MaturitasPub Date : 2025-07-03DOI: 10.1016/j.maturitas.2025.108656
Weder Alves da Silva , Diego Christofaro , Pablo del Val Martín , Adilson Marques , Miguel Peralta , Carlos Cristi-Montero , Leandro F.M. Rezende , Gaspar Chiappa , Gerson Ferrari
{"title":"Joint association of physical activity and sleep duration with all-cause and cause-specific mortality: A prospective study of 153,866 Mexican adults","authors":"Weder Alves da Silva , Diego Christofaro , Pablo del Val Martín , Adilson Marques , Miguel Peralta , Carlos Cristi-Montero , Leandro F.M. Rezende , Gaspar Chiappa , Gerson Ferrari","doi":"10.1016/j.maturitas.2025.108656","DOIUrl":"10.1016/j.maturitas.2025.108656","url":null,"abstract":"<div><h3>Objective</h3><div>This study investigated the joint association of physical activity (weekly frequency and duration) and sleep duration with all-cause and cause-specific mortality.</div></div><div><h3>Methods</h3><div>We conducted a prospective cohort study of 153,866 participants from the Mexico City Prospective Study. Cox proportional hazards regression was used to estimate the joint associations of frequency (none, < 1, 1–2, and ≥ 3 times/week) and session duration (none, < 30, 30–60, and ≥ 60 min/day) of physical activity and sleep duration (recommended: 7–9 h/day; below/above recommended: <7 or > 9 h/day) with the risk of all-cause and cause-specific mortality (cardiovascular disease, cancer, and respiratory diseases).</div></div><div><h3>Results</h3><div>Over 15.6 years of follow-up, higher risks of all-cause, cardiovascular diseases, and cancer mortality were observed among participants with: no physical activity and recommended sleep duration; < 1 time/week of physical activity and below/above recommended sleep; and no physical activity and below/above recommended sleep (compared to higher physical activity and recommended sleep duration. Similar positive associations were observed when considering physical activity duration. The highest risks of all-cause, cardiovascular disease, and cancer mortality were found among participants with no physical activity (duration) and below/above recommended sleep duration.</div></div><div><h3>Conclusions</h3><div>Our findings suggest that low levels of physical activity and non-recommended sleep durations jointly increase the risk of all-cause and cause-specific mortality.</div></div>","PeriodicalId":51120,"journal":{"name":"Maturitas","volume":"199 ","pages":"Article 108656"},"PeriodicalIF":3.9,"publicationDate":"2025-07-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144570835","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
MaturitasPub Date : 2025-07-03DOI: 10.1016/j.maturitas.2025.108657
Samantha E. Mannion , Carin Y. Smith , Jennifer A. Buzzard , Liliana Gazzuola Rocca , Jennifer St. Sauver , Walter A. Rocca , Ekta Kapoor
{"title":"Incidence of de novo migraine after premenopausal bilateral oophorectomy","authors":"Samantha E. Mannion , Carin Y. Smith , Jennifer A. Buzzard , Liliana Gazzuola Rocca , Jennifer St. Sauver , Walter A. Rocca , Ekta Kapoor","doi":"10.1016/j.maturitas.2025.108657","DOIUrl":"10.1016/j.maturitas.2025.108657","url":null,"abstract":"<div><h3>Objective</h3><div>Little is known about the effects of premenopausal bilateral oophorectomy on the development of migraine. We compared migraine outcomes for women undergoing oophorectomy with those of referent women.</div></div><div><h3>Study design</h3><div>The cohort included 1243 women who underwent premenopausal bilateral oophorectomy in Olmsted County, MN, US between 1988 and 2007 and 1415 age-matched (±1 year) referent women. Women diagnosed with migraine before oophorectomy (or index) were excluded. Estrogen therapy after oophorectomy was assessed as a time-dependent factor.</div></div><div><h3>Results</h3><div>Women who underwent oophorectomy had an increased risk of de novo migraine compared with referent women (HR, 1.59; 95 % CI, 1.24–2.05). The risk was particularly higher for women who underwent oophorectomy under the age of 45 years. An increased risk of migraine without aura, but not of migraine with aura, was observed, as is characteristic of menstrual migraines. The risk of de novo migraine in the women with oophorectomy off estrogen was comparable to that of the referent women (HR, 0.80; 95 % CI, 0.43–1.52). By contrast, women with oophorectomy on estrogen had an increased risk of migraine (HR, 2.08; 95 % CI, 1.47–2.92).