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Background: The prevalence and severity of perimenopausal symptoms are typically associated with multiple factors, including demographic characteristics. The sociodemographic characteristics of women living in rural areas differ from those residing in urban areas, and it has been suggested that these differences could potentially influence the prevalence of symptoms experienced during perimenopause., Objectives: To evaluate if perimenopausal women living in Spanish rural areas have a higher prevalence of perimenopausal symptoms and assess their influence on health-related quality of life., Methods: A cross-sectional study was conducted in a sample of 270 perimenopausal women residing in rural and urban areas. The participants completed the Cervantes Scale Short Version and Beck Depression Inventory 2., Results: Perimenopausal women in rural areas reported a higher incidence of perimenopausal symptoms and a lower perception of health-related quality of life compared to those in urban areas, as evidenced by higher scores on the total Cervantes Scale Short Version scale (33.2 (±16.2) vs. 26.4 (±18.1), p  = .001). No differences in the Beck Depression Inventory 2 score were detected., Conclusions: Perimenopausal women residing in rural areas of Spain reported a higher prevalence of perimenopausal symptoms and experienced a poorer Health-Related Quality of Life compared to those living in urban areas of Spain.

Mango is a good source of carotenoids for use in food, cosmetic, and pharmaceutical products because of their organoleptic and health-promoting properties. Safe and sustainable methods for their extraction is required. The present investigation was aimed to study concentration and carotenoid profile of 'Kent' mango pulp through a conventional extraction (CE) and ultrasound-assisted extraction (UAE) using traditional solvents (tetrahydrofuran-THF and diethyl ether: petroleum ether-DE:PE) and green solvents (GS) (2-metiltetrahydrofuran, 2 m-THF; cyclopentyl methyl ether, CPME). Mango showed (μg/g d.w.) β-carotene (29.4), zeaxanthin (1.28), β-cryptoxanthin (2.8), phytoene (18.68) and phytofluene (7.45) in a CE using DE:PE. Similar results were obtained applying DE:PE in UAE and GS in a CE, so CPME and 2-mTHF seem suitable solvents to replace DE:PE in CE. The yield of total carotenes, xanthophylls and carotenoids using GS combined with UAE was lower than with CE, but important enough to be used as a sustainable procedure for obtaining carotenoids from mango pulp., Competing Interests: Declaration of competing interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2024 The Authors. Published by Elsevier Ltd.. All rights reserved.)

Introduction: Osteoporosis is a chronic systemic skeletal disorder characterized by compromised bone strength and an increased risk of fracture, with a high prevalence worldwide. It is associated with a negative quality of life and an increased morbidity and mortality. Postmenopausal women are more prone to develop osteoporosis, and many of them will suffer at least one fragility fracture along their lifetime., Areas Covered: This review starts by summarizing the pathogenesis of postmenopausal osteoporosis (PMO), with focus on the estrogen deficiency-associated bone loss. It continues with the current PMO diagnostic and fracture risk prediction tools, and it finally addresses management of PMO. All the efficacy and safety profiles of the current and future osteoporosis medications are reviewed. Furthermore, strategies to optimize the long-term disease management are discussed. For this review, only publications in English language were selected. References were extracted from PubMed, Embase, and Medline., Expert Opinion: PMO disease management is far from being ideal. Educational and communication programs with the goal of improving disease knowledge and awareness, as well as reducing the health-care gap, should be implemented. In addition, most effective sequential prevention and treatment strategies should be initiated from the early menopause.

Background: Vaginal dryness (VD) represents a significant concern affecting women across diverse life stages, encompassing both pre- and postmenopausal women at any age. Dyspareunia, defined by genital pain that can be experienced before, during, or after intercourse, is often associated with vaginal dryness., Aim: This study aimed to evaluate the effectiveness and safety of a water-based vaginal lubricant with hyaluronic acid to reduce sexual discomfort associated with vaginal dryness., Methods: A prospective, multicenter, uncontrolled clinical investigation was conducted over a three-month period in women aged 18 years or older experiencing pain or difficulty during sexual intercourse for whom the use of a vaginal lubricant was recommended., Results: Significant improvements were observed in the FSFI scores, indicating enhanced sexual function ( p  < .001). Vaginal dryness symptoms, including irritation, dryness, itching, and dyspareunia, significantly decreased after product use ( p  < .001)., Clinical Implications: This study contributes to the limited scientific knowledge on the application of lubricants in the context of symptoms associated with VD., Strengths & Limitations: In addition to the short study period, inherent limitations of the study design, and lack of placebo control, it is pertinent to acknowledge that some of the pros used in this study were not based on validated questionnaires. However, as far as we know, this study is the only one that analyzes well-being and sexual pleasure as results using a lubricant formulated with hyaluronic acid., Conclusion: This tested vaginal lubricant with hyaluronic acid has demonstrated efficacy in improving vaginal dryness and female sexual function, particularly in reducing pain and improving lubrication during sexual intercourse, and showed a favorable safety profile, with minimal and transient adverse events.

