; improving communication and interactions with coaches and support staff, and by facilitating team support. Specifically, using tracking increased the opportunities for open conversations with coaches, support staff and teammates regarding their MC. Overall, the findings highlight benefits of menstrual cycle tracking within this group of naturally menstruating rugby players, particularly in helping players and coaches understand the individual nature of the MC, engage in conversations, and establish support from teammates.

Mosquito Feeding Habits in Coastal French Guiana: Mammals in the Crosshairs?

Pathogens transmitted by mosquitoes (Diptera, Culicidae) in sylvatic or urban cycles involve wild or domestic animals and humans, driven by various mosquito species with distinct host preferences. Understanding mosquito-host associations is crucial for ecological insights and pathogen surveillance. In this study, we analyzed mosquito blood meals from coastal French Guiana by amplifying and sequencing host DNA from blood-fed females. Using the 12S ribosomal RNA gene and Sanger sequencing, we identified blood meals from 26 mosquito species across six genera, with 59% belonging to the Culex genus. Nanopore sequencing of selected samples showed 12 mosquito species with one to three mixed blood-meal sources. Mammals were the primary hosts (88%), followed by birds (7%), squamates (3%), and amphibians (2%), indicating a strong preference for mammalian hosts. A total of 46 vertebrate host species were identified, demonstrating high host diversity. This research provides insights into mosquito host usage and highlights the complexities of monitoring arboviruses of public health concern.

Association between Estrogen Levels and Temporomandibular Disorders: An Updated Systematic Review.

The aim of this systematic review is to evaluate the impact of estrogen levels on the occurrence of temporomandibular disorders (TMDs) in humans. Searches were conducted in the same databases as follows: PubMed, the Cochrane Collaboration database, and the Scopus database. In accordance with the MeSH database and previous work, the following keywords were used: 'estrogens' and 'temporomandibular joint disorders'. Twelve studies were included in the review and were assessed for the quality of evidence. Estrogen levels are associated with pain modulation in the temporomandibular joint and the entire orofacial region. There is insufficient evidence to either confirm or refute the influence of estrogen on the occurrence of TMDs. The study was registered under the identifier: 10.17605/OSF.IO/BC7QF.

Assessment of Binge Eating Behavior, Body Shape Concerns, and Associated Factors among Female Adolescents of Northern Saudi Arabia: A Cross-Sectional Study.

Globally, binge eating behavior has emerged as a significant public health concern, especially among female adolescents. Body shape concerns in female adolescents can lead to body dissatisfaction and other mental health issues. Using a cross-sectional study design, we evaluated the frequency of binge eating behavior, body shape concerns, and associated factors among 400 female adolescents. We utilized a pretested Arabic binge eating scale (BES) and a body shape questionnaire-shorter version (BSQ-8C) to collect the required data. We performed Spearman's correlation analysis to find the strength and direction of the correlation between the BES and BSQ-8C scores. Finally, we applied binomial logistic regression analysis to identify the predictors of body shape concerns. Of the studied participants, 5.5% and 6.2% had medium and severe binge eating behavior. We found a significant positive correlation between the BES and BSQ-8C scores (rho = 0.434, p < 0.001). Also, we found that body shape concerns were significantly higher among the monthly family income category of 5000 to 7000 SAR (p = 0.005), the severe binge eating categories (p = 0.009), and obese adolescents (p = 0.001). The present study results can be applied to the development of focused interventions and strategies to address these concerns in this group.

Type I Interferonopathy among Non-Elderly Female Patients with Post-Acute Sequelae of COVID-19.

The pathophysiological mechanisms of the post-acute sequelae of COVID-19 (PASC) remain unclear. Sex differences not only exist in the disease severity of acute SARS-CoV-2 infection but also in the risk of suffering from PASC. Women have a higher risk of suffering from PASC and a longer time to resolution than men. To explore the possible immune mechanisms of PASC among non-elderly females, we mined single-cell transcriptome data from peripheral blood samples of non-elderly female patients with PASC and acute SARS-CoV-2 infection, together with age- and gender-matched non-PASC and healthy controls available from the Gene Expression Omnibus database. By comparing the differences, we found that a CD14+ monocyte subset characterized by higher expression of signal transducers and activators of transcription 2 (STAT2) (CD14+STAT2high) was notably increased in the PASC patients compared with the non-PASC individuals. The transcriptional factor (TF) activity analysis revealed that STAT2 and IRF9 were the key TFs determining the function of CD14+STAT2high monocytes. STAT2 and IRF9 are TFs exclusively involving type I and III interferon (IFN) signaling pathways, resulting in uncontrolled IFN-I signaling activation and type I interferonopathy. Furthermore, increased expression of common interferon-stimulated genes (ISGs) has also been identified in most monocyte subsets among the non-elderly female PASC patients, including IFI6, IFITM3, IFI44L, IFI44, EPSTI1, ISG15, and MX1. This study reveals a featured CD14+STAT2high monocyte associated with uncontrolled IFN-I signaling activation, which is indicative of a possible type I interferonopathy in the non-elderly female patients with PASC.