</div></div><div><h3>Conclusions</h3><div>Premenopausal bilateral oophorectomy is associated with an increased risk of migraine. Although estrogen is known to mitigate the severity of menopause-related symptoms, the higher risk for migraine among women using estrogen could be the result of them being prescribed estrogen because of greater severity of menopause symptoms. We encourage future studies to examine how the type, dose, and route of estrogen impact migraine outcomes after oophorectomy.</div></div>","PeriodicalId":51120,"journal":{"name":"Maturitas","volume":"200 ","pages":"Article 108657"},"PeriodicalIF":3.9,"publicationDate":"2025-07-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144632885","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Vaginal CO2 laser treatment for urinary stress incontinence: A randomized controlled trial","authors":"Hrefna Bóel Sigurdardóttir , Benny Kirschner , Josephine Obel , Mubeena Aziz , Cathrine Blegvad Stenz , Jeppe Bennekou Schroll","doi":"10.1016/j.maturitas.2025.108658","DOIUrl":"10.1016/j.maturitas.2025.108658","url":null,"abstract":"<div><h3>Objectives</h3><div>The effect of laser treatment for stress urinary incontinence is inconclusive. The aim of this study was to determine the efficacy and safety of vaginal CO<sub>2</sub> laser in women with stress urinary incontinence.</div></div><div><h3>Study design</h3><div>Single-site, patient-blinded, placebo-controlled randomized trial at Hvidovre University Hospital, Denmark. Thirty-seven women with mild to severe symptoms of stress urinary incontinence were included. They were randomized to either laser or sham treatment and received three treatments, four weeks apart. At first and last visit, the women completed the ICIQ-UI SF questionnaire and had a standardized urinary stress test. Both groups received supervised pelvic floor muscle training, and postmenopausal women were recommended vaginal estrogen treatment.</div></div><div><h3>Main outcome measures</h3><div>The primary outcome was post-treatment score on the International Consultation on Incontinence Questionnaire-Urinary Incontinence Short Form (ICIQ-UI SF). Scores were compared using Student's <em>t</em>-test and 95 % confidence intervals (CI). The secondary outcome was performance on the post-treatment standardized stress test.</div></div><div><h3>Results</h3><div>Baseline characteristics did not differ between the groups. There was no difference in ICIQ-IU SF scores post-treatment between the two groups: mean score for the laser group 12.2 vs. 12.7 for sham (mean difference 95 % CI: −2.15 to 3.15; <em>p</em>-value 0.70). Likewise, we found no difference between the groups in performance on the post-treatment standardized stress test (95 % CI: −4.33 g to 40.73 g; p-value 0.11). One adverse event occurred, a bladder infection that required hospital admission.</div></div><div><h3>Conclusions</h3><div>In this study, CO<sub>2</sub> vaginal laser did not improve the symptoms of stress urinary incontinence. It is acknowledged that the study population was small.</div><div>ClinicalTrials.gov (<span><span>NCT04136652</span><svg><path></path></svg></span>).</div></div>","PeriodicalId":51120,"journal":{"name":"Maturitas","volume":"199 ","pages":"Article 108658"},"PeriodicalIF":3.9,"publicationDate":"2025-07-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144549155","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
MaturitasPub Date : 2025-06-30DOI: 10.1016/j.maturitas.2025.108650
Jiaqi Yu , Hejing Chen , Yang Yang , Xuanzhi Liu , Zihang Tu , Yufeng Wang , Huaxin Si , Wendie Zhou , Yanyan Li , Beibei Yuan , Bei Wu , Cuili Wang
