Virtual Health Library Research Articles

A Systematic Review on Biomarkers: Are There Reliable Molecular Biomarkers in Patients With Rheumatoid Arthritis-Associated Interstitial Lung Disease?

Despite advances in the study of rheumatoid arthritis-associated interstitial lung disease (RA-ILD), the pulmonary manifestation remains an important cause of morbidity and mortality. However, there is a lack of biochemical markers for this manifestation in the literature. Therefore, the objective of this study was to carry out a qualitative systematic review on biochemical markers associated with RA-ILD in the PubMed, Web of Science, Embase, Cochrane Library, and Virtual Health Library (VHL) between January 2015 and July 2024, using the following descriptors: #1 "biomarkers" (MeSH) AND #2 "rheumatoid arthritis" (MeSH) AND #3 "Lung Diseases, Interstitial" (MeSH). Of the 1497 articles found, 27 presented eligibility criteria. The findings were divided into three sessions: "Main biomarkers for RA-ILD," "Other biomarkers for RA-ILD activity," and "Other biomarkers for RA-ILD prognosis." Among the evaluated markers, KL-6, RF, ACPA,ESR, and CRP appear to have prognostic value and association with damage in patients with RA-ILD. The association of some molecules such as sPD-1, sCD25, VCAM-1, MCP-1, and ADMA with tissue damage is intriguing. Longitudinal and randomized studies are imperative to comprehensively delineate the history of RA-ILD and evaluate potential serum biomarkers.

Association of Tobacco Use and Cancer Incidence in India: A Systematic Review and Meta-Analysis.

To estimate the strength of the association between tobacco use and cancer incidence among the Indian population. Data from PubMed, Embase, and Virtual Health Library were searched from inception of databases till April 30, 2022. There were no restrictions except for English language and human study. Case-control and cohort studies on cancer incidence in relation to tobacco use were selected. Data were extracted independently by two investigators, and discrepancies were resolved by a third reviewer. The Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines were followed. The quality assessment was done using the Newcastle Ottawa Scale. The majority were case-control designs (60, 89.6%), covering diverse geographic regions, with Maharashtra (18, 30%) and Kerala (12, 20%) being the most studied. Pooled effect sizes were calculated using the random-effects model, and forest plots were generated. The risk of any cancer associated with smoked and smokeless tobacco was 2.71 (95% CI, 2.25 to 3.16) and 2.68 (95% CI, 2.22 to 3.14), respectively, indicating similar risks. Gender-wise, smoked tobacco had an association of 2.35 (95% CI, 2.05 to 2.65) for males, whereas for smokeless tobacco, it was 1.77 (95% CI, 1.47 to 2.07) for males and 2.34 (95% CI, 1.26 to 3.42) for females. Regardless of gender, tobacco type, and affected body parts, the risk of cancer due to tobacco use was consistent in the Indian population. Site-specific analysis showed higher risks of respiratory system cancers of 4.97 (95% CI, 3.62 to 6.32) and head and neck cancers of 3.95 (95% CI, 3.48 to 4.42). This study underscores that both smoked and smokeless tobacco are equally harmful to human health among the Indian population, providing insights for stakeholders and policymakers to arrive at tobacco-specific interventions.

Healthcare actions offered to homeless people: state of the art.

The number of homeless people (HP) has been increasing in recent years. Government actions have been implemented to improve the living conditions for this population, especially those focused on health care. This study has as research question: What are the healthcare strategies of services and programs being offered to the homeless population in Brazil? Its objective is to analyze the health care strategies adopted by services and programs offered to the homeless population in Brazil. To achieve this purpose, a search was conducted in the Virtual Health Library (VHL), Latin American and Caribbean Literature in Health Sciences (Lilacs), and Scientific Electronic Library Online (SciELO) databases, resulting in 21 articles. The analysis revealed the scope and challenges of the health care networks, indicating drug use as the main reason for seeking the services, with the Street Clinics (CnaR, Consultório na Rua) being an important service capable of promoting the creation of links between the HP and other sectors. of health. The importance of networking and the complexity of population health care were recurring topics in the discussions, as they deal with actions aimed at vulnerable and stigmatized people, showing needs and singularities in the way of living in society.