Introduction and Hypothesis: This report aims to prospectively describe the effectiveness and safety of injected cross-linked hyaluronic acid (HA) for the treatment of chronic vulvar fissures., Methods: A descriptive prospective case series design including 15 patients affected by chronic vulvar fissures who were treated with cross-linked HA filler between December 2020 and July 2021. The validated 21-item Vulvovaginal Symptoms Questionnaire (VSQ) was used to evaluate the results from baseline up to 9 months after the HA infiltration., Results: A total of 15 patients suffering from chronic vulvar fissures were treated with an injection of 19 mg/mL HA filler. We found a significant improvement in VSQ scores at the end of the treatment compared to baseline. Patients reported excellent tolerance of the procedure, and no complications were recorded., Conclusions: Cross-linked HA infiltration of the vulvar vestibule and posterior vaginal wall appeared to be a promising approach for chronic vulvar fissures., (© 2022. The International Urogynecological Association.)

Purpose: We evaluated the obstetrical outcomes, ultrasonographic characteristics, and final diagnosis in pregnancies with fetal megacystis (FM). Methods: We evaluated the obstetrical outcomes and associated structural abnormalities of fetuses with FM detected between FM between 2000 and 2021. Results: 17 FM were diagnosed, 16 had follow up. 16 were early megacystis. 14/16 (87.5%) of pregnancies were terminated, 1/16 (6.25%) resulted in intrauterine death, and 1/16 (6.25%) survived. FM was associated with 13 other abnormal sonographic findings in 12/16 (75%) pregnancies. The most common associated ultrasound abnormality was umbilical cord cyst in 3/16 (18.75%). Recognized etiologies included posterior urethral valves (2), trisomy 18 (2), trisomy 13 (1), Prune Belly syndrome (1), and Megacystis-Microcolon-Hypoperistalsis syndrome (1). Conclusion: Most FM are detected in the 2nd trimester, most are electively terminated, are associated with other ultrasonic abnormalities in 75%, most commonly umbilical cord cyst, and have an identifiable cause in 44%.

Aims: This systematic review and meta-analysis examined maternal and cord blood betatrophin levels in pregnant women with gestational diabetes mellitus (GDM) and normoglycemic controls., Material and Methods: PubMed, Cochrane Library, Embase, LILACS, WangFang, and China National Knowledge Infrastructure were searched for literature from inception until May 2022. The primary outcomes were maternal and cord blood betatrophin levels. A random-effect meta-analysis was used to estimate the pooled results. The mean differences (MDs) or standardised MDs (SMD) and their 95% confidence intervals (CIs) were calculated. I 2 tests were used to evaluate the heterogeneity. The quality of studies was evaluated using the Newcastle-Ottawa Scale., Results: Betatrophin levels were reported in 22 studies with a total of 3034 pregnant women, and in seven studies including cord blood from 456 infants. Women with GDM display higher betatrophin levels than the normoglycemic controls (SMD = 0.85, 95% CI: 0.38-1.31) during the second half of the pregnancy. The sensitivity analysis indicated that no single study had significantly influenced the betatrophin overall outcomes. There was heterogeneity between the studies as evidenced by high I 2 values. Meta-regression analysis indicated a significant regression coefficient for maternal betatrophin and glycosilated haemoglobin. There was no significant difference in cord blood betatrophin in infants from women with and without GDM (SMD = 0.34, 95% CI: -0.15-0.83). Women with GDM also had significantly higher insulin, glucose, glycosylated haemoglobin, HOMA-IR, LDL-cholesterol, HDL-cholesterol, triglycerides, and body mass index compared with the normoglycemic controls., Conclusions: Maternal betatrophin levels were higher in women with GDM than in the normoglycemic controls. There was no difference in cord blood betatrophin., Systematic Review Registration: PROSPERO CRD42022311372., (© 2023 The Authors. Diabetes/Metabolism Research and Reviews published by John Wiley & Sons Ltd.)