{"title":"Barriers to and facilitators of integrated care for community-dwelling frail older adults: A qualitative study applying implementation science frameworks","authors":"Jiaqi Yu , Hejing Chen , Yang Yang , Xuanzhi Liu , Zihang Tu , Yufeng Wang , Huaxin Si , Wendie Zhou , Yanyan Li , Beibei Yuan , Bei Wu , Cuili Wang","doi":"10.1016/j.maturitas.2025.108650","DOIUrl":"10.1016/j.maturitas.2025.108650","url":null,"abstract":"<div><h3>Objectives</h3><div>To identify the barriers to and facilitators of the implementation of integrated care for frail community-dwelling older adults by primary care teams in China.</div></div><div><h3>Design</h3><div>Qualitative explorative study, using semi-structured interviews and traditional content analysis.</div></div><div><h3>Methods</h3><div>This study was conducted from January 2024 to June 2025, recruited 28 deliverers of integrated care and 16 recipients through purposive sampling. Participants underwent individual in-depth interviews. The updated Consolidated Framework for Implementation Research and the Theoretical Domains Framework were applied to guide interviews, analysis and reporting of findings.</div></div><div><h3>Results</h3><div>The findings highlighted 56 implementation determinants of the implementation of integrated care for frail individuals: 26 barriers, 28 facilitators and 2 mixed factors. Common barriers were insufficient healthcare human resources, the complexity of integrated care with multiple components, its low priority compared with specific disease treatment, and poor beliefs about capabilities.</div></div><div><h3>Conclusions</h3><div>The implementation of integrated care is influenced by barriers and facilitators from multiple levels (organizational and individual) and multiple sources (implementers and recipients). The findings will inform policy makers and practitioners in similar settings of potential strategies to overcome barriers and enhance facilitators, promoting the implementation of integrated care and improving older adults' quality of life and reducing healthcare costs.</div></div>","PeriodicalId":51120,"journal":{"name":"Maturitas","volume":"199 ","pages":"Article 108650"},"PeriodicalIF":3.9,"publicationDate":"2025-06-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144549154","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Retirement, reemployment, and bio-psycho-social health among older adults in Taiwan","authors":"Wei-Hsuan Yen , Wan-Ju Cheng , Shu-Chun Chuang , I-Chien Wu , Hsing-Yi Chang , Chiu-Wen Cheng , Wei-Ting Tseng , Chih-Cheng Hsu , Chao Agnes Hsiung , Chi-Shin Wu","doi":"10.1016/j.maturitas.2025.108649","DOIUrl":"10.1016/j.maturitas.2025.108649","url":null,"abstract":"<div><h3>Objectives</h3><div>This study examined the associations between retirement, reemployment, and health outcomes—covering physical, mental, and social domains—among middle-aged and older adults in Taiwan.</div></div><div><h3>Study design</h3><div>Data were drawn from the Healthy Aging Longitudinal Study in Taiwan (HALST), with 4015 participants (mean age 68.2 ± 7.7) and two waves of follow-up. We applied difference-in-differences analyses to evaluate the effects of retirement and reemployment on health outcomes.</div></div><div><h3>Main outcome measures</h3><div>Quality of life was assessed using the 12-item Short Form (SF-12) survey. Physical health was assessed using the Short Physical Performance Battery (SPPB) and Fried's frailty criteria. Mental health was measured via the Mini-Mental State Examination (MMSE), CES-D scale, and self-reported insomnia. Social networks were also evaluated.</div></div><div><h3>Results</h3><div>Newly retired individuals, especially men and those under 65, experienced declines in physical health, including lower SF-12 physical scores (−1.62), poorer SPPB performance (−0.52), and greater risk of frailty (1.66). In contrast, reemployment, particularly full-time, was linked to better physical health (SF-12 1.78; SPPB 0.39), with stronger effects among women and older adults. Part-time reemployment was associated with enhanced social networks, though physical gains were limited. No consistent mental health effects were observed, except for higher depressive symptoms in those retiring for non-voluntary reasons.</div></div><div><h3>Conclusions</h3><div>Retirement was linked to physical health decline, while reemployment, especially full-time, offered protective effects. Policies should be tailored to the diverse needs of retirees, accounting for age, gender, and reasons for retirement, to support healthier aging across populations.</div></div>","PeriodicalId":51120,"journal":{"name":"Maturitas","volume":"199 ","pages":"Article 108649"},"PeriodicalIF":3.9,"publicationDate":"2025-06-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144481659","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
MaturitasPub Date : 2025-06-26DOI: 10.1016/j.maturitas.2025.108651