WASH services and menstrual hygiene management among reproductive age females in the IDPs camps of Shire town in Tigray region of Ethiopia: a cross- sectional study.

Menstruation is a natural cyclic occurrence experienced by reproductive age females in a good health which deemed a proper management, otherwise, it ends with various health complications and impaired quality of life. The aim of this study was to investigate the menstrual hygiene management practice and its determinant factors among reproductive age females living in the IDPs camps of Shire town, Northern Ethiopia. A cross-sectional study was conducted among 633 reproductive age females in Shire town from May to June 2022. Data were entered, cleaned, and analyzed using SPSS version 23. Descriptive analysis and binary and multivariable logistic regression were conducted to obtain the descriptive findings and to investigate the strength of the association respectively. P-value < 0.05 was considered statistically significant. The prevalence of good menstrual hygiene management practice among the reproductive age females was 41.9% (95% CI, 38-45.8%). Menstrual hygiene management practice was significantly (p < 0.05) associated with access to sanitary materials, educational level, availability of continuous water supply and sex-separated latrines. The results of this study demonstrated that more than a half of the reproductive age females did not have good menstrual hygiene management practices. Consequently, it is recommended to work collaboratively to enhance the menstrual hygiene practice, especially in IDPs camps.

Menstrual Dysfunction in Adolescent Female Athletes.

Despite the benefits of exercise on mental and physical health, excessive training loads can lead to health problems in the long term, including a wide spectrum of menstrual dysfunction (MD). This narrative review aims to analyze the relationship between physical exercise and MD in adolescent female athletes to support regular menstrual health monitoring and promote educational programs on reproductive risks. When dealing with MD in young athletes, several factors entangled with maturation of the hypothalamus-pituitary-ovarian axis should be considered. Firstly, some disciplines seem to have a higher prevalence of MD due to the high loads of training regimes and the early introduction of athletes to a competitive career. Moreover, low energy intake and a low body mass index appear to exacerbate existing MD. Lastly, disordered eating behaviors and psychological stress can contribute to MD in female athletes. The type of sport, influencing the intensity and duration of exercise, as well as individual psycho-physiological and environmental factors, may influence the role of physical activity in the manifestation of MD. Early recognition and management of MD, along with collaboration between sports organizations and health professionals, are crucial to minimize risks, ensure proper nutrition, and balance training with recovery. Keeping an open discussion on the topic may prospectively improve awareness, early diagnosis, and treatment strategies, as well as reduce injury risk and enhance sports performance.

Sexual dimorphism in fish innate immunity: a functional and transcriptional study in yellowtail kingfish.

Sexual dimorphism in immunity has been extensively documented across vertebrates, with marked contrasts observed in immune responses between males and females. These variations are mainly attributed to oestrogens conferring enhanced immune responses in females, while males exhibit greater susceptibility to pathogens. However, in the light of the data, consensus is lacking, as different physiological and environmental factors such, as epigenetics, may impact sex-biased immunity. In fish, the regulation of immune responses through sex hormones is primarily determined by the leucocyte function, which contains sex steroid receptors. However, comparative sex-based research in fish immunity is still very limited. This study aimed to evaluate, for the first time, the disparities between males and females yellowtail kingfish (Seriola lalandi) juveniles in several parameters of local humoral innate immunity related to mucosae (skin mucus and foregut homogenates) and reproductive tissue (ovary and testis homogenates), as well as in serum. We investigated the sexual dimorphism in the expression patterns of genes coding for antimicrobial peptides, antiviral markers, and cytokines. Our findings revealed that the yellowtail kingfish males exhibit significantly higher levels of innate immune parameters, both functionally and transcriptionally, compared to females. These results suggest that females may have a higher susceptibility to pathogen infections, potentially leading to latent infections, which deservers further investigations. Understanding these sex-based differences in immunity could guide breeding strategies improvements and disease management in aquaculture facilities.