Phytoene (PT) and phytofluene (PTF) are colourless carotenoids presents in the human diet and in blood, faeces and tissues and are biologically active. However, there is very little data on these carotenoids. This study aims to assess PT and PTF concentrations in serum from healthy Spanish normolipemic subjects ( n = 101, 45-65 years) and the effect of a fruit and vegetable dietary intervention (4 weeks, n = 29) on PT and PTF concentration in serum and faeces and dietary intake. Serum and faecal concentrations were analysed by HPLC and dietary intake by 3 × 24 h recalls. PT showed higher concentrations than PTF in serum, faeces and in the dietary intake. Considering both studies, PT and PTF concentrations in serum were 0.16 ± 0.07 and 0.05 ± 0.04 µmol/L, respectively, in faeces 17.7 ± 20.3 and 6.5 ± 7.9 µg/g, respectively, and in dietary intake the median was 2.4 and 0.6 mg/p/day, respectively. Carrots and tomatoes were the major dietary contributors of these carotenoids. The dietary intervention did not cause significant variations in the PT and PTF intake or serum concentrations, but a lower concentration in faeces was observed for the fruit group (PT: p = 0.024; PTF isomer-3: p = 0.034). These data highlight the need for further research on the activities of these carotenoids in humans.

Cesarean scar pregnancy (CSP) is a rare form of ectopic pregnancy located in the lower uterine segment. The current increase in the percentage of cesarean sections is accompanied by significant growth in the incidence of CSP, while advances in ultrasound diagnostic techniques have led to a greater number of CSP diagnoses. A misdiagnosed CSP, or one that is diagnosed too late, is life-threatening to the pregnant patient and predisposes her to complications such as uterine bleeding or rupture, which often require hysterectomy and thus result in the irreversible loss of fertility. We present the case of a 50-year-old woman with a history of undiagnosed CSP after multiple consultations for intermittent bleeding and hemorrhage. She was diagnosed by ultrasound and the diagnosis was confirmed by hysteroscopy. She underwent conservative medical treatment that was successful., Competing Interests: The authors declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article., (Copyright © 2022 Manuel Sánchez-Prieto et al.)

Ovarian cancer is one of the most common gynecologic cancers and has the highest mortality rate. The risk/protective factors of ovarian cancer suggest that its etiology is multifactorial. Several factors are involved in age-related increases in carcinogenesis, including the accumulation of senescent cells, inflammaging (a chronic inflammatory state that persists in the elderly), and immunosenescence (aging of the immune system) changes associated with poor immune surveillance. At sites of inflammation, exposure to high levels of inflammatory mediators, such as reactive oxygen species, cytokines, prostaglandins, and growth factors, contributes to increased cell division and genetic and epigenetic changes. These exposure-induced changes promote excessive cell proliferation, increased survival, malignant transformation, and cancer development. Furthermore, the proinflammatory tumor microenvironment contributes to ovarian cancer metastasis and chemoresistance. This narrative review of the literature was carried out to delineate the possible role of inflammaging in the etiopathogenesis of ovarian cancer development. We discuss the current carcinogenic hypotheses, sites of origin, and etiological factors of ovarian cancer. Treatment of inflammation may represent an attractive strategy for both the prevention and therapy of ovarian cancer., Competing Interests: The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (© 2022 The Author(s).)