Renée J. Dietz , Nick J. van de Berg , Annemarie J. van der Vegt , Caroline B. van den Berg , Imke C. van der Marel , F. Heidy van Wijk , Marianne Maliepaard , Heleen J. van Beekhuizen , Helena C. van Doorn
{"title":"Impact of vulvar lichen sclerosus and lichen planus on quality of life, mobility, bicycling, physical activity, and health","authors":"Renée J. Dietz , Nick J. van de Berg , Annemarie J. van der Vegt , Caroline B. van den Berg , Imke C. van der Marel , F. Heidy van Wijk , Marianne Maliepaard , Heleen J. van Beekhuizen , Helena C. van Doorn","doi":"10.1016/j.maturitas.2025.108651","DOIUrl":"10.1016/j.maturitas.2025.108651","url":null,"abstract":"<div><h3>Objective</h3><div>To assess perceived quality of life, physical activity, and the impact of vulvar symptoms on daily function in women with lichen sclerosus or lichen planus.</div></div><div><h3>Study design</h3><div>A cross-sectional questionnaire study was conducted among 603 women (mean age 59 ± 12 years) from one university medical centre, two regional hospitals, and two patient advocacy groups in the Netherlands. Participants completed three questionnaires: EQ-5D-5L for quality of life, SQUASH for physical activity, GO-Bicycling2 for bicycling experiences.</div></div><div><h3>Main outcome measures</h3><div>Quality of life and health index scores, reported bicycling difficulties, and adherence to national physical activity guidelines.</div></div><div><h3>Results</h3><div>Participants had significantly lower quality of life (0.814 ± 0.147 vs. 0.907 ± 0.112, <em>p</em> < 0.001) and health index scores (74.8 ± 16.4 vs. 81.1 ± 22.1, p < 0.001) compared with reference population values for similarly aged women. Nevertheless, 57.2 % met national physical activity guidelines, and 57.4 % reported exercising weekly, with fitness training being most common (40.2 %). Weekly bicycling was reported by 71.9 % of participants, yet 75.7 % experienced bicycling impediments attributed to their vulvar condition. Symptoms included moderate to severe irritation (54.5 %) or pain (47.0 %) of the vulvar skin, itching (26.6 %), or numbness (24.6 %).</div></div><div><h3>Conclusions</h3><div>Women with vulvar lichen sclerosus or lichen planus report lower quality of life and greater mobility challenges than their peers. Participants showed a high rate of compliance with national physical activity guidelines, and bicycling was an often-reported activity. However, bicycling was associated with high rates of pain and discomfort. Targeted solutions are needed to address mobility challenges in women with lichen sclerosus or lichen planus and support healthy aging and sustained physical activity across the life course.</div></div>","PeriodicalId":51120,"journal":{"name":"Maturitas","volume":"199 ","pages":"Article 108651"},"PeriodicalIF":3.9,"publicationDate":"2025-06-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144513706","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
MaturitasPub Date : 2025-06-26DOI: 10.1016/j.maturitas.2025.108652
Annette J. Dobson, Richard Hockey, Mohammad Reza Baneshi, Gita D. Mishra
{"title":"Intergenerational patterns of multimorbidity: Evidence from the Australian longitudinal study on women’s health","authors":"Annette J. Dobson, Richard Hockey, Mohammad Reza Baneshi, Gita D. Mishra","doi":"10.1016/j.maturitas.2025.108652","DOIUrl":"10.1016/j.maturitas.2025.108652","url":null,"abstract":"<div><h3>Objectives</h3><div>The prevalence of multimorbidity is increasing in many countries due to population aging and other factors. Most studies are cross-sectional, so they do not capture generational differences in multimorbidity. We used longitudinal data over more than 20 years to examine patterns of multimorbidity among cohorts of women of different ages in Australia, and the impact of multimorbidity on their health-related quality of life and use of health services.</div></div><div><h3>Study design</h3><div>We used data from more than 40, 000 participants in the Australian Longitudinal Study on Women’s Health, a national cohort study with repeated survey data linked to administrative records of health service use. The women were born in 1989-95, 1973-78 and 1946-51 and followed from 2013 to 2019, 1996 to 2021 and 1996 to 2022, respectively.