Health Care Resource Use and Total Mortality After Hospital Admission for Severe COVID-19 Infections During the Initial Pandemic Wave in France: Descriptive Study.

BACKGROUND: Little is known about post-hospital health care resource use (HRU) of patients admitted for severe COVID-19, specifically for the care of patients with postacute COVID-19 syndrome (PACS). OBJECTIVE: A list of HRU domains and items potentially related to PACS was defined, and potential PACS-related HRU (PPRH) was compared between the pre- and post-COVID-19 periods, to identify new outpatient care likely related to PACS. METHODS: A retrospective cohort study was conducted with the French National Health System claims data (SNDS). All patients hospitalized for COVID-19 between February 1, 2020, and June 30, 2020 were described and investigated for 6 months, using discharge date as index date. Patients who died during index stay or within 30 days after discharge were excluded. PPRH was assessed over the 5 months from day 31 after index date to end of follow-up, that is, for the post-COVID-19 period. For each patient, a pre-COVID-19 period was defined that covered the same calendar time in 2019, and pre-COVID-19 PPRH was assessed. Post- or pre- ratios (PP ratios) of the percentage of users were computed with their 95% CIs, and PP ratios>1.2 were considered as "major HRU change." RESULTS: The final study population included 68,822 patients (median age 64.8 years, 47% women, median follow-up duration 179.3 days). Altogether, 23% of the patients admitted due to severe COVID-19 died during the hospital stay or within the 6 months following discharge. A total of 8 HRU domains were selected to study PPRH: medical visits, technical procedures, dispensed medications, biological analyses, oxygen therapy, rehabilitation, rehospitalizations, and nurse visits. PPRs showed novel outpatient care in all domains and in most items, without specificity, with the highest ratios observed for the care of thoracic conditions. CONCLUSIONS: Patients hospitalized for severe COVID-19 during the initial pandemic wave had high morbi-mortality. The analysis of HRU domains and items most likely to be related to PACS showed that new care was commonly initiated after discharge but with no specificity, potentially suggesting that any impact of PACS was part of the overall high HRU of this population after hospital discharge. These purely descriptive results need to be completed with methods for controlling for confusion bias through subgroup analyses. TRIAL REGISTRATION: ClinicalTrials.gov NCT05073328; https://clinicaltrials.gov/ct2/show/NCT05073328.

Relationship Between Food Insecurity and Healthy Eating Behavior for Gestational Diabetes Risk Reduction Among American Indian and Alaska Native Adolescent and Young Adult Females: A Qualitative Exploration.

OBJECTIVE: To understand the perspectives of key informant experts regarding the relationship between food insecurity and gestational diabetes mellitus risk reduction behaviors among young American Indian and Alaska Native females. METHODS: Participants were adult key informants with expertise in food/nutrition and health within Tribal communities (N = 58) across the US. Data were collected through 1:1 interviews using a semistructured moderator guide and analyzed using thematic content analysis methods. RESULTS: Three themes included (1) diet and nutrition habits are formed through intergenerational food preferences and are driven by lasting implications of colonization; (2) young people are influenced by what their peers eat and the food environment, including outside of the home; and (3) the methods used to understand household food insecurity and nutrition habits in the parent study were likely limited. CONCLUSIONS AND IMPLICATIONS: Findings provide guidance as to where nutrition education and interventions may best support young Native females.

HPV Vaccination Rates in Military Females: The Need for a Multi-Level and Evidence-Based Approach.

To mitigate the impact of personal and structural barriers hindering HPV vaccination in military women, multiple research studies have advocated for adding the HPV vaccine to the mandatory list for enlistees. Intervention Mapping (IM) is a systematic and stepwise theory-based approach that has been used to inform the development of health promotion interventions and implementation strategies in community and clinical settings at national, regional, and global levels. Development and evaluation of effective strategies and multi-level interventions using IM may increase the uptake of the HPV vaccine among military females who are at-risk of HPV infections and associated co-morbidities.