Lutein is mainly supplied by dietary fruit and vegetables, and they are commonly jointly assessed in observational and interventional studies. Lutein bioavailability and health benefits depend on the food matrix. This study aimed to assess the effect of dietary intervention with lutein-rich fruit or vegetables on lutein status markers, including serum and faecal concentrations (by high pressure liquid chromatography), dietary intake (24 h recalls ×3), and macular pigment optical density (MPOD) and contrast threshold (CT) as visual outcomes. Twenty-nine healthy normolipemic subjects, aged 45-65 y, consumed 1.8 mg lutein/day supplied from fruits (14 subjects, 500 g/day of oranges, kiwi and avocados) or vegetables (15 subjects, 180 g/day of green beans, pumpkin, and sweet corn) for four weeks. Serum lutein concentration increased by 37%. The effect of the food group intervention was statistically significant for serum lutein+zeaxanthin concentration ( p = 0.049). Serum α- and β-carotene were influenced by food type ( p = 0.008 and p = 0.005, respectively), but not by time. Serum lutein/HDL-cholesterol level increased by 29% (total sample, p = 0.008). Lutein+zeaxanthin/HDL-cholesterol increased, and the intervention time and food group eaten had an effect ( p = 0.024 and p = 0.010, respectively) which was higher in the vegetable group. The MPOD did not show variations, nor did it correlate with CT. According to correlation matrixes, serum lutein was mainly related to lutein+zeaxanthin expressed in relation to lipids, and MPOD with the vegetable group. In faecal samples, only lutein levels increased ( p = 0.012). This study shows that a relatively low amount of lutein, supplied by fruit or vegetables, can have different responses in correlated status markers, and that a longer intervention period is needed to increase the MPOD. Therefore, further study with larger sample sizes is needed on the different responses in the lutein status markers and on food types and consumption patterns in the diet, and when lutein in a "pharmacological dose" is not taken to reduce a specific risk.

Objective: To assess the relationship of breastfeeding duration with maternal ultrasound carotid intima-media thickness (CIMT) in later life., Methods: PubMed, Scopus, Web of Science, Embase, and Cochrane Central database searching up to December 15, 2020, for eligible studies that reported on the breastfeeding duration and ultrasound measurement of CIMT in later life. The exposed group corresponded to breastfeeding duration ≥ 6 months whereas the control group was women with breastfeeding of shorter duration or nil breastfeeding. The methodological quality of reviewed articles was appraised using the Newcastle-Ottawa Scale (NOS). Results are reported as the mean difference (MD) or the standardized MD (SMD) and their 95% confidence intervals (CIs). The study was registered in the PROSPERO database., Results: Of 532 unique studies, three studies met inclusion criteria including 1721 women with a mean age ranging between 36.6 ± 6.9 and 55.7 ± 5.3 years, comparing breastfeeding duration ≥ 6 months versus 1-5 months (NOS: 7-8). Common CIMT was lower in women who breastfed for a longer duration (SMD = -0.10, 95% CI -0.20 to -0.00). Circulating HDL-cholesterol was higher in women with longer breastfeeding duration (MD = 3.25, 95% CI 0.88-5.61). There were no significant differences for total cholesterol, LDL-cholesterol, triglycerides, glucose, and blood pressure between breastfeeding 6 or more months and the control group., Conclusions: The available studies showed lower CIMT and higher HDL-cholesterol levels in women who breastfed for 6 or more months as compared to controls.

Introduction: The aim of this study was to investigate whether postmenopausal women with breast cancer (BC) on adjuvant aromatase inhibitor (AI) therapy have a higher prevalence of female sexual dysfunction (FSD). Second, the aim was to determine the quality of life (QoL) and level of anxiety depending on whether or not they are AI users., Methods: A prospective cross-sectional study involving 168 patients was performed. Three questionnaires were carried out: sexual functioning was evaluated with the Female Sexual Function Index (FSFI), while the EORTC QLQ-BR23 measures to study QoL in patients with BC and the State-Trait Anxiety Inventory (STAI) questionnaire (trait and status) were used to assess anxiety status in patients under treatment with AIs or not., Results: 47.6% (80/168) of the postmenopausal BC survivors were not sexually active (mean time after surgery: 48.6 months) despite a relatively low mean age (56.43 years). Postmenopausal AI-treated women had significantly worse sexual function as measured by the FSFI (23.40 ± 5.26 vs. 30.16 ± 2.24; p = 0.000). There were significant differences between both groups in all domains, except orgasm. The QoL score was 37.67 ± 7.38 in AI users versus 39.00 ± 1.44 among nonusers ( p = 0.053). Patients under endocrine treatment also presented STAI scores significantly higher (25.83 ± 4.99 vs. 19.00 ± 7.12; p = 0.000). Trait anxiety was high in both groups, but this was not statistically significant., Conclusions: We observed a high prevalence of sexual inactivity among BC survivors regardless of AI use. Patients with AI use presented significantly higher prevalence of FSD, worse QoL, and greater anxiety., Competing Interests: The authors did not report any potential conflicts of interest., (Copyright © 2020 by S. Karger AG, Basel.)

