Obesity is a significant health issue associated with increased cancer risks, including gynecological malignancies. The worldwide rise in obesity rates is significantly impacting both cancer development and treatment outcomes. Adipose tissue plays a crucial role in metabolism, secreting various substances that can influence cancer formation. In obese individuals, dysfunctional adipose tissue can contribute to cancer development through inflammation, insulin resistance, hormonal changes, and abnormal cholesterol metabolism. Studies have shown a strong correlation between obesity and gynecological cancers, particularly endometrial and breast cancers. Obesity not only increases the risk of developing these cancers but is also associated with poorer outcomes. Additionally, obesity affects the perioperative management of gynecological cancers, requiring specialized care due to increased complications and resistance to therapy. Treatment strategies for managing metabolic dysregulation in patients with gynecological cancers include weight management, statin therapy, and insulin-sensitizing medications. Emerging studies suggest that interventions like intermittent fasting and caloric restriction may enhance the effectiveness of cancer treatments. Furthermore, targeting cholesterol metabolism, such as with statins or proprotein convertase subtilisin/kexin type 9 (PCSK9) inhibitors, shows potential in cancer therapy. In conclusion, addressing metabolic issues, particularly obesity, is crucial in preventing and treating gynecological malignancies. Personalized approaches focusing on weight management and metabolic reprogramming may improve outcomes in these patients.

This review examines hormone replacement therapy (HRT) in cases of surgical menopause following gynecological malignancies. It aims to capture current knowledge, summarize recent findings, and provide recommendations for clinical settings. Unlike natural menopause, surgical menopause occurs abruptly, without an adjustment period, and is associated with a notably higher risk of fractures, arthritis, cognitive decline, dementia, Parkinson’s disease, and various metabolic disorders affecting glucose and lipid levels—all of which contribute to an increased risk of major cardiovascular events. In 2017, The North American Menopause Society recommended that, barring contraindications, HRT should be initiated in women who enter surgical menopause before age 45. If these women do not experience vasomotor symptoms or other issues, HRT should be maintained consistently at least until age 52. This guideline reflects contemporary knowledge and is the result of a multidisciplinary consensus, based on a review of existing literature and several randomized clinical trials focusing on women who have survived gynecological cancers and whose quality of life is significantly impacted by surgical or early menopause. Estrogen supplementation is particularly beneficial, as it is linked to marked improvements in quality of life, including delayed onset of chronic cardiovascular issues, reduced fracture risk, enhanced cognitive function, reduced inflammation, and improved self-esteem, as well as better social and work performance. Clinical implementation of HRT, however, requires a highly individualized approach. This approach must consider the type and stage of malignancy, histopathological characteristics, risk factors for recurrence (such as diet, concurrent medications, medical history, and genetic predispositions), and a thorough assessment of the potential benefits and risks of HRT, as well as the patient’s personal wishes and expectations.

Obesity is characterized by chronic low-grade inflammation (meta-inflammation) and metabolic dysregulation. Adipose tissue acts as an immunometabolic organ, with macrophages playing a central role. This review examines inflammatory memory in adipose tissue, focusing on CD68+ macrophages and their role in cardiometabolic and cancer risk during weight cycling. (2) Narrative synthesis of evidence from immunology, obesitology, and oncology, with emphasis on macrophage polarization and signaling pathways. (3) Weight cycling induces persistent immune memory in adipose tissue, characterized by exaggerated macrophage responses upon weight regain. CD68+ macrophages contribute to extracellular matrix remodeling, tumor signaling, and metabolic dysfunction. Key mechanisms include PI3K/AKT/mTOR dysregulation, FOXO1/KLF10 axis impairment, and CREB-mediated transcription. This inflammatory memory promotes atherosclerosis progression, insulin resistance, and increased cancer risk, despite prior weight loss. (4) Macrophage-driven inflammatory memory represents a key mechanistic link between obesity, cardiometabolic disease, and cancer. Targeting meta-inflammation independent of body weight should be integral to future therapies.

Introduction/Objective. Breastfeeding prevalence in Serbia remains low compared with global estimates. Breastfeeding self-efficacy scale - Short form (BSES-SF) is widely recognized as a key, modifiable determinant of breastfeeding outcomes, with growing evidence that improving it is associated with higher breastfeeding rates. This study aimed to translate and culturally adapt the scale for use in Serbian language, establish its psychometric adequacy within a population of breastfeeding mothers throughout the first postpartum year, and examine differences in scores by selected sociodemographic and obstetric characteristics. Methods. A total of 70 breastfeeding mothers who delivered at the Clinic for Gynecology and Obstetrics, University Clinical Center of Vojvodina participated in this cross-sectional study. The validated Croatian version served as the basis for the adaptation process, which followed standardized cross-cultural procedures. Internal consistency was evaluated using item-total statistics and Cronbach’s α. Group differences were compared using the Mann-Whitney Utest. Results. The participants' mean age was 32.19 years (SD = 5.17). The instrument showed strong internal consistency (Cronbach’s α = 0.81; 95% CI: 0.73-0.87). Corrected item-total correlation coefficients ranged from 0.13 to 0,73. The mean score was 54.11 ± 10.81, indicating high breastfeeding self-efficacy. Lower scores were observed among mothers with cesarean delivery, shorter intended breastfeeding duration, early cessation, lack of early initiation, and insufficient breastfeeding support. Conclusion. The Serbian version of the scale exhibited good internal consistency and preliminary validity as an instrument for assessing breastfeeding self-efficacy.

Introduction. The thyroid gland is a bilobed endocrine organ connected by a thin isthmus and may also present with a pyramidal lobe. A thyroid nodule is defined as a localized structural alternation of the thyroid tissue. Laser thermal ablation represents a novel minimally invasive intervention, with contemporary guidelines and evidence from randomized trials, observational studies, and multicenter retrospective analyses consistently demonstrating its safety and clinical efficacy in the treatment of symptomatic cold thyroid nodules. Radiofrequency ablation is increasingly employed in the management of papillary thyroid microcarcinoma and offers a valuable alternative for patients with medullary thyroid carcinoma who are not suitable surgical candidates. It is also particularly effective in treating recurrent cystic nodules following ethanol ablation and clinically significant lesions with large residual noncystic components. Microwave ablation is a newer technique that has shown substantial improvements in symptom relief and in cosmetic outcomes while preserving thyroid function; however, it has been associated with a relatively higher rate of procedure-related complications. High-intensity focused ultrasound is with a noninvasive, computer-guided technique that enables precise targeting while preserving surrounding thyroid tissue. Owing to its lower overall efficacy, higher cost, and limited scientific validation, interventionist use should be restricted to carefully selected patients who are not eligible for other treatment options. For benign thyroid nodules with a significant cystic component, particularly recurrent or symptomatic lesions, current guidelines recommend percutaneous ethanol injection as the preferred treatment. Conclusion. Whereas surgical intervention was historically the standard approach for thyroid nodules, advances in minimally invasive techniques now provide effective, thyroid-preserving alternatives for appropriately selected patients.