A simple and low-cost environmental enrichment program improves the welfare of Calomys callosus, a species that adapts to animal facilities.

An environmental enrichment protocol is essential for testing experimental models because it upholds animal welfare, aligns with ethical principles in animal experimentation, and reduces the number of animals needed. Calomys callosus, a South American rodent from the Cricetidae family, is bred in rodent animal facilities for its ease of handling, longevity, prolificacy, and effectively mimicking diseases like Toxoplasmosis, Leishmaniasis, Chagas, and Schistosomiasis. There are no reports on environmental enrichments for this species or their impact on reproductive parameters. This study aimed to analyze the influence of the Environmental Enrichment Program (EEP) on the reproductive and zootechnical performance of C. callosus kept in the Rodents Animal Facilities Complex of Universidade Federal de Uberlândia (UFU). Two experimental groups were established: with environmental enrichment EE+ and without environmental enrichment EE-. The materials used in the experimental design were changed weekly and alternated between dietary, occupational, physical/cognitive, and non-enrichment items. After the inclusion of the EEP, an improvement in the reproductive indices of C. callosus was identified in the EE+ group. These improvements included increased female precocity, a decreased interbirth interval, and a higher number of pairs producing more offspring. The postpartum zootechnical indices were also better, such as the number of animals born alive, improved weaning rates, and a reduced average number of deaths from birth to weaning. After the inclusion of the EEP, the general health status of C. callosus improved, reducing cases of non-infectious lumbar alopecia. Therefore, EEP allows C. callosus to express natural reproductive behaviors and improves parental care.

The Prevalence of Stress Fractures and the Associated LEAF-Q Responses, Self-Reported Exercise Volume and Dietary Behaviors in Female Recreational Runners.

Previous research suggests a high prevalence of low energy availability (LEA) and stress fractures (SF) among competitive female endurance athletes. However, much less is known about these issues among recreational female runners. This study aimed to assess the prevalence and number of self-reported SF and risk of LEA among noncompetitive, recreationally active female runners, aged 18 - 25 years. Additionally, it compared characteristics between females with a history of multiple SF vs. one or no SF, and between those 'at risk' vs. 'not at risk' of LEA. Female recreational runners (n=485) completed an online survey that included the Low Energy Availability in Females Questionnaire (LEAF-Q) and the Disordered Eating Screening Assessment (DESA-6). Thirty-three percent of participants reported ≥ 2 SF. Eighty-two percent of the ≥ 2 SF group were classified as 'at risk' of LEA (LEAF-Q score ≥ 8). In addition, ≥ 2 SF was associated with higher total LEAF-Q score, self-reported intentional food restriction for weight loss, and self-reported current eating disorder while weekly exercise duration was inversely associated with ≥ 2 SF. In conclusion, one-third of participants had multiple SF with a majority (82%) of this group classified as 'at risk' of LEA. Screening tools such as the LEAF-Q and DESA-6 are useful tools to identify characteristics associated with multiple SF in this demographic, especially questions regarding food restriction and the presence of a current or previous eating disorder.

Post-dural Puncture Headache: A Comparative Study Using 25 G Quincke's Needle in Midline and Paramedian Approaches in Patients Undergoing Elective Cesarean Section.