Vulvar malignant melanoma is the second most common subtype of vulvar cancer, accounting for 5-10% of all vulvar cancers. The prognosis is still very poor, although some advances have been achieved in the last years. One of the most significant changes in its management has been the development of less invasive surgical techniques that diminish the risk of postoperative morbidity and long-lasting sequelae. In this article, we review the surgical management of the pathology, based on the comment of 3 cases with vulvar melanoma treated at our institution., Competing Interests: The authors declared no potential conflicts of interest with respect to the research, authorship, and publication of this article., (Copyright © 2021 by S. Karger AG, Basel.)

Purpose: To examine the prevalence of depressive and anxiety symptoms and the corresponding risk factors among pregnant women during the confinement due to the COVID-19 outbreak in Spain., Materials and Methods: Between 15 April and 14 May 2020, a multicentre cross-sectional survey was performed to study depression, anxiety and resilience in a sample of Spanish pregnant women during the lockdown set up by the Government in response to COVID-19 pandemic outbreak. We designed an anonymous online self-administered questionnaire (https://bit.ly/34RRpq1) that included the Spanish validated versions of the Edinburgh Postpartum Depression Scale (EPDS), the State-Trait Anxiety Inventory (STAI) and the Connor-Davidson Resilience 10-items Scale (CD-RISC-10)., Results: A total of 514 pregnant women completed the survey. 72.8% had been confined < 40 days and 27.2% between 41 and 60 days. 182 (35.4%) participants scored over 10, with 21.3% scoring over 13 (75th Percentile) in depressive symptoms rates. We found high trait and anxiety scores, with 223 (43.4%) and 227 (44.2%) pregnant women scoring over the trait and state mean scores. Neither depression, anxiety or resilience levels showed any significant correlation with the length of confinement. We found low CD-RISC-10 scores., Conclusions: We found a high prevalence of depression and anxiety symptoms during the quarantine, although we did not find an increased prevalence of psychological distress according to length of home confinement. Resilience correlated negatively with depression and anxiety.

Introduction: The dietary carotenoids lutein (L) and zeaxanthin (Z) are transported in the bloodstream by lipoproteins, sequestered by adipose tissue, and eventually captured in the retina where they constitute macular pigment. There are no L&Z dietary intake recommendations nor desired blood/tissue concentrations for the Spanish general population. Our aim was to assess the correlation of L&Z habitual dietary intake (excluding food supplements), resulting serum concentrations and lipid profile with macular pigment optical density (MPOD) as well as the contrast sensitivity (CT), as visual outcome in normolipemic subjects (n = 101) aged 45-65., Methods: MPOD was measured by heterochromatic flicker photometry, serum L&Z by HPLC, the dietary intake by a 3-day food records and CT using the CGT-1000-Contrast-Glaretester at six stimulus sizes, with and without glare., Results: Lutein and zeaxanthin concentrations (median) in serum: 0.361 and 0.078 μmol/L, in dietary intake: 1.1 mg L+Z/day. MPOD: 0.34du. L+Z intake correlates with their serum concentrations (rho = 0.333, p = 0.001), which in turn correlates with MPOD (rho = 0.229, p = 0.000) and with fruit and vegetable consumption (rho = 0.202, p = 0.001), but not with lutein+zeaxanthin dietary intake. MPOD correlated with CT, with and without glare (rho ranges: -0.135, 0.160 and -0.121, -0.205, respectively). MPOD predictors: serum L+Z, L+Z/HDL-cholesterol (β-coeficient: -0.91±0.2, 95%CI: -1.3,-0.5) and HDL-cholesterol (R2 = 15.9%). CT predictors: MPOD, mainly at medium and smaller visual angles (corresponding to spatial frequencies for which sensitivity declines with age) and gender (β-coefficients ranges: -0.95,-0.39 and -0.13,-0.39, respectively)., Conclusion: A higher MPOD is associated with a lower ratio of L+Z/HDL-cholesterol and with a lower CT (higher contrast sensitivity). The HDL-cholesterol would also act indirectly on the CT improving the visual function., Competing Interests: The authors have declared that no competing interests exist.

