Context: Sex hormones play a vital role in reproductive health and influence muscle function and metabolism. Exercise affects these hormones by raising testosterone levels and improving metabolic markers. However, the impact of team sports on female sex hormone levels remains understudied. Objectives: This review aims to systematically examine how sports like soccer, volleyball, basketball, and handball influence female sex hormone levels. Evidence Acquisition: This systematic review was conducted without any restrictions on language, publication date, or study type, based on the guidelines for systematic reviews and meta-analyses [preferred reporting items for systematic reviews and meta-analyses (PRISMA)] on Google Scholar, PubMed (MEDLINE), Scopus, Embase, and Web of Science databases on June 22, 2024. The search strategy utilized a combination of keywords and their synonyms from MeSH and Emtree-controlled vocabulary, including "Sex Hormone", "testosterone", "cortisol", "team sport", and "women." Results: Among the 690 articles identified, 11 were selected and used based on the inclusion criteria. Studies have shown that football, netball, volleyball, and handball have varying effects on testosterone and cortisol levels in athletes. Football generally increases both hormone levels, whereas netball often raises cortisol and lowers the testosterone-to-cortisol ratio. Volleyball tends to increase testosterone significantly, though with fluctuating trends, whereas handball mainly raises cortisol without a significant change in testosterone levels. Conclusions: Despite the limitations of the included studies, such as sample size, study design, data collection standards, reporting practices, and potential biases, this systematic review indicated that playing team sports like football, basketball (netball), volleyball, and handball can alter testosterone and cortisol levels in females. However, further research is needed to fully understand these hormonal changes' effects.
Context: Cervical cancer (CC) is a significant global health issue primarily associated with human papillomavirus (HPV) infection. While most HPV infections resolve spontaneously, persistent infections can lead to chronic inflammation and the development of precancerous lesions. High-risk HPV types, particularly HPV-16 and HPV-18, are notably linked to the majority of CC cases, establishing a clear causal relationship between HPV infection and CC through extensive epidemiological studies. Evidence Acquisition: The databases of PubMed, Scopus, Web of Science, and Google Scholar were utilized for the search. Papers without a time limit until 2024 were included, encompassing clinical studies, review articles, systematic reviews, and meta-analyses. The following keywords were systematically employed to identify relevant publications for this comprehensive review: "HPV", "pathogenesis", "immune response", "immune evasion", "cervical cancer", "diagnostic methods", "prevention", and "treatment". Results: The study reveals that while most HPV infections are transient, persistent infections significantly elevate the risk of developing CC over time. Screening methods such as Pap smears and HPV vaccination are crucial for early detection and prevention. The incorporation of sensitive biomarkers for early-stage detection is essential for effective management of CC. Conclusions: Cervical cancer is largely preventable, highlighting the need for increased awareness and access to vaccination and screening programs to reduce incidence and mortality rates globally. Ongoing research into HPV's pathogenicity is vital for developing targeted prevention strategies against CC.
Background: Evidence on the safety and efficacy of phosphate (P) replacement in hypophosphatemic intensive care unit (ICU) patients remains limited. Objectives: To evaluate the efficacy and safety of a 24-hour weight-based intravenous phosphate replacement protocol. Methods: Adult ICU patients with hypophosphatemia received potassium acid phosphate (25 mL) diluted in 500 mL of saline or 5% glucose, administered via infusion pump. Dosing was 0.3 mmol/kg/24 h for mild hypophosphatemia (0.65 - 0.73 mmol/L) and 0.6 mmol/kg/24 h for moderate to severe cases (≤ 0.64 mmol/L). Phosphate levels were measured every 24 hours. Efficacy was defined as normalization of phosphate within 24 hours. Safety outcomes included hypocalcemia, hypotension, hyperphosphatemia, hyperkalemia, and acute kidney injury. Results: Among 134 patients (aged 67.6 ± 14.6 years; 55% female; median APACHE II median 18), 197 hypophosphatemia episodes were treated. Phosphate normalized within 24 hours in 121 episodes (61%). Mild adverse events occurred in 28 patients (21%); no severe complications were reported. Conclusions: This protocol is not a replacement for standard guidelines in symptomatic hypophosphatemia and unstable patients. It proved effective and generally safe in critically ill patients with mild to severe hypophosphatemia, offering a feasible approach in resource-limited ICU settings where oral formulations are unavailable and frequent laboratory monitoring is unfeasible.
Background: Mothers of children with type 1 diabetes often experience significant stress and anger. Spirituality is a promising source of support and an important dimension of self-care. Objectives: To determine the effect of spirituality-based self-care on the stress and anger of mothers of children with type 1 diabetes. Methods: A clinical trial was conducted in 2024 at the Diabetes Center of Imam Reza (AS) Specialized Clinic in Zabol, Iran. Seventy mothers were randomly assigned to experimental (n = 35) and control (n = 35) groups. Data collection tools included a demographic questionnaire, the Parenting Stress Index, and the Spielberger Anger Expression Scale. The experimental group received a spirituality-based self-care training package over six sessions, while the control group received routine care. Stress and anger levels were measured before the intervention and three months afterward. Data were analyzed using chi-Square, or Fisher's Exact test, and independent t-tests via IBM SPSS version 23. Results: There was no significant difference in pre-test stress scores between groups (P = 0.220). Post-intervention stress scores also showed no significant difference (102.25 ± 6.22 vs. 99.25 ± 8.77; P = 0.104). Pre-test anger scores were not significantly different (P = 0.880); however, post-intervention anger scores differed significantly between groups (121.28 ± 5.97 vs. 134.20 ± 7.05; P < 0.001). Conclusions: Spirituality-based self-care interventions can effectively reduce anger in mothers of children with type 1 diabetes. Integrating such training into nursing practice is recommended. However, this intervention alone was insufficient to reduce stress, indicating the need for additional support strategies.