PD-L1 expression in non-small cell lung carcinoma in Latin America: a systematic review and meta-analysis.

Programmed cell death ligand 1 (PD-L1) expression in non-small cell lung carcinoma (NSCLC) is a crucial factor in predicting responses to immunotherapy. This systematic review and meta-analysis focuses on the prevalence of PD-L1 expression and clinicopathological features among Hispanic/Latino (H/L) populations. Embase, LILACS, Medline, and Virtual Health Library were searched for studies that evaluated the prevalence of PD-L1 in H/L patients. The protocol was submitted to PROSPERO with ID CRD42023488547. We employed the Joanna Briggs Institute Checklist for Systematic Reviews and Research Syntheses to assess the methodological quality and applicability of the included studies. Meta-analyses were done to determine the prevalence using a random effects model. The meta-analysis, encompassing 21 articles with 16,486, revealed that 80.2% of patients had PD-L1 expression data available (n=13,222). The prevalence calculated of PD-L1 expression in Latino NSCLC patients was 55% [95% confidence interval (CI): 0.54-0.55], with 31% (95% CI: 0.27-0.36) showing a tumoral proportion score (TPS) of 1-49%, and 23% (95% CI: 0.16-0.30) registering a TPS ≥50%. Higher expression was observed in male gender, smoking, adenocarcinoma subtypes, poor tumor differentiation, and advanced stages. PD-L1 expression was most frequent in EGFR wild-type status (82.5%) with a odds ratio (OR) 1.54 (95% CI: 1.24-1.92) and PD-L1 expression was associated with ALK positive (OR =1.54; 95% CI: 1.24-1.92). This meta-analysis provides a comprehensive overview of PD-L1 expression in NSCLC in the H/L population. The findings underscore the significant prevalence of PD-L1 expression and emphasize the relevance of immunotherapy in this population. Understanding the clinicopathological features associated with PD-L1 expression can contribute to tailored treatment strategies for NSCLC in Latin America.

Factors associated with cervical cancer prevention coverage

Objective: To evaluate the factors associated with cervical cancer prevention coverage. Methods: an integrative literature review was conducted, articles retrieved from the secondary databases Virtual Health Library, Latin American and Caribbean Health Sciences Literature, Scientific Electronic Library Online and Online System for Search and Analysis of Medical Literature were analyzed, based on Boolean operators. Results: the factors associated with this outcome were being married/widowed/separated/divorced, not being a smoker, having health insurance, having seen a doctor in the last year and having a domicile registered in the Basic Family Health Unit, factors such as not being scheduled by the professional, women with a family income of up to 1 minimum wage, who studied up to the 4th grade, residents in the Northeast region and in municipalities with up to 20,000 inhabitants, women who had never attended school, with four or more children, a history of four or more births, who did not use contraception and had inadequate knowledge about the test, feelings of shame, fear and fear of the diagnosis represented barriers to the performance of the test. Conclusion: the data of the study indicate that the factors that influence the coverage of cervical cancer prevention tests may be individual, structural and access, technical and cultural.

Effect of the use of low power laser in the treatment of chronic wounds: an integrative review

Objective: The objective was to identify the effects of low-power laser on the healing of chronic wounds. Method: This is an integrative literature review, carried out in the Medline / Pubmed, Cochrane Library and Virtual Health Library (VHL) databases, limited to Randomized Clinical Trials, in which 68 articles were identified, of which 19 were pre-selected and seven were included in the final sample, after checking the eligibility criteria. Results: Most articles (n = 05) included patients with injuries resulting from diabetes mellitus located in the regions of the feet and two studies addressed venous ulcers. Most of the selected studies showed that the use of low-level laser therapy was able to accelerate the tissue repair process, with a significant reduction in the wound area, showing effectiveness in promoting healing, when compared to the treatments presented in the different studies. The significant reduction in pain in the laser-treated group was also an important effect reported in some studies. The wavelength in nanometers (nm) used for laser application varied from 632.8 to 830 nm and the doses in joules (J) were from 3 to 7J / cm2. The duration of laser therapy treatment averaged 4 weeks. Conclusion: The low-power laser can be an alternative therapy in the treatment of chronic wounds in clinical practice to optimize and enhance the healing process.