Objective: Ovarian cancer (OvCa) is the deadliest gynaecologic malignancy. Knowing that OvCa, as a disease, has different origins has allowed us to relate them to the mechanisms of action of different contraceptive methods with the aim of evaluating the possibility of their use in reducing risk., Study Design: This commentary review article will instead focus on the recent findings on the role of contraceptive methods in preventing of OvCa., Results: Combined hormonal contraceptive (CHC) use is an effective method of chemoprevention for OvCa in the general population and in women with genetic disorders. Salpingectomy, better than tubal ligation, should be offered for ovarian/tubal/peritoneal cancer prevention. Progestogen-only methods can decrease the risk of OvCa via reduced menstrual bleeding and by changes in the hormonal environment that surrounds the ovary. IUDs of any type, through different mechanisms, decrease the risk of OvCa. Barrier methods prevent the passage of germs into the tubes and ovaries and the inflammatory state they produce., Conclusions: Most contraceptive methods have a mechanism of action that may favour a reduction in the risk of OvCa. The theories of incessant ovulation, retrograde menstruation, and that the fallopian tubes are the site of origin of a proportion of high-grade serous OvCa, have led to the recommendation that anovulatory methods, those that decrease menstrual bleeding, and those that blocked tubes, or even better, 'opportunistic salpingectomy' are a current approach to prevent OvCa in the population general and, above all, in the population at risk.

The objective of this study was to investigate whether the BC tumor biology in women with larger breast volume, in obese women and especially in women with central adiposity at the moment of diagnosis of BC is more aggressive than in those women without these characteristics. 347 pre- and postmenopausal women with a recent diagnosis of BC were analyzed. In all patients, anthropometric measurements at the time of diagnosis was collected. In 103 of them, the breast volume was measured by the Archimedes method. The Breast volume, BMI, WHR and the menopausal status were related to different well-known pathological prognostic factors for BC. At the time of diagnosis, 35.4% were obese (BMI > 30 kg/m 2 ), 60.2% had a WHR ≥ 0.85, 68.8% were postmenopausal and 44.7% had a breast volume considered "large" (> 600 cc). Between patients with a large breast volume, only a higher prevalence of ER (+) tumors was found (95.3% vs. 77.2%; p = 0.04) compared to those with small breast volumes. The obese BC patients showed significantly higher rates of large tumors (45.5% vs. 40.6%; p = 0.04), axillary invasion (53.6% vs. 38.8%; p = 0.04), undifferentiated tumors (38.2% vs. 23.2%) and unfavorable NPI (p = 0.04) than non-obese women. Those with WHR ≥ 0.85 presented higher postsurgical tumor stages (61.7% vs. 57.8%; p = 0.03), higher axillary invasion (39.9% vs. 36.0%; p = 0.004), more undifferentiated tumors (30.0% vs. 22.3%; p = 0.009), higher lymphovascular infiltration (6.5% vs. 1.6%; p = 0.02), and a higher NPI (3.6 ± 1.8 vs. 3.2 ± 1.8; p = 0.04). No statistically significant differences were found according to menopausal status. We conclude that obesity, but especially central obesity can be associated with a more aggressive tumour phenotype. No relation between breast volume and tumoral prognostic factors was found, except for a higher proportion of ER (+) tumor in women with higher breast volume.

Aim: To systematically compare sexual function between non-treated women with and without endometriosis., Methods: A systematic review was performed on PubMed/Medline, Scopus, EMBASE, Web of Science and Cochrane Library databases searching studies that analyzed sexual function (assessed with the 19-item Female Sexual Function Index [FSFI]), and dyspareunia, chronic pelvic pain and dysmenorrhea (assessed with a visual analogue scale [VAS]) in women with and with endometriosis., Results: In 4 studies, non-treated women with endometriosis presented a higher risk of female sexual dysfunction (mean total FSFI score ≤ 26.55; OR = 2.38; 95% confidence interval [CI] = 1.12, 5.04). Although mean total FSFI scores were not significantly different between women with and without endometriosis (mean difference [MD] = -2.15; 95% CI -4.96, 0.67); all FSFI domain scores were significantly lower in women with endometriosis ( n  = 4 studies): desire (MD = -0.43; 95% CI -0.57, -0.19); arousal (MD = -0.66; 95% CI -1.15, -0.17); lubrication (MD = -0.41; 95% CI -0.79, -0.02); orgasm (MD = -0.40; 95% CI -0.73, -0.06); satisfaction (MD = -0.45; 95% CI -0.72, -0.18); and pain (MD = -1.03; 95% CI -1.34, -0.72). Women with endometriosis displayed differences (more severity) in terms of VAS scores (2 studies) for dyspareunia (MD = 1.88; 95% CI 0.38, 3.37) and chronic pelvic pain (MD = 2.92; 95% CI 1.26, 4.58); but not for dysmenorrhea., Conclusion: Non-treated women with endometriosis displayed altered sexual function as evidenced by lower scores in all FSFI domains, and severity of dyspareunia and chronic pelvic pain.