</div><div>Main outcome measures</div><div>Multimorbidity was defined as the cumulative number of chronic conditions common among women aged 18 to 76 years. General practice and pharmaceutical data were obtained from the universal health insurance scheme. Physical and mental health summary scores were calculated from participants’ survey responses.</div></div><div><h3>Results</h3><div>The conditions that were most prevalent differed between cohorts. Multimorbidity was higher among women born in 1989-95 than among those born in 1973-78 when they were the same age. Health service use and health scores generally increased more with the number of chronic conditions than with age.</div></div><div><h3>Conclusions</h3><div>The composition of multimorbidity changes across the life-course. Generational factors other than age contribute to increases in multimorbidity. Projections of future health service needs must consider these complexities.</div></div>","PeriodicalId":51120,"journal":{"name":"Maturitas","volume":"199 ","pages":"Article 108652"},"PeriodicalIF":3.9,"publicationDate":"2025-06-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144535118","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
MaturitasPub Date : 2025-06-26DOI: 10.1016/j.maturitas.2025.108648
Zihao Hu , Panpan Long , Ruping Quan , Jiayu Su , Longfei Li , Minghua Zeng , Hongmei Xiao
{"title":"Pathogenic TP73 variants may lead to premature ovarian insufficiency by hyperactivating primordial follicles via the PI3K/AKT/FOXO3A pathway","authors":"Zihao Hu , Panpan Long , Ruping Quan , Jiayu Su , Longfei Li , Minghua Zeng , Hongmei Xiao","doi":"10.1016/j.maturitas.2025.108648","DOIUrl":"10.1016/j.maturitas.2025.108648","url":null,"abstract":"<div><h3>Background</h3><div>Premature ovarian insufficiency (POI) is characterized by primary or secondary amenorrhoea before the age of 40, alongside high levels of follicle-stimulating hormone (FSH) and reduced levels of estrogen, severely impairing female fertility. This study aimed to identify novel genetic factors contributing to POI.</div></div><div><h3>Methods</h3><div>We performed whole-exome sequencing and whole-genome sequencing on 93 patients with POI and 465 healthy female controls to identify variants in the <em>TP73</em> gene. In-vitro culture models of mouse ovaries were utilized to evaluate the effects of identified <em>TP73</em> variants on activation of primordial follicles.</div></div><div><h3>Results</h3><div>Two missense variants in <em>TP73</em>, p.R538C (NM_005427.4: c.1612C>T) and p.L560P (NM_005427.4: c.1679T>C), were identified. In mouse ovaries, overexpressing these variants significantly increased activation of primordial follicles. Transcriptomic analysis revealed 276 differentially expressed genes in the p.R538C group and 119 in the p.L560P group, with downregulation of key genes, including <em>S100A8</em> and <em>S100A9</em>. Functional experiments demonstrated that these genes regulate the PI3K/AKT/FOXO3A signaling pathway, which was activated in mutant groups, resulting in the overactivation of primordial follicles.</div></div><div><h3>Conclusion</h3><div>Variants in <em>TP73</em> appear to activate the PI3K/AKT/FOXO3A signaling pathway, leading to primordial follicle overactivation and accelerated depletion of the ovarian reserve, which may trigger POI. This research offers novel understanding of the genetic foundation of POI and identifies possible therapeutic targets for maintaining ovarian function.</div></div>","PeriodicalId":51120,"journal":{"name":"Maturitas","volume":"199 ","pages":"Article 108648"},"PeriodicalIF":3.9,"publicationDate":"2025-06-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144513705","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Effects of cardiac rehabilitation on female patients with heart disease: A systematic review and meta-analysis","authors":"Ayami Osumi , Yuji Kanejima , Masahiro Kitamura , Kodai Ishihara , Kazuhiro P. Izawa","doi":"10.1016/j.maturitas.2025.108653","DOIUrl":"10.1016/j.maturitas.2025.108653","url":null,"abstract":"<div><div>In recent years, “women-focused cardiac rehabilitation” or “women-only cardiac rehabilitation” has been implemented to address low referral, participation, and adherence among women in conventional cardiac rehabilitation programs. This review examined the effects of women-focused cardiac rehabilitation on psychological and physical outcomes and program adherence. Randomized clinical trials with patients 18 years and older with cardiovascular