Experimental Protocols Used to Mimic Gastrointestinal Protein Digestion: A Systematic Review.

Bioactive peptides derived from native proteins modulate physiological processes in the metabolic pathways. Given that multiple protocols in the literature mimic the digestion of dietary components, gathering studies that use such models directed at protein digestion processes is critical. This systematic review aimed to gather evidence that adopted adequate experimental models to simulate human protein digestion. The databases searched were PubMed, Web of Science, ScienceDirect, Embase, Virtual Health Library, and Scopus. A total of 1985 articles were found, resulting in 20 eligible in vitro studies. The Office of Health Assessment and Translation was used to evaluate methodological quality. Seven studies used plant-based protein sources, twelve used animal protein sources, and one used both. The duration of the oral phase varied, although 60% of the studies employed a protein digestion period of 120 min. Amylase, pepsin, and pancreatin enzymes were utilized in 40% of the studies, with pH levels of 7, 3, and 7, respectively, during the oral, gastric, and intestinal phases. The INFOGEST harmonized static model was adopted by 65% of the studies; INFOGEST is the most effective model for simulating gastrointestinal protein processes in humans and can be used to answer several research questions because it describes experimental conditions close to the human physiological situation.

Proteins and Peptides Studied In Silico and In Vivo for the Treatment of Diabetes Mellitus: A Systematic Review.

Bioinformatics has expedited the screening of new efficient therapeutic agents for diseases such as diabetes mellitus (DM). The objective of this systematic review (SR) was to understand naturally occurring proteins and peptides studied in silico and subsequently reevaluated in vivo for treating DM, guided by the question: which peptides or proteins have been studied in silico for the treatment of diabetes mellitus? The RS protocol was registered in the International Prospective Register of Systematic Reviews database. Articles meeting the eligibility criteria were selected from the PubMed, ScienceDirect, Scopus, Web of Science, Virtual Health Library (VHL), and EMBASE databases. Five studies that investigated peptides or proteins analyzed in silico and in vivo were selected. Risk of bias assessment was conducted using the adapted Strengthening the Reporting of Empirical Simulation Studies (STRESS) tool. A diverse range of assessed proteins and/or peptides that had a natural origin were investigated in silico and corresponding in vivo reevaluation demonstrated reductions in glycemia and/or insulin, morphological enhancements in pancreatic β cells, and alterations in the gene expression of markers associated with DM. The in silico studies outlined offer crucial insights into therapeutic strategies for DM, along with promising leads for screening novel therapeutic agents in future trials.

Quality of life of professionals working in primary care

Objective: To analyze the factors associated with the quality of life of health professionals working in primary care. Methods: an integrative literature review was conducted using the secondary databases Virtual Health Library, Latin American and Caribbean Health Sciences Literature, Scientific Electronic Library Online and Online System for Search and Analysis of Medical Literature based on the specific descriptors retrieved from the Health Sciences Descriptors. Results: the following factors were identified as associated with the outcome: inadequate conditions to perform work, lack of organization and difficulty in social relationships, professional occupation, with community health agents being the professionals with the lowest quality of life, followed by mid-level professionals, in the qualitative data, the perspectives that most impact the quality of life were infrastructure and salary deficits, Regarding the quality of life domains, there was great variation in the findings of the various studies. Conclusion: the data of the study indicate that the factors that influence the quality of life of professionals working in primary care are complex and multifaceted, ranging from individual variables or to the work environment.

