Search Results (1,372)

Quality-of-life (QoL) needs among gynecologic cancer survivors are multifaceted and culturally mediated, yet limited research has examined how survivors in the Middle East prioritize key domains such as sexual function, emotional well-being, and relational quality. This study aimed to identify subgroups of survivors based on the perceived importance of these domains and to explore demographic and clinical predictors of subgroups within the Saudi Arabian context. We conducted a cross-sectional, survey-based study among 129 women with a history of breast or cervical cancer attending a tertiary oncology center in Jeddah, Saudi Arabia. Participants rated the importance of sexual, emotional, and relational QoL domains using a 4-point Likert scale. Latent class analysis (LCA) was used to segment survivors based on their perceived domain importance. Differences in demographic and clinical characteristics across classes were assessed using chi-square tests. A decision tree classifier was employed. Three latent classes emerged: Class 0 (48.8%) prioritized all domains highly; Class 1 (17.8%) reported low importance across domains; and Class 2 (33.3%) emphasized emotional and relational domains while downplaying sexual function. Class group was significantly associated with age (p = 0.001), education (p = 0.04), nationality (p = 0.03), and number of children (p < 0.001). Decision tree analysis identified number of children, age, and marital status as the strongest predictors of high-importance class group. Gynecologic cancer survivors in Saudi Arabia hold diverse priorities regarding QoL domains, primarily shaped by sociocultural context than clinical variables. Tailored survivorship interventions that reflect survivors’ lived values, particularly in relation to age, family structure, and cultural norms, are critical for person-centered oncology care in the region. Full article

Background: Endocrine therapy (ET) with or without ovarian function suppression (OFS) is a cornerstone treatment for estrogen receptor-positive (ER+) breast cancer (BC) in premenopausal women, but its impact on quality of life (QoL) and sexual health remains a concern. Methods: We conducted a multicenter, prospective, observational study including premenopausal women (≤50 years) diagnosed with stage I–III ER+ BC and treated in private healthcare facilities in Brazil between 2013 and 2023. Patients received ET alone (ET-only) or combined with OFS (OFS-ET). QoL was assessed at baseline and 3, 6, 9, 12, and 24 months using the EORTC QLQ-BR23. Sexual functioning and sexual enjoyment were prespecified primary outcomes. Logistic regression identified factors associated with OFS use, and Fisher’s exact test was applied for categorical comparisons at 24 months. Results: Among 363 patients (80% ET-only, 20% ET + OFS), younger age, advanced stage, and chemotherapy were independently associated with OFS use. Both groups reported early declines in sexual functioning and enjoyment. By 24 months, ET-only patients had returned to baseline, whereas OFS patients remained below baseline. At the item level, no significant differences were observed in sexual desire (51.5% vs. 42.0%; p = 0.33) or enjoyment (26.0% vs. 13.5%; p = 0.20). Lack of sexual activity was more frequent in the OFS group (60.6% vs. 41.2%; p = 0.05). Body image was significantly more impaired with OFS, with a higher proportion of patients reporting feeling less attractive (38.2% vs. 19.9%; p = 0.04) and less feminine (26.5% vs. 11.7%; p = 0.05). Conclusions: ET impairs sexual health in young BC survivors, particularly when combined with OFS. These findings underscore the need for routine sexual health assessments and supportive interventions in survivorship care. Full article

The Nile tilapia (Oreochromis niloticus), a key aquaculture species, displays marked sexual growth dimorphism, with males growing faster than females. This process is governed by intricate interactions between antagonistic regulators, including transcription factors, growth factors, and steroid hormones, operating through sex-specific developmental pathways. While circular RNAs (circRNAs) are known to modulate gene expression by sponging microRNAs (miRNAs), their role in teleost sex differentiation remains poorly understood. To address this gap, we profiled circRNA expression in tilapia gonads by constructing six circRNA libraries from testes and ovaries of 180 days after hatching (dah) fish, followed by high-throughput sequencing. We identified 6564 gonadal circRNAs distributed across all 22 linkage groups, including 226 differentially expressed circRNAs (DECs; 108 testis-biased, 118 ovary-biased). Functional enrichment analysis linked their host genes to critical pathways such as cAMP signaling, cell adhesion molecules, and—notably—sexual differentiation processes (e.g., estrogen signaling, oocyte meiosis, and steroid hormone biosynthesis). Furthermore, we deciphered competing endogenous RNA (ceRNA) networks, uncovering circRNA–miRNA–mRNA interactions targeting germ cell determinants, sex-specific transcription factors, and steroidogenic enzymes. This study provides the first systematic exploration of circRNA involvement in tilapia sex differentiation and gonadal differentiation, offering novel insights into the post-transcriptional regulation of sexual dimorphism. Our findings advance the understanding of circRNA biology in fish and establish a framework for future studies on aquaculture species with similar reproductive strategies. Full article