Objective: To examine mortality rates related to coronavirus disease 2019 (COVID-19) by gender among European countries., Methods: PubMed, preprint medRxiv and bioRxiv repositories, and Google were searched for the terms COVID-19, mortality rates, gender, and Europe. Only Google provided a website with appropriate information. COVID-19 cases and deaths from European countries were extracted by gender from the Global Health 50/50 repository up to May 23, 2020. Extracted data included country, the total number of COVID-19 cases and the number of related deaths by gender. Random effects models with the inverse variance method were used for meta-analyses. Results are reported as death risk ratios (RRs)., Results: We identified information from 23 European countries that reported separately by gender mortality rates related to COVID-19. The sample comprised 484,919 men and 605,229 women positive for COVID-19. The mortality rate was significantly higher in men than in women (risk ratio = 1.60, 95 % confidence interval [CI] 1.53, 1.68). The trend was similar when countries reporting < 5000, or < 10,000 cases were excluded from the analysis (RR = 1.60, 95 % CI 1.52, 1.69 and RR = 1.68; CI 1.62, 1.76, respectively)., Conclusion: In Europe, the new zoonotic coronavirus causes significantly more deaths in men than in women., (Copyright © 2020 Elsevier B.V. All rights reserved.)

Carotenoids are bioactive compounds with widely accepted health benefits. Their quantification in human faeces can be a useful non-invasive approach to assess their bioavailability. Identification and quantification of major dietary carotenoids in human faeces was the aim of the present study. Faeces and dietary intake were obtained from 101 healthy adults (45-65 years). Carotenoid concentrations were determined by HPLC in faeces and by 3-day food records in dietary intake. Carotenoids quantified in faeces (µg/g dry weight, median) were: β-carotene (39.5), lycopene (20), lutein (17.5), phytoene (11.4), zeaxanthin (6.3), β-cryptoxanthin (4.5), phytofluene (2.9). α-carotene (5.3) and violaxanthin were found 75.5% and 7.1% of the faeces. The carotenoids found in the highest concentrations corresponded to the ones consumed in the greatest amounts (µg/d): lycopene (13,146), phytoene (2697), β-carotene (1812), lutein+zeaxanthin (1148). Carotenoid concentration in faeces and in dietary intake showed correlation for the total non-provitamin A carotenoids (r = 0.302; p = 0.003), phytoene (r = 0.339; p = 0.001), phytofluene (r = 0.279; p = 0.005), lycopene (0.223; p = 0.027), lutein+zeaxanthin (r = 0.291; p = 0.04) and β-cryptoxanthin (r = 0.323; p = 0.001). A high proportion of dietary carotenoids, especially those with provitamin A activity and some of their isomers, reach the large intestine, suggesting a low bioavailability of their intact forms., Competing Interests: The authors declare no conflict of interest.

Red peppers ( Capsicum annuum ) are rich in carotenoids and are widely grown and consumed all over the world. Today's consumption patterns are characterized by periodical purchases of food and longer food storage periods, including raw fruits and vegetables, which could have a negative effect on healthy components. This study aims to investigate the individual carotenoid content in Lamuyo-variety red peppers in cool storage (7 °C) for three weeks. Carotenoid concentrations expressed in µg/100g of the edible portion were; lutein (1203), zeaxanthin (853), α-carotene (272), β-carotene (2167), β-cryptoxanthin (525), violaxanthin (770), capsanthin (9667), phytoene (348) and phytofluene (143). Carotenoid concentrations did not significantly vary after 21 days under household refrigeration conditions and thus the nutritional supply of provitamin A carotenoids and of carotenoids with eye health benefits such as lutein and zeaxanthin, as well as others with potential health benefits in humans such as capsanthin, violaxathin, phytoene and phytofluene., Competing Interests: The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (© 2020 The Authors.)