Barriers and facilitators to implementing Communities That Care (CTC) in different countries

Communities That Care (CTC) is a prevention system that aims to support the healthy development of children and adolescents through the organization and training of community coalitions aimed at implementing evidence-based preventive interventions, focusing on drug abuse and involvement with violence. The objective of this article is to present the current state of knowledge on the primary barriers and facilitators for implementing or adapting CTC in different communities and countries. This is an integrative review, with a search performed in the databases: Pubmed, Web of Science, Scopus, PsycINFO and Virtual Health Library (VHL), using the indexes ("Communities That Care" OR "CTC") AND (fidelity OR implementation). Among the 16 studies selected based on the inclusion/exclusion criteria, most had a quantitative or mixed approach, with an experimental or quasi-experimental, longitudinal design, published between 2005 and 2021. The main barriers faced were: coalition mobilization, community readiness challenges, epidemiological data collection, and the use and implementation of evidence-based preventive interventions. As facilitators, the use of training and provision of technical assistance was identified to increase community readiness, to leverage the work of the coalition and to sensitize the community on the importance of implementing evidence-based interventions.

Are bodybuilding and cross-training practices dangerous for promoting orofacial injuries? A scoping review.

Bodybuilding and cross-training exercises bring health benefits. However, orofacial injuries can occur during practice. This study aimed to map, analyze, interpret, and synthesize data from studies on the main orofacial injuries resulting from bodybuilding and cross-training practices. This scoping review followed the Joanna Briggs Institute and PRISMA-ScR methods, with high-sensitivity searches in PubMed, Web of Science, Scopus, ScienceDirect, Embase, Virtual Health Library and the Google Scholar. Original scientific articles published up to May 2024 were included, which evaluated the presence of self-reported or professionally diagnosed orofacial injuries by bodybuilding and cross-training practitioners aged 18 years or older. Literature reviews, editorials, and guidelines were excluded. Tables and figures were used to map and summarize the results. Out of 30.485 potentially eligible articles, four were included. The main orofacial injuries identified in both bodybuilding and cross-training practitioners were dental damage (n = 4), temporomandibular joint (TMJ) disorders (n = 3), and traumas to oral soft tissues (n = 2) and facial soft tissues (n = 2). Dental damage and TMJ disorders were the most prevalent conditions among bodybuilding and cross-training practitioners. Therefore, dental damage and TMJ disorders were the most prevalent conditions among bodybuilding and cross-training practitioners. However, further prospective studies with more in-depth methodological designs and fewer biases are necessary.

Ecological and Medicinal Importance of Lampreys (Cyclostomata: Petromyzontiformes: Petromyzontidae)

For Pacific lampreys, life is not just about moving from freshwater to saltwater when they reach maturity, these ancient fish have to return to the same river environment where they were born. Going from a saltwater creature to a freshwater creature is not easy, however, and several modifications in appearance and physiology are necessary to survive the dramatic change in salinity. Their return to freshwater is not random, based on chemical signals left by the migration of lamprey larvae to return to rivers They can return to the same place they came from, but, unlike Pacific salmon, this precision is not always guaranteed, however, this transformation and the mapping of rivers require a lot of energy, and the animals resort to parasitization to survive. Lamprey swimming is among the most efficient in the world, as its movements generate zones of low pressure around the body, pulling the body through the water rather than pushing. The objective of this article was to characterize lampreys (Cyclostomata; Petromyzontiformes; Petromyzontidae) regarding their ecological and medicinal importance. The methodological analysis included studies of a particular topic. In its construction process, it is necessary to go through six essential stages: Identification of the theme and selection of the hypothesis or research question; establishment of criteria for inclusion and exclusion of studies/sampling or literature search; definition information to be extracted from selected studies/categorization of studies; evaluation of included studies; interpretation of results; and presentation of knowledge review/synthesis To carry out the study, a search for scientific articles was carried out through Virtual Health Library, in the SCIELO, LILACS, and PUMED databases, using the terminologies registered in the Health Sciences descriptors. Regarding the inclusion criteria, the following were used: Full articles, in Portuguese, and English.