Background and objectives: Atopic dermatitis (AD) is a chronic inflammatory skin disease that affects not only physical health but also psychological well-being. While the emotional and social burden of AD is well documented, there is still limited research on how AD affects sexual health. The study aimed to evaluate quality of life (QoL), mental health, and risk factors for impaired sexual life, as well as their relationships. Materials and Methods: A total of 201 participants (96 patients with AD and 105 healthy controls) were enrolled in the study. Socio-demographic and clinical data were obtained using a specifically developed questionnaire. In addition, participants completed validated scales, including the DLQI, HADS, FSFI, IIEF-5, and SRSLQ. AD severity was assessed using the SCORAD questionnaire. Results: Our study found that patients with AD had statistically significantly higher mean anxiety (6.8 ± 3.6 vs. 5.0 ± 3.2; p < 0.001), depression (5.2 ± 3.4 vs. 3.9 ± 2.9, p < 0.01), and skin-related sexual dysfunction scores (15.0 ± 4.5 vs. 4.4 ± 4.7, p < 0.001), as well as QoL scores (12.3 ± 6.1 vs. 1.8 ± 3.1, p < 0.001), than healthy controls. Female AD patients reported higher values of depression and anxiety compared to male patients (5.9 ± 3.1 vs. 4.4 ± 3.5, p = 0.03, 7.6 ± 2.9 vs. 6.0 ± 4.1, p = 0.03, respectively) and lower FSFI scores compared to healthy women (24.8 ± 8.0 vs. 31.3 ± 3.0, p < 0.001). Deterioration in sexual health, assessed by the SRSLQ score, was strongly correlated with QoL impairment (R = 0.5, p < 0.001), anxiety (R = 0.51, p < 0.001), and depression (R = 0.5, p < 0.001). Finally, we found that sex life negatively correlates with AD severity (p=0.001), involvement of a genital area (p = 0.005), intensity of pruritus (r = 0.284, p = 0.005), and insomnia (r = 0.366, p < 0.001). Conclusions: AD significantly affects patients’ quality of life, including their sex life. Many factors associated with the disease also contribute to the deterioration of patients’ sexual health. Routine assessment of sexual life in dermatological practice, using validated tools, could facilitate early identification and support for affected patients. Significance: This study highlights the often-overlooked impact of atopic dermatitis on patients’ sexual health. Our findings demonstrate that sexual function is significantly impaired in individuals with atopic dermatitis—particularly among women—and that such dysfunction is closely associated with disease-related symptoms. These results have important implications for improving the quality of care provided to individuals affected by the condition. Full article

Introduction: Prostate cancer is one of the most common neoplasia in men, and its clinical evolution is highly influenced by psycho-emotional factors, especially in elderly patients. Comorbidities, the perception of one’s identity and its impact on life quality become relevant variables in the therapeutic decision. Sexual dysfunction after treatment along with decreased libido, erectile dysfunction and ejaculatory dysfunction are significant problems in patients with prostate cancer. Case presentation: The present study presents the oncological evolution of an elderly patient with a dual diagnosis, prostate adenocarcinoma and lung squamous cell carcinoma, who faced a significant amount of medical and psychological challenges. Reluctance to hormone therapy was closely linked to the fear of sexual dysfunction, a very common reaction in elderly men concerned with maintaining autonomy and intimacy. The peculiarity of the case consists in the interaction between the evolution of the disease, the therapeutic decisions and the psychological impact on the patient. Discussion: Androgen deprivation therapy negatively influences multiple aspects of sexual function, significantly impairing the life quality of patients diagnosed with prostate cancer. In this context, therapy through acceptance and commitment is the appropriate one, its main purpose being to change the patient’s relationship with suffering—from struggle and rejection to active acceptance and value of the present. The intervention of the psychologist or the psychotherapist is essential in decision-making counseling, using coping techniques, the clarification of personal values and the involvement of the family in the decision-making process. Oncological psychology helps the patient redefine their life goals and priorities, not just to choose a treatment. Conclusions: Sexuality and psychological health are deeply affected by prostate cancer. Psychological flexibility and emotional support can mitigate this negative impact. The integration of therapy through acceptance and commitment in the rehabilitation after treatment increases effectiveness and patient satisfaction. Full article