Background and objectives Spinal anesthesia (SA) has become a preferred anesthetic technique for elective cesarean sections due to its rapid onset, profound sensory and motor blockade, and minimal impact on the newborn. It lowers the risk of development of thrombus in the veins and pulmonary vessels and permits early ambulation. The most popular technique used to reach the subarachnoid space is the midline technique, though it can be challenging to use in some cases, including those involving elderly patients with degenerative abnormalities in the vertebral column, patients who are unable to flex the vertebral column, noncooperative patients, and hyperesthetic patients. The paramedian technique resolves the challenges posed by the midline technique. It is also relatively easy to carry out. Based on the midline technique's inadequacies, we hypothesized that the paramedian method of SA would be less complicated than the midline approach, with a relatively low occurrence of post-dural puncture headaches (PDPH). Methodology Using the midline and paramedian approaches during cesarean surgeries, we performed an observational descriptive longitudinal study to assess the occurrence and magnitude of PDPH. During an elective cesarean delivery, the seated patient received 2.0-2.5 ml of hyperbaric bupivacaine using the midline or paramedian approaches and a 25 G Quincke's needle at the L3-L4 level. Eighty-four pregnant females with American Society of Anesthesiologists (ASA) physical status II, aged 18 to 35 (n = 42 in each group), were included in this research. The occurrence and severity of PDPH were compared among the groups during a period of five days. Result In comparison to the paramedian group (7.1%), the midline group had a higher incidence of PDPH (14.3%). There was a significant correlation between the technique and the occurrence of PDPH (p = 0.041). The visual analogue scale (VAS) was employed to quantify pain five days after surgery. Pain levels in Group B (paramedian) were consistently less than those in Group A (midline). On day 1, Group B had a mean score of 0.49 ± 1.16 (p = 0.030) compared to Group A's mean VAS score of 1.27 ± 1.95. Day 5 (p = 0.032): Because this tendency persisted through day 5, the p-values for days 2, 3, 4, and 5 remained significant. These findings suggest that the midline technique is linked to a higher occurrence and magnitude of PDPH than the paramedian approach. Conclusion Employing a paramedian technique has been associated with a noteworthy decline in the frequency of PDPH and a decrease in the need for additional analgesics, which could lead to a less severe case of PDPH. The paramedian approach needed fewer attempts and needle passes, which leads to a lower incidence of headache, backache, and injection site pain and better patient satisfaction.

Sex- and gender-based medicine in pediatric nutrition.

Consistent evidence increasingly highlights the significance of integrating sex and gender medicine to ensure a precision approach according to individual patient needs. Gender discrepancies emerge across various areas, even from pediatric age. The importance of recognizing these differences in pediatric nutrition is critical for the development of targeted nutritional strategies and interventions, particularly in cases of associated pathologies, including obesity, metabolic-associated fatty liver disease, eating disorders, and inflammatory bowel disease. The review highlights the biological and sociocultural factors that contribute to different nutritional needs and health outcomes in male and female children. By examining current evidence, we underscore the necessity for precision medicine approaches in pediatric care that consider these sex- and gender-based differences. Moreover, differences in dietary requirements and dietary patterns between males and females are evident, underscoring the need for precise nutrition strategies for a more accurate management of children and adolescents. This approach is essential for improving clinical outcomes and promoting equitable healthcare practices. This review aims to provide an overview of nutrition-related medical conditions exhibiting sex- and gender-specific discrepancies, which might lead to distinct outcomes requiring unique management and prevention strategies. Future research and public health initiatives should address these differences in designing effective lifestyle education programs and nutrition interventions targeting both children and adolescents.

Do sex and gender aspects influence non-adherence to secondary prevention measures after myocardial infarction?

Objective: This study aimed to determine the prevalence of non-adherence to preventive interventions, its clinical consequences, and factors associated with non-adherence to secondary prevention measures, with a special emphasis on sex and gender. Methods: Prospective observational study of patients hospitalized for acute myocardial infarction (AMI) in whom an evaluation of adherence to medication, Mediterranean diet, physical activity, and cardiac rehabilitation was performed after 6 and 12 months, with systematic assessment of predictors including patient-, disease-, psychological-, social-, and gender-related factors using self-administered questionnaires. Results: Of 503 patients included, 101 (20,1%) were females. At one year, 85% of patients did not adhere to at least one of the recommendations with no differences between females and males. However, two factors more frequent in females, caregiver burden (adjusted OR, 1.45; 95%CI, 1.08-1.94) and depressive symptoms (adjusted OR, 1.40; 95%CI, 1.03-1.92) predicted non-adherence to all measures together. Chronic kidney disease (aOR, 3.24; 95%CI, 1.02-10.48) and being female (aOR, 2.21; 95%CI, 1.18-4.13) were associated with non-adherence to the Mediterranean diet; diabetes with organ damage (aOR, 12.06; 95%CI, 1.93-7.69) and older age (aOR, 0.96 per year; 95%CI, 0.93-0.99), among others, with physical activity; and higher body mass index with cardiac rehabilitation participation (aOR, 1.07; 95%CI, 1.002-1.14) and completion (aOR, 1.14; 95%CI, 1.03-1.26). Conclusion: Adherence to all secondary prevention measures after AMI remains very low and is associated with several gender-related factors. Multidisciplinary intervention strategies targeting the most vulnerable patient groups, such as females or patients with diabetes, obesity, chronic kidney disease, or depression, are warranted.