Preemptive oral analgesia with steroidal and nonsteroidal anti-inflammatory drugs in periodontal surgery: a systematic review.

Introduction: Periodontal procedures can promote prolonged intense pain, particularly in clinical situations requiring surgical procedures. In this context, preemptive analgesia has also been assessed for its utility in controlling post-operative pain and discomfort in patients undergoing periodontal invasive procedures. This study assessed the efficacy and safety of preemptive oral analgesia with steroidal and non-steroidal anti-inflammatory drugs in periodontal surgeries. Methods: This systematic review performed a search in the following electronic sources: the Cochrane Central Register of Controlled Trials (CENTRAL), MEDLINE (via PubMed), EMBASE (via Ovid), Web of Science, Virtual Health Library and in clinical trials electronic databases for relevant randomized clinical trials (RCTs); published up to July 2023. Primary outcomes assessed were post-operative pain, edema and trismus. A narrative synthesis of the findings was carried out. Results: Six RCTs, involving a total of 250 participants, were included. The studies reviewed had a high risk of bias, particularly due to allocation concealment and blinding of participants and personnel. The RCTs reported only the outcome pain. The preemptive use of dexamethasone 8mg, etoricoxib 90mg or 120mg and ketorolac 20mg seems to be more effective for controlling post-operative pain than placebo. Discussion: The anti-inflammatory drugs evaluated proved to be effective for controlling post-operative pain. However, given the limitations regarding lack of studies, methodological biases, disparities in drugs and doses, report restricted the pain outcome; further RCTs confirming the effectiveness and safety of these drugs in periodontal surgical procedures are warranted.

456 Comparison of Postoperative Outcomes Between Robotic and Laparoscopic Surgery for Inflammatory Bowel Disease: A Systematic Review and Meta-Analysis

Abstract Aim To evaluate comparative outcomes of robotic versus laparoscopic bowel resection in patients with inflammatory bowel disease (IBD). Method A systematic online search was conducted using the following databases: PubMed, Scopus, Cochrane database, The Virtual Health Library, Clinical trials.gov and Science Direct. Comparative studies comparing robotic versus laparoscopic resection for IBD were included. Primary outcomes were post-operative complications rate. Operative time, conversion to open, length of hospital stays, and mortality were the evaluated outcome parameters. Results Eleven studies with total number of 5,566 patients divided between those undergoing robotic (n=365) and conventional laparoscopic (n=5,201) surgery. Moreover, subgroup analysis for sub-total colectomy group showed shorter LOS [MD: -1.62, P=0.03]. Overall complications rate was significantly higher in the laparoscopy group compared to robotic group [OR: 0.48, P=0.03], however the operative time was longer in the robotic group [MD: 40.61, P=0.00001]. Pooled analysis showed comparable results regarding conversion to open [OR: 0.46, P=0.15], anastomosis leak [OR: 0.92, P=0.84], abdominal abscess / collection [OR: 0.34, P=0.21], and mortality [RD: 0.00, P=1.00]. Conclusions Compared to laparoscopic approach, Robotic surgery provides a significantly lower rate of post-operative complications and shorter LOS at the expense of operative time with similar 30-day Mortality.