Background/Objectives: Sexuality is a frequently overlooked but clinically significant dimension in patients with obsessive–compulsive disorder (OCD). Beyond comorbid anxiety and depressive symptoms, OCD can substantially affect sexual functioning and include obsessions and compulsions relating to sexual content. This review aims to synthesize current evidence on sexual dysfunction in OCD and the role of sexuality in OCD symptom dimensions, as well as associated neurobiological, cognitive, and clinical outcomes. Methods: We conducted a review of the literature including studies published in the last 20 years using the PubMed and Cochrane databases. Our search strategy used the terms “sexual AND (Obsessive-compulsive disorder OR OCD)”, retrieving a total of 582 articles. After a screening and eligibility assessment based on predefined inclusion and exclusion criteria, 200 studies were included. Additional papers were retrieved through citation tracking. Results: Sexual dysfunction is highly prevalent in OCD patients, particularly among women, ranging from low desire and arousal to anorgasmia and pain during intercourse. Sexual obsessions affect a large proportion of OCD patients and are associated with an early onset, male sex, greater symptom severity, poorer insight, and suicidality. These obsessions often co-occur with aggressive or religious themes. Neuroimaging studies indicate distinct patterns of brain activation in patients with sexual obsessions. Treatment with SSRIs and CBT is often less effective in this subgroup, suggesting the need for targeted interventions. Conclusions: Sexuality-related symptoms in OCD patients constitute a distinct and clinically relevant domain that affects functioning, prognosis, and treatment response. Recognizing and addressing these symptoms is essential for the holistic and effective care of patients with OCD. Full article

Background: While survival outcomes for breast and cervical cancer have improved in Saudi Arabia, little is known about the long-term sexual and psychosocial well-being of survivors. This study aimed to assess sexual satisfaction, emotional health, and social relationship quality among Saudi women diagnosed with cervical and breast cancers and to identify sociodemographic predictors of quality of life (QoL) across these domains. Methods: A cross-sectional survey was administered to 129 women with a history of breast or cervical cancer during May–July 2021. The instrument combined validated tools measuring three core QoL domains: sexual function and satisfaction, psychological and emotional well-being, and social and relationship qualities. Multivariable ordinal logistic regression was used. Results: A total of 129 women with cervical and breast cancers (51.2% cervical, 48.8% breast) participated. Most were aged 31–45 years (45.7%), married (83.0%), with 48.1% holding a bachelor’s degree. Overall, 74.4% of participants reported high to moderate emotional well-being; 48.8% reported satisfactory sexual function, and only 41.1% perceived high quality in social relationships. Younger age (21–30 years), higher education, and having more children were significantly associated with lower emotional well-being (p < 0.05). Conversely, current treatment status and higher parity were associated with better sexual function. Social and relationship quality was significantly higher among younger and employed women. Perceived importance of domains varied, with emotional well-being rating the highest (82.9%). Conclusions: Sexual and social QoL are underserved yet critical components of survivorship care. Cultural, familial, and educational contexts play significant roles in shaping post-treatment experiences. Interventions tailored to age, family dynamics, and treatment stage are needed to improve the holistic well-being of survivors in Saudi Arabia. Full article

Background/Objectives: Gender (roles as household load and job strain, and identity) represent an effect modifier of the interference between pain experience and sex because it is different between men and women. This study validates a new scale developed to assess how life functioning is impacted by Chronic Non-Cancer Pain (CNCP) due to gender. Methods: A total of 193 Spanish ambulatory CNCP patients (60 [51–73] years old, 69.4% women, 31% retired) were interviewed. Exploratory Factor Analysis (EFA) yielded 3-factor structure: Gender Self-identity, Roles, and Chronic Pain Impact on Social, Familial, Work and Sexual Life. Results: The Gender-Pain Questionnaire, with the presented factor structure, is an evaluation instrument with enough reliability and internal validity for CNCP patients. Conclusions: This study presents the psychometric properties of a scale for assessing the interference of CNCP patients’ experience on gender and how it affects their daily life activities, relationships and self-identity. It represents the first original questionnaire known in Spanish language to date. This measure could potentially help researchers and clinicians to obtain gender key information to design appropriate and equity healthcare interventions. Full article

Social isolation is a critical but understudied concern for people living with HIV (PLHIV), particularly in rural U.S. communities where social visibility is high and access to supportive services is limited. Disclosure of HIV status is often framed as a health-promoting behavior that facilitates engagement with care and access to social support, yet it can also increase vulnerability to exclusion and isolation, especially where confidentiality is difficult to maintain. Using data from a pilot survey of rural PLHIV in the United States ($n=17$), this study examines when disclosure may function adaptively and when it may coincide with a heightened social burden. A Social Isolation Index was constructed from 15 indicators of exclusion across family, community, and institutional domains. Disclosure was measured both by the number of people informed and whether sexual partners were told. Typological methods and Qualitative Comparative Analysis (QCA) were applied to explore how disclosure patterns relate to race, sexual identity, and reported isolation. The results indicate that disclosure is not uniformly protective: several participants who disclosed widely also reported high levels of isolation, with heterosexual and Black participants often reporting a higher cumulative burden. These findings challenge one-size-fits-all assumptions about disclosure in public health messaging and underscore the need for tailored strategies that recognize both disclosure and nondisclosure as potentially adaptive responses in rural and marginalized communities. Full article