disease that provided women-focused cardiac rehabilitation and assessed at least one of the outcomes of psychological impacts, physical impacts, or adherence were included. Literature searches were conducted in PubMed, Web of Science, and CiNii from inception to April 9, 2024. Meta-analyses were performed using “EZR” software. From 653 relevant studies identified, 16 studies were included. Women-focused cardiac rehabilitation significantly improved depressive symptoms (standardized mean difference = −0.40, 95 % confidence interval [−0.61, −0.19]) but had no significant effect on anxiety (standardized mean difference = −0.15, 95 % confidence interval [−0.55, 0.25]). Some studies suggested potential improvements in quality of life and 6-min walk distance, although effect sizes varied and many outcomes were not statistically significant. Tailored or supervised cardiac rehabilitation was also associated with high adherence to both exercise and educational programs in some studies. Due to the small number of studies per outcome, variability in intervention formats, and the overall high risk of bias, conclusions should be interpreted with caution. Women-focused cardiac rehabilitation may provide psychological benefits, particularly in reducing depressive symptoms, but further high-quality trials are needed to better understand its effects on physical outcomes and adherence.</div></div>","PeriodicalId":51120,"journal":{"name":"Maturitas","volume":"199 ","pages":"Article 108653"},"PeriodicalIF":3.9,"publicationDate":"2025-06-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144518939","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
MaturitasPub Date : 2025-06-25DOI: 10.1016/j.maturitas.2025.108647
Javier Casquero-Sánchez , Luis Miguel Martín-de Los Reyes , Miguel Rodríguez-Barranco , Dafina Petrova , Oscar Mendoza-García , Daniel Redondo , Encarnación González-Flores , María-José Sánchez
{"title":"Risk of a second primary cancer after breast cancer in Southern Spain: a population-based study over 3 decades","authors":"Javier Casquero-Sánchez , Luis Miguel Martín-de Los Reyes , Miguel Rodríguez-Barranco , Dafina Petrova , Oscar Mendoza-García , Daniel Redondo , Encarnación González-Flores , María-José Sánchez","doi":"10.1016/j.maturitas.2025.108647","DOIUrl":"10.1016/j.maturitas.2025.108647","url":null,"abstract":"<div><h3>Objective</h3><div>To estimate the risk of developing a second primary cancer (SPC) among women diagnosed with breast cancer in Granada, Spain.</div></div><div><h3>Study design</h3><div>This population-based observational cohort study utilized data from the Granada Cancer Registry. We included all women aged 15 and above diagnosed with malignant breast cancer from 1985 to 2019.</div></div><div><h3>Main outcome measures</h3><div>The analysis used the standardized incidence ratio to compare breast cancer patients' risk of developing a SPC with the risk in the general population.</div></div><div><h3>Results</h3><div>Out of 12,260 women diagnosed with breast cancer, 1032 (8.4 %) developed a SPC. The median time to SPC diagnosis was 7.2 years. The most common types of SPC were non-melanoma skin, colorectal, endometrial and haematological malignancies. The overall excess risk of a SPC was 33 % (95 % CI = 25 %–41 %), with the highest increased risks observed for non-melanoma skin, digestive, and genitourinary malignancies. The risk of a SPC was 2.2 times greater than expected in women under 50, and 1.2 times in women over 50. For those under 50, the risk was nearly 6 times higher for digestive sites, and 3 to 5 times higher for lung, non-melanoma skin, genitourinary, and haematological cancers. In women over 50, excess risks were also observed in those sites, but to a lesser extent.</div></div><div><h3>Conclusions</h3><div>Women with breast cancer have a significantly increased risk of developing a SPC, especially non-melanoma skin, digestive, and genitourinary cancers. Personalized prevention and follow-up strategies are needed to reduce the risk in women diagnosed with breast cancer, particularly younger women.</div></div>","PeriodicalId":51120,"journal":{"name":"Maturitas","volume":"199 ","pages":"Article 108647"},"PeriodicalIF":3.9,"publicationDate":"2025-06-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144481658","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}