THERAPEUTIC STRATEGIES FOR THE TREATMENT OF PERINATAL DEPRESSION: An integrative review

Perinatal depression can occur during pregnancy and/or in the following year after childbirth, with adverse repercussions for maternal and child health if left untreated. The aim of this study is to characterize the therapeutic strategies found in the literature for the treatment of perinatal depression in women. An integrative literature review was conducted in the Virtual Health Library and Pubmed databases in December 2023, using the following controlled descriptors: depression; depression, postpartum; pregnancy; pregnant women and treatment. The results came to a final sample of 15 articles and revealed that all of them were conducted in high-income countries. The majority of the studies belonged to the quantitative approach (86.67%) and presented five main therapeutic strategies: bright light therapy, cognitive-behavioral therapy, interpersonal therapy, group music therapy and zuranolone. The review indicated bright light therapy as a promising intervention for perinatal depression, although it requires further studies. It demonstrated the positive impact of cognitive-behavioral therapy and interpersonal therapy in different formats for this period. In postpartum depression, the study showed a favorable outcome for group musical interventions and the use of zuranolone medication for symptom management. It is suggested that future research be carried out using qualitative and qualitative-quantitative approaches, including in countries with limited resources.

Hacia una mejor predicción de la mortalidad en pacientes oncológicos en UCI: análisis comparativo de escalas pronósticas: revisión sistemática de la literatura

ObjectiveTo evaluate the predictive ability of mortality prediction scales in cancer patients admitted to intensive care units. DesignA systematic review of the literature was conducted using a search algorithm in October 2022. The following databases were searched: PubMed, Scopus, Virtual Health Library (BVS), and Medrxiv. The risk of bias was assessed using the QUADAS-2 scale. SettingIntensive care units admitting cancer patients. ParticipantsStudies that included adult patients with an active cancer diagnosis who were admitted to the intensive care unit. InterventionsIntegrative study without interventions. Main variables of interestMortality prediction, standardized mortality, discrimination, and calibration. ResultsSeven mortality risk prediction models were analyzed in cancer patients in the ICU. Most models (APACHE II, APACHE IV, SOFA, SAPS-II, SAPS-III, and MPM II) underestimated mortality, while the ICMM overestimated it. The APACHE II had the SMR (Standardized Mortality Ratio) value closest to 1, suggesting a better prognostic ability compared to the other models. ConclusionsPredicting mortality in intensive care unit cancer patients remains an intricate challenge due to the lack of a definitive superior model and the inherent limitations of available prediction tools. For evidence-based informed clinical decision-making, it is crucial to consider the healthcare team's familiarity with each tool and its inherent limitations. Developing novel instruments or conducting large-scale validation studies is essential to enhance prediction accuracy and optimize patient care in this population.

Analysis of thumb pulp reconstruction based on different local flaps: A systematic review

BackgroundThe reconstruction of the thumb's pulp is challenging when considering that there is no consensus on which local flap will provide better prognosis and less financial impact. The aim of this study was to analyze the outcomes of the most used flaps for the trauma to the volar substance of the thumb, validating the main indications. MethodsThis systematic review adhered to PRISMA guidelines and electronic searches were conducted in multiple databases (MEDLINE/PubMed, Virtual Health Library, Embase and Scopus) with studies published in the last ten years - until April 2022. ResultsThe search resulted in the screening of 573 records, and twenty studies were included. Among the flaps analyzed and compared by outcomes and prognostic factors, there are First Dorsal Metacarpal Artery (FDMCA), modified (MFDMCA), Moberg flap, Heterodigital Neurovascular Island, Neurovascular Island Pedicle and Modified Littler. ConclusionThrough this literature review, we can analyze different flaps widely used in the daily life of hand surgeons. The flaps that were also positive in a global context, but with few criticisms, are the MFDMCA, Moberg Flap, Neurovascular Island pedicle flap and FDMCA. However, it is important for the surgeon to consider different prognostic factors when choosing the flap, since these aspects directly impact the return to daily activities after the procedure.