Background and Objectives: This study compares laparoscopic and robotic surgical techniques for rectal cancer, focusing on oncologic outcomes, mesocolic excision quality, lymph node yield, and postoperative sexual and urinary function, while also exploring patient satisfaction and recovery trajectories through clinical outcomes and validated questionnaires. Materials and Methods: A retrospective analysis was conducted on 100 patients who underwent rectal cancer surgery between 2017 and 2021 at our tertiary center—53 underwent laparoscopic and 47 robotic surgery. Demographic data, tumor characteristics, and surgical details (procedure type, lymph node yield, morbidity, and mortality) were collected, and postoperative outcomes, including local recurrence, metastasis, need for reoperation, urinary incontinence, and sexual dysfunction, were compared. Functional outcomes were evaluated using the LARS questionnaire, Wexner score, IPSS, IIEF, and FSFI. Results: No significant differences were found in age, BMI, tumor size, or ASA scores between groups. Robotic surgery was associated with shorter hospital stays (p < 0.001), no conversions to open surgery (vs. 28.3% in laparoscopy), and zero cases of positive circumferential margins (vs. 35.8% in laparoscopy; p < 0.001). Lymphatic and perineural invasion rates were similar. Tumor recurrence occurred in four robotic and six laparoscopic cases, and factors significantly associated with recurrence included pathological stage, hospital stay, and adjuvant treatment. Robotic surgery showed improved urinary and sexual function, with lower Wexner, IPSS, and FSFI scores. Conclusions: Robotic surgery is a safe, effective, and patient-friendly alternative to laparoscopy, offering better preservation of continence and sexual function, reduced conversion rates, and shorter hospitalization, and should be considered the preferred approach in appropriately selected rectal cancer patients. Full article

Postpartum body image is a critical aspect of maternal well-being, influenced by sociocultural, psychological, and relational factors. Theoretical models offer a broader framework for understanding these influences, whereas regression analyses identify specific associations. This systematic review aimed to identify theoretical models assessing postpartum body image and to examine its association with relevant constructs using regression analysis. A search was conducted of four databases (PubMed, EMBASE, Web of Science, and American Psychological Association) between August 2022 and March 2024. Studies including mothers over 18 years old, within 0–24 months postpartum, that applied theoretical models and/or regression analyses were included. Of 169 articles retrieved from databases and 1 identified through backward snowballing, 18 studies met the inclusion criteria. Three theoretical models were identified, and highlighted sociocultural influences, social support, and breastfeeding as key determinants of body dissatisfaction. Regression analysis identified association between postpartum body image and maternal weight, depression, mode of delivery, sexual function, breastfeeding, and social support. Given these influences, the review emphasizes the importance of adopting holistic approaches to support maternal well-being. Interventions addressing postpartum body image should integrate strategies that consider cultural expectations, promote adequate social support, and address physical and emotional health challenges, such as weight management and mental health care. PROSPERO (CRD42022352992). Full article

Pollen–stigma interactions have been studied extensively because they play an important role in sexual reproduction and crop yield. The vast majority of studies have focused on dry stigmas, which are typical of many model and agricultural plants; however, the data obtained are difficult to apply to plants with wet stigmas, such as tomato and tobacco. Pollen germination in this case occurs in a liquid, an exudate, which has a complex, species-specific composition. UPLC-ESI-MS-based hormone screening was carried out for six plant genera belonging to Solanaceae, Bromeliaceae, and Gesneriaceae families and revealed jasmonic acid (JA), abscisic acid (ABA) and/or jasmonoyl-L-isoleucine (IleJA) in stigma exudates of tobacco, tomato, and Streptocarpus sp. To assess the physiological significance of plant hormones in stigma exudate we tested their effect in vitro, finding that JA, IleJA, and MeJa significantly stimulated germination of tobacco pollen, with JA being most effective in accordance with its predominance in the stigma exudate; furthermore, ABA stimulated pollen germination in all tested species including bromeliads despite the lack of this hormone in their exudates. Both JA and ABA had an anti-oxidant effect on germinating pollen. Possible functions of hormones and ROS in exudate as well as ways of implementing the anti-oxidant effect of phytohormones are discussed. Full article

This paper offers a critical analysis of traditional Muslim sexual morality and questions its validity in the present. It focuses on two elements: (1) nikāḥ as a legal marriage contract characterized by asymmetrical gender roles and (2) historically permitted sexual relations with enslaved women, as well as Muslim positions on sexual intercourse with minors. After a conceptual clarification of sexual autonomy, I examine the positions of different legal schools and contextualize their norms within broader social and intellectual histories. Building on the approach of “overcoming the text,” I argue that foundational religious texts can no longer serve as the normative basis for a contemporary sexual ethic. Instead, I redefine the notion of “illegitimate sexuality” (zinā) based on the principle of sexual autonomy and show how modern legal and social frameworks (rule of law, welfare state, medical evidence) render earlier functions of sexual regulation obsolete. The Qurʾanic concept of maʿrūf serves as a dynamic ethical reference point. The goal is a paradigm shift toward a Muslim sexual ethic that centers autonomy, equality, and human dignity while critically dismantling inherited structures. Full article

Background/Objective: Pelvic exenteration (PE) is a radical procedure with significant physical and psychosocial consequences. Despite increasing survival rate following PE, quality of life (QoL) outcomes remain inconsistently reported and poorly understood in clinical practice. This study aims to explore: (1) What is the current evidence on QoL after pelvic exenterations? and (2) How do patient-reported experiences align with or differ from findings in the literature? Methods: We conducted a mixed-methods study consisting of two components: (1) a qualitative analysis of 5 in-depth, semi-structured interviews with patients who underwent PE for advanced pelvic cancers; and (2) a narrative review of 28 quantitative and qualitative studies evaluating QoL after PE, published between 1975 and 2023, encompassing 1149 patients. Thematic analysis was performed using an interpretative phenomenological approach. Results: Qualitative findings revealed recurrent themes of identity disruption, social withdrawal, emotional resilience, and a need for personalized, preoperative information. Patients often described a mismatch between surgical expectations and lived experience, and expressed a strong desire for better psychological support and realistic communication. The review of published studies showed heterogeneous findings, with moderate recovery in global QoL scores by 6–12 months postoperatively, but persistent impairments in physical function, sexual health, and emotional well-being. Only a minority of studies included patient-reported outcomes tailored to specific domains such as body image or psychological adaptation (17.8%). Conclusions: Recovery after pelvic exenteration extends beyond physical healing and requires attention to emotional, social, and existential dimensions. Integrating psycho-oncologic support and patient-centered communication into standard care is essential. This hybrid analysis underscores the importance of addressing quality of life proactively—not only as an outcome, but as a fundamental component of survivorship care. Full article

Melanocortin receptors (MCRs) are responsible for various functions ranging from skin pigmentation, regulation of appetite, stress response and cognition, steroid synthesis, and energy balance to cellular regeneration and immunomodulation. The genetic polymorphism with tissue distribution ranging from the brain, limbic system, and adrenal cortex to neutrophils, monocytes, and macrophages is evident in MCRs. The mutations in MC1R, MC2R, MC3R, and MC4R genes are associated with risk of melanoma, familial glucocorticoid deficiency, obesity, and type 2 diabetes mellitus, respectively. Meanwhile, MC1R, MC2R, and MC5R genes are involved in the risk of major depressive disorder. Melanocortin receptors are involved in different inflammatory disorders, i.e., atopic dermatitis, autoimmune uveitis, sarcoidosis, respiratory diseases, multiple sclerosis, scleroderma, inflammatory bowel disease, amyotrophic lateral sclerosis, Alzheimer’s disease, arthritis, and reperfusion injury. Several newer therapeutic agents related to MCRs have numerous advantages over the current anti-inflammatory drugs, demonstrating therapeutic relevance. Among them, α-MSH analogs play a role in atopic dermatitis and scleroderma, and MC1R agonist Dersimelagon has shown effectiveness in systemic sclerosis. The FDA has recently approved the repository corticotropin injection (RCI) to treat sarcoidosis. The FDA has also approved various melanocortin agonists, i.e., Bremelanotide, Afamelanotide, and Setmelanotide, for the treatment of hypoactive sexual desire disorder, Erythropoietic protoporphyria, and obesity, due to pro-opiomelanocortin and leptin receptor deficiency, respectively. Therefore, this review aims to summarize the function and genetic polymorphism of melanocortin receptors, regulatory pathways involving MCRs, and the existing evidence of the prime effect of MCRs on inflammatory responses via different mechanisms and their potential therapeutic use in inflammatory diseases. Full article