Xanthophylls (lutein, L; zeaxanthin, Z) and anthocyanins are often included in food supplements to improve ocular health. There are no dietary reference intakes for them. The aim was to assess the effects of L, Z and anthocyanin supplementation on short and long-term lutein status markers (serum concentration and macular pigment optical density (MPOD)). Seventy-two postmenopausal women were randomized into a parallel study of 8 months: Group A-anthocyanines (60 mg/day); Group X-xanthophylls (6 mg L + 2 mg Z/day); Group X+A-anthocyanines (60 mg/day) + xanthophylls (6 mg L + 2 mg Z/day). At the beginning of the study, 4 and 8 month serum L and Z concentrations were determined (HPLC), as well as L, Z and anthocyanine dietary intake and MPOD (heterochromic flicker photometry). Baseline concentrations of L (0.35 ± 0.19 μmol/L), Z (0.11 ± 0.05 μmol/L), L+Z/cholesterol/triglycerides (0.07 ± 0.04 μmol/mmol) increased in Group X (2.8- and 1.6-fold in L and Z concentrations) and in group XA (2- and 1.4-fold in L and Z concentrations). MPOD (baseline: 0.32 ± 0.13 du) was not modified in any of the groups at the end of the study. There were no differences in the dietary intake of L+Z and anthocyanin at any point in time in any group. Supplementation of L and Z at a dietary level provoked an increase in their serum concentration that was not modified by simultaneous supplementation with anthocyanins.

The aim of this pilot study was to evaluate pre-emptive analgesia using the combination tramadol plus meloxicam compared with each individual drug alone for the reduction of pain after extraction of third molars. Fifty-one patients were randomised into three groups (n=17 in each), using a series of random numbers: the first group was given tramadol 25mg and meloxicam 7.5mg; the second tramadol 50mg, and the third meloxicam 15 mg, all intramuscularly. Treatments were prepared in identical syringes by an independent investigator and were given immediately. The teeth were removed 50 min after the analgesics had been given. Intensity of pain, consumption of analgesics, and adverse effects were evaluated. The intensity of pain was evaluated using a visual analogue scale (VAS) and the area under the curve of the VAS showed significant differences amongst the groups. In conclusion, the study showed that the combination of tramadol 25mg and meloxicam 7.5mg had an analgesic effect similar to that of meloxicam 15 mg, but both were better than tramadol 50mg for relief of pain after the extraction of mandibular third molars., (Copyright © 2011 The British Association of Oral and Maxillofacial Surgeons. Published by Elsevier Ltd. All rights reserved.)

Purpose: To compare the pre-emptive analgesic effectiveness of 15 mg of meloxicam and 50 mg of tramadol after mandibular third molar surgery., Patients and Methods: This pilot study was a double-blind, randomized, parallel-group clinical trial. The patients were randomized into 2 treatment groups, each with 15 patients, by use of a series of random numbers: group A was administered 15 mg of meloxicam intramuscularly (IM) 50 minutes before the surgery and group B was given 50 mg of tramadol IM 50 minutes before the surgery. We evaluated pain intensity, analgesic consumption, swelling, and trismus., Results: The group receiving 15 mg of meloxicam IM showed differences in pain intensity evaluated by the area under the curve of the visual analog scale and total analgesic consumption when compared with the group receiving 50 mg of tramadol IM., Conclusion: The patients receiving 15 mg of preoperative meloxicam had less pain intensity and total analgesic consumption than those receiving 50 mg of preoperative tramadol., (Copyright © 2012 American Association of Oral and Maxillofacial Surgeons. Published by Elsevier Inc. All rights reserved.)

Synovial Chondromatosis (SC) is a disease whose etiology is unknown, can be defined as a benign synovial process characterized by the formation of metaplastic cartilaginous nodes inside connective tissue of articular surfaces, is considered an active metaplastic phenomenon better than a neoplastic process; it presents a greater preference to affect women who constitute almost 70% of reported cases, the age range is wide and oscillates between 18-75 years (average 44.6 years). Between the main clinical findings are: pain, crackle, volume augmentation and a limited buccal opening. SC is an unusual state and the reports in the English literature are no more than 75 cases, only 66 of those where histologically verified, most of those were affecting great joints like hip, knee and shoulder, but if SC is not frequent in this sites, is even more infrequent on temporomandibular joint. The aim of this paper is to report a clinical case and at the same time to realize a brief review of the literature.

A study exposing the situation affecting the population of San Luis Potosí in central México, caused by dental fluorosis. Findings point to the need of implementing devices capable of regulating the concentrations of Fluorine ion (generating the efficient prevention of dental cavity incidence), to maintain them at optimal levels and without deletereal effects.