Stimulation of sensory receptors by dynamic muscle reprogramming in patients with immediate post-stroke sequelae and proprioceptive neuromuscular facilitation: a systematic review

Objective: Review and synthesize the effectiveness of the dynamic muscle reprogramming method with proprioceptive neuromuscular facilitation after stroke. Method: This is a literature review carried out in the Pubmed, Scielo, Physiotherapy Evidence Databese, Virtual Health Library, and Cochrane Library databases, between August 2021 and April 2022, including works that addressed PNF and the dynamic muscle reprogramming method. Results: 286 articles were found in the different databases and analyzed in different stages, starting with the title and abstract. 1 selected from PubMed, 4 eligible and only 1 selected; only selected from Cochrane Library; and in PEDro only 1 included. Conclusion: We did not achieve the aim of the study, however, we can elucidate that both methods promote effective stimulation of the somatosensory system. RDM stimulation is by voice command, without manipulation by the therapist, and micro-movements are made in the proprioceptive elements by the individual themselves to achieve the desired results.

Peri-operative, oncological and functional outcomes of robotic versus transanal total mesorectal excision in patients with rectal cancer: A systematic review and meta-analysis.

Comparative outcomes of robotic low anterior resection (rTME) and trans-anal total mesorectal excision (TaTME) in patients with low rectal cancer were evaluated. A systematic online search was conducted using the following databases: PubMed, Scopus, Cochrane database, The Virtual Health Library, Clinical trials.gov and Science Direct. Comparative studies of rTME versus TaTME for low rectal cancer were included. Primary outcomes were postoperative complications, including anastomotic leak, surgical site infection, and Clavien-Dindo complication rate. Total operative time, conversion to open surgery, intra-operative blood loss, intensive therapy unit (ITU) and total hospital length of stay (LOS), oncological outcomes and functional outcomes were the other evaluated outcome parameters. A total of 12 studies with a total number of 3025 patients divided between rTME (n = 1881) and TaTME (n = 1144) groups were included. There was no significant difference between the two groups for total operative time (P = 0.39), conversion to open surgery (P = 0.29) and intra-operative blood loss (P = 0.62). Clavien-Dindo ≥ 3 complication rate (P = 0.47), anastomotic leak (P = 0.89), rates of re-operation (P = 0.62) and re-admission (P = 0.92), R0 resections (P = 0.52), ITU LOS (P = 0.63) and total hospital LOS (P = 0.30) also showed similar results between the two groups. However, the rTME group had higher rates of total harvested lymph nodes (P = 0.04) and complete total mesorectal excision (TME) resections (P = 0.05). Albeit with a limited dataset, the Wexner and low anterior resection syndrome (LARS) scores showed better functional results in the rTME group compared with the TaTME group (P = 0.0009 and P = 0.00001, respectively). Compared with TaTME, rTME seems to provide better functional outcomes, higher lymph node yield and more complete TME resections with a similar post-operative complications profile.

Mortality of Young Women due to Breast Cancer in Low, Middle and High-Income Countries: Systematic Literature Review and Meta-Analysis.

To identify the difference in breast cancer mortality rates among young women according to countries' economic classification. A systematic literature review included retrospective studies on breast cancer mortality rates in women aged 20 to 49 years. Databases used were PubMed, Web of Science, Scopus, and Virtual Health Library, with articles selected in English, Portuguese, and Spanish. The study selection and analysis were conducted by two pairs of researchers. Data from 54 countries were extracted, including 39 high-income, 12 upper-middle-income, and 3 lower-middle-income countries. A meta-analysis was performed with the quantitative data from two studies. Six articles met the inclusion criteria. Four were analyzed descriptively due to data diversity, and two were included in the meta-analysis. The pooled mortality rate for high-income countries was 10.2 per 100,000 women (95% CI: 9.8-10.6), while for upper-middle-income countries, it was 15.5 per 100,000 women (95% CI: 14.9-16.1). Lower-middle-income countries had a pooled mortality rate of 20.3 per 100,000 women (95% CI: 19.5-21.1). The decrease in mortality rates in high-income countries was statistically significant (p<0.05). Mortality rates for breast cancer among young women have decreased significantly in high-income countries but have increased in lower-income countries. This disparity underscores the impact of insufficient investment in preventive measures, health promotion, early diagnosis, and treatment on young women's mortality in